There were 12 patients who were all type C1 or C3 epipod comminuted fracture.By means of the internal fixation,all patients were transplanted with the nanometer artificial bones,comprising hydroxyapatite and ?-tricalcium phosphate.The 12 patients used the bacteriophages preoperation,during operation and 3 days postoperation.They were free from pressure dressing and started to take exercises 48 hours postoperatively.Followed up for 6-12 months,all of the 12 patients healed well.So nanometer artificial bone is an effective method for the epipodite comminuted fracture,without any severe toxicity or complications.

Objective To discuss the efficacy of Neurotropin in the treatment of senile postherpes neuralgia.Methods 58 senile patients with postherpes neuralgia were randomly divided into Neurotropin group and Carbamazepine group. Before and after treatment, symptoms and signs of neuropathy including pain and numbness were evaluated by vision ambiguity scales(VAS). The side effects of drugs were also observed.Results 2,4,6 weeks of post-therapy,the VAS of Neurotropin group was decreased obviously than that of pretherapy (all P

Objective To analyze the short-term impact of fast track surgery (FTS) combined with minimally inva-sive surgery on elderly patients with colorectal cancer. Methods 200 patients with colorectal cancer received laparo-scopic surgery from July 2013 to July 2015 were selected and randomly divided into control group and FTS group. Patients in control group received conventional perioperative treatment and patients in FTS group received perioper-ative management according to fast track surgery. Status of intraoperative, postoperative recovery and the postopera-tive complication rate were compared between the two groups. Patients' quality of life were analyzed after two weeks of operation. Results Compared with the control group, the blood loss, operation time and number of lymph node dissection of patients in FTS group showed no significant difference ( > 0.05). Flatus time, ambulation time, start eating time, the infusion time and length of hospital stay in FTS group was significantly shorter than the control group, the difference was statistically significant ( <0.05). The total cost of hospitalization of FTS group was signifi-cantly lower than the control group ( <0.05). The incidence of sore throat, abdominal distension, lung infections and overall complications incidence rate in FTS group were significantly lower than the control group, the difference was statistically significant ( <0.05). The satisfaction rate in FTS group was 96.0%(96/100), and was significantly high-er than the control group 82.0 %(82/100), the difference was statistically significant ( < 0.05). QLQ-C30 results showed that scores of overall health, emotional function and social function of FTS group were significantly higher than the control group ( <0.05), and scores of nausea and vomiting, pain, insomnia, anorexia, constipation were sig-nificantly lower than the control group ( < 0.05). Conclusion Laparoscopy combined with FTS is safe and effective in treatment of colorectal cancer in the elderly patients, which can promote postoperative rehabilitation, improve pa-tient satisfaction and quality of life in short term.

Objective To explore the fixation method of tibial helical plate for treatment of proximal and middle one-third of humeral fractures and evaluate the clinical outcome. Methods A review was performed on 15 patients with proximal and middle one-third of humeral fractures treated by tibial helical plate from May 2004 to February 2009. There were 10 males and five females, at age range of 19-65 years ( average 38.0 years). The surgical method was summarized and the shoulder function evaluated.Results The follow-up lasted for 7-24 months (mean 13 months) , which showed bony union in all patients, with mean union time of 4.7 months. There was no implant loosening or failure. According to Neer 's criteria, the result was excellent in seven patients and good in six, with excellence rate of 86.7%.Conclusions Open reduction and internal fixation using tibial helical plate is simple and effective for treatment of proximal and middle one-third of humeral fractures.

Pancreatic cancer is a highly malignant, fast progressive digestive system neoplasm with poor prognosis, and the incidence has increased significantly in the recent years. The treatment mode of pancreatic cancer has been transformed from surgery-first approach to multidisciplinary approach including surgery, chemotherapy, radiotherapy and other comprehensive treatment modalities, accompanying with significant improvement in clinical efficacy. During the last decade, the molecular mechanism of pancreatic cancer has been explored in depth. Indeed, we had a clearer understanding of the disease, which provides clues for translation of basic research into clinical practice. This review summarized recent high quality studies on pancreatic cancer including pathogenic factor, advances in basic research, and clinical treatment.

Objective To investigate the possible formation mechanism and imaging features of the hyperintense vessel sign (HVS) on fluid attenuated inversion recovery (FLAIR) in patients with ischemic stroke or transient ischemic attack (TIA).Methods The baseline data of the patients with middle cerebral artery (MCA) ischemic stroke or TIA with digital subtraction angiography (DSA) showing the lesions of MCA M1 segment in clinical practice were retrospectively retrieved from Nanjing Stroke Registry Program from January 2010 to July 2011.FLAIR was used to observe HVS,and DSA was used to evaluate the degree of vascular stenosis and cerebral collateral circulation.Results A total of 101 patients were enrolled,76 (75.2％) were males,and their mean age was 53.94 ± 13.47 years; 90 patients (89.1％) with ischemic stroke and 11 patients (10.9％) with TIA; 55 patients (54.5％) were HVS negative and 46 (45.5％) were HVS positive.Among the patients whose MCA stenosis ＜50％,50％-70％,70％-90％ and ≥90％,the positive rates were 0％ (0/8),25.0％ (3/12),17.6％ (3/17),and 62.5％ (40/64),respectively.There were significant differences (Z=-4.479,P＜ 0.001).The leptomeningeal collateral circulation of the HVS positive group was significantly more than that of the HVS negative group (Z =-6.196,P ＜ 0.001).Multivariate logistic regression analysis showed that the degree of MCA stenosis was an independent risk factor for influencing the formation of HVS (odds ratio 3.943,95％ confidence interval 2.03-7.659; P ＜0.001).Conclusions The formed intracranial leptomeningeal colhteral circulation after severe intracranial vascular stenosis or occlusion is a major pathophysiological basis of HVS formation on FLAIR sequences in patients with ischemic stroke or TIA.

ObjectiveTo explore the role of β-catenin in the proinvasive consequences of hypoxia in hepatocellular carcinoma (HCC).MethodsWe established in vitro and in vivo hypoxic models using the highly metastatic MHCC97 and the stable red fluorescent protein-expressing MHCC97-R cells.The role of β-catenin in hypoxia-mediated aggressiveness was investigated by β-catenin knockdown.ResultsHypoxia caused a pronounced arrest of proliferation in MHCC97 cells,suppressed tumor growth in MHCC97-R xenografts,but promoted in vitro invasiveness and in vivo metastasis.β-Catenin-silencing by short hairpin significantly inhibited the enhanced invasiveness of MHCC97 cells due to hypoxia,reduced the increase in distant metastasis by hepatic arterial ligation,but failed to further restrain cell proliferation.Conclusionβ-Catenin in HCC cells plays an essential role in the hypoxia-induced metastatic potential.A reduction of βcatenin expression inhibited the proinvasive consequences of hypoxia in HCC.

Objective:To investigate the influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 104 patients with pancreatic head cancer who underwent radical resection in Fudan University Shanghai Cancer Center from May 2014 to May 2015 were collected. There were 62 males and 42 females, aged (61±10)years. Patients underwent carative pancreaticoduodenectomy. Observation indicators: (1) surgical situations; (2) follow-up; (3) influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer. Follow-up was conducted using telephone interview to detect recurrence of patients up to postoperative 1 year. Measurement data with normal distribution were represented as Mean±SD. Count data were described as absolutes numbers, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was analyzed using the Logistic regression model. Results:(1) Surgical situations: 104 patients underwent curative pancreaticoduodenec-tomy successfully. The volume of intraoperative blood loss was (474±280)mL and the number of lymph node dissection was 21±10. (2) Follow-up: 104 patients received postoperative follow-up, 44 of whom had early recurrence. Of the 44 patients with early recurrence, 42 cases had intraperitoneal recurrence including 23 cases with liver metastasis, 7 cases with metastasis in surgical site, 7 cases with retroperitoneal lymph node metastasis, 5 cases with omentum metastasis, 2 cases had extraperitoneal recurrence including 1 case with pleural metastasis and 1 case with pulmonary metastasis. (3) Influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer: results of univariate analysis showed levels of preoperative CA19-9, levels of postoperative CA19-9, the number of lymph node dissection were related factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer ( χ2=5.833, 9.276, 4.261, P<0.05). Results of multivariate analysis showed that postoperative CA19-9 >37 U/mL was an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer ( odd ratio=3.599,95% confidence interval as 1.551-8.347, P<0.05). Conclusion:Postoperative CA19-9>37 U/mL is an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.

Objective To observe the effect of crocin pretreatment on the learning memory ability, the ultrastructure and SIRT1/PGC-1α expression in hippocampus under hypoxia at high altitude in rats. Methods 96 male SD rats were randomly divided into Hypoxia model group and Hypoxia treatment group with 48 in each.The group rats in treatment group were injected with Crocin once daily(50 mg/kg) and the model group were injected with the same dose of 0.9%NaCl for 3 days,and then they were shifted to high al-titude under hypoxic environment and then the samples were taken at 1 d,3 d,5 d,7 d.Morris water maze test was used to observe learning and memory behaviors of rats.The level of SIRT1/PGC-1αprotein was detected by Western blot and the level of mRNA was detected by RT-PCR.Results Compared with the model group (1d(37.55±1.34)s,3d(46.51±6.19)s,5d(42.12±2.73)s),treatment group showed significant less time in looking for platform in Morris water maze experiment at (1d(33.58±2.23)s,3d(30.19±3.35)s and 5d (37.10±1.48)s;all P<0.05),and reduced damage in hippocampal tissues of ultrastructure.The results of RT-PCR showed that the mRNA levels of SIRT1 and PGC-1α in hippocampus of rats were higher in treat-ment group (1d(0.24±0.01),(0.34±0.02);3d(0.27±0.01),(0.37±0.02);5d(0.26±0.08),(0.26± 0.03)) than those in model group(1d(0.23±0.02),(0.32±0.03);3d(0.12±0.02),(0.19±0.02);5d(0.20 ±0.01),(0.24±0.03);all P<0.05),and there was no significant difference at 7d in two groups(P>0.05). Western blot showed that the protein expression levels of SIRT1 and PGC-1α in hippocampus of rats were higher in treatment group (1d(0.72±0.02),(0.72±0.02);3d(0.76±0.03),(0.75±0.021);5d(0.54± 0.03),(0.74±0.01)) than those in control group (1d(0.53±0.04),(0.62±0.04);3d(0.15±0.02),(0.13± 0.02);5d(0.23±0.03),(0.21±0.02);all P<0.05),and there was no significant difference at 7d between groups(P>0.05).Conclusion Crocin pretreatment can ameliorate mitochondrial damage and improve the a-bility of learning and memory under hypoxia at high altitude in rats,which may be achieved through increased expression of SIRT1 and PGC-1α in the hippocampus.

Lymph metastasis has great impact on the prognosis of pancreatic cancer patients, which can relfect the biological and invasive potential of pancreatic cancer. However, currently, there is no standard in the clinical management of the lymph metastasis in pancreatic cancer. In this report, we will discuss and summarize the followings:lymph metastatic rate and its impact on prognosis, the rule of lymph metastasis, sentinel lymph node, intra-operative lymph nodes mapping, TNM staging, regional lymph nodes resection, number of lymph nodes examined, lymph node ratio, guiding adjuvant treatments, lymphatic targeted therapy.