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The visible light positioning system is the hot spot of current indoor positioning technology research. Aiming at the problem of inaccurate azimuth angle acquisition in single-lamp positioning system, this paper proposes a single Light Emitting Diode (LED) indoor positioning system based on marked LED. The scheme uses a single LED light with a non-flickering lamp bead as the transmitter to transmit information while realizing the lighting function. The smartphone acts as the receiver to capture images with bright and dark stripes, and obtain the azimuth angle by combining the geometric features of the projection and processing the algorithm. Then the position of the receiver is obtained by further calculation. The results show that in the actual application scenario, when the experimental heights are 1.75 and 1.45 m. The system can achieve average positioning errors of 6.9 and 6.5 cm, which verifies the feasibility and effectiveness of the scheme.

The visible light positioning system is the hot spot of current indoor positioning technology research. Aiming at the problem of inaccurate azimuth angle acquisition in single-lamp positioning system, this paper proposes a single Light Emitting Diode (LED) indoor positioning system based on marked LED. The scheme uses a single LED light with a non-flickering lamp bead as the transmitter to transmit information while realizing the lighting function. The smartphone acts as the receiver to capture images with bright and dark stripes, and obtain the azimuth angle by combining the geometric features of the projection and processing the algorithm. Then the position of the receiver is obtained by further calculation. The results show that in the actual application scenario, when the experimental heights are 1.75 and 1.45 m. The system can achieve average positioning errors of 6.9 and 6.5 cm, which verifies the feasibility and effectiveness of the scheme.

Objective To broaden the differential diagnosis thinking of diffuse cystic lung diseases and multiple nodular lung disease, and to deepen the understanding of clinical phenotypes of tuberous sclerosis complex (TSC). Methods A case of TSC with complaint of diffuse lung diseases detected during a routine check-up was presented and relevant literatures were reviewed. Results Further examination confirmed multisystem involvement in the patient including heart, kidney, liver and bone, mimicking metabolic malignant tumor. However, percutaneous renal mass biopsy showed angiomyolipoma, which suggested TSC combined with “Confetti” skin lesions found on physical examination. Peripheral blood whole exome sequencing confirmed the diagnosis of TSC. The pulmonary lesions were improved after treatment with sirolimus. Conclusions High clinical awareness of TSC is essential in the patients with diffuse cystic lung diseases and multiple nodular lung diseases, especially in women. In-depth knowledge of multisystem manifestation in TSC is critical for early diagnosis and treatment of this rare disease.

A high performance liquid chromatographic (HPLC) method was developed for simultaneous determination of seven antioxidants in plastic eye drops bottles and their migration in pharmaceuticals. The samples were ultrasonically extracted and separated by Shim-pack GIST C18 chromatographic column with methanol-water as mobile phase for gradient elution. The flow rate is 1.0 mL/min, the column temperature is 35 °C, the detection wavelength is 276 nm, and the injection volume is 10 μL. The results show that the seven antioxidants have a good linear relationship in the corresponding mass concentration range (R²=0.999 9). The detection limit is 0.15~0.31 μg/mL, and the lower limit of quantification is 0.53°C1.04 μg/mL. The recoveries of extraction test and migration test are 87.02%*105.28% and 84.79%~104.77%, respectively. The relative standard deviation (RSD) of each recovery is not more than 4.80%. Six antioxidants are detected in plastic medicinal eye drops bottles with the content of 3.86~203.54 μg/g. Antioxidant is not detected in migration test eye drops. The method is simple, accurate and reliable, and can be used to investigate the antioxidants in plastic medicinal eye drops bottles and their migration in medicinal. [ABSTRACT FROM AUTHOR]

We use Petri nets to simulate the parallel processing arising in cloud control systems. We introduce performance indexes called clock period, through-put rate and task completion time, and use the max-plus algebra to analyze and optimize the parallel processing performance of cloud control systems. By using the method of segmenting sub-processes and solving the optimal control problem, we design the optimization scheme for parallel task assignment to minimize the completion time, and develop an effective algorithm to compute such a minimum time. Computer performances can be improved through parallel connection of bottle-neck roads. We use the Petri nets to realize the parallel control of bottle-neck sub-processes and present an application of the parallel control in cooperative cloud control systems. [ABSTRACT FROM AUTHOR]

The plant root-associated microbiomes include root microbiome and rhizosphere microbiome, which are closely related to plant life activities. Nearly 30% of photosynthesis products of plants are used to synthesize root compounds, there is evidence that root compounds regulate and significantly affect the root microbiome Tanshinones are the main hydrophobic components in Salvia miltiorrhiza. In order to study whether these compounds can regulate the root-associated microbiomes of S. miltiorrhiza, our study first identified a white root S. miltiorrhiza(BG) which contains little tanshinones. Retain of the fifth intron of tanshinones synthesis key enzyme gene SmCPS1 leading to the early termination of the SmCPS1 gene, and a stable white root phenotype. Further, wild type(WT) and BG were planted in greenhouse with nutrient soil(Pindstrup, Denmark) and Shandong soil(collected from the S. miltiorrhiza base in Weifang, Shandong), then high-throughput sequencing was used to analyze the root-associated microbiomes. The results showed that the tanshinones significantly affected the root-associated microbiomes of S. miltiorrhiza, and the impact on root microbiomes was more significant. There are significant differences between WT and BG root microbiomes in species richness, dominant strains and co-occurrence network. Tanshinones have a certain repelling effect on Bacilli which belongs to Gram-positive, while specifically attract some Gram-negative bacteria such as Betaproteobacteria and some specific genus of Alphaproteobacteria. This study determined the important role of tanshinones in regulating the structure of root-associated microbiomes from multiple angles, and shed a light for further improving the quality and yield of S. miltiorrhiza through microenvironment regulation.

Objective To investigate diabetes-mediated changes in the neuromuscular pharmacodynamics of rocuronium in rats. Methods Diabetes mellitus was induced by a single injection of streptozotocin in rats.A total of 24 male SD rats were assigned to four groups using random number table:the normal control group,diabetic 2-week group,diabetic 4-week group,and diabetic 8-week group(6 rats per group).The sciatic nerve was stimulated in a rain-of-four(TOF)pattern,and the twitch tension changes in the tibialis anterior muscle were demonstrated by mechanomyography after intravenous injection of rocuronium in vivo.The time course characteristics of rocuronium,including onset time,and the recovery time from rocuronium injection to TOF ratio 75%(RT75%)and 90%(RT90%),were recorded,and half maximal inhibitory concentration(IC 50 )values of rocuronium were determined using a four-parameter dose response curve. Results Compared with the normal controls,the diabetic rats had significantly prolonged onset time of rocuronium,while the RT75% and RT90% were decreased at all rocuronium doses(P<0.001).The time course changes became increasingly significant as the duration of diabetes lengthened(P<0.001).The IC 50 and 95% confidence interval values for rocuronium in the normal control group,diabetic 2-week group,diabetic 4-week group,and diabetic 8-week group were 0.37(0.35-0.38)mg/kg,0.44(0.43-0.46)mg/kg,0.59(0.57-0.61)mg/kg,and 0.64(0.61-0.66)mg/kg,respectively.IC 50 values were significantly higher in the diabetic groups vs.normal control(P<0.001)and gradually increased as the duration of diabetes lengthened(P<0.001). Conclusion Diabetes is associated with the rat skeletal muscle hyposensitivity to rocuronium,which is featured by prolonged onset time of rocuronium,decreased RT 75% and RT 90%,and right shift of the cumulative dose-response curve of rocuronium.

Different combinations of low impact development (LID) technologies can be applied for control of urban non-point source pollution. There are currently few evaluations of urban non-point source pollution and pollution load reduction based on a combination of porous asphalt and bio-retention. Taking Shenzhen International Low Carbon City as an example, road-deposited sediments were collected prior to and after rainfall events. Runoff was monitored under six typical rainfall events, from porous asphalt and the inlet/outlet of bio-retention. Through analysis of changes in the process of "build-up-wash-off-transport" of pollutant loads, the average build-up of road-deposited sediments in the study area was found to be (15.80±3.79) g·m -2 ; the mass percentage of road-deposited sediments (size>250 μm) was approximately 65.14%. The average wash-off percentage of six different intensity rainfall events was 17.15%, and road-deposited sediments (size<105 μm) were carried by 62.71%-74.94%. The average pollution loads of surface runoff pollutants SS, TN, and TP were 2.02, 0.025, and 0.0013 g·m -2 , respectively. The removal rates of SS, TN, and TP through porous asphalt under infiltration and filtration were 70.26%, 46.29%, and 19.27%, respectively. The secondary purification removal rates of runoff water in bio-retention were 85.25%, 20.22%, and 70.27%, respectively. Pollutant loads into Dingshan River totaled 0.08, 0.011, and 0.0003 g·m -2 , representing 4.05%, 43.47%, and 24.39% of runoff. The combination thus had a significant effect on runoff purification. Through quantitative research on the formation of non-point source pollution, this paper provides a scientific basis for estimating pollution loads of urban non-point source pollution and evaluating the performance of LID projects. It makes suggestions for the popularization and application of LID and sponge city design in China.

Objective: To observe the effects of blocking and activating chloride channels on hemolysis induced by puerarin injection in rabbits and to investigate the roles of chloride channels in hemolytic reaction induced by puerarin injection., Methods: Rabbit erythrocyte suspension was incubated with different concentrations of puerarin injection(0.75, 1.5, 3, 6, 12 mg/ml) at 37 o C for 6 hours. The cell imaging system was employed to observe whether puerarin injection induced hemolysis. The hemolysis rate was detected by microplate reader and flow cytometry. Effects of activating and closing chloride channels on the hemolysis induced by puerarin injection were explored., Results: Puerarin injection could induce the hemolysis of rabbit erythrocytes in vitro . In the range of 1.5 mg/ml~12 mg/ml, puerarin injection could induce hemolysis in a concentration-dependent manner ( n =3, P <0.01). The chloride channel blockers tamoxifen (20 μmol/L) and ATP (10 mmol/L) significantly inhibited the hemolysis induced by puerarin injection ( n =3~5, P <0.01). Application of low concentration ATP (50 μmol/L) to activate the chloride channel significantly increased puerarin injection induced hemolysis ( n =4, P <0.01)., Conclusions: The hemolytic effect of puerarin injection is dose-dependent in vitro , and the activation of chloride channel is closely related to the hemolysis induced by puerarin injection.

Objective: To explore the therapeutic effects of distal humeral lateral closing wedge osteotomy followed by modified pinning combined with external tension band fixation in the treatment of cubitus varus deformity in children., Methods: Total 26 adult patients with cubitus varus deformity were treated by operation from March 2011 to June 2015, 15 patients were boys and the other 11 patients were girls, ranging in age from 4 to 13 years, with an average of 7.8 years. The cubitus varus angel ranged from 11 degrees to 24 degrees, with a mean(17.50±6.73) degrees, 3 patients complicated more than 10 degrees constriction of flexion. Lateral closing wedge osteotomy retaining the medial 3 to 4 mm intact cortex by lateral elbow approach was applied in these 26 patients. The wedge defect were closed and fixed by crossing pinning. The lateral column compression was achieved with external tension band(the crossing pins were bended laterally and the pin ends were hooked mutually). The pre-operative, post-oparetive and contralateral carrying angles were compared and Laupattarakasem criteria was used to evaluate the results at follow-up., Results: All the patients got bony union 2 months after operation and there was no infection or nerve palsy. The average follow-up period was 18.8 months (ranged, 13 to 29 months). The carrying angle was restored to(11.50±3.17) degrees(ranged, 8 to 14 degrees). According to the Laupattarakasem evaluation criteria, 14 patients got an excellent result, 13 good and 1 fair., Conclusions: Normal carrying angle and elbow flexion could be restored by lateral closing wedge osteotomy, and stable fixation could be achieved with crossing pinning and external tension band, which is available for early mobilization., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

Siliva as a kind of biomarker containing a variety of bioactive components can be used to help disease diagnosis. Compared with the urine and blood, the collection of saliva is more simple and convenient while the collection process is completely non-invasive. Therefore, saliva detection attracts more and more attention in non-invasive disease diagnosis. Histatins are a family of small, cationic, histidine-rich peptides, which secreted by salivary bringing innate defense of the oral cavity. It has been reported that histatins are related to many other diseases, such as HIV and AIDs. Thus the detection of histatins in saliva is significantly important for oral healthy monitoring and disease diagnosis. In this paper, a new label free method for rapid detection of histidine-rich peptides was developed based on the fact that histidine-rich peptides can interact with 3-azidocoumarin through hydrogen bonds which decreases the electron-donating ability of the azido group and results in fluorescence enhancement of the system. The results showed that the fluorescence intensities were dramatically increased when histatin 5 were incubation with 3-azidocoumarin. There is a good relationship with the linear co r of 0.994 between the enhanced fluorescence and histatin 5 concentration ranging from 0.23 to 31.05 μmol·L-1, and the limit of detection is 72 nmol·L-1 (3σ/k). Moreover, the detection of histidine-rich peptides in saliva was successfully achieved by the new developed label free method since amino acids and proteins in saliva will not be interfered with the detection with the recoveries between 96.7%~111.6%. Compared with the existing saliva analysis methods, this method has the advantage of simple, fast and low cost. It might be applied in non-invasive disease diagnosis.

Fruit quality inspection techniques play a very important role in the production and consumption of fruits. In the field of quality non-destructive inspection and grading for fruits, the light-based techniques using optical properties of fruit products were widely used as one of the most practical and the most successful techniques. Quantitative understanding of light interaction with fruits is critical to designing better optical systems for inspection of food quality. In this paper, a fruit model consisted of two layer tissues was developed using Monte Carlo simulations to explore the light transport process and properties in the pome fruits, such as apples and mandarins, which were used as the thin-skinned and thick-skinned fruits respectively. The simulation results obtained are based on the assumption that the light source is a Gaussian beam at the wavelength 808 nm. This paper reports that the effects of skin thickness on light transmission characteristics in fruit tissues, including diffuse reflectance, transmittance, absorptivity, penetration depth etc. The inspection efficiency of flesh tissues was also demonstrated. The results indicated that the transmittance and the penetration depth decreases with the fruit skin increasing. As for the absorbed energy density, the fruit skin tissues have the wider distribution at the radial distance than the fruit flesh tissues. The absorbed energy density always tended to decrease with the inside depth of the fruit tissues increasing, especially decreased more apparently at the radial direction. The diffuse reflectance at the radial distance from 0.2 to 1.2 cm decreased with the decreasing of fruit skin, however it showed the inverse relationship in the radial distance range from 1.2 to 4.0 cm, the diffuse reflectance decreases with the increasing fruit skin. This paper proposed that the interaction between light and fruits skin in transmission or reflective approach, should be considered for developing optical techniques of non-destructive fruit quality inspection. And it provided a theoretical basis for designing more efficient optical detection device, including how to confirm the light source power, size and position of the detector, etc. It has very important significance for fruit quality inspection by optical techniques.

Objective: To summarize our experiences in the treatment of type C3 (AO/OTA) distal radius fractures fixed with AO 2.4 mm locking plates combined with percutaneous pinning after manipulative reduction., Methods: From May 2009 to March 2012, 19 patients (2 cases of both sides) with type C3 (AO/OTA) distal radius fractures were treated with volar locking plates combined with percutaneous pinning for distal radius after manipulative reduction. Among the patients, the average age was (45.3 ± 17.4) years old (ranged, 31 to 66 years old). The fracture were complicated with ulnar styloid fracture in 14 wrists and 6 wrists had distal radioulnar joint instability. All the patients had closed fracture and the mean duration was (6.7 ± 3.5) days (4.5 to 9 days). The Henry approach was applied to expose the fracture site. Joint capsule and ligaments were retained for indirect reduction. After indirect reduction, the poking reduction technique was used to correct the residual compression, and congruence of distal ulnar radial joint was verified under fluorscopic guidance. Styloid process was first pinned percutaneously and then AO 2.4 mm volar locking plate was used to support rigid fixation. The fractures complicated with distal radioulnar joint instability and ulnar styloid fracture were treated with forearm plaster support in supination for 6 weeks., Results: Nineteen patients (21 wrists) were followed up for an average duration of 10.5 months (ranged, 7 to 17 months). Radiographic bone union of distal radius was achieved in all cases, nonunion of the ulnar styloid occurred in 3 cases, and no distal radioulnar joint instability occurred. Tendon irritation was found in 2 cases and disappeared after the internal fixation was removed. The volar tilt, radial angle, radial length, incongruence of articular surface and distal radioulnar joint were observed at the follow-up. According to Batra and Gupta scoring system, 13 wrists were assessed to have a score of more than 80, 5 wrists 70 to 90, 3 wrists less than 70. Meanwhile, the subjective and objective evaluation was executed,range of motion of wrist, residual deformity and complications were observed. According to Sarmiento's modification of the system of Gartland and Werley, 17 wrists got an excellent result, 3 good and 1 fair., Conclusion: Type C3 (AO/OTA) distal radius fractures could be managed with manipulative reduction. Locking plate internal fixation combined with percutaneous pinning can offer enough support for early mobilization and rehabilitation, resulting in a better clinical outcome and satisfactory prognosis.

Objective: To compare the molluscicidal effects between "Luo-wei" (TDS), a plant molluscicide in 4 percent, and metaldehyde and niclosamide (MNSC) in the field., Methods: A natural ecological environment with Oncomelania hupensis was selected as the test area, the test concentrations of TDS and MNSC were 2.5 g/m3 and 2 ml/m3 respectively by the immersion method; the test doses of TDS and MNSC were 3 g/m2 and 2 ml/m2 respectively by the spray method; the doses of WPN in a control group were 2 g/m3 and 2 g/m2 respectively by the two methods above-mentioned. The molluscicidal effects between TDS and MNSC were compared by using the synchronous design method and parallel comparative method., Results: In the TDS group, the death rate of snails was 90.70% by immersion for 24 hours, reached to 81.40% after spraying for 7 days, and there were no significant differences among the observation time points in molluscicidal effects (P > 0.05). One day after the spraying, the death rate of snails was less in the TDS group compared with that in the MSCN group (P < 0.01), but the death rates of snails were similar in both groups 3 days after the spraying (P > 0.05). In the MSCN group, the death rate of snails was 99.17% by immersion for 24 hours, reached to 66.07% by spraying for 1 day. In the WPS group, the death rate of snails was 97.15% by immersion for 24 hours, reached to 71.43% after spraying for 1 day, and there were no significant differences (both P > 0.05)., Conclusion: TDS has a good molluscicidal activity and stable efficacy, and the molluscicidal effect of TDS is similar to that of MSCN in the filed, but the molluscicidal sensitivity of TDS is lower than that of MSCN.

Objective: To study the efficacy of umbilical cord-derived mesenchymal stem cells (UC-MSCs) for bleomycin-induced pulmonary fibrosis in mice., Methods: UC-MSCs were isolated from the umbilical cord after parental consent. One hundred C57BL/6 mice were randomly divided into 4 groups (12 of these for preliminary experiment). Mice in the control group (n = 20) were instilled with PBS via trachea and NS was injected via the tail vein after 3 days. Mice in the stem cell group (n = 20) were instilled with PBS via trachea and were injected with MSC via the tail vein after 3 days. Mice in the bleomycin group (n = 24) were instilled with bleomycin via trachea and NS was injected via the tail vein after 3 days. Mice in the bleomycin plus stem cell group (n = 24) were instilled with bleomycin via trachea and were injected with MSCs via the tail vein after 3 days. All of the mice were sacrificed at the 21(th) day, and the lungs were immediately fixed with 4% paraformaldehyde for 48 h, embedded in paraffin and sectioned at 5 µmol/L thickness. The sections were stained with hematoxylin and eosin (H&E) and Masson-trichrome. Histopathological scoring of pulmonary fibrosis was performed according to Ashcroft's method. The concentrations of matrix metalloproteinases-2 and tissue inhibitor of metalloproteinase-1were determined using immunohistochemistry., Results: Compared with the bleomycin group, MSC transplantation significantly reduced pulmonary inflammation, fibrosis and deposition of collagen in the bleomycin plus stem cell group [(1.55 ± 0.51) vs (2.16 ± 0.77), and (1.45 ± 0.60) vs (2.32 ± 0.82), respectively, P < 0.05]. There was no difference between the control group and the stem cell group [(0.35 ± 0.49) vs (0.37 ± 0.50), P > 0.05]. The expression of MMP-2 in the bleomycin plus stem cell group was lower than the bleomycin group [(1.59 ± 0.59) vs (2.37 ± 0.68), P < 0.05], but there was no difference between the control group and the stem cell group [(0.80 ± 0.69) vs (0.84 ± 0.77), P > 0.05]. The expression of TIMP-1 in the bleomycin plus stem cell group was higher than the bleomycin group [(1.95 ± 0.58) vs (0.79 ± 0.71), P < 0.05], but there was no difference between the control group and the stem cell group [(1.10 ± 0.72) vs (1.32 ± 0.58), P > 0.05]., Conclusion: UC-MSC transplantation could relieve bleomycin-induced fibrosing alveolitis in mice. The mechanism might be related to the expression of MMP-2 and TIMP-1. UC-MSC had no effect on normal lungs.

Objective: To evaluate the effect of Notoginseng Radix on hepatic expression of transforming growth factor beta1 (TGF-beta1) and connective tissue growth factor (CTGF) in rats with alcoholic liver disease (ALD), in order to discuss its protective effect on alcoholic cirrhosis., Method: Fifty SD male rats were divided into the normal control group, the model group, the high-dose and low-dose Notoginseng Radix groups (3.0, 12.0 g x kg(-1)) and the magnesium isoglycyrrhizinate group (24 mg x kg(-1)), with 10 rats in each group. Apart from the control group, other groups were administered with ethanol-cornoil-pyrazole for 14 weeks to establish the alcoholic liver disease model. During the establishment of the model, the high-dose and low-dose Notoginseng Radix groups were administered with 12 g x kg(-1) x d(-1) Notoginseng Radix for 14 weeks, once everyday. Efforts were made to detect liver function, pathology with Masson staining, and the expressions of TGF-beta1, Smad3, Smad7 and CTGF mRNA., Result: Compared with the rats in model group, rats in Notoginseng Radix groups showed significant reduction in liver ALT, AST, collagen fiber deposition, and TGF-beta1, Smad3 and CTGF mRNA expressions in liver tissues, with the increase in the expression quantity of Smad7 mRNA. There were differences between the Notoginseng Radix groups. No significant difference was observed between the high-dose Notoginseng Radix group and the magnesium isoglycyrrhizinate group., Conclusion: Notoginseng Radix can affect TGF-beta1/Smads signaling pathway and reduce the expression of CTGF.

Objective: To investigate the clinical effects of modified Nirschl surgical techniique in treating refractory lateral epicondylitis., Methods: From March 2009 to January 2011,21 patients (21 elbows) with refractory lateral epicondylitis were treated in our hospital. There were 8 males and 13 females,ranged in age from 25 to 59 years with an average of (48.3+/-13.4) years and the duration time from 8 to 33 months with an average of (17.1+/-7.7) months;affected position in dominant sides of 16 cases and non-dominant sides of 5 cases. The patients had already received multiple non-operative treatments. Modified Nirschl surgical technique was performed,and operative origination from origin of musculus extensor carpi radialis brevis to discard process with small incision, the process place of extensor digitorum communis would be removed. The incisions were nursed by ice compress for 2 days after operation. Range of motion (ROM) and strengthening exercise of elbow joints started at the 1 week after plaster slab fixation; ROM and strengthening exercise of wrist joints also started at the 2 week after fixation. The pain, power of gripping and patient staisfaction were recorded after operation. Verhaar scaling were used to estimate the recovery., Results: Seventeen patients were followed up from 13 to 22 months with an average of 16.3 months. According to Verhaar standard, 15 cases obtained excellent results and 2 good. No postoperative complication such as instability was found., Conclusion: Modified Nirschl surgical technique is an effective method in treating refractory lateral epicondylitis but correct to diagnosis and exclusion the coexisting diseases,accurate removal the process are important guarantee.

Objective: To investigate the approach of open reduction and internal fixation for the treatment of anteromedial coronoid facet fractures and associated injury., Methods: From July 2009 to August 2011, 6 coronoid anteromedial facet fractures were treated (4 males and 2 females,the average age was 32.6 years old,ranged from 19 to 49 years old) in our hospital. Three patients had fractures in the left side and 3 in the right(4 dominant sides and 2 non dominant sides). All the patients had close fractures. All the fractures were subtype 2 or subtype 3 of coronoid anteromedial facet fracture according to O'Driscoll classification. The anteromedial incision of elbow and the approach of splitting flexor digitorum superficialis between flexor carpi radialis and palmaris longus were used to apply internal fixation with mini-plate. After fixation of coronoid fracture, widening of radiohumeral joint interspace under varus stress occurred in 3 cases,elbow varus posteromedial rotational instability was showed,and the exploration and repair of radial collateral ligament was not carried out. Plaster was applied for 2 weeks before rehabilitation and the time of plaster application extended to 4 weeks in the patients showed varus posteromedial rotational instability. The motion degree,pain and stability, strength of elbow and hand were recorded,the elbows were evaluated with modified An and Morrey functional rating index., Results: All the patients were followed up,and the average duration was 9.3 months (ranged from 7.5 to 13 months). The strength of elbow and hand were equal to that in the contralateral side. The average flexion was (129.0+/-6.5) degree (ranged from 120 to 135 degree); the average extention was (4.0+/-4.2) degree (ranged from 0 to 10 degree); the average forearm pronation was (84.0+/-6.5) degree (ranged from 75 to 90 degree); average supination was (89.0+/-7.1) degree (ranged from 80 to 100 degree). One patient had ulnar sensory neuropathy after operation and healed in half-year, no postoperative complications as pain and instability accured. All the patients obtained excellent results according to modified An and Morrey functional rating index., Conclusion: The approach of splitting flexor digitorum superficialis between flexor carpi radialis and palmaris longus could be used in open reduction and internal fixation of anteromedial coronoid facet farcture, rehabilitation should be postponed in the patient showed elbow varus posteromedial rotational instability.

Objectives: To observe the immunohistochemical staining of IgG4 in nonspecific interstitial pneumonia (NSIP) and to study the clinicopathological features of IgG4-related NSIP., Methods: Retrospective analysis was carried out for 32 patients with NSIP who had been admitted into Peking Union Medical College Hospital from November 2002 to October 2010. The diagnosis of NSIP was established by surgical lung biopsy and all specimens were fixed in neutral formalin and embedded in paraffin. Sections were cut for HE and immunohistochemical stain. According to the diagnostic criteria for IgG4-related disease, 4 cases were confirmed to be IgG4-related NSIP. The clinicopathological features including clinical history, laboratory examination, and pathologic evaluation were studied., Results: The 4 patients with IgG4-related NSIP included 1 man and 3 women, with a median age of 48 years (range, 44 - 56 years). The presenting symptoms were dry cough or shortness of breath. One patient (1/4, 25.0%) was found to have a positive autoantibody but no cases showed positive RF in serum. The histological finding of the 4 cases was characterized by inflammatory cell infiltration in interstitium with fibrosis, and 1 case showed obliterative arteritis. The numbers of IgG4-positive plasma cells in the 4 cases were 42/hpf, 22/hpf, 11/hpf, and 33/hpf respectively, while the percentages of IgG4-positive to IgG-positive plasma cells were 70%, 71%, 57%, 43% respectively., Conclusions: IgG4-related interstitial pulmonary disease can be characterized as the NSIP pattern. The pathological features of IgG4-related NSIP include infiltration of lympho-plasmacytes and eosinophils in interstitium with fibrosis, and lymphoid follicles are frequently identified in the area of lymphocyte aggregation, but obliterative arteritis is infrequently identified in the lesion. Immunohistochemical staining of IgG and IgG4 is very helpful for a definite diagnosis of IgG4-related disease.

Objective: To study the differential in vitro motor and invasion capacities of methotrexate (MTX) enantiomer-resistant tumor cells., Methods: The incremental concentrations and successive low-dose induction were employed to acquire the cell series resistant to 15 µmol/L MTX enantiomer, namely L-(+)-MTX/A549 and D-(-)-MTX/A549. Their drug-resistant indices were determined by MTT assay and their migration capacities by wound healing assay. Double soft-agar clone formation was used to detect the colony efficiency and size. And Transwell was employed to detect the in vitro movement and invasion capacity of three cell types., Results: The resistance indices of L-(+)-MTX/A549 and D-(-)-MTX/A549 were (6.1 ± 1.0) and (20.3 ± 1.8) respectively. At 72 hours after wound healing assay, the number of L-(+)-MTX/A549 entering scratch zone was fewer than that of D-(-)-MTX/A549; The numbers of colony formation in D-(-)-MTX/A549, L-(+)-MTX/A549 and parental cells were (50 ± 7), (44 ± 6), (52 ± 7) and the rates of colony formation (1.68% ± 0.23%), (1.49% ± 0.18%), (1.73% ± 0.23%) respectively. And there was no significant significance among three groups (P > 0.05). But the size of D-(-)-MTX/A549 was larger than that of L-(+)-MTX/A549. Transwell detected infiltration and invasion through artificial basement membrane Matrigel. The numbers of D-(-)-MTX/A549, L-(+)-MTX/A549 and parent cells were (267 ± 30), (106 ± 16) and (134 ± 16) respectively. The data were significant between D-(-)-MTX/A549 cells and L-(+)-MTX/A549 or parent cells (P < 0.05) but not significant between L-(+)-MTX/A549 and parent cells (P > 0.05)., Conclusion: The D-(-)-MTX-induced NSCLC A549 cells have greater motor and invasion capacities than those of L-(+)-MTX-induced ones. It suggests that MTX enantiomer has different capacities of tumor invasion and metastasis after acquiring resistance.

Objective: To understand the trends and influential factors on infant mortality in Henan province from 2000 to 2010., Methods: Descriptive method, Cox-Stuart trend test and multiple linear regression were used to study the infant mortality trends and related influential factors in the regions with monitoring programs of Henan province, from 2000 to 2010., Results: The total urban and rural infant mortality rates dropped significantly, from 30.91 per thousand, 10.05 per thousand, 33.99 per thousand in 2000 to 7.12 per thousand, 5.51 per thousand, 8.03 per thousand in 2010, respectively. The average annual rates of decrease were 13.65 percent, 5.83 percent and 13.44 percent. The downward trends were statistically significant (P < 0.05). The infant mortality rates dropped more significantly in rural areas (25.96%) than in the urban areas (4.54%). Difference between urban and rural areas reduced from 23.49% to 2.52%. Rates on factors as setting up maternal record cards, carrying on postpartum visits, hospital delivery, or under help by new midwives and low birth weight rate etc. were remarkably influencing the rate on infant mortality (F = 229.738, P = 0.004). In order, the impact of strengths on those factors showed as: hospitalized delivery rate, low birth weight rate, the rate of 'clean' delivery, setting up record cards on postpartum visits., Conclusion: Total provincial, urban and rural infant mortality rates all showed downward trends. The infant mortality rates dropped more significantly in rural areas than in urban areas. Difference between urban and rural areas was gradually getting small. Rates on setting up maternal record cards, carrying on postpartum visit, hospital delivery and under help by new midwives rate were important factors that significantly impacting the infant mortality rate. Work on setting up record cards and hospital delivery should be further strengthened.

Objective: To describe the characteristic of Th17 cells in peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) from patients with sarcoidosis, and to investigate the effect of glucocorticoid therapy on the expression of RORγt mRNA, and therefore to explore the role of Th17 cells in the immunopathogenesis of pulmonary sarcoidosis., Methods: Ten patients with active pulmonary sarcoidosis who were prescribed with prednisone according to the guidelines were defined as the study group. All of them had positive pathological results and had definite response to corticosteroids. Ten healthy controls were recruited from volunteers with similar sex distribution and age. The proportion of CD(4)(+)IL-17A(+)T cells in peripheral blood mononuclear cells (PBMC) and BALF were calculated by flow cytometry. The mRNA expression of RORc in PBMC was measured by Real-time PCR., Results: The mean age was (52 ± 8) years in both the study group and the controls, and there were 9 females and 1 male in both groups. The proportion of CD(4)(+)IL-17A(+)T cells was higher in the PB of sarcoidosis patients compared to that of the controls [(1.61 ± 1.09)% vs (0.51 ± 0.43)%, t = 3.02, P = 0.014]. For the same patients, the proportion of CD(4)(+)IL-17A(+)T cells was higher in the BALF compared to that in the PB [(3.05 ± 1.87)% vs (1.61 ± 1.09)%, t = 2.94, P = 0.001]. After 4 to 6 week therapy with glucocorticoids, all the 10 patients showed definite response. The level of RORc mRNA in the PB did not decrease significantly after treatment [(0.952 ± 0.367) vs (0.168 ± 0.272), t = 1.76, P = 0.057], although a trend was noted., Conclusions: Th17 cells was probably involved in the immunopathogenesis of sarcoidosis, and glucocorticoids might modulate the disturbance of Th17 cells in pulmonary sarcoidosis.

Objective: To explore therapeutic effects of Modified pinning combined with external tension band for the treatment of Gartland type III humeral supracondylar fractures in children., Methods: From February 2009 to November 2010, 79 children with Gartland type III humeral supracondylar fractures were treated by modified pinning (pinning cross internal and external condyle assisted with lateral condyle) combined with external tension band (crossing needle end and hooking around) through lateral approach of elbow. There were 47 males and 32 females, with an average age of 8.7 years (ranging from 2.5 to 14 years). The time from injury to operation was 2 h to 8 d. The elbow joint function and Carrying angle were observed before and after treatment. The Flynn criteria were used to evaluate therapeutic effects., Results: Sixty-one patients were followed up (18 patients' data were lost) for 6-30 months (mean 13.5 months). According to Flynn criteria, 53 patients got excellent result, 7 good and 1 fair., Conclusion: Treatment of child Gartland type III humeral supracondylar fractures with modified pinning combined with external tension band through lateral approach of elbow is believed to be an ideal method, which has advantages of reliable fixation, rapid recovery and less complications.

Objective: To assess the control effect of transmission control of schistosomiasis in 14 counties (cities, districts) of Jiangsu Province., Methods: According to the requirement of the national assessment scheme of schistosomiasis, the effect of schistosomiasis control was evaluated. The schistosomiasis morbidity and changes in Oncomelania snail status in recent 2 years were assessed. The field survey was done by using the stratified sampling method. A heavy-endemicity administrative village was randomly sampled from the townships with low, moderate and heavy endemicities in each county, respectively as the assessment villages. The morbidity in resident populations and free-grazing domestic animals and the snail infections in the settings where snails were detected and frequent human and domestic animal activities were observed in recent 3 years., Results: During the period from 2007 through 2010, the transmission control effect of schistosomiasis was assessed in 14 counties (cities, districts) of Jiangsu Province, and field surveys were performed in 42 villages of 39 townships. A total of 264 settings, 1 679.73 hm2 and 39 894 frames were surveyed, and 2 179 snails were collected. Of the 405 living snails dissected, no infected snails were detected, and the snail infection rate was 0. Totally 22 147 residents were investigated. The serum examination of schistosome infection was performed in 22 147 residents, and 300 were sero-positive, with a sero-positive rate of 1.35% (0.30%-4.26%). The stool examination was done in 297 sero-positive cases, and no cases were stool-positive, with a stool-positive rate of 0. A total of 2 931 domestic animals were investigated, including 230 head of cattle, 2 333 pigs and 368 sheep, and no infections were detected. The files regarding the schistosomiasis morbidity and snail status have been established in 14 counties (cities, districts). All infected snails were killed in the 14 counties (districts, cities) 2 years prior to the assessment, and the mean time that no infected snails were detected was 2.71 years (2-4 years). No acute schistosomiasis patients were found in all 14 counties (districts, cities) more than 3 years prior to the assessment., Conclusion: According to the Criteria for Control and Elimination of Schistosomiasis in China (GB 15976-2006), the transmission of schistosomiasis in 14 countries (cities, districts) of Jiangsu Province has been controlled.

Objective: To explore an ideal procedure with more lasting aesthetic results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy, which can help to correct the crow's feet successfully., Methods: During rhytidectomy, dissection was performed subcutaneously and also under pericranium and superficial temporal fascia at temporal area. Then the superficial temporal fascia flap was formed by cutting between pericranium and superficial temporal fascia. The fascia flap was reversed to cover the lateral orbicularis oculi muscle with fixation., Results: From May 2004 to May 2010, 18 cases were treated with a follow-up period of 6-12 months. The crow's feet was corrected better with long lasting results, compared with conventional rhytidectomy. No complication happened., Conclusions: The crow's feet can be corrected markedly with long lasting results by covering the orbicularis oculi muscles with the superficial temporal fascia flap in rhytidectomy.

Objective: To develop a small-caliber vascular grafts and study its morphologies, mechanical properties and biocompatibility., Methods: The effects of electrospinning conditions on the microstructure and porosity of the resulting scaffolds were investigated for preparation of a small-caliber (4 mm) polyurethane vascular grafts with optimum microstructures and mechanical properties. The mechanical properties and biocompatibility of the prepared grafts were evaluated., Results: The polyurethane vascular grafts showed a three-dimensional reticular structure consisting of nanofibers, with an average porosity of (51.48∓4.47)% and tensile strength of 5.85 ∓ 0.62 MPa. The grafts provided a better long-term support than e-PTFE graft for endothelial cell growth and endothelialization., Conclusion: The polyurethane vascular prosthesis possessed favorable microstructures, excellent mechanical properties and good biocompatibility for potential clinical application.

Objective: To investigate the prognostic implications of clinical and physiological variables, and the cellular classification of bronchoalveolar lavage fluid (BALF) in patients with idiopathic pulmonary fibrosis (IPF). The effect of treatment with glucocorticoids with or without cytotoxic drugs was also evaluated., Methods: The significances of clinical, arterial blood gas analysis, pulmonary function test, lung high-resolution computed tomography, echocardiography and BALF in the prognosis of patients with IPF were assessed in 65 patients with IPF at diagnosis. Univariate Cox proportional-hazards regression analysis was used to evaluate the various parameters associated with hazard ratio. The survival rates of all groups were compared using the Kaplan-Meier method., Results: In 38 months of average follow-up time, the survival rate of the patients was 43.1%, and the median survival time was 39 months after diagnosis. Univariate Cox proportional-hazards regression analysis showed that body mass index, clubbing fingers, ESR, PaO(2)/FiO(2), SaO(2), TLC%, D(L)CO%, pulmonary arterial pressure and the percent of neutrophil in BALF were factors that affected the prognosis of the patients with IPF (HR 0.842 - 1.945, Wald 3.782 - 12.963, P < 0.05). In the meanwhile, the patients were divided into 2 groups by the median of significant variables in univariate Cox proportional-hazards regression analysis (the cut off point value), and the survival rate group comparison showed statistically significant difference in body mass index, clubbing fingers, ESR, TLC% as well as D(L)CO% (Log-rank 3.907 - 10.452, P < 0.05), while glucocorticoids with or without cytotoxic drugs for patients with IPF did not change the prognosis (Log-rank 2.405, P > 0.05)., Conclusions: Body mass index, clubbing fingers, ESR, PaO(2)/FiO(2), TLC%, and D(L)CO% maybe the factors affecting the prognosis of patients with IPF, while glucocorticoids with or without cytotoxic drugs did not change the course of IPF.

Objective: To describe the clinical characteristics of 9 cases of idiopathic pulmonary alveolar proteinosis (iPAP) with secondary infections., Method: The clinical and radiological data of 9 patients with iPAP and secondary infections admitted into Peking Union Medical College Hospital from 1st January 1990 to 1st January 2010 were retrospectively analyzed., Results: In that period, there were 97 patients of iPAP were admitted in our hospital. There were 9 patients of iPAP with secondary infections, aged (46.4 ± 14.6) y. There were 5 males and 4 females. Among them, 6 patients were misdiagnosed as interstitial pneumonia and corticosteroids were given to them. When the infection appeared, corticosteroids were still given to 3 patients, and the other 3 patients had stopped corticosteroids for 3 to 15 and a half months. Five patients had accepted mono-lung or whole lung lavage before 1, 2, 9, 14, 24 months. The clinical manifestations were fever (8 cases), cough (9 cases), expectoration (8 cases), hemoptysis (2 cases), chest pain (1 case) and moist rales (1 case). Glass-ground opacities (9 cases) and cavitations (4 case) were the main manifestations of chest radiology. Pleural effusions (1 case) was not common. The locations of infection was limited in chest: 9 cases had pulmonary infection and one case was associated with pleurisy. The infectious pathogens were the acid-fast tubercle bacillus (4 cases), fungus (3 cases, candida albicans, penicillium and aspergillus fumigatus for each one) and nocardia (2 cases, one case was associated with cytomegalovirus infection)., Follow-Up: 6 patients were cured, 1 patient was improved and 2 patients were died., Conclusions: For patients with iPAP, especially when they had been receiving corticosteroids, if they had fever and/or recently exaggerated dyspnea, especially whose chest radiology showed nodules and cavitations, the clinicians should be aware of infections diseases for them. Further specific microbiological studies and sufficient therapy should be obtained as quickly as possible.

Objective: To investigate the relationship between the resistance of methotrexate (MTX) enantiomer and the gene expression levels of folylpolyglutamate synthetase (FPGS)., Methods: The cell lines of MTX enantiomer resistance from 15 - 55 µmol/L were obtained when the A549 cell lines were exposed intermittently and progressively to an incremental dose of each MTX enantiomer. The resistant index of MTX resistance cell lines were detected by MTT. The gene expressions of FPGS in cytoplasm and mitochondria were detected by real-time quantitative polymerase chain reaction (PCR)., Results: The resistance indice of D-(-)-MTX resistant cell lines were higher than those of L-(+)-MTX resistant cells (32.7 ± 9.3 vs 11.5 ± 2.9, P < 0.05). The resistant indice of L-(+)-MTX/A549 were from 5 to 15, which mean the middle resistance. The resistant indice of D-(-)-MTX/A549 were more than 15, which mean the severe resistance. The expression of mFPGS had difference between resistant cell lines of L-(+) and D-(-)-MTX except at 15 µmol/L MTX (at 25 µmol/L, 1.3 ± 0.7 vs. 2.3 ± 0.9; at 35 µmol/L, 1.1 ± 0.9 vs. 2.6 ± 0.3; at 45 µmol/L, 1.0 ± 1.0 vs. 1.4 ± 0.8; at 55 µmol/L, 0.2 ± 0.1 vs. 1.0 ± 0.2; all P < 0.05). The expressions of cFPGS had no difference between resistant cell lines of L-(+) and D-(-)-MTX at 15 µmol/L MTX, while at 25 - 55 µmol/L, the cFPGS levels and resistance indice of D-(-)-MTX/A549 resistant cell lines showed a highly negative correlation (r = -0.95, P < 0.05)., Conclusion: There may be a different mechanism between the first time treatment with 15 µmol/L dosage and the continual treatment with more than 25 µmol/L dosage in A549 cell lines. There had higher resistant index in D-(-)-MTX/A549 cell line than in L-(+)-MTX/A549 cell line. The results indicated that the difference in chirality should be considered in clinical treatment with MTX.

Objective: To summarize the epidemiology and risk factors of deep venous thrombosis (DVT) during pregnancy and develop therapeutic strategies., Methods: Twenty-nine pregnant women with DVT were admitted into our hospital between 1991 and 2010. And their clinical data were retrospectively reviewed., Results: Among all cases, the occurrence (69%, 20/29) of DVT in the first trimester was highest as compared with those in the second and third trimesters. A previous history of DVT was a leading risk factor (24%, 7/29). Twenty-four cases (82.8%, 24/29) involved left lower extremities. Anticoagulation was the primary therapy. All cases were initially intravenously administrated with unfractioned heparin (UFH) or injected subcutaneously with low-molecule-weight heparin (LMWH). LMWH continued throughout pregnancy in 7 cases. The fetus had a normal development. Due to financial problems, 11 cases in the first trimester and 2 cases in the second trimester switched to oral warfarin from LMWH after the initial treatment. And warfarin was substituted by LMWH by Week 34. However the fetuses died in 4 cases while the other fetuses were normal. Nine cases in the first trimester decided to terminate pregnancy., Conclusion: Treatment decisions during pregnancy carry potential implications for both maternal and fetal health and life. Therefore the DVT strategies during pregnancy differ from those during non-pregnancy. Special cautions should be exercised for the treatment of DVT during pregnancy.

Objective: To describe the clinical characteristics of nocardiosis., Method: The clinical and radiological data of 26 patients with nocardiosis admitted into Peking Union Medical College Hospital from 1st January 1990 to 1st January 2010 were retrospectively analyzed. All of the patients had our microbiology laboratory identified nocardia species in one or more clinical specimens., Results: Nocardiosis was diagnosed in 10 men, aged from 29 to 80 years, mean (52 ± 14) years, and in 16 women, aged from 15 to 71 years, mean (42 ± 17) years. No cases were identified in children. Six patients had no significant underlying conditions, while the other patients had at least one underlying condition, including autoimmune diseases (n = 6), chronic lung disease (n = 6), neoplastic disease (n = 2), chronic renal disease (n = 3), diabetes mellitus (n = 1), chest crush injuries (n = 1) and Cushing's syndrome (n = 1). Eleven cases had been receiving corticosteroids. The most common manifestations were moderate to high fever (n = 25), cough (n = 22), expectoration (n = 19), pleuritic chest pain (n = 10), hemoptysis (n = 8) and moist rales (n = 10). Some of them had subcutaneous (n = 5) and brain abscess (n = 4). Blood tests showed elevated ESR in 14 cases and decreased albumin levels in 14 cases. Patchy infiltrates or consolidation (n = 21) and cavitations (n = 10) were the main manifestations of chest radiology. Pleural effusions (n = 13) were common complicated manifestations. Thoracic lesions were always bilateral (n = 15). Only 4 patients were diagnosed by sputum culture. The other patients were diagnosed by culture of specimens obtained invasively: 8 positive pleural effusions, 2 positive bronchioalveolar lavage culture, 1 positive bronchial washings, 4 positive abscesses, 7 positive lung tissues, and 1 positive brain abscess. Nocardia brasiliensis (n = 9) and Nocardia asteroids (n = 6) were the main species. There was one case with Nocardia otitisdiscaviarium infection and the other cases with Nocardia undifferentiated. Result of antimicrobial susceptibility was unavailable in 10 cases. Among the other 16 results, 7 strains of nocardia were resistant to trimethoprim sulfamethoxazole (TMP(CO)). Six cases were treated with a single drug, 5 cases with trimethoprim-sulfamethoxazole and 1 with minocycline. The other patients were given combination treatment, including trimethoprim-sulfamethoxazole, amikacin, cefuroxime, ceftriaxone, amoxicillin-clavulanic acid, streptomycin, evofloxacin, ciprofloxacin, minocycline and imipenem. Four patients died, 2 patients relapsed and the other 20 cases cured., Conclusions: For immunosuppressed patients, nocardia infections should be considered when they had moderate to high fever and respiratory manifestations, especially accompanied with subcutaneous and/or brain abscess, and the chest radiology showed patchy infiltrates and/or consolidations. Further specific microbiological studies and sufficient therapy should be obtained as quickly as possible.

Objective: To analyze the correlation between myocardial ischemia and carotid atherosclerosis in hypertensive patients., Methods: The clinical data were collected from 85 hospitalized hypertensive patients admitted between May 2005 and September 2008 without the complication of coronary artery disease as confirmed by cardiac computed tomographic angiography (CTA). According to the results of treadmill exercise test, the patients were divided myocardial ischemia group and ischemia-free group. Univariate and multivariate analyses were used to screen the risk factors of myocardial ischemia. The correlations were analyzed between myocardial ischemia, common carotid artery intima-media thickness (IMT), Crouse score of the carotid plaque, thickness of the intraventricular septum and left artrium. The receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of IMT and Crouse score in predicting the presence of myocardial ischemia in hypertensive patients., Results: Carotid plaque formation was identified as the major risk factor of myocardial ischemia in hypertensive patients (OR=4.982, P=0.004). The incidence of myocardial ischemia in the hypertensive patients with carotid plaques was significantly higher than that in the patients without the plaque (Chi2=9.317, P=0.002). Myocardial ischemia in hypertensive patients was positively correlated to the thickness of the intraventricular septum (r=0.362, P=0.001) and left artrium (r=0.298, P=0.009), and the IMT of the common carotid artery was positively correlated to the thickness of the intraventricular septum (r=0.231, P=0.045). The area under cure (AUC) of the ROC curve of Crouse score was 0.726-/+0.061 in predicting the presence of myocardial ischemia in the hypertensive patients (P=0.001), and that of IMT was 0.682-/+0.061 (P=0.006)., Conclusion: Carotid plaque formation is the major risk factor of myocardial ischemia in hypertensive patients and shows a positive correlation to the onset of myocardial ischemia, but both the common carotid artery IMT and the Crouse score of the carotid plaque are not accurate markers for predicting myocardial ischemia in patients with hypertension.

Objective: The purpose of this paper was to investigate the clinical and radiological features of pulmonary tuberculosis presenting as interstitial lung diseases (ILD)., Methods: We analyzed the data of cases suspected of diffuse parenchyma lung diseases at this hospital between October 2003 and October 2007. The diagnosis of active pulmonary tuberculosis was based on epithelioid granuloma or positive acid-fast bacilli in lung biopsy and changes on serial radiographs obtained during treatment., Results: The data of a series of 230 consecutive patients with suspected ILD were retrospectively analyzed. The diagnosis was confirmed by lung biopsy. Twelve patients were confirmed to have pulmonary tuberculosis. There were 5 males and 7 females with a mean age of 38 +/- 11 years (range, 17 - 68). The median course of disease in these patients was 3 months (range, 0.5 - 18 months). Patients with pulmonary tuberculosis presented with fever (11/12), cough (9/12), weight loss (7/12), dyspnea (7/12), lymphadenopathy (4/12), and splenohepatomegaly (2/12). On chest CT scan, ground-glass attenuation was identified in 4, bilateral patchy infiltration in 5, tree-in-bud appearance 1, and centrilobular lesions in 2 of the 12 patients. During the follow-up period (median, 9 month, range from 3 to 12 month), 11 patients improved, but 1 died of diabetic ketoacidosis., Conclusion: The diagnosis of pulmonary tuberculosis should be considered in suspected ILD patients presenting with fever, splenohepatomegaly and lymphadenopathy.

Objective: To study the effect of the treatment for comminuted fractures of proximal humerus with open reduction and internal fixation, and the influence of the different internal fixation., Methods: From January 2003 to June 2007, 423 cases of comminuted fractures of proximal humerus were treated with open reduction and internal fixation. Among them, 139 patients included 51 males and 88 females were treated with the Kirschner needle with an average age of 55.8 years old ranging from 35 to 72 years, and the average course was 7 days (from 3 to 20 days); 103 patients included 48 males and 55 females were treated with the cloverleaf plate with an average age of 56.7 years old (from 22 to 76 years), and the average course was 8.5 days (from 3 to 23 days); 181 patients included 85 males and 96 females were treated with the locking plate with an average age of 57.1 years old (from 29 to 77 years), and the average course was 7.9 days (from 3 to 21 days). The pain, daily activities, orbit, and the strength of the shoulder were evaluated with the Constant's scale., Results: The wound of all the cases was primary healing. All patients were followed-up for over 12 months, the sings and symptoms of all the patients were improved very well. There was significant difference between, before and after operation on Constant's scoring. While there was not significant difference among the different internal fixation., Conclusion: Open reduction and internal fixation is effective for comminuted fractures of proximal humerus. There is no significant difference on therapeutic efficacy in different internal fixation.