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.

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

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.

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 evaluate the value of MSCTA in combination with CTV in diagnosis of pulmonary embolism and deep venous thrombosis (DVT) of lower limb. Methods 47 patients with pulmonary embolism proved clinically were examined with MSCTA using 120 kV,210 mA,collimater of 0.75 mm and the automatic bolus traching technique,the speed of contrast agent infu-sion was 3～4 m/s after 170 s delayed,venous scan of lower limbs was performed. Results 47 cases were well perform the trunk of bilateral pulmonary artery, pulmonary lobar artery, pulmonary segemental artery, pulmonary inferior segmental artery could be showed by MSCTA, MPR, MIP and VRT. 363 arterial segments were involved and 31 cases accompanied with DVT. Conclusion MSCTA in combination with CTV is of significant value in detecting pulmonary embolism accompanied with deep venous thrombo-sis.

Objective To study ultrasonic parameters characteristics of lactation mastitis,breast cancer by using color doppler flow imaging(CDFI)and ultrasonic elastography(UE),and to explore its clinical value.Methods Retrospective analysis was conducted in the clinical data of 85 female patients (a total of 85 breast lesions).All patients were confirmed by pathology,and according to the results of pathology,they were divided into non lactation mastitis group(group NLM,a total of 28 cases),breast cancer group(group Ca,a total of 57 cases).All patients accepted CDFI and UE before treatment,and compared ultrasound parameters between the two groups.Results The proportions of class 0~I(71.43%)and RI<0.7(82.14%)in group NLM were significantly higher than those in group Ca,while the proportions of classⅡ ~Ⅲ(28.57%)and RI≥0.7 (17.86%)were significantly lower than 75.44%,84.21% in group Ca(χ2 =17.185,35.217,all P<0.05).The UE ratings(1.75 ±0.97)and the strain rate ratio (1.64 ±0.83)in NLMgroup were lower than (4.19 ±0.74),(5.03 ±1.08)in group Ca(t=-12.873,-14.623,all P<0.05).The accuracy of CDFI +UE(89.41%)was higher than the accuracy of UE(76.47%)or the accuracy of CDFI(67.06%)(χ2 =12.337,P<0.05).Conclusion CDFI,UE have a certain diagnosis ability for non lactation mastitis and breast cancer,combining both can obtain better diagnostic value,which is worthy of clinical application.

Objective To detect and analyze the levels of preoperative serum carcino-embryonic antigen (CEA) and CA15-3 in early invasive breast cancer patients and their correlation with pathological parameters. Methods Electrochemical luminescence immunoassay (ECLI) technology was used to detect serum levels of CEA and CA15-3 in 223 cases of early invasive breast cancer patients, 109 patients with benign lesions, and 30 cases of heath control. Immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) were used to detect the estrogen receptors (ER), progesterone recepter (PR), and its HER-2 pathological indicators.Besides, the correlation of serum CA15-3, CEA levels and pathological parameters was analyzed. Results The serum CA15-3 and CEA levels of Breast cancer patients [(22.27±15.11) U/ml, (5.03± 0.49) μg/L] were significantly higher than that of patients in benign lesion group [(14.13±3.04) U/ml, (2.72± 0.11) μg/L] (P< 0.05). CEA level of patients with histological grade Ⅲ was (6.34 ±0.93) μg/L, significantly higher than the level Ⅰ-Ⅱ (4.23±0.50) μg/L (P< 0.05). CA15-3 level was (19.26±15.08) U/ml in T1 tumors, and CA15-3 level was (28.73 ±11.53) U/ml in T2 tumors (P<0.05). The serum levels of CEA and CA15-3 between different histology, pathologic stage, lymph node status, ER, PR, HER-2, pathological characteristics had no significant difference (P>0.05). CEA positive rate of breast cancer group was significantly higher than that of benign lesions(13.5%vs. 3.7%, 26.5%vs. 1.8%, P<0.05). 30 cases of normal control group had no positive one. The joint monitoring sensitivity of CEA and CA15-3 breast cancer group was 9.4 %, the sensitivity was 0 in benign lesion group. There was significant difference (P < 0.05). Conclusion The changes of Serum CA15-3 and CEA levels in breast cancer patients can be considered as the judgment standard for early diagnosis, pathological staging, prognosis and clinical effect monitoring.

Objective:On the basis of synthetic antigens on minoxidil ,we prepared its polyclonal antibody and established a ELISA method to detect minoxidil .Methods:We synthesized minoxidil artificial antigen with glutaraldehyde and identified by UV scan -ning.We had established a detection of minoxidil competition ELISA .Results: The UV scan showed that the minoxidil successfully coupled to a carrier protein.The conjugate of minoxidil-BSA was used to immunize BALB/c mice.And the produced antiserum showed high titer of 1:12 800 in the indirect ELISA.Its ELISA curve equation:y=-0.082 3 x+0.938 ( R2 =0.9811 ) , minoxidil mass concentration and the absorbance in 0.001-10 μg/ml showed a good linearity .Conclusion: This method has been successfully preparing minoxidil artificial antigen and polyclonal antibodies and established ELISA detection method for minoxidil ,which provides a basis for the practical application of minoxidil immunoassay method .