[Objective]To explore the indications and operative techniques for comminuted fracture of proximal humerus. [Method] Twelve patients with fracture of proximal humerus were chosen, observation was made after locking proximal humerus plate fixation with anterior acromioplasty. [Result]The average follow-up period were 12 months (6～24months). All patients' fracture in surgery group had been union and all shoulder had good functions. No incidence of avascular necrosis and nonunion was found. [Conclusion]Rigid fixation of displaced comminuted fractures of proximal humerus with anterior acromioplasty is a simple and effective technique to prevent subacromial impingement syndrome after surgery. Precise osteotomy and early postoperative exercises are the key to success.

Objective To observe the findings of 1H magnetic resonance spectroscopy ( 1H MRS) and explore its value for diagnosis of radiation induced-temporal lobe necrosis in nasopharyngeal carcinoma (NPC). Methods Thirteen patients with definite clinical diagnosis of radiation induced temporal lobe necrosis in NPC underwent 1H MRS. All 1H MRS examinations were performed on a Singa Horizont 1.5 T whole body MR system with point resolved spectroscopy (PRESS) and chemical-shift selective saturation (CHESS) (TR=2000?ms,TE=144 ?ms). The voxel (2?cm ? 2?cm ? 2?cm) was positioned in both of the lesion and the contralateral side of the temporal lobe as the control (except for bilateral lesions). 2THZ]Results The interval between radiation and the examination ranged from 32 to 172 months ( median, 42 months). Eighteen lesions were observed in 13 patients (5 patients with bilateral lesions). 1H MRS was performed on 17 lesions and 8 control temporal lobes. The mean values of NAA/ Cr in the lesions and the control temporal lobes were 1.33?0.28、1.78?0.34 respectively(t=3.22, P=0.005). Three lesions showed NAA、Cho and Cr peak absent (2 lesions with Lip peak ). Among 8 patients with the control temporal lobes 1H MRS examined, Cho/Cr decreased in 6 patients (75%). Four lesions showed Lip , Lac and MI, respectively. Conclusions The radiation-induced temporal lobe necrosis shows abnormal features on 1H MRS. Significant decrease of NAA/ Cr as well as Cho/Cr are observed in most patients. 1H MRS may play a role in the diagnosis of radiation induced temporal lobe necrosis.

AIM: To provide experimental evidence for gene therapy of thrombophilia disease, we constructed the eukaryotic expression plasmid with human thrombomodulin (hTM) gene and observed the alteration of hTM expression on the surface of human umbilical vein endothelial cells (HUVECs) with and without the reconstructive plasmid. METHODS: The whole expressive fragment of hTM gene was amplified by PCR from human genome. Both hTM gene and pcDNA3.1(+)/neo empty vector was digested by HindⅢ and EcoRⅠ. Two digested fragments were ligated into pcDNA3.1/hTM with T_4DNA ligase. After identifying, the reconstructive plasmid transfected into HUVECs using lipofectin. The hTM antigen on the HUVECs was detected by immunohistochemistry. RESULTS: The hTM reconstructive plasmid was confirmed by double endonuclease redigesting and sequencing. About 10% HUVECs were transfected by pcDNA3.1/hTM plasmid with lipofectin and the high-level hTM was detected on the transfected cells. CONCLUSION: We constructed the pcDNA3.1/hTM plasmid successfully, and it could be expressed on the HUVECs. [

Objective The nursing staff's output and journals distribution of core scientific journals papers were analyzed, providing evaluation data and a decisive basis for scientific research management. Methods A retrospective analysis was performed to the publication of core journals papers of nursing staff in 2013-2015 based on the publication from different nursing positions , the ranking of published nursing papers from different departments and different journals by using analysis method of bibliometric. Results About 1550 nursing papers were published , of which the number of authors whose paper was published in core journals was 216 , the number of papers published in core journals was 378, and 38 authors published more than 3 papers (17.6%). The core journals papers published rate in different position was statistically significant (P<0.01). The papers published journals were concentrated in nursing class. Dominated the first 3 places in the list of core journals paper number of departments were department of nursing , cancer center and operation room, respectively. Conclusion In order to improve the nursing scientific research level of nursing staff, it is necessary to establish a theoretical system of scientific knowledge training , formulate a long-term effective mechanism in paper management , focus on scientific research talent introduction and training and mobilize the nursing research enthusiasm of nursing staff.

Objective To analysis the human T lymphotropic virus (HTLV) infection status in Wenzhou among voluntaty blood donors.Methods Selected 72 417 voluntary blood donors of Wenzhou from from March,1,2016,to November,30,2016,to screen HTLV-Ⅰ / Ⅱ antibody by ELISA method.The positive samples were reexamined two times,two test results of samples were determined positive by ELISA.HTLV positive samples was confiemed by Western Blotting (WB).Results Screened 23 cases of anti-HTLV positive by ELISA method,then confirmed 9 cases of HTLV positive by Western Blotting (WB).HTLV infection rate of Wenzhou blood donors was 0.01％ (9/72 417).Conclusions HTLV infection was found among volunteer blood donors in Wenzhou,but the HTLV infection rate of volunteer blood donors in Wenzhou is still at a relatively low level.

Objective To retrospectively analyze whether the kyphosis exists after removal of the internal fixators for thoracolumabar vertebrae fractures. Methods A total of 18 patients (35-68 years old) with thoracolumabar vertebrae fractures (T11-L2 ) were fixed with short segment pedical screw. The fixators were removed one year postoperatively to observe the changes of the Cobb' s angle and trauma vertebra'height. Results All the patients were followed up for 6-24 months ( average 18.7 months),which showed no intraoperative or postoperative complication, breakage or loosening of the screws. Compared to the Cobb angle and the vertebra height before removal of the internal fixators, the average loss of the Cobb angle was 0.7° and that of the vertebra height was 0.8 mm six months after removal of the fixators, 1.9° and 1.1 mm respectively one year after removal of the fixators, and 2.4° and 1.3 mm respectively two years after removal of the fixators in 16 patients without osteoporosis (P ＞0. 05). Among two patients with osteoporosis, the average loss of the Cobb angle and the vertebra height was 6° and 8°respectively and 3 mm and 5 mm respectively six months after removal of the fixators; 13° and 17° respectively and 5 mm and 7 mm respectively one year after removal of the fixators; 15° and 19° respectively and 6 mm and 7.5 mm two years after removal of the fixators. Conclusions After the internal fixation for thoracolumbar vertebrae burst fractures, kyphosis develops mildly, with insignificant change of the vertebral height. While the kyphosis becomes worse after removal of the fixators for thoracolumbar vertebrae burst fractures in patients with osteoporosis.

Objective To investigate the virus-carrying rate of non-polio enteroviruses ( NPEV) in patients with acute flaccid paralysis ( AFP) in Yunnan province of China in 2015 and to analyze the genetic characteristics of enterovirus 71 (EV71) strains. Methods A total of 213 cases under 15 years old with AFP were reported by Center for Disease Control and Prevention ( CDC) of Yunnan Province of China. Virus isolation was conducted for all samples and the serotypes of isolated NPEV strains were identified by VP1 se-quencing. The isolation rates of NPEV in the past consecutive 5 years were analyzed by SPSS22. 0 software. Phylogenetic trees of NPEV and EV71 strains were constructed by MEGA6. 06 software based on neighbor-joining algorithm and Kimura 2-parameter substitution model and the reliability of the phylogenetic trees was determined by bootstrap analysis with 100 pseudo replicate datasets. Results Altogether, 23 NPEV strains were isolated from 213 AFP cases. Among the 23 strains, 7 strains belonged to EV-A group (2 serotypes, 6 strains of which were EV71 ) , 14 strains belonged to EV-B group ( 8 serotypes ) and the other 2 strains belonged to EV-C group. No NPEV strains of EV-D group were identified. Statistical analysis showed that no significant differences in the isolation rates were observed in the past 5 years ( P=0. 101 ) . Conclusion The isolation rate of NPEV in patients with AFP in Yunnan province in 2015 was similar to that of the previ-ous years. The EV71 strains of C4 subgenotype were the predominant strains circulating in Yunnan province.

Objective To analyze the clinical features of infants infected by respiratory syncytial virus (RSV) or human rhinovirus (HRV) in lower respiratory tract in Suzhou area based on the month age and the month of the year.Methods From January 2013 to December 2015,2 206 nasopharyngeal aspirates specimens were collected from the infants with lower respiratory tract infection.Direct immunofluorescence assay was performed to test RSV.Reverse transcription-polymerase chain reaction(RT-PCR) method was used to test HRV.The medical history was collected and pulmonary function tests were performed in some infants who were infected with RSV and HRV.Results In 2 206 cases,total RSV positive rate was 19.90％ (439/2 206 cases) and simple RSV infection positive was detected in 399 cases.Total HRV positive rate was 14.14％ (312/2 206 cases),in which simple HRV infection positive was detected in 250 cases and the detection rate of RSV was significantly higher than that of HRV(x2 =25.88,P ＜0.05).The incidence rate of wheezing in simple RSV infection was 68.17％ (272/399 cases),which was significantly higher than that of simple HRV infection (42.80％,107/250 cases) (x2 =11.174,P ＜ 0.05).RSV infection was frequent from November to February of the next year in which the detection rate in December was highest with the proportion of 50.00％ (99/198 cases) while the rate in June was only 0.57％ (1/175 cases).The detection rate of HRV was 22.86％ (40/175 cases),20.47％ (35/171 cases) and 20.33％ (25/123 cases) in June,July and September respectively.The detection rate of HRV was lower during December to February of the next year.In January,the detection rate was only 4.68％ (11/235 cases),which was the lowest in the whole year.The detection rates of RSV were 33.33％ (4/12 cases),25.21％ (118/468 cases),23.46％ (84/358 cases) and 23.81％ (60/252 cases) in the age group of 28 d-1 month,＞ 1-2 month,＞ 2-3 month and ＞ 3-4 months respectively.Up to the age of 4 months old,the detection rate decreased gradually,and with the increase of age and the detection rate in ＞ 7-8 month group was only 10.96％ (16/146 cases).The detection rate of HRV was 0 (0/12)and 9.40％ (44/468 cases) in the age group of 28 d1 month,＞ 1-2 month,respectively.After 2 months age old,the detection rate fluctuation ranged from 13.22％ to 16.67％.The incidence rate of severe RSV infection was 12.30％ (54/439 cases) and the incidence rate of severe HRV infection was 5.13％ (16/312 cases).Increased respiratory rate was more common in patients with severe RSV infection while severe HRV infection in infants were accompanied by multiple lobar involvement.After RSV infection,the incidence rate of pulmonary function damage was 89.03％ (276/310 cases).After HRV infection,89.27％ (183/205 cases)of the infants suffered from pulmonary function damage.Both RSV and HRV infection might cause pulmonary function damage.Conclusions RSV and HRV are the major pathogens in infants of Suzhou areas.The incidence of RSV-induced wheezing is significantly higher than that of HRV.RSV is detected positive mainly in winter and early spring and the infants within 4-month old are susceptible population.HRV is detected positive mainly in June,July and September and the infants older than 2 months are susceptible population.The incidence of severe RSV infection is significantly higher than that of HRV.Severe RSV infection may cause increased respiratory rate and severe HRV infection mainly cause multiple lobar involvement.RSV and HRV infection may cause pulmonary function damage.

Objective To investigate the therapeutic effects of anti-B7-H3 blocking monoclonal antibody(McAb) in a murine model of neutrophilic asthma. Methods Twenty-four female BALB/c mice were randomly divided into four groups: PBS control group (group A), neutrophilic asthma group (group B),anti-B7-H3 McAb group (group C) and IgG isotype control group (group D). Those in group A were sensitized by injection of PBS and challenged with PBS through inhalation,while the other mice were sensi-tized by injection of ovalbumin (OVA) plus airway instillation of lipopolysaccharide(LPS),and then chal-lenged with OVA. Moreover,mice in group C and group D were respectively injected with anti-B7-H3 McAb and IgG isotype control in the induction period. Each mouse′s performance was observed. Samples of bron-choalveolar lavage fluid (BALF) and lung tissues were collected. Total and differential cell counts in BALF were determined by using microscope. Levels of cytokines including IFN-γ,IL-4,IL-6,IL-17,tumor nec-rosis factor-α (TNF-α) and granulocyte colony stimulating factor (G-CSF) in BALF were measured by ELISA. Lung sections were stained with hematoxylin and eosin (HE) and periodic acid-Schiff (PAS) to identify tissue inflammation and mucus production,respectively. Immunohistochemistry was used to measure the expression of B7-H3 in frozen mouse lung sections. Results Mice in group B and group D showed asth-matic symptoms such as breathlessness,dysphoria and incontinence after nebulization,while these symptoms in group C were alleviated due to anti-B7-H3 McAb treatment. No abnormalities were observed in group A. Compared with group A,the other three groups showed increased total cell count in BALF and higher per-centages of neutrophil and eosinophil(P<0.05). These three indicators in group C were lower than those in group B and group D (P<0.05). With regard to lung infiltration by Th1,Th2 and Th17 cells,the levels of IFN-γ,IL-4,IL-6,IL-17,TNF-α and G-CSF in BALF were increased in group B,group C and group D as compared with those in group A. Compared with group C,group B and group D showed higher levels of IL-6, TNF-α,IL-17 and G-CSF(P<0.05),but lower level of IL-4(P<0.05). No statistical difference in the level of IFN-γ was observed among group B, group C and group D. Histological staining of lung sections showed that no obvious inflammatory cells and mucus secretion was observed in group A. Massive infiltration of inflammatory cells and neutrophils and mucus hypersecretion were detected in group B and group D. Treatment with anti-B7-H3 McAb inhibited the accumulation of neutrophils and mucus hypersecretion in lung tissues of group C. Compared with group A, levels of B7-H3-positive cells were significantly increased in group B and group D. Anti-B7-H3-treated mice showed reduced levels of B7-H3-positive cells in lung tissues as compared with those in group B and group D(P<0.05). Conclusion Treatment with anti-B7-H3 bloc-king McAb in an early stage can relieve the asthmatic syndrome, reduce airway inflammatory cells, inhibit mucus production and down-regulate Th17 cell-related cytokine secretion,which helps to alleviate airway and systematic inflammation in mice with NA,and partially inhibit the development of NA.

Objective: Through a retrospective analysis of serology and nucleic acid screening data of unpaid blood donors in south Zhejiang region, the role of nucleic acid detection in the reduction of transfusion-related infectious diseases was discussed. Methods: 179 369 unpaid blood donation in south Zhejiong province from Jan, 2016 to Dec, 2016 was chosen. Enzyme linked immunosorbent (ELISA) test for blood index of infectious hepatitis B virus surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), human immunodeficiency virus antigen and antibody. At the same time the roche, haoyuan nucleic acid detection system were used for HBV-DNA, HCV-RNA, HIV-RNA in 6 or 8 doses mix samples three projects joint detection.NAT results of the serum with negative results in the serological tests were made statisticala analysis. Results: A total of 259 ELISA-/NAT+ samples were detected, HBV-DNA+ 255 cases, HCV-RNA+ 5 cases, one case of HBV-DNA and HCV-RNA + , with a positive rate of 0.14%. The analysis system of roche nucleic acid mix inspection rate of positive was 1.40%, and the split inspection rate of positive was 60.72%. The mix inspection positive rate of the haoyuan analysis system was 1.63%, and the split inspection rate of positive was 41.67%. Conclusions The detection of nucleic acid can make up the deficiency of serological test, and effectively reduce the leakage of transfusion-related infectious diseases, and ensuring the blood safety in this area.