Objective To study the advantage and disadvantage of different treatments of unstable distal radial fractures in elderly patients. Methods In the period from August 2005 to January 2010, 55 elderly patients with unstable d istal radial fractures were treated with manual diaplasis and external plaster splint fixation, operation and internal plate fixation, or external fixation. Clinical outcomes were evaluated by Gartland-Werley wrist scoring systems and questionnaire of the disabilities of the Arm, Shoulder and Hand (DASH). We used SPSS13.0 software package for statistical analysis. Results Compared with the manual diaplasis group, the operation and internal plate fixation group or external fixation group was better in Gartland-Werley scores, the differences were statistically significant (P<0.05), but there were no differences in DASH scores among the 3 groups. Conclusions The treatment of unstable distal radial fractures in elderly patients should be chosen based on the characteristics of the fractare and patients desire.

Objective To observe the effects of green fluorescence protein mediated by lentivirus in bladder, and to de?termine the amount of virus obtained good transfection effects. Methods lentivirus carring GFP gene was perfused using transurethral approach into bladder of guinea pigs. Samples of bladder, liver, kidney and lungs were collected for frozen sec?tions after feeding seven days. The distribution of green fluorescence was observed using laser confocal microscopy. Re?sults The titer of lentivirus was 4 × 108. GFP was found under the mucosa when the amount of lentivirus transurethral was 30μL. GFP was distributed widely in muscle layer using 40μL lentivirus. GFP was detected even stronger in muscle layer when the amount was 50μL. GFP was found in muscle layer when 25μL lentivirus was injected intravenously. GFP was not found in other tissues than in bladder via transurethral perfusion. There was higher GFP in liver, lungs and other organs than in bladder via intravenous injection. Conclusion Lentivirus can mediate GFP transfecting bladder of guinea pig successful?ly and escape the distribution of GFP all over the body intravenously, which will bring new research direction and method for clinical treatment of diseases in bladder.

Objective:To prepare and purify siRNA targeting a proliferation-inducing ligand targeted(APRIL-siRNA),so as to provxde a basis for studying the role of APRIL in human pancreatic cancer.Methods:pET-22b-APRIL was constructed to express APRIL dsRNA of human pancreatic cancer cell line CFPAC-1 in E.coli and the product was purified by chromatography using CF-11 column.APRIL dsRNA was digested by RNaseⅢto prepare APRIL siRNA,then the reaction mixture was loaded onto a DEAE ion exchange chromatography to remove RNaseⅢfrom oligonucleotides,and size exclusion chromatography was used to purify 21 bp siRNA.The purified APRIL siRNA was used to transfect Chinese hamster ovary(CHO)cells and the expression of APRIL in CHO cells was observed under fluorescence microscope Results:APRIL dsRNA was successfully expressed in E.coli after IPTG induction and was purified by CF-11 column.dsRNA was hydrolyzed with RNaseⅢand was purified by DEAE ion exchange chromatography and size exclusion chromatography.15% nondenaturing PAGE and 12% SDS- PAGE confirmed that RNaseⅢwas removed from oligonucleotides and 21 bp siRNA was purified with size exclusion chromatography.It was also found that APRIL siRNA obviously depressed APRIL expression in CHO cells.Conclusion:We have successfully constructed APRIL siRNA targeting APRIL gene of CFPAC-1 cells with in vitro transcription,which provides a basis for knock-down of APRIL gene in CFPAC-1 cells.

[Objective] To sum up the clinical experience of treating nasopharyngeal carcinoma with TCM syndrome differentiation by professor Piao Bingkui. [Method] By analyzing the idea of Piao's therapy and medication of the proven case, it elaborates Pro. Piao Bingkui's clinical experience on using Chinese herbs, supporting the health and strengthening the root, anti-cancer and detoxification, to treat nasopharyngeal carcinoma. [Results] Pro. Piao Bingkui adepted at long-term maintenance therapy of TCM, which relieved the patient's clinical symptoms, and improved the quality of life significantly, and achieved satisfactory clinical outcome, according to the patient's previous treatment, the condition changes. [Conclusion] Pro. Piao Bingkui treated nasopharyngeal carcinoma depending on the different courses of individual, who used the methods of supporting the health and strengthening the root, anti-cancer and detoxification, could reduce the radiotherapy and chemotherapy toxicity, improve the body's resistance to disease and reduce the recurrence rate. It has important clinical significance.

Objective To investigate the therapeutic effects and the possible mechanism of fecal transplantation on rats with Clostridium difficile-associated pseudomembranous colitis. Methods A total of 40 Sprague-Dawley rats were divided into four groups including the healthy control group, model group, fecal transplant treatment group and vancomycin treatment group. Rats in three experimental groups were subcuta-neously injected with clindamycin phosphate (10 mg), followed by treatment with toxin producing Clostridi-um difficile (ACTT43255) enema 24 hours later. The rats in fecal transplant treatment group and vancomy-cin treatment group were respectively treated with fecal suspension and vancomycin one day after modeling. The rats were fasted for one day after the last administration and then executed. The levels of potassium ion ( K) , sodium ion ( Na) , albumin ( ALB) , white blood cells ( WBC) , C-reaction protein ( CRP) , interleu-kin-1β ( IL-1β) , interleukin-10 ( IL-10 ) , interleukin-12 ( IL-12 ) and interleukin-17 ( IL-17 ) as well as the percentage of neutrophils ( N%) in serum samples were detected. The colon tissue samples were collect-ed for pathology examination. Results The rat model of pseudomembranous colitis was successfully estab-lished by subcutaneous injection of clindamycin in combination with toxin-producing Clostridium difficile (ACTT43255) enema. The signs of intestinal inflammation including serious weight loss, remarkably short-ened colon length and significantly increased colon wet weight index were observed in rats from the model group (P<0. 05). Compared with the rats from model group, the rats received fecal transplant showed sig-nificantly increased levels of K, ALB, IL-10 and IL-10/IL-12 in serum and decreased levels of WBC, N%, CRP, IL-1β and IL-17 (P<0. 05). Conclusion Fecal transplantation was proved to be an effective ap-proach for the treatment of pseudomembranous colitis. The therapeutic mechanism might due to its impacts on serum inflammatory factors.

Objective To evaluate the clinical effect of transcatheter closure with Amplatzer duct occluder offers in infants with patent ductus arteriosus(PDA).Methods Thirty-seven PDA infants underwent transcatheter closure of PDA at(8.7 ? 3.3)months and weight of(8.6 ? 3.5)kg.A lateral view aortogram was made to determine the morphology and the narrowest diameter of the ductus and selected the size of the device.Occluder was implanted using the anterograde venous approach.Follow-up evaluations were made with chest X-ray and echocardiogram at 24 hours and 1,6 and 12 months after implantation.Results The narrowest diameter of the ducts measured by angiographically was(3.3 ? 1.5)mm.Ninteen patients(54.29%) achieved immediate complete occlusion.On color Doppler the closure rates at 1 month after implant were 34 cases(97.14%).No residual shunt exsisted in all implanted patients at 6 and 12 months follow-up.Procedure time at(57 ? 43)minutes and fluoroscopy time(23.0?14.9)minutes.Conclusions Percutaneous PDA closure with the Amplatzer duct occluder decice is an safety and effective method for the treatment of PDA in infants,but caution shall be exercised to the anatomic characteristics in the infant age group in solving clinical complications.

0.05),but the rate of depression and anxiety were significantly higher in the study group(P

Objective To investigate the therapeutic efficacy of short course chemotherapy (SCC)on drug resistant tuberculosis (DR-TB) cases and related influencing socioeconomic factors. TB patients registered in local county TB dispensaries of two rural counties were followed up in Deqing and Guanyun of Eastern China, during 2004/2005. Methods Culture-positive patients (Deqing: 182, Guanyun: 217)were selected as subjects of this study. A cohort of TB patients was established at the beginning of their treatment and each patient was followed-up three times by questionnaires. Proportional method of drug susceptibility test was used to define the resistance to the 1st-line anti-TB drugs.χ2 test Kaplan-Meier method and Cox analysis were applied in multivariate analysis to investigate the negative conversion of smear positive sputum, treatment result of SCC and its socioeconomic influencing factors. Results The cure rates of multi-drug resistant TB (MDR-TB),other drug resistant TB (ODR-TB) and pan-drug susceptible TB,were 58.3%, 91.0%, 98.7% and 51.3%, 89.5%, 93.5% respectively in Deqing and Guanyun. The liver dysfunction (RR = 0.18, 95% CI:0. 04-0. 69 ) and previous treatment history (RR = 0.26,95% CI:0.07-0.93) were associated with treatment result among MDR-TB. Result on treatment in ODR-TB was influenced by previous treatment history (RR = 0.66, 95% CI:0. 44-0. 98 ) and Patient delay (＞2 weeks)(RR = 0.67, 95% CI: 0.46-0.97). Conclusion The priority in treating MDR-TB would include:managing side effect, developing the fast sensitive drug susceptibility test and modifying the treatment regimen corresponding to drug resistance.

Objective To investigate the contribution of recent transmission in the epidemic of drug-resistant Mycobacterium tuberculosis (M. TB) and related factors from biomedical and social-demographic perspectives in the Eastern rural areas of China. Methods Identified by proportio5n method of drug susceptibility test, 223 drug resistant M. TB isolates and their hosts were included in the present study. These drug resistant tuberculosis isolates were first genotyped by Mycobacterial Interspersed Repetitive Units(MIRU),and those isolates with identical MIRU defined as two patients' M. TB isolates harboring the identical MIRU genotype and IS6110-based RFLP pattern simultaneously. Unique strains denoted those with the unparalleled MIRU genotype in the study collection. Socio-demographic and biomedical characteristics of host patients were compared between the clusters and unique groups through univariate and multivariate logistic regression analysis. Results Based on the MIRU-IS6110 pattern, there were 52 isolates belonged to the "cluster" group and 171 as the "unique" group. Drug resistant M. TB strain isolated from patients at the age of 30-60 year had a higher probability of being clustered, comparing to those from patients below 30 years of age (30.9% vs. 11.9%;OR=3.297; 95%CI: 1.169-9.297). Such finding were also seen in the isolates from patients with previous treatment history compared to newly diagnosed patients (32.9% vs. 18.4%; OR=2.163, 95% CI: 1.144-4.090). The multi-drug resistant M. TB strain was found to have been more frequently clustered when comparing to the mono-drug resistant M. TB (47.2% vs. 15.5%; OR=4.773; 95%CI: 2.316-9.837). The transmission pattern of drug resistant tuberculosis was presented mainly by the sporadic distribution in small group within rural villages. Conclusion Transmission of drug-resistant tuberculosis was seen in the population living in the Eastern rural areas of China, and causal contact within villages was considered as the main route of recent transmission. Patients at middle age and having previous tuberculosis treatment history might have increased the risk of transmission by patients with drug resistant tuberculosis.

OBJECTIVETo evaluate clinical outcomes of fixation for the treatment of radial head fracture with collapse of anterior articular surface.

METHODSFrom March 2006 to January 2013,17 patients with radial head fractures with collapse of anterior articular surface were analysed. According to the Mason classification, there were 12 cases with Mason type II fractures and 5 cases with Mason type III fractures. All the patients were treated with open reduction through posterolateral entrance of elbow joint and Herbert or titanium cannulated screw internal fixation.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months, with a mean of 11.3 months. According to the Broberg and Morrey score system, 2 patients got an excellent result, 12 good and 3 fair. There were no complications such as infection of elbow joint, nerve injury, non-union, traumatic osteoarthritis, heterotopic ossification and elbow instability. However, the postoperative activity range of elbow in the injuried side was less than that in the normal side.

CONCLUSIONRadial head fracture with collapse of anterior articular surface is easily misdiagnosed, and it can be treated with open reduction and internal fixation through posterolateral entrance.

Adult ; Aged ; Elbow Joint ; physiopathology ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular