BACKGROUND:There are many reports about clinical effect of femoral fractures with intramedul ary nail and distal femoral fractures with locking plate. However, there is less report about clinical effect of femoral and distal femoral fractures.
OBJECTIVE:To investigate the clinical effect of femoral and distal femoral fractures using intramedul ary nail combined with locking plate.
METHODEighteen patients with femoral and distal femoral fractures were treated by internal fixation with intramedul ary nail combined with locking plate. Among them, six cases had femoral and supracondylar fractures, seven cases had femoral and condylar fractures, and five cases had femoral and intercondylar fractures.
According to the AO classification, three cases were type 33A2, three cases were type 33A3, two cases were type 33B1, five cases were type 33B2, one case was type 33C1, three cases were type 33C2, and one case was type 33C3. The fractures union and complications were fol owed up and observed, and knee joint function was judged by HSS score.
RESULTS AND CONCLUSION:Al the 18 patients were fol owed up for 12-24 months. The time for fracture union ranged from 3 to 5 months, average 3.4 months. No infection and disunion, no fracture malunion, no internal fixation loosening and breaking, no refracture happened. The HSS score ranged from 68 to 96 points, average 86.8 points. There were 12 excellent cases, 5 good cases, and 1 common case. The excellent and good rate was 94.4%. The internal fixation using intramedul ary nail combined with locking plate is a good method for treatment of femoral and distal femoral fractures, due to less surgical trauma, simple and reliable fixation, high rate of fracture healing, low rate of complications, and excellent function.

The main acupoints ofZhongwan (CV 12), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Dachangshu (BL 25) and Shenque (CV 8), in combination with the corresponding acupoints based on the syndrome differentiation, were selected to treat 28 cases of chronic nonspecific ulcerative colitis, the result showed clinical cure in 18 cases, clinical effect in 15 cases, failure in 5 cases. The most treatment times were 46, and the least 25.

AIM: The purpose of this study was to determine whether the signal transduction systems were activated at the molecular atrial tissue level in patients with atrial fibrillation (AF) and whether atrial expression of extracellular-signal regulated kinase (ERK) and protein phosphatases is altered. METHODS: Atrial tissue sample of 30 patients undergoing cardiac surgery were examined. 20 patients had AF, 10 patients had no history of AF. The mRNA expression of calcineurin B and MKP-1 were detected by semi-quantitative RT-PCR. ERK1 and phospho-ERK1 were analyzed at the protein level by Western blot. RESULTS: Western blot analysis showed that atrial fibrillation did not induce significant change in ERK1 expression level in the left atrium. In contrast , phospho-ERK1 content was increased in the patients with AF in comparison with those who had sinus rhythm (SR). The mRNA expression of calcineurin B and MKP-1 in the patients with AF were significantly higher than that in patients with SR. CONCLUSION: The activation of extracellular-signal regulated kinase and protein phosphatases may have correlation with the initiation or maintenance of atrial fibrillation.

[Objective]To compare the clinical outcomes of fresh embryo transfer of the in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)in different age groups as well as in different responders using gonadotropin-re-leasing hormone agonist(GnRH-a)long protocol or GnRH antagonist(GnRH-ant)protocol.[Methods]A retrospective analysis was performed on 737 IVF/ICSI cycles,including 386 cycles of GnRH-a long protocol(group A)and 351 cycles of GnRH-ant protocol (group B),from August 28,2015 to December 31,2016. Then all the cycles were divided into sub-groups by ages and retrieved oo-cyte numbers:group a1(<38 years),group a2(≥38 years);group b1(n≤5),group b2(6≤n≤15),group b3(n>15). The basic information of patients and clinical outcomes were compared.[Results](1)Comparable results were obtained from group A and group B in these following variables such as fertilization rate,normal fertilization rate,biochemical pregnancy rate and miscarriage rage. But the stimulation period,the total gonadotropin(Gn)dosage,estradiol(E2)level and endometrial thickness on the day of human chorionic gonadotropin(hCG)administration,number of oocytes retrieved and mature oocytes,ovarian hyperstimulation syn-drome(OHSS)rate,implantation rate and clinical pregnancy rate were significantly higher in group A than group B(P<0.05),and significantly higher cancellation rate of fresh embryo transfer was observed in group B(P<0.001).(2)When divided by ages,no mat-ter in sub-group a1 or sub-group a2,the implantation rate was slightly lower in GnRH-ant protocol than in GnRH-a long protocol, although they failed to reach significant difference(sub-group a1:32.6%vs 39.8%,P=0.067;sub-group a2:9.7%vs 17.9%,P=0.066). The clinical pregnancy rate was comparable using these two protocols in sub-group a1(54.8%vs 50.4%,P=0.429),but it was significantly lower by using GnRH-ant protocol than GnRH-a long protocol in sub-group a2(19.6%vs 39.1%,P=0.021).(3) When divided by numbers of oocytes retrieved,the implantation rate was significantly lower when using GnRH-ant protocol in sub-group b1(13.1%vs 26.0%,P=0.026),but we failed to observe significant differences in other two sub-groups. The clinical preg-nancy rates were comparable in all sub-groups ,whereas differed considerably in sub-group b1 (36.6% vs 19.3%,P = 0.056).[Conclusion]Overall,the implantation rate and clinical pregnancy rate were higher in GnRH-a long protocol than those in GnRH-ant protocol. Nevertheless,GnRH-ant protocol could reduce the dosage of Gn,shorten the treatment duration,and effectively reduce the occurrence of OHSS. There were similar pregnancy outcomes in two protocols for normal responders and high responders ,while for advanced patients or other poor responders,the implantation rate and clinical pregnancy rate were higher in GnRH-a protocol.

Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.

Objective To study the dosimetric impact of different angle fields in intensitymodulated radiotherapy (IMRT) and the feasibility of beam angle optimization (BAO) for multiple intracranial metastases.Methods In total,11 patients with multiple intracranial metastases were included in these analyses.Two treatment techniques were designed for each patient:the 7 equal spaced fields (BAF group) IMRT,and 7 fields by beam angle optimization (BAO group) IMRT.The dose distribution in the target,the dose to the organs at risk and normal brain tissues,and total MU in two groups were compared to explore the dosimetric differences.Results In comparison to the BAF group,the BAO group reduced the maximum dose to left and right lenses by an average of 45％,37％ (t =-5.707,-4.438,P ＜ 0.05);the mean dose to the left and right eyes were reduced by an average of 42.6％,44.5％ (t =-4.380,-5.638,P ＜0.05);the maximum dose to the right eyes were reduced by an average of 32.5％ (t =-2.518,P ＜ 0.05).The maximum dose of the right optic nerve and the mean dose of normal brain tissue were reduced by an average of 23％ and 3％ (t =-3.105,-3.437,P ＜0.05),respectively.For the target dose,conformity and homogeneity in PTV,no statistical differences were observed between the two groups (P ＞ 0.05).The BAO group reduced the maximum dose of the brainstem and the optic chiasm,as well as the number of MU,however,the differences were not statistically significant (P ＞ 0.05).Conclusions In comparison to the BAF group,the BAO group shows a similar target dose and reduces the dose for the organs at risk.For multiple intracranial metastases,IMRT protocols with BAO are feasible and beneficial.

This study was aimed to observe the effect ofJian-Zhong-Li-Lao(JZLL) decoction-mediated serum on the TGF-β1-induced proliferation of HBZY-1 cells, the expression of matrix metalloproteinases and its inhibitory enzyme, in order to investigate the mechanisms of JZLL decoction in treatment of the renal fibrosis of chronic renal failure. HBZY-1 cells were culturedin vitro. JZLL decoction-mediated serum was prepared. The experiment contained the blank control group, TGF-β1-induced group, control serum group, low-dose JZLL decoction group, high-dose JZLL decoction group, and theNiao-Du-Qinggroup. The cytotoxic effects of JZLL decoction-mediated serum on HBZY-1 cells were assessed by LDH assay. The morphology and proliferation of HBZY-1 cells were examined by CCK8 assay. The expression of matrix metalloproteinases (MMP-2, MMP-9) and its inhibitory enzymes (TIMP-1, TIMP-2) were examined by ELISA assay. The results showed that there was no cytotoxic effect of JZLL decoction-mediated serum on HBZY-1 cells (P > 0.05). Compared with the model group, JZLL decoction can obviously inhibit TGF-β1-induced proliferation of HBZY-1 cells (P < 0.05). JZLL decoction can obviously increase the expressions of MMP-2 and MMP-9 (P < 0.05), and inhibit the expressions of TIMP-1 and TIMP-2 (P < 0.05). It was concluded that JZLL decoction-mediated serum significantly inhibited TGF-β1-induced proliferation of HBZY-1 cells, relieved the renal fibrosis of chronic renal failure through affecting the expression of matrix metalloproteinases and its inhibitory enzymes.

Objective To explore the clinical outcomes of surgical treatment of brachial plexus cord terminal branch injuries combined with rupture of major upper limb vessels and discuss the optimal timing and surgical procedures.Methods From June,2007 to June,2012,there were 9 cases of the brachial plexus cord terminal branch injuries with concomitant major vessel injuries.Two cases had combined subclvian arterial injuries,1 had combined the first part of axillary arterial injuries,1 had the third part of axillary arterial injuries and 5 had brachial arterial injuries.Depending on the region,type and severity of the injuries,nerve and vascular reconstruction was done simultaneously in the acute phase of the injuries in 3 cases and in the subacute phase in another 2 cases.In 4 cases,the vessels were repaired acutely while nerve reconstruction was carried out in a second stage.Results Nine patients were followed-up from 50 to 78 months with an average of 61.8 months.There was no necrosis of the affected limbs.CTA showed that all the artificial blood vessels were patent after surgery.Nerve functions recovered to various extents.The muscle strength was recovered to grade 3 or better in 9 patients,except 3 cases in which the intrinsic muscles were control by ulnar nerve.(S) or better sensory recovery was seen in all repaired nerve area in 4 patients,and S3 or better sensory recovery was seen in part of the repaired nerve area in 5 patients.Conclusion The brachial plexus cord terminal branch injury is rare and complicated,which request a reasonable treatment program.Under the guideline of saving life first,primary and simultaneous reconstruction of both the nerves and vessels should be attempted by microsurgical treatment whenever possible for improving the success rate of surgery and a better functional recovery.

OBJECTIVETo study the predicting effect of proly 4-hydroxylase beta polypeptide (P4HB) in treating non-small cell lung cancer (NSCLC) patients by Yiqi Chutan Recipe (YCR).

METHODSTotally 46 stage III and IV NSCLC patients were treated by YCR for 4 therapeutic courses. Effect was assessed by RECIST of solid tumor. P4HB expression was detected in the lung cancer tissue by immunohistochemical assay. Factors affecting disease control rates (DCR) of YCR were analyzed by Logistic regression analysis. The correlation between P4HB expression and the effect of YCR was analyzed.

RESULTSThe DCR of advanced NSCLC treated by YCR was 36.96% (17/46 cases). P4HB was high expressed in advanced lung cancer tissue (6/15 cases). Gender, initial treatment, and retreatment are independent factors for affecting DCR of treating lung cancer by YCR.

CONCLUSIONP4HB might be taken as a factor for predicting the effect of YCR in treating NSCLC.

Carcinoma, Non-Small-Cell Lung ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Lung ; Lung Neoplasms ; drug therapy ; metabolism ; Male ; Procollagen-Proline Dioxygenase ; metabolism ; Protein Disulfide-Isomerases ; metabolism

The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C < 7.0%,and HbA1C>7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.