[Objective]To compare the influence of hypothermia environment on healing of limb gunshot fracture in sheep with debridement and internal plate fixation at different time after wounded.[Method]Thirty sheep were divided into normal environment group(NE group) and hypothermia environment group(HE group) at random.They were kept in 26℃ and -25℃ environment respectively for 3 h,and then one side of hind limb was made fracture at middle part of the tibia by a 7.7 type handgun.The wound track was debrided at 6,12 and 24 h after wounded.The fracture was fixed by plate respectively.The healing of the wound track and fracture were observed and compared between groups.[Result]At 24 h after wounded,infection of the wound track occurred in 2 cases,and osteomylitis occurred in one by X-ray and in two by pathological examination in NE group.The healing of the wound track and fracture were excellent in HE group,and no osteomyelitis was observed by X-ray and pathological examination in HE group.The earlier the management started,the better the wound and fracture healed.[Conclusion]The hypothermia environment benefit the healing of the wound and the fracture after debrided and internal fixation.It is suggested that the management of gunshot fracture in hypothermia environment can make the time-limit of debridement and internal fixation prolonged.

Objective To discuss the clinical significance of internal fixation through anterolaterel and posteromedial approaches in the treatment of closed sagittal Pilon fractures of Topliss classification and compare the effects of the two approaches.Methods The study involved 57 patients with closed sagittal Pilon fractures treated with open reduction and internal fixation from 2007 to 2010,including 29 patients treated through anterolateral approach (Group A) and 28 through posteromedial approach (Group B).All patients were with closed fractures,and all surgery time windows were 10-19 days.The two groups were compared in aspects of gender,age,type of fractures,soft tissue graduation,injury factors,condition of combined fibula fracture,surgery time window,operation time,intra-operative blood loss,ambulation time,infection and necrosis rate of skin and soft tissue,length of stay,ankle joint function recovery after internal fixation,and intra-operative X-ray reduction.Results All patients were followed up for 12-26 months (mean,20 months) except for one patient in the Group A,with total follow-up rate of 98％.The two groups showed no significant differences regarding the gender,age,type of fractures,soft tissue graduation,injury factors,condition of combined fibula fracture,surgery time window selection,operation time,intra-operative blood loss,and ambulation time (P ＞0.05).While,the infection and necrosis incidence of skin and soft tissue,and the hospital stay we re significantly lower and shorter in the Group A than that in the Group B (P ＜ 0.05 ).Two patients in the Group A were complicated with toe extensor tendon adhesion,which was released by removing the fixation.Fifteen patients had wound infection during hospitalization,including three patients in the Group A and 12 in the Group B,but they were all cured after treatments like dressing.Fifteen patients were treated with stage Ⅰ allogeneic bone graft and 11 with autologous iliac bone graft.All the patients obtained bone union.Conclusions Topliss classification of closed sagittal Pilon fractures has clear clinical significance in surgical plan selection and operative procedures.Both of the anterolateral and posteromedial approaches can achieve good effects in the treatment of closed sagittal Pilon fractures due to high energy injury.However,the anterolateral approach is relatively a better choice,for it brings in a lower incidence of infection and necrosis of skin and soft tissue and a shorter length of hospital stay.

Objective To explore the prognostic value of ventricular wall motion score (WMS) and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction (AMI) combined with heart failure (HF) in the recent 12 months Methods We selected hospitalized AMI patients in our department from Jan. 2014 to Nov. 2014. Cardiac ultrasound was performed to detect WMS and LVEF within 48 hours and during the 6?month follow?up period and the occurrence of HF was recorded. Results Totally 127 AMI patients were recruited, including 20 cases combined with HF. The WMS was higher in HF group than those in non?HF group (23.55 ± 3.73 vs 20.11 ± 3.13, P<0.01), while the LVEF in HF group was lower than those in non?HF group (48.77 ± 8.08 vs 56.99 ± 5.17, P<0.01). Multiple logistic regression analysis revealed that WMS and LVEF were both independent predictors of HF in the recent 12 months (P < 0.05). The prediction effect of WMS ROC curve area was 0.81 (P < 0.01) , and LVEF 0.76 (P < 0.05). WMS and LVEF combined assessment area under ROC curve was 0.82 (P < 0.01). Conclusion WMS and LVEF are independent predictors of HF in patients with AMI in the recent 12 months and the combined application of WMS and LVEF can significantly improve the prediction effect.

ObjectiveTo observe the expression of nerve growth factor(NGF)and its receptors (TrkANGFRand P75NTR) in hepatocytes and to explore the biological effects of exogenous P75NTR protein on hepatocytes.MethodsL02 hepatocytes were cultured in vitro.The expression of NGF,TrkANNGFR and P75NTR in L02 cells were assessed by immunocytochemistry and fluorescent quantitation polymerase chain reaction (PCR). The effects on L02 cell proliferation by exogenous P75NTR,NGF,NGF+ P75NTR,anti-TrkANGFR and anti-P75NTR were detected by XTT assay.The effect of exogenous P75NTR on L02 cell apoptosis was measured by flow cytometry (Annexin V/PI) and the effect of exogenous P75NTR on L02 cell cycle was determined by flow cytometry (PI).ResultsL02 cell proliferation was promoted by P75NTR and in dose-dependent manner.The A value of NGF group and NGF+ P75NTR group was 0.4916±0.0565 and 0.5839 ± 0.0733,respectively,and there was statistical significance compared with control group (0.3601 ± 0.0310,P＜0.05).The A value ot anti-TrkANGFR group was 0.2689±0.0229,and there was statistical significance compared with control group (P=0.003).The A value of anti P75NTR was 0.3524 ± 0.0312,and there was no statistical significance compared with control group (P=1.000). Exogenous P75NTR had anti-apoptosis effect on L02 cells,the antiapoptosis effect was strongest when 100 ng/ml P75NTR was added and the expression quantity was 3.70 ±0.26.However there was no statistical significant compared with control group (4.10 ± 0.62,P=1.000).P75NTR affected the cell cycle S phase of L02 cells and in dose-dependent manner,which was inverted U shaped curve.The effect was strongest when the concentration was 100 ng/ml (25.60 ±0.40) and there was statistical significance compared with control group (20.10 ±1.00,P=0.000).Exogenous NGF,P75NTR and NGF + P75NTR up regulated the gene expression of NGFmRNA,TrkANGFRmRNA and P75NTR mRNA in L02 cells and there was statistical significance compared with control group (P＜0.05).There was no significant difference in the gene expression of NGFmRNA,TrkANGFFR mRNA and P75NTR mRNA between anti-TrkANGFR,anti-P75NTR groUp and control group (P＞0.05).Conclusion NGF and its receptors TrkANGFR and P75NTR were expressed in L02 cells.The appropriate dose of exogenous P75NTP protein promoted L02 cells proliferation via TrkANGFR/P75NTR heterodimer signal pathway.

Objective To investigate the effects of tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis (RA) curative effect and peripheral blood of patients with IL-6, effects of IL-10 and TNF- alpha. Methods 80 patients with RA from February 2014 to August 2016 in our hospital were retrospectively analyzed. According to the different treatment methods by for the observation group, the control group (40 cases). To compare and analyze the curative effect before and after short-term treatment and treatment of patients in the 2 groups were the main clinical symptoms and signs of change and ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index. Results The total effective rate of observation group (92.50％) was significantly higher than the control group (77.50％), the difference was statistically significant (P<0.05), 2 groups of patients before treatment of main clinical symptoms and signs, there was no significant difference, after treatment, clinical symptoms and signs of 2 groups of patients were compared with those before treatment was statistically significant to alleviate the differences (P<0.05), and the observation group of main clinical symptoms and signs were lower than the control group and the remission (down), the difference was statistically significant (P<0.05).Before ESR, the treatment of 2 patients with RF, CRP, TNF- IL-6, alpha, IL-10 index level, no statistical significance, the 2 groups after treatment in patients with ESR, RF, CRP, IL-6, TNF- alpha, IL-10 index level than before treatment with significant difference (P<0.05), and the observation group ESR, RF, CRP, TNF- alpha, IL-6 average index of water compared with the control group decreased significantly, IL-10 index increased significantly than the control group. The difference was statistically significant (P<0.05). Conclusion Tripterygium glycosides combined with methotrexate in treatment of rheumatoid arthritis And it can effectively inhibit the expression of peripheral serum L-6 and TNF- alpha, promote the expression of IL-10 and alleviate the inflammatory reaction

Objective To investigate the expression of circulating tumor cells (CTC) in peripheral blood of patients with different stages of colorectal cancer (CRC), and to evaluate its significance in early diagnosis of colorectal cancer metastasis. Methods Sixty patients with CRC (42 inⅡ-Ⅲstage and 18 in IV stage ) and 30 patients with benign rectal disease were recruited from January 2014 to December 2015. The CTC in peripheral blood was purified with Immunomagnetic Separation Technologie, and detected by immunofluorescence in situ hybridization (imFISH). The serum levels of CEA were detected by electrochemiluminescence method meanwhile. The correlation between CTC and CEA was analyzed. Results CTC positive rates in CRC patients were significantly higher than those in benign rectal disease controls. CTC positive rates inⅣstage were significantly higher than those inⅡ-Ⅲ stage. The expression of CTC was significantly correlated with CEA (r = 0.6652, P < 0.01). Conclusions The expression of CTC in CRC patients is significantly higher than that in benign rectal disease control group. It is closely related to clinical stages. Detection of peripheral blood CTC has important clinical significance in the early diagnosis of CRC metastasis.

ObjectiveTo investigate the effect of NGF on apoptosis of HSC in vitro and explore the possible mechanism.MethodsHSC was incubated with different concentrations of NGF.HSC apoptosis was identified by FCM.The expressions of apoptosis-regulating proteins Caspase-3,p53 and Bcl-2 of HSC after apoptosis induced by NGF were examined by immunohistochemical staining.Expressions of NGF and p75NTR were detected by immunofluorescence.ResultsApoptosis index of HSC was higher than that of control group [(22.36±9.51)％ vs (5.88±1.36)％] after treated with NGF (100 ng/ml) (P＜0.05).After incubating with 100 ng/ml NGF for 24 h,the positive expression rates of p53 and Caspase-3 of HSC increased significantly than those of control group [(78.41±4.00)％ vs (34.96±3.84)％,(39.26±1.57)％ vs (9.27±1.01)％,P ＜0.05].The positive expression rate of Bcl-2 protein of HSC significantly decreased compared with that of control group (18.12±1.38)％ vs (91.53±2.98)％ (P＜0.05).When HSC was stimulated with 100 ng/ml NGF for 24 h,the average optical density of NGF increased significantly than control group (6.53±1.40 vs 1.77±0.17) (P＜0.05),while the expression of p75NTR was not significantly changed (3.52±0.36 vs 4.24±0.38) (P＞0.05).ConclusionsThe mechanism of NGF to induce HSC apoptosis may be associated with the up-regulating expression of Caspase3,P53 and down-regulating expression of Bcl-2 on HSC.NGF could be used as an initiating factor and effect factor to increase the expression of NGF on HSC,but it had no significant effect on p75NTR expression.

Objective To discuss the clinical values of transabdominal ultrasonic diagnosis of nontraumatic hiatal gastric hernia of esophagus in middle-aged and elderly people.Methods Thirty-two cases were examined with fasting and filing methods in half-sitting,standing,supine and supine right anterior oblique positions.The findings were contrasted with X-ray barium meal examination,endoscopy and operation.Results Twenty-nine cases were of sliding hiatal gastric hernia of esophagus,3 of impacted hernia.The ultrasonic diagnosis coincidence rate was 100%.The signs and symtoms of acoustic images were widening of esophageal hiatus diaphragmatic muscle(≥1.37 cm),echoes of gastric mucosa were found in superior phrenic hernail sac and inside hernial sac.The display rates were 100%,100%,15.6%respectively.Conclusions The transabdominal ultrasonic diagnosis of nontraumatic hiatal gastric hernia of esophagus in middle-aged and elderly people is brief and accurate.

Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.

Objective To investiagate cell apoptosis and expressions of Bax,Bcl-2 andCaspase-3 in gambogic acid-treated colorectal cancer cells. Methods SW480/LOVO colorectal cancer cells were treated by gambogic acid. Cell Counting Kit-8 assay (CCK-8) was used to test cell proliferation. Microscopy was used to check the morphological changes. Immunofluorescence staining technique was used to detect cell apoptosis. Expressions of Bax,Bcl-2 and Caspase-3 protein were detected by Western blot assay. Results Gambogic acid inhibited the proliferation of SW480/LOVO in a dose and time-dependent manner. Gambogic acid could induce cell apoptosis. Gambogic acid increased expressions of Caspase-3 and Bax, increased the ratio of Bax/Bcl-2, and decreased Bcl-2 protein expression. Conclusion Gambogic acid can inhibit proliferation and induce apoptosis of SW480LOVO cells, with the mechanism of up-regulation of Bax/Bcl-2 and activation of Caspase-3.