OBJECTIVETo compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws.

METHODSFrom January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect.

RESULTSAll patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group.

CONCLUSIONLocking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; surgery ; Treatment Outcome

Objective To evaluate the safety of dynamic anterior plate fixation for cervical distractive flexion injuries and compare its rigidity between different types of plate design. Methods Twelve sets of cadaveric calf spine were used in this test. All the specimens were made into distractive flexion injury models (C4-C5) ac- cording to Allen's method. After discectomy and grafting, they were randomized into three groups in which Orion, Codman, and Window instrumentations were used respectively. The stiffness of each construct was tested in flexion, extension, lateral bending and axial torsion conditions sequentially. Results Compared with an intact cervical spine, the range of motion (ROM) of an injured cervical spine increased whatever plate was applied. Orion in- strumentation presented stiffness the closest to that of the normal control, except for less torsional stiffness. Codman instrumentation provided stiffness close to that for normal and Orion groups only in lateral bending. Window's was the weakest mad not enough in all kinds of movement. Conclusions Static anterior fixation is the first choice for cervical injuries. Dynamic plate fixation may sacrifice stiffness to some extent, especially when a shifting kind of design is to be chosen.

In this paper, a detailed analysis was made on relevant literatures about bear bile powder in terms of chemical component, pharmacological effect and clinical efficacy, indicating bear bile powder's significant pharmacological effects and clinical application in treating various diseases. Due to the complex composition, bear bile powder is relatively toxic. Therefore, efforts shall be made to study bear bile powder's pharmacological effects, clinical application, chemical composition and toxic side-effects, with the aim to provide a scientific basis for widespread reasonable clinical application of bear bile powder.
Animals ; Bile ; chemistry ; metabolism ; Bile Acids and Salts ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Powders ; chemistry ; metabolism ; pharmacology ; Ursidae ; metabolism

Objective To investigate the correlation between Dishevelled protein expression and the proliferation and invasion of glioma cells.Methods 67 cases of brain glioma specimens were collected.The expression of Dishevelled protein was detected with immunohistochemical method.The immunoreactivity score (IRS) of Dishevelled protein,and proliferation index (PⅠ) and invasion index (Ⅱ) were measured and their correlations were analyzed.Results The positive rate of Dishevelled protein in glioma was 65.7 ％ (44/67).IRS,PⅠ and Ⅱ were 4.15±3.13,(30.93±17.92) ％,(20.38±13.36) ％,respectively.Both PⅠ and Ⅱ significantly increased with an increase in the pathological grade of brain glioma (P ＜ 0.001).Furthermore,PⅠ and Ⅱ were significantly higher in the Dishevelled protein-positive group than those in the Dishevelled protein-negative group [(38.27±17.60) ％ vs (16.02±8.92) ％ of PⅠ and (30.03±13.81) ％ vs (10.63±4.41) ％ of Ⅱ,respectively,P ＜ 0.001].PⅠ and Ⅱ of glioma cells were positively correlated with IRS of Dishevelled protein (r =0.940 between PⅠ and IRS,and r =0.953 between Ⅱ and IRS,respectively).Conclusion Dishevelled protein plays an important role in the proliferation and invasion of brain malignant glioma.

[Abstract] Objective To evaluate the effect of Mycobacterium tuberculosis Direct Assay (MTD) for rapid detecting Mycobacterium tuberculosis rRNA and Multi-locus PCR for M.bovis BCG strain typing in patients with suspected extra-pulmonary tuberculosis.Methods From June 2010 to December 2011,47 children and 75 adult patients with suspected extra-pulmonary tuberculosis in Shanghai public health clinical center were recruited.Also 48 non-tuberculosis patients were taken as a negative control.Clinical specimens from these patients were collected.Acid fast stain,solid culture,liquid culture,and MTD were used to detect all clinical specimens simultaneously.Screen tuberculosis strains of the culture isolates by MPT64 antigen assay and use Multi-locus PCR for the BCG strain genotyping of the isolates without MPT64 antigen.SPSS16.0 was used to analyse the results.Results The sensitivity for acid fast stain,solid culture,liquid culture and MTD test was 10.7％ (13/122),11.5％ (14/122),16.4％ (20/122) and 37.7％ (46/122),respectively.And the specificity of MTD was 100.0％.Six clinical isolates from children were identified as BCG by Multi-locus PCR typing,the same with chemical tests.Conclusions The MTD assay and the MGIT960 liquid culture are effective and reliable method for diagnosing extra-pulmonary tuberculosis.And Multi-locus PCR can be assisted for the early diagnosis of extra-pulmonary tuberculosis patients with suspected BCG infection.

Objective:To summarize and analyze the disease characteristics of the patients in Chinese Level-II Hospital for UN Peacekeepers in Liberia,for offering some references to the pre-mission training of the successive contingents as well as the improvement of medical support to the peacekeeping mission.Methods:A statistical analysis was made of the case history of all the outpatients and inpatients received in Chinese Level-Ⅱ Hospital for UN Peacekeepers in Liberia from May 2004 to December 2005. Results:Out of the total of 7107 outpatients,2539(35.7%) were medical cases,1205(17.0%) surgical,1136(16.0%) dental,787(11.1%) dermatological and 763(10.7%) contagious cases.Malaria was the main type of contagious disease,which accounted for 86.1% of all the contagious cases.There were 39 cases of AIDS/HIV(acquired immunodeficiency syndrome / human immunodeficiency virus).Of the 453 inpatients,233(51.4%) were contagious and 166(36.7%) medical cases,and 185(40.8%) of the total number suffered from malaria.The average hospital stay was 5.2 days.Conclusion:Adequate drugs and equipments should be prepared for both common and special diseases in the peacekeeping mission area.During the pre-mission training at home,special emphasis should be laid on the prevention and treatment of common diseases and frequently occurring diseases,particularly on the diagnosis of and protection against AIDS.

Objective To develop a spectrophotometry in tetra component complex system of A1-CAS-CTMAB-OP for the determination of aluminum in floured food.Methods The sample was processed by combustion and the content of aluminum in foods was determined by spectrophotometry with Al-CAS-CTMAB-OP as color system.Results A linear relationship between the aluminum content and absorbency was in the range of 0.04～0.32 ?g/ml with the regression equation equating to A =3.551 2x-0.005 34,the correlation coefficient was 0.997 6,the detection limit was 0.001 4 ?g/ml and the recovery rate was in the rang of 98.6%～ 103.2%.Conclusion This method has been applied successfully to determine the aluminum in floured food for its special features, such as simple,rapid and accuracy.

Objective To investigate the clinical efficacy of laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach.Methods The clinical data of 68 patients who underwent laparoscopic anatomical hepatectomy by Glissonean pedicle transection approach at the Southwest Hospital of Third Military Medical University between March 2009 and December 2013 were retrospectively analyzed.All the patients received intravenous-inhalation general anesthesia.The splitting of liver was carried out after Glissonean pedicles were completely dissected and occluded under the laparoscope according to anatomical structure.The patients with hepatolithiasis underwent intraoperative bile duct exploration and stone removal with T-tube placement based on the conditions of extrahepatic biliary lesions.The fragmented specimens from benign lesions of liver were taken out through a Trocar hole with the diameter of 12mm.The complete specimens from malignancy tumors of liver were taken out through an enlarged Trocar hole or transverse incision at the symphysis pubis.According to the recheck results of benign and malignancy lesions,the patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as (x) ± s.The survival curve was drawn by Kaplan-Meier method.Results Among the 68 patients,laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach was performed on 64 patients and 4 patients were coverted to open surgery.Laparoscopic anatomical left hemihepatectomy was performed on 30 patients,anatomical right hemihepatectomy on 19 patients,anatomical right posterior lobectomy on 10 patients and anatomical right anterior lobectomy on 9 patients.The mean operation time,volume of intraoperative blood loss,rate of perioperative blood transfusion,time of postoperative gastrointestinal function recovery and duration of hospital stay were (224 ± 117)minutes,(413 ± 349) mL,5.9％ (4/68),(3.0 ± 0.5) days and (8.0 ± 3.0) days,respectively.There was no perioperative death,and 6 patients with postoperative complication were cured by symptomatic treatment.The tumor diameter and distance to resection margin in 29 patients with malignancy tumors of liver were (4.4 ± 1.6) cm and (2.0 ± 0.9)cm,respectively.The results of pathological examination showed that hepatolithiasis was detected in 22 patients,cavernous hemangioma of liver in 12 patients,hepatic focal nodular hyperplasia in 1 patient,hepatic adenoma in 1 patient,hepatic angiomyolipoma in 1 patient,hepatic multiple cysts in 1 patient,hepatic tuberculosis in 1 patient,hepatocellular carcinoma in 27 patients and cholangiocarcinoma in 2 patients.All the 68 patients were followed up for 6-60 months with a mean time of 24 months.No recurrence and residual stones or lesions in 39 patients with benign lesions of liver were detected during the follow-up.The 1-,3-,5-year overall survival rates and tumor-free survival rates in 29 patients with malignant tumors of liver were 92％,84％,60％ and 83％,59％,42％,respectively.Conclnsion Laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach is safe and feasible,and is suitable not only for left hemihepatectomy,but also for right hemihepatectomy of high technical specification.

Objective Overexpressions of epidermal growth factor(EGF)and EGF receptor have been associ- ated with progression and invasive phenotype of pancreatic cancer.However,the underlying molecular mechanism by which EGF worked in pancreatic cancer cells has not been completely understood.In this study,effect of EGF on the invasion and metastasis of pancreatic cancer cells and its regulatory mechanism were investigated.Methods The effects of EGF on the proliferation,adhesion and invasion of pancreatic cancer cells were detected by WST-1 prolif- eration assay,adhesion assay and invasive assay,respectively.The activity and expression of MMP-2 and MMP-9 were examined by zymography,Western blot and RT-PCR,respectively.The activity of NF-?B was examined by EMSA.Results EGF could significantly promote the invasiveness of pancreatic cancer cells but did not affect cell proliferation or adhesion.The expressions of NF-?B and MMP-9 were significantly increased by EGF,but EGF did not affect the activity and expression of MMP-2.Furthermore,EGF stimulated the NF-?B binding activity.Pre- treatment with NF-?B inhibitors,pyrrolidine dithiocarbamate(PDTC),could significantly inhibit the activity of NF-?B induced by EGF.Meanwhile,the EGF-induced expression and activity of MMP-9,as well as cell invasiveness were also inhibited by NF-?B inhibitor.Conclusion EGF could increase the expression and promote the invasiveness of MMP-9 via the activation of NF-?B in pancreatic cancer cells,which implies that NF-?B inhibitant,such as PDTC,may diminish the invasiveness of pancreatic cancer cells.

Objective To develop mycobacterial inducible expression vectors which permit to overexpress Mycobacterium tuberculosis (Mtb) immunodominant antigen, and to analyze its immunogenicity after purification by affinity chromatography. Methods The regulatory region of M. smegmatis (Ms) acet-amidase(pACE) was obtained by PCR amplification, and was used as promoter to construct the mycobacteri-al inducible expression vectors, pMF series. The coding gene of Mtb chimeric antigen Ag856A2 which is a recombinant Ag85A with 2 copies of ESAT-6 inserted in its Acc Ⅰ site and showed excellent immunogenicity in the animal experiments we described previously, was cloned into the pMF vector series, and was induced to express by the addition of acetamide. The recombinant protein expressed in the Ms was purified by the Ni~(2+)-NTA affinity chromatography, the resulted homologous recombinant antigen was added into the spleen cells separated from BCG vaccinated mice, and the immunogenicity was analyzed by the IFN-γ ELISPOT as-say. Results The mycobacterial inducible expression vectors, pMF series was constructed successfully, target antigen could be. induced to express in the Ms by the addition of 0.02% acetamide, and could be puri-fied by the Ni~(2+) -NTA affinity chromatography due to the addition of 6×His tag in the vector pMF406. Fur-thermore, the mycobactefial homologous antigen could induce more IFN-γ secretion than the heterogonous one. Conclusion The mycobacterial inducible expression system based on the regulatory region of Ms acet-amidase as promoter could permit the Mtb target antigen of interest overexpression and purification, and the immunogenicity of the homologous antigen from Ms is better than that of be expressed from E. coli, which may be more potential for immunological detection of tuberculosis.