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 prepare and purify siRNA targeting a proliferation-inducing ligand targeted(APRIL-siRNA),so as to provxde a basis for studying the role of APRIL in human pancreatic cancer.Methods:pET-22b-APRIL was constructed to express APRIL dsRNA of human pancreatic cancer cell line CFPAC-1 in E.coli and the product was purified by chromatography using CF-11 column.APRIL dsRNA was digested by RNaseⅢto prepare APRIL siRNA,then the reaction mixture was loaded onto a DEAE ion exchange chromatography to remove RNaseⅢfrom oligonucleotides,and size exclusion chromatography was used to purify 21 bp siRNA.The purified APRIL siRNA was used to transfect Chinese hamster ovary(CHO)cells and the expression of APRIL in CHO cells was observed under fluorescence microscope Results:APRIL dsRNA was successfully expressed in E.coli after IPTG induction and was purified by CF-11 column.dsRNA was hydrolyzed with RNaseⅢand was purified by DEAE ion exchange chromatography and size exclusion chromatography.15% nondenaturing PAGE and 12% SDS- PAGE confirmed that RNaseⅢwas removed from oligonucleotides and 21 bp siRNA was purified with size exclusion chromatography.It was also found that APRIL siRNA obviously depressed APRIL expression in CHO cells.Conclusion:We have successfully constructed APRIL siRNA targeting APRIL gene of CFPAC-1 cells with in vitro transcription,which provides a basis for knock-down of APRIL gene in CFPAC-1 cells.

Objective To evaluate the treatment of PCI on hibernating myocardium..in ischemic cardiomyopathy with heart failure.Methods All patients identified iscbemic cardiomyopathy with heart failure by coronary angiography were randomly divided into PCI group and contrast group.61 patients in contrast group were just received the treatment of medi- cine while 60 patients in PCI group were received PCI as well.Compare the grade of NYHA ,the size of left ventricle and the ejection fraction r between two groups3 months late.Results There were no deference between groups in the grade of NYHA,the size of left ventricle and the ejection fraction at the beginning of treatment,but the grade of NYHA,the size of left ventricle and the ejection fraction in PCI group were better than contrast group 3 months later(P

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 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.