Objective To evaluate the clinical value of humeral antegrad e interlocking nails. Method 21 patients with humeral shaft fracture were treate d with open reduction and internal fixation with antegrade interlocking nail. Re sult The patients were followed up for 3 to 20 months (mean 14.6months). All pat ients acquired bone healing, and only one case had temporary injury of radius ne rve. Conclusion The humeral antegrade interlocking nail is an effective method t o treat humeral shaft fracture, with advantages of good elbow function and less complications of infection and injury of radius nerve.

Objective To examine clusters of anti-nuclear antibodies (ANA) and their associations with clinical features in patients with systemic lupus erythematosus (SLE).Methods It was a retrospective study.113 SLE patients were reviewed from March 2010 to May 2012 in Department of Rheumatology,Jinhua Central Hospital.ANA and specific autoantibodies to 15 kinds of nuclear antigens were tested by indirect immunofluorescence assay (IIF) and line immunoassay (LIA) respectively.Hierarchical clustering method was performed to analyze specific clusters of ANA profiles in SLE.Chi-square tests were used to investigate relationship between antibody clusters and clinical features of SLE.Results The positive rate of LIA for ANA was 97.3％,consistent with IIF method,and the total accordance rate of the both methods was 98.2％.Thirteen kinds of antigen-specific antibodies were detected in SLE patients by LIA.Clustering analysis for these antibodies showed three specific clusters in SLE,Nuc/His/dsDNA cluster (C1),low-Ro/low-La cluster (C2),and Ro/Sm/RNP cluster (C3),accounting for 36.3％,24.8％,38.9％ of the total cases respectively.There were significant difference of AST levels among three clusters [(32.62 ± 21.92)U/L,(25.56 ± 16.63) U/L,(50.41 ± 60.86) U/L respectively for C1,C2 and C3].High incidences of chronic cutaneous lupus,abnormal renal indicators and inflammatory synovitis were found in all three clusters.Besides,there were significant differences among three clusters for the incidences of chronic cutaneous lupus (39.0％,39.3％,63.6％ respectively for C1,C2,C3) and leukopenia/lymphopenia (56.1％,25.0％,56.8％ respectively for C1,C2,C3) (P ＜ 0.05).Patients in Ro/Sm/RNP cluster showed higher incidences of lupus nephritis (43.2％/26.8％ or 39.3％); patients in low-Ro/low-La cluster showed low risk of hypertension (7.1％/19.5％ or 22.7％) ; patients in Nuc/His/dsDNA cluster showed high incidences of thrombocytopenia (41.5％/21.4％ or 25.0％) and high risk of lung or upper respiratory tract infection (46.3％/28.6％ or 29.5％),but low incidence of neurologic symptoms (0％/ 3.6％ ％ or 11.4％).Conclusion Three characterized ANA clusters are identified in SLE patients in this pilot study.Different clusters are associated with certain clinical features and complications ofSLE.However,the correlations found in this study need to be investigated further in larger populations.

Objective To investigate whether systemic inflammatory response syndrome(SIRS) after cerebral infarction is associated with poor outcome and its associated clinical factors.Methods We prospectively studied 500 patients with cerebral infarction.recorded the associated clinical factors on presentation and calculated the mortality at 21 st day.Results There are 85 SIRS patients in 500 patients with cerebral infarction,31 with total anterior cerebral infarction(TACI),34 with partial anterior cerebral infarction(PACI),15 with posterior cerebral infarction(POCI)and 5 with lacunar cerebral infarction (LACI).The frequency of SIRS was positively correlated with mortality rate according to Oxfordshire Commanity Stroke Project(OCSP)subtypes in cerebral infarction patients with fever(Spearman correlation coefficient=1.0:P＜0.001).Single factor analysis showed that the risk factors for both SIRS and mortality of cerebral infarction were as follows:age,infection,48h Chinese Stroke Scale score,48h Glassgow score,OCSP subtypes and dysphagia.Diabetes Was the risk factor for SIRS.but had no effect on mortality.On Cox regression,48h Glassgow score was the sole independent risk factor of outcome.However.if SIRS was included in the formula.P＞0.05.ConclusionsSIRS is the predictor of poor outcome after acute cerebral infarction.It is important to prevent SIRS especially in TACI and POCI.Diabetes is the risk factor for SIBS.but has no effect on mortality.

Objective:To carry out the large sample research of the importance of medical ethics in the stand-ardized resident doctor training. Methods:Randomly selected 100 graduated resident doctors from Jiangsu province, Zhejiang province,Shanghai and Jiangxi province of standardization training. Using the questionnaire survey form to investigate the doctor-patient relationship and carry out correlation analysis. Results:Two groups of subjects after research statistics, the analysis found the doctor-patient relationship in the model show the current mutual partici-pation pattern of the more advanced undergraduate group was 22%, 16% in the graduate student degree group has significant difference;While 66% of bachelor's degree group and 70% graduated degrees performance as the guide-cooperation mode. Conclusion:It should strengthen medical ethics in the stage of standardized training, this study further strengthen standardized training for the future stage of low qualification resident ethics application guide the importance and the influence on the doctor-patient relationship in the future physician has provided the basis, at the same time, also provides certain theoretical guidance for doctor-patient relationship training methodology.

ObjectiveTo investigate the relationship of the polymorphism of endothelial nitric oxide synthase (eNOS), the 27-bp variable number of tandem repeats (VNTR) in intron 4 with essential hypertension (EH) of the northern Han nationality in China.MethodsGenotypes, the level of plasma nitric oxide metabolites (NOx) and the activity of nitric oxide synthase (NOS) of 207 EH subjects and 231 healthy subjects were measured by polymerase chain-reaction (PCR).ResultsThe frequencies of ecNOS4a/a,ecNOS4b/a, and ecNOS4 b/b in the healthy group were 0.43%, 13.42% and 86.15% respectively. The frequency of the b allele was 92.86%, and the frequency of the a allele was 7.14%. While the frequencies of ecNOS4 a/a, ecNOS4 a/b,and ecNOS4 b/b in the EH group were 0.49%, 19.32% and 80.19% respectively. The frequency of the a allele in EH group (n=42, 10.15%) was significantly higher than that in the healthy group (n=33, 7.14%)(P<0.05). The plasma NOx level of the EH group was 70.04±14.68 mol/L, and significantly lower than that 84.09±27.27 mol/L in the healthy group (P<0.05). Similarly, both the plasma TNOS and iNOS activities of the EH group were 35.49±12.8 U/ml and 14.92±7.93 U/ml, and markedly lower than that 41.47±13.2 U/ml and 10.11±6.21U/ml in the healthy group (P<0.05). But the activities of eNOS in the EH group and healthy group were not significantly different (P>0.05).ConclusionThe variations of ecNOS4 gene locus may be responsible for the decrement of plasma NOx, both plasma NOx level and activity of NOS decreases in EH patients, so it may be a genetic susceptibility marker for EH of the Han nationality in China.

Objective To investigate the in vitro anti-candidal activity of the essential oil of Illicium verum (EOIV) alone and in combination with fluconazole. Methods The minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of EOIV were determined in 130 clinically isolated Candida strains by NCCLS-M27-A microdilution method, and fluconazole was used as positive control. Meanwhile the checkerboard microdilution method was applied to assay the combined effect of EOIV and fluconazole in 18 candidal strains. Results For the 18 candidal strains the MICs and the MFCs of EOIV were 1 517.16 ?g/mL and 2 248.55 ?g/mL for C. albicans, 1 169.24 ?g/mL and 2 338.49 ?g/mL for C. glabrata, 1 320.03 ?g/mL and 1 741.79 ?g/mL for C. parapsilosis, 1 203.50 ?g/mL and 2 407.01 ?g/mL for C. tropicalis, 1 516.32 ?g/mL and 2 144.40 ?g/mL for C. krusei, and 1 072.64 ?g/mL and 2 144.40 ?g/mL for C. guilliermondii, respectively. Significant synergistic and additive effects were observed after the combination of EOIV with fluconazole, and no antagonism was found. There was no significant difference in the mean fractional inhibitory concentration index (FICI) between the fluconazole-susceptible and the fluconazole-resistant candidal strains (P = 0.671). Conclusion EOIV has antifungal effects on medically important Candida spp.. The combination of EOIV with fluconazole presents a synergistic and additive effects.

Objective To genotype Candida strains by random amplified polymorphic DNA(RAPD)technique,and to analyse the analogy of different Candida strains based on similarity coefficient.Methods Candida strains were isolated from vaginal secretion taken from patients with vulvovaginal can-didiasis by Sabouraud' s dextrose agar,C.albicans was differentiated from non-C.albicans strains by germ tube test,chlamydospore test and CHROMagar-Candida,and further identified by API20c Aux test Kits.The genomic DNA of45Candida isolates,including Candida albicans,Candida glabrata,Candida krusei,Candida parapsilosis and Candida tropicalis were amplified by RAPD,and DNA polymorphisms of inter-species and intraspecies were evaluated by using the DNA pattern-clustering of5primers.Results Thirty strains of C.albicans could be classified into7groups,and further divided into19subgroups,while15strains of non-C.albicans could be identified to species level.C.albicans isolates were related to each other with the similarity coefficients of more than90%,while different Candida species were connected to each other with the similarity coefficients of80%~90%.Conclusion C.albicans,which is the predominant pathogen of vulvovaginal candidiasis,could be classified into different genotypes by use of RAPD method.

Objective To study the effects of anti-oncogene WWOX on cell growth of epithelial ovarian cancer,in order to find a new approach of gene therapy for ovarian cancer.Methods A eukaryotic expression vector containing WWOX was transfected into ovarian cancer cell line HO8910 in vitro (recombinant plasmid group),and positive cell clones were selected and amplified.Expression of WWOX protein was detected by western blot. Untransfected cell(blank contrast group) and transfected empty plasmid cell(empty plasmid group)were served as control groups.In vitro,the biology effect of WWOX on HO8910 cell was analyzed throush the methyl thiazolyl tetrazolium test,transwell chamber cell invasion assay in vitro,agarose clony-formation and flow cytometry.In vivo,the cell of transfection was transplanted intraperitoneally in to BALB/c nude mice.The survival time and growth ability of nude mice were observed.Results (1)Recombinant plasmid group cell could steadily express WWOX protein,while in empty plasmid group and blank control group the expression of WWOX protein were not detected.(2)The growth rate of recombinant plasmid group cell was inhibited.(3)The agnrose clony-formation rate of recombinant plasmid group(19.8%)was significantly lower than that of the empty plasmid group(54.5%)and blank control group(56.0%,P＜0.05).(4)Flow cytometry showed that(72.08±0.39)% of cells was arrested at G0/G1 stage in recombinant plasmid group, while in empty plasmid group and blank control group G0/G1 stage cells were at (41.02±1.08)% and (39.31±0.67)% (P＜0.05). (5) In vitro invasion assay showed that invasion cell number in recombinant plasmid group (89.7±3. 1 ) was not significantly different from that of empty plasmid group(91.2±1.3) and blank control group(91.4±1.3, P ＞0. 05). (6) In vivo test in nude mice showed that WWOX gene could inhibit tumor growth of the HO8910 cells. Conclusions Tumor suppressor gene WWOX could interfere with the cell cycles of ovarian cancer cell and inhibit cell proliferation. As a new valuable tool,it premises to have application in the gene therapy of ovarian cancer.

Objective To explore the influence of G4 cyberknife treatment of large hepatocellular car-cinoma on liver function,and to evaluate its treatment safety.Methods Sixty-three large liver cancer patients treated with routine G4 cyberknife treatment were retrospectively analyzed,and then statistical analysis of the difference in liver function before and after treatment was conducted.Results After G4 cyberknife treatment of 1 2 months,the levels of ALT,ALP,TBIL,PA were respectively 23.00 U /L,1 1 1 .00 U /L,1 3.70 μmol/L, (81 .87 ±1 3.94)%.Compared with the levels before treatment [28.00 U /L,32.00 U /L,1 1 .30 μmol/L, (86.07 ±1 4.07)%],there were no signi-ficant differences found (Z =-1 .677,P =0.094;Z =-0.504, P =0.61 4;Z =-1 .945,P =0.053;t =1 .271 ,P =0.21 3).The level of ambumin was (34.84 ±4.75)g/L at 1 2 months after treatment,which decreased and the difference compared with the level before treatment [(37.45 ±4.1 4)g/L]was significant (t =3.357,P =0.002).The Child-Pugh grade was 5.80 ±1 .1 7 respectively at the time points of 1 2 months after treatment,and no significant difference was found compared with the Child-Pugh grade before treatment (5.48 ±0.81 ,t =-1 .668,P =0.1 06).Conclusion G4 cyberknife treatment does not cause liver injury.It is safe and reliable in large liver cancer treatment.So,it is worth widely clinical popularizing.

Objective To study the sleep improvement function of DHA-PC.Methods The mice were randomly divid-ed into control, vehicle, DHA+Lecithin (60+200 mg/kg) and DHA-PC(50,100,200 mg/kg) groups.Ten mice were enrolled in each group .The mice of control were administered with normal food , the vehicle group was orally given normal saline at the dosage of 0.2 ml/10 g, while both DHA-PC and DHA+Lecithin were orally given corresponding drugs at the dosage of 0.2 ml/10 g.All the groups were treated for 30 days except control group .The direct sleep-inducing test, the test of lengthening sleep time induced by pentobarbital sodium , the test of pentobarbital sodium subthreshold-hypnosis and the test of barbital sodium sleep latency were conducted to observe the inductive effect of DHA -PC.Results Neither the effect on mice body mass nor directly-induced sleep was observed .DHA-PC (50,100, and 200 mg/kg) could prolong sleep time to (56.2 ±13.7),(57.9 ±25.4) and(64.1 ±18.4) min, respectively,compared to vehicle(32.9 ±10.8)min (P<0.05).DHA+Lecithin could not prolong sleep time (38.6 ±11.7)min compared to (32.9 ±10.8)min of vehicle.There was significant difference compared with DHA-PC at the dosage of 200 mg/kg (64.1 ±18.4)min (P<0.05).DHA-PC (200 mg/kg) enhanced pentobarbital sodium subthreshold-hypnosis (70%) compared to vehicle (10%) (P<0.05),so did DHA+Lecithin (60%) compared to vehicle (10%) (P<0.05).Both DHA-PC (200 mg/kg)[(22.9 ±4.1)min ] and DHA+Lecithin [(19.5 ±2.7) min ]could shorten sleep latency compared to vehicle (31.3 ±6.9) min(P<0.01), and the sleep latency of DHA +Lecithin (19.5 ±2.7) min was shorter than that of DHA-PC(50,100 mg/kg).Conclusion DHA-PC has some effect some sleep improvement in mice .