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 investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.

Adult ; Agriculture ; Antibody Formation ; Female ; Humans ; Immunity, Cellular ; Male ; Middle Aged ; Occupational Exposure

Adenocarcinoma ; drug therapy ; pathology ; surgery ; Adenoma, Villous ; drug therapy ; pathology ; surgery ; Adult ; Cell Transformation, Neoplastic ; Follow-Up Studies ; Humans ; Male ; Neoplasm Recurrence, Local ; Urinary Bladder Neoplasms ; drug therapy ; pathology ; surgery

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 evolution of cognitive function and its influence factors,so as to provide evidence for guiding treatment of cognitive impairment after stroke.Methods A total of 98 cases of patients with stroke admitted in the First and Second Affiliated Hospital of Medical College of Xi'an Jiaotong University and Shaanxi Provincial People's Hospital between April and September 2009 were enrolled and recruited.Mini-mental state examination(MMSE) and Montreal cognitive function rating scale (MoCA) were adopted to assess the evolution of cognition at acute phase( within 2 weeks),6 weeks,and 12 weeks after stroke among patients within 2 weeks after onset,questionnaire score≤56,without aphasia and consiousness disturbance and at least one side of upper extremities muscle force ≥ grade 3.Results When using MMSE scale as criteria,the incidence of cognitive impairment was 24.5% at acute phase,12.1% at 6 weeks and 9.9% at 12 weeks after stroke,while the incidence was 86.8%,68.2%,and 38.0% respectively when using MoCA scale as criteria.The scales of MMSE and MoCA were increased and the incidence of cognitive impairment was decreased within 12 weeks after stroke.Logistic regression analysis indicated that,advanced age( β = -0.124 ),hypertension ( β = -3.705 ),low education level ( β = 0.560 )and depression after stroke ( β =4.613 ) were related with cognitive impairment after stroke ( all P values ＜0.05 ); low education level ( β = 0.710 ),coronary heart disease ( β = -3.649 ),elevated total cholesterol (TC) ( β = -3.361 ) and low density lipid cholesterol (LDL-C) ( β = - 5.833 ),and depression ( β =-3.612) delayed recovery of cognition after stroke.Conclusions The cognitive function improves and the incidence of cognitive impairment lowers as the time goes on within 12 weeks after stroke.The factors that may affect the improvement of cognitive function include low educational level,coronary heart disease,elevated TC and LDL-C,and post-stroke depression.

Objective:To explore the expression of mammalian target of rapamycin (mTOR)and its relationgship with the prognosis of breast cancer,and to provide evidence-based basis for the using of mTOR inhibitor in the treatment of breast cancer.Methods: A systemical literature search was conducted based on the following databases:PubMed,EMBbase,Cochrane Library,ISI Web of Science,and CNKI up to November 24,2015.The outcome measures were hazard ratio (HR)with 95% confidence interval (CI) for the association between the mTOR expression and the prognosis of patients with breast cancer.The primary end points including disease-free survival (DFS ), and overall survival (OS ). STATA 12.0 was used to conduct the statistical analysis. Results:A total of seven cohort studies,1 758 patients were included. The risk of recurrence and metastasis of the breast cancer patients with positive expression of mTOR was 2.05 times of the patients with negative expression of mTOR (HR= 2.05, 95% CI: 1.01 - 4.13,P = 0.003);the risk of death in the breast cancer patients with positive expression of mTOR was 2.63 times of the patients with negative expression of mTOR (HR = 2.63, 95%CI:1.45-4.80,P = 0.736).Conclusion:The positive expression of mTOR can significantly increase the recurrence,metastasis and death risk of the patients with breast cancer.

Objective To investigate the value of shear wave elastography (SWE)on characterizing components and identifying the vulnerability of atherosclerotic plaques in vivo on a rabbit model.Methods The accuracy,as well as the inter-and intra-observer variance of quantifying the Young's modulus by SWE technique was first evaluated with the CIRS? phantoms as the golden standard.Animal model was developed by abdominal aorta endothelium denudation and high-cholesterol diet for 24 weeks on 20 purebred New Zealand rabbits.SWE images of atherosclerotic plaques found in the abdominal aortas were acquired in situ to acquire the Young's modulus.Then the plaques were harvested and matched with the distance between the right renal artery and the plaques recorded during SWE imaging.Histological slices were stained for fat,collagen,smooth muscle cells (SMC)and macrophages by Oil O red,picric Sirius red and anti-α-SMC,anti-RAM-1 1 immunohistology.Vulnerability index was also calculated as the percentage of (macrophage+fat)/(smooth muscle cell+collagen ).The correlation between the Young's modulus and plaque components and vulnerability index was analyzed.The value of SWE on differentiating plaque types was evaluated by ROC analysis.Results High agreement was found between the estimated Young's modulus by SWE and the gold standard.The coefficient of variant of inter-and intra-observer was very low at the range of 1.0%-3.8%.Ten fatty and twenty fibro-fatty plaques were obtained,totally.The maximal and mean Young's moduli of the fatty plaque were (49.90±22.95)kPa and (40.15±22.60)kPa,which were lower than those of the fibro-fatty plaques [(88.49±37.27)kPa and (72.93±29.21)kPa,respectively].The maximal Young's modulus obtained by SWE correlated positively with collagen and SMC (r =0.567 and 0.561,respectively with P <0.001),and negatively with fat and macrophage infiltration (r =-0.542 and-00.482,respectively with P <0.005).The mean Young's modulus also correlated positively with collagen and SMC (r=0.532 and 0.550,respectively with P <0.05),and negatively with fat and macrophage (r=-0.527 and -0.421,respectively with P <0.05).The same inclination could be observed between the minimal Young's modulus and the above components without statistical significance.Both the maximal and the mean Young's modulus correlated negatively with the vulnerable index (r =-0.620 and -0.619, respectively with P <0.001 ).ROC analysis revealed high sensitivity (85%)and specificity (80%)for differentiating fatty plaques from fibro-fatty plaques by Young's modulus.Conclusions SWE can be used for estimation of the Young's modulus of atherosclerotic plaques with high accuracy and reproducibility. Good correlation is evidenced between the Young's modulus and plaque components and vulnerability.Fatty and fibro-fatty plaques can be differentiated by Young's modulus with high sensitivity and specificity.Thus, SWE technique is promising for identifying vulnerable plaques.

Objective To determine the incidence of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture and to investigate the multiple factors correlated to avascular femoral head necrosis.Methods All the patients of intra-capsular femoral neck fracture who accepted closed reduction and cannulated compression screws fixation between 2001 and 2010 in Jiangsu Province were reviewed in multi-centers retrospectively.The multiple factors were analyzed including age,gender,affected side,mechanism of injury,fracture classification,procedure delay,quality of reduction,time of full-weight-bearing,configuration of the screws and removal of the screws.Multiple correlation factors were analyzed with SPSS 13.0 statistic system.Results Complete case records were documented in 1849 cases who were followed up for an average 6.5±2.7 years (range,2-10 years).Avascular necrosis occurred in 246 cases (13.3％).The average time of diagnosis of avascular necrosis was 17±4.6months (range,8-72 months) after injury.The average Harris score of the hips which didn't develop to avascular necrosis was 93.8±8.9 (range,78～100) at the last follow up.Multiple correlation factors analysis indicated that displacement degrees of fracture and the quality of reduction were significantly correlated to the incidence of avascular necrosis (OR=2.078,3.423).Conclusion Closed reduction and cannulated compression screws fixation after the intra-capsular femoral neck fracture can get satisfactory results.Displacement degrees of fracture and the quality of reduction are significantly correlated to the incidence of avascular femoral head necrosis.

To study the changes of pupil diameter and its effects during phacoemulsification. METHODS: Block design, prospective study. 60 cataract patients (60 eyes) were selected, which divided into two groups according to the age, young age group (group A, 20 eyes of 20 patients) and older age group (group B, 40 eyes of 40 patients). Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase: before the corneal tunnel incision ( t1 ) , after injection of sodium hyalurantae ( t2 ) , before artificial lens implantation (t3), at the end of the surgery ( t4 ). Statistical analysis of data using SPSS18. 0 software.RESULTS: The pupil diameter measurements of t1-t4 were followed respectively:group A were 8. 36 ± 0. 65, 8. 97±0. 50, 8. 67±0. 63, 8. 72±0. 96mm; group B were 7. 73± 0. 58, 8. 23 ± 0. 59, 7. 89 ± 0. 16, 7. 70 ± 0. 63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase ( F = 26. 696, P< 0. 05 ). Comparisons between the two groups at different time points: the pupil diameter of t1-t4 in group A was larger than that in group B, with statistically differences (P<0. 05). The pupil diameter of each groups had a tendency to change in different operation phrases, with no statistically differences (F=2. 617,P>0. 05). Comparisons in a group at different time points: the pupil diameter of t2 was larger than that in t1, with statistically differences ( P>0. 05), the pupil diameter of t3 and t4 were decreased in group B, with statistically differences (P<0. 05).CONCLUSlON: Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.