OBJECTIVETo investigate the type and corresponding operation methods of ulnar lateral mass in distal radial fractures.

METHODSFrom January 2004 to September 2010,32 cases of distal radial fractures with ulnar lateral mass were treated by surgical incision and relocate ulnar lateral mass,including 23 males and 9 females with an average age of (34 +/- 9) years old ranging from 28 to 65 years old. According to the classification of Melone-Doi, 2 cases with type I, 24 cases of type II, 6 cases with type III. The operative appoach involved palm-radial, palm-ulnar, radial-dorsal. Among them, 28 patients with closed fractures were fixed with plate, 4 cases (including 2 cases of open fractures) were fixed by Kirschner pin and braces.

RESULTSThirty-two patients were followed up for 8 to 18 months with an average of 12 months. All fractures were healing without complications. According to modified Gartland-Werley scoring system (GWSS), the total score was 1.12 +/- 0.45, the remain deformity was 0, subjective evaluation was 0.50 +/- 0.30, objective evaluation was 0.30 +/- 0.21, complications was 0.40 +/- 0.09; the result was excellent in 21 cases, good in 11 cases.

CONCLUSIONThe location of ulnar lateral mass in distal radial fractures is one of the important prognostic factors in wrist function and surgical treatment is an effective method of fixing ulnar lateral mass in distal radial fractures.

Adult ; Aged ; Bone Nails ; Bone Plates ; External Fixators ; Female ; Fracture Fixation ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Treatment Outcome ; Ulna Fractures ; surgery

Objective To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)on advanced non-small cell lung cancer (NSCLC)patients with different EGFR mutation status (exon 1 9 deletion and exon 21 mutation).Methods Seventy-two advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled.All of the patients received first-line EGFR-TKI.The relationships between EGFR mutation status and objective response rate (ORR),disease control rate (DCR),progression free survival (PFS ) and overall survival (OS ) were analyzed.Results Of the 72 patients,37 patients expressed exon 1 9 deletion,35 patients expressed exon 21 mutation,and all of them could be evaluated.The ORR and DCR of patients with exon 1 9 deletion were higher than those of patients with exon 21 mutation (75.7%vs.51 .4%,χ2 =4.583,P=0.032;89.2%vs.68.6%,χ2 =4.636,P=0.031 ).The modified median PFS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (1 3.2 month vs.1 0.8 month,χ2 =4.700,P=0.030).The median OS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (30.2 month vs.25.6 month,χ2 =4.686,P=0.030).The side effects were similar between the two groups.The most common adverse reaction was rash,and the incidence had no significant difference between the two groups (48.7% vs.48.6%,χ2 =0.000,P=0.995 ).Conclusion EGFR mutation status is a predictor for PFS,OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.NSCLC patients with EGFR exon 1 9 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

Objective To investigate the expression of B-cell activating factor ( BAFF ) and its specific receptor BAFF-R in patients with B-cell non-Hodgkin′s lymphoma ( B-NHL) and to analyze the cor-relations between BAFF and the development of B-NHL.Methods RTQ-PCR and Western blot assay were used to measure the expression of BAFF and its specific receptor BAFF-R in patients with B-NHL.Fluores-cence immunocytochemical staining was used to determine the localization of BAFF and BAFF-R in Raji cells, a B-NHL cell line.The expression of BAFF in tumor tissues from patients with B-NHL of different his-tologic subtypes was measured by immunohistochemistry.WST proliferation and TUNEL assays were used to evaluate the effects of BAFF and BAFF-R on the proliferation, survival rate and apoptosis of Raji cells.Lin-ear correlations between the concentrations of lactate dehydrogenase ( LDH) and the expression of BAFF and BAFF at mRNA and protein levels in patients with B-NHL were analyzed.Results BAFF and its specific receptor BAFF-R were expressed in Raji cells and played an important role in the survival and proliferation of B-NHL cell line.The expression of BAFF in tumor cells from patients with B-NHL varied with the different histologic subtypes of B-NHL.Patients with small B-cell malignant lymphoma, large B-cell lymphoma ( LBCL) , mucosa-associated lymphoid tissue lymphoma ( MALT lymphoma) and follicular lymphoma showed higher levels of BAFF, while those with mantle cell lymphoma showed lower levels of BAFF.Compared with the healthy subjects, patients with B-NHL showed significantly increased expression of BAFF at mRNA and protein levels.The levels of LDH were closely related to the expression of BAFF at mRNA and protein lev-els.Conclusion BAFF and its specific receptor BAFF-R might play an important role in the growth and survival of malignant B cells.

Altitude ; Altitude Sickness ; Animals ; Hypoxia ; Iron ; Mice ; Spleen

Objective To explore the clinical characteristics of monochorionic or dichorionic twin pregnancy and the high-risk factors for selective intrauterine growth restriction.Methods 460 women with twin pregnancy were divided into a monochorionic group and a dichorion group.The related clinical features were compared between the two groups.Logistic regression was used to analyze the high-risk factors for selective intrauterine growth restriction.Results The maternal age,conception way,and mode of delivery differed significantly between the two groups (P ＜ 0.05).There were significant differences in the rates of selective intrauterine growth restriction and preterm premature rupture of membranes (P ＜ 0.05).The neonatal weight (large or small) and the rate of neonatal transfer differed significantly (P ＜ 0.05).Logistic regression showed that gestational age and birth weight were the risk factors.Conclusions The chorionic nature plays an important role in the process and outcomes of maternal pregnancy.Monochorionic pregnancy is a high risk factor for selective intrauterine growth restriction,meaning the major cause of selective intrauterine growth restriction may originate from the placenta,with should be a placenta-derived disease.

Objective To analyze the relations between medical students' burnout and some related factors for providing some suggestions for educational practice. Methods A total of 80 medical students were investigated and assessed by organizational justice questionnaire and Maslach Burnout Inventory-General Survey(MBI-GS). Results Some subjects were found to experience job burnout.Means of total distributive justice were significantly lower than medians.Means of participation and complaint mechanism were not discrete to medians.Means of motional exhaustion and cynicism were significantly lower than medians.Means of reduced professional efficacy were significantly higher than medians.Conclusion Job burnout existed among interns from non-211 and 211 Project universities.Medical students should establish scientific view of profession through psychological lessons,lectures,simulated diagnosis,clinical practice and self-sentience.

Objective To explore the relationship between mutation status of epidermal growth factor receptor (EGFR) and efficacy of EGFR tyrosine kinase inhibitor (EGFR-TKI) in patients with advanced nonsmall ccll lung cancer (NSCLC).Methods The data of 72 outpatients and inpatients with stage Ⅲ b/ⅣNSCLC diagnosed by histopathology and harbored EGFR-activating mutations (exon 19 and exon 21) from January 2008 to December 2013 in Xuzhou Cancer Hospital were collected.All of them received first-line EGFR-TKI.The relationships between EGFR gene status and response rate or progression-free survival (PFS)were analyzed.Results Of the 72 patients with EGFR mutation,37 patients harbored exon 19 deletion,and 35 patients harbored exon 21 L858R point mutation.The efficacies of all patients were assessable.The objective response rate (ORR) was 63.9 ％ (46/72) and disease control rate (DCR) was 79.2 ％ (57/72) in all patients,including 2 cases of complete remission (CR),44 cases of partial remission (PR),1 1 cases stable disease (SD) and 15 cases of disease progression (PD).Patients with exon 19 deletion had a higher ORR [75.7 ％ (28/37) vs 51.4 ％ (18/35),P =0.032] and a higher DCR [89.2 ％ (33/37) vs 68.6 ％ (24/35),P =0.031]than patients with exon 21 L858R mutation.The PFS of patients with exon 19 deletion was significantly longer than that of patients with exon 21 L858R mutation (12.0 months vs 9.5 months,P =0.030).Cox multivariate analysis indicated that the gender,histological type,smoking history were the major influence factors of PFS.The differences of toxicity between the two groups were not significant.Conclusion EGFR-activating mutation is a predictor for PFS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.

Objective:To investigate the type and corresponding operation methods of ulnar lateral mass in distal radial fractures. Methods:From January 2004 to September 2010,32 cases of distal radial fractures with ulnar lateral mass were treated by surgical incision and relocate ulnar lateral mass,including 23 males and 9 females with an average age of (34±9) years old ranging from 28 to 65 years old. According to the classification of Melone-Doi,2 cases with type I,24 cases of type I-I,6 cases with type III. The operative appoach involved palm radial,palm ulnar,radial dorsal. Among them,28 patients with closed fractures were fixed with plate,4 cases (including 2 cases of open fractures) were fixed by Kirschner pin and braces. Results:Thirty two patients were followed up for 8 to 18 months with an average of 12 months. All fractures were healing with-out complications. According to modified Gartland-Werley scoring system (GWSS),the total score was 1.12±0.45,the remain deformity was 0,subjective evaluation was 0.50±0.30,objective evaluation was 0.30±0.21,complications was 0.40±0.09;the result was excellent in 21 cases,good in 11 cases. Conclusion:The location of ulnar lateral mass in distal radial fractures is one of the important prognostic factors in wrist function and surgical treatment is an effective method of fixing ulnar lateral mass in distal radial fractures.

OBJECTIVETo increase the probability of successful renal artery angiography with a three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA).

METHODS3D CE-MRA was performed in 33 patients with hypertension. To calculate the scan delay time, a testing contrast agent bolus of 2 ml was injected for single sagittal slice real-time scanning, followed by oblique coronal 3D Fast TOF SPGRE. With maximum intensity projection, a set of images was acquired.

RESULTSExact scan delay time was obtained in all the cases from which clear images were acquired with the exception of two cases in which failure of breath-holding occurred during the scanning.

CONCLUSIONThis examination enhances the performance by adopting elliptical-centric k-space recording for data acquisition for the center in k-space at the beginning of acquisition, and utilizing preceding testing bolus injection and signal intensity/time curve for determining the scan delay time, using slice selection and multiview image reconstruction.

Adolescent ; Adult ; Aged ; Contrast Media ; Female ; Humans ; Hypertension, Renovascular ; diagnosis ; Image Enhancement ; methods ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Angiography ; methods ; Male ; Middle Aged ; Renal Artery

OBJECTIVETo study therapeutic effects of minimally invasive percutaneous plate osteosynthesis for the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients.

METHODSFrom December 2007 to April 2010, 23 patients with intertrochanteric femoral fractures were reviewed. Among the patients, 11 patients were male and 12 patients were female,ranging in age from 62 to 90 years, with a mean of 72.8 years. According to Evans classification, 13 patients were type III and 10 patients were type IV. All the patients were treated with proximal femoral locking plate (minimally invasive percutaneous plate osteosynthesis, MIPPO) surgery.

RESULTSThe operative time ranged from 45 to 60 min, with an average of 50 min. The blood loss ranged from 60 to 100 ml, averaged 80 ml. All the patients were followed up,and the duration ranged from 9 to 18 months, with an average of 11 months. The healing time based X-ray ranged from 3 to 6 months, with an average of 4 months. According to hip scoring criteria evaluation: 18 patients got an excellent results, 5 good.

CONCLUSIONFor the treatment of intertrochanteric femoral fractures of Evans III, IV in elderly patients, MIPPO has advantages such as small trauma, reliable fixation, which has good clinical application.

Aged ; Aged, 80 and over ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; instrumentation ; methods ; Hip Fractures ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; instrumentation ; methods ; Skin ; Treatment Outcome