Objective Comparative analysis of pressure in the compress interlocking intramedullary nail and interlocking intramedullary nail in the treatment of tibial shaft fracture stress level changed.Meth-ods Collection of 44 cases of tibial specimens were divided into two groups:A group :normal tibial inter-locking fixation group locking intramedullary nail .B group :internal fixation group locking intramedullary nail.Analyze and measure the biomechanical properties of the system.Results Pressure in a fixed group of interlocking intramedullary nail fixation group and normal tibial interlocking intramedullary nail in compres-sive interlocking intramedullary nail fixation of superior performance,low stress shielding,has more obvious advantage in strength,stiffness and stability,at the same time,it can make the tibial stump maintain normal stress level,and the operation is convenient,not easy to broken nails.Conclusions Internal compression interlocking intramedullary nail can control the physiological stress and conduction,the broken end of tibia stress level close to the normal stress level,to solve the clinical internal fixation fracture without stress con-duction problem,and can effectively control the harmful stress,low stress shielding,when fixed intramedul-lary fixation device before a new generation of tibial fracture.

10.3969/j.issn.2095-4344.2013.26.011

Objective To explore the expression and significance of matrix metalloproteinase-2 (MMP-2) and basic fibroblast growth factor (bFGF) in human glioma.Methods The expression levels of bFGF and MMP-2 in 56 cases of human glioma and 9 cases of normal brain tissue specimen were detected by immunohistochemistry technique.Furthermore,the correlation between the expression of the bFGF and MMP-2 was compared.Results In normal brain tissue,grade Ⅰ,Ⅱ and grade Ⅲ,Ⅳ,the positive expression of bFGF were (9.51 + 2.69)％,(24.78 ±- 7.57 )％,(41.23 ± 12.35 )％,respectively,and MMP-2were (7.18 ± 2.12)％,(21.56 ± 3.85 )％,(54.32 + 7.32)％,respectively.The differences were significant among them (P ＜0.05).bFGF and MMP-2 were positive correlated (r ＝0.71,P ＜0.01).Conclusions There is an intrinsic correlation between the expression of the bFGF and MMP-2 and histological grade of human gliomas.These findings suggest that the synergistic interaction of bFGF and MMP-2 play an important role during the tumor invasion.

Objective To compare the clinical results of distal clavicular anatomical plates and clavicular hook plates in treatment of distal clavicular fractures.Methods Twenty-six patients with lateral 1/3 clavicular fractures of Craig Ⅱ type Ⅱ or Ⅴ treated from August 2009 to January 2011 were enrolled in the study.Eleven patients were managed by anatomic plates,including eight patients with type Ⅱ fractures and three with type Ⅴ fractures,while the rest 15 patients were treated by clavicular hook plates,including 11 patients with type Ⅱ fractures and four with type Ⅴ fractures.General information of the two groups was comparable before operation.Shoulder function after operation was evaluated by Constant-Murley score system.Postoperative radiographic findings and complications of patients in the two groups were studied comparatively.Results The distal clavicular anatomical plate group presented a lower incidence of shoulder pain and better mobility of shoulder,as compared with the clavicular hook plate group,but there were no significant differences in incision infection and implant loosening between the two groups.According to the Constant-Murley evaluation standard,excellence rates of the distal clavicular anatomical plate group and clavicular hook plate group were 91％ and 73％,respectively.Conclusion The distal clavicular anatomical plate is conducive to decrease of incidences of shoulder pain,increase of range of motion of shoulder and reduction of complications for treatment of Craig Ⅱ type Ⅱ or Ⅴ distal clavicular fractures and hence is in favor of early functional recovery of the limbs.

Objective To observe the differences in functional areas of the brain in response to two different acupuncture techniques using functional magnetic resonance imaging (fMRI).Methods Deqi and non-deqi acupuncture were performed on twenty healthy right-handed volunteers.fMRI was conducted in the process of acupuncture.The experiment adopted a single-chunk design and the procedure contained periods of stimulation and rest.The brain regions stimulated during deqi and non-deqi acupuncture were assessed using xjview software.Results After acupuncture at the Zusanli point (ST36),differences in activity were observed between the deqi and non-deqi groups in the language,sports,perception and limbic systems.Conclusions ①Under deqi conditions,acupuncture at ST36 increases circulation and the activation of brain areas dealing with language,sports,perception and the limbic system.This may be one of the mechanisms by which acupuncture can improve aphasia,coordination and perception.②Under deqi conditions acupuncture at ST36 decreases circulation and deactivates brain areas associated with the limbic system.This may explain acupuncture's analgesia and regulation of autonomic nerve and endocrine function,its amelioration of internal organ functions and regulation of immunologic function.

Objective To introduce the methods and key points for the external fixation combinel with limited percutaneous internal fixation plus colostomy in the treatment of open pelvic fracture concomitant with perineal laceration.Methods Nine patients with open pelvic fractures concomitant with perineallaceration were treated by external fixator combined with limited percutaneous internal fixer plus colostomy. Data including injury details, management and outcomes were collected for comparison.Results All the patients survived and attained bony union except for two patients with local infection that was healed several days after repeated wound debridement and use of wide spectrum antibiotics. All the patients had good extremity function at the latest follow-up. Conclusion External fixation combined with limited percutaneous internal fixation plus colostomy is a reliable, safe and less invasive procedure for the treatment of open pelvic fractures concomitant with perineal open wound.

Objective To Summarize the application of digital artery dorsal distal interphalangeal joint perforator flap to repair finger tip skin defect,and at the same time,the method and effect of anastomosis of finger dorsal branch of digital nerve sensory reconstruction.Methods From September 2012 to March 2015,78 patients 92 fingers were treated in Orthopedics Department of Jinshan Branch Hospital of the Sixth People′s Hospital of Shanghai,all patients with finger artery distal interphalangeal joint dorsal cutaneous branches of the dorsal flap pedicled with retrograde,transferred to repair the skin defect of finger end,and anastomosis of dorsal branch of the proper digital nerve reconstruction.Results Postoperative vascular crisis occurred in 8 cases,2 cases of partial flap necrosis and healed after symptomatic treatment.All flaps survived,the wounds healed in I stage,and the donor site healed in I stage.All the 73 cases were followed up,the follow-up period ranged from 3.0 to 12.0 months,an average of (7.8±2.5) months.The postoperative appearance and feel good,soft texture,abrasion resistance,no tenderness,cold resistance,dynamic two-point recovered to 4.0-8.0 mm,average (5.3±0.9) mm.Static two-point discrimination was 4.0-9.0 mm,average (5.8±1.2) mm.The method of TAM was used to determine the function of the 67 fingers,good for the 7 finger,but also for the 5 finger and the difference of the 0 finger.The excellent and good rate was up to 93.7%.Conclusion The operation without sacrifice of major arteries and nerves by finger,the middle finger dorsal skin for non functional surface area,and at the same time by anastomosis of dorsal branch of the proper digital nerve reconstruction,without surgery two times,is one of the ideal surgical repair of skin defect of the finger end.

Non-coding RNA refers to a class of RNAs that cannot encode proteins, and they play a very important role in regulating cellular activities. Pulmonary arteryhypertension is a group of diseases characterized by progressive elevation of pulmonary vascular pressure. Its pathogenesis is complex and its influencing factors are numerous. The study found that non-coding RNA, as a transcription product that does not participate in translational functions, plays an important role in the pathogenesis of patients with pulmonary arteryhypertension. With regard to the more well-studied and relatively mature circRNAs, lncRNAs, and miRNAs in non-coding RNAs, this article review the pathophysiological processes involved in the formation of pulmonary arteryhypertension.

BACKGROUND:There is a linker between Hsp65 and Esat6 coding a segment of water repellent polypeptide.It is very gentle and easy to be folded,which is profitable to translate the keno-folding correctly between the two proteins and to make the space structure of fusional proteins consistent with those two native ones.Then,a correct structure is formed and the immunogenicity of the fusional proteins is improved.OBJECTIVE:This study was to clone the fusional genes Hsp65-Esat6 from mycobacterium tuberculosis(MTB)H37Rv, then to construct into a eukaryotic expressing vector which contains an enhanced green fluorescent protein(EGFP) reporter gene,and finally to identify the expression of Hsp65 protein and Esat6 protein by IHC methods.DESIGN:Single sample experiment.SETTING:Department of Microbiology ＆ Immunology,Medical College of Jinan University.MATERIALS:Plasmid pVAE was donated by Professor Cao from South China University of Technology.MTB H37Rv,E.coil DH5 α,expressing plasmid pEGFP-C1 and Hela cells were donated by Doctor Hu Ping.METHODS:The experiment was conducted at the Department of Microbiology ＆ Immunology and the Medical Experimental Center of Jinan University between September 2005 and June 2006.The whole-genome was extracted from MTB H37Rv by molecular cloning technique,and used it as template to amplify Hsp65 (no terminator) gene by polyrnerase chain reaction (PCR),to recombine it with pEGFP-C1 vector after purification to construct pEGHsp65(no terminator)recombination vector.pVAE vector was used as template to amplify Linker-Esat6 gene(with terminator)by PCR, and then to recombine it with pEGHSP65(no terminator)to construct an eukaryotic expressing vector pEGHsp65-Esat6 with the fusional genes Hsp65-Esat6 inside.Finally,genes Hsp65-Esat was checked by molecule biology methods such as PCR, restriction endonuclease and DNA sequencing.Hela cells were transfected with pEGHsp65-Esat6 and the expression of EGFP and the efficiency of transfection were observed.The expressions of Hsp65 protein and Esat6 protein were detected by IHC methods.MAIN OUTCOME MEASURES:①The size of pEGHsp65-Esat6.②The DNA sequencing result of the pEGFP-C1.③The expression of EGFP in the transfected Hela cells.④The IHC results of Hsp65 protein and Esat6 protein in Hela cells.RESULTS:①The size of pEGFP-C1 was 4.7 kb,that of pEGHsp65 was 6.4 kb,and that of pEGHsp65-Esat6 was 6.7 kb.There were differences between their speeds In agarose electrophoresis.②The results showed that it was the same as reported Hsp65 sequence and Esat6 sequence of MTB H37Rv.③After transfecting pEGHsp65-Esat6 for 24 hours,EGFP was found in 30% of Hela through Laser scanning confocal microscope. But there was no EGFP in non-transfected Hela.④Hsp65 protein and Esat6 protein with biological activities were detected in transfected Hela cells by IHC methods.CONCLUSION: Using Hsp65 and Esat6 as immunogens,we have successfully cloned and constructed a eukaryotic expressing vector which contain fusionaI genes Hsp65-Esat6 of MTB H37Rv and EGFP.

Objective To evaluate the clinical outcome in the treatment of humerus shaft comminuted fractures using limited open reduction and internal fixation combined with an external fixator.Methods Data of 80 patients with comminuted humerus shaft fractures treated from January 2005 to January 2013 were analysed retrospectively.All the patients underwent limited open reduction and internal fixation combined with an external fixator (treatment group) and open reduction and plate fixation (control group) according to the random number table.In the treatment group,there were 40 patients (28 males,12 females),at mean age of 33.5 years (range,21-54 years),with causes of injury including traffic accidents in five patients,falls in nine,crashes in seven and others in six.There were seven patients with open fractures and 33 with closed fractures.In the control group,there were 40 patients (25 males,15 females),at mean age of 32.9 years (range,19-55 years),with causes of injury including traffic accidents in 16 patients,tumbling in seven,crush in seven and others in ten.There were eight patients with open fractures and 32 with closed fractures.The operation time,intraoperative blood loss,bone union time and complications in both groups were recorded.Clinical efficacy was evaluated using the Stewart and Hundley standard.Results Mean follow-up was 19 months (range,15-24 months).Treatment and control groups showed significant differences in operation time [(55.5 ± 10.3) minutes vs.(120.5 ± 15.3) minutes],intraoperative blood loss [(120.4 ± 20.7) ml vs.(245.4 ± 26.7) ml] and bone union time [(11.6 ± 1.3) weeks vs.(14.9 ± 2.3) weeks] (P ＜ 0.05).Rate of incision infection was 8％ (3/40) in treatment group and 10％ (4/40) in control group (P ＞ 0.05).In treatment group the results were excellent in 31 patients and good in nine.In control group the results were excellent in 27 patients,good in nine,fair in one and poor in three.One patient with radial nerve injury after a second surgery for implant removal and two patients with osteomyelitis or bone nonunion were noted in control group.Conclusion Limited open reduction and internal fixation in combination with an external fixator is associated with small trauma,easy operation,short operation time,few bleeding,rigid fixation,early functional exercises and reduced bone nonunion for treatment of comminuted humerus shaft fractures,which exhibits great clinical value.