ABSTRACT
Objective To explore the value of peripheral blood samples in KRAS mutation testing of colorectal cancer patients and the correlation between the number of circulating tumor cells and KRAS mutation testing.Methods We detected KRAS mutation using amplification refractory mutation system PCR method in paraffin embedded tissues and matched peripheral blood samples obtained from 112 colorectal cancer patients and 10 proctitic peripheral blood samples in Affiliated Hospital of Jiangnan University between 2013 and 2014.Meanwhile,immunofluorescence in situ hybridization method was used to count the circulating tumor cells in peripheral blood samples and proctitic control samples.Results Among the 112 colorectal cancer samples tested,25 cases of peripheral blood samples found KRAS mutation (41.1％) and which was 46 in formalin fixed paraffin embedded tissues testing (22.3 ％),with a significant difference (x2 =40.12,P ＜ 0.001).One case with KRAS wild type in formalin fixed paraffin embedded tissues was mutation type in peripheral samples.In another case,mutation site was different in different kinds of samples.The sensibility of KRAS mutation testing was 73.3％,41.9％ and 16.7％ when the number of circulating tumor cells was more than 15,5 to 15,and 1 to 5,respectively,with significant differences (x2 =23.70,P ＜ 0.001).No KRAS mutation and no circulating tumor cells were found in 10 proctitic control samples.Conclusion We find high specificity in KRAS mutation testing of peripheral blood samples.but the accurate rate is not satisfying.KRAS mutation testing in peripheral blood samples may be an optional choice to test KRAS mutations for colorectal cancer patients who were not subjected to surgery.The sensibility of KRAS mutation testing in peripheral blood samples has a corretion with the number of circulating tumor cells.
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Objective Comparison of the modified Weaver-Dunn method with AO clavicular hook plate for acromioclavicular joint dislocation efficacy.Methods Surgical treatment of Rockwood Ⅲ to the V Type acromioelavicular joint dislocation 35 cases,depending on the surgical approach,were divided into 2 groups of the modified Weaver-Dunn method and AO clavicular hook plate.Operation time,blood loss,hospitalization costs,postoperative Xray film results,the clinical efficacy results and complications were compared between two groups.Results Modified Weaver-Dunn method Section of the longer operative time,mean intraoperative blood loss more.Shoulder pain,the incidence of postoperative modified Weaver-Dunn method group is significantly lower than the AO clavicular hook plate group,abduction activity was better than AO clavicular hook plate group.AO clavicular hook plate group prone to shoulder mobility and shoulder pain.Postoperative Karlsson assessment standard,modified Weaver-Dunn method were excellent in 10,good in 4 cases and poor in 1,excellent rate was 93％ ;AO clavicular hook plate group were excellent in 8 cases,good in 7 cases and poor in 5 cases,excellent rate of 75 ％.Conclusion Modified Weaver-Dunn method is used to treat complete acromioclavicular joint dislocation.Postoperative shoulder pain and shoulder mobility are in low incidence of shoulder function recovery effect.
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Objective To explore the main points of early diagnosis,the principles and the efficacy of surgical treatment of Lisfranc injury.Methods The clinical data and follow-up results of 23 cases of patients with Lisfranc injury treated from April 2004 to February 2011 (17 males,6 females,aged from 19 to 57 years old) were collected and analyzed.All patients underwent open reduction and internal fixation,among them,13cases with Kirschner wire fixation and 10 cases with screws fixation.Efficacy was evaluated in accordance with Maryland foot score.Results Twenty-one patients were followed up for 6 - 46 months with an average of (28.5 ± 2.6) months.In the last follow-up no patients has internal fixation fracture,loss of reduction and other complications.The score was 56 - 97 points with an average score of ( 86 ± 8 ) points.The results showed excellent in 6 cases,good in 10 cases and fair in 3 cases,good rate was 76.2％.Conclusion Lisfranc injury can be diagnosed by early signs and symptoms,and can be confirmed by combining with radiographic examination.Lisfranc injury should be treated with open reduction and internal fixation with Kirschner wire or screw,both of the two fixation methods can achieve good results.