Objective To compare patellar ring,Kirschner wire tension band and patellar ring plus Kirschner wire in fixation for treatment of patella fractures.Methods A retrospective analysis was conducted on the 285 patients with patellar fracture who had been treated between September 2009 and January 2016.They were 155 men and 130 women,with an average age of 45.5 years (from 18 to 70 years).Their fractures included 176 transverse,28 longitudinal split and 81 comminuted ones.They were divided into 3 groups according to their different internal fixation methods:patellar ring fixation (98 cases),Kirschner wire tension band (92 cases),patellar ring plus Kirschner wire fixation (95 cases).The 3 groups were compared in terms of operative time,intraoperative bleeding,fracture healing time,knee function by B(o)stman score at the last follow-up and postoperative complications.Results The operative time in the patellar ring group(58.9 ±6.4 min) was significantly shorter than in the Kirschner wire group (71.8 ± 7.8 min) and in the patellar ring plus Kirschner wire group (74.4 ± 8.0 min) (P ＜ 0.05).There were no statistical significant differences between the 3 groups in fracture healing time and intraoperative bleeding (P ＞ 0.05).The good to excellent rate of knee function at the last follow-up in the Kirschner wire tension band group was 100.0％ (92/92),significantly higher than in the patellar ring group (90.8％,89/98) and in the patellar ring plus Kirschner wire group (91.6％,87/95) (P ＜ 0.017).There was no significant difference in postoperative complication rate between the patellar ring fixation group (2.0％,2/98),Kirschner wire tension band fixation group (1.1％,1/92) and the patellar ring plus Kirschner wire group (2.1％,2/95) (P ＞ 0.05).Conclusion Internal fixation with Kirschner wire tension band has definite curative effect on patellar fractures,showing the advantages of less operative invasion,fewer postoperative complications,better functional recovery of the affected knee joint,and lower price over the other 2 internal fixation methods.

BACKGROUND: Compared with the traditional organic fluorescent dyes, quantum dots present good biomarker characteristics. Especially, quantum dots for cell labeling and targeted bioimaging present unique optical properties.OBJECTIVE: To investigate the biocompatibility of CdSe/ZnS quantum dots with mononuclear macrophages.METHODS: The macrophages RAW264.7 were inoculated into 96-well plates containing 0, 50, 100 mg/L CdSe/ZnS quantum dots for 1 or 2 hours. Then, the fluorescent signal was detected by flow cytometry. After 0-24 hours of culture,the fluorescence signal intensity of the macrophages cultured with 50 mg/L CdSe/ZnS quantum dots was detected by flow cytometry. After 18 hours of culture, quantitative PCR was used to detect the levels of tumor necrosis factor α and interleukin 1β in macrophages, and macrophage proliferation cell apoptosis were detected by MTT and flow cytometry,respectively.RESULTS AND CONCLUSION: The fluorescence signal intensity was positively correlated with the mass concentration of CdSe/ZnS quantum dots, and the intensity of the fluorescent signal was increased with the labeling time. After labeling using 50 mg/L CdSe/ZnS quantum dots, the fluorescence signal of macrophages increased continuously with time, and reached the peak at 18 hours. Compared with 0 mg/L quantum dot group, 50, 100mg/L quantum dot groups could significantly promote the expression of tumor necrosis factor α and interleukin 1β in macrophages (P < 0.01 or P < 0.05).The level of tumor necrosis factor α in the 100 mg/L quantum dot group was higher than that in the 50 mg/L quantum dot group (P < 0.01). The expression of interleukin-1β showed no difference between 50 and 100 mg/L quantum dot groups.The cell proliferation in the 50 and 100 mg/L CdSe/ZnS quantum dot groups was significantly higher than that in the 0 mg/L quantum dot group (P < 0.05), but there was no difference between the former two groups. In addition, 50 and 100 mg/L CdSe/ZnS quantum dots had no significant effect on apoptosis of macrophages. To conclude, CdSe/ZnS quantum dots could activate macrophages and promote their proliferation and secretion of inflammatory factors, but did not affect their apoptosis.

Paeonol is a major phenolic micromolecular component of Moutan cortex Radicis, a traditional Chinese Medicine. It has shown antitumor effects in previous studies; however, the underlying mechanisms remain unknown. This study investigated the mechanism by giving treatments of placebo, cyclophosphamide, paeonol of 150 and 300 mg/kg to 4 groups of mice bearing EMT6 breast cancer. Apoptosis in tumor cells were confirmed by morphology analysis, including hematoxylin, eosin staining and TUNEL staining. The results showed that the weight of EMT6 breast tumor was significantly reduced in the groups treated with both 150 and 300 mg/kg of paeonol. Immunohistochemical and Western blot results showed that the expression of Bcl-2 was down-regulated while the expression of Bax, caspase 8 and caspase 3 was up-regulated respectively. These results suggest that paeonol exhibits antitumor effects and the mechanism of the inhibition is via induction of apoptosis, regulation of Bcl-2 and Bax expression, and activation of caspase 8 and caspase 3.
Animals ; Apoptosis* ; Blotting, Western ; Breast Neoplasms* ; Caspase 3 ; Caspase 8 ; Cyclophosphamide ; Eosine Yellowish-(YS) ; Hematoxylin ; In Situ Nick-End Labeling ; Medicine, Chinese Traditional ; Mice* ; Phenol

Background: and Purpose: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most-common form of autoimmune encephalitis, but its early diagnosis is challenging.This study aimed to identify the risk factors for a poor prognosis in anti-NMDAR encephalitis and construct a prognostic composite score for obtaining earlier predictions of a poor prognosis. Methods: We retrospectively analyzed the clinical data, laboratory indexes, imaging findings, and electroencephalogram (EEG) data of 60 patients with anti-NMDAR encephalitis. The modified Rankin Scale (mRS) scores of patients were collected when they were discharged from the hospital. The mRS scores were used to divide the patients into two groups, with mRS scores of 3–6 defined as a poor prognosis. Logistic regression analysis was used to analyze independent risk factors related to a poor prognosis. Results: This study found that 23 (38.3%) and 37 (61.7%) patients had good and poor prognoses, respectively. Logistic regression analysis showed that age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were significantly associated with patient outcomes. An age, consciousness, and slow waves (ACS) composite score was constructed to predict the prognosis of patients with anti-NMDAR encephalitis at an early stage based on regression coefficients. Conclusions Age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were independent risk factors for a poor prognosis. The ACS prognostic composite score could play a role in facilitating early predictions of the prognosis of anti-NMDAR encephalitis.

Objective:To evaluate an anticoagulation management method based on mobile health technology and artificial intelligence.Methods:The study was a single-center, prospective, randomized, controlled, non-inferiority clinical trial. From November 2017 to September 2018, 67 patients who received warfarin therapy after mechanical valve replacement were consecutively enrolled and randomized into two groups: 34 were randomized to intervention group and 33 to control group. The intervention group was managed via Anticlot Assistant and the control group was handled as routine care. Evaluations were performed at least 3 months after enrollment and ended on 30 September 2019. Non-inferiority was evaluated using one-sided tests with a non-inferiority margin set 11.0% for time in therapeutic range (TTR) and 10.0% for the percentage of international normalized ratio (INR) in the therapeutic range.Results:The mean TTR was (58.2±23.4)% in the intervention group and (54.8±23.6)% in the control (the difference: 3.4%; low limit of one-side 95% confidence interval for the difference: -6.4%; and P value for non-inferiority was 0.009). The percentage of INR in the therapeutic range was (55.4±21.9)% in the intervention group and (52.8±22.5)% in the control (the difference: 2.6%, low limit of one-side 95% confidence interval for the difference: -6.6%; and P value for non-inferiority was 0.012). Conclusion:The outcomes of patients managed via the anticoagulation management method base on mobile health technology and artificial intelligence are not inferior to those handled as routine care.

Objective:To investigate the effect of butyrate produced by bacterial metabolism on immune features of murine bone marrow-derived dendritic cells(BMDCs) and its potential mechanisms.Methods: BMDCs were prepared from bone marrow cells of C57BL/6 mice by being cultured with GM-CSF and IL-4.The expression of CD80,CD86,B7-DC and MHCⅡ on BMDCs and its pri-ming ability on the proliferation of OVA257-264 antigen specific CD8+T cell were analyzed by using Flow cytometry.The mRNA levels of IL-6 and IL-12 in BMDCs were detected by real-time fluorescence quantitative PCR(q-PCR).Simultaneously,Griess reaction and Western blot was used for analyzing the levels of NO2-in BMDCs culture supernatant and the ERK phosphortylation in BMDCs respectivly.Results:Butyrate could decrease the levels of CD80,CD86,MHCⅡand B7-DC,and downregulate the capability of BMDCs in priming the proliferation of CD8+T cells.Furthermore,the secretions of IL-6,IL-12,NO2-and the phosphorylation of ERK were sup-pressed.Conclusion:Butyrate down-regulats the immune functions of BMDCs via inhibition of ERK phosphorylation in TLR 4 signaling pathway.

Objective To evaluate the effects of traditional monitoring and self-monitoring in patients who take the oral anticoagulation medicine after mechanical valve replacement surgical operations.Methods A great number of Chinese and English literatures about this subject were investigated in detail,and these literatures were selected from the Cochrane Central Register of Controlled Trials,EMBase,MEDLINE,Web of Knowledge,CNKI,CNKI,VIP,and WanFang Data.It should be noted that all of the literatures were published before October,2015.Based on the results of the literature investigation,several studies were selected as the candidates.Moreover,many aspects about these candidates such as the experimental designs,characteristics of the objects of the studies and the results of the studies were filtered and recorded by two researchers independently.Furthermore,RevMan 5.3 were employed to analyze the data of the candidates.Results Eight randomized controlled trials were studied,which included 1 262 cases in self-monitoring group and 1 198 cases in traditional monitoring group.The results of metaanalysis indicated that compared with the traditional monitoring group,lower incidence of thromboembolism (Z =3.50,P =0.000) and lower mortality (Z =4.64,P =0.000) were observed,and the bleeding difference (Z =0.07,P =0.940) had no significant statistical meaning.Moreover,compared with the traditional monitoring,the international normalized ratio (INR) of the patients who were controlled in the range of treatment of the self-monitoring increased from 6％ to 20.9％,and the total number of the INR tests was increased by 2.1 to 4.98 times.Conclusions Self-monitoring could obviously reduce the possibilities of the thromboembolism and death of the patients who took the oral anticoagulation medicine after mechanical valve replacement surgical operations.Furthermore,self-monitoring could not only control the INR in the range of treatment but also increase the total number of the INR tests.In short,self-monitoring has practical value of clinical application.

Objective To evaluate the effects of traditional monitoring and self-monitoring in patients who take the oral anticoagulation medicine after mechanical valve replacement surgical operations.Methods A great number of Chinese and English literatures about this subject were investigated in detail,and these literatures were selected from the Cochrane Central Register of Controlled Trials,EMBase,MEDLINE,Web of Knowledge,CNKI,CNKI,VIP,and WanFang Data.It should be noted that all of the literatures were published before October,2015.Based on the results of the literature investigation,several studies were selected as the candidates.Moreover,many aspects about these candidates such as the experimental designs,characteristics of the objects of the studies and the results of the studies were filtered and recorded by two researchers independently.Furthermore,RevMan 5.3 were employed to analyze the data of the candidates.Results Eight randomized controlled trials were studied,which included 1 262 cases in self-monitoring group and 1 198 cases in traditional monitoring group.The results of metaanalysis indicated that compared with the traditional monitoring group,lower incidence of thromboembolism (Z =3.50,P =0.000) and lower mortality (Z =4.64,P =0.000) were observed,and the bleeding difference (Z =0.07,P =0.940) had no significant statistical meaning.Moreover,compared with the traditional monitoring,the international normalized ratio (INR) of the patients who were controlled in the range of treatment of the self-monitoring increased from 6％ to 20.9％,and the total number of the INR tests was increased by 2.1 to 4.98 times.Conclusions Self-monitoring could obviously reduce the possibilities of the thromboembolism and death of the patients who took the oral anticoagulation medicine after mechanical valve replacement surgical operations.Furthermore,self-monitoring could not only control the INR in the range of treatment but also increase the total number of the INR tests.In short,self-monitoring has practical value of clinical application.

Objective To investigate the clinical value of thrombelastogram (TEG) in prediction for the cause of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods In this study, there were 30 patients with DCI (group DCI) and 45 patients without DCI (group No-DCI). TEG was performed in all the patients at post-bleeding day 1, 5, 10 and 15 after aSAH(PBDn, n=1,5,10,15). The changes of reaction time (R value), coagulation time (K value),coagulation angle (α value),maximum thrombus consistency (MA value) and coagulation index (CI value) were examined at different time points after aSAH. Results Thirty of 75 aSAH patients developed DCI and the incidence of DCI was 40 percent. According to linear mixed model, both MA value and CI value were significantly statistical different at different time points within each group (P<0.05,for all) as well as between No-DCI group and DCI group.MA value and CI were significantly statistical different at same time point (P<0.05,for all). The results of logistic regression analysis showed that modified Fisher levelⅢ-Ⅳ,△MA5-1(OR=1.124,P=0.024,95% CI=1.015~1.244), PBD5 MA>70(OR=5.605,P=0.011,95% CI=1.464~21.457)were the independent risk factors of DCI.By using ROC curve to define a threshold for prediction of the occurrence of DCI,the rate of DCI was significantly increased when △MA5-1>3.05.Conclusion aSAH Patients, especially those with DCI have severe hypercoagulation. The MA value in PBD5 has an important predictive value for DCI.

Objective To investigate the effect of prior statin use on outcome after intravenous thrombolysis in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke treated with intravenous thrombolysis at the Department of Neurology, the Third People's Hospital of Chengdu from July 2014 to August 2017 were enrolled, and divided into the statin use group and nonstatin use group according to prior statin use. Symptomatic intracranial hemorrhage and the outcome at 90 days after onset (good outcome and poor outcome were defined as the modified Rankin Scale score 0-2 and > 2, respectively) in the two groups were compared, and multivariate logistic regression analysis was used to identify the effect of prior statin use on the outcome. Results A total of 327 patients were enrolled, including 68 (20. 80％ ) in the statin use group, and 59 (79. 20％ ) in the nonstatin use group. There were no significant differences in the incidence symptomatic intracranial hemorrhage (7. 35％ vs. 10. 04％; χ2 = 0. 453, P = 0. 501), good outcome rate at 90 days (69. 12％ vs. 66. 02％; χ2 = 0. 232, P = 0. 630), and mortality rate (7. 35％ vs. 7. 34％; P = 1. 000) between the statin use group and the nonstatin use group. Multivariable logistic regression analysis showed that prior statin use were not an independent risk factor for symptomatic intracranial hemorrhage (odds ratio 0. 658, 95％ confidence interval 0. 233-1. 857; P = 0. 429) and poor outcome at 90 dafter onset (odds ratio 0. 848, 95％ confidence interval 0. 424-1. 696; P = 0. 641) in patients treated with intravenous thrombolysis. Conclusion Prior statin use is not associated with symptomatic intracranial hemorrhage and outcome after intravenous thrombolysis in patients with acute ischemic stroke.