BACKGROUND:The conservative treatment of humeral fracture is difficult to achieve a good reduction. Minimaly invasive percutaneous plate fixation has been widely used, and has good repair results, but the specific mechanism of action is not clear.
OBJECTIVE:To compare the repair effect of different fixation methods on proximal humerus fractures.
METHODS: From August 2011 to October 2014, we selected 96 patients with proximal humerus fractures from the Shougang Hospital of Peking University. These patients were equaly divided into two groups according to the principle of random draw. Patients in the control group were treated with open reduction and conventional surgery fixation. Patients in the treatment group received minimaly invasive percutaneous plate fixation. Operation time, intraoperative blood loss, incision length and postoperative hospital stay were recorded in both groups. At 8 weeks after treatment, patients received radiography to identify the reduction. Range of motion of the shoulder joint was scored. Within 8 weeks after treatment, the occurrence of complications was observed and compared in both groups.
RESULTS AND CONCLUSION:Intraoperative blood loss, incision length and postoperative hospital stay were significantly less in the treatment group than in the control group (P < 0.05). No significant difference in operation time was found between the two groups (P > 0.05). At 8 weeks after treatment, the excelent and good rate of reduction was significantly higher in the treatment group than in the control group (98%, 81%,P < 0.05). Flexion, abduction, external rotation and internal rotation scores were significantly higher in the treatment group than in the control group (P < 0.05). Bone compartment syndrome, vascular injury, infection and bleeding were significantly lower in the treatment group than in the control group (P < 0.05). These findings confirm that compared with open reduction and internal fixation, minimaly invasive percutaneous plate fixation of proximal humerus fractures has less impact on the body, can promote reduction of the fracture, has few complications, and contributes to the recovery of shoulder function.

Objective To retrospectively report 30 cases of distal femoral fractures treated with retrograde intramedullary interlocking naill( GSH nail). Methods From February 1999 to December 2002, 30 cases of distal femoral fractures were treated with GSH nails.According to AO/ASIF classification system, there were 11 cases of type A1, 7 A2, 3 A3, 5 C1, 3 C2 ,and 1 C3 .The follow up period ranged from 6 to 54 months. Results The average time for bone healing was 16 weeks. According to Neer s knee rating scale, there were 21 excellent cases and 5 good; the excellent and good rate was 86.6% . Conclusion It's a good method to treat type A& C (AO/ASIF) distal femoral fractures with GSH nail.

Objective By comparing clinical efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with conventional low viscosity bone cement for osteoporotic vertebral compression fractures,to explore the clinical value of treatment of osteoporotic vertebral compression fractures with high viscosity bone cement.Methods In this prospective study,100 patients with one-level OVCF and older than 70 years were diagnosed and treated in our hospital from June 2014 to December 2015,which were randomly divided into 2 groups (50 patients in each),applied unilateral percutaneous vertebroplasty with high viscosity bone cement and bilateral percutaneous kyphoplasty with conventional low viscosity bone cement,respectively.Collected data of basic clinical informations (including age,gender,body mass index,etc.),preoperative and postoperative visual analog scales (VAS),Oswestry disability questionnaire (ODI),operative time,intraoperative X-ray times,the amount of bone cement injection,leakage of bone cement,anterior vertebral height and kyphosis (Cobb angle) of preoperative and postoperative,and statistical analysis.Results There were significant improvement of both VAS and ODI scores of the postoperative 1 day,3 months and 12 months compared with preoperative,but there was no significant difference between two groups;The operative time,intraoperative fluoroscopy times,bone cement injection amount and intraoperative bone cement leakage of high viscosity bone cement PVP group were significantly less than those of low viscosity bone cement PKP group (P＜0.05);the anterior vertebral height and kyphosis improved,and there was a significant difference between preoperative and postoperative of low viscosity bone cement PKP group (P＜0.05).Conclusion The efficacies of unilateral PVP with high viscosity bone cement and bilateral PKP with conventional low viscosity bone cement for osteoporotic vertebral compression fractures are the same,which can relieve pain and improve function of life significantly.However,the high viscosity bone cement PVP is simpler surgical procedure,with shorter operative time,less intraoperative radiation,less bone cement leakage rate.The domestic bone cement injection device can significantly reduce the cost of surgery,it worth to be widely used for clinical application.

Objective: FF456 is a new gene cloned in our lab, which belongs to c-type G protein-coupled receptors and has high homology to the olfactory receptor family. Northern blotting and RT-PCR showed that the expression of FF456 was exclusively restricted in liver and was significantly down-regulated in hepatoma. In an effort to study the function of FF456 gene, high titer antibody is indispensable. Methods:Full-length cDNA of FF456 was reconstructed into pcDNA3.1(-) vector, which was used for immunizing 6- to 8- weeks old female BALB/c mice. The effects of different injection manners, solvents and dosages on the antibody production have been compared. For detecting the titer and specificity of the antisera produced by DNA immunization, a peptide containing FF456 specific sequence was expressed by E.coli expression system. Results:Finally specific antisera with titers as high as 1 ∶ 50 000 was obtained. Conclusion:Immunofluorescence assays showed FF456 was expressed in hepatocytes with high tissue specificity. The FF456 expression in hepatoma cells was decreased dramatically.

Objective To investigate the frequency of ocular complication and the quality of patient's life after radiation therapy in nasopharyngeal carcinoma ( NPC ) . Methods 254 NPC patients who initially received radiation were followed and analysed. Visual acuity, automational visual field, slit-lamp microscopic findings, pattern visual evoked potential ( P-VEP ) and fundal findings were determined before, during and after radiation therapy. The severity of retinal impairment was assessed according to the international criteria on late tissue effects. Results The radiation dose was more than 70 Gy in 241 (94.9%)NPC patients, giving a radiation retinopathy incidence of 8. 7 % (22) patients after a mean of 46. 8 ? 14. 4 months. After being diagnosed as radiation retinopathy, 16 patients received combined-modality therapy of the modern medicine and Chinese traditional medicine. The disease condition was controlled in 56% (9) patients but progressed into optic neuropathy in 7 patients, 3 of whom developed radiation encephalopathy in 14 to 20 months after onset of retinopathy. The morbidity of radiation retinopathy was not associated with the patient' s age, but was related to the radiation dose. The retinopathy rate was as high as 13.6% in the 75-79 Gy group, which is significantly higher than 5.6% in the 70-74 Gy group ( P

Objective To investigate the effects of remifentanil postconditioning on apoptosis in hippocampal neruons in a rat model of cerebral ischemia-reperfusion(I/R)and the mechanism involved.Methods Twentyfour male SD rats weighing 250-300 g were randomly divided into 4 groups(n = 6 each): sham operation group (group S);global cerebral I/R group(group I/R);remifentanil 0.6μg·kg- 1·min-1+global cerebral I/R group (group R1)and remifentanil 1.8μg·kg-1·min-1 + global cerebral I/R group(group R2).Global cerebral ischemia was induced by 10 min occlusion of bilateral common carotid combined with hypotension.In group R1 and R2,remifentanil at 0.6 and 1.8μg·kg-1·min-1 were infused for 5 min before ischemia respectively.The cognitive function was tested with Morris water maze and step-down tests from the day 3 to day 8 after reperfusion.When Morris water maze test was finished,rat brains were removed for HE staining and determination of the expression of caspase-3 in hippocampal CA1 region by immuno-histochemistry.Apoptosis in neurons in hippocampal CA1 region was detected by TUNEL assay.Results Compared with group S,the cognitive function was significantly decreased and the number of apopotic neurons in hippocampus CA1 region increased in group I/R,R1 and R2,and the expression of caspase-3 was up-regulated in group I/R(P＜0.05).Compared with group I/R,the cognitive function was significantly increased,the expression of caspase-3 was down-regulated,and the number of apopotic neurons in hippocampus CA1 region was significantly decreased in group R1 and R2(P＜0.05).Conclusion Remifentanil postconditioning can improve the cognitive function through down-regulating caspase-3 expression and inhibiting the apoptosis in hippocampal neruons in a rat model of cerebral I/R.

Objective To explore the clinical value of MRI in diagnosing and treating cesarean scar pregnancy (CSP).Methods A retrospective analysis was conducted on the clinical manifestations of 54 patients diagnosed with CSP between January 2009 to January 2013 in Peking University Third Hospital.Based on the patients' MRI image and other clinical datas,we did transvaginal operation on patients with CSP1,and transvaginal combined with abdominal operations on patients with CSP2.The intraoperative blood loss,operation time,postoperative hospital stay,and the length of time required for of serum hCG dropping to normal of the patients were analyzed.Results The average age of the 54 patients was (34±5) years and the average duration of gestation was (56± 16) days,all patients' vital sign were stable,the hCG level was 23-142 962 U/L before treatment.Twelve patients were diagnosed with CSP1 by MRI,and 5 of them had focus of 1-2 cm in diameter,the 5 patients' serum hCG level was 436-1 159 U/L and 23-32 days after drug administration,their hCG level returned to normal; the other 7 patients had focus of 2.0-4.4 cm in diameter,and their hCG level was 2 218-63 446 U/L,lesion resection was done on the 7 patients by hysteroscope or under B-uhrasound monitor.Forty-two patients were diagnosed with CSP2,and their focus were 1.0-7.1 cm in diameter,and serum hCG level were 23-142 962 U/L.We did bilateral uterine artery occlusion by laparoscope or laparotomy during operation for 22 patients or bilateral uterine artery embolization (UAE) before operation for 20 patients,then we did lesion resections.The blood loss during operation of CSP1 or CSP 2 was 50.1,267.2 ml; operation time was 30,128 minutes; postoperative hospital stay was 4.6,6.7 days;their serum hCG returned to normal 13-30 days after the surgery.All the 54 patients' uterus were preserved,and the patients undergoing operations were all cured without the second operation.Conclusion MRI is an effective method to conduct clinical treatment in CSP.

Objective To investigatethe constituents of enteroviruse which can cause hand‐foot‐and‐mouth disease(HFMD) ,and prevent against the development of new prevailing strains and provide basis for prevention and control of HFMD in Luoyang city . Methods Reverse‐transcription polymerase chain reaction (RT‐PCR) was used to identify the type of RNA of stool specimen of HFMD cases in Luoyang ,to distinguish the subtype of strain ,9 enterovirus‐positive specimens which coxcackie virusA16(CA16)‐and enterovirus71(EV71)‐negative were selected randomly for 5′UTR sequencing .strain‐specific primers were used to detect posi‐tive samples in 75 CA16‐ and EV71‐negative but other enterovirus‐positive specimens by using real time RT‐PCR .Composition characteristics of CA6 were further analyzed .Results Primary screening was conducted with the results of 5′UTR sequencing of 9 commonent erovirus‐positive specimens and there were 5 CA6‐positive ,which were prevailing strains;there were 20 CA6‐positive of 75 commonenterovirus‐positive specimens ,the proportion of CA6‐positive in enterovirus‐positive specimens was 29 .76% (25/84) . Thirteen samples were collected from male and 12 from female ,2 cases resulted in severe symptoms ,5 from city and 20 from coun‐try .Conclusion The composition of commonent erovirus which results in HFMD was complex and the proportion of CA6 was higher ,which should be pay more attention .

Using the technique of fluorescent-labled mRNA differential display, new apoptosis related gene 2ass-bnip3 of type 2 diabetic cardiomyopathy was found, the sequence of 1594 bp with coding 187 amino acids was obtained by the full-length clone, and its structural and functional predictions were performed. 2ass-bnip3 may play an important role in the development of diabetic cardiomyopathy via a regulatory pathway of calcium regulation and apoptosis.

Objective To investigate the effects of fresh lumbar osteoporotic vertebral compression fracture (OVCF) on spinopelvic sagittal parameters and distribution of Roussouly types.Methods One hundred and eight patients with one-level fresh lumbar OVCF and 110 patients with simple osteoporosis (OP) were diagnosed and treated at Department of Orthopedic Surgery,Shougang Hospital from January 2016 to August 2017.The basic clinical data of all the patients were documented and their lumber spines were classified by Roussouly types.The 2 groups were compared in terms of spinopelvic sagittal parameters such as pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),and lumbar lordosis (LL) and Roussouly types.The correlation between Roussouly types and fracture segments was observed in OVCF group.Results There was no significant different in PI between OVCF and OP groups (50.35° ± 11.00° versus 51.96° ± 11.73°) (P ＞ 0.05).PT in OVCF group (18.79°± 9.51°) was significantly larger than that (16.19°± 9.03°) in OP group while SS (31.56° ± 7.88°) and LL (40.22°± 12.29°) in the former significantly smaller than those in the latter (35.77° ± 8.82° and 47.89° ± 13.20°,respectively) (P ＜ 0.05).Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OVCF group were 35,40,28 and 5 cases,respectively,with types Ⅰ and Ⅱ accounting for 69.5％;Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OP group were 17,30,49 and 14 cases,respectively,with type Ⅲ being predominant (44.5％).There was a significant difference between the 2 groups in distribution of Roussouly types (P ＜03.05).In OVCF group,fractures of L1 and L2 vertebrae accounted for 82.4％.There was a significant correlation between fracture segments and lumbar Roussouly types (P =0.034).Conclusions Patients with fresh lumbar OVCF tend to have a forward gravity and sagittal disequilibrium,leading to posterior pelvic rotation,increased PT,decreased SS,and downward shift of the apex of the lumbar curve.Their Roussouly classification is mainly type Ⅰ or type Ⅱ.