[Objective]To investigate the causes and treatment methods of postoperative complications of femoral fractures treated with interlocking intramedullary nails.[Method]A total of 243 cases of femoral fractures from Jan 1999 to Dec 2004 were treated with interlocking intramedullary nails.There were 14 cases having complications,delayed union in 1,nonunion in 3,nailing failure in 6(locking scerw loosen in 4,locking scerw folding in 1,locking scerw breakage in 2),nail breakage in 1,re-fracture in 1 and knee ankylosis in 1.Two cases with delayed union to convert the fixation from statictody namicin time;3 cases with nonunion were treated with bone grafting.Breakage nail and re-fractuer cases were treated with enlarging intramedullary tunels,exchanging nails and bone grafting.One of locking scerw loosen were treated with exchanging nails and bone grafting.Knee ankylosis were treated with quadriceps plasty.[Result]Through treatment,the delayed union and the nonunion were all healed and got recovery of knee function.[Conclusion]Though it has certain complications,the interlocking intramedullary nails used for femoral fractures have more advantages than other internal fixations.It needs to take valid measures to reach a satisfying result when complication appears.

Objective To compare sinus tarsi approach(STA) and extensile L shape approach (ELA) in the surgical treatment of calcaneal fractures. Methods A total of 51 cases of calcaneal fractures treated from May 2014 to December 2016 were enrolled. Twenty of them were performed ORIF via the sinus tarsi approach, while the other 31 cases were performed ORIF via lateral extensile L shape approach. X-ray films were taken postoperatively to record the changes of B?hler angle and Gissane angle. The AOFAS, VAS and SF-36 scores were adopted to assess the therapeutic effect. Results The average follow-up period of STA group was 15.5 months. And patients in ELA group were followed up for an average period of 18.4 months. All the fractures in the series had a boney union at or before the final follow-up. The final correction of B?hler angle (34.60 ± 2.91)° , and Gissane angle (114.45 ± 2.91)° was significantly increased in the STA group; and the final correction of B?hler angle (33.55 ± 2.73)° , and Gissane angle (112.81 ± 4.15)° was also significantly increased in the ELA group; while there was no significant difference between the two groups. The final AOFAS scores , VAS scores and SF-36 scores of the STA were (83.56 ± 7.13), (1.78 ± 0.89), (88.95 ± 4.31) scores, while those in ELA group were (81.91 ± 9.89), (2.01 ± 1.33) and (86.65 ± 4.95) scores. There was no significant difference between the two groups (P>0.05). No wound problem happened in STA group, but there were 2 cases who had wound complications in ELA group. Conclusions No significant difference is found between the two groups in the short-term efficacy of the treatment for calaneal fracture. However, STA has the advantages of lower soft tissue complication rate.

Objective To evaluate advantages of the Herbert screw in treating displaced radial head fractures. Methods The Herbert screw was used to treat 25 segmental fractures of the radial head from since 1991 and the results were compared with those of other treatment methods mentioned in the literature. Results A follow up averaging 6 years and 8 months showed that postoperative function was all excellent or good and that most cases recovered to normal absolutely, without complications. Conclusions The Herbert screw provides such rigid internal fixation for displaced radial head fractures that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. This method of treatment appears to offer significant advantages over conventional techniques.

Objective To study surgical treatment of complex fractures of the tibial plateau. Methods Forty eight cases of complex fractures of the tibial plateau were treated with internal fixation from January 1997 to December 2001. According to Schatzker classification, 12 cases were type Ⅲ, 9 cases type Ⅳ, 14 cases type Ⅴand 13 cases type Ⅵ. They were treated with open reduction and internal fixation with buttress plates and allograft implantation for defective fractures. Results Forty six cases of the forty eight were followed up for 1 to 4 years. The excellent and good rate was 77%. Conclusion The complex fractures of the tibia plateau should be treated surgically, and the operation procedures should be varied according to the fracture types.

Duck enteritis virus (DEV) is a herpesvirus that causes an acute, contagious and fatal disease. In the present article, the DEV UL4 gene was cloned and sequenced from a vaccine virus. A degenerate oligonucleotide primer for the consensus site of herpesvirus UL3 gene and a specific primer located in UL5 were used in the polymerase chain reaction (PCR) to amplify a DNA product 2 086 bp in size. DNA sequence analysis revealed that a 714 bp open reading frame (ORF) of DEV encoding a 237 amino acid polypeptide is homologous to the family of herpesvirus UL4 proteins and therefore has been characterized as a DEV UL4 gene. Alignment of the DEV UL4 protein sequence with those of other alphaherpesviruses showed that 10 amino acid residues are completely conserved. Phylogenetic tree analysis showed that the seventeen alphaherpesviruses viruses analyzed were classified into four large groups, and the duck enteritis virus branched separately, closely related to the Mardiviruses group comprising Gallid herpesvirus 2 (GaHV-2), Gallid herpesvirus 3 (GaHV-3) and Meleagrid herpesvirus 1 (MeHV-1). The present study showed that the evolutionary relationship of the UL4 protein could be used for classification of alphaherpesviruses.

AIM：The mechanism of tumor necrosis factor-alpha (TNF-α) induced pulmonary artery hypertension(PAH) in endotoxic shock (ES) is not clear. Cholecystokinin-octapeptide (CCK-8) had anti-ES and anti-PAH effects. The impact of CCK-8 on changes in vascular reactivity and endothelial ultrastructure induced by TNF-α was studied. The role of nitric oxide (NO) was preliminarily studied. METHODS：Rabbit pulmonary artery rings were divided into four groups: TNF-α, TNF-α+CCK-8, CCK-8 and Vehicle. The rings were incubated for 2 h, 7 h or 14 h. Relaxative responses to ACh(10-8-10-5 mol/L)， SNP (10-9-10-6 mol/L) and contractile responses to PE(10-8-10-5 mol/L) were generated seperately. The NOS activity of rings was detected and the ultrastructure of endothelium was observed in the groups that incubated for 7 h.RESULTS:The relaxative responses to ACh were not affected by TNF-α and CCK-8 after incubation for 2 h. TNF-α(7 h,14 h) significantly reduced ACh-induced endothelium-dependent relaxation response of pulmonary artery. CCK-8 reversed the effect. CCK-8 itself had no effect on responses of normal pulmonary artery. Contraction to PE and relaxation to SNP were unaffected by TNF-α, CCK-8. The NOS activity increased in the TNF-α and the TNF-α+CCK-8 groups. While no significant difference was obseved between the Vehicle and the CCK-8 groups. Endothelial injury in TNF-α group and alleviated changes in TNF-α+CCK-8 group were observed. CONCLUSION:TNF-α significantly inhibits endothelium-dependent relaxation, which be one of the mechanisms of PAH induced by TNF-α during ES. It was found for the first time that CCK-8 reversed TNF-α induced impairment of endothelium-dependent relaxation and alleviated structural injury of endothelium, which might be one of the mechanisms of anti-PAH effect by CCK-8 during ES. The effects of TNF-α and CCK-8 might be related to NO.

Objective:To construct a human Fab phage antibody library and to obtain some recombinant clones which can express Fab fragment antibody against ? 1-adrenergic receptor.Methods:Fd heavy chain gene and ??? light chains gene of IgG obtained by RT-PCR from peripheral lymphocytes of DCM patients whose anti ? 1-AR antibodies are present were cloned into pComb3 vector and the human Fab phage antibody library was constructed.The library was panned by phage display technology with ? 1-ARECⅡ as antigen.Results:A human Fab phage antibody library with 1.4?10 6 capability was constructed successfully,a positive clone against human ? 1-AR was screened from the phage antibody library.Conclusion:The recombinant clones which express Fab antibody against ? 1-AR can be obtained by phage display technology.

AIM and METHODS: To elucidate the mechanism of anti-endotoxic shock of cholecystokinin octapeptide(CCK-8), the effects of CCK-8 on changes in rabbit thoracic aortic reactivities induced by lipopolysaccharides(LPS) in vitro were studied, and the ultrastructure of the endothelial cells was observed under scanning electron microscope. RESULTS: Incubation of thoracic aortic rings(TARs) with LPS(100 mg/L) resulted in an time-dependent impairment of the endothelium-dependent relaxations to acetylcholine(incubation for 3, 7, 14 h), a reduction of contractive response to phenylphrine(incubation for 14 h) and ultrastructural injury in endothelial cells(incubation for 7 h), all of which were alleviated by concomitant incubation with CCK-8(1 mg/L). In contrast, neither the vascular contractions nor the relaxations were affected by CCK-8 (1 mg/L) alone. CONCLUSION: CCK-8 improved the vascular reactivities in the presence of LPS, which may be one of the anti-endotoxic shock mechanisms of CCK.

AIM: To investigate the effect of cholecystokinin octapeptide(CCK-8) on the L-arginine-nitric oxide(NO) pathway in rabbit thoracic aortae treated with lipopolysaccharide(LPS). METHODS: The isolated thoracic aortic rings(TARs) from rabbits were incubated with LPS, LPS+CCK or vehicle for 14 h. Then the contractility to phenylephrine(PE) by TARs and the response to L-arginine(L-Arg) by pre-contractile TARs were measured. In addition, we added NO synthase(NOS) inhibitors aminoguanidine(AG)and N ?-nitro-L-arginine(L-NNA) into organ baths to observe the changes of vascular contractility to PE. NOS activity in isolated TARs were also detected. RESULTS: Incubation of TARs with LPS for 14 h resulted in an increase of NOS activity and a reduction of contractility to PE. Treatment with CCK-8 significantly inhibited the increased NOS activity in thoracic aortae and improved the hypocontractility of TARs to the same degree as AG. CONCLUSION: CCK-8 may improve the hypocontractility of TARs induced by LPS by inhibiting the activity of NOS.

Objective To investigate the impact of blood glucose level on the prognosis of breast cancer patients with type 2 diabetes mellitus. Methods Clinical data of 416 breast cancer patients with type 2 diabetes mellitus in Tianjin Medical University Cancer Institute and Hospital from January 2005 to December 2009 were analyzed retrospectively. Patients were divided into 2 groups according to the postprandial 2 hours of blood glucose level (＜11.1 mmol/L and ≥11.1 mmol/L). Clinicopathological characteristics and survival of the two groups were compared. Results There were 310 cases of postprandial 2 hours of blood glucose level (＜11.1 mmol/L), and 106 cases of postprandial 2 hours of blood glucose level (≥11.1 mmol/L) in 416 patients. There was no statistical difference in the clinicopathological features between the two groups (both P＞ 0.05). Univariate analysis showed that the 5-year disease-free survival rate was 81.6 % (253/310) and 67.0 % (71/106) for patients with postprandial 2 hours of blood glucose level＜11.1 mmol/L and postprandial 2 hours of blood glucose level ≥11.1 mmol/L, respectively (χ2= 8.575, P=0.003). The 5-year overall survival rate was 87.7 % (272/310) and 75.5 % (80/106) for patients with postprandial 2 hours of blood glucose level ＜11.1 mmol/L and postprandial 2 hours of blood glucose level≥11.1 mmol/L, respectively (χ2=8.722, P =0.003). Multivariate analysis showed that 2 hours of blood glucose level≥11.1 mmol/L was an independent risk factor of 5-year disease-free survival rate ( HR=1.701, 95 % CI 1.110-2.604, P= 0.015) and 5-year overall survival rate ( HR= 1.972, 95 % CI 1.186-3.279, P= 0.009) for diabetic breast cancer patients. Conclusion The poor control of blood glucose level for the breast cancer patients complicated with type 2 diabetes is related with the increased risk of 5-year recurrence and death, which requires to strictly control the blood glucose level for improving the prognosis of type 2 diabetic breast cancer patients.