Objective To compare open reduction and internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the operative treatment of complicated proximal humeral fractures.Methods From January 2014 to October 2015,55 complicated proximal humeral fractures were treated at our department.They were 32 men and 23 women,from 21 to 81 years of age (average,51 years).According to Neer classification,34 cases belonged to three-part fractures and 21 ones to four-part fractures,14 of which were complicated with dislocation.Of them,35 received ORIF and 20 underwent MIPPO.The 2 groups were compared in terms of operation time,intraoperative blood loss,incision length and Neer scoring of the shoulder function at the final follow-ups.The 2 groups were compatible without significant differences in preoperative demographic data (P ＞ 0.05).Results The 55 patients were followed up for 6 to 12 months(mean,9 months).The operation time (100.5 ± 10.2 min),intraoperative blood loss (80.0 ± 10.5 mL),and incision length (7.5 ± 3.2 cm) in the MIPPO group were significantly better than those in the ORIF group (120.0±10.1 min,200.5±10.2mL,and10.5±5.3cm,respectively) (P ＜0.05).According to the Neer scoring of the shoulder function at the final follow-ups,the good to excellent rate was 71.4％ (25/35) in the ORIF group and 85.0％ (17/20) in the MIPPO group,showing a significant difference (P ＜ O.05).The incidence of humeral head necrosis was 15 in the ORIF group,significantly higher than that (3) in the MIPPO group (P ＜ 0.05).Conclusion In treatment of complex proximal humeral fractures,compared with ORIF,MIPPO may lead to less damage to local blood supply,less trauma,and quicker functional recovery due to early functional exercise.

Objective To investigate the relationship between the mechanism of ischemic postconditioning-induced activation of nuclear factor-E2 related factor 2 (Nrf2)-antioxidant response element (ARE) signaling pathway during myocardial ischemia-reperfusion (I/R) and reactive oxygen species (ROS).Methods Healthy male Sprague-Dawley rats, aged 16-20 weeks, weighing 250-300 g, were heparinized and anesthetized with intraperitoneal 1％ pentobarbital sodium 40 mg/kg.Their hearts were excised and perfused in a Langendorff apparatus with K-H solution.Thirty-two isolated rat hearts were randomly divided into 4 groups (n=8 each) using a random number table: control group (group C) , group I/R,ischemic postconditioning group (group IPO) , and N-(2-mercaptopropionyl)-glycine (a ROS scavenger) + IPO group (group M + IPO).After 20 min of equilibration, group C was continuously perfused with K-H solution for 100 min, and the isolated hearts received the drugs via the perfusion system in the other groups.Group I/R was perfused with cardioplegic solution 4 ℃ St.Thomas, and then was subjected to 40 min of ischemia at 32 ℃ followed by 60 min of reperfusion.In group IPO, ischemic postconditioning was induced by 6 cycles of 10 s reperfusion followed by 10 s limb ischemia starting from the onset of reperfusion, and the hearts were then perfused for 58 min.In group M + IPO, the hearts were perfused with K-H solution containing N-(2-mercaptopropionyl)-glycine 2 m mol/L for 3 min starting from the onset of reperfusion,underwent 2 min of ischemic postconditioning, and then was perfused for 55 min.Heart rate (HR), left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (LVEDP),and positive maximal pressure of left ventricular increase (+dp/dtmax) were recorded at the end of equilibration and of reperfusion.At 5 min of reperfusion and the end of reperfusion, myocardial specimens were obtained from the left ventricle for determination of ROS content by enzyme-linked immunosorbent assay.At the end of reperfusion, myocardial specimens were obtained from the left ventricle for examination of the ultrastructure of myocardial cells and for determination of Nrf2, heme oxygenase-1 (HO-1) , quinone oxidoreductase 1 (NQO1), and superoxide dismutase 1 (SOD1) mRNA and protein expression (by using Western blot and real-time polymerase chain reaction).The damage to myocardial mitochondria was assessed using Flameng scoring.Results Compared with group C, HR, +dp/dtmax and LVDP were significantly decreased, and LVEDP was increased at the end of reperfusion in I/R and M+IPO groups, HR and LVDP were decreased, LVEDP was increased, and no significant changes were found in +dp/dtmax at the end of reperfusion in IPO group, Flameng score was increased in I/R, IPO and M+IPO groups , the ROS content was increased at the end of reperfusion in I/R, IPO and M+IPO groups, and Nrf2, HO-1,NQO1 and SOD1 mRNA and protein expression was down-regulated at the end of reperfusion in I/R, IPO and M+IPO groups.Compared with group I/R, HR, +dp/dtmax and LVDP were significantly increased, and LVEDP and ROS content were decreased at the end of reperfusion, Nrf2, HO-1, NQO1 and SOD1 mRNA and protein expression was up-regulated at the end of reperfusion in IPO and M+IPO groups, Flameng score was decreased in IPO group, there was no significant change in Flameng score in M+IPO group.Compared with group IPO, HR, +dp/dtmax and LVDP were significantly decreased, LVEDP and ROS content were increased at the end of reperfusion, Flameng score was increased, and Nrf2, HO-1, NQO1 and SOD1 mRNA and protein expression was down-regulated in M+IPO group.Conclusion Ischemic postconditioning can regulate ROS level and activate Nrf2-ARE signaling pathway, thus attenuating myocardial I/R injury in rats.

Objective To observe the activation mechanism of Nrf2-ARE pathway in protective effect of ischemia and pinacidil postconditioning on isolated rat hearts.Methods The hearts of adult male Sprague Dawley rats were established ischemia-reperfusion injury model,and devided into six groups(n =8,each group),i.e.Normal group(Group N),ischemiareperfusion group (Group Con,I/R),ischemic postconditioning group (Group IPO),pinacidil postconditioning group (Group P50),N-(2-mercaptopropionyl)-glycine(MPG,2mmol/L) + IPO group(Group M + IPO),MPG + P50 group(Group M + P50).Rat hearts were perfused with Krebs-Henseleit(K-H) buffer for 20 minutes for equilibration.Subsequently,Group N was perfused with K-H buffer for 100 minutes after equilibration,Group Con was perfused with 4℃ ST.Thomas solution to stop the heart beating after equilibration,then the hearts were underwent 40 minutes global ischemia under 32℃,and followed by the K-H solution for 60 minutes.Group IPO after global ischemia period,the hearts were subjected to six 10-seconds cycles of ischemia/reperfusion at the beginning of reperfusion,then were reperfused for 58 minutes.Group P50 after global ischemia,rat hearts were perfused with K-H buffer containing pinacidil(50.μmol/L) for 2 minutes before reperfusion.Group M + IPO after global ischemia,the hearts were subjected to perfuse with K-H buffer containing MPG(2 mmol/L) for 3 minutes,and then underwent six 10-seconds cycles of ischemia/reperfusion before reperfusion.Group M + P50 after global ischemia,the hearts were perfused with K-H buffer containing MPG(2 mmol/L) for 3 minutes,and then subjected to perfuse with K-H buffer containing pinacidil(50 μmol/L) for 2 minutes before reperfusion.Cardiac function indexes(such as HR,LVDP,LVEDP,and the Max dp/dt) at the end point of equilibration and repeffusion were observed and recorded.The ultrastructure of myocardial tissue was observed by electron microscopy and the mitochondrial Flameng score was calculated.RT-PCR and western-blot were applied to detect the gene transcription and protein expression of HO-1,NQO1,SOD1,and Nrf2 in left ventricular myocardial tissue after reperfusion.Results The HR,LVDP and + dp/dtmax at the end of reperfusion:the cardiac function indexes are lower among each group compared with group N,group 1PO and group P50 are better than group Con (P ＜ 0.05).Compared with group IPO,there is no significant difference in group group P50,but group M + IPO is obviously decreased(P ＜ 0.05).Compared with group P50,group M + P50 index is decreased significantly(P ＜ 0.05).The LVEDP at the end of reperfusion is lower than that among each group as compared with group Con,which is significantly increased in group Con (P ＜ 0.05).Compared with group IPO,there is no significant difference in group P50,but group M + IPO is significantly increased(P ＜ 0.05).Compared with group P50,the group M + P50 is obviously decreased(P ＜ 0.05).The ultrastructure of myocardial tissue in group N is mostly normal,group Con presence serious damage.The ultrastructure damage of myocardial tissue is improved in group IPO and group P50 as compared with that in group Con,while group M + IPO is more serious than group IPO,group M + P50 is more serious group P50.The mitochondrial Flameng score is higher among each group as compared with group N (P ＜ 0.05),the score is lower in group IPO and group P50 as compared with group Con and corresponding nonblocking group (M + IPO,M + P50,P ＜0.05).The mRNA and the protein expressions of HO-1,NQO1,SOD1 and Nrf2 among each group are lower as compared with group N(P ＜0.05).Compared with those in group Con,the mRNA and the protein expressions in group IPO and group P50 are obviously increased(P ＜ 0.05),group IPO and group P50 are higher than those in group adding active oxygen scavenger(MPG) (P ＜ 0.05).Conclusion Ischemic postconditioning and pinacidil postconditioning have protective effect of myocardial tissue from ischemia reperfusion injury,while improve the cardiac function index.The cardiac protective effect of Ischemic and Pinacidil postconditioning methods may be involved the ROS in early reperfusion,which activate the Nrf2-ARE pathway,and up-regulate the expression downstream antioxidant protein and phase Ⅱ detoxifying enzyme,ultimately improve the cardiac function index during the reperfusion period.

Objective The study was to provide evidence for the development of local community health services through the analysis of patiems' expectations for community health services. Methods The expectations were indirectly evaluated by investigating the patients in the willingness-to-pay. Results The patients had a generally high expectation for health community services and they would be highly disappointed once their expectations fall short. Conclusions Those expectations that could be realized with short-term efforts ought to attract high attention of community health service providers and made important goals to achieve in the near future.

Objective To investigate cognitive functions in first-episode schizophrenia and unaffected first-degree relatives of different patients.Methods A total of 52 patients with first-episode schizophrenia (patient group),48 unaffected first-degree relatives of different patients (relatives group) and 50 healthy normal controls (control group) was recruited in the study.The attention,memory,and executive functions of all the subjects were assessed by a battery of neuropsychological tests,including cancellation test (CT),trail making test (TMT),digit span (DS),visual reproduction (VR),verbal fluency task (VFK),Wisconsin card sorting test (WCST) and HANOI tower.Results There were statistically significant difference among three groups in net scores of CT,TMTA,TMT-B,backward and total scores of DS,scores of VR,VFK,total errors and perseverate errors of WCST and all indicators of HANOI Tower (P ＜0.05 or P ＜ 0.01).Post Hoc multiple comparisons showed that,compared with the control group,the patient group had worse scores in all tests above except TMT-A in the relatives group (P ＜0.05 orP ＜0.01).However,compared with the patient group,the relatives group had better scores in net scores of CT,TMT-A,TMT-B,scores of VR,VFK,total errors and perseverate errors of WCST (P ＜ 0.05 or P ＜ 0.01).Conclusions Patients with first-episode schizophrenia have global cognitive functions deficits.Unaffected first-degree relatives of different patients also have cognitive deficits to a certain extent.Our study indicates that cognitive functions deficits may be viewed as a biomarker for candidates reflecting genetic liability for schizophrenia.

Objective To evaluate the efficacy of aerosol inhalation ofXiyanpingversus ribavirin for the treatment of respiratory tract infections in children.MethodsPubMed, Embase, Cochrane database of Systematic Reviews, CNKI, cqvip and wanfangdata were searched. The randomized controlled trials(RCTs) of aerosol inhalation ofXiyanpingversus ribavirin injections for the treatment of respiratory tract infections in children were incuded. The quality of trials was evaluated and data analyses were performed with the Cochrane Collaboration’s software RevMan 5.0.Results A total of 7 trials were included, involving 857 patients(437 treated withXiyanping, 420 treated with ribavirin). Both of the clinical cure rate(50.11%vs. 40.71%) and clinical effective rate(91.08%vs. 75.95%) in theXiyanping group were significantly higher than those in the ribavirin group, withOR(95%CI) 1.49(1.13 to 1.97) and 3.54(1.87 to 6.71), respectively.Conclusions Aerosol inhalation ofXiyanping superior to aerosol inhalation of ribavirin for the treatment of respiratory tract infections in children. Owing to the poor quality and the small sample size of included trials, more larger good quality CRTs are required to confirm this conclusion.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; immunology ; pathology ; Cytokines ; blood ; Esophageal Neoplasms ; immunology ; pathology ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-12 ; blood ; Interleukin-4 ; blood ; Interleukin-5 ; blood ; Lymphatic Metastasis ; Male ; Middle Aged ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Tumor Necrosis Factor-alpha ; blood

Objective:To optimize the formula of metronidazole and borneol sustained-release films. Methods: The mass ratio of Rhizoma Bletillae polysaccharide and polyvinyl alcohol 124(PVA-124) and the dosage of glycerol and sodium carboxymethyl cellulose ( CMC-Na) as the influencing factors ,the appearance of films and the release rate of metronidazole at 0. 5h and 4h as the comprehen-sive evaluation indices, the formula of the film-forming materials was optimized by orthogonal test. Results:The mass ratio of Rhizoma Bletillae polysaccharide and PVA-124 was the key factor affecting the quality of the films. When the mass ratio of Rhizoma Bletillae pol-ysaccharide and PVA-124 was 20∶80, and the dosage of glycerol was 3. 5g and that of CMC-Na was 0. 14g, the appearance of the films was satisfied, the release rate of metronidazole at 0. 5h and 4h was 25. 17% and 69. 64%, respectively, and the average cumulative re-lease rate at 8h was over 90%. Conclusion:The films prepared by the optimized formula are flat, smooth, clean and moderately soft, which can not only remain the drug release characteristics of the films made by the original formula, but also exhibit the pharmacologi-cal effect of Rhizoma Bletillae.

AIM: To study effects of hyperbaric oxygen (HBO) and cyclosporin A (CsA) on the contents of active oxygens and nitric oxide (NO) in spleens of skin transplanted mice. METHODS: The donor mice BALB/C and receptor mice Cs7BL/6 were tested for skin transplantation. The HBO group mice were,treated with 99.2 % oxygen under 0.25 MPa for 1.5 hours, while CsA group mice were treated with CsA 0.5 rmg· kg- t· d- 1 by abdomen injection. After 14 days, the spleen were extracted the contents of malondialdehyde (MDA) and NO and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH - PX), catalase (CAT) and NO synthases (NOS) were determined. RESULTS: (1) Compared with the control group, the transplantation group, HBO group and CsA group have markedly increased the content of MDA and the activities of GSH - PX and CAT; Compared with the transplantation group, the CsA group have markedly increased activity of SOD and reduced activities of GSH - PX and CAT; the HBO group have markedly reduced the activity of GSH - PX and increased the activities of CAT and SOD (P < 0.01 ). (2) Compared with the control group, the transplantation group have markedly increased the content of NO and the activity of NOS; Compared with the transplantation group, the HBO group have markedly increased the activity of NOS and reduced the content of NO ( P < 0.01 ); The content of NO and the activity of NOS in CsA group was not changed significantly. CONCLUSION: In the lymphocytes of the transplantation group, the peroxidation is intensified, and the content of NO and the activity of NOS increased. HBO and CsA may activate the systems of oxidation/antioxidation and NO/NOS in spleen, which may be related to their mechanism of inhibition rejection.

BACKGROUND:The cardiomyocytes obtained by traditional culture methods exhibit poor purity and viability, cells grow in clusters, the connection between cells is less, and most of cells beat separately. OBJECTIVE: To obtain high-purity cardiomyocytes presenting with a sheet-like growth by modified culture method. METHODS: Myocardial tissues were digested using 0.1% trypsin at 4℃ overnight, and then digested repeatedly through the addition of type Ⅱ collagenase, and finally were isolated and purified by differential adhesion method combined with chemical inhibitors. The morphology of cardiomyocytes was observed under inverted phase contrast microscope. The purity of cardiomyocytes was identified by cardic troponin T antibody after cultured for 48 hours. The beating frequency of cardiomyocytes was recorded every two days for 10 consecutive days. RESULTS AND CONCLUSION:The cardiomyocytes adhered within 24 hours of culture, distributed in clusters at 72 hours and grew in sheets at 5-7 days of culture. The survival rate of cardiomyocytes was 96% and the purity identified by immunofluorescence was over 97%. There was no significant difference in the beating frequency at different time. These results suggest that the high-purity and high-viability cardiomyocytes are obtained by the modified culture method, which is an effective method for culturing neonatal cardiomyocytes.