BACKGROUND:Closed reduction and interlocking intramedullary nailing can protect blood supply of fractured bone,decrease infection and promote bone healing.which is becoming the first choice for treating femoral shaft fracture However,it is difficult to conduct in closed reduction and keep stabilization of fractured bone.OBJECTIVE:To explore the curative effect of closed reduction and interlocking intramedullary nailing in treating femoral shaft fracture with assist of rubber tourniquet 360°elastic fixation METHODS:From May 2008 to November 2009,18 patients(14 males,4 females;aged 18-65 years)with closed femoral shaft fracture were treated at the Dongguan Hospital of Traditional Chinese Medicine.Body skin was protected by cloth,elastic rubber tourniquet was doubled and 360°wrapped around the fractured bone with the length of 10 cm from up and down.Supracondylar femur was reamed by Kernig-needle;fractured bone was dealt with countertraction and horizontal rotation.Another assistant compressed the fractured bone according to the displacement of fracture,which contributes to bone fracture reduetion and interlocking intramedullary nailing.RESULTS AND CONCLUSION:All 18 patients were followed up postoperatively,no case was found with skim necrosis and damage of nerve and blood vessel.16 cases were bone union with excellent 15 cases,fine 1 case;2 cases were still being followed up.Callus was firstly found 1 month after operation and was obviously found in 3e months postoperatively The result suggested that the treatment of closed reduction and interlocking intramedullary nailing with assist of rubber tourniquet360°elastic fixation is a simple and applicable approach.which reduces the interruption of blood supply for fractured bone and closed reduction gets good result,which reduces the chance of open reduction.

Objective To observe the efficacy of zhibituo combined with atorvastatin on type 2 diabetic patients with hyperlipidemia and its impact on blood lipids,fibrinogen (Fib) and D-dimer.Methods One hundred and seventy type 2 diabetic patients with hyperlipidemia visited our hospital from January 2010 to December 2012 were randomly divided into observation group and control group(with 85 cases in each group).Control group were given atorvastatin (1 0 mg,1 times / day),and the observation group were treated with zhibituo(1.05 g,3 times/day) on the basis of atorvastatin treatment,both treatment were 8 weeks.The levels of fasting plasma glucose (FPG),glycosylated hemoglobin (HbAlc),lipids,Fib and D-dimer were observed before and after treatment,and the efficacy of the two groups were compared.Results The efficacy in observation group was significantly higher than that in the control group (92.94％ (79/85) vs.81.18％ (69/85),x2 =4.229,P ＜ 0.05).There was significant difference on the levels of total cholesterol (TC) ((7.46 ±1.83) mmol/L vs.(4.28 ± 1.94) mmol/L,triglycerides (TG) (3.57 ± 1.32) mmoL/L vs.(1.47 ± 0.86)mmol/L,low-density lipoprotein cholesterol (LDL-C) (4.68 ± 1.04) mmol/L vs.(2.19 ± 0.72) mmol/L,high density lipoprotein cholesterol (HDL-C) (0.85 ± 0.21) mmol/L,vs.1.47 ± 0.43) mmol/L,fasting plasma glucose (FPG) ((8.65 ± 2.19) mmol/L vs.(6.38 ± 0.83) mmol/L).glvcosvlated hemoglobin (HbAlc) ((7.49 ± 1.67)％ vs.(6.28 ± 1.48)％),fibre(FiB) ((7.42 ± 1.38) mg/L vs.(3.76 ± 1.18)mg/L),and D-dimer ((1.18 ±0.17) g/L vs.(0.51 ±0.18) g/L) in observation group before and after treatment(t =10.993,12.289,18.849,11.945,8.936,4.999,18.584,24.949 respectively,all P ＜ 0.05).And there was also significant difference on the levels ofTC ((7.51 ± 1.27) mmol/L vs.(5.10 ±2.18) mmol/L),TG((3.48 ± 1.29) mmol/L vs.(1.88 ±0.37) mmol/L),LDL-C((4.57 ± 1.18) mmol/L vs.(2.81 ±0.83) mmol/L),HDL-C ((0.83 ± 0.22) mmol/L vs.(1.16 ± 0.28) mmol/L),FPG((8.72 ± 1.92) mmol/L vs.(7.42 ± 1.82) mmol/L),HbAlc((7.53 ± 1.32)％ vs.(6.79 ± 1.23)％),Fib((7.38 ± 1.63) mg/L vs.(4.41 ± 1.02) mg/L) and D-dimer ((1.20 ±0.15) g/L vs.(0.65 ±0.12) g/L) in control group before and after treatment (t =8.807,10.992,11.248,8.544,4.530,3.781,14.240,26.397,respectively,all P ＜0.05).The elevated levels of the observation group were more obvious compared with control group ((t =2.591,4.038,5.202,5.570,4.793,2.443,3.842,5.967 respectively,all P ＜0.01).Conclusion The efficacy of zhibituo combined with atorvastatin is obvious in type 2 diabetic patients with hyperlipidemia,it is helpful to regulate the disorders of fibrinolysis and coagulation.

Objective To investigate the protective effect of transection of cervical sympathetic trunk (TCST) on the noise-induced hearing loss (NIHL) in guinea pigs. Methods Thirty-six guinea pigs were ran-domly divided into three groups (n = 12): the operation group, the sham group and the blank control group. TCST was performed in the operation group , while the cervical sympathetic trunk in the sham group was only ex-posed and separated. The auditory brainstem response (ABR) thresholds was measured. Levels of superoxide dis-mutase (SOD) and malondialdehyde (MDA) in pasma were detected before operation (T0), before noise expo-sure (T1) and on the time of stopping noise exposure (T2), respectively. The damage situation of the outer cochlear hair cells was also checked. Results (1) At the time of T2, ABR thresholds of operation group and sham group were higher than that of the blank control group (P < 0.01), and ABR thresholds of the sham group are higher than the of the operation group (P < 0.05). (2) Levels of SOD and MDA post-noise exposure (T2) were significantly different among the three groups (P < 0.05). (3) Injured hair cells were more serious in the sham group than that in the operation group. Conclusion TCST has protective effect on NIHL in guinea pigs through increasing SOD and decreasing MDA.

Objective To establish a method of quantiying trace α-galactosidase from Bacteroides fragilis in enzymatic conversion of blood group B to O red blood cells ( B-ECO RBCs) .Methods BALB/c mice were immunized with purified recombinant B.fragilisα-galactosidase ( the purity>90%) to prepare monoclonal antibodies.The ascites were prepared using hybridoma cell lines stably secreting antibody and purified by HiTrap rProtein A column.The antibody titer and spe-cificity were detected by ELISA and Western blotting, respectively.Purified monoclonal antibody and rabbit polyclonal an-tibody were applied to detect residual enzyme in B-ECO RBCs and the washing solution was analyzed by indirect ELISA. Results A high titer and purity antibody was obtained.Western blotting showed that the antibody specifically reacted with B.fragilisα-galactosidase.Moreover, indirect ELISA was sensitive enough to detect the minimal amount of residualα-gal-actosidase at the concentration of 1 ng/ml.After four repeat washing cycles with 1∶4 ( v/v) phosphate-buffered saline, the amount of residual enzyme in B-ECO RBCs was less than 10 ng/ml.Conclusion An effective method of detecting the min-imal amount of residual α-galactosidase in blood conversion is established for safety evaluation of universal RBCs prepara-tion by enzymatic treatment.

Objective To evaluate the value of transvaginal color Doppler sonography(TVCD)in the conservative treatment of early tubal pregnancy(TP).Methods Fifty cases of early TP were examined by TVCD before medical treatment,including the size of TP mass,blood flows graded according to Alder,hemodynamics parameters.All data were ananlized and compared with therapeutic results.Results Fortyfive cases were treated successfully(45/50),and 5 failed.According to TVCD,TP masses flow were graded from O to Ⅲ.In the successful group,4 cases were graded 0,21 Ⅰ,16 Ⅱ and 4Ⅲ,blood flow signals were measured in 41 cases,the mean velocity was(5.452±4.327)cm/s,PI(1.597±0.696),RI 0.680±0.107.In the failure group,all TP masses flow were graded Ⅲ,the mean velocity was(16.774±9.855)cm/s,PI 0.95 1±0.193,RI 0.567±0.034.Conclusions In the medical treatment of early TP,TVCD findings associated with the treatment outcome closely,it plays an important role in assessing conservative treatment of early TP.

Objective To reduce immunogenicity of porcine skin by removingα-Gal epitopes expressed in cell surface and extracellular matrix using recombinant α-galactosidase produced by Bacteroides fragilis.Methods The porcine skin was harvested from healthy 2-month-old pigs without any skin disorders before being sterilized by iodine and 75%alcohol, respectively.Enzymatic removal of α-Gal antigen was followed by washing with PBS.The α-Gal antigen in the prepared porcine skin was measured with immunofluorostaining of cryosections and the residual enzyme was measured with a double-antibody sandwich ELISA method.Enzymatic removal procedures were optimized by detecting residual enzyme and the effi-cacy ofα-Gal removal under different enzymatic and washing conditions.Results Efficient enzymatic and washing methods were established to removeα-Gal antigen.Theα-Gal removal efficacy was above 90% and residual enzyme was undetect-able (αprescribed minimum ofα-galactosidase detection with indirect ELISA was 1 ng/ml) .Conclusion It is feasible to efficiently removeα-Gal antigen under these enzymatic and washing conditions, and a method of producing low-immunoge-nicity pig skin dressing for burn is established.

Objective: To explore the relationship between plasma level of B-type natriuretic peptide (BNP) and short term prognosis in patients of sudden cardiac arrest with successful cardiopulmonary resuscitation (CPR). Methods:A total of 60 relevant patients were divided into 3 groups based on their plasma levels of BNP. Group A, the patients with plasma level of BNP < 200 pg/ml at immediately, 3 hours and 12-24 hours after CPR,n=16. Group B, the patients with consistently increased BNP and at 3 hours, 12-24 hours after CPR and the BNP level > 200 pg/ml , n=22. Group C, the patients with obviously increased BNP at 3 hours after CPR, while at 12-24 hours after CPR, BNP level decreased to lower than 3 hours level,n=22. All patients were followed-up for 6 months to compare the mortality incidence among different groups. Results: There was no patient died in Group A, the mortality incidence in Group B was 11 and in Group C was 3. The 6 months survival rate in Group A was higher than that in Group B (χ2 = 11.337,P=0.001), the survival rates were similar between Group A and Group C (χ2 = 2.330,P=0.127), and the survival rate in Group B was lower than that in Group C (χ2=7.435,P= 0.006). Conclusion: Consistently increased plasma level of BNP may imply heart failure in patients of sudden cardiac arrest with successful CPR, those patients could have poor short term prognosis. It is critical to improve the cardiac function and increase the important organ infusion to make better recent clinical prognosis.

Objective:To evaluate the immunological efficacy of a novel DNA vaccine against West Nile virus (WNV) in a mouse model.Methods:A DNA vaccine VRC-prME expressing the precursor membrane (prM) and envelope protein (E) of WNV Xinjiang strain (XJ11129-3) was constructed and its ability to express virus-like particles was verified in vitro. C57BL/6 mice were immunized twice with VRC-prME via intramuscular injection combined with electroporation with an interval of four weeks. Enzyme-linked immunoassay (ELISA) was used to detect serum antibodies after immunization. WNV (NY99 strain) single-round infectious particles were used to detect neutralizing antibodies. Cellular immune responses were analyzed by enzyme-linked immunoblot assay (ELISPOT) and intracellular cytokine staining (ICS). Results:VRC-prME induced a strong Th1-biased antibody response in mice that could cross-neutralize the WNV (NY99 strain) single-round infectious particles two weeks after the boost immunization. Moreover, the vaccine also elicited antigen-specific multifunctional CD8 + T cell responses (IFN-γ, IL-2, TNF-α). Conclusions:The novel DNA vaccine prepared in this study, expressing the prME protein of WNV XJ11129-3 strain, could induce stronger humoral and cellular immune responses in mice, which was worthy of further research and development for the prevention of WNV infection in China.

OBJECTIVEToday metal-ceramic restorations are widely accepted in dental practice because of their good aesthetic and biocompatible properties, but there are still several problems to be resolved, among which the influences of their margins on gingival health is noticeable. The purpose of this study was to investigate the influences of metal-ceramic restoration margin on gingival health.

METHODS129 abutments of metal-ceramic restorations, including their margins' fitness, location and smoothness were examined and their influences on gingival health were analyzed.

RESULTSThere was a close relation between the metal-ceramic restorations' margins and the gingival health.

CONCLUSIONIn order to maintain the gingival health, the margins should be smooth, closely fitted, no overhanging and in a moderate location (i.e. not below the gingival more than 1 mm).

Female ; Gingival Diseases ; etiology ; Gingivitis ; etiology ; Hemorrhage ; etiology ; Humans ; Male ; Metal Ceramic Alloys ; adverse effects

ObjectiveTo investigate the characteristics of EGFR gene mutations among NSCLC patients in south of China and analyze the correlation between mutations and clinical features.Methods Specimens of lung cancer tissues were collected from 185 NSCIC patients in our hospital.DNA was extracted from specimens.Exon 18,19,20 and 21 of EGFR gene were amplified by FQ-PCR to be bi-directional sequenced.ResultsEGFR gene mutations in 62 (33.5％) of 185 NSCLC patients was identified in carcinoma tissues,of which,2cases,41cases,5 cases and 14 cases respectively located at exon 18,exon 19,exon 20 and exon 21.The mutation of Del L747 → P752 (P753S) ( proportion 8.1％ ),Del E746 → A750 ( proportion 45.1％ ) at exon 19 and L858R ( proportion 22.6％ ) at exon 21 were the predominant mutation in 16 kinds of mutations.Four cases of mutation at exon 19 got the different results in bi-directional sequencing.The silent mutation 2361G→A at exon 20 was observed (28.1％ ).The mutation rate in women was significantly higher than men (46.2％ vs 24.3％,x2 =9.670,P =0.002).Non-smokers had significantly higher mutation rate than smokers (41.4％ vs 17.1％,x2 =7.380,P =0.007) ; Adenocarcinoma patients had significantly higher mutation rate than squamous cell carcinoma (38.3％ vs 6.3％,x2 =6.426,P =0.011).Clinical stage Ⅲ patients had significantly lower mutation ratethan patients with stage Ⅱ orⅣ ( 10.8％ vs 53.8％,x2 =8.026,P =0.003 ;10.8％ vs 41.3％,x2 =9.518,P =0.002).No statistically significance correlation was found between the mutation ratio and age.ConclusionsEGFR gene mutation has a close relationship with females,non-smokers and adenocarcinoma.Most mutations occur in exon 19 and 20 among patients in south of China.