Objective To explore the impact of modified vacuum sealing drainage (VSD) on prevention of tension blisters during treatment of opening fracture wounds.Methods From March 2015 to February 2016,53 patients with 60 open fracture wounds were treated after surgery by VSD at our department.They were 28 males (33 wounds) and 25 females (27 wounds),aged from 24 to 65 years (average,41.1 years).The patients were divided into 2 groups.Group A (33 wounds) were subjected to traditional VSD after surgery while group B (27 wounds) to modified VSD.The mean time from injury to surgery was 5.2 hours (from 2.0 to 8.3 hours).The VSD dressing was first removed to observe whether any tension blisters would appear surrounding the dressing 5 days after surgery.Results Tension blisters appeared around 9 wounds in group A (with an incidence of 27.3％) but around one wound in group B (with an incidence of 3.7％).The difference between the 2 groups was statistically significant (P =0.037).Conclusion In treatment of open fracture wounds,the modified VSD can effectively prevent formation of tension blisters surrounding the dressing while it is used to cover a wound.

Objective To establish a specific fluorescence quantitative method for determining the mRNA expression of Toll-like receptor3(TLR3)in peripheral blood mononuclear cells(PBMCs).Methods Using the Beacon Designer 2.1 software,specific primers and Taqman-MGB probe were designed.The plasmid pMD18-T-TLR3 was constructed as calibrator and the amplified fragment was obtained by reverse- transcript-PCR(RT-PCR).RNA quantification based on cycle threshold values(Ct)was used to establish the standard curve.According to which,the TLR3 mRNA levels in 30 normal individuals,20 patients with primary biliary cirrhosis(PBC)and 20 ones with chronic liver cirrhosis induced by HBV were calculated automatically by software after the fluorescence of PCR product was detected continuously during amplification.Results The linear detection range of the assay for TLR3 gene and ?-actin was 10~2-10~8(r= -0.9974)and 10~3～10~8(r=-0.9984),respectively.The coefficient of variation of both intra-and inter- assay reproducibility for high concentration sample were 6.7% and 8.7%,respectively,and those for low concentration sample were 12.3% and 14.0%.The TLR3 mRNA expression level ranges from 3.46?10~2- 4.51?10~3 copies/?g RNA,4.92?10~2-1.42?10~4 copies/?g RNA and 2.58?10~2-7.17?10~3 copies/?g RNA for 30 healthy individuals,20 PBC patients and 20 ones with chronic liver cirrhosis induced by HBV, respectively.Conclusion We have successfully set up a FQ-RT-PCR method for detecting TLR3 mRNA, which may be used as an excellent tool for the clinic and basic study on the expression of TLR3 gene.

Objective:To evaluate arthrography-assisted reduction in minimally invasive treatment of tibial plateau fractures.Methods:From January to May 2019, 9 patients with tibial plateau fracture were treated by arthrography-assisted minimally invasive surgery at Department of Orthopaedics and Traumatology, Hong-Hui Hospital. They were 6 males and 3 females with an average age of 45.5 years (from 27 to 63 years). According to the Schatzker classification, there were 6 cases of type Ⅱ, one of type Ⅲ and 2 cases of type Ⅳ. Arthrography was used to determine the lowest filling point of contrast medium after intra-articular injection and to ensure satisfactory reduction of articular surface after fracture reduction and bone grafting, followed by minimally invasive percutaneous plate implantation. Comparisons were made between preoperation and 6 months postoperation in the range of knee motion and knee scores of The Hospital for Special Surgery (HSS). Knee X-ray films were evaluated by the Rasmussen imaging system at 6 months postoperation. Collapse of articular surface was recorded pre- and post-operation as well as postoperative complications.Results:All the 9 patients were followed up for 6 to 9 months (average, 7 months). All patients achieved bony union within 12 weeks postoperation. The preoperative knee flexion (60.7°±13.1°) and HSS (51.9±5.7) were significantly improved to 122.4°±10.8° and 84.9±5.3 at 6 months postoperation ( P<0.05), but there was no significant difference between preoperation and 6 months postoperation in knee extension (4.4°±2.5° versus 4.6°±2.9°) ( P>0.05). The collapse of articular surface was improved from preoperative 9.5 mm (from 5 to 15 mm) to postoperative 1.3 mm (from 0 to 3 mm). The Rasmussen imaging scores at 6 months postoperation showed 6 excellent and 3 good. No such postoperative complications occurred as incision infection, joint stiffness, loosening or breakage of implants. Conclusion:Arthrography helps minimally invasive treatment of tibial plateau fracture because it can better display fracture collapse during operation and accurately judge indirect reduction of articular surface.

OBJECTIVETo evaluate the expression of microRNA (miR)-let-7b in peripheral blood cells of patients with primary biliary cirrhosis (PBC) and investigate its relationship to clinical disease parameters.

METHODSPeripheral blood and serum samples were obtained for study from 60 PBC patients and 60 healthy controls. Peripheral blood cells were extracted and subjected to real-time PCR to measure miR-let-7b expression. Serum levels of interleukin (IL)-18, total bilirubin (TBIL), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) were measured by standard biochemical assays. The relationship between miR-let-7b expression and disease parameters was assessed by Spearman's rank correlation test.

RESULTSPBC patients showed significantly lower expression of miR-let-7b in peripheral blood cells than healthy controls (P less than 0.001); moreover, the miR-let-7b expression level decreased in parallel to increases in disease severity (stage I > II / III > IV). In PBC patients, the miR-let-7b expression was significantly correlated with Mayo risk scores (r = -0.4930, P less than 0.001), IL-18 (r = -0.4643, P less than 0.001) and ALP (r = -4119, P less than 0.001), but not with TBIL or GGT.

CONCLUSIONDecreased expression of miR-let-7b may be associated with development and progression of PBC, and this miRNA may represent a novel target of improved diagnostic and preventive strategies for PBC.

Adult ; Aged ; Alkaline Phosphatase ; blood ; Bilirubin ; blood ; Case-Control Studies ; Female ; Humans ; Interleukin-18 ; blood ; Liver Cirrhosis, Biliary ; blood ; Male ; MicroRNAs ; metabolism ; Middle Aged ; gamma-Glutamyltransferase ; blood

Animals ; Disease Models, Animal ; Graft vs Host Reaction ; Liver Cirrhosis, Biliary ; Mice

Objective To evaluate the clinical application of our self-designed ultradistal locking tool in the intramedullary nailing for tibial fractures.Methods From January 2014 to May 2016,175 patients with tibial fracture were treated at our department.They were 119 men and 56 women,from 19 to 73 years of age (average,46.3 years).They were divided into 2 groups according to the different targeting devices used in the intramedullary nailing.Conventional locking tools were used in the 83 patients from January 2014 to January 2015 and our self-designed new ultradistal locking tools in the 92 patients from February 2015 to May 2016.The 2 groups were compared in terms of operation time,frequency of intraoperative fluoroscopy,and successful rate of one-time locking.Results There were no significant differences between the 2 groups in general clinical data(P ＞ 0.05),showing similarities of the 2 groups.The operation time(59.8 ±4.3 min),frequency of intraoperative fluoroscopy(11.0 ± 2.1 times),and rate of one-time successful locking[94.4％ (238/252)] in the ultradistal locking group were significantly better than those in the conventional locking group [73.6 ± 5.3 min,23.0 ± 3.8 times and 85.7％ (180/210),respectively] (P ＜ 0.05).Conclusions Our new ultradistal locking tools are superior to the conventional ones in that they lead to shorter operation time,less intraoperative fluoroscopy and higher successful rate of one-time locking.Additionally,the new locking tools are easy to handle and incur no extra costs.

Objective： To investigate the effect of oxLDL and VitE on the expression of CD40 and CD40 ligand(CD40L) in cultured human monoc ytes. Methods： The expression of CD40 and CD40L on monocytes su rface were measured by indirect immunorescence technique in combination with flo w cytometry. Results： Low concentration of oxLDL（≤200 μg/L） significantly increased the expression of CD40 and CD40L in a dose and time dep endent manner. High concentration (>200 μg/L）of oxLDL markedly reduced the exp ression of CD40 and CD40L. When VitE was added, it significantly reduced the ex pression of CD40 and CD40L on monocytes surface induced by oxLDL in a dose-depe ndent manner. Conclusion：It is an important mechanism that the high expression of CD40 and CD40L induced by oxLDL may be contributed to the for mation of atherosclerosis. Antioxidan VitE can partially inhibit the high expres sion of CD40 and CD40L on monocytes surface induced by oxLDL.

Objective To detect anti-M_2 autoantibody using recombinant BCOADC-E_2.Methods We purified recombinant BCOADC-E_2 by Ni~(2+)affinity chromatography column and then detect anti-M_2 autoan- tibody in the sera of patients with primary biliary cirrhosis(PBC)by Western blot test(WBT)and enzyme linked immunosorbent assays(ELISA).Results Among 60 sera from PBC patients,33 were positive,all of controls were negative.Conclusion The recombinant BCOADC-E_2 can be used to detect anti-M_2 autoanti- body specifically and sensitively.It is helpful for the diagnosis of PBC.

Objective:To study the correlation between HBV Pre-S1 antigen,HBeAg levels and HBV DNA copies,so as to assess the clinical value of Pre-S1 in detection of HBV replication.Methods:A total of 363 HBsAg-positive samples were col- lected.The levels of Pre-S1 antigen,HBeAg and HBV DNA copies were determined by ELISA,time-resolved immuno-fluores- cent method and real-time fluorescent quantitative PCR(FQ-PCR),respectively.The correlation between the determination re- sults was analyzed.Results:Pre-S1 antigen level was correlated with the level of HBeAg(X~2=94.4,P