Objective To improve the accuracy of X-ray diagnosis of the deltoid ligament injury by evaluating the influence of plantar flexion on the diagnosis.Methods Twenty-four patients with ankle supination-extemal rotation fracture which was distal fibula fracture but no medial malleolus fracture were treated from February 2010 to December 2010.All the patients were taken Mortise radiograph with the ankle in four positions of plantar flexion(0°,15°,30° and 45°)applied with rotational stress and the deltoid ligament injury was identified with MRI.The medical clear space(MCS)and the superior clear space(SCS)on each radiograph were measured.The results were tested by a one-way analysis of variance model(ANOVA),based on the following criteria:(1)the MCS≥ 4 mm and MCS ＞ SCS,or when MCS≥5 mm and MCS ＞SCS.The MRI examination was taken as the gold standard to compare the influence of X-ray diagnosis of the deltoid ligament injury with different plantar flexions and different standards.Results The average MCS in four positions of plantar flexion(0°,15°,30°,and 45 °)with rotational stress were(4.10 ±0.79)mm,(4.55 ±0.72)mm,(4.99 ±0.56)mm and(5.71 ±0.86)ram,with statistical difference(P ＜0.05).The average SCS in four positions of plantar flexion(0°,15°,30°,and 45°)were(3.56 ±0.41)mm,(3.50 ±0.43)mm,(3.71 +0.44)mm and(3.93 ±0.51)mm,with no statistical difference in the four groups(P ＞0.05).With the MSC≥4 mm and MSC ＞ SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 50.0％,66.7％,88.9％ and 94.4％ respectively.With the MSC≥5 mm and MSC ＞SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 5.6％,11.1％,38.9％ and 77.8％ respectively.Condusions Different plantar flexion angle is an important factor for X-ray diagnosis of deltoid ligament injury of the ankle joint.The prevalence of false-positive findings of deltoid injury increases with the increase of plantar flexion.

Objective To evaluate correlation of radial head fracture with forearm interosseous membrane (IOM) injury.Methods Twenty-six patients with radial head fractures were studied prospectively between September 2007 and June 2010.There were 15 men and 11 women,with an average age of 37.6years (range,21-53).According to the Mason classification,there were 7 cases of type Ⅰ,9 cases of type Ⅱ,10 cases of type ⅢL All patients were subjected to forearm X-ray,CT scans and the MR within a week.Clinical and radiographic data of all the patients were collected.Spearman rank correlation statistical analysis was used to analyze the correlation between the radial head fracture and the IOM injury.Results The radial head fractures and IOM injury were directly related.The IOM injury was noted in all type of radial head fracture.The more severity radial head fracture had,the more IOM injury happened.In Mason Ⅰ-Ⅲ fractures,IOM injury was found in 2,4 and 7 cases respectively.The different degree of radial head fracture caused different effects on IOM injury.The severity of radial head fracture was correlated with damage degree of IOM.In Mason type Ⅰ and type Ⅱ fractures,the IOM injury were just partial disruption with distal part of the IOM and did not reach the biomechanically essential central band.In type Ⅲ fractures,central band disruption was found in 3 cases.Conclusion Mason Ⅰ-Ⅲ radial head fractures are associated with forearm IOM injury.There was a positive correlation between radial head fractures and IOM injury.If IOM lesions are suspected,magnetic resonance imaging should be performed,especially Mason Ⅲ fractures.

Objective:To analyze the characteristics of respiratory tract adenovirus infection in hospitalized children and the correlation between adenovirus infection and wheezing symptoms.Methods:The detection of adenovirus in 48 153 children with acute respiratory tract infection in Children’s Hospital of Hebei Province from January 1st, 2014 to December 31st, 2019 was retrospectively analyzed. The adenovirus infection in different years, different seasons and different age groups was compared and analyzed. Multivariate conditional Logistic regression was used to analyze the related factors of wheezing symptoms caused by adenovirus infection in children.Results:Of the 48 153 children, adenovirus was positive in 603 children, the positive rate was 1.25%. No significant difference was found in the positive rate between boys and girls ( X2=0.592, P = 0.442). There was no significant difference in adenovirus positive rate between different years ( X2=10.251, P = 0.068). Adenovirus was detected in four seasons, and the positive rate in winter and spring (1.50%, 1.31%) was higher than those in summer and autumn (0.98%, 1.08%), and the difference in the detection rate of adenovirus in different seasons was significantly ( X2=15.490, P = 0.001). The highest detection rate was 2.13%(199/9 339 cases) in the group of ~ ≤ 6 years old, and the lowest detection rate was 0.82% (146/17861 cases, 0.82%) in children under 1 year old. There was significant difference among different age groups ( X2=89.580, P < 0.001). The detection rate of adenovirus in wheezing group (362/21 015 cases, 1.72%) was higher than that in non-wheezing group (241/27 138 cases, 0.89%), and the difference was significant ( X2=66.702, P < 0.001). Multivariate conditional Logistic regression analysis showed that atopic constitution, history of recurrent respiratory tract infections, obesity, premature birth and maternal pregnancy-induced hypertension were risk factors for children’s wheezing symptoms associated with adenovirus infection ( OR=7.463, 5.772, 2.992, 2.119, 1.714). Conclusions:Adenovirus infection rate in winter and spring is higher than that in summer and autumn, and children aged 3-6 years are susceptible. The detection rate of wheezing children is higher than that of non-wheezing children. Atopic constitution, history of recurrent respiratory tract infections, obesity, premature birth and maternal pregnancy-induced hypertension were the risk factors for children’s wheezing symptoms associated with adenovirus infection.

Background and Aims:Methylenetetrahydrofolate dehydrogenase 1(MTHFD1)is essential in various tumors.However,the role of MTHFD1 in pancreatic cancer remains unclear.This study was conducted to explore the expression and clinical significance of MTHFD1 in pancreatic cancer through bioinformatics analysis and clinical sample validation,as well as to analyze its potential mechanisms of action in pancreatic cancer. Methods:The GEPIA2 online platform was used to analyze the differential expression of MTHFD1,survival,and pathological stage in TCGA pancreatic cancer data,examining the relationship between MTHFD1 expression and clinicopathologic features of pancreatic cancer patients.Univariate and multivariate analyses were performed using the Cox proportional hazards model on TCGA data.GO,KEGG,and GSEA analyses were conducted to predict the possible mechanisms of MTHFD1 in pancreatic cancer.The expression of MTHFD1 in 80 cases of pancreatic cancer and adjacent tissues was detected using immunohistochemistry,qRT-PCR,and Western blot and its expression with clinicopathologic characteristics was analyzed. Results:In the TCGA database,MTHFD1 expression in pancreatic cancer tissues was significantly higher than in normal tissues(P＜0.05).High expression of MTHFD1 was significantly associated with poor prognosis in pancreatic cancer patients(P=0.007).TCGA data indicated a close correlation between MTHFD1 expression and tumor stage(P＜0.05).MTHFD1 expression was identified as an independent prognostic factor for pancreatic cancer(HR=1.777,P=0.01).GO,KEGG,and GSEA analyses showed that MTHFD1 was related to the cell cycle,and correlation heatmaps indicated a strong association between the MTHFD1 gene and the cell cycle.In the TIMER database,MTHFD1 expression level was significantly correlated with various immune cells,including B cells,CD8+T cells,CD4+T cells,macrophages,neutrophils,and dendritic cells(all P＜0.05).The GDSC database revealed that patients with low MTHFD1 expression were more sensitive to various therapeutic agents than those with high expression.In clinical pancreatic cancer specimens,the positive expression rate of MTHFD1 and its mRNA and protein levels were significantly higher in cancer tissues than in adjacent tissues(all P＜0.05).MTHFD1 expression was associated with tumor differentiation,clinical stage,lymph node metastasis,and neural infiltration(all P＜0.05).Patients with high MTHFD1 expression had significantly shorter overall survival than those with low expression(P＜0.05). Conclusion:MTHFD1 is highly expressed in pancreatic cancer tissues and is associated with poor prognosis.It may participate in the occurrence and development of pancreatic cancer through the cell cycle and is related to the infiltration of tumor immune cells.

OBJECTIVES: Heparin is mainly used as an anticoagulant in clinic, and it also has a certain anti-inflammatory effect. At present, after portal vein islet transplantation in diabetic patients, heparin is mainly infused through the peripheral veins of the limbs to achieve the purpose of anticoagulation and protection of the graft, rather than through the portal vein. In this study, animal experiments were conducted to investigate the effect of heparin infusion via the portal vein and marginal ear vein on the instant blood-mediated inflammatory reaction (IBMIR) after portal vein islet transplantation, which is the choice of anticoagulation methods for clinical islet transplantation to provide a basis for decision-making. METHODS: A total of 50 neonatal pigs (Xeno-1 type, 3-5 days) were selected. Islets were isolated and purified from the pancreas of neonatal pigs. Ten non-diabetic Landrace pigs (1.5-2.0 months) served as recipients, and 12 000 IEQ/kg neonatal porcine islets were transplanted into the liver through the portal vein. All recipients received bolus injection of 50 U/kg of heparin 10 minutes before transplantation. After the bolus injection of heparin, the experimental group received heparin via the portal vein [10 U/(kg·h), 5 recipients], and the control group received heparin via the marginal ear vein [10 U/(kg·h), 5 recipients]. The superior vena cava blood was collected from the 2 groups pre-operation at 1, 3, 24 h post-operation of the transplantation. The portal vein blood was collected from the experimental group at 1 and 3 h after the transplantation as well. The levels of complement C3a, C5a, thrombin-antithrombin complex (TAT), β-thromboglobulin (β-TG), and D-dimer as well as activated partial thromboplastin time (APTT) in superior vena cava blood from 1 and 3 h post-transplantation were detected in the 2 groups, and the levels of anti-Xa and anti-IIa in the portal vein and superior vena cava blood from 1 and 3 h post-transplantation in the experimental group were detected. Twenty four hours after the transplantation, the liver tissues in the 2 groups were collected for pathological examination to observe the inflammatory cell infiltration and peripheral thrombosis around the islets graft in liver. RESULTS: Before transplantation, there was no statistically significant difference in C3a, C5a, TAT, β-TG, D-dimer levels and APTT between the 2 groups (all P>0.05). At 1 and 3 h after transplantation, the C3a, TAT, and D-dimer levels in the experimental group were significant decreased than those in the control groups (all P<0.05), and at 3 h after transplantation the C5a was significant decreased than that in the control group (P<0.05). At 1 and 3 h after transplantation, the anti-Xa and anti-IIa levels in the portal vein blood were significantly increased than those in the superior vena cava blood in the experimental group (all P<0.05). Pathological results showed the presence of islet cell clusters in the liver blood vessels. The thrombus formation and neutrophil infiltration around islet graft was not obvious in the experimental group, while massive thrombus formation and neutrophil infiltration in the control group. CONCLUSIONS Compared with marginal ear vein infusion of heparin, the direct infusion of heparin in the portal vein has a certain inhibitory effect on complement system, coagulation system activation and inflammatory cell infiltration in portal vein islet transplantation, which may attenuate the occurrence of IBMIR.
Animals ; Anticoagulants/therapeutic use* ; Heparin/therapeutic use* ; Humans ; Islets of Langerhans/pathology* ; Islets of Langerhans Transplantation/physiology* ; Portal Vein ; Swine ; Vena Cava, Superior

To investigate the feasibility and clinical application of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) technique in non-invasive assessment for early chronic allograft nephropathy (CAN).
 Methods: A total of 23 renal allograft recipients were recruited from inpatients or outpatients according to the inclusion and exclusion criteria for this study. Recipients were divided into a CAN group (n=12, pathologically confirmed early CAN patients) and a control group (n=11, volunteers with long-term stable renal function). Abdominal MRI was performed on patients of renal allograft with a multi-b value DWI sequence. IVIM2b-new software was used for obtaining the IVIM-DWI quantitative parameter pseudo-color maps and the values of IVIM-DWI of renal parenchyma, including the pure diffusion coefficient (D), perfusion correlation diffusion coefficient (D*) and perfusion fraction (f). The IVIM quantitative parameters between the two groups were compared using independent sample t test. ROC analysis was performed when the differences in parameter were statistically significant and the area under curve (AUC) was calculated.
 Results: In IVIM bi-exponential analysis, The D value was significantly decreased in the CAN group compared with the control group (P<0.05), whereas there are no significantly difference in value of D* and f between the two groups (all P>0.05). The AUC of D value for distinguishing the early CAN from the control were 0.784 with sensitivity and specificity at 58.3% and 90.9%, respectively.
 Conclusion: The IVIM-DWI quantitative parameter D can non-invasively assess early CAN to some extent. IVIM-DWI technique is expected to be an effective, easy and non-invasive method to detect early CAN, and assist early diagnose as well as dynamically monitor CAN.
Allografts ; Diffusion Magnetic Resonance Imaging ; Humans ; Kidney Diseases ; surgery ; Kidney Transplantation ; Magnetic Resonance Imaging ; Motion

OBJECTIVES: To investigate whether necrostatin-1 (Nec-1) can protect islet cells from the damage induced by TNF-α. METHODS: After isolation and purification, the neonatal porcine islet cell clusters (NICCs) were divided into 3 groups (islets 10 000 IEQ/group): a Nec-1 group (Nec-1+TNF-α was added to the culture medium), a TNF-α group (TNF-α was added to the culture medium), and a control group (pure medium). The number of cells was observed after 48 h of co-culture. The cell death was evaluated by AO/EB staining. Insulin secretion and DNA of islets were detected by chemiluminescence and nucleic acid quantitative analysis. RT-PCR assay was used to examine the mRNA expressions of insulin gene, glueogan gene and somatostatin gene. Flow cytometry analysis was used to detect the viability of B cells. RESULTS: The number of islets in Nec-1 group, TNF-α group and the control group were (8 425±2 187), (4 325±778), and (7 122±1 558) IEQ, respectively. Compared to the other two groups, the number of dead cells in TNF-α group was greatly increased. The insulin/DNA values in the Nec-1 group, TNF-α group and blank control group were (13.21±3.15), (2.47±0.45), and (7.44±0.97) mIU/mg, respectively. Compared to the TNF-α group and the control group, the mRNA relative expression levels of insulin gene (6.73±1.07), glucagon gene (10.13±1.98), somatostatin gene (8.57±1.11) were significantly increased in the Nec-1 group (all <0.05), the rate of live cells (97.32±1.87)% and live B cells (90.86±3.68)% were increased significantly in the Nec-1 group (all <0.05). CONCLUSIONS TNF-α can induce neonatal porcine islet cells damage, which is attenuated in the presence of Nec-1. Nec-1 can increase the content of endocrine cells in NICCs.
Animals ; Imidazoles ; Indoles ; Insulin ; Islets of Langerhans ; Swine ; Tumor Necrosis Factor-alpha ; genetics