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 study the effect of baicalin on the content of glutamate acid (Glu), aspartic acid (Asp), ?-aminobutyric acid (GABA) in the brain of rat with experimental intracerebral hemorrhage. Methods The intracerebral hemorrhage rat model was induced by collagen enzyme + heparin sodium. The rats were randomly divided into sham group, model group and high, middle, low dose group of baicalin. Rats were treated with the physiological saline and different concentration of baicalin respectively. The brain of each group was taken out three days later and the brain homogenate was prepared. The content of Glu, Asp and GABA was measured with the high performance liquid chromatography (HPLC). Results Compared with the sham group, the levels of Asp were obviously higher (P0.05) in each dose group of baicalin. Compared with the sham group, the contents of Glu were increased obviously (P

10.3969/j.issn.2095-4344.2013.25.024

BACKGROUND:Intertrochanteric fracture can obtain good curative effects after active effective internal fixation in early stage.
OBJECTIVE:To compare dynamic hip screw+trochanter stabilizing plate and Gamma nail fixation for treatment of Evans type IIIB and type IV intertrochanteric fracture.
METHODS:A total of 67 patients with Evans type IIIB and type IV intertrochanteric fracture, including 28 cases undergoing dynamic hip screw+trochanter stabilizing plate and 39 cases undergoing Gamma nail, were selected from Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2009 to November 2012. Al patients received antibiotics and functional exercises after treatment. Time of therapy, intraoperative bleeding amount, fracture healing time and Harris Hip Score were retrospectively analyzed in patients of both groups.
RESULTS AND CONCLUSION:Al patients were fol owed up for 6-45 months, averagely 21 months. (1) One patient affected infection in the dynamic hip screw+trochanter stabilizing plate group. He was healed after fixation removal half a year after drug exchange. One obese patient experienced injury again during out-of-bed activity at 3 weeks after treatment in the Gamma nail group. Fracture appeared at distal end of lock pin, and healed after replaced by Gamma nail. Trochanteric stabilizing plate was unstable in four patients of the Gamma nail group. They affected severe pneumonia after over 6 weeks of lying in bed, and healed after treatment in the medical department (2) Coxa vara appeared in two cases of the dynamic hip screw+trochanter stabilizing plate group, and three cases in the Gamma nail group. Fracture healing was achieved in al patients. (3) The time of therapy was longer, and intraoperative bleeding amount was significantly more in the dynamic hip screw+trochanter stabilizing plate group compared with the Gamma nail group (P<0.05). No significant difference in healing time and Harris Hip Score was detected between the two groups (P>0.05). Dynamic hip screw+trochanter stabilizing plate and Gamma nail are effective methods for treatment of Evans type IIIB and type IV intertrochanteric fracture. To choose a suitable fixator, we should aggregately analyze fracture stability, healing state and the degree of osteoporosis.

Objective To analyze the related risk factors for delayed gastric emptying ( DGE) after pancreaticoduodenectomy .Methods Clinical data on 308 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili hospital from January 2009 to December 2014 were retrospectively analyzed , and patients were divided into DGE group and non-DGE group.Univariate analysis and multivariate logistic regression analysis were used to study the risk factors associated with DGE during perioperative period .Results DGE occurred in 55 patients (17.9%).The incidences of grade A, grade B and grade C DGE were 7.1%(22/308), 6.2%(19/308) and 4.5%(14/308), respectively.The univariate analysis showed the method of pancreatic digestive tract reconstruction ( pancreaticogastrostomy or pancreaticojejunostomy ) , postoperative pancreatic fistula, postoperative biliary fistula and postoperative intraabdominal infection were risk factors for DGE after surgery. Multivariate analysis indicated that the method of pancreatic digestive tract reconstruction (OR=1.19, P=0.046), postoperative pancreatic fistula ( OR=1.33, P=0.014), postoperative biliary fistula (OR=1.43, P=0.047) and postoperative intraabdominal infection (OR=1.51, P=0.001) were independently associated with DGE . Postoperative pancreatic fistula (OR=3.692, P=0.021) and intraabdominal infection (OR=3.725,P=0.003)were also the independent risk factors for Grade B and Grade C DGE. Conclusions DGE after pancreaticoduodenectomy was strongly related to the postoperative complications .Postoperative pancreatic fistula , biliary fistula and intraabdominal infection were associated with increased risk of DGE , while pancreaticogastrostomy reduced the incidence of DGE by decreasing the incidence of pancreatic or biliary fistula .

In recent years, artificial intelligence (AI) has been widely applied in the field of drug discovery and development.In particular, natural language processing technology has been significantly improved after the emergence of the pre-training model.On this basis, the introduction of graph neural network has also made drug development more accurate and efficient.In order to help drug developers more systematically and comprehensively understand the application of artificial intelligence in drug discovery, this article introduces cutting-edge algorithms in AI, and elaborates on the various applications of AI in drug development, including drug small molecule design, virtual screening, drug repurposing, and drug property prediction, finally discusses the opportunities and challenges of AI in future drug development.

Objective To elucidate the roles of TANK-binding kinase-1(TBKl)in hepatitis B virus (HBV)infection induced interferon antiviral immunity.Methods Peripheral blood monocytes were separated by CD14 magnetic microbeads from healthy volunteers(HV)and chronic hepatitis B(CHB)patients.Purified mDCs were induced and proliferated in the culture medium with human granulocyte-macrophage concentration of 25 mg/L were stimulated.The mRNA expressions of TBK1,interferon regulatory factor (IRF)3 and interferon(IFN)-βwere quantified by real time polymerase chain reaction(PCR).The levels of IFN-β in supernatants were determined by enzyme-linked immunosorbent assay(ELISA).Reslllts The mRNA levels of TBK1,IRF3 and IFN-β did not change significantly at 0,12,24 and 48 h after the significantly at 0, 12, 24 and 48 h in CHB group, whereas, it was significantly up-regulated at 12 h in HV group. Conclusions Our results suggest that there may be some disorders in host antiviral signal transduction pathways downstream the binding between ligands and receptors on mDC surface. The insufficient IFN-β expression after HBV infection may result in persistent chronic infection.

To investigate the cell-killing effect and its possible mechanism of rClone30-hDR5 in combination with TRAIL on human hepatic carcinoma (HCC) cell line, first of all, recombinant plasmid pee12.4-hDR5 was introduced into HepG2 cells by liposome transfection. After five rounds of screening by flow cytometry, HepG2 cells expressing high levels of DR5 on cell surface were isolated. The cytotoxicity of TRAIL to selected cells was higher than that of TRAIL to HepG2 cells by MTT method (P < 0.01). The result suggested that the cloned hDR5 gene had biological activity. MTT assay showed that, rClone30- hDR5 in combination with TRAIL more efficiently inhibited the tumor growth of HepG2 cells compared to rClone30-hDR5 or TRAIL in vitro. The results of Annexin V-FITC/PI staining and Quantitative Real-time PCR indicated that rClone30-hDR5 in combination with TRAIL significantly increased the mRNA levels of caspase 3 and caspase 8, and induced the apoptosis of tumor cells. HepG2 cells were infected with rClone30-hDR5 or rClone30 at MOI of 1. The expression of hDR5 on tumor surface increased significantly by rClone30-hDR5 compared to that by rClone30, which contributed to the sensitivity to TRAIL. In conclusion, rClone30-hDR5 in combination with TRAIL has potential application value in cancer treatment.

Objective To establish a method for measuring blood phosphatidylethanol by liquid chromatography coupled with tandem mass spectrometry(LC-MS/MS), which can be applied for objective and quantitative of alcohol intake.Methods Whole blood samples were treated with isopropanol to precipitate protein,and phosphopropanol(16:0/16:0)was used as the standard.After centrifugation, the supernatants were transferred and evaporated under a stream of nitrogen until dryness.Then the residuals were analyzed by LC-MS/MS.Various methodological parameters, including linearity, limit of detection (LOD), limit of quantitation(LOQ), recovery, and precision, were investigated.Finally, blood samples from 40 Chinese individuals with more than one year of regular drinking habits were analyzed, and distributions of phosphatidylethanol were evaluated.Results The correlation coefficients were higher than 0.9992.The LOD and LOQ were lower than 0.74 and 2.48 ng/ml, respectively.The inter-and total assay coefficient of variations were 0.77%-3.18% and 2.30%-6.95%, respectively, with recoveries ranged from 96.88% to 102.99%.The relationship between phosphatidylethanol level and self-reported alcohol consumption was significantly and positively correlated(r =0.769, P <0.001).Furthermore, Kruskal-Wallis analysis showed a significant difference in total phosphatidylethanol levels among individuals with different levels of alcohol intake(χ2=18.850,P<0.001).Conclusions An LC-MS/MS method for whole blood phosphatidylethanol detection has been developed.This method is simple,sensitive and accurate and can effectively reflect light,moderate and heavy alcohol intake.The method will be applied to the assessment of alcohol consumption and its association with the risks of drinking related diseases.