BACKGROUND:At present, the clinical application of intramedul ary nail in the treatment of tibial shaft fractures has achieved good results. However reamed and unreamed intramedul ary nail in repair of tibial fractures in adults remains controversial. OBJECTIVE:To evaluate clinical efficacy and safety of reamed versus unreamed intramedul ary nailing for the treatment of tibial fractures in adults. METHODS:The literature related to application of reamed or unreamed intramedul ary nailing for tibial fractures published from 1980 to 2015 were searched from Springer, PubMed, and Wanfang database. Related Chinese and English journals of orthopedics were hand-searched. Al randomized control ed trials were col ected. RevMan5.0 provided by Cochrane was used to analyze the data. RESULTS AND CONCLUSION:Seven randomized control ed trials were included according to inclusion criteria, including 1 331 patients. There were 682 cases in the reamed intramedul ary nailing group and 649 cases in the unreamed intramedul ary nailing group. Meta-analysis results showed that compared with the reamed intramedul ary nailing group, implant failure rate was significantly higher in the unreamed intramedul ary nailing group [MD=0.37, 95%CI (0.24, 0.57), P<0.000 01], and nonunion rate was significantly higher [MD=0.54, 95%CI (0.31, 0.93), P=0.03]. There was no significant difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate. Results suggested that no difference in the incidence of compartment syndrome, the rate of malunion and postoperative infection rate was found in reamed and unreamed intramedul ary nailing in the repair of adult tibial fractures. Reamed intramedul ary nailing has advantages of low implant failure rate and nonunion rate.

Objective To evaluate the effect of open reduction and multi-dimensional several pin fixation of Gartland type Ⅲ supracondylar fractures with late callus formation in children.Methods The study involved 37 children of Gartland type m supracondylar fractures with late callus formation undergone posteromedial elbow incision,open reduction via bilateral triceps sparing approach,several K-wire internal fixation and early functional rehabilitation from May 2009 to May 2011.There were 23 males and 14 females at 3-13 years of age (mean,7 years).Postoperative results were evaluated according to Flynn standard.Mean 9.5 months of follow-up was made.Results The results were excellent in 28 cases,good in five,fair in two and poor in two.No serious complications occurred after operation.Conclusion Open reduction and multi-dimensional several K-wire fixation is an effective treatment for Gartland type Ⅲ supracondylar fractures with late callus formation in children and hence provides a choice for clinical use.

BACKGROUND:At present, it remains controversial whether open reduction plate fixation is needed for distal radius fracture in the elderly to restore anatomic reduction of imaging.
OBJECTIVE:To systematical y evaluate the curative effects of operative and nonoperative treatments for distal radius fractures in the elderly.
METHODS:We retrieved PubMed, Springer and Wanfang database using computer. Relevant English and Chinese journals of orthopedics were retrieved by hand. Al literatures on curative effects of operative and nonoperative treatments for distal radius fractures in the elderly were col ected. RevMan 5.0 software provided by Cochrane was used to statistical y analyze the data.
RESULTS AND CONCLUSION:Six literatures were included, including two of randomized control ed study and four of retrospective cohort study. Meta-analysis results displayed that there were no significant differences in both groups in range of motion of wrist joint extension [mean difference (MD)=-0.87, 95%confidence interval (CI) (-3.31, 1.58), P=0.49], range of motion of wrist joint flexion [MD=-2.79, 95%CI(-6.47, 0.88), P=0.14], range of motion of wrist pronation [MD=-0.08, 95%CI(-1.49, 1.64), P=0.92], range of motion of supination [MD=-0.7, 95%CI(-3.52, 2.12), P=0.63] and the occurrence of complication [MD=1.35, 95%CI(0.71, 2.56), P=0.36]. The length of radius in the surgery group was similar to that of normal [MD=2.46, 95%CI(1.78, 3.15), P<0.01]. Ulnar inclination [MD=3.73, 95%CI(2.97, 4.48), P<0.000 01] and palmar tilt angle [MD=6.81, 95%CI(3.72, 9.90), P<0. 000 1] in the surgery group were close to that of normal. There are no significant differences in extension, flexion, pronation and supination activities of wrist and posttreatment complication between two groups. Operative treatment result is superior to that of nonoperative treatment in anatomic reduction.

Objective To introduce transfusion monitoring system to optimize nursing flow under field conditions.Methods The organization and arrangement of nursing staffs were optimized with high-precision droplet sensor and transfusion monitoring system.A post of caring nurse was added to execute mental healthcare of the patient.Results Humanistic care was carried out by the caring nurse with daily nursing completed,and there's no need for additional nursing staff.Conclusion The transfusion monitoring system is rapid in deployment and withdrawal,optimizes nursing flow and enhances nursing quality,and thus is worthy promoting widely.

Objective To explore the expression of livin and survivin and its correlation with caspase-3 and clinicopathology in breast cancer. Methods We examined paraffin-embedded archival specimens from 76 cases of malignant breast tumor and 17 cases of benign breast disease for the expression of livin,survivin and caspase-3 with immunohistochemistry. The relationship of livin and survivin expression with caspase-3 and clinicopathological characteristics was analyzed. Results The positive rates of livin and survivin protein expression were increased gradually in normal breast tissues,livin and survivin proliferating disease,preinvasive carcinoma and invasive breast carcinoma,while the caspase-3 protein expression was significantly decreased. The expression of livin and survivin was negatively correlated with that of caspase-3 in the four groups (P0.05). The expression of survivin was related to lymph node metastasis and tumor size (P0.05). Conclusion Livin and survivin may play an important role in accelerated tumor proliferation by inducing caspase-3 to inhibit apoptosis in breast carcinoma. Livin may be more correlated with carcinogenesis in young patients while survivin may promote metastasis and invasion in breast carcinoma.

Objective To observe the differential gene expression in human nasopharyngeal carcinoma (NPC) cell line with different radiosensitivity by cDNA microarray analysis. Methods A radioresistant cell line, CNE-2R, was established from a human nasopharyngeal carcinoma cells line CNE-2 by repeated X-ray irradiation. The differential gene expression of CNE-2 and CNE-2R was screened with cDNA microarray by BioStarH-141s profile gene chip. Results There were expressed 308 genes to be screened out between CNE-2R cell line with different radiosensitivity and its parental CNE-2 cell line, while 176 up-regulated genes in CNE-2R cells and 132 down-regulated genes were found. In them, there were 40 up-regulated ones and 36 down-regulated ones whose ratios were higher than 6.0 or lower than 0.1. The different genes included DNA damage- and repair-related genes; cell cycle-related and cytoskeleton-related proteins; and apoptosis-related genes. Conclusion The radioresistant CNE-2R cells were isolated from the CNE-2 cell line by repeated X-ray irradiation. The stable radioresistance is the result of co-effect by polygene and multiple factors, which provide several gene targets to sensitize the radioresistant cells for improving the radiocurability of NPC.

Tumor necrosis factor-α induced protein 8 family is a group of newly discovered proteins induced by tumor necrosis factor-α. This protein family owns four highly homologous members:TIPE, TIPE1, TIPE2, TIPE3. With the deepening of the research, we found that TNFAIP8 family plays an important role in cell apoptosis, signal transduction, invasion and metastasis of tumor cell proliferation. This paper reviews the structure, mechanism, and biological function of the TNFAIP8 family.

Objective:To investigate the differences of integral alpha 3 (ITGA3) mRNA and protein expressions in gliomas of different grades and different cell lines, and gliomas tissues of different clinical and molecular characteristics, and evaluate their prognostic values in brain glioma patients.Methods:(1) ITGA3 mRNA expression data in the brain gliomas and clinical data of these glioma patients were obtained from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA). The differences of ITGA3 mRNA expressions in glioma patients with different gender, ages, WHO grading, isocitrate dehydrogenase 1 ( IDH) mutation statuses, and 1p/19q co-deletion statuses were compared. Kaplan-Meier method was used to plot and compare the survival curves of patients with ITGA3 mRNA high expression and ITGA3 mRNA low expression. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficiency of ITGA3 mRNA expression in survival rate of gliomas. Univariate and multivariate Cox regression analyses were used to explore the independent influencing factors for prognoses in glioma patients. The independent influencing factors for prognosis were used to construct nomograms and the calibration diagram was used to verify the reliability of nomograms in predicting the prognoses of these patients. (2) Intracellular localization of ITGA3 and ITGA3 protein expression in low- and high-grade gliomas were determined by on-line database of Human Protein Atlas (HPA). (3) Brain glioma cells U87, U118, U251 and human astrocytes SVG were cultured in vitro, and the ITGA3 mRNA and protein expressions in cells were detected by Western blotting and reverse transcription (RT)-PCR, respectively. Results:(1) In TCGA database, the ITGA3 mRNA expressions in gliomas of WHO grading II, III and IV increased successively, with significant differences (P<0.05). In CGGA database, the ITGA3 mRNA expression in glioma of WHO grading IV was statistically higher than that in glioma of WHO grading II and III ( P<0.05). In TCGA and CGGA databases, the ITGA3 mRNA expressions in glioma patients aged ≤40 years and >40 years, patients with IDH wild-type and IDH mutation, and patients with chromosome 1p/19q deletion and chromosome 1p/19q non-deletion were statistically different ( P<0.05). The survival rate of patients with low ITGA3 mRNA expression was significantly higher than that of patients with high ITGA3 mRNA expression, no matter in low-grade glioma, glioblastoma, or entire glioma samples ( P<0.05). ROC curve showed that, in TCGA database, the area under the curve (AUC) of ITGA3 mRNA in predicting 1, 3, and 5 years survival was 0.791, 0.786, and 0.708 in glioma patients; in CGGA database, the AUC of ITGA3 mRNA in predicting 1, 3, and 5 years survival was 0.661, 0.667, and 0.659. Multivariate Cox regression analysis showed that, in TCGA database, age, WHO grading, IDH mutation, chromosome 1p/19q deletion and ITGA3 mRNA expression ( HR=1.018, 95%CI: 1.006-1.030, P=0.0.003) were independent influencing factors for prognoses of glioma patients ( P<0.05); and in CGGA database, WHO grading, IDH mutation, chromosome 1p/19q deletion, and ITGA3 mRNA expression ( HR=1.445, 95%CI: 1.132-1.844, P=0.003) were independent influencing factors for prognoses of glioma patients ( P<0.05). Nomograms showed that age had the greatest influence in survival, followed by ITGA3 mRNA expression. Calibration plots showed that nomogram was reliable in predicting 1-, 3-, and 5-year survival in glioma patients. (2) Immunofluorescence localization showed that ITGA3 protein mainly aggregated in cell membrane and vesicles. Immunohistochemical staining showed that the ITGA3 protein expression in high-grade glioma tissues was obviously higher than that in low-grade glioma tissues. (3) The results of RT-PCR and Western blotting revealed that the ITGA3 mRNA and protein expressions in glioma cell lines U87, U118 and U251 were significantly higher than those in SVG cells ( P<0.05). Conclusion:The ITGA3 mRNA and protein expression levels are correlated with the malignant degrees of glioma; patients with ITGA3 mRNA low expression tend to have a high overall survival; ITGA3 mRNA expression can be used as an index to evaluate the prognoses of glioma patients.

Objective:To establish an analytical method for the simultaneous determination of five fat-soluble vitamins in serum using isotope dilution ultra high performance liquid chromatography-tandem mass spectrometry (ID-UPLC-MSMS).Methods:Fat-soluble vitamins were obtained from serum samples which collected from Shanghai Tenth People′s Hospital between April 2019 and August 2019 by the extraction method, and were detected by ID-UPLC-MSMS. The performance of the method was verified by referring to the relevant documents of the Clinical and Laboratory Standards Institute (CLSI).Results:The ID-UPLC-MSMS method for the rapid detection of various fat-soluble vitamins in serum was proposed and successfully verified. The linear range of the method: vitamin A: 25-2 500 μg/L, 25(OH)D 2: 2-200 μg/L, 25(OH)D 3: 2-200 μg/L, vitamin E: 0.25-50 mg/L, vitamin K1: 0.1-20 μg/L. The intra- and inter-assay precision standard deviations of the five analytes were within ± 15%, and the accuracy of the test results of the 25(OH)D 2 and 25(OH)D 3 standards was 96.44%-102.37%. Conclusion:The performance of ID-UPLC-MSMS method for the simultaneous determination of five fat-soluble vitamins is satisying, and the result is accurate and reliable, which suggested it can be used for the clinical sample.

Objective: To study the response of Escherichia coli (E. coli) HB101 (plasmid pUC19) and its carried antibiotic resistance genes to the process of cholorination under different environmental conditions. Methods: The E. coli strain was reacted with sodium hypochlorite at the concentration of 0.5, 0.75, 1.00, and 0.55 mg/L, then the residual chlorine and the colonies were detected at the 0.25, 1, 2, 5, 10, 20, and 30 min of the reaction, respectively. The first order disinfection kinetic model and EFH model were used to evaluate the inactivation effect of E. coli (plasmid pUC19) treated by sodium hypochlorite, while the plasmid pUC19 and antibiotic resistance gene amp^r were detected by PCR method. Besides, the logarithm of Ct (residual chlorine in t) under different concentration were calculated. Results: The temperature and pH value played important roles on the inactivation of E. coli and elimination of plasmid pUC19 and amp^r under the function of sodium hypochlorite. The Ct value needed for 5-log of E.coli HB101(pUC19) inactivation at 4, 20, 36 ℃ was 11.92, 10.28, 7.67, respectively, and when the pH was in 6.0, 7.0, 8.0, with chloride concentration were 0.75, 0.70, 0.55 mg/L, the Ct value needed for reached to 6.68, 10.28, 15.73 min·mg/L. At pH 7.2 condition, when the temperature was 4, 20, 36 ℃, and chloride concentration were 9, 5, 3 mg/L.The required Ct values to completely destroy the transformation function of free antibiotic resistant plasmids were 36.11, 34.17,16.09 min·mg/L. Sodium hypochlorite disinfection can release free ampr gene and even the transformed plasmid pUC19, and pollute the water body. Only when the Ct value reached 903.03 min·mg/L, the complete ampr gene can be destroyed which was far more exceed the bacterial lethal Ct value. Conclusion Even if all the antibiotic resistant bacteria were inactivated, the antibiotic resistant plasmids or genes might still maintain complete with the transformable function, which may result in new potential risks of waterborne diseases.