ObjectiveTo explore the efficacy of external fixation in treatment of unstable distal radius fractures. Methods33 patients with distal radius fracture were treated by external fixation or Kirschner wire supplemented,and absorbable screw fixation.The clinical efficacy was observed. Results33 patients were followed up for 4 ～24 months(mean 12 months).All fractures were healed,the average healing time was 8 weeks.Wrist function were assessed according to Sarmiento standard,excellent in 20 cases,good in 9 cases,3 cases and poor in 1 case,good rate of 87.87%. ConclusionThe external fixation in treatment of distal radius fractures had reliable efficacy,and early exercise could be taken after operation,and it was worthy of promotion.

Objective To evaluate the clinical value of anti-cyclic citrullinated peptide (anti- CCP) anti-body in patients with rheumatoid arthritis(RA) in different agagroup.Methods Anti-CCP antibody was detected by ELISA in 220 cases of RA who were divided into three groups by onset age: juvenile group(n=24) ,adult group (n = 162) and older age group (n = 34).Results The ratio of anti-CCP in three groups were 14.3% (2/14), 81.7% (98/120) and 67.9% (19/28)(χ2 = 42.819, P <0.01).There was good coherence between the of anti-CCP and rheumatic factors (RF), with coherence coefficients of 71.4% (10/14 ), 82.2% (97/118) and 82.1% (23/28).Positive rank correlation was only found between anti-CCP and stages of X-rays(rs=0.243,P=0.002).Patients of juvenile group with anti-CCP were all present in poly-article subtype.There was a linear correlation be-tween anti-CCP and numbers of swollen joint, index of swollen joint in patients of juvenile group (r=0.563, P=0.045;r=0.574,P=0.040).The stage of both hand joints in older patients with anti-CCP positive was poorer than in those with anti-CCP negative[X-ray stage Ⅲ + Ⅳ was 52.2% (12/23), Ⅰ + Ⅱwas 0(0/9),χ2 =2.298,P =0.022].Conclusion The incidences of anti-CCP vary significantly among different age patients with RA.Anti-CCP in patients of juvenile group is related with poly-joint subtype, indicating the worsened swollen of joint.Anti-CCP in older age-onset patients with RA means the more severity of bone erosion.

The radiation techniques for lung cancer stereotactic body radiotherapy (SBRT) include intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT).Concerning the target conformity and dosimetric homogeneity index, HT and VMAT technologies are superior to IMRT.On the contrary, HT and VMAT technology can increase low dose area irradiated of lung.Comparing to other two technologies, VMAT can obviously shorten the treatment time.At present, there is no consensus how to choose individually optimized radiotherapy technology for different location and stages lung tumors.

BACKGROUND:Inflammatory cellactivation and the generation of oxygen free radicals are important factors of lung ischemia-reperfusion injury. Adding the drugs with anti-inflammation and antioxidant effects into the lung preservation solution used, can improve the protection fluid, and play a crucial role in the study of lung ischemia-reperfusion injury and protection of the function of transplanted lung. OBJECTIVE:To discussion the effect of harmine in canine model of pulmonary ischemia-reperfusion injury. METHODS:Twelve healthy hybrid dogs were randomly divided into two groups, with six rats in each group. A canine model of lung ischemia-reperfusion injury was established, and the protecting liquid was perfused with the clockwise irrigation method. Control group:low potassium dextran protective fluid;experimental group:low potassium dextran+harmine protective fluid. After 2 hours of ischemia, the left lung circulation was recovered. The left lung tissue and blood samples were col ected from two groups of animal models after reperfusion, and their cytokines levels and the lung wet/dry weight ratio were detected and calculated. Bronchoalveolar lavage fluid was col ected to observe the pathological indicators. The main pulmonary artery pressure, left and right pulmonary artery pressure were recorded by continuous monitoring. RESULTS AND CONCLUSION:There were no statistical y significant differences in the interleukin-17, tumor necrosis factorαand endothelin 1 content in the left lung tissue and the blood between the two groups at 2 and 4 hours after reperfusion (P>0.05). After 4 hours of reperfusion in both groups, the neutrophil number, the number of lymphocytes, alveolar edema index, and vascular wal damage in bronchoalveolar lavage fluid showed no statistical y significant differences (P>0.05). Through the analysis of variance, the main pulmonary artery pressure, left pulmonary artery pressure and right pulmonary artery pressure also had no statistical significance between the two groups (P>0.05). By the analysis of cytokines, pathological indicators, lung wet/dry weight ratio, and pulmonary arterial pressure, harmine has no significant lung protection effect in canine model of lung ischemia-reperfusion injury.

Objective To explore and evaluate the changes of hemorheology and fracture healing in patients undergoing spinal operation with intraoperative autologuous blood transfusion.Methods A total of 80 patients underwent internal fixation of spine in our hospital from January 2012 to December 2014 were selected in this study.Digital random table method were utilized for dividing them into two groups.Autologous blood transfusion was used in group A,allogeneic blood transfusion was applied in group B.Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte sedimentation rate (ESR) and the level of sICAM-1,sVCAM-1 were collected and compared 1,4,8,12 weeks after the operation.Fesults Concentrated red cell and plasma volume infusion in group A was lower than that in group B,the level of sICAM-1,sVCAM-1 1,4,8,12 weeks after operation in group A were significantly lower than that in group B.There was no delayed fracture healing patients in group A,but there was 3 patients with delayed fracture healing in group B (P＜0.05).Blood viscosity,plasma viscosity,hematocrit,fibrinogen,erythrocyte and ESR 1,4,8,12 weeks after the operation compared in both group were not statistically significant (P＞0.05).Conclusion Autologous blood transfusion is not only a safe and effective method for blood transfusion,but also can improve the tissue blood supply,reduce inflammation,and conducive to fracture healing.

Objective This study aimed to assess the adherence to guideline-recommended therapies according to risk stratification in the management of acute coronary syndrome(ACS). Methods We analyzed 1,001 consecutive patients admitted with ACS. Patients were stratified using the GRACE risk score into low- and high-predicted risk of mortality at 6 months. We evaluated the use of hospital angiography,revascularization,and guideline-recommended medications between high and low-risk patients. Results High-risk compared to low-risk patients were less likely to underwent coronary angiography and/or revascularization during the hospitalization. The use of hospital-initiated pharmacotherapies was also lower in high-risk patients(P<0.05). Advanced age, increased creatinine level and higher GRACE score were independent predictors for failure to administer evidence-based therapies. Conclusion Patients with ACS at high risk of mortality were paradoxically less likely to undergo revascularization or receive medications according to guidelines. Better adherence to evidence-based therapies in high-risk patients may improve clinical outcome and quality of health care.

Objective To explore the clinical significance of the union between marrow smear and marrow biopsy in the myelodysplastic syndrome(MDS) diagnosis. Methods Bone marrow aspirate and smear were initially abtained, then bone tissues encircled drill and section at the same point which is called as. easy one-step technology to 86 MDS patients were analysed. Results In 86 cases of MDS patients, there were 30 cases of hyperplasia extreme degree of reduction by 34.88 %, 56 eases of active, obvious and extremely active active (65.12 %), 43 cases for red RCMD (50.00 %), 32 cases for the granulocyte dysplasia (37.21%), 22 cases for megakaryocyte RCMD (25.58 %) in bone marrow aspiration smears; compared with 15 cases of hyperplasia extreme degree of reduction and the reduction (17.44 %), 71 eases of active, obviously active and extremely active (82.56 %); 16 cases for red RCMD (18.61%), 52 cases for the granulocyte dysplasia (60.47 %), 56 cases for megakaryocyte RCMD (65.12 %) in bone marrow biopsy sections. 66 cases in 86 cases of bone marrow biopsy and bone marrow smear of WHO classification were in line with the rate of 76.74 %.Conclusion The biopsy slide and the puncture smear synchronization observation is more advantageous than the conventional puncture smear morphology observation and combining two method may increase the accuracy in the MDS diagnosis.

Objective · To understand the medical treatment willingness and place among migrant workers in Shanghai and relevant influencing factors. Methods · The questionnaire survey was used to investigate migrant workers in some areas of Shanghai and the data were analyzed with constituent ratio,χ2 test, and Logistic regression. Results · Regional differences in medical treatment willingness and place existed between migrant workers in surveyed areas and local workers. Differences between actual and intended medical treatment places existed among migrant workers. Main factors influencing the medical care seeking behavior of migrant workers were medical insurance, economic factors, and demographic factors. Conclusion · The medical security system and the accessibility of basic medical services for migrant workers should be further improved.

Objective To evaluate the efficacy and safety of consolidation chemotherapy after thoracic radical concurrent chemoradiotherapy for patients with oligometastatic non?small cell lung cancer ( NSCLC) . Methods Sixty?six NSCLC patients with more than five metastases from 2008 to 2013 were enrolled, and image?guided radiotherapy with conventionally fractionated or hypofractionated doses were performed for these patients. Platinum?based doublets chemotherapy was applied for both concurrent chemoradiotherapy and consolidation chemotherapy. Short?term outcome, adverse reactions, and survival rate were assessed for the patients after treatment. Results Sixty?four patients completed the treatment. The median biologically equivalent dose for planning target volume of thoracic primary tumor lesions was 72 Gy, with a median number of chemotherapy cycles of 4. The objective response rate for thoracic lesions was 70%. The follow?up rate was 97%. The 1?, 2?, and 3?year overall survival ( OS) rates were 72%, 53%, and 31%, respectively, with a median OS time of 25 months;the 1?, 2?, and 3?year progression?free survival ( PFS) rates were 56%, 26%, and 7%, respectively, with a median PFS time of 14 months. The incidence of grade 2?3 acute radiation pneumonitis and radiation esophagitis was 1% and 17%, respectively, and the incidence of grade 3?4 decreases in leukocytes, hemoglobin, and platelet count was 39%, 11%, and 16%, respectively. Conclusions Radical radiotherapy combined with concurrent and consolidation chemotherapy for oligometastatic NSCLC can achieve good short?term outcome and long?term survival, with tolerable adverse effects.

Objective To explore the inhibitory effect of anti-miRNA-17 oligonucleotide on leukemic K562 cells.Methods K562 cells were transfected with anti-miRNA-17 oligonucleotide,cell viability was analyzed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetra-zoliunbromide (MTT) assay.Apoptosis was detected by flow cytometry,expression of miRNA-17 in K562 cells was measured by real-time PCR.Results MTT results showed transfection of antisense nucleic acid significantly decreased cell proliferation activity,after 24,48,72 h they were respectively 0.8719±0.001,0.7102±0.002,0.5507±0.001,the difference being statistically significant (P ＜ 0.05) when compared to the random control (t =182.575,269.77,660.4) or control group (t =537.98,571.20,1230.51).FCM test results showed that after 48 h of transfecting antisense nucleic acid apoptosis rate was (20.14 ± 0.01) ％,and was statistically significant compared to the randomized control or blank control group (t =2347.6,2568.2,P ＜ 0.01).Fluorescence real-time quantitative PCR confirmed antisense nucleic acid significantly decreased the relative expression level of miR-17 in K562 cells (0.07).The difference was statistically significant compared to the random group or blank group (1,1.01) (t =148.63,147.04,P ＜ 0.05).Conclusion Targeted inhibition of miR-17 with oligonucleotide can suppress K562 cell growth and induce apoptosis.