Objective To investigate the anti-erythropoietin antibody level and its clinical significance in maintenance dialysis patients. Methods Eighty maintenance hemodialysis (HD) and 30 peritoneal dialysis (PD) patients were enrolled in the study. Serum anti-erythropoietin antibody levels of above 110 dialysis patients were measured by ELISA. Immunoreactive parathyroid hormone (iPTH), Scr, BUN, Hb, and CRP were determined by conventional methods at the same time. Correlations among these indexes were examined. Results The anti-erythropoietin antibody levels of the dialysis patients were significantly higher than those of healthy people (P＜0.05), but no significant difference was found between HD patients and PD patients. There were no significant differences of anti-erythropoietin antibody, Hb, BUN, Scr, iPTH and CRP among different primary diseases. Hb was negatively correlated with anti-erythropoietin antibody and CRP (r=-0.56, -0.20,P ＜0.05), but was not correlated with BUN, Scr, iPTH. There was no correlation of antierythropoietin antibody with BUN, Scr, CRP and iPTH. One patient receiving recombinant human erythropoietin (rHuEPO) treatment with anti-erythropoietin antibody 43.63 U/L developed pure red cell aplasia diagnosed by marrow biopsy. Conclusions The anti-erythropoietin antibody levels of the dialysis patients are significantly higher as compared to healthy people, but are not significantly different between HD and PD patients. Anti-erythropoietin antibody is not correlated with BUN, Scr,iPTH and CRP. Hb is negatively correlated with anti-erythropoietin antibody and CRP. The rHuEPO can induce the anti-erythropoietin antibody leading to pure red cell aplasia in dialysis patients.

Objective　To review the experience in the management of burned patients inflicted by inhalation injury in our institute in the past 42 years. Methods　Patients with inhalation injury were analyzed chronically in three different periods as 1958 to 1980, 1981 to 1990, and 1991 to 2000. Results　The mortality rates in general and in terms of different degrees decreased obviously with the elapse of time. In other words, the rates were 48.93%, 26.60% and 8.53 for the above three periods. Conclusion　The mortality of inhalation injury was decreased dramatically during the last decade in our institute. Five main measures consisting of inhalation of high concentration or pure oxygen, preventive tracheotomy, frequent tracheal lavage with small amount of lavage fluid at early stage of postburn, mechanical ventilation with PEEP and humidification as early as possible, and application of exogenous pulmonary surfactant contribute greatly to the decrement of death rate in the patients with inhalation injury.

Objective To summarize the characteristics of nosocomial infections in the patients treated in intensive care unit (ICU).Methods The incidence of nosocomial infections was monitored in ICU from March 2012 to August 2012.The incidence rate of infection was adjusted with Average Severity of Illness Score (ASIS)score and analyzed in relation to three invasive pro-cedures.Pathogen distribution of nosocomial infections in ICU was also analyzed.Results Nosocomial infection was identified in 357 of the 3 700 ICU patients (9.65%).The overall daily infection rate was 30.34‰,specifically,49.10‰ for ventilator asso-ciated pneumonia (VAP),13.86‰ for catheter-related bloodstream infections (CRBSI),and 1.09‰ for catheter-associated urinary tract infections (CAUTI).Of the 688 bacterial isolates,gram negative bacteria accounted for 82.70%.The top three bacterial species were Acinetobacter baumanii ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .Conclusions ICU is the focus for surveillance of nosocomial infections.Objective investigation is critical for nosocomial infection surveillance.

Objective To study the effects of midkine (MK) gene-targeting small interfering RNA (siRNA)on the invasion of melanoma cells.Methods Three MK gene-targeting siRNAs (S1,S2 and S3)were designed,constructed,and transfected into human A375 melanoma cells.Real-time PCR was performed to measure the expression of MK gene and to screen the siRNA with best efficacy.Then,A375 cells were transfected with the optimal siRNA of various doses (3.125,6.25 and 12.5 nmol/L)followed by additional culture of various durations(24,48,72 hours).Some A375 cells remaining untreated served as the blank control group,and some transfected only with liposomes served as the vector control group.Reverse transcription (RT) -PCR and Western blot were conducted to detect the mRNA and protein expression of MK,respectively,MTT assay to observe the adhesion of A375 cells,and Boyden chamber was used to evaluate cell invasion.Results The expression of MK mRNA was downregulated by all the three siRNAs,especially by the siRNA S3,which was used in the following transfection experiment.Real-time quantitative PCR revealed that the MK mRNA expression was reduced by the siRNA in a dose- (r24hours=-0.906,r4Bhours=-0.922,r72hours=-0.939,all P<0.01)and time-dependent(r3.125nmol/L=-0.889,r625nmol/L=-0.935,r125nmol/L=-0.928,all P<0.01)manner.MTT assay showed that the percentage of adhesing cells was 73.66%±2.25%,49.36%±2.16%and 28.35%±1.68%in A375 cells transfected with the siRNA of 3.125,6.25 and 12.5 nmol/L,respectively.The number of cells migrating across the chamber filter was 23.9±1.6,12.1±1.5,5.6±1.2 among A375 cells transfected with the siRNA of 3.125,6.25 and 12.5 nmol/L,respectively,significantly lower than that in the blank control group(36.8±1.5).The percentage of adhesing cells and number of migrating cells decreased with the dose of siRNA(r=-0.936,-0.915,P<0.01,0.05,respectively).Conclusions MK gene might play an important role in the adhesion and invasion of melanonla cells.To down-regulate the expression of MK gene by siRNA may suppress the adhesion and invasion of melanoma cells.

Objective To investigate the effects of Puerarin on glucose and lipid metabolism and gastric motility in early period type 2 diabetic (T2DM) rats.Methods Rat model of T2DM was established by high fat-sugar diet fed and low-dose streptozotocin-treated. SD rats were divided randomly into normal control group (NC), normal+Puerarin group (NP), diabetes control group (DC) and diabetes+Puerarin group (DP). NP and DP rats were given Puerarin 400 mg/(kg?d) once per day for 5 weeks, NC and DC rats were given PBS. Half time of gastric emptying and emptying rate were evaluated by SPECT. The serum level of FBG, GSP, FFA, TC, TG and INS were measured by kit.Results Compared with NC group, DC rats had higher FBG, FFA, TC, GSP, TG and emptying rate, but INS and half time of gastric emptying decreased significantly (P<0.05,P<0.01). Compared with DC group, TG, GSP, FFA and emptying rate of DP rats were reduced (P<0.05), but had more half time of gastric emptying (P<0.05). The results of multivariate stepwise regression analysis showed that FBG related to half time of gastric emptying.Conclusion Type 2 diabetic rats have faster gastric motility, higher blood glucose and lipid. Puerarin might improve the disorders of GSP, TG, FFA and gastric emptying in diabetic rats.

Objective To explore clinical application of retrograde medial and lateral gastrocnemius muscle flap for soft tissue defects of the middle and lower third of the leg. Methods From August 2008 to December 2009, in our hospital we adopted retrograde medial and lateral gastrocnemius muscle flap to renovate 5 cases of refractory soft tissue defects of the middle and lower third of the leg. Results Five cases of retrograde medial gastrocnemius muscle flap were survived, morphology and function of soft tissue defects were renovated well. Conclusion This operation is an effective and reliable technique for soft tissue defects of the middle and lower third of the leg, which is performed without sacrificing the major blood vessels, probing vascular pedicle and matching vascular anastomosis.

Objective:To explore the clinical outcome of measured resection combined with gap balancing technique in total knee arthroplasty (TKA).Methods:From January 2016 to October 2017, 61 cases of varus knee joint flexion deformity were applied the procedure of measured resection combined with gap balancing technique in primary total knee arthroplasty, including 24 male and 37 female; the average age was 66.80±8.2 years old (range from 60 to 78 years old). All patients underwent antero-medial incision of knee joint,medial parapatellar approach and posterior stabilized prosthesis. Measurement osteotomy technique was used to localize osteotomy. Gap balancing technique was vitrificated flexion and extension. Operation time, surgical blood loss and osteotomy volume were recorded. Radiographic evaluation included alignment of lower extremity, knee joint linedistance, tibiofemoral joint angle, rotation angle of femoral prothesis and posterior condylar offset (PCO). Joint functions were assessed including KSS scores, ROM and patient satisfaction.Results:The average operation time was 54±12 min (range from 45 to 65 min). The average postoperative drainage was 140±26 ml (range from 120 to 180 ml). The difference in hemoglobin values were 22±8.5 g/L(range from 20 to 30 g/L) between preoperative and postoperative 5 days. The lateral proximal tibial bone mass was 10.2±1.5 mm (range from 9.2 to 11.5 mm). The lateral distal femoral bone mass was 9.1±1.5 mm (range from 8.8 to 10 mm). The bone mass of posterior lateral condyle of femur was 8.6±1.5 mm (range from 7.8 to 10 mm). The bone mass of posterior medial condyle of femur was 9.2±1.2 mm (range from 8.6 to 10 mm), compared with the bone mass of posterior lateral condyle of femur, and the difference was statistically significant ( t=2.44, P=0.006). The intraoperative angle between osteotomy line of gap balanced osteotomy technique (line B) and connecting line of screw hole in measure osteotomy (line A) was 1.15°±0.47° (range from 1.02° to 2°). The external rotation angle was27.8%, the internal rotation angle was72.2%. There was no significant difference between preoperative knee joint line distance 40.55±4.32 mm and postoperative knee prosthesis joint line distance 40.99±3.86 mm. Postoperative knee straight and bent-knee 90° stress X-ray demonstrated that medial-lateral tibiofemoral joint angle showed no significant difference ( P >0.05). Cross-sectional CT of knee joint post operation, rotation angle of femoral prosthesis ≤±2°. Most of them were mainly concentrated in the internal rotation angle. There was no significant difference between preoperative PCO 31.55±3.18 mm and postoperative PCO 31.55±3.18 mm ( P>0.05). The KSS score and patient satisfaction score post operationwere significantly higher than those preoperation. The KSS score and patient satisfaction score at 3 months after operation were 89.2±9.4 points and 7.2±2.6 points, which were higher than that at 1 month after operation (78.0±3.5 points and 5.2±1.8 points), with statistically significant differences ( t=1.897, P=0.026; t=1.753, P=0.038). The KSS score was above 90 at 6 months after operation. The knee ROM after 1 month (94.7°±10.6°) had no statistical significance compared with that preoperation (91.9°±12.5°) ( t=1.286, P=0.245). The knee ROM at 3 months after surgery (105.8°±14.7°) was significantly higher than that before operation (91.9°±12.5°) ( t=1.924, P=0.041). There was no significant difference between the scores of the follow-up time points and those of 3 months after operation ( P >0.05). Conclusion:TKA were performed by using measured resection combined with gap balancing technique. Not only can good alignment of lower extremity be restored, but also flexion-extension gap balance can be obtained. Equal osteotomy with less soft tissue release. There are better ROM of knee and KSS functional scores in the early postoperative period. However, it is easy to cause femoral pseudointernal rotation.

Objective To introduce clinical application of retrograde medial pedicled skin flap of the leg to repair the plantar cutaneous deficiency. Methods From January 2002 to May 2008, in our hospital we adopted retrograde medial pedicled skin flap to renovate 12 cases of plantar cutaneous deficiency. The size of the skin flaps ranged from 10 cm× 7 cm to 13 cm × 12 cm. Results Ten cases of retrograde medial pedicled skin flap were survived, the rest had partial necrosis because of distal blood flow obstacle. One was cured by changing dressings; the other was repaired by secondary operation. Morphology and function of soft tissue defects were renovated well with 6-18 months follow-up. Conclusion This operation is an effective and reliable technique for plantar cutaneous deficiency.

ObjectiveTo investigate the effect of arsenic trioxide (As2O3) on the metastasis capability of Ewing's sarcoma ceils. MethodsMTT assays were performed to choose appropriate concentrations of As2O3 (＜ 2 μmol/L) for the experiments.Migration and invasion assays were performed to assess the effect of As2O3 on the metastasis of Ewing's sarcoma cells. Changes in matrix metalloproteinase(MMP)-9 expressions were detected by gel zymography assay and the phosphoinositide 3-kinase/AKT(PI3K-AKT)pathway was investigated using Western blot. ResultsThe amount of Ewing's sarcoma cells across basal membrane of Transwell in migration and invasion assay decreased gradually with the increase in As2O3 concentration. The average quantities of A-673 across the membrane after treatment by gradual concentrations accounted for 54.3 ％,49.0 ％ and 17.0 ％ of that of untreated group respectively in migration assay (F=112.78,P ＜ 0.01), while 52.7 ％, 32.3 ％ and 10.3 ％ in invasion assay(F =183.76, P ＜ 0.01). Similarly, the percentage of RD-ES was 46.0 ％,39.0 ％ and 8.0 ％ in migration assay (F =408.25,P ＜ 0.01) and 58.7 ％,22.3 ％ and 9.0 ％ in invasion assay (F =373.25, P ＜ 0.01)respectively. The difference had statistics significance.The expression of MMP-9 was suppressed by As2O3 treatment according to gel zymography assay.Western blot assay showed that PI3K-AKT pathway was inhibited and nuclear factor kappa B(NF-κB)was inactivated.ConclusionLow-concentration As2O3 may inhibit metastasis capability of Ewing's sarcoma cells.

A growing body of evidence suggests that p300 histone acetyltransferase plays important roles in cancer cell differentiation and proliferation. Here, we employed structure-based hierarchical virtual screening method to identify novel lead compounds of p300 histone acetyltransferase. From a screening library containing approximate 100 000 diverse druglike compounds, 33 compounds were chosen for experimental testing and one compound, 4-acetyl-2-methyl-N-morpholino-3,4-dihydro-2H-benzo[b][1, 4]thiazine-7-sulfonamide (17), showed as micromolar inhibitor. Based on its predicted binding pose, we investigated its binding characteristics by designing two series of structural modifications. The obtained structure-activity relationship results are consistent with the predicted binding model. We expect that the identified novel p300 histone acetyltransferase inhibitors will serve as starting points for further development of more potent and specific histone acetyltransferase inhibitors.