Objective The purpose of this study was to evaluate the relationship between the initial X-ray display and prognosis of intracapsular fractures of the proximal humerus, and to probe a new criterion which can accurately predict the prognosis of the fracture. Methods Between April 1999 and February 2004, 459 cases of intracapsular fractures of the proximal humerus were treated conservatively, among which 211 cases had completed at least 9 months of follow-up and their complete data were available(mean age, 54.2 years; minimum, 17 years; maximum, 81 years; 82 males, 129 females), all the patients were followed up for 1.7 years on the average (ranging from 9 months to 3 years). According to the original X-ray, the fractures were classified by Neer classification. There were 68 cases of one part fractures, 39 cases of two parts fractures, 59 cases of three parts fractures and 45 cases of four parts fractures. The original X-ray and that of at least 9 months postoperatively of every case were assessed by seven structured standards and studied the relationship between the standards and prognosis. The seven standards are listed as follow: Neer classification; the length of the medial side of proximal humerus; displacement between humeral head and shaft; displacement of greater tuberculosis relative to shaft; displacement of medial cortex in fracture site; glenohumeral dislocation and humeral head split. Results 79% of the cases with a length of the medial side of proximal metaphyseal less than 8 mm, and 84% case with medial cortex displacement over 2 mm and 68% of Neer four-part fractures have a poor prognosis. The prognostic significance of predictors were listed as follow: the medial cortex displacement more than 2 mm (accuracy, 0.85), the length of the medial proximal metaphyseal less than 8 mm (accuracy, 0.83), Neer four-part fractures (accuracy, 0.76), Neer three-part fractures (accuracy, 0.72), glenohumeral dislocation (accuracy, 0.64), head-split components (accuracy, 0.64), displa-cement of the head more than 10 mm (accuracy, 0.54). Conclusion The new criterion provides a precise pr-ognosis prediction for intracapsular fractures of the proximal humerus thus it may be helpful in selecting a proper procedure.

OBJECTIVE:To determine the median effective dose (ED50) of propofol with single intravenous injection in alcohol dependence or withdrawal model rats,and to observe the anaesthetic effect of 2-fold ED50 propofol. METHODS:Fifty SD rats were divided into drinking group(n＝23)and control group(n＝27)based on whether the consumption of alcohol was greater than 3.0 g/(kg·d). Drinking group continued to drink freely and intermittently to establish alcohol dependence model. Control group was only given drinking water for ethanol elution 16 rats were randomly selected from each group to determine ED50 of propofol with single intravenous injection by sequential method,and initial dose was 6.02 mg/kg. After eluting for a week,alcohol dependence rats stopped drinking for 24 hours and had alcohol withdrawal symptoms to establish alcohol withdrawal model. ED50 of propofol in alcohol withdrawal group and control group were determined with same method. After eluting for a week,anaesthetic effect [disappearance time and reappearance time of forepaw righting reflex(FRR),time of activity complete recovery] of 2-fold ED50 propofol with single intravenous injection were observed in alcohol dependence group,alcohol withdrawal group and control group,and corresponding time point and the frequency of respiration before administration were also observed. Changes of liver function indexes(serum albumin,alanine transaminase,total bilirubin,γ glutamyl transaminopeptidase)and liver histomorphology were observed 48 h after medication,10 in each group. RESULTS:ED50 of propofol in alcohol dependence model rats was 9.563 mg/kg,which was higher than 5.623 mg/kg of control group. ED50 of propofol in alcohol withdrawal model rats was 4.086 mg/kg,which was lower than 5.297 mg/kg of control group. Compared with control group,reappearance time of FRR was prolonged significantly in alcohol dependence group and alcohol withdrawal group (P＜0.05). There was no statistical significance in disappearance time of FRR or activity complete recovery time (P＞0.05). The frequency of respiration during FRR disappearance was lower than before propofol injection,FRR reappearance and activity complete recovery (P＜0.01). After intravenous injection of 2-fold ED50 propofol,reappearance time of FRR in alcohol dependence group and alcohol withdrawal group were longer than control group(P＜0.05)；the alcohol dependence group was longer than the alcohol withdrawal group(P＜0.05).The time of activity complete recovery in alcohol dependence group was longer than control group and alcohol withdrawal group (P＜0.05). The frequency of respiration in 3 groups during FRR disappearance were all lower than before propofol injection,FRR reappearance and activity complete recovery(P＜0.01). There was no significant difference in the change of liver function indexes or liver histomorphology. CONCLUSIONS:ED50 of propofol is increased in alcohol dependence rats,while ED50 of propofol is decreased in alcohol withdrawal rats. 2-fold ED50 of propofol has no significant toxicity to liver function.

Objective: To explore the genetic basis of a pedigree affected with hereditary spherocytosis. Methods: Peripheral blood samples were collected from 17 members of the pedigree. Genomic DNA of the proband was subjected to next generation sequencing. Candidate variant was validated by co-segregation analysis. pCAS2^{c.5798+ 1G} and pCAS2^{c.5798+ 1A} plasmids were constructed by homologous recombination and transfected into 293T cells. Reverse transcription PCR, TA cloning and Sanger sequencing were used to analyze the effect of candidate variant on splicing. Meanwhile, peripheral blood RNAs were extracted to analyze the effect of candidate variant on splicing in vivo. Results: The proband was found to carry a c. 5798+ 1G>A variant of the SPTB gene. The variant has co-segregated with the phenotype in the pedigree. In vitro and in vivo splicing experiments confirmed that the mutation has significantly affected the splicing, resulting in shift of reading frame and produced a premature termination codon. Conclusion The novel c. 5798+ 1G>A variant of the SPTB gene probably underlies the pathogenesis of hereditary spherocytosis in this pedigree.