[Objective]To study the effects of AO double plates in internal fixation of humeral intercondylar fractures and to analyze the causes of the disfunction in elbow.[Method]From March 2001 to March 2006,21 cases (male 14, female 7) of humeral intercondylar fractures were reviewed, with an average age of 35.3 years (ranged,15～64 years).Left elbow:9 cases;right elbow:12 cases.According to AO/ASIF classification,type C1∶6,type C2∶10, and type C3∶5,2 cases of all were open fractures. Posterior operating approach of elbow: trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of AO double plates were performed in all cases.The patients began the active training of elbow joint as soon as possible postoperatively.[Result]Twenty-one cases were followed up for 8～38 months and the average time was 14.8 months.Bone union was obtained in all cases.One case complicated wound infection,it recovered after 3 weeks of dressing.And 1 case complicated with radial nerve injury,which recovered with neural nutrients.According to the Cassebaum scoring system,the effects were evaluated as excellent 7,good 10,and fair 4,and the excellent-good rate was 80.9%.[Conclusion]The application of AO double plates was proved to be a good method to treat humeral intercondylar fractures at present. But the severity of the bone comminution and soft-tissue lesion, the effective fixation,earlier active exercise were the main causes that influence the functional recovery of elbow joint.

Objective To evaluate the viability of residual tumor after insufficient thermal ablation of rabbit VX2 liver tumor and investigated the efficacy of sorafenib as an adjuvant therapy.Methods Twenty-one rabbits were implanted with VX2 tumor to establish orthotopic liver tumor models.They were allocated randomly into 3 groups:control (n =7),ablation (n =7),and combination treatment (n =7).Microwave coagulation therapy was conducted with 20 W for 1 min and viable tumor tissue remained at the periphery.A laparotomy was performed in the control group.Sorafenib was given at 20 mg/kg/d during the following 10 days in the combination treatment group,and saline was given to the control and ablation group.Tumor volume was recorded before and after treatment,immunohistochemistry detected CD31 and proliferating cell nuclear antigen (PCNA) expression,and the micro-vessel density (MVD) and proliferation index (PI) were calculated accordingly.Results Ten days after insufficient ablation,tumor volume of the ablation group was larger than that of the control group (P ＜0.05).The MVD and PI of residual tumor were higher compared with those of the control group (P ＜ 0.05).With adjuvant therapy of sorafenib after insufficient ablation,tumor volume showed a decrease on the 10th day compared with tumors undergoing insurfficient ablation alone (P ＜ 0.05).The MVD and PI of residual tumor were lower than those of the ablation group (P ＜0.05).Conclusion Insufficient thermal ablation promotes residual tumor progression,but adjuvant therapy of sorafenib serves as an effective way to suppress the overgrowth and neovasculation of the residual tumor.

Purpose To describe the clinical and pathological features of atypical vascular lesions (AVLs) after conservative surgery and radiation of the breast cancer,and to discuss the association with post-radiation angiosarcoma.Methods The clinical and pathological features in one case of AVLs was evaluated.The literatures were reviewed.Results The patient is a 57-yeAR~-old female who underwent a conservative surgery of the right breast because of a carcinoma.She received standard dose of radiation as adjuvant therapy.Three years later, multiple erythematous plaques developed around the former scar, which radiated to the nipple.Clinically,the plaques were considered as relapses of the carcinoma.However, fine needle aspiration gave negative results.Biopsy of one large plague revealed a circumscribed vascular lesion confined to the superficial dermis.It was composed of thin-walled anastomosing lymphatic vessels lined by attenuated endothelial cells.In focal areas, the vessels extended to the mid-dermis.Immunohistochemically, the endothelial cells were positive for CD31, CD34 and D2-40,with absent of α-SMA positive pericytes.Review of the breast tumor sections showed an invasive micropapillary carcinoma.Conclusions AVLs is a rare vascular lesion related with conservative surgery and post-radiation therapy of the breast.AVLs may represent as a precursor of breast angiosarcoma.Being familiar with the clinicopathologic characteristics of AVLs is important not only for the pathologists but also for the clinicians.

Objective To investigate the expression and methylation status of HOXA7 gene in human pancreatic cancer cell lines, and to explore the relationship between them.Methods HOXA7 mRNA expression of human pancreatic cancer cell lines BxPC3, CFPAC1, PANC1 and SW1990was detected by RT PCR.Bisulfite sequencing PCR (BSP) and combined bisulfite restriction analysis (COBRA) was used to test promoter methylation status.All the cell lines were treated by 5-aza-2-deoxycytidine (5-aza-dC), and HOXA7mRNA expression, methylation status was detected before and after this treatment.Results HOXA7 mRNA was expressed in BxPC3, CFPAC1 and SW1990, while there was no expression of HOXA7 mRNA in PANC1.HOXA7 promoter methylation rates of CFPAC1, BxPC3, PANC1 and SW1990 were 93.16%, 90.65%,90.09% ,52.30%.HOXA7 promoter methylation rate of SW1990 was significantly lower than those in other 3cell lines ( P ＜0.01 ).After 5-aza-dC treatment, HOXA7 mRNA of PANC1 was expressed again, and HOXA7mRNA of BxPC3 was increasingly expressed;while the expression of HOXA7 mRNA in CFPAC1 and SW1990was not significantly changed after 5-aza-dC treatment.Conclusions The expression of HOXA7 mRNA in BxPC3 and PANC1 was closely correlated with promoter hypermethylation, while there was no obvious relation in CFPAC 1 and SW1990.

Objective To determine the methylation status and expression of Ras association domain family 1A (RASSF1A), and the possible effect between promoter aberrant methylation and pathogenesis of pancreatic cancer. Methods The methylation status of RASSF1A promoter CpG island (CGI) pancreatic cancer cell line BxPC3 was detected in 5 cases of normal pancreatic tissue and 13 pairs of pancreatic cancer tissues (tumor and peri-tumor) by using COBRA (combined bisulfite restriction analysis) and the methylation rate was calculated. The RASSF1A mRNA expression of BxPC3 was compared between pre- and post-treatment of the inhibitor of DNA methyltransferase (5-Aza-2-deoxycitydine, 5-Aza-dC). Results The average methylation rate of RASSF1A promoter CGI was 62.90% in BXPC3, 9.14% in normal pancreas, 53.79% in peri-tumors (TP), and 55.82% in tumors. The methylation rates in port-tumors and tumors were significantly increased when compared with that of normal pancreas (P < 0.01), while there was no significant difference between in peri-tumors and tumors (P > 0.05). After 5-Aza-dC treatting BxPC3 cells, the methylation rates decreased to 42.5% (P < 0. 05) and RASSF1A mRNA expression was enhanced. Conclusions Aberrant hypermethylation of RASSF1A promoter CGI could be considered as an early event in the process of pancreatic cancer and participates in the pathogenesis of pancreatic cancer.

Objective To evaluate one-stage arthroscopic reconstruction of anterior crueiate ligament (ACL)and posterior cruciate ligament(PCL)using Achilles tendon-bone allografts. Methods From July 2000 to February 2005.we treated 15 patients(11 males and 4 females)whose ACL and PCL were ruptured at one knee but the eontralateral knee was intact.Their associated meniscus injuries were treated arthroscopically according to established procedures prior to ligament reconstruction.Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees at one stage.Reconstruction of both ligaments was performed at subacute or chronic phase(>3 to 8 weeks)in 12 casses,and at acute phase in 3 cases(<3 weeks).All knees were graded pre-and postoperatively using the International Knee Documentation Committee(IKDC)and Lysholm scoring systems.At follow-up,functions were evaluated for all patients and compared with those of the contralateral healthy knee. Results All patients were followed up for a minimum of 3 years(mean,38 months).Preoperatively,the IKDC ratings showed all the injured knees were severely abnormal.At final postoperative f0Uow-up,9 knees received a normal rating,5 a nearly normal one and 1 an abnormal one.The differences in Lysholm score were statistically significant (t=15.660,P<0.05)between pre-and postoperative analyses.The most noticeable postoperative complication was a short localized fever coupled with arthroedema in 1 case. Conclusions Achilles tendon-bone allograft offers an alternative for simultaneous arthroseopic reconstruction of ACL and PCL.However,problems inherent in allograft tissues entail further investigation to ensure future application.

Objective To investigate the effect of treatment for frozen shoulder by manipulation release combined with hydraulic pressure distension.Methods In this randomized trial,78 patients with frozen shoulder syndrome randomly divided into three groups were enrolled in the study.28 patients were treated by manipulation release under interscalene brachial plexus anesthesia.23 patients were treated by sodium hyaluronate injection into glenohumeral joint combined with manipulation release.27 patients were treated by hydraulic pressure distension combined with manipulation release.All patients were followed for six months.Effective rate evaluation combined with pain evaluation and functional evaluation were adopted for final evaluation.Results There were significant difference between pre-treatment and post-treatment in each group.Effective rate of hydraulic pressure distension combined with manipulation release was 92.6%,which was superior to manipulation release (78.6% ) and sodium hyahronate injection combined with manipulation release ( 82.6% ).There were no significant difference in functional evaluation of the three groups.Conclusion Hydraulic pressure distension combined with manipulation release under interscalene brachial plexus anesthesia is a successful treatment for idiopathic frozen shoulder.

Objective To analyze current situation of incentive mechanism and investigate the countermeasures.Provide the evidence for improving the incentive mechanism of scientific research at the hospital.Methods Questionnaire survey was conducted to investigate current situation and countermeasures of incentive mechanism of scientific research.Database was building using EpiData3.1,and was performed by descriptive analysis.Results 194 questionnaires were available.For the current incentive mechanism,86.5％ respondents thought the content is comprehensive,The over 50 years old,bachelor or below,and clinical examination group thought the content were less comprehensive.Respectively,81％,82.5％,76.2％ of respondents thought stimulation on achievements has positive effect to research,team work,and individual accounted for.The over 41 years old college or bellow,clinical treatment group felt less effect.For improving measures of incentive mechanism,the top three positions of contents were technological reward,high level project and SCI paper;and incentive methods were promotion,material rewards and training.Conclusions Incentive mechanism can promote scientific research to some extent.To further promote scientific research development,individual incentive measures need to be taken,the contents need to be expanded,variety incentive methods need to be used.

Objective To investigate the anti-apoptosis effect of transgiutaminase 2 (TG2)in osteosarcoma cell line MG-63 and to explore the mechanism of inhibiting apoptosis of tumor cells.Methods The TG2-tgrgeted siRNA was designed,and the hypoxia culture model of MG-63 cells was established by a hypoxia incubator and the cells were divided into four groups:normal oxygen group,the cells were cultured under normal oxygen;hypoxia group, the cells were cultured in hypoxic incubators;control siRNA hypoxia group,the cells were cultured in hypoxic incubators after transfection of control siRNA;TG2 siRNA hypoxia group , the cells were cultured in hypoxic incubators after transfection of TG2 siRNA.The expressions of Bax and cytochrome C (Cyt C)and the apoptotic rates were observed at different time (6,12,24,48,and 72 h)after hypoxia culture.Microtiter plate assay was performed to monitor the intracellular TG2 activity.RT-PCR was used to detect the mRNA expressions of TG2 and Bax.The expressions levels of TG2,Bax and Cyt C were observed by immunohistochemical staining and Western blotting method.The apoptotic rates were analyzed using flow cytometry.Results Compared with normal oxygen group,the activity of TG2,the mRNA and protein expression levels of TG2 in hypoxia group and control siRNA hypoxia group were increased remarkably with the prolongation of the hypoxia time (P<0.01);the expression level of Bax protein was decreased significantly (P<0.01 ), but the expression level of Bax mRNA had no significant change (P>0.05);the expression levels of Cyt C protein in cytoplasm and mitochondria and the apoptotic rates had no markedly changes (P>0.05).Compared with hypoxia group and control siRNA hypoxia group,the expression levels of mRNA and protein of TG2 in TG2 siRNA hypoxia group were decreased significantly at different time points (P<0.01);the protein expression levels of Bax and Cyt C in cytoplasm and the apoptotic rates were increased markedly (P<0.01 );the expression level of Cyt C in mitochondria was decreased (P<0.01).Conclusion TG2 can inhibit the apoptosis of tumor cells through down-regulating the Bax expression and preventing Cyt C releasing into the cytoplasm.

OBJECTIVE To analyze the correlation between number of tissue eosinophils(Eos) and blood Eos levels in patients with chronic rhinosinusitis with nasal polyps(CRSwNP), and to investigate if tissue and blood eosinophilia predicts disease severity and prognosis in CRSwNP. METHODS A retrospective analysis of 102 patients, who diagnosed with CRSwNP was carried out in this study. Surgical specimens were evaluated for degree of tissue Eos, which was compared with blood Eos. Patients were divided into two groups according to the results of endoscopy one year after surgery: recurrent and non-recurrent group. Statistical analysis was performed to compare tissue and blood Eos and CT Lund-Mackay scores. RESULTS Blood and tissue Eos in recurrent group was significantly higher than that in non-recurrent group(P=0.032, 0.033, 0.017). There was not a statistical difference of CT scores between two groups(P =0.089). There was a significant correlation between tissue Eos and absolute number of blood Eos(r=0.637, P=0.000) as well as between tissue Eos and percentage of blood Eos(r=0.542, P=0.000). However Eos and CT scores were not correlated statistically(P>0.05). CONCLUSION Blood Eos levels can predict the degree of Eos infiltration in nasal polyps. Blood and tissue Eos correlate with prognosis.