BACKGROUND:K-wire and steel wire tension band wiring is the most commonly method for the treatment of patel ar fracture. However, there have been many reports of complications related to the mental implants. Based on the reasons above, some scholars begin to replace the steel wire with braided polyester sutures for the treatment of patel ar fracture. OBJECTIVE:To observe the effect of patel ar ring pins and FiberWire braided polyblend sutures tension band fixation for treatment of patel ar fracture. METHODS:We performed a retrospective analysis involving 26 patients with patel ar fracture (16 males, 10 females, at the age of 36-54 years with a mean age of 44.6 years) who were treated with patel ar ring pins and FiberWire braided polyblend sutures tension band fixation. RESULTS AND CONCLUSION:Al the patients were fol owed-up for 6-18 months, average of 12 months. Al patients were primary healing and achieved bone union in 8-16 weeks, averaged in 12 weeks from surgery. There was no fracture fragment displacement, internal fixation loosening and break. No pins protruding from the subcutaneous and irritate the skin. According to the Lysholm&Gil quist scales, 18 cases were excellent, four cases were good, and four cases were fair, with the excellent and good rate of 85%. Tension band fixation using patel ar ring pins and FiberWire braided polyblend sutures resulted in good outcomes with few complications.

Objective To assess diagnostic value of Wells and Geneva seales in patients with suspected pulmonary embolism(PE).Methods Clinical data of 958 consecutive cases of suspected PE admitted to Shanghai Pulmonary Hospital form January 1,1995 to January 1,2009,were analyzed retrospectively,and all patients were assessed with Wells and Geneva scales,respectively for likelihood of PE,as compared to those diagnosed by lung imaging Results Three hundred and forty-seven patients with PE were diagnosed with lung imaging as gold standard,sensitivity,specificity,and positive and negative predictive values for Wells scale and Geneva scale in diagnosis for PE were 82.4%,58.1%,52.8%and 85.3%.and 88.8%,55.3%,53.1%and 89.7%,respectively,with positive and negative likelihood ratios.Youden index and crude agreement of 1.97,0.30,0.41 and 0.21,and 1.99,0.20,0.44 and 0.25.respectively.Area under the receiver operating characteristic(ROC) curve of Geneva scale(0.79)was significantly more than that of Wells scale(0.73)(Z=2.25,P＜0.05).As compared to Wells scale,sensitivity and specificity for Geneva scale in diagnosis for PE was significantly higher(χ2=7.12 and 6.84,respectively,P＜0.05).Conclusions Although there is a considerable gap in accuracy between clinical scales and lung imaging in diagnosis for PE.both Wells and Geneva scales can be used in clinical screening for PE to save unnecessary cost.however,Geneva scale is more practical and accurate than Wells scale,worthwhile to be popularized clinically.

BACKGROUND:It has been demonstrated that there are different expressions of fatty acid binding proteins (FABPs) in most malignant tumors such as breast cancer, prostate cancer, liver cancer, lung carcinoma and bladder carcinoma;therefore, FABPs are closely related to the occurrence, metastasis, invasion and drug resistance of malignant tumors. OBJECTIVE:To investigate the effects of fatty acid binding protein-5 (FABP-5) silencing on the proliferation, invasion and apoptosis of U251 cel s (human glioma cel s). METHODS:siRNA molecules targeting the mRNA of FABP-5 was designed and chenical y synthesized, which was transiently transfected into U251 cel s. U251 cel s were divided into three groups:Lv-shRNA-FABP-5 was added into FABP-5-shRNA group, LV-shRNA-NC added into negative control group, and blank control group underwent normal culture. mRNA and protein expressions of FABP-5 were detected by RT-PCR and western blot assay, respectively. The cel proliferation in vitro was determined by cel counting kit-8 assay, the cel cycle, apoptosis and expressions of CD44+and CD133+were detected by flow cytometry, and the apoptosis was observed using TUNEL staining. RESULTS AND COUNCLUSION:mRNA and protein expressions of FABP-5 in the FABP-5-shRNA group were significantly lower than those in the negative control and blank control groups. Compared with the negative control and blank control groups, the cel growth rate was significantly decreased, the cel cycle arrested in the G0/G1 phase, and the cel number in the S phase was decreased, and moreover, the proportion of CD44+/CD133+expression was significantly decreased in the FABP-5-shRNA group (P<0.05). Besides, compared with the negative control and blank control groups, the apoptosis rate was significantly increased, and the cel proliferation and invasiveness were significantly decreased in the FABP-5-shRNA group (P<0.05). In conclusion, it is possible that FABP-5 directly or indirectly regulates the cel cycle and apoptosis of glioma cel s, and its expression changes share a close relationship with the invasiveness of tumor cel s.

Objective To investigate the effect of ganoderic acid A( GA-A) on apoptosis, invasion and KDR expression of human U251 cells.Methods Ganoderic acid A( GA-A) was prepared, human U251 cells were treated with 0.1, and 0.5 mmol/L GA-A, and the experiment was divided into blank control, low concentration and high concentration group.The expressions of KDR mRNA and KDR protein was assayed by RT-PCR and Western blot.The effect of GA-A on the proliferation and invasion capability of U251 cells was determined by CCK-8 and transwell assay in vitro, respectively.Flow cytometry was used to detect the influence of GA-A on the cell cycle and apoptosis of U251 cells, and TUNEL staining was detected the cell apoptosis too.Results Compared with the control group, KDR mRNA and protein expression of high concentration and low concentration group were significantly decreased(P <0.05), GA-A can significantly reduce the cell growth rate, reduce the proportion of cells in G1 phase and increase the proportion of S phase and G2 /M phase,cells apoptosis was significantly increased in the high concentration and low concentration group ( P <0.01), and cells proliferation and invasion was significantly decreased (P <0.05).Compared with low concentration group, the high concentration group induce cell apoptosis and inhibit the expression of KDR more significant (P <0.05). Conclusions Ganoderma acid A can induce apoptosis in U251 cells, inhibit proliferation and invasion, and can inhibit the expression of KDR mRNA and protein, which may be one of the mechanisms of anti-tumor.

Objective To evaluate the MR imaging features of chondrnblastoma. Methods MRI examinations of 20 patients with histological proven chondroblastoma were reviewed retrospectively. The MRI findings of chondroblastoma including the signal intensity, the shape, the growth patterns, and the surrounding bone marrow edema and the adjacent soft tissue edema, the periosteal reaction, the adjacent joint effusion were analyzed . Results All 20 cases demonstrated heterogeneous MR signal intensity on T1WI and T2WI images and showed Iobular margins. Sixteen cases demonstrated expansive growth patterns. Surrounding bone marrow edema was found in 18 cases and adjacent soft tissue edema in 14 cases. Periosteal reaction was identified in 6 cases. In 7 cases the tumor extended to adjacent soft tissue. Adjacent joint effusion was visible on MRI in 6 cases. Conclusion Heterogeneous signal intensity, lobular margins and expansive growth pattern, adjacent bone marrow and soft tissue edema were the common features of chondroblastoma on MRI.

To retrospectively analyze the clinical data of 48 patients with allergic bronchopulmonary aspergillosis (ABPA) at Shanghai Pulmonary Hospital.There were 23 males and 25 females with a mean age of (36 ± 15) years.Their clinical manifestations included wheeze,cough,sputum production,sputum plugs,fever,hemoptysis,weight loss,chest pain,weakness and night sweats.They had a high peripheral blood eosinophilia,a higher serum total IgE,a higher level of aspergillosis fumigatus-specific IgE and positive immediate skin-prick test to aspergillus fumigatus.Aspergillus species were detected in sputum samples of 26 patients.Chest computed tomography (CT) was performed in 48 patients.There were patchy infiltrations (n =45),transient infiltrations (n =40),central bronchiectasis (n =35) and mucoid impaction (n =18).Obstructive ventilation dysfunction was confirmed by lung function test.

Objective To study the value of Geneva score assessment combined with simplified rapid plasma D-dimer assay(SRPDDA)for early diagnosis of pulmonary embolism(PE).Methods Clinical data of 658 suspected cases of PE hospitalized at Shanghai Pulmonary Hospital during January 1,1995 to November 30,2007 were retrospectively analyzed.The patients were divided into three categories based on their Geneva score assessment,highly suspected with equal to or greater than 9 scores,intermediately suspected with 5-8 scores and mildly suspected with equal to or less than 4 scores,respectively.Clinical diagnosis for PE of the patients was made based on their probability Geneva score developed by Wicki,SRPDDA,and both Geneva score assessment and SRPDDA,respectively,and compared with results of lung imaging.Results Finally,PE diagnosis was established in 267 cases.Sensitivity for Geneva score and SRPDDA to diagnose PE was 88.4%and 90.3%,with negative predictive value(NPV)of 88.9%and 90.2%and Youden Index(YI)of 51.7%and 51.4%,respectively.And,sensitivity of both Geneva score assessment combined with SRPDDA wag 97.8%,with NPV and YI of 97.3%and 53.8%,respectively,with a likelihood ratio(LR)for both positive test results of 2.62 and a LB for both negative test results of 0.04,respectively.Conclusions As a routine and non-invasive diagnostic test,Geneva score assessment,as well as SRPDDA,play a screening role in early diagnosis for PE,which can help to save unnecessary cost of imping,and complement each other so to improve accuracy of diagnosis and reduce misdiagnosis.

Objective To investigate the effects of different general anesthesia protocols on immune function in patients with oral malignant tumor. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing elective radical operation for oral malignant tumor were randomly divided into 3 groups ( n = 20 each): group Ⅰ total intravenous anesthesia (TIVA); group Ⅱ combined intravenous-inhalational anesthesia (IV-INH) and group Ⅱ inhalational anesthesia (INN). Anesthesia was induced and maintained with propofol and remifentanll in group Ⅰ; with sevoflurane,propofol and remifentanil in group Ⅱ and with sevoflurane and remifentanil in group Ⅲ. Peripheral venous blood samples were taken at 30 min before (To) and 1 h (T1), 3 h (T2 ) and 5 h (T3) after induction of anesthesia, the end of operation (T4 ) and at 24 h (T5 ), 48 h (T6 ) and 72 h (T7) after operation for determination of the percentages of T lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4+/CD8+ ratio). Natural killer (NK) cells (CD16+ ,CD56+ ) and B lymphocyte (CD19+ ) with flow cytometer. Results The percentages of CD3+ , CD4+ , NK cells, B lymphocyte and CD4+/CD8+ ratio were significantly decreased during and after operation at T1-5 in all groups and the percentges of CD3+ ,CD4+ ,NK cells and CD4+/CD3+ ratio were decreased at T6 in groups Ⅱ and Ⅲ as compared with the baseline values before anesthesia at To. The percentage of CD4+ cells and CD4+/CD8+ratio were significantly lower during anesthesia at T2,3,6 in group Ⅱ than in group Ⅰ . The percentages of CD4 +and NK cells and CD4+/CD8+ ratio were significantly higher after operation at T4,5 in group Ⅱ than in group Ⅲ.The percentages of CD3 + , CD4 + , NK cells and CD4 +/CD8 + ratio were significantly lower at T2-6 in group Ⅲthan in group Ⅰ . Conclusion TIVA with midazolam, propofol and remifentanil has less impact on immune function than inhalational and combined intravenous-inhalational anesthesia in patients with oral malignant tumor under-going elective radical operation.

Objective To compare the effects between propofol and sevoflurane on NK cells and B lymphocytes in patients undergoing radical operation for tongue cancer.Methods Forty patients (male 25 cases,femal 1 5 cases,aged 44-67 years,ASA Ⅰ or Ⅱ)undergoing elective radical operation for tongue cancer were randomized into 2 groups:group P received 2.0-2.5 mg/kg propo-fol,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for induction and 4-6 mg · kg- 1 · h- 1 propofol, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance; group S received 8 %sevoflurane with 5 L/min fresh gas flow,1-2 μg/kg remifentanil,0.1 5 mg/kg cis-atracurium for in-duction and 2 %-3 % sevoflurane, 0.2-0.3 μg · kg- 1 · min- 1 remifentanil for maintenance. Peripheral venous blood samples were taken at 3 0 min before (T0 )and 1 h (T1 ),3 h (T2 )and 5 h (T3 )after induction of anesthesia,the end of operation (T4 )and at 2 4 h (T5 ),4 8 h (T6 )and 7 2 h (T7 )after operation for determination of the percentages of NK cells (CD3 - CD1 6 + 5 6 + )and B lymphocytes(CD3 - CD1 9 + )by the flow cytometer.Results Compared with T0 ,the percentages of CD3 - CD1 6 + 5 6 + and CD3 - CD1 9 + in two groups were significantly decreased at T1-T5 (P <0.0 5 ),and the percentage of CD3 - CD1 6 + 5 6 + in group S was significantly decreased at T6 (P <0.0 5 ).The percentage of CD3 - CD1 6 + 5 6 + in group S were significantly lower than that in group P at T2-T6 (P < 0.0 5 ).There were no significant difference in the percentages of CD3 - CD1 9 +between two groups at the same time points.Conclusion Compared with sevoflurane,propofol can maintain a higher percentage of NK cells,and was helpful to maintain the immune function in patients undergoing radical operation for tongue cancer.

Objective To study the clinical effect of microsurgical surgery for the treatment of intracranial aneurysms in the acute phase. Methods 88 patients with intracranial aneurysm who were treated with the microscopic surgery in our hospital were selected as the research object. The prognosis was evaluated by Glasgow scale ( GOS) ,and the mortality rate during the follow-up period and postoperative complications were observed. Results All the patients received surgery success. The operation time was (60. 5 ± 20. 3) min,and the intraop-erative blood loss was (45. 2 ± 21. 5) mL. 12 months after operation,according to the GOS score of daily living ability,42 patients were of good prognosis and the other 46 cases were of poor prognosis. The good prognosis rate was 47. 7% and it is significantly higher than that of 3 months and 6 months after surgery. The difference was statistically significant (P<0. 05). There were 4 cases died among the 88 patients with a mortality of 4. 5%. Conclusion Using microsurgical treatment to treat intracranial aneurysms can receive good prognosis and low mortality rate. Complications were significantly improved after symptomatic treatment.