A new method known as continuous arterio-venous perfusion and clearing of thick sections according to Mulligan's procedure Were applied. After the vessels of the mesencephalon were perfused, arteries revealed red colour and the -veins blafck. Under SXP-1 stereo-microscope, the morphology, rate of occurrence, tributaries and drainage of the interpeduncular veins, the posterior communicating vein, the lateral peduncular veins, the circumpeduncular veins, the veins of the pontomesencephalic sulcus, the lateral mesencephalic veins, the veins of the brachium conjunctivum, the precentral cerebellar vein and the quadrigeminal veins of 27 (54 sides) adult mesencephala were observed. The origin, course, drainage and outlet of internal veins such as antero-medial, anterolateral, lateral and posterior veins of 10 adult mesencephala were investigated and compared with 3 venograms of mesencephalon from other specimens. The clinical significance of some of the above vessels were discussed.

BACKGROUND:At present, a large number of studies have confirmed that reconstruction plate compared to Kirschner wire in the treatment of clavicular fracture showed good effects, but there is no precise report on the specific advantages at present. Clinical randomized controled study is less, and lacks of systematic evaluation. OBJECTIVE:To systematicaly evaluate the efficacy and safety of the treatment of the clavicle fractures with the reconstruction plate and the Kirschner wire by using a meta-analysis. METHODS: We retrieved the MEDLINE, Embase, PubMed, Cochrane library, CNKI, Wanfang database and VIP database from 2008 to 2015 by computer to colect al controled study relevant to reconstruction plate and Kirschner wire in the treatment of clavicle fracture, and screened the literatures that met the inclusion criteria. Al literatures were analyzed in strict quality evaluation. Excelent rate, delayed healing of incision, malunion, postoperative infection, loosening of internal fixation, postoperative fracture displacement, operation time, intraoperative bleeding volume and fracture healing time were selected as the evaluation indexes of a meta-analysis. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Colaboration. RESULTS AND CONCLUSION:Finaly 12 Chinese articles published from 2008 to 2014 were included, with 911 patients. Meta-analysis results showed that compared with Kirschner wire, the reconstruction plate has a certain advantage in improving the excelent and good rate, shortening the delayed wound healing and reducing deformity healing, reducing postoperative infection, preventing the loosening of internal fixation and avoiding postoperative fracture displacement. However, the two surgical methods in the treatment of clavicular fracture were not significant in operation time, intraoperative blood loss and fracture healing time. These results suggest that compared with the Kirschner wire, reconstruction plate fixation for treatment of clavicular fracture had better curative effect. The reconstruction plate can be firstly selected in the permit of patient economic conditions and hospital conditions. Due to the limited sample size in this study, the multicenter, large-sample and long-term clinical randomized controled studies with more strict design are needed to increase the reliability of the evidence.

BACKGROUND:Now a lot of studies have confirmed that in contrast with the dynamic hip screw, the proximal femoral nail anti-rotation has a better therapeutic effect on the treatment of intertrochanteric fractures in the elderly, but there is no definite conclusion on the specific superiority at present. OBJECTIVE:To compare the curative effects of proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fracture using a meta-analysis. METHODS: We searched VIP database, Wanfang database, PubMed database and Embase database from 2011 to 2015, and colected randomized controled trials on proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fracture. Operation time, intraoperative blood loss, hospital stays, fracture healing time, Harris score, length of incision, bed time walking after the operation were used as evaluation indexes of meta analysis. Data were analyzed using RevMan 5.3 software. RESULTS AND CONCLUSION:In the end, we used 9 literatures, which contained 858 patients of intertrochanteric fractures in the elderly. The time of publication was from 2011 to 2015, and al of them were published in Chinese. The results of Meta-analysis showed that, compared with dynamic hip screw, proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly could effectively reduce operation time, blood loss, hospital stays, fracture healing time, length of incision and the time of walking after the operation was earlier, and it could obtain better recovery of hip function. We can point out that compared with dynamic hip screw, proximal femoral nail anti-rotation has certain advantages in the treatment of intertrochanteric fractures in the elderly. In some conditions, the patients and the hospitals can give priority to choose the proximal femoral nail anti-rotation in the treatment of intertrochanteric fractures in the elderly.

Objective:To explore whether the limit of "before the equal-diameter period" is reasonable in the current criteria for "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010) in children, and to provide basic data and technical support for revision of the criteria for "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010).Methods:In 2018, the historical Kashin-Beck disease (KBD) areas in Heilongjiang Province were selected as the investigation sites. The right-hand X-ray films of all children aged 7-12 years old were taken. According to the different X-ray manifestations of the growth and development of the phalangeal epiphysis, they were divided into five periods: before the equal-diameter period, equal-diameter period, ultra-diameter period, pre-closure period and closure period. Firstly, after stratifying by basic data such as age and gender, the data were standardized and analyzed. Secondly, the detection rates of metaphysis-epiphysis (CRME) in each period were calculated and compared. Finally, based on the mean value of the detection rate of metaphyseal change in Linkou and Fuyu counties of Heilongjiang Province in 1990, the rates of expected detection and missed diagnosis of metaphyseal changes of KBD among investigated children were calculated and compared under the limitation of before the equal-diameter period, before the ultra-diameter period or age range reduction.Results:A total of 5 019 children were investigated. The proportion of children before the equal-diameter period was 53.94% (2 707/5 019), and that of before the ultra-diameter period was 77.92% (3 911/5 019). The results showed that the equal-diameter period mainly appeared in 7-10 years old, and showed a decreasing trend with the increase of age (χ 2trend = 390.10, P<0.05); the ultra-diameter period mainly occurred in 10-12 years old, showing a decreasing trend with the increase of age (χ 2trend = 65.39, P < 0.05); the pre-closure period mainly occurred in 10-12 years old, with an increasing trend with the increase of age (χ 2trend = 51.86, P<0.05); the closure period mainly occurred in 11-12 years old and increased with age (χ 2trend = 7.58, P<0.05). The CRME of children in ultra-diameter period was 14.78% (158/1 069), however CRME did not occur in children with equal-diameter period. Among children before equal-diameter period, before ultar-diameter period and aged 7-10 years old, the expected detection rates of metaphyseal changes of KBD were 5.90%, 8.53% and 7.42%, respectively. The expected missed diagnosis rates of metaphyseal changes of KBD were 5.06%, 2.45% and 3.52%, respectively. Conclusion:In order to improve the rate of expected detection and lower the rate of missed diagnosis of metaphyseal changes of KBD, children in "equal-diameter period" should be included in X-ray diagnosis and disease monitoring of KBD.

Objective To investigate the expression of Member RAS Oncogene Family(RAB10)in pancreatic cancer(PAAD)and its effects on the proliferation,migration,invasion and apoptosis of SW1990 cells(human pancreatic cancer cells).Methods The expression of RAB1 0 mRNA in PAAD tissues wasanalyzed by the cancer gene database GEPIA(Gene Expression Profiling Interactive Analysis)and TCGA(The Cancer Genome Atlas).Cox regression analysis was used to detect relationship between RAB10 mRNA expression and the prognosis of pan-creatic cancer patients.We targeted small interfering RNA(R4B10-siRNA)targeting RAB10 as the silence group,and constructed an overexpression plasmid(RAB10-OE)for overexpression of RAB10 as the overexpression group.The effects of silencing and overexpressionweredetected by Q-PCR;protein expression levelsweredetected by West-ern blot.EdUcellproliferation test,wound healing test,Transwelltestand flow cytometry test were used to determine the effects of RAB10 on the proliferation,migration,invasion and apoptosis of SW1990 pancreatic cancer cells.Re-sults RAB10 mRNA expression in PAAD tissues was higher than that innormal pancreatic tissues(P＜0.05).The results of EdUcellproliferation testshowed that the proliferation rate of SW1990 cells in the RAB10-OE group was higher thanthat in the control group,and the proliferation rate of SW1990 cells in the RAB10-siRNA group was lower than that inthe control group(P＜0.05).The results of the Transwell test and wound healing test showed that the invasion rate and mobility rate of RAB10-OE group were higher thanthose of the control group,and the mobility and invasion rate of RAB10-siRNA group were lower than those of the control group(P＜0.05).The re-sults of flow cytometry test showed that the apoptosis rate was lower in the RAB10-OE group than the control group,and the apoptosis rate in the RAB10-siRNA group was higher than the control group(P＜0.05).The median sur-vival time of RAB10 high expression group was significantly lower than that of RAB10 low expression group(P＜0.05).Cox regression analysis showed that clinical grade,T stage,M stage and RAB10 mRNA expression were re-lated to survival and prognosis of pancreatic cancerpatients(P＜0.05).Multivariate Cox regression analysis showed that the expression level of RAB10 mRNA was the independent risk factor affecting the prognosis of pancre-atic cancer patients(P＜0.05).Conclusion RAB10 is highly expressed in PAAD tissues and RAB10 can pro-mote the proliferation of pancreatic cancer cells,accelerate the ability to invade and migrate,and inhibit the apop-tosis of pancreatic cancer cells.RAB10 is an independent risk factor for survival prognosis in patients with pancreat-ic cancer.

The aim of this study was to prepare a high drug-carrying capacity micellar drug delivery system(CTD@Sol)of the polymer zebra tetracycline and to preliminarily investigate the feasibility of this drug delivery system for the treatment of breast cancer.Firstly,CTD@Sol was prepared using sol as the carrier material and CTD as the model drug,and its pharmacological properties such as appearance and morphology,particle size,potential and in vitro release were evaluated.The growth inhibitory and apoptotic effects of CTD@Sol on breast cancer(4T1)cells were investigated by MTT assay and Annexin V-FITC/PI double staining assay;the uptake efficiency of 4T1 to this delivery system was investigated by flow cytometry;and the in vivo tissue distribution of the delivery system and the targeting of tumour tissues were investigated by small animal in vivo imaging technique.The results showed that CTD@Sol appeared as a light pale blue creamy white colour,with an average particle size of(159.73±1.96)nm,a PDI of 0.198±0.006,Zeta potential of-(47.60±1.77)mV,an encapsulation rate of(90.29±1.69)%and a drug loading capacity of(45.00±0.84)%;the in vitro release and haemolysis experiments showed that the drug release rate of CTD@Sol in acidic environment(pH 5.5)was significantly faster than that in neutral environment(pH 7.4),suggesting that the system is acid-sensitive and has good biosafety under endocytosed pH conditions.Cellular uptake,cytotoxicity and apoptosis experiments showed that CTD@Sol was more lethal to 4T1 cells,and the sol-gel polymer micelles as a drug delivery vehicle could significantly improve the cellular uptake efficiency of the drug;in vivo experiments showed that the delivery system had a significant targeting effect on tumour tissues.In conclusion,this study has successfully produced a CTD@Sol drug delivery system with high drug loading capacity(>45%),good pharmacological performance,strong targeting and biosafety,which has the potential to be used in the treatment of breast cancer.

Objective:To investigate the effects of hypertensive disorders during pregnancy (HDP) on preterm newborns in terms of umbilical cord blood serum ferritin (SF), hemoglobin (Hb) at birth and outcome.Methods:Among inpatients of the First Maternity and Infant Health Hospital Affiliated to Tongji University from October 1, 2015 to December 31, 2016, totally 1 419 cases of preterm newborns were prospectively collected.Preterm infants whose mothers with diagnosis of HDP were recruited as the HDP group.Meanwhile, premature newborns whose mothers without HDP were recruited as the control group.Umbilical cord blood SF levels, Hb levels at birth, outcome of preterm newborns and the basic information for maternity were compared between the two groups.The data of normal distribution between the two groups were compared by independent sample t test.The count data was tested by χ2, and the count data with frequency <5 was tested by Fisher′ s exact test. Results:SF levels of HDP group were significantly lower than the control group [(85.6±67.2) μg/L vs. (103.9±95.5) μg/L]. But Hb levels of HDP group were much higher than the control group [(206.2±33.8) g/L vs. (193.2±31.9) g/L]. The difference between two groups was statistically significant ( t=2.791, 4.825 all P<0.05). Umbilical cord blood SF levels were negatively correlated with Hb levels at birth ( r=-0.120, P<0.001). Moreover, compared to the control group, statistically significant lower incidence of neonatal respiratory distress syndrome (NRDS), pneumonia and bronchopulmonary dysplasia (BPD) in HDP group was observed (all P<0.05). Conclusions:HDP was correlated with umbilical cord blood SF levels and Hb levels at birth in premature newborns.Higher Hb levels and relatively lower incidences of NRDS, pneumonia and BPD were observed in these newborns delivered by mothers with diagnosis of HDP.

Objective:To explore the expression and significance in regulating immune balance of programmed cell death protein 1 (PD-1) and its ligands PD-L1, PD-L2 in allergic rhinitis (AR).Methods:Eighty-two patients who received outpatient treatment due to high nasal reaction symptoms or were hospitalized due to nasal septum deviation and underwent nasal septum correction surgery in Department of Otorhinolaryngology Head and Neck Surgery of Renmin Hospital of Wuhan University from May 2018 to May 2019 were enrolled, including 42 males and 40 females, with the age ranging from 14 to 38 years old. Blood, inferior turbinate nasal mucosal tissue and relevant clinical data were collected. Patients were divided into AR group and control group due to clinical manifestation, skin prick test and detection of specific IgE (sIgE) in serum. Immunohistochemistry was used to detect the expression of PD-1 and its ligands in nasal mucosa of the two groups. Flow cytometry was used to detect the proportions of PD-1 +CD4 +T cells, PD-L1 + myeloid dendritic cells (mDCs), PD-L2 +mDCs and Th2 cells in peripheral blood of the two groups. The expression levels of total IgE, sPD-1, sPD-L1 and sPD-L2 in serum of the two groups were detected by ELISA. The measurement data of normal distribution or normal distribution after the logarithm conversion to Ln were compared by t test. Pearson correlation or Spearman correlation was used to analyze the correlation among the indicators. P<0.05 was considered statistically significant. Results:The expression of PD-1 and its ligands on the surface of immune cells in the nasal mucosa of the AR group was significantly higher than that of the control group. The ratio of PD-1 +CD4 +T cells, PD-L1 +mDCs and Th2 cells in peripheral blood of AR group was significantly higher than that of the control group ((15.24±6.45)% vs (8.71±5.33)%, (8.79±2.01)% vs (5.74±2.90)%, (7.89±1.95)% vs (2.52±1.34)%, all P<0.05). There was no significant difference in the ratio of PD-L2 +mDCs between the two groups. Correlation analysis found that the proportion of PD-1 +CD4 + T cells was positively correlated with the Visual Analogue Scale (VAS) score of AR, total IgE concentration and the serum sIgE concentration ( r value was 0.501, 0.541, 0.608, respectively, all P<0.05). The proportion of PD-L1 +mDCs was positively correlated with the VAS score of AR and the serum sIgE concentration ( r value was 0.604, 0.563, respectively, all P<0.05). The proportion of Th2 cells in peripheral blood was positively correlated with the proportion of PD-L1 +mDCs and PD-1 +CD4 +T cells ( r value was 0.538, 0.623, respectively, all P<0.05). Serum total IgE, sPD-1 and sPD-L1 in the AR group were significantly higher than those in the control group ((6.34±1.38) ng/ml vs (4.89±1.10) ng/ml, (4.40±1.01) pg/ml vs (3.79±1.21) pg/ml, (3.88±0.25) pg/ml vs (3.57±0.23) pg/ml, all P<0.05), and there was no significant difference in sPD-L2 levels between the two groups. Correlation analysis showed that sPD-L1 was positively correlated with total IgE and sIgE concentration ( r values was 0.32, 0.45, respectively, all P<0.05). Conclusions:PD-1 and PD-L1 are highly expressed on the surface of immune cells in peripheral blood and nasal mucosa of AR patients, and sPD-1 and sPD-L1 expression levels in peripheral blood of AR patients are increased. The PD-1/PD-L1 signaling pathway promote AR inflammatory response by inducing Th2 type immune response.

OBJECTIVE: Surgical wounds that can’t complete primary healing three weeks after surgery are called postoperative refractory wounds. Postoperative refractory wounds would bring great physical and life burdens to the patients and seriously affect their quality of life. To investigate the effect of platelet fibrin plasma (PFP) on postoperative refractory wound healing.APPROACH: The composition of PFP was analyzed using blood routine and blood biochemicals. Clinical data were collected that met the inclusion criteria after treatment with PFP, and the efficacy of PFP was evaluated by wound healing rate and days to healing. Next, growth factor content in PFP, PRP, and PPP was analyzed using ELISA, and PFP-treated cells were applied to investigate the effect of PFP on fibroblast and endothelial cell function. RESULTS: PFP component analysis revealed no statistical difference between platelet concentration in PFP and physiological concentration. Clinical statistics showed that PFP treatment was effective in the postoperative refractory wound (four-week wound healing rate [ 90%), significantly better than continuous wound dressing. Meanwhile, our result also proved that PFP treatment significantly enhanced vascularization by upregulated the expression level of CD31 and improved granulation tissue thickness. Activated PFP, PRP, and PPP could continuously release growth factors in vitro and the amount of growth factors released by PRP and PFP was significantly higher than PPP. In vitro studies demonstrated that active PFP could improve cell proliferation, migration, adhesion, and angiogenesis in fibroblasts and endothelial cells.INNOVATION: Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The modified PFP (responsible for accelerating wound healing and enhancing the migration and proliferation of fibroblasts and endothelial cells) was prepared and analyzed for its clinical effectiveness in postoperative refractory wounds. CONCLUSION Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The preparation of PFP could significantly reduce the amount of prepared blood, with a good application value for postoperative wounds. PFP can be considered a treatment option, especially for postoperative refractory wounds.

OBJECTIVE: Surgical wounds that can’t complete primary healing three weeks after surgery are called postoperative refractory wounds. Postoperative refractory wounds would bring great physical and life burdens to the patients and seriously affect their quality of life. To investigate the effect of platelet fibrin plasma (PFP) on postoperative refractory wound healing.APPROACH: The composition of PFP was analyzed using blood routine and blood biochemicals. Clinical data were collected that met the inclusion criteria after treatment with PFP, and the efficacy of PFP was evaluated by wound healing rate and days to healing. Next, growth factor content in PFP, PRP, and PPP was analyzed using ELISA, and PFP-treated cells were applied to investigate the effect of PFP on fibroblast and endothelial cell function. RESULTS: PFP component analysis revealed no statistical difference between platelet concentration in PFP and physiological concentration. Clinical statistics showed that PFP treatment was effective in the postoperative refractory wound (four-week wound healing rate [ 90%), significantly better than continuous wound dressing. Meanwhile, our result also proved that PFP treatment significantly enhanced vascularization by upregulated the expression level of CD31 and improved granulation tissue thickness. Activated PFP, PRP, and PPP could continuously release growth factors in vitro and the amount of growth factors released by PRP and PFP was significantly higher than PPP. In vitro studies demonstrated that active PFP could improve cell proliferation, migration, adhesion, and angiogenesis in fibroblasts and endothelial cells.INNOVATION: Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The modified PFP (responsible for accelerating wound healing and enhancing the migration and proliferation of fibroblasts and endothelial cells) was prepared and analyzed for its clinical effectiveness in postoperative refractory wounds. CONCLUSION Physiologically concentrated platelet plasma promoted wound healing and improved related cellular functions. The preparation of PFP could significantly reduce the amount of prepared blood, with a good application value for postoperative wounds. PFP can be considered a treatment option, especially for postoperative refractory wounds.