Objective To compare the therapeutic effect of anatomy plate and locking compression plate in the treatment of humerus surgical neck fracture. Methods Fifty one patients with humerus surgical neck fracture were enrolled into the study and divided into two groups randomly to accept anatomy plate or locking compression plate treatment. In the anatomy plate treatment group ( n = 35 ), 19 cases were type- Ⅲ fractures and 16 cases were type-Ⅳ fractures according to Neer classification. In the locking compression plate treatment group (n = 16) ,9 cases were type-Ⅲ fractures and 7 cases were type-Ⅳ fractures according to Neer classification. Results In anatomy plate group,28 cases were followed up for 4 months to 48 months ( average period was [21 ± 2] months). According to the Constent score criteria, 19 cases got excellent outcome,8 cases got good outcome,1 case got fair outcome. In locking compression plate group, 14 cases were followed up for 1 month to 24 months (average period was[12 ± 1] months). Ten cases got excellent outcome,4 cases got good outcome. Conclusion Both anatomy plate and locking compression plate treatments are good for the humerus surgical neck fracture.

Objective To assess whether mTOR was activated in peripheral T lymphocytes of acute coronary syndrome (ACS)patients and to investigate the relationship among mTOR,regulatory T cells and cytokins. Methods Patients with acute coronary syndrome (n=32) were selected in ACS group. Meanwhile, patients who complainted of chest pain but were proven to be normal in ECG and in coronary arteriography, were excluded as ACS patients but were diagnosed as Chest Pain Syndrome (CPS) and selected in CPS group (n=28). The expression levels of mTOR, phospho-p70S6KT389 (indicative of mTORC1 activity) and phospho-AKTS473(indicative of mTORC2 activity) were investigated in T cells, which were isolated from peripheral blood of patients in ACS group or CPS group, using Western blot. The proportion of CD4+CD25+Foxp3+Tregs over CD4+cells were evaluated by FACS. And T cell subset related cytokines such as IFN-γ, IL-4, IL-17 and TGF-β1 were exam?ined by ELISA. Then we investigated the relationship among mTOR,regulatory T cells and cytokins by Spearman analysis. Results mTOR and p-p70S6KT389 expression were significantly enhanced in ACS group as compared with those in patients from CPS group (P<0.01). Higher levels of IFN-γ, IL-17 but lower level of TGF-β1 cytokines as well as decreased propor?tion of Tregs were observed in ACS group than those in CPS group (P<0.05). There was no significant difference in the level of IL-4 and p-AKTS473 between the two groups (P>0.05). By correlation analysis, p-p70S6KT389 expression level positively correlated with IFN-γ, IL-17(rs=0.91,092,P<0.01)and negatively correlated with Tregs and TGF-β1(rs=-0.85,-0.80, re?spectively, P<0.01). Conclusion mTORC1 pathway was activated in peripheral T lymphocytes of ACS patients, and Tregs insufficiency and cytokins imbalance both contribute to the activation of mTORC1 pathway and pathological process of ACS.

OBJECTIVE:To study the pharmacokinetics of oral single dose adefovir dipivoxil(ADV) tablet in Chinese healthy volunteers.METHODS:The study was a randomized,open,three-way crossover study.Twelve healthy volunteers were randomly assigned to receive single oral dose of 5 mg(Group A),10mg(Group B) or 30 mg(Group C) ADV tablets in three weeks.The plasma concentrations of ADV were determined by LC/MS/MS method.The pharmacokinetic parameters were computed.RESULTS:The main pharmacokinetic parameters in Group A,B and C were as follows:Cmax were(11.4? 3.7),(25.4? 8.2) and(76.3? 23.0) ng? mL-1;tmax were(1.69? 1.41),(0.90? 0.56) and(0.94? 0.50) h;AUC0～ t were(102.7? 51.7),(235.0? 82.3) and(715.4? 267.6) ng? h.mL-1;AUC0～ ∞ were(168.7? 30.7),(266.2? 83.7) and(741.5? 273.9) ng? h? mL-1,respectively.CONCLUSION:ADV tablets had a rapid absorption in healthy volunteers and the Cmax and AUC of adefovir tablets were directly correlated to doses.It is safe for healthy volunteers to take ADV tablets at a dose of 5～30mg.

Objective To investigate whether mTOR/p70S6K signal was activated in peripheral T lymphocytes of the coronary heart disease (CHD) patients and to investigate its possible role in the pathogenesis of coronary atherosclerosis. Methods The mRNA expressions of mTOR andp70S6K were detected by RT-PCR and protein expressions of mTOR, p70S6K and phosphorylated-p70S6K (p-p70S6K) were detected by Western blot assay in T cells isolated from peripheral blood of the CHD patients (including AMI, UAP, SAP) and the CPS patients. Results Levels of mTOR and p-p70S6K were significantly enhanced in the AMI and UAP groups as compared with those in the SAP and CPS groups (P < 0.05, respectively). The mRNA expressions of mTOR and p70S6K were significantly increased in the AMI and UAP groups as compared with those in the SAP and CPS groups (P < 0.05). Conclusion The mTOR/p70S6K pathway is activated in the peripheral T lymphocytes of CHD patients with AMI and UAP , which may participate in the pathological process of coronary atherosclerosis.

Objective To analyze the clinical efficacy of internal rib fixation combined with external chest fixation and mechanical ventilation for traumatic flail chest with pulmonary contusion.Methods Sixty cases of traumatic flail chest with pulmonary contusion treated from January 2011 to December 2014 were assigned to experimental group (30 cases) and control group (30 cases) according to the random number table.Patients in control group received thoracic external fixation combined with mechanical ventilation.In experimental group the patients received the same care but in addition they had rib fixation.The two groups were compared with regard to general condition, arterial blood gas as well as vital signs before treatment and 24 hours after treatment, lung function 3 months after discharge, complication rate and mortality.Results ICU stay [(6.8 ± 1.0) d], hospital stay [(15.0 ± 1.8) d] and duration of mechanical ventilation [(4.8 ± 1.0) d] in experimental group were significantly lower than these in control group [(13.6 ± 2.5) d, (21.4 ± 2.6) d, (10.3 ± 1.3) d, respectively] (P ＜ 0.01).After treatment for 24 hours in either group, the pH value, PaO2, oxygenation index and systolic pressure (SBP) were significantly increased, and partial pressure of carbon dioxide (PaCO2), heart rate (HR) and respiratory rate (RR) were significantly lowered as compared to these before treatment (P ＜0.05).After treatment for 24 hours, experimental group demonstrated significantly enhanced levels in pH value,PaO2, oxygenation index and SBP but lowered levels in PaCO2, HR and RR as compared to control group (P ＜ 0.05).Three months after discharge, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), 75％ forced expiratory flow (FEF75％) and total lung capacity (TLC) in experimental group were (81.7 ±2.6)％, (75.4 ±4.1)％, (83.2 ±4.6)％,(69.1 ±2.3)％, and (88.7 ±3.4)％ respectively, significantly higher than (69.0 ±3.6)％, (71.3 ± 3.9) ％, (78.9 ± 4.3) ％, (62.3 ± 3.3) ％, and (79.0 ± 4.6) ％ respectively in control group (P ＜0.01).In experimental group, there were four cases of pulmonary infection (13％), three pulmonary atelectasis(10％) and one intercostal neuralgia (3％).In control group, there were six cases of pulmonary infection (20％), five pulmonary atelectasis (17％), four intercostal neuralgia (13％) and four thoracocyllosis(13％)(P ＜0.05).There was no significant difference in mortality between the two groups.Conclusion Treatment effect of internal rib fixation for flail chest with pulmonary contusion is improved in combination with mechanical ventilation and external chest fixation.

Objective To study the relationship between chromosomal abnormality and Y chromosome microdeletions and male infertility. Methods Lymphocytes were cultured from peripheral blood of 1975 male infertility patients and stained with Giemsa. The chromosomes were analyzed under microscope. Y chromosome specific sequence tags (STS) were selected, then the Y chromosome microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in azoospermia and oligozoospermia patients. Results There were 305 cases of detected chromosomal abnormalities (15.44%) in the 1975 cases. There were 101 cases (5.11 %) with autosome abnormalities which clinically manifested as oligozoospermia and teratospermia. There were 204 cases (10. 33%) of sexual chromosome abnormalities and the patients were mainly characterized with Klinefelter's syndrome. Y chromosome microdeletions were detected in 109 (14.97 %) of the 728 cases of azoospermia or oligozoospermia. The most common microdeletion of Y chromosome was AZFc (62.39%) and these patients were characterized with azoospermia and oligozoospermia. Five patients (4. 59%) who suffered Y chromosome microdeletion in AZFa region and AZFb region were characterized with azoospermia. Fifteen cases (13.76%) with microdeletion in AZFb region and AZFc region were mainly characterized with azoospermia. There were 6 cases (5. 50 % ) of microdeletion in AZFa, AZFb and AZFc regions,these patients were all characterized with azoospermia. Conclusions Both Chromosome abnormalities and Y chromosome microdeletions are important causes for male infertility.

Objective To discuss the effectiveness of anterolateral thigh propeller flaps for treatment of inguinal skin and soft tissue defects.Methods From June,2009 to October,2014,12 patients with inguinal skin and soft tissue defects were treated with anterolateral thigh propeller flaps pedicled with perforator of descending branch of lateral circumflex femoral artery.Of them there were 8 males and 4 females,aged from 22 to 51 years.The left side was involved in 3 cases and right side 9 cases.Defects were caused by traffic accident injury in 5 cases,crash injury of heavy object in 7 cases.There were mere skin and soft tissue in 2 cases,combined with bone fractures,nerves,vessels and muscles injury in 10 cases.The area of defects ranged from 9.0 cm×5.0 cm to 22.0 cm×9.0 cm.During operation,anterolateral thigh propeller flaps ranging from 11.0 cm×7.0 cm to 24.0 cm×1 1.0 cm were used to repair the wounds.Results All flaps and skingrafts survived after operation and the wounds obtained primary healing.After 8-24 months follow-up,all flaps were characterized by soft texture,good color,and satisfactory appearance.According to the Britain's Medical Research Council at 8 months after operation,the sensation of the flaps were recovered to S2 ～ S3+,No obvious scar contracture and chromatosis were observed at donor site.Conclusion Anterolateral thigh propeller flaps pedicled with artery descending branch of lateral circumflex femoral perforator is an ideal choice for the reconstruction for inguinal skin and soft tissue defects.

Objective To investigate the effect of Peg-Interferon α-2a therapy on the quality of life (QOL) of patients with chronic hepatitis C,and to evaluate the effect of healthcare insurance policy in Guangzhou city on these patients.Methods Totally 102 patients with chronic hepatitis C were enrolled.Forty-two patients (group A) were treated with Peg-Interferon α-2a plus ribavirin whose medical expenses were covered by medical insurance; 30 patients (group B ) received the same therapy but at their own expenses ; and the other 30 patients ( group C) were not treated with Peg-Interferon α-2a.QOL of patients in three groups were investigated using the general quality of life inventory questionnaire (GQOLI-74) before and after Peg-Interferon α-2a treatment.Wilcoxon test was used to compare on all scales and total scores before and after treatment in each group,and Kruskal-Wallis test was performed to compare on all scales and total scores among three groups.Results Before treatment,the physical function,psychological function,social function,material life and total score of group A were 55.3,58.8,61.9,60.6 and 58.5 ; those of group B were 57.5,60.4,61.1,55.2 and 58.3; those of group C were 58.6,60.3,57.5,54.8 and 56.4.There was no statistic difference on all scales and total scores among three groups (Z =- 1.177,- 0.846,- 1.062,-0.377 and - 1.085,P ＞ 0.05).After treatment,group A had higher QOL on all scales (67.1,76.4,68.1,70.1) and total score (72.6) than group C (54.6,54.0,53.3,57.5 and 54.6,P ＜0.01) ; group B had higher QOL (P ＜0.05) on three scales (65.1,65.0 and 69.6) and total score ( 64.3 ) except material life ( 56.3 ) than group C ; group A had higher QOL on psychological function,material life and total score than group B ( P ＜ 0.05 ).Conclusions QOLs of chronic hepatitis C patients treated with Peg-Interferon α-2a are higher than those without Peg-Interferon α-2a treatment.Patients whose medical expenses are covered by medical insurance may have higher QOLs than those at their own expenses.

Objective To analyze the epidemiology and clinical characteristics of the children with measles. Methods Retro-spectively analyzed methods were applied to analyze the timing, and season of the break, age distribution, clinical manifestations and major complications of 3431 children with measles (<12 years) in the Second Hospital of Nanjing from 2008 to 2015. Results It found that there was a peak incidence of measles in children each in 2009, 2013, and 2015 , peaking in March to May. Onset age of measles mainly within the first year of life, and incidence increased with age within the first 8 months. Typical clinical manifestations are mainly fever, rash, cough, and catarrhal symptoms. The main complications of measles were pneumonia, laryngitis and heart failure. Conclusions Early diagnosis and effective treatment of the children with measles needs to be strengthened.

Objective To test the effect of Undaria pinnatifida soluble dietary fiber on endothelial function in hyperlipidemic rats. Method Forty rats were divided into 4 groups(n=10) :control group,hyperlipidemic model group,low dose dietary fiber-treated group(5%) ,high dose dietary fiber-treated group(10%) . After treatment for 8 w. Endothelium-dependent vasorelaxation in isolated aortic rings,the content of plasma malondialdohyde(MDA) ,nitric oxide(NO) and endothelin-1(ET-1) were determined. The protein expression of endothelial NO synthase(eNOS) was measured by Western blotting. Results Undaria pinnatifida soluble dietary fiber treatment significantly decreased MDA and ET-1 level. It also significantly improved endothelial function and plasma NO level concomitantly with unregulation of the expression of eNOS protein. Conclusion In hyperlipidemic rats Undaria pinnatifida soluble dietary fiber could improve vascular endotheliual function,which might be explained by its action to decreasing plasma ET-1 level and increased NO production.