To study the characteristic of the metacarpal fracture and the forensic investigation of severity of the injury.52 cases with metacarpal fracture were reviewed.The incidence and the location as well as the patterns of fracture were analyzed.The severity of the fracture were different with different mechanism.

The method for ultrasonic detection of air bubble in race track is studied in this paper. A automatic detection system is established, which mainly consists of the ultrasound emitter and receiver, high-speed A/D acquisition card and PC.

Animals ; Autophagy ; Biomarkers, Tumor ; metabolism ; Caveolin 1 ; deficiency ; metabolism ; Drug Delivery Systems ; Humans ; Myofibroblasts ; pathology ; Neoplasms ; metabolism ; pathology ; Prognosis ; Stromal Cells ; metabolism ; Tumor Microenvironment

Oral drug-loaded nano-system include nano-gel drug delivery system, nano-suspension drug delivery system, nano-particle drug delivery system, liposomes drug delivery system, nano-micelles drug delivery system, alcohol liposoms,nano-framework drug delivery system, nano-emulsions drug delivery system, nano-self assembly drug delivery system.These nano-drug delivery systems can serve as multi-functional drug carriers.They may significantly improve the physicochemical and stabilization and biological properties of the free drug, enhance the therapeutic efficiency and reduce toxic side effects.This paper reviews the recent research progress in oral drug-loaded nano-systems.

Objective To assess the values of automated breast volume scanner (ABVS) for differentiating of benign and malignant breast masses.Methods A total 174 breast masses in 148 patients were subjected both to conventional handheld B-mode ultrasound (HHUS) and ABVS examinations.The masses were defined as five categories of benign,probably benign,equivocal,probably malignant,and malignant with each method.The results of ABVS and HHUS were compared with pathology.By using the definitive diagnosis and the five levels of suspicion categories,receiver operating characteristic (ROC) curves were drawn to evaluate their diagnostic results.In addition,the diagnostic accuracy for breast masses of futures including retraction phenomenon and hyperechoic rim in coronal plane of ABVS was evaluated.Results The area under the ROC curve of ABVS (0.927) was larger than that of HHUS (0.903) (Z =2.256,P =0.024).The specificity and the positive predictive values both reached to 100％ and false positive rate was 0 with retraction phenomenon,and the specificity and the negative predictive value were 88.89％ and 94.51％ respectively with hyperechoic rim in coronal plane of ABVS.Conclusions ABVS plays an important role in the clinical practice.The retraction phenomenon and hyperechoic rim of breast masses in coronal plane of this new modality have high specialty for differentiating malignant from benign breast masses.

Indole alkaloid family has been the biggest so far among the various alkaloids,which contains pharmaceutical and effective constituents of various plants featuring diverse biological activities.Thanks to the development of metabonomics,to reveal the biosynthetic pathway of active components for the molecular mechanism of indole alkaloids and the regulation research of plant metabolism present a growing importance and significantly direct the researches of improving biological production.This paper reviewed the biosynthetic pathways of some indole alkaloids in accordance with the structure classification of indole alkaloids to lay a foundation for the further studies on the biosynthetic pathways of indole alkaloids and provide a reference for the biosynthetic pathways of other indole alkaloids.

Objective To study the effect of limited fluid resuscitation (LFR) on coagulation in patients with severe traumatic brain injury (sTBI) and investigate its clinical significance.Methods Seventy-nine patients were assigned to low volume group (≤ 2 000 ml,40 cases) and high volume group (＞ 2 000 ml,39 cases) according to the random number table.LFR was performed for all patients.Prothrombin time (PT),partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB) level were measured in both groups at different time points.Mean heart rate,blood pressure,blood gas values and blood electrolytes were monitored.Meantime,NICU days,hospital length of stay and incidence of multiple organ dysfunction syndrome (MODS) were recorded.Glasgow Outcome Scale (GOS) was evaluated.Results In constrast to high volume group,PT,APTT and TI were shortened and FIB was elevated in low volume group (P ＜ 0.05).But there were no significant differences between the two groups in NICU days [(13.84 ±3.02)d vs (15.28 ±3.79)d],hospital length of stay [(36.85 ±6.73)d vs (40.01 ± 7.21) d],MODS incidence (15.0％ vs 17.9％) and mortality (27.5％ vs 38.5％) (P ＞ 0.05).The chances of good recovery in low volume group was higher than that in high volume group (22.5％ vs 7.3％) (P＜0.05).Mean heart rate,blood pressure,blood electrolytes,and blood gas values did not differ significantly between the two groups (P ＞ 0.05).Conclusion For patients with sTBI,low volume LFR can ameliorate coagulation disorders and improve prognosis,indicating a safe and effective therapy.

Objective To examine the effects and mechanisms of siRNA targeting aquaporin 4 (AQP 4) in combination with hyperbaric oxygen therapy(HBO) on cerebral edema and apoptosis in the brain tissue of rats after hemorrhage.Methods Rats were randomly divided into four groups,the control group,the hyperbaric oxygen group,the AQP-4 siRNA group and the combination therapy group (24 rats).Thrombin Ⅶ was injected into the caudate nucleus to establish the hemorrhage model.Construction of siRNA targeting aquaporin 4 was conducted.The mRNA expression of AQP-4 was detected by RT-PCR at day 3.Changes in brain moisture and blood-brain barrier perme ability were measured by a wet/dry weight method and Evans blue fluorometry.The nerve cell apoptosis rate was analyzed by Annexin V andTdT-mediated dUTP-biotin nick end labeling (TUNEL).The expression of proteins including AQP-4,MMP-2,MMP-9,Bcl-2 and caspase-3 was detected by Western Blotting.All the animals were given a score for their nerve function at day 3.Results AQP-4 siRNA treatment obtained better effects than HBO in decreasing the brain edema leveland silencing AQP-4 mRNA(P＜0.05)while,the combination therapy group achieved the best results(P＜ 0.05).Compared with the control group,the percentage of apoptotic cells decreased in all the three treatment groups,with the most marked decrease observed in the combination treatment group(4.24± 0.04)％(F=13.76,P=0.001).The expression of AQP-4,MMP-2,MMP-9 and caspase-3 was lower (P＜0.05) and the expression of Bcl-2 was higher(P＜0.01)in the combination treatment group than in the other three groups.Compared with the control group,all the other three groups received better scores on nerve function defect evaluation at day 3 after hemorrhage(P＜0.05),with the combination treatment group again achieving the most favorable score (4.7 ± 1.1) (F=7.21,P =0.013).Conclusions Targeted siRNA interference combined with hyperbaric oxygen can effectively reduce cerebral edema after cerebral hemorrhage,inhibit neuronal apoptosis and promote neuron function recovery.The underlying mechanisms may be related to down-regulation of AQP-4,MMP 2,MMP-9 and caspase-3 expression and up-regulation of Bcl-2 expression.

OBJECTIVESTo study the progression of cirrhosis in patients with HIV/HCV coinfection.

METHODSThe patients were divided into two groups, HIV/HCV coinfection group (n = 140) and simple HCV infection group (n = 33). A retrospective study was designed to compare the development of cirrhosis in a 15-year period between the two groups.

RESULTSThe development of cirrhosis in the HIV/HCV coinfection group was higher than that in the simple HCV infection group (16.4% vs. 3.0%, P=0.045). Counts of CD4+ T and CD8+ T in the HIV/HCV group were 200.0+/-134.1 cells/microl and 880.6+/-444.2 cells/microl, respectively. The counts of CD4+ T and CD8+ T in the group of simple HCV infection were 752.3+/-251.7 cells/microl and 529.0+/-170.7 cells/microl, respectively. There were significant differences between the two groups regarding the counts of CD4+ T and CD8+ T. Comparing the cases of HCV RNA (+) and anti-HCV (+) with the cases of HCV RNA (+) and anti-HCV (-), we found that the ratio was 89 to 15 in the group of HIV/HCV coinfection, and 25 to 0 in the group of simple HCV infection. The difference between the two groups was statistically significant (P = 0.043).

CONCLUSIONHIV/HCV coinfection can accelerate the progression of cirrhosis, which may be due to the effect of HIV on cellular immunity and humoral immunity.

Adult ; CD4-CD8 Ratio ; China ; epidemiology ; Female ; HIV Infections ; complications ; immunology ; HIV-1 ; Hepatitis C ; complications ; immunology ; Humans ; Liver Cirrhosis ; complications ; epidemiology ; Male ; Middle Aged ; Retrospective Studies

Objective:To evaluate the improved efficacy of transversus thoracic muscle plane (TTP) block combined with general anesthesia for off-pump coronary artery bypass grafting (OP-CABG).Methods:Sixty American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients of both sexes, aged 55-63 yr, weighing 65-81 kg, scheduled for elective OP-CABG, were divided into 2 groups ( n=30 each) using a random number table method: TTP block combined with general anesthesia group (group TG) and general anesthesia group (group G). Midazolam-propofol-sufentanil-rocuronium was used to induce anesthesia, and sevoflurane-remifentanil-propofol was used to maintain anesthesia.In group TG, ultrasound-guided TTP block was performed at 20 min before anesthesia induction, and 0.375% ropivacaine plus 0.5% lidocaine 20 ml was injected between bilateral intercostal and transverse pectoral muscles.Both groups received patient-controlled intravenous analgesia with sufentanil, oxycodone 0.05 mg/kg was intravenously injected as rescue analgesic, and the postoperative visual analogue scale scores were maintained≤ 4 points.The intraoperative consumption of remifentanil and propofol, consumption of sufentanil within 24 h after operation, and requirement for rescue analgesia were recorded.The postoperative length of stay in intensive care unit, time to first flatus, length of hospitalization, postoperative nausea/vomiting, lung inflammation, pruritus and nerve block-related complications were recorded. Results:Compared with group G, the consumption of intraoperative remifentanil and postoperative sufentanil after operation were significantly reduced, the requirement for postoperative rescue analgesia was decreased, the postanesthesia care unit stay time, length of hospitalization and time to first flatus were shortened, and the incidence of postoperative nausea/vomiting and lung inflammation was decreased in group TG ( P<0.05). No pruritus and nerve block-related complications were found in the two groups. Conclusion:Ultrasound-guided TTP block combined with general anesthesia can provide good perioperative analgesia for the patients undergoing OP-CABG and reduce the amount of opioids used, which is helpful in improving the prognosis.