BACKGROUND:The lower and middle humeral shaft fractures are common upper limb fractures. Incidence rate and recurrence rate were high in the elderly population. However, there is a lack of a method with ideal curative effect. OBJECTIVE:To compare andanalyze the biomechanical differences between common compression plate and locking plate fixation in the repair of middle and lower complex humeral shaft fracture in the elderly. METHODS:30 pairs of antiseptic elderly humerus specimens were selected to make models of middle and lower humeral shaft fracture. Two humeri from the same individual were randomly assigned to two groups, and subjected to locking plate and common compression plate fixation. Experimental mechanics models were used to determine displacement and torsion angle under compression, bending and torsion. Data were analyzed and compared between the two groups. RESULTS AND CONCLUSION:(1) After exclusion of relevant factors, specimens with high bone density and excelent quality were selected from al specimens. (2) Under axial load of 500N, the bending load of 7.0N?m and torsional load of 3N?m or less, the strain was smaler in locking plate group than in common compression plate group under compression, bending and torsion (P< 0.05). Relative displacement under the above loading was smaler in locking plate group than in common compression plate group (P< 0.05). (3) Above data suggested that locking plate has good compressive, flexural and torsional rigidity, can ensure the stability and integrity of the fracture connection.

Objective To explore the value of abdominal wall lifting devices in laparoscopic cholecystectomy.Methods Patients who were going to receive laparoscopic cholecystectomy were randomly divided into two groups:one group underwent pneumoperitoneum(Gas group,n=38),the other group was treated with gasless technique using a subcutaneous abdominal wall lifting devices(Gasless group,n=37).Parameters including operation time,blood loss,real-time results of arterial blood gas analysis,postoperative hospital stay,post-operative ACTH and complications were compared between the two groups.Results The operation was completed in both the groups.There existed significant difference in the mean operation time and blood loss between the two groups [Gas group vs Gasless group:(34.2?7.7) min vs(46.7?16.8) min,t=-4.160,P=0.000 and(10.4?2.0) ml vs(14.8?7.2) ml,t=-3.627,P=0.000];whereas,no significant difference was found between the two in the real-time results of arterial blood gas analysis,postoperative hospital stay [(3.7?0.7) d vs(3.9?1.2)d,t=0.884,P=0.379] and post-operative level of ACTH(5.66 pmol/L vs 5.48 pmol/L,Z=0.748,P=0.436).No severe complications occurred in both the groups.In the gasless group,20 of the 37 patients developed subcutaneous emphysema,while none of the Gas group showed the symptom.Conclusion Gasless abdominal wall lift device is safe and simple,resulting in quick recovery without leading to pneumoperitoneum-related complications.

Aplastic anemia (AA) is a Tlymphocyte-mediated autoimmune disease. The research on AA was focused on three areas, which were the pathogenesis of immune dysfunction, hematopoietic stem cell damage and abnormal hematopoietic microenvironment. In recent years, more attentions have been paid on abnormal immune mechanisms in the blood. There are complex intracellular cytokine and signal transduction pathway of pathogenesis in AA. And T-bet/IFN-γ signaling pathway plays an important role in development and progression of AA. This article aimed to review T-bet/IFN-γ signaling pathways in AA.

Objective:To investigate the suppressed e ects of total hedysarum polybotrys saccharide(THPS) alone and THPS combined with Cytoxan(CTX) on tumor-bearing mice and its mechanisms.Method:Kunming mice inoculated with S180 were given low,moderate and high dose THPS and THPS combined with CTX by intraperitoneal injection.Fourteen day later,tumor weight,inhibition rate,thymus index and spleen index were observed.CD4+ and CD8+ lymphocyte were counted though the ow cytometer.Results:Compared with the control,the moderate dose THPS showed signi cantly suppressed e ect on the growth of S180 tumor(P

This study was aimed to investigate the effect of Bu-Shen Y i-Sui Sheng-Xue (BSYSSX) method on pro-liferation and differentiation mechanisms of hematopoietic progenitor cells. The rat models were established by 60Co-γrays and cyclophosphamide. Compound Chinese medicine was gavaged to rats of the normal control group, model group, stanozolol group, Yi-Sui Sheng-Xue (YSSX) group, Wen-Shen Sheng-Xue(WSSX) group and Zi-Shen Sheng-Xue (ZSSX) group. Then, serum of rat was prepared. Rat bone marrow cells were incubated with AA rats serum ac-counted for 20% and the number of hematopoietic progenitor cells colony-forming units (CFU) were counted. The level of GATA-1 and PU.1 mRNA in colony cells were detected with RT-PCR. The results showed that compared with the normal control group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM, as well as the expres-sion of GATA-1 and PU.1 mRNA in the model group decreased significantly (P< 0.01). Compared with the model group, the number of bone marrow cells, CFU-E, BFU-E, CFU-GM of each treatment group were significantly in-creased (P< 0.01). CFU-E and BFU-E of the ZSSX group were better than the YSSX group (P < 0.01). CFU-GM of the ZSSX group was better than the YSSX group and the WSSX group. The expression of GATA-1 and PU.1 mR-NA in each treatment group were significantly higher than the model group (P< 0.01). The expression of GATA-1 mRNA in the ZSSX group was better than the YSSZ group and WSSX group (P< 0.05). The expression of PU.1 mR-NA in the ZSSX group was higher than the YSSX group and WSSX group. It was concluded that BSYSSX method may increase the expression of GATA-1 and PU.1 mRNA in order to promote the proliferation and differentiation of bone marrow hematopoietic progenitor cells. The ZSSX method was better than the YSSX method and WSSX method.

This paper was aimed to observe the effect of Yisui Shengxue (YSSX) granules on CD4+ CD25 + regulatory T cells (Treg cells) and its treatment mechanism in aplastic anemia (AA) rats.Male SD rats were selected and randomly divided into different groups according to their weight.In the model group,subcutaneous injection of benzene (1 mL· kg-1)was given every other day for 7 consecutive weeks.Ten days before the rats were sacrificed,intraperitoneal injection of CTX (25 mL · kg-1) was given for 3 consecutive days.On the 4th week,model rats were divided into the model group,stanozolol group,and the YSSX granules group.Intragastric administration of corresponding drug was given.Same volume of normal saline was given to the normal group and the model group.At the end of the experiment,WBC,RBC,HGB and PLT in peripheral blood were detected.Blood smear and bone marrow smear were prepared.The Foxp3 protein expression of Treg cells in spleen tissues was detected by immunohistochemistry (IHC).RT-PCR was used to detect the Foxp3 mRNA expression in bone marrow tissues.The results showed that compared with the normal group,WBC,RBC,HGB and PLT in the model group were significantly reduced (P ＜ 0.01).The blood smear showed poor permeability of blood cells,reduced WBCs,and increased degenerated cells.The bone marrow smear indicated significantly increased fat drops,significantly reduced hematopoietic cells,and increased nonhematopoietic cells.After the treatment of YSSX granules,WBC,RBC,HGB and PLT were significantly increased (P ＜ 0.01).Both the blood smear and bone marrow smear showed cell permeability improvement,cell form returns to normal,fat drops significantly reduced,significantly increased hematopoietic cells,significantly increased Foxp3 protein expression in spleen tissues and Foxp3 mRNA expression in bone marrow tissues (P ＜ 0.01).It was concluded that YSSX granules can upregulate both gene and protein expression of Foxp3,regulate AA immune function in order to improve the AA immune environment,promote the recovery of bone marrow hematopoietic function,which played an important role in AA treatment.

Objective To understand the distribution and drug resistance of pathogens from patients with anastomotic fistula infection after esophageal cancer surgery, and provide basis for clinical diagnosis and treatment.Methods Patients were admitted to a hospital due to anastomotic fistula after esophageal cancer surgery between January 2012 and December 2015, microbial culture and antimicrobial susceptibility testing results of patients were retrospectively analyzed.Results 1 986 patients underwent radical resection of esophageal cancer within 4 years, 148 of whom developed anastomotic fistula, 104 (70.27％) were with positive microbial culture.A total of 197 pathogenic strains were isolated, 52(26.40％)and 145 (73.60％)strains were isolated from intrathoracic anastomotic fistula and cervical anastomotic fistula respectively;127 (64.47％)strains were gram-negative bacteria, the major were Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii, 62(31.47％) strains were gram-positive bacteria, the major were Staphylococcus aureus, Enterococcus spp., and Streptococcus viridans, 8 strains (4.06％) were fungi.49(47.12％) cases were with mixed pathogenic infection.The resistance rates of gram-negative bacteria to imipenem were 17.86％-47.62％, to polymyxin B was 0, resistance rates of Pseudomonas aeruginosa to other antimicrobial agents were all<50％, Klebsiella pneumoniae to piperacillin and aztreonam were both>70％, Acinetobacter baumannii to most antimicrobial agents were all>50.00％;resistance rates of gram-positive bacteria to clindamycin and tetracycline were both>50.00％, to linezolid, vancomycin, and teicoplanin were all 0, resistance rates of Staphylococcus aureus to penicillin, oxacillin, and ciprofloxacin were all>60％,resistance rate of Enterococcus spp.to quinupristin/dalfopristin was 100.00％.Conclusion Postoperative anastomotic fistula combined with infection can affect the prognosis of patients after esophageal cancer surgery, regular monitoring on distribution and drug resistance of pathogens can provide the basis for initial empirical treatment, and is conducive to the early treatment and rational use of antimicrobial agents.

BACKGROUND: Bone marrow stromal cells(BMSCs) are the ideal gene target cells and will have a bright future in the gene therapy of spinal cord injury.OBJECTIVE :To detect the expression of glial cell line - derived neurotrophic factor(GDNF) gene after BMSCs were infected by adenovirus-medialed GDNF (Adv-GDNF) in vitro and to explore its biological activity.DESIGN: A randomized controlled trial study.SETTING: Laboratory of Orthopedic DepartmentMATERIALS: The experiment was completed in the Laboratory of Orthopedic Department, Affiliated Tongji Hospital of Tong ji Meidcal College,Huazhong University of Science and Technology. Twenty-four SD rats of either gender, weighing (180 ± 20) g.INTERVENTIONS: BMSCs were infected by Adv-GDNF in vitro and then cocultured with spinal cord dorsal root ganglion. The three methods, immunofluorescent chemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay(ELISA) were used to evaluate GDNF expression in the BMSCs. The biological activity of GDNF was observed by a phase contrast microscope.MAIN OUTCOME MEASURES:Primary outcomes:①RT-PCR;②results of immunofluorescent chemical examination;③biological activity of GDNF in vitro. Secondary outcomes:①culturing and identification of BMSCs②time-effect relationship of GDNF expression revealed by ELISA.RESULTS: Immunofluorescence displayed expression of GDNF in BMSCs 48hours after Adv-GNDF infection. RT-PCR analysis demonstrated expression of GDNF mRNA 24 hours after Adv-GNDF infection. ELISA confirmed the presence of GDNF in the liquid supernatant of BMSCs 24 hours after Adv-GDNF infectionn and showed that GDNF was secreted. The supernatant can promote the neurite outgrowth in the rat dorsal root ganglion(DRG).CONCLUSION: It is demonstrated that BMSCs infected by Adv-GDNF can express GDNF steadily and the expressed GDNF has the activity of promoting neurite outgrowth, which lays a foundation of the GDNF gene therapy for spinal cord injury.

Objective To investigate an evaluation program for external quality assessment ( EQA) of quality indicators ( QIs) and develop a software .Methods According to GB/T 27043-2012 ( ISO/IEC 17043:2010,IDT) mode 3, 28 provincial centers for clinical Laboratories were organized by National Center for Clinical Laboratories to launch an investigation on “QIs in clinical laboratory” with the use of Clinet-EQA online .Participants were asked to collect data of April 2014 and report related results online .Mean, median, the 5 th, 25 th, 75 th and 95 th percentiles of defectpercentages for biochemistry , immunology, blood and body fluid and microbiology were calculated , respectively .Sigma values were also calculated . Meanwhile , 25 th of sigma value and 75 th of defect percentages were chosen as preliminary quality specifications for each QI so that laboratories can evaluate related process quality .Results Take incorrect sample type rates for example , 4 771 laboratories were involved in this study .Among four subjects , incorrect sample type rates were lowest (0.01%, 6σ) for immunology tests, followed by blood and body fluids tests (0.06%, 4.7σ) and biochemistry tests (0.06%, 4.7σ), and were highest for microbiology tests (0.33%, 4.2σ).Evaluation reports will besent back to participants so that they can understand national , provincial , and their own sigma levels well .Preliminary quality specifications of incorrect sample type for biochemistry, immunology, blood and body fluid, and microbiology tests were 0.08% (4.6σ), 0.03%(5σ), 0.09%(4.6σ) and 0.43%(4.1σ), respectively.Conclusion Clinical laboratories were advised to establish and monitor suitable QIs within laboratory and participate in QIs EQA schemes , thus they can improve their quality continuously .

Objective:To investigate the clinical and laboratory characteristics of lupus nephritis(LN) patients by detecting the anti-nucleosome antibodies, anti-C1q antibodies and anti-double stranded antibodies(anti-ds DNA), and to clarify the risk factors of LN in the patients with systemic lupus erythematosus(SLE),and the significance of three kinds of antibodies in diagnosis of LN.Methods:A total of 120 SLE patients were selected and divided into LN group(n=60) and non-LN group(n=60).The ANAS data of 120 patients were retrospectively analyzed,the levels of anti-C1q antibodies were measured.The clinical symptoms and laboratory data of the patients with positive anti-dsDNA,-nucleosome and-C1q antibodies (3-pos group)and negative three kinds of antibodies(non 3-pos group) were analyzed in LN group.Results:The positive rate of anti-C1q antibody of the patients in LN group (40.00%) was higher than that in non-LN group (21.67%) (χ2=4.728, P=0.03).The positive rate of anti-dsDNA antibody in LN group was 66.67%, and it was 46.67% in non-LN group;the positive rates of the patients had significant difference between two groups (χ2=4.887, P=0.027).The positive rate of anti-nucleosome antibody in LN group was 58.33%, and it was 40.00% in non-LN group;the positive rates of the patients had significant difference between two groups (χ2=4.034, P=0.045).The positive rates of U1-snRNP, SmD1 and other antibodies Jo-1, SSA/Ro60kD, SSA/Ro52kD, SSB, ScL-70, CENP-B,and P0 had no significant differences between two groups(P>0.05).The levels of C3 and C4 and hemoglobinin of the patients in 3-pos group were higher than those innon 3-pos group (P<0.05);the age,the levels of immunoglobulin protein and C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), white blood cell (WBC) and platelet had no statistically significant differences between 3-pos and non 3-pos groups(P>0.05).The clinical symptoms were not statistically significant in 3-pos and non 3-pos groups (P>0.05).Conclusion:The anti-nucleosome, anti-C1q and anti-dsDNA antibodies are the risk factors of SLE complicated with LN;the positive antibodies can improve the diagnostic rate of LN.The 3-pos patients have more severe damage in complements and blood system with higher renal disease activities.