Objective To estimate the effect of open reduction and internal fixation for treating the trimalleolar fracture in the elderly.Methods 57 aged patients suffered from the trimalleolar fracture and were treated with internal fixation from January 2009 to June 2012.25 males and 32 females with an average age of 71.5 years ranged from 65 to 81 years were involved in this study.The supination-external rotation type were in 41 cases and pronation-external rotation type in 16 cases according to Lauge-hansen's classification.The posterior and lateral approach was taken for surgical procedure of lateral malleolar frature.The routine or locking plates were used to fix the fratures.The posterior malleolar fractures were usually fixed through the posterolateral approach as well.The screws or tension band fixation was selected for fixing the medial malleolar fragments.The parallel screwing fixation could be helpful for fixing the tibiofibular syndesmosis.Results The ankle function was evaluated by the criteria system of the American Orthopaedic Foot and Ankle Society (AOFAS).The efficacy was excellent in 23 patients,good in 24 patients,fair in 7 patients.The skin problems such as super facial infection and delayed union of incision were in 7 cases.Conclusions If choosing reasonable operation method and suitable internal plant,the open reduction and internal fixation has better effect in treating the trimalleolar fracture in the elderly,with fewer complications.

OBJECTIVE To compare the treatment effects of secreory otitis media with artificial eustachian tube insertion and tympanotomy tube insertion.To provide useful information for the treatment of secretory otitis media.METHODS Seventy-one patients(86 ears) with secretory otitis media were randomly divided into tow groups:experimental group(36 cases,44 ears) and control group(35 cases 42 ears).The experimental group was treated by artificial eustachian tube insertion under nasal endoscope.Drugs were injected through the tube into the tympanic cavity everyday after flushing it. The control group were treated by traditional method—the tympanic ventilation tube.All patients were followed up for 6 months.RESULTS The experimental group: 21 ears(47.73%) were cured,19 ears(43.18%) were straightened up,and no effects observed in 4 ears (9.09%).The control group:12 ears(28.57%) cured,17 ears(40.48%) wered straightened up and no effects obsered in 13 ears(30.95%).The efficiency rate of the experimental group(90.91%) was much higher than the control group(69.05%,P

Objective To sum up the experience of renal transplantation in order to improve transplant effect and enhance the long-term survival and recovery rate.Methods The data of renal transplantation of 1 124 cases who received renal transplantation from Jul. 1978 to Oct. 2001 were summarized. All the possible factors that could influence the transplant effect such as pre-operative preparation, HLA match, donors' quality, surgical procedure, immunosuppressive therapy and so on were analyzed. Results The 1-, 3-, 5-year survival rate (%) of patient/kidney was 83.1/ 70.3, 74.6/ 68.6 and 62.6/ 56.1 respectively. The rate of AR was decreased significantly from 3.09?% only with LXM to 0.89?% with LXM test in combination with HLA serological test. The rate of HAR and AR in 130 cases with additional PRA test were lower than those only with LXM test.Conclusions The well pre-operative preparation, the ideal HLA match, the high quality of donor's kidney and transplant operation were keys for successful renal transplantation. Reduction of the complications, individual and combined medication in reason and long-term follow-up were very important in the long-term survival time.

Objective Currently, the effect of hydrogen peroxide solution( H2 O2 ) flush on the recovery of peripheral nerve injury are still undetermined. This study aims to explore the effects of different H2 O2 flushing time course on recovery of peripheral nerve injury during surgical debridement. Methods 18 New Zealand male white rabbits were randomly divided into isotonic saline group( isotonic saline flush) , H2 O21 min group ( hydrogen peroxide solution flush 1 min + isotonic saline flush) , H2 O23 min group ( H2 O2 flush 3 min + isotonic saline flush. Each group has 6 rabbits. We established rabbit sciatic nerve injury model. After 12 weeks, we executed the animals, drew materials at the suture nerve, detected motor nerve conduction velocity and observed pathological HE staining, as well as measuring the sciatic nerve function indexes( SFI) of rabbits at the 8th and 12th week, respectively. Results Nerve conduction velocity in H2O21min group and isotonic saline group[(25.89±1.42), (26.46±1.67) m/s] were higher than that in the H2O23min group[(23.80±2.91)m/s](P<0.05). Pathological section shows that the isotonic saline group has a better sheathstructure, nerve fibers structure damage is not obvious and myelin degeneration degree is mild in H2 O21 min group. blurred sheath structure and myelin axons obvious deformation in H2 O23 min group. 8 weeks and 12 weeks after operation, SFI in isotonic saline group [(-43.00±0.82), (-39.17±0.91) m/s] was significant higher than H2O21 min group [ (-49.79±1.47), (-46.60±0.79) m/s] and H2O23min group [(-51.66±1.27), (-46.39±0.94) m/s], thedifference was statistically significant (P<0.05). SFI in group of H2O21min [(-49.79±1.47)m/s] was higher than group og H2O23 min [(-51.66±1.27) m/s][P<0.05]. Conclusion H2O2 solution has side effect on the recovery of damaged peripheral nerve inju-ry and with prolonging the H2 O2 flushing time, the damage of peripheral nerve can be aggravated. So in the process of clinical surgical debridement, under the premise of guaranteed sterilization the time of H2 O2 flush should be shortened as far as possible.

Metformin is the most commonly prescibed drug for type 2 diabetes mellitus as it is inexpensive, safe, and efficient in ameliorating hyperglycemia and hyperinsulinemia. Numerous epidemiological studies indicate that diabetic population is not only at increased risk of cardiovascular complications, but also at substantially higher risk of many forms of malignancies. Meanwhile, epidemiological and clinical observation studies have shown that metformin use reduces risk of cancer in patients with type 2 diabetes mellitus and improves prognosis and survival rate of the cancer patients. Furthermore, metformin has been used for cancer therapy in clinical trials. Thus, metformin is emerging as a new cancer therapy or adjuvant anticancer drugs. This review summarizes recent progress in studies of metformin use and its molecular mechanism.
Antineoplastic Agents ; therapeutic use ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Metformin ; therapeutic use ; Neoplasms ; drug therapy

Objective:To investigate the existence of side population cells with the potency of stem cells in human gallbladder carcinoma cell line GBC-SD and the differences in ABCG2,Oct-4 and CD34 expression among SP cells,non-SP cells and GBC-SD cells.Methods:SP and non-SP cells were sorted from GBC-SD cells by fluorescence-activated cell sorting(FACS).The expression of ABCG2,Oct-4 and CD34 in SP cells,non-SP cells,and GBC-SD cells was detected by reverse transcription-polymerase chain reaction(RT-PCR),Western blot,flow cytometry(FCM)and immunofluorescence chemistry.Results:SP cells with stem cell potency were isolated from GBC-SD cells with a proportion of(0.64±0.08)%.The metastatic ability of SP cells was obviously higher than that of non-SP cells and GBC-SD cells(P<0.05).The expression of ABCG2 was significantly higher in SP cells than in non-SP cells and GBC-SD cells[(89.56±3.86)%vs.(1.32±0.49)%and(12.37±1.61)%,P=0.001].The expression of Oct-4 in these cells was(94.87±1.40)%,(88.16±2.34)%and(90.17±1.61)%,respectively(P>0.05).CD34 was neady absent in these cells on protein level[(1.78±0.51)%vs.(0.63±0.21)%and(0.96±0.381)%,P>0.05)],but it was highly expressed in non-SP cells and GBC-SD cells and absent in SP cells off mRNA leve;.Conclusion:SP calls which hava the potency of stem cells,exist in human gallbladder carcinoma GBC-SD cell line and have the phenotype of ABCG2+Oct-4+CD34-.

Objective To investigate the proliferation inhibition and apoptosis induction effect of thalidomide(Thal) and its joint effect with 5-Fu on MGC-803 cell line. Methods The morphological changes of MGC-803 cells with AO/EB stain were observed under fluorescence microscope. The proliferation inhibition effeet was evaluated with MTT. The apoptosis induction effect was determined by FAM. Results The results of MTr array were as below: the difference was significant between Thai groups of 25 mg/L or above concentration and the control group (P＜0.05), 5-Fu of all testing concentrations showed significant difference compared with the control gToup(P＜0.01). For combined groups with the same concentration of 25 mg/L 5-Fu,combined groups showed distinct difference from the corresponding 5-Fu group (P＜0.01), but two combined groups showed no distinct difference with each other (P＞0.05). For combined groups with the same concentration of 5-Fu 12.5 mg/L, 5-Fu plus 50 mg/L or 100 mg/L Thai showed no distinct difference from 5-Fu group of 25 mg/L(P＞0.05). With FAM study, all test groups showed significant difference compared with the control group (P＜0.01). There was also significant difference between two test groups arbitrarily (P＜0.01).Conclusion Both Thai and 5-Fu could inhibit the proliferation and induce the apoptosis of MGC-803 cells.The effect is reinforced with the combination significantly. Combination with Thai could decrease the concentration of 5-Fu but have the similar effect.

Objective To discuss the indication, technical points and long-term effects of endovascular embolization for non-functioning renal graft with detachable coils, and to get further evaluation of its practical value.Methods Monitored by DSA, endovascular embolization with detachable coils was performed on 11 patients with non-functioning renal graft.Results Renal arteries all had been successfully blocked in 11 cases.Good recovery without any complication was obtained.Conclusion Endovascular embolization for non-functioning renal graft with detachable coils is safe, minimally invasive and convenient, and can be used as an alternative to the resection of the renal grafts.

Objective To prepare recombinant human prothrombin-2 expressed in Pichia pastoris, and assay the enzymatic and clotting activities of prothrombin-2 activated by prothrombin activator ecarin.Methods Human prothrombin-2 gene and Echis carinatus ecarin gene were synthesized separately on the basis of the cDNA sequences published in GenBank.The gene of prothrombin-2 was cloned into the expression vector pPICZαA.The expression vector pPICZαA/prothrombin-2 was transformed into glycoengineered P.pastoris, and then prothrombin-2 engineered P.pastoris was screened.The expression products were induced by methanol, purified by two-step chromatography and identified by diges-tion by PNGase F and analysis of pepetide fingerprint.The ecarin gene was cloned into the expression vector pcDNA3.1. The expression vector pcDNA3.1/Ecarin was transformed into HEK 293T cells and the culture supernatant of HEK 293T/Ecarin was collected.The reaction product of HEK 293T/Ecarin cell culture supernatant and purified prothrombin-2 was analyzed by S-2238,which was the chromogenic substrate for thrombin.Fibrinogen was used to measure blood clotting time. Results The purified protein of P.pastoris expressed prothrombin-2 culture supernatant was 37 ×103 .The relative molecular mass(Mr) of the purified protein was reduced to 35 ×103, which was consistent with the theoretical Mr of prothrombin-2 molecular weight.The purified protein was proved to be prothrombin-2 by peptide fingerprint identification. The purified prothrombin-2 processed by HEK 293T/Ecarin culture supernatant could hydrolyze S-2238 to produce yellow pNA, and D405 of pNA increased with the volume of the processed prothrombin-2 that could promote the plasma coagulation.The blood clotting time was close to that of the thrombin kit.Conclusion Prothrombin-2 is prepared by P.pastoris and activated toα-thrombin by ecarin.This technique may replace the method of extraction of prothrombin from plasma and can be used for the treatment of war wounds or for future clinical research.

OBJECTIVE:To observe the efficacy and safety of eprosartan in the treatment of hypertensive patients with coro-nary heart disease. METHODS:160 hypertensive patients with coronary heart disease randomly divided into observation group and control group. All patients were given aspirin,nitroglycerin,low molecular weight heparin,statins and other conventional treat-ment;control group was additioanlly given 50 mg Losartan potassium tablet,orally,once a day. Observation group was additional-ly given 600 mg Eprosartan tablet,orally,once a day. The treatment course for both groups was 6 months. Clinical efficacy,sit-ting systolic blood pressure and diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase(AST),urea (UREA),creatinine(Cr),uric acid(UA),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C),the Mini-Mental status (MMSE) scale and activities of daily living (ADL) scale scores before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:There was no signifi-cant difference in the total effective rate between 2 groups(P>0.05). After treatment,the sitting systolic blood pressure and diastol-ic blood pressure,MMSE and ADL scale scores in 2 groups were significantly lower than before,and sitting systolic blood pres-sure in observation group was lower than control group,the differences were statistically significant(P<0.05),and there were no significant differences in sitting diastolic blood pressure,MMSE and ADL scale scores between 2 groups(P>0.05),and no signifi-cant differences in ALT,AST,UREA,Cr,UA,TC,TG,HDL-C and LDL-C between 2 groups before and after treatment(P>0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Eprosartan can effectively reduce sitting systol-ic blood pressure in hypertensive patients with coronary heart disease,and improve cognitive function,with good safety.