Objective:To investigate the differences between emergency surgery and selective surgery treatment of ankle fractures with dislocation .Methods:In the study , 40 patients with ankle fracture and dislocation were treated and followed up from May 2013 to May 2014, and all the data were collected and analyzed .The subjects involved 29 male patients and 11 female patients .The patients were randomly separated into two groups , and the patients in group A were given surgical intervention within 6 hours af-ter injury , while those in group B were initially given close reduction and given selective operation when the soft tissue condition got better .Group A contained 13 male patients and 7 female patients with average age of 37.10;Group B consisted of 15 male and 5 female, with average age of 37.85.Results:The Baird-Jackson score was applied for assessment of the patients ’ outcomes.According to the score , the outcomes were classified into excellent , good, fair, and poor.In group A (emergency group), the outcomes were 13 (65.0%), 4 (20.0%), 3 (15.0%), and 0, respectively.In group B ( selective group), they were 11 (55.0%), 7 (35.0%), 2 (10.0%), and 0, respectively.The numbers of the patients from excellent to poor were 24 (55.0%), 11 (27.5%), 5 (12.5%), and 0, respectively. Conclusion: There is no significant difference in postoperative function between the two groups , however , early surgical intervention can benefit in accomplishing anatomical reduction much easier and shortening the time of hospitalization , which is cost-saving for the patients .

Objective To develop a quantitative assessment of the severity of femoral neck fractures with CT scan.Methods The preoperative X-ray and CT data were reviewed of 229 patients with femoral neck fracture who had been treated in our department from December 2008 to April 2012.Posterior fracture fragment,posterior angulation,longitudinal maximum displacement,location of fracture line,and difference in neck-shaft angle were measured in the 3-D reconstruction images of CT scans.The severity of the fracture was categorized as slight,(score ≤5,grade Ⅰ),moderate (score 6 to 8,grade Ⅱ) and severe (score ≥9,grade Ⅲ) according to the measurements of the above 5 indexes.A comminuted fracture was categorized into grade Ⅲ.Results Posterior comminutions were found in 35 cases (15.3％),but not in the other 194 ones (84.7 ％).No posterior angulation was observed in 27 cases (11.8％).Posterior angulation ≤30° was found in 44 cases (19.2％),that from 30° to 60° in 115 cases (50.2％),and that ≥60° in 43 cases (18.8％).Twenty patients(8.7％) had no displacement.Fracture displacement ≤ 10 mm was observed in 96 cases (41.9％),that from 10 to 20 mm in 96 cases (41.9％),and that ≥20mmin 17 cases (7.4％).The facture line was located below the head in 131 cases (57.2％),at the head-neck in 88 cases (38.4％),and across the neck in 9 cases (3.9％).The difference in neck-shaft angle was 0° in 12 cases (5.2％),≤ 10° in 105 cases (43.4％),10° to 20° in 84 cases (35.3％) and ≥20° in 28 cases (17.6％).In the 229 cases,our severity scores were related to Garden classification in the following manners:all Garden Ⅰ cases belonged to grade Ⅰ; Garden Ⅱcases contained grade Ⅰ in 15 cases (45.5％) and grade Ⅱ in 18 cases (54.5％);Garden Ⅲ cases included grade Ⅰ in 6 cases (3.1％),grade Ⅱ in 123 cases (64.7％) and Grade Ⅲ in 61 cases (32.2％); all Garden Ⅳ cases were Grade Ⅲ.Conclusion In assessment of the severity of femoral neck fractures,CT scans can be more accurate,objective and reliable,and can be quantified as well.

Objective To observe the clinical efficacy of alprostadil combined with valsartan in treatment of chronic glomerulonephritis proteinuria.Methods 78 patients with chronic glomerulonephritis proteinuria were randomly divided into two groups,and each group had 39 cases.The control group was given conventional treatment,while the observation group was given alprostadil combined with valsartan on the basis of the control group.The clinical outcomes were compared between the two groups.Results The total effective rate of the observation group was 92.31％,which was significantly higher than 74.36％ of the control group (x2 =9.825,P ＜ 0.05).After treatment,the 24h Upro,BUN and SCr of the observation group were (1.00 ± 0.39) g/24h,(7.11 ± 0.15) mmol/L and (80.86 ± 0.65) μmol/L,which were significantly lower than those of the control group [(1.30 ± 0.48) g/24h、(9.18 ± 2.21) mmol/L and (98.71 ± 4.34) μmol/L],the differences were statistically significant (t =9.32,7.83,7.12,all P ＜ 0.05).Conclusion Alprostadil combined with valsartan in the treatment of chronic glomerulonephritis proteinuria has significant effect,and it can significantly alleviate clinical symptoms,improve renal function,which should be widely applied in clinical.

SUMMARY Pregnancy-related pelvic ring disease brings great suffering to pregnant women, including the separation of the pubic symphysis and sacroiliac joint pain.Hormonal changes leading to ligamentous laxity is the main reason for pregnancy-related pelvic ring disease.In normal pregnant cases, and the physiologic widening at the symphysis is about 3-7 mm.When the widening of the symphysis is more than 10 mm, it may lead to symptoms and need active treatment.Currently the diagnosis of the pubic symphysis separation is based on the clinical symptoms and signs.The treatment of acute pubic symphysis separation bases on conservative therapy, includes bed rest and physical therapy.But when the widening of the symphysis is more than 4 cm, the surgery intervention may be a good treatment.If the conservative treatment is not obviously effective, the surgery consists of plate fixation in the pubic symphysis and sac-roiliac screw fixation.Other indications for the surgical intervention include inadequate reduction, recur-rent diastasis, intractable symptoms, and open rupture.

BACKGROUND: Studies have shown that umbilical cord mesenchymal stem cells are ideal seed cells for tissueengineering research.OBJECTIVE: To isolate, culture and identify tree shrew umbilical cord mesenchymal stem cells, in order toestablish a standardized tree shrew umbilical cord mesenchymal stem cell lines.METHODS: Caesarean-isolated tree shrew umbilical cord samples were used to isolate and culture umbilical cordmesenchymal stem cells using tissue explant adherent method. Flow cytometry assay was used to detect cellsurface markers. Osteogenic and adipogenic induction media were used to induce umbilical cord mesenchymalstem cells to differentiate into osteoblasts and adipocytes.RESULTS AND CONCLUSION: The cultured umbilical cord mesenchymal stem cells expressed CD90 and CD105 with the positive rate of 99.9% and 99.8% respectively. Hematopoietic stem cell marker CD34 expression ratewas 0.0% and the endothelial cell marker CD31 expression rate was 0.7%, in line with the characteristics of umbilicalcord mesenchymal stem cell surface markers. Calcium nodules by alizarin red staining and lipid droplets by oil red Ostaining were observed in the induced cells. These experimental findings indicated that umbilical cord mesenchymalstem cells from tree shrews capable of osteogenic and adipogenic differentiation were successfully isolated and cultured.

Objective:To analyze the chicken egg-white extracts were co-cultured with cells whether elevated stem cells protein,whether the cells transformation into stem cell.Methods:Four kinds of cells,making a common culture,a 50% chicken egg-white extract co-cultured for 3 days,cells were collected and frozen at -80 degrees,sending the company to do stem cell protein microarray.Results:C57-BMSC has three proteins occurred statistically significant change , TS-UC-MSC has one proteins occurred a statistically significant change ,293T has one protein occurred a statistically significant change ,and 293T-GFP has one protein occurred a statistically significant change.Conclusion:50% chicken egg-white extract co-cultured cells,the cells occurred the phenomenon of transformation into stem cells.

Objective To investigate the affecting factors on auditory and speech performances in preschool children with unilateral cochlear implantation (CI) .Methods The clinical data of the preschool children (n=165) with unilateral cochlear implantation in the Second Xiangya hospital from January 2006 to April 2013 were collected . These children received rehabilitation according to the method recommended by the China Rehabilitation Research Center for Deaf Children ,and the data were analyzed retrospectively .The categories of auditory performance (CAP) and speech intelligibility rating (SIR) were used to assess their auditory and speech performances .The relationships between the performance and gender ,implanted age ,genotype ,inner ear malformation ,history of hearing aid were evaluated .Results Implanted ages and genotypes were associated with the auditory and speech performance of par‐ticipants (P<0 .05) ,while genders ,hearing aid experience ,and inner ear malformations(enlarged vestibular aque‐duct syndrome ,EVAS)were not significant related (P<0 .05) .Children were found to have achieved better CAP and SIR growths when CI was implanted during 1~3 years old and 2~4 years old ,respectively (P<0 .05) .The outcomes of CI recipients with GJB2 mutation were significantly better than those of the GJB2-nonrelated CI recipi‐ents (P<0 .05) .Conclusion This study provides evidence that CIs during first 1~3 years old having better auditory rehabilitation results than those of during 4~6 years old ,and CIs during 2~4 years old obtaining a better speech development in the first 12 months after operation .Deaf children with GJB2 mutation show better auditory and speech performances after CIs than those of the peers without GJB2 mutation .CIs can be effectively performed in deaf children associated with EVAs as in those without EVAS .

Mercury is one of the common heavy-metal toxins,which can cause damage throughout the body in a variety of ways. Cases of renal toxicity of mercury poisoning are increasing clinically. However,little is known about nephrotoxicity mechanisms,and treatment remains unsatisfactory. The mechanism of mercury toxic nephropathy is reviewed in this paper,including the direct toxic effect on the kidney,the injury to the biomembrane system,generation of Hg-metallothionein,imbalance of intra?cellular calciumion,oxidative damage,induced apoptosis,and immune injury. Besides,the mechanism and limitation of common therapies,potential developments of the field are discussed. This review will facilitate further investigations therapies about both the mechanism and treatment of mercury toxic nephropathy.

Objective To establish a method of identification of DKO mouse model of Duchenne muscular dystro-phy, and to assess the dystrophin regeneration after stem cell transplantation.Methods Heterozygous mice were mated and the resulting offspring were used to identify their genotype by SSP-PCR.The plasma creatine kinase level was measured by biochemical analyzer and histological changes in the DKO mice were analyzed using HE staining.Human umbilical cord mesenchymal stem cells were prepared and injected into the DKO mice hindlimb muscle, and dystrophin expression was de-tected by immunofluorescence staining at 2 months after injection.Results Mating of heterozygous mice generated three kinds of genotype offsprings, and 21.2%of the offsprings were identified as DKO genotype (285 bp) .DKO mice showed dystrophic symptoms, their plasma creatine kinase level was as high as 16988.52 ±617.48 IU/L, and significant histologi-cal changes including diverse myocyte sizes, numerous centrally nucleated cells and connective tissue proliferation or in-flammatory cells infiltration.Human dystrophin expression was detected in the DKO mouse hindlimb muscle at two months after injection of human umbilical cord mesenchymal stem cells.Conclusion DKO mouse genotype can be identified by SSP-PCR, and DKO mouse is an ideal animal model for studies of stem cell therapy for Duchenne muscular dystrophy.

BACKGROUND:Systemic lupus erythematosus is an autoimmune disease characterized as an emergence of a variety of autoantibodies in serum and multi-system and multi-organ lesions. Currently, there is a lack of effective treatment options, and umbilical cord mesenchymal stem cel s are a promising therapy for systemic lupus erythematosus based on cel biological roles. OBJECTIVE:To observe the therapeutic efficacy of human umbilical cord mesenchymal stem cel transplantation in the treatment of systemic lupus erythematosus in mice. METHODS:Human umbilical cord mesenchymal stem cel s were isolated and cultured fol owed by labeling with DiR fluorescence. Experimental mice were divided into normal control group (C57BL mice), model control group (C57BL/lpr mice), low-, medium-and high-dose umbilical cord mesenchymal stem cel therapy groups (C57BL/lpr mice), with 10 mice in each group. Mice in the low-, medium-and high-dose groups were respectively injected 0.5×106, 1×106, 2×106 human umbilical cord mesenchymal stem cel s, once a week, for 3 consecutive weeks. At the end of treatment, blood samples were col ected to measure antinuclear antibody, anti-histone antibody, anti-double stranded DNA antibody changes;OPG and Foxp3 gene expression changes were detected by quantitative PCR method. RESULTS AND CONCLUSION:After treatment, the levels of anti-nuclear antibodies, anti-histone antibodies and anti-double stranded DNA antibodies in the peripheral blood of mice were al declined in the low-, medium-and high-dose groups, while the number of peripheral blood CD4+CD25+T cel s was significantly elevated. OPG and Foxp3 gene expression was also increased dramatical y in the low-, medium-and high-dose groups, which was similar to that in the normal control group and significantly different from that in the model control group (P<0.01). Experimental findings demonstrate that after transplantation of human umbilical cord mesenchymal stem cel s, al relevant indicators in C57BL/lpr mice recovered to the normal levels, and the high-dose treatment group had the most obvious effect.