OBJECTIVE:To establish a method for the contents determination of triamcinolone acetonide acetate and tretinoin in Dimensional ointment. METHODS:HPLC was performed on the column of Diamonsil C18 with mobile phase of methanol-0.1%Phosphoric acid solution(87:13,V/V),detection wavelength was 254 nm(0-5 min)and 350 nm(5-20 min),at a flow rate of 1.0 ml/min,column temperature was 25℃,and volume injection was 10 μl. RESULTS:The linear range was 0.5-5 μg/ml for triamcin-olone acetonide acetate(r=0.999 9)and 4.96-49.6 μg/ml for tretinoin(r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 1%;recoveries were 98.37%-100.03%(RSD=0.58%,n=6)and 98.21%-100.38%(RSD=0.78%,n=6). CON-CLUSIONS:The method is simple,accurate and fast,and suitable for the contents determination of triamcinolone acetonide ace-tate and tretinoin in Dimensional ointment.

Objective To investigate the effect of silence of human protection of telomeres 1 (hPOT1), which was induced by RNA interference, on expression of telomeric repeat factor 1 (TRF1), telomeric repeat factor 2 (TRF2) and Tankyrase 1 in human gastric cancer cell BGC823. Methods The ex-pression of TRF1 ,TRF2 and Tankyrasel at mRNA level were determined by semi-quantitative RT-PCR. Re-sults Significant increase in expression of TRFI, marked decrease of TRF2 and Tankyrase1 at mRNA level were observed in cells of hPOT1 siRNA. Conclusion The significant increase in expression of TRF1 and the marked decease in TRF2 and Tnakyrasel at mRNA level after the inhibited expression of hPOT1 in human gastric cancer cell BGC823 indicate that hPOTI is highly correlated with the expressions of other three te-lomere-specific binding proteins.

Objective:To investigate the effect of the transcriptional coactivator Mediator 1 (Med1) on mouse hair regeneration, and to explore potential mechanisms.Methods:Med1 flox/flox C57BL/6J mice were mated with K14-Cre mice, and the mice with epidermis-specific knockout of Med1 gene, namely K14-Cre-expressing Med1 flox/flox mice (knockout group) , were obtained by using the Cre-Loxp system, while Med1 flox/flox mice without K14-Cre expression served as control group. Mice in the two groups (3 mice in each group) were raised together for 8 weeks followed by dorsal hair removal. Hair regeneration was observed for 12 consecutive days after hair removal. After 12 days, all mice in the two groups were sacrificed, their depilated and non-depilated dorsal skin tissues were resected, and total RNA was extracted from the tissues. Real-time quantitative PCR was performed to determine the mRNA expression of hair keratin genes, vitamin D receptor/β-catenin pathway-related genes, and genes associated with maintenance of hair follicle stem cell proliferation and quiescence. Paraffin-embedded sections of depilated and non-depilated mouse skin tissues were prepared, and immunofluorescence staining was conducted to determine the number of stem cells in the hair follicle bulge. Two-independent-sample t test was used for comparisons between two groups. Results:From days 0 to 12 after depilation, hair regeneration was delayed in the depilated skin area in the knockout group compared with the control group. Real-time quantitative PCR showed significantly decreased mRNA relative expression levels of hair keratin genes Ha1 and Krt2-16, vitamin D receptor/β-catenin pathway-related genes S100a3, Dlx3 and Tubb3, and genes associated with maintenance of hair follicle stem cell proliferation and quiescence including Lhx2, Sox9 and Nfatc1 in the depilated skin tissues in the knockout group (22.09 ± 12.32, 2.07 ± 0.20, 0.02 ± 0.01, 12.36 ± 2.12, 1.75 ± 0.46, 0.39 ± 0.02, 4.42 ± 0.76, 0.44 ± 0.07, respectively) compared with the control group (70.53 ± 9.46, 7.76 ± 0.49, 0.05 ± 0.01, 26.16 ± 2.96, 2.60 ± 0.14, 0.71 ± 0.09, 11.93 ± 0.42, 0.75 ± 0.04, respectively; t = 5.40, 18.64, 3.89, 6.57, 3.04, 6.10, 15.03, 6.18, respectively, all P < 0.05) . Immunofluorescence staining showed that the number of CD34 +K15 + hair follicle stem cells in the hair follicle bulge in both depilated and non-depilated skin tissues was significantly lower in the knockout group than in the control group. Conclusion:Med1 gene knockout may down-regulate the expression of downstream genes of the vitamin D receptor/β-catenin pathway and genes associated with maintenance of hair follicle stem cell proliferation and quiescence (Sox9, Nfatc1 and Lhx2) , and reduce the number of hair follicle stem cells, leading to hair follicle differentiation disorder and hair regeneration delay.

Objective:To investigate the values of combined detection of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet count (PC), platelet count/mean platelet volume (PC/MPV) and platelet plateletcrit (PCT) in the diagnosis of chronic periprosthetic joint infection (PJI).Methods:From January 2013 to December 2019, 441 patients underwent hip or knee joint revision at Department of Articular Surgery, The First Hospital Affiliated to Xinjiang Medical University. The patients were divided into a chronic PJI group and an aseptic prosthetic loosening group. In the chronic PJI group of 147 cases (86 hip ones and 61 knee ones), there were 64 males and 83 females, with a mean age of 66 (54, 72) years. In the aseptic prosthetic loosening group of 294 cases (210 hip ones and 84 knee ones), there were 98 males and 196 females, with a mean age of 63 (49, 72) years. The preoperative levels of CRP, ESR, PC, PC/MPV and PCT were compared between the 2 groups. The best cut-off value, sensitivity and specificity of the above indicators for the diagnosis of chronic PJI were recorded. The diagnostic efficacy of the 5 indicators in combination for chronic PJI was evaluated by comparing the area under the curve (AUC) among the indicators and analyzing the results of combined diagnostic detections.Results:Except for gender and joint revision site, there was no significant difference in the other general data between the 2 groups, showing comparability ( P>0.05). The levels of CRP, ESR, PC, PC/MPV and PCT in the PJI group were significantly higher than those in the aseptic prosthetic loosening group ( P<0.05). For CRP, ESR, PC, PC/MPV and PCT, respectively, the best cut-off values were 9.05 mg/L, 38.5 mm/h, 288×10 9/L, 29.34 and 0.33%, the sensitivities 83%, 71%, 44%, 44% and 33%, the specificities 85%, 86%, 84%, 84% and 90%, and the AUCs 0.868, 0.822, 0.688, 0.696 and 0.659. For CRP+ESR+PC+PC/MPV+PCT and CRP+PC+PC/MPV+PCT, respectively, the AUCs were 0.871 and 0.882, the sensitivities 80% and 84%, and the specificities 86% and 84%, showing significant differences in the diagnosis of chronic PJI compared with ESR, PC, PC/MPV and PCT alone ( P<0.05). Conclusion:In the diagnosis of chronic PJI, serum CRP and ESR combined with PC, PC/MPV and PCT have a reference value, but PC, PC/MPV or PCT alone only has a limited value.

0.05).There was excellent correlation between the lesion size on EC Ⅲ-60 enhanced T_1-weighted MR images and histomorphometry(r=0.999,P

Objective:To investigate the diagnostic value of erythrocyte sedimentation rate/C-reactive protein (ECR), fibrinogen and D-dimer in periprosthetic infection after artificial knee replacement.Methods:A total of 205 patients, including 62 males and 143 females, aged 66.9±9.5 years (range 26-84 years), who underwent revision of artificial knee joint at Department of Joint Surgery, The First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2021 were retrospectively collected.122 cases of periprosthetic joint infection (PJI), including 43 cases of acute infection; 79 cases of chronic infection (13 cases of chronic infection combined with rheumatoid arthritis were analyzed separately); there were 83 cases without PJI, including 73 cases of aseptic loosening, 8 cases of prosthesis dislocation and 2 cases of joint stiffness. Erythrocyte sedimentation rate, C-reactive protein, white blood cell count, fibrinogen and D-dimer levels were examined before surgery, and the sensitivity and specificity of the indicators were calculated using the receiver operating characteristic (ROC) curve. The diagnostic value of different inflammatory markers was compared according to the area under curve (AUC).Results:The levels of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and D-dimer in acute PJI group were 2.47±2.91, 50 (38, 62) mm/1 h, 31.6 (13.9, 79.3) mg/L, 4.25±0.94 g/L, 763 (453, 1 157) ng/ml, respectively. The chronic PJI group was 3.06±2.95, 50 (34, 64) mm/1 h, 20.4(12.7, 43.3) mg/L, 4.19±0.91 g/L, 586 (317, 1 122) ng/ml, and the non-PJI group was 6.20±4.64, 22 (15, 34) mm/1 h, 4.6 (2.7, 7.74) mg/L, 3.10±0.59 g/L and 363 (181, 591)ng/ml were statistically significant ( P<0.05). The AUC of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and D-dimer in the acute PJI group were 0.82, 0.85, 0.90, 0.88, and 0.76, respectively.The optimal critical values were 2.89, 37.00 mm/1 h, 13.6 mg/L, 3.86 g/L, and 443.0 ng/ml, respectively, with sensitivity of 76.7%, 79.1%, 76.7%, 69.8%, and 82.4%, and specificity of 79.5%, 78.3%, 94.0%, 94.0%, 90.4%, and 63.8%, respectively. The AUC of ECR, erythrocyte sedimentation rate, C-reactive protein, fibrinogen, D-dimer, and white blood cell count in the chronic PJI group were 0.77, 0.82, 0.87, 0.85, 0.67, and 0.63, respectively. The optimal critical values are 2.91, 33.00 mm/1 h, 10.9 mg/L, 4.01 g/L, 558.5 ng/ml, and 5.575×10 9 /L, respectively, with sensitivity of 68.2%, 78.8%, 81.8%, 63.6%, 57.9%, and 75.8%, and specificity of 79.5%, 73.5%, 88.0%, 95.2%, 72.5%, and 49.4%, respectively. Conclusion:Fibrinogen has a higher diagnostic value for knee joint PJI, followed by ECR, and D-dimer has the lowest diagnostic value for knee joint PJI.

Objective:To investigate the gender differences in serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet (PLT), fibrinogen (FIB) and D-dimer for the diagnosis of chronic periprosthetic joint infection (PJI).Methods:A total of 470 patients who underwent revision arthroplasty in the Department of Joint Surgery, First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021 were retrospectively analyzed. According to gender and diagnosis, they were divided into four groups: 78 cases of male chronic PJI, 108 cases of male aseptic loosening, 95 cases of female chronic PJI, and 189 cases of female aseptic loosening. The serological results of CRP, ESR, PLT, FIB and D-dimer were collected before operation. The receiver operating characteristics (ROC) curves were used to determine the optimal cut-off values of CRP, ESR, PLT, FIB and D-dimer for the diagnosis of chronic PJI in different genders, and to calculate their sensitivity and specificity. The diagnostic efficacy of the index was analyzed by comparing the area under curve (AUC) of different indicators.Results:The levels of ESR, PLT and D-dimer in the male chronic PJI group were 43 (20.0, 52.5) mm/1 h, 249×10 9 (204×10 9, 306×10 9) /L, 449 (219,833) μg/L, respectively, which were lower than those in the female group of 56 (40, 65) mm/1 h, 295×10 9 (228×10 9, 364×10 9) /L, and 645 (345, 1 157) μg/L, with statistically significant differences ( Z=-4.17, P<0.001; Z=-2.17, P=0.030; Z=-2.82, P=0.005). The AUC of CRP in the male chronic PJI group was 0.841, which was higher than the AUC of the other four indicators; CRP was combined with ESR, PLT, FIB and D-dimer to establish a joint prediction model for male chronic PJI. The ROC curve showed that the combination of CRP+FIB had a maximum AUC [0.849, 95% CI (0.79, 0.91)], sensitivity of 80% and specificity of 86%. The AUC of CRP in the female chronic PJI group was 0.866, which was higher than the AUC of the other four indices; CRP was combined with ESR, PLT, FIB and D-dimer to establish a combined prediction model for female chronic PJI. The ROC curve showed that the combination of CRP+PLT had the maximum AUC [0.883, 95% CI (0.84, 0.93)], sensitivity of 87% and specificity of 79%. Conclusion:Serologic indicators in patients with chronic PJI are gender-specific. CRP combined with FIB has the highest diagnostic value for the chronic PJI in males, while CRP combined with PLT has the highest diagnostic value for the chronic PJI in females.

Objective:To investigate the diagnostic value of plasma fibrinogen (FIB) in chronic periprosthetic joint infection (PJI).Methods:A total of 470 patients who underwent revision hip and knee arthroplasty after primary hip and knee arthroplasty in the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021 were retrospectively analyzed. According to the diagnosis of the disease, 173 patients (112 hips and 61 knees) were divided into chronic PJI group, including 78 males and 96 females, aged 65 (53, 72) years; and 297 patients (216 hips and 81 knees) were divided into aseptic loosening group, including 108 males and 189 females, aged 63 (50, 72) years. The preoperative levels of FIB, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer and platelet were compared between the two groups, and the sensitivity and specificity of the diagnosis of chronic PJI were calculated. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off values of FIB, CRP, ESR, platelet and D-dimer for the diagnosis of chronic PJI. The diagnostic efficacy of each indicator was analyzed by comparing the area under curve (AUC) and using a combined diagnostic test.Results:FIB, CRP, ESR, platelets and D-dimer in the chronic PJI group were 4.05 (3.52, 4.72) g/L, 19.5 (10.7, 40.0) mg/L, 50 (28, 60) mm/1 h, 270 (221, 351)×10 9 /L, 514 (261, 873) μg/L, respectively, which were higher than 3.25 (2.80, 3.63) g/L, 3.7 (2.0, 6.7) mg/L, 20 (12, 30) mm/1 h, 225 (182, 269)×10 9 /L, and 310 (167, 569) μg/L in sterile loosening group, with statistically significant differences ( P<0.05). The AUC of FIB, CRP, ESR, platelets and D-dimer in the diagnosis of chronic PJI were 0.78 (95% CI: 0.73, 0.82), 0.86 (95% CI: 0.82, 0.89), 0.80 (95% CI: 0.76, 0.85), 0.68 (95% CI: 0.63, 0.73), 0.64 (95% CI: 0.59, 0.69); the optimal cut-off values were 3.73 g/L, 9.64 mg/L, 39 mm/1 h, 280×10 9 /L, 624 μg/L; the sensitivity was 68%, 79%, 69%, 47%, 43%; the specificity was 81%, 85%, 85%, 81%, 79%, respectively. When CRP, ESR, FIB, platelets and D-dimer were combined sequentially to diagnose patients with chronic PJI, the sensitivity and specificity of the series test were 12.7% and 99.7%, and those of the parallel test were 100% and 37.3%. The combined diagnostic test showed that the maximum AUC of FIB combined with CRP was 0.85 (95% CI: 0.81, 0.89), with a sensitivity of 76% and a specificity of 89%. Conclusion:The clinical value of plasma FIB in the diagnosis of chronic PJI is not superior to that of CRP and ESR, but the combination of FIB and CRP can improve the specificity.

Objective:To analyze the risk factors leading to the failure of early periprosthetic joint infection (PJI) treated by debridement, antibiotics and implant retention (DAIR) combined with intra-articular injection of antibiotics.Methods:A total of 100 patients who received DAIR combined with intra-articular injection of antibiotics between January 2010 and October 2020 in the Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, were retrospectively analyzed. There were 47 males and 53 females, with an average age of 62.8±13.0 years (26-84 years). 75 patients were diagnosed as PJI after primary surgery while 25 PJI after revision or debridement, involving 41 hips and 59 knees. According to the clinical outcomes, the patients were divided into the cured group (78 cases) and the uncured group (22 cases). Risk factors were screened by univariate analysis on their gender, age, body mass index, site of infection (hip/knee), synovial white blood cell count, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), time of infection, types of pathogenic bacteria (gram-positive bacteria, gram-negative bacteria or fungi), preoperative sinus tract and previous surgical history. For the factors with P<0.20, multivariate binary logistic regression analysis was performed to determine the independent risk factors. Kaplan-Meier survival curve was drawn and any cause that led to treatment failure was seen as the end point event. Calculate prosthetic survival time and 10-year survival rate. Results:The average follow-up was 59.8±40.6 months (0.3-129.0 months). The infection control rate of DAIR combined with intra-articular injection of antibiotics in the treatment of early PJI was 78% (78/100). The univariate analysis showed that the successful rate of non-fungal infection group (81%, 77/95) was significantly higher than the fungal infection group (20%, 1/5) and the successful rate of the group without previous surgical history (85.3%, 64/75) was significantly higher than that with previous surgical history (56.0%, 14/25, χ 2=7.07, P=0.008; χ 2=9.40, P=0.002). The multivariate binary Logistic regression analysis showed that fungal infection [ OR=0.08, 95% CI(0.01, 0.79), P=0.031] and history of previous surgical intervention [ OR=0.25, 95% CI(0.09, 0.73), P=0.001] were independent risk factors for treatment failure. Kaplan-Meier survival curves showed that the survival time of the prosthesis was 96.83±5.30 months, and the 10-year survival rate was 68.1%. Meanwhile, the survival rate of patients with fungal infection and previous surgical history was significantly lower than that of patients without fungal infection or previous surgical history, the difference was statistically significant (χ 2=15.49, P<0.001; χ 2=8.91, P=0.030). Conclusion:The time of PJI, bacterial virulence and species, and preoperative inflammatory indicators had no effect on the outcome of DAIR combined with intra-articular injection of antibiotics in the treatment of early PJI. However, DAIR was not recommended for patients with a history of surgical intervention and fungal infection.

ObjectiveTo explore the effect of targeted intervention measures based on risk score of venous thromboembolism （VTE）， on the prevention of senile type 2 diabetes inpatients， as well as their influence on the occurrence of venous thromboembolism. MethodsA total of 134 elderly patients with type 2 diabetes mellitus who were hospitalized in geriatrics department of Peking university third hospital during June 1， 2018 to September 30， 2018 were selected as the research subjects. All the patients were divided into control group and observation group according to random number table method， with 67 patients in each group. Patients in the control group were treated with conventional intervention methods， and patients in the observation group were treated with targeted intervention measures based on VTE risk score. After one month of intervention， the Padua score， blood glucose level and coagulation indexes of the two groups were compared. The incidence of thrombosis during the intervention period was also recorded. ResultsThe Padua score in observation group （2.09±2.17） points was significantly lower than that （3.19±2.37） points in control group （P<0.05）. The indexes of fasting blood glucose， 2h postprandial blood glucose and HbA1c in observation group were significantly lower than those in control group （P<0.05）. The fibrinogen， D-dimer， activated partial thromboplastin time and prothrombin time in observation group were significantly lower than those in control group （P<0.05）. The incidence of DVT， PVT， lower limb swelling， pain and abnormal skin color in the observation group were 4.00%， 2.00%， 2.00%， 2.00%， and 0， respectively， and in the control group were 12.00%， 10.00%， 10.00%， 12.00%， and 8.00%， respectively. The incidence of adverse events in observation group was significantly lower than that in control group （P<0.05）. ConclusionTargeted intervention based on VTE risk score can significantly reduce the risk of VTE occurrence， improve blood clotting function and blood glucose level in elderly patients with type 2 diabetes mellitus. This nursing measure has important clinical application value.