OBJECTIVETo investigate a manipulating therapy for treatment of anterior shoulder dislocation in elderly.

METHODSFrom October 2011 to June 2012,27 elderly patients with anterior shoulder dislocation were treated by extorsion traction and pushing manipulation with fingers, including 7 males and 20 females aged from 65 to 86 years old with an average of 77. The course of disease ranged from 1 h to 1 d. The shoulder manifested square deformity, Dugus signs showed positive, and X-ray displayed anterior shoulder dislocation. Dugus fixation was applied for and removed external fixation at 3 weeks after operation and carried out shoulder functional exercise. Functional evaluation standard on shoulder joint injuries was used for evaluate clinical outcomes.

RESULTSAll patients were gained reduction for the first time, and followed up at 3 months after operation, no dislocation occurred. According to functional evaluation standard on shoulder joint injuries, 22 cases got an excellent result,2 cases good,and 1 case moderate.

CONCLUSIONExtorsion traction and pushing manipulating therapy for treatment of anterior shoulder dislocation in elderly, which has advantages of simple, convenient, less painful, and can avoid iatrogenic injury, is feasible to widespread.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Shoulder Dislocation ; physiopathology ; therapy ; Shoulder Joint ; physiopathology ; Traction ; Treatment Outcome

Objective By means of value-added reflection of students' learning behavior, this article gives an objective description of the current situation of pharmaceutical undergraduate education and puts forward some suggestions to strengthen the connotation construction of pharmaceutical education.Method Using the Chinese College Student Survey (CCSS) developed by Tsinghua University and Indiana University (US), 1100 students participated in a one-to-one web-based anonymous questionnaire, and using SPSS19.0 to analyze the data.Five comparable indexes and students' recognition behaviors were discussed using descriptive analysis and independent sample t test.Result The five comparable index scores and learning behavior skill index scores of the students in Chinese traditional medicine specialty and pharmacy were higher than the national overall level of all kinds of colleges and universities of science categories.Compared with the national norm of medical colleges, except that the score of 43.36 of the five comparable indexes in pharmaceutical professional academic challenge (level of academic challenge, LAC) was less than 43.63 national medical colleges LAC norm level, the other index scores were higher.LAC and active collaborative learning scores of Chinese pharmaceutical majors were lower than those of pharmacy students, and the difference was statistically significant (P＜0.05).In the study of behavioral skills, the scores of two major students' use, evaluation and comprehensive behavior were lower than the national standard of medical institutions, and there was a statistically significant difference in the scores of Chinese medicine and pharmaceutical majors (P＜ 0.05).Conclusion Teaching experience and learning support need to be optimized for pharmaceutical students.Learning scientificalness and comprehensive abilities in pharmaceutical education need to be improved.Mid and higher level of learning behavior needs to be enhanced for pharmaceutical students.

Objective To investigate the clinical manifestation of bacterial urinary tract infections among old patients with diabetes in recent seven years.Methods In this retrospective study,contrast analysis of clinical features was per- formed on urinary tract infections in old patients between 56 cases with diabetes and 56 cases without it diagnosed during 1998 to 2005.measuring fasting blood glucose,2 hour blood glucose,plasma albumin,24-hour microalbuminuria. Results Incidences of diabetic nephropathy,diabetic retinopathy,neuropathic bladder in observed group are signifi- cantly higher than control group.FBG、2hPBG、24-hour microalbuminuria are significantly higher than control group and plasma albumin is lower than control group.Conclusion The urinary tract infection in old patients with diabetes is associated with fasting blood glucose concentration,complication,gender,disease period and ages,etc.

Recent studies have confirmed that both CD40 molecule and its ligand CD40L played important roles in various stages of atherosclerosis.The critical cell component of atherosclerosis- endothelial cells,macrophages,and smooth muscle cells on which there are expressions of CD40 and CD40L.The combination of both induces human vascular endothelial cells expressing various active media,participating in the formation of atherosclerosis.However,blocking the CD40-CD40L pathway can prevent atherosclerosis or prevent the plaques from progressing.CD40L may participate in thrombosis and activation of platelet.The soluble CD40L levels increase persistently in patients with acute cerebral infarction and acute coronary syndrome.Some drugs may down-regulate CD40L level.It has provided a new approach for preventing the occurrence of vascular events.

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

Background and purpose:Drug-resistance is the main obstacle in terms of efficacy of chemotherapy for leukemia, RNA interference(RNAi) strategy possesses the characteristics of specilization, high-efficiency and low-toxicity, and can effectively and specifically inhibit the overexpression of given gene. This study was designed to investigate the effect of small interfering RNA (siRNA) on expression of mdr1 gene and drug-resistance in multidrug-resistant human leukemia K562/ADM cell.Methods:Human multidrug-resistant leukemia cell line K562/ADM over-expressing mdr1 gene was used as the target cells, Two siRNAs (si-mdr1-1 and si-mdr1-2) targeted mdr1 gene were chemically synthesized and transfected into K562/ADM cells. Expression of mdr1 mRNA was determined by RT-PCR, P-glycoprotein (P-gp) expression was measured using flow cytometry (FCM), and the sensitivity of K562/ADM cells to adriamycin was assessed with a MTT colorimetric assay.Results:Two siRNAs (si-mdr1-1 and si-mdr1-2) specially designed in this study could markedly down-regulate the expression of mdr1 mRNA and its product P-gp in K562/ADM cells. After cells transfected with si-mdr1-1 or si-mdr1-2 for 24h and 48h, the inhibition of mdr1 mRNA expression in the cells for si-mdr1-1 was 55.5% and 22.5%; and for si-mdr1-2, 16.0% and 57.6%, respectively. Treated with siRNA for 72h, the expression intensity of P-gp in the two transfected cell lines decreased 74% and 85%, respectively. Both si-mdr1-1 and si-mdr1-2 significantly enhanced the sensitivity of K562/ADM cells to adriamycin and reversed their drug-resistance, the reversal efficiency was 2.52-folds and 1.96-folds, respectively.Conclusions:The siRNA could effectively and specifically silence the expression of mdr1 gene and overcome the drug-resistance mediated by P-gp in K562/ADM cells.

Objective The role of long non-coding RNA Linc00467 in human lung adenocarcinoma is not yet clear.This study was to investigate the expression of long non-coding RNA Linc00467 in human lung adenocarcinoma, its clinical significance, and the effects of Linc00467 on the functions of the tumor and endothelial cells in vitro.Methods Lung adenocarcinoma tissue and normal tissue surrounding the malignance were obtained from 60 patients with pathologically proved stage I-Ⅲa lung adenocarcinoma.Human umbilical vein endothelial cells (HUVECs) were transfected with the over-expressed plasmid pccl-Linc00467 (HUVEC experimental group) or the empty vector pccl (HUVEC control group), A549 cells with Linc00467-siRNA (A549 experimental group) or negative siRNA (A549 control group), and H1299 cells, too, with Linc00467-siRNA (H1299 experimental group) or negative siRNA (H1299 control group).The expression level of Linc00467 in the lung adenocarcinoma tissue was detected by qRT-PCR with an analysis of its correlation with the clinicopathological characteristics of the patients;the influence of Linc00467 on the proliferation of the A549, H1299 and HUVEC cells was assayed with CCK-8;and the role of Linc00467 in the angiogenesis of the HUVECs was assessed by fibrin bead sprouting assay.Results The expression of Linc00467 in the lung adenocarcinoma tissue was 2.72±1.31 times as high as that in the normal lung tissue (P<0.01), and those in the A549 and H1299 cells were 3.45±0.25 and 3.22±0.33 times as high as those in the human bronchial epithelial (HBE) cells (P<0.01).The expression level of Linc00467 was significantly correlated with the tumor size and vascular invasion (P<0.05).After transfection of Linc00467-siRNA, the expressions of Linc00467 in the A549 and H1299 experimental groups were down-regulated by 72% and 68% as compared with those in the A549 and H1299 control groups (P<0.01).The number of living cells was remarkably decreased in the A549 experimental group in comparison with the A549 control at 48 h (1.29±0.07 vs 1.51±0.09), 72 h (1.53±0.15 vs 2.13±0.11), and 96 h after culturing (1.98±0.18 vs 3.02±0.12), and so was it in the H1299 experimental versus the H1299 control group, but markedly increased in the HUVEC experimental versus the HUVEC control group (P<0.05).At 5 days, HUVEC experimental group, as compared with the HUVEC control, showed a significantly increased number of newly formed vascular branches (7.36 vs 4.25/superbead, P<0.01) and relative length of the blood vessels (3.12 vs 1, P<0.01).Conclusion Linc00467 promotes tumor cell proliferation and angiogenesis and is highly expressed in the lung adenocarcinoma tissue, which is correlated with the tumor size and vascular invasion and suggests that Linc00467 could be a potential biomarker and therapeutic target.

Objective To explore the therapeutic effect and safety of high-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy on malignant seroperitoneum of advanced gastric carcinoma.Methods Fifty-two advanced gastric carcinoma patients with malignant seroperitoneum were divided into observation group and control group.Twenty-five patients in observation group were received DDP 60 mg/m2 combined with 5-Fu 600 mg/m2 and IL-2 3 000 000 U intraperitoneal perfusion chemotherapy,as well as oral S-1 of 40mg bid on day 1-14 of every 21 days for a total of two or three cycles.High-frequency diathermic therapy was administered thirty minutes after intraperitoneal perfusion chemotherapy,twice a week for 3 weeks.Twenty-seven patients in control group were treated with S-1 and intraperitoneal perfusion chemotherapy only.Results In observation group,4 patients were CR,15 patients were PR,5 patients were SD,1 patient was PD,and the response rate (CR+PR) was 76 ％.In control group,3 patients were CR,14 patients were PR,7 patients were SD,3 patients were PD,and the response rate (CR+ PR) was 63 ％ (P ＞ 0.05).Median survial time for observation group was 10.0 months,8.0 months for control group (P ＞ 0.05).Karnofsky scores after treatment in observation group was higher than that in control group,patients' clinical benefit rate were 80.0 ％ (20/25) and 51.9 ％ (14/27).The difference in life quality between the two groups was statistically significant (P ＜ 0.05).There was no significant difference in adverse reactions between the two groups (x2 =4.544,P =0.033).Conclusion High-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy for advanced gastric carcinoma with malignant seroperitoneum has good short-term curative effects and security,and this method should be further studied.

Objective To investigate the distribution of high-arsenic drinking water in Honghu city of Hubei province in order to provide a scientific basis for prevention and control of endemic arsenic disease.Methods Investigations were made in 22 townships(towns,districts),68 natural villages of the drainage areas of the Dongjing River,the Neijing River and the Yangtse River in 2006 and 2007,with the townships(towns,districts)around Shahu town in Xiantao city as the focal point.1000 water samples were drawn each year,which was 10% of all the wells in every natural village.Using sampling investigation,water arsenic Was determined by half-quantitative fast reagent kit.All samples of water with arsenic exceeding the standard(≥0.03 mg/L)were re-determined according to state standard.Surveys on the disease was carried out in the villages(brigades)where arsenic exceeded the standard.Results A total of 2000 samples were surveyed from 68 natural villages,of which there were 401 samples from 48 villages exceeding the standard in a rate of 20.05%(401/2000).The highest arsenic content Was 0.71 mg/L.The high arsenic water sources were distributed mainy in the drainage areas of the Dongjing River and the Neijing River,but no patients with endemic arsenic disease were found.Conclusions The high arsenic water sources are distributed mainly in the drainage areas of the Dongjing River and the Neijing River.It is suggested that the interrelated government departments should take precise measures to impmve the quality of drinking water and ensure safe water to the residents in high arsenic areas.

Objective:To construct a DNA vaccine co-expressing the HBV compound multi-epitope antigen gene, the hIL-12 and the anti-HBV siRNA genes, and to express this DNA vaccine in HepG2 cells. Methods:The HBV multi-epitope antigen gene was designed and synthesized before it was fused with enhanced green fluorescent protein(EGFP) gene, and cloned into the multi-clone site(MCS) of the eukaryotic expression vector pVAX1. The expressinig units of hIL-12 and siRNA were cloned into the BspH I and Mlu I site of pVAX1 respectively. Then the recombinant plasmid pVAX1-siHBV-HB-EGFP-hIL12 was transiently transfected HepG2 cells. The expression of HBV compound multi-epitope gene was observed through EGFP report gene. The expression of hIL-12 was analyzed by ELISA and the effects of anti-HBV siRNA was confirmed with rtPCR . Results: The analysis of enzyme digestion and sequencing both demonstrated that the trible-expressing HBV DNA vaccine has been constructed successfully. The green fluorescent image was detected in the transfected cells which could confirm the expression of the multi-epitope antigen gene. The amount of hIL-12 secretion was 1289pg/ml in supernatant at 48h after transfection and 1712pg/ml at 72h after transfection. The mRNA amount of HBV S gene, which was the siRNA target, had been obviously knockdown. Conclusion: The DNA vaccine co-expressing the HBV compound multi-epitope antigen gene, the hIL-12 and the siRNA genes was constructed and transiently expressed in HepG2 cells, and siRNA had shown us a good anti-HBV effect. It laid a foundation of further study on anti-HBV effect of the new DNA vaccine.