BACKGROUND:Chronic ankle instability can cause traumatic joint disease and secondary adhesive capsulitis, and even result in permanent dysfunction.
OBJECTIVE: To explicit the forming reason of chronic ankle instability and to investigate the diagnosis and treatment methods of chronic ankle instability based on the biomechanical analysis of the ankle joint.
METHODS: PubMed and Wanfang databases were retrieved for review and basic research papers about the anatomy, biomechanics, diagnosis and treatment of chronic ankle instability published from January 1990 to December 2014. The keywords were “chronic ankle instability, anatomy of ankle joint, biomechanics, therapy, research” in English and Chinese, respectively. After screening, 40 papers were included to summarize the anatomical structure of the ankle joint, mechanism and classification, diagnostic methods, and treatment methods of chronic lateral ankle instability.
RESULTS AND CONCLUSION:Diagnostic methods of chronic ankle instability include ankle varus stress test, ankle anterior drawer test, ultrasonic test, modern imaging detection; and therapeutic methods for chronic ankle instability can be divided into conservative treatment and surgical treatment, and the surgical treatment can be subdivided into non-anatomic reconstruction and anatomical repair of the damaged ligament. Early diagnosis and effective treatment are recommended for patients with chronic ankle instability, and the treatment programs should be determined based on comprehensive analysis of ankle anatomical structure, biomechanical characteristics, pathogenesis, and diagnostic results.

Objective To observe the effect of different ultraviolet on HaCaT and offer experimental evidences for further studies of the pathogenesis of photodermatitis. Methods Using different dose of UVA and UVB to irradiate HaCaT cell line respectively. 12 hours later, the morphology of HaCaT cells was observed and the sum was calculated. Results The cell linkage was loose and the refraction was weak with some dead cells. The effect of large dosage of UVB was more obvious. Conclusions the effects on keratinocyte after UV exposure are different according to the dose of irradiation, which offers experimental evidences for the further study of the pathogenesis of photodermatitis.

Objective To explore the characteristics of nosocomial infection and its related factors among those very low birth weight infant(VLBWI)for coming up with appropriate preventive measures.Methods Fifty-eight infants with birth weight of 1500 g or below in the hospital from January to June in 2012 were studied actively and retrospectively about their nosocomial infection and related risk factors.Results Thirty-five cases of nosocomial infection occurred among the 58 infants with a prevalence of 60.34%. The mainly pathogenic bacteria was Gram-positive bacteria(88.47%)and mostly,infections presented with lung infections(82.90%) within 21 days after birth.The risk factors included mechanical ventilation,PICC,Apga score<7,fluconazole administration and premature rupture of membranes of VLBWI.Conclusion VLBWI are prone to nosocomial infections,mostly lung infection on day 21 after birth.Management should be strengthened within 3 weeks after birth of VLBWI to minimize infections.Reduction of invasive procedures on children and antibiotic use is particularly important.On the other hand,strengthening the health care in the perinatal period and reducing the incidence of preterm birth cannot be ignored.

Objective To study the clinical and pathologic changes in gigantomast.Methods Tissue sections were prepared from 180 cases of breast hypertrophy and 45 cases of normal breast tissues.The morphological changes and the expression and localization of ERRγwere evaluated on the HE and immunohistochemistry stained sections between hypertrophy and normal breast tissues.Results Compared with normal breast,hypertrophic breast showed expended ducts and obvious hyperplasia of the duct epithelial papillary.Hypertrophic breast tissues demonstrated strong expression of ERR-γ in ducts and lobules.Conclusions Upregulated expression of ERRγ is identified in hypertrophic breast tissues that may associate with the development of gigantomastia.

Antithrombin III (AT III) is the most important anti-clotting substance. Recombinant human antithrombin III (rhAT III) expressed in transgenic goat milk attracts more and more attention. Develop an effective purification route for rhAT III is vital to its industrial production. An efficient purification method was developed for the rapid purification of rhAT III by isoelectric precipitation and heparin affinity chromatography. First, casein was effectively removed by isoelectric precipitation. rhAT III was further purified by heparin affinity chromatography. In the process of heparin affinity chromatography, the effects of pH and temperature on the stability of rhAT III were studied, and the effects of operating conditions, elution gradient, flow rate and sample loaded, on the purification efficiency were also studied. Under the optimized conditions, the protein recovery of rhAT III was about 90% with purity over 99%, while its activity recovery was about 50%. Such a purification process is very simple and effective, and it would provide a valuable reference for the further scaling-up of industrial production.
Animals ; Animals, Genetically Modified ; Antithrombin III ; biosynthesis ; Chromatography, Affinity ; Female ; Goats ; Heparin ; Humans ; Mammary Glands, Animal ; metabolism ; Milk ; chemistry ; Recombinant Proteins ; biosynthesis

OBJECTIVETo reconstruct a simpler and reliable composite tissue transplantation model-the femur osteomyocutaneous flap for the replacement of hindlimb transplantation.

METHODSTen femur osteomyocutaneous flaps from 5 Lewis rats were transplanted into 10 syngeneic recipients' inguinal region. Their nutrient vessels were anastomosed with recipients vessels. The graft of this model was consisted of the groin flap and partial femur. To verify the feasibility of this model, gross and histological appearance were studied after transplantation to evaluate the viability of grafts.

RESULTSThe operative time was (159.0 +/- 8.3) min with the harvesting time of (68.0 +/- 4.8) min and the ischemia time of (55. 8 +/- 6.8) min. The methylene blue injection showed rich blood supply of transplanted femur osteomyocutaneous flap. All the 10 flaps survived completely with pink skin color and hair regrowth. The histologic examination of the flaps also revealed the normal appearance of the viable skin and bone marrow.

CONCLUSIONSThe femur osteomyocutaneous flap is a simple and reliable model for composite tissue transplantation, and its establishment will provide a new tool for the study of composite tissue allografts.

Animals ; Bone Transplantation ; Femur ; transplantation ; Male ; Models, Animal ; Muscle, Skeletal ; transplantation ; Rats ; Rats, Inbred Lew ; Skin Transplantation ; Surgical Flaps ; Tissue Transplantation

BACKGROUND:Mouse pluripotent stem cel s are induced to differentiate into insulin-secreting cel s that can effectively improve blood glucose levels in diabetic mice. OBJECTIVE:To detect mRNA and protein levels of insulin-like cel clusters from induced pluripotent stem cel s and to investigate the function of insulin-secreting cel s in vitro and in vivo. METHODS:Mouse induced pluripotent stem cel s cultured in vitro were induced to differentiate into insulin-secreting cel s using combined inducers through three stages. The morphology of endodermal cel s, islet-derived progenitor cel s and mature islet cel s in each stage was observed and relative gene expression levels were detected by PCR. Mature insulin-like cel clusters underwent dithizone staining and functions of insulin released in vitro were observed by ELISA assay. Final y, the insulin-secreting cel s were transplanted into the subrenal capsule of diabetic mice, and then blood glucose levels were observed. RESULTS AND CONCLUSION:The mature spherical insulin-like cel clusters were successful y obtained in vitro, which were in iron red by dithizone staining, and expression of insulin mRNA was determined by PCR. The insulin-like cel clusters could secrete insulin in response to various blood glucose levels by ELISA assay. In addition, after the cel s clusters were transplanted into the subrenal capsule of mice with type 1 diabetes, the blood glucose levels were marbedly improved.

Chronic refractory wound refers to the wound with unclear etiology, multiple and complex injury factors, slow healing, and no obvious tendency of healing after treatment for 4 weeks. The formation and evolution process of chronic refractory wounds are very complex, involving re-epithelialization of wound tissue, cell proliferation, tissue remodeling, and angiogenesis and lymphangiogenesis. The abnormal expression of long non-coding RNA may be involved in the formation of chronic refractory wounds, but the specific pathogenesis and related molecular biological changes are still controversial. In this paper, we reviewed the process and role of long non-coding RNA in regulating keratinocyte differentiation, fibroblast proliferation, and regeneration of vascular and lymphatic endothelial cell in chronic refractory wounds.

Objective:To observe the effect of immunofluorescence double staining for foamy macrophages and Mycobacterium tuberculosis (MTB) in paraffin-embedded tissue of clinical tuberculous wound, in comparison with three routine staining methods. Methods:The experimental method was used. From April 2019 to May 2020, 10 patients with tuberculous wound (5 males and 5 females, aged 28-77 years) meeting the inclusion criteria were treated in the Department of Burns and Plastic & Wound Repair Surgery of Xiang′an Hospital of Xiamen University. The paraffin-embedded wound tissue were collected during extended debridement and preserved in the Department of Pathology of this hospital. Forty paraffin sections were made from the wound tissue of each patient. Hematoxylin-eosin (HE) staining, immunohistochemical staining, Ziehl-Neelsen and immunohistochemical double staining, immunofluorescence double staining were performed respectively, with 10 sections in each method. The section rejection rate of four staining methods were calculated. The recognition and detection of wound granuloma tissue in the four staining methods were observed and counted, and the recognition and detection of foamy macrophages in the wound tissue stained with four methods were observed. The MTB detection in the wound granuloma tissue and non-granuloma tissue in the four staining methods were compared. The subtyping and distribution of foamy macrophages and detection rate of MTB in the wound granuloma tissue and non-granuloma tissue, the morphologic clarity of foamy macrophages, as well as the non-specific staining rate and the loss rate of positive reaction of MTB and foamy macrophages by Ziehl-Neelsen and immunohistochemical double staining were compared with those of immunofluorescence double staining. Data were statistically analyzed with Fisher′s exact probability test, one-way analysis of variance, independent sample t test and Wilcoxon signed rank test. Results:The section rejection rate of HE staining, immunohistochemical staining, Ziehl-Neelsen and immunohistochemical double staining, and immunofluorescence double staining were 3% (3/100), 1% (1/100), 6% (6/100), and 2% (2/100), respectively. There was no statistically significant difference among the four groups ( P=0.26). All the four staining methods could identify granuloma tissue, and the number of granuloma structures was similar ( F=1.284, P=0.28). All the four staining methods were able to identify foamy macrophages in the wound tissue, which was detected in each section. No MTB was observed in the wound granuloma tissue or non-granuloma tissue by HE staining or immunohistochemical staining. MTB was observed distributing in the wound granuloma tissue and non-granuloma tissue by Ziehl-Neelsen and immunohistochemical double staining and immunofluorescence double staining, and most MTB distributed in the wound granuloma tissue. Ziehl-Neelsen and immunohistochemical double staining could not distinguish foamy macrophages engulfed MTB from that non-engulfed MTB. Immunofluorescence double staining showed that foamy macrophages engulfed MTB mostly distributed in the wound granuloma tissue, and the foamy macrophages non-engulfed MTB mostly distributed in the wound non-granuloma tissue. The detection rates of MTB in wound granuloma and non-granuloma tissue in immunofluorescence double staining were (89.00±0.08)% and (82.67±0.05)%, respectively, which were significantly higher than (54.56±0.14)% and (44.44±0.13)% in Ziehl-Neelsen and immunohistochemical double staining ( t=-12.495, -7.961, P<0.01). Compared with that of Ziehl-Neelsen and immunohistochemical double staining, immunofluorescence double staining showed better foamy macrophages clarity in wound tissue ( Z=-3.162, P<0.01). The nonspecific staining rate and positive reaction loss rate of MTB and foamy macrophages in wound tissue of immunofluorescence double staining were (9.11±0.07)% and (9.22±0.07)%, respectively, which were significantly lower than (20.67±0.06)% and (44.00±0.12)% of Ziehl-Neelsen and immunohistochemical double staining ( t=4.569, 15.519, P<0.01). Conclusions:Compared with HE staining, immunohistochemical staining, and Ziehl-Neelsen and immunohistochemical double staining, the immunofluorescence double staining is easy to operate, giving clear and intuitive images. It allows accurate imaging co-localization of MTB and foamy macrophages in paraffin-embedded tissue of clinical tuberculous wound.

Objective To investigate the therapeutic effect of the microdissected thin fibular skin flap of the great toe to repair the finger pulp defect,and to discuss the operation and outcome of the flap for finger pulp defect.Methods From September,2012 to January,2016,12 cases of finger pulp defect were treated with the thin fibular skin flap of great toe removed partially subcutaneous fat under the microscope.One case for index finger,3 cases for middle finger,4 cases for ring finger,and 4 cases for little finger.Among them,5 cases were crush injury,6 cases were stamping injury,1 case was avulsion injury.The flap area was 3.0 cm×1.5 cm-3.2 cm×2.2 cm.The donor site was closed directly or covered with flap.Results All the 12 flaps survived completely without blood supply crisis,and the primary healing was achieved in donor site.Ten cases were followed-up from 6 months to 36 months.The blood-supply,texture and elasticity of transferred flaps and the shape of fingers pulp were excellent.Function recovery of the fingers was good.Pain and temperature sense were regained without hypersensitivity,two-point discrimination of finger pulp was 5-8 mm.Conclusion It is a reliable approrach for the repare of the finger pulp defects using the microdissected thin fibular skin flap of the great toe,especillay in repare finger pulp defect of ring and little finger.