Objective To compare the clinical efficacy of intramedullary pin versus plate fixation for displaced mid-shaft clavicle fractures.Methods The databases,PubMed,CENTAL and CBM,were searched according to the standards of the Cochrane Collaboration for all the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) comparing intramedullary pin with plate fixation for treatment of displaced mid-shaft clavicle fractures.In addition,hand search was also conducted in relevant journals.Time limit for search was from the beginning till December 2013.Trial quality was assessed using the modified Jadad scale and effective data were pooled for Meta analysis with software RevMan5.2.7,including wound infection,hospital stay,wound size,intraoperative blood loss,operation duration,implant irritation,implant problems,delayed union,malunion,nonunion,total complications and Constant scoring.Results Three RCTs and 7 CCTs with 697 patients were included in our study.The modified Jadad scoring showed fine quality of the 10 trials.Intramedullary fixation was significantly superior to plate fixation in wound size,intraoperative blood loss,operation duration,hospital stay,wound infection,and symptomatic hardware (P ＜ 0.05),but led to a significantly higher rate of implant problems (P ＜ 0.05).However,no significant differences were identified in total complication rate,delayed union,nonunion,malunion or Constant score (P ＞ 0.05).Conclusions The superiority of intramedullary fixation for displaced mid-shaft clavicle fracture lies in its advantages of minimally invasion,such as limited incision,less intraoperative bleeding,shorter operation time and hospital stay,less wound infection and implant irritation.Ahhough intramedullary fixation may lead to a higher rate of implant problems,it shows no significant differences from plate fixation in bone healing and functional recovery.

To study the clinical significance of combined measurement of neuron specific enolase(NSE), carcinoembryonic antigen(CEA) and Cytokeratin19 fragment 21 1 (CYFRA 21 1 ) in the diagnosis of lung cancer. The serum levels of CEA, NSE, and CYFRA 21 1 in 75 lung cancer patients as well as in 22 benign pulmonary diseases patients were measured by radioimmunoassay. Patients with pulmonary adenocarcinoma had a highest CEA level. Small cell lung carcinoma (SCLC) patients had a highest NSE level, while patients with squamous cell carcinoma of lung had a highest CYFRA 21 1 level. The positive rate of the combination of CEA, NSE, and CYFRA 21 1 for lung cancers was 82 67%. The results suggested that the combined measurement of CEA, NSE, and CYFRA 21 1 was helpful in the diagnosis of lung cancer.

Objective To discuss fluvastatin intervention on ventricular remodeling and plasma brain natri-uretic peptide( BNP) levels in dilated cardiomyopathy( DCM) .Methods 64 cases of DCM patients were selected and randomly divided into the intervention group and control group,each group in 32 cases.Both groups were treated with conventional drug therapy, including angiotensin-converting enzyme inhibitors,β-blockers, diuretics, etc.In conven-tional drug treatment intervention group based on the use of fluvastatin 40mg/d.Intervention in both groups before and 6 months after the intervention,plasma BNP levels were examined and ventricular remodeling indicators,analyzed and compared using Pearson Univariate correlation of each index.Results The total efficiency of the intervention group was higher than that of the control group(87.51%vs 65.63%,χ2 =4.730,P<0.05);6 months after the interven-tion groups,plasma BNP levels were significantly decreased left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD) and relative wall thickness(RWT) were significantly improvements.BNP levels and LVEF and RWT was negatively correlated( r=-0.45,-0.39,all P<0.05);Positively correlated with LVESD and LVEDD showed(r=0.35,0.44,all P<0.05),the difference was statistically significant.Conclusion Fluvastatin intervention can significantly reduce plasma BNP levels in DCM and improve ventricular remodeling.

Objective To investigate the distribution of interstitial Cajal-like cells(ICLC) in ampulla and the myoelectric activities of the sphincter of Oddi(SO) of adult guinea-pigs.Methods C-Kit immunohistochemical staining was carried out on whole-mount preparations of guinea-pigs' ampulla region.The myoelectric activities of SO were recorded by using the contact electrode on mucosa.Result C-Kit-positive ICLC were observed in both exterior and inner wall of ampulla.Some of these cells were distributed in the circular and longitudinal smooth muscle cell(SMC) layers assuming a spindle-like shape.Another sub-group of ICLC,which were located between the longitudinal and circular SMC layers,were shown to have oval or triangle cell bodies with projection of more than three long processes.These cells interlaced into a cellular network,closely resembling the interstitial cells of Cajal(ICCs),around the myenteric nervous plexus(ICC-MY) in the duodenum.At the inner side of circular SMC layer of the exterior wall,ICLC were similar to ICCs associated with the deep muscular plexus(ICC-DMP) of small intestine.In the inner wall of the ampulla,a large amount of ICLC were found in the SMC layers or bundles,running parallel with them.At the opening of the ampulla,a number of ICLC surrounded the opening to form a ring.The spontaneous rhythmic myoelectric activities could be recorded in the SO.Conclusion It is suggested that the ICLC might contribute to the regulation of the spontaneous rhythmic contraction,and it might be related to development of motility disorders of the SO.

Objective To assess the outcomes of modified spiral ileal orthotopic neobladder.Methods From January 1998 to January 2008, 32 patients (all male) underwent radical cystectomy and spiral ileal orthotopic substitution for muscle invasive bladder cancer. A segment of 40 to 45 cm ileal loop was isolated, detubularized, and reconfigured in spiral shape to form a pouch. Bilateral ureters were reimplanted by inserting the 1 cm distal segment into the pouch to form a Split-Cuff nipple.The bottom of the pouch was opened and anastomosed with the urethra (4 stitches). Results There were no perioperative deaths. The mean operative time was 281.2±48.7 min. Blood loss was 545.4±181.9 ml. Twenty cases required a blood transfusion, the mean volume of intraoprative blood transfusion was 430.8±235.9 ml. The average hospital stays were 26.8±9. 7 days. Rate of daytime continence was 93. 7% (30/32) while nighttime continence was 81.3% (26/32). Urodynamic studies were carried out in 23 cases 6 months after surgery. Neobladder capacity at first desire to urinate was 315.0± 33.4 ml(270-420 ml). The maximum neobladder capacity was 490. 3±39.7 ml(350-600 ml).The maximum flow rate (Qmax) was 16.5 ± 5.9 ml/s. Full resting pressure was 22. 5 ± 11.8 cm H2O. Peak voiding pressure was 78.3 ± 14.7 cm H2O. After mean 58. 4 months' follow up (range 22 to 132), 4 cases died of metastasis of bladder cancer. Conclusion Modified spiral ileal orthotopic neobladder is a reasonable option for treating invasive bladder cancer.

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

Objective To investigate the characteristic of the cisplatin-induced damage of hair cells in cochlear organotypic cultures. Methods Three to four-day-old (P3～4) C57 mice were used for this study. The cochlear basilar membrane was cultured for 6~8 hours and then treated with different doses of cisplatin(0?mol/L, 10?mol/L, 50?mol/L, 100?mol/L, 400?mol/L, 1000?mol/L,7 cochlears for 0-100?mol/L group, 6 cochlears for the rest dosage, control group used the dose of 0?mol/L)for 48 hours.TRITC-phalloidin and DAPI were used for stain. The entire cochlear hair cells were observed and counted under Nicon fluorescent microscope. Data was analyzed by LS for hair cells loss graph and SAS 8.0 for linear regression analysis. Results Hair cells loss had rarely been seen in the control group of cochlear tissue under the culture condition. How ever, in cisplatin treated groups, the hair cells loss increased from 14.5% to 78.4% with the concentration of cisplatin increased in the range of 10?mol/L-100?mol/L, while decreased from 48.8% down to 8.77% with the dose getting further higher to 400?mol/L and 1000?mol/L. Apoptosis was confirmed by the DAPI stain in the hair cells loss area. The hair cell loss shows no difference from the apex to the basal turn of the basilar membrane. Conclusion Cisplatin-induced hair cell death shows characteristic damage that it is dose-dependent in a certain range of dosage, and it decreases when the cisplatin dose higher than the one caus maximal damage under the condition of cochlear organotypic cutures. Apoptosis happens evenly in inner and outer hair cells in all turns of basilar membrane.

Osteomyelitis (OM) is still a major problem for orthopedists. Numerous studies have shown that genetic factors may play an important role in the pathogenesis of OM. As a third generation genetic marker, single nucleotide polymorphisms (SNPs) have received increasing attention from scholars who are studying genetic susceptibility to OM. In-depth research on the SNPs of susceptibility genes will help to explore new strategies for prevention, diagnosis and treatment of OM. This article reviews the research advances concerning gene SNPs and OM susceptibility.

BACKGROUND: Early clinical researches suggest that mediodespidine capsule can decrease blood pressure of patients with primary hypertension on the basis of yanggan qinggan pinggan technique.OBJECTIVE: To observe the effect of mediodespidine capsule on primary hypertension and angiotensin Ⅱ (Ang- Ⅱ ) of patients in the types of yin deficiency, yang excess and liver fire.DESIGN: Randomized controlled case observation.SETTING: Department of Cardiology, First Affiliated Hospital, Hunan University of Traditional Chinese Medicine.PARTICIPANTS: Patients were selected from the Inpatient Department and Out-patients Clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between April 1999 and April 2000. Inclusion criteria: Patients, who were diagnosed with the criteria of primary hypertension, who belonged to the types of yin deficiency, yang excess and liver fire, who could endure this test, who were coincidence with the criteria of mental-stress test, were all consent. Exclusion criteria: Patients who had severe congestive heart failure, atrophic arthritis and unable tolerance were excluded. There were 60 cases in total, including 29 males and 31females. All patients were divided into mediodespidine group and verapamil group with 30 in each group on the basis of randomly digital table.METHODS: Patients who had positive results of awaken mental-stress test were involved in this study. Cases in mediodespidine group were treated with mediodespidine capsule, which was made of tall gastrodia tuber, spine date seed and fourstamen stephania root at the dosage of 0.43 g/pill and were provided by the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (wei yao ji zi: 05-047, batch number: 990503), five pills each for 3 times a day. Cases in verapamil group were treatedwith verapamil (40 mg/pill, Shanghai Huanghe Liya PharmaceuticalCompany Limited,batch number: 980301B) 80 mg each for 3 times a day. The course in both groups was 4 weeks. ① Effect of blood pressure: Average value of blood pressure tested for 3 successive days were regarded as the blood pressure before treatment, and average value of blood pressure tested for 3 times after treatment was regarded as the blood pressure after treatment. ② Effect of symptom:Scores were recorded as four levels according to main symptoms, such as vertigo, headache, pain and weakness of waist and knees, before and after treatment. ③ Values of Ang- Ⅱ were measured with radioimmunoassay before and after cold pressor test. Effect on Ang- Ⅱ was evaluated with effect of decompression, effect of clinical symptom and criteria of clinical effect.MAIN OUTCOME MEARUSES: Clinical symptoms, values of blood pressure, heart rate and Ang- Ⅱ before and after cold pressor test.RESULTS: A total of 60 patients with primary hypertension were involved into the final analysis.① Totally effective rate of clinical symptoms of patients in mediodespidine group was higher than that of patients in verapamil group, but the effect of decompression was not significant between the two groups (P ＞ 0.05). ② There was remarkably significant difference of heart rate in both groups before and after treatment (P ＜ 0.01), especially the decrease in verapamil group was great, and there was significant difference (P ＜ 0.05). ③ Values of systolic pressure and diastolic pressure were decreased in both groups after cold pressor test (P ＜ 0.01), but there was no significant difference between the two groups (P ＞ 0.05). ④ There was no significant difference in clinical effect between the twogroups (P ＞ 0.05).⑤ After treatment, concentration of Ang- Ⅱ at basic level in both groups was decreased, and there was significant difference between them (P ＜ 0.01);concentration of Aug-Ⅱ was decreased in both groups after cold pressor test as compared with that before treatment, but there was no significant difference between them (P ＞ 0.05).CONCLUSION: Mediodespidine capsule can decrease blood pressure stably, and the effect is stronger than that of verapamil at the aspect of decompression and improving symptoms. Blood pressure of patients with primary hypertension in the types of yin deficiency and yang excess or liver fire can be decreased by decreasing the level of plasma Ang-Ⅱ to a certain degree.

Objective To observe the clinical curative effect of cinobufacini injection in the treatment of primary bronchopulmonary carcinoma.Methods 120 patients with primary bronchopulmonary carcinoma were randomly divided into the control group and treatment group,60 cases in each group.Patients of the control group were treated with the general,symptomatic and dialectical therapy.Patients of the treatment group were given general,symptomatic,dialectical treatment and cinobufacini injection.The curative effect was determined by the standard efficacy of tumor,the survival quality of the patients was judged by the Karnofsky score.The adverse reactions,median survival time and the survival rate were compared between the two groups.Results The effective rate of the control group was 40.0％,that of the treatment group was 56.7％,the difference was statistically significant (x2 =4.034,P ＜ 0.05).By the Karnofsky score,27 patients of the control group were stable,39 patients of the treatment group were stable,the difference was statistically significant(x2 =12.265,P ＜0.05).Median survival time of the control group was (168 ± 16) d,that of the treatment group was (178 ± 20)d,the difference was statistically significant(x2 =12.265,P ＜ 0.05).One year survival rates of the control group and the treatment group were 5.0％,10.0％,the difference was statistically significant.There was no statistically significant difference between two groups in adverse reactions (P ＞ 0.05).Conclusion Cinobufacini injection can improve the quality of life and prolong survival of patients with primary bronchopulmonary carcinoma.It is effective and safe in clinical application.