[Objective]To explore the effect of external fixator combined with vaccum sealing drainage(VSD) for the treatment of infection after internal fixation in tibial and fibular fracture.[Method]Thirty-six patients with infection after internal fixation in tibial and fibular fracture were treated by external fixator combined with VSD from June 2004 to June 2008.[Result]During the following-up period from 8-30 months in thirty-two patients,the infection in all cases were controlled effectively,no case of recurrence was found in all patients,and satisfactory healing were found in 32 cases.The average time of fracture union were 4.5 months;the removal time of external fixation were 5 months on average.[Conclusion]The combined operative procedure is simple,reliable and less traumatic and allow to early functional exercises.Therefore,it is a satisfactory measure for the infection after internal fixation in tibial and fibular fracture.

Objective To observe the effect of LIGHT on synovial macrophage-osteoclast difier entiation in rheumatoid arthritis.Methods Synovial macrophages were collected from 8 synovial tissues har vested from RA patients by digestion with conagenase.The macrophages from each patient were divided into 5 subgroups:group 1 was co-cultured with Macrophage Colony Stimulating Factor(MCSF).group 2 was co cultured with MCSF and LIGHT.group 3 was co-cultured with MCSF and Receptor activator for Nuclear Fac tor kB ligand(RANKL),group 4 was co-cultured with MCSF and LIGHT and RANKL group 5 was co-cul tared with LIGHT.After two weeks of culture.tartrate resistant acid phosphatase(TRAP)and F-actin staining were used to detect the formation of osteoclast on cover slip(CS).Functional evidence of osteoclasts was as sessed by the formation of resorption pits ou dentine slice(DS).Results TRAP and F-actin were both nega tive in group 1 and group 5 and no pit on dentine slice could be observed.In group 2.there were some small round and ovoid osteoclasts with TRAP(+)and F-actin(+).Pits on DS were small and discrete.In group 3. there were many large irregular osteoclasts with TRAP(++)and F-actin(++).The number and volume of pits were both increased.In group 4.there were even more and larger osteoclasts with TRAP(+++)and F-actin (+++).The pits were even larger and became confluent,ie,pits(++++).Conclusion LIGHT can promote RANKL-mediated osteoclastogenesis in RA synovial macrophages.and it can induce osteoclast formation through a mechanism independent of RANKL.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cells with multi-directional differentiation ability and play an important role in the healing of fractures. Therefore, it is of great significance to explore how to promote the BMSCs migration in vivo, thereby promoting bone defect repair.OBJECTIVE:To study the effects of different concentrations of musk ketone on in vivo migration of exogenous BMSCs, and to preliminarily explore the mechanism of fracture healing and cited theory.METHODS:A rat model of skull defects was made. Passage 3 BMSCs were harvested by using adherence method,labeled with DAPI, and then injected via the tail vein into the model rats. After that, the rats were intragastrically administrated with 0 (blank control), 42 (low dose), 84 (middle dose), 168 μL/kg (high dose) musk ketone, respectively.RESULTS AND CONCLUSION:The number of exogenous BMSCs in the defect region, and the expression of stem cell factor and Fractalkine showed a significant increase in the low- and middle-dose groups compared with the high-dose and blank control groups. These findings indicate that the low- and middle-dose musk ketone can promote the in vivo migration of exogenous stem cells.

Objective To explore the value of arginase-1(Arg-1) and glypican-3 (GPC-3) combined examination in the differential diagnosis of hepatocellular carcinoma (HCC),metastatic carcinoma (MC) of liver and intrahepatic cholangiocarcinoma (ICC).Methods From January 2005 to December 2011,a total of 54 patients with HCC were selected,including 10 cases with high differentiation,25 cases with moderate differentiation and 19 cases with poor differentiation.At the same time,25 patients with MC of liver and 20 patients with ICC were selected.A total of 31 normal liver specimens were set as control.The expressions of Arg 1 and GPC-3 in the above tissues were detected by immunohistochemistry method.The sensitivity and specificity of the examination in the diagnosis of HCC were analyzed.Chi-square test was performed for count data analysis.Results The positive expression rate of Arg-1 in HCC,MC of liver,ICC and normal liver tissues was 87.0％ (47/54),4.0％ (1/25),5.0％ (1/20) and 100.0％ (31/31),respectively.The Arg 1 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC,and the difference was statistically significant (x2 =66.98,P＜0.05).The positive expression rate of GPC-3 in HCC,MC of liver,ICC and normal liver tissues was 70.4％ (38/54),12.0％ (3/25),5.0％ (1/20) and 0 (0/31),respectively.The GPC-3 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC and the difference was statistically significant (x2=37.98,P＜0.05).The sensitivity and specificity of Arg-1 or GPC-3 positive in HCC diagnosis was 92.6％ (50/54) and 86.7％ (39/45).The sensitivity and specificity of both Arg 1 and GPC-3 positive in HCCdiagnosis was 64.8％ (35/54) and 100.0％ (45/45).Conclusion Arginase-1 and glypican-3 combined examination has an important value in HCC diagnosis and differential diagnosis.

Objective To discussion the feasibility and effect of total hip arthroplasty (THA) of postoperative ankylosis in patients with hip peripheral fracture.Methods From January 2008 to October2013,cementless THA was performed in 23 patients with ankylosis after internal fixation of hip peripheral fracture.There were 16 males and 7 females,aged 23 to 67 years (mean,43 years).Interval between internal fixation and THA was 12 to 73 months (mean,38 months).Results Mean follow-up was 28 months (range,3 to 60 months).All patients presented good press-fit prostheses with mean acetabular valgus of 43.3°,mean acetabular anteversion of 22.5°,and mean femoral anteversion of 16.4°.Primary wound healing was detected with no occurrence of infection,prosthetic loosening or dislocation,and periprosthetic fracture.Femoral vein incomplete embolism was diagnosed in one patient with limb swelling 2 months after operation,but swelling subsided after 3 months of bed rest,elevation of the affected limb and anticoagulant therapy.Length of the bilateral limbs was almost equal in 19 patients with the difference within 0.5 cm,but the affected limb was 0.8-1.4 cm shorter in 3 patients and was 0.8 cm longer in 1 patient.Harris hip score improved from (42.16 ± 3.03)points before operation to (93.08 ± 5.23) points at the last follow-up (P ＜ 0.05).Conclusion THA is associated with good hip function recovery and improved quality of life during the treatment of postoperative ankylosis in patients with hip peripheral fracture.

BACKGROUNDAmniotic fluid (AF) supernatant contains cell-free fetal DNA (cffDNA) fragments. This study attempted to take advantage of cffDNA as a new material for prenatal diagnosis, which could be combined with simple quantitative fluorescent polymerase chain reaction (QF-PCR) to provide an ancillary method for the prenatal diagnosis of trisomy 21 syndrome.

METHODSAF supernatant samples were obtained from 27 women carrying euploid fetuses and 28 women carrying aneuploid fetuses with known cytogenetic karyotypes. Peripheral blood samples of the parents were collected at the same time. Short tandem repeat (STR) fragments on chromosome 21 were amplified by QF-PCR. Fetal condition and the parental source of the extra chromosome could be determined by the STR peaks.

RESULTSThe sensitivity of the assay for the aneuploid was 93% (26/28; confidence interval, CI: 77%-98%) and the specificity was 100% (26/26; CI: 88%-100%). The determination rate of the origin of the extra chromosome was 69%. The sensitivity and the specificity of the assay in the euploid were 100% (27/27).

CONCLUSIONSTrisomy 21 can be prenatally diagnosed by the QF-PCR method in AF supernatant. This karyotype analysis method greatly reduces the requirement for the specimen size. It will be a benefit for early amniocentesis and could avoid pregnancy complications. The method may become an ancillary method for prenatal diagnosis of trisomy 21.

Amniotic Fluid ; metabolism ; Chromosomes, Human, Pair 21 ; genetics ; Down Syndrome ; diagnosis ; genetics ; Female ; Humans ; Microsatellite Repeats ; genetics ; Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods