Objective To investigate the clinical efficacy of fixation of distal radius fracture with dorsal instability with locking compression plate (LCP) via radial approach.Methods From September 2009 to October 2012, 21 cases underwent LCP fixation of the distal radius fracture with dorsal instability via radial approach.The study included 14 males and 7 females (mean age, 54.5 years;range, 38-81 years).Twelve cases were injured in traffic accidents, 7 in falls and 2 in high falls.Fracture AO classification was type A3 in 10 cases, type C1 in 8 cases and type C2 in 3 cases.Two cases (one type A3 and one type C1) had malunion.When the lateral column, intermediate column, radial edge and dorsal plane were exposed by radial incision, LCP fixation with bone grafting was performed to restore the height of radial styloid process, ulnar deviation and palmar tilt.According to the GartlandWerley score, wrist joint function was evaluated.Results Mean duration of follow-up was 13.5 months (range, 12 to 24 months).Stage Ⅰ bone union was shown on X-rays, with the healing time of 7.5 weeks.Based on the X-rays at postoperative 6 months, 1 year and 2 years, the shortening of radial styloid process was ≤ 2 mm, mean volar tilt was 12.5°(range, 8°-17°) , mean ulnar tilt was 20.5° (range, 15°-26°), and step-off or gap of the articular surface was ≤ 2 mm.In postoperative wrist motion assay, mean volar flexion was 60°(range, 30°-70°), mean dorsal flexion was 55° (range, 30°-65°), mean radial deviation was 17°(range, 10°-20°), mean ulnar deviation was 25.5° (range, 20°-30°),pronation was 65.5° (range, 60°-70°) , and mean supination was 75.5° (range, 60°-80°).Mean grip strength was 75％ (60％-95％)of the contralateral side.Two cases suffered from pain (one complained of moderate pain and one minor pain occasionally).According to the Gartland-Werley score, 16 cases were rated excellent, 2 good, 2 fair and 1 poor, with the excellent rate of 86％.No complication was found as injury of the superficial branch of radial nerve, infection, nonunion, nail loosening, medium neuritis and tendon injury.Conclusions Lateral column, intermediate column, radial edge and dorsal plane can be shown via the radial approach.LCP fixation combined with bone grafting contributes to fracture anatomical reduction.

Objective To apply Nutritional Risk Screening-2002(NRS-2002) to perform primary screening for nutritional risk in patients with esophageal cancer who undergo radiotherapy, and assess their nutritional status, and to investigate the value of NRS-2002 in such patients.Methods A total of 97 patients who were diagnosed with esophageal cancer and underwent radiotherapy in Zhejiang Cancer Hospital from January 2010 to April 2014 were analyzed retrospectively.The Kaplan-Meier method was applied to analyze the difference in survival, and the chi-square test and the Pearson correlation analysis were applied to analyze the correlation between NRS-2002 score and blood parameters.Results Of all patients, 26.8%had nutritional risk before radiotherapy, which gradually increased with the progress of radiotherapy.The 1-year overall survival rates of the patients with NRS-2002scores of ≤3 and ≥4 on admission were 91.1%and 61.9%, respectively (P=0.010).As for the patients with the highest NRS-2002 scores of ≤2 and ≥3 during treatment, the 1-year overall survival rates were 94.2% and 77.5%, respectively (P=0.012).As for the patients with the lowest NRS-2002 scores of ≤3 and ≥4 during treatment, the 1-year overall survival rates were 91.3% and 54.5%, respectively ( P=0.018).The NRS-2002 score was correlated with prealbumin on admission and at week 1 of radiotherapy (P=0.000 and 0.002), and the NRS-2002 score was correlated with albumin at week 3 of radiotherapy (P=0.036).The multivariate analysis showed that the TNM stage of esophageal cancer and the highest NRS-2002 score during treatment were the independent prognostic factors in esophageal cancer (P=0.001 and 0.005).Conclusions The patients with esophageal cancer undergoing radiotherapy have high nutritional risk, and NRS-2002 score is the independent prognostic factor in these patients and can be used as a tool for primary screening for nutritional risk.

Objective: To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods: The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results: Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.

Objective : To investigate the effects of dihydroartemisinin ( DHA) on cell growth , migration invasion and vasculogenic mimicry ability of non⁃small cell lung cancer ( NSCLC) . Methods : Different concentrations of DHA were added to NSCLC cell lines A549 and H3255 , and after 24 hours , the cell viability was detected by CCK8 method , and the migration and invasion ability of NSCLC cells was detected by Transwell experiment . qRT⁃PCR and Western blot detected E ⁃cadherin , N ⁃cadherin , and Vimentin mRNA and protein expression levels , respectively .Three⁃dimensional cell was cultured to observe the vascular⁃like morphological generation of cells . qRT⁃PCR and Western blot detected human vascular endothelial cadherin (VE⁃cadherin) mRNA and protein expression levels as marker of vasculogenic mimicry . Results : DHA inhibited cell growth of A549 and H3255 and showed time⁃dependent and concentration⁃dependent . DHA inhibits the invasion and metastasis ( all P < 0. 001) of A549 and H325 cells ; DHA upregulated the expression of E ⁃Cadherin at mRNA(all P < 0. 001) and protein(P < 0. 001;P < 0. 01) levels in A549 and H3255 cells , and downregulated the expression of N ⁃cadherin at mRNA (all P < 0. 01) and protein (all P < 0. 001) levels as well as the expression of Vimentin at mRNA (P < 0. 01;P < 0. 001) and protein (all P < 0. 001) levels . The results of three⁃dimensional cell culture showed that the 12⁃hour vasculogenic mimicry generation capacity of DHA⁃treated A549 cells and H3255 cells was reduced , and the expressions of VE⁃cadherin at mRNA (P < 0. 001;P < 0. 01) and protein (all P < 0. 001) levels were downregulated . Conclusion Dihydroartemisinin inhibits the growth , migration invasion and vasculogenic mimicry ability of non⁃small cell lung cancer cells

Objective: To explore the correlation between epidermal growth factor receptor ( EGFR) mutation and brain metastasis in lung adenocarcinoma． Methods: Comparisons of brain metastasis between lung adenocarcinoma patients with EGFR exon 19 deletion ( 19 Del) and a single point mutation of L858R in exon 21 (21 L858R) at initial diagnosis and after EGFR-TKIs targeted therapy were analyzed．The CCK-8 assay was used to detect and calculate the semi-inhibitory concentration (IC50 ) of gefitinib against EGFR-mutated lung adenoma cell lines PC9 and H3255 . Results: Of the 410 patients with lung adenocarcinoma，a total of 153 (37. 3% ) cases had brain metastasis．Age，lymph node metastasis and 21 L858R mutation were high-risk factors for brain metastasis of lung adenocarcinoma．Among newly diagnosed 48 EGFR-mutated lung adenocarcinoma patients with brain metastasis ，the number of 19 Del and 21 L858R were 14 and 34，respectively (P = 0. 006) ．There were 17 patients with 19 Del and 20 patients with 21 L858R were observed to complicated by brain metastasis after receiving EGFR-TKIs targeted therapy．The median time of brain metastasis after EGFR-TKIs treatment were 15 months (8. 50，25. 00) and 7 months (4. 25，12. 25 ) ，respectively ( P = 0. 013 ) ． The IC50 of PC9 and H3255 to gefitinib were (0. 037 ± 0. 008) and (0. 150 ± 0. 040) μmol / L，respectively (P = 0. 007) ． Conclusion Age younger than or equal to 60 years，lymph node N2-3 stage，and EGFR 21 L858R mutation are high-risk factors for brain metastases in patients with lung adenocarcinoma，and the latter still has a shorter time to brain metastases than 19 Del mutations after treatment with EGFR-TKIs，which may be related to drug sensitivity.

Objective: To investigate the mechanism of down-regulation of the phosphatase and tensin homolog deleted on chromosome ten(PTEN) caused by hepatitis B virus(HBV) infection and the antiviral activity of interferon α(IFN-α). Methods: HepG2 cells and HepG2.2.15 cells were cultured under suitable conditions. HepG2 cells were transfected with empty vector(pcDNA3.1) and HBV1.3 plasmid respectively, and the protein expression of PTEN was detected by Western blot; pcDNA3.1 and PTEN over-expression(PTEN-OE) plasmid were transfected into HepG2.2.15 cells respectively. Chemiluminescence was used to analyze the expression of HBV-related antigens in the cell culture supernatant, and real-time quantitative PCR(qRT-PCR) was used to analyze the expression of HBV pregenomic RNA(HBV pgRNA); the synthetic RNA duplex [poly(I∶C)]was used to stimulate PTEN-OE cells, qRT-PCR was used to analyze IFN-α mRNA expression and Western blot was used to analyze the expression of interferon regulatory factor 9(IRF9) protein as well as myxovirus resistance protein 1(MxA) protein in the JAK/STAT signaling pathway. Results: In HepG2 cells expressing HBV transiently and HepG2.2.15 cells stably expressing HBV, the expression of PTEN protein both decreased; the expression of HBV-related antigens and HBV pgRNA decreased in PTEN-OE HepG2.2.15 cells compared with the control group. After the treatment by poly(I∶C), the level of IFN-α mRNA was significantly higher than that of the control group, and the expression of IRF9 and MxA ptotein related to the JAK/STAT signaling pathway both increased. Conclusion HBV may play a role in antagonizing the antiviral activity of IFN-α by down-regulating the expression of PTEN.