[Objective]To evaluate the clinical application and results of the anterolateral acromial approach with minimal incision in the treatment of proximal humerus fracture.[Method]From December 2006 to December 2008,42 patients with proximal humeral fracture were treated by the anterorlateral acromial approach using locking plate.There were 25 males and 17 females.All the fractures were classified with AO/OTA classification.There were 5 A2-fractures,11A3-fractures,7 B1-fractures,12 B2-fractures,3 C1-fractures,4 C2-fractures.Anterolateral acromial approach with minimal incision was applied and the deltoid muscle was seperated to expose the fracture fragments.Under direct vision the direct and indirect reduction of the fractures were performed.The locking plate was inserted distally beneath the deltoid muscle and between the distal plate and the humeral shaft was adjusted through another small skin incision on the lateral upper arm.Locking screws were inserted to the proximal and distal plate.Operation time,incision length,blood loss,reduction,Neer scores at 1 year were analyzed in different time points.[Result]All the cases were completed with minimal incision.There were significant differences(P

Humans ; Macrophage Activation Syndrome ; etiology ; Rheumatic Diseases ; complications

Objective To investigate the risk factors for deep vein thrombosis (DVT) of lower limbs after laparoscopic surgery.Methods A total of 230 patients underwent laparoscopic surgery were selected in Huanggang Central Hospital from January 2014 to August 2016.The patients were divided into DVT group and non-DVT group according to DVT of the lower limbs,and the related risk factors for DVT of lower limbs after laparoscopic surgery were analyzed.Results In the 230 patients,there were 10 patients with DVT of lower limbs and 220 patients without DVT of lower limbs,the incidence of DVT of lower limbs was 4.35％ (10/230).Logistic regression analysis showed that age ≥40 years old,operation time ≥120 min,postoperative ambulation time ≥ 30 h,the intraoperative position of high-head and low-foot,plasma D-Dimer level ≥0.5 mg · L-1 were the independent risk factors for DVT of lower limbs after laparoscopic surgery (P ＜ 0.05).Conclusion There is a certain incidence of DVT of the lower limbs after laparoscopic surgery.The effective prevention measures should be taken to reduce the incidence of DVT after laparoscopic surgery according to the related factors of DVT.

Background Cytokines play a crucial role in mediating immune tolerance or immune rejection of corneal transplantation.However,the study on the expression of cytokines in corneal graft is seldom.ObjectiveThe purpose of the study is to investigate the change of cytokine expression in allografts at different time points after corneal transplantation.Methods BALB/c and C57BL/6 mice aged 6 to 8-week old were used to establish autologous and allografts keratoplasty models.BALB/c mouse was use as donor and receipt in autologous group,and the cornea of C57BL/6 mouse was used to graft on the BALB/c mouse in the allografts group.The graft inflammation was clinically scored,and graft inflammatory scores of ≥5 or opaciflcation scores of ≥2 were identified as rejection.BALB/c mice were randomized into normal control group(3 mice)and allografts group(15 mice).Reverse transcriptPCR (RT-PCR) was used to detect the expression of interleukin-4 (IL-4) mRNA,interferon-γ (IFN-γ) mRNA,IL-10mRNA and tumor necrosis factor(TNF-α) mRNA in graft 6 hours and 1 day,3,7,14 days after operation.Results The corneal graft opacification score was ＜2 and inflammatory score was ＜5 in the 10 mice with autologous keratoplasty until 60 days with the survival rate 100％.The edema,opacification and new blood vessel were seen in the BALB/c mice received allografts keratoplasty.The inflammatory score was ≥ 5 and the opacification score was ≥2 24 days after surgery with the rejection rate 100％,in the allografts group,and the graft survival time was (17.80±4.66)days.RT-PCR showed that IL-4 and IFN-γ were positively expressed,and IL-10 and TNF-α were absently expressed in normal mouse cornea.In the allografts keratoplasty mice,positive responses for IL-4,IFN-γ and IL-10 were found in 6hours after operation,but TNF-α was absent.From 1 day through 3 days after operation,the expressions of IL-4,IFN-γand TNF-α were enhanced but IL-10 was disappeared in the graft.IL-10,IFN-γ and TNF-α were expressed till the 7th day,but on the 14th day,only IL-10 was detected in graft in the allografts keratoplasty mice.Conclusions TNF-αis a main factor among the variety of cytokines that may influent corneal allograft rejection locally.

Objective To evaluate the diagnostic accuracy of ultrasound miniature probe(UMP)examination in tumor invasion(T staging) and local lymphatic node metastasis(N staging) for colorectal carcinoma. Methods Preoperative UMP examinations(12 MHz) were performed on 53 patients with colorectal carcinoma undergoing surgeries.The diagnosis accuracy of UMP examination in T and N staging was determined by comparison of the results of operation exploration and histopathologic findings. Results The accuracy in T staging for colorectal carcinoma was 86% with UMP examination,and that for early stage colorectal carcinoma was 100%.The accuracy,sensitivity and specificity in N staging for colorectal carcinoma were 81%,77%,and 84%,respectively with UMP examination. Conclusion UMP examination works well in determining T stage of colorectal carcinoma,especially for early stage colorectal carcinoma and those with tumor stenosis.

OBJECTIVE To observe the effect of vacuum-assisted closure in clinical persistent infection patients.METHODS Thirty two sufferers infected in soft tissue,bones and joints were treated by general methods but without durable concrescence.It lasted averagely 138 days.In our department it treated by vacuum-assisted closure in 23 days.Thereby a comparison of self-control came into being.RESULTS Thirty two cases were cured after following at least one year except for one case with recrudescence.CONCLUSIONS Vaccum-assisted closure is the most effective surgery therapy measurement and is a kind of unidirectional drainage.If we can use it felicitously then we can treat infection in orthopedics′ effectively.

Objective To observe the effect of gene gun transduction of K-RAS Antisense gene on the expression of K-RAS P21 protein in human pancreatic carcinoma cells.Methods K-RAS Antisense gene was transduced into pancreatic carcinoma cells by gene gun transduction, the expression of K-RAS P21 protein on BxPC-3、AsPC-1 and MiaPaCa-2 pancreatic carcinoma cells line were examined by western blot and immunocytochemistry staining. Results The expression of K-RAS P21 protein in AsPC-1 and MiaPaCa-2 pancreatic carcinoma cells was obviously lower after the transduction of specific K-RAS Antisense gene,which has little impact on BxPC-3 pancreatic carcinoma cells. Conclusion Gene gun transduction of K-RAS Antisense gene is a potential method for treatment of pancreatic carcinoma.

Objective To investigate the time-effect relationship and dose-effect relationship of the expression of adenovirus mediating Smad 7 gene regulated by irradiation via Egr-1 promoter in the lung of C57BL mice. Methods Recombinant adenovirus (AD.Egr-Smad 7) was made up through replication-defective adenovirus enclosed radio-inducible elements from the Egr-1 gene promoter and cDNA encoding Smad 7. Mice infected by intratracheal instillation with AD.Egr-Smad 7 were irradiated to their whole lungs after 24 hours. 324 mice were randomly divided into 6 groups, and the lungs were harvested at different time points following irradiation with single dose of 8?Gy to observe the time-effect relationship of Smad7 gene expression with different time intervals. 108 mice randomly divided into 3 groups were irradiated respectively by different single irradiation dose and the lungs were harvested 5 hours after radiation to evaluated the dose-effect relationship of Smad 7 gene expression with different radiation doses. The expression of exogenous Smad 7 was detected by Western blot analysis. Results The expression of adenovirus mediating Smad 7 gene regulated by Egr-1 promoter could be induced by radiation markedly as compared with the control groups(P

Objective Objective To study the effect of adenovirus mediating Smad 7 gene regulated by radiation via Egr-1 on the primary tumor and lung metastasis in C57BL mice implanted with Lewis lung cancer.Methods The radio-inducible elements from the Egr-1 gene promoter were inserted upstream to a cDNA encoding Smad7 and integrated into a replication-defective adenovirus to generate recombinant adenovirus(AD.Egr-Smad 7).270 mice implanted with Lewis lung cancer in the hind legs were used and the experiment was started when the transplanted tumor diameter reached 0.8 to 1.0cm.Then three investigations were undertaken,each demanding 90 mice implanted with Lewis lung cancer respectively.To each group,90 mice models were randomized into 3 groups: the normal control group;the NS control group;and the implanted AD.Egr-Smad 7 group.Every 6 mice in each group were irradiated by different single dose to study the following: 1.The maximal and minimal diameters of the tumor were recorded to observe the tumor growth tendency,the tumor growth delay and the mice survival time,2.The incidence of lung metastasis two weeks after the radiation was recorded.3.The incidence of lung metastasis when the tumor volume was four times as large as that at the beginning of radiation was recorded.Results The adenovirus mediating Smad 7 gene expression regulated by irradiation via Egr-1 in C57BL mice implanted with Lewis lung cancer was able to inhibit the progression of the primary tumor and prolong the survival of the mice significantly as compared with the control group(P0.05).Conclusions The gene expression of AD.Egr-Smad 7 regulated by radiation is not risky in promoting the local progression and distant metastasis of Lewis lung cancer in mice.On the other hand,the gene expression of AD.Egr-Smad 7 regulated by radiation could inhibit the progression of the primary tumor and prolong the survival time of the mice significantly.It is safe,to some extent,of using AD.Egr-Smad 7 to block the signal transduction of TGF-?locally as a novel strategy for gene therapy aiming at the prevention of radiation-induced lung

Aim To investigate the protective effect of non-mitogenic human acidic fibroblast growth factor (nm-haFGF) on cerebral ischemia-reperfusion injury in mice. Methods Cerebral ischemia-reperfusion model was made by ligating bilateral carotid for 20 minutes in mice. These mice were randomly divided into model group( iv NS), two doses of nm-haFGF (iv 25、50 ?g?kg-1) groups, rhaFGF group(iv 50 ?g?kg-1) and sham- operated group. Step down test and Y-type electric maze were used to examine the effect of nm-haFGF on learning and memory of mice, then Even′s Blue(EB) level and NO level in brain of these mice were measured. Results The nm-haFGF significantly decreased numbers of errors of mice in 5 min in step down test and in Y-type electric maze test; EB and NO levels in brain of these mice were lower than those of model group respectively. Conclusion The nm-haFGF can protect cerebral ischemia-reperfusion injury in mice.