This paper deals with three cases of long jumpers suffering from fracture at middle one-third of the femoral shaft. This kind of fracture is transverse and produced by indirect force at the landing moment. This is a characteristic fracture which we call a jumping femoral fracture.Physical examination reveals swelling with tenderness and deformity of the injured thigh. X-ray shows a transverse fracture and angulating deformity at middle one-third femoral shaft in all cases.Two cases were performed by open reduction and internal fixation with K?ntschcr or medullary nail, and one case was performed by traction through the intercondylus of the lower femur. All patients got good result after one year, but open reduction was better than skeletal traction.According to clinical observations, CT examination of the femur in normal person and experiment of the femoral shaft with fresh cadaver, the mechanism is based on the imbalance of the body rising high into the air, which produces both scissors stress and rotational force at landing. In the meanwhile the posterior group muscles of the thigh were more likely to be relaxed reflectively, leaving the femoral shaft unprotected.

5-fluorouracil (5-Fu) as an antimetabolite drug,has been widely used in the treatment of various solid tumors.However, due to the heterogeneity of tumor and the impact of the individual, some patients still have drug resistance or serious lethal toxicity reaction.The text focuses on the research progress of pharmacogenomics and pharmacogenetics of some forecast elements which affect the efficacy and toxicity of 5-Fu,and discussed their guiding role on the choice of chemotherapy drugs.

BACKGROUND: It has been proved that matrix metalloproteinase-9 (MMP-9) has a correlation with stability of atherosclerotic plaque, and propolis flavone plays a role in anti-atherosclerosis. OBJECTIVE: To investigate the effect of propolis flavone on expression of MMP-9 in human umbilical vein endothelial cell (HUVEC). DESIGN, TIME AND SETTING: The comparative observation was performed at the Institute of Life Science, Taishan Medical University from January to August 2008. MATERIALS: The propolis flavone was extracted by the Institute of Life Science, Taishan Medical University. The neonatal umbilical cord with 1 hour was supplied by Tai’an Central Hospital, and the informed consent was obtained from the puerperant. METHODS: HUVEC was cultured and identified in vitro, followed by treated with propolis flavoneat with different concentrations for 24 hours. The blank was used as the control group. MAIN OUTCOME MEASURES: The effect of propolis flavone on expression of MMP-9 in HUVEC was detected by cytoimmunochemical staining and ELISA. RESULTS: Propolis flavonecan with all concentrations can restrain the expression of MMP-9 after co-culture with the cells for 24 hours, which showed in a dose-dependent manner. CONCLUSION: The propolis flavone can obvious depress the expression of matrix metalloproteinase-9 in HUVEC.

ObjectiveTo observe the effect of dehydroepiandrostrone (DHEA) on retinal capillary pericytes’ proliferation under high glucose and research the prevention and treatment of diabetic retinopathy (DR).MethodsRetinas were dissected from eyes of fresh killed cattle and retinal capillary pericytes were separated and cultured.The effect of DHEA (10、50、100、500、1 000nmol/L) on pericytes’ proliferetion was evaluated by 3H-thymidine incorporation and li-quid scintillation techniques.ResultsThere was significant difference between DHEA (50、100、500、1 000nmol/L) and control culturing for 48h.The increasing rate was 42.67% in DHEA of 500nmol/L.ConclusionDHEA could promote pericytes’ proliferation under high glucose.This provided reliable evidence for selecting effective drugs for prevention and treatment of DR clinically.

Objective　To observe the effect of high glucose on retinal capillary pericytes in vitro and research the pathogenesis of diabetic retinopathy (DR). Methods　Retinas dissected from eyes of fresh killed cattle were separated and retinal capillary pericytes were cultured. The effect of high glucose on pericytes was evaluated by measurement of lactate dehydrogenase(LDH),3H-thymidine incorporation and liquid scintillation techniques.Morphological changes were observed under microscope and electric microscope.Results　There was no significant difference in LDH activity in the supernatants between high glucose(10、20、40mmol*L-1) and normal glucose(5mmol*L-1)cultured for 48h or 96h. High glucose had an effective inhibition on pericytes' proliferation cultured for 48h,96h and 144h, and the inhibition rate increased when the glucose concentration rised and time passed by. The inhibition rate of pericytes was 78.09% after cultured in high glucose (40mmol*L-1) for 144h. Conclusion　High glucose has an effect inhibition on pericytes' proliferation, and the inhibition rate increase when the glucose concentration rises and time passes by.

Objective To investigate clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma (MPCC). Methods A retrospective analysis was made on 37 patients with MPCC admitted from 1974 to 1998. ResultsThe incidence of MPCC was 2 74%(37/1 348) with 15 cases being synchronous carcinoma (SC) and 22 cases diagnosed as metachronous carcinomas (MC). Most tumors were located in right colon and rectum. Twelve out of twenty-two (55%) of MC were diagnosed within 3 years from the primary operation and 41% (9/22) of MC occurred after 8 years. JP2Radical resections were performed in all patients except for 1 case. The 5 year survival rate of SC was 5/9 and that of MC after the first cancer or second cancer were 15/21 and 7/18, respectively. Conclusions The results indicated the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and active radical resection can increase survival rate of MPCC.

AIM:To investigate the ameliorative effect of ischemic postconditioning (I-postC) on pia mater microcirculation in rats subjected to cerebral ischemia reperfusion (I/R) and its mechanisms. METHODS:Thirty-two male Wistar rats were randomly divided into sham,I/R,I-postC,and ischemic preconditioning (IPC) groups. The global cerebral I/R injury was induced by shunting carotid artery in rats. Pia mater microcirculation and cerebral microcirculatory perfusion were measured after reperfusion. The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma was detected using enzyme linked-immunosorbent assay (ELISA). Myeloperoxidase (MPO),malondialdehyde (MDA),and superoxide dismutase (SOD) in cerebral tissue were detected. The expressions of vascular endothelial cell cadherin (VE-cadherin) and NF-?B p65 in cerebral tissue were assayed by Western blotting. RESULTS:(1) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by I-postC. In addition,I-postC alleviated significantly the decrease in diameters of microvesseles,cerebral microcirculatory perfusion and cerebral VE-cadherin content induced by I/R (P

Objective:To investigate the predictive value of preoperative and postoperative serum tumor markers, namely, carcinoem-bryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and CA72-4, in the diagnosis of gastric cancer recurrence at different stag-es. Methods:Analysis was performed in 564 patients who underwent curative resection for gastric cancer between January 2002 and March 2007, received no chemotherapy at our hospital, and received complete follow-up according to the schedule determined pro-spectively. The values of CEA, CA19-9, and CA72-4 were evaluated before and after surgery. Results:In the pTNM-Ⅰ and pTNM-Ⅱ stage groups, patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels showed recurrence rates of 50.0%, 24.1%, and 22.6%, respectively. Similarly, the recurrence rates of patients with positive postoperative serum CEA, CA72-4, and CA19-9 levels were 42.9%, 21.7%, and 14.3%, respectively. Multivariate analysis showed that the positive preoperative serum CEA level could be an inde-pendent factor of recurrence. In the pTNM-Ⅲ stage group, the recurrence rates of patients with positive preoperative serum CEA, CA19-9, and CA72-4 levels were 50.0%, 55.2%, and 47.6%, respectively. The recurrence rates of patients with positive postoperative se-rum CEA, CA19-9, and CA72-4 levels were 75.0%, 66.7%, and 66.7%, respectively. Multivariate analysis showed that high postoperative serum CA72-4 levels could be an independent factor of gastric cancer recurrence. Conclusion:Serum tumor markers exhibited differ-ent predictive values in different pTNM stages. Preoperative CEA level could be used to predict recurrence in patients with pTNM-Ⅰ and pTNM-Ⅱ stages of gastric cancer. Moreover, postoperative CA72-4 level could be used to predict recurrence in patients with pTNM-Ⅲ stage gastric cancer.

Objective To evaluate the emergency repair method and its effect for treatment of extensive avulsion injury of the lower extremity in the elderly patients.Methods From May 2008 to February 2015,11 patients aged over 60 years sustaining large avulsion injury (across the knee or ankle joint) of the lower limb in traffic crushes were treated by emergency debridement and one-stage repair with the procedures of autologous skin replantation,arteriovenous anastomosis and vacuum sealing drainage (VSD).Two patients sustained injury to both lower limbs,and nine patients sustained a unilateral injury.Effect of wound repair was evaluated with skin flap survival area.Active and passive motility of the knee and ankle were recorded at postoperative 24 h.Results One patient with multiple fracture and extensive muscular inactivity due to severe crush injury to the lower limbs had poor blood supply after the replantation and was amputated at postoperative 24 h.The remaining ten patients with large skin avulsion showed 90％ of the avulsed skin survived after operation.At the follow-up of 3-24 months,the ten patients showed no obvious pigmentation or scar tissue,were satisfied with the function recovery in knee (106°-110° in flexion and 0°-5°in extension) and ankle joint (15°-20°in dorsiflexion and 30°-35° in plantar flexion),and could walk freely,including excellence outcomes in 3 patients and good outcomes in 6 patients.Conclusion The emergency repair methods including autologous skin replantation,arteriovenous anastomosis and VSD combined with one-stage in situ repair can attain satisfactory clinical effect.

Objective To establish a continuous monitoring assay of serum argininosuccinate lyase (ASL) activity with automatic biochemistry analyzer, and perform methodology validation and preliminary clinical application.Methods According to the chemical reaction catalyzed by ASL and the working characteristics of automatic biochemistry analyzer, an enzyme coupled reaction system with high specificity was set up, and the methodology validation was performed.Three hundred and nine patients with various liver diseases, 269 non-liver disease patients and 40 healthy controls were enrolled in this study.Serum ASL, ALT, and AST level were determined in all subjects.Results A new kinetics assay of ASL activity was set up with automatic biochemistry analyzer.The methodological validation demonstratod that inter-assay and intra-assay coefficient of variation were 4.0% and 5.9% respectively and the mean recovery was 100.5%.The linear range was 0-167.7 U/L.The lowest detection limit was approximately 0 U/L.The interference test showed that there is no significant interferences while the concentration of bilirubin is less than 342 μmoL/L or commonly used anticoagulants is employed at their routine concentrations.However,interference was significant when Hb level is more than 0.06 g/L.Preliminary study of clinical application showed that there was no significant difference of serum ASL level between non-liver disease group and healthy group ( q = 0.027, P = 0.979 ), but there was significant differences for both serum ALT and AST levels (ALT:q =6.461,P =0.000;AST:q =6.481,P =0.000).Conclusions A continuous monitoring assay for the determination of serum ASL activity is successfully established. Serum ASL may be a good biomarker for liver injury.