Nineteen patients with comminuted fractures in middle and distal humerus were treated by dual-plate internal fixation in the prone position in the Department of Orthopaedics,Xiangya Third Hospital of Central South University from January 2005 to June 2007.There were 12 males and 7 females.The average age of the patients was 35.63 years(range 19-65 years),among which 10 cases were left and nine cases were right.All the cases were closed comminuted fractures and 13 cases of them were simple fracture while the other six cases with radical nerve injury.Humerus metal bone plate,with pattern number YJQⅠ(recondition),was used in this study.All patients got the bone union in the average follow-up time of 10 months without complications such as delayed union,nonunion and wound infection.The average healing time was three months.Aitken and Rorabeek score:excellent in 14 cases,good in 3,common in 2,and poor in 0.Totally 89.47% of the patients achieved excellent and good effect.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin,baicalin and imperatorin in Urticaria pill. METHODS:HPLC was performed on the column of Alltima C18 with mobile phase of methanol-water-Phosphoric ac-id(55∶45∶0.2,V/V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm for paeoniflorin,280 nm for baicalin and 300 nm for imperatorin,column temperature was 30 ℃,and the volume injection was 10 μl. RESULTS:The linear range was 5.40-54.0 μg/ml for paeoniflorin(r=0.999 8),11.29-112.9 μg/ml for baicalin(r=0.999 7)and 24.95-249.5 μg/ml for imperatorin (r=0.999 9),respectively;the linit of quantitation were 5.4、11.2、30.0 ng,the lirnit of detection were 1.8、2.8、7.5 ng;RSDs of pre-cision, stability and reproducibility tests were lower than 2%;recoveries were 95.88%-98.33%(RSD=0.95%,n=6), 96.86%-99.96%(RSD=1.20%,n=6)and 98.07%-100.55%(RSD=0.92%,n=6),respectively. CONCLUSIONS:The method is simple and accurate with strong specificity and good reproducibility,and can be used for the simultaneous determination of paeoni-florin,baicalin and imperatorin in Urticaria pill.

Objective To evaluate the clinical significance of orthotopic continent detenial sigmoid neobladder.Methods 12 patients with bladder cancer were admitted and underwent radical cystectomy and detenial sigmoid neobladder.Results All the 12 patients were followed up for a mean of 18.6 months(range from 6 to 29 months).The blood Cr and BUN levels were both in the normal range without acidosis in all the cases.Only 1 had unilateral ureteral urine reflux during cystography.Of the 12 patients,11 cases(91.7%) achieved continence during daytime;2 cases(16.7%)were incontinent at night,but 1 case could control uri- nation by being woken up at night.The capacity of the neobladder was 220 to 550ml with a mean of 350ml and the maximal pressure of the neobladder during filling was 15 to 55cm H_2O(1cm H_2O=0.098kPa)with a mean of 35cm H_2O.Conclusion As a simple operation the detenial sigmoid neobladder can be performed easily with less complications and more reliable results.This operation may be generally applied in clinical practice.

Objective To summarize the experience of nursing cancer patients with anal fistula treated with blood stem cells transplantation (BSCT). Method 8 critical cancer patients with anal fistula treated with BSCT from August 2013 to November 2014 were intervened by nursing measures such as prevention of constipation and diarrhea , protecting the anus from infection and health education . Results Two patients of them contracted with mild crissum infection , 1 moderate , 0 severe . With the pertinent nursing intervention , no serious complications occurred . The hospital stay was 20~30 d , with an average of ( 24 . 75 ± 2 . 30 ) . Conclusion The nursing measures including preventing constipation and diarrhea, keeping the anus from infection and health education can be effective in avoiding anal fistula infection and its related complications and reducing patients′pain , which are worth clinical promotion .

To investigate the effect of menopause on chemokine receptor CXCR2 expression on monocyte, 21 postmenopausal and 20 premenopausal women were enrolled in the present study. Fasting venous blood was collected, and plasma estrogen levels were determined with radio immunoassay. Monocytes were separated from peripheral blood with gelatin method. Protein expression of chemokine receptor was assayed with flow cytometry and mRNA concentration was measured with RT PCR. The results showed that the levels of plasma estrogen decreased, whereas protein and mRNA expression of chemokine receptor CXCR2 increased after menopause. The plasma estrogen levels were negatively correlated with chemokine receptor CXCR2 expression in monocytes. These data suggested that the changes in CXCR2 on monocytes might contribute to,at least partially,the increased risk of developing coronary heart disease associated with estrogen secretory changes.

ObjectiveTo investigate the association of bacterial translocation (BT) with cachexia and its impact on the outcome of gastric cancer patients.MethodsSixty cachectic gastric cancer patients,50 age- and sex-matched non-cachectic gastric cancer patients,and 55 healthy controls were enrolled in this study between January 2008 and July 2009.Polymerase chain reaction was performed to detect bacterial DNA in the peripheral blood of cancer patients and healthy controls,Cytokine levels were tested by enzyme-linked immunosorbent assay.Flow cytometry was used to detect immune indicators.All the enrolled patients were followed up for two years,and the two-year survival rate was calculated.ResultsThe BT ratio was significantly higher in cachectic patients than in non-cachectic patients (25.0％ vs.8.0％,P =0.019) and healthy controls (25.0％ vs.0.0％,P =0.000).BT-positive cachectic patients had significantly higher levels of IL-1α,IL-6,TNF-α,and IFN-γ compared with BT-negative cachectic patients ( P =0.012,0.003,0.036,and 0.017,respectively ) and BT-positive non-cachectic patients ( P =0.011,0.034,0.000,and 0.022,respectively).The two-year survival rate in BT-positive cachectic patients was significantly lower than in BT-negative cachectic patients (P =0.023 ).The levels of CD3 +T,CD4+ T,natural killer cells,and CD4 + T/CD8 + T in gastric cancer patients were significantly lower than in healthy controls ( P =0.023,0.031,0.016,0.041,respectively),whereas CD8 + T level was significantly higher in gastric cancer patients than in healthy controls (P =0.038).ConclusionBT may contribute to the development of cancer cachexia and influence the long-term survival of locally advanced gastric cancer patients.

Objective To establish a rat model of liver metabolism profile in chronic heart failure (CHF), to explore the dynamics of liver metabolism in CHF from the point of view of metabolism, and to find the characteristic metabolites valuable for the molecular mechanism and management of CHF.Methods Twenty male Wistar rats were assigned to the CHF group to receive aortic coarctation or to the control group to receive sham surgery, and were bred for 24 weeks following surgery.The metabolic profiling of the rat liver tissues was analyzed on a metabonomics research platform. Orthogonal partial least squares-discriminant analysis ( OPLS-DA) model and principal component analysis ( PCA) model were established for liver tissues of the CHF rats, and the characteristic metabolites were finally derived by data processing with SPSS 19.0 software.Results The PAC and OPLS-DA models were established successfully.Ten characteristic metabolites with significant differences between the CHF and control groups, including lysophosphatidyl choline, lysophosphatidyl ethanolamine, oleic acid, glycocholic acid, and dehydroepiandrosterone sulfate, were screened and identified from the models.Conclusions The metabolic disorders in CHF rats are well fitted to the established metabolic profile models, and these identified characteristic metabolites may provide reference for the pathophysiological molecular mechanism and management, etc., of chronic heart failure.

In order to study the effect of nitric oxide (NO) on the expression of hypoxia-inducible factor-1 alpha (HIF-1alpha) mRNA in hypoxic pulmonary hypertension (HPH) rats, 30 healthy male Wistar rats were randomly divided into normoxic control group, chronic hypoxic group and hypoxia plus L-arginine (L-Arg) group. The animal model of HPH was developed. The mean pulmonary arterial pressure (mPAP) was measured by inserting a microcatheter into the pulmonary artery. The HIF-1alpha mRNA expression levels were detected by in situ hybridization (ISH) and semiquantitative RT-PCR. It was found that after 14 days hypoxia, the mPAP in normoxic control group (17.6 +/- 2.7 mmHg, 1 mmHg=0.133 kPa) was significantly lower than that in chronic hypoxic group (35.8 +/- 6.1 mmHg, t=0.2918, P<0.05) and mPAP in chronic hypoxic group was higher than that in hypoxia plus L-arginine group (24.4 +/- 3.8 mmHg, t=0.2563, P<0.05). ISH showed that the expression of HIF-1alpha mRNA in the intraacinar pulmonary arteriolae (IAPA) in normoxic control group (0.1076 +/- 0.0205) was markedly weaker than that in chronic hypoxic group (0.3317 +/- 0.0683, t=3.125, P<0.05) and that in chronic hypoxic group was stronger than that in hypoxia plus L-arginine group (0.1928 +/- 0.0381, t=2.844, P<0.05). RT-PCR showed that the content of HIF-1alpha mRNA in chronic hypoxic group (2.5395 +/- 0.6449) was 2.16 times and 1.75 times higher than that in normoxic control group (1.1781 +/- 0.3628) and hypoxia plus L-arginine group (1.4511 +/- 0.3981), respectively. It is concluded that NO can reduce the mPAP by the inhibition of the expression of HIF-1alpha mRNA, which may be one of the mechanisms through which NO affects the pathogenesis of HPH.
Anoxia/metabolism ; Arginine/pharmacology ; Hypertension, Pulmonary/*metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; Nitric Oxide/*pharmacology ; RNA, Messenger/biosynthesis ; RNA, Messenger/genetics ; Random Allocation ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription Factors/*biosynthesis ; Transcription Factors/genetics

Objective To evaluate the effect of ecoimmunonutrition on maintenance of the mucosal barrier function in pigs with severe acute pancreatitis(SAP).Methods Twenty pigs were injected with5% sodium taurocholate and trypsin into the pancreatic duct to establish SAP models.Twenty four hours later,18 suvival pigs were randomly given parenteral nutrition(PN group,n=6),elemental enteral nutrition(EEN group,n=6),or ecoimmunonutrition(EIN group,n=6)for 8 days.The serum amylase,endotoxin and intestinal permeability were determined on different times.All pigs were sacrificed 8days later,and their venous blood,mesenteric lymph nodes(MLN),liver,lung,spleen and pancreas specimens were cultured quantitatively and qualitatively with standard techniques.The morphology of small bowel was observed and pathological changes of the pancreas was analyzed.Results Serum amylase of all groups were obviously elevated,but there was no significant difference among them(P＞0.05).The plasma endotoxin and intestinal permeability were lower in EIN group[(1.50±0.18)EU/L and(42.8±20.0)×10-3 respeetively]compared to EEN group[(1.98 4±0.20)EU/L and(67.4±23.0)×10-3 respectively]and PN group[(3.96±0.40)EU/L and(197.2±47.4)×10-3.respectively](all P value＜0.05).The incidence and the magnitude of bacterial translocation in EIN group were lower than those in PN and EEN groups.However,the ileum mucosa thickness,villus height,crypt depth and the rate of the normal intestinal villi in EIN group were(398.27±52.93)μm,(269.72±41.66)μm,(681.98±58.33)μm and 79%,respectively,but in PN group were(218.32±35.81)μm,(145.76±23.34)μm,(376.20±48.23)μm and13%,respectively and in EEN group were(305.70±42.72)μm,(192.52±38.17)μm,(507.31±68.23)μm and 47%,respectively.Conclusions EIN can maintain the integrity of intestinal mucosal barrier and decreasing intestinal bacterial and endotoxin translocation in SAP pigs.

Objective To explore the clinical,laboratory,and pathologic manifestations of the interstitial lung disease(ILD)associated with primary Sj(o)gren's syndrome(pSS,pSS-ILD).Methods Clinical data of 15 patients with pSS-ILD admitted to our hospital from 2006 to 2008 were collected and the different features were compared with 18 patients with pSS without ILD.Eight patients with pSS-ILD were followed up and observed the changes of high-resolution computed tomography (HRCT).Results The age at onset was later in pSS-ILD[(57±11)years]than in pSS without ILD[(43±11)years](P<0.01).The initial symptoms in six of patients with pSS-ILD were cough,expectoration,chest distress or dyspnea upon exertion.The respiratory clinical manifestations,circulationsystem involvement and pulmonary artery hypertension (PAH) were more common in pSS-ILD than in pSS without ILD(P<0.01).Compared with patients with pSS without ILD,patients with pSS-ILD had significantly higher serum IgG level(P<0.01).The common findings of HRCT included reticular changes,irregular linear hyper-attenuating areas,and nodules.Pleural involvement was found in 8 patients,honeycomb change in 5 patients and PAH in 3 patients.After treated for 6 months of 8 patients,radiological findings improved in 4 patients,stable in 2 patients,and worse in 2 patients.The comlnon histological findings included focal fibrosis in alveolar wall and alveolus with and alveolar space inflammatory cell infiltration,interstitial inflammation with mulifocal lymphocyte infiltration.One patient had the pathological changes of nonspecific interstitial pneumonia(NSIP).Conclusion The age at onset of pSS-ILD is late and tends to produce respiratory symptoms and prone to have circulationsystem involvement such as PAH and elevated serum IgG level.Honeycomb change in HRCT can be seen in one third of patients and most patients can improve after treatment,however.NSIP can be observed in histopathologieal