Objective: To review the research progress of wrist arthroscopy assisted treatment of distal radius fractures. Methods: To summarize and describe the anatomical characteristics and fracture classification of the distal radius, indications and contraindications of wrist arthroscopy-assisted treatment, surgical methods, and associated soft tissue injuries, and summarize the advantages and disadvantages of the operation through a large number of literature at home and abroad on the treatment of distal radius fractures assisted by wrist arthroscopy. Results: Wrist arthroscopy as a minimally invasive technique for the treatment of distal radius fractures, compared with traditional surgery, can accurately observe intra-articular damage and perform operations under the microscope to avoid secondary damage to blood vessels, nerve, and tendon, etc., and can achieve one-stage repair and reconstruction by repairing the ligament, trigonal fibrocartilage complex, and carpal dislocation. It has the advantages of less trauma, fast postoperative recovery, extensive indications, fewer complications, and satisfactory effectiveness. Conclusion: Wrist arthroscopy has advantages that traditional X-ray film, CT, MRI, and arthrography examinations do not have. Moreover, wrist arthroscopy has achieved satisfactory effectiveness in the adjuvant treatment of intra-articular distal radius fractures.

Objective To discuss the postoperative complications of hypertensive intracerebral hemorrhage treated with freehand drilling skull minimally invasive puncture drainage therapy .Methods The clinical data of 158 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed .The incidence rate ,causes and preventative measures of the postoperative complications of hypertensive intracerebral hemorrhage treated with free -hand drilling skull minimally invasive puncture drainage therapy were analyzed .Results 10 cases of scalp bleeding , 4 cases of epidural hemorrhage , 9 cases of puncture pathway bleeding , 24 cases of secondary bleeding , 1 case of intracranial infection,3 cases of low intracranial pressure ,5 cases of pneumoencephalos and 2 cases died.Conclusion Freehand drilling skull minimally invasive puncture drainage leads to less complications and so far it is a safe and effective therapy for hypertensive intracerebral hemorrhage .

Objective To investigate the activation of nuclear factor-κB(NF-κB),which was stimulated by angiotensin-Ⅱ(AngⅡ)through classical pathway in human pulmonary microvascular endothehal cells(HPMEC).Method The experiment was divided into two groups:in Ang Ⅱ group,HPMECS were incubated with 10-6mol/L AngⅡ for 0,0.5,1,2 and 4 hours,respectively;in losartan group,HPMEC was pretreated with 10-6mol/L losartan(inhibitor of AngⅡ type 1 receptor)for 1 hour,and then stimulated with 10-6mol/L AngⅡ for 2 hours,and the nucleax protein and the cell plasma protein were prepared by lysis and centrifugation.Electrophoretic mobility shift assay(EMSA)was used to detect the NF-κB DNA binding activity.The inhibitor of κBa(IκBα)was detected by Western blotting.The data were expressed as(x±s)and analyzed with one way analysis of variance.A P value less than 0.05 indicated significant difference.Results Compared with the activity of NF-κB at 0 h (100.0±25.1)after AngⅡstimalation,the activity increased significantly at 0.5 hour(144.5±16.1,P＜0.05),and reached peak value at 2 hours(270.1±27.2,P＜0.05).The concentration of IκBα at 0 hours was 44.4%±2.1%,decreased markedly at 0.5 hours(38.9%±3.6%,P＜0.05),and to the lowest level at 2hours(32.6%±2.3%,P＜0.05).The activity of NF-κB(115.4±10.7)and the concentration of IκBα(43.6%±3.7%)in losartan group had ilo significant difference with AngⅡ group at 0 h(P＞0.05).The activity of NF-κB and the concentration of IκBα in losartan group had significant difference with AngⅡ group at 2hours.Conclusions NF-κB can be activated through classical pathway,which stimulated by AngⅡ in HPMEC.

Objective To investigate the carcinogeic role of miR-365 in cuntanerous squamous cell carcinoma (cSCC).Methods Normal HaCaT cells were divided into control and irradiation groups,the later was exposed by UVB irradiation (50 J/m2).MicroRNA expression profiles of the two groups were analyzed by microRNA array.The expression variations of miR-365 in HaCaT,A431,Tca8113 and HSC-1 cells were validated by qRT-PCR analysis.The colony-forming and invasion capacities were dectected by colony forming assay and Transwell migration assay in vitro,respectively.HaCaTpre-miR365-2 highly expressing miR-365 was constructed by retroviral vector infection.Tumorigenicity evaluation was carried out by subcutaneously inject of the cells at the right back flank of nude mice.Results There were 30 microRNAs differentially expressed in HaCaT cells after UVB irradiation and miR-365 was one of the most sensitive miRNAs(as high 6.7 times as control).Expression of miR-365 in all the cSCC cell lines A431,Tca8113 and HSC-1 were significantly higher than that in HaCaT cell,in which the maximum was A431 (15.67 ±1.12 times,P ＜ 0.01),and the minimum was TcaS113 (4.72 ± 0.85 times,P ＜ 0.05).Knockdown of miR-365 in cSCC cell lines significantly inhibited the colony forming ability (t =13.68,P ＜ 0.05) and cell migration (t =19.98,P ＜ 0.05) in vitro.HaCaT cells overexpressing miR-365 by transient transfection significantly increased the ability of colony formation (t =7.11,P ＜ 0.05) and cell migration (t =22.03,P ＜0.05) in vitro.In addition,HaCaTpre-miR-365-2 cell line stably expressing miR-365 could successfully establish tumors in nude mice.Conclusions MiR-365 is an oncogene for cutaneous squamous cell carcinoma.

Objective To observe the outcomes of toe amputations in diabetic patients and to analyze the affecting factors.Methods Two-hundred and forty-five patients were divided into 2 groups:202 cases with the wound healed after toe amputation,and 43 patients whose wound did not heal after toe amputation.The factors related to healing were analyzed.Patients with healed wounds after toe amputations ( n =202 ) were followed,regarding reappearance of new ulcers,reamputations,mortality,activities of daily life,and the affecting factors.Results The rate of wound healing was 82.4％.The rate of follow-up in the healed group was 91.6％.The rates of reappearance of new ulcers after 1,3,and 5 years of observation were 27.3％,57.2％,76.4％,respectively.The rates of reamputations after 1,3,and 5 years of observation were 17.5％,22.3％,47.1％,respectively.The mortality rates by 1,3,and 5 years after the toe amputations were 3.8％,15.1％,32.7％,respectively.Mean survival time of the fatal cases after the first amputation was 3.8 (95％ CI 3.4-4.1 )years.Multivariate analysis showed that HbA1c (＞9％)was an independent predictor of wound healing,reappearance of new ulcers,and reamputations after toe amputations,and age ( ＞ 70 years ) was an independent predictor of reamputations,mortality,and hampered daily activities.Conclusion Despite a satisfactory initial healing process after the first amputation,the long-term outcomes of the followed-up patients are not optimistic.Senile patients are often with poor prognosis,and good blood glucose control may improve the prognosis.

Objective To explore the guiding role of serum procalcitonin (PCT) in antibiotic therapy during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 72 patients with AECOPD were randomly divided into PCT group (n=40) and conventional therapy group(n=32).For patients in PCT group,the use of antibiotics was based on PCT serum levels,antibiotics were stopped when PCT＜0.25 μg/L,while in conventional treatment group,the use of antibiotics was based on clinical symptoms of patients.The main observation indexes included ratio of antibiotic usage,time of antibiotics use,hospital stay,clinical efficacy,aggravating cases and death cases. Results There were no significant difference in clinical efficacy between the two groups(82.5％ vs.75.8％,x2 =0.217,P=0.641),however,the ratio of antibiotics usage in PCT patients was significantly lower than conventional therapy group (47.5％ vs.71.9％,x2 =4.346,P=0.037),average time of antibiotics use and days of hospital stay were shorter in PCT treatment group than conventional therapy group [(6.84±3.27) d vs.(10.22±3.67)d,x2 =3.116,P=0.003; (11.7±5.2) d vs.(20.3±8.7) d,x2 =5.202,P=0.000].There were no difference in double infection incidence (2.5％ vs.18.8％,x2 =3.657,P=0.056),aggravating cases (3 cases vs.4 cases,x2 =0.097,P=0.756) and mortality (2.5％ vs.6.3％,x2 =0.039,P=0.843) between the two groups.Conclusions Serum PCT level may be an appropriate indicator to guide antibiotic therapy in patients with AECOPD in view of its effective decreases of excessive use of antibiotics,double infection opportunities and hospitalization time.

Objective To summarize and evaluate our surgical approach of tetralogy of Fallot with complete atrioventricular septal defect.Methods 11 patients underwent surgical correction at our institute between June 2007 and April 2012.All of the 11 patients received biventricular or partial biventricular repair through a combined right atrial and right ventricular outflow tract approach.Two-patch technique was used in all 11 children.To minimize the incision in the right ventricular outflow tract(ROVT),8 patients underwent a transatrial approach to close ventricular septal defect.A transannular patch was needed in 7 patients,and a monocuspid valve was inserted in 1 of these patients.Results One hospital death occurred during intensive care stay due to severe low cardiac output syndrome and one late death took place six months after operation because of pneumonia and heart failure.The mean follow-up time was (21.20 ± 19.08) months (range,3-60 months).The KaplanMeier curve for the survival rate was 79.5％ at 5 years.Several postoperative complications occurred during the first 3 months,including 1 mild RVOT obstruction and 1 pulmonary artery stenosis,2 tiny residual atrial septal defects and 1 slight residual ventricular septal defect.Moderate pulmonary valve regurgitation was present in all patients,whether transannular patch was used or not.All survivors remained in good condition in NYHA class Ⅰ or Ⅱ.Conclusion Outcomes of complete correction of tetralogy of Fallot with complete atrioventricular septal defect are favorable during follow-up time.It is feasible to close a ventricular septal defect with a 2-patch technique through a transatrial approach alone.Accurate suturing is the key to the success of the surgery.

Objective To explore neurocognitive characteristics of human immunodeficiency virus (HIV)-infected patients ,and to compare the efficacy of highly active antiretroviral therapy (HAART ) among patients with different cognitive functions .Methods Cognitive function was evaluated using the Montreal cognitive assessment (MoCA) Chinese version in 118 HIV-positive patients and 62 HIV-negative controls .Among 59 patients on HAART ,CD4 + T cell count and viral load were assessed at enrollment and one-year follow-up .The mean of measurement data was compared using t test ,and enumeration data was analyzed using chi-squared or Fisher exact test when appropriate .Univariate and multivariate analysis were examined using bivariate Logistic regression models .Results Compared with control group ,HIV-infected group was characterized by higher rate of neurocognitive impairment (46 .6% vs 12 .9% , t =20 .30 ,P< 0 .05) ,and generally lower MoCA subscores for visuospatial abilities ,the clock drawing test , naming ,attention ,abstraction and delayed recall (t= - 3 .761 , - 2 .638 , - 4 .263 , - 3 .769 , - 3 .858 and- 3 .111 ,respectively ,all P< 0 .05) .Among patients on HAART ,subjects who scored < 26 showed no significant differences in viral load at three time points (pre-HAART ,post-HAART at enrollment and one-year follow-up) with those who scored ≥ 26 (t = 0 .557 ,0 .737 and - 0 .758 ,respectively ,all P >0 .05) .The former group had lower CD4 + T cell counts both at enrollment ([286 ± 127]/μL vs [363 ± 160]/μL) and one-year follow-up ([334 ± 122]/μL vs [411 ± 152]/μL) than the latter group (t= - 2 .027 and - 2 .067 ,respectively ,both P < 0 .05 ) ,while there were no obvious differences of pretreatment CD4 + T cell counts ([135 ± 77]/μL vs [155 ± 80]/μL) and HAART duration ([22 .29 ± 21 .20] months vs [18 .74 ± 16 .63] months) between these two groups (t= - 0 .968 and 0 .702 ,respectively ,both P>0 .05) .Multivariate analysis revealed that age (OR = 1 .044 ,95% CI :1 .008 - 1 .081 , P < 0 .05) and education time (OR = 0 .820 ,95% CI :0 .723 - 0 .930 , P < 0 .05 ) were independent predictors for neurocognitive impairment among HIV-infected patients . Conclusions Neurocognitive impairment is common among HIV-infected patients ,which is characterized by poor performance in multiple domains , and patients with neurocognitive impairment performed poorly in immune recovery .MoCA could be a useful screening tool of cognitive function in HIV-infected patients . Neurocognitive function has no relationship with pre- and post-treatment viral levels .

Objective To establish a canine model with pulmonary thromboembolism(PTE) of selective lobar pulmonary artery embolization mimicking chronic thromboembolism, to assess the effects of an inhaled nitric oxide (NO) 20 ppm on vital signs, blood gas, hemodynamic parameters and neutrophils in the alveolar of the canine model. Methods Twenty canines were divided into four groups: group 1: sham group (n=5); group 2; ischemic lung group (PTE group without embolectomy, n=5); group 3; reperfusion lung group (PTE group with embolectomy, n=5); group 4: reperfusion lung group with inhaled NO (PTE group inhaled 20 ppm NO after embolectomy, n=5). And central venous pressure (CVP), mean pulmonary arterial pressure (MPAP), pulmonary arterial wedge pressure (PAWP) and carbon monoxide (CO) were recorded, pulmonary vascular resistance (PVR) was also calculated. Vital signs, blood gases were measured before embolectomy and at 2, 4, 6 hours after the operation. Albumin in bronchoalveolar lavage fluid (BALF) was measured by chromatometry of Coomassie brilliant blue. Lung wet to dry weight ratio(W/D) was also measured. Lung tissue pathology and alveolar PMN in the left lower lobar were observed by optical microscopy. Results MPAP increased significantly at 2 hours after reperfusion [(3. 20±0.53)kPa vs. (2. 27±0. 67)kPa,F=63,P=0.02]; At 6 hours after reperfusion as compared with baseline,HR increased significantly [(175±8) beats/min vs. (155±5) beats/min, F=38.72, P=0.01],PaO_2/FiO_2 also decreased significantly (41.70±8.04 vs. 54.71±3.78,F=48.36,P=0.03). MPAP decreased significantly in group 4 as compared with group 3 at 2 hours after reperfusion [(2.53±0.4)kPa vs. (3. 20±0. 53)kPa,F=55,P=0.04]. At 4 hours after reperfusion,PaO_2/FiO_2 raised in group 4,but there was no significant difference as compared with group 3 (49.17±7.37 vs. 39.71±7.31, F=2.36, P=0. 11). The quantities of alveolar PMN infiltration in group 4 decreased significantly as compared with group 3 (19±6/10 HPF vs. 31±11/10 HPF, F=98, P=0.01).Conclusions Lung ischemia-reperfusion injury can be induced by embolectomy from lower pulmonary artery in the PTE model embolized for one week. An inhaled NO 20 ppm can decrease the elevated pulmonary artery pressure induced by ischemia-reperfusion injury and may alleviate the injury by reducing the PMN immigration into the alveoli.

Objective To evaluate the vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty elderly patients with moderate to severe OSAHS and twenty-eight control subjects were studied. Their blood concentration of nitric oxide (NO) were quantified. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin ( an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Subjects with OSAHS were treated by nasal continuous positive airway pressure (nCPAP) for 4 weeks, and the level of NO in plasma and vascular endothelial function were measured. Results Compared with control group, there was a significant decrease of NO level in elderly patients with moderate to severe OSAHS [(50. 35±8.65)μmol/L vs. (57.31±9.31)μmol/L, t=2.95,P=0.005], and the level of NO in plasma was increased after nCPAP treatment for 4 weeks [(55.77±8.87)μmol/L vs. (50.35± 8.65)μmol/L,t=2.40,P=0.023. The elderly patients with moderate to severe OSAHS had lower endothelium-dependent flow-mediated dilation (FMD) compared with control subjects [(9.78± 4.82)%vs. (13.21±5.81)%,t=2.45, P=0.017], and there was no significant difference in endothelium-independent nitroglycerin ( NTG)-induced dilation [( 16.87±6.15)% vs. (14.74 ± 5.82)%,t=1.36,P=0.18]. After nCPAP treatment for 4 weeks, the patients with moderate to severe OSAHS had significant increase in FMD[(14.33±6.13)% vs. (9.78±4.82)%, t=3.20,P= 0.002], whereas there was no significant change in NTG-induced dilation [(14.74±5.82)% vs. (15.15±4.21)%, t=0.31,P=0.76]. Conclusions The elderly patients with moderate to severe OSAHS have abnormal vascular endothelial function, and nCPAP treatment can reverse the dysfunction effectively, which may be associated with the reversal of intermittent hypoxia.