OBJECTIVETo investigate the method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus.

METHODSFrom January 2010 to December 2013,31 patients with medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus, including 18 males and 13 females ranging in age from 26 to 58 years old with a mean of 37 years old. The time between injury and operation was 1 to 8 days with an average of 4.5 days. According to AO classification, 7 fractures were type A1, 3 fractures were type A2, 6 fractures were type A3, 2 fractures were type B1, 4 fractures were type B2, 2 fractures were type B3, 4 fractures were type C, 3 fractures were type C2. No patients had any signs of radial nerve injury. The results were evaluated with DASH (disability of arm-shoulder-hand) Questionnaire by the American Academy of Orthopedic Surgeons (AAOS) which 0 indicated normal upper extremity function, and 1 to 100 indicated varying degrees of damage to the function of the upper extremties.

RESULTSThere was no neurologic complication or postoperative wound infection in this series. The followed-up period ranged form 8 to 15 months (means 11 months) postoperatively. The clinical outcomes were evaluated with DASH Questionnaire, the score before operation was 76.2±11.8, the final follow-up score was 8.2±7.4, the final follow-up score was significant higher than before operation (P<0.01). The function of the upper extremities recovered satisfactorily.

CONSLUSIONThe method of medial transposition of the radial nerve in plate fixation of lower segment fracture of humerus can avoid iatrogenic radial nerve injury effectively.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Humerus ; innervation ; surgery ; Male ; Middle Aged ; Radial Nerve ; injuries ; surgery

AIM To investigate the effects of Tongluo Xingnao Effervescent Tablets (Chuanxiong Rhizoma,Angelicae sinensis Radix and Scutellariae Radix) on the learning and memory function in SAMP8 mice,and improvements in cognitive function.METHODS Morris water maze was used to evaluate the change of cognitive function in SAMP8 mice after they were treated with Tongluo Xingnao Effervescent Tablets for 60 d,and the activity of superoxide dismutase (SOD),the concentration of protein carbonyls (PC),the ratio of NAD +/NADH in brain tissue were detected by ELISA,the expression of Nampt,SIRT1 and FOXO3 in hippocampus were measured with immunohistochemical methods.RESULTS Tongluo Xingnao Effervescent Tablets shortened escape latency and obviously increased percentage of time in target quadrant in hidden platform test and increased the times entering the target quadrant in spatial probe test in SAMP8 mice.It evidently enhanced the activity of SOD,the ratio of NAD +/NADH and distinctly decreased the protein carbonyls level.Moreover,Tongluo Xingnao Effervescent Tablets could markedly up-regulate the expression of Nampt and SIRT1,but evidently down-regulate FOXO3 protein expression.CONCLUSION The experimental data show that Tongluo Xingnao Effervescent Tablets can enhance the cognitive function of SAMP8 through regulating Nampt/SIRT1/FOXO3 signal pathway.

Objective To obtain a lasting and purified cell line of vascular smooth muscle cells (VSMCs) by primary culture, and to provide these test materials related research. Methods The primary and transfer culture was done by tissue - piece inoculationand trypsin digestion,respectively. The cells were frozen in liquid nitrogen,and cultured cells were identified by phase contrast microscopy and immunohistochemical SP kit. Results 85% of inoculated tissue pieces survived. More than 90% of VSMCs regrew in transfered culture. The frozen cells could recover their proliferation by several culture transfers. The VSMCs showed the typical "peak and valley" characteristics under microscopy. Immunohistochemical staining with antibody against SM - a - actin expression in these cells was positive. Conclusion The tissue - piece inoculation is a simple method for obtaining satisfactory VSMCs in short term.

Objective To explore the value of urinary N-terminal telopeptide of type Ⅰ collagen (uNTX) combined with bone scintigraphy (BS) for the diagnosis of bone metastases.Methods A total of 227 patients suspected of bone metastases by BS were selected from Jan to May of 2012.UNTX was tested for each subject.The threshold of uNTX was chosen as 65 nmol bone collagen equivalents (BCE)/mmol creatinine (Cr) for the diagnosis of bone metastasis.Patients with uNTX greater than 65 nmol BCE/mmol Cr would be diagnosed as having bone metastasis.Other examinations (CT,MRI,PET/CT or bone biopsy) were also performed to confirm the diagnosis.The uNTX values of benign and malignant bone lesions were compared using two-sample t test.The diagnostic efficacy of uNTX combined with BS was evaluated.A ROC curve was analyzed to evaluate the cut-off value of uNTX for the diagnosis of bone metastasis.Results The mean value of uNTX of all 227 patients was (84.30± 13.29) nmol BCE/mmol Cr,which was significantly higher than the upper limit of normal range (t =21.875,P＜0.01).Using 65 nmol BCE/mmol Cr as the threshold,197 cases were diagnosed as with and 30 without bone metastases,in which 188 and 27 were respectively confirmed by other examinations.The mean uNTX was (88.73 ± 8.37) and (60.76± 9.14) nmol BCE/mmol Cr in patients with and without bone metastases,respectively (t =-18.134,P＜0.01).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index of uNTX combined with BS were 98.4％ (188/191),75.0％ (27/36),95.4％ (188/197),90.0％ (27/30),94.7％ (215/227) and 73.4％ respectively.The cut-off value by ROC curve analysis was 78.88 nmol BCE/mmol Cr and the area under the curve was 0.982.Using 78.88 nmol BCE/mmol Cr as threshold,the corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 97.4％(186/191),94.4％(34/36),98.9％(186/188),87.2％(34/39),96.9％(22/227) and 91.8％ respectively.Conclusions Using the cut-off value of 78.88 nmol BCE/mmol Cr,uNTX may have clinical value in helping the differential diagnosis of bone scintigraphy for patients suspected of metastatic bone disease.

It is generally believed that liposomes modified with polyethylene glycol (PEG) have no or lower immunogenicity. However, based on many recent literatures, when the PEGylated liposomes were repeatedly applied to the same animal, the immune responses occurred. The first injection of PEGylated liposomes resulted in a reduction in the circulation time and an increase in hepatic and splenic accumulation of the second dose of PEGylated liposomes in a time-interval, which was called "accelerated blood clearance (ABC)" phenomenon. Such immunogenicity of PEGylated liposomes presents a barrier in the research of liposomal formulations and their use in the clinics. This review focused on the definition, the method of verification, the development of the reason for ABC phenomenon, influencing factors of ABC phenomenon, and discussed if other PEGylated nanocarriers also induce ABC phenomenon.

Objective To investigate the association between polymorphism of TNFα-308 and mutations of HBV C region in patients with chronic HBV infection. Methods Ninety-five patients with chronic HBV infection were recruited in the study. The single nucleotide polymorphism(SNP) of TNFα-308 Was determined by restriction fragment length polymorphism(RFLP). Mutations of nt1762/1764, nt1896, nt1899, nt1862, as60, aa87 and as97 in HBV C region were detected by direct sequencing after PCR amplification. Mutations of the above points among different genotypes were compared by Fisher's exget test. Results Three different genotypes G/G(63/95, 66.3%), G/A(28/95, 29.5%) and A/A(4/95, 4.2%) were found in TNFα-308 site. The rates of mutations of aa87 and aa97 points in patients with G/G, G/A and A/A genotype were 39.3%(24/61), 11.5%(3/26) and 50.0% (2/4), respectively(F=7.658, P<0.05);while the mutation rates of nt1762/1764, nt1896, nt1864, nt1899 and aa60 were of no statistical significance among different genotypes(F=0.669, 1.542, 1.123, 2.420 and 0.966, P>0.05). Conclusion Compared with G/G genotype, antigenicity of HBV may be more stable in patients with TNFα-308 G/A genotype, which is beneficial to HBV clearance.

Objective To investigate the effect of non-alcoholic fatty liver disease (NAFLD) on virologic response in chronic hepatitis B patients treated with nucleos(t)ide analogues.Methods Three hundred and thirty-two treatment-naive patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) who visited clinic or hospitalized in the First Affiliated Hospital of Wenzhou Medical College from January 2007 to December 2009 were enrolled and finally 316 patients completed the research.Among them,106 patients were diagnosed with CHB complicated with NAFLD by ultrasonography (NAFLD group),and the remaining 210 patients were diagnosed with simple CHB (CHB group).Patients in both groups were treated with combination therapy of lamivudine (LAM) plus adefovir dipivoxil (ADV) or entecavir (ETV) monotherapy for 96 weeks.Alanine aminotransferase (ALT) levels,virologic response and serological response were compared pre-and post-treatment in both groups.Enumeration data was compared using x2 test,and correlation analysis was performed using Logistic multivariate regression analysis.Results Rates of hepatitis B virus (HBV) DNA clearance in the NAFLD group at week 12,24 and 48 were 46.2％,61.3％ and 74.5％,respectively,which were all significantly lower than those in CHB group (61.9％,73.8％ and 83.8％,x2 =7.051,5.195,3.895,respectively; all P＜0.05).However,rates of HBV DNA clearance were 85.8％ in the NAFLD group and 91.9％ in the CHB group at week 96.This difference did not reach the level of significance (x2 =2.838,P＞0.05).Rates of HBeAg loss in the NAFLD group were 27.4％ at week 48 and 37.7％ at week 96,compared to 33.3％ and 44.8％ in the CHB group.There was no significant difference in these two groups (x2 =1.169,1.424,both P＞0.05).Rate of HBeAg seroconversion in the NAFLD group was significantly lower than that in the CHB group at week 96 (17.9％ vs29.5％,x2=4.972,P＜0.05).Rates of ALT normalization were also found to be significantly lower in the NAFLD group than those in the CHB group at week 48 (69.8％ vs 80.5％,P＜0.05) and at week 96 (82.1％ vs 91.0％,P＜0.05).Multivariate regression analysis demonstrated that serum levels of triacylglycerol (OR=3.725,P=0.000),uric acid (OR=1.005,P=0.040) and fasting blood-glucose (OR=3.067,P=0.000) were independent risk factors associated with NAFLD.NAFLD was found to be a risk factor of virologic response at each time point throughout the treatment.(week 12,OR=2.749,P=0.001; week 24,OR=1.981,P=0.030; week48,OR=2.348,P=0.021; week 96,OR=8.053,P=0.001).Conclusions During antiviral therapy,NAFLD may affect biochemical and serological responses in CHB patients treated with nucleos(t) ide analogues,and may affect early virologic response in these patients.

Objective To investigate the left ventricular (LV) torsion parameters of type B WolffParkinson-White syndrome (B-WPW) and to explore alternation of the left ventricular motion pattern in patients with B-WPW.Methods Thirty-eight patients with B-WPW were studied.And 40 volunteers were selected as control.Two-dimensional speckle tracking imaging (2D-STI) was used to acquire left ventricular torsion parameters,including peak value and time to peak value of LV twist,LV apex rotation,and LV base rotation.Apical-basal rotation delay (RDA-B) was calculated.Biplane Simpson method was used to measure LV end-diastolic volume (LVEDV),end-systolic volume (LVESV) and ejection fraction (LVEF).All above parameters were measured in patients with B-WPW before (B-WPW-B group) and after (B-WPW-A group) radiofrequency catheter ablation and in control group.The QRS width of lead Ⅱ was recorded,and the relationships between all above parameters with the RDA-B or QRS width were analyzed.Results Compared with the contrd group,in patients with B-WPW,the peak value of LV apex rotation (RotA),LV base rotation (RotB) and LV twist (TwistLV) were lower(LV base was more obvious than LV apex)(P ＜0.05),the time to RotB (TTPB) was shorter (P =0.004),RDAB was longer(P =0.002),the left ventricular enlarged and the QRS prolonged (P =0.000).After radiofrequency catheter ablation,the left ventricular torsion parameters in patients with B-WPW recovered significantly(P ＜0.05),but still lower than those in the control group(P ＜0.05).Conclusions The left ventricular motion pattern of patients with B-WPW alters,including the changes of peak value and time to peak value in LV apex rotation,LV base rotation and LV twist,as well as LV myocardium dyssynchrony.The motion pattern of LV in patients with B-WPW is improved in acute stage after radiofrequency catheter ablation but not yet recover totally.

Objective To investigate the efficacy and safety of secondary anti-fungal prophylaxis (SAP) in haematopoietic stem cell recipients who had a history of antecedent invasive fungal infection(IFI). Methods The patients with hematological diseases,who were scheduled to undergo haernatopoietic stem cell transplantation (HSCT) in our unit from April 2005 to July 2008, received our routine conditioning regimen. Patients,who had a history of antecedent IFI,were given SAP from the start of conditioning chemotherapy until the end of the at-risk period. We chose the effective antifungal drug that was used for antecedent IFI as the secondary prophylaxis drug. Results There were 26 patients at entry. Six patients had probably adverse events (AEs) related to the secondary prophylaxis drug during the prophylactic process and the secondary prophylaxis terminated in two patients because of AEs. The remaining patients received SAP for a medium of 75 days (range 10-212 days). Relapsing IFI occurred in four patients during SAP and in one after SAP. The rate of reLapsing IFI was 19. 2% (5/26). The median time of re]apsing IFI was day 42(range,1-146). The mortality rate among relapsed patients was 60. 0% (3/5). No risk factors that might be associated with IFI was identified by logistic regression model. Conclusion Prior IFI is not an absolute contraindication for HSCT. Secondary antifungal prophylaxis can reduce the risk of recurrent infection in patients with prior IFI, but its schedule and time of therapy need further study.

theengraftment of neutrophil and platelet after HLA-matched sibling allogeneic blood and marrow transplantation.Duration from diagnosis to trarmplantation was another factor influencing engraftment of platelet.