Objective To analyze the clinical effects of sinus tarsi approach with minimal-inva-sive percutaneous screw fixation of calcaneal fractures. Methods From February 2014 to July 2015,28 ca-ses of calcaneal fracture patients(Sanders Ⅰ ~ Ⅲ)were treated with minimal-invasive percutaneous screw fixation via sinus tarsi approach in our department. There were 18 males and 10 females with age ranging from 16 to 68 years(mean,32 years). According to the classification of Sanders,six cases were classified as Type I,twelve as Type Ⅱ,and ten as Type Ⅲ. The Bohler angle and Gissane angle were compared be-fore and after operation. Clinical results were evaluated with the Maryland foot scoring system. Results All the patients were followed up for 14 to 20 months(mean,15. 5 months). Anatomic or almost anatomic reduction was achieved in all patients according to the results of postoperative images. All fractures healed,and the healing time ranged from 4 to 7 months(average,5. 3 months). There was no wound infec-tion,necrosis or bone nonunion. According to the Maryland foot scoring system,16 cases were defined as excellent,10 cases as good,and 2 cases as poor. The good and excellent rate was 92. 8% . Conclusion For calcaneal fractures,sinus tarsi approach with minimal-invasive percutaneous screw fixation has the ad-vantages of small trauma,safe operation,limited complication,and stable fixation,which is a satisfactory clinical treatment.

After autologous transplantation of sciatic nerve segments into the retinae of adult golden hamsters for 1-4 months, anterograde and retrograde labelling with horseradish peroxidase demonstrated that ganglion cell axons have regrown into the peripheral nerve graft for a distance up to 2 cm. The regenerating axons into the grafts were distributed within fan-or beltshaped areas between the sites of grafting and the limbus of the retina, their numbers being greater for grafts near the optic disc than for those in the outer portions of the retina. Histogram of cell soma areas of labelled neurons from retinae with grafts indicated that all normal cell sizes were represented and there was a substantial population of enlarged neurons. Retrograde labelling with fluorescent dyes, Nuclear Yellow, applied to the optic tract and True Blue to the graft, demonstrated that the regenerating axons originated from axotomized ganglion cells rather than by axonal collateral sprouting of undamaged neurons.

A segment of autologous sciatic nerve was transplanted into the 17/18a borderoregion or near the midline of the occipital brain in the adult golden hamsters.After42-131 days survival time,HRP (50% in saline) was administered to the cut endof the graft.It was found that the neurons of different sizes and shapes in visualcortex can be induced to regenerate their fibers into the peripheral nerve graft forup to 10mm;Some of the regenerated cells became larger than that of the normal cells.in the visual cortex,which is similar to that in the retina,but the ability of regenera-tion of the cortical neurons is much lower than that of the retinal ganglion cells.Fluorescent dye double-labelling method was used and it was demonstrated thatthe callosal neurons in visual cortex can regenerate their fibers into peripheral nervegraft,the regenerative fibers originated from axotomized neurons rather than fromcollateral sprouting of undamaged neurons.Predegeneration treatment for the sciaticnerve did not enhance the regeneration of neurons in the visual cortex.Extradamagemade near the graft insertion does not seem to increase the quantity of regenerationcells in the visual cortex.The results of the experiment suggest that peripheral nerve graft can induceregeneration of neurons in visual cortex and the local environment is one of theimportant factors affecting the ability of regeneration of mammalian CNS.

Objective To characterize the systolic torsion in dilated cardiomyopathy (DCM) by velocity vector imaging(VVI).Methods Eighty-seven subjects were studied using VVI:27 patients with DCM and 60 healthy control subjects.Left ventricular short-axis acoustic images were acquired at base and apex levels.The rotation angle and rotation velocity of endocardium and epicardium were measured.Results LVEF of DCM group was significantly lower than that of control group ( P＜0.01).The basal and apical rotation angle, rotation velocity were significantly lower in DCM group.The endocardial and epicardial rotation angle, rotation velocity were also significantly lower in DCM group than those in control group (P＜0.01).Conclusions VVI is a rapid and noninvasive tool to quantitatively assess cardiac torsional deformation in DCM patients,which providing another useful modality for evaluating cardiac function.

Objective To observe the clinical efficacy of coupled plasma filtration adsorption (CPFA) combined with high volume hemofiltration (HVHF) for severe acute pancreatitis (SAP) and explore the practicality, the safety and the therapeutic mechanism. Methods This was a prospective, randomized clinical trail. A total of 29 patients with SAP were di-vided into two groups:treatment group (n=15, CPFA and HVHF) and control group (n=14, HVHF). The APACHEⅡscore, se-rum triglyceride, liver and kidney function, white blood cell (WBC), heart rate (HR), respiration, mean arterial pressure (MAP) and oxygenation index were compared before and after treatment between two groups. The organ function was as-sessed, and the adverse reactions and prognosis were observed in two groups. Results After treatment, there were signifi-cant decreases in APACHEⅡscore and WBC, and significant increase in PaO2/FiO2 in two groups, especially significant in treatment group. There was a significant decrease in the level of triglycerides in 7-d treatment group than that of 3-d treat-ment group (P＜0.05). There were no thrombocytopenia, bleeding, allergies, blood clotting and other adverse reactions in two groups of patients. There were significant decreases in the blood purification time and the length of hospital stay in treatment group than those of control group (P＜0.05). There was no significant difference in mortality between two groups. Conclu-sion CPFA combined with HVHF can effectively control inflammation, reduce the serum level of triglyceride and improve the prognosis in patients with SAP.

Objective To evaluate the expression of WWOX gene in breast cancer and its relation to hypermethylation of WWOX gene CpG island. Methods The expression of WWOX protein was evaluated by immunohistochemical staining in breast cancer cell line and breast cancer tissues.Methylation specific PCR(MSP)was used to check whether it Was methylated in the promoter and exon 1 of WWOX.Results Deletion in the WWOX expression was observed more frequently in invasive breast tumors,(32.2%)than normal breasttissues(5.4%)(P＜0.01).20.3% of premenopause eases were completely negative for WWOX expression compared to 57.2% of postmenopause breast carcinomas(P＜0.01).Furthermore,23.1% of Stage Ⅰ(6/26),28.6%of Stage Ⅱ(10/35),46.2%of Stage Ⅲ(12/26)tunlors showed negative WWOX protein expression.In breast cancer specimens.methylation rate of promoter and exon 1 CpG island of WWOX gene was 55%and 45%respectively.Whereas.WWOX CpG islands of normal mammary tissues were completely unmethylated in all cases.CpG islands of WWOX promoter and exon 1 were methylated in MDA-MB-231 cell line but not MCF-7 cell.Conclusions Some deletion in WWOX expression is common in breast cancer and methylation of WWOX DNA CpG islands plays a crucial role in the silence of WWOX.WWOX may play a role in the carcinogenesis and development of breast cancer.

ObjectiveTo explore the potential value of diffusion weighted imaging(DWI) in the clinical diagnosis of soft-tissue tumors.MethodsDiffusion-weighted MRI was performed in 48 histologically proven soft-tissue tumor cases using diffusion-weighted spin-echo sequences.Of the 48 soft-tissue tumor cases,there were 28 cases of sarcoma and 20 cases of benign tumor.The apparent diffusion coefficient(ADC) values of a large region with no necrosis,scar tissue,hemorrhage or calcification representing the lesion were measured.ADC values of benign tumors,malignant tumors and normal muscles were compared.ResultsThe ADC value of the malignant tumors (0.95 ± 0.31 )× 10-3mm2/s was significantly lower than that of benign lesions( 1.87 ±0.66) × 10-3mm2/s and muscles( 1.62 ±0.50) × 10 -3mm2/s.There was no significant difference in ADC value between benign lesions and muscles.Sensitivity(75％ ) and specificity(89％ ) were obtained when the ADC value was 1.38 × 10-3mm2/s in the differentiation of benign and malignant tumors.ConclusionDiffusion-weighted MRI had potential value in differentiating benign softtissue tumors from malignant ones.

Objective To compare the therapeutic effects of locking compression plate distal ulna hook plate (LCP-DUHP) and cannulated screws in the internal fixation for fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ.Methods This retrospective study included 67 patients who had been treated for fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ from July 2013 through December 2015.Of them,29 were treated by internal fixation with cannulated screws,including 17 men and 12 women with an average age of 46.6 years.There were 13 zone Ⅰ fractures and 16 zone Ⅱ fractures according to the Lawrence-Botte partition.The other 38 patients were treated by internal fixation with LCP-DUHP,including 20 men and 18 women with an average age of 33.7 years.There were 20 zone Ⅰ fractures and 18 zone Ⅱ fractures according to the Lawrence-Botte partition.The therapeutic effects were evaluated at the final follow-ups using visual analogue scale (VAS) for the affected feet,American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system,and incidence of postoperative complications.Results All this series were followed up for 51 to 87 weeks (average,57weeks).There were no significant differences between the cannulated screws group and the LCP-DUHP group in terms of fracture healing time (13.9 ± 1.6 weeks versus 14.2 ± 1.8 weeks),VAS scores (4.9 ± 1.3 versus 4.8 ± 1.O) or AOFAS midfoot scores (87.9 ± 3.4 versus 88.6 ± 2.5) (P ＞ 0.05).Bony union was achieved in all.No implant failure was observed in this series.Conclusion Both LCP-DUHP and cannulated screws can lead to satisfactory therapeutic effects in the treatment of fractures of the fifth metatarsal base at zones Ⅰ and Ⅱ.

Objective To investigate the regulatory effects of cyclic diguanylate (c-di-GMP) signaling on CheB and CheR, which were chemotaxis regulatory proteins relating to the motility of Leptospira interrogans.Methods Real-time PCR was used to determine the expression of cheB1, cheB2, cheB3, cheR1 and cheR2 genes at mRNA level during Leptospira interrogans infection.Fragments of these genes were amplified and cloned into the expression vector pET-28a, respectively, to construct the prokaryotic expression system for them.Colony morphologies of Escherichia coli (E.coli) strains that overexpressed the target genes were observed to determine the regulatory effects of c-di-GMP on CheB and CheR.Results The expression of cheB1 gene at mRNA level increased 60 min after infection and reached the peak at 90 min.Compared with the control group, the expression of cheB3 gene at mRNA level were up-regulated, while no significant difference in the expression of cheB2 and cheR genes was observed 60 min after infection.The prokaryotic expression system for the five genes was successfully constructed and the purified proteins were obtained.CheB1, CheB3 and CheR2 improved the motility of E.coli, but that was inhibited by the inhibitor of diguanylate cyclase (DGC) or phosphodiesterase (PDE).Conclusion CheB and CheR regulate the swarming motility of E.coli and are affected by intracellular c-di-GMP.

Objective To propose SHA.LIN nephrolithometry scoring system for assessing and predicting the stone-free rate of percutaneous nephrolithotomy ( PCNL) and to investigate the clinical value of SHA.LIN scoring system for nephrolithiasis in patients undergoing PCNL .Methods A literature review from 1976 to 2014 was performed to identify clinically relevant and reproducible variables that could affect the outcomes of PCNL. Six reproducible variables available from preoperative noncontrast-enhanced computed tomography were measured , including stone size ( S) , hydronephrosis ( H) , anatomic distribution (A), length of tract(L), indicator of CT(I), number of involved calices(N) and was named as SHA.LIN nephrolithometry scoring system .A retrospective analysis was conducted of clinical data of 116 patients with nephrolithiasis undergoing PCNL from June 2011 to March 2015. The general conditions , preoperative information , stone characteristics and perioperative variables were collected . The correlation of nephrolithometry scores based on SHA.LIN scoring system with stone-free status, operation time, blood loss, length of hospital stay and postoperative complications were analyzed . Receiver operating characteristic ( ROC) curves was drawn to detect sensitivity and specificity of SHA .LIN score in predicting the stone-free rates of PCNL.Results The SHA.LIN score was 9.13 ±2.24 in this cohort.The stone free rate was 75.9%(88/116).Postoperative complications occurred in 32 (27.6%) cases.In those patients with stone
free, the SHA.LIN score was 8.27 ±1.62, significantly lower than that in those patients with residual stones 11.86 ±1.72 ( t =-10.069, P=0.000) .The SHA.LIN score showed significant correlation with the postoperative stone free status, operation time, estimated blood loss (P<0.01).But, it did not correlate with postoperative complications and length of hospital stay (P>0.05).The area under curve of ROC curves for the SHA.LIN scoring system was 0.923 ( 95%CI 0.870 -0.975 ) . Conclusions The SHA.LIN nephrolithometry scoring system can predict postoperative stone-free status of PCNL and can be used for disease related assessment.Further research is required to evaluate its performance in predicting peri-operative variables and postoperative complications .