BACKGROUND:According to worldwide statistics, internal fixation was commonly selected to treat patients with distal femoral fractures and acromioclavicular joint dislocation. The firmness of Kirschner wire is poor during fixation, so needle withdrawal easily appears, and the fixation would be failure. To reduce complications after fixation, AO/ASIF clavicular hook plate as a novel fixator has been used in treatment of distal clavicle fractures and acromioclavicular joint dislocation. OBJECTIVE:To explore the safety and effectiveness of AO/ASIF clavicular hook plate in the treatment of distal clavicle fractures and acromioclavicular dislocation, and to compare with Kirschner wire tension band.METHODS:100 patients with distal clavicle fractures and acromioclavicular joint dislocation, who were treated in the Department of Orthopedics of Tongcheng People’s Hospital from June 2010 to December 2013, were enrol ed in this study. They were equal y assigned into Kirschner wire tension band group and AO/ASIF clavicular hook plate group according to different fixation methods. The excel ent and good rate of shoulder function recovery, shoulder function score and upper limb functional recovery were observed and compared between the two groups after fixation. RESULTS AND CONCLUSION:The excel ent and good rate of shoulder function recovery was 98%in the AO/ASIF clavicular hook plate group after fixation, which was significantly higher than Kirschner wire tension band group (64%). The incidence of acromioclavicular re-dislocation was 0 after removal of fixator in the AO/ASIF clavicular hook plate group, which was lower than Kirschner wire tension band group (12%), showing significant differences between groups (P<0.05). Japanese Orthopaedic Association score was significantly higher at 5 and 10 weeks after fixation in both groups compared with pre-fixation. Japanese Orthopaedic Association score was significantly higher in the AO/ASIF clavicular hook plate group than in the Kirschner wire tension band group (P<0.05). The ranges of motion of adduction, abduction, flexion and extension were significantly higher in the AO/ASIF clavicular hook plate group than in the Kirschner wire tension band group at 10 weeks after fixation (P<0.05). Above results suggested that AO/ASIF clavicular hook plate is a safe effective fixator for repair of distal clavicle fractures and acromioclavicular joint dislocation, and characterized by smal incision, reliable fixation, and early shoulder activities.

Objective To study the release of synthetic gene expression induced by vasopressin Ⅱ (U Ⅱ ) in hypoxic pulmonary hypertension. Methods Rat model of HPH was establish. RIA was used to observe the different time points of hypoxia in plasma and the dynamic changes of U Ⅱ , ADM content in bronchoalveolar lavage fluid (BALF). The impact of the release of U Ⅱ , as well as the relation-ship among U Ⅱ , ADM and HPH were explored to reveal the role of U Ⅱ in the pathophysiology of HPH. Results Rat HPH model was successfully established. Hypoxia promoted the expression, synthesis and release of U Ⅱ in lung tissue. U Ⅱ involved in the pathogenesis of HPH. HPH took place in the development of U Ⅱand was positive correlated with ADM. Conclusion The two peptides have opposite physiological effects on blood vessel, which suggest that these two peptides play an important role in maintaining the balance between the pul-monary circulation and lung ventilation as well as the stability of pulmonary artery pressure.

Objective To observe the curative effect of cervical traction combined with low-cycle or intermediate frequency electrical current in cervical vertebrae.Methods 171 patients with cervical vertebrae were randomly divided into the therapy group and control group,86 cases in therapy group were performed the curative measure of cervical traction and low-cycle,85 cases in control group underwent the curative measure of cervical traction and intermediate frequency electrical current.Both of the two groups carried out continuous therapy for 10 days.Results There was significant difference before and after treatment within each group in CASCS score(P ＜ 0.01)and there was also significant difference after treatment between the two groups(P ＜ 0.05),the effective rate of therapy groupwas significant higher than that of control group(P ＜ 0.05).Conclusion The methods of cervical traction and low cycle or intermediate frequency electrical current has better curative effect in cervical vertebrae and cervical traction and low-cycle do much benefit in cervical vertebrae treatment.

Objective To observe and analyse the efficacy of retrograde gonarthritis with interference current and drug-iontophoresis direct current. Methods 185 patients with retrograde gonarthritis were randomly divided into treatment group 92 cases and control group 93 cases. The patients in treatment group underwent interference current and drug-iontophoresis direct current and patients in control group performed modulated medium frequency drug-ionto-phoresis direct current for two treatment courses. Results The comprehensive score of various kind of symptom such as pain、swelling、flexion、walking ability, up-down stair ability in treatment group significantly improved than that of control group (P < 0.01). Conclusion The interference current and drug-iontophoresis direct current is one of effec-tive and safe measurement in treating arthritis with main manifestation of pain and soft tissue disease.

Objective To analyze the characteristics of PHPT patients of our hospital.Methods Retrospective analyze 82 PHPT patients who hospitalized in our hospital from 1974 to 2006,male 41,female 41,age 16～83 years,course 1 month～40 years.All of the final diagnosis was PHPT clinically,while 67 were confirmed by pathology.Results (1)The number of diagnosed PHPT patients was increasing year by year,the cases diagnosed in 2002—2006 were more than the sum of past years.(2)The first visit department was widespread for PHPT patients,up to 47.6% went to urology department firstly,while only 24% went to endocrinology department.(3)Clinical presentation:42.7% patients presented simple urinary system calculus,15.9% ostalgia with urinary system calculus,17.1% simple ostalgia,while 20.7% with pathologic fracture,and 7.3% chronic renal failure,3.6% peptic ulcer,2.4% chronic pancreatitis.69.5% occurred typical hypercalcinemia and hypophosphatemia,30.5% revealed hypophosphatemia chiefly.(4)The coincidence rate between the examinations preoperation and pathology:B type ultrasound 64.5%,CT scan 37.3%,99m Tc-MIBI scan 90%.(5)Pathology presentation:73% single adenoma,17.9% hyperplasia,2.9% adenoma with hyperplasia,1.5% carcinoma,other 4.5% only seen some parathyroid tissue.Conclusion PHPT patients have various clinical presentation,so there are generally missed diagnosis and misdiagnosis.we should investigate serum calcium,phosphate and PTH level to exclude PHPT.

Objective:To evaluate the efficacy and safety of combined cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel for treatment of synchronous peritoneal carcinomatosis (PC) from gastric cancer. Methods:Fifty patients with synchronous PC from gastric cancer were treated by 52 CRS+HIPEC procedures with 100 mg of lobaplatin and 120 mg of docetaxel in 12000 mL of normal saline at (43 ± 0.5)℃for 60 min. The primary and secondary endpoints were overall survival (OS) and perioperative safety profiles, respectively. Results:At a median follow-up of 22.5 months, the median OS rate was 14.3 (95%CI:7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. No perioperative deaths or serious adverse events occurred in 12 cases (23.1%). Multivariate analysis indicated that completeness of cytoreduction, nor-mality of perioperative tumor markers, and adjuvant chemotherapy of more than six cycles were independent predictors for improved survival. Conclusions:CRS+HIPEC with lobaplatin and docetaxel could improve the OS and ensure perioperative safety of patients with synchronous PC from gastric cancer.

Objective:To investigate whether the omental-adipose stromal cells (O-ASCs) exposing to gastric cancer-conditioned medi-um (CM) could be inducted to differentiate into carcinoma-associated fibroblasts (CAFs) and the effect of ERK signaling pathway in the process. Methods: We identified O-ASCs by examining their ability to differentiate osteogenic and adipogenic lineages and through flow cytometry. O-ASCs were co-cultured with MGC803 and SGC7901CM. The expression of CAFs markers (α-SMA, FSP-1, and vimentin) and paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) were evaluated by RT-PCR and Western blot. In vitro cultures of O-ASCs were divided into three groups:the control, SGC7901-CM, and SGC7901-CM+U0126 groups. Cells were collected after 12 h. West-ern blot was performed to evaluate the expression ofα-SMA, FSP-1, ERK, and p-ERK1/2. Results:The primary cells were O-ASCs. The expression levels of CAFs markers (α-SMA, FSP-1, and vimentin) and O-ASC paracrine factors (VEGFA, TGF-β1, FAP, and SDF-1) clearly in-creased (P<0.05). In comparison with the control, the expression of ERK in SGC7901-CM group did not change (P>0.05), while the ex-pression of p-ERK1/2,α-SMA, and FSP-1 significantly improved (P<0.05). Comparison of SGC 7901-CM+U0126 and SGC 7901-CM groups showed that the expression levels of ERK had no statistical difference (P>0.05), while the expression levels of p-ERK1/2,α-SMA, and FSP-1 decreased (P<0.05). Conclusion:O-ASCs participate in the peritoneal metastasis of gastric cancer through differentiation by CAF and paracrine factors. The ERK signaling pathway is important in the differentiation of O-ASCs towards CAFs.

Objective: To investigate the efficacy and safety of using pegylated recombinant human granulocyte-colonystimulating factor (PEG-rhG-CSF) in preventing neutropenia in multiple chemotherapy cycles. Methods: A multicenter, prospective, open-label, singlearmstudy was designed. Patients with malignant tumors, such as lung, ovarian, and colorectal cancers, who received multiple cycles of chemotherapy with the prophylactic use of PEG-rhG-CSF for 2-4 consecutive cycles participated in the study. Results: After the prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 4.76% (13/273) in the first cycle to 1.83% (5/273), 1.15% (2/174), and 2.08% (2/96) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 11.36% (31/ 273) in the first cycle to 6.23% (17/273), 2.87% (5/174), and 3.13% (3/96) in subsequent cycles. The incidence of febrile neutropenia (FN) during the first cycle was 0.73% (2/273). The duration of FN was 2 days in one case and 5 days in another case. FN was not observed during the second, third, or fourth cycle. After the secondary prophylactic use of PEG-rhG-CSF, the incidence of grade IV neutropenia decreased from 25% (7/28) to 3.57% (1/28), 0% (0/28), and 6.67% (1/15) in subsequent cycles. Meanwhile, the incidence of grade III neutropenia decreased from 71.43% (20/28) to 10.71% (3/28), 14.29% (4/28), and 0% (0/15) in subsequent cycles. The proportion of patients who received antibiotic therapy during the entire chemotherapy period was 10.48% (44/420). Conclusion: The application of PEG-rhG-CSF once per chemotherapy cycle can effectively reduce the occurrence of neutropenia in patients under multiple cycles of chemotherapy treatment with good safety.

Objective:To study the genetic profile of neonatal hyperbilirubinemia with unknown etiology in Guangdong Province and the clinical significance of jaundice-related genetic screening.Methods:From July to September, 2021, neonates with hyperbilirubinemia of unknown etiology born in different hospitals in Guangdong Province were studied. 24 neonatal jaundice-related exons were sequenced using targeted capture and high-throughput sequencing technology. The pathogenic variants were analyzed.Results:A total of 331 cases, 139 (42.0%) cases showed positive screening results with five diseases, including 65 (19.6%) cases of Gilbert syndrome, 48 (14.5%) cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency,18 (5.4%) cases of sodium taurocholate cotransporting polypeptide deficiency, 4 (1.2%) cases of Citrin deficiency and 4 (1.2%) cases of Dubin-Johnson syndrome. 149 (45.0%) cases carried one or more genetic variants and 43 (13.0%) cases showed no clinically significant variants. The 8 high-frequency mutation loci (carrier rate >1%) are UGT1A1 gene c.211G>A and c.1091C>T, G6PD gene c.1466G>T and c.1478G>A, SLC10A1 gene c.800C>T, SLC25A13 gene c.852_855del TATG, HBB gene c.126_129delCTTT and c.316-197C>T.Conclusions:Genetic factors are important for neonatal hyperbilirubinemia with unknown etiology in Guangdong. The common pathogenic genes are UGT1A1, G6PD, SLC10A1, and SLC25A13 and the population carries high-frequency mutation loci. Therefore, genetic screening in neonates with hyperbilirubinemia of unknown etiology has important clinical significance.