Objective To evaluate the method, clinical effects and influential factors of using three dimensional external fixators in the treatment of severe open comminuted tibiofibular fractures 5 cm near the knee or ankle joints. Methods We retrospectively analyzed 32 cases of open comminuted tibiofibular fracture 5 cm near the knee (11 cases) or ankle joints (21 cases). They were treated with three dimensional external fixators from October 2000 to May 2005. The patients with small wounds were treated with manipulative reduction or leverage reduction through the wound under the guidance of C-arm radiography. In case of malreduction or soft tissue being tangled by the fracture ends, visible reduction was carried out after the wound was lengthened or a small incision was added. Limited internal fixation was used in case of necessity. The results were evaluated in terms of shortening of the fractured limbs, X-ray manifestation, bilateral flexion differences and postoperative walking complaints. Results Follow-ups from 5 to 18 months (nine months on average) showed that all the cases achieved osseous union. The mean union time was 5.6 months. The total excellent and good rates of fracture healing and functional recovery were 81.3% and 87.5% respectively. Conclusion Application of the three dimensional external fixator is appropriate for the treatment of severe open comminuted tibiofibular fracture 5 cm near the knee or ankle joints, because its operative procedure is simple, the injury it causes is minimal, its fixation is reliable and its complications are quite limited.

Objective To investigate the therapeutic effect and side effect of prourokinase (Pro-uk) on the patients with acute myocardial infarction. Method From May 2004 to May 2005, a total of 68 cases of acute myocardial infarction treated by thrombolytic agents within 6 hours after onset were divided randomly into Pro-uk group ( n = 43) and urokinase (UK) group ( re = 25). In the Pro- uk group, there were 22 eases treated with 50 mg Pro-uk and 21 cases prescribed in 60 mg Pro-uk. The patency of involved coronary artery was evaluated by using selective coronary angiography at 90 minutes after thrombolytic therapy. The incidence of early heart events, bleeding and adverse reaction, were alse observed. Results (1) The total rates of resumed patency of obstructed coronary artery (TIMI grade 2 and 3 flow) were 76.7% in Pro-uk treated patients and 52.2% in UK treated patient ( P = 0. 041). (2) The occurrence of hyporrhea was lowered more significantly in Pro-uk treated patients than in UK treated patients (P = 0.029), but there were no intracranial hemorrhage found in both group. (3) Early cardiac events and adverse reactions were similar between two groups. Conclusions Pro-UK is safe and effective for the patients with acute myocardial infarction.

Objective To investigate the expression and clinical significance of silent mating type information regulation 2 homolog-1(SIRT-1)and nuclear factor-κB(NF-κB)in non-small cell lung cancer (NSCLC). Methods The expressions of SIRT-1 and NF-κB were evaluated by immunohistochemistry in 108 selected cases of primary NSCLC and 48 samples of para-carcinoma normal tissue. The relationships of the expressions of SIRT-1 and NF-κB and clinical pathological features were analyzed,respectively. Results Immunohistochemical results showed that the positive expression rates of SIRT-1 and NF-κB in NSCLC tissue were 90. 7%(98 / 108)and 94. 4%(102 / 108),respectively,significantly higher than those in normal lung tissue 4. 2%(2 / 48),16. 7%(8 / 48),χ2 = 108. 237,P = 0. 000;χ2 = 96. 683,P = 0. 000,and the expre-ssion of SIRT-1 and NF-κB showed a positive correlation(r = 0. 480,P = 0. 001). There were significant posi-tive correlations between the expression of SIRT-1 and tumor size(r = 0. 227,P = 0. 018),TNM stage(r =0. 298,P = 0. 002)and lymph node metastasis(r = 0. 280,P = 0. 003),and there was negative correlation between the expression of SIRT-1 and differentiation(r = - 0. 300,P = 0. 002),and there were no correlation between the expression of SIRT-1 and sex,age and histological type in NSCLC tissues. There were significant positive correlation between the expression of NF-κB and TNM stage(r = 0. 256,P = 0. 009)and lymph node metastasis(r = 0. 261,P = 0. 006),and there was negative correlation between the expression of NF-κB and differentiation(r = - 0. 235,P = 0. 013),and there were no correlation between the expression of NF-κB and sex,age,histological type and tumor size in NSCLC tissues. Conclusion The positive expression rates of SIRT-1 and NF-κB in NSCLC tissue are significantly higher than those in normal lung tissue,and they are rela-ted to TNM stage,lymph node metastasis and differentiation,and the former is also related to tumor size. High expression of SIRT-1 and NF-κB may play important roles in the occurrence and development of NSCLC.

ncing analysis validated that all four-type base-quenched probes could provide unbiased genotyping results ( Kappa =1, P=0.00), although. Conclusion This method is simple, economic and suitable for large-scale genotyping studies.

OBJECTIVE:To investigate therapeutic efficacy and safety of levamlodipine and telmisartan combined with hydro-chlorothiazide in the treatment of anti-dipper hypertension. METHODS:Totally 150 patients with anti-dipper hypertension were ran-domly divided into group A,B,C,with 50 cases in each group. Group A was given Telmisartan tablet 40 mg+Hydrochlorothiazide tablet 10 mg,once a day,in the morning. Group B was given Levamlodipine tablet 5 mg,once a day,in the night. Group C was given Telmisartan tablet(usage and dosage same as group A)+Hydrochlorothiazide tablet(usage and dosage same as group A)+Le-vamlodipine tablet(usage and dosage same as group B). Treatment courses of 3 groups lasted for 8 weeks. The changes of electro-lyte and 24 h ambulatory blood pressure were observed and compared among 3 groups before and after treatment. The incidence of adverse reactions was recorded. RESULTS:There was no statistical significance in the electrolyte indexes in 3 groups before and af-ter treatment(P>0.05). Before treatment,there was no statistical significance in 24 h blood pressure among 3 groups(P>0.05). Af-ter treatment,the 24 h blood pressure of the patients in the 3 groups after treatment was lower than before treatment,and group C was lower than that of the group A and group B(P<0.05). After treatment,the rate of anti-dipper rhythm reversal in group C was significantly higher than group A and B,with statistical significance(P<0.05). There was no statistical significance in the inci-dence of ADR among 3 groups(P>0.05). CONCLUSIONS:Levamlodipine and telmisartan combined with hydrochlorothiazide show good therapeutic efficacy for anti-dipper hypertension,and can reduce 24 h blood pressure and effectively reverse anti-dipper rhythm with good safety.

Objective To investigate the expression and clinical significance of Sir2?related enzymes?1(SIRT1)in colorectal cancer. Methods The expression of SIRT1 was evaluated by immunohistochemistry in 86 selected cases of primary Colorectal cancer and 30 samples of normal rectum tissues besided carcinoma. The relationship of the expression and clinical pathological features were analyzed. Results The positive expression rate of SIRT1 in Colorectal cancer tissue was 88.4%,and significantly higher than in normal rectum tissue besided carcinoma(P<0.001). There were no correlation between the expression of SIRT1 and sex,age and tumor diameter,and significant positive correlation between the expression of SIRT1 and TNM stage (P<0.05),lymph node metastasis(P<0.05),infiltrating depth(P<0.05),and negagtive correlation between the expression of SIRT1 and tumor differentiation(P<0.05). Conclusion The positive expression rate of SIRT1 in colorectal cancer tissue was significantly higher than in normal rectum tissue besided carcinoma and intimate correlation with tumor differentiation,TNM stage,lymph node metastasis and Infiltrat?ing depth. Conclusion SIRT1 may be an important assistance gene to diagnose and judge prognosis,and may improve diagnostic rate and auxiliari?ly judge prognosis as a important Colorectal cancer marker.

Objective To explore the effects of estrogen on apolipoprotein M ( apoM ).Methods ApoM mRNA was assayed in HepG2 cells by RT-PCR after incubation of estrogen with or without estrogen receptor antagonist at different concentrations and durations.SD female rats were divided into five groups:OVX group,Sham group,OVX+ EB group,normal group and normal + EB group.From a week of being operated,the rats were injected subcutaneously estradiol beuzoate or vehicle.After 12-hrs fasting,serum levels of triglycerides (TG),LDL-cholesterol,HDL-cholesterol,total cholesterol ( TC ) at months 1,2 and 3 after operation were measured.The expression of apoM in rats was detected by using real time RT-PCR and Western blot.Results Estrogen increased mRNA levels of apoM and apoAI in the HepG2 cells with a dose- and time-dependent manner,which could be abolished by addition of estrogen receptor antagonist.Serum apoM,TG,TC,HDL and LDL levels were significantly increased in the ovariectomized or normal rats which received estrogen treatment than those in OVX or normal group rats at month 1 after treatments.Conclusions Estrogen upregulates apoM expression via its receptor.

Objective To investigate the clinical and genetic characteristics in a male patient with 21hydroxylase deficiency combined with adrenal and testicular tumors.Methods Clinical features and laboratory data were collected from the patient.Testicular biopsy was performed.The CYP21 gene was sequenced for mutations.Results The patient presented left adrenal and testicular enlargements.The laboratory examinations showed that plasma ACTH,androstenedione,testosterone,progesterone,and 17-hydroxyprogesterone were markedly elevated.CT scan revealed that the right adrenal gland being resected and the left adrenal with nodular enlargement.Furthermore,testicular biopsy showed a prominent peritubular fibrosis with increased number of peritubular fibroblasts,tubular hyalinisation,and calcification.Sequencing analysis showed a A>G homozygous mutation at intron 2.Conclusion Patients with untreated 21-hydroxylage deficiency may.have adrenal adenomas and(or)testicular adrenal rest tumor simultaneously.

Objective To investigate the clinical and genetic characteristics in two patients with androgen insensitivity syndrome. Methods Clinical features and laboratory data were collected from the patients and their families. All exons of the androgen receptor gene were amplified by PCR and PCR products were sequenced. Results Patient 1 presented with unambiguous female external genitalia, unilateral gynecomastia and primary amenorrhea. He did not have axillary hairs or pubic hairs. Patient 2 presented with undervirilization including scanty body hairs, gynecomastia and hypospadias. A missense mutation of

Objective To investigate the effect of diltiazem, one of calcium antagonists, on the function of rat beta cells and the re- lease of insulin induced by D860. Methods Intravenous glucose tolerance test (IVGTY) was conducted to assess beta-cell function of rats among control, dihiazem, D860, and dihiazem plus D860 groups, followed by treatment with dihiazem and D860 for 4 weeks respectively. Another IVGTT was carded out at the end of the study. Results The data showed that diltiazem could inhibit insulin released from normal SD rats. Moreover, it reduced the hypoglycemic effect promoted by D860. However, in long term, the rise of blood sugar in rats treated with D860 respectively was not found. Conclusion Diltiazem did not impair beta cells function and interfere the hypoglycemic effect of D860 in rats in long time.