BACKGROUND:Internal fixation methods for traditional proximal clavicle fractures and sternoclavicular joint dislocation include Kirschner wire, Kirschner wire with tension band, clavicular hook plate and ordinary T-shaped plate fixation. However, al of these are easy to fal off, damage nerves and blood vessels and affect the fine motion of the sternoclavicular joint. OBJECTIVE:To investigate the therapeutic effects of internal fixation with T-shaped stainless steel locking plate on proximal clavicular fractures and sternoclavicular joint dislocation as wel as to observe the biocompatibility of materials with the host. METHODS: Twelve patients with proximal clavicular fractures and sternoclavicular joint dislocation were enroled at Shanxian Central Hospital from March 2011 to January 2014, including seven cases of proximal clavicular fractures and five cases of sternoclavicular joint dislocation. Al of patients were subject to open reduction and internal fixation with T-shaped locking plate. RESULTS AND CONCLUSION:Al the 12 patients were folowed up for 3-14 months, with an average of 9 months. Al incisions healed wel, with no local eminence. No major substernal blood vessels and organ damage occurred. X-ray films showed that fractures healed without further dislocation and steel plate fracture. At the last folow-up, Rockwood scoring system showed that the excelent rate of shoulder function was 100%. These findings indicate that the internal fixation with stainless steel T-shaped locking plate is reliable and effective in the treatment of proximal clavicle fractures and sternoclavicular joint dislocation, with low risks and satisfactory outcomes, by which, patients can maximize the recovery of shoulder function.

Objective To investigate the changes in the levels of motilin in the gastric body in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups (n =42 each):normal saline group (NS group) and incisional pain group (P group).In group P an 1 cm long incision was made in the plantar surface of right hindpaw under sevotlurane anesthesia.Six rats were chosen from each group and paw withdrawal threshold to mechanical stimulation (MWT) and paw withdrawal latency to nociceptive thermal stimulation (TWL) were measured at 24 h before operation (To) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the gastric mucosal tissues were prepared for measurement of motilin levels by ELISA.Results Compared with group NS,MWT,TWL and motilin levels were significantly decreased at T1-4 (P ＜ 0.05) and no significant change was found at T0 and T5 in P group (P ＞ 0.05).Compared with the baseline value at To,MWT,TWL and motilin levels were significantly decreased at T1-4,and no significant change was found at T5 in group P (P ＞ 0.05).MWT,TWL and motilin levels were significantly higher at T3-T5 than at T1 in group P (P ＜ 0.05).MWT,TWL and motilin levels were increased gradually at T3-T5 in P group (P ＜ 0.05).The motilin levels were positively correlated with MWT and TWL (r =0.9597 and 0.9231,respectively,P ＜ 0.01) in group P.Conclusion The levels of motilin in the gastric body is significantly decreased in a rat model of incisional pain and the decreasing range is positively corre lated with the degree of incisional pain.

Objective To explore the improving effect of L-leucine on memory impairment in plateau and the mecha-nism. Methods After successfully trained in the 8-arm radial maze,50 male Kunming mice were selected and randomly divid-ed into normoxic control group (NC group),model group,and L-leucine (low,medium and high dose) groups.Animals in L-leu-cine groups were intragastrically given 0.473 g?kg-1 ,0.945 g?kg-1 and 1.89 g?kg-1 L-leucine for 7 days and those in NC and model control groups were administered the same volume of purified water for the same period of time.At the 4th day of the treat-ment,the mice in the model control group and L-leucine groups were placed in a large low-pressure and low-oxygen chamber to simulate low-pressure hypoxic environment of the plateau (7 500 m,3 d).The 8-arm radial maze was used to measure the spatial learning and memory ability of mice and dry-wet method to measure the water content of brain tissue.HE staining was employed to observe the cell morphological changes in CA1 region of the hippocampus.The expression levels of mTOR,P70S6K and 4E-BP1 mRNA in the hippocampus were detected by SYBR Green real-time PCR. Results The reference memory error ( RME) ,total error ( TE) ,testing time ( TT) ,and water content of brain tissue were significantly increased,the neuron injury was exacerbated in CA1 region of the hippocampus,and the expression levels of mTOR and P70S6K mRNA were markedly decreased in model control group when compared with those in NC group (P<0.05 or P<0.01).These indexes,however,were significantly improved in L-leu-cine groups,especially in high-dose group. Conclusion L-leucine can improve memory impairment in plateau,and the mecha-nism may involve the activation of mTOR and its downstream substrates (4E-BP1 and P70S6K).

Objective To evaluate the changes in the levels of motilin in the duodenum in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6-8 months,weighing 180-220 g,were randomized into 2 groups (n =42 each) using a random number table:control group (group C) and incisional pain group (group P).The animals were anesthetized with sevoflurane.In group P,a 1 cm long incision was made in the plantar surface of right hindpaw.Six rats were chosen from each group and mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before operation (T0) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the duodenal mucosal tissue was prepared for measurement of motilin levels by ELISA.Pearson linear correlate analysis was performed between the motilin level and pain threshold at each time point in group P.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and motilin levels were significantly increased at T1-4,and no significant change was found at T0 and T5 in group P.The motilin levels were negatively correlated with MWT (r =-0.8 910) and TWL (r =-0.8 463) in group P.Conclusion Incisional pain can promote the secretion of motilin in the duodenum.

Objective To observe the clinical efficacy and safety of 5% imiquimod cream in topical treatment of anogenital warts. Methods A randomized, double-blind, parallel placebo-controlled clinical study was conducted. Patients with anogenital warts were instructed to apply the test drug topically and then clean the drug with water 6 ~ 8 hours later, three times a week for 8 weeks. Patients whose warts cleared completely were followed up for one month to determine recurrence rates. Results Two hundred and thirty-one patients with anogenital warts were enrolled in this trial. One hundred and sixteen patients were randomly selected to receive 5% imiquimod cream; and the other receive placebo cream. For 2, 4, 6, 8 weeks, the cure rates were 8.41%, 30.84%, 49.53%, 61.68%, respectively in the study group, and 2.68%, 7.14%, 16.07%, 24.11%, respectively in the control group (P

Objective To observe the clinical curative effect of modified Qiwei Baizhu Powder for mesenteric lymphadenitis in children with spleen deficiency and dampness retention. Methods A multi-center randomized and controlled trial was carried out in 150 cases of mesenteric lymphadenitis in children with spleen deficiency and dampness retention. The patients were randomized into Chinese medicine group, western medicine group and combination group, 50 cases in each group. Chinese medicine group was treated with modified Qiwei Baizhu Powder, western medicine group was treated with Cefaclor for Oral Suspension, and the combination group was treated with modified Qiwei Baizhu Powder plus Cefaclor for Oral Suspension. Before treatment and after treatment for 7 days, one month and 3 months, changes in syndrome manifestations and the size of abdominal mesenteric lymph nodes were monitored. The total effective rate and cure rate of the three groups were compared, and the safety of the regimen was also evaluated. Results (1) In Chinese medicine group, 5 patients dropped out, and a total of 45 cases completed the trial; in western medicine group, 3 patients dropped out, and a total of 47 cases completed the trial; in the combination group, 7 patients dropped out, and a total of 43 casescompleted the trial.(2) The total effective rate of Chinese medicine group and combination group after treatment for 7 days, one month and 3 months was significantly higher than that of western medicine group (P < 0.05), and the cure rate after treatment for one month and 3 months was also significantly higher than that of western medicine group (P<0.01). The differences of total effective rate and cure rate were insignificant between Chinese medicine group and combination group(P>0.05) at various time points.(3) After treatment for 7 days, one month and 3 months, the transverse and longitudinal diameters of mesenteric lymph nodes in Chinese medicine group and combination group were shorter than those of western medicine group (P < 0.05) , but the difference was insignificant between Chinese medicine group and combination group (P>0.05). (4) Except for the drop-out cases, all of the children finished the trial. During the treatment, no obvious adverse reaction was found. Conclusion Modified Qiwei Baizhu Powder exerts certain efficacy for the treatment of mesenteric lymphadenitis in children with spleen deficiency and dampness retention.

Objective To compare the changes of skin thickness and collagen content in mouse models of scleroderma after irradiated with different doses of UVA1, so as to seek the suitablc irradiation dose in the treatment for scleroderma. Methods Sixty mice were randomly and equally divided into 6 groups: blank control group (no injection and no irradiation), model control group (injected only and killed 2 days after the last injection), high-dose (HD) UVA1 group (injected with bleomycin and irradiated with UVA1 of 100 J/cm2), medium-dose (MD) UVA1 group (injected with bleomycin and irradiated with UVA1 of 60 J/cm2), low-dose (LD) UVA1 group (injected with bleomycin and irradiated with UVA1 of 20 J/cm2), and negative control group (injected only and killed until the end of irradiation). Experimental mouse models of scleroderma were established by subcutaneous injection of 100 μL bleomycin (BLM) at 400 μg/mL into the back of BALB/c mouse once a day for 4 weeks. Phototherapy was performed 3 times weekly for 10 weeks. Thereafter, skin specimens were obtained from the injected or irradiated back of mice, and subjected to an observation on pathological changes of skin tissue and thickness, as well as the measurement of collagen content. Results There was statistical differences between blank control group and model control group in both the skin thickness (t= 4.945, P<0.001) and collagen content (t=3.712, P<0.01). UVAI phototherapy improved the skin sclerosis and reduced the thickness in mouse models, but significant effect was only observed with HD-UVA1 in both the parameters(both P<0.05). There was significant difference among the 3 groups receiving phototherapy in the changes of skin thickness (F=14.853, P<0.01) and collagen content (F= 6.317, P<0.01), and HD-UVAI was significantly more effective than MD-UVA1 and LD-UVA1. Conclusion High-dose UVAI irradiation could significantly reduce the changes in skin thickness and col- lagen content in mouse model of sclerosis induced by bleomycin,which may be related to its inhibition on collagen fiber proliferation and decrease in collagen content.

Objective To investigate the effects of sirolimus and 3-methyladenine (3-MA) on the autophagy in,as well as matrix matalloproteinase (MMP)-1 and MMP-3 secretion by,human skin fibroblasts (HSFs).Methods HSFs were isolated from the circumcised foreskin of a healthy male,and subjected to primary culture.After 3 to 10 passages,HSFs were incubated with sirolimus of 20,50,100,250 nmol/L and 3-MA of 0.5,2.0,5.0,10.0 mmol/L respectively for 4 hours followed by the observation of autophagy and detection of MMP-1 and MMP-3 levels in the supernatant by enzyme linked immunosorbent assay (ELISA).Those HSFs remaining untreated or treated with dimethyl sulfoxide served as the control.Results The percentage of autophagy-positive cells was 59.075％ ± 6.884％,76.350％ ± 5.226％,85.063％ ± 6.002％,86.288％ ± 5.558％ and 96.825％ ± 1.500％ respectively in HSFs treated with sirolimus of 0,20,50,100 and 250 nmol/L; significant differences were observed between the 5 groups (P ＜ 0.01 ) but not between the cells treated with sirolimus of 50 and 100 nmol/L (P ＞ 0.05).After being treated with 3-MA of 0,0.5,2.0,5.0 and 10.0 mmol/L,the percentage of autophagy-positive cells in HSFs was 63.037％ ± 5.876％,34.425％ ± 5.183％,19.700％ ± 3.028％,12.900％ ± 3.334％ and 7.775％ ± 2.293％ respectively with a significant difference between these groups (all P ＜ 0.01 ).Elevated levels of MMP-1 and MMP-3 were observed in the supernatant of HSFs treated with sirolimus of 250 nmol/L and 3-MA of 10.0 mmol/L (all P ＜ 0.05).Conclusions The autophagy in HSFs can be upregulated by sirolimus,but downregulated by 3-MA.For the secretion of MMPs by HSFs,3-MA and high concentrations of sirolimus exert a promotive effect,and the effect of 3-MA is in a concentration-related manner,but the influences of sirolimus at lower concentrations remain unclear.

Objective To investigate the role of high mobility group protein box 1 (HMGB1) in pulmonary vascular remodeling in a rat model of acute lung injury (ALI).Methods Thirty healthy pathogen free male Wistar rats weighing 220-250 g were randomly divided into 3 groups (n =10 each) ∶ group control (group C) ;group LPS (group M) and group LPS + HMGB1 antibody (group H).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 7 ml/kg.ALI was induced with LPS 1 mg/kg infused iv over 30 min in groups M and H.In group H HMGB1 antibody 2 mg/kg was injected iv at 12,24 and 36 h after LPS administration respectively.The animals were sacrificed at 72 h after LPS administration.The left lung was removed for microscopic examination,measurement of the thickness of the medial layer (tunica media) of pulmonary arterioles and determination of the expression of PCNA (by immune-histochemistry) and HMGB1 protein (by Western blotting).Results The medial layer of pulmonary arterioles was significantly thicker and the expression of PCNA and HMGB1 higher in group M than in group C.LPS also induced significant inflammatory cell infiltration within the alveoli and damage to the septa.In group H HMGB1 antibody significantly attenuated the above-mentioned LPS-induced changes.Conclusion HMGB1 may play an important role in the LPS-induced pulmonary vascular remodeling.

Objective To observe the changes of autophagy in human skin fibroblast (HSF) model for photoaging. Methods HSF model for photoaging was established through repeated exposure to ultraviolet B (UVB). Those HSFs receiving no irradiation served as the control. The degree of aging was evaluated by p-galactosidase assay, and autophagy level was detected. Results After repeated exposure to UVB, most pho-toaged HSFs were deformed and distorted, and some of them even died. The percentage of P-galactosidase-positive cells was 50.60% ± 5.04% and 14.58% ± 2.69%, respectively in photoaged and control HSFs (P< 0.01). Significant difference was also observed in the proportion of cytophagosome-positive cells between photoaged and control HSFs (14.91% ± 4.59% vs 68.45% ± 8.25%, P < 0.01). Conclusion The HSF model for photoaging shows obviously abnormal appearance and stagnant growth with increased degree of senescence and decreased autophagy compared with normal control HSFs.