BACKGROUND:Distal femoral fractures are complex and unstable, and combined with severe injury to local soft tissue and microcirculation. Fracture healing is difficult. Condylar buttress plate is commonly used in the clinic. However, the factors affecting its prognosis are various, and the reports are diverse. OBJECTIVE:To investigate the factors affecting clinical efficacy of femoral condylar buttress plate for distal femoral fractures. METHODS:Clinical data of 84 patients with distal femoral fractures undergoing surgical treatment with femoral condylar buttress plate were retrospectively analyzed. Possible influential factors were screened by univariate analysis and logistic regression analysis. RESULTS AND CONCLUSION:Of the 84 patients, 63 cases (75%) rated as excellent by Neer scores. Univariate analysis of variance showed significant differences in age, fracture category, type of injury, timing of surgery, quality of reduction and CPM exercise among groups (P<0.05). Logistic regression analysis showed that older patients had poorer therapeutic effects (OR=0.797). Patients with satisfactory reduction, type fracture and CPM exercise had good therapeutic effects (OR=2.275, 1.756, 2.885, respectively). Results exhibited that satisfactory reduction, fitting joints, and early CPM exercises could effectively contribute to functional recovery of knee joint during implantation of condylar buttress plate in patients with distal femoral fractures. For patients with type C fracture, double plates can be used to strengthen fixation and to elevate therapeutic effects.

Objective To investigate the roles of Thl7 cells in the immunological pathogenesis of vitiligo. Methods Forty patients with progressive or stable vitiligo and 20 normal human controls were included in this study. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the level of serum IL-17, and SYBR Green I real-time RT-PCR to detect the mRNA expression of RORγt in peripheral blood mononuclear cells (PBMCs) from these patients. The correlation of the above parameters with disease activity was assessed. Results The levels of serum IL-17 and ROR-yt mRNA in PBMCs were significantly higher in patients with progressive and stable vitiligo than in normal human controls (all P< 0.01). Conclusion Thl7 cells may be closely associated with the pathogenesis of vitiligo.

ObjectiveTo detect the expression of CD146 in sera and peripheral blood mononuclear cells (PBMCs)of patients with Henoch-Sch(o)nlein purpura(HSP),and to assess its role in the pathogenesis of HSP.MethodsSixty patients with HSP in acute or recovery stage and 20 normal human controls were included in this study.Enzyme-linked immunosorbent assay (ELISA)was performed to measure the expression levels of serum soluble CD146(sCD146),and real-time fluorescence-based quantitative reverse transcription-PCR to detect the mRNA expression levels of CD146 in PBMCs.The correlation of the above parameters with disease activity was assessed.ResultsThe levels of serum sCD146 and CD146 mRNA in PBMCs in patients with HSP in recovery stage were significantly higher than those in the normal human controls(0.52 ± 0.15) ng/L vs. (0.23 ± 0.08) ng/L,t =8.90,P ＜ 0.05; 14.18 ± 2.49 vs.10.08 ± 2.08,t =6.92,P ＜ 0.05),but lower than those in patients with HSP in acute stage(0.84 ± 0.49) ng/L,t =3.44,P ＜ 0.05; 26.34 ± 2.55,t =18.69,P ＜0.05).ConclusionCD146 may participate in the pathogenesis of HSP.

Primary mediastinal large B-cell lymphoma represents a distinct entity with unique clinicopathologic features and a molecular gene-expression signature. There is no standard regimens. Retrospective analysis suggests that dose-dense and dose-intensive regimens are more effective than CHOP. The addition of rituximab may mitigate such difference. The role of mediastinal radiotherapy upon completion of chemotherapy remains unclear. The role of PET scanning requires prospective examination, which may allow the de-escalation of treatment if it can be shown to yield reliable prognostic information.

Congenital disorders of glycosylation(CDG)are a group of rare inherited metabolic diseases due to defects in the glycosylation of glycoproteins and/or glycolipids.Most of them are autosomal recessive and have multisystemic manifestations, which is characterized by dysmorphic facial features, developmental delay, growth failure, hypotonia, neurological abnormalities, hypoglycemia and multisystem disfunctions.Isoelectrofocusing(IEF)analysis of transferrin(Tf)and mass spectrometry(MS)technology can diagnose some subtypes of CDG, while many currently rely on genomic sequencing technology for diagnosis.A few subtypes can be clinically relieved or even cured by treatment, but most have no effective treatment.Development of molecular, biochemical and facial recognition techniques may deepen our understanding of this disease.

Objective To discuss the clinical value of endoscopic retrograde cholangio panecreatography (ERCP) and endoscopic sphincterotomy (EST) for the treatment of extrahepatic bile duct stones. Metbods Forty-five cases were treated with ERCP and EST. Other 55 patients treated with opening proedure were selected to serve as the controls. Results The effective rate was 97.8% by ERCP and EST and 90.9% by opening procedure(P>0.05). The rate of residual stone was 2.22% by ERCP and EST and 20.00% by opening procedure(P<0.05). The rate of complications was 4.44% by ERCP and EST and 18.18% by opening procedure(P<0.05). Conclusion Therapeutic efficacy of ERCP and EST is better than the opening procedure in the treatment of extrahepatic bile duct stones. It is a safe, effective and simple method for the treatment of extrahepatic bile duct stones.

Objective To explore the expressions and significance of Yes-associated protein (YAP) and large tumor suppressor gene 1 ( LATS1 ) in renal clear cell carcinoma (RCCC).Methods There are 30 cases of RCCC,15 males and 15 females.The median age was 63 (36 - 77) years.There were 17 cases of stage Ⅰ - Ⅱ,13 cases of stage Ⅲ - Ⅳ.There were 8 cases well differentiated,13 cases moderately differentiated and 9 cases low differentiated.The expressions of YAP,LATS1 mRNA and proteins in 30 cases of RCCC and normal renal tissues were tested by RT-PCR and immunohistochemistry,and were analyzed with clinical data.ResultsThe expression level of YAP mRNA in RCCC was higher than that in normal renal tissues (0.569 ± 0.066 vs 0.515 ±0.068,P =0.003 ),and the level of LATS1 mRNA in RCCC was lower than that in normal renal tissues (0.454 ± 0.115 vs 0.514 ± 0.093,P =0.029 ).Thepositive rate of YAP proteins in RCCC was obviously higher than that in normal renal tissues (63.3％ vs 33.3％,P =0.020),and the positive rate of LATS1 proteins in RCCC was lower than that in normal renal tissues (46.7％ vs 76.7％,P =0.017).The positive rate of YAP proteins was 33.3％ in well differentiated tissues,61.5％ in moderately differentiated tissues and 88.9％ in low differentiated tissues ( P =0.018),and the positive rate of LATS1 proteins was 75.0％ in well differentiated tissues,53.8％ in moderately differentiated tissues and 11.1％ in low differentiated tissues (P =0.024).The positive rate of YAP proteins was 47.1％ in stage Ⅰ - Ⅱ and 84.6％ in stage Ⅲ - Ⅳ ( P =0.034 ),and the positive rate of LATS1 proteins was 64.7％ in stage Ⅰ - Ⅱ,23.1％ in stage Ⅲ - Ⅳ ( P =0.024 ).ConclusionYAP and LATS1 play important roles in the development of renal clear carcinoma,and may become new targets in the treatment of RCCC.

Objective To explore and analyze the related factors for cirrhosis patients with hospital infection.Methods Clinical data of 750 patients with cirrhosis in our hospital were retrospectively analyzed.Related factors for hospital infection including gender,age,length of hospital stay,Child-Pugh classification,accompanying invasive procedures,associating the underlying disease,using antibacterial drugs and the sites of hospital infection and pathogen distribution were analyzed.Results The infection rate was 20.7％ (155/750).The infections were mainly spontaneous bacterial peritonitis [54.8％ (85/155)],followed by respiratory,digestive,urinary tract and skin.Pathogenic bacteria were mainly Gram-negative bacteria [56.1％ (101/1)],followed by Gram-positive bacteria and fungi.Patients aged over 70 years,with hospital stay over 4 weeks,with higher Child-Pugh classification,associated with invasive procedures,combined with underlying diseases,and treated with antimicrobial drugs were much easier to get hospital infection (x2=12.2,16.3,49.46,55.2,20.95,26.24,all P＜0.05).Conclusions Patients aged over 70 years with long hospital stay and more severe liver damage,accompanied by invasive procedures,combined with basic diseases and treated with antimicrobial agents are the related factors for hospital infection in patients with cirrhosis.

Objective To compare the efficacy and toxicity of melphalan + prednisone + thalidomide regimen (MPT) and melphalan + prednisone regimen (MP) in the treatment of multiple myeloma (MM).was given 100-200 mg/d everyday. 21 cases in MP group, the dose of melphalan and prednisone were the same as that in MPT group. The efficacy was evaluated after 6 cycles of treatment. Results The overall response rate (ORR) of MPT group and MP group were 65.4 % and 42.9 %, respectively (P＞O.05). The median response time in MPT group versus MP group was 2 months versus 3 months. Compared with the MP group. the increase of hemoglobin and albumin concentration in the MPT group is significantly higher (P＜ 0.05).The incidence of adverse effects of MPT group was higher than that of MP group (P ＜0.05), but the percentage of grade 3 and grade 4 toxicity was no different. The median PFS in MPT group was 11 months, 2-year PFS was 66.18 %. Conclusion Compared with MP, MPT could achieve higher response rate, improve the life quality and prolong the survival time of MM patients with better tolerance.

Objective To detect the expression of interleukin (IL)-27,-35 and their common subunit Epstein-Barr virus-induced gene 3 (EBI3) mRNA in peripheral blood from patients with psoriasis vulgaris (PV).Methods Peripheral blood was collected from patients with psoriasis vulgaris (PV) in progressive (n =22),stationary (n =20) and regressive (n =20) stage as well as 30 healthy human controls.A competitive enzymelinked immunosorbent assay (ELISA) was performed to determine the serum level of IL-27 and IL-35.SYBR Green-based real-time reverse transcription (RT)-PCR was carried out to measure the mRNA expression of EBI3 in peripheral blood mononuclear cells (PBMCs).Results The patients with psoriasis vulgaris showed a higher level of IL-27 and IL-35 compared with the healthy controls.The serum level of IL-27 was significantly higher in the patients with progressive,stationary and regressive psoriasis vulgaris than in the healthy human controls ((226.72 ±71.32) ng/L,(160.80 ± 20.02) ng/L and (181.93 ± 27.36) ng/L vs.(138.66 ± 33.93) ng/L,P＜ 0.01,0.05,0.01,respectively),and higher in the patients with progressive and regressive psoriasis vulgaris than in those with stationary psoriasis vulgaris (P ＜ 0.01,0.05,respectively).Increased serum level of IL-35 was observed in the patients with regressive psoriasis compared with those with progressive and stationary psoriasis and healthy controls ((355.78 ± 49.82) ng/L vs.(309.36 ± 36.10) ng/L,(299.14 ± 31.98) ng/L and (292.43 ± 36.26) ng/L,all P ＜ 0.01),while no statistical difference was observed between the patients with progressive and stationary psoriasos and healthy controls.The mRNA expression level of EBI3 in the patients with progressive,stationary and regressive psoriasis was 20.15,16.17 and 19.74 times,respectively,higher than that in the healthy controls.Conclusion IL-27,IL-35 and EBI3 may function as anti-inflammatory factors in the development,as well as the reversal of progression,of psoriasis.