Objective To compare the clinical efficacy of proximal humeral locking plate and traditional AO plate in treatment of the elderly with proximal humerus fracture.Methods 96 elderly patients with proximal humerus fracture were divided into observation group and control group by random number table,48 cases in each group.The control group was treated with traditional AO plate,while the observation group was treated with proximal humeral locking plate.Results 1 month,3 months and 1 year after operation,the SPADI index were (75.3 ± 3.1) points,(57.2 ± 2.7) points and (35.1 ± 2.2) points in the observation group,which were significantly lower than (87.1 ±2.8) points,(68.8 ± 2.9) points and (44.6 ± 2.5) points of the control group (t =8.442,7.025,6.293,all P ＜0.05).Excellent clinical efficacy of the observation group accounted for 72.92％,which was significantly higher than 54.17％ of the control group (x2 =3.64,P ＜ 0.05) ; the poor efficacy of observation group accounted for 8.33％,which was significantly lower than the 22.91％ of the control group (x2 =3.87,P ＜ 0.05).Conclusion The proximal humeral locking plate has good clinical efficacy for the treatment of the elderly with proximal humerus fractures,and it is worth to be promoted in clinical.

0.05),peaked at 6h and it was higher than normal at 72h(P

Objective To study CT and MRI value in diagnosis of osteoblastoma,in order to achive more information about the disease. Methods The clinical,CT,MRI and histological data of 12 patients with osteoblastomas. Results(1)There were 6 patients wereexamined by CT,the lesions showed mainly lytic with varying degrees of matrix mineralisation,and mild adjacent reactive sclerosis;(2)10 patients were examined by MRI(included 4 patients who have been examined by CT),the lesions presented mixed signal intensity with compart,slightly low and intermediate signal intensity on T_1-weighted images,high signal intensity on T_2-weighted images were found in 9 cases and mainly low signal intensity was found in 1 case.8 cases showed clear low signal intensity surrounding the lension borh on T_1 and T_2,2 cases showed blurry high signal in the adjacent tissue;(3) The tumors presented moderate enhancemen with low dense area inside the lesions after injection of contrast media. Conclusion Osteoblastomas have classical features on CT,while show no characteristic appearances on MRI.

Objective To evaluate the inhibitory effects of NF-κB inhibitor pyrrolidine dithiocar-bamate (PDTC) on NF-kappa B activity and the serum inflammatory mediators in hypertensive-ventricular hypertrophy-congestive heart fail?ure rats. Methods The rat model of hypertension-cardiac hypertrophy-heart failure was made from 42 male Dahl salt sen?sitive rats. Rats were randomly divided into seven groups including group A (normal diet group), group B (high salt diet group), group C (NF-κB inhibition in early stage), group D (NF-κB inhibition in hypertensive stage), group E (NF-κB inhibi?tion in cardiac hypertrophy stage of week 12) and group G (NF-κB inhibition in heart failure stage). There were six rats for each group. Rats were administrated 8%high salt diet and injected PDTC 100 mg/(kg·d)intraperitoneally according to the prescribed time. Changes of blood pressure, left ventricular end diastolic interventricular septal thickness (IVSD), left ven?tricular end diastolic posterior wall thickness (LVPWD), left ventricular end diastolic diameter (LVEDD), systolic left ventric?ular end diastolic diameter (LVESD), left ventricular ejection fraction (LVEF), heart, lung weight/ body weight ratio, NF-kappa B activity, tumor necrosis factor (TNF)-α, interleukin (IL)-6, monocyte chemotactic protein (MCP)-1 and C-reactive protein (CRP) were observed in different treatment time points of PDCT. Results Levels of NF-κB and proinflammatory cy?tokines were reduced after early administration of PDTC, and the cardiac function was also decreased. The longer the treat?ment time, the greater the protective effect on heart. PDTC can effectively control blood pressure, and block left ventricular hypertrophy and left ventricular failure in a certain extent. The effects of PDTC were limited after persistent hypertension, and myocardial hypertrophy formation accompanied by heart failure. Conclusion PDTC plays a role in prevention and treatment of hypertension, left ventricular hypertrophy and congestive heart failure in model rats. Early application of PDTC could obviously maintain the normal cardiac function in rats with heart disease.

ObjectiveTo investigate the clinical effect and possible mechanism of modified Shenling Baizhu Powder （参苓白术散） and Xiaoluo Pill （消瘰丸） in the treatment of children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation. MethodsOne hundred and thirty children with adenoid hyperplasia due to spleen deficiency and phlegm accumulation were randomly divided into 65 cases each in the observation group and control group. The control group was given mometasone furoate nasal spray， one spray into each nostril， once a day， while the observation group was given modified Shenling Baizhu Powder and Xiaoluo Pill orally， one dose per day， and both groups were treated for 8 months. The pre- and after-treatment electronic nasopharyngoscope scores， specific quality of life survey scale （OSA-18） scores， total TCM symptom scores， serum cysteine leukotrienes （CysLTs）， interleukin 2 （IL-2）， tumor necrosis factor α （TNF-α）， and interleukin 10 （IL-10） levels were compared to determine the clinical efficacy after treatment. ResultsAfter treatment， the electronic nasopharyngoscope scores， OSA-18 scores， total TCM symptom scores， serum CysLTs， IL-2 and TNF-α levels significantly decreased， while IL-10 levels increased in both groups （P＜0.01）. Compared between the two groups after treatment， the electronic nasopharyngoscope score， OSA-18 score， total TCM symptom score， serum CysLTs， IL-2 and TNF-α levels were significantly lower， and the IL-10 level was higher in the observation group than in the control group （P＜0.01）. The total effective rate of the observation group was 95.38% （62/65）， superior to 81.54% （53/65） of the control group （P＜0.05）. ConclusionFor children with adenoid hypertrophy due to spleen deficiency and phlegm accumulation， modified Shenling Baizhu Powder and Xiaoluo Pill can help to improve symptoms， increase quality of life and clinical efficacy， and its mechanism may be related to reducing the inflammatory response.

Triple negative breast cancer is a special subtype of breast cancer , including basal -like breast cancer and unclassified breast cancer .Since it was defined in 2005 ,the differences from other subtypes in biological characteristics and poor prognosis of TNBC have became priorities and hotspots which are researched by epidemiologists ,pathologists and clinicians .According to the research ,the risk factors of TNBC include race ,obe-sity,age,women′s reproductive process,oral contraceptive use,physical activity,abortion history,family history, socio-economic factors and so on .This review focuses on race ,obesity,age,women′s reproductive process ,oral contraceptive use ,according to the latest research results of risk factors of TNBC ,helping healthy people get a bet-ter understanding of TNBC and preventing the incidence of TNBC ,suggesting clinicians combine the biological characteristics and epidemiological features and further instructing people to take precautions .This paper also pro-vides theoretical basis for researcher on the further investigaticans of the etiology of TNBC .

Objective To conduct a preliminary study on the efficacy and mechanism of Chinese traditional medicine Zeguilongshuang capsule for benign prostatic hyperplasia (BPH). Methods 20 patients with BPH were randomized into treatment group and control group (10 patients in each group).The medical history,International Prostate Symptom Score (IPSS),digital rectal examination,ultrasonography and uroflowmetry were done at the baseline.Patients in the treatment group used two Zeguilongshuang capsules three times per day for one month with repeated IPSS and above-mentioned examinations. They underwent prostatectomy on the next day when the treatment was completed.Patients in the control group received prostatectomy directly. After the pathological diagnosis of BPH was made,the expression of basic fibroblast growth factor (bFGF),platelet-derived growth factor (PDGF) and androgen receptor (AR) in the BPH tissue were assessed by immunohistochemistry. Results Patients in the treatment group reported improvement of low urinary tract symptoms, the mean IPSS decreased by 11.2%,the mean volume of the prostate reduced by 16.7%,and the mean maximum flow rate increased by 35.6%.Compared with the control group,the expression of bFGF in BPH tissue was down regulated ( P

Objective To study the serum levels of homocysteine(Hcy) and the polymorphism of C677T mutation of methylenetetrahydrofolate reductase (MTHFR) gene in pregnant women to explore their role in the pathogenesis of pre-clampsia. Methods Fifty pregnant women with preclampsia (study group) including 14 mild pre-eclampsia and 36 severe pre-eclampsia and 40 healthy ones (control group) were selected. Hey concentration was determined by fluorescence polarization immunoassay. The mutations of the 677C→T and 1298A→C of MTHFR were investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The mean level of plasma Hey in the study group was higher than that of control 1(12. 00±4. 59) μmol/L vs (7. 85:1:1.51) μmol/L, P<0.05], and that of the severe pre-eclampsia group was higher E(13. 30±2. 06) μmol/L, P<0. 01]. However, no significant difference was found between the control and the mild pre-clampsia group[(8. 63±3. 94) μmol/L, P>0.05]. There was significant difference in the genotype frequencies of MTHFR 677CT, TT genotype(C/T:42.0% ;T/T:14. 0%)and the total frequency of mutant T (T: 35.0%) allele between the study and control groups (P < 0. 05). Conclusions Hyperhomocysteinemia plays an important role in the pathogenesis of pre-clampsia. The polymorphism of MTHFR C677T might be associated with the development of pre-clampsia as it affects the metabolism of Hey.

Objective To compare the efficacy and clinical value of early enteral immunonutrition (EIN) combined with glutamine with early standard formula enteral nutrition (EEN) in patients with severe acute pancreatitis(SAP).Methods Twenty-eight patients with SAP were divided into two groups by random number table.Both groups were fasted,given treatments of anti-infection,gastrointestinal decompression,acidoresistance,spasmolysis,pancreatic enzyme inhibition,reduce the burden on the pancreas insulin,water electrolyte balance and parenteral nutrition upon admission into hospital.Spiral nasointestinal tube was implemented within 72 hours of patients' admission.The 14 cases in the EEN group were given treatment of early standard enteral nutrition by nasojejunal tube.The 14 cases in the EIN group received early enteral immunonutrition (glutamine granules,0.2 g/(kg · d),at least three times oral administration by dissolving in enteral nutritious agent peptison with a small amount of warm water).During the treatment,the dose of glutamine granules was reduced gradually until withdrawal when the patients in the EIN group started normal diet.The changes were observed in patients in terms of APACHE Ⅱ,Ranson score,inflammatory markers,nutritional and immune indicators,while monitoring the first defecation time,ICU care unit stay,total hospital stay,total hospitalization costs,complication rate and mortality data.Results Patients of both groups tolerated early enteral nutrition treatment.Fourteen days after treatment,the value of the immune indicator IgG was significantly higher in the EIN group than in the EEN group((19.14 ± 2.03) g vs.(13.79 ± 3.29) g,P ＜0.05).The first defecation time,ICU care days,total hospital costs were significantly shorter or less in patients in the EIN group than in those in the EEN group (first defecation time:((4.29 ± 1.64) d vs.(5.36 ± 0.84)d,t =2.179 ; ICU care:(2.57 ± 0.85) d vs.(3.64 ± 1.60) d,t =2.213 ; total hospital costs:(343.6 ±35.9)thousand yuan vs.(438.6±94.3) thousand yuan,t =3.518; P ＜0.05).Conclusion It is feasible and safety to implement EIN treatment in patients with severe acute pancreatitis.EIN and EEN could significantly reduce the inflammatory response and improve the nutritional status of patients with severe acute pancreatitis.But EIN is better in improving immune function and the prognosis of patients with severe acute pancreatitis than the EEN.

Purpose：To study the clinical and pathological characteristics of multicentric angiofollicular lymph node hyperplasia (MCD).Methods：Eight patients with histologic diagnosis of angiofollicular lymph node hyperplasia (CD) were identified in the pathologic data base.The lymph node lesions were categorized as PC,Mix and HV types according to the criteria described by Frizzera. Patient with MCD had to have histology of CD within at least one regional group of lymph nodes and all underwent extensive lymphadenectomy.Results：The histologic features of 8 patients were six with PC,one with Mix and one with HV.Five patients presented with systemic symptoms. Three patients had splenomegaly and hapatomegaly. Five patients had local recurrence.Conclusions：MCD tends to recur and has a progressive clinical course with potential for malignancy ,and further study is needed to clarify the pathogenesis. Close follow-up and periodic surveillance are necessary to detect minimal disease and secondary malignant lesions. The patients with MCD should be candidates for multimodality therapy.