Objective To explore the treatment methods for brachial artery trauma associated with humeral super-middle fracture.Methods Thirty-two patients of brachial artery trauma associated with humeral super-middle fracture were treated in our department from March 2001 to April 2005 with in tramedallary expanded self-locking nail (IESN) combined with autotransplantation of great saphenous vein to repair brachial artery.Results All patients were followed up for 12 to 18 months,13.6 months on the average.No stenosis occurred at the anastomosed veins according to color Doppler ultrasound.All fractures achieyed clinical healing and the limbs survived well.Conclusion The IESN combined with autotransplantation of great saphenous vein to repair brachial artery is an effective method to treat brachial artery traumaassociated with humeral super-middle fracture,having the advantage of reasonable operation procedure.stabile immobilization and satisfactory functional recovery.

Objective To discuss the selection and application of internal fixators in the treatment of aged patients suffering from femoral condyle fracture. Methods 82 aged patients with femoral condyle fracture were treated from February 1995 to June 2002. According to AO/ASIF classifcation,26 cases were classified as type A,17 cases type B, and 39 cases type C. They were treated with internal fixation by 95?angle plate (19 cases), T type plate(5 cases), AO condyle supporting plate (11 cases), dynamic condylar screw (DCS) (23 cases) and Green Seligsen Henry (GSH) (24 cases). Measures of auto ilium transplant or homologous allograft bone transplant (28 cases) were also taken. Results All the cases were followed up for an average of 14.6 months. Merchan grading method was applied to evaluate their knee joint functions. The total excellent and good rate was 90.2%. Conclusions Aged patients with femoral condyle fracture should be treated specially. The fixation should be chosen according to their fracture type so as to ensure fine clinical results. The goal of the operation is to keep the integrity of articular surface of the femoral condyle and to acquire secure internal fixation.

Objective To investigate the relationship between tumor necrosis factor-alpha (TNF-α) and development of chronic obstructive pulmonary disease (COPD).Methods COPD patients and controls were divided into three groups: COPD group (n=66), smoker control group (n=42) and health control group (n=23). COPD group was further divided into the serious group (n=23) and non-serious group (n=43). The concentration of TNF-α of all cases was detected by human Th1/Th2 cytokine kit.Results The concentration of TNF-α in the COPD group was significantly higher than that of the smoker and healthy groups ( P<0.01). Furthermore, compared to non-serious COPD group, the concentration of TNF-α was higher in the serious COPD group ( P<0.05).Conclusion The concentration of TNF-α might be related with the pathogenesis and development of COPD.

The present study aims to investigate the kinetic histocytochemical changes of acupoints in different condition. The expression of tryptase (+) mast cells, histamine (HA) , serotonin (5-HT) and nociceptive neuropeptides including calcitonin gene-related peptide (CGRP) and substance P (SP) were observed by immunohistochemistry combined with confocal technology. Mast cells were labeled with anti-mast cell tryptase antibody and simultaneously with HA or 5-HT primary antibodies to observe their co-expression. The results showed that: (1) SP and CGRP were expressed more highly on the cutaneous nerve fibers of "Hegu" (LI 4) after acupuncture stimulation than that of the control. Mast cells aggregated in close proximity to the blood vessels in intra-epidermis and dermis, and some of them with degranulation in the lower dermis and subcutaneous tissue of "Hegu" (LI 4). Both mast cells and their granules appeared with HA (+) and 5-HT (+) expression at stimulated LI 4 sites, while a few intact mast cells with a little expression of 5-HT and HA were distributed in areas of non-stimulated Ll 4. (2) The acupoints in different locations such as Baihui (GV 20), Weishu (BL 21), Zhongwan (CV 12) and LI 4 had the same constituent but the contents were different. (3) The histocytochemical responses of acupoints sensitized by the Gastric mucosa injury (GMI) were also investigated. GMI resulted in neurogenic plasma extravasation by Evans Blue (EB) in the skin of the acupoints over the back and abdomen, which mostly occurred in the T9-T11 dermatomere. The EB extravasation dots just like acupoints sensitization appeared after GMI and disappeared gradually during the natural self-recovery of the gastric mucosa. More SP and CGRP positive nerve fibers were distributed in EB dots than in regions beside EB dots and in the control, mostly distributed in the nerve fibers around both the vessels and root of hair follicle. Mast cells also aggregated and degranulated to release algogenic substances of 5-HT and HA around the vessels in areas of the EB dots. Collectively the acupoints displayed the same histocytochemical responses due to either acupuncture stimulation or GMI. This may potentially be the histocytochemical basis in the local acupoints and acupoints displayed kinetic changes in different condition.
Acupuncture Points ; Acupuncture Therapy ; Animals ; Calcitonin Gene-Related Peptide ; metabolism ; Gastric Mucosa ; chemistry ; metabolism ; Histocytochemistry ; Humans ; Mast Cells ; chemistry ; metabolism ; Mice ; Rats ; Serotonin ; metabolism ; Skin ; chemistry ; metabolism ; Substance P ; metabolism

Here we reported a research project based on Black-board to integrate medical curriculum .The key points of this research is application of clinical cases as teaching data and facilitate learning of knowledge following the principle of learning by doing and , input the concept of precision medicine and informatics in learning process with an individually designed framework of learning .The learning outcome is evaluated with big data tech-nology and thus creates a student-centered pathway of medical education .

Purpose To study the expression and interaction of iNOS and COX-2 in colorectal adenocarcinoma, as well as their relationship with the biological behaviors of colorectal adenocarcinoma.Methods Intestinal biopsy specimens of colorectal adenocarcinoma were collected in the 78 cases and 33 normal intestinal mucosal tissues.The expression of iNOS and COX-2 proteins was detected by immunohistochemical staining (SP method).Results The positive rates of iNOS and COX-2 protein was significantly higher in normal intestinal mucosa than that in colorectal adenocarcinoma (P<0.05).The expression of iNOS and COX-2 protien had significant relation with lymph node metastasis (P<0.05).The positive expression of iNOS and COX-2 in intestinal adenocarcinoma was related with TNM stage:the positive expression in patients with Ⅲ+Ⅳ stage was higher than that with Ⅰ+Ⅱstage (P<0.05). The expression of iNOS was closely correlated with COX-2 (P<0.05).Conclusions The overexpression of COX-2 and iNOS participates in the pathogenesis of colorectal carcinoma and is associated with lymph node metastasis and TNM stage of colorectal adenocarcinoma.The expression of iNOS is correlated with COX-2 in the cancer.

Objective To study the relationship between the genetic polymorphism of interleukine-6 (IL-6)-174 and the response to benazepril treatment in patients with hypertensive renal damage. Methods Two hundred and eighty-four patients with hypertension were enrolled in this study. The hypertensive renal damage was defined by the measurement of urinary albumin excretion rate (UAER). One hundred and sixty healthy subjects were enrolled simultaneously as control group. Blood samples were obtained from all the subjects, and plasma levels of IL-6 and the genotype of gene IL-6-174 were detected. The patients with hypertensive renal damage were treated with benazepril for 16 weeks. The responses were evaluated by the changes of UAER level to benazepril in different genotypes. Results Genotype CC was the most common of the gene IL-6-174 in patients with hypertension, followed by GG and GC successively, with the G/C allele frequency of 47%and 53%(P<0.05), while in patients with hypertensive renal damage, GG was the most common genotype of the gene IL-6-174, followed by GC and CC successively, with the G/C allele frequency of 68%and 32%(P<0.05). After benazepril treatment, the UAER was decreased most in patients with genotype CC, followed by GC and GG successively ( P<0.05). Conclusion The G allele frequency of the gene IL-6-174 is related with hypertensive renal damage in patients in Ningxia, with GG as the most common genotype. The patients with CC genotype have the best response to benazepril treatment, with most decreased UAER.

Objective To study the correlation between the genetic polymorphism of tumor necrosis factor-α(TNF-α)-308 with benazepril treatment response in the patients with hypertensive renal damage in Ningxia area.Methods Two hundred and eighty-four patients initially diagnosed as hypertension were enrolled and the hypertensive renal damage defined by the measurement of urinary albumin excretion rate(UAER).At the same time 160 individuals undergoing healthy physical examination were selected as the normal blood pressure control group.The plasma samples were obtained from all the subjects,and plasma level of TNF-α and TNF-α-308 gene polymorphism were detected.Then the patients with hypertensive renal damage were interfered with benazepril as one of the antihypertensive drugs,and the treatment response of different TNF-α-308 genotypes to benazepril was observed,and the comparative analysis was performed.Results Among the TNF-α-308 genotypes in the patients with simple hypertension,genotype GA was the most common,followed by GG and AA successively,with the G/A allele frequency of 53 ％/47 ％ (P＜0.05).In the patients with hypertensive renal damage,genotype GG was the most common,followed by GA and AA successively,with the G/A allele frequency of 70％/30％,the genotypes and allele frequency had no statistical difference(P＜0.05).Before and after benazepril treatment,the change range of UAER in the patients with genotype AA was maximal,followed by the genotype GA and GG,the difference among 3 groups was statistically significant(P＜0.05).Conclusion The TNF-α-308 gene is correlated with hypertensive renal damage and its response to benazepril treatment.

Objective: To observe the clinicopathologic features of oropharyngeal squamous cell carcinoma associated with human papilloma virus (OPSCC-HPV) and discuss the role and value of different in situ hybridization (ISH) detection methods for HPV in pathologic diagnosis. Methods: Fifteen cases of OPSCC-HPV were collected from Department of Pathology, Beijing Tongren Hospital, Capital Medical University from January 2016 to August 2018. These cases were diagnosed in accordance with the WHO classification of head and neck tumors. The histopathologic features and the clinicopathologic data were retrospectively analyzed. Immunohistochemistry (two-step EnVision method) was done to evaluate the expression of p16, Ki-67 and p53. ISH was used to detect HPV DNA (6/11 and 16/18). RNAscope technology was used to evaluate the presence of HPV mRNAs (16 and 18). Results: The mean age for the 15 patients (8 males, 7 females) was 47 years (range from 30 to 69 years). OPSCC-HPV typically presentedat an advanced clinical stage, six patients had cervical lymphadenopathy (large and cystic), seven had tonsillar swelling, one had tumor at base of tongue, and one had odynophagia. Microscopically the tumors exhibited distinctive non-keratinizing squamous cell carcinoma morphology. Cervical nodal metastases were large and cystic, with thickening of lymph node capsules. OPSCC-HPV raised from crypt epithelium and extended beneath the tonsillar surface epithelial lining as nests and lobules, often with central necrosis. Tumor cells displayed a high N: C ratio, and high mitotic and apoptotic rates. Tumor nests are often embedded within lymphoid stroma, and may be infiltrated by lymphoid cells.Fifteen cases (15/15) were strongly positive for p16; Ki-67 index were 60%-90%; they were focally positive or negative for p53. Ten cases (10/10) were negative for HPV 6/11 DNA, and one case(1/10) was focally positive for HPV16/18 DNA. Eleven cases (11/11) were strongly positive for HPV16 mRNA, one case was focally positive for HPV18 mRNA. Conclusions OPSCC-HPV is a pathologically and clinically distinct form of head and neck squamous cell carcinoma. OPSCC-HPV is associated with high-risk HPV (type 16) in all cases. Detection of high-risk HPV16 mRNA by RNAscope is of great significance in the final diagnosis and pathogen identification.

Radiotherapy (RT) can potentially induce systemic immune responses by initiating immunogenic cell death (ICD) of tumor cells. However, RT-induced antitumor immunologic responses are sporadic and insufficient against cancer metastases. Herein, we construct multifunctional self-sufficient nanoparticles (MARS) with dual-enzyme activity (GOx and peroxidase-like) to trigger radical storms and activate the cascade-amplified systemic immune responses to suppress both local tumors and metastatic relapse. In addition to limiting the Warburg effect to actualize starvation therapy, MARS catalyzes glucose to produce hydrogen peroxide (H₂O₂), which is then used in the Cu⁺-mediated Fenton-like reaction and RT sensitization. RT and chemodynamic therapy produce reactive oxygen species in the form of radical storms, which have a robust ICD impact on mobilizing the immune system. Thus, when MARS is combined with RT, potent systemic antitumor immunity can be generated by activating antigen-presenting cells, promoting dendritic cells maturation, increasing the infiltration of cytotoxic T lymphocytes, and reprogramming the immunosuppressive tumor microenvironment. Furthermore, the synergistic therapy of RT and MARS effectively suppresses local tumor growth, increases mouse longevity, and results in a 90% reduction in lung metastasis and postoperative recurrence. Overall, we provide a viable approach to treating cancer by inducing radical storms and activating cascade-amplified systemic immunity.