BACKGROUND:Proximal humeral fracture fixation can provide a more stable fixation, has a stronger biomechanical stability, but open reduction and fixation wil cause extensive soft tissue dissection and heavy damage to the rotator cuff. Closed wear nail has a high failure rate of fixation, fracture re-displacement and other defects. OBJECTIVE:To investigate the technical methods of applying closed reduction, percutaneous pinning anatomical external fixation in repair of proximal humeral fracture, and to analyze the application characteristics and safety in different types of proximal humerus fractures. METHODS:Based on the special anatomical structure of proximal humerus, a shoulder external fixator has been independently researched and developed by author. The clinical data of 23 patients treated with closed reduction and percutaneous pinning anatomical external fixation (homemade) because of proximal humerus fracture at the Department of Traumatology, Tianjin Hospital during March 2010 to March 2014 were retrospectively analyzed. In accordance with Neer classification type, there were 19 cases of 2-part fractures of the humerus, 4 cases of 3-parts fractures of the humerus, with greater tuberosity avulsion fractures, which were al fresh fractures and were treated with closed reduction pinning and external fixation. Regular fol ow-up was conducted after treatment. Radiographic assessment, pain and function evaluation were conducted during fol ow-up, so as to work out the functional recovery, determine the final repair result. RESULTS AND CONCLUSION:Al patients were fol owed up for 6-24 months. Total y 23 patients initial y healed in fracture within 8 weeks. After treatment, visual analogue pain score of patients was 0.8 points. In the final fol ow-up, the American Shoulder and Elbow Surgery Association of shoulder function scoring system (ASES) score was an average of (91.7±2.6) points, Constant shoulder function score was an average of (88.3±4.7) points, the University of California (UCLA) shoulder joint scoring system score was (31.9±3.1) points, simple shoulder test (SST) system score was an average of (9.6±2.4) points. The shoulder function assessment (UCLA score) of these 12 patients was excel ent, of 9 cases was good, and of 2 cases was poor. The excel ent rate reached 91%after treatment. These results suggest that the application of closed reduction, percutaneous nailing anatomical external fixation in repair of proximal humerus fractures has the features of stable fixation, and smal damage of soft tissue. Standardizing the angle of closed nailing and entrance point, fixing from the intersection of three planes in arcuate-shape and connecting with external fixation can achieve a more stable fixed effects.

Objective To verify the correlation between rs17118 polymorphism of xyluloknase homolog (XYLB) gene and risk of ischemic stroke in a Chinese Han population.Methods A case-control study design was used.The case group was the patients with first-ever ischemic stroke and the control group was the healthy subjects from hospital physical examination.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs17118 C/A polymorphisms.Results A total of 475 patients with ischemic stroke and 483 controls were enrolled in the study.The proportion of hypertension (67.9％ vs.22.2％;x2 =292.982,P ＜ 0.001) and diabetes (24.2％ vs.7.3％;x2 =25.864,P ＜ 0.001),as well as the levels of triacylglycerol (1.649 ± 1.126 mmol/L vs.1.157 ±1.480 mmol/L;t=3.592,P＜0.001),and low-density lipoprotein cholesterol (3.499 ± 1.163 mmol/L vs.3.105 ± 0.627 mmol/L;t =-6.227,P ＜ 0.001) in the case group were significantly higher than those in the control group,but the total cholesterol level was significantly lower than that in the control group (5.144 ± 1.296 mmol/L vs.5.491 ± 1.335 mmol/L;t =4.650,P ＜ 0.001).The AA genotyp e (11.4％ vs.7.5 ％;x2 =6.136,P =0.016) and A allele (32.3 ％ vs.26.4％;x2 =8.093,P =0.005) frequencies in the case group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke in AA genotype carriers was 1.97 times of the CC genotype carriers (odds ratio 1.971,95％ confidence interval 1.040-3.736,P=0.038).Conclusions The rsl7118C/A polymorphism of XYLB gene may be associated with the risk of ischemic stroke in the Chinese Han population.

Objective To evaluate the application effect of‘incorrect cases’in medical statis-tics teaching. Methods The junior students (n=307)of clinical medicine were selected as research subjects by random cluster sampling. They were divided into the teaching improving group (n=151) who accepted case teaching and control group (n=156)who accepted traditional teaching. At the end of the term,the teaching effect was surveyed by questionnaires and compared between the two groups. Measurement data was analyzed by t test,enumeration data by χ2 test and ranked data by rank sum test. Results Students' interests of medical statistics and understanding the importance of the course in teaching improving group were significantly higher than that in control group (Z=-2.375,P=0.018;Z=-2.971,P=0.003). The proportion of students with learning difficulties in teaching improving group was obviously lower than that in control group (Z=-2.488,P=0.013). The satisfaction with theory and practical teaching in teaching improving group (84.10% and 88.74%,respectively)was significantly higher that in control group (73.08%and 71.79%,respectively)(χ2=5.530,P=0.013;χ2=13.841,P<0.001). Although no difference was observed in the test score between the two groups (t=1.230,P=0.220),knowledge of parameter estimation,hypothesis testing and science research design in teach-ing improving group was significantly higher than that in control group (χ2=6.829,P=0.009;χ2=5.835, P=0.016). Conclusions Application of ‘incorrect cases’in medical statistics teaching could arouse students' learning interests and improve clinical medical students' comprehensive analy sis ability of medical statistics.

Objective To observe the anti-tumor effects of Agrimonia Pilosa Ledeb(APL) ,a Chinese herbal medicine ,on hepato-cellular carcinoma cells in vitro and investigate the underlined mechanisms preliminarily .Methods APL water extracts were pre-pared .SMMC-7721 cells were cultured with the medium containing different concentrations of APL water extracts ,and at different time points ,cell viabilities were measured by the MTT assay and inhibitory rates (IR) were calculated ;cell morphologic changes were observed under a light microscope ;apoptotic ratios were measured by flow cytometry ;and the expressions of Bcl-2 and P53 proteins were examined by immunocytochemistry .Results After the cells were cultured with the medium containing APL water ex-tracts for 24 h ,48 h and 72 h ,no obvious effects were found on the cell proliferation in 5 mg/mL group and 10 mg/mL group ,but IR were 0 .5% ,23 .9% and 27 .5% in 20 mg/mL group and 23 .3% ,51 .7% and 71 .6% in the 40 mg/mL group ,respectively .In the groups with effects on the cells proliferation ,morphological characteristics of apoptosis were obvious ,and the cell apoptotic ratios were 19 .5% and 23 .0% in 20 mg/mL group and 33 .4% and 42 .7% in 40 mg/mL group at 48 h and 72 h .The expressions of Bcl-2 protein were 71 .9% and 58 .5% in 20 mg/mL group and 47 .9% and 26 .5% in 40 mg/mL group at 48 h and 72 h ,and the ex-pressions of P53 protein were 22 .9% and 50 .6% in 20 mg/mL group and 48 .7% and 83 .7% in 40 mg/mL group at 48 h and 72 h . Conclusion The water extracts of APL are able to inhibit proliferation and induce apoptosis of SMMC-7721 cells dose-time depend-ently in vitro ,which might be associated with the expression changes of Bcl-2 and P53 protein .

The effects of PEG10 on hydrogen peroxide (H(2)O(2))-induced apoptosis in human normal liver cell line L0(2) were investigated. The PEG10 gene was transfected into L0(2) cells by lipofectamine, the positive clone was screened by G418 and defined as L0(2)/PEG10, while the cell transfected with empty expression vector (pEGFP-N1) was defined as L0(2)/vector. L0(2)/vector and parental L0(2) cells served as control. RT-PCR and Western blotting were employed to detect the expression of target genes. H(2)O(2) (50-400 mmol/L) was administered to induce the apoptosis of L0(2) cells. Cells viability was measured by MTT and the morphological changes of apoptotic cells were determined by fluorescence microscopy using hoechst33342 nuclei staining. DNA fragmentation was observed by agarose gel electrophoresis. PEG10 mRNA and protein levels in L0(2)/PEG10 cells were significantly increased as compared with those in the control cells. After treatment with 400 mmol/L H(2)O(2) for 24 h, the cellular growth inhibition rate of L0(2)/PEG10 cells was significantly lower (58.2%) than that of L0(2) (92.5%) and L0(2)/vector (88%). Distinct morphological changes characteristic of cell apoptosis such as karyopyknosis and conglomeration were not observed in L0(2)/PEG10. Ladder-like DNA fragmentation in a dose-dependent manner was observed in both L0(2) and L0(2)/vector cell lines, but not in L0(2)/PEG10. PEG10 over-expression significantly inhibited cytotoxicity induced by H2O2 on human normal liver cell line L0(2) by antagonizing H(2)O(2)-induced apoptosis.

Alemtuzumab (Campath) was successfully injected in 21 kidney transplant patients,7 islet transplant patients and 1 simultaneous kidney and islet transplant patient for either prevention or treatment of graft rejection.Prophylactic administration was successfully completed in all patients without discontinuation.Adverse events were not observed in 11 patients (38%),but hypertension in 18 patients (62%),shivering in 3 patients (10.3%),high fever in 3 patients (10.3%),and bronchospasm in 1 patient (3%),respectively.All complications alleviated after proper therapy.During the prophylactic administration of alemtuzumab,strict,timely and proper ward-management was needed.Care for lung,perineum,skin,diet and psychological nursing were necessary.Neither graft acute rejection nor graft chronic rejection episode occurred in all patients during 6 months to 2 years follow-up.Therefore,long term effects of Alamtuzumab and consequences of lymphocytopenia need further observation.

Objective To establish a new technique of isolating pancreatic islet of langerhans and glueoeortieoid-free immunosuppressive regimen and to evaluate the clinical efficacy and safety of simultaneous adult islet-kidney transplantation in the treatment of type 1 diabetes mellitus with endstage renal failure.Methods Pancreases were stored using the"2-layer method"of the oxygenated perfluoroehemieal and UW solution.The pancreases were digested by Liberase collagenase enzyme and purified using continuous gradients of Ficoll-diatrizoic acid on a refrigerated COBE 2991 centrifuge to separate the islets.Cadaver kidney was transplanted by conventional method and cultured islets were infused by surgical approach to the liver via portal vaseulature using glucocorticoid-free immunosuppressive regimen.Clinical metabolic data such as blood glucose,dose of insulin,C-peptide,HbAlc,liver function and renal function,were determined and compared with the pre-transplant data.ResuitsIslets of langerhans were isolated successfully in 23 pancreases.The average islet yield was 300000 islet equivalents(IEQ).Islet purity and viability were 91.6%,94.6%,respectively.The stimulation index as assessing function of human islet was 3.16 and etiology results in vivo were negative.Twelve islet transplant infusions were carried out in 7 patients after kidney transplantation.Three recipients received 2 islet infusions,1 patient had 3 transplants,and 3 patients received 1 transplant only.The average islet mass for infusion was 1 1 820 IEQ/kg.The immunosuppressive regimen glucocorticoid.During 18 months to 3 yearg follow-up,4 recipients had insulin independence,the dosage of insulin decreased by 70%in 3 patients.The level of blood glucose and H bAlc,liver and renal function were normal throughout follow-up period.C-peptide of all patients was positive after islet transplantation.No adverse effects and complications related to islet infusion procedure were found.Conclusions New technique has proved tO be suitable for isolating pancreatic islet of langerhans.Simuhaneous adult islet-kidney transplantation could be used as an effective and safe way for treating type 1 diabetes mellitus with end-stage renal failure.

Objective To understand the research hotspots and research trends about convolutional neural networks in the field of oncology imaging diagnosis by analyzing the characteristics of published literature at home and abroad over the past decade. Methods The SCI-E database was used as the data source to retrieve literature about convolutional neural networks in the field of oncology imaging diagnosis published from 2012 to 2022. The distribution characteristics of countries, institutions, journals, co-cited authors, and keywords of the studies were analyzed by CiteSpace software. Results A total of 1088 papers were eventually included, and they were mostly from China, the United States, and India. A total of 39 papers were published by Sun Yat-sen University, the research institution with the highest number of publications. Radiology Nuclear Medicine Medical Imaging was the journal with the highest number of publications. A total of 25 high-frequency keywords and 15 burst keywords were obtained. The formation of 12 author co-citation clusters such as image segmentation and lung nodule, as well as 11 keyword clusters such as automatic segmentation and breast cancer, was observed. Conclusion Current research on convolutional neural networks for oncology imaging diagnosis focuses on oncology segmentation, lung-nodule recognition, assisted diagnosis of breast cancer, and other high-frequency oncology.

Objective: To develop a method that can continuously monitor duration of students outdoor activities for a long time, so as to provide data support for the relationship between outdoor activity duration and students health. Methods: From April 28 to July 6, 2022, 1 168 students from a primary school in Shenzhen were selected. Fixed cameras were placed on the top of school classrooms, corridors and critical paths were used to identify student data and duration in the picture. And AI, cloud computing and other methods were used to measure students-non-classroom time instead of outdoor activity time in school. Results: The average length of time spend on outdoor activities in school of the 24 pilot classes were 67.6-113.0 min, and showed a downward trend by grade ( F =42.74, P <0.05). The duration of outdoor activities among students was negatively correlated with the detection rate of myopia and overweight( r =-0.74, -0.45, P <0.05). Conclusion The data on outdoor activity time calculated by AI image recognition is basically in line with the reality. Monitoring students outdoor activity time at school through AI image recognition is feasible and popularized.

Objective:To explore the clinical value of peripheral blood lymphocyte subsets in the differential diagnosis of BK virus nephropathy (BKVN) in renal transplantation recipients.Methods:From 2014 to 2018, a total of 172 renal transplant recipients were recruited. Their peripheral blood lymphocyte subsets were detected. According to the pathological puncture results of transplanted kidney, they were divided into acute rejection group (AR, n=68), BKVN group ( n=73) and stable graft function group (STA, n=31). The proportion and absolute number of peripheral blood lymphocyte subsets in each group were measured by flow cytometry and the proportion and absolute count of peripheral blood lymphocyte subsets in each group compared. Results:The proportion and absolute number of CD19 + B cells were markedly lower in BKVN group than those in AR group ( P=0.005, 0.003; 8.5% vs 13.2%, 0.094×10 9/L vs 0.202×10 9/L) and STA group ( P=0.005, 0.003; 8.5% vs 14.8%, 0.094×10 9/L vs 0.198×10 9/L); the proportion of CD3 + CD8 + T cells was significantly higher in BKVN group than that in AR group ( P=0.013; 36.9% vs 31.2%). In addition, no obvious difference existed in the proportion and absolute number of lymphocytes, CD3 + T, CD3 + CD4 + T and CD16 + CD56 + natural killer (NK) among three groups ( P>0.05). No obvious difference existed in the proportion of CD3 + CD4 + / CD3 + CD8 + T cells among three groups ( P>0.05). Conclusions:No difference exists in T cell-related lymphocyte subsets between BKVN and acute rejection recipients. However, the number and proportion of CD19 + B cells decrease markedly in BKVN.