Objective:To investigate the clinical significance of preserving supraclavicular nerve in the reduction and fixation of clavicular fracture.Methods:A retrospective study was conducted of the 68 pa-tients with clavicular fracture who had been treated surgically from October 2016 to April 2018 at Department of Orthopedics and Traumatology, Heyuan Hospital of Traditional Chinese Medicine.They were 35 males and 33 females, aged from 25 to 45 years (average, 34.8 years).The supraclavicular nerve was preserved in the re-duction and fixation of clavicular fracture in 32 patients (reservation group) but not in the other 36 ones (control group).The 2 groups were compared in terms of operation time, intraoperative blood loss, fracture healing time; postoperative pain tolerance, feeling (by the British Medical Research Council assessment), shoulder function (by the Constant-Murley scoring) and impact of numbness on life.Results:The 2 groups were compatible due to insignificant differences in the general clinical data between them ( P>0.05).All the 68 patients were followed up for 12 to 26 months (average, 15 months).There was no significant difference between the 2 groups either in intraoperative blood loss or fracture healing time ( P>0.05).The preservation group had significant longer operation time (72.6 min±7.2 min) than the control group (47.3 min±7.4 min), but a significantly lower rate of analgesic usage on the postoperative day [6.3%(2/32)] than the control group [91.7%(33/36)] (both P<0.05).By the British Medical Research Council assessment, the postoperative feeling was rated as S3 or S4 in 93.8%(30/32) of the patients in the preservation group, significantly higher than the 72.2% (26/36) of the control group ( P<0.05).The preservation group was also significantly better than the control group in Constant-Murley scores of the injured shoulder [100.0 (93.5, 100.0) versus 87.0 (81.0, 89.0)] and impact of numbness on life [0 versus 50.0%(18/36)] (both P<0.05). Conclusion:In surgical treatment of clavicular fracture, preservation of the supraclavicular nerve can have a positive effect on reducing postoperative pain in the operative area and impact of numbness on life.

Objective To investigate the expression and significance of myeloid cell leukemia-1 (Mcl-1 )gene and protein in Hepatocellular Carcinoma(HCC).Methods The expression of Mcl-1 was detected respectively by Reverse Transcription-Polymerase Chain Reaction (RT-PCR),Western blot and ENVISION immunohistochemistry in 20 HCC specimens,19 liver cirrhosis(LC)specimens,and 12 control ones.Their relationship with clinical and pathological characteristics of HCC was investigated.Results The expression of Mcl-1 mRNA in the control group,LC group and HCC group was 0.52±0.17, 3.46±1.7,3.65±2.93,respectively.The level in HCC and LC group was statistically different compared with the control group,respectively (t=7.925,5.334,P<0.05).The relative expression of Mcl-1 protein in LC group (0.51±0.35)and HCC group (0.75±0.36)were significantly higher than that in the control group (0.21±0.19)(t=5.526,6.355,P<0.05).The positive expression rate of Mcl-1 in HCC group was 55.00% (11/20),significantly higher than that in the con-trol group 33.33% (4/12)(t=7.835,P<0.05).The positive expression of Mcl-1 was related to tumor necrosis and TNM staging (χ2=4.201,P<0.05).Conclusion Mcl-1 gene and protein are differentially expressed in HCC,LC and the control, which may be involved in the occurrence,development and malignant transformation of HCC.

Objective To study the influence of hydrogen sulfide (H2 S)on the mitochondrial function of pulmonary artery smooth muscle cells of the rats with high pulmonary blood flow pulmonary hypertension, and to clarify the function and its mechanism in the occurrence of high pulmonary blood flow pulmonary hypertension.Methods A total of 27 rats were randomly divided sham operation group,operation group,and operation+sodium hydrosulfide (NaHS)group (n=9).The pulmonary hypertension rat model was built by left lung resection.After fed for 35 d, the mean pulmonary artery pressure (mPAP),ratio of right ventricle/body weight (RV/BW),and ratio of right ventricle/(left ventricle+septum)[RV/(LV + S)]of the rats in three groups were measured.The plasma H2 S levels and the CSE activities in pulmonary artery tissue of the rats were detected;the activities of total mitochondrial ATP enzyme,superoxide dismutase (SOD),glutathione peroxidase (GSH-Px)and malondialdehyde (MDA)levels were determined;the ultrastructure of pulmonary artery smooth muscle mitochondria was observed through transmission electron microscope.Results Compared with sham operation group,the plasma H2 S level and the CSE activity in pulmonary artery tissue of the rats in operation group were decreased(P<0.01);the mitochondrial membrane of pulmonary tissue was swelling, and the mitochondrial activity was decreased (P<0.01);the mitochondrial ATP enzyme,SOD and GSH-Px activities were significantly decreased,and the MDA level was significantly increased (P<0.01).Compared with operation group,the H2S level in plasma and the activity of CSE in pulmonary tissue of the rats in operation + NaHS group were increased (P<0.01 );the mitochondrial membrane swelling was reduced, and the vitality was restored;the ATP enzyme, GSH-Px, and SOD level in pulmonary tissue were significantly increased (P<0.01),and the MDA level was significantly reduced (P<0.01).Conclusion H2 S can enhance the activities of mitochondrial ATP enzyme,GSH-Px,and SOD,and decrease the mitochondrial lipid peroxidation level,thus it plays a protective effect on rat pulmonary artery smooth muscle.

Objective To investigate the possible mechanisms of the attribution of psychological stress to the temporomandibular joint disorder(TMD) ,through the evaluation of the animal model and detection of the proinflammatory cytokines in the TMJ.Methods The animal models of communication box were built to mimic the psychological stress.The concentration of the serum Cor and ACTH was detected in the control group, Psychological Stress group ( PS group), and diazepam ( anti-anxiety drug) group ( PS + DI group).The expression of the proinflammatory cytokines IL-1 and IL-6 in the rat TMJ in the different phases of psychologicalstress was detected by RT-PCR.Results The results of the serum concen- tration of Cor and ACTH showed that there was significant difference between the control group and the PS group(P＜0.01 ) ,while no significant difference between the control group and the PS + DI group(P＞0.05).The expressions of IL-1 and IL-6 were comapared in all group.The expressions of IL-1 in CON group were (0.453± 0.021 ) mg/L, (0.439 ± 0.028 ) mg/L and (0.454 ± 0.023 )mg/L.These values were markedly increased compared with those of the PS group(0.981 ±0.024)mg/L, (0.746±0.017)mg/L and (0.510 ±0.016)mg/L respectively, P＜0.01 ) ,but no significant differences compared with PS + DI group(0.549 ± 0.014 ) mg/L, ( 0.498 ± 0.014 ) mg/L and ( 0.444 ± 0.022 ) mg/L respectively, P ＞ 0.05).Similar changes were observed in expressions of IL-6.The expressions of IL-6 in the CON rats were (0.525 ±0.028)mg/L,(0.515 ±0.028)mg/L and (0.518 ±0.022)mg/L,respectively,while those of PS group were(0.820 ± 0.023 ) mg/L, (0.694 ± 0.019 ) mg/L and (0.579 ± 0.015 ) mg/L, respectively, which were significan- tly higher in the PS groups(P＜ 0.05 ).But there were no significant differences between CON group and PS + DI group( (0.599 ±0.015)mg/L, (0.541 ±0.015)mg/L, (0.487 ±0.008)mg/L respectively, P＞0.05).Conclusion The psychological stress can play important role in the formation of TMD.

Objective To investigate the relationship between expression of nuclear factor kappa B p65 ( NF-κB p65) and hippocampal neuronal apoptosis in acute necrotizing pancreatitis (ANP) rats with brain injury. Methods Sixty-four SD rats were randomized into normal saline group (NS) and ANP group. The ANP rat model was induced by retrograde injection of 4% sodium taurocholate into the pancreaticobiliary duct of SD rats. Nissle stain was used to detect the brain injury. Neuronal apoptosis was determined by TUNEL.NF-κB p65 expression was detected by immunohistochemistry and RT-PCR. Results Hippocampal neuron was absent, karyopyknosis, unclear nucleolus and decreased Nissl bodies were found, the injuries was aggravated with time. The apoptosis index at the 3, 6 and 12 h in ANP group was 10.63 ±0.24, 21.02±0.25, 17.12±0.36, respectively, while they were 0.33±0.19,0.71±0.67, 0.45 ± 0. 33 in NS group, and the difference was statistically significant ( P ＜ 0. 01 ). The expressions of NF-κB p65 mRNA were 0. 63 ± 0.05,1.05 ±0.06,0.92 ±0.05, which were significantly higher than those in the NS group (0.11 ±0.01,0.12±0.01,0.08±0.01,P＜0.05).The chatge of expression of NF±κB p65 protein was consistent with that of NF-κB p65 mRNA. Conclusions The brain injury of ANP rats was highly correlated with neuronal apoptosis at the early and middle phase of ANP, and its mechanism may be related with NF-κB p65 activation.

Objective To study the characteristics of MR imaging and proton MR spectrscopy(~1H MRS)of stroke-like lesions in MELAS.Methods Clinical,MR imaging and proton spectroscopic findings of stroke-like lesions in 7 patients with confirmed MELAS were analyzed retrospectively.Results A total of 12 MR investigations had been performed in 7 patients.Stroke-like lesions showed by MR imaging included superacute in 12,acute in 12,subacute in 10 and chronic stage in 6.Early stroke-like lesions were demonstrated as focal edematous foci mainly involved cortex/subcotical areas of occipital,temporal and parietal lobes.At MR diffusion imaging,stroke-like lesions in the superacute(＜3 days)stage were showed as well-circumscribed lesions with high signal intensities for cytotoxic edema.During the acute(4～7 days),sub-acute(2～4 weeks)and chronic(＞4 weeks)stages,the lesions gradually expanded,and became blur,and presented with vasogenic edema mainly.Proton spectroscopy showed a prominently elevated lactate,varied decrease of NAA concentration and other brain motabolites in the stroke-like lesions early after onset,and depicted gradual decrease of lactate level and partial recovery of NAA concentration subsequently.Conclusion Stroke-like lesions in MELAS mainly involve the cerebral cortex and subcortical areas,in which cytotoxic edema appears early but for a short period.In ~1H MRS,the lesions are characterized by a double lactate peak with decrease of NAA concentration.

Objective To study the efficacy of RNA interference targeting 5-LOX on 5-LOX and VEGF expression as well as the growth of tumor xenografts in the nude mice,in order to evaluate the value of the clinical application.Methods SW1990 cells were injected into the back of BALB/c nude mice.Once the visible tumors were evidenced about 100mm3,the animals were divided randomly into 4 groups (6 animals/group) and treated with shRNA1 and shRNA2 targeting 5-LOX,negatrve control shRNA (shNC) or control LipofectamineTM 2000 (Lipo) by intratumoral injection.Observing the effect of the shRNA on the growth of tumor xenografts,investigating the expression of 5-LOX and VEGF by immunohistochemistry and RT-PCR.Results Two nude mice were dead in shNC group and Lipo group because of the wasting disease.Other nude mice had no changes in body weight,spirit,appetite,and activity.The growth of tumor xenografts was suppressed potently when administered with shRNA.Compared with shNC and Lipo group,the mean tumor size in groups treated with shRNA was reduced markedly at every point of test time.Between two treat groups,they did not have significant difference.5-LOX and VEGF were both expressed in the pancreatic cancer tissue.The level of the 5-LOX expression in shRNA groups was stronger than that in shNC or Lipo group.The VEGF had the game situation.Between the two treat groups,the difference was not significant.Conclusions RNA interference targeting 5-LOX can inhibit the growth of tumor tumor xenografts in the nude mice by depressing the expression of 5-LOX directly and depressing the expression of VEGF indirectly.

Objective To review the status of diagnosis and treatment for invasive fungal pulmonary infections(IFPI)in Lishui Central Hospital.Methods The clinical data of 79 patients with IFPI were retrospectively analyzed.Results The diagnostic status could be classified ills follows:6 eases had confirmed diagnosis,30 had clinical diagnosis,35 had suspected diagnosis and 8 misdiagnosed.The treatments were all effeetive in 6 COnfirmed cases;in 30 clinically diagnosed cases,6 were eriective.21 were inefiective and 3 died;in 35 suspected cases.3 were effective.25 were iHefieetive and 7 cflses did not receive antifungal treatment.Aspergillus and Cryptococcus pulmonary infections were predominant in confirmed cases.and the antifungal treatment lasted for 3 to 6 months.Conclusion Diagnosis and treatment for IFPI need to be improved.

Objective To investigate the suppression effects of Tripotolide (TL) on the pancreatic cancer xenograft models and angiogenesis. Methods The growth suppression effect of TL on SW1990 was determined using cell count kit (CCK-8), apoptotic cells induced by TL were examined by morphology and terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) assay. The inhibitory effects of TL on the growth of tumor xenografts and tumor microvascular density (MVD) were investigated. ResultsTL inhibited the growth and proliferation of SW1990 cells in a concentration-dependent and time-dependent manner. The inhibition ratios of cells treated at 160 mg/ml TL for 24 h was 50. 6%, the apoptotic rate increased from 9.6% in the control group to 45.1% (P <0.01 ). The inhibition rate of cancer xenograft growth was 89.9% when TL was intratumorally injected at the dose of 0.5 mg/kg. The expression of VEGF in tumor tissue decreased while MVD also decreased from 36.25±8.64 to 9.87±3.34 (P <0.01 ). ConclusionsTL induced prominent growth inhibition and apoptosis in human pancreatic cancer cell lines. TL.can attenuate the growth of pancreatic caner xenografts through its effect on antiangiogenesis.

OBJECTIVE To detect genes sul1 and sul2 in Stenotrophomonas maltophilia,and their relationship to drug resistance to trimethoprim-sulfamethoxazole(SXT).METHODS K-B was carried out to detect the drug resistance to SXT of S.maltophilia;minimal inhibitory concentration(MIC) was measured with micro broth dilution method.Genes sul1 and sul2 were amplified by PCR.RESULTS Eight isolates(7.8%) showed resistance to trimethoprim-sulfamethoxazole,sul1 Was positive in four isolates in which one contained sul2 also.Four isolates showed high MIC to SXT.CONCLUSIONS Genes sul1 and sul2 of S.maltophilia are associated with the high drug resistance to SXT.