BACKGROUND:Combination of mid-third clavicle fracture with acromioclavicular joint dislocation is a rare injury. The internal fixation treatment of this injury remains controversial.
OBJECTIVE:To investigate the treatment of a rare injury of mid-third clavicle fracture combined with acromioclavicular joint dislocation.
METHODS:Three patients with mid-third clavicle fracture with acromioclavicular joint dislocation from 2005 to 2011 were analyzed retrospectively. The three patients were treated with clavicle anatomic locking plate+wire subcoracoid cerclage, clavicle anatomic locking plate+clavicular hook plate and clavicle anatomic locking plate+dual Endobutton plate coracoclavicular ligament reconstruction, respectively. The treatment effects of these three methods were compared, including the operation time, blood loss, and the shoulder function evaluation.
RESULTS AND CONCLUSION:One case was misdiagnosed as simple mid-third clavicle fracture. Al the three patients were fol owed-up for more than 12 months, and the clavicle fracture healed in al three cases. The internal fixators were moved out at 12, 9 and 11 months, the Endobutton plate was stil in the body, and no redislocation happened in al cases. The pain, daily function, activity and muscle strength were compressively assessed before and after internal fixator removal. The scores of the three patients were 64, 71 and 92 before surgery, and 68, 79 and 95 after surgery. Patient treated with double Endobutton and locking plate had the best recovery. Double Endobutton plus clavicle plate are good choice as internal fixation in the treatment of mid-third clavicle fracture combined with acromioclavicular joint dislocation.

Objective To present the experience of diagnosis and treatment of 21 cases of retrocaval ureter. Methods 21 cases of retrocaval ureter were retrospectively analysed. Results The main clinical symptom was right waist pain in 20 cases,4 of them with typical renal colic.8 cases had gross hematuria and calculus in the renal pelvis.1 case was void of symptom.The diagnosis of the disease depended mainly on intravenous urography (IVU) and retrograde ureteropyelography (RGU).IVU and RGU showed a "S" shaped upper ureteral segment with dilatation. Ureteral replacement and ureteroplasty were carried out in 20 cases which have been followed up from 2 months to 28 years with an average of 13 years.The symptom disappeared in 19 cases,with hydronephrosis and hydroureter significantly reduced on IVU and ultrasonography.1 case underwent ureteral reanastomosis because of stenosis at anastomosis site. Conclusions In patients with hydronephrosis and hydroureterosis of upper segment on the right side,the possibility of retrocaval ureter should be considered.Intravenous urography and retrograde ureteropyelography are the main means of diagnosis.Ureteral replacement and ureteroplasty are the treatment of choice.

Objective To improve the levels of diagnosis and treatment of testicular torsion. Methods The clinical data of 39 cases of testicular torsions were summarized and analyed.All the 39 cases had the essential clinical symptom of colic in testis,and 20 cases had the positive Prehn's sign.Eight cases underwent out examination of radionuclide imaging of scrotum,which showed unilateral defect of radionuclide distribution.The 8 cases were all diagnosed as testicular torsions.B-ultrasound showed that the positions of testis and epididymis were changed in scrotum and the blood supply in testis was reduced clearly or disappeared. Results Five cases who received operation within 12 hours from attack time had testicles survival.Of 5 cases who had operation within 12 to 24 hours from attack time 3 had testicles survival.Of 27 cases who had operation more than 24 hours from attack time only 6 had testicles survival.Two cases had no operation. Conclusions It is helpful to get diagnosis for early testicular torsion by Radionuclide imaging of scrotum and B-ultrasound are helpful to make diagnosis of early testicular torsion.Early diagnosis and timely treatment are key of improving therapeutic effect.

[Objective]To study the transfection and expression of green fluorescent protein gene in rat chondrocytes by constructing a combination lentiviral vector containing green fluorescent protein gene.[Method]293T cells were co-transfected with the vector plasmids pLentiLox 3.7,the packaging plasmids pRSV-REV,pMDL g/p RRE and the envelope plasmids VSV-G to produce lentiviral vector particles.Rat chondrocytes were isolated,cultured and infected by the lentiviral vector particles.The expression of reporter gene GFP was observed under fluorescent microscope.[Result]At 96 hours after transfection,a strong expression of GFP could be found in 293T cells.The viral titer was 3.0?103ifu/?l.GFP expression was observed in about 80% of the rat chondrocytes.[Conclusion]A combination lentiviral vector containing green fluorescent protein gene was successfully established and it could infect rat chondrocytes efficiently,which will provide a basis for gene modification of chondrocytes through RNA interference.

Objective To evaluate the methods and efficacy of microsurgical treatment for the premalignant and malignant lesions of the conjunctiva. Methods Forty-seven patients witn premalignant and malignant lesions of the conjuncitva were managed by microsurgical, these patients include 12 melanoma, 26 squamous cell carcinoma, 6 Bowen’ diseases, 3 primary acquired melanosis. The surgical method differs with limbal tumors, extralimbal tumors, and primary acquired melanosis. Results In all 47 patients, the tumor was completely removed in in one procedure. After follow-up for 4~60 months(mean 17 months), these were no tumor recurrence. Conclusion It is effective methods that premalignant and malignant lesions of the conjunctiva are managed by microsurgical resection, alcohol application, and supplemental cryotherapy. Careful propeirativa clinical evaluation of patient with a conjunctiva neoplasm is important in making the correct diagnosis and planning the surgical approach.

Objective:To explore the expression of ROR?t in pulmonary tissue of asthmatic mice and to investigate the association between the expression of ROR?t and the airway inflammation.Methods:Thirty female BLAB/c mice were randomly divided into the control group,asthmatic group and dexamethasone (Dex)-treated group.The asthma model was induced by classical method with ovalbumin(OVA).The concentration of IL-17 in bronchoalveolar lavage fluid (BALF) and serum was measured by enzyme-linked immunosorbent assay(ELISA).Airway inflammation was evaluated by HE staining.The expressions of IL-17,ROR?t mRNA and protein was measured by reverse transcription-polymerase chain reaction(RT-PCR) and Western blot respectively.Results:The level of IL-17,ROR?t mRNA and protein of asthmatic group was significantly higher than those of control group and Dexamethasone treated group (P

AIM: To investigate the influence and mechanism of recombinant macrophage migration inhibitory factor(rMIF) on fibroblasts.METHODS: MRC-5 fibroblasts were divided into two groups: the treated group was treated with rMIF(25-100 ?g/L,12 h,24 h or 48 h) and the control was non-rMIF treatment.The activity of proliferation in both groups was investigated and compared by CCK-8 means.Synthesis of collagen in the culture supernatants was detected by the hydroxyproline.The expression of collagen type I mRNA was examined using RT-PCR analysis.The level of collagen type I protein induced by rMIF was quantified by Western blotting.RESULTS: The production of proliferation ratio of fibroblasts treated with 50 ?g/L and 100 ?g/L rMIF at 24 h or 48 h were increased obviously(P

Background:Excessive immune cell activation-inflammatory factor theory is one of the most important pathogenic mechanisms of acute pancreatitis(AP). As the release of inflammatory factors is associated with systemic inflammatory response syndrome,seeking of serum cytokine markers for severity assessment of AP is of great clinical importance. Aims:To determine the dynamic changes of interleukin-6(IL-6),hepatocyte growth factor(HGF),and angiopoietin-2(Ang-2) in peripheral blood of AP patients in the first week after admission,and investigate preliminarily the clinical significance of these markers in AP. Methods:Seventy-two AP patients were prospectively recruited from Apr. 2014 to Oct. 2014 at the First Affiliated Hospital of Soochow University and were assigned into three groups:mild AP(MAP,n = 54),moderately severe AP(MSAP,n = 12)and severe AP(SAP,n = 6)according to the Atlanta classification of AP-2012. Thirty healthy subjects were served as controls. Serum levels of IL-6,HGF and Ang-2 were determined by ELISA on the 1st,3rd and 7th day after admission. Results:In the first week after admission,serum levels of IL-6,HGF and Ang-2 were significantly higher in AP patients than in controls(P < 0. 05). In MAP group,all three markers were gradually decreased in the first week;while in MSAP group,IL-6 was gradually increased,Ang-2 was gradually decreased,and HGF decreased after reaching the peak;in SAP group,IL-6 decreased after reaching the peak and HGF and Ang-2 increased again after a decrease. Serum levels of IL-6,HGF and Ang-2 were higher in MSAP group and SAP group than in MAP group at all the time points,but no statistically significant differences were observed between MSAP group and SAP group(P > 0. 05). Conclusions:IL-6,HGF and Ang-2 might play important roles in the pathogenesis of AP,and being the promising serum markers for severity assessment and dynamic monitoring of AP.

Chronic pancreatitis (CP) is a kind of disease with the sustainable and irreversible damage of the tissue structure and function of pancreas,which may be caused by alcohol,gene,gallstone,metabolism,deformity and other factors.The clinical manifestations are intractable abdominal pain and disorder of the internal and external secretion of pancreas.At present,the main purpose of the treatment for chronic pancreatitis is to relieve patients' pain,and to maintain the secretion function of pancreas as far as possible.The main surgical procedures for chronic pancreatitis includes the pancreatic resection,nerve block and decompression drainage of the pancreatic duct.In recent years,people hve paid more attenntion to the whole pancreas resection combined autologous transplantation due to retaining some functions of the islet cells.After whole pancreas resection combined autologous transplantation,the abdominal pain will relieve and the life quality will improved significantly.At the same time,it will effectively reduce the occurrence of pancretogenic diabetes since the surgery retains some function of the islet cells.

Objective To investigate and summarize the clinical characteristic of autoimmune pancreati-tis(AIP).Methods Clinical data of 13 patients with AIP, admitted to the West China Hospital from 2009 to 2013, were retrospectively analyzed .Results The median age of the 13 patients was 48 years old.The main clinical manifestations included epigastric pain or discomfort (8 cases), obstructive jaundice(7 cases)and weight loss(10 cases).Diffuse enlargement of pancreas and localized pancreatic enlargement were observed in 6 cases, pseudocyst and pancreatic stones were observed in 1 case.Dilation of pancreatic duct was found in 4 cases.Bili-ary stricture and thickened wall of bile duct were detected in 8 cases, dilated gallbladder with delayed enhance-ment of the thickened wall in 7 cases, retroperitoneal fibrosis surrounding the aorta in 1 case, abdominal lymph-adenopathy in 6 cases, stenosis of splenic vein in 4 cases, and Sjogren's disease and ulcerative colitis in 1 case. The positive rate of serum IgG, RF, ANA was 71.43%(5/7), 42.86%(3/7), and 42.86%(3/7), respec-tively.8 patients were misdiagnosed and underwent surgery .Steroid therapy was administered in all patients with satisfactory response.Conclusions AIP is a rare and autoimmune disease ,without speci? c symptoms,and often be misdiagnosed as pancreatic cancer or bile duct carcinoma .We must give more attention to AIP and keep pa-tients from undergoing unnecessary surgery .