Objective To report the result of minimally invasive treatment of scaphoid non-union in soldiers. Methods Twenty-two soldiers 19 to 27 years of age were admitted for the treatment of non-union of fracture of scaphoid bone. The duration of non-union ranged from 11 to 54 months (average 16 months).All the non-union was located at the scaphoid waist, with a gap of 2 to 5 mm (average 2.5mm) as shown by radiological examination. Cyst-like changes occurred in 6 cases and displacement of the sclerotic fracture ends was found in 3 cases. Under local anethesia, a needle was inserted into the site of non-union under X-ray monitor, and 5-10 ml red bone marrow harvested from the iliac crest was injected into the site of non-union. The wrist was immobilized in functional position with elastic bandage or plaster of paris cast after the injection. Radiological follow-up was carried out every one month postoperatively. Bone marrow injection could be repeated 1 month later when necessary. Results Bone union was found in 19 cases 3-15 months (average 6 months ) after the operation. Non-union recurred in 3 patients in whom displacement of the sclerotic fracture ends was found. No complications, such as infection or joint stiffness, occurred. Conclusion Minimally invasive treatment of scaphoid non-union in soldiers can relieve pain, reduce the hospitalization days and cost, and the result is satisfactory.

BACKGROUND:Celastrol is one of the active components extracted from the traditional Chinese medicine Celastrus orbiculatus characterized by expel ing the wind and promoting blood circulation and relieving swel ing and pain.
OBJECTIVE:To investigate the effects of celastrol on tumor necrosis factor-α(TNF-α) induced proliferation and inflammatory responses in RAW264.7 cel s.
METHODS:In vitro inflammatory cel models induced by TNF-α(0, 1, 10, 100μg/L) were treated with celastrol (0.1, 0.5, 1.0, 2.0μmol/L). Interleukin-1β,-6,-8 and prostaglandin E2 in the models were measured by enzyme-linked immunosorbent assay. Cel survival was determined by cel counting kit-8. The inflammatory mediator nitric oxide secretion was detected by nitrate reductase assay. mRNA expressions of inducible nitric oxide synthase, cyclin D1 and cyclin E1 were detected by real-time polymerase chain reaction technique.
RESULTS AND CONCLUSION:Significantly increased secretion of interleukin-1β,-6,-8, prostaglandin E2 and nitric oxide, cel proliferation, and mRNA expressions of inducible nitric oxide synthase, cyclin D1 and cyclin E1 were observed after the induction of TNF-α(0.1, 10, 100μg/L) compared with the control group (without the induction of TNF-α) (P<0.05);especial y, 10μg/L of TNF-αexhibited the strongest effects. 0.4μmol/L celastrol significantly suppressed TNF-α-induced release of interleukin-1β,-6,-8, prostaglandin E2 and nitric oxide, cel proliferation, and mRNA expressions of inducible nitric oxide synthase, cyclin D1 and cyclin E1 in RAW264.7 cel s (P<0. 05). Our results demonstrate that celastrol can inhibit TNF-α-induced inflammatory response and proliferation in RAW264.7 cel s.

In handling crises in hospitals caused by natural disasters like earthquake, systemati cpractical measures of crisis management are needed, which include: early contact with top managements for support in counter disaster supplies, immediate organization of temporary first aid stations by hospital staff, logistic support by full time personnel to solve problems such as drugs and medical equipments as well as food and drinking water, and psychological consultation to patients and staff members.

Objective To retrospectively investigate the disease spectrum of inpatients aged over 65 year and cost constitution in Sichuan Provincial People's Hospital from 2010 to 2014,so as to provide baseline data for further study.Methods The inpatients'disease spectrum and costs were collected from hospital information system.The diseases were classified according to the International Classification of Diseases(ICD-10).The data were analyzed using SPSS 18.0 software.Results The total number of old inpatients was 111,935,and male (55.2 ％) was more than female (44.8 ％).The average age was (74.5 ±6.8)years.The top four systematic diseases of primary diagnosis were circulatory system disease (21.0 ％),respiratory system disease (13.7 ％),digestive system disease (12.7％)and neoplasms (12.1％).The total number of male inpatients was more than the female inpatients.The average cost per capita was increased from (￥)18,778.1 yuan to (￥)23,391.9 yuan since 2010.The proportion of all costs accounted for by drugs in elderly inpatients was decreased from 45.5％ to 38.9％ since 2010.Nosocomial infection was decreased from 3.19％ to 0.16％ since 2010.Conclusions The number of elderly inpatients are more in male than in female in Sichuan Provincial People's Hospital from 2010 to 2014.The most common systematic disease is circulatory system diseases,and followed by respiratory system diseases,digestive system diseases and neoplasms.The proportion of all expenditures accounted for by drugs was declined in five years,while the average cost per capita is increased.

Objective To investigate the effectiveness of femoral troehanter reconstruction and artificial femoral head replacement in treatment of unstable intertrochanterie fractures in the elderly pa- tients. Methods Femoral trochanter reconstruction and artificial femoral head replacement was done on 106 patients with unstable intertrochanterie fractures. There were 45 males and 61 females, at age range of 80-105 years (average 88 years). Most of patients slipt in the room and got fractured. According to the Evans classification, there were 31 patients with type ⅢA fractures, 45 with type ⅢB and 30 with type IV. We used 4 kinds of methods to reconstruct the fracturad imertrochanters : (1) shape of" ∞ " ten- sion band fixation after intertrochanterie fracture reduction;(2) wire loop fixation of the lesser troehanter around proximal femur;(3)defect within the femoral ealear was filled with bone cement and remodeled; (4) for patients with relative intact base of femoral neck, the intertrochanterie fracture was transformed in- to femoral neck fracture and the femoral ealear was fixed with femoral prosthesis stem. Results All the operations continued successfully, with duration of the operation for 45-70 minutes (average 55 minutes). No artificial femoral head dislocation occurred during hospitalization. Of all, 79 patients were followed up for 6-48 months (average 16 months). No Late loosening, dislocation or infections occurred, with total excellence rate of 87.3%. Conclusions For elderly patient with unstable intertrochanterie fractures, reconstruction of femoral intertrochant and artificial femoral head replacement can restore the proximal femoral anatomy, maintain stability of the hip joint and help early functional exeereise, as can reduce ease fatality rate and improve the quality of life.

Objective:To collect the clinical materials of primary liver cancer patients treated by gamma knife and analyze the treatment methods as well as short-term efficacy,and to provide a reference for the clinical treatment of primary liver cancer patients.Methods:A total of 633 patients with inoperable primary liver cancer were treated by body gamma knife.According to the TNM staging method of Union for International Cancer Control(UICC), there were 351 cases with clear TNM staging.Among them, there were 251 cases (71.5%) at T3 stage and 57 cases(16.2%) at T4 stage.The prescription dose of 200-600 cGy each time to the 40%-85% dose line covering the planned target volume(PTV), this program was performed 5 times per week, and the number of treatment ranged from 2 to 13.The biochemical and imaging changes were observed 2-3 months after treatment to evaluate the short-term efficacy.Results:During the treatment, 229(36.2%)patients had adverse reactions,100 (15.8%) patients appeared the reduced white blood cells, and 137 (21.6%) patients appeared the reduced platelets.On discharge from the hospital, 601 patients were improved, 22 patients had no obvious change, 5 cases were worse, and 5 cases died.The proportion of improved patients who received the cumulative dose between 3 000 cGy to 4 000 cGy was higher than those who received the cumulative dose less than 3 000 cGy(P<0.05).After treatment, the curative effects were evaluated in 45 patients during two and three months, including PR 77.8%(35/45) and SD 22.2%(10/45), and the total effective rate was 77.8%(35/45).No statistical differences in effective rates were found between different tumor diameter, single dose, and cumulative dose groups(P>0.05).Conclusion:The proportion of adverse reactions in the primary liver cancer patients treated with body gamma knife is relatively low and the short-term efficacy is ideal.Body gamma knife treatment is a safe and effective treatment method for the primary liver cancer patients.

With the development of modern computing technology and medical physics,radiotherapy has made great progress.The theoretical basis of radiobiology seems to lag behind the clinical application of radiotherapy,which hampers the further improvement of treatment efficacy and the optimization of treatment modality.In this paper,some emerging challenges of precision radiotherapy technology to the traditional theory of radiobiology,such as radiosensitivity,dose-response curve and survival curve,linear-quadratic model,4Rs theory,as well as the interaction between cancer and microenvironment,radiation-induced second primary cancers (RISPC),will be discussed.The interplay between precision radiotherapy and traditional radiobiology theories will be addressed with the aim to potentially solve some of the challenging problems.

To review the literatures on the treatment of COPD combined with anxiety and depression treated by TCM in recent years, which conclude that to treat this kind of disease is usually by taking drugs, as well as non-drug therapy such as traditional Chinese exercises, acupuncture and massage, and music, etc, which could improve patients unhealthy emotions and quality of life. The recent clinical researches on TCM treatment has been increased, but the overall number of the research of this kind is limited, with problems such as small sample size, singular observing indicator, and requiring multi-center research. There still lacks related basic research and needs more attention.

Objective To evaluate the clinical efficacy and safety of stereotactic radiotherapy (SRT) combined with bevacizumab for brain metastases in patients with lung adenocarcinoma.MethodsThe clinical data of 95 patients with brain metastases of lung adenocarcinoma were retrospectively analyzed, including 36 patients treated with SRT and bevacizumab (bevacizumab group) and 59 patients treated with SRT, corticosteroids, and mannitol (traditional drug group).The tumor response rate, peritumoral edema control rate, improvement in Karnofsky Performance Scale (KPS) score, and adverse reactions were analyzed.Results Compared with the traditional drug group, the bevacizumab group had significantly higher tumor response rate (P=0.033) and peritumoral edema control rate (P=0.000) at 1-4 weeks after treatment, as well as an obvious improvement in KPS score and reduced doses of corticosteroids and mannitol.In addition, the adverse reactions in the bevacizumab group were mild and controllable.Conclusions SRT combined with bevacizumab for brain metastases in patients with lung adenocarcinoma can achieve higher short-term tumor response rate and peritumoral edema control rate and improve patients' quality of life.

Objective To explore the mechanism of percutaneous laser disc decompression (PLDD) for treating prolapse of intervertebral disc. Methods 15 rabbits were divided into 3 groups randomly: sham group, model group with PLDD treatment, model group without PLDD treatment. The nerve conduction velocity (NCV) of L6 nerve root and the activity of phospholipase A2 (PLA2) in the intervertebral disc of L5-6 were determined 2 weeks after the initial surgery. Results NCV in the group with PLDD was significantly faster than that in the group without PLDD (P<0.001); NCV in the group without PLDD was significantly lower than that in the sham group (P<0.001). The activity of PLA2 in the group with PLDD was significantly lower than that in the group without PLDD (P<0.001); The activity of PLA2 in the group without PLDD was significantly higher than that in the sham group (P<0.001). Conclusion The activity of PLA2 in the herniated discs is higher than that in normal discs, which result in NCV falls remarkably. The PLDD can reduces chemical factors such as PLA2.