Objective To study possible clinical relationships of myeloperoxidase (MPO) and carotid atherosclerosis in diabetic patients on maintenance hemodialysis(MHD).Methods Levels of plasma MPO and serum elastase (ELT) of diabetic patients on MHD were determined by enzyme-linked immunosorbent assay.Carotid intima media thickness(CIMT),quantity and area of carotid plaque were measured by B-mode ultrasonography.Results Plasma MPO was significantly higher after hemodialysis(HD) than before HD(414.6 (198.9,671.5) μg/L vs 176.4 (69.9,243.3) μg/L,Z =-4.51,P ＜ 0.01).There was no significant difference of serum ELT before and after HD(198.0(146.9,270.5) μg/L vs 230.9(40.2,308.0) μg/L,Z =-1.87,P ＞ 0.05).There was positive correlation between the age and CIMT,quantity or area of carotid plaqueor(correlation coefficient:0.764,0.416 and 0.446 respectively,P ＜ 0.01 or P ＜ 0.05),There was positive correlation between MPO level before HD and age,Levels of serum ELT before HD,or CIMT(correlation coefficient:0.592,0.476 and 0.810 respectively,P ＜ 0.01).There was positive correlation between MPO level after HD and levels of serum ELT after HD (correlation coefficient:0.364,P ＜ 0.05).There was no correlation between the levels of plasma MPO after HD and CIMT,quantity or area of carotid plaqueor (P ＞ 0.05).Conclusion (1) Age and MPO level before HD contribute to carotid atherosclerosis in patients on MHD.(2)There was no relation between higher MPO level after HD and carotid atherosclerosis.

Objective To investigate the serum C-reactive protein (CRP) level in patients with acute cerebral infarction and acute massive cerebral infarction with multiple organ dysfunction syndrome (MODS),and analyze the clinical value of CRP. Methods The serum CRP level of 50 patients of control group and 50 patients of cerebral infarction admitted to hospital within 7 days (30 patients were admitted into acute cerebral infarction group and 20 patients into acute massive cerebral infarction with MODS group) were determined by immune scatter turbidimetry. Results (1)In cerebral infarction patients,serum CRP level in 48 cases(96%) was equal and over 5 mg/L.In control group,serum CRP level in 3 cases(6%) was equal and over 5 mg/L(P＜0.0 5).(2)The level of serum CRP acute in cerebral infarction group and in acute massive cerebral infarction with MODS group increased significantly than that in control group (P＜0.01).The level of serum CRP in acute massive cerebral infarction with MODS group increased significantly than that in acute cerebral infarction group.(3)When the level of CRP＜25 mg/L,the incidence of MODS in patients with acute cerebral infarction was zero.When the level of CRP≥25 mg/L,the incidence of MODS increased gradually with the rise of CRP. Conclusions There is positive correlation between the serum level of CRP and the severity of acute cerebral infarction and the incidence of MODS.CRP is a useful marker in predicting the prognosis of acute massive cerebral infarction with MODS.

Objective To evaluate the curative effects of percutaneous osteoperiosteal decortication combined with distraction osteogenesis for treatment of nonunion of lower-extremity bones.Methods A retrospective analysis was performed of the 32 patients who had been treated using osteoperiosteal decortication combined with distraction osteogenesis from September 2011 to December 2014 for nonunion of lower-extremity fractures.They were 23 males and 9 females,with a mean age of 33.4 years (range,from 15 to 62 years).After their former internal or external fixators were removed,the 2 fracture ends were fixated by a retractile mono-lateral or circular external fixator.Under radiographic monitoring,a percutaneous incision was made with a 5 mm sharp chisel,down to the bone.Scar and ossified tissue between the fracture ends were debrided and cut along the fracture line.Mter the marrow cavity was reamed,a new irregular wound was created at sclerotic fracture ends.Scale-shaped chips (1 mm thin and 5 mm in diameter) were elevated using a chisel on surface of the cortical bone within 2 cm from the fracture ends.The external fixators were adjusted to compress the fracture sites.On the 8th day after operation,the eternal fixators were applied to distract and compress at nonunion sites to stimulate the osteogenesis.Results All the patients were followed up for an average of 12.5 months (range,from 8 to 42 months).Primary union was successfully achieved in 28 patients while delayed union occurred in 3 patients who finally achieved union after adjuvant therapies like shock wave and or local injection of bone marrow blood.The average time for union was 4.6 months(range,from 4 to 7 months).The mean time for external fixation was 6.2 months (range,from 5 to 8 months).One patient encountered nonunion of lateral tibial cortical bone 6 months after surgery but eventually achieved union by autologous ilium grafting.Joint functions in all postoperative patients were similar to those before operation.Conclusion Percutaneous osteoperiosteal decortication combined with distraction osteogenesis is a simple,minimally invasive and effective treatment for nonunion of lower-extremity bones,avoiding disadvantages brought by traditional surgery,like massive trauma and excessive bleeding.

BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.

OBJECTIVE: To investigate the effect of 1,2-dichloroethane(1,2-DCE) acute inhalation exposure on the differential gene expression of phase Ⅰ metabolic enzymes. METHODS: The specific pathogen free SD rats were randomly divided into control group(16 rats), low-and high-dose groups(24 rats in each group, half males and half females). Low-and high-dose group were given daily 600, 1 800 mg/m~(3 ) of 1,2-DCE, and the control group given the fresh air by dynamic inhalation for 8 hours per day for consecutive 7 days. After the end of exposure, the relative mRNA expression of cytochrome P450 2 E1(CYP2 E1), alcohol dehydrogenase(ADH1) and acetaldehyde dehydrogenase 3 alpha 1(ALDH3α1) in the liver tissue was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS: The relative expression of CYP2 E1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ADH1 in male low-and high-dose groups was higher than that in male control group(P<0.05). The relative expression of ADH1 in male high-dose group was higher than that in male low-dose group and female high-dose group(P<0.05). The relative expression of ALDH3α1 in high-dose group was higher than that in control group and low-dose group(P<0.05). CONCLUSION: High dose 1,2-DCE could increase the gene expression of phase Ⅰ metabolic enzymes in rat liver. The 1,2-DCE has more obvious effect in male rats than in female rats.