Objective To compare the therapeutic effect between Kirschner wire- loop plating and clavicular hook plate in the treatment of distal clavicle fractures. Methods Forty- two patients with type Neer Ⅱ distal clavicle fracture were selected, among whom 23 patients were treated with Kirschner wire- loop plating (group A), and 19 patients were treated with clavicular hook plate (group B). The operative time, fluoroscopy time, length of incision, intra- operative bleeding volume and hospitalization time etc were recorded. The patients were followed up at 6 weeks, 3 months, 6 months and 12 months after operation. The American shoulder and elbow society (ASES) score was evaluated, and the therapeutic effect was evaluated by Karlsson standard. Results The operative time and fluoroscopy time in group B were significantly lower than those in group A: (63.5 ± 12.4) min vs. (71.5 ± 11.1) min and (3.6 ± 1.9) s vs. (4.8 ± 1.5) s, but the intra- operative bleeding volume, length of incision and cases of postoperative shoulder pain in group A were significantly lower than those in group B:(91.5 ± 18.5) ml vs. (108.7 ± 32.5) ml, (6.6 ± 0.7) cm vs. (11.3 ± 0.9) cm and 2 cases vs. 14 cases, and there were statistical differences (P<0.05 or <0.01). There was no statistical difference in hospitalization time between 2 groups (P>0.05). There was no statistical difference in ASES score at 6 weeks and 3 months after operation between 2 groups (P>0.05); but the ASES score at 6 and 12 months in group A was significantly higher than that in group B: (89.9 ± 12.6) scores vs. (79.7 ± 12.6) scores and (96.1 ± 4.8) scores vs. (86.1 ± 12.4) scores, and there was statistical difference (P<0.05 or <0.01). There was no statistical difference in the cases of good and excellent at 6 weeks, 3 months and 6 months after operation (P>0.05);but the cases of good and excellent at 12 months in group A was significantly more than that in group B:23 cases vs. 13 cases, and there was statistical difference (P<0.05). Conclusions Kirschner wire- loop plating provides a new treatment option for type Neer Ⅱ distal clavicle fractures. It is conducive to decrease the incidence of shoulder pain and improve the range of motion of should joint. Besides, this technology has advantage of small incision, relatively simple operation steps and small damage to the surrounding soft tissues of the acromioclavicular joint. It may be superior to the clavicular hook plate.

Objective To explore the association between blood cadmium levels (BCLs) and clinicopathological characteristics of patients with breast cancer.Methods The clinicopathological characteristics and blood specimens of 186 patients diagnosed with breast cancer were collected between July and December 2009.BCLs were detected by graphite-furnace atomizer absorption spectrophotometer.Mann-Whitney U test and Kruskal-Wallis H test were used to compare the BCLs of patients with different clinical characteristics.Spearman rank correlation analysis was used to evaluate the relationships between BCLs and some indices of clinical characteristics.Results The BCLs was 2.280 (1.579) μg/L.The BCLs were significantly different in patients with different age and body mass index (BMI) (Z =-2.075,P =0.038;x2 =7.429,P =0.023).Also,there were significant differences in different T stages (x2 =10.137,P =0.017),M stages (Z =-2.225,P =0.026),clinical stages (x2 =16.060,P =0.001) and human epidermal growth factor receptor-2 (HER-2) status (Z=-2.072,P=0.038).Excepting for age (r =0.126,P =0.066),BCLs were positively associated with BMI,T stage,M stage,clinical stage and HER-2 status (r=0.159,P =0.030;r =0.171,P=0.020;r =0.166,P =0.044;r=0.154,P =0.040;r =0.152,P =0.038).Conclusion The BCLs are associated with some clinicopathological characteristics of breast cancer,and high blood cadmium burden may promote the development of breast cancer.

Aim To investigate the pharmacodynamic experiment and molecular mechanisms of a diterpenoid from cortex pseudolaricis, pseudolaric acid B ( PB ) , on immunoregulation. Methods The mouse models of contact hypersensitivity ( CHS) were induced by 2,4-dinitrofluorobenzene ( DNFB ) . Then , the ear swelling and spleen index were measured after administered o-rally with PB. The pathological changes such as in-flammatory cell infiltration in ear skin were observed by hematoxylin and eosin ( HE ) staining. Besides, the expression of peroxisome proliferater-activated receptorγ ( PPARγ) and the phosphorylation of Akt were ana-lyzed by Western blot. The activity of PPARγ was fur-ther detected by luciferase reporter gene assay. Results The results showed that PB could both alleviate the ear thickness, inhibit the spleen index, and reduce the inflammatory degree of their ear skin, which might be involved in inducing PPARγexpression and activation, associated with suppressing Akt signaling pathway. Conclusion It is suggested that PB might regulate PPARγ-related Akt pathway, which indicates the pos-sibility of developing PB as a novel immunoregulation agent for treating inflammatory-immune disease.

Objective To compare the clinical efficacy of different treatments for injuries of medial collateral ligament (MCL) Ⅲgrade and anterior cruciate ligament (ACL). Methods Forty-six patients with MCLⅢgrade and ACL injuries admitted to Dalian Central Hospital from June 2013 to April 2017 were retrospectively analyzed, including 28 males and 18 females. Sixteen patients underwent arthroscopic reconstruction of the ACL, and medial collateral ligament was repaired with two anchors simultaneously in 2 weeks (group A); 15 patients were treated with reconstruction of the ACL in 2 weeks, and 4 times extracorporeal shock wave therapies were performed 2 weeks after surgery (group B); 15 patients were treated with reconstruction of the ACL in 2 weeks, and fixed with external fixation (group C). Patients were assessed in 3 months, 6 months and 12 months after surgery, and the Lysholm knee function score, the international knee documentation committee knee evaluation form (IKDC) score and the knee joint range of motion (ROM) were recorded. Results Three months after operation, the levels of Lysholm scores, IKDC scores and ROM in three groups were significantly improved compared with those before operation (P < 0.05). The IKDC scores and Lysholm scores in both group A and group B [IKDC score: (51.8 ± 3.1), (49.7 ± 3.9) scores; Lysholm score: (70.3 ± 3.7), (69.5 ± 3.4) scores] were better than those in group C [(44.5 ± 3.4), (59.3 ± 4.7) scores], and there were significant differences (P<0.05). Six months and 12 months after operation, the IKDC score, Lysholm score and the knee joint ROM in group A were better than those in group B and group C (P<0.05). Conclusions For knee joint MCLⅢgrade combined with ACL injuries, surgical treatment will obtain better functional scores and activity, and the effect of conservative treatment of MCL injury with extracorporeal shock wave therapy is not good.

This study was aimed to develop an HPLC method for simultaneous determination of five active components in Baihu and Guizhi decoction.Simultaneous determination of mangiferin,neomangiferin,glycyrrhizic acid,liquiritin,and cinnamic acid in Baihu and Guizhi decoction were conducted by HPLC-PDA under multiple UV wavelengths.An Waters xBridge BEH C18 Column (4.6 mm × 250 μm,5 μm) was used.The mobile phase was acetonitrile-0.01％ formic acid solution.The flow rate was 1 mL·min-1.The column temperature was kept at 24℃.The detection wavelength was set at 255 nm and 280 nm.The results showed that the linear range of mangiferin,neomangiferin,glycyrrhizic acid,liquiritin,and cinnamic acid was 66-1 976 μg (r =0.999 3),70-3487 μg (r =0.999 7),30-913 μg (r =0.999 5),35-1 734 μg (r =0.999 5),0.6-187 μg (r =0.999 8) in 70 min,respectively.The average recovery was between 95.29％ and 100.17％.It was concluded that the method was convenient,stable,reliable and accurate for simultaneous determination of the five components in Baihu and Guizhi decoction.It provided an evaluation method for the quality control of Baihu and Guizhi decoction and the research o its granules.

Objective:To investigate the characteristics of new mutations of CCM1 gene in a family with familial multiple cerebral cavernous malformation (CCM). Methods:A family with familial multiple CCM diagnosed in our hospital in 2013 and followed up for a long time were selected in our study. Peripheral blood samples and/or pathological tissue samples of some patients and healthy subjects in this family were collected for full exon sequencing of genomic DNA. Combined with the databases of Clin Var, HGMD and ExAC, the possible pathogenic genes in this family were screened by bioinformatics analysis; the three-dimensional structure prediction analysis of protein products was performed and Sanger sequencing was used to verify the pathogenic genes.Results:Whole exon sequencing showed that a novel deletion-frameshift mutation (c.1635delA) in CCM1 gene was noted in these patients, and this mutation leaded to deletion of reference nucleobase "T" ; this deletion had not been reported; while no above mutation was noted in the healthy subjects. Sanger sequencing showed that deletion of nucleobase "A" was noted in 1635 locus, No. 15 exon of CCM1 gene; this deletion would result in changes of CCM1 gene reading frame, which leaded to premature appearance of termination codon TAG at nucleotide of position 1652-1654. Three-dimensional structure prediction analysis showed that this new mutation might lead to the lack of Ferm-3 domain in the C-terminal of KRIT1 protein. Conclusion:The new deletion-frameshift mutation (c.1635delA) of CCM1 gene in this family leads to familial multiple CCM.

Fibrotic remodeling is an adverse consequence of immune response-driven phenotypic modulation of cardiac cells following myocardial infarction (MI). MicroRNA-146b (miR-146b) is an active regulator of immunomodulation, but its function in the cardiac inflammatory cascade and its clinical implication in fibrotic remodeling following MI remain largely unknown. Herein, miR-146b-5p was found to be upregulated in the infarcted myocardium of mice and the serum of myocardial ischemia patients. Gain- and loss-of-function experiments demonstrated that miR-146b-5p was a hypoxia-induced regulator that governed the pro-fibrotic phenotype transition of cardiac cells. Overexpression of miR-146b-5p activated fibroblast proliferation, migration, and fibroblast-to-myofibroblast transition, impaired endothelial cell function and stress survival, and disturbed macrophage paracrine signaling. Interestingly, the opposite effects were observed when miR-146b-5p expression was inhibited. Luciferase assays and rescue studies demonstrated that the miR-146b-5p target genes mediating the above phenotypic modulations included interleukin 1 receptor associated kinase 1 (IRAK1) and carcinoembryonic antigen related cell adhesion molecule 1 (CEACAM1). Local delivery of a miR-146b-5p antagomir significantly reduced fibrosis and cell death, and upregulated capillary and reparative macrophages in the infarcted myocardium to restore cardiac remodeling and function in both mouse and porcine MI models. Local inhibition of miR-146b-5p may represent a novel therapeutic approach to treat cardiac fibrotic remodeling and dysfunction following MI.