BACKGROUND:The open reduction and internal fixation in treatment of middle and inferior humeral fractures often choose anterolateral approach. As the rapid development of microsurgical technique in recent years, some domestic hospitals try to adopt the medial approach, but the operation safety and efficacy are rarely reported. OBJECTIVE:To evaluate the clinical efficacy of two different approaches of open reduction and internal fixation for treating the middle and inferior humeral fractures.
METHODS:A total of 68 patients with the middle and inferior humeral fractures were selected from Orthopedic Center of Xinjiang Medical University from January 2010 to January 2012, and were retrospectively analyzed. According to the approach of incision, the involved patients were divided into anterolateral approach group (n=33) and medial approach group (n=35). The blood loss in two groups was analyzed using Gross equation. The postoperative complications and functional recovery were compared.
RESULTS AND CONCLUSION:During the fol ow-up at 12-18 months, X-ray results showed that the fractures achieved bone healing, fracture healing time was 16.9±3.9 weeks in anterolateral approach group and 15.5±2.2 weeks in the medial approach group. Shoulder Neer system score was 86±5 points in anterolateral approach group and 84±4 points in the medial approach group;elbow Mayo system score was 78±7 points in anterolateral approach group and 81±8 points in the medial approach group. Three cases in anterolateral approach group and one case in medial approach group presented postoperative radial nerve numbness and wrist dorsiflexion weakness, which were self-healed after 3 months. There was no nonunion, chronic osteomyelitis for other complications. The fracture healing time, the incidence of complications and the functional recovery between the two groups showed no significant difference (P>0.05). The medial approach is a feasible and safe surgical approach of internal fixation for treating the middle and inferior humeral fractures.

Objective To provide diagnostic basis for blood stasis syndrome (BSS) ,from the point of laboratory medical science . And to further analysis the correlation between qi deficiency and blood stasis ,qi stagnation and blood stasis ,cold coagulation and blood stasis syndrome with clinical testing indicators .Methods Chinese medicine qi deficiency and blood stasis ,qi stagnation and blood stasis ,cold coagulation and blood stasis syndrome and healthy (healthy group) 50 cases each were analyzed .Blood samples were collected ,Hemorheological indexes ,coagulation indexes ,blood‐lipoid indexes and endothelin (ET ) ,nitric oxide (NO ) ,atrial natriuretic peptide (ANP) ,serum free calcium (F‐Ca2+ ) ,C‐reactive protein (CRP) were tested .Results Compared with the healthy ,the results of hemorheological indexes ,blood‐lipoid indexes ,ET ,NO ,ANP ,F‐Ca2+ ,CRP of three types of blood stasis syn‐drome group were different significantly(P<0 .05) .qi deficiency and blood stasis group and qi stagnation and blood stasis group were compared ,the difference of hemorheological indexes (except plasma viscosity ) ,blood‐lipoid indexes ,and ET ,NO ,ANP ,CRP was statistically significant(P<0 .05) .Cold coagulation and blood stasis syndrome group and qi deficiency and blood stasis group were compared ,the difference of hemorheological indexes ,coagulation indexes ,blood‐lipoid indexes ,and ET ,NO ,ANP ,CRP was statistically significant (P<0 .05) .Cold coagulation and blood stasis syndrome group and qi stagnation and blood stasis group were compared ,the difference of hemorheological indexes ,coagulation indexes ,blood‐lipoid indexes ,and ET ,NO ,ANP ,CRP was statisti‐cally significant (P<0 .05) .Conclusion Study shows that clinical laboratory test index provide the experimental basis for the diag‐nosis of qi deficiency and blood stasis ,qi stagnation and blood stasis ,cold coagulation and blood stasis syndrome .Improve the objec‐tivity of classification of blood stasis syndrome .To provide a new way of for the development of modern science in promoting tradi‐tional Chinese medicine diagnostics .

cerebral small vessel disease refers to the small vessel lesion and the resulting changes in the cerebral tissue.Both the small vessels detected by cerebrovascular reserve and the lesion of cerebral small vessel disease are in the same segment,so we can take advantage of cerebrovascular reserve as means to inspect and evaluate the small vessel lesion itself.

Objective To investigate the feasibility and safety of minimally invasive pereutaneous nephro-lithotomy(MPCNL) in treating impacted upper ureteral calculi. Methods 50 cases with impacted upper ureteral cal-culi treted with MPCNL were analyzed retrospectively. Results All cases were rendered stone free at one session, clearance rate was 100%, 1 case required transfusion,no other major complications was observed. Conclusion MPC-NL was safe and effective in treating impacted upper ureteral calculi with a high clearance rate.

[Objective]To investigate the means and effect of total hip arthroplasty(THA) for treating serious flexed hips caused by ankylosing spondylitis(AS). [Methods]A total of 20 male patients(28 hips) and 1 female patient(1 hip)with ankylosing spondylitis underwent THA.Eight patients had bilateral surgery.The mean age were 32.4 years(ranged 21~49 years).The disease course were 3~32 years,with the mean of 15.6 years.And the flexed deformation were 30?~95?,with the mean of 58.6,including ankylosis in 23 hips(79.3%).There were 17 patients(22 hips)in the biological prosthesis group and 4 patients(7 hips) in the cement group.The clinical results were evaluated by the Harris hip scoring system.[Results]The mean duration of follow-up were 4.5 years,all hip joints function were improved,and the postoperative Harrris Score were 83.2 versus the preoperative Harrris Score of 21.7.The serious flexed deformity of the involved hips were disappeared.The average range of motion of hip joint were 196?.The pain of the hips were disappeared almost completely and pain of lowerwaists and knees were relieved obviously.Patients got their gait right and could care themselves approximately.[Conclusion]Total hip arthroplasty is an effective treatment for serious flexed hips caused by ankylosing spondylitis.

Objective To evaluate the expression and significance of survivin and PCNA in human colorectal carcinoma. Methods Using in situ hybridization and immunohistochemistry(S-P method) respectively to detect survivin mRNA, and survivin and PCNA proteins in 64 cases of colorectal carcinoma. Results The survivin expression wasn't detected in the tumor adjancent tissues. The positive rate of survivin mRNA and protein expressions was 53% and 53% respectively, which was significantly associated with the histological type and lymph node metastasis of colorectal carcinoma (P

ObjectiveTo evaluate the radial rotation osteotomy and ulnadouble rotation osteotomy obstetric brachial plexus injury (obstetric brachial plexus palsy) forearm pronation deformity sequelae value.MethodsFrom August 2007 to August 2011, twenty cases of obstetric brachial plexus palsy sequelae in children with forearm pronation deformity, the implementation of a simple radial rotating radial osteotomy (5cases),double-rotation radius and ulna osteotomy (15 cases) and two surgical type,and by 6 to 54 months after surgery (mean 25 months) follow-up.The groupfunctions to forearm pronation angle and conscious function improvement as the evaluation criteria. ResultsThe 15 cases of radius and ulna osteotomy in children with dual function and appearance in 14 cases significandy improved,one case of supination deformity;five underwent simple radial pronation osteotomy,three patients had improved function and appearance,followed up for 6 months, eight months after the merger which radial head dislocation in 2 cases due to poor efficacy of dual-line radius and ulna osteotomy, twenty patients in this group did not appear nonunion.ConclusionSimple radial rotation osteotomy surgery in obstetric brachial plexus palsy forearm pronation deformity complications without radial head dislocation has some value, radius and ulna double osteotomy in forearm pronation deformity with radial head dislocation aftermath of the effect is more excellent.

OBJECTIVE:To establish a method and a technical process for the purification of total alkaloids from Gelsemium elegans Benth.with macroporous resin.METHODS:Different types of macroporous resin were used to separate and purify total alkaloids,the HPLC peak areas of the main ingredient of the alkaloids form Gelsemium elegans Benth.were compared and the optimum technological parameters were investigated.RESULTS:The HPD-500,HPD-600,HPD-800type macroporous resin showed better comprehensive absorption property,and HPD-800type macroporous resin were used to investigate parameter.CONCLUSIONS:The method of using HPD-800type and eluting with grade ethanol-water can be used to purify the total alkaloids from Gelsemium elegans Benth..

BACKGROUND: Chronic rejection limits the long-term success of cardiac transplantation and the underlying causes of the disease are unknown. Connective tissue growth factor (CTGF) is considered as a mitogenic and chemotactic factor for fibroblasts and is associated with cell proliferation and collagen synthesis.OBJECTIVE: To evaluate the role and significance of expression of CTGF in rat chronic rejection heart aliografta.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Laboratory Animal Center of the Second Xiangya Hospital between April and August 2007.MATERIALS: Twenty Wistar rats serving as donors and twenty Sprague-Dawely (SD) rats serving as recipients were included. An additional 10 Wistar rats were included as controls.METHODS: After intra-abdominal heterotopic heart transplantations, rats received cyclosporine A, mycophenolate, and methylprednisolone immunosuppression. Ten recipient rats were anesthetized and sacrificed for heart harvesting at 2 and 8 weeks postoperation, respectively.MAIN OUTCOME MEASURES: Coronary vessel density, fibrosis grade, and intimal occlusion were observed by hematoxylin-cosin staining and Van Gieson staining. Myocardial fibrosis was semi-quantitatively scored. CTGF expression was detected by immunohistochemistry. The associations between CTGF expression and allograft fibrosis and CAV formation were analyzed.RESULTS: Allografts harvested at 8-week post-surgery showed more obvious coronary intimal proliferation, fibrosis and higher CTGF expression compared with the 2-week allografts and the controls (P < 0.05-0.01 ) while the cardiac artery density was lower than the control group (P < 0.05). However, the control group in our study showed negligible CTGF expression. There were strong negative correlations between the gray value of CTGF protein expression and cardiac fibrosis and coronary intimal occlusion (r = -0.734, -0.713, P < 0.01), demonstrating that CTGF protein expression was positively correlated with cardiac fibrosis and coronary intimal occlusion.CONCLUSION: CTGF is expressed in cardiac myocyte with CAV. The increased expression of CTGF in the cardiac allograft is associated with CAV development and fibrosis formation and is involved in the pathogenesis of cbronic heart rejection

Objective To detect the expression of connective tissue growth factor (CTGF) in acute heart allograft rejection in rats and to investigate the relationship between CTGF expression and cardiac allograft fibrosis. Methods Sixteen Wister rats served as donors and another 16 Sprague-Dawely (SD) rats served as recipients. Intra-abdominal heterotopic heart transplantation was performed. All rats received 10 mg/(kg·d) cyclosporine,40 mg/(kg·d)CellCept, and 3 mg/(kg·d)methylprednisolone immunosuppression after the surgery. Ten allografts were harvested 2 weeks postoperation while 10 normal Wister rats served as controls. The paraffin sections of harvested heart specimens were stained with hematoxylin and eosin (HE),and van Gieson(VG) for the examination of morphological changes to observe the lumen loss of myocardial coronary arteries and myocardial fibrosis. The expression of CTGF was studied by immunnohistochemical method and was measured semi quantitatively. The correlation between the CTGF expression and allograft fibrosis was studied. Results The allografts showed a typical symbol of acute rejection with excessive granulocyte infiltration around the vessel wall and myocardial interstice. There were also intimal proliferation and obvious fibrosis in the acute group and the differences between the acute and control group were significant (P<0.05). The expression of CTGF protein was mainly located around the vascular and myocardial lesions in the acute group while the control group showed no CTGF expression. The gray scale value of CTGF was (AR vs NH: 103.52±6.42 vs. 182.61±8.72,P<0.05). Strong negative correlations were found between the gray scale value and fibrosis formation(r=-0.734,P<0.01). Conclusion CTGF was overexpressed in acute allograft rejection rat hearts and might be involved in the pathogenesis of transplanted heart fibrosis.