Objective To investigate therapeutic effects of CT-guided percutaneous minimally invasive treatment by using Herbert screws for wrist scaphoid fracture . Methods From September 2010 to October 2012, 21 patients with scaphoid fracture were treated by internal fixation by using Herbert screws under the guidance of CT .The results of the procedure were assessed in terms of osseous union , pain extent , grip strength , and active motion of the wrist .Postoperative outcomes were evaluated by wrist standard scores based on patients’ perception of functions. Results The operation time was 25 -55 min (mean, 35.3 min).The intraoperative blood loss was 8-40 ml (mean, 18.6 ml).Fracture fragments were cured with bone union , with an average healing time of 10.4 weeks (range, 8-17 weeks).All the 21 cases were followed up for 8 -13 months (mean, 9.8 months).The VAS scores at the last follow-up was (1.2 ±0.8) points, which was significantly lower than that before the operation (5.3 ±1.4) points (t=11.785, P=0.000).The grip strength was (39.6 ±3.5) kg, which was significantly higher than that preoperatively [(19.4 ± 2.4) kg, t=-21.624, P =0.000].The Angle of wrist flexion and extension was 115.2°±7.4°, significantly higher than preoperative measure (89.8°±10.4°, t =-9.103, P =0.000).The wrist ulnar radial deflection angle was 53.7°±5.5°, significantly higher than preoperative one (39.4°±3.4°, t =-10.116, P=0.000).At the last follow-up assessment of wrist functions, excellent result was recorded in 18 cases, and good in 3 cases, with a good-or-excellent rate of 100%. Conclusion Treatment of scaphoid fracture with Herbert screws under the guidance of CT is a minimally invasive method , bearing advantages of little incision, simple operation performance , and good effects .

Objective To study the efficacy and safety of pulse cyclophosphamide(CTX)therapy for refractory adult-onset Still's disease(AOSD).Methods Eleven patients with refractory AOSD received the treatment of intravenous pulse cyclophosphamide with 500～750 mg/m2 body surface area.The features of clinical manifestations and lab findings before and after the treatment were compared.The literatures associated with pulse CTX therapy were reviewed.Results After the first time of pulse CTX therapy,nine cases returned body temperature to normal within 72 hours,and the other two within 1week.Fever relapse was seen in five patients after the first time of pulse CTX therapy,and they returned body temperature to persistent normal after the second time of pulse CTX therapy.At the point of 1 week after the first time of pulse CTX therapy,serum C-reactive protein(CRP)significantly decreased when compared with that before treatment(P

The research and quality control of traditional Chinese medicine has meaningful importance, because it has influence not only in the health and treatment of patients, but also in the solid growth and development of phar-maceuticals companies. In some cases, for the complex of TCM, the common QC method on single or multi-target compounds can't really and truly disclose the quality of the Chinese materia medica. Therefore, a lot of researchers do plenty of works to make clear the effectiveness basis, to improve the quality and realize the modernization of TCM. All of these works close together with modern analysis and separation technology. In this article, a novel analy-sis technology-UltraPerformance Convergence Chromatography (UPC2) based its characters and applications should be introduced. It should be a helpful technology for the TCM researchers to facilitate the study and QC works.

Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.

Objective To explore the effects of inhibiting DDR2 expression by siRNA on hepatic stellate cells and evaluate the role of DDR2 gene in hepatic fibrogenesis. Methods (1) Three pairs of chemically synthesized siRNAs targeting DDR2 were respectively transfected into HSC-T6 cells for evaluation of silence efficacy, and the most effective siRNA was used. (2) HSC-T6 cells were divided into three groups, group A served as normal controls, group B served as negative control and group C was RNA interference DDR2 (siRNA-DDR2) expression of HSC. The most effective RNA interference sequences targeting DDR2 gene was chosen to transfect HSC-T6 cells by plasmid transfection. The tendency of DDR2, α-smooth muscle actin(α-SMA) and collagen-Ⅰ mRNA expression were estimated using RT-PCR, and the protein expression of DDR2 was evaluated by Western blot. Meanwhile, MTT assay was employed to analyze the proliferation of HSC. Results (1) DDR2 siRNA, which began at nt 868, inhibited DDR2 gone expression stronger than the other two siRNAs. (2) After transfection of siRNA-DDR2, the mRNA expression of DDR2 (P<0.01) and α-SMA (P<0.01) significantly decreased compared with the normal group, and the protein expression of DDR2 also significantly decreased (P<0.01). In addition, the proliferation of HSC was also markedly suppressed as compared with the normal group (P<0.01). However, compared with the negative control group, none of them was markedly suppressed. Conclusion SiRNA targeting DDR2 significantly suppresses the activation, proliferation of HSC, and thus attenuates hepatic fibrogonesis in vitro.

The clinical data of 585 patients with connective tissue diseases (CTD) were retrospectively analyzed. Thyroid diseases were detected in 236 cases (40.3%) , in which the prevalence of hypothyroidism was the highest (47.9%) , followed by euthyroid sick syndrome (33.1%), Hashimoto thyroiditis (11.4%) and hyperthyroidism (5.1%) ect. Determination of thyroid function and autoantibodies to thyroid gland were essential in these patients.

Objective To investigate the significance of procalcitonin (PCT) and C-reactive protein (CRP) in the early diagnosis of sepsis in patients with percutaneous nephrolithotomy (PCNL). Methods One hundred and ninety-eight patients who had underwent PCNL were divided into sepsis group (148 cases) and control group (50 cases). The PCT and CRP 6 h before and after operation were compared between 2 groups, and the receiver operating characteristic curve was drawn. The area under curve (AUC), optimal diagnostic boundary value, susceptibility and specificity were calculated. Results The PCT and CRP before operation in sepsis group were significantly higher than those in control group:(3.911 ± 2.011) ng/L vs. (1.353 ± 0.311) ng/L and (54.85 ± 8.75) g/L vs. (38.65 ± 10.76) g/L, and there were statistical differences (P<0.01). The AUC of PCT was 0.974, and the AUC of CRP was 0.853. The optimal diagnostic boundary value of PCT was > 1.65 ng/L, and the susceptibility and specificity were 97.91% and 91.01%; the optimal diagnostic boundary value of CRP was > 43.54 g/L, and the susceptibility and specificity group were 93.51% and 79.21%. Conclusions For patients with sepsis after PCNL, PCT is more significant than CRP for early diagnosis. PCT detection can be used as an important auxiliary examination for clinical diagnosis of sepsis, which could help clinicians to detect and treat the sepsis early and can greatly improve the survival rate of patients.

Objective To evaluate the mechanism of altered gastrointestinal motility in portal hypertensive rats. Methods Thirty-two male Sprague-Dawley rats were divided into four groups:sham- operation control (SO, n=8), prehepatic portal hypertension by partial stenosis of the portal vein (PHPH, n=8 ), intrahepatic portal hypertension induced by injection of CCl 4 (IHPH, n=8), and intrahepatic portal hypertension with portacaval shunt (IHPH-PCS, n=8). Gastrointestinal myoelectrical activity and motility were monitored. Gastrointestinal hormones were measured with radioimmunoassay.Results Compared with SO rats, gastrointestinal motor index(MI) were reduced and abnormal myoelectrical activity were recorded (P

Objective: To investigate all trans retinoid Acid (ATRA) inhibition of cell growth in human retinoblastoma Y79 cells, and its mechanism. Methods: Antiproliferation effects of ATRA on Y79 cells were determined by 3 H thymidine incorporation. Cell cycle analysis was performed by flow cytometry. JNK phosphorylation was analyzed by Western blot analysis. Results: After 36 h treatment with 10 -6 mol?L -1 ATRA, 3 H thymidine incorporation decreased to 40%, under the same condition, Y79 cells were arrested in G 0 /G 1 and Sub G 1 peak appeared. Curcumin, JNK blocker, blocked the growth inhibition by ATRA. JNK was phosphorylated in 10 to 20 min. Conclusion: JNK phosphorylating mediated ATRA inhibition of apoptosis in Y79 cells. These results suggested that ATRA might have clinical application for treatment of retinoblastoma.

Objective To evaluate measures in the prevention of pancreatic fistula after distal pancreatectomy.Methods Clinical data of 124 cases of distal pancreatectomy performed during 2000 and 2009 in our hospital were retrospectively analyzed,including 86 cases of pancreatic carcinoma,12 cases of pancreatic pseudocyst and pancreatic benign tumor,18 cases of gastroenteric tumor with pancreatic body/tail invasion,3 cases of chronic pancreatitis with body/tail pseudocyst,5 cases of pancreatic injury.Cases were divided into two groups retrospectively by ways the stump pancreas were closed.Group A included 63 cases in which the stump end was closed by simple interrupted mattress suture,group B including 61 cases in those the stump was sutured by interrupted mattress combined with a safe ligation of the main pancreatic duct.Results Pancreatic fistula occurred in 22 cases in group A,the incidence was 34.9％,among the 22 cases,10 cases were high-flow type,12 cases were low-flow type; while the pancreatic fistula occurred in 9 cases in group B,the incidence was 14.7％,there was no high-flow type fistula.Conclusions Interrupted mattress suture combined with interlocking suture and suture of main pancreatic duct is effective in decreasing the rate of pancreatic fistula after distal pancreatectomy.