BACKGROUND:The best repair method for proximal humeral fractures remains controversial at present. Although different techniques have been described for proximal humerus fractures, al these techniques have high postoperative complications, such as cut-out or back-out of the screws, nonunion, and subacromial impingement. Given the shortcomings of conventional plate fixation system, we had designed a new type of proximal humeral wing-shape anatomical plate for the repair of proximal humeral fractures. OBJECTIVE:To evaluate clinical outcomes and complications of proximal humeral wing-shape anatomical plate fixation for proximal humerus fractures. METHODS:A total of 60 patients with proximal humerus fractures who underwent proximal humeral wing-shape anatomical plate fixation from September 2012 to September 2013 were retrospectively analyzed. According to Neer classification system, 24, 31 and 5 patients had 2-part, 3-part, and 4-part fractures, respectively. Functional evaluation of the shoulder was done using Constant-Murley score and Visual Analogue Scale was utilized for assessing the degree of shoulder pain. RESULTS AND CONCLUSION:Al 60 patients were fol owed up for 12-24 months after fixation, and obtained bone healing. The healing time was 15.3±2.7 weeks (range 12-20 weeks). At the final fol ow-up, the Constant-Murley score was 81.5±14.6 (range 45-98). The mean Visual Analogue Scale score was 0.9 ± 0.9 points (range 0-7 points). During the fol ow-up, the overal rate of complications was 18%in 11 cases of 60 cases, including intraarticular screw penetration in 3 patients (5%), back-out of the screws in 1 patient (2%), varus malunion in 5 (8%) patients (containing 2 cases combined with screw penetration), humeral head necrosis in 2 patients (3%), subacromial impingement in 1 patient (2%) and superficial infection of incision in 1 patient (2%). No cases of avascular necrosis or hardware failure were noted. Above data suggested that self-made new-type proximal humeral wing-shape anatomical plate fixation for repairing proximal humerus fractures can obtain satisfactory outcomes, effectively reduce the incidence of postoperative subacromial impingement, is helpful to the recovery of shoulder function, and deserves to be further used.

Objective To study the relationship between slow coronary flow and endothelium disorder.Methods One hundred and twelve patients with normal coronary angiography were divided into the slow flow group(n=38)and the normal flow group(n=84)in terms of their TIMI frame counts.Risk factors including sex,age,cholesterol,hypertension,diabetes,history of smoking and blood levels of endothelium-1,nitric oxide and interleukin-6 were compared between the 2 groups.Results Slow coronary flow was more common in male than in female(45 vs 39).Patients who smoked showed a higher incidence of slow coroany flow than non-smoker patients(P=0.010).The blood levels of ET-1(108.42?0.81 pg/mL vs 84.74?39.16 pg/mL,P=0.001)and IL-6(158.28?178.86 pg/mL vs 108.07?84.43 pg/mL,P=0.019)was higher in the slow flow group but with a lower levels of NO(35.66?12.28 ?mol/L vs 42.74?17.51 ?mol/L,P=0.032)when compare with the nomal coronary folw group.Conclusion Slow coronary flow is related to endothelium disorder but other risk factors should also be taken into consideration.

Objective To investigate the effect of tumor necrosis factor receptor 1 (TNFR1) in angiogenesis and neurogenesis during cerebral ischemia in mice.Methods Twenty-four wild-type and 24 TNFR1 knockout mice were randomly divided into either a sham operation group or a focal cerebral ischemia group (n =12 in each group).5-bromodeoxyuridine (BrdU) was injected intraperitoneally at day 3 after cerebral ischemia and sham operation.At day 7 and 28 after cerebral ischemia,the double-label immunofluorescence staining of glucose transporter-1(Glut-1)/BrdU was used to evaluate the angiogenesis surrounding the areas of infarction.A labeled BrdU was used to detect the neural stem cell proliferation in the subventricular zone.Double-labeled doublecortin (DCX)/BrdU and neuronal nuclei antigen (NeuN)/BrdU were used to detect the migration and survival of neural stem cells,respectively.Results Under the normal condition,there was no significant difference in angiogenesis and the number of BrdU-positive cells in the subependymal zone (SVZ) between the wild-type (418.000 ± 28.404) and TNFR1 knockout (528.000 ± 60.597) mice (t =-1.644,P =0.131).At day 7 after cerebral ischemia,the number of Glut-1/BrdU-positive cells in the TNFR1 knockout mice was significantly less than that in the wild-type mice (14.833 ± 2.182 vs.27.5 ± 4.209) (t =2.672,P =0.023),and the number of DCX/B3rdU-positive cells was also significantly less than that in the wild-type mice (163.000 ± 11.106 vs.257.168 ± 12.213) (t =5.705,P =0.000).At day 28 after cerebral ischemia,the number of NeuN/BrdU-positive cells in the TNFR1 knockout mice was significantly less than that in the wildtype mice (6.000 ± 0.577 vs.11.000± 1.571) (t=2.988,P=0.014).Conclusions TNFR1 may play a promoting role in the neurovascular reggeneration in late cerebral ischemia.

Objective To explore the expression of annexin A10 (ANXA10) in human hepatocellular carcinoma (HCC),and analyze its correlation with matrix metalloproteinases-9 (MMP-9) and vascular endothelial growth factor (VEGF),thus to provide the basis for clinical diagnosis and assessment of HCC.Methods 88 HCC patients were selected,and they were all performed surgical treatment,HCC stage Ⅰ in 11 cases,stage Ⅱ 25 cases,stage Ⅲ 31 cases,stage ⅣV 21 cases.The expressions of ANXA10,MMP-9,VEGF of HCC cancer tissues,adjacent liver tissues and normal liver tissues were tested by immunohistochemical method.The correlation of ANXA10 with VEGF and MMP-9 was analyzed.Results The absorbance value of ANXA10 expression in the HCC cancer tissue was (0.074 ± 0.012),which was lower than that in the adjacent liver tissues [(0.091 ± 0.013)] and normal liver tissues[(0.131 ±0.025)],and ANXA10 expression of the adjacent liver tissue was lower than that of the normal liver tissues,the differences were statistically significant (t =8.96,9.44,8.71,all P ＜ 0.05).The absorbance values of MMP-9 and VEGF expression in the HCC cancer tissue were (0.147 ± 0.017) and (0.127 ± 0.028),respectively,which were higher than those in the adjacent liver tissues [(0.096 ± 0.012),(0.091 ± 0.015)] and normal liver tissues [(0.075 ± 0.014),(0.077 ± 0.019)].The absorbance values of MMP-9 and VEGF of the adjacent liver tissues were higher than those of the normal liver tissues,the differences were statistically significant (t =8.05,9.30,8.11;8.28,9.51,8.02,all P ＜ 0.05).The absorbance value of ANXA 10 expression in the HCC stage Ⅲ + Ⅳ cancer tissue was (0.056 ± 0.010),which was lower than that in the stage Ⅰ + Ⅱ cancer tissue [(0.082 ±0.016)],the difference was statistically significant (t =8.90,P ＜ 0.05).The absorbance values of MMP-9 and VEGF expression in the stage Ⅲ + Ⅳ cancer tissue were (0.157 ± 0.022) and (0.169 ± 0.033),respectively,which were higher than those in the stage Ⅰ + Ⅱ cancer tissue [(0.114 ±0.015),(0.091 ±0.021)],the differences were statistically significant (t =9.13,9.72,all P ＜ 0.05).ANXA10 was correlated with MMP-9 and VEGF (r =0.324,0.295,all P ＜ 0.05).Conclusion ANXA10 presents lower expression in HCC cell,and the expression decreased with the increase of staging.It is negatively related with the MMP-9 and VEGF.ANXA10 expression missing or inactivation of malignant change may be one of the most important features in HCC.

Objective To preliminarily understand and evaluate the fertility ability of male infertility patients by analyzing the semen routine testing results to assist further clinical diagnosis and treatment .Methods 7 586 cases of semen routine detection re‐sults were performed the retrospective analysis and statistics by classification according to the indexes of semen volume ,pH value , liquefaction time ,sperm density ,sperm activity and sperm deformation rate .Results Among 7 586 cases of semen routine examina‐tion ,there were 1 450 cases(19 .1% ) of semen volume less than 2 .0 mL ;1 372 cases (18 .1% ) of pH < 7 .2 ;2 740 cases(36 .1% ) of liquefaction time > 60 min ;989 cases(13 .0% ) of sperm density lower than 20 × 106 /mL ;3 719 cases(49 .0% ) of sperm activity grade a + b less than 50% ;3 431 cases(45 .2% ) of sperm deformation rate less than 15% ;141 cases(1 .9% ) of aspermatism ;1 119 cases (14 .8% ) had no abnormality in each index .Conclusion Semen liquefaction ,sperm motility and sperm deformation rate are the indexes with the highest abnormal rate in the semen routine detection ;the semen routine detection provides the important exper‐imental data for clinical diagnosis and treatment of male infertility ,the objective and correct analysis of the detection result is of great significance to the judgment of male fertility .

Objective To assess the value of exercise treadmill testing (bruce protocol) in diagnosing early atherosclerotic lesions of the lower limb. Methods Between March and September 2008, 173 outpatients with high risks of peripheral arterial disease (PAD) were enrolled randomly from the cardiology clinic of Chinese PLA General Hospital. The patients were subjected to exercise treadmill testing (Bruce protocol) and ankle-brachial index (ABI) determination, as well as lower limb artery ultrasonography within one week. Using ultrasonic findings as diagnostic criteria, the diagnostic sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of exercise treadmill testing for early atherosclerotic lesions of the lower limb were analyzed, and the diagnostic value of exercise treadmill testing was assessed using the ROC curve. Results After exercise, ABI decrement (R value) increased in subjects with high risks for PAD with atherosclerotic lesions of the lower limb aggravating. Using the presence of large atherosclerotic plaques (area > 20 mm2 ), atherosclerotic plaques and atherosclerotic lesions in lower limb arteries as positive diagnostic criteria, the area under curve of ROC was 0. 80 (95% CI: 0.72-0.88), 0.78 (95% CI: 0.71-0.85) and 0. 60 (95% CI: 0.44-0.76), respectively. Using the presence of large atherosclerotic plaques in lower extremities as positive diagnosis, R value was 0.80, with a sensitivity of 54. 0%, a specificity of 96. 7%, a LR+ of 16. 4, and a LR- of 0. 58, meanwhile, R value was 0. 85, with a sensitivity of 70.0%, a specificity of 91.9%, a LR + of 8.64, and a LR- of 0.33. Conclusions Exercise treadmill testing (Bruce protocol) in combination with ABI determination is a safe, accurate, objective tool for detecting early atherosclerotic lesions of the lower limb. Immediately after exercise, 0.85 is the cut-off R value appropriate for diagnosing large atherosclerotic plaques of the lower limb (area > 20 mm2).

left ventricle=cerebral cortex =urinary bladder smooth muscle. CONCLUSION mRNA expression levels of Kir2 1 and Kir3 1 in different tissues were different, this different expressions have physiological significance.

Objective To investigate the correlation between plasma cystatin C (CysC) level and carotid atherosclerotic plaque in patients with ischemic stroke.Methods The clinical data in patients with acute ischemic stroke were analyzed retrospectively.According to the results of carotid artery ultrasound,the patients were divided into either a non-plaque group or a plaque group.Then the plaque group was redivided into a stable plaque subgroup and a vulnerable plaque subgroup.Multivariate logistic regression analysis and Pearson correlation analysis were used to explore the risk factors for carotid atherosclerotic plaque.Results A total of 226 patients with acute ischemic stroke were enrolled,172 of them had carotid plaque,and 54 had no plaque.Of the patients with carotid plaque,94 were stable plaque and 78 were vulnerable plaque.The age (71.82 ± 9.94 years vs.60.74 ± 13.81 years; t =6.160,P =0.014),proportion of patients with ischemic heart disease (11.6％ vs.1.9％; x2=6.169,P=0.020),systolic blood pressure (148.770± 21.007 mm Hg vs.142.240 ± 19.404 mm Hg; t =2.029,t =0.044),plasma CysC concentration (1.046 ± 0.438 mg/L vs.0.860 ±0.214 mg/L; t =3.006,P =0.003),and carotid IMT (1.122 ±0.278 mm vs.0.878 ±0.250 mm; t =5.762,P=0.000) in the plaque group were significantly higher than those in the non-plaque group.Multivariate logistic regression analysis showed that the age (odds ratio [OR] 1.079,95％ confidence interval [CI] 1.044-1.116; P=0.000) and IMT (OR 31.450,95％ CI 6.233-158.692; P=0.000) was the independent risk factor for carotid plaque,while there was no significant independent correlation between the plasma CysC level and carotid plaque (P =0.217).Only IMT in the stable plaque subgroup was significantly higher than the vulnerable plaque group (1.176 ±0.285 mm vs.1.058 ±0.258 mm; t =-2.824,P =0.005),and it was the independent protective factor for the carotid plaque stability (OR 0.195,95％ CI 0.059-0.064; P =0.007).Pearson correlation analysis showed that the plasma CysC level was positively correlated with the age (r =0.375,P =0.000) and serum creatinine level (r =0.462,P =0.000),but it was not significantly correlated with carotid IMT (r =0.075,P =0.264).Conclusions In patients with ischemic stroke,no correlations were found between the plasma CysC level and carotid atherosclerotic plaque,plaque stability,and IMT.

Objective At present, the methods of separating and identifying nasopharyngeal cancer stem cells are not yet mature.This study was to explore the methods of culturing nasopharyngeal cancer stem cell microspheres and identify the cancerous stem cell biological features of CNE-2 cell microspheres. Methods We conducted suspension culture of human nasopharyngeal cancer CNE2 cells and C666-1 cells in serum-free medium ( SFM) containing growth factors.Then we measured the proportion of CD133 +cells in CNE2 monolayer ( CNE2-MN) and CNE2 microsphere cells ( CNE2-SC) by flow cytometry, determined their in vitro invasiveness through Transwell chamber experiments, and detected their in vivo tumorigenicity via nude mouse experiments.We ob-served the differentiation potency of the CNE2-SCs in the adherent-cultured serum-containing medium and detected the expressions of the cancer stem cell-related genes Bmi-1, Oct4, and Twist1 in CNE2-MN and CNE2-SCs by flow cytometry and RT-PCR analysis. Results In the special blend of SFM, both of the cell lines can form microspheres that can be stably transferred.Fresh SFM prepara-tion, substituting cell separation agent Accutase for pancreatic enzyme for transfer, and maintaining the state of cell suspension contrib-uted to the formation and proliferation of microspheres.Adherent culture with serum-containing medium induced the differentiation of CNE2-MN cells, which exhibited no significant difference from the CNE2 microsphere cells.The CD133 +cells accounted for 98.79%in the CNE2 microspheres, significantly higher than 0.98%in the CNE2 cells (P<0.01).Compared with the CNE2-MN cells, the CNE2-SCs showed highly increased expressions of Bmi-1, Oct4, and Twist1 (P<0.01).The numbers of membrane-penetrating cells in the CNE2-SCs and CNE2-MN cells were 122 ±6 and 36 ±7 per visual field, the former with a stronger invasive ability than the latter genesis of 1 ×106 CNE2-SCs vs that of the same number of CNE2 -MNcells was (2.332 ±0.549) cm 3 sv (0.669 ±0 .278) cm3 ( P<0.01). Conclusion Using suspension culture with a specially prepared SFM, nasopharyngeal cancer CNE2 microsphere cells can be obtained, in which there are large numbers of cancer stem cells.This culture method may provide a base for further studies of naso-pharyngeal cancer stem cells.

Objective To study the effect of magnetic doxorubicin stealth liposome on human gastric cancer xenografts in nude mice.Methods Human gastric cancer cell line MKN-45 was implanted into 36 nude mice.Different kinds of drug were injected through the caudal vein of tumor bearing nude mice divided into 6 groups .Permanent magnet was put into tumor in targeting group.Results The growth speed of tumor in the group of MDL (+) significantaly slowed down than other groups.The rate of tumor restrain in tumor weight and tumor volume of MDL (+) group were 71% and 70%, which were remarkably higher than those of the DOX and MDL (-) group (all P