Objective To discuss the clinical efficacy of internal fixation assisted by thoracoscope in treatment of rib fractures.Methods The study enrolled 180 patients with rib fractures associated with thoracic deformity hospitalized from July 2010 to June 2013.Ninety out of the patients were operated on by thoracoscope-assisted internal fixation (operation group),and the remaining 90 fractures were treated non-operatively (non-operation group).Clinical markers recorded were duration of pain,time of ventilator use,hospital length of stay and complications.Patient mental health was measured with self esteem scale (SES).Patient mobility was evaluated at follow-up.Results Between operation and non-operation groups differences were observed in duration of pain [(3.1 ± 1.0)d vs (8.9 ± 1.2) d],time of ventilator use [(3.0 ± 1.0) d vs (4.8 ± 1.0) d] and hospital length of stay [(10.0 ± 1.1) d vs (15.8 ± 1.0) d] (P ＜ 0.01).SES in operation group was (28.3 ± 2.1) versus (24.4 ± 3.3) points in non-operation group (P ＜ 0.01).No major complications occurred in operation group,but there were 20 pleural effusion,15 severe thoracic collapse or deformity,14 lung infection,10 refractory chest pain and 2 upper limb dysfunction in non-operation group (P ＜0.01).Two patients presented mobility limitation in operation group,but 12 had evident loss of mobility in non-operation group (P ＜0.01).Conclusions Thoracoscope-assisted internal fixation is effective to accelerate the pace of recovery,relieve pains,reduce complications and thus can be a priority method for treatment of rib fractures.

Objective:To explore the changes of NK and NKT cells and the expression levels of their activated, inhibitory receptors in the peripheral blood of patients with newly diagnosed rheumatoid arthritis ( RA), and to reveal the potiential role of NK and NKT cells played in the pathogenesis of RA.Methods:32 patients with new onset RA and 15 healthy controls were recruited.Activated and inhibitory NK and NKT cells in peripheral blood were quantified by flow cytometry.The frequency of spontaneous and stimulated IFN-γ+NK and NKT cells and CD107aγ+NK cells were examined.Finally,the potential relationship between the frequency of NK and NKT cells subsets and clinical indexes were analyzed.Results:The frequencies of NK cells in peripheral blood in RA patients were sig-nificantly lower than those in the controls ( P=0.026 ).The frequencies of NKG2D+, NKP46+activated NK cells and NKG2C+, NKG2D+,NKP46+activated NKT cells in RA patients were significantly higher than those in the controls (P=0.011,P=0.010,and P<0.001,P=0.032,P=0.001,respectively),whereas the frequencies of KIR2DL3+,KIR3DL1+and NKG2A+inhibitory NK cells and KIR2DL3+,NKG2A+inhibitory NKT cells in RA patients were significantly lower (P=0.002,P=0.002,P=0.014,and P=0.027,P=0.002,respectively).Moreover, the frequencies of stimulated IFN-γ+NK cells and IFN-γ+NKT cells, spontaneous and stimulated CD107 aγ+NK cells in RA patients were significantly higher than that in the controls ( P=0.037, P=0.004 and P=0.001, P=0.001, respectively).Furthermore,the frequencies of NK cells,NKG2Aγ+and KIR2DL3γ+inhibitory NK cells were correlated significantly with the values of DAS28 in RA patients (r=0.357,P=0.045;r=0.399,P=0.024;r=0.468,P=0.021,respectively).Conclusion:Lower frequencies of NK cells, higher frequencies of activated NK cells and activated NKT cells, lower frequencies of inhibitory NK cells and inhibitory NKT cells, and higher NK cell activity may induce the autoimmune reaction involved in the pathogenesis of RA.

ObjectiveTo investigate the influence factors of operative effect in complex acetabular fracture. MethodsSixty-seven patients with complex acetabular fractures were selected. All patients were used surgical treatment,the clinical curative effect by Merle d'Aubigne-Postel hip scoring function to evaluate,set the age,sex, operation time,operative approach,the quality of fracture reduction,complex dislocation of the hip fracture and type of complex acetabular fractures with comparative index,the results were statistically analyzed. ResultsPatients were followed up for 6-24 months,the mean time was 14.6 months. Univariate analysis showed that the fine efficacy of surgery taken in no more than 2 weeks [84.0％ (42/50)]was better than more than 2 weeks [64.7％ ( 11/17 )](P ＜ 0.05 ). The high-quality of reduction [86.4％ ( 19/22 )]was better than low-quality of reduction [44.4％ (4/9)] (P ＜ 0.01 ). The compare of age,sex,operative approach,complex dislocation of the hip fracture were no statistically different (P ＞0.05).Complex acetabular fractures of T-shaped fracture healing rate was 85.7％ (12/14),the excellent rate was significantly higher than posterior column with posterior wall fractures[77.8％ (7/9)],transverse with posterior wall fractures [75.0％ (15/20)], anterior column with half of transverse fractures [66.7％ (2/3)],double-column fractures[71.4％ (15/21)],the results were statistically different. Conclusion The necessary conditions for ensuring fracture prognosis is the quality of reduction,timing of surgery,and type of fracture.

AIM: To investigate the variation of ?-AR in pulmonary microvascular endothelial cells and variation of GRK2 in lung and to explore the therapeutic effect of methlyprednisolone in severe acute pancreatitis-associated lung injury model in rats.METHODS: 36 rats were divided into three groups randomly: the control group,the experimental group,and the intervention group.In the experimental group,severe acute pancreatitis-associated lung injury model was induced in SD rats by retrograde injection of 5% sodium taurocholate into biliopancreatic duct.In the control group,laparotomy was performed,duodenum and pancreas were flipped only.In the intervention group,methlyprednisolone(30 mg/kg) was injected into rump muscle of rats after model developed.At 6 and 12 h after model was developed,the maximum binding capacity(Bmax) and the Kd value of ?-AR were detected in lung by means of radioactive ligand binding assay.GRK2 expression was detected in lung by means of immunofluorescence.RESULTS: The scores of the severity of pancreatitis and the severity of lung injury in the experimental group were obviously higher than those in control group.In the experimental group,Bmax was obviously lower,Kd and GRK2 were obviously higher than those in control group and the intervention group.CONCLUSION: The ?-AR in lung is lower down and GRK2 expression in lung is up-regulated in severe acute pancreatitis-associated lung injury model in rats.The therapeutic effect of methlyprednisolone to severe acute pancreatitis-associated lung injury is positive.

Aim To investigate the effects of PGF_(2?) upon glucose-stimulated insulin secretion and the calcium response in NIT-1 beta cells.Methods Using the radioimmunoassay(RIA),the amount of PGF_(2?) augmentation of glucose-stimulated insulin secretion was determined in different conditions and the confocal laser scanning methods by Fluo-3AM as a fluorescent probe were used to analyze the NIT-1 beta cell intracellular calcium response in correlated various terms.Results In the presence of 16.5 mmol?L~(-1) glucose,PGF_(2?)(0.1,1,5 ?mol?L~(-1)) dose-dependently augmented glucose-induced insulin secretion in NIT-1 beta cells,especially at 5 ?mol?L~(-1)(P0.05).Meanwhile,Exposure of the NIT-1 cells to 5 ?mol?L~(-1) PGF_(2?) induced a rapid increase of intracellular calcium(P

0.05). However, in the presence of 16.5 mmol/L glucose, PGF_ 2? increased significantly in insulin secretion (P

ObjectiveTo observe the therapeutic effect of radiofrequency catheter ablation for idiopathic left ventricular tachycardia.To explore the relationship between surface electrocardiography and successful radiofrequency ablation location. MethodsThe electrophysiological data of surface electrocardiography and radiofrequency ablation,and the data of Holter in postorperation after 24 h and a half months,and tracking follow-up of 30 patients (23 males and 7 females)with idiopathic left ventricular tachycardia onset were retrospectively analyzed. ResultsRadiofrequency catheter ablation was successful in 29 patients(96.7%).The Holter was conducted in 29patients before and after the operation,the difference in average beats/24h before the operation(20 997 ± 10 786)and after the operation(921 ± 1 337)was statistically significant(P＜0.01).During the period of 1 to 3 months follow-up,2 patients relapsed and were all successfully re-ablated.No complication was found.The ventricular tachycardia lesions in left ventricular septum were found in 21 patients,of which 19 cases were located in a quadrant axis (-75.83 ± 19.36)°(-30 °～-90 °),and those in the left ventricular apex were in 9 cases,of which 7 cases were in the 2 quadrant axis(-102.6 ± 5.93)°(-91 °～-110 °). ConclusionRadiofrequency catheter ablation was an effeetive treatment technique for idiopathic left ventricular tachycardia with high successful rate,it could be selected as the first line treatment in patients with idiopathic left ventricular tachycardia.During idiopathic left ventricular tachycardia onset,the surface electrocardiography could help determine the initial site of ventricular tachycardia.

Mimecan belongs to a family of leucine-rich proteoglycans that are secreted into the extracellular matrix. In order to investigate the function of mimecan, the coding region of mimecan was amplifed from a human pituitary cDNA by PCR and the recombinant prokaryotic expression vector pGEX-M was constructed. The vactor was transformed into E.coli BL21(DE3)and the GST-M fusion protein of 38 Kd was ecpressed in the bacteria under induction of IPTG. After purification, the fusion protein was infucted into New Zealand rabbits to prepare polyclonal antibody. The antibody was tested by Western blotting for their specificity and sensitivity. Using the antibody it was found the mimecan was expressed highly in certain types of human pituitary tumor tissues. These results make it possible for studying the biological function of mimecan.

This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.