OBJECTIVE To determine the germicidal efficacy and corrosiveness of San Xiao pyrogen inactivator.METHODS Its germicidal efficacy was measured with carrier test.RESULTS The killing rate of Bacillus subtilis var.niger spores exposed to its solution containing available chlorine 750mg/L for 30 min attained 100%.Its solution containing available chlorine 500 mg/L with a 15 min contact time could destroy HBsAg antigenicity in suspension.Its germicidal efficacy decreased in presence of organic substance.Its water solution containing available chlorine 1000mg/L was not corrosive to stainless steel,moderately corrosive to carbon steel and severely corrosive to copper and aluminum.CONCLUSIONS San Xiao pyrogen inactivator is a kind of original disinfectant which has better germicidal efficacy and uses safely.

Objective To investigate the relationship between the expressions of proliferating cell nuclear antigen (PCNA), p53 and Bcl-2 protein and clinical chemothreapy, prognosis in bone marrow cells in children with acute leukemia (AL). Methods Immunohistochemical SP method was used to detect the expressions of PCNA, p53 and Bcl-2 in specimens of bone marrow puncture of 59 children with AL and 15 healthy children as control. Results There was a significant difference in the expressions of PCNA, p53 and Bcl-2 proteins between the initially treated patients and healthy subjects, and between the remission patients and non remission ones. There was not a significnat difference in PCNA expression between the refractory patients and healthy subjects, and PCNA expression was related to the chemotherapeutic sensitivity. There was a significant difference in the 6-week remission rate between the patients with and without PCNA expression, but there was no significant difference in the over 3 years survival rate without illness. The expression levels of Bcl-2 and p53 were significantly higher in the refractory patients than those in healthy subjects. The patients with the high expression of p53 and Bcl-2 were resistant to chemotherapy, low in the remission rate and poor in prognosis. Conclusion The AL patients with PCNA expression were higher in remission rate, and PCNA expression was not associated with long-term prognosis. The AL patients with the expression of p53 and Bcl-2 were lower in remission rate, and their expression was associated with long-term prognosis. Both p53 and Bcl-2 protein may serve as a molecular marker to predict chemotherapeutic sensitivity and prognosis. PCNA, p53 and Bcl-2 may be involved in the pathogenesis of child AL by various ways. It is more valuable for predicting prognosis to simultaneously detect the expression of PCNA, p53 and Bcl-2 proteins.

This study was aimed to verify the effects of staged sequential therapy on expressions of matrix metalloproteinase-9 (MMP-9) and its inhibitor TIMP-1 within lung tissues in asthmatic rats with the airway remodeling, by applying a series of tests such as the immunohistochemistry, western blot and real-time fluorescent quantitative PCR. SD rats were randomly divided into 7 groups, which were the asthmatic group (Group X), the normal group (Group Z), the No. 1 sequential therapy group (Group A1), the No. 2 sequential therapy group (Group A2), the No. 3 sequential therapy group (Group A3), the montelukast group (Group M), and the budesonide group (Group B). The asthmatic model was established in each group except Group Z, by sensitization with both ovalbumin (OVA) and aluminium hydroxide via injection at the 1st, 8th and 15th day in a 22-day duration, followed by OVA aerosol inhalation every other day for 8 weeks for asthma activation. At the 8th day after the asthmatic model was established, Group A1 was orally given Ma-Xing Er-Chen Tang (MXECT) during acute phase while given normal saline (NS) during catabasis and stable phase; Group A2 was given MXECT during acute phase, and given modified Jin-Shui Liu-Jun Jian (JSLJJ) during catabasis as well as given NS during stable phase; Group A3 was given MXECT during acute phase, and given modified JSLJJ during catabasis as well as given Liu-Wei Di-Huang (LWDH) Powders during stable phase;Group M was given salbutamol via aerosol inhalation after stimulation, while orally given montelukast during catabasis and stable phase; Group B was given salbutamol via aerosol inhalation after stimulation, while given inhaled budesonide during catabasis and stable phase; Group X was given NS. After the 7-week intervention, the immunohistochemistry, western blot and real-time quantitative PCR were applied to analyze the location and quantitative expression of MMP-9 and TIMP-1, so as to find out the biological mechanism on expressions of MMP-9 and TIMP-1 in lung tissues of asthmatic rats from molecular levels to gene levels. The results of immunohistochemistry, western blot and real-time fluorescent quantitative PCR showed as follows. Compared with Group Z, the contents of MMP-9 and TIMP-1 increased significantly within lung tissues in Group X. Compared with Group X, the contents of MMP-9 and TIMP-1 decreased within lung tissues of asthmatic rats in each treatment group. It was concluded that the expression of MMP-9 and TIMP-1 elevated during asthma. TCM staged sequential therapy can regulate the ratio between MMP-9 and its inhibitor so as to block the airway remodeling, by decreasing the expression of MMP-9 and its inhibitor within lung tissues in asthmatic rats. This is one of the important action mechanisms.

OBJECTIVE1-Bromo-3-chloro-5,5-dimethylhydantoin (BCDMH) is a solid oxidizing biocide for water disinfection. The objective of this study was to investigate the toxic effect of BCDMH on zebrafish.

METHODSThe developmental toxicity of BCDMH on zebrafish embryos and the dose-effect relationship was determined. The effect of BCDMH exposure on histopathology and tissue antioxidant activity of adult zebrafish were observed over time.

RESULTSExposure to 4 mg/L BCDMH post-fertilization was sufficient to induce a number of developmental malformations, such as edema, axial malformations, and reductions in heart rate and hatching rate. The no observable effects concentration of BCDMH on zebrafish embryo was 0.5 mg/L. After 96 h exposure, the 50% lethal concentration (95% confidence interval (CI)) of BCDMH on zebrafish embryo was 8.10 mg/L (6.15-11.16 mg/L). The 50% inhibitory concentration (95% CI) of BCDMH on hatching rate was 7.37 mg/L (6.33-8.35 mg/L). Histopathology showed two types of responses induced by BCDMH, defensive and compensatory. The extreme responses were marked hyperplasia of the gill epithelium with lamellar fusion and epidermal peeling. The histopathologic changes in the gills after 10 days exposure were accompanied by significantly higher catalase activity and lipid peroxidation.

CONCLUSIONThese results have important implications for studies on the toxicity and use of BCDMH and its analogs.

Animals ; Antioxidants ; metabolism ; Disinfectants ; toxicity ; Dose-Response Relationship, Drug ; Embryo, Nonmammalian ; drug effects ; Hydantoins ; toxicity ; Time Factors ; Water ; chemistry ; Water Pollutants, Chemical ; toxicity ; Zebrafish

Diabetic foot ulcer is a major complication of diabetes which is the most expensive and the most difficult to deal with and leads to a high rate of non-traumatic amputation.Diabetic foot osteomyelitis results from aggravation of diabetic foot ulcer.Unfortunately,the current therapeutic outcomes of diabetic foot osteomyelitis are still unsatisfactory because of its difficult diagnosis and special treatment protocols which are entirely different from those for conventional soft tissue infections.This paper summarizes the latest advances achieved in diagnosis and treatment of diabetic foot osteomyelitis.

Objective:To compare the clinical effects on new bone formation and foot-ankle function between proximal tibial bone transport and distal tibial bone transport in the treatment of massive bone defects after tibial osteomyelitis debridement.Methods:From July 2012 to July 2017, 42 patients with chronic tibial osteomyelitis received bone transport surgery at Department of Orthopaedics, Nanfang Hospital.According to the Cierny-Mader classification for chronic osteomyelitis, all of them belonged to diffusive tibial osteomyelitis (type IV).Of them, 32 were treated by proximal tibial bone transport after tibial osteomyelitis debridement.In the proximal group, there were 27 males and 5 females, aged from 17 to 65 years and involving 20 left and 12 right sides. The other 10 cases received distal tibial bone transport. In the distal group, all of them were male, aged from 25 to 63 years and involving 6 left and 4 right sides. The 2 groups were compared in terms of external fixation index (EFI) and American Orthopaedic Foot & Ankle Society(AOFAS) Ankle and Hindfoot Scale.Results:There were no significant differences between the 2 groups in the preoperative general data such as gender, age or osteomyelitis site, indicating the 2 groups were comparable ( P>0.05). Both groups obtained complete follow-up. The proximal group was followed up for 590.1 d ± 287.3 d and the distal group for 615.6 d ± 130.6 d, showing no significant difference between groups ( P>0.05). In the proximal group 2 cases developed talipes equinovalgus after bone transport while in the distal group 3 cases did, and surgical intervention was needed for them. Surgical intervention was also carried out for16 cases of non-union at the docking site in the proximal group and for 2 ones in the distal group. The EFI was 76.2 d/cm±50.0 d/cm for the proximal group and 84.3 d/cm ± 59.9 d/cm for the distal group, showing no significant difference between groups ( P>0.05). The AOFAS scores were 81.4±10.1 for the proximal group and 60.0±5.9 for the distal group, showing a significant difference ( P<0.05). Conclusion:In the treatment of massive bone defects after tibial osteomyelitis debridement, no significant difference has been observed in the effect on bone formation between proximal tibial bone transport and distal tibial bone transport, but the former transport may have a less adverse effect on foot-ankle function.

Objective:To analyze the role of perfusion index(PI)in assessing the severity of neonatal illnesses.Methods:A total of 502 newborns admitted to the Department of Neonatology within 24 hours of birth at Xinxiang Central Hospital from October 2018 to July 2019 were recruited.Neonatal critical illness score(NCIS)was graded within 24 hours of admission, and newborns were categorized into non-critical(NCIS>90 scores), critical(NCIS 70-90 scores)and extremely critical(NCIS<70 scores). PI was monitored in all newborns within 24 hours of birth in a resting state.A total of 502 PIs were recorded, including 341 cases of non-critical, 110 cases of critical and 51 cases of extremely critical.Results:The medium PI [ M( P25, P75)] of newborns in non-critical, critical and extremely critical groups were 1.80(1.40, 2.60), 0.96(0.74, 1.43)and 0.65(0.41, 1.10), respectively.PI values in extremely critical group was significantly lower than those in critical group and non-critical group( P<0.05). The medium PI [ M( P25, P75)] of full-term newborns, moderate/late preterm newborns and extremely/very preterm newborns were 1.70(1.20, 2.70), 1.60(1.10, 2.30) and 1.35(0.80, 2.30), respectively.PI in full-term newborns was significantly higher than those in moderate/late preterm newborns and extremely/very preterm newborns( P<0.05). PI was moderately positively correlated with NCIS in newborns( r=0.791, P<0.01). The area under the receiver operating characteristic curve of NCIS predicted by PI value was 0.846, and the prediction sensitivity and specificity were 85.0% and 70.8% when PI was 0.56. Conclusion:PI is correlated with NCIS in newborns, which is able to reflect the severity of neonatal illnesses.A low PI indicates severe conditions of neonatal illnesses.

Objective: To investigate the effects of miR-23a-3p on proliferation, migration and apoptosis on human acute myeloid leukemia (AML) cells by targeting SMC1A. Methods: Microarray analysis was used to screen differentially expressed microRNAs and mRNAs in human AML cells. Real-time fluorescence quantitative PCR (RT-qRCR) was used to detect the expressions of miR-23a-3p and SMCA in human AML cell line U937. TargetScan database was used to analyze the correlation between miR-23a-3p and SMC1A. Double luciferase reporter gene was used to detect the interaction between miR-23a-3p and SMC1A. The effect of miR-23a-3p expression on the proliferation of U937 cells was detected by clonal assay. The migration, apoptosis, cell cycle and caspase-3 activity of U937 cells regulated by miR-23a-3p were detected by cell scratch assay and flow cytometry, respectively. Western blot was used to detect the expressions of Bax and Bcl-2 in U937 cells. Results: Compared with human normal monocyte SC group (1.00), the expression of miR-23a-3p in U937 cells was up-regulated (2.56±0.78) (P<0.01), while the expression of SMC1A was down-regulated (0.48±0.56, P<0.01). miR-23a-3p specifically bond to SMC1A 3′UTR and regulated the expression activity of SMC1A. Overexpression of miR-23a-3p promoted the proliferation and migration of U937 cells and inhibited the apoptosis of U937 cells, while up-regulation of SMC1A inhibited the proliferation and migration of U937 cells and promoted the apoptosis of U937 cells. The percentages of G₀/G1 phase, G₂/M phase and S phase cells in the negative control group were (37.48±0.21)%, (16.78±0.18)% and (45.74±0.15)% respectively, and those in the miR-23a-3p mimics group were (19.96±0.11)%, (41.69±0.24)% and (38.24±0.34)%, respectively. The difference was statistically significant (all P<0.05). The proportions of G₀/G₁ phase, G₂/M phase and S phase cells in the group of miR-23a-3p mimics+ pcDNA3.1-SMC1A were (36.88±0.21)%, (30.44±0.33)% and (32.88±0.16)%, respectively, without significant difference when compared with those of the miR-23a-3p mimics group (P>0.05). The relative expression levels of Bax and Bcl-2 protein in the negative control group were 0.55±0.45 and 0.31±0.54, respectively. Overexpression of miR-23a-3p inhibited the expression of Bax protein in U937 cells (0.23±0.13, P<0.001), promoted the expression of Bcl-2 protein (0.50±0.23, P<0.01), while SMC1A increased the expression of Bax protein in U937 cells (0.40±0.11, P<0.01), and inhibited the expression of Bcl-2 protein (0.37±0.15). In the negative control group, caspase-3 activity was (25.82±0.89)%. Overexpression of miR-23a-3p inhibited caspase-3 activity in U937 cells (3.64±0.56)%, P<0.01, while up-regulation of SMC1A promoted caspase-3 activity in U937 cells (15.29±0.85)%, P<0.01. Conclusion miR-23a-3p can inhibit the proliferation and migration and promote apoptosis of human AML cells by targeting SMC1A.

Infectious bone defect is bone defect with infection or as a result of treatment of bone infection. It requires surgical intervention, and the treatment processes are complex and long, which include bone infection control,bone defect repair and even complex soft tissue reconstructions in some cases. Failure to achieve the goals in any step may lead to the failure of the overall treatment. Therefore, infectious bone defect has been a worldwide challenge in the field of orthopedics. Conventionally, sequestrectomy, bone grafting, bone transport, and systemic/local antibiotic treatment are standard therapies. Radical debridement remains one of the cornerstones for the management of bone infection. However, the scale of debridement and the timing and method of bone defect reconstruction remain controversial. With the clinical application of induced membrane technique, effective infection control and rapid bone reconstruction have been achieved in the management of infectious bone defect. The induced membrane technique has attracted more interests and attention, but the lack of understanding the basic principles of infection control and technical details may hamper the clinical outcomes of induced membrane technique and complications can possibly occur. Therefore, the Chinese Orthopedic Association organized domestic orthopedic experts to formulate An evidence-based clinical guideline for the treatment of infectious bone defect with induced membrane technique ( version 2023) according to the evidence-based method and put forward recommendations on infectious bone defect from the aspects of precise diagnosis, preoperative evaluation, operation procedure, postoperative management and rehabilitation, so as to provide useful references for the treatment of infectious bone defect with induced membrane technique.

Objective: To investigate the correlation between Toll like receptor 4 (TLR4) expression and apoptosis in periventricular leukomalacia (PVL) rat model induced by hypoxia-ischemia. Methods: One hundred and forty three-day-old sprague-dawley (SD) rats, which were divided into experimental group (ischemia-hypo-xia group) and control group (sham operation group) randomly, were used to establish a hypoxic model by ligating the right common carotid artery and inhaling gas mixtures with 60 mL/L oxygen and 940 mL/L nitrogen.The rats were killed 6 h, 12 h, 24 h, 3 d, 7 d after model reproducing and the brain tissues were used for the following experiments.The pathological changes and apoptosis of brain tissues were detected by way of hematoxylin and eosin (HE) staining and terminal deoxynucleotidyl transferase dUTP nick end labeling (Tunel) assay respectively, and TLR4 expression was detected by adopting immunohistochemistry and reverse-transcription polymerase chain reaction(RT-PCR). The data were analyzed by using the SPSS 19.0 software. Results: TLR4 expression in the modeling rat brain commenced to increase in 6 hours (0.541±0.069, 0.166±0.058)and reached the peak in 3 days(1.932±0.161, 0.300±0.039), and then began to decline in 7 days (1.242±0.109, 0.220±0.025) post hypoxia-ischemia.Compared with the control group, there were statistical significances at 6 h, 12 h, 24 h, 3 d and 7 d (all P<0.05). The apoptosis of brain ti-ssue cells in the modeling rat brain started to increase at 6 hours(21.33±3.50) and reached the peak in 3 days (35.97±4.20), and then began to decline in 7 days (31.02±4.22) post hypoxia-ischemia.Compared with the control group, there were statistical significance at 6 h, 12 h, 24 h, 3 d and 7 d (all P<0.05). The TLR4 expression was positively correlated with cell apoptosis (r=0.774, 0.575, all P<0.05). Conclusions In the rat model of PVL induced by hypoxia-ischemia, TLR4 is likely to injure the neural cell through apoptosis.