OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

OBJECTIVEStudy the effects of β-glucan in highland barley on blood glucose and serum lipid in high fat diet induced C57 mouse.

METHODSUsing table of random number, 40 male C57BL/6 mice were randomly divided into 4 groups (10 mice in each group) by weight: high dosage group (4% β-glucan and high fat diet), low dosage group (2% β-glucan and high fat diet), high fat diet group and normal control group. Food-intake and body weight of C57 mouse were observed. Glucose tolerance tests and examinations of fasting blood glucose were performed at the end of 11 weeks of intervention. Mice were sacrificed after 12 wk of treatment, and serum specimens were obtained to test relevant biochemical indicators.

RESULTSAfter 12 weeks raise, among high dosage group, low dosage group, high fat diet group and normal control group, the weight was (32.8 ± 1.5), (40.4 ± 1.9), (40.7 ± 2.1) and (33.5 ± 1.3) g, respectively (F = 55.26, P < 0.05); average food intake was (3.48 ± 0.56), (3.69 ± 0.76), (3.66 ± 0.81) and (3.54 ± 0.61) g/d respectively (F = 0.26, P > 0.05); fasting blood-glucose was (5.29 ± 1.59), (6.13 ± 1.75), (7.63 ± 1.09) and (4.24 ± 0.98) mmol/L respectively (F = 9.54, P < 0.01); serum insulin level was (1.97 ± 0.10), (2.44 ± 0.24), (3.02 ± 0.36) and (1.48 ± 0.28) ng/ml respectively (F = 47.58, P < 0.01); the area under blood glucose concentration curve was (25.81 ± 1.44), (30.42 ± 2.01), (35.17 ± 1.20) and (21.03 ± 1.24) mmol×L(-1)×h(-1), respectively (F = 64.98, P < 0.05); insulin resistance index was (9.84 ± 3.78), (13.69 ± 4.48), (21.54 ± 3.27) and (5.81 ± 1.59) respectively (F = 30.18, P < 0.01); serum total cholesterol (TC) level was (4.05 ± 0.88), (4.30 ± 0.48), (4.73 ± 0.66) and (3.37 ± 0.40) mmol/L respectively (F = 6.70, P < 0.01); serum triglyceride (TG) level was (0.90 ± 0.09), (0.98 ± 0.09), (1.05 ± 0.06) and (0.76 ± 0.26) mmol/L respectively (F = 6.75, P < 0.01); serum high-density lipoprotein cholesterol (HDL-C) level was (2.91 ± 0.59), (3.34 ± 0.46), (4.89 ± 0.42) and (3.24 ± 0.37) mmol/L respectively (F = 31.73, P < 0.01); serum low-density lipoprotein cholesterol (LDL-C) level was (0.25 ± 0.15), (0.42 ± 0.19), (0.72 ± 0.12) and (0.32 ± 0.11) mmol/L, respectively (F = 17.27, P < 0.01); free fatty acids (FFA) level was (1.06 ± 0.03), (1.05 ± 0.05), (1.18 ± 0.32) and (1.04 ± 0.02) mmol/L, respectively (F = 1.36, P > 0.05); HDL-C/LDL-C was (13.77 ± 5.51), (9.11 ± 3.53), (7.04 ± 1.65) and (11.21 ± 3.31), respectively (F = 5.24, P < 0.01).

CONCLUSIONThe β-glucan in highland barley reduced the serum glucose and serum lipid, as well as insulin resistance and the risk of arterial sclerosis in high-fat induced C57 mouse.

Animals ; Blood Glucose ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Diet, High-Fat ; adverse effects ; Glucose Tolerance Test ; Hordeum ; Lipids ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Triglycerides ; blood ; beta-Glucans ; pharmacology

Eupafolin, a constituent of the aerial parts of Phyla nodiflora, has neuroprotective property. Because reducing the synaptic release of glutamate is crucial to achieving pharmacotherapeutic effects of neuroprotectants, we investigated the effect of eupafolin on glutamate release in rat cerebrocortical synaptosomes and explored the possible mechanism. We discovered that eupafolin depressed 4-aminopyridine (4-AP)-induced glutamate release, and this phenomenon was prevented in the absence of extracellular calcium. Eupafolin inhibition of glutamate release from synaptic vesicles was confirmed through measurement of the release of the fluorescent dye FM 1-43. Eupafolin decreased 4-AP-induced [Ca2+ ] i elevation and had no effect on synaptosomal membrane potential. The inhibition of P/Q-type Ca2+ channels reduced the decrease in glutamate release that was caused by eupafolin, and docking data revealed that eupafolin interacted with P/Q-type Ca2+ channels. Additionally, the inhibition of calcium/calmodulindependent protein kinase II (CaMKII) prevented the effect of eupafolin on evoked glutamate release. Eupafolin also reduced the 4-AP-induced activation of CaMK II and the subsequent phosphorylation of synapsin I, which is the main presynaptic target of CaMKII. Therefore, eupafolin suppresses P/Q-type Ca2+ channels and thereby inhibits CaMKII/synapsin I pathways and the release of glutamate from rat cerebrocortical synaptosomes.

Omega-3 polyunsaturated fatty acids (or omega-3 PUFAs, n-3 PUFAs) are essential nutrients throughout the life span.Recent studies have shown the importance of n-3 PUFAs supplementation during prenatal and perinatal period as a potential protective factor of neurodevelopmental disorders. N-3 PUFAs have been reported to be lower in youth with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD).N-3 PUFAs supplementation has shown potential effects in the improvement of clinical symptoms in youth with ADHD, ASD, and MDD, especially those with high inflammation or a low baseline n-3 index. Moreover, it has been suggested that n-3 PUFAs had positive effects on lethargy and hyperactivity symptoms in ASD. For clinical application, the following dosage and duration are recommended in youth according to available randomized controlled trials and systemic literature review: (1) ADHD: a combination of eicosapentaenoic acid (EPA) ＋ docosahexaenoic acid (DHA) ≥ 750 mg/d, and a higher dose of EPA (1,200 mg/d) for those with inflammation or allergic diseases for duration of 16−24 weeks;(2) MDD: a combination of a EPA ＋ DHA of 1,000−2,000 mg/d, with EPA:DHA ratio of 2 to 1, for 12−16 weeks;(3) ASD: a combination of EPA ＋ DHA of 1,300−1,500 mg/d for 16−24 weeks as add-on therapy to target lethargy and hyperactivity symptoms. The current review also suggested that n-3 index and inflammation may be potential treatment response markers for youth, especially in ADHD and MDD, receiving n-3 PUFA.

Aplastic anemia (AA) is a bone marrow failure disease caused by abnormal activation of T lymphocytes, resulting in the apoptosis of hematopoietic cells and bone marrow failure. Currently, hematopoietic stem cell transplantation (HSCT), immunosuppressive - therapy (IST), and supportive care (e.g. transfusion adjuvant therapy, hematopoietic growth factors, and prevention of infection) are the main treatments of AA. Granulocyte transfusion has recently been accepted as an useful adjuvant therapy of HSCT and intensive IST. This article reported a severe AA patient who failed to respond to IST, but achieved spontaneous remission three times after granulocyte transfusions from related donors. Such cases have rarely been reported. Existence of human leukocyte antigen (HLA) cross between the patient and his relatives may influence the T cell-mediated immunity, which might explain this patient's recovery.
Adult ; Anemia, Aplastic ; immunology ; physiopathology ; therapy ; Granulocytes ; transplantation ; Humans ; Leukocyte Transfusion ; Male ; Remission, Spontaneous

OBJECTIVETo evaluate the prevalence of TET2 gene mutation in acute myeloid leukemia (AML) patients, and analyze their clinical characteristics and prognosis.

METHODSPolymerase chain reaction (PCR) and direct sequencing were used to sequence exon 3 to 11 of TET2 gene.

RESULTSAmong 96 AML patients, TET2 gene mutation was detected in 13 (13.54%) patients (95%CI 6.70% - 20.38%). The median age was 54 years in mutated group and 41 years in unmutated group (P = 0.010). Mutated and unmutated patients did not significantly differ in gender, white blood cells (WBC) count at diagnosis, platelet count, PB and BM blast percentage and chromosome karyotype, excepting for hemoglobin level 84 (70 - 108) g/L in mutated group versus 70 (55 - 87) g/L in unmutated group (P = 0.032). TET2 gene mutation had no significant correlation with C-KIT, FLT3, JAK2V617F mutations, but did with NPM1 mutation. TET2 mutated patients had lower CR1 rate and 2-year overall survival than unmutated in non-M(3) patients (P < 0.05).

CONCLUSIONSTET2 gene mutation is more prevalent in older AML patients and has a certain correlation with clinical characteristics and outcome. It may be a molecular marker for poor prognosis in AML.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; DNA Mutational Analysis ; DNA-Binding Proteins ; genetics ; Exons ; Female ; Humans ; Karyotype ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Proto-Oncogene Proteins ; genetics ; Young Adult

OBJECTIVE: To establish a database of high-fall death cases for future forensic study and practice, based on the scene investigation, injury characteristics and other informations. METHODS: Five hundred and four cases of high-fall death from 5 provinces and cities were included in the study. Data including personal information of the deceased, scene investigation, autopsy findings, history of mental illness and the results of toxicology were collected and analyzed. RESULTS: The male accidental death rate was significantly higher than that of female. No case of suicide was found in the 0-10 age group, while the suicide rate was apparently higher in the 60 years or over age group than that of accident. Most of the accident cases occurred at workplace, with head landing first and foot or lower-extremity landing first observed from height below 10 m and between 10-25 m, respectively. CONCLUSION The majority of cases have obvious conclusions. A substantial set of the cases, however, is still difficult to determine the mechanism of injury and the manner of death. So further study should be performed.
Accidental Falls ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; Female ; Forensic Pathology ; Homicide/statistics & numerical data* ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sex Distribution ; Suicide/statistics & numerical data* ; Wounds and Injuries/pathology* ; Young Adult

OBJECTIVE: FTIR (Fourier transform infrared) spectroscopy was applied to observe the process of postmortem degradation in rats' cardiac muscle and provided a new method for the estimation of post-mortem interval (PMI). METHODS: The rats were sacrificed by cervical dislocation and the bodies were kept in a controlled environmental chamber set at (20 +/- 2) degrees C. The FTIR spectra was applied to measure the changes of different chemical group from rats' left ventricle muscle at the different time point postmortem. RESULTS: There were not obvious changes for the main FTIR absorbance peaks. But the different FTIR absorbance at the wave-number (cm(-1)) indicated the three types: increase, decrease, stable. The various absorbance ratios also demonstrated the similar changes. CONCLUSION FTIR spectroscopy may be potentially used as an effective method for estimating PMI in forensic practice using cardiac muscle tissue.
Animals ; Autopsy ; Fatty Acids/metabolism* ; Forensic Pathology ; Male ; Models, Animal ; Myocardium/metabolism* ; Nucleic Acids/metabolism* ; Postmortem Changes ; Rats ; Rats, Sprague-Dawley ; Spectroscopy, Fourier Transform Infrared/methods* ; Time Factors

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR12) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. Thesafety profiles were reported. Results: The SVR12 rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5–94.2%), 94.1% (95% CI, 87.8–97.3%), and 100% (95% CI, 96.2–100%). Number of patients who failed to achieve SVR12 were attributed to virologic failures. The SVR12 rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR12, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16–14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 m2/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 m2/month; P<0.001). Conclusions SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis.