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.

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

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

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 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.

BACKGROUND:Discectomy and pedicle fixation fusion are golden standard to repair lumbar degenerative disease, but the treatment would induce other complications such as degeneration of adjacent segments or severer pre-existing spinal degeneration. For the problem of lumbar fusion and fixation, lumbar elastic fixation has recently been a hot focus. ＜br> OBJECTIVE:To evaluate the short-term effectiveness of dynamic lumbar pedicle fixation in repair of lumbar spinal stenosis and lumbar disc herniation. ＜br> METHODS:From December 2010 to December 2012, 62 cases of lumbar spinal stenosis and lumbar disc herniation treated with lumbar dynamic system were included. The involved segments included:5 cases at L 3/4 , 20 cases at L 4/5 , 20 cases at L 5 S 1 , 6 cases at double segment L 3/4 and L 4/5, 8 cases at double segment L 4/5 , L 5 S 1 , 3 cases at L 3/4 and L 5 S 1 . There were 34 males and 28 females with an average age of 50.8 years (range 32 to 72 years). According to different fixation systems, they were assigned to three groups:general dynamic lumbar fixation system in 17 cases, K-Rod posterior dynamic stabilization system in 28 cases, and Dynesys system in 17 cases. The fol ow-up time was from 24 to 48 months. Evaluation indexes included visual analogue scale, Oswestry disability index, imaging analysis and excellent and good rate of curative effects. ＜br> RESULTS AND CONCLUSION:Compared with before treatment, visual analogue scale score and Oswestry disability index were significantly improved at 6 months after treatment and final fol ow-up (P＜0.01). No apparent changes were detected in the length of inserted segments and adjacent segments before treatment and during final fol ow-up. There were no significant differences in the excellent and good rate in each group after treatment (P>0.05). These data indicated that the lumbar dynamic system was an effective option for lumbar disc herniation and spinal stenosis. Although there are some differences in the structure of three kinds of flexible fixation, no obvious difference in early therapeutic effects was detected. Long-term effects deserve further investigations.

Objective To evaluate the expression of KAII (CD82) gene inhibited by small interfering RNA (siRNA) in human pancreatic cancer cell line T3. Methods Four sequences of siRNA including A, B,C, D were designed, which were based on the KAI1 gene sequence using online RNA interfering designing software and lentivirus vector was built. Then they were used to transfect T3 cells by liposome 2000 and virus titer was determined. Empty vector containing siRNAd1 lentivrus particle ( MOI =5) was also used to infect T3 cells. The expression of CD82 mRNA was detected by real-time PCR. Results The expression of CD82 mRNA in normal control group, empty vector group, A group, B group, C group, D group were 1. 398 ±0.242,1. 311±0.048, 0. 664 + 0. 093, 0. 345 ± 0. 032, 0. 641 ± 0. 049 and 0. 147 ± 0. 049, respectively, the difference between the expression of CD82 mRNA in empty vector group and that of A, B, C, D groups was significant (P＜0.01 ). Conclusions RNAi was able to inhibit the expression of KAI1 gene CD82 in human pancreatic cancer cell line T3.

Objective To analyze the imaging features and to enhance the understanding of pancreatic and renal involvement in yon Hippel-Lindau disease (VHLD). Methods CT and MRI appearances and clinical data of six patients with pancreatic and renal involvement in VHLD were studied retrospectively.Six patients underwent CT scanning, and two of them also had MRI.Results Pancreatic cysts found in all six patients varied from several small cysts to cystic replacement of the entire gland.Calcifications were detected in four patients. Multiple bilateral renal lesions were detected in six patients.The renal lesions were classified as cystic, cystic with solid components and solid.Multiple combined renal lesions were found in five patients, and multiple simple cysts in one patient.Unilateral nephrectomy was performed in two patients, and the renal masses were diagnosed as clear cell carcinoma by pathology.Bile carcinoid was found in one patient, and retroperitoneal metastasis in another.Conclusion Multiple pancreatic cysts and/or multiple and bilateral combined renal lesions are highly suggestive of VHLD.