Objective To study the advantage and disadvantage of different treatments of unstable distal radial fractures in elderly patients. Methods In the period from August 2005 to January 2010, 55 elderly patients with unstable d istal radial fractures were treated with manual diaplasis and external plaster splint fixation, operation and internal plate fixation, or external fixation. Clinical outcomes were evaluated by Gartland-Werley wrist scoring systems and questionnaire of the disabilities of the Arm, Shoulder and Hand (DASH). We used SPSS13.0 software package for statistical analysis. Results Compared with the manual diaplasis group, the operation and internal plate fixation group or external fixation group was better in Gartland-Werley scores, the differences were statistically significant (P<0.05), but there were no differences in DASH scores among the 3 groups. Conclusions The treatment of unstable distal radial fractures in elderly patients should be chosen based on the characteristics of the fractare and patients desire.

Objective: To investigate the expression of ER, PR, HER-2, PCNA and P53 in breast cancer patients in Shanghai and the relevant clinical significance. Methods: Expressions of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients in Shanghai were detected by immunohistochemistry methods. Statistical analysis was applied to analyze the relationship of these immunohistochemical indices with the clinicopathological features of breast cancer. Results: The positive rates of ER, PR, HER-2, PCNA and P53 in the breast cancer tissues of 544 patients were 62.2%, 57.2%, 15.1%, 82.6% and 58.5%, respectively. The expressions of ER, PCNA and P53 were correlated with the tumor size (P<0.05, P<0.01). The expressions of HER-2 and PCNA were correlated with axillary lymphatic metastasis (P<0.05, P<0.01). ER expression was positively correlated with PR expression(r=0.452, P=0.000) and PR expression was positively correlated with P53 expression (r=0.520, P=0.03). The 123 (22.6%) patients with triple-negative breast cancer (TNBC) had a higher axillary lymphatic positive rate than patients with non-TNBC (P<0.01). Co-expression of HER-2 with PCNA and co-expression of HER-2 with P53 were positively correlated with lymphatic metastasis (P<0.05). Conclusion: Population aging has a influence on the immunohistochemical characteristics of breast cancer patients patients in Shanghai. Combined examination of ER, PR, HER-2, PCNA and P53 is of clinical significance in the diagnosis, treatment, and prognosis prediction of breast cancer patients.

Atrial fibrillation ( AF) is the most common sustained arrhythmia in clinical practice and it is associated with an in-creased thromboembolism risk , due mainly to embolism from the left atrial appendage ( LAA) .Percutaneous left atrial appendage clo-sure ( PLAAC) provides a valid alternative to oral anticoagulation ( OAC) mainly in patients who cannot tolerate this therapy due to a high bleeding risk .Recent studies showed PLAAC can substantially reduce stroke incidence .This article reviews the safety and efficacy of PLAAC preventing thromboembolism by retrospectively analyzing related studies of PLAAC .

Objective To discuss the clinical application of MSCT-guided BARD gun biopsy in diagnosing pulmonary lesions. Methods Under MSCT-guidance percutaneous transthoracic biopsy of lung with BARD gun was performed in 68 patients with pulmonary lesions. Results All the procedures were well performed with the technical successful rate of 100%. The final diagnosis was based on the pathological findings or clinical follow-up observation. The accuracy of the qualitative diagnosis was 94.1%. Of 68 patients, squamous cell carcinoma was found in 30, adenocarcinoma in 21, metastases in 7, inflammatory pseudotumor in 3, lung abscess in 2, and tuberculosis in one. The false-negative rate in making diagnosis was 5.9%. The complication occurrence was 8.8%. Conclusion BARD gun has the advantage of making coaxial- multipoint biopsy. With the help of MSCT-guidance and the full use of the operating advantage of BARD gun, this technique is safe and reliable, with higher accuracy and less complications.

Adult ; Aged ; Female ; Fistula ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Pharyngeal Diseases ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

Objective To observe the effects of intensive insulin therapy on IL-10 level and NF-ΚB activity in peripheral blood mononuclear cells in patients undergoing cardiopulmonary bypass.Methods The non-diabetic patients undergoing cardiopulmonary bypass in our department were selected and assigned to intensive therapy group (group A,n=40) and received strict glycemic control after the initiation of surgery.And those who undergoing cardiac surgery but without strict glycemic control were assigned to routine therapy group (group B,n=40) as controls.The blood glucose in group A was maintained at 4.4～8.3mmol/L,whereas the glucose in group B was below 11.lmmol/L.The concentration of serum IL-10 and NF-ΚB activity in peripheral blood mononuclear cells was measured at different time points.Results There were no significant differences in general data between two groups.The concentration of IL-10 in group B was significantly lower than that in group A(P<0.05).compared with group B,strict glycemic control markedly suppressed NF-KB activation (P<0.05).Conclusion Intensive insulin therapy could reduce the activity of NF-ΚB and then reduce the expression of IL-10.Strict glycemic control could significantly mitigate the systemic inflammatory response.

Objective To investigate the therapeutic effects and the possible mechanism of fecal transplantation on rats with Clostridium difficile-associated pseudomembranous colitis. Methods A total of 40 Sprague-Dawley rats were divided into four groups including the healthy control group, model group, fecal transplant treatment group and vancomycin treatment group. Rats in three experimental groups were subcuta-neously injected with clindamycin phosphate (10 mg), followed by treatment with toxin producing Clostridi-um difficile (ACTT43255) enema 24 hours later. The rats in fecal transplant treatment group and vancomy-cin treatment group were respectively treated with fecal suspension and vancomycin one day after modeling. The rats were fasted for one day after the last administration and then executed. The levels of potassium ion ( K) , sodium ion ( Na) , albumin ( ALB) , white blood cells ( WBC) , C-reaction protein ( CRP) , interleu-kin-1β ( IL-1β) , interleukin-10 ( IL-10 ) , interleukin-12 ( IL-12 ) and interleukin-17 ( IL-17 ) as well as the percentage of neutrophils ( N%) in serum samples were detected. The colon tissue samples were collect-ed for pathology examination. Results The rat model of pseudomembranous colitis was successfully estab-lished by subcutaneous injection of clindamycin in combination with toxin-producing Clostridium difficile (ACTT43255) enema. The signs of intestinal inflammation including serious weight loss, remarkably short-ened colon length and significantly increased colon wet weight index were observed in rats from the model group (P<0. 05). Compared with the rats from model group, the rats received fecal transplant showed sig-nificantly increased levels of K, ALB, IL-10 and IL-10/IL-12 in serum and decreased levels of WBC, N%, CRP, IL-1β and IL-17 (P<0. 05). Conclusion Fecal transplantation was proved to be an effective ap-proach for the treatment of pseudomembranous colitis. The therapeutic mechanism might due to its impacts on serum inflammatory factors.

Objective To observe the effects of green fluorescence protein mediated by lentivirus in bladder, and to de?termine the amount of virus obtained good transfection effects. Methods lentivirus carring GFP gene was perfused using transurethral approach into bladder of guinea pigs. Samples of bladder, liver, kidney and lungs were collected for frozen sec?tions after feeding seven days. The distribution of green fluorescence was observed using laser confocal microscopy. Re?sults The titer of lentivirus was 4 × 108. GFP was found under the mucosa when the amount of lentivirus transurethral was 30μL. GFP was distributed widely in muscle layer using 40μL lentivirus. GFP was detected even stronger in muscle layer when the amount was 50μL. GFP was found in muscle layer when 25μL lentivirus was injected intravenously. GFP was not found in other tissues than in bladder via transurethral perfusion. There was higher GFP in liver, lungs and other organs than in bladder via intravenous injection. Conclusion Lentivirus can mediate GFP transfecting bladder of guinea pig successful?ly and escape the distribution of GFP all over the body intravenously, which will bring new research direction and method for clinical treatment of diseases in bladder.

Objective To explore the histopathological manifestations of various complications after transplantation,the patients in our hospital after liver transplantation liver puncturebiopsy pathology data were analyzed,and then provide a reliable clinical diagnosis and treatment for the patients scheme.Methods A retrospective analysis of our hospital 198 cases of liver transplantation in 249 cases diagnosis of liver puncture biopsy pathology data,HE staining method to analyze the pathological morphological changes,using rejectionpathological criteria,according to clinical examination and treatment effect of international unified Banff.Results All biopsy materials,acute rejection rate is the highest,a total of 71 cases(28.5％),biliary complications occurred in 39 cases (15.7％),hepatitis B virusinfection and recurrence in 28 cases (11.2％),34 cases of drug-induceddamage (13.7％),reperfusion injury in 35 cases (14.1％),CMV infection of 14cases (5.6％),tumor recurrence in 7 cases (2.8％),chronic rejection in 16cases (6.4％),primary graft non function in 2 cases (0.8％),it is difficult to determine in 3 cases (1.2％).Conclusion Transplantation of liver biopsy can provide correct cause for abnormal liver function,and to guide the clinical treatment of accurate,effective treatment,suggested that thetransplantation center will transhepatic listed for liver transplantationpostoperative routine inspections,periodic biopsies,the survival of the state to better protect the graft.

BACKGROUND:Whether transplanted bone marrow mesenchymal stem cells under hypoxic conditions can survive is crucial for the successful celltransplantation. Therefore, studies on the growth of bone marrow mesenchymal stem cells under hypoxic conditions in vitro can provide experimental evidence for in vivo celltransplantation. OBJECTIVE:To observe the expression of vascular endothelial growth factor in bone marrow mesenchymal stem cells under hypoxia. METHODS:Rat bone marrow mesenchymal stem cells were obtained and cultured, and observed under light microscopy. Passage 3 cells were cultured under normoxia (21%O2) and hypoxia (3%O2 hours. Then cellcounting kit-8 assay and flow cytometry were employed to detect cellproliferation in the two groups. Western blot assay was adopted to detect the expression of hypoxia-inducible factor-1αand vascular endothelial growth factor in the two groups. RESULTS AND CONCLUSION:(1)Rat bone marrow mesenchymal stem cells were obtained and cultured successful y, which were fusiform cells and had uniform shape under the light microscope. (2)The results of cellcounting kit-8 assay showed that the number of cells in the hypoxic group was higher than that in the normoxic group at each time point, and cellviability increased significantly at hours 36 and 48 (P<0.05). (3)The results of flow cytometry demonstrated that the proportion of cells in S phase and cellproliferation index in the hypoxic group were significantly increased, compared with the normoxic group (P<0.05). (4)Western blot results showed ), respectively, for 72 that there was a smal amount of the expression of hypoxia-inducible factor-1αand vascular endothelial growth factor in the normoxic group, but the expression of these two proteins in the hypoxic group was increased in a time-dependent manner (P<0.05). These findings suggest that hypoxia can induce proliferation of rat bone marrow mesenchymal stem cells cultured in vitro, and also raise hypoxia-inducible factor-1αand vascular endothelial growth factor expression in a time-dependent manner.