Objective:To describe the clinical characteristics and diagnosis and treatment process of one patient with primary thyroid mucosa-associated lymphoid tissue(MALT)lymphoma,in order to broaden the diagnostic and therapeutic strategies for this disease. Methods:The clinical features,diagnosis and treatment of one patient with primary thyroid MALT lymphoma were reported,and the relevant literatures were reviewed. Results:The patient complained of"bilateral thyroid enlargement for over 3 months",and the preoperative thyroid B-ultrasound and neck CT examination showed significant enlargement of thyroid.The patient underwent thyroidectomy on the right lobe behind the sternum,and postoperative pathological diagnosis confirmed primary thyroid MALT lymphoma.After a definitive diagnosis,the radiotherapy was performed on the thyroid lesion and cervical lymph node drainage area at a dose of 30 Gy/15 sessions.There was no disease progression 7 months after radiotherapy. Conclusion:Primary thyroid MALT lymphoma is a subtype of primary thyroid lymphoma(PTL)that commonly occurs in elderly female patients(＞60 years)accompanied by Hashimotos's thyroiditis(HT),and presents progressive enlargement of neck masses or lymph nodes in a short period.The clinical diagnosis of PTL relies on pathological biopsy,and there are significant differences in the clinical manifestations,treatment approaches,and prognosis among different subtypes of PTL.

Objective To study the survival status of very elderly patients with intertrochanteric fracture admitted in hospital and its risk factors.Methods Clinical data of 54 patients with intertrochanteric fracture aged 90 years and over admitted in hospital from Jan.2006 to Dec.2013 were retrospectively analyzed.5 patients were lost to follow-up.The survival status of patients was analyzed.Results Patients were followed up until January 2015.The period of follow-up ranged from 85 months to 0.2 months,with an average follow-up of 33.3 months.17 cases were survived.Harris scores were(61.2 ± 10.6).The overall 1-,3-,5-year survival rates were(0.88 ± 0.05),(0.35 ±0.08),(0.18 ± 0.08),respectively.The mean and median survival times were (33.3 ± 4.6) months and(25.0±5.4) months.Cox proportional hazard regression model showed that American Society of Anaesthesiologists(ASA) score,operation time and the number of comorbidities were the risk factors for the survival time of very elderly patients with intertrochanteric fracture (all P ＜0.05).Conclusions Compared with conservative treatment,surgical treatment can increase the survival time of the elderly patients with intertrochanteric fracture.ASA score,operation time and the number of comorbidities may be the risk factors for the survival time of very elderly patients with intertrochanteric fracture.

Objective To evaluate the efficacy, safety and compatibility of a new type of atrial septal defect ( ASD) occluder in atrial spetal defect mini-pigs model.Methods Five Tibet mini-pigs were selected as the ASD models which were established by the combination of atrial septal puncture and balloon dilation.Then the new type occluder was implanted for the therapy of ASD.Transthoracic echocardiography with color Doppler was used in all animals during closure and in follow up examinations.The animals were killed at 3 months after occlusion for electron microscopical observation and microscopic examination.Result The ASD models had been created in five piglets successfully without complication, all of whom were implanted successfully with the new device without shunts.Postmortem and microscopic examination of the 5 specimens 3 months after placement showed complete.Conclusion Transcatheter ASD occlusion with new type ASD occluder is safe,feasible and effective.This occlusion can repair the atrial septal defect successfully.

Objective To investigate whether hyperbaric oxygen preconditioning (HBOP) could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups:the hyperbaric oxygen preconditioning (HBOP) group(n =149)and the control group(n =138).On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group (P ＜ 0.05).And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ O.05).Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.

Objective To investigate whether hyperbaric oxygen preconditioning (HBOP) could decrease the incidence of postoperative complications in patients with distal tibiofibular fracture.Methods Two hundred and eighty-seven cases of distal tibiofibular open fracture admitted into the Zhongshan Hospital Affiliated to Fudan University for treatment from January 2004 to March 2013 were randomly divided into 2 groups:the hyperbaric oxygen preconditioning (HBOP) group(n =149)and the control group(n =138).On the basis of routine therapy prior to internal fixation,the HBOP group was administered with HBO therapy,while the control group was left there without HBO therapy.All the patents had 12-26 months of medical follow-ups to assess the results of different treatment.Then,the incidence of postoperative complications and functional recovery level were compared between the 2 groups.Results The incidence of postoperative complications in the HBOP group was obviously lower than that in the control group (P ＜ 0.05).And functional recovery level in the patients of the HBOP group was significantly superior to that of the control group,and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ O.05).Conclusions HBO preconditioning before surgical treatment of the patients with distal tibiofibular fracture could effectively decrease the incidence of postoperative complications and improve their functional recovery level.

Objective:To evaluate the efficacy of anteromedial extensile approach in the treatment of complicated closed pilon fractures classified as type AO/OTA C2 or C3 . Methods:Twenty‐three patients ,who suffered from complicated closed pilon fractures of distal tibia(25 lesions) ,underwent open reduction and internal fixation with anteromedial extensile approach . Among the 23 patients , there were 18 males and 5 females , with mean age of (43 .7 ± 9 .0 ) years . According to AO classification ,there were 11 lesions of type C2 and 14 lesions of type C3 .Operating time ,blood loss ,time of fracture healing , situation of complications ,and American Orthopedic Foot&Ankle Society(AOFAS) score were recorded ,so as to analyze the safety ,the indication ,and the pros and cons of this approach . Results:The average operating time was (119 .6 ± 23 .6)min . The intraoperative blood loss was (168 ± 64 .4) mL .And the time of fracture healing was (12 .5 ± 5 .4)weeks .The AOFAS scores were 81 .9 ± 18 .2 and 79 .9 ± 19 .5 at 12 month and 24 month after surgery ,respectively .Four cases of complications were observed , and there was no patient with invalid internal fixation . Conclusion:During the surgical treatment of complicated closed pilon fractures ,the anteromedial extensile approach allows complete access to the medial and lateral column of distal tibia and the articular surface ,so that the incidence rate of soft tissue complications was low and the clinical efficacy was satisfactory .

Objective:To explore the accuracy of CT three dimensional reconstruction technique for the diagnosis of tibia shaft fracture accompanied by ankle injury .Methods:Both X‐ray examination and three dimensional CT scanning were conducted for the 117 patients with closed tibia shaft fracture ,who went to Zhongshan Hospital of Fudan University ,before surgery .The numbers of patients ,who were diagnosed with tibia shaft fracture accompanied by ankle injury ,were compared between the two examination methods .Results:Nineteen patients with tibia shaft fracture were diagnosed with accompanied posterior malleolar fracture by X‐ray examination before surgery . However ,34 patients were diagnosed with accompanied posterior malleolar fracture by CT three dimensional reconstruction images . Thus , 15 more patients were diagnosed by CT three dimensional reconstruction technique than that by X‐ray imaging .Conclusions:Comparing with X‐ray examination , three dimensional CT reconstruction technique could increase the diagnosis accuracy for posterior malleolar fracture associated with tibia shaft fracture and reduce the rate of missed diagnosis .

Objective:To analyze the etiology of patellofemoral pain syndrome (PFPS) in basketball players and the effect of isometric exercise of the quadriceps femoris .Methods:A total of 20 basketball players from Shanghai sports bureau with PFPS were selected as research group ,and 28 healthy player without PFPS were chosen as control group .The differences regarding the Q‐angle and the moving track of patella between the 2 groups were analyzed .The training method in the research group consisted of quadriceps femoris isometric and isotonic contraction while that in the control group was isotonic contraction .The incidence rate of patellofemoral pain during the training ,as well as the effect of two kinds of training on the quadriceps femoris , was analyzed .Results:There was no significant difference regarding Q‐angle between the 2 groups .The incidence rate of patella maltracking in the research group was higher than that in the control group(P< 0 .05) .There was no significant difference regarding the incidence rate of patellofemoral pain during the training between the two groups . There was no significant difference regarding the force change of quadriceps femoris after training between the two groups ,however ,the muscular endurance change in the research group was lower than that in the control group(P< 0 .01) .Conclusions:The occurrence of PFPS in basketball player was not significantly related to Q‐angle ,however ,it was related to patella maltracking . Comparing to the isotonic exercise ,the training method consisting of isometric and isotonic contraction can achieve a similar effort regarding muscle force ,but muscular endurance .

Objective This study aimed to investigate the expression of SOX7,β-catenin and cyclin D1 in invasive breast cancer and hyperplastic disease of the breast,and explore their relationship with clinical pathology charactersis in invasive breast cancer in order to provide valuable biomarkers for the treatment and prognosis.Methods The expression of SOX7,β-catenin and cyclin D1 was neasured in 50 invasive breast cancer tissues and 30 hyperplastic disease of the breast by immunohistochemical SP method.The correlations of SOX7,β-catenin and cyclin D1 in invasive breast cancer to clinicopathologic features were analyzed,such as age,size of tumor,axillary lymph node metastasis,histological grade,pTNM stage,ER,PR,Her-2 expression and the risk.Results Immunohistochemical results showed that the positive rates of SOX7 and cyclin D1 in invasive breast cancer were 42％ (21/50)and 70％ (35/50),and the abnormal expression rates of β-catenin in invasive breast cancer was 70％ (35/50).The positive rates of SOX7 in invasive breast cancer was significantly lower than that in hyperplastic disease of the breast 70％ (21/30).The expression of SOX7 had difference between two groups (P =0.021 ＜0.05).The abnormal expression rates of β-catenin and the positive rates of cyclin D1 in invasive breast cancer wcre significantly higher than that in hyperplastic disease of the breast 43.3％ (13/30) (P =0.033 ＜ 0.05) and 20％ (6/30) (P =0.000 ＜ 0.001).The expression of β-catenin and cyclin D1 had difference between two groups.In invasive breast cancer,SOX7 and β-catenin protein expression in 12 cases,while negative expression in 5 cases; SOX7 and cyclin D1 protein positive expression in H 1 cases,while negative expression in 5 cases; β-catenin and cyclin D1 protein positive expression iu 28 cases,while negative expression in 8 cases.Results of the analysis by Spearman showed that in invasive breast cancer the SOX7 protein expression was negatively correlated with the abnormal expression of β-catenin protein and the expression of cyclin D1 protein(r =-0.282,P =0.046 ＜ 0.05 ;r =-0.327,P =0.020 ＜ 0.05)while the abnormal expression of β-catenin protein was positively correlated with the expression of eyclin D1 protein(r =0.333,P =0.018 ＜ 0.05).In invasive breast cancer the expression of SOX7 protein was correlated with age,axillary lymph node metastasis,histological grade,pTNM stage,ER,PR,Her-2 expression and the risk(P ＜0.05),but with no correlation with size of tumor (P ＞ 0.05).However,the abnoral expression of β-catenin and the positive expression of cyclin D1 in invasive breast cancer were correlated with size of tumor,axillary lymph node metastasis and pTNM stage(P ＜ 0.05),but with no correlation with age,histological grade,ER,PR,Her-2 and the risk(P ＞0.05).Conclusions SOX7.β-catenin and cyclin D1 are frequently abnormality-regulated in invasive breast cancer tissues,and the three protein may play a regulatory role through the same pathway in the development and progression of invasive breast cancer.SOX7,β-catenin and cyclin D1,s abnormal expression in invasive breast cancer correlate with the clinical pathology charactersis,and the three protein may be valuable marker for assessing the prognosis for invasive breast cancer.

Study found that in some human tumors such as breast cancer,SOX7 gene is highly likely to be a tumor suppressor gene.The tumor suppressor role of SOX7 may be accomplished by regulating the Wnt/β-catenin signaling pathway mediated the transcription process,and the abnormal Wnt/β-catenin signaling pathway is likely to play its role through the regulation of its downstream target gene Cyclin D1,etc,so that the ahnormal cell proliferation activity is unable to carry on,and thus plays the function of tumor suppressor.This review will summarize the research progress of the role of SOX7 geue and its closely related β-catenin,Cyclin D1 gene in breast cancer.