Objective To compare the clinical efficacy of manipulative reduction and splint external fixation and open reduction and internal fixation in the treatment of fractures of the proximal humerus .Methods 62 patients with proximal humeral fractures were randomly divided into the two groups .31 cases in the manipulation group re-ceived manual reduction and splint external fixation;31 patients in the open reduction and internal fixation group were treated by open reduction and internal fixation .The clinical efficacy was compared between the two groups .Results The average healing time of the manual reduction group was (98.34 ±0.42) d,which was shorter than (121.53 ± 0.45)d of open reduction and internal fixation group (t=209.76,P<0.05).The incidence rate of pain in the manu-al reduction group was 22.58%,which was lower than 48.39% in the open reduction and internal fixation group (χ2 =4.51,P<0.05).The excellent and good rate of the manual reduction group was 96.77%,which was higher than 80.65%of the open reduction and internal fixation group (χ2 =4.03,P<0.05).Conclusion The clinical curative effect of manual reduction and splint external fixation in the treatment of proximal humerus fractures is better than open reduction and internal fixation ,it is a reliable choice for treatment of fractures of the proximal humerus .

Objective To investigate the bacterial distribution and drug sensitivity characteristics of chronic suppurative sinusitis.Methods Nasal secretions of 89 cases of chronic suppurative sinusitis patients before operation were collected in this study,and nasal secretions were culture in medium.Disk diffusion method (Kirby-Bauer,K-B)was used for drug sensitivity test.Sensitivity of bacteria strain to cefazolin,ceftazidime,cefepime,imipenem,mero-penem,vancomycin,cefoperazone -sulbactam,ciprofloxacin and other antibiotics were analyzed.Results After the submission of purulent secretion specimens of nasal meatus in 89 cases chronic suppurative sinusitis patients with sticky,we found that 80 of the patients were detected bacteria.The positive rate was 89.89% (80/89).80 patients were detected in 82 strains of bacteria,a total of 15 species,of which 1 cases of nasal meatus sticky purulent secretion specimens there were 2 strains of bacteria.In 15 kinds of staphylococcus aureus were detected bacteria,staphylococcus aureus,escherichia coli,pseudomonas,enterobacter aerogenes,5 kinds of bacteria occupy the top 5,respectively, accounted for 21.95%,18.29%,14.63%,13.41%,10.98%.Drug sensitivity test of staphylococcus aureus showed that all of the staphylococcus aureus was sensitive to vancomycin,the sensitivity was 100%;the sensitivity of cefazo-lin,ceftazidime,cefepime,imipenem,meropenem,cefoperazone sulbactam,ciprofloxacin and other antibiotics were 0.00%.All the staphylococcus epidermidis were sensitive to imipenem,meropenem,vancomycin,cefoperazone sulbac-tam,the sensitivity was 100.00%;followed by cefazolin,the sensitivity was 86.67%,and to ceftazidime,cefepime, ciprofloxacin sensitive,were all below 30.00%.Escherichia coli,pseudomonas aeruginosa and enterobacter aerogenes and other gram negative bacteria were sensitive to imipenem,meropenem,the sensitivity was 100.00%.Conclusion The bacterial infection in patients with chronic suppurative sinusitis pathogens,including staphylococcus epidermidis, staphylococcus aureus,escherichia coli,pseudomonas,enterobacter aerogenes,bacterial culture positive to vancomy-cin,imipenem,meropenem,cefoperazone Shubatan,cefazolin and antimicrobial susceptibility,and so on antimicrobial treatment but should closely monitor the antimicrobial spectrum of change,in order to adjust the medication.

Objective To investigate the expression of HIF-1α and survivin in renal clear cell carcinoma (RCC) and normal renal tissue ( NRT) and explore the correlation between HIF-1α and survivin expression. Method SABC immunohistochemical staining was performed to detect the expression in 32 cases of RCC and 10 cases of NRT.Results The level of positive HIF-1α immunostaining in RCC(0. 037 ±0. 0182,0. 093 ±0. 0384,respectively) was higher than NRT(0. 008 ±0.0055,0. 014 ±0. 0059, respectively) ( P<0. 05). The level of positive survivin immunostaining in RCC(0. 053 ±0.0179,0. 137 ±0.0291) was higher than NRT( P<0. 05). The expression of HIF-1α and survivin had positive relationship with clinical stage in RCC(0. 029 ±0. 0117,0.070±0.0154)( P <0.05). The expression of HIF-la had relation with survivin in RCC( r = 0. 655, P < 0. 05).Conclusion The expression of HIF-1α was strongly positive correlated with survivin ( r = 1.000,0. 655, P <0. 05).

The incidence of cholangiocarcinoma is rising, poor prognosis due to lack of viable treatment.Recent investigations into the underlying molecular mechanisms of cholangiocarcinogenesis and tumor growth have contributed greatly to our understanding of this disease, which will lead to the identification of therapeutic targets for this devastating cancer. The purpose of the following review is to address what has been learned over the past decade concerning the molecular basis of cholangiocarcinogenesis and factors regulating cholangiocarcinoma growth. Through a better understanding of these mechanisms, more specific diagnostic, therapeutic, and preventative strategies may be developed and hopefully improve the outcome of this devastating disease.

BACKGROUND: As a specially differentiated central nerve, optic nerve is once injured, retinal neurons are hard to restore and regenerate. As a result, visual function is lost permanently. Currently, an effective clinical treatment is not available. Due to the multi-directional differentiated potential of stem cells, their role in optic nerve protection and restoration following injury is becoming a hot research spot.OBJECTIVE: To review the classification and transplantation of stem cells in optic nerve protection study, as well as roles of stem cells transplantation in optic nerve protection and repair following injury.METHODS: The database of ISI Web of Knowledge platform was searched on computer from February 1994 to April 2009, with the key words "stem cells, optic nerve" in English. In the same way, the database of CNKI from February 1994 to April 2009 was also screened, with the key words "stem cells, optic nerve" in Chinese.RESULTS AND CONCLUSION: A total of 98 literatures related to stem cells in optic nerve protection and restoration after injury are collected, in which 23 papers are Chinese and 75 papers are English. The studies published earlier, repetitively and similarly are removed, and 38 papers which comply with the standards are involved into this review. Stem cells own the potential of self-renew physiologically, as well as potential of repairing the injuries. At present, most of the researches on stem cells in optic nerve protection and restoration after injury are represented in morphosis. How to implant stem cells safely and effectively and how to recover stable visual function still need our efforts. Stem cells derived from skin, peripheral blood, fat and other tissues are convenient to draw materials and are commendable subjects, we should study them deeply to make preferable use.

Objective To investigate the clinical effect of alendronate sodium on bone metabolism and bone mineral density (BMD) for treating the elderly female with osteoporotic distal radius fractures.Methods Ninety elderly female with osteoporotic distal radius fractures patients were divided into treatment group and control group with 45 cases each according to the method of random number list.The two groups were given the medication treatment after 3 d of external fixation stenting.The control group was given calcium dimension D and the treatment group was given alendronate sodium and calcium dimension D.The course of treatment was 6 months.Before and after treatment,the BMD and bone metabolism [bone alkaline pbosphatase(BALP),tartrate-resistant acid phosphatase-5b(TRACP-5b)] were detected in both groups.The wrist function of two groups was evaluated.Results Before treatment,the level of BMD of treatment group and control group were (0.472 ± 0.157),(0.519 ± 0.173) g/cm2,there was no significant difference (P ＞0.05).After treatment,the level of BMD of treatment group and control group were (0.893 ±0.298),(0.571 ± 0.184) g/cm2,the BMD of treatment group after treatment was significantly higher than that before treatment and control group after treatment(P ＜ 0.05).The level of BMD of control group after treatment had no significant difference compared with before treatment (P ＞ 0.05).Before treatment,the level of BALP,TRACP-5b of treatment group and control group were (53.76 ± 17.92),(5.61 ± 1.87) U/L and (51.86 ± 17.29),(5.54 ± 1.85) U/L,the level of BALP,TRACP-5b after treatment had significant difference compared with before treatment and control group after treatment (P ＜0.05).There was no significant difference in control group before treatment and after treatment (P ＞ 0.05).The good rate of rehabilitation of wrist function in treatment group was 91.1％ (41/45),significantly higher than that in control group [51.1％ (23/45)] (x2 =17.524,P ＜0.01).Conclusions The alendronate sodium has a role to suppress bone resorption and increase BMD.It can promote the recovery of wrist function.

The appliance status of computer assistant technology in biological identification was summarized and compared.The author considered that at the present time,the technology of expert system was relatively advanced.The technology of expert system was presented in detail.The status and foreground of the application of expert system in parasites identification was also generally expatiated.

Objective To investigate the effects of polysaccharide sulfate(PSS)on lipopolysaccharide(LPS)-induced mice pulmonary microvascular endothelial cell(PMVEC) injury in vitro .Methods PMVEC were divided into the blank control group (C) ,LPS stimulation group (L) and PSS+ LPS group (LP) .The effect of PSS on the viability of LPS-induced PMVEC was ob-served by MTT assay .The influence of polymorphonuclear(PMN) on the PMVEC adhesion number was measured by the rose Ben-gal staining .The concentrations of TNF-αand ICAM-1 in culture supernatant of PMVEC were detected by ELISA assay .Results PSS could inhibit the decrease of PMVEC viability caused by LPS(P=0 .001) ,compared with the group C ,the adhesion number of PMVEC and PMN in the group L was significantly increased(P=0 .000) ,the expression of TNF-αand ICAM-1 was significantly increased(P=0 .000);compared with the group L ,PSS pretreatment for 1 h could significantly decrease the LPS caused adhesion of PMVEC and PMN(P=0 .000) ,the expression of TNF-αand ICAM in the group LP was significantly decreased (P<0 .05) .Con-clusion PSS can inhibit LPS-induced PMVEC injury and adhesion of PMVEC and PMN ,its mechanism may be related with the de-crease of ICAM-1 and TNF-αexpression .

Objective To study the advantages and summerize the practice of laparoscopic appendectomy (LA) for elderly patients. Methods Forty one elderly patients with appendicitis aged from 60 to 76 were treated with LA. The operative procedure, surgical indications, recovery, postoperative pain, and complications, as well as the period and the cost for hospitalizing were studied. Results All 41 patients were comfirmed appendicitis through LA. Thirty nine patients undergone LA were operated smoothly. Only two patients were cured with exploratory laparotomy. The preoperative diagnosis was confirmed in 6 patients and the complication of other diseases were found in 5 cases by LA. Two cases were operated by abdominal incision during LA. Postoperative complications, such as infection of the incision and pain were less occurred. The concurred diseases with appendicitis need simple treating. The hospitalizing period was 4 days on the average and the cost was 20%～30% higher than other procedures. Conclusions Most of elderly patients can be early diagnosed and timely treated by LA. LA could be a more popular choice for the elderly patients with appendicitis since its advantages of safe and minimal invasion. It has been an outstandihg method in treating appendicitis compared to other traditional methods.

Objective To understand the environmental lead pollution level caused by a lead smeltery.Methods From the surrounding of the investigated factory,the farmland soil,sediment,water,ambient air,courtyard dust,waste and 7 kinds of crops were collected to determine the lead level.Results Respectively,the lead concentration was 3.1 mg/L in the agriculture irrigation water,exceeded the allowed limit by 30 times,was 0.07 mg/L in the pond water,exceeded the allowed limit by 0.4 time,was 1 101.5 mg/kg in the sediment of the pond,exceeded the allowed limit by 0.10 time,was 7 400.0 mg/kg in the river sediment,exceeded the allowed limit by 6.40 times,was 47.0-287.9 mg/kg in the farmland soil and within the 400 m bound around the lead smeltery,the average level in the soil was 195.0 mg/kg.Conclusion The lead smeltery has caused the lead environment pollution in degrees,it is the main source of lead pollution that caused high blood lead in some people living in that area.