OBJECTIVETo explore the surgical method and its clinical effects of minimally invasive osteosynthesis on the treatment of complex ankle fractures.

METHODSFrom January 2007 to December 2011, 53 patients with complex ankle fractures were treated with minimally invasive osteosynthesis. There were 31 males and 22 females, with an average age of 38.2 years old (ranged, 18 to 65). According to the system of Lauge-Hansen, 32 fractures were supination external rotation injury (grade WV), 13 fractures were pronation external rotation (grade III or IV), 5 fractures were pronation abduction (grade III); and 3 fractures can not be classified due to serious comminution fracture of fibula. According to the system of Denis-Weber, there were 4 cases with type A, 34 cases with type B and 15 cases with type C. Seven cases were open fractures. The duration from injuries to operation ranged from 2 hours to 14 days with an average of 5 days. The sequence of reduction and fixation of ankle fractures was firstly posterior malleolus, then medial malleolus and lateral malleolus, and inferior tibiofibular syndesmosis lastly. The fractures of posterior malleolus were reduced and fixed through anterior ankle approaches; the fractures of medial and lateral malleolus were percutaneously fixed with bolts or blade plate or tensile force band; and inferior tibiofibular syndesmosis were firmly fixed if necessary. Baird-Jackson scoring system was used to evaluate clinical effects.

RESULTSForty-eight patients were followed up from 10 to 36 months with an average of 13 months. The fractures got healing with an average time of 12 weeks (ranged, 10 to 18). According to the Baird-Jackson scoring system, the mean score of ankle function was 94.7 +/- 4.2, and 28 cases obtained excellent results, 15 good, 3 fair and 2 poor. One case experienced superficial infections and was cured by changing dressings, 2 cases experienced fixed syndesmosis screw breakage.

CONCLUSIONThe surgical method of minimally invasive osteosynthesis can ensure the anatomical join restoration, protect the blood supply of fracture end, rebuild the function of ankle joint, obtain satisfactory clinical results in treating complex ankle fractures.

Adolescent ; Adult ; Aged ; Ankle Fractures ; Ankle Joint ; physiopathology ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods

Objective To study correlation between MRI signal intensity of the lumbar intervertebral disc and collagen content in the nucleus pulposus.Methods Thirty-one cases with lumbar intervertebral disc herniation(male 21,female 10)received percutaneous lumbar disketetomy.Thirty-one specimens of nucleous pulposus were obtained from percutaneous lumbar disketctomy procedure and collagen content in them was measured with reformed hydroxyproline measurement method.The signal intensity(SI) of lumbar intervertebral disc and cerebrospinal fluid was measured in T_2 WI sagittal image and then ratio of disc SI to cerebrospinal fluid SI was calculated.The Pearson analysis was used to analyze the correlation between the collagen content and SI ratio and disc SI on T_2 WI.Results Collagen content and SI ratio were (231.0?63.5)mg/g and 0.19?0.07,respectively.There was negative correlation between them (r=-0.61,P

Objective To assess the proficiency of water monitoring laboratory at rural, county, and provincial levels in Guangdong province, to ensure the province's drinking water monitoring results accurate and reliable. Methods State quality of certified reference materials as water arsenic, fluoride and chloride of 90 copies each were numbered and distributed to 90 monitoring laboratories in the province for testing, The measurement results of the participatory labs were evaluated through normative values and expanded uncertainty, and were compared with those of robust statistics method. Results All participatory labs had timely feedback of their measurement results. The qualified rate was higher when arsenic was tested by hydride generation atomic fluorescence spectrometry and zinc-new silver salt of sulfuric acid spectrophotometric system, while fluoride and chloride by ion chromatography. The average qualified rates of water arsenic, fluoride and chloride of the province's rural drinking water quality monitoring laboratory were 66% (59/90), 72% (65/90) and 72% (65/90), respectively.Seven participatory labs failed the proficiency testing of all three analytes and unqualified rate was 7.8% (7/90)among the ninety participated monitoring labs. The qualified rates of robust statistics method for arsenic fluoride and chloride were greater than those evaluated by the expanded uncertainty, and large deviations with small sample sizes. Conclusions The testing ability of drink-water monitoring labs in Guangdong province has improved.However, by comparison with the requirements of national quality control and testing skills, there is still a gap. It is suggested that internal quality control be included in routine inspeetion to improve laboratory testing technology.

Objective To analysis the characteristics of medical cost of case classification in a basic level hospital to provide the basis for the appli-cation of case classification in basic level hospitals.Methods Taking some first-class public hospital as an example , analysis the first page data on medical records in new version to summarize the structural characteristics of the case classification;compare the medical cost between patients with and without medical insurance;and to calculate the reference ranges of medical standard cost of main cause diseases.Results The AB rate of this hospital was as high as 96.9%; the cost of patients with medical insurance was higher than the others’ in every mode of classification;the reference ranges of standard cost could be used to develop medical insurance reimbursement standard or medical quality cost management.Conclusion Basic level hos-pitals are based on simple cases and have a possibility that medical insur-ance funds were inefficiently used and wasted.It is suitable for the imple-mentation of simple and feasible case classification technology.

To investigate the cellular mechanisms of pressure-overload cardiac hypertrophy transition to heart failure, we observed time course of changes in morphology and contractile function of cardiomyocytes in transverse abdominal aortic constriction (TAC) rats. Since TAC rats suffered higher stress, body weight had a slower growth rate compared with that of synchronous control rats. Therefore, the left ventricular to body weight ratio produced experimental bias to evaluate the degree of cardiac hypertrophy. Length and width of collagenase-isolated cardiomyocyte were directly measured. Length, width and calculated surface area of cardiomyocyte showed a progressive increase in 8-, 16-, and 20-week TAC rats. The increasing rate of surface area in cardiomyocytes was higher at the middle stage of TAC (from the eighth to sixteenth week). Due to the constraint of fibrosis formation, the increasing rate of surface area in cardiomyocytes was slower at the late stage of TAC (from the sixteenth to twentieth week). The sarcomere length of cardiomyocytes was unchanged, whereas sarcomere numbers were significantly increased in 8-, 16-, and 20-week TAC rats. Shortening amplitude of unloaded contraction in single cardiomyocyte was significantly enhanced in 1-week TAC rats, but not altered in 8-week TAC rats compared with that in the synchronous control rats. On the contrary, unloaded shortening amplitude of single cardiomyocyte was significantly reduced in 16- and 20-week TAC rats. The above results suggest that the reduced shortening amplitude may be associated with intrinsic molecular alterations in hypertrophied cardiomyocytes.
Animals ; Aorta, Abdominal ; Cardiomegaly ; etiology ; physiopathology ; Cell Enlargement ; Constriction ; Hypertension ; complications ; pathology ; physiopathology ; Male ; Myocardial Contraction ; physiology ; Myocytes, Cardiac ; pathology ; physiology ; Rats ; Rats, Sprague-Dawley

A sensitive high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS) method was established for the determination of eplerenone (EP) in human plasma. The plasma samples of EP were extracted with ethyl acetate and separated by HPLC on a reversed phase C18 column with a mobile phase of 10 mmol x L(-1) ammonium acetate water solution-methanol (30 : 70, v/v). EP was determined with electrospray ionization-mass spectrometry (ESI-MS) in the selected ion monitoring (SIM) mode. The calibration curves were linear over the range of 2-4 000 ng x mL(-1) for EP. The lower limit of quantification was 2 ng x mL(-1). The method has been successfully applied in the pharmacokinetic study of the EP tablets. The main pharmacokinetic parameters of EP after oral administration of 25 mg, 50 mg, 100 mg were as follows, t1/2: (4.9 +/- 2.1), (4.7 +/- 1.5), (5.9 +/- 1.2) h; AUC(0-infinity): (4 402 +/- 1 735), (8 150 +/- 2 509), (13 783 +/- 4 102) microg x h x L(-1); and MRT: (6.2 +/- 2.1), (6.6 +/- 1.3), and (7.2 +/- 1.6) h. Parameters of EP after oral administration of multiple doses of 50 mg were as follows, t1/2: (6.1 +/- 1.7) h; AUC(ss): (10 071 +/- 4220) microg x h x L(-1); MRT: (8.1 +/- 2.3) h; and DF: (3.2 +/- 1.0).
Chromatography, High Pressure Liquid ; methods ; Humans ; Spectrometry, Mass, Electrospray Ionization ; methods ; Spironolactone ; analogs & derivatives ; blood ; pharmacokinetics

OBJECTIVETo screen the proteins interacting with FXR1P for functional investigation of FXR1P.

METHODSThe yeast strain AH109 transformed with the recombinant expression vector pGBKT7/FXR1 was mated with the yeast strain Y187 pretransformed with human fetal brain cDNA library. The positive clones were screened and identified by sequence analysis.

RESULTSThe recombinant expression vector pGBKT7/FXR1 was constructed successfully. Five proteins binding to FXR1P were screened from human fetal brain cDNA library using the yeast two-hybrid system, including CMAS, FTH1, GOLGA4, HSD17B1 and CSH1.

CONCLUSIONSThese results provide new clues for investigating the biological functions of FXR1P and the pathogenesis of Fragile X syndrome.

Autoantigens ; genetics ; metabolism ; Estradiol Dehydrogenases ; genetics ; metabolism ; Ferritins ; genetics ; metabolism ; Gene Library ; Humans ; Membrane Proteins ; genetics ; metabolism ; Protein Binding ; Protein Interaction Domains and Motifs ; genetics ; RNA-Binding Proteins ; genetics ; metabolism ; Two-Hybrid System Techniques

OBJECTIVETo explore the relationship between the polymorphism of TNF-α gene 308, 238 locus and the susceptibility to pneumoconiosis.

METHODSEighteen published case-control studies about TNF-α gene 308, 238 locus polymorphism and pneumoconiosis susceptibility were searched out from sino-foreign databases from January 1994 to December 2010. Meta-analysis was applied on the published research to calculate the pooled OR value (95%CI) and stratified analyze the types and species of pneumoconiosis.

RESULTSEleven of the published research articles were selected into the analysis, including 10 research focusing on TNF-α gene 308 locus, with 1408 cases and 1639 controls in total. The meta-analysis showed that comparing with Gln/Gln carriers, Arg/Arg, Arg/Gln, Gln/Arg + Arg/Arg carriers were 1.89-fold (95%CI: 1.10 - 3.24), 1.53-fold (95%CI: 1.25 - 1.87), and 1.56-fold (95%CI: 1.28 - 1.90) more susceptible to pneumoconiosis, respectively. The stratified analysis showed that among coal workers, the TNF-α gene 308 locus Arg/Arg, Arg/Gln, Gln/Arg + Arg/Arg carriers were separately 2.29-fold (95%CI: 1.22 - 4.29), 1.56-fold (95%CI: 1.20 - 2.03), 1.64-fold (95%CI: 1.28 - 2.11) more susceptible to pneumoconiosis than Gln/Gln carriers; and among Asian people, the TNF-α gene 308 locus Gln/Arg, Gln/Arg + Arg/Arg carriers were separately 1.58-fold (95%CI: 1.28 - 1.95) and 1.57-fold (95%CI: 1.28 - 1.94) more susceptible to pneumoconiosis than the Gln/Gln carriers. Four case-control research focus on the study of TNF-α gene 238 locus, including 391 cases and 391 controls in total. The analysis showed that comparing with the non-carriers, TNF-α gene 238 locus Arg/Arg, Arg/Gln, Gln/Arg + Arg/Arg carriers were 6.03-fold (95%CI: 1.35 - 26.97), 1.87-fold (95%CI: 1.07 - 3.30) and 2.36-fold (95%CI: 1.37 - 4.07) more susceptible to pneumoconiosis.

CONCLUSIONTNF-α gene 308, 238 locus Arg/Arg, Gln/Arg, Gln/Arg + Arg/Arg carriers are more susceptible to pneumoconiosis.

Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Pneumoconiosis ; genetics ; Polymorphism, Genetic ; Tumor Necrosis Factor-alpha ; genetics

OBJECTIVETo analyze the kinetics of hematopoietic cell chimerism in the early period after non-myeloablative stem cell transplantation (NAST) and to investigate the correlation between molecular and hematologic assessment of engraftment or rejection.

METHODShort tandem repeat-polymerase chain reaction (STR-PCR) analysis of chimerism status was carried out in 6 patients who received NAST from HLA-matched sibling donors.

RESULTSIn 5/6 patients, the peripheral blood samples collected on the first day after allograft infusion displayed the presence of mixed chimerism. STR-PCR analysis revealed a gradual increase of the donor-specific allelic signal which became dominant over the recipient-specific allele by day +7. On day +14, hematologic chimerisms were completely donor origin. Their molecular engraftments (ME) were detected at a median time of 6 days, preceding hematologic engraftment by a median of 5 days (P > 0.05). But the sixth patient showed more than 50% host residual cells on day +7 and had no signs of ME on day +14.

CONCLUSIONIt suggested that molecular monitoring of the early dynamics of chimerism after NAST could be useful in predicting engraftment, or rejection. If the engraftment was less than 50% on day +7 and failed to get ME on day +14, the graft rejection would occur.

Adult ; Graft Rejection ; Graft vs Host Disease ; diagnosis ; etiology ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Kinetics ; Middle Aged ; Polymerase Chain Reaction ; Tandem Repeat Sequences ; Transplantation Chimera ; Transplantation, Homologous

Background and Objectives: Voice therapy (VT) is considered to be the gold standard of treatment of vocal fold nodule in children. This study was designed to analyze the success rate of pediatric VT and investigate the predictive factors for good response of periatic VT for vocal fold nodule.Materials and Method This was a retrospective cohort study of 23 patients under 18 years old who were diagnosed with vocal fold nodule and received pediatric VT. We divided the patients into responding and non-responding groups. We analyzed clinical and voice parameters related to the voice results. Results: Twelve patients showed improved findings after VT. By univariate analysis, female patients (85.7%) and adolescence children (100%) showed a good response to VT. In multivariate analysis, female sex (p<0.05) and adolescence children (p<0.05) were significantly related to a successful voice response. Proton pump inhibitor or antihistamine, mucolytics treatment and pre-VT voice parameters did not significantly influence voice outcomes. Conclusion Pediatric VT is more effective in female and adolescence children.