OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Objective To imitate the pathological process of bronchiolitis obliterans(BO) post lung transplantation and in-vestigate the phenomenon of epithelial-mesenchymal transition ( EMT ) in small airway epithelial cells and its relation to BO . Methods We established the rat model of allogeneic orthotropic left lung transplantation with grafts from F 344 rats transplanted to Lewis rats by the Tri-cuff anastomosis.Then rats were daily injected intraperitoneally with cyclosporine (5 mg· kg-1 · d-1 ) for 10 days, intratracheally applied with lipopolysaccharide(0.5 mg/kg) at the 28th day and killed at the 90th day post-surger-y.We observed the histological structure of the lung grafts by HE and Masson staining , detected E-cadherin and Vimentin ex-pression in lung grafts and normal ones of F344 rats by immunohistochemistry, then analyzed the relation between small airway remodeling and the alterations in EMT markers expression .Enumeration data was analyzed with Fisher exact test and Spearman rank correlation was applied in correlation analysis .Results We found inflammatory cell infiltration , fibroplasia of bronchiole walls and significant lumen stenosis in lung graft mesenchyma.In lung grafts, the positive expression of E-cadherin was 5(total 13), which was significantly lower than that in normal lungs(7/8, P<0.05), and conversely the positive expression of Vim-entin was higher than normal ones(10/13 vs 2/8, P <0.05).The Spearman rank correlation analysis demonstrated that E-cadherin expression bear a negative correlation with Vimentin expression(r=-0.750, P<0.01).Conclusion Our study established a disease model imitating the pathological process of BO .And EMT was observed in small airway epithelial cells of the BO-exhibited lung grafts, indicating that EMT was involved in the process of BO airway remodeling .Thus it may reveal no-vel therapeutic targets for BO post lung transplantation by further investigation into the mechanism and pathological significance of EMT in small airway epithelial cells.

Objective To explore the prevalence and clinical significance of metabolic disorder of lipids, glucose and uric acid at different fibrosis stages of patients with chronic hepatitis B (CHB).Methods From January 2006 to December 2014, 1 812 CHB patients in Department of Infectious Diseases, Shunde Hospital of Southern Medical University were retrospectively enrolled and analyzed.All biochemistry indexes were obtained by automatic biochemical instrument.Polymerase chain reaction was used for detecting serum hepatitis B virus (HBV) DNA, and particles immune detection kit was used for detecting hepatitis B e antigen (HBeAg).In statistical analyses, chi-square test, nonparametric test and Logistic analysis were used.Results The metabolic disorder prevalence in 1 812 CHB patients was as follows, 455 cases (25.1%) with decreased high density lipoprotein, 435 cases (24.0%) with increased uric acid, 342 cases (18.9%) with increased total cholesterol, 254 cases (14.0%) with increased triglyceride, 171 cases (9.4%) with decreased apolipoprotein A, 165 cases (9.1%) with increased apolipoprotein B, 162 cases (8.9%) with increased low density lipoprotein and 117 cases (6.5%) increased fasting blood glucose.Patients who had mild liver fibrosis tended to have metabolic disorders of uric acid (26.4%), total cholesterol (22.8%) and high density lipoprotein cholesterol (20.5%).Patients who had moderate liver fibrosis tended to have metabolic disorders of high density lipoprotein (27.2%) and uric acid (20.9%).Patients who had severe liver fibrosis tended to have metabolic disorders of high density lipoprotein (33.6%) and uric acid (22.2%).Multivariate Logistic regression analysis showed that inflammation activty (OR=17.31, 95% CI: 13.410-22.336, P=0.001), age (OR=1.019, 95%CI:1.005-1.035, P=0.010), sex (OR=1.497, 95% CI: 1.061-2.111, P=0.022), apolipoprotein A (OR=0.50, 95% CI: 0.281-0.892, P=0.019) and HBV DNA (OR=0.904, 95% CI: 0.858-0.952, P=0.001) may be independent predictors of moderate and severe liver fibrosis.Conclusions CHB patients with mild liver fibrosis tend to have metabolic disorders of uric acid, total cholesterol and high density lipoprotein cholesterol;patients with moderate liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid;and patients with severe liver fibrosis tend to have metabolic disorders of high density lipoprotein and uric acid.

Objective AMI is a prevalent global health condition.This study assessed the effects of PLGF and VEGF in a rat model of post-AMI.Methods Wistar rats underwent LAD ligation and injection of VEGF,PLGF,VEGF + PLGF,antiVEGFR1,anti-VEGFR2,anti-VEGFR1 + anti-VEGFR2,IgG2α,or saline,into the infarct border zone.We also set up a pseudo-operation group.Two weeks later,heart function was detected by hemodynamic and geometry,then the hearts were dis sected and HE stained.We assessed vW factor and α-SMA by immunohistochemistry and cardiomyocyte apoptosis rate by TUNEL.Results Rats in the VEGF + PLGF group performed significantly well in cardiac function,had weaker LV remodeling and less cardiomyocyte apoptosis.There were no obvious changes in VEGF group.The use of VEGFR1/VEGFR2 antibody didnt deteriorate the rat's cardiac function.More new-born arteries were seen in PLGF and VEGF + PLGF rats,and change wasnt found in other groups.Lastly,the most angiogenesis,the least left ventricular remodeling and the best heart function were observed in VEGF + PLGF group.Conclusion Earlier intervention with PLGF or VEGF + PLGF can improve heart function in rats with AMI; VEGF alone didnt improve heart function.VEGFR1/VEGFR2 antibody didnt aggravate the rat's heart function.This indicates that left ventricular and coronary remodeling may involve other factors.

Objective To explore the expression of tankyrase (TNKS) and its relationship with WNT/β-catenin signal?ing pathway in lung acinar adenocarcinoma. Methods Seventy-two samples of single subtype alveolar like lung adenocarci?noma (lung adenocarcinoma group) and 67 specimens of normal lung tissue adjacent to carcinoma (adjacent to carcinoma group) were collected. Immunohistochemical method was used to detect expressions of TNKS, beta-catenin (β-catenin) and c-myc protein. The correlation of each protein expression in lung adenocarcinoma tissues was analyzed. The differential ex?pression of TNKS was detected by Western blot assay in two groups. Results Tankyrase protein was mainly expressed in cy?toplasm. The expression ofβ-catenin protein was mainly in cytoplasm and nuclear of lung adenocarcinoma. The expression ofβ-catenin was mainly in cytoplasm, and a small amount was in nuclear of the adjacent group. The c-myc protein was ex?pressed mainly in the nucleus. The positive expression rates of TNKS,β-catenin and c-myc protein were significantly high?er in lung adenocarcinoma group than those of adjacent to carcinoma group (P<0.05). The expression ofβ-catenin in cyto?plasm and nucleus was positively correlated with the expression of TNKS and c-myc (P<0.05). Western blot analysis showed that the relative expression level of TNKS was significantly higher in lung adenocarcinoma group than that of adja?cent to carcinoma group (0.497 ± 0.021 vs. 0.237 ± 0.015, t=13.00, P<0.01). Conclusion Abnormally high expression of TNKS in lung adenocarcinoma may promote the occurrence of lung cancer by regulating the WNT signaling pathways. Inhib?iting TNKS expression may become a new target to treat lung adenocarcinoma.

Objective:To analyze clinical, laboratory and imaging characteristics of different subtypes of linear morphea (LM) , and to propose an appropriate approach to the diagnosis and severity assessment of LM.Methods:Clinical data were collected from patients with clinically and/or pathologically confirmed LM in Department of Dermatology, West China Hospital, Sichuan University from January 2018 to December 2019, and retrospectively analyzed.Results:A total of 107 patients with LM were enrolled into this study, including 63 with LM of the limbs/trunk, 22 with morphea en coup de sabre, 11 with progressive hemifacial atrophy and 11 with eosinophilic fasciitis. Disease severity was evaluated by using the modified localized scleroderma skin severity index (mLoSSI) and localized scleroderma skin damage index (LoSDI) scores in 88 patients, with the mLoSSI scores ranging from 0 to 51 points, and the LoSDI scores ranging from 0 to 40 points. Routine blood examination of 10 patients with eosinophilic fasciitis showed increased eosinophil counts in 4 patients. Thirteen (14.8%) of 88 patients with LM were positive for antinuclear antibody, with titers of ≥ 1∶320. Magnetic resonance imaging (MRI) examination showed ipsilateral cerebral hemisphere atrophy and contralateral white matter hyperintensity on T2-weighted images in 2 out of 4 patients with progressive hemifacial atrophy, myofascial thickening in 26 out of 28 patients with LM of the limbs/trunk (92.9%) , subcutaneous septal and myofascial thickening in all 11 patients with eosinophilic fasciitis.Conclusions:The preliminary assessment of disease activity, severity and prognosis of LM can be made by mLoSSI and LoSDI. MRI examination is recommended for patients with clinical signs of involvement of subcutaneous structures.

Objective To explore the relationship between the polymorphism of excision repair cross-complementation group 1 (ERCC1) C8092A locus and the efficacy and prognosis of platinum-based chemotherapy for lung cancer (LC), and to provide a theoretical basis for precision treatment of LC. Methods From January 2014 to October 2017, 120 patients from two tertiary hospitals in Haikou City, and with pathologically confirmed lung cancer treated with platinum-based chemotherapy were selected as the research objects. After informed consent was obtained, peripheral blood samples were collected for DNA extraction, and the genotype of ERCC1 C8092A locus was detected by mass spectrometry. WHO's Response Evaluation Criteria in Solid Tumours (RECIST) was used to judge patients' chemotherapy efficacy and patients' survival status was obtained by telephone follow-up and other means. Results Among the 120 LC patients, the genotype frequencies of ERCC1 C8092A locus were 67 cases of CC wildtype (55.8%), 45 cases of CA heterozygous type (37.5%), and 8 cases of AA rare mutation type (6.7%), which conformed to Hardy-Weinberg equilibrium (χ2=0.140, P>0.05). The total effective rate of chemotherapy was 32.5%, with the highest effective rate in patients with the CA genotype (42.2%) at the ERCC1 C8092A locus and the lowest in patients with the CC genotype (25.4%). The overall one-year survival rate was 68.3% and the three-year survival rate was 35.8%. The patients with ERCC1 C8092A AA genotype had the lowest survival rate, with a one-year survival rate of 50.0% and three-year survival rate of only 25.0%. However, there were no statistical differences in the overall survival rate among the three genotypes of carriers of ERCC1 C8092A (χ2=0.328, P=0.849). Conclusions The polymorphism of ERCC1 C8092A locus is associated with the efficacy of platinum-based chemotherapy for LC, and patients with CA genotype have the highest efficacy. The one-year and three-year survival rates of patients with CC genotype are significantly higher than those of CA and AA genotypes.

We used retroviral-mediated gene transfer of the human interleukin (IL)-2 gene into murine neuroblastoma cells to investigate whether locally-secreted IL-2 is able to influence the generation of anti-tumor immune responses. Supernatant obtained from cultures of approximately 1 x 10(6) IL-2 gene-transduced, G-418 selected neuro-2a cells was assayed for human IL-2 production by ELISA kit. First, to estimate whether the local secretion of IL-2 from the genetically-modified tumor cells would affect their tumorigenicity in vivo, IL-2-secreting neuro-2a cells were s.c. injected into A/J mice and tumor growth was measured weekly. And to estimate whether IL-2 transfected neuroblastoma cells protect mice from tumor development after wild-type tumor cell challenge, IL-2-secreting neuro-2a cells were s.c. injected into A/J mice. Seven days after IL-2 gene-transfected neuroblastoma cell injection, unmodified neuro-2a cells were s.c. injected into the contralateral site of A/J mice and tumor growth was measured weekly. Finally, to estimate IL-2 effect on pre-established large tumor burdens, IL-2-secreting neuro-2a cells were s.c. injected into A/J mice with established tumor and its growth was measured weekly. The IL-2 gene-transduced neuro-2a clones secreted 120.25-177.3 IU of IL-2 per ml per 10(6) cells during 24 hr. None of the mice injected with IL-2-secreting neuro-2a cells developed tumors within 6 weeks, while all of the mice injected with wild-type neuro-2a cells developed tumors. Immunization of mice with IL-2 gene-transfected, irradiated neuro-2a cells protected these animals against a subsequent challenge with wild-type tumor cells. Finally, the size of large neuroblastomas decreased after IL-2-secreting neuro-2a cell injection into mice. Local secretion of IL-2 gene-transduced tumor cells abrogates their tumorigenicity and induces protective immunity and may inhibit the growth of neuroblastoma.
Animal ; Antibody Formation ; Gene Transfer Techniques* ; Human ; Immunization/methods ; Interleukin-2/therapeutic use ; Interleukin-2/genetics* ; Mice ; Neoplasm Transplantation ; Neuroblastoma/therapy ; Neuroblastoma/prevention & control ; Neuroblastoma/pathology ; Neuroblastoma/genetics* ; Retroviridae/genetics* ; Tumor Cells, Cultured

OBJECTIVETo explore the genetic etiology of fetal abnormalities detected by prenatal ultrasound through single nucleotide polymorphism (SNP array) analysis.

METHODSTwo hundred and eight fetuses were tested with SNP array and conventional karyotyping. Complex copy number variations (CNVs) were verified with fluorescence in situ hybridization (FISH), multiplex ligation-dependent probe amplification (MLPA) and quantitative fluorescence polymerase chain reaction (QF-PCR).

RESULTSFor the 208 cases, the diagnostic yields of conventional karyotping and SNP assay were 8.2%(17/208) and 13.9%(29/208), respectively. For fetuses with malformations of the cardiovascular system, central nervous system or multiple systems, pathogenic CNVs was detected in 4.6% (8/174), 2.3%(4/174), and 1.1% (2/174) of all fetuses, respectively. No pathogenic CNVs was detected among those with abnormalities of the renal system, digestive system, skeletal system, facial dysmorphism or respiratory system.

CONCLUSIONCNVs are significantly related with birth defects. Compared with conventional karyotyping, SNP array is a better platform for CNVs detection and can provide more clues for genetic counseling, recurrence risk assessment and prenatal diagnosis.

Adult ; Chromosome Aberrations ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; diagnostic imaging ; genetics ; Genome-Wide Association Study ; Humans ; Infant, Newborn ; Karyotyping ; Male ; Polymorphism, Single Nucleotide ; Pregnancy ; Pregnancy Complications ; diagnosis ; diagnostic imaging ; genetics ; Prenatal Diagnosis ; Ultrasonography ; Young Adult

The authors designed a new biplanar method of measuring femoral anteversion, which may be considered a modified Magilligan's method. In addition to true A-P view, a true lateral view is taken, instead of trans-cervical lateral view in the Magilligan's technique. Acute angles(α and r) between the long axis of the femoral shaft and the femoral neck on both the A-P and lateral films are measured. The true angle (r1) of anteversion is calculated by substituting the values of tan(90-α) and tan (90-r) for the trigonometric formula tan r1 = tan(90-α)/tan(90-r). The measurement by the Magilligan's and the author's methods and the conventional CT method were compared with direct measurement for their accuracy in 20 sdult dried femora. Also correlativity among these three methods were analyzed clinically in 40 femora of 20 children. Following results were obtained, 1. Compared with the direct measurement, the Magilligan's, suthor's methods and CT method deviated an average of + 6.050 degrees, + 3.600 degrees and −1.150 degrees, respectively, all three being statistically accurate(p>0.05). The values for the latter two were closer to that of direct measurement. However, there was no statistical difference between the two. 2. The Magilligan's method overestimated in 95% and underestimated in 5% of the cases, and there was over-or under- estimation of less than 5 degrees in 20% and less than 10 degrees in 95%. The author's method overestimated in 70% and underestimated in 0% of the cases, and there was over-or under-estimation of less than 5 degrees in 55% and less than 10 degrees in 100%. The CT method overestimsted in 30% and underestimated in 60% of the cases, and there was over-or under-estimation of less than 5 degrees in 95 and less than 10 degrees in 100%. Both Magilligan's and autor's methods tended to overestimate and the CT method tended to underestimate(p<0.05). 3. The correlation coefficients among the Magilligan's and author's methods, the Magilligan's and CT methods, and author's and CT methods were 0.830, 0.592, 0.478 respectively, in clinical aspects. It is concluded that author's new method of biplanar measurement of femoral anteversion is more accurate than the Magilligan's method, while it is not less accurate than the conventional CT method.
Child ; Femur Neck ; Humans ; Methods ; Triacetoneamine-N-Oxyl