[Objective]To summarize the clinical effect of revolving self-lock nails and normal operative therapy for humerus shaft fracture,and discuss the perfect treatment methods.[Method]We retrospectively analyzed and compared the outcome and complications of the the humerus shall fracture by normal operative therapy in 96 cases(compression plate 42 cases,monolateral fixator 26 cases,embracing fixator 28 cases);revolving self-lock nails 39 cases.[Result]The operative time,volume of blood loosing,the radial nerve injury,the infection rate and the breakage rate of the group treated with normal operative therapy were obviously more than the group treated with revolving self-lock nails,and the satisfactory rate after operation of the group treated with normal operative therapy was less than the group treated with revolving self-lock nails.[Conclusion]Revolving self-lock nails can avoid much shortcoming of transverse locking nails.The advances of revolving self-lock nails are convenient in operative procedure,with little invasive of operation,solid internal fixation and safety compared with the normal operative therapy.And revolving self-lock nails has two kind choices:anterograde transfixation and retrograde transfixafion,thus it can protect function of shoulder joint in some ways,so revolving self-lock nails is one of the idea choices to treat the fracture of shaft of humerus.In opposition,normal operative has much shortage and it is restricted by type of fractures.

Objective: To evaluate the malignant potential of oral lichen planus (OLP) by measuring and analyzing the dimensions of spinous cell in mucosal epithelium.Methods:Paraffin-embedded samples of oral mucosa, including normal (N,7 cases), OLP(16 cases), oral leukoplakia(12 cases) with mild and moderate epithelial dysplasia (LK) and well differentiated oral squamous cell carcinoma (SCC,10 cases), were analyzed by MIAS-99 System.The planar and stereoscopic dimensions of spinous cells were measured and compared.Results:The values of morphometric and stereologic parameters in OLP were between those in normal mucosa and in LK, significantly different from those in SCC and not significantly different from those in normal epithelium.Conclusion:Based on the changes of cell morphometric parameter value, OLP is generally a benign lesion with some degree of malignant potentiality that is less than LK.Nucleus/cytoplasm volume ratio and volume density of cell nucleus of spinous cells in mucosal epithelium are of value in distinguishing benign from maliganant lesions.

Objective To investigate the risk factors for nosocomial bacteremia and decrease the prevalence of nosocomial bacteremia.Methods We collected the data of bacteremia patients in our hospital from January,2006 to December,2009.According to the criterion of nosocomial infection,the patients were divided into nosocomial bacteremia group (83) and community-onset bacteremia group (119).The influence of a series of variables on the development on both types of bacteremia was analyzed by Student＇s t test and x2 test.The risk factors were performed using multivariate logistic regression.Results Compared to that of community-onset bacteremia group,the proportion of malignancy (21/83 vs 12/119,x2 =8.2846,P ＜ 0.01 ),venous catheter ( 28/83 vs 3/119,x2 =36.67,P ＜ 0.01 ),diabetes ( 37/83 vs 0/119,x2 =68.226,P ＜0.05),surgical operation(37/83 vs 0/119,x2 =68.226,P ＜0.01),previous antibiotics(78/83 vs 10/119,x2 =173.5657,P ＜ 0.01 ) in nosocomial bacteremia group were higher.Multivariable logistic regression analysis showed that only 4 factors were significantly and independently responsible for nosocomial bacteremia,They were malignancy ( P ＜ 0.05,OR =3.186),diabetes ( P ＜0.001,OR =4.821 ),venous catheter( P ＜ 0.05,OR =2.135),previous antibiotics ( P ＜ 0.05,OR =2.135 ).The bacteria in nosocomial bacteremia group showed more ability to resist to antibiotics.Conclusions We should pay more attention to the patients with diabetes or malignancy or venous catheter or previous treated with antibiotics.These patients have more chances to develop to nosocomial bacteremia and infect by the drug-resistant bacteria.

Objective To calibrate and assess the dose distribution of 125 I seed brachytherapy. Methods Twenty 125 I seeds, each with activity of 12.2 MBq, were implanted on the circumference of a circle 15mm across in a phantom. Into a designed prostate model, 70 125 I seeds were implanted in four planes. The absorbed dose rate of the target volume was monitored by Farmar 2570 dosimeter and thermoluminescence dosimeters (TLD) with the isodose curves drawn on Kodak films. Results The central dose rates of the circular target volume assessed by Farmar 2570 and TLD were 8.4, 7.9 cGy/h in the phantom and 12.0, 11.1 cGy/h in the prostate model. For the target volume of the prostate model, the total absorbed dose was 24?219 cGy. The dose rate 4 cm from the prostate cancer as shown by the isodose curves was only 10% of the central dose rate. Conclusion The central dose rate of target volume measured by the two methods are similar.

Objective To explore the activity of Elemene for glioma cell from the cellular and molecular level. Methods The human glioma cell U251 was cultured. The effect of Elemene for human glioma cell proliferation was studied by MTT assay. Cell cycle, Fas, PCNA, bcl-2, intracellular Ca~(2+) and apoptosis were evaluated by flow cytometry analysis. Results Elemene exhibited antiproliferative effect on human glioma cell U251 markedly. The fifty percent inhibition on concentration (IC_(50)) of Elemene against glioma cells at different time points. 24 h was 40.60 μg/ml, the 48 h 38.14 μg/ml and the 72 h 34.35 μg/ml.Cell cycle was blocked in the S and G_2/M phases. The apoptosis ratio was increased by Annexin V staining markedly. Elemene decreased the gene expressions of PCNA and Fas, increased the intracellular Ca~(2+). There was no significant effect on the bcl -2 gene expression. Conclusion Elemene exhibits a marked antiproliferative effect on glioma cells and induces apoptosis by decreasing the expression of PCNA and increasing intracellular Ca~(2+). It also influences the expression of Fas. It might have no relationship with bcl-2 gene expression.

Objective To compare the difference of T-stage between Chinese 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma,and to investigate the optimization of T-stage and provide suggestions for further revision.Methods The MRI data of 183 patients with histology-proven newly diagnosed nasopharyngeal carcinoma in our hospital were enrolled from September 2009 to May 2017.All the anatomic sites mentioned in the two staging systems were marked,and all patients were staged according to the 2017 staging system and the 2008 staging system for nasopharyngeal carcinoma.Comparisons of T-stage were made between the two staging systems.Results Involvement of oropharynx,nasopharynx,prevertebral muscles,cervical vertebra,hypopharynx and orbit were 100％ accompanied with other same or more advanced T-stage classifications.The invasion rates of the cervical vertebra,orbit and hypopharynx were very low (all ＜ 5.00％).The incidence of involvement of pterygoid structure was 15.30％,most of which incorporated with erosion of skull base,only 1 case was invaded alone.All cases of involvement of paranasal sinuses were incorporated with erosion of skull base.Compared with the 2008 staging system,the consti-tuent ratio of T1 + T2 in the 2017 staging system increased from 36.61％ to 61.75％,and that of T3 + T4decreased from 63.39％ to 38.25％,the constituent ratio of T-stage between the 2017 staging system and the 2008 staging system was significantly different (x2 =26.94,P ＜ 0.001).There was moderate consistency of T-stage between these two staging systems (Kappa =0.514,P ＜ 0.001).Conclusion The T-stage of 2017 staging system still has a larger simplification and optimization space.Therefore,according to the principle of concise,the T-stage parameters including oropharynx,nasopharynx,prevertebral muscles,paranasal sinuses,cervical vertebra,orbit and hypopharynx are recommend to delete,and it does not have an impact on the composition of T-stage.We suggest that the pterygoid structure shall combine with the skull base to be one anatomical structure.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.