Objective To explore the clinical efficacy of radial head replacement with titanic prosthesis for comminuted fractures of the radial head associated with elbow instability. Methods From 2000 to 2003, a total of 18 patients, 13 men and 8 women (mean age, 34.8 years, range, 24-47 years) underwent radial head replacement with titanic prosthesis for comminuted fractures associated with elbow instability. All were the close fractures, left elbow in 8 and right elbow in 10 cases. 3 patients suffered multiple fractures in ipsilateral elbow, including proximal comminuted fracture of radius in 1, fracture of coronoid process in 2. 4 patients suffered simultaneous fracture in ipsilateral upper extremity, including distal fracture of radius in 3, fracture of surgical neck of humerus in 1. According to Mason classification, 10 fractures were of type Ⅲ, 7 of type Ⅳ, and 1 with Essex-Lopresti injury. 4 cases were old fractures and dislocations, the other 14 were of fresh injuries within 2 weeks. Operations were undertaken averagely in 9 days after injury (range, 4-26 days). Results Patients were followed from 12 to 44 months (average, 29 months). According to Broberg and Morrey scoring system, 8 patients (44.4%) were rated as excellent, 8 (44.4%) as good, 1 (5.6%) as fair, and 1 (5.6%) as poor. The rate of excellent and good results was 88.9%. No cases of infection, neural injury, foreign body reaction, exacerbation of cubitus valgus or deformity of wrist was found. On X-ray films, all of the titanic radial head prosthesis were stable, no shortening or proximal migration of radius, or subluxation of distal radioulnar joint was found. No sign of inflammatory reaction was noted. Mild heterotopic ossification was found in 6 elbows, but no distinct resulted limitation of locomotion. Conclusion The radial head replacement with titanic prosthesis provides an effective method for the treatment of comminuted fractures of the radial head associated with elbow instability.

Objective: To construct a prediction model of non-alcoholic fatty liver disease (NAFLD) in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), so as to provide basis for early screening and prevention of T2DM complicated with NAFLD. Methods: Patients aged 45 years and above and diagnosed with T2DM in Karamay Hospital of People's Hospital of Xinjiang Uygur Autonomous Region in 2021 were collected as the study subjects. The data of general demographic characteristics and biochemical test results were collected. The patients were randomly divided into training group (n=3 241) and validation group (n=1 389) according to the ratio of 7∶3. LASSO regression and multivariable logistic regression model were used to select predictive factors. The nomograph model for prediction of NAFLD risk in T2DM patients was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC), adjusted curve and decision clinical analysis. Results: Totally 4 630 T2DM cases were included, including 1 279 cases (27.62%) complicated with NAFLD. LASSO regression and multivariable logistic regression analysis identified gender, age, diastolic blood pressure, body mass index, alanine transaminase, triglycerides, low density lipoprotein cholesterol and platelet count as risk prediction factors for NAFLD in T2DM patients. The area under the ROC curve was 0.823 (95%CI: 0.814-0.832) for the training group and 0.809 (95%CI: 0.799-0.818) for the validation group, and Hosmer-Lemeshow test showed a good fitting effect (P>0.05). Decision curve analysis showed higher net clinical benefit of using the predictive model to predict NAFLD risk when the risk threshold probability was 0.27 to 0.85. Conclusion The nomogram model established has a good predictive value for the risk of NAFLD in T2DM patients aged 45 years and above.

According to the onset age, a total of 5 674 outpatients with gout admitted in the affiliated hospital of Qingdao University from January 2011 to January 2016 were divided into youth group (≤44 years, n=3 058), middle age group (45~64 years, n=2 101), and elderly group (≥65 years, n=515).Their clinical and biochemical characteristics were analyzed.The results showed that the proportion of gout in the males in three groups was higher than that in the females.The proportions of gout in male youth, middle age, and elderly groups were 98.1%, 93.4%, and 83.1%, respectively.The proportion of gout in females increased with age.The proportion of gout family history in youth group was higher than that in middle age and elderly groups(P<0.05).The proportions of hypertension and impaired fasting glucose(IFG) in elderly group were higher than those in youth and middle age groups (P<0.05), with lower proportions of hypertriglyceride and obesity (P<0.05).The levels of systolic blood pressure, blood urea nitrogen, creatinine in elderly group were increased compared with youth and middle age groups (P<0.05) while the levels of uric acid and triglyceride were decreased (P<0.05), with higher ratio of renal dysfunction (P<0.05).There were no differences in tophus and kidney calculi among three groups (P>0.05).The distributions of the onset joint among three groups revealed statistical difference(P<0.05), but the first plantar toe joint was mostly involved in each group.These results suggest that the clinical characteristics of patients with gout at different onset ages are not identical, should be treated differently.

OBJECTIVE:To systematically review the efficacy and safety of intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection,and to provide evidence-based reference in the clinic. METHODS:Re-trieved from PubMed,Medline,CJFD,VIP,Wanfang databases,randomized controlled trials(RCTs)about intrathecal injection of vancomycin combined with dexamethasone in the treatment of intracranial infection were collected. Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies according to Cochrane system review manual 5.0.1. Then Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:Total of 8 RCTs were included,involv-ing 543 patients. Meta-analysis showed that,compared with intravenous dripping of ceftriaxone or vancomycin,intrathecal injec-tion of vancomycin combined with dexamethasone could significantly increase response rate [RR=1.18,95%CI(1.11,1.26),P<0.001] and bacterial clearance rate of CSF[RR=1.13,95%CI(1.01,1.27),P<0.001] of intracranial infection patients,shortened treatment time [SMD=-1.60,95%CI(-1.89,-1.30),P<0.001],reduce the incidence of ADR [RR=0.48,95%CI(0.32,0.73), P<0.001]. At the same time,it also could improve changes of intracranial pressure[SMD=-1.78,95% CI(-2.10,-1.47),P<0.001],changes of protein quantitation of CSF[SMD=-0.18,95%CI(-0.25,-0.11),P<0.001] and changes of glucose quantita-tion of CSF[SMD=1.77,95%CI(0.91,2.63),P<0.001],with statistical significance. CONCLUSIONS:Intrathecal injection of van-comycin combined with dexamethasone shows good clinical efficacy for intracranial infection,improves bacterial clearance rate, shortens treatment duration,significantly lowers intracranial pressure and protein quantitation,improves glucose quantitation of cere-brospinal fluid,with good safety.

Aim To explore the effects of heat stress on TNF-?-induced fever and the content of cAMP in rat hypothalamus. Methods ①We examined the peak time of HSP70 expression in hypothalamus after heat stress; ②We studied the change of TNF-?-induced fever and the content of cAMP in hypothalamus after heat stress. Result The maximum expression of HSP70 in hypothalamus was attained at 12 h after heat stress. Heat stress limited TNF-?-induced fever and decreased the content of cAMP in hypothalamus. Conclusion Heat stress can inhibit TNF-?-induced fever in rats, and this effect may be related with the inhibition of cAMP synthesis induced by high expression HSP70 in hypothalamus.

Objective To compare the effect of coronoid fixation combined with lateral collateral ligament repair versus hinged external fixator in treatment of elbow varus posteromedial rotational instability.Methods This retrospective cohort research included 34 patients with elbow varus posteromedial rotational instability operated between January 2011 and June 2015.All patients had coronoid process fractures of O'Driscoll type Ⅱ[(six with subtype 1,24 with subtype 2 and four with subtype 3).Fifteen of the 34 patients were operated by coronoid fixation combined with lateral collateral ligament repair (Group A) and other 19 patients were operated by coronoid fixation combined with placing hinged external fixator (Group B).Interval between injury and operation,operation time and blood loss were recorded.At final follow-up,elbow range of motion,Mayo elbow performance score (MEPS) and Hastings and Graham heterotopic ossification classification were measured.Results There were no significant differences in the interval between injury and operation,operation time and blood loss between the two groups (P ＞0.05).Median period of follow-up was 30 months in Group A and 40 months in Group B.Last follow-up showed flexion of the affected elbow in Group B [145° (135°-150°)] was better than that in Group A [140° (130°-145°)] (P ＜ 0.05),while between-group differences were insignificant in elbow extension,elbow extension-flexion,forearm pronation-supination and heterotopic ossification classification (P ＞ 0.05).MEPS in Group A scored 100 in 10 patients,90 in three,85 in one and 70 in one;MEPS in Group B scored 100 in 13 patients,90 in one,85 in four and 80 in one.There was no significant difference in MEPS between the two groups (P ＞ 0.05).Conclusion For treating elbow varus posteromedial rotational instability,either lateral collateral ligament repair or hinged external fixation after anatomic reduction and coronoid fixation can achieve good results.

Objective The aim of this study was to inve-stigate the associations between genetic variants in interleukin (IL)-33 and susceptibility to gout.Methods The genetic distributions of rs3939286 were detected in 1 100 men with gout and 1 227 ethnically matched controls using Taqman allelic discrimination real-time polymerase chain reaction (PCR).Hardy-Weinberg was used to verify the representativeness of the samples.Differences in genetic distributions between groups were investigated using x2 tests.The genotypephenotype relationship among gout patients was tested by analysis of variance.Results The frequencies of AA,AG and GG genotypes were1,101 and 998 (0.1％,9.2％ and 90.7％) among gout patients,while they were 1 132 and 1 094 (0.1％,10.7％ and 89.2％) among the controls.There were no significant differences in genetic distributions of IL-33 rs3939286 polymorphism between gout patients and controls (P=0.478 by genotype,x2=1.46,P=0.309 by allele).Conclusion Our results have revealed that the rs3939286 variant in IL-33 gene may be not involved in the development of gout in male gout patients of Shandong.However,further studies in other ethnic groups are needed to confirm the results.

Objective To evaluate the effect of angiotensin Ⅱ ( Ang Ⅱ ),angiotensin- (1-7) [ Ang- ( 1-7 ) ],and co-action of Ang Ⅱ and Ang-( 1-7 ) on β cell insulin signaling pathway.Methods Mouse pancreatic β cell line NIT-1 was incubated with( 1 )0,10-7,10-6,10-s,10-4 mol/L concentrations of Ang Ⅱ for 24 h ; ( 2 )0,10-7,10-6,10 -5,10-4 mol/L concentrations of Ang- ( 1-7 ) for 24 h; ( 3 ) co-administration of Ang Ⅱ and Ang- ( 1-7 ) was divided into control,10-5mol/L Ang Ⅱ,10-6mol/L Ang-( 1-7 ),10-5mol/L Ang Ⅱ + 10-6mol/L Ang-( 1-7 ) group.Tyrosine phosphorylation of insulin receptor β subunit(IR-β-Tyr) and serine phophorylation of protein kinase B(Akt-Ser) were detected by Western blot.ResultsInsulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation was significantly decreased in Ang Ⅱ 10-5 and 10-4 mol/L group; no significant changes in insulin-stimulated IR-β-Tyr and Akt-Ser phosphorylation were detected between Ang-( 1-7 ) treatment groups and control; Ang-( 1-7 ) blocked the inhibitory effect of Ang Ⅱ on Akt-Ser phosphorylation,yet exerted no effect on Ang Ⅱ-induced IR-β-Tyr phosphorylation inhibition.Conclusion Ang Ⅱ significantly inhibits insulin signaling pathway in β cell; Ang-( 1-7 ) reverts the inhibitory effect of Ang Ⅱ on insulin-stimulated Akt-Ser phosphorylation in β cell.

IFIT family genes are a kind of interferon stimulated genes (ISGs), and play important roles in antiviral sector and immunity regulation. To study the regulatory effect of IFIT family genes during influenza A virus (IAV) infection, we used RNA-sequencing analysis (RNA-Seq) technique and found that when 293T cells were infected by A/WSN/33 (WSN), the concentration of IFIT family genes were increased. Further study reveals that overexpression of IFIT2 or IFIT3 could inhibit IAV replication and transcription, and cause the dose-dependent inhibition of polymerase activity of vRNP. In addition, IFIT2 and IFIT3 encoding protein could colocalize with NS1 in 293T cells infected by WSN, indicating that they might interact with each other. The results suggest that IFIT family genes can inhibit the replication and transcription of IAV, which contributes to our understanding of the regulatory effect of host factors during influenza virus infection.
HEK293 Cells ; Humans ; Influenza A virus ; physiology ; Influenza, Human ; genetics ; Intracellular Signaling Peptides and Proteins ; genetics ; Proteins ; genetics ; Virus Replication

Objective To perform the sample survey on the recognition degree of abdominal compartment syndrome (ACS) among domestic pediatric healthcare providers (PHCP) Methods Three hundred self‐designed questionnaires were distributed to the participants at the twelfth Chinese Medical Association Congress of Pediatric Critical Care Medicine in November 2011 .Results A total of 194 effective questionnaires were reclaimed with the recovery rate of 64 .7% .28 .9% (56/194)of respondents did not heard of ACS .49 .5% (96/194)of them heard of ACS ,but did not contact ACS .Only 21 .6% (42/194)of respondents were well fa‐miliar with ACS .Among the medical staffs who were aware of ACS (familiar or just heard of ) ,only 7 .2% (10/138)knew the real definition of ACS .83 .3% (35/42) of respondents who were familiar with ACS used the intravesical route to measure the intra -ab‐dominal pressure(IAP) .However ,only 57 .1% (20/35)of respondents knew the correct saline volume for measuring IAP .Conclusion The recognition degree of ACS is low among domestic PHCP .It is necessary to strengthen the ACS related education among do‐mestic PHCP for increasing the awareness of ACS and promoting its treatment .