AIM: To investigate the application of atomic force microscope (AFM) in clinic diagnosis. METHODS: Topographic images and some parameters of large range field and microstructures of erythrocytes in the blood of normal subjects, lung cancer and myelodisplastic syndrome (MDS) patients were examined by atomic force microscope. RESULTS: Many clear topographic images of many erythrocytes, single erythrocyte, and microstructure of erythrocyte membrane surface were obtained. Many erythrocytes in lung cancer patients were found to change into echinocytes. One erythrocyte had 10-20 protuberances, most of which, with a mean width of 589.0 nm and a length of 646.7 nm, were on the edge of cells. The protuberances on the center of echinocytes are lodged and embedded. The erythrocytes of MDS patients were biconcave in shape. Many apertures with different diameters of tens to hundreds nanometer appeared on the surface of cell membrane. CONCLUSIONS: AFM can be widely applied in clinic pathological inspection, including quantification of cells, obtainment and comparison of many parameters (such as diameter, thickness, volume, surface, surface area/volume ratio), observation of topograph of single cell, and observation and comparison of membrane surface microstructure of cells, and so on.

BACKGROUND:For distal clavicle fracture, clavicular hook plate and Kirschner wire tension band were used in the clinic, but they cannot keep the dual function of stability and functional protection. However, the application of microporous locking plate of distal clavicle makes it possible to double efficacy. OBJECTIVE:To compare and analyze the clinical outcomes of distal clavicle microporous locking plate and clavicular hook plate. METHODS:From March 2011 to March 2013, 40 patients with distal clavicle fractures were involved in this study. They were divided into two groups with the voluntary principles:distal clavicle microporous locking plate group and clavicular hook plate group. We compared and observed perioperative indicators (operation time, blood loss, and hospitalization days), clinical curative effects (University of California at Los Angeles scoring system and American Shoulder and Elbow Surgeons Scale), the score of shoulder joint function (Karlsson standard) and the overal treatment (removed the plate and functional training costs). RESULTS AND CONCLUSION:Al patients successful y underwent surgery. At 1 year after surgery, internal fixators were taken out. Necessary relevant rehabilitation training was performed for more than 3 months. There was no significant difference in perioperative indicators (P>0.05). However, clinical curative effects and the score of Karlsson shoulder joint function showed significant advantages in the microporous locking plate group (P<0.05). Although the distal clavicle microporous locking plate material cost was high, but there was no significant statistic difference in the overal treatment for better protection shoulder function (P>0.05). We draw the conclusion that distal clavicle microporous locking plate can effectively reconstruct the stability of the fracture site, and better retain the function of the joints at the same time.

AIM: We tested the hypothesis that marrow s tr omal cells (MSCs), when implanted into self-myocardium, can undergo milieu-depen dent differentiation, express cardiomyogenic phenotypes and enhance angiogenesis and cardiac function of ischemic hearts in vivo. METHODS: In order to achieve a safe and persistent effect, we ex plored the potential of autologous MSCs transplantation. One week after myo cardial infarction induced by occlusion of left anterior descending artery, auto logous MSCs labeled with BrdU (bromodeoxyuridine) in vitro was administered intramyocardially into the infarct area of the same donor rabbits. RESULTS: By 1 months, transplanted MSCs demonstrated to be myoge nic differentiation with the expression of ?-sarcomeric actin (5C5). MSCs impla ntation significantly increased vascular density in the infarct zone and resulte d in markedly improved the left ventricular contractility. CONCLUSION: The finding indicates that autologous MSCs transplan tation may represent a promising therapeutic strategy with free of ethical conce rns and immune rejection.

Rheumatoid arthritis(RA) is very common in immune rheumatism, with high disease incidence and long course, hard to cure. The medicines and bio-preparation used in treating RA in modern medicine are difficult to spread and for long application owing to their unsatisfactory effect or much toxic or side effects. However, the acupuncture has definite effect without side effects. As the unique therapy in acupuncture field—abdominal acupuncture, can it bear the task of treating RA The article makes analysis and discussion on its availability.

Objective To study the relationships between hepatocellular carcinoma (HCC) and the polymorphisms,promoter methylation,and expression of glutathione S-transferases P1 gene (GST) P1 gene.Methods Using methylation-special PCR (MSP),the methylated status of CpG islands of GSTP1 gene in tumor tissues of 53 HCC and its adjacent nontumor tissues were studied.The enzyme activities of GSTP1 were evaluated by ultraviolet colormetry.And using PCR-RFLP,the genetic polymorphisms of the GSTP1 genes of 74 healthy controls and 53 HCC patients were studied.Results The diffe-rences of the frequency of GSTP1 Ile/Ile,Ile/Val and Val/Val genotypes between HCC patients and the normal controls did not reach statistical significance (X~2=0.84,v=2,P=0.656).The frequency of methyla- tion of CpG islands of GSTP1 gene was significantly higher among the HCC tumor tissues when com- pared to the corresponding nontumor tissues (X~2=19.08,P＜0.001),and significantly higher in stageⅢ-Ⅳcases when compared to the stageⅠ-Ⅱcases (X~2=4.84,P=0.028).GSTP1 enzyme activities of cytoplasm in tumor cells were lower significantly than that in the adjacent nontumor tissues (t=2.49, P=0.014),and significantly higher in stageⅠ-Ⅱcases when compared to the stageⅢ-Ⅳcases (t= 2.31,P=0.025).On the other hand,the GSTP1 enzyme activities of cytoplasm in tumor cells with methylated status of GSTP1 gene were significantly lower than that in tumor cells with unmethylation (t=3.50,P=0.001).Conclusion GSTP1 inactivation via CpG island hypermethylation may contrib- ute to the pathogenesis of HCC.

Objective To investigate the effects of rapamycin on renal tissue and function of rats with protein overload nephropathy and to explore the protective mechanism of losartan. Methods Experimental rat models with protein overload nephropathy, induced by intraperiotoneal injection of BSA (2. 0 g/d)into female Wistar rats, were divided into three groups: control group, rapamycin group(injected intraperitoneally with rapamycin) and losartan group(injected intraperitoneally with rapamycin and given orally with losartan). At different time points, the quantity of 24-hour urine protein and renal function were measured, and the morphologic changes of renal tissues were evaluated by HE staining and electron microscope. Results Both at day 7 and day 14, rats received BSA developed intense proteinuria. At day 7, compared with control group, 24-hour proteinuria increased markedly in rapamyein group (P<0.05). Nevertheless,proteinufia was notably alleviated in losartan group (P<0.05). At day 14, 24-hour-urine protein of rapamycin group was also significantly higher than that of the losartan group (P<0.05), but therewas no significant difference between control group and losartan group (P>0.05). Proteinuria and intratubular albumin cast formation were alleviated notably in losartan group. The fusion of focal podocytes in rapamycin group was obvious in comparison with control group. Conclusions Rapamycin can agrravate proteinuria in rats with protein overload nephropathy through changing the barrier of glomerular filtration by damaging podocytes. Furthermore, losartan can alleviate severe proteinuria induced by rapamycin.

Objective To evaluate the early therapeutic effect of flail chest with pulmonary contusion by using different mode of mechanical ventilation. Methods Twenty-nine patients of flail chest with pulmonary contusion were analysed retrospectively. All the patients were treated with the ventilator Bear1000. Two groups were established: invasion group was treated with SIMV+PEEP(8 cases) and CPAP+PSV (7 cases), noninvasion group was treated with NIPPV(14 cases). Results There was no death in all the patients. CPAP+PSV was more effective than SIMV+PEEP not only in decreasing breath rate and improving hypoxemia but also in decreasing peak inspiratory pressure(P

Objective To explore the factors influencing pneumococcal vaccination uptake among the el-derly people in Guangzhou. Methods A survey by questionnaire was performed among 827 subjects aged 60 years or above and living in Guangzhou for five consecutive years. Chi-square test and multiple logistic regression analysis were applied to identify factors influencing pneumococcal vaccination uptake among the elderly. Results The positive factors for vaccination uptake among the elderly people included age of over 70 years (OR=1.677, 95%CI: 1.156 ~ 2.434), mental workers (OR = 1.837, 95%CI: 1.214 ~ 2.779), education background of over-three-year-course training (OR=1.769, 95%CI:1.039~3.012), and history of chronic diseases (OR=1.659, 95%CI:1.096~2.512) were positively associated with pneumococcal vaccination uptake. Monthly disposable income was not an influencing factor (OR=1.420, 95%CI: 0.895 ~ 2.251). Conclusion Strengthened publicity of pneumo-coccal vaccination among the elderly people and flexible measures tailored to the needs of different groups are rec-ommended in order to improve pneumococcal vaccination uptake among the elderly people.

Objective · To explore whether stiffness parameter β could help carotid intima-media thickness (IMT) to predict ischemic stroke.Methods · Ninety-nine patients with acute ischemic stroke and transient ischemic attacks were retrospectively evaluated by routine ultrasound and divided into increased IMT group and normal IMT group. The normal IMT group cases were further divided into 30~ 39 years, 40 ~ 49 years, 50 ~ 59 years and ≥ 60 years groups, and were compared with healthy crowd respectively. Results · ① The common carotid artery wall β of both increased IMT group and normal IMT group were significantly higher than healthy crowd (each P=0.000). ② Further analysis showed that β of ≥ 60 years group were significantly higher than healthy crowd (left side P=0.047, right side P=0.007); while the difference was not found across younger age groups (30 ~ 39 years,40 ~ 49 years and 50 ~ 59 years). Conclusion · Stiffness parameter β may help carotid intima-media IMT to predict ischemic stroke in high risk subjects≥ 60 years old without morphology changes.

Objective To investigate the correlation between the deletion of exon 13 of hMSH2 mRNA in peripheral blood leu-kocyte and ISV12(-6) T>C polymorphism with sporadic colorectal cancer .Methods Total RNA and genomic DNA were extracted from peripheral blood of colorectal cancer patients and healthy controls .RT-PCR and PCR were used to amplified the mRNA and exon 13 of hMSH2 gene .The sequences of amplified hMSH2 cDNA ,ISV12(-6) T>C polymorphism and exon 13 sequence were confirmed by DNA sequencing .Results 23 of 23 (100% ) patients and 31 of 35 controls (88 .6% ,P>0 .05) were found to have an hMSH2 truncated transcript caused by a deletion of exon 13 .No deletions of exon 13 in hMSH2 gene were identified in genomic DNA .16 of 23 patients (69 .5% ) and 19 of 35 control (52 .3% ,P>0 .05) were found to have the T >C transition six bases up-stream of exon 13 of hMSH2 .Conclusion Deletion of hMSH2 mRNA exon 13 in peripheral blood leukocyte and the ISV12(-6) T>C polymorphism are common variants in population and have no correlation with sporadic colorectal cancer .The variant of splice site ISV12(-6)T>C is not a reason causing the deletion of hMSH2 mRNA exon 13 .