[Objective]To analyze the character of the complex proximal humeral fracture,study their operative methods and evluate the efficiency of treatment for complex proximal humeral fracture in elder patients with LCP plate.[Method]From(Oct 2004 to June 2006,16 elder patients with complex proximal humeral fracture were admitted and treated with open reduction and LCP plate internal fixation,regular clinical follow-up was executed by our medical team,the postoperative results were observed and the efficiency were evaluated by us.[Result]Sixteen cases obtained postoperative clinical results from 6 to 18 months(average 12.3 months),the fracture were healed in all cases,the shoulder function were evaluated with Neer shoulder functoin scoring systerm,the execellent result were 11,good 2,normal 2 and poor 1,the execellent and good results were 81.3% in all cases,6 cases got anatomic reduction,6 cases got nearly anatomic reduction,3 normal and 1 poor which were certified by radiographic examination.[Conclusion]The treatment for complex proximal humeral fracture in elder with LCP plate has less invasive,firm internal fixation and satisfactory shoulder function recovery.It is a very satisfactory internal fixtion for complex proximal humeral fracture in elder patients.

AIM:To observe the expression of Toll like receptor 4 (TLR4) in the left ventricle of Goldblatt rats and to explore the role and mechanism of TLR4 in left ventricular remodeling of hypertension.METHODS:Goldblatt model of Two-kidney,one-clip (2K1 C) renovascular hypertension was induced in twenty-five rats(H group),and twenty rats served the sham-operated group(sham group).The tail cuff blood pressure was detected every week and echocardiogram was observed every other week.After eight weeks of operation,the rats were killed and the samples of the left ventricle were collected.The concentration of Ang Ⅱ in left ventricle was assessed by tadioimmunoassay.Western blotting and RT-PCR were used to exam the mRNA and protein expression of TLR4 in the left ventricle.Immunohistochemistry was adopted to exam the location of TLR4 in the myocardium.RESULTS:TLR4 mRNA and protein expression were consistently upregulated in the left ventricle of H group compared with sham group.In H group, predominantly sarcolemmal staining was observed,especially focal areas of intense TLR4 staining were found in juxtaposed regions of two or more adjacent myocytes;However,in sham group,TLR4 expression was diffuse and presumably cytoplasmic.Considerable correlation was found between blood pressure,MESS,LVMI,RWT,the concentration of Ang Ⅱ in left ventricle and the protein expression of TLR4 in myoeytes.CONCLUSION:During the development of left ventricular remodeling of Goldblatt rats,expression of TLR4 increases significantly.Enhanced expression of TLR4 locates in the sarcolemma,especially in juxtaposed regions of two or more adjacent myocytes.These indicate that TLR4 transmembrane receptor which is closely relative with inflammation and immunity probably contributes to the development of ventricular remodeling.[KEY WORDS]Hypertension;Ventricular remodeling;Receptors,Toll-like;Goldblatt rats

BACKGROUND:The brachial plexus injury anastomosis suture technique is necessary to understand the mechanics characteristic of brachial plexus nerve stress relaxation.Previous studies mainly focused on single tension mechanics of brechial plexus nerve,but few studies concerning stress relaxation and creeping elasticity.OBJECTIVE:To observe and analyze experimental animal brachial plexus nerve stress relaxation mechanics characteristic in the description manner of function,to provide experimental parameters for clinic.DESIGN,TIME AND SETTING:The experimental observations to use function as a way to describe from 1~(st) to 10~(th_ March,2007 at the Experimental Center of Jilin University.MATERIALS:The experimental male Sprague Dawley rats aged 6 months were provided by Changchun Gaoxin Medicine Animal Experimentation Center.METHODS:The stress relaxation experiment was performed in Experimental animal Brachial plexus Nerve on the the electronic universal testing machine (Shimadzu,Japan).The stress relaxation experiment strain increased speed was 1%/s,setting time of 7 200 seconds.100 empirical data were collected and disposed by one-way linear regression analysis.MAIN OUTCOME MEASURES:The stress relaxation data and curve,the Stress and time change rule were measured.RESULTS:The stress relaxation quantity of animal brachial plexus nerve test specimen at 7 200 s was 0.316 MPa.Stress relaxation curve changed with logarithm.Stress relaxation changed rapidly at 600 seconds,decreased gradually,and reached a balance level at 7 200 seconds.CONCLUSION:The stress relaxation curve changed with the logarithm relations.Brachial plexus has visco-elastic mechanical properties.

Objective To evaluate the vaccine effectiveness ( VE) in children who received one dose of live attenuated varicella vaccine. Methods A questionnaire-based 1 ∶ 2 matching case-control study was conducted during May, 2015 to April, 2016 to evaluate the VE based upon the demographic data, vacci-nation status and clinical symptoms of 127 children with varicella and 254 healthy subjects under 12 years old. Results Compared with the healthy subjects, 83. 46% of the patients with varicella were immunized with one dose of varicella vaccine, which was lower than that of the control group (90. 55%) (χ2=4. 08, P<0. 05). The overall protective rate of one dose of varicella vaccine reached 64. 29% (95% CI:42. 00%-78. 00%). Of the 127 cases of varicella, 83. 46% were breakthrough cases immunized with one dose of var-icella vaccine. Primary cases presented more severe clinical symptoms than breakthrough cases. The longer the interval between vaccination and varicella-zoster virus infection was, the more severe the breakthrough cases would be. Conclusion Varicella vaccine is effective for preventing varicella, but the VE of one dose of varicella vaccine is limited. A two-dose varicella vaccination strategy should be proposed in our country as soon as possible.

Objective To investigate the effect of electroacupuncture on serum insulin (INS) levels and gastric antral cholecystokinin (CCK) content in rats with diabetic gastroparesis (DGP).Methods Sixty SD rats were randomized into groups A, B, C, D and E, 12 rats each. Group A is a normal control. A DGP model was made by an intraperitoneal injection of 2% streptozocin (STZ) plus an irregular high sugar and fat diet in groups B, C, D and E. group B is a model one and did not receive treatment. Group C received electroacupuncture at points Zusanli, Sanyinjiao and Liangmen; group D, electroacupuncture at the control points of Zusanli, Sanyinjiao and Liangmen. Group C, an oral gavage of metoclopramide tablet solution. Blood sugar and urine sugar were determined using a OneTouch lood glucose meter and Tes-Tape, respectively. The gastric emptying rate and the intestinal migration rate were measured by an oral gavage of phenol red. Serum INS levels and gastric antral CCK content were measured by ELISA in every group of rats before and after treatment.Results There were statistically significant differences in blood and urine sugar values between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or E (P<0.05). There was a statistically significant difference in the gastric emptying rate between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or D (P<0.01,P<0.05). There was a statistically significant difference in the intestinal migration rate between group B or D rats and group A (P<0.01) and between group C rats and group B or D (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups B and A rats (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups D and A rats (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups C or E rats and group B (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups C and D rats (P<0.05).Conclusions Electroacupuncture can markedly improve gastrointestinal functions and promote gastric emptying in DGP rats. Its therapeutic effect may be related to electroacupuncture raising serum INS levels and reducing gastric antral CCK content.

Objective To observe the effect of music therapy on stroke patients with depression.Methods 70 post-stroke depression patients were divided into the observation group and the control group according to the hospitalized number,the control group received conventional therapy neurology without giving antidepressants;the observation group were given music therapy group basis.Both groups were at the time of enrollment and after treatment using the Hamilton Depression Rating Scale (HAMD),Self-rating Depression Scale (SDS) for the two groups of patients assessed the degree of depression.Results After the treatment,the HAMD score of the observation group was (23.57 ± 10.33)points,compared with the control group[(28.20 ± 8.83)points],the difference was statistically significant (t =2.02,P ＜ 0.05);the SDS score of the observation group was (61.00 ± 10.67) points,compared with the control group [] (66.11 ± 10.38) points],the difference was statistically significant (t =-2.03,P ＜ 0.05).Conclusion Music therapy for depression in patients with post-stroke recovery has a positive meaning.

Objective: To observe the effect of moxibustion on acupoints Zusanli (ST 36) and Liangmen (ST 31) on cell proliferation and cell apoptosis of gastric mucosa in rats with stress ulcer, investigatethe mechanism of moxibustion in promoting the repair of gastric mucosal injury at cellular and molecular levels. Methods: Sixty healthy Sprague-Dawley rats were randomly divided into four groups: the restraint control group, model group, moxibustion on acupoints group and moxibustion on non-acupoints group. Water immersion and restraint stress (WRS) was used to copy the stress ulcer model of rats, radio-immunoassay was used to detect the content of transforming growth factor (TGF-α), and S-P immunohistochemical assay was adopted to determine the HSP70 expression, the proliferating cell nuclear antigen (PCNA) and cell apoptosis index in gastric mucosa. Results: For the WRS-induced gastric ulcer model of rat,the gastric mucosal injury (gastric ulcer index, UI) was increased, the content of TGF-α was decreased, PCNA was also decreased, HSP70 expression and cell apoptosis index were all increased (P＜0.01). Moxibustion on acupoints Zusanli (ST 36) and Liangrnen (ST 31) could decrease UI, increase the content of TGF-α, promote the expression of PCNA and HSP70,decrease cell apoptosis index in gastric mucosa, with significant differences when compared with the model group and control group (P＜0.01). Conclusions: Moxibustion on acupoints Zusanli (ST 36) and Liangmen (ST 31) had protective effect on the gastric mucosa of stress ulcer, its mechanism may be promoting the TGF-α synthesis, stimulating cell proliferation in gastric mucosa and inhibiting cell apoptosis in gastric mucosa, and this process is related to the moxibustion-induced HSP70 expression.

Objective: To observe the effect of electroacupuncture (EA) at Zusanli (ST 36) on the gastrointestinal motility and the ultrastructures of pacemaker cells [the interstitial cells of Cajal (ICC)] in diabetic gastroparesis (DGP) rats and explore the mechanism of EA for DGP.Methods: A total of 50 Sprague-Dawley (SD) rats were randomly divided into group A, group B, group C, group D and group E, with 10 rats in each group. Group A was the blank control; a single intraperitoneal injection of 2% streptozotocin (STZ) was performed in rats of group B, group C, group D and group E, with high glucose and high fat diet for 8 weeks to establish the DGP rat models. Group B was the model group and the rats did not receive any treatment; group C was EA at acupoint group and the rats received EA at Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6); group D was EA at non-acupoint group and the rats received EA at the control points of Zusanli (ST 36), Liangmen (ST 21) and Sanyinjiao (SP 6); group E was metoclopramide group and the rats were treated by intragastric administration of metoclopramide. Blood glucose was detected using ONE TOUCH blood glucose meter; gastric emptying rate and small intestine migration rate were measured using intragastric phenol red; ultrastructures of gastric antrum ICC were detected by transmission electron microscopy.Results: The differences of blood glucose between group B, group C, group D, group E versus that of group A were statistically significant after modeling (P<0.01); after treatment, the differences of blood glucose between group D, group E versus that of group C were statistically significant (P<0.05,P<0.01); the gastric emptying rate of rats in group B was statistically significant different from that in group A (P<0.01); the gastric emptying rate of rats in group C was statistically significant different from that in group B (P<0.01). The migration rates of rats' small intestines in group B, group C, group D and group E were all statistically significant different from that in group A (P<0.01); the migration rate of rats' small intestines in group C was statistically significant different from that in group B (P<0.01). The ultrastructure of rat's ICC in group B showed apoptosis compared with that in group A; rat's ICC in group C had complete basement membrane, more cytoplasm mitochondria, Golgi and rough endoplasmic reticulum, showing clear structure, occasional mitochondria swelling and gap junctions with adjacent smooth muscle cells; there were no significant differences between group D, group E versus group B.Conclusion: EA at Zusanli (ST 36) plus other acupoints can regulate the blood glucose and promote gastrointestinal motility in DGP rats, and the mechanism may be related to repairing the damaged ICC structure.

Objective To investigate the diagnostic value of transbronchial lung biopsy (TBLB) under virtual bronchoscopic navigation (direct path), endobronchial ultrasonography with a guide sheath (GS) and rapid on-site evaluation (ROSE) for solitary pulmonary nodules (SPNs). Methods One hundred and seventy-eight patients who were underwent transbronchial lung biopsy in the Tianjin Medical University General Hospital between January 2015 to December 2016 were retrospectively evaluated. CT images of all patients showed solitary pulmonary nodules surrounded by lung tissue, and ROSE was undergone during the procedure. The patients were divided into conventional (C-TBLB) group, virtual bronchoscopic navigation (VBN) group, endobronchial ultrasonography with a guide sheath (GS) group, and virtual bronchoscopic navigation combined with endobronchial ultrasonography with a guide sheath group (combination) depending on the different devices. The diagnostic yield and the location or the effect of lesion on the diagnostic rate were compared between four groups. The coincidence rate of ROSE and the histopathological findings of TBLB were compared. The value of ROSE for the early diagnosis of disease was further evaluated. Results The diagnostic rates were 32.5％(13/40), 66.7％(24/36), 68.2％(30/44) and 75.8％(44/58) for C-TBLB group, VBN group, GS group and combination group, respectively. There were significant differences in diagnostic rates between C-TBLB group and other tree groups (χ2=8.853, 10.677 and 18.293, P<0.008). But there were no significant differences in diagnostic rates between VBN group, GS group and combination group (P>0.008). The diagnostic rates for peripheral pulmonary nodules were 12.5％ (2/16), 42.9％ (6/14), 40.0％ (4/10) and 75.9％(22/29) in C-TBLB group, VBN group, GS group and combination group. The diagnostic rate was significantly higher in combination group than that of other three groups (χ2=17.434, P<0.05). The result of ROSE was consistent with result of histopathology (Kappa = 0.775, P<0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ROSE during transbronchial biopsy for solitary pulmonary nodules were 90.7％, 87.0％, 86.7％, 90.9％ and 88.8％, respectively. No pneumothorax, hemoptysis or other serious complications were found in patients. Conclusion Virtual bronchoscopic navigation, endobronchial ultrasonography with a guide sheath for solitary pulmonary nodules by transbronchial lung biopsy can improve the diagnostic rate of solitary pulmonary nodules.

Objective To clone and express the alkaline protease AprA , one important virulence factor secreted by Pseudomonas aeruginosa(PAE)in Escherichia coli, to clone and express the inhibitor of AprA (AprI) and its substrate flagellin , and to detect the function of AprA and the inhibitory function of AprI .Methods The genes encoding AprA ,AprI and flagellin gene were amplified respectively by PCR using PAE PAO 1 genome DNA as the template .The expression vec-tors (pET-28a-AprA, pET-28a-AprI and pET-28a-Flagellin) were constructed and transformed into E.coli BL21(DE3) respectively.The recombinant AprA protein was expressed by IPTG induction and purified via denaturing and renaturation. The recombinant AprI and flagellin were expressed and purified by Ni 2+affinity chromatography .The cleavage activities of AprA on flagellin were detected by SDS-PAGE.Results Recombinant AprA , AprI and flagellin protein were expressed and purified .It was demonstrated that AprA cleaved flagellin , which was blocked by AprI .Conclusion Recombinant AprA could cleave its substrates as an alkaline protease , and its inhibitor AprI inhibits the activities of AprA .This study will contribute to further investigations on the role of AprA in the pathogenesis of PAE .