AIM:To investigate the effect of Toll-like receptor 9(TLR-9)gene rs5743836(1237 T/C)single nucleotide polymorphism on recurrent infec-tion in patients with diabetic foot(DF).MEHTODS:A total of 128 DF patients admitted to our hospital from June 2020 to June 2022 were collected and di-vided into an infected group(n=53)and a non-in-fected group(n=75)according to the presence or absence of recurrent infection.The general data and TLR-9 gene polymorphism were compared be-tween the two groups.The genotypes and allele frequencies of TLR-9(1237 T/C)gene polymor-phism were detected and compared between the two groups.Logistic regression was used to analyze the correlation between TLR-9 gene 1237 T/C poly-morphism and recurrence of DF patients.RESULTS:There were significant differences between the two groups in invasive operation,course of antibiotic use and peripheral vascular disease of both lower limbs(P＜0.05).The wild type TT homozygote pro-duced two fragments of 108 bp and 27 bp in length,the variant CC homozygote produced three fragments of 60 bp,48 bp and 27 bp in length,and the heterozygous TC produced four fragments of 108 bp,60 bp,48 bp and 27 bp in length.The TLR-9(1237 T/C)gene identity was 100％.The genotype frequencies met the Hardy-Weinberg genetic equi-librium(P＞0.05).There were significant differences in CC gene frequency,TC gene frequency,TT gene frequency,C gene distribution and T gene distribu-tion between the two groups(P＜0.05).Logistic re-gression analysis showed that TLR-9 CC genotype increased the risk of recurrent infection in DF pa-tients in the co-dominant model(OR=5.357,95％CI:1.901-15.100).After adjusting for sex,age and smoking(OR=5.341,95％CI:1.874-15.015,P＜0.01),the C allele significantly increased the risk of recur-rent infection in DF patients(OR=2.328,95％CI:1.874-15.015,P＜0.01).1.078-5.936),and the differ-ence was statistically significant(P＜0.01).The TT genotype and CC+TC genotype of TLR-9 were not significantly associated with smoking history,Wag-ner grade,peripheral neuropathy,retinopathy,hy-pertension,osteoporosis and lower extremity arte-riosclerosis obliterans in DF patients(P＞0.05).There were significant differences in the course of DM,DF,levels of HbAlc,LDL-C,CRP and PCT be-tween patients with CC genotype and patients with TT+TC genotype(P＜0.05).CC genotype,DM dura-tion ≥9 years,DF duration ≥5 months,HbAlc＜5.00％,LDL-C≥3.03 mmol/L,CRP≥23.25 mg/mL,PCT≥0.87 ng/mL were risk factors for recurrent infec-tion in DF patients(P＜0.05).HbAlc,LDL-C,CRP and PCT all showed interaction with TLR-9(1237 T/C)gene.The risk of recurrent infection in DF patients with abnormal HbAlc,LDL-C,CRP and PCT levels and TLR-9(1237 T/C)gene polymorphism interac-tion combination was 2.659 times higher than that in DF patients without the above combination,and the difference was statistically significant(P＜0.05).CONCLUSION:CC genotype and C allele of TLR-9 gene 1237 T/C are independent risk factors for re-current infection in DF patients.

AIM:To investigate the effect of Toll-like receptor 9(TLR-9)gene rs5743836(1237 T/C)single nucleotide polymorphism on recurrent infec-tion in patients with diabetic foot(DF).MEHTODS:A total of 128 DF patients admitted to our hospital from June 2020 to June 2022 were collected and di-vided into an infected group(n=53)and a non-in-fected group(n=75)according to the presence or absence of recurrent infection.The general data and TLR-9 gene polymorphism were compared be-tween the two groups.The genotypes and allele frequencies of TLR-9(1237 T/C)gene polymor-phism were detected and compared between the two groups.Logistic regression was used to analyze the correlation between TLR-9 gene 1237 T/C poly-morphism and recurrence of DF patients.RESULTS:There were significant differences between the two groups in invasive operation,course of antibiotic use and peripheral vascular disease of both lower limbs(P＜0.05).The wild type TT homozygote pro-duced two fragments of 108 bp and 27 bp in length,the variant CC homozygote produced three fragments of 60 bp,48 bp and 27 bp in length,and the heterozygous TC produced four fragments of 108 bp,60 bp,48 bp and 27 bp in length.The TLR-9(1237 T/C)gene identity was 100％.The genotype frequencies met the Hardy-Weinberg genetic equi-librium(P＞0.05).There were significant differences in CC gene frequency,TC gene frequency,TT gene frequency,C gene distribution and T gene distribu-tion between the two groups(P＜0.05).Logistic re-gression analysis showed that TLR-9 CC genotype increased the risk of recurrent infection in DF pa-tients in the co-dominant model(OR=5.357,95％CI:1.901-15.100).After adjusting for sex,age and smoking(OR=5.341,95％CI:1.874-15.015,P＜0.01),the C allele significantly increased the risk of recur-rent infection in DF patients(OR=2.328,95％CI:1.874-15.015,P＜0.01).1.078-5.936),and the differ-ence was statistically significant(P＜0.01).The TT genotype and CC+TC genotype of TLR-9 were not significantly associated with smoking history,Wag-ner grade,peripheral neuropathy,retinopathy,hy-pertension,osteoporosis and lower extremity arte-riosclerosis obliterans in DF patients(P＞0.05).There were significant differences in the course of DM,DF,levels of HbAlc,LDL-C,CRP and PCT be-tween patients with CC genotype and patients with TT+TC genotype(P＜0.05).CC genotype,DM dura-tion ≥9 years,DF duration ≥5 months,HbAlc＜5.00％,LDL-C≥3.03 mmol/L,CRP≥23.25 mg/mL,PCT≥0.87 ng/mL were risk factors for recurrent infec-tion in DF patients(P＜0.05).HbAlc,LDL-C,CRP and PCT all showed interaction with TLR-9(1237 T/C)gene.The risk of recurrent infection in DF patients with abnormal HbAlc,LDL-C,CRP and PCT levels and TLR-9(1237 T/C)gene polymorphism interac-tion combination was 2.659 times higher than that in DF patients without the above combination,and the difference was statistically significant(P＜0.05).CONCLUSION:CC genotype and C allele of TLR-9 gene 1237 T/C are independent risk factors for re-current infection in DF patients.

Objective:To investigate the risk factors for axial deviation in the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport.Methods:A retrospective study was performed to analyze the clinical data of 90 patients who had been treated for tibial bone defects by the Orthofix unilateral external fixator at Department of Microrepair and Reconstruction, The First Hospital Affiliated to Xinjiang Medical University from May 2012 to June 2019. There were 77 males and 13 females with a mean age of 41.2 years (from 17 to 63 years).The bone defects ranged from 4 to 13 cm in length. According to the Paley criteria for axial deviation, the 90 patients were divided into 2 groups: a deviation-free group with no axial deviation or an axial deviation ≤5° and a deviation group with an axial deviation>5°. The 2 groups were compared in terms of age, number of prior surgery, defect length, placement angle of Schanz screws, external fixation time, external fixation index and bending degree of Schanz screws at the last follow-up.The factors with P<0.05 were analyzed by multivariate logistic regression to find the risk factors for coronal axial deviation. Results:The 90 patients were followed up for an average of 23 months (from 12 to 40 months). The incidence of axial deviation in this cohort was 36.7% (33/90).The deviation group had a significantly larger number of prior surgery [5 (3, 6) times], a significantly longer defect length [8 (8, 9) cm], a significantly longer external fixation time [400.0 (341.8, 426.3) d], and a significantly greater bending degree of Schanz screws at the last follow-up [1.2° (0.4°, 3.5°)] than the deviation-free group [3 (2, 3) times, 6 (5, 8) cm, 340.8 (226.5, 422.8) d, and 0.8° (0.2°, 3.7°)] (all P<0.05). Multivariate logistic regression analysis showed that the number of prior surgery ( OR=2.581, 95% CI: 1.496-4.450, P=0.001) and the defect length ( OR=5.310, 95% CI: 1.952-14.442, P=0.001) were the risk factors for the axial deviation. Conclusion:In the treatment of tibial defect susing Orthofix unilateral external fixator and proximal tibial osteotomy for bone transport, the more prior surgeries and the longer a bone defect, the higher the risk for axial deviation.

OBJECTIVETo explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor (DSRCT), and to improve the understanding and management of this tumor.

METHODSThe clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed.

RESULTSNine patients with DSRCT, 5 males and 4 females, with an average age of 21 years (range 8-56 years) were included in this study. Ultrasound examination revealed irregular low-density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i. e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy (no concrete plan was available). Another case was lost to follow-up. Two of the three patients without surgery received chemotherapy with CAP (cyclophosphamide+adriamycin+carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen (DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow-up.

CONCLUSIONSDesmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

Abdominal Neoplasms ; complications ; diagnosis ; mortality ; therapy ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; analysis ; Carboplatin ; administration & dosage ; Child ; Combined Modality Therapy ; methods ; Cyclophosphamide ; administration & dosage ; Desmoplastic Small Round Cell Tumor ; complications ; diagnosis ; mortality ; therapy ; Doxorubicin ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Paclitaxel ; administration & dosage ; analysis ; Prognosis ; Retrospective Studies

BACKGROUND:Copper-titanium aloy has been fabricated in previous studies to improve the antibacterial property and biocompatibility of titanium materials. OBJECTIVE:With reference to the principle and experimental method specified by GB/T16886-ISO10993, to fuly and systematicaly assess the biocompatibility of copper-titanium aloy. METHODS:Based on the pre-experimental results, titanium aloy containing 10% copper was selected and subjected to oral mucosa stimulation experiment, skin stimulation test, acute systemic toxicity test, hemolytic test, prothrombin time test and dynamic coagulation test for biocompatibility evaluation. RESULTS AND CONCLUSION:The copper-titanium aloy has no oral mucous membrane irritation, no short-term systemic toxicity, no skin sensitization, and no hemolysis, indicating it has a good biocompatibility.

Objective To explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor ( DSRCT ) , and to improve the understanding and management of this tumor. Methods The clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed. Results Nine patients with DSRCT, 5 males and 4 females, with an average age of 21 years ( range 8?56 years) were included in this study. Ultrasound examination revealed irregular low?density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i.e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy ( no concrete plan was available) . Another case was lost to follow?up. Two of the three patients without surgery received chemotherapy with CAP ( cyclophosphamide + adriamycin + carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen ( DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow?up. Conclusions Desmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

Objective To explore the clinical diagnostic features and treatment of desmoplastic small round cell tumor ( DSRCT ) , and to improve the understanding and management of this tumor. Methods The clinicopathological data of nine patients treated in our hospital from October 2004 to June 2014 were retrospectively analyzed and a review of the literature was made. The clinical manifestations, pathological characteristics, diagnosis and differential diagnosis, treatment and prognosis of this tumor were summarized and analyzed. Results Nine patients with DSRCT, 5 males and 4 females, with an average age of 21 years ( range 8?56 years) were included in this study. Ultrasound examination revealed irregular low?density mass shadow in the abdominal cavity. CT examination found that 6 cases had abdominal and retroperitoneal multiple solid tumor nodules, uneven density, and visible low density fluid area. Postoperative pathological examination revealed that the tumor cells were small, mostly elliptic, gathered to form clear structure of nests with clear irregular boundaries. The central portion of large tumor nests often showed necrosis. Scattered fibroblasts and large amount of hyalinization of collagen fibers were seen in the interstitial tissue around the nests. Six patients received laparotomy surgery, however, all failed to resect the tumor completely. Three patients received postoperative chemotherapy, i.e. two cases had carboplatin and paclitaxel chemotherapy, and one case of chemotherapy regimen not specified. Two patients had radiation and chemotherapy ( no concrete plan was available) . Another case was lost to follow?up. Two of the three patients without surgery received chemotherapy with CAP ( cyclophosphamide + adriamycin + carboplatin) and total rectal lesions, pelvic and inguinal lymph nodes, ilium metastases radiation therapy. Another one patient received EP regimen ( DDP+VP16) which was then changed into a TP chemotherapy alone. Eight of the nine cases died shortly after surgery, and only one patient treated with chemotherapy alone was still alive after 11 months of follow?up. Conclusions Desmoplastic small round cell tumor is a very rare, special type of soft tissue tumor, with very poor prognosis. This tumor may be preliminarily diagnosed according to the imaging characteristics and detection of tumor markers, however, final diagnosis is made by pathology. Surgery is the priority of treatment, combined with complementary radiation and chemotherapy.

Objective To study the value of the preoperative detrusor contractility to the outcome assessment of prostatectomy for benign prostatic hyperplasia (BPH).Methods A total of 109 patients with BPH were analyzed.Their ages ranged from 62 to 83 years with a mean of 71 years.All patients underwent urodynamic study to confirm a diagnosis of BOO preoperatively.Further more, their BOO was not caused by nervous, endocrine or other diseases.Pateints were divided into two groups based on maximum detrusor contractility.Group Ⅰ (n =61, BPH with maximum detrusor contractility ≥ 40 cm H2O, 1cm H2O =0.098 kPa) underwent TURP or open surgery, respectively.Group Ⅱ (n =48, BPH with maximum detrusor contractility ≤ 20 cm H2O ) underwent TURP and suprapubic punctural cystostomy simultaneously,the bladder fistula was kept open continuously for at least two weeks postoperatively.The difference in outcome between the two grous was assessed by using urodynamic parameters including maximum detrusor contractility, Qmax and residual urine at one and three months postoperatively respectively.Student's t-test was used to compare the result for normally distributed data and Wilcoxon's signed-ranks test for skewed data in this study.Results There was significant difference in preoperative maximum contractility, Qmax between group Ⅰand groupⅡ (78.4 ±37.0 cm H2O) vs (19.2 ±5.4 cm H2O)(P＜0.01), (7.6±2.2 ml/s) vs (2.5 ± 1.1 ) ml/s (P ＜ 0.05) respectively.Although there was significant difference at one month postoperatively in Qmax (17.4 ±2.9)ml/s vs (12.5 ±2.0)ml/s (P＜0.05), no significant difference was found in Qmax between the two groups after three months ( 18.3 ±2.8 ml/s) vs ( 15.2 ± 1.8)ml/s (P ＞ 0.05).Conclusions The Qmax may improve and the impaired detrusor recovered gradually after the BOO was removed.Performing an operation on patients with BOO accompanied with detrusor underactivity may be useful to recover detrusor contractility.

Objective To evaluate the growing condition of human umbilical vein endothelial cells (HUVECs), which were cultured on the membrane of different component, such as Chinese medicine, before or after the alkali treatment of 3-hydroxybutyrate-co-3-hydroxyhexanoate copolyesters (PHBHHx) and the biocompatibility between PHBHHx flim and endothelial cell. Methods The HUVECs were harvested by Baudine method,and identified by immunohistochemical method.Then the HUVECs of third passage were inoculated on the material surface and cultured for 8 hours,12 hours and 24 hours. After that, the morphology of HUVECs on different surfaces were observed by scanning electron microscopy, the distribution condition on different membranes were compared by cell-labeling immunofluorescence, and the cell viabilities of all groups were detected by MTT method. Results The HUVECs were successfully separated,and immunohistochemistry staining of FLK-1 and factor Ⅷ was positive.The result of HUVECs culture showed that cells on the material surface growed well, and proliferated significantly. The MTT analysis showed that the PHBHHx film of surface modification and adding some certain proportion of Chinese medicine could promote the growth and proliferation of HUVECs in vitro,and the cells were thriving, full shape, distribution on the surface by scanning electron microscopy and fluorescence microscopy.Conclusion The PHBHHx film of surface modification and containing certain proportion of Chinese medicine coating had good compatibility of HUVECs, which was favourable to cell growth, adherence and proliferation in vitro.