OBJECTIVETo study clinical effects of inversive LISS (less invasive stabilization system, LISS) plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures.

METHODSFrom January 2009 to Janurary 2012, 11 patients with Seinsheimer type V subtrochanteric femoral fractures were treated with inversive LISS plate combined with steel wire, including 8 males and 3 females, ranging in age from 35 to 61 years old (averaged, 51 years old). Causes of injury: 8 patients caused by accident and 3 patients caused by falling down. According to X-ray examination, all the patients were type V subtrochanteric femoral fractures and were treated with LISS plate combined with steel wire. Merle d'Aubigne scores were used to evaluate therapeutic effects on hip.

RESULTSThe mean period of follow-up was 16 months (ranged, 12 to 28 months). All the patients obtained bone union for average 3.8 months (ranged from 3 to 4.3 months). There were no complications such as deep infection,deep vein thrombosis, pulmonary embolism and bone nonunion. According to Merle d'Aubigne scores, 7 patients got an excellent result and 4 good.

CONCLUSIONInversive LISS plate combined with steel wire for the treatment of Seinsheimer type V subtrochanteric femoral fractures is satisfactory, Which can provide stable fixation for fracture end and provide an ideal internal fixation method for treatment of this kind of fractures in the future.

Adult ; Bone Plates ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged

Objective To understand the incidence trend of ventilator -associated pneumonia(VAP)in ICU and to evaluate the effects of the interventions on the incidence of VAP,so as to provide scientific evidences for the prevention of VAP.Methods A study of 149 patients with VAP occurred in the 3 710 patients of ICU before and after intervention during 7 /2010 -12 /2014 in Wujin People's Hospital,Changzhou city was conducted.It was divided into two stages:baseline survey and stem expectations,VAP interventions included:training and education,chlorhexidine oral care and maintain appropriate endotracheal tube cuff pressure,elevated head of bed to up to 30°and improved hand hygiene.Hospital infection control professionals collected the number of patients,basic information,length of hospital stay,days of receiving mechanical ventilation and the VAP incidence data in ICU.And then change of the VAP incidence of the intervention before and after the intervention was compared and evaluation of the effect of combined intervention measures.Results Prospective data from 3 710 patients hospitalized in ICU were collected for an aggregate of 14 831 days,the utilization rate of ventilator was 55.2%.The occurrence of VAP was 149 cases.The average rate of VAP was 18.2 cases per 1 000 ventilator -day.VAP was associated with a crude mortality of 7.56%and with increased ICU LOS of 13.2d.As the results of the interventions,the rate of VAP was decreased from 52.38 /1 000 during 7 /2010 -6 /2011 to 5.71 /1 000 during 1 /2014 -12 /2014.Conclusion The rate of VAP in the inves-tigated ICU has led to a decreased incidence of VAP under the comprehensive interventions.

6cm,the recrudescenc rates when factors were male,mild or moderate malignant,stage of Dukes C,distance from tumor to anus 4～6cm were significantly higher(?2=4.53,P

Ahigh-resolutionmethodforhumanleukocyteantigen-B(HLA-B)genotypingwasestablished based on the optimized polymerase chain reaction, cloning and sequencing technology. The exon2 and exon3 of HLA-B gene were amplified with primers based on the HLA-B gene sequence. These produced heterozygous alleles were effectively cloned into plasmid DNA based on the principle of plasmid incompatibility, and were followed by bacterial culture. Then Sanger sequencing was carried out and after analyzing the result by software ClustalX2 and IMTG/HLA database comparison, the HLA-B genotype of the samples was achieved. Seven clinical samples were detected, and the results were consistent with those of PCR-SBT genotyping method. The method was cost-effective, high-resolution and it did not require technical software. The use of universal primers simplified the cumbersome design and optimization process of specific primers.

Objective To explore molecular mechanisms underlying the in vitro counteracting effect of curcumin on malignant melanoma.Methods Cultured A375 and C8161 human melanoma cells were cultivated in vitro,and randomly divided into several test groups and a control group to be treated with different concentrations of curcumin and dimethyl sulfoxide respectively for different durations.Then,methyl thiazolyl tetrazolium (MTT) assay,Transwell assay,flow cytometry and Western blot were performed to evaluate the effect of curcumin on the proliferation,invasion and cell cycle of,as well as expressions of AKT/mTOR signaling pathway-related proteins in A375 and C8161 cells respectively.Statistical analysis was carried out by using t test.Results MTT assay showed that the treatment with curcumin of 5-35 mg/L for 24-96 hours significantly inhibited the proliferation of both A375 and C8161 cells compared with that with dimethyl sulfoxide (all P ＜ 0.001),and the inhibitory effect was in a dose-dependent manner within the range of 5-15 mg/L for A375 cells and within the range of 5-10 mg/L for C8161 cells,and in a time-dependent manner from 0 to 48 hours for both cells.After treatment for 24 hours,the 50％ inhibitory concentration (IC50) of curcumin against A375 cells and C 8161 cells was 10 mg/L and 5 mg/L respectively.Transwell assay demonstrated that the invasion of A375 and C8161 cells was significantly suppressed by 72-hour treatment with curcumin at 10 mg/L and 5 mg/L respectively (both P ＜ 0.001).Flow cytometry showed that the cell cycle of A375 and C8161 cells was arrested at G2/M phase after 24-hour treatment with curcumin at 10 mg/L and 5 mg/L respectively,with significant differences in the proportion of A375 cells and C8161 cells in G2/M phase between the test group and control group (A375 cells:35.00％ ± 3.54％ vs.120.80％ ± 7.46％,P＜ 0.001;C8161 cells:19.33％ ± 4.04％ vs.85.00％ ± 9.53％,P ＜ 0.001).Western blot revealed that the expressions of AKT/mTOR signaling pathway-related proteins were decreased in A375 and C8161 cells after 24-hour treatment with 10 mg/L and 5 mg/L curcumin respectively.Conclusion Curcumin can inhibit the proliferation and invasion of A375 and C8161 cells,likely by blocking cell cycle and inhibiting activation of the AKT/mTOR signaling pathway.

Surgical nutrition therapy is a novel course for undergraduates who are major in food hygiene and nutrition.In this study,the purpose,content,model and specific teaching approaches of the course were discussed,and the essentials of clinical practice for surgical nutrition therapy were pointed out.We hope that our experience would be helpful for the development of the course.

A method for the real-time polymerase chain reaction ( PCR ) coupled with high specific invader assay to detect single nucleotide polymorphism ( SNP) was established. To reduce the background signal, the amount of flap endonuclease 1 ( FEN1 enzyme ) and wild-type detection probe was optimized. Under the optimum conditions including 0. 05 μmo/L invasive oligonucleotide probe, 0. 125 μmol/L wild-type detection probe, 0. 5 μmol/L mutation detection probe, 0. 25 μmol/L each fluorescence resonance energy transfer (FRET) probe and 1. 5 U FEN1, the background signal of wild-type sample and mutation sample was dramatically decreased and the background interference to the detecting results was thus eliminated. A total of 21 cases of aldehyde dehydrogenase-2*2 ( ALDH2*2 ) , 19 cases of cytochrome p450 2 C19*2 ( CYP2 C19*2 ) and 19 cases of CYP2C19*3 were analyzed with the established method, and the genotypes of ALDH2*2 were 10 cases of GG homozygote, 8 cases of GA heterozygote and 3 cases of AA homozygote; the genotypes of CYP2C19*2 were 9 cases of GG homozygote, 8 cases of GA heterozygote and 2 cases of AA homozygote;and the genotypes of CYP2C19*3 were 18 cases of GG homozygote and 1 case of GA heterozygote. These results were consistent with those by pyrosequencing. The established method was specific, simple, short time-consuming and low cost, and could be used for the detection of SNP genotyping with non-polluting in single closed tube.

Objective:To analyze the clinical effect of different surgical methods on giant-cell tumor of bone (GCTB). Methods:Between January 2007 and June 2012, 37 patients receiving treatment for GCTB were enrolled in this study. These patients included 20 males and 17 females whose ages ranged from 20 to 56 (average=31.6). The prosthesis replacement and nonprosthetic replacement op-eration on the postoperative recurrence, limb function, comprehensive evaluation of the curative effect, as well as morbidity and recur-rence rate among different nations and in the upper and lower limbs of GCTB patients were analyzed. Results:The predilection age of the cases ranged from 20 to 50 years old. The incidence was higher in the Uighur population of Xinjiang, China. However, the recur-rence rate in ethnic difference was not statistically significant (P>0.05). Conclusion:The predilection age of GCTB cases was 20~50 years old, with higher morbidity in Uighur than in Han and other ethnic groups. The morbidity and recurrence rate were higher in the lower limbs than in the upper limbs of patients. The scraping bone graft and bone cement filling, the internal fixation of the scraping bone graft, and the artificial joint replacement of tumor resection were all reliable modes of treatment.

Objective:To investigate the effect of intermittent hormonal therapy(IHT) for patients with different stage/grade prostate cancer(PCa).Methods:The number of cycles and the duration of ON/OFF therapy for 45 PCa patients receiving IHT were observed.Maximal androgen blockade(MAB) the-rapies were used for six to nine months,and then stopped until the serum prostate specific antigen(PSA) was decreased below 0.2 ?g/L,which lasted for three months.It was decided whether MAB went on according to the level of PSA.Results:The average follow-up time was 40.7?13.4 months.Forty-one patients started the second cycle of treatment,of whom,8 became androgen-independent and 7 were at T3-4M0 or M1 stages and the Gleason scores were above 8.Sixteen patients entered the third cycle,of whom,14 were at lower than stage Ⅲ and 13 had the Gleason scores below 7.From the first to the fourth courses of treatment,the average intervals were 8.7?5.4(47.1%),8.4?4.9(49.3%),7.0?3.4(43.7%),and 3.7?0.6(42.5%)months respectively.Five patients developed bone metastasis.No one died up to now.According to the evaluation criteria,patients were divided into tolerance(n=16) and intolerance groups(n=29).Compared with the intolerance group,the patients who tolerated the treatment well had lower Gleason scores(P=0.002),lower PSA levels(P=0.053) and lower tumor stages(P=0.001).There was no evidence that age,lymph node metastasis,bone metastasis and the state of recurrence were associated with an increased risk of the outcome.Non-conditional Logistic regression analysis showed that the proportion of patients at stage Ⅳ was the only independent risk factor for the tolerance of the treatment(OR=12.113,95%CI 1.330-110.312,P=0.027).Conclusion:Intermittent hormonal therapy is more effective and proper for the patient with highly differentiated tumor and at lower stages(≤Ⅲ).The patients who progressed to hormone-independence are mostly at stage Ⅳ with poorly differentiated tumor.Intermittent hormone therapy could be more adaptive for the patients at lower than stage Ⅲ.

Objective To clarify the effectiveness of QS Nd ∶ YAG laser on melasma in Chinese patients.Methods A group (n=45) of patients previously diagnosed as facial melasma were treated with QS Nd ∶ YAG laser at approximately 1 week intervals.Eleven to twenty treatments were per formed for each patient.The treatment efficacy of QS Nd ∶ YAG laser was evaluated by patients and doctors,respectively,at various time point such as before treatment,5 weeks and 10 weeks after treatment and end of the treatment.The skin melanin index and the transepidermal water loss were e valuated by the skin multifunction tester at different time point,respectively.Results Compared with untreated,the melanin index of melasma areas decreased significantly after the laser treatment for 5 weeks,10 weeks and the end of treatment.But there was no significant difference in the melanin index of normal skin areas with or without laser treatment.Compared with untreated,the transpidermal water loss of melasma areas increased significantly after the laser treatment for 5 weeks,10 weeks and end of treatment.The patients' skin became smooth,delicate,pores shrink and more flexible.In 45 melasma patients treated by QS Nd ∶ YAG laser,8 cases basically cured (17.78 ％),25 cases were markedly effective (55.56 ％),12 cases improved (24.44 ％) and only 1 case was uneffective (2.22 ％).Theoverall effective rate was 73.33 ％.Conclnsions QSNd∶ YAG laser is a useful treatment modality for Chinese women who have melasma with precise efficacy,less side effects and high safety.