Objective To explore the effect of vacuum-assisted closure (VAC) in the treatment of diabetic foot.Methods Sixty-seven cases patients with diabetic foot in Chaoyang Central Hospital from January 2010 to January 2016 were recruited successively,according to wagner criteria for 2-5 diabetic foot classification.They were divided into VAC group with 34 cases and control group with 33 cases according to the different treatment methods.Both groups were given debridement treatment.After debridement,the patients in control group were given wound dressing every day or every other day.When fresh granulation tissue on wound surface became well-stacked,skingrafting or skin flap reparation was carried out.After debridement,patients in VAC group were given VAC treatment for 5 days.When fresh granulation tissue on wound surface became wellstacked,skingrafting or skin flap reparation was performed.The wound healing duration,healing rate and amputation rate were compared between the two groups.Results The wound healing time,healing rate and amputation rate of VAC group were (30.91 ± 15.61) d,97.1％ (33/34) and 3％ (1/34) respectively,of the control group were (58.86± 14.23) d,75.8％ (25/33) and 24.2％ (8/33) respectively.There were significant differences between the two groups(P＜0.05).Conclusion VAC treatment of diabetic foot ulcer has significant effect,can promote wound healing,improve the healing rate and reduce the risk of amputation(toe).

Objective To investigate expression and correlation of IL -10 +CD +19 regulatory B cells (Breg)and CD +4CD25high regulatory T cells (Treg)in patients with chronic hepatitis C.Methods 45 patients with chronic hepatitis C and 25 healthy individuals were involved in this study.Flow cytometry was used to analyze the expression of Breg and Treg.ELISA was employed to determine serum IL -10 and TGF -β.Results The expression of Breg in group of HCV was higher than that of the health controls[3.55%(2.40% -4.14%)vs.1.66%(1.24% -2.02%),t =6.78,P <0.001],and Treg in patients with chronic hepatitis C was also higher than that of the health controls[4.55%(3.35% -5.88%)vs.2.05%(1.39% -2.61%),t =7.17,P <0.001].Breg was correlated with Treg positively in group of chronic hepatitis C (r =0.374,P =0.019)and no correlation was found in the health con-trols.Serum IL -10 in patients infected with HCV was significantly higher than that in the health controls[(78.65 ± 17.21)pg/mL vs.(53.21 ±11.47)pg/mL,t =7.51,P <0.001].Conclusion Breg and Treg may play regulatory roles by IL -10 in patients with chronic hepatitis C promote persistence of HCV infection and exhaustion of effector T cells.

Benzene ; analysis ; chemistry ; Benzene Derivatives ; blood ; urine ; Humans

Objective To investigate the effect of propofol on the liver function of offspring rats de?livered by cesarean section. Methods Twenty?four Sprague?Dawley rats, at 20 days of gestation, weig?hing 230-270 g, were divided into 4 groups ( n=6 each) using a random number table: control group (group C), propofol 2.0 mg∕kg group (group P2), propofol 4.0 mg∕kg group (group P4), and propofol 8.0 mg∕kg group (group P8). In P2, P4 and P8 groups, the corresponding doses of propofol were injected intravenously, and the cesarean section was performed at 30 min after loss of righting reflex. In group C, the pregnant rats were sacrificed by cervical dislocation at the corresponding time point, and the offspring rats were removed immediately and inhaled oxygen sufficiently. The neonatal rats were sacrificed immediate?ly, and the blood samples were taken from the heart for determination of plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations, and the livers were removed and cut into sections which were stained with haematoxylin and eosin for microscopic examination of the pathological changes. Results Compared with group C, the plasma ALT and AST concentrations in the offspring rats were significantly increased in P2, P4 and P8 groups (P<0.05). Compared with group P2, the plasma ALT and AST concentrations in the offspring rats were significantly increased in P 4 and P 8 groups ( P<0.01). Compared with group P4, the plasma ALT and AST concentrations in the offspring rats were signifi?cantly increased in group P8 (P<0.01). In P2, P4 and P8 groups, marked pathological changes of liver tissues were observed, and the severity was gradually aggravated in turn in offspring rats. Conclusion Propofol can induce damage to the livers of offspring rats delivered by cesarean section in a dose?dependent manner.

[Objective]The purpose of this study is to investigate articular cartilage injuries in patients undergoing arthroscopy of knee joint.[Method]From November 2004 to September 2005,568 patients underwent arthroscopy in the orthopedic department of Chinese PLA General Hospital.[Result]Totally 923 cases of articular cartilage injuries in 389 patients were documented,with the incidence rate of 68%.The main articular cartilage injuries were found on the medial femoral condyle(26%)and patella(25%).The incidence rate had signicant difference between patients over and under 40 years(88% VS 36.5%).Patients between 40 and 60 years were most susceptable to articular cartilage injuries.[Conclusion]Articular cartilage injuries are common in patients after arthroscopy.Early arthroscopy and treatment may benefit the patients.

Objective To investigate the therapy of DHS,PFNA and Intertan nail for the treatment in elderly patients with intertrochanteric femoral fractures.Methods One hundred and one elderly patients with intertrochanteric fractures were collected.Thirty-four cases of them were undertaken DHS (DHS group),33 cases for PFNA (PFNA group),and 34 cases for Intertan nail (INTERTAN group).Operative time,blood loss and complications were observed.Results The Operative time of patients in DHS,PFNA and Intertan groups were (85.1 ± 8.9) min,(63.1 ± 8.2) min,(57.9 ± 9.2) min respectively and the difference was significant (F=12.761,P＜0.001).The blood loss amount in DHS group were (350.1 ±80.2)ml,lower that those in PFNA and Intertan groups ((137.5 ± 35.4) ml and (125.2 ± 38.2) ml,F =20.462,P ＜ 0.001).Meanwhile,the postoperative drainage in DHS group was (125.3 ± 20.4) ml,significantly higher than PFNA group and INTERTAN group ((69.4 ± 9.2) ml and (74.6 ± 10.4) ml; F =15.871,P ＜0.001).Operative time,blood loss amount in INTERTAN group were less than that in PFNA group,but no significant difference (P ＞0.05).Nonunion in DHS group was significantly higher than the other two groups (8.82％ vs 0％ and 0％,x2 =6.092,P =0.047).Excellent rate in DHS group,PFNA group and Intertan group were 82.3％ (28/ 34),87.8％ (29/33),85.3％ (29/34) respectively,and there was no significant difference (x2 =0.591,P ＞ 0.05).Conclusion Compared with DHS,Intertan nail and PFNA have advantage of shorter operative time,stronger anti-rotation capability and less various postoperative complication rates,thus they are more suitable for elderly osteoporotic intertrochanteric fracture.

Objective To investigate the effect of treatment of avascular necrosis of femoral head in adolescence by implanting a composite of autogenous bone marrow, bone morphogenetic protein(BMP), and noncelluar tissue engineered bone allograft. Methods The BMP was partially purified from bovine cortical bone (bBMP) by Urist method. The bone allograft chips were mixed with bBMP and bone marrow. The composite was implanted into the necrotic area of the femoral head after core decompression, then partial deminerallized allograft fibula segments were inserted in the core decompression holes to support the necrotic area in preventing the collapse in 64 adolescent patients (78 hips). Results 55 cases (67 hips) were followed up for 3 months to 6 years(mean 44 months). 28 case(36 hips) in FicatⅠ,Ⅱ were followed up over 3 years, of whom there were no obvious pain and dysfunction in 18 cases(22 hips), high density new bone was shown in core decompression area in CT scanning, and no evidence of progressive necrosis. There was no worsening of the symptoms in 4 cases(6 hips) in Ficat Ⅰand Ⅱ, but the lesion progressed. In 6 cases (8 hips) in Ficat Ⅲ, there were no obvious pain and dysfunction in 2 cases, but 4 cases underwent total hip replacement because of persistent pain and progressive lesion. Conclusion The partial demineralized allograft fibula can provide direct mechanical support to prevent the necrotic femoral head from progress and collapse, autogenous bone marrow and BMP is able to promote new bone formation. The method can be used as an alternative for the treatment of osteonecrosis of femoral head at stage Ⅰ,Ⅱ.

Objective To analyze the cause for complications of the long bone fractures treated with the interlocking nail and indicate the prevention and treatment measures. Methods From January 1998 to May 2000,168 patients with long bone fractures were treated with the interlocking nail. Of them, there were 77 cases of femoral fractures, 67 tibial fractures and 24 humeral fractures. Results All patients were followed up for 5-24 months. Complications occurred in 14 cases (8.33%) including 4 cases of infections, 1 lower limb necrosis, 2 internal fixation failure due to incorrect indication, 2 re-fractures during the operation, 2 distal screw misinserted,1 nail into the ankle joint, 1 distal screw broken and 1 distal screw loosening. Conclusions We should attach great importance to the following points during treatment of long bone fractures with interlocking nail:(1) The indications must be correctly handled. (2) The technique for interlocking nail must be performed strictly during operation; close inserting nail is proposed.(3) As for the comminuted fractures, bone continuity should be reconstructed and the time to start weight bearing properly delayed. (4) C-Arm X-ray supervision is necessary during operation.

Objective To evaluate the effects of supine and prone position on ventilation function in neonates in the initial six-hour period after weaning. Methods Sixty-four neonates weaned from mechanical ventilation and with normal body temperature hospitalized from Sep. 2004 to Apr. 2006 in our NICU were randomly divided into prone group and supine group. All of them were oxygen administrated through head net, oxygen flow rate was adjusted continously to keep SpO2 at normal level by monitoring SpO2 and RR. FiO2、RR were recorded at 15 minutes,1 h,2 h,3 h,4 h,5 h,6 h after weaning. Arterial blood gas was meas-ured at 1 h ,6 h after weaning and A-aDO2, RI, OI were calculated. Results (1) At 1～6 h after weaning the values of FiO2 in prone group were significantly lower than those in the supine group(P<0.01). (2) After weaning there was a decreasing tendency of RR in the prone group and the significant decrease was found at 4 h ,5 h ,6 h compared with supine group (P<0.01). (3) At 1h and 6h after weaning, the value of PaO2 and OI were significantly higher and the value of A-aDO2, RI were lower in the prone group than in the supine group(P<0.05,P<0.01). (4) At 6 h the PaCO2 in prone group were obviously higher than that in supine group (P<0.05). Conclusion At first 6h after weaning prone position can improve ventilation functions.

Objective To investigate the effects of α7 nicotinic acetylcholine receptor (α7nAChR) on the inflammatory response induced by lipopolysaccharide (LPS) in RAW264.7 macrophages and its molecular mechanisms. Methods RAW264.7 macrophages were culturedin vitro. Inflammatory cell model was constructed by LPS stimulation. Cells were challenged by LPS (1, 10, 100 and 500μg/L) for 5 hours or 100μg/L LPS for 0, 2, 4, 8, 12, 24, 48 and 72 hours, and the release of tumor necrosis factor-α (TNF-α) was detected by the enzyme linked immunosorbent assay (ELISA). The location of α7nAChR was examined in RAW264.7 macrophages by immunofluorescence. Then the cell proliferation and toxicity kit (CCK-8) was used to detect 1, 10, 100, 1000μmol/L GTS-21, a α7nAchR agonist, on the cell viability after LPS stimulation. ELISA was used to detect 1, 10, 100, 1000μmol/L GTS-21 on the levels of TNF-α, interleukin 1β (IL-1β) after LPS stimulation. Cells were challenged with 100μg/L LPS and 100μmol/L GTS-21, then, the level of high mobility group box 1 (HMGB1) was detected by Western Blot and the intracellular location of HMGB1 and nuclear factor-κB p65 (NF-κB p65) was tested by immunofluorescence.Results LPS increased the level of TNF-α to a peak at the concentration of 100μg/L and at 24 hours after stimulation. Theα7nAChR expressed on the macrophages. The cell viability was decreased in a dose-dependent manner [(96.2±1.0)%, (92.0±1.1)% vs. (86.5±2.2)%, bothP < 0.05]. Compared with the control group, the levels of TNF-α and IL-1βin the supernatant of LPS group were significantly increased [TNF-α (ng/L): 453.0±60.6 vs. 100.8±3.2, IL-1β(μg/L): 8.21±0.31 vs. 0.87±0.16, bothP < 0.05]. TNF-α and IL-1β were significantly decreased by 10μmol/L and 100μmol/L GTS-21 in a dose-dependent manner [TNF-α (ng/L): 227.5±17.5, 81.0±8.8 vs. 453.0±60.6;IL-1β (μg/L): 4.86±0.72, 2.32±0.45 vs. 8.21±0.31, allP < 0.05]. GTS-21 significantly reduced the expression of HMGB1 which was induced by LPS management (gray value: 0.788±0.130 vs. 2.061±0.330,P < 0.05) and reversed LPS-induced HMGB1 cytoplasmic transfer. GTS-21 also reversed LPS-induced nuclear translocation of NF-κB p65. Conclusion GTS-21 reduces the inflammatory response via inhibiting the activation of NF-κB.