Objective To analyze the clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with the old Lisfranc injuries. Methods Fifty patients (16 feet) with Lisfranc injuries were treated with staged reduction. Mean duration between injury and surgery was 4. 8month ( 3 to 8 month) . In first stage an external fixator was applied across the Lisfranc joint and distraction was done at 1 milliliter per day to 2 milliliter per day. In the second staged the ORIF ( open reduction and internal fixation) was doneand we were able to reduce all the fractures and dislocations. Extra-Articular screws and staple fixation were used for fixation. We compared categorical variables using Fisher’ s exact test and continuous variables using paired t-test or Wilcoxon signed-rank test. Results All patients were followed up 1 to 3 years ( mean 2. 2 years) in the clinic. The visual analogue scale score averaged 3. 1 points at the final follow-up, the average AOFAS scores for these patients were 55. 8 points ( range, 43 to 98 points), with a significant increase than before surgery ( P=0. 001). The mean duration between two surgeries was 3. 2 weeks (range 2. 5-4. 5 weeks). Anatomic reduction was obtained in all 15 patients. At the last follow-up, 2 patients had lost reduction. Posttraumatic osteoarthritis was observed in 5 patients, and all of them were scheduled for arthrodesis because of persistent pain. Conclusions The study have displayed that staged reduction and Extra-Articular fixation should be considered for old Lisfranc injuries with a good reduction, the firm stability, low risk of intraoperative fracture. The short-term effectiveness is good, but the long-term effectiveness needs further follow-up.

Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging ; Health Services for the Aged ; Humans ; Population Dynamics ; Quality of Life ; Singapore

Adenocarcinoma ; drug therapy ; immunology ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; drug therapy ; immunology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Killer Cells, Natural ; immunology ; Lung Neoplasms ; drug therapy ; immunology ; Male ; Middle Aged ; Phytotherapy ; Quality of Life ; T-Lymphocyte Subsets ; immunology

Objective To investigate the association between morning blood pressure surge(MBPS) and carotid atherosclerosis in patients with essential hypertension.Methods According to the results of 24 h ambulatory blood pressure monitoring,137 patients were classified as the morning BP surge group(MBPS group,n=75),and non-surge group(NMBPS group,n=62).Patients underwent carotid ultrasound and the intima-medial thickness(CCA-IMT) and plaques were examined.Results ① The CCA-IMT of the MBPS group was significantly thicker than that the NMBPS group [CCA-IMT,MBPS group(1.34?0.13) mm vs NMBPS group(0.98?0.43) mm,P

Objective:To investigate the potential pro-apoptotic activity of arsenic trioxide (ATO) in human leukemia HL-60 cells,as well as the potential mechanism with focus on mitochondrial pathway.Methods:After treatment with different concentrations of ATO (1 μg/mL,5 μg/mL or 10 μg/mL) for 24 h,apoptotic cell death was detected by flow cytometry,oxidative stress was determined by measuring MDA and GSH levels,the expression of apoptotic factors was detected by western blot,and mitochondrial membrane potential (MMP) was determined by immunofluorescence staining.Results:ATO at the concentrations of 5 μg/mL or 10 μg/mL induces apoptotic cell death and increases oxidative stress in human leukemia HL-60 cells.ATO significantly increases the expression of pro-apoptotic factors (Bax and Caspase-3),whereas decreases the expression of anti-apoptotic factor Bcl-2.Compared with the control group,ATO treatment significantly decreases the MMP level in HL-60 ceils.Conclusions:Arsenic trioxide induces apoptotic cell death through mitochondrial pathway in human leukemia HL-60 cells.

Anticoagulants ; therapeutic use ; Child ; Coagulants ; blood ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Purpura, Schoenlein-Henoch ; blood ; drug therapy ; Signal Transduction ; Thromboplastin

Objective To investigate the relationship between recent chlamydia pneumoniae (Cp)infection and active ankylosing spondylitis (AS). Methods Seventy nine AS outpatients and 73 normal controls (NC) were enrolled into this study. Serum anti-Cp antibodies (CpIg) were tested using the enzymelinked immunosorbent assay (ELISA). Clinical and experimental data were collected. Patients with positive CpIgM or CpIgA were considered as having a recent Cp infection. Wilcoxon test, Student's t test, χ2 test and multivariate logistic regression were used for statistical analysis. Results Both AS patients and normal controls had a high prevalence for sero-positive CpIgG, which was 89％(70/79) vs 92％(67/73) respectively,while AS patients had a higher frequency of CpIgA and CpIgM when compared with NC [52％(41/79) vs 32％(23/73), χ2=6.61, P=0.010 for CpIgA; 80％(63/79) vs 21％(15/73), χ2=44.031, P＜0.01 for CpIgM]. The presence of CpIgM or CpIgA favored AS, the OR was 17.1 (95％CI 7.4～39.5), or 3.1 (95％CI 1.3～7.2),respectively. In addition, CpIgM was associated with disease activity parameters including ESR (χ2=2.56, P=0.021), CRP (χ2=7.28, P=0.007) and BASDAI (χ2=6.79, P=0.009). Furthermore, consecutive positive CpIgM favored the persistent active or relapsed disease, while negative CpIgM favored a reduced disease activity.There was no correlation between CpIgM/CpIgA and peripheral joint disease and enthesitis. Conclusion Recent Cp infection is highly associated with AS and CpIgM antibody relates with active AS, which indicates that Cp infections may be a critical triggering factor for active AS.

Objective To evaluate the accuracy of ultrasound-measured inferior vena cava (IVC) diameter in assessment of the preoperative blood volume in elderly patients.Methods Sixty patients,aged 60-75 yr,with body mass index 20-25 kg/m2,of ASA physical status Ⅰ-Ⅲ,scheduled for elective transurethral resection of prostate,were randomly divided into 3 groups (n =20 each):control group (group C),lactated Ringer's solution group (group RL),and hydroxyethyl starch group (group H).Lactated Ringer's solution 8 ml/kg was infused intravenously in group RL.Hydroxyethyl starch 130/0.4 8 ml/kg was infused intravenously in group H.SpO2,mean arterial pressure (MAP),HR and central venous pressure (CVP) were monitored before and after fluid therapy.The IVC diameters,both during expiration (IVCe) and inspiration (IVCi),were measured using ultrasound.IVC collapsibility index (IVC-CI) was calculated.Results The IVCeand IVCi were significantly increased,and IVC-CI was decreased after fluid therapy as compared with those before fluid therapy in RL and H groups.Compared with group C,the IVCe and IVCi were significantly increased,and IVC-CI was decreased after fluid therapy in RL and H groups.IVCe and IVCi were positively correlatedwith CVP (r=0.746 and 0.697,respectively).IVC-CI was negatively correlated with CVP (r =-0.547).Conclusion Ultrasoundmeasured IVC diameter provides better accuracy in assessing the preoperative blood volume in elderly patients.

Objective: To study the antitumor effects of transmembrane TNF-? and secretory TNF-? in vivo. Methods: Three types of TNF-? cDNA plasmids (wild type TNF-?; transmembrane TNF-? mutant; secretory TNF-? mutant) were directly injected into tumor-tearing mice. Results: The three types of TNF-? could be expressed by tumor cells and all of them could inhibit evidently the rate of tumor growth. The tumor regression after treatment with transmembrane TNF-? mutant at the early stage was more significant than that with the other two types of TNF-?( P