Objective To observe the clinical efficacy of relatively proximal humeral locking compression plate( LPHP) with the traditional plate for treatment of proximal humeral fractures .Methods The proximal humeral fractures in patients with 58 cases,the patients were divided into two groups ,the treatment group of 32 cases of locking compression plate in the treatment of T plate ,clover plate in the treatment of 26 patients of the control group received traditional.According to the Neer score compared with two groups of patients with postoperative recovery and compli -cations.Results All the 58 patients for 11 ~15 months of follow-up,the treatment group found no fracture ,fracture nonunion,screw and plate humeral head necrosis ,4 cases of shoulder pain was limited;15 cases of excellent score Neer function,good in 12 cases,5 cases,the excellent and good rate was 84.4%.The control group had 3 cases,2 ca-ses of screw loosening of plate fracture ,3 cases of nonunion ,2 cases of humeral head necrosis ,7 cases of shoulder pain limited.6 cases of excellent score Neer function ,good in 9 cases,3 cases,poor in 8 cases,the excellent and good rate was 57.7%.There was significant differences between the two groups (χ2 =5.113,P <0.05) excellent rate. Conclusion LPHP exact treatment of proximal humeral fractures has fewer complications , which can help patients with early rehabilitation exercises .

Objective To identify,construct and express scFv CD133,verify its biological function.Methods VL and VH were isolated from hybridoma of mAb CD133 by using antibody engineering technology.Its DNA sequencing and CDR were determined.scFv CD133 was then cloned into pET32a,transformed into Origami,induced by IPTG,purified by Ni2+-NTA His resin.Its affinity and specificity were tested by NH4SCN elution and ELISA.Results The size of VL and VH of scFv CD133 was 339 bp and 342 bp,which coded 113 and 114 amino acid separately.Its VL belonged to mouse Igκ chain and VH belonged to mouse IgG heavy chain subtype I.The molecular weight of scFv CD133 was about 27 × 103 which was testified by SDSPAGE and Western blot.Its affinity and specificity were also verified.Conclusion scFv CD133 has been successfully constructed and expressed in Origami,which could supply basis for target therapy of CD+133 cancer stem cell.

Objective To study the value of dual energy cerebral arteries computed tomographic angiography (CTA) in diagnosis of cerebral aneurysm.Methods As a gold standard of digital subtraction angiography (DSA) findings,the dual energy cerebral arteries CTA imaging features of 30 cases confirmed by DSA for cerebral aneurysm were retrospectively analyzed.The diagnosis accuracy of cerebral aneurysm between dual energy cerebral arteries and DSA was compared.Results Dual energy cerebral arteries CTA could display the direct signs of cerebral aneurysms,it played better in the signs of aneurysm of the siphon segment of internal carotid artery than that by conventional cerebral arteries CTA.The measurement of the size and neck by dual energy cerebral arteries CTA had good agreement to DSA,there was no statistical difference (P ＞ 0.05).The radiation dose of dual energy cerebral arteries CTA was 19.1-25.4(21.7 ± 0.5)mSv.Conclusion The dual energy cerebral arteries CTA can show the size and neck of cerebral aneurysm clearly,has high value in clinical application of the diagnosis of cerebral aneurysm.

AIM: To study the expression of Survivin and its relationship to prognosis in human hepatocellular carcinoma(HCC).METHODS: The expression of Survivin protein in 83 cases of HCC and their neighboring noncancerous tissues was detected by immunohistochemistry. The expression of Survivin mRNA in 11 cases of HCC and their neighboring noncancerous tissues was detected by semi-quantitative RT-PCR. RESULTS: Survivin protein expression was detected in 53 of 83 (63.9%) HCC tissues and 21 of 53 (39.6%) corresponding noncancerous tissues. 22 of 53 Survivin-positive HCCs (41.5%) showed punctate nuclear staining in HCC cells, 24 of 53 Survivin-positive HCCs (45.3%) showed cytoplasmic staining in HCC cells and the remaining 7 showed both nuclear and cytoplasmic staining. The positive rates of nuclear Survivin expression in cases of envelope invasion or tumor metastasis were significantly higher than those in cases without envelope invasion or tumor metastasis (P

Pass an overview about medical social work ethics and analyzed the reasons.Based on China′s na-tional conditions and the basis of the particularity of medical social work in China, puts forward the paths of the lo-calization of medical social work ethics, namely, improve the adaptability of western medical ethics of social work, realizes the Chinese traditional culture and western medical social work ethics, mutual accommodation, with the so-cialist core values at the head of the medical social work ethic construction in our country.

Objective To analyze the characteristics and clinical value of time intensity curve (TIC) of contrast-enhanced ultrasound (CEUS) in recurrent small hepatocellular carcinoma (RSHCC) and primary small hepatocellular carrcinoma (PSHCC). Methods Sixty-five cases of RSHCC (all lesions ≤3 cm) were devided into group B1 with 42 cases of RSHCC (≤2 years ) , and group B2 with 23 cases of RSHCC ( > 2 yeras ) and group A invloved 49 cases of PSHCC (all lesions ≤3 cm). Enhancement patterns in arterial, portal and delayed phase were evaluated respectively in three groups through CEUS and analytic software Sonoliver was applied to obtain quantitative features of CEUS in the region of interest. Receiver operating characteristic (ROC) was drawn and the area under curve (AUC) was calculated. Results CEUS showed hyper-enhancement difference in arte-rial phase in group B2 (72.4%) and group A (94.8%)(P′ = 0.008) showed statistical significance, but no sig-nificance was found in enhanced iso in portal phase (P = 0.078). Hypo-enhancement in the delayed phase in group B2 (75.9%), group A (96.6%) and group B1 (95.3%) (P′ = 0.003, P′ = 0.005). TIC showed HT difference (half time of descending) in B2 group, A group and B1 group (P′ = 0.007, P′ = 0.013) indicated statistical significance but RT, TTP, MTT(P = 0.319,P = 0.104, P = 0.461) showed no difference. AUC was 0.841 (half time of descending). Conclusions Enhancement patterns of CEUS (RSHCC) are related to recur-rent time . En hancement patterns of RSHCC (> 2 years ) is not typical so CEUS should be combined with quanti-tative analysis of TIC to provide reference for its treatment and prognosis.

Objective To determine the expressions of miR-200a, miR-141, miR-205 and miR-34a in epithelial ovarian cancer (EOC) samples and to explore their clinical significance. Methods According to FIGO staging, 44 EOC pa?tients were divided into two groups:early FIGO stage (stageⅠ-Ⅱ, n=15) and late FIGO stage (stageⅢ-Ⅳ, n=29). Expres?sions of 4 miRNAs were detected by real time quantitative PCR, and were compared between two groups. The correlation of 4 miRNAs was calculated. EOC patients were divided into high miRNA expression group and low expression group according to the median value of miRNAs expression. Kaplan-Meier survival analysis and Cox multivariate analysis were used to com?pare the age, FIGO state, tumor residual after operation and post-operative chemotherapy of ovarian cancer between two groups. Results The expression of miR-141 was elevated in stagesⅢandⅣcompared with that of stagesⅠand Ⅱ(P=0.036). There was a positive correlation between expression of miR-141, miR-200a and miR-205, but a negative correlation with miR-34a (P<0.05). There was a positive correlation between miR-200a and miR-205 (P<0.05). Lower miR-200a ex?pression was associated with shorter progress free survival in ovarian cancer analyzed by log-rank test ( P=0.035). The sur?vival rate was significantly higher in FIGO stages ⅠandⅡthan that of FIGO stagesⅢandⅣ(P<0.05). Cox regression analysis revealed that miR-200a, FIGO stage and age were influential factors of overall survival time and progress-free sur?vival time of ovarian cancer, while miR-141, miR-205, miR-34a and tumor residual after operation and post-operative che?motherapy were not influential factors. Conclusion The expression of miR-200a is closely correlated with the progress and prognosis of ovarian cancer and may be used as an independent indicator for ovarian cancer prognosis.

Objective To investigate ultrasonographic (US) features of mucinous breast carcinoma with pathological correlation and to improve the early diagnosis for the mucinous breast carcinoma.Methods Twenty-two patients with 23 focuses mucinous carcinoma of the breast confirmed by pathology were included in this study,retrospectively evaluate sonographic features according to the American College of Radiology(ACR) Breast Imaging Reporting and Data System(BI-RADS) Lexicon,all cases were classified by BI-RADS before operation.Histological type of mucinous breast carcinoma included mixed and pure two forms,the latter was classified into cellular variants and hypocellular variants.The correlation between the ultrasonographic findings of mucinous carcinoma and histologic features in different types were analysed.Results On US examination,all 22 cases presented as solid mass.In pure form,they showed well-defined margins with no pseudocapsule and isoechogenic or hypoechoic internal echo pattern relative to that of subcutaneous fat in 86.7％ (13/15) focuses which histological type were pure type.93.3％ (14/15) of pure type focuses had posterior enhancement.All pure type focuses demonstrated that the orientation of the mass is parallel to the skin line.75.0％ (6/8) of mixed type focuses and 13.3％ (2/15) of pure type focuses,however,demonstrated ill-defined and or spiculated margins with more hypoechogenic structure (P ＜0.01).Mixed type focuses have more aggressive malignant features.65.2％ (15/23) of cases being classified as BI-RADS 4 or 5 were suspected as malignancy,which included 6 mixed type focuses and 9 pure type respectively accounting for 75.0％ (6/8) and 60.0％ (6/15) of each type focuses.Conclusions Mucinous breast carcinoma especial pure type did not have the typical malignant breast masses sonographic features,which showed some benign masses sonographic features except no pseudocapsule benign feature.Mixed type mucinous carcinomas tumors have more aggressive margin imaging characteristics.It is suggested that mucinous breast carcinoma should be classified category 4 by BI-RADS to avoid diagnosis delay.

Objective To explore a more effective way of lavage so as to improve the curative effect of management for postoperative femoral infection.Methods A retrospective analysis was performed in 76 patients who received lavage therapy by using two connecting lavage tubes admitted into Department of Orthopedics,Second Hospital of Tangshan from March 2001 to May 2008.The advantages and disadvantages of this lavage method were discussed.Results All the wounds in 76 patients were healed at one stage.There was no recurrence after more than six months of follow-up.Conclusion Lavage using two connecting lavage tubes is an modification to conventional lavage,for it can reduce loss rate and blocking rate of the irrigation tube.

Objectives To detect the cord blood vitamin D level in neonates and to determine the association between the cord blood vitamin D level and neonatal outcomes. Methods A total of 223 eligible mother-and-singleton-offspring pairs were recruited. The information of mothers' pregnancy was collected by questionnaires. The weight, length, and head circumference of neonates were measured. The levels of 25(OH)D in cord blood of neonates and in blood of late pregnancy mothers were determined by chemiluminescence immunoassay. Results The median concentration of 25(OH)D in cord blood was 20.7 nmol/L, and 82.1% of neonate had vitamin D deficiency, and 12.1% had severe vitamin D deficiency (<10 nmol/L). The concentration of 25(OH)D in cord blood was consistent with that in blood of late pregnancy mother. The distribution of concentration of 25(OH)D in cord blood was significantly different in neonates in different seasons of birth (P<0.05). There were more cases <10 nmol/L in winter and spring. The concentration of 25(OH)D in cord blood had no significant associations with the incidences of low birth weight (LBW) and small for gestational age (SGA) (P>0.05). After the variables of sex, gestational age and birth season are controlled, the birth weight and head circumference were significantly different in neonates with different concentrations of 25(OH)D in cord blood (P<0.05). Conclusions The concentration of 25(OH)D in cord blood in term neonates was generally lower. The vitamin D status in neonates was consistet with that in their late pregnancy mothers. Cord blood 25(OH) D levels were associated with neonates' birth weight and head circumference, but it should be confirmed by larger sample size in the future.