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 investigate the Tiaogan Yunpi Decoction on the region of interest regional encephalic activation MR signal intensity variation among diarrhea type irritable bowel syndrome(IBS) patients.Method Adopting self-paired collated method,functional fMRI was used to observe the regional interest MR signal variation of anterior cingulate cortex(ACC),island cortex(IC),prefrontal cortex(PFC),hypothalamus(THAL) before and after the treatment,as well as after the controlled treatment using placebo among 18 diarrhea dominant IBS patients when they were rectum stimulated.Results After the treatment,when the injected gas reached 90 mL,the change of MR signal variation of IC was signifycantly decreased compared with that before the treatment(P

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.

As the major pathway mediating specific protein degradation in eukaryotes, ubiquitin-proteasome system (UPS) is involved in various physiological and pathological processes such as cell cycle regulation, immune response, signal transduction and DNA-repair. Deubiquitinases (DUB) maintain the balance of UPS and related physiological processes via reversibly removing ubiquitin from the covalently modified protein substrates, which have been implicated in various disease processes in case of their imbalance expression. Because DUB plays critical regulating roles in the UPS pathway, they may be also the ideal drug targets for severe and intractable human diseases, such as cancer and neurodegenerative disease. With the rapid development of proteomic technology, systematical investigation of specific substrates and interacting proteins of varied DUB via mass spectrometry approach may shed light on these DUB's biological function and regulating roles in the physiological and pathogenic states. In this review, we briefly introduce the characteristics of DUB and summarize the recent application and progresses of proteomics in DUB research.
Humans ; Mass Spectrometry ; Proteasome Endopeptidase Complex ; metabolism ; Proteomics ; Signal Transduction ; Ubiquitin ; metabolism ; Ubiquitin-Specific Proteases ; metabolism

BJ-DRGs grouping process was cited as an example, to describe the factors affecting the grouping process, grouping results and assessment results, and the solutions in transferring homepages into WJT form 4-1 for inpatient medical record homepages (WJT form 4-1 for short).Authors analyzed how to better information acquisition quality of such homepages by unifying the data interface standard of WJT form 4-1, for the purposes of enhancing BJ-DRGs grouping efficiency, and expanding its functions as a tool for medical quality management and that for medical insurance payment management.

AIM: To investigate the inhibitory effect of L-carnitine on high glucose-induced apoptosis of human aortic endothelial cells (HAECs) and the molecular mechanisms.METHODS: The apoptosis of HAECs was induced by high-glucose incubation.HAECs were treated with L-carnitine at different concentrations (50, 100 and 200 μmol/L).The cell viability was measured by MTT assay.The cell apoptosis was assessed by Hoechst 33258 staining and flow cytometry.Colorimetric method was employed to detect the caspase-3 activity in the HAECs.The protein expression and phosphorylation levels were determined by Western blot.RESULTS: High-glucose incubation dramatically decreased the cell viability and induced apoptosis.The protein kinase R-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme-1 (IRE1) and activating transcription factor 6 (ATF6) signaling pathways of endoplasmic reticulum stress were activated to induce cell apoptosis via down-stream caspase-4/3 cascade.However, L-carnitine treatment significantly attenuated the cell apoptosis and increased the cell viability in a concentration-dependent manner.L-carnitine also significantly suppressed endoplasmic reticulum stress and ATF6 signaling in high glucose-incubated HAECs without attenuating PERK and IRE1 signaling.The expression of site-1 protease (S1P) and site-2 protease (S2P) was inhibited by L-carnitine treatment, thus decreasing pro-apoptotic factor ATF6 p50 produced by ATF6 cleavage.CONCLUSION: L-carnitine inhibits high glucose-induced apoptosis of HAECs by inhibiting ATF6 signaling.

Objective To evaluate the protective effect of epigallocatechin gallate (EGCG) against interleukin (IL)-17-induced injury to keratinocytes,and to explore its mechanism.Methods Some cultured HaCaT cells were divided into 3 groups to be treated with IL-17 alone at concentrations of 50,70,90 μg/L,respectively,with those receiving no treatment as the blank control group.Some HaCaT cells were divided into 5 groups:IL-17 group treated with 90 μg/L IL-17 alone,IL-17 + EGCG group treated with 90 μg/L IL-17 and 60 μmol/L EGCG,IL-17 + SP600125 group treated with 90 μg/L IL-17 and SP600125 (a JAK signaling pathway inhibitor),IL-17+ EGCG + anisomycin group treated with 90μg/L IL-17,60xmol/L EGCG and anisomycin (a Janus kinase signaling pathway activator),and blank control group receiving no treatment.After different durations of treatment,CCK-8 assay was performed to evaluate cellular proliferative activity,flow cytometry to detect cell apoptosis,enzyme-linked immunosorbent assay (ELISA) to measure expression levels of IL-6,IL-23 and IL-8,and Western-blot analysis to determine protein expressions of c-Jun N-terminal kinase (JNK) and phosphorylated JNK (P-JNK).Results IL-17 promoted cellular proliferation of HaCaT cells,and the proliferation rate,which was correlated with the concentration of IL-17,reached the maximum in the 90-μg/L IL-17 group (P ＜ 0.05).EGCG at 60 μmol/L significantly inhibited cellular proliferation of,promoted apoptosis in,and reduced IL-6,IL-23 and IL-8 expressions in,HaCaT cells induced by 90 μg/L IL-17 (all P ＜ 0.05).Compared with the IL-17 group,the IL-17 + EGCG group and IL-17 + SP600125 group both showed significantly decreased P-JNK expression,cell proliferation rate and IL-6,IL-23 and IL-8 expression levels (all P ＜ 0.05).However,compared with the IL-17 + EGCG group,the IL-17 + EGCG + anisomycin group showed significantly increased protein expression of P-JNK,cell proliferation rate and IL-6,IL-23 and IL-8 expression levels (all P ＜ 0.05).Conclusion EGCG protected against IL-17-induced injury to HaCaT cells,such as abnormal cell proliferation,apoptosis and inflammatory response,likely by inhibiting the JNK signaling pathway.

OBJECTIVE:To systematically review the efficacy and safety of gemcitabine combined with docetaxel in the treat-ment of non-small cell lung cancer(NSCLC),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Elsevier,CJFD,Wangfang Database and VIP,randomized controlled trials(RCT)about the ef-ficacy and safety of gemcitabine combined with docetaxel(test group)versus the 3rd generation chemotherapeutic agents combined with cisplatin(control group)in the treatment of NSCLC were collected. Meta-analysis was performed by using Rev Man 5.3 soft-ware after quality evaluation by modified Jadad scale. RESULTS:Totally 9 RCTs were included,involving 1 986 patients. Results of Meta-analysis showed,there were no significant differences in the total effective rate [RR=0.93,95%CI(0.83,1.05),P=0.27], 1-year survival rate [RR=0.97,95%CI(0.87,1.09),P=0.64],the incidences of liver dysfunction [RR=0.35,95%CI(0.06,2.18), P=0.26] and leukopenia [RR=0.80,95%CI(0.57,1.10),P=0.17] and decreased rate of hemoglobin [RR=0.65,95%CI(0.25, 1.69),P=0.38] in 2 groups;the incidences of liver dysfunction [RR=0.09,95%CI(0.02,0.38),P=0.001] and neurotoxicity in test group were significantly lower than control group,while the incidence of lung injury [RR=8.71,95%CI(2.04,37.12),P=0.003] was significantly higher than control group,the differences were statistically significant. CONCLUSIONS:Gemcitabine com-bined with docetaxel shows similar efficacy to the 3rd generation chemotherapeutic agents combined with cisplatin in the treatment of NSCLC,less effect on renal function and nerve while high on pulmonary toxicity.

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.

Objective To analyze imaging findings of IPH and to study the correlation between the HRCT findings and the pulmonary function of IPH.Methods The information of 15 children with IPH were reviewed.Results The X-ray findings of IPH included ground glass opacity(n=9),exudative shadows(n=10),reticulonodular shadows(n=7),nodular shadows(n=6).The HRCT signs included abnormal bronchovascular bundles(n=12),ground glass opacity(n=12),exudative shadows ( n=11 ) ,disseminated micronodular shadows ( n=8 ) , thickened pulmonary lobular septa ( n=9 ) . The correlation between ground glass opacity and pulmonary function was 0.5394 ( P=0.134); The correlation between thickened pulmonary lobular septa and the pulmonary function was 0.9963(P=0.0001).Conclusion The HRCT examination is better than the X-ray examination. The positive correlation between thickened pulmonary lobular septa and pulmonary function change is significant,it is beneficial to estimate the damage of the palmonary.