ObjectiveTo investigate the accuracy of percutaneous iliosacral screw fixation in sacroiliac joint fracture-dislocation with minimally invasive guider with CT-guided.MethodsFrom January 2011 to May 2011,8 patients with sacroiliac joint fracture-dislocation were treated using percutaneous iliosacral screw fixation assist with minimally invasive guider in CT-guided,which included 5 males and 3 females,with the average age of 32 years (ranged from 26 to 56 years).All patients suffered with vertically unstable pelvic fractures.Bone traction was used in femoral condyle for 6 cases which displaced more than 2cm in sacroiliac joints.Patients were prone position on the CT bed.First sacroiliac joint CT-scan was performed,then marked the needle position on affected side buttocks after measure the best position and track of needle that expected on CT computer screen.According to the data of CT-scan,the angle of the devices was adjusted,which could control 3D direction of the minimally invasive guider,then insert the Kirschner wire into sacroiliac joint guided with the front end of the sleeve of the minimally invasive guider,confirmed the track of needle was excellent with CT-scan (3D),then the guider was moved out and put the hollow screw (dia 7.3 mm Synthes) into the sacroiliac joint along the Kirschner wire.ResultsAll 8 patients were successfully insert the Kirschner wire.The operation time was from 10 to 20 min(mean,14 min).All screws were in the position expected before surgery,no cut out of bone with the CT-scan immediately after operation,the shape of sacroiliac joint was restored satisfied and the fixation was stable.No numbness and radiation-like pain appeared among the operation in the lower limb for all patients,no case had vascular and neurological complications postoperative.ConclusionThe minimally invasive guider can improve the accuracy,security and simplicity of the percutaneous iliosacral screw fixation with CT-guided,and also avoid the deviation of needle insertion angle that determined by operator himself.

Objective To investigate the clinical outcomes of sternoclavicular hook plate in treatment of the anterior sternoclavicular joint dislocation. Methods A new device named sternoclavicular hook plate was devised by our team. Between May 2002 and Octorber 2009, 66 patients with sternoclavicular joint anterior dislocation were treated with the new device, among whom there were 47 males and 19 females,aged 21-68 years old (average, 32.6 years old). Twenty-one cases were caused by crush injury, 5 cases by falling and 40 cases by traffic accident. Anterior fracture-dislocation was found in 41 cases. According to the Allman system, there were 35 cases of type Ⅱ and 31 cases of type Ⅲ. Patients were evaluated with serial clinical and radiographic examinations. Rockwood score were used after the operation to assess the curative effect. Results The average operative time was 33 min (range, 20-48 min). The mean blood loss was 60 ml (range, 20-90 ml). There were no vascular or peripheral nerve injuries in the patients. All incisions healed smoothly. The X-ray and CT showed that the reduction of sternoclavicular joint and the location of internal fixation were satisfactory. All the 66 patients were followed up for 12-37 months (average, 17 months). There was no internal fixation failure, redislocation or other complications. The sternoclavicular hook plate was removed 12 months after operation. The mean Rockwood's score was 13.2 (8 to 15). There were excellent in 50cases, good in 15 cases, and fair in 1 case. Conclusion The sternoclavicular hook plate is a new, safe and liable technique for sternoclavicular fracture-dislocation. This new technique is helpful for early functional exercises.

AIM: To investigate the effect of advanced glycosylation end products on the expression of receptor for advanced glycosylation end products in human monocyte-derived dendritic cells. METHODS: Monocytes were purified (over 98%) using anti-CD14+ microbeads. After 8 d culture in RPMI-1640 medium containing rhGM-CSF (100 ?g/L) and rhIL-4 (50 ?g/L), immature MDCs were derived, then exposed to AGE-BSA (0 or 200 mg/L) for 24 h. Expression of RAGE was semi-quantified by RT-PCR and Western blotting. At the same time, supernatants were collected. IFN-? and IL-12 were analyzed by ELISA. RESULTS: mRNA and protein of RAGE incubated by 200 mg/L AGE-BSA was higher than that in control at 24 h. Treatment of DCs with AGE-BSA resulted in about two-fold increase in the expression of RAGE (P

AIM: The purpose of this study is to investigate the mechanisms related to oxidized low-density lipoprotein(ox-LDL) and dendritic cells(DCs) in the process of atherosclerosis.METHODS: Human DCs were prepared from human CD14~+ peripheral blood monocytes using rhGM-CSF((100 ?g/L)) and rhIL-4(40 ?g/L).Cells were incubated with(100 mg/L) native or oxidized LDL for 72 h.The formation of foam cells was investigated by electron microscopy and oil red O staining.Phenotypic and immune functional assays were used with FACS,FITC-dextran phagocytosis,allogeneic mixed T lymphocytes reaction and secretion of Th1/Th2(IL-12/IL-2) cytokines were also conduced.RESULTS: DCs treated with ox-LDL,but not native LDL were induced into foam cells after cultured for 72 h.Compared with native LDL,ox-LDL-treated DCs were less potent in FITC-dextran phagocytosis.ox-LDL promoted allogeneic T cells proliferation.Moreover,ox-LDL upregulated CD80(72.4? 9.6 vs 89.5?10.1,P

Objective To analyze the voice quality of children post operation for complete cleft palate through subjective and objective evaluation and explore the correlation between them. Methods Electroglottography analysis was used in the natural sound/a/of 30 postoper-ative children with complete cleft palate and 34 normal children, and the difference was compared. The natural prolonged sound/a/was as-sessed with GRBAS (grade, roughness, breathiness, asthenia, strain) in the children with complete cleft palate, and the correlation between the subjective and objective results was analyzed. Results F0, harmonic to noise ratio (HNR) were less, and the shimmer, jitter, normalized noise energy (NNE) and nasalance was greater in postoperative children with complete cleft palate than in normal children. For the children with complete cleft palate, G and R mainly rated as levels 1 and 2, B also rated as levels 1 and 2 in less than half of the children. There were low or very low correlation between all subjective and objective results, excepted G, R, B and F0, which showed moderate correlation. Con-clusion The vocal cords vibrate slowly and irregularly in postoperative children with complete cleft palate, suggesting mild and moderate voice disorder, and they sound hoarsely with roughness and breathiness. There are poor correlations between the subjective and objective as-sessment, and need to be used in combination for the children with complete cleft palate.

A lean management practice had been in place in Taizhou Enze Medical Center during the COVID-19 epidemic period, featuring the " principle-system-tool" theory of the Shingo model, in an effort to build a new model of COVID-19 prevention and control. The center upheld such five principles of lean management as overall planning, total involvement, system collaboration, concern with process and continuous improvement, and people-oriented practice. Under such principles, the center set up five supportive systems of lean management tools, namely risk identification, rapid screening, homogeneous treatment, customized follow-up and employee care. Integrated use of multiple tools of lean management, had improved the hospital′s crisis response ability, achieving desirable outcomes in stages in combating COVID-19 epidemic.

OBJECTIVE Aim to explore the value and the selection of observation target of P1 component in children with cochlear implant(CI). METHODS 13 children(4.37±0.73 years old) with right side CI and one year of regular post-CI rehabilitation were recruited as CI group. 15 gender and age (4.25±0.84)years matched children with left side external and middle ear malformation were selected as control group. We collected their AEP which showed their reaction to 1000 Hz pure tone and analyzed the P1 component. RESULTS The cut off value between CI group and control groupwas 10.4mV for P1 Amplitude(P1A) and 110.5 mV for P1 Latency(P1L). More precisely, the values of CI group were above the cut off value while the values of control group were below it. Whether choosing P1A or P1L as dividing standard, the AUC were between 0.5 and 0.9(AUC: P1A0.733, P1L0.800), which showed medium distinguishing significance. P1L component showed greater You-den index(0.590>0.471) and sensitivity(0.923> 0.538) while P1A showed greater specificity(0.933>0.667). CONCLUSION P1L shows greater ability in distinguishing the difference between CI group and control group while P1A has advantage in determining their common feature. Generally, P1L shows higher value in studying CI children. We need to make choice between P1A and P1L in different situation and use P1A and P1L standard in series or parallel.

Objective:To investigate effect of vitexin on macrophage polarization and its impact on tumor growth in a mouse model of prostate cancer.Methods:C57BL/6J male mice were used to establish RM-1 prostate cancer xenograft model.Mice were ran-domly divided into model group,vitexin-low,medium and high doses groups(40,80,160 mg/kg),and cisplatin group as positive control.After continuous administration for 16 days,mice were euthanized and tumor mass was measured.HE staining was performed to observe tumor morphology.Immunohistochemistry was used to detect Ki67 positive rate.Flow cytometry was conducted to measure expressions of CD86+CD11b and CD206+CD11b in tumor-associated macrophages.CCK8 assay was performed to assess cytotoxic effect of vitexin on RAW264.7 macrophages to determine suitable concentrations.RT-qPCR was used to measure mRNA expressions of M2 macrophage markers,including arginase-1(ARG-1),Fizz1 and Ym1.Results:Vitexin inhibited tumor volume and weight,induced tumor tissue necrosis,suppressed Ki67 protein expression,increased expression of CD86+CD11b+M1 macrophages,and inhibited CD206+CD11b+M2 macrophage expression in mouse tumor tissues in vivo.Vitexin at concentrations of 10～20 μmol/L showed no cyto-toxicity on RAW264.7 macrophages in vitro,and promoted expression of iNOS in IL-4-induced M2 macrophages while inhibiting CD206 expression,as well as suppressed mRNA expressions of ARG-1,Fizz1 and Ym1.Conclusion:Vitexin effectively inhibits tumor growth in a mouse model of prostate cancer,possibly by regulating M2 macrophages towards an M1 phenotype and exerting immunomodulatory effects.

Objective To detect the expression of pan-neuronal marker protein gene product ( PGP)9.5 and its clinicopathologic significance in breast cancer .Methods The expression of PGP9.5 was examined by immunohistochemistry EnVision method in 196 cases during 2007 to 2011, including 20 normal tissues, 14 cases of fibroadenoma , 18 cases of ductal carcinoma in situ ( DCIS) and 144 cases of invasive ductal carcinoma (IDC) of the breast.The relationship between PGP9.5 expression and clinicopathologic characteristics of IDC was assessed.Results PGP9.5 expression was localized in the stroma of all normal breast tissues, but there was no expression observed in all fibroadenomas and DCIS.Overall, the expression rate of PGP9.5 in IDC was 61.8%(89/144).PGP9.5 expression increased from grade 1 tumors (29.4%, 10/34) to grade 2-3 tumors (71.8%, 79/110; P=0.000).In addition, patients with less than 3 years disease-free survival tended to show higher PGP9.5 expression (64.8%, 35/54), compared to patients with equal to and/or more than 3 years disease-free survival (46.7%, 42/90;P=0.035).However, there was no correlation between PGP 9.5 expression and tumor size , tumor stage , lymph metastasis , hormone receptor expression.Conclusion PGP9.5 expression is correlated with tumor grade and prognosis in IDC of the breast.

Objective:To compare the clinical outcomes of arthroscopic external tension band fixation versus open reduction and internal fixation in the treatment of greater tubercle fracture of the humerus.Methods:A retrospective cohort study was conducted on 55 patients with greater tubercle fracture of the humerus admitted to Taizhou Hospital of Zhejiang Province from September 2019 to June 2022, including 24 males and 31 females, aged 26-80 years [(61.7±10.5)years]. Out of them, 35 patients treated with open reduction and internal fixation (open reduction group), and 20 patients were treated with external anchor tension band under arthroscopy (arthroscopy group). The operation time, and the Visual Analogue Scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and shoulder active range of motion (anterior flexion, abduction and posterior extension) before operation, at 1 month after operation and at the last follow-up were compared between the two groups. Bone healing was observed in both groups at the last follow-up. Postoperative complications were compared between the two groups.Results:All the patients were followed up for 12-29 months [(16.9±4.0)months]. There was no significant difference in operation time between the two groups ( P>0.05). There were no significant differences in the VAS score, ASES score, Constant-Murley score and shoulder active range of motion between the two groups before operation ( P>0.05). The VAS score of the arthroscopy group was 3(2, 3)points at 1 month after operation, which was significantly lower than that of the open reduction group [4(3, 4) points] ( P<0.01). No significant difference was found in the VAS score at the last follow-up between the two groups ( P>0.05).The ASES scores of the arthroscopy group were (70.6±4.2)points and (90.2±3.7)points at 1 month after operation and at the last follow-up respectively, which were significantly higher than those of the open reduction group [(64.7±6.4)points and (87.5±4.9)points respectively] ( P<0.05 or 0.01). There was no significant difference in the Constant-Murley score between the arthroscopy group [(71.8±4.3)points] and the open reduction group [(70.9±5.3)points] at 1 month after operation ( P>0.05), while the Constant-Murley score of the arthroscopy group was (94.1±3.1)points at the last follow-up, which was significantly higher than that of the open reduction group [(89.2±4.7)points] ( P<0.01). At 1 month after operation and at the last follow-up, ranges of motion of the anterior flexion, abduction and posterior extension were (52.7±12.3)° and (140.0±16.9)°, (57.4±8.6)° and (125.0±14.3)°, and 16(15, 19)° and 25(20, 30)° in the arthroscopy group respectively, which were significantly higher than those in the open reduction group [(42.2±5.2)° and (110.9±14.0)°, (52.8±6.0)° and (103.7±11.7)°, and 10(10, 20)° and 16(15, 25)° respectively] ( P<0.05 or 0.01). At the last follow-up, it was found that bony union was achieved in both groups. There were no obvious complications such as incision infection or joint stiffnessin both groups. In the open reduction group, 2 patients had internal fixation failure within 1-3 months after operation but was treated with revision operation; 6 patients developed shoulder stiffness at 3-6 months after operation but had outpatient rehabilitation. The incidence rate of postoperative complications in the arthroscopy group [0%(0/20)] was significantly lower than that in the open reduction group [23%(8/35)] ( P<0.05). Conclusion:Compared with open reduction and internal fixation with plates and screws, arthroscopic external anchor tension band fixation in the treatment of greater tuberosity fracture of the humerus has the advantages of earlier pain relief, better shoulder functional improvement, better recovery of shoulder mobility, and fewer complications.