Objective To retrospectively compare the clinical results of locking plate of proximal humerus (LPPH) and traditional AO plates in treatment of proximal humerus fractures in aged osteoporotic population. Methods From July 2002 to May 2005, 37 old osteoporotic patients with humerus fractures were treated with LPPH and traditional AO plates respectively in our department. The results were compared retrospectively. Results Follow-ups were conducted six weeks, 12 weeks and one year postoperatively to assess shoulder scores, bone healing and necrosis of humerus head. Comparison showed that the results for LPPH group were statistically better than those for traditional AO plate group in rate of implant loosening and SPADI (shoulder pain and disability index) scores. Conclusion LPPH has an obvious advantage over traditional AO plate in treatment of proximal humerus fractures in aged osteoporotic people.

Background and purpose: Accumulation of genetic and epigenetic changes that lead to the activation of proto-oncogenes or inactivation of tumor suppressor genes play important roles in development and progression of bladder cancer. We aimed to investigate the methylation patterns of TWIST1 gene in bladder cancer. Methods:A total number of 78 histologically conifrmed bladder tumor samples and paired 75 urine samples constituted the study group and was compared with 75 age-matched and gender-matched non-cancerous individuals. DNA was puriifed from both tumor, adjacent tissues and urine samples. The methylation status of the TWIST1 gene was analyzed by methylation-specific polymerase chain reaction (MSP) in both urinary bladder cell carcinoma samples, adjacent tissues and urine samples. Sensitivity and speciifcity values of the method were assessed and compared with the results of the cytology test. Results:Methylation of TWIST1 was detected in 88.5%of carcinoma samples and 84%of the paired urine samples,respectively;11.5%carcinoma adjacent tissues and 5.3%control urine sample was methylated. The sensitivity by urine cytology detection method was 49.3%in in bladder cancer patients, and was 17.3%in control group. The sensitivity of TWIST1 genes was 66.7%for low-grade cases. The sensitivity of urine cytology was 33.3%for the same low-grade cases. Conclusion:The methylation analysis of TWIST1 gene may be a simple, non-invasive, sensitive, and speciifc method for early detecting bladder cancer cells in urine.

Objective To evaluate the effect of continuous renal replacement therapy (CRRT) on extracorporeal membrane oxygenation (ECMO)-induced expression of inflammatory factors in pig kidney.Methods Twenty-four adult pigs of either sex,weighing 25-32 kg,were randomly divided into 4 groups (n =6 each) using a? random number table:control group (group C),sham operation group (group S),ECMO group and CRRT group.Anesthesia was induced with ketamine,diazepam and atropine and maintained with ketamine and diazepam.The pigs were tracheotomized,intubated and mechanically ventilated.The left femoral arteries were cannulated for MAP monitoring.Heparin 150 U/kg was injected intravenously.Right femoral artery and left internal jugular vein were cannulated for blood-letting and fluid infusion.In ECMO and CRRT groups,ECMO was performed for 24 h starting from 1 h after cannulation,in addition CRRT was performed for 24 h simultaneously in ECMO group.The pigs were then sacrificed and kidney specimens were obtained for determination of the content of interleukin-1β (IL-1 β),IL-6 and tumor necrosis factor-α (TNF-α) by ELISA.Results There was no significant differ-ence in the content of IL-1β,IL-6 and TNF-α between C and S groups (P ＞ 0.05).Compared with C and S groups,the content of IL-1β,IL-6 and TNF-α was significantly increased in E and CRRT groups (P ＜ 0.01).Compared with group E,the content of IL-1β,IL-6 and TNF-α was significantly decreased in group CRRT (P ＜0.01).Conclusion CRRT can decrease ECMO-induced expression of inflammatory factors in pig kidney to some extent,indicating that it can alleviate the inflammatory responses in kidney.

Background and purpose:The patients with aggressive lymphoma who have a poor prognosis and unlikely to be cured with conventional chemotherapy. This study was aimed to evaluate the effect of high-dose etoposide in mobilization followed auto-SCT in treating refractory lymphoma. Methods:40 patients [median age 33 (13-61) years] with refractory non-Hodgkin’s lymphoma (NHL, n=32) or Hodgkin’s lymphoma (HD, n=8) received high-dose etoposide [VP16 10-15 mg/(kg·d)×2 d] in mobilization in our center. Remission status prior to mobilization was PD (n=40). The use of such granulocyte colony-stimulating factor [G-CSF, 5-10μg/(kg·d)] mobilized peripheral blood stem cells (PBSC) after high-dose etoposide until the end of leukapheresis. Peripheral blood stem cell was collected and frozen in-80℃refrigerator. All these patients received auto peripheral blood stem cell transplantation (auto-PBSCT). Conditioning regimen was BEAM (n=19, 47.5%) or CBV (n=21, 52.5%). Results:Twenty-eight pa-tients (70%) were assessable for response after high-dose etoposide at a median pretreatment time of 39 days (range 17-172 days), 12 patients (30%) had no response. Median follow-up of 28 (4-66) months, 16 patients (40%) reached CR after auto-PBSCT. Fifteen of the 28 patients (53.6%) who had response to high-dose etoposide reached CR, 4 patients (14.3%) reached PR, 9 patients (32.1%) succumb to progression of disease. One of the 12 patients (8.3%) who had no response to high-dose etoposide reached CR, 1 patients (8.3%) reached PR, 10 patients (83.4%) succumb to progression of disease. The estimated 1-year OS and EFS were 69%and 56.7%respectively, 2-years OS and EFS were 63%and 52%respectively. The prognosis of the patients who had no response to etoposide was poor. The estimated 1-year OS and EFS were 25%and 16.7%respectively. Two group of comparison differences have statistics signiifcance (P<0.01). Conclusion: High-dose etoposide could be used in refractory lymphoma as rescue therapy in mobilization. It can increase the EFS and OS of patients who had response. The hematopoietic stem cells collection and hematopoietic reconstitution are not affected by etoposide.

Objective To analyze the independent factors affecting the prognosis of gastrointestinal stromal tumor(GIST) patients undergoing radical operation.Methods The clinical characteristics and follow up data of the 97 patients with GIST underwent radical opsration from January,2001 to January,2003 in our hospital were retrospectively analyzed by univariate and multivariate methods.Results In the univariate analysis of the 97 cases,gender,tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were found to be related to the prognosis of GIST.Multivariate Cox model analysis showed that tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were independent prognostic factors for patients with GIST.Conclusions Tumor location,tumor size,tumor cell type,necrosis,mitotic count are important prognostic factors for patients with GIST undergoing radical operation.

OBJECTIVE:To establish a RP-HPLC method for simultaneous determination of chlorapheniramine maleate,furacilin and ephedrine hydrochloride in Puma nose drops.METHODS:The analysis was carried on a XDB C 8 column;the mo?bile phase was composed of methanol(A),acetonitrile(B)and0.02mol/L potassium dihydrogen phosphate solutions(containing0.2%triethylamine and adjusted to pH3.0with phosphoric acid,C)with linear gradient elution(0min～3.5min,A∶B∶C=6∶13∶18,8.5min,A∶B∶C=6∶30∶64)and the flow rate was1.0ml/min;the detection wavelength was254nm and the column temperature was30℃.Chloramphenicol was used as the internal standard.RESULTS:The linear ranges were0.04～0.20mg/ml for chlorapheniramine maleate,0.02～0.10mg/ml for furacilin,0.50～2.50mg/ml for ephedrine hydrochlo?ride.The average recoveries were99.44%(RSD=0.48%,n=3)for chlorapheniramine maleate,101.36%(RSD=0.41%,n=3)for furacilin and99.43%(RSD=0.59%,n=3)for ephedrine hydrochloride.CONCLUSION:The method is reliable,accurate and suitable for quality control of Puma nose drops.

Objective To discuss causes and corresponding prevention for groin pain occurred early after total hip arthroplasty(THA).Methods A retrospective study was done on 189 cases(193 hips)treated with THA including unilateral procedures in 185 hips and bilateral procedures in eight hips to analyze common causes for early groin pain.Results Groin pain was found in 9.3% hips(18/ 193)during hospital stay,including 1.6%(3 cases)with deep infection,1.6%(3 cases)with incision infection,1%(2 cases)with posterior dislocation,4.1%(8 cases)with leg lengthening and 1%(2 cases)with hematoma.Conclusions Despite of the numerous diagnostic alternatives available to the orthopedic surgeon,detailed history,careful physical examination,necessary laboratory and imaging stud- ies can contribute to a correct determination of causes for groin pain.Meanwhile,appropriate indication, accurate preoperative radiographic measurement,intraoperative standardized surgical procedures and per- fect rehabilitation are necessary to avoid complications.

Objective To analyze the impact and quality of life of minimally invasive surgery combined with catheter attract surgery on patients with cerebral hemorrhage.Methods A total of 90 patients with cerebral hemorrhage in our department from February 2013 to De-cember 2014 were randomly divided into invasive group and the control group.Minimally invasive surgery group were given to cerebral hemor-rhage minimally invasive surgery combined with catheter attract surgery,the control group received traditional craniotomy.The postoperative recovery,nerve function scores,quality of life and morbidity between two groups were compared.Results The operation time and edema vol-ume of tissue postoperative 7 days in minimally invasive surgery group was significantly lower than those of the control group.The hematoma clearance rate 1 day after surgery was higher than that of control group,with statistically significant difference(P <0.05).NIHSS scores of two groups were gradually decreased 7 d,15 d,30 d after surgery(P <0.05).NIHSS scores of the minimally invasive surgery group 7 d,15 d, 30 d after surgery were lower than that of control group,with statistically significant difference(P <0.05).The scores of vitality,physiological function,physical function,general health,bodily pain,emotional function,social function,mental health after 6 months of the surgery in the min-imally invasive group was higher than those of control group,with statistically significant difference(P <0.05).The rate of postoperative pulmo-nary infection,electrolyte imbalance,gastrointestinal bleeding in MIS group were lower than those in the control group,with statistically signifi-cant difference(χ2 =5.400 0,4.405 7,4.615 4,P <0.05).Conclusion Minimally invasive surgery combined with catheter attract surgery can improve neurological function and quality of life for patients with intracerebral hemorrhage, and reduce the incidence of complications.

To explore the clinical characteristic and intervention strategies for pregnancy complicated with heart failure. The clinical data of 67 pregnant women with heart failure during January 1998 to December 2010 were collected and analyzed.The rate of heart failure in pregnancy with heart diseases was 31％ (67/216).The causes of pregnancy complicated with heart failure were peripartum cardiomyopathy ( n =33,49％ ) and hypertensive disorder complicating with pregnancy heart disease( n =28,42％ ).Heart failure in pregnancy appeared at an average of (36.0 ± 2.7 ) weeks.The average terminating time of pregnant women with heart failure was ( 36.5 ± 2.1 ) weeks.Cesarean section was the main safe choice of delivery for pregnant women with heart failure.The average weight of newborns for pregnant women with heart failure was(2517 ±541 )g.The rate of neonatal asphyxia was 22％ (11/50).Strengthening routine antenatal examination and treating pregnant complications timely can prevent and reduce the incidence of heart failure.

Objective To retrospectively analyze the effect of preemptive treatment on cytomegaloviras (CMV) infection in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The data of one hundred and three patients who underwent alIo-HSCT with preemptive treatment to prevent CMV associated diseases were retrospectively analyzed. Fluorescence quantitative PCR was used to detect CMV-DNA. The incidences of CMV viremia and CMV associated diseases were analyzed. Results CMV viremia was confirmed 63 times in 51 of the 103 patients. The incidence of CMV viremia was 49. 5% and the median time of onset was 40 days after transplantation. All the patients with CMV viremia received preemptive antiviral therapy and 19 of them developed CMV associated diseases, including 14 hemorrhagic cystitis, 3 CMV associated pneumonia and 2 CMV associated enteritis. The total incidence of CMV associated diseases was 18. 4%. After treatment with ganciclovir and/or foscarnet, 60 of the 63 times of CMV viremia disappeared. One patient was not included in the analysis because he died of intracranial hemorrhage and GVHD only 3 days after the treatment. The total response rate was 96. 8% (60/62). The remaining two cases who did not respond to treatment died of CMV associated pneumonia in combination with acute GVHD. The direct mortality rate of CMV infection was 1.9% (2/103). Conclusion The incidences of CMV viremia and CMV associated diseases do not increase in patients receiving preemptive therapy as compared with those receiving prophylaxis therapy. Preemptive treatment can not only prevent the progression of CMV viremia to CMV associated diseases in majority of the cases but also control CMV associated diseases effectively.