Fractures of the clavicle are common and have been typically addressed to nonoperative treatment.However,to the comminution or complete displacement,there is a marked risk of nonunion,malunion,and poor outcome.Several treatments have been proposed,but there is no consensus about the treatment of choice.This article investigates the most common treatments and tries to find the indications for the treatments,and the new direction for the treatments of fractures of the clavicle.

Fractures of the clavicle are common and have been typically addressed to nonoperative treatment.However,to the comminution or complete displacement,there is a marked risk of nonunion,malunion,and poor outcome.Several treatments have been proposed,but there is no consensus about the treatment of choice.This article investigates the most common treatments and tries to find the indications for the treatments,and the new direction for the treatments of fractures of the clavicle.

Objective To explore the clinical value of heart-type fatty acid binding protein testing (H-FABP) in the diagnosis of early myocardial ischemia injury.Methods One hundred and eighty cases diagnosed with myocardial ischemia from January 2016 to December 2016 were selected as the experimental group,then according to the disease time,the subjects were divided into the earlier group(≤3 h),middle group(3~6 h)and later group(≥6 h),each group 60 cases.180 cases with healthy physical examination results were enrolled in the control group.The concentration of serum H-FABP and IMA were detected in order to analyze the clinical value comprehensively.Results Compared with the control group,the concentration of serum H-FABP ((11.54±4.31) μg/L) and IMA ((92.72±5.31)U/ml) in the experimental group increased greatly,the differences were statistically significant(t=2.305,3.001,P<0.05).Among the subgroups in the experimental group,the concentration of IMA was the highest in the early stage and decreased in the middle and later stages,and there were significant difference between the earlier group and later group(t=2.326,P<0.05).The concentration of serum H-FABP and IMA in the experimental group and control group were positively correlated (r=0.9237,P<0.05).Positive detection rate analysis showed that the positive rates of H-FABP and IMA among the subgroups were above 80.00%,and the positive rate of combined detection was obviously improved (P<0.05).The clinical diagnosis was used as the gold standard,the Kappa of the results of H-FABP detection and clinical diagnosis was 0.85 (P<0.05).Conclusion H-FABP has a positive clinical significance in the diagnosis of early myocardial ischemia,as IMA has high positive detection rate,and has high consistency with clinical diagnosis results,it can effectively reduce the misdiagnosis rate and combined detection can reduce the rate of missed diagnosis.

Objective:To study the effect of p75NTR gene on the apoptosis of tongue squamous cell carcinoma Tca8113 cells. Methods:p75NTR +Tca8113 cells were isolated from Tca 8113 cell line and transfected by p75NTR siRNA using lipofectamine. p75NTR mRNA and protein expression was examined by real time RT-PCR and western blot respectively.Cell proliferation was stud-ied by MTT assay,cell apoptosis was examined by flow cytometry.Results:Proliferation of p75NTR + cells was faster than that of p75NTR - cells.Transfection of p75NTR siRNA inhibited p75NTR mRNA and protein expression in p75NTR + Tca8113 cells,inhibi-ted the proliferation and increased the apoptosis of the cells.Conclusion:p75NTR gene plays a role in the apoptosis of Tca8113 cells.

Objective To investigate the correlation between mucosal healing after treatment and prognosis of ulcerative colitis (UC).Methods UC patients who were remitted after treatment (n =82) were divided into MH group(A:DA1,0-1 ; Geboes,0-1) and non-MH group (B:DAI,0-1 ; Geboes,2-5) according to the assessment and were followed up for 2 years.The baseline characteristics,histological parameters,serologic indices (albumin,ESR,CRP,ANCA,IL-1 β,IL-6 and IL-15) at 0,12,24 months or recurrence and hospitalization,colon surgery,colon cancer were recorded.The correlation between mucosal healing and prognosis were assessed.Results There were no significant differences between group A and B in recurrence rate and recurrence time(P ＞ 0.05).The multivariate Cox regression analysis showed that gender (female),past recurrence,pANCA and basal plasmacytosis were independent risk factors for recurrence of UC (P ＜ 0.05).The rehospitalization rate [27.5％ (group A) VS 44.1％ (group B) ; P =0.018 ; OR=2.24,95％CI (1.11-3.98)] and colectomy rate [0％ (group A) VS 17.6％ (group B); P=0.035; OR =5.43,95％ CI (2.14-7.64)] between groups have significant differences,however,rates of cancer [0％ (group A) VS 2.7％ (group B) ; P=0.643; OR =3.43,95％CI (0.14-7.64)] were not significantly different.Conclusion Mucosal healing after treatment is associated with UC prognosis.

Background:With the development of capsule endoscopy,small intestinal injury induced by non-steroidal anti-inflammatory drugs( NSAIDs)has become an issue of growing concern. Although there are a variety of drugs used for NSAIDs-induced gastric mucosal injury,small intestinal injury caused by NSAIDs is lack of effective prevention and treatment modalities. Aims:To investigate the protective effect and possible mechanism of rebamipide on human colon cancer cell line Caco-2 injury induced by aspirin. Methods:In aspirin group,Caco-2 cells were treated with aspirin 10 mmol/L;in rebamipide group,Caco-2 cells were treated with aspirin and different concentrations of rebamipide(0. 1, 0. 5,1. 0 mmol/L),and a negative control group was established. Cell proliferation inhibition was measured by MTT assay. Cell apoptosis was determined by flow cytometry. Morphological changes of cells were observed under inverted phase contrast microscope. Permeability of cells was assessed by Transwell assay. Expressions of tight junction proteins occludin and zonula occluden-1(ZO-1),as well as mitogen activated protein kinase(MAPK)signaling pathway-associated proteins including extracellular signal-regulated kinase(ERK)1/2,phosphorylated ERK1/2(p-ERK1/2),p38,p-p38,c-Jun N-terminal kinase( JNK),and p-JNK,were determined by Western blotting. Results:Proliferation inhibition rate,apoptosis rate and permeability of Caco-2 cells in rebamipide 0. 1,0. 5,1. 0 mmol/L groups were significantly lower than those in aspirin group in a dose-dependent manner(P<0. 05). Injuries of Caco-2 cells were seen in aspirin group by inverted phase contrast microscope and rebamipide could reduce these injuries. Expressions of occludin,ZO-1 and p-JNK were significantly higher and expressions of p-p38 and p-ERK1/2 were significantly lower in rebamipide 0. 1,0. 5,1. 0 mmol/L groups than those in aspirin group in a dose-dependent manner(P<0. 05). Conclusions:Rebamipide have a protective effect against aspirin-induced Caco-2 cell injury,probably through regulating MAPK signaling pathway( inhibiting p38 and ERK1/2 phosphorylation,stimulating JNK phosphorylation),and subsequently up-regulating the expressions of tight junction proteins and decreasing the permeability of cells.

OBJECTIVETo study the biological characteristics of p75 neurotrophin receptor positive (p75(NTR+)) tongue squamous cell carcinoma cells which were separated by flow cytometry cell sorting.

METHODSTo determine the biological characteristics of p75(NTR+) cells which were separated from Tca-8113 and Cal-27 tongue squamous cell carcinoma cells by flow cytometry cell sorting, including study the capacity of cloning, 3-(4,5)-demethylthiazo(z-y1)-3,5-diphenytetrazoliumromide (MTT) assay, wound healing assay. p75(NTR+) cells with non-sorted cells were as control group.

RESULTSIn Tca-8113 and Cal-27 tongue squamous cell carcinoma cell lines, the percentage of p75(NTR+) cells were 3.1% and 1.9%. Compared with p75(NTR+) cells with non-sorted cells, p75(NTR+) cells possess higher capacity of cloning (Tca-8113, P=0.024; Cal-27, P=0.009). The percentage of p75(NTR+) cells of the progeny cells generated from monoclonal p75(NTR+) cells decreased to 14.5% (Tca-8113) and 5.8% (Cal-27) after cultured two weeks. p75(NTR+) cells possessed higher proliferation ability and higher metastasis ability than non-sorted cells.

CONCLUSIONp75(NTR+) cells isolated from tongue squamous cell carcinoma have the characteristics of cancer stem cells.

Objective To investigate the molecular mechanism of P75NTR gene-induced apoptosis in tongue squamous cell carcinoma Tca8113 cell lineage.Methods P75NTR specific siRNA was transferred into P75NTR positive tongue squamous cell carcinoma Tca8113 cells.P75NTR positive Tca8113 cells were divided into 4 groups:blank group (without transfection),negative control group (transfected with negative control siRNA ), experiment group-776 (transfected with siRNA-P75NTR-776 ) and experiment group-1234 (transfected with siRNA-P75NTR-1234).Transfection efficiency and cell apoptosis were detected by flow cytometry.The interference effect of P75NTR mRNA expression was detected by fluorescence quantitative PCR. 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide assay was applied in measuring cell prolife-ration.The protein changes of P75NTR were detected by Western blotting.The distributions of nuclear factor-κB(NF-κB)of cells were observed by cell immunofluorescence labeling method.Results The transfection efficiency was 30%.The apoptosis rate of experiment group-776,experiment group-1234 and negative control group was (20.35 ±0.18)%,(12.32 ±1.51)% and (2.63 ±0.10)% respectively.Compared with the negative control group,the differences of the former two group had statistical significance (t =177.20,P <0.005;t =37.12,P <0.005).The P75NTR gene interference was successful.The inhibition rate of P75NTR protein reached 31% in experiment group-776.The cell viability of Tca8113 cells after P75NTR-siRNA inter-
ference was 70.02%,78.01% and 95.81% in experiment group-776,experiment group-1234 and negative control group.And there were significant differences between experiment group-776 and negative control group (χ2 =235.3,P <0.010),and between experiment group-1234 and negative control group (χ2 =117.5,P <0.005 ).NF-κB distribution was increased in cell cytoplasm in the interference group than that in control group.Conclusion P75NTR may promote the proliferation or inhibit the apoptosis of tongue squamous cell carcino-ma,and the molecular mechanism may be correlated with hindering the transportion of NF-κB into cell nuclear.

Objective To investigate the protective effects and its mechanism of rebamipide on aspirin-induced injury in human gastric mucosal epithelium cells (GES-1).Methods GES-1 cells monolayer culture model was established in vitro.Then the cells were divided into negative control group,aspirin injured group and combination of rebamipide at different concentration (0.2,0.5,1.0 mrnol/L) and aspirin groups.The cell proliferation,the content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) of each group were detected.The ultrastructural changes of each group were observed by transmission electron microscopy (TEM).The expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) at protein level in the cells of each group were detected by Western blot.Nrf2 interfering suppression test was performed and then the influence of Nrf2 small interfering RNA (siRNA) on the expression of HO-1 protein was observed.One-way analysis of variance was performed for comparison among multi-groups and t-test was used for comparison between the two groups.Results The cell viability of aspirin injured group and combination of rebamipide at different concentration (0.2,0.5,1.0 mmol/L) and aspirin groups were (49.56±3.88)％,(59.34±4.36) ％,(70.79 ± 5.96) ％ and (86.07 ± 5.20) ％,respectively,and the difference was statistically significant (F=30.634,P＜ 0.01).Compared with aspirin injured group,the content of MDA significantly lowered in combination of rebamipide at different concentration (0.2,0.5,1.0 mmol/L) and aspirin groups ((2.26±0.25) nrnol/rng vs (1.85±0.13) nmol/mg vs (1.62±0.11) nmol/mg vs (1.13±0.15) nmol/mg),and the difference was statistically significant (F=23.821,P＜0.05).Compared with aspirin injured group,the activity of SOD significantly increased in combination of rebamipide at 0.5 and 1.0 mmol/L and aspirin groups ((8.49±0.89) U/rng vs (11.50±1.03) U/mg vs (13.74±0.76) U/mg),the difference was statistically significant (F=25.666,P＜0.05).Under TEM,the cell ultrastrucmral was obviously inured in aspirin treated,while rebamipide could relieve the injury.The differences of relative expression quantity of Nrf2 and HO-1 at protein level among combination of rebamipide at 0.2,0.5 and 1.0 mmol/L and aspirin groups and aspirin injured group were statistically significant (0.35±0.04 vs 0.46± 0.05 vs 0.84±0.08 vs 0.15±0.02,0.72±0.09 vs 0.93±0.11 vs 1.29±0.14 vs 0.39±0.07,F=92.550and 38.235,both P＜0.05).After transfected with Nrf2 siRNA,the expression of HO-1 was 0.38±0.04 in aspirin injured group and 0.62±0.08 in combination of rebamipide and aspirin group,which was lower than that before transfection (0.61 ± 0.05,1.33± 0.09),respectively.The differences were statistically significant (t =6.276 and 10.444,both P＜0.05).Conclusion Rebamipide may activate Nrf2/HO-1 pathway and relieve aspiriwinduced oxidative stress in GF1 ceils.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.