Objective To study the classification, management and outcome of the fracture of ulna coronoid process. Methods Retrospective analysis was carried out in 31 patients with fracture of ulna coronoid process. There were 19 males and 12 females with an average age of 29.8 years old (range, 18-52 years old). The fractures of ulna coronoid process were classified into 4 major groups based on the condition of the injury of ulna coronoid process, the anterior bundle of the ulnar collateral ligaments(UCL) and the elbow stability. The fracture of coronoid process within half of the height was defined as type Ⅰ. The half of coronoid process fracture with the injury of UCL was defined as type Ⅱ. The base of coronoid process fracture with the dislocation of elbow joint was defined as type Ⅲ, sometimes with the injury of UCL. The severe comminute fracture of coronoid process with elbow instability was defined as type Ⅳ. There were 11 cases in typeⅠ, 9 typeⅡ, 6 type Ⅲ and 5 type Ⅳ in our group. According to the type of injury we choose correlative treatment. Results The follow-up was 18-72 months(average 28.6 months). All the patients got fracture union, and without inflammation, neural injuries and elbow instability. 1 type Ⅲ and 2 type Ⅳ had traumatic osteoarthritis, and 2 type Ⅲ and 2 type Ⅳ occurred heterotopic ossification. There was a statistical significance when the motion range of two-side joints was compared in type Ⅳ. Conclusion We choose conservative treatment in the fracture of typeⅠ. But if the piece of bone affected motion of elbow joint, we can choose operative treatment, and elbow stability is not affected. The fracture of type Ⅱ and type Ⅲ with elbow instability should be reduced internal fixation and the ligament must be repaired or reconstructed. In cases of type Ⅳ, bone reconstruction is necessary to recover of elbow stability. Proper post-operative rehabilitation can decrease the rate of traumatic osteoarthritis.

Lung adenocarcinoma is usually thought to follow a linear multistep progression schema,that is precancerous lesions progress to adenocarcinoma in situ,and progress to micro-invasive adenocarcinoma,eventually some lung adenocarcinoma happen diffusion.However,recent findings reveal that this linear progression schema might not occur in all lung adenocarcinoma subtypes,and some subtypes show a kind of non-linear progression schema.The study of these two kinds of schemas can help for early detection of lung adenocarcinoma.

To compare the chemical change of Paeoniae Radix Alba (PRA) after vinegar-baking processing, as well as the effect of vinegar types exerted on the processing, 1H NMR-based metabolomic approach combined with multivariate statistical analysis was used to investigate the different metabolites between the raw and two vinegar-baked PRA. More than thirty metabolites were identified in the 1H NMR spectrum of PRA, and the multivariate statistical analysis showed that raw and two vinegar-baked PRA could be separated obviously. After vinegar-baking, the contents of isoleucine, lactate, alanine, arginine, albiflorin, and 5-hydroxymethyl furfural (5-HMF) elevated, while those of sucrose, paeoniflorin and its analogues (calculated by benzoate) decreased. The chemical compositions of two vinegar-baked PRA were also different. Shanxi vinegar- baked PRA showed higher levels of leucine, isoleucine, valine, and albiflorin, while rice vinegar-baked PRA contained more sucrose and paeoniflorin's analogues (calculated by benzoate). And the chemical changes in Shanxi vinegar-baked PRA were greater than those of rice vinegar-baked PRA. The results revealed the chemical differences between raw and vinegar-baked PRA, as well as the influence of vinegar type on processing, in a holistic manner, the results obtained suggested that the correlations between the chemical change and the drug action after processing, as well as the vinegar type used in processing, should be further studied.

Water soluble extract (WSE) is an important index for the quality evaluation of Astragali Radix (AR). In this study, the WSE of the wild AR from Shanxi province (SX) and the cultivated AR from Gansu Province (GS) were compared. The WSEs of two types of AR were determined according to the appendix of Chinese pharmacopoeia. Then the WSEs were subjected to NMR analysis, and the obtained data were analyzed using HCA, PCA, OPLS-DA, microarray analysis, and Spearman rank analysis. In addition, the Pearson correlation of differential metabolites were also calculated. The results showed that the WSE content of GS-AR (37.80%) was higher than that of SX-AR (32.13%). The main constituent of WSE was sucrose, and other 18 compounds, including amino acids, organic acids, were also detected. Multivariate analysis revealed that SX-AR contained more choline, succinic acid, citric acid, glutamate, taurine and aspartate, while GS samples contained more sucrose, arginine and fumaric acid. In addition, the Pearson correlations between different metabolites of the two types of AR also showed apparent differences. The results suggested that the WSE of two types of AR differs not only in the content, but also in the chemical compositions. Thus, the cultivation way is important to the quality ofAR. This study supplied a new method for the comparison of extract of herbal drugs.

Objective:To observe the effect of electroacupuncture at Baihui and Dazhui on cognitive function of vascular dementia rats and explore its possible mechanism. Methods:Male Sprague-Dawley rats were randomly divided into the sham operation group, model group and electroacupuncture group, with 10 rats in each group. Rats in the model group and the electroacupuncture group were made as vascular dementia models by carotid artery ligation of the two sides. After 2 weeks of modeling, the electroacupuncture group received electroacupuncture at Baihui and Dazhui for 4 weeks. Before and after the intervention, take the novel object recognition behavior test to detect the 1, 24 h new object preference coefficient; and use magnetic resonance spectroscopy to scan the levels of NAA/Cr and Cho/Cr neurometabolites in the hippocampus. q-PCR was used to detect the expression of caspase-3 and Bax in apoptotic cells. Immunohistochemistry was used to detect synapsin SYN expression. Results:Compared with the model group, the preference coefficient of new object of the electroacupuncture group at 1 h [(69.85 ± 11.26)% vs. (50.26 ± 8.85)%] and 24 h [(60.85 ± 11.86)% vs. (43.26 ± 10.25)%] significantly decreased ( P<0.01). The content of NAA/Cr (1.344 ± 0.149 vs. 0.892 ± 0.178) significantly increased ( P<0.01), and the content of Cho/Cr (0.661 ± 0.142 vs. 0.902 ± 0.178) in the hippocampus significantly decreased ( P<0.01). The expression of hippocampus caspase-3 (1.342 ± 0.041 vs. 2.437 ± 0.089), Bax (2.135 ± 0.083 vs. 4.358 ± 0.137) significantly decreased ( P<0.01), and the expression of SYN (0.577 ± 0.035 vs. 0.315 ± 0.025) significantly increased ( P<0.01). Conclusion:Electroacupuncture at Baihui and Dazhui can effectively improve the cognitive dysfunction of rats with vascular dementia, which may be related to the improvement of neuronal metabolites NAA, Cho content and inhibition of neuronal apoptosis and improvement of neuronal touch function.

1H NMR metabonomics approach was used to reveal the chemical difference of urine between patients with Xiao-Chaihu Tang syndrome (XCHTS) and healthy participants (HP). The partial least square method was used to establish a model to distinguish the patients with Xiao-Chaihu-Tang syndrome from the healthy controls. Thirty-four endogenous metabolites were identified in the 1H NMR spectrum, and orthogonal partial least squares discriminant analysis showed the urine of patients with Xiao-Chaihu Tang syndrome and healthy participants could be separated clearly. It is indicated that the metabolic profiling of patients with Xiao-Chaihu Tang syndrome was changed obviously. Fifteen metabolites were found by S-pot of OPLS-DA and VIP value. The contents of leucine, formic acid, glycine, hippuric acid and uracil increased in the urine of patients, while threonine, 2-hydroxyisobutyrate, acetamide, 2-oxoglutarate, citric acid, dimethylamine, malonic acid, betaine, trimethylamine oxide, phenylacetyl glycine, and uridine decreased. These metabolites involve the intestinal microbial balance, energy metabolism and amino acid metabolism pathways, which is related with the major symptom of Xiao-Chaihu Tang syndrome. The patients with Xiao-Chaihu Tang syndrome could be identified and predicted correctly using the established partial least squares model. This study could be served as the basis for the accurate diagnostic and reasonable administration of Xiao-Chaihu-Tang syndrome.

ObjectiveTo compare the therapeutic effects of a new surgical endoscopic technique, the transilluminated powered phlebectomy (TriVex System, Smith+Nephew) and pointed phlebectomy in the treatment of varicosis of the great saphenous vein of the lower limbs. Methods Thirty-nine patients (46 limbs) received TriVex operations under spinal, or epidural anesthesia. The powered vein resector and an irrigated illuminator device-a minimally invasive system was used for varicose vein surgery. During the same period, 41 patients (46 limbs) underwent pointed phlebectomy. Results The average postoperative hospital stay was 4.6 days in patients receiving TriVex, and 8.1 days for pointed phlebectomy. Compared with the pointed phlebectomy, the incision of TriVex procedure was shorter and the number less. Conclusion This new surgical device is easy to operate, minimally invasive, efficacious and time saving with satisfactory results.

12E7 Antigen ; Adolescent ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Diagnosis, Differential ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Lymph Node Excision ; Lymphatic Metastasis ; Lymphoma ; metabolism ; pathology ; Male ; Neoplastic Cells, Circulating ; Nephrectomy ; Neuroblastoma ; metabolism ; pathology ; Neuroectodermal Tumors, Primitive, Peripheral ; metabolism ; pathology ; surgery ; Synaptophysin ; metabolism ; Venae Cavae ; pathology ; Vimentin ; metabolism ; Wilms Tumor ; metabolism ; pathology

Objective To compare various risk factors of bipolar disorders with and without suicidal behavior. Methods A total of 5452 inpatients were divided into 2 groups; with (n=1739)and without (n=3713) suicidal behavior within 1 week. Socio-demographic and clinical data were compared between two groups. Multiple logistic regression models were used to assess risk factors of bipolar disorders with suicidal behavior. Results Compared to without suicidal behavior group, the suicidal behavior group had significantly higher rate of the following characteristics:older age [34.8±13.6 vs. 33.3±12.8, t=-3.46, P<0.01], female (58.3％vs. 52.7％,χ2=14.83, P<0.01), history of mental trauma (10.6％vs.7.8％,χ2=10.72, P<0.01), history of suicide (4.1％vs. 0.1％,χ2=140.11, P<0.01), family history of suicide (6.7％vs. 3.9％,χ2=20.22, P<0.01), family history of mental illness (33.8％vs. 29.6％,χ2=9.33, P<0.01) and history of suicide (4.1％ vs. 0.1％, χ2=140.11, P<0.01). Logistic regression analysis showed that female (OR: 1.192, 95％CI:1.043-1.363), older age (OR: 1.008, 95％CI: 1.003-1.013), history of mental trauma (OR: 1.355, 95％CI:1.083-1.696), history of suicide (OR:39.139, 95％CI:12.230-125.256) and family history of suicide (OR:1.648, 95％CI: 1.223-2.221) were significantly correlated with suicidal behavior in bipolar disorders. Conclusions The study indicates that female, older age, history of mental trauma, history of suicide and family history of suicide may be the key independent risk factors to suicidal behavior in bipolar disorders.

Background and purpose. Gastric stromal tumor (GST) is the most common mesenchymal tumor of the gastrointestinal tract and most often arises in the stomach. In the past, surgery was the only effective treatment. The diagnosis and treatment of GST has been revolutionized over the past, since expression of the receptor tyrosine kinase KIT (CD117) was shown to occur on these tumors, the outcome of GST treatment has dramatically been improved. This study focused on the therapeutic experience of GST and analyzed the pathological features and prognostic factors of GST in our center. Methods: All the 26 cases underwent surgical resection and three of them were treated over 6 months with imatinib 400 mg/d. The clinical pathological and follow-up data of 26 patients with GST admitted in our hospital between Jan. 2000 and Dec. 2008 were analyzed retrospectively. Results. All the cases underwent curative resections, including palliative liver resection in 3 patients with liver metastasis. Recurrence occured on 6 patients, including 1 case with low risk group, 1 case with intermediate risk group, 4 cases with high risk group. Tumor size ranged from 2 to 15 cm with the mean of 5.5 cm. The immunohistochemistry results revealed that the positive rates of CD117, CD34 and Vimentin were 92.3%, 80.8% and 96.2% respectively. After operation, three patients accepted imatinib mesylate therapy over 6 months. Two of them were alive, but one had liver metastasis. The follow-up period ranged from 4 to 36 months (median: 28 months). Four cases were lost. The 1-, 3-year overall survival rates of 26 cases were 96.2% and 84.6%. Conclusion: Tumor size, location, mitosis and immunohistochemical data are important variables to evaluate GST behavior and prognosis. Surgical resection is the main therapy for GST and targeted therapy will improve the prognosis.