[Objective]To investigate the effect of minimally invasive treating proximal humeral fracture with PHILOS plate under acromial anterior lateral deltoid splitting approach.[Method]A retrospective analysis was done on 31 patients treated with minimally invasively with Philos plate under modified approach from April 2005 to March 2009.There were 17 males and 14 females,12 of them were injured in a traffic accident and 19 in daily life,with their ages ranging from 42 to 89 years.According to Neer classification,there were 5 cases of two-part fractures,11 cases of three-part fractures,and 15 cases of four part fractures.[Result]The postoperative radiographs verified good position of all screws,with satisfactory bone fracture reduction.Follow-up for 8-36 months(average 18.8 months) showed no necrosis of head of humerus and injury of axillary nerve and all patients gained bone union,supficial infection occurred in two patients but relieved by care.According to Neer scoring,the excellent to good result rate was 87.1%.[Conclusion]Philos plate for proxima humeral fracture using acromial anterior lateral deltoid splitting approach possesses such advantages as better individuation,less disturbance of the blood supply,stable fixation of the fracture.It is an new method to treat proximal humeral fractures.

Objective To evaluate the charateristics of CT and MR imaging of struma ovarii(SO).Methods 10 lesions of 10 pa-tients confirmed by pathology were analyzed retrospectively.6 cases were performed plain and enhanced CT scan and 4 were under-went MR before operation.Imaging features were analyzed retrospectively correlated with histological findings.Results All the SO tumors were appeared as solitary,well-defined,lobulated or oval masses.The largest diameter was less than 10 cm.Ascites were found in 4 cases.Six of SOs were solid-cystic and four were cystic.The cystic portion was low density or high density on CT images. High density cysts were shoewed in 4 cases.On MR images,the cystic portion was hypointenstiy on T1 WI and hypo/hyperintensity on T2 WI.Vacuum phenomenon (hypointenstiy on T1 WI and extremly hypointensity on T2 WI)was observed in 1 case.Solid compo-nent and cystic wall showed remarkable enhancement.Conclusion CT and MR images of SO can reflect its histopathologic charater-istics,which provides important value in the diagnosis and differential diagnosis of SO.

BACKGROUND:Transferrin (Tf) is one suitable ligand to be conjugated to drug delivery systems to achieve site-specific targeting and desired therapeutic effect, due to its specific binding to transferrin receptors (TfR), and high expression on the surface of tumor cells. Contrast agents are also modified with Tf to achieve specific tumor imaging. OBJECTIVE:To prepare Tf-labeled magnetoliposomes (MLs), and characterize their utility as TfR targeted MR specific contrast agent in vitro. METHODS:MLs and Tf-MLs were prepared by lipid film hydration method and covalent coupling method, respectively. Tf-MLs were characterized by their mean size, zeta potential, polyindex, r2 relaxivity, Tf-binding efficacy and cytotoxicity.In vitro MRI contrasting properties of the suspended nanoparticles incubated with HepG2 cells were determined. RESULTS AND CONCLUSION:The mean diameter, polydisperisity index, zeta potential and r2 relexivity of Tf-ML were 95.1 nm, 0.21,-1.25 mv and 94.62 mmol-1/s, respectively. The coupling efficiency was calculated and the values obtained were 59.4 μg Tf/μmol phospholipid corresponding to about 27 molecules of Tf-MLs. After a 2-hour incubation with rhodamine-labeled Tf-MLs, rhodamine fluorescence was detected intensively in the plasma membrane and the cytoplasm of the TfR-overexpressing HepG2 cells. In contrast, Tf-ML showed little binding in MCF-7 cells that had low TfR level. HepG2 cels incubated with Tf-ML showed much higher intracellualar iron density than incubated with non-targeted MLs.In vitro MR T2WI of cells demonstrated the centrifuge tube containing HepG2 cells incubated with Tf-MLs produced a lower visible signal intensity than that treated with non-targeted MLs. Tf-MLs showed their potentials such as high r2 relaxivity, specific binding ability characteristics. These results suggest the availability of Tf-MLs to serve as a targeted contrast agent.

OBJECTIVE: From biomechanics, to summarize the application advances of metal screw implantation intemal fixation in cervical diseases. METHODS: A total of 22 articles of biomechanical analysis and clinical application of cervical screw implantation published between 2000 and 2008 were collected to analyze the anatomic basis, biomechanics, clinical application and advantages and disadvantage of cervical screw implantation. RESULTS: Lateral mass screw, pedicle screw internal fixation, and transarticular screw fixation can enhance biomechanical stability of cervical diseases. CONCLUSION: Screw implantation is an effective lower cervical intemal fixation technique and can be used in lower cervical instability and defects caused by various factors, in particular posterior column partial defect.

Objective:To research the effect of Shengmai capsules on the matrix metalloproteinase(MMPs)& tissue inhibitor of metalloproteinase(TIMPs)in chronic congestive heart failure(CHF)rats.Methods:75 SD female rats weredivided randomly into 5 groups:sham-operation group(A),CHF model group(B),CHF model treated by Shengmai capsules group(Shengmai capsule group,C),CHF model treated by Captopril group(Captopril group,D),CHF model treated by Shengmai capsule and Captopril group(shengmai capsule&captopril group,E),15 rats each group.Suprarenal abdominal artery constriction was operated to prepare CHF rat models.After 7 week treating respectively,the contents of MMP-3&TIMP-1 of cardiac muscle in rats were detected.Results:The content of cardiac MMP-3 was higher in group B than in group A(P

BACKGROUND: The decrease of activity level of choline acetyltransferase (ChAT) and reduction of membrane protein of synaptic vesicles are the main biochemical indexes in Alzheimer disease. Traditional Chinese bushen yizhi formula is of the effects of strengthening the kidney, replenishing qi, generating marrow and nourishing the brain, its medicine-containing serum can effectively protect these changes resulting from amyloid protein.OBJECTIVE: To investigate whether the medicine-containing serum of bushen yizhi formula can improve the pathological injury of neurons induced by amyloid protein metabolites in Alzheimer disease, thus to estimate the therapeutic effect of bushen yizhi formula on Alzheimer disease.DESIGN:A randomized and controlled trial. SETTING:Institute of Neuroscience, Second Affiliated Hospital, Guangxi College of Traditional Chinese Medicine, Nanning 530011, Guangxi Zhuang Nationality Autonomous Region, China; Encephalopathic Institute of Guangzhou University of Traditional Chinese Medicine.MATERIALS:The experiment was conducted from September 2003 to March 2004 at the Research and Development Center of New Drugs of Guangxi College of TCM. Totally 60 healthy Wistar rats of clean grade,three months, were at random divided as blank control and bushen yizhi groups, with 30 in each group. The bushen yizhi formula consisted of Fructus Lycii, Fructus Cnidii, Radix Gingeng, Radix Polygoni Multiflori,Cortex Moutan Radicis, Borneolum, etc. The medicine was prepared before use as 0.176 g/Ml liquid(including 1.13 g/Ml rude drugs).METHODS:① Each of the rats in bushen yizhi group was by garage given 1.0-1.5 Ml prepared liquid per day for consecutive 30 days. Within 4hours after the last administration the serum was isolated at 5 000 r/min for 5 minutes, filtered aseptically, the compliment was inactivated at 56 ℃,then the medicine-containing serum was obtained. The rats in blank control group were given saline of the same volume, and the serum was prepared with the same method. ② For NG108-15 cells, the concentration of amyloid protein 25-35 segments in the culture liquid was 5 μ mol/L, or 1-42 segments, 200 nmol/L, was suitable. ③ NG108-15 cells was first in cubated for a day in CO2 incubator with Dulbecco-improved Eagle medium of 0.1 molarity at 37 ℃, then 5 μmol/L amyloid protein 25-35 segment or 200 nmol/L segment 1-42 was added to continuously incubate for a day, after that the cell models of Alzheimer disease was ready. Then 50 g/L medicine-containing serum or Dulbecco-improved Eagle medium of blank control group serum was taken to replace the original culture liquid, and the amyloid protein segments of the above-mentioned concentration was still added for maintaining the cell models of Alzheimer disease, after 5 days'differentiation incubation, the indexes were detected with those in non-amyloid protein as control. ④ Western blotting, radioimmunoassay and electrophysiological examination were used to investigate the ChAT activity,synapsin protein level and rate of functional synapse formation of NG108-15cells in Alzheimer disease after treatment with the medicine-containing serum of bushen yizhi formula.MAIN OUTCOME MEASURES :The effects of the medicine-containing serum of bushen yizhi formula on ChAT activity, synapsin protein level,rate of functional synapse formation of NG108-15 cells and frequency of miniature plate potential in NG108-15 cells.RESULTS:Totally 60 rats involved all entered the final result analysis.① The effect of the medicine-containing serum of bushen yizhi formula on ChAT activity: In the conditions when there was no amyloid protein or the final concentration of amyloid protein 1- 42 was 200 nmol/L, the ChAT activity in bushen yizhi group was obviously higher than that in blank control group [(1651.2±134.5), (1336.1±268.2), ( 586.1±223.4),(1290.7±381.5)μmol/(g·h); P ＜ 0.05] . ② The effect of the medicinecontaining serum of bushen yizhi formula on synapsin protein level: The absorbance values of synapsin Ⅰa and Ⅰb, in the conditions when there was no amyloid protein, amyloid protein 25-35 and 1-42, were respectively 5.02, 1.36 and 2.46 in bushen yizhi group; and 3.18, 0.57 and 0.71 in blank control group. The values in bushen yizhi group were respectively 1.6,2.4 and 3.5times those in blank control group. ③ The effect of the medicine-containing serum of bushen yizhi formula on functional synapse formation of NG108-15 cells: In the conditions when there was no amyloid protein or amyloid protein 1-42, the levels of functional synapse formation in bushen yizhi group wereall higher than those in blank control group [(90.6±6.0)%, (63.2±17.0)%, (58.0±13.1)%, (34.2±13.0)% ;P＜0.05].④ The effect of the medicine-containing serum of bushen yizhi formula on frequency of miniature plate potential in NG108-15 cells: In the conditions when there was no amyloid protein or amyloid protein 1-42, the frequencies of miniature plate potential in bushen yizhi group were all higher than those in blank control group [(9.28±4.1), (5.48 ±5.14), (5.55±5.85),(3.05±4.46)/min; P ＜ 0.01, P＜ 0.05].CONCLUSION:In the conditions when there existed no amyloid protein or amyloid protein, the medicine-containing serum of bushen yizhi formula can raise ChAT activity, not only correct the decrease of cellular synapsin caused by amyloid protein, but also raise the expression of synapsin protein, the rate of functional synapse formation and neurotransmitter release under the condition of no amyloid protein. It was shown that the prescription can antagonize the pathological development of Alzheimer disease, and play the therapeutic effect through enhancing the release power of neurotransmitter.

Objective To evaluate the diagnosis of proximal vas deferens and epididymis with contrast-enhanced ultrasonography (CEUS) in healthy adult canines. Methods Six healthy male adult dogs were dissected to expose unilateral vas deferens. CEUS was performed after injecting ultrasound contrast agents into vas deferens by catheter. X ray angiography was taken after injecting compound meglumine diatrizoate. The image features of CEUS and X ray angiography were displayed by CEUS. Results Under CEUS, inguinal segment of proximal vas deferens were straight and symmetrical in diameter, scrotal segment of vas deferens were tortuous,and the tail of epididymis were speckled which enhanced shaped as a comma. The inguinal and scrotal segment of vas deferens section was display well by X-ray angiography.Conclusions CEUS is a new method in proximal vas deferens and tail of epididymis examination. It can provide guidance for the disease diagnosis of seminal vesicle and ductal system.

OBJECTIVE To find out relative risk factors of nosocomial infection in order to provide the evidence for taking measures to effectively control and reduce the infection rate.METHODS A retrospective survey was carried out on 19 535 cases of hospitalized patients during Jan and Dec of 2006.RESULTS In 2006,the nosocomial infection patients were 389,and the nosocomial infection rate of hospitalized patients was 1.99%;the sections with higher infection rates were respectively as follows: ICU,department of neurology,department of oncology,department of nephrology and department of pediatrics;the infected part of the body mainly occurred in respiratory tract,urinary tract,and gastrointestinal tract.In the nosocomial infection,132 strains were detected and its main pathogens were Gram-negative bacteria(52.27%).CONCLUSIONS The effective measures to control and prevent nosocomial infection rates should involve rational use of antibiotic drugs,increasing in the rate of delivering samples,shortening the period of hospitalization,decreasing in the aggressive operations and strengthening inspections of key departments.

BACKGROUND: The extramedulary fixation system including dynamic hip screw (DHS) is commonly used in treatment of Intertrochanteric fracture. However, in patients with unstable intertrochanteric fracture, extramedulary fixation system often leads to the failure of fracture fixation. Intramedulary fixation system including both proximal femoral nail antirotation (PFNA) and InterTan nail has been widely used in the treatment of unstable intertrochanteric fractures. OBJECTIVE:To compare the therapeutic effects of extramedulary fixation system containing DHS, PFNA and InterTan nail in the treatment of intertrochanteric fracture. METHODS:Literatures were searched in Wanfang, PubMed, Embase, Medline, the Cochrane library to screen literatures published from January 1990 to November 2014. Relevant studies addressing extramedulary fixation system containing DHS, PFNA and InterTan nail were screened. RESULTS AND CONCLUSION: 346 articles were screened, and 13 of them were in accordance with the inclusion criteria. 1 271 patients with different types of intertrochanteric fracture were assessed in this study. Compared to DHS group, patients treated with PFNA and InterTan nail had shorter operation time and less blood loss. No significant difference in rehabilitation time and Harris score was detected among three kinds of fixation methods. Additionaly, PFNA and InterTan nail had a similar effect. These findings verify that compared with DHS, PFNA and InterTan nail can optimize the surgery, but cannot elevate postoperative outcomes.

Objective:To investigate clinical features, risk factors and prognostic effects of paradoxical response(PR)in children with tuberculous meningitis(TBM)during anti-tuberculosis treatment.Methods:The clinical and follow-up data of TBM children admitted to the Department of Pediatrics, the Affiliated Hospital of Zunyi Medical University between January 2013 and December 2018 were retrospectively analyzed.The children were divided into the PR group and the non-PR group.Influencing factors of PR were selected by the univariate analysis, and independent risk factors were screened from these influencing factors by using the multivariate Logistic regression model.The effect of PR on long-term prognosis (≥9 months) of TBM was evaluated. Results:There were 31 cases(35.6%)with PR among the 87 TBM children enrolled, including 16 boys and 15 girls, with median age of 92(8-168)months.The median time for PR occurrence during the anti-tuberculosis treatment was 33(15-180)days.PR could present dete-rioration or recurrence of original symptoms, cerebrospinal fluid(CSF)deterioration and neuroimaging deterioration, accounting for 71.0%(22/31 cases), 80.6%(25/31 cases)and 51.6%(16/31 cases), respectively.Univariate analysis showed that stage Ⅱ, limb paralysis, cranial nerve palsy, positive tests of tuberculosis infection(T-SPOT), an increased lactate dehydrogenase(LDH)level in CSF, basilar meningeal enhancement, and tuberculosis infection outside the central nervous system were the influencing factors of the PR(all P<0.05). Multivariate analysis showed that limb paralysis, cranial nerve palsy, an increased CSF-LDH level, and positive T-SPOT were independent risk factors of PR(all P<0.05). PR was not associated with prognosis( P=0.165). Conclusions:PR occurs in 35.6% of children with TBM.Limb paralysis, cranial nerve palsy, an increased CSF-LDH level and positive T-SPOT are independent risk factors of PR.PR does not adversely affect the outcome.Identifying PR is extremely important for the prevention of some clinical misunderstandings.