10.3969/j.issn.2095-4344.2013.25.018

[Objective] To investigate the correlation of ulnar variance with gender and age. [Method]Two hundreds healthy volunteers were randomly selected,right handedness,including 117 men,83 women,aged 18 to 84 years old,with an average age of 41.7~16.4.They had no previous history of acute or chronic disease of the wrist and no wrist or forearm fracture history.All the volunteers were randomly selected for unilateral or bilateral wrist X-ray.A total of 309 valid results were obtained.Numerical ulnar variance were divided into groups according to gender,age and left or right hand for statistical analysis.[Result]Among the volunteers,the incidence of ulnar variance were: 48.9% positive,39.8% neutral,and 11.3% negative.Among the male volunteers,the incidence of ulnar variance were: 50.0% positive,39.2% neutral,10.8% negative.Among the female volunteers,the incidence of ulnar variance were: 47.4% positive,40.6% neutral,and 12.0% negative.With the age increasing,the incidence of positive and negative ulnar variance on increased,but that of the neutral variance decreased.There was no significant difference between males and females.The incidence of ulnar variance of the left side were: 49.7% positive,39.3% neutral,and 11.0% negative.The incidence of the right side were 48.2% positive,40.6% neutral,and 11.5% negative.The incidence of ulnar variance showed no significant difference between the two sides.[Conclusion](1) In healthy people,the positive and neutral ulnar variance are more commonly seen than the negative variance.(2) With the growth of age,the ulnar variance tends to change dynamically.(3) In healthy people,the distribution of the ulnar variance at the same age shows no significant difference between men and women.(4) In healthy people,the distribution and change of the ulnar variance are not influenced by the daily activities of the wrist.

=3) in spinal fluid. The intra and inter-day relative standard deviation of analysis were less than 3.0 % (n = 5). The recovery of lidocaine was between 98.3 % - 102.7 % . Lidocaine assay was carried out in a medical case by using the method established. Conclusion Spinal fluid is suitable for assay lidocain in forensic toxicological analysis and other medical studies by using the HPLC method which is sensitive, rapid and accurate.

Objective To investigate the effect of Hedan tablet combined with fluvastatin on serum LDL and heart rate variability in patients with coronary atherosclerotic heart disease (CHD).Methods 110 patients with coronary heart disease who were treated from March 2015 to June 2016 in our hospital were selected and randomly divided into observation group and control group, with 55 cases in each group.The patients in the observation group were treated with Hedan tablet combined with fluvastatin, and the control group was treated with fluvastatin.The changes of heart rate variability, blood lipids and inflammatory factors were compared before and after treatment, and the clinical curative effect was observed.Results After treatment, the total effective rate of the observation group was 96.4%, significantly higher than the control group 85.5%, the difference was statistically significant (P<0.05).The SDNN of the observation group was (85.42 ±9.11) ms and the SDANN was (49.11 ±5.13) ms, was significantly higher than those in the control group (76.87 ±8.12) ms, (44.16 ±4.76) ms.In the observation group, TC was (4.14 ±0.45) mmol/L, TG was (1.26 ±0.16) mmol/L, LDL was (2.08 ±0.31) mmol/L, significantly lower than the control group (4.78 ±0.51) mmol/L, (1.42 ±0.18) mmol/L, (2.43 ± 0.27) mmol/L, and HDL levels was (1.51 ±0.18) mmol/L, significantly higher than those in the control group (1.35 ±0.15) mmol/L, the difference was statistically significant (P<0.05), and the levels of inflammatory factors in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion Hedan tablets combined with fluvastatin in treating coronary atherosclerotic heart disease can effectively reduce serum LDL levels, improve heart rate variability, significantly improve the treatment effect.

Objective To study curative efficacy of benazepril combined with atorvastatin on N-terminal pro-brain natriuretic peptide (NT-proBNP) and its efficacy in the treatment of chronic cardiac failure. Methods 90 patients of chronic heart failure were selected as research objects. The control group were treated with benazepril, while the observation group were treated with benazepril combined with atorvastatin, 45 cases in each group. Then before and after treatment of 6 months, the cardiac function of left ventricular end-diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD), left ventricular eject fraction (LVEF), C-reactionprotein (CRP), interleukin- 6 (IL-6, tumor necrosis factor α (TNF-α) and plasma NT-proBNP levels were compared between two groups, and the efficacy was observed. Results After treatment, LVEDD and LVESD in observation group were lower than those in control group, the LVEF was higher than that in control group(P<0.05). The CRP,IL-6 and TNF-αlevels in observation group were lower than those in control group(P<0.05). The plasma NT-proBNP level in observation group was significantly lower than that in control group(P<0.05). The total effective rate of observation group was statistically higher than that that in the control group 95.55%(43/45)vs. 77.77%(35/45)(P<0.05). Conclusion Benazepril combined with atorvastatin in the treatment of chronic heart failure is significant, can reduce plasma NT-proBNP levels, improve the inflammatory factor.

Objective To study the gene expression of Wnt signal transduction pathway in experimental liver fibrosis and to investigate its role in liver fibrosis. Methods Liver fibrosis model was induced with carbon tetrachloride in 8 SD rats. Another 8 healthy rats were served as control. The gene expression in liver tissues of models and controls were examined using real time PCR array. The differential gene expression was identified as either up- or down-regulated 2-fold. The expressions of smooth muscle actin (SMA), Wnt4, Frizzled2 and β-catenin in the tissues were examined by immunohistochemistry and Western blot. Results The examination confirmed that 36 genes were differentially expressed, including 25 genes up-regulated and 11 genes down-regulated. Compared with the controls, the expressions of Wnt4, Wnt5 a and W nt11 were up-regulated more than 13.9-, 16.5-and 2.17-fold respectively, while the expressions of Wntl and Wnt3 were down-regulated more than 2.32- and 2.15-fold respectively in fibrotic liver. Immunohistochemistry and Western blot showed that the expressions of SMA, Wnt4 and Frizzled2 in fibrotic liver were remarkably higher than those in normal controls. While the level of phosphorylated β-catenin was decreased. Conclusion Both canonical and noncanonical Wnt signal transduction pathway may involve in the mechanism of liver fibrogenesis.

Abstract?AlM:To evaluate the accuracy and practicability of three - dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.?METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall ( n = 26, 55%), medial wall ( n = 12, 26%), and floor ( n = 9, 19%) . The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three -dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography ( CT) scan. The practicability of clinical use of AO three - dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.?RESULTS: Postoperative orbital CT scan showed an anatomic three- dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients ( 87%) had a successful enophthalmos correction. 25 patients ( 86%) had a successful recovery from diplopia.?CONCLUSlON: Three- dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.

Objective To measure the tensile strength of the normal medial patellofemoral ligament (MPFL), and evaluate the biomechanics of different fixation methods of the hamstring tendon graft on the patella.
Methods Eight fresh cadaver knees were prepared by isolating the patella, leaving only the MPFL as its attachment to the medial condyle of femur. The MPFL was reconstructed by three different methods:four-suture fixation, anchors-single suture fixation, and anchors-double suture fixation. The tensile strength and the elongation of the normal MPFL and the tendon grafts were measured.
Results The tensile strength of the four-suture fixation group (234.86±49.02 N) was stronger than that of the normal MPFL (146.91±25.30 N, P=0.0014) and the anchors-single suture group (159.17±49.07 N, P=0.0077), while weaker than that of the anchors-double suture group (314.74±78.46 N, P=0.0052)
Conclusions With regard to the tensile strength, the four-suture fixation method is reliable for clinical use. Compared with the anchor-suture method, the four-suture fixation method which has no specific implants is more economical, convenient and efficient.

Objective To establish a sensitive,specific,simple and high-throughput method for detection of the epidermal growth factor receptor (EGFR) mutation in the plasma samples of patients with non-small cell lung cancer (NSCLS) by the use of mutant-enriched liquid chip (MEL) assay.Methods The specific probes for the EGFR exon19 E746-750 deletion,exon 21 L858R mutation and wild-type sequence were designed and coupled to the microspheres coding with different fluorescent dye.The probe coupling efficiency was verified by crossing hybridization test with biotin-labeled reverse sequence.A blood-based MEL approach which integrates a sensitive mutant-enriched PCR and quantitative high throughput liquid chip assay for assessment of EGFR mutations was developed.The sensitivity and specificity of MEL was further evaluated using the mixture with different copy numbers of mutant and wild-type plasmids as template.The mutations of exon 19 and 21 of EGFR gene in plasma samples from 201 patients with stage ⅢB or Ⅳ NSCLC who enrolled in the First Affiliated Hospital of Guangzhou Medical College from September 2008 to April 2010 were analyzed by both the MEL and the mutant-enriched PCR assay.The result comparison was made between direct sequencing and MEL in 50 cases whose EGFR gene type had been tested by MEL and mutantenriched PCR.The correlation of EGFR gene mutation and the response to the Geftinib treatment was analyzed in 16 patients with lung adenocarcinoma as well.Results The probes were successfully coupled to the microspheres encoding with different fluorescent dye,and could be specifically recognized by the corresponding target sequence.The MEL was capable of detecting as few as 10 copies of EGFR mutants (sensitivity was 0.1％).Among the enrolled 201 cases of advanced NSCLC,the detection rate of the EGFR exon19 E746-750 del and exon 21 L858R was 55.7％ (112/201) by MEL assay.Conpared with mutantenriched PCR[58.2％ (117/201)],the coincidence rate was 97.5％ (196/201).There was no statistically significant difference between the results of mutant-enriched PCR and MEL (x2 =3.20,P ＞ 0.05).The mutations detection rate was 22.0％ (11/50) by directing sequencing,which was significantly lower than by MEL[50.0％ (25/50),x2 =12.07,P ＜ 0.05].Among the 16 patients treated with Gefitinib,9 cases who had EGFR mutation showed a higher response rate(P =0.041)and prolonged progression-free survival (x2 =6.76,P =0.009) after the treatment compared to those 7 who without EGFR mutation.Conclusions A new method of MEL with accuracy,specificity,fast and high-throughput is established for the detection of EGFR 19 E746-750 deletion and exon 21 L858R mutations in plasma from advanced NSCLC patients.It has the ability to provide the most direct and valuable guidance for clinicians to make decision on EGFR tyrosine kinase inhibitors therapy in the advanced NSCLC paticnts.

Objective To establish normal reference indexes of aorta during gestation and cut-points for detection of fetuses with coarctation of aorta.Methods From long-axis views of the aortic arch,the internal diameter of the aortic root,ascending aorta,transverse aortic arch,aortic isthmus,descending aorta,anonyma,left common carotid artery,left subclavian artery were measured in 234 normal fetuses at different time ranging from 14 to 41 weeks during gestation.Reference values of each aortic segment were constructed by linear regression analysis.The ratio of each aortic segment to the ascending aorta were calculated.ResultsThe internal diameter in each aortic segments increased as pregnancy progressed (P<0.01).In the prenatal diagnosis of fetus with coarctation of the aorta,the ratio of the aortic isthmus to the ascending aorta and descending aorta to the ascending aorta were significantly lower than the normal fetuses(all P<0.01).Conclusions The ratio of the aortic isthmus to the ascending aorta and ratio of descending aorta to the ascending aorta detected by echocardiography may be helpful in the prenatal diagnosis of coarctation of aorta.