Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods Forty-one patients with Hawkins Ⅲ talus neck fracture were treated.The fractures occurred on the left side in 21 patients and on the right side in 20 patients.All patients were performed internal fixation by internal and lateral approaches.The weight bearing should be adjusted with follow-up.The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).Results The average duration of follow-up was (37.7 ± 8.2) months.All fractures gained union and the average union time was (4.1 ±0.5) months.The average AOFAS score after treatment was (79.3 ± 2.6) scores which was higher than that before treatment [(35.1 ± 8.0) scores],and there was significant difference (P =0.026).There were 11 cases in excellent,17 cases in good,11 cases in fair and 2 cases in poor.The excellent and good rate was 68.3％ (28/41).Traumatic arthritis occurred in 18 cases (43.9％,18/41),involved tibial astragaloid joint in 4 cases,involved subtalar joint in 6 cases,involved tibial astragaloid joint and subtalar joint in 8 cases.Avascular necrosis occurred in 7 cases (17.1％,7/41).Conclusions The effect of surgical treatment for Hawkins Ⅲ talus neck fracture via a bilateral approaches is satisfactory.Pay more attention to protect blood circulation intraoperative and perform anatomic reduction according to the characteristic of body of talus displacement.After operation,functional rehabilitation should be directed by the principle of early movement,later weighted.

Objective To evaluate the effect of intraperitoneal water soluble lipopolymer (WSLP)/ N-methyl-D-aspartate receptor subunit 2B (NR2B) siRNA compound on the neuropathic pain (NP) in rats.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6 weeks,weighing 180-220 g,were randomly divided into 7 groups (n =12 each) using a random number table:control group (group C),sham operation group (group S),NP group,WSLP/NR2B siRNA group (siWSLP group),WSLP/negative control siRNA group (ncWSLP group),PEI/NR2B siRNA group (PEI group) and WSLP group (WSLP group).NP was produced by ligation of the left L5 spinal nerve.In group S,the left L5 spinal nerve was only exposed,but not ligated.In group C,the rats underwent no treatment.Groups siWSLP,ncWSLP,PEI and WSLP received single intraperitoneal injection of WSLP/NR2B siRNA,WSLP/negative control siRNA,PEI/NR2B siRNA and WSLP compound 2 ml,respectively,at 10 days after NP.At 1 day before operation,7 days after operation,and 3,7,14 and 21 days after intraperitoneal injection,6 rats in each group were chosen randomly to measure mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL).At 3 days after intraperitoneal injection,the left 6 rats in each group were sacrificed and the spinal cord was removed for detection of NP2B mRNA expression (using PCR) and NR2B expression (by Western blot).Results Compared with group C,MWT was significantly decreased,and TWL was shortened on 7 days after operation and 3,7 and 21 days after intraperitoneal injection,and the expression of NR2B mRNA and protein was down-regulated on 3 days after administration in the other groups.Compared with group NP,MWT was significantly increased,and TWL was prolonged on day 3 and 7 after intraperitoneal injection,and the expression of NR2B mRNA and protein was down-regulated on day 3 after administration in siWSLP group.Conclusion Intraperitoneal WSLP/NR2B siRNA compound can effectively relieve the NP in rats.

Objective:To discuss the clinical efficacy of minimally invasive locking plate and the traditional open reduction with internal fixation in the treatment of proximal humerus fractures.Methods:89 cases of patients with proximal humeral fractures were selected and divided into two groups according to different surgical methods.The observation group (45 cases) was given minimally invasive locking plate,while the control group (44 cases) was treated with the traditional open reduction and internal fixation.The operation time,hospitalization time,fracture healing time,intraoperative blood loss,Neer score and Constant-Murley score at 1 month after postoperatiion were compared between two groups.Results:The operation time,hospitalization,fracture healing time of observation group were significantly shorter than those of the control group,and the bleeding amount of observation group was less than that of the control group (P＜0.05).At 1 months after operation,the Constant-Murley scores of observation group were significantly better than those of the control group (P＜0.05).The For Neer scores,excellent rate of observation group (91.1％) were significantly higher than those of the control group (68.1％,P＜0.05).Conclusion:Compared with the traditional open reduction with internal fixation,minimally invasive locking plate was better,safer,faster and more effectively for promoting the recovery of shoulder function of patient with proximal humerus fractures.

Objective To study the diagnostic value of relative parameters and time-relative-intensity curve(TRIC) in malignant and benign liver tumors with contrast-enhanced ultrasound(CEUS). Methods Fifty-nine focal liver lesions were examined with CEUS and drawed time-intensity curve(TIC) with QLAB software. The relative parameters of malignant and benign liver tumors were calculated and analysed. The relative intensity equaled the echo intensity of lesion substracted the encho intensity of liver. TRIC were drawed with time as abscissa and relative intensity as the ordinate. The types of TIRC were analysed comparatively in different groups (benign and malignant). Results There were significant differences in relative peak time, relative peak intensity, relative enhancement time and relative decline slope between malignant and benign lesions( P ＜0. 05). TRIC appeared quick-ascending and quick-descending types in the malignant lesions,the decline curve of TRIC droped down to 0 dB at (28.24 ± 8. 14)s and down to lowest - 8 dB continually, meanwhile fluctuated slightly. While TRIC appeared slow-ascending and slow-descending types in the benign lesions, the decline curve of TRIC droped down to the lowest 4 dB continually, meanwhile fluctuated slightly. Conclusions The relative parameters and TRIC are new quantitative indicators of CEUS for diagnosis of malignant and benign liver tumors.

Aim To investigate the potential applica-tion of a non-viral gene carrier Tat-LK15 for delivering siRNA targeting nNOS in vitro, which provides evi-dence of Tat-LK15 mediating siRNA targeting nNOS in vivo for treatment of neuropathic pain. Methods 1. Tat-LK15 was mixed with siRNA, then the mixture was analyzed the best ratio by Gel retardation. The trans-fection efficiency of FAM-siRNA mediated by Tat-LK15 on RGC-5 cells was examined by Flow Cytome-try. The apoptosis ratio of RGC-5 was identified by Flow Cytometry 24 h after treated with the different do-ses of Tat-LK15 (1, 2. 5, 5, 10 and 20 μg). 2. The model of RGC-5 cell overexpression of nNOS protein was prepared. 3. RGC-5 cells were randomly divided into 5 groups:control group,model group, Tat-S group ( Tat-LK15 mediate nNOS/siRNA transfection model cell) , Lipo-S group ( LipofectamineTM RNAiMAX me-diate nNOS/siRNA transfection model cell) and Tat-N group ( Tat-LK15 mediate NCsiRNA transfection model cell) . Real-time Quantitative polymerase chain reac-tion( Q-PCR) and Western blot were used to evaluate nNOS expression level assay. Results It indicated that the Tat-LK15/siRNA complex completely formed at the weight ratio of 2∶ 1 (μg/μg) , and the transfec-tion efficiency was (84. 4 ± 3. 9)%. It caused cotytox-icity when Tat-LK15 dose was 20 μg ( 6. 1 μmol · L-1 ) , and the apoptosis rate more than control group [(10. 3 ± 1. 1)% vs (7. 4 ± 0. 9)%, P<0. 05]. The nNOS protein level of RGC-5 cells was significantly el-evated after modeling. Compared with that of model group, Tat-LK15/siRNA efficiently inhibited the ex-pression of nNOS at transcriptional level or protein leve1 of Tat-S group ( P <0. 05 ) , and there was no significant difference of the efficiency inhibited between Tat-S group and Lipo-S group. Conclusions Tat-LK15’ advantage is with high efficiency, low cytotox-icity. The Tat-LK15 can deliver siRNA targeting nNOS in vitro efficiently and safely.

Objective To investigate the therapeutic effect of cell penetrating peptide Tat-LK15 mediating small interfering RNA (siRNA) interference with the expression of neuronal nitric oxide synthase (nNOS) in rat spinal dorsal horn on neuropathic pain. Methods The transfection reagent, Tat-LK15, was used to mediate the transfection of rat spinal dorsal horn (SDH) neuronal cells with carboxyfluorescein (FAM), and then the transfection effect was observed under inverted fluorescence microscope. Fifty healthy male SD rats were randomly divided into 5 groups (n=10): control group, sham operation group (sham group), neuropathic pain group (SNL group), Tat-LK15-nNOS siRNA group (TS group) and Tat-LK15-NC siRNA group (TN group). Neuropathic pain was induced by spinal nerve ligation (SNL), rats in control group did not receive operation and only the spinal nerve was exposed in sham group. Groups SNL, TS and TN were made into the models by SNL and implanted intrathecal catheter, intrathecal administration was performed from the 7th day after model establishment, and 10μl normal saline, 10μl TS complex (including 5μg siRNA) and 10μl TN (including 5μg siRNA) were injected intrathecally each day for 7 days. Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured at 1 day before (baseline) and 3, 7, 10 and 14 days after model establishment. Then animals were sacrificed on the 14th day after the operation and the lumbar segment (L4-6) of the spinal cord was removed to detect the expressions of nNOS mRNA and protein using q-PCR and Western blotting analysis. Results Tat-LK15 effectively mediated FAM-siRNA into SDH neuronal cells. Compared with sham group, SNL significantly decreased PWMT and PWTL and increased expressions of nNOS mRNA and protein from the 3rd day (P<0.01), but there was no significant difference between the sham and control group. Tat-LK15-nNOS siRNA complex significantly increased PWMT and PWTL and down-regulated nNOS mRNA and protein expressions in TS group compared with SNL group on the days 10 and 14. There was no significant difference between TN and SNL group. Conclusion Tat-LK15 not only can mediate successful nNOS siRNA transfection and inhibit the expression of nNOS, but also effectively relieve SNL-induced neuropathic pain in rats.

Objective:To understand the age composition of breast cancer patients. Methods:The medical records of 115 patients were classified. Results:<60,<50 and<70 age group accounted for 35%, 23%and 20%, and in the same age group, the patients with the birth of one child were in the highest proportion (68%) . In 65 postmenopausal patients,<60 and <50 in postmenopausal age group was 57%and 25%. The clinical stage II ratio was 61.7%, and the distribution in the<60,<50 and<70 age group was in higher proportion. The proportion of nonspecific invasive breast carcinoma (85%) was the highest in all types,<60,<70 and<50 age group accounted for IV the proportion with 35.7%, 22.4%and 20.4%. Conclusions:The percentage of the middle-aged and the aged group (40-69 years old) with breast cancer is significantly higher than the ones of young group (<40 years old) and the senile group (≥70 years old) . Clinical stage II and nonspecific invasive breast carcinoma are also concentrated in this stage. Women should improve health consciousness,take regular check to discover timely.

Objective To explore the mechanism of self-awareness in the heavy smokers(HS)by using regional homogeneity(ReHo)combined with resting-state functional MRI(fMRI).Methods Thirty HS and 31 healthy non-smokers(NS)matched for age and sex underwent a 3.0 T resting-state fMRI.The data were post-processed by SPM 5 and then the ReHo values were calculated by REST software.The ReHo values between the two groups were compared by two-sample t-test.The brain map with significant difference of ReHo value was obtained.Results Compared with that in NS group,the regions with decreased ReHo value included the bilateral precuneus,superior frontal gyrus,medial prefrontal cortex,right angular gyrus,inferior frontal gyrus,inferior occipital gyrus,cerebellum,and left middle frontal gyrus in HS group.The regions of increased ReHo value included the bilateral insula,parahippocampal gyrus,white matter of parietal lobe,pons,left inferior parietal lobule,lingual gyrus,thalamus,inferior orbital gyrus,white matter of temporal-frontal lobe,and cerebellum.The difference was more obvious in the left hemisphere.Conclusions In HS,abnormal ReHo on a resting state which reflects network of smoking addiction.This method may be helpful in understanding the mechanism of self-awareness in HS.

Objective To clone a gametocyte specific protein Pfgdv1 of Plasmodium falciparum,express and identify re?combinant Pfgdv1 protein in vitro. Methods PCR was performed to amplify Pfgdv1 from P. falciparum DNA which was got from the patient who was infected with P. falciparum,and the PCR product was inserted into pET28a(+)vector. pET28a?Pfg?dv1 recombinant plasmid was constructed and transformed into E. coli host BL21(DE3+). IPTG was used to induce the recombi?nant Pfgdv1 protein fused with His tag,and the protein was purified by His?NTA affinity chromatography. The recombinant pro?tein was identified by SDS?PAGE and Western blotting. Results The PCR product of Pfgdv1 gene was about 1.65 kb,meeting the expectation of predicted fragment size. The recombinant protein was about 67 kDa,which could be recognized by His?Tag monoclonal antibody. Conclusion The Pfgdv1 gene of P. falciparum is successfully cloned,and the recombinant Pfgdv1 pro?tein is expressed,thereby providing an opportunity for further study on transmission blocking vaccine.

Objective: To study the therapeutic effect of hyaluronic acid chitosan?based microemulsion ( HAC?ME) and carboplatin in a Wistar rat model bearing cerebral C6 glioma xenografts. Methods:C6 rat glioma cells were cultured normally. A total of 30 Wistar rats bearing orthotopic C6 glioma xenografts were randomly divided into 3 groups, and administrated with physiological saline, carbopl?atin or HAC?ME and carboplatin in each group. There are 10 rats in each group. The rat apoptosis changes and survival time were ob?served after treated with physiological saline, carboplatin or HAC?ME and carboplatin in each group. Results:Glioma cells were nega?tive in saline group with TUNEL staining, the nuclei of individual glioma cells in glioma tissue were stained with brown, indicating ap?optosis occur in carboplatin group, the apoptosis of glioma cells in glioma tissue significantly increased in HAC?ME and carboplatin group with TUNEL staining. The survival time in HAC?ME and carboplatin group was longer than that in saline group and carboplatin group ( P<0?05) . Conclusion:Administration of HAC?ME and carboplatin can suppress the growth of C6 glioma in rats and may pro?vide experimental basis for clinical treatment of glioma.