[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

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.

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.

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.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia ; blood ; complications ; diagnosis ; Prognosis ; Retrospective Studies ; Sepsis ; blood ; complications ; diagnosis ; Tumor Necrosis Factor-alpha ; blood

Objective To determine the inhibitive effect of interferon-a on hepatic metastasis of colon cancer. Methods Metastatic model of human colon cancer was established by orthotopic implantation of histologically intact human tumor tissue into the colon wall of nude mice.The mice were randomly divided into 4 groups:(1)Control group(receiving saline solution only);(2)5-FU treatment group;(3) IFN-?-2b treatment group;and(4)5-FU combined with IFN-?-2b treatment group(combined group). 5-FU and IFN-?-2b were given via peritoneum injection 1 time/2 days for eight weeks.The mice were killed at nine weeks.The tumors were weighed,the microvessel density(MVD) was detected,and the liver was examined histologically in order to discover the micrometastasis. Results In control group, 5-FU group,IFN-2b group and combined group,the tumor weight was(1.53?0.78)g,(0.87?0.59)g,(0.81?0.43)g and ( 0.23?0.09)g, respectively;the tumor inhibition rate was 0,43.1%,47.1% and 84.9%, respectively;the hepatic metastasis rate was 85.7%,78.6%,21.4% and 0 respectively.MVD in IFN-? group and combined group was significant lower than that in control group and 5-FU group. Conclusions IFN-? can inhibit the growth and hepatic metastasis of orthotopic implanted human colon cancer by inhibiting the tumor angiogenesis.It may be more effective when INF-? combined with cyotoxic agents.

Objective To investigate the relativity of the lupus anticoagulant(LAC), anticadiolipin antibody(aCL) - IgG,aCL-IgM,aCL-IgA levels and clinical symptoms of systemic lupus erythematosus (SLE), and to determine the significance of the LAC level in the prognosis of idiopathic thrombocytopenic purpura (ITP) by detecting the LAC and aCL-IgG, IgM,IgA levels in 310 children with SLE and 249 children with ITP. Methods Kadin-cephalin clotting time(KCCT) and correcting test to detect the plasma LAC level and to the serum aCL- IgG, IgM, IgA levels with enzyme - linked immunosorbent assay. Results In SLE group, there were 66.1% patients with higher LAC among whom 45.9% patients suffered from lupus nephritis , aCL subantibody level elevated in 46.8% patients (90.2% IgG and/or IgM) serum; 46.9% and 11.7% patients suffered from central nervous system diseases and blood diseases with SLE respectively. In ITP group, 36.2% patients with LAC positive were diagnosed as SLE by detecting the serum antinuclear antibody level, and 7.6% suffered from SLE subsequently in the period of 2 months to 2.4 years. Conclusions The LAC and aCL subantibody levels may have an important relativity with the clinical symptoms of SLE. The LAC is the predominant pathologic autoantibody in patients with lupus nephritis, and the aCL subantibody( IgM, IgG) levels were related to lupus thromboangiitis. The IAC level of children with ITP should be monitored in order to determine the prognosis of the disease as soon as possible.

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