Objective To study the mechanism and characteristics of calcaneal fracture involving calcaneocuboid joint and its surgical clinical results. Methods 71 cases with 90 calcaneal fractures accompanied calcaneocuboid joint injury were reviewed in our hospital from February 1997 to April 2001, which included 61 ankles of 46 males and 29 ankles of 25 females with an average age of 38.7 years (range, 18 to 67 years). AP, lateral and axial view X-ray of both feet, broaden view X- ray of the affected foot, and CT scan were taken preoperatively. Among them, 45 ankles were examined with three dimensional reconstruction of CT as well. The calcaneocuboid joint injury were divided into 4 types as follows: typeⅠ(46/90) with one articular fracture line but no displacement; type Ⅱ(26/90) with one articular fracture line accompanied the displacement of fragment and the subluxation of calcaneocuboid joint; type Ⅲ (11/90) with two fracture articular lines, and the displacement of fragment as well as the subluxation of calcaneocuboid joint; and type Ⅳ (7/90) with three articular fracture lines and comminuted fracture or the subluxation of calcaneocuboid joint. Of 71 cases, 63 were operated at 3 to 7 days after injury, and 8 delayed at 10 to 14 days. The incision started at the middle point between the fibula and Achilles tendon proximal to the apex of lateral malleolus, and extended distally to the adjacent part of dorsal and plantar skin, then anterior to the base of fifth metatarsus. After the reduction of fractures, type Ⅰcalcaneal plate, designed by authours, was used for type Ⅰ,Ⅱand Ⅲ fractures, the anterior part of calcaneus was fixed with the vertical wing of plate; type Ⅱ calcaneal plate was used for type Ⅳfractures, the horizontal wing of plate was fixed to cuboid to stabilize the comminuted fragments of anterior calcaneus. Results Of 90 ankles, 78 were followed up for an average of 18.7 months (range, 12 to 32 months). The total excellent and good rate was 94.9% according to Marryland foot score. Furthermore, In type Ⅰ, the excellent and good rate was 100%, type Ⅱ 95.7%, type Ⅲ 88.9% and type Ⅳ 60%. Among the types Ⅳ fracture, 7 ankles obtained satisfied internal fixation, but in 4 of them the plates were broken after weight bearing walking. Conclusion The injury of calcaneocuboid joint is related with the severity of calcaneal fracture, attention should be paid and carried out with reliable internal fixation.

Objective To introduce the reconstruction of calcaneal thalamus by bone autograft and subtalar arthrodesis for severe deformities caused by malunion of calcaneal fractures and to discuss the indications and its advantages of the management. Methods From November 1998 to August 2002, 17 cases with 21 malunited calcaneal fractures were treated, which were 13 males and 4 females with an average age of 35.4 years( 25 to 45 years). Unilateral calcaneus was involved in 13 cases, and bilateral calcaneus was affected in 4 cases. The primary treatment was manipulation and immobilization with a cast in all patients. The interval from injury to the operation was on an average of 33.6 months(7 to 50.4 months). The common complaints were painful heels and walking difficulty. Furthermore, there was subluxation of talonavicular joint in 5 cases, protruded osteophyte and fragment from the lateral wall of calcaneus in 12 cases. Lateral, axial, and oblique roentgenograms were taken preoperatively, and three dimensional reconstruction of CT scan as well. Results The modified extended L-shaped approach lateral to calcaneus was used. The bulging lateral wall of calcaneus was excised and reserved for reconstruction of calcaneal thalamus if possible. While in some cases the bone autograft had to be harvested from iliac crest if the excised lateral wall was not available. After the cartilage of subtalar joint was removed completely, the calcaneal thalamus was reconstructed with the bone and fixed with 2 to 3 screws, the contour and position of calcaneus was conformed without valgus or varus by "C" arm intensifier. A short leg cast was used for immobilization one month after operation. Among the patients, 18 feet were followed up on an average of 14.5 months (9 to 22 months). The total excellent and good rate was 88.8% according to Maryland foot score system. Plain radiography showed that B hler angle, Gissane angle, talus inclining angle, width of calcaneus and height of calcaneal thalamus were restored to nearly normal. Conclusion The reconstruction of calcaneal thalamus by bone autograft combined with subtalar arthrodesis is an effective operation for severe malunion of calcaneal fractures, which can improve calcaneal abnormality, and make recovery of the shape of hind foot and functions satisfactorily.

Objective To introduce calcaneal osteotomy without subtalar fusion for calcaneal malunion and to discuss its indications, advantages and disadvantages. Methods From November 1998 to May 2003, 24 cases with 26 calcaneal malunion for 1 to 9 months were treated by calcaneal osteotomy without subtalar fusion. The average age was 32.6 years (range, 28 to 42 years). All patients underwent radiography including plain, axial and lateral views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, 13 cases were of type Ⅱ(9Ⅱb, 4Ⅱc), 13 of type Ⅲ(8 Ⅲac, 5 Ⅲbc). Through the modified lateral L-shaped approach, the protruding lateral wall of calcaneus was resected and the posterior subtalar facet was reduced by elevating the fragment of the posterior subtalar facet upwards and backwards. The defect of calcaneus was filled with bone autografts. Iliac crest bone graft was used in 19 feet and the bone graft resected from the extruding lateral wall of calcaneus in 7 feet. The calcaneus was fixed with plate and screw. Results 21 feet were followed up for an average of 14.5 months (range, 9 to 22 months). No complications such as wound infection, screw breakage and calcaneum varus were found postoperatively. The average time for bone healing was 11.2 weeks (range, 10.5 to 13.3 weeks). The postoperative functional evaluation by Maryland foot score system revealed excellent result in 8 feet, good in 10, fair in 3. The rate of excellent to good results was 86%. Plain radiographs showed the nearly complete restoration of Bhler angle, Gissane angle, talus inclining angle, calcaneal width and height of the calcaneal thalamus. Conclusion Calcaneal osteotomy without subtalar fusion is an effective method for calcaneal malunion with advantages of correcting deformity markedly, restoring the function and the outer aspect of hindfoot satisfactorily.

Objective To study the clinical and the epidemiological features of hospitalized children with influenza virus infection. Methods Two hundred and fifty-three inpatients with laboratory-confirmed influenza virus infection from 1999 to 2008 were reviewed for analyzing the clinical and epidemiological characteristics. Type A and B influenza viruses in the nasopharyngeal aspirates were detected by immunofluorescence assay. Mann-Whitney U test were performed for comparing the median age and the length of hospitalization. Chi-square test was performed for comparing the proportion of patients with fever and cough. Results Among 253 hospitalized children aged between 5 days and 127 months, 182 (71.9%) were boys and 71 (28. 1%) were girls. The median age was 18 months. Fifty-three cases were infants younger than 6 months. 95 cases were children aged between 6 months and 2 years, 85 cases were aged between 2 years and 5 years and 20 cases were older than 5 years. The diagnosis of influenza-related admission included pneumonia (190 cases), bronchitis (49 cases) and upper respiratory tract infection (14 cases). Eleven cases developed febrile convulsion, 6 cases had acute exacerbation of asthma and 3 cases had concomitant viralencephalitis. Twenty-nine cases had basic diseases. Cough and fever were the most common symptoms. Two hundred and thirty-eight cases presenting cough and 209 case presenting fever. Sixty-seven percent (140/209) had high fever with body temperature higher than 39 ℃. The average duration of fever was (5. 0 ±2. 9) days. Fever and cough were both more common in children older than6 months (X2 = 22. 895,P<0. 01; X2 = 16. 992,P<0. 01, respectively). Febrile convulsion occurred in children older than 2 years. Fifteen point five (39/251) developed leukocytopenia. Conclusions Children younger than 5 years old are at high risk of influenza-related hospitalization. We should emphasize influenza vaccination in previously healthy children aged between 6 months and 5 years and children with underlying diseases.

Objective To understand the epidemiology of respiratory syncytial virus(RSV),influenza virus type A and type B(IV-A and IV-B),parainfluenza virus type 1,2,3(PIV-1,2,3)and adenovirus(ADV) among children with acute respiratory tract infection in Shanghai.Methods A retrospective epidemiological investigation was conducted to analyze the prevalence rate,seasonality and susceptible pediatric population of seven common respiratory viruses among hospitalized pediatric patients(<15 years old) with acute respiratory tract infection in Children's Hospital Affiliate to Fudan University Shanghai during 2003 to 2006.Nasopharyngeal aspirates were collected for detecting viral antigens of RSV,IV-A,IV-B,PIV-1,PIV-2,PIV-3 and ADV by direct immunofluorescence assay.Results Total 11214 children were collected during the consecutive four years,among whom 98.7% were presented with acute lower respiratory tract infection.The overall positive detection rate of these seven respiratory viruses was 24.2%.RSV accounted for 17.7%,followed by PIV-3(2.8%),ADV(2.2%),IV-A(0.7%),PIV-I(0.5%),PIV-2(0.3%),IV-B(0.1%)and mixed(0.2%).RSV season often occurred in winter and spring,however,an early season began in autumn every two year.PIV-3,ADV and IV were usually prevalent sporadically and the seasonal patterns were not typical.The median ages of infected pediatric patients were 4 months for RSV,8 months for PIV-3,9.5 months for PIV-1,10.5 months for PIV-2,12 months for ADV,13 months for IV,respectively,which were significantly different by statistical analysis(X2=154.319,P<0.01).The infants and younger children were more susceptible for developing RSV and PIV-3 related diseases.RSV infection significantly decreased along with the age increased.Conclusions RSV is the most commonly identified virus,while infants and neonates are the most susceptible populations for RSV infection.Typically,RSV is prevalent during spring and winter but begins to be active in fall every other year. PIV-3 is found to be the second common viral pathogen and young children are susceptible population.ADV ranks the third pathogen and children with ADV infection tend to be elder. Nevertheless,IV is rare among pediatric population in recent years in Shanghai.In our study,the outbreaks of ADV and IV infections among children are not observed.

Objective To develop a method for the simultaneous separation and determination of 10 kinds of sedative hypnotica drugs in the functional food with high performance liquid chromatography mass spectrometry system.Methods The mobile phase consisted of acetonitrile and 15 mmol/L ammonium acetate solution(0.1% formic acid ),chromatographic column was Zobax SB C 18.Identification was based on the compound's absolute retention time,protonated molecular ion,and representative fragment ion by multiple reaction monitoring.The condition of determination was investigated and optimized.Results With this method,the linear range for the 10 drugs was 10-1 080 ?g/kg,the average recoveries ranged from 80.5%-97.1% and the detection limits were from 0.35-12.0?g/kg respectively.Conclusion The method established in the present paper is applicable to monitoring sedative hypnotica drug in the functional food.

ObjectiveTheaimofthisstudywastoprovideabetterpositivecontrolforallergictestbycomparing the allergic effect of two kinds of positive materials , human albumin and ovalbumin , on active systemic anaphylaxis in guinea pig.Methods Guinea pigs were randomly divided into 14 groups, and were given human albumin , ovalbumin (2, 10, 100 mg/animal), or 0.9%sodium chloride injection as test substances , to assess the symptoms and incidence of systemic allergic responses induced by different sensitizing substances in different challenge doses and different challenge intervals.Results In the range of 2 to 100 mg/animal, the guinea pigs showed a 100%incidence rate of positive allergic reaction to human albumin and ovalbumin , the severity of anaphylactic symptoms was increasing along with the increase of sensitizing doses and challenge doses , and the allergic reaction was more strong induced by the same dose of ovalbumin than human albumin .Conclusions Our findings indicate that in the active systemic anaphylaxis test in guinea pigs , we recommend ovalbumin as the positive control in a dose of 2 mg/animal.

ProTide technology is a kind of prodrug design strategy invented by the team of Christopher McGuigan. ProTides are aryloxyphosphoramidates (or aryloxyphosphonamidates) which contain a phosphorus atom combined with an amino acid ester and an aryloxy group. These prodrugs can efficiently cross the cell membrane and escape from the first rate-limiting step of phosphorylation, which afford effective solutions to the drawbacks of current nucleoside analogues. At present, ProTide technology has been extensively applied in the field of antiviral research. It has been successful in providing a number of approved drugs and clinical candidates, such as sofosbuvir and so much more, highlighting the promising future in drug discovery. This review summarizes the brief history and characteristics of ProTide technology, as well as its application in the exploration of antiviral drugs.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Salmonella Infections ; etiology ; transmission ; Salmonella enterica

OBJECTIVETo investigate the mechanism that the formulas for activating blood and resolving stasis can regulate hemopoietic stem cell to produce new blood.

METHODRats were established animal model of acute cerebral infarction by referencing Olivette' method. They were randomly divided into model group, the group of the high, middle, low dose of the formulas for activating blood and resolving stasis. Each group and then wasrandomly divided into subgroups by 1, 3, 7, 14, 28 d. Xuesaitong capsule was formulated into 20, 40, 60 g x L(-1) with normal saline. The rats were given gavage drugs once a day until the experient ended, and the model group was administrated by intragastrical perfusion of normal saline. ELISA was used to detect the expression of SCF in peripheral blood and bone marrow among different groups at different time points. Flow cytometry was used to observe the changes of CD117 in blood and bone marrow.

RESULTThe CD117+ HSC and SCF concentration in peripheral blood and bone marrow of model group were increasing during 1-14 d,there was a peak on the 14th day, then the expression was reducing. CD117+ HSC and SCF concentration rising trend in the group of the high, middle dose of the formulas for activating blood and resolving stasis was preceded model group (P < 0.05).

CONCLUSIONActivating blood and resolving stasis can regulate hemopoietic stem cell to produce new blood, and it is through the regulation of CD117+ HSC number to achieve the purpose.

Animals ; Bone Marrow Cells ; drug effects ; metabolism ; Capsules ; Cerebral Infarction ; blood ; drug therapy ; genetics ; metabolism ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; administration & dosage ; Hematopoietic Stem Cells ; drug effects ; metabolism ; Humans ; Male ; Proto-Oncogene Proteins c-kit ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Stem Cell Factor ; genetics ; metabolism