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.

Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Liver ; surgery

Objective To study the distribution of IL-10 and TNF gene polymorphisms in patients with gastroduodenal diseases in Hubei Han ethnic and their association with Helicobacter pylori (Hp) infection. Methods Six hundred and five patients with gastroduedenal diseases (196 chronic gastritis, 189 gastroduodenal ulcer and 220 gastric cancer) as well as 624 healthy controls were genotyped with PCR-RFLP method for IL-10-1082,-819,-592 and TNFα-308, lymphotoxin-α (LTα) Nco Ⅰ and AspH Ⅰ gene polymorphisms. Hp infection status was determined with ELLS& Results (1) There was significant difference of IL-10-1082 AG + GG genotype among the gastric cancer group with the non-malignant gastric diseases groups and healthy control group (P <0. 05). There was no significant difference of IL-10-592 and -819 gene polymorphisms among gastric cancer patients,non-malignant gastric disease patients and healthy controls (P>0. 05). The genotype frequencies of IL-10-819 were the same as those of IL-10-592. (2) Frequency of IL-10-1082 AG + GG genotype in gastric cancer patients with positive Hp was significantly higher than that in the other three groups (P < 0. 05). (3) Frequency of LTα Nco I AG genotype in gastric cancer patients with Hp infection was signiilcandy higher than that in Hp positive healthy controls (P < 0. 05). There were no other associations between TNFα-308, LTα Nco Ⅰ and AspH Ⅰ gene polymorphisms and Hp infection in gastroduodenal diseases. Conclusions (1) Allele AG + GG of IL-10-1082 was associated with gastric cancer in Han nationality of Hubei province. (2) IL-10-1082 AG + GG,LTct Nco ⅠAG heterozygous genotype may be associated with Hp infection in patients with gastric cancer in Han nationality of Hubei province.

PurposeTo evaluate the existence and extent of magnetic resonance(MR) artifacts caused by frequently used metallic dental materials and to compare the influence of different MRI sequences on artifacts.MethodsA total of 22 kinds and 25 metallic dental samples were tested with 1.5 T MR imager and gradient-echo sequence. Spin-echo and fast spin-echo were added to parts of these samples. Results Of all the 25 metallic dental samples, 11 including gold, amalgam, and silver point did not produce artifact. Titanium alloy and porcelain product fused in metal had mild artifacts. Whereas the remaining 12 samples such as the retention pin and pivot pin showed severe artifacts. Artifacts produced by retention pin, nickel chromium crown and so on were less severe on fast spin-echo. ConclusionsAttention should be paid to some of the metallic dental materials, which could cause severe MR artifacts and image degradation, when undergoing face,jaw and head MR examination. Artifacts can be alleviated by using proper metallic materials or choosing proper imaging sequence and parameters.

Arthroplasty, Replacement ; methods ; Clavicle ; injuries ; Fractures, Bone ; surgery ; Humans ; Joint Instability ; surgery ; Shoulder Fractures ; surgery ; Shoulder Injuries ; Shoulder Joint ; surgery

Disease Notification ; Humans ; Occupational Diseases ; diagnosis

Objective To investigate the possibility of survivin inhibition by lentiviral vector-mediated RNA interference and the influence on cell apoptosis in pancreatic cancer cell line.Methods The lentiviral vector of SiRNA targeted against survivin(LV-shRNA-survivin-1,LV-shRNA-survivin-2,LV-shRNA-survivin-3) was constructed and transfected into the packaging cells 293T,and then the supernatant with virus was collected to transfect SW1990 cells.Quantitative real-time fluorescent PCR and Western-blot were used to detect the expression of survivin.DAPI staining and detection of enzymatic activity of caspase 3/7 were employed to examine cell apoptosis.Results Three lentiviral vector-survivin-shRNA were constructed successfully.In the LV-shRNA-survivin-1 group,the survivin mRNA and protein expression inhibitory rate was 73.50% and 87.64% respectively;when compared to control group,the activity of caspase-3/7 increased significantly,which showed a 14.5-fold increase,and apoptosis increased 11.95%.Conclusions Lentiviral vector-mediad RNA interference targeted against survivin can effectively inhibit survivin expression and increase cell apoptosis significantly.

ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

OBJECTIVESTo investigate the results of two-part surgical neck fractures of proximal humerus treated with locking intramedullary nail for proximal humerus, and to discuss the indication, surgical technique and the effectiveness.

METHODSThe data of the 22 patients with two-part surgical neck fractures fixed with proximal humeral nail was retrospectively reviewed. The mean age was 57 years. X-ray film and visual analogue scale (VAS), American shoulder and elbow surgeon (ASES) score, Constant-Murley score, University of California, Los Angeles (UCLA) scoring system and simple shoulder test (SST) questionnaire were used to evaluate the patients' shoulder function recovery at final follow-up.

RESULTAll the patients were followed up with an average time of 13 months. All fractures united within 8 weeks postoperatively. No infection, avascular necrosis or complications which concerning with hardware was found during follow-up. The average active forward flexion was 147.8 degrees , the average external rotation was 45.5 degrees and the average internal rotation was T10. The mean VAS score was 1.5. The mean ASES score, Constant-Murley score, UCLA score and SST score were 81.2, 85.4, 29.9 and 9.5 respectively. Eighteen patients were rated as "excellent" or "good", while 4 others were rated "poor". All patients were satisfied with their results.

CONCLUSIONWith good indication control, meticulous intraoperative management and strict postoperative rehabilitation, close reduction and internal fixation with proximal humeral nail can be an effective method for the treatment of two-part surgical neck fracture.

Adult ; Aged ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Humans ; Humerus ; surgery ; Internal Fixators ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the indications and clinical results of displaced proximal humeral fractures treated by locking proximal humeral plate (LPHP).

METHODSFrom September 2004 to March 2006, 75 patients which were treated by open reduction and internal fixation with LPHP were available to follow-up, with an average time of 17 months (12 - 30 months). There were 60 fresh fractures and 15 delayed fractures. The range of motion, muscle strength, visual analogue scale (VAS) for pain, American shoulder and elbow surgeon (ASES) score, Constant-Murley, University of California, Los Angeles (UCLA) scoring system and simple shoulder test (SST) for function evaluation were all recorded.

RESULTSThe average forward flexion was (147.3 +/- 17.7) degrees , external rotation was (30.5 +/- 16.2) degrees and internal rotation was to T9. The mean ASES was 86.7 +/- 12.7, Constant-Murley was 87.4 +/- 10.5, UCLA was 30.1 +/- 4.2. The total good or excellent rate was 89.3%. Compare with fresh fractures, the delayed group showed significant less forward flexion and ASES (P = 0.021 and 0.036 respectively). In 9 patients with late complications, there were significant differences regarding ASES, UCLA scoring system and Constant-Murley compared with patients without any complication.

CONCLUSIONWith strict indication control and appropriate surgical technique, satisfactory results can be expected for the displaced proximal humeral fractures treated with locking proximal humeral plates.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome