OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

Objective To expore CT diagnostic values for hyaline-vascular type of giant lymph node hyperplasia(GLNH).Methods CT findings in 4 patients with hyaline-vascular type of GLNH confirmed by surgery and pathology were respectively analyzed and relevant literatures were reviewed.CT examination included plain and enhanced scan with contrast medium bolus injection.Results Lesions were located 2 at the posterior mediastinum,1 at the restroperitonum and 1 at the neck.The characteristic CT appearances were a large soft tissue mass round or oval in shape with homogenous density,well and regular margin.The masses were all markedly enhanced after contrast,their attenuation were similar to but slightly lower than the larger arteries in the same section.Conclusion GLNH is an uncommon disease and it′s clinical diagnosis is difficult.But CT scanning could showed some features.When CT found a mass with benign characters locating in lymph node regions,especially marked enhancement,Hyaline-vascular type of GLNH should be considered.

AIM:To test the hypothesis that wild-type p53 regulates the expression of p-glycoprotein. METHODS: While Hep3B cells lack expression of both p53 and retinoblastoma tumor suppressor genes because of deletions, were transfected to a wild-type (wt) p53 cDNA and control vector by a liposome method. After G418 selection, stable wt-p53 transformants, and control vector transformants (pNeo) were obtained. The expression of the p53,p21 and P-gp was analyzed by Northern or Western blot methods. In both transformants, cytotoxic effect of doxorubicin and mitomycin was evaluated by MTT assay, and accumulation of doxorubicin was detected by flow cytometer. RESULTS: In wt-p53 transformants, induction of transcriptionally active p53 was confirmed by the increase of P21 waf1/cip1 protein. Levels of P-gp reduced in the cells expressing wild-type p53 were linked to wt-p53 activity. The wt-p53 transfectants were more sensitive to doxorubicin and mitomycin compared with the pNeo transformants, and the accumulation of doxorubicin in the wt-p53 transfectants was 13 times as much as pNeo transformants. After both transformants were treated with doxorubicin at 0.2 mg/L for 24 hours, apparent apoptosis occurred in the wt-p53 transrormants. CONCLUSION: Restoration of wt-p53 activity in Hep3B leads to more sensitive to chemotherapeutic agents because of decrease of p-glycoprotein expression.

OBJECTIVE To search a method for identifying Clostridium perfringens and genotyping their toxin for gene diagnosis by multiplex PCR.METHODS The mutiplex PCR was developed with three sets of primers(designed) based on the sequences of three C.perfringens toxin genes(CP?,CP? and CPE) published in GenBank to identify C.perfringens and genotype their three toxin genes.RESULTS Three expected(sequences) were (obtained) successfully by multiplex PCR and identified by electrophoresis.CONCLUSIONS The(specific) sequences of C.perfringens could be amplified and their three genes of toxins could be identified by this multiplex PCR(system).Such method should be helpful for developing gene diagnosis well.

Objective To investigate the clinical features of cerebral infarction complicated with diabetes mellitus (DCI) compared withthose without diabetes mellitus (NCI). Methods 80 DCI and 86 NCI hospitalized patients were reviewed with their serumal glucose, lipid,uric acid, hemorheology and carotid ultrasound. Results The total cholesterol, low density lipoprotein and uric acid were significantly higherin DCI group than in NCI group (P<0.05), while high density lipoprotein was significantly lower (P<0.05). There were significant differencesbetween these two groups in Hemorheological indicators except hematokrit (P<0.01). The carotid intima media thickness (IMT) wassignificantly higher in the DCI group than in the NCI group (P<0.05). Conclusion DCI patients suffered in more serious lipid, uric acid,hemorheological disorder, and IMT compared with NCI.

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

OBJECTIVE To present the modified intranasal endoscopic dacryocystorhinostomy (MIEDCR) and the clinical results. To discuss the modified operative technique and its purpose. METHODS A total of 31 cases (35 eyes) with chronic dacryocystitis who underwent MIEDCR were included in this study. There were 27 female and 4 male. The age was ranged from 9 to 70 years (mean 31 years). The preoperative dacryocystography was taken in all cases. The follow up time was 6 to 20 months. RESULTS Among the 31 cases with chronic dacyocystitis, 4 patients suffered bilateral chronic dacyocystitis. Dacryocystitis related to nasal endoscopic surgery was found in 2 cases (2 eyes). Four cases (5 eyes) had prior laser lacrimal duct surgery. Two patients had external dacrypcystorhinotomy experience. 34 MIEDCR procedures (97.1 %) were successful. Twenty eight patients (32 eyes) were free of their symptoms and kept stoma patency. The shift of mucosal flap was found in one case when Merocel was removed. The rhinostomy of another 2 cases were closed due to mucosal scar and one of them received revision surgery. There were no operative complications. CONCLUSION The preserved nasal mucosal flap which was replaced over the denuded bone would avoid scar formation and hyperostosis and is benefit to gain a satisfied and good clinical effects of dacryocystorhinostomy.

Background and purpose: The literature on dose-volume parameters and pneumonitis is extensive. The results are inconsistent, both for the best predictive metrics and significant comorbid factors. This study aimed to investigate a prospective functional equivalent uniform dose (fEUD) with perfusion single photon emission computed tomography (SPECT) images as predictors of radiation pneumonitis (RP) in patients undergoing curative radiotherapy (RT). Methods: Functional lung imaging was performed using SPECT for perfusion imaging. Perfusion factors were defined as the mean percentile perfusion levels of the 4 areas, top to 75%, 75% to 50%, 50% to 25%, 25% to 0%, re-spectively. fEUD was calculated from perfusion factors and standard dose-volume parameters extracted from treatment planning computed tomography (CT) scans. Total lung (TL), ipsilateral (IL) and contralateral lung (CL) volumes minus gross tumor volume (GTV), whole-lung V5, V20, whole lung fEUD, IL and CL fEUD, and general equivalent uniform dose (gEUD) were analyzed to evaluate correlations between RP using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Statistical significance was defined as P<0.05. Results: A total of 15 patients treated with intensity modulated RT or 3D conformal RT were analyzed, grades≥3 RP were observed in 6 patients. There was only a trend toward significance for unilateral (UL) fEUD of higher dose side (P=0.007). Whole-lung V5, V20 were almost identical between patients who developed pneumonitis and patients who did not, as the values were below the recommended thresholds from published papers. Unilateral fEUDs were linear with unilateral gEUDs (t=0.815, P=0.000). Conclusion: SPECT-based equivalent uniform dose appears to be a better predictor of RP compared to stan-dard dose-volume parameters. Planning constraints should aim to keep unilateral fEUD below 21 Gy.

Objective To evaluate the effect of endoscopic retrograde cholangiopancreatography (ERCP) in treatment of biliary complications after liver transplantation. Methods Data of 39 patients who underwent ERCP between January 2005 and December 2007 because of biliary complications after liver trans-plantation were retrospectively evaluated. Endoscopic sphincterotomy, dilatation, nasal-biliary drainage (ENBD) and stent placement were performed in 25 patients with biliary strictures (14 at anastomosis site and 11 at non-anastomosis site). ENBD and stent placement were applied in 6 patients with biliary leakage, while endoscopic sphincterotomy, ENBD and stone extraction with baskets were performed in 16 patients with biliary stones. Procedures were repeated when necessary. Results ERCP was successfully performed at a rate of 95.9% (94/98) without any severe complications. Strictures at anastomosis site were resolved in all patients (100%, 14/14), while for strictures at non-anastomosis site, only 27.3% (3/11) were cured. Biliary leakage was resolved in 83.3% (5/6) patients. Complete bile duet clearance was achieved in 81.3% (13/16) of the patients with biliary stones. Conclusion ERCP proves to be safe and effective in the treatment of post liver transplantation biliary complications with low incidence of severe complications.

Objective To establish a model of cervical spondylosis in rats. Methods Sixty SD rats (four months old) were ran-domly divided into control, muscle imbalance and posterior column instability group, ten rats in each group. Then the degeneration of X-ray film and motion function were evaluated by oblique board test. Results After analyzed the cervical films of control groups, the nature curve still existed, vertebral clearance had no abnormal. No ostensis spurs or ossifies in Luschka joint and joint processes were found. But in mus-cle imbalance and posterior column instability groups, the nature curve was disappeared or stiff, vertebral clearance were stenosis, osteosis spur formed, ossify or sclerosis emerged in Lnschka joint and joint process. Compared with control group in oblique board test, the muscle force decreased in muscle imbalance and posterior column instability group. There were no statistic significant difference between 2 and 4 months of control group, and also no difference in muscle imbalance and posterior column instability group, but there were significant differ-ence in 2 and 4 months of muscle imbalance and posterior column group. Conclusion Not only cervical posterior column instability but also muscle imbalance could result in cervical spendylosis, both muscle force balance and posterior column were important factors in maintaining spine stability.