Astract:Objective To compare the clinical efficacy of minimally invasive percutaneous osteosynthesis and supercutaneous plating with closed reduction in the treatment of distal tibial comminuted fractures. Methods A total of 40 patients with close distal tibial comminuted fractures in our hospital from April 2012 to April 2014 were divided into minimally invasive percutaneous osteosynthesis group and external fixation group. External fixation group were treated by supercutaneous plating,while the minimally invasive percutaneous osteosynthesis group were treated by minimally invasive percutaneous osteosynthesis. And the operative duration,hospital stay,the time of weight loading and frac-ture healing,postoperative complications and function of ankle were compared between the two groups. Results In the supercutaneous plating group,the operative duration was (60. 17 ± 5. 64) minutes,the hospital stay was (8. 651 ± 2. 21) days,the time of weight loading was (49.26 ±9.85)days,the time of fracture healing was (13.82 ±4.23)weeks,the incidence of postoperative complications was 5.00%,and the excellent and good rates was 95. 00%. In the minimally invasive percutaneous osteosynthesis group,the operative duration was (74. 64 ± 6. 82)minutes,the hospital stay was (18. 22 ± 2. 32)days,the time of weight loading was (57. 56 ± 11. 32)days,the time of fracture healing was (17. 47 ± 2. 31)weeks,the incidence of postoperative complications was 25. 00%,and the excellent and good rates was 80. 00%. There were significant differences in operative duration(χ2 =9. 922,P=0. 007),hospital stay(χ2 =10. 48,P=0. 015),time of weight loading (χ2 =14. 618,P=0. 001) and fracture healing(χ2 =40. 16,P=0. 000) between the two groups. The AOFSA score of supercutaneous plating group was (89. 1 ± 3. 9)point,compared with (90. 5 ± 4. 1)point of minimally invasive percutaneous osteosynthesis group,and the difference was statistically significant(χ2 =0. 463,P=0. 793). Conclusion Distal tibial fractures may be treated successfully with minimally invasive plate osteosynthesis or supercutaneous plating. However,supercutaneous plating offers multiple advantages in terms of mean operative dura-tion,hospital stay,the time of weight loading and fracture healing.

Objective To observe the recent clinical efficacy of the sequential therapy hormone in the treatment of active rheumatoid arthritis.Methods In accordance with the principle of digital sheet,160 patients with active rheumatoid arthritis were randomly divided into the observation group and the control group,80 cases in each group.On the basis of methotrexate and leflunomide in both groups,the hormone sequential therapy was given in the observation group,but prednisone was given in the control group.The clinical efficacy of treatment after 1 week and 3 months were compared in two groups.Results In the observation group,the indicators in 7 d after treatment were significantly reduced,compared with untreated(t =19.90,7.63,14.73,7.58,6.84,14.09,all P ＜0.01),In the control group,three indicators of the duration of morning stiffness,joint tenderness index and joint swelling index in 7d after treatment were significantly reduced,compared with untreated (t =13.42,3.34,7.24,all P ＜ 0.01),Compared the indicators in the two groups in 7 d after treatment,there were statistically significant differences (t =13.07,4.92,10.51,5.23,5.74,15.03,all P ＜ 0.01).The indicators in the 3 months after treatment in both groups were signifi cantly decreased,buttherewasnosignificantdifferencebetweenthetwogroups (t =1.80,1.73,1.59,1.22,1.21,1.35,all P ＞ 0.05).The total effective rate was 80% in the observation group; but the rate was 75 % in the control group;there was no statistically significant difference in the two groups(x2 =0.57,P ＞ 0.05).Conclusion The sequential hormone therapy is an effective means for the treatment of active rheumatoid arthritis,by controlled the symptoms of rheumatoid arthritis effectively and alleviated the patient's condition.

Objective:To explore the early evaluation value of calprotectin (S100A8/A9) and ischemia modified albumin (IMA) for adult acute appendicitis (AA) and adult non-simple acute appendicitis.Methods:The data of 62 patients with histologically confirmed appendicitis and 57 healthy controls in the physical examination center of our hospital during the same period from May 2018 to October 2019 were collected. According to postoperative pathological data, patients with appendicitis were divided into the simple appendicitis group and the non-simple appendicitis group . The measurement data conforming to normal distribution were expressed as mean ± standard deviation (Mean±SD), and Student's t test was used for comparison between groups. S100A8/A9, IMA, C-reactive protein (CRP), procalcitonin (PCT), and blood routine parameters were compared after grouping.The area under the ROC curve (AUC) was used to evaluate the early efficacy of S100A8/A9 and IMA for acute appendicitis and non-simple acute appendicitis. Results:There were no significant differences in sex, age, platelet count (PLT), and red blood cell count (RBC) between the appendicitis group and healthy control (all P>0.05), while white blood cell count (WBC), CRP, PCT, neutrophils to lymphocytes ratio (NLR), S100A8/A9, and IMA levels in the appendicitis group were higher than those in healthy control (all P<0.05). The AUC of S100A8/A9 (≥366.9 μg/L), IMA (≥0.29), and S100A8/A9 combined with IMA in predicting acute appendicitis were 0.735, 0.891, and 0.913, respectively. There was no significant difference in WBC between the non-simple appendicitis group (21 cases) and the simple appendicitis group (41 cases) ( P>0.05).The levels of CRP, PCT, NLR, S100A8/A9 and IMA in the non-simple appendicitis group were significantly higher than those in the simple appendicitis group ( P<0.05). The AUC of S100A8/A9 (≥532.9 μg /L), IMA (≥0.41) and S100A8/A9 combined with IMA in predicting non-simple acute appendicitis were 0.866, 0.873 and 0.936, respectively. Conclusions:S100A8/A9 and IMA could be used as biomarkers for the diagnosis of AA, which have certain clinical value for the assessment of acute appendicitis and non-simple acute appendicitis.

Objective To explore the mechanism that Staphylococcus aureus(S.aureus) α-toxin(Hla) regulate miR-142 expression and inhibit macrophage phagocytosis.Methods BALB/C mice and RAW264.7 cells were infected with wild type S.aureus(WT S.aureus),Hla deletion S.aureus(△HlaS.aureus) or phosphate buffered saline(PBS),and the expression level of miR-142 of skin tissues and cells were detected.miR-142 mimics and inhibitor were then applied in the RAW264.7 culture to examine the effect on phagocytosis.Direct targeting of miR-142 on protein kinase Cα(PKCα) was assessed by luciferase assay and western blotting.Results miR-142 expression in △HlaS.aureus group were significantly down-regulated than WT S.aureus group(P<0.05).MiR-142 mimics inhibited RAW264.7 phagocytosis ability and inhibitor enhanced RAW264.7 phagocytosis ability.PKCα was directly targeted by miR-142.MiR-142 mimics significantly decreased the mRNA expression levels of PKCα in RAW264.7 cells(P<0.05).Conclusion Hla could promote miR-142 expression in macrophages.MiR-142 could inhibit macrophage phagocytosis through down-regulated PKCα.

Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.

Aim To study on the diuretic effect of a phenylphthalazines compound PU1424 and its influence on electrolyte balance, glucose and lipid metabolism, hepatic and renal functions.Methods Male Sprague Dawley rats were randomly divided into solvent control group,PU1424 treated group and HCTZ treated group.Urine was collected per 6 h and blood samples were collected at the end of drug administration.Urinary osmolality was measured by Freezing Point Osmometer;urea concentration was measured by Urea Detection Kit;ion level, blood glucose level, blood lipid level, hepatic and renal function were analyzed by Automatic Biochemical Analyzer.Results Compared to the solvent control group, and urine output of rats treated with PU1424 and HCTZ was increased as 1.52 times and 1.78 times and water intake increased as 1.42 times and 1.56 times respectively.Urine osmolalities were decreased as 61.5% and 50.4% of the control group, and urine urea concentration was decreased as 57.1% and 56.8% of the control group.Urinary electrolytes were decreased by administration of PU1424 and HCTZ compared to the intact plasma electrolytes.The blood glucose levels and blood lipid levels of rats treated with PU1424 had no changes, while the blood glucose and total cholesterol were increased by administration of HCTZ.The urea nitrogen, creatinine, alkaline phosphatase and total protein were intact by administration of PU1424 and HCTZ except the alanine/straw ration increased by HCTZ.Conclusion New diuretic candidate compound PU1424 displays significant diuretic effect with electrolyte balance, blood glucose level, blood lipid level, hepatic and renal function intact.

Problem-based learning (PBL) teaching method combined with formative evalua-tion was used in the teaching practice of pediatrics education. This method was implemented by four phases: courses designing, group-preparing, problems-organizing and teaching practice. The method was evaluated by students' feedback and survey results of patients, teachers and teaching councilors. It was showed that the teaching effects of PBL combined with formative evaluation was better than tra-ditional teaching method in pediatrics teaching.

Objective To explore high concentrations of urea-induced human brain microvascular endothelial cell line( HBMECs) to produce inflammatory cytokines and possible mechanism .Methods HBMECs were incubated in high concentrations of urea or mannitol ( as osmotic control ) for 3,6,12 and 24 hours.Expression of TNF-αand iNOS was observed by immunofluorescence .Western blot analysis was employed to assess the protein expressions of TNF-α, iNOS, COX-2, NF-κB/P65 and p-P65.NO concentration was determined by a commercial NO assay kit . Results Immunofluorescence showed high positive immunostaining of TNF-αand iNOS after incubation in high concentration of urea stimulued as compared with control group .The protein expressions of TNF-α, COX-2 and p-P65 were significantly increased at 3 and 6 hours after high urea treatment (P<0.01), and iNOS was continued to increase from 3 to 24 hours ( P<0.01 ) .Moreover , NO content was increased at 3 hours after high urea treatment ( P<0.05 ) .Conclusions High concentration of urea can induce HBMECs to produce inflammatory cytokines .

AIM:To investigate the gene expression profile of human lung squamous cell carcinoma in early stage.METHODS:The mRNA was extracted from cancer tissue and normal lung tissue.The mixed probes were labeled and hybridized with chip containing 480 carcinoma related genes,then analyzed by SuperArray Image software to study the gene expression patterns in lung squamous cell carcinoma.RESULTS:192 genes associated with lung squamous cell carcinogenesis were found,which were grouped into transporter,adhesion molecules,cytoskeleton proteins,transcription regulator,genes associated with metabolism and immune response according to functions.127 gens were positive to lung squamous cell carcinogenesis and 65 genes were negative to lung squamous cell carcinogenesis.CONCLUSION:The screen of gene expression profile of human lung squamous cell carcinoma provides valuable information for the research of molecular mechanism of the lung squamous cell carcinogenesis.

AIM: The effect of urotensin II (U-II) on proliferation of cultured pulmonary arterial smooth muscle cells (PASMCs) of rabbits and its mechanism are investigated. METHODS: PASMCs were isolated using explant technique. RPASMCs were incubated in serum-free medium with different concentrations of nicardipine, calcimodulin antagonist W 7, PKC inhibitor H 7 or MAPK inhibitor (PD 98059 ), with or without U-II. RPASMC proliferation was examined by MTT [3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay and by the increase in [ 3H]-thymidine incorporation into DNA. RESULTS: U-II (10 -9 mol/L-10 -7 mol/L) increased A value of PASMCs by MTT assay and [ 3H]-thymidine incorporation in PASMCs in a dose-dependent manner. U-II induced a maximal effect at a concentration of 10 -7 mol/L. A value and [ 3H]-thymidine incorporation rose 42 9% and 68 5% ( P