Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.

The purpose of this study was to investigate the mechanism of effects of interferon-alpha (IFN-alpha) on chronic myeloid leukemia (CML). Bone marrow mononuclear cells (BMMNC) were obtained from heparinized blood of CML patients by Ficoll-Paque density gradient centrifugation. The expressions of CD1a, CD83, CD86, HLA-ABC, HLA-DR and CD54 on DC induced by IFN-alpha + GM-CSF, IFN-alpha + GM-CSF+IL-4 and IL-4 + GM-CSF for 7 days in vitro were assayed by flow cytometry. The morphologic features were observed by transmission and optical microscopy. The mixed lymphocyte reactions (MLR) with DC were evaluated by MTT assay. The results showed that the DC cultured in different cytokine combinations expressed significantly higher levels of CD1a, HLA-ABC, HLA-DR, CD86, CD54, and CD83 than those in the precultured. The DC growing with IFN-alpha + GM-CSF expressed significantly higher levels of HLA-ABC, HLA-DR than those in GM-CSF + IL-4. The CD86 expression and MLR levels in IFN-alpha + GM-CSF + IL-4 increased significantly. The expression rate of DC antigens and MLR in the IFN resistant group significantly lower than those in the newly diagnosed and the effectively treated groups after at least 6 months of IFN-alpha treatment (P < 0.05). The DC from the IFN resistant group did not express significantly CD86 and MLR in IFN-alpha + GM-CSF + IL-4 groups compared to those in the newly diagnosed and IFN effective treated groups. It is concluded that the BMMNC from CML cultured in combination with IFN-alpha and other cytokines can be induced into DC with typical morphologic and immunophenotypic characteristics. Addition of IFN-alpha + GM-CSF + IL-4 to DC cultures can significantly up-regulate the expression of major histocompatibility complex molecules, co-stimulatory molecules and various adhesion molecules. The deficiency of DC differentiation and function may play a role in the development of clinical resistance to IFN-alpha.
Bone Marrow Cells ; immunology ; pathology ; Cell Differentiation ; drug effects ; Cells, Cultured ; Cytokines ; pharmacology ; Dendritic Cells ; immunology ; pathology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Interferon-alpha ; pharmacology ; Interleukin-4 ; pharmacology ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; immunology ; pathology ; Leukocytes, Mononuclear ; pathology

This study examined the prevalence of primary open-angle glaucoma (POAG) among residents aged ≥50 years living in Yongchuan district of Chongqing. Stratified cluster sampling was employed in random selection to estimate the prevalence of glaucoma from April to June, 2005. Twenty-nine villages or neighborhood communities were randomly selected in urban area (Zhongshan Road), suburban area (Shanjiao Town) and exurban area (Zhutuo Town) of this district. All the respondents underwent detailed ophthalmic examinations. The examinations included questionnaire investigation, visual acuity test, naked-eye examination, measurement of peripheral anterior chamber depth (Van Herrick's technique), detection of intraocluar pressure (IOP) with a Perkins hand-held applanation tonometer (HA-2) and examination of the optic disc by using a 78 diopters (D) lens (including the cup-disc ratio, cup/disc ratio asymmetries, horizontal and vertical diameter, notching and optic disc hemorrhages). A total of 5938 residents were actually examined, and the response rate was 85.19%. The crude prevalence of POAG was 0.86% (n=51/5938, 95% CI 0.64%-1.11%). There were 24 males and 27 females in the glaucoma group. The glaucoma prevalence was not significant different in case number between the male and female subjects (P=0.4900). Furthermore, no association between age or schooling and POAG was noted (P=0.8030, 0.0734). Out of 51 subjects with POAG, unilateral glaucoma-related blindness occurred in 38 subjects (74.5%) and bilateral glaucoma-related blindness was found in 7 subjects (13.7%). This study exhibited that the prevalence of POAG was 0.86% among residents aged ≥50 years living in Yongchuan District of Chongqing. The vision loss caused by POAG in this population was obviously higher than that previously reported in other studies. Glaucoma management, detection of affected persons and handling of the burden of glaucoma should be the priorities of the agenda of local health authorities of Western China.
Aged ; Blindness ; diagnosis ; epidemiology ; China ; epidemiology ; Female ; Glaucoma, Open-Angle ; diagnosis ; epidemiology ; physiopathology ; Gonioscopy ; methods ; Health Surveys ; methods ; statistics & numerical data ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Prevalence ; Surveys and Questionnaires ; Vision Disorders ; diagnosis ; epidemiology

OBJECTIVETo evaluate the efficacy of hepatitis B vaccination on hepatitis B prevention and on hepatocellular carcinoma.

METHODSBirth cohort study, cross-sectional seroepidemiological survey, and surveillance of hepatitis B (HBV) and hepatocellular carcinoma were used to evaluate the efficacy of hepatitis B vaccination.

RESULTSDuring the 14 years after hepatitis B vaccination, the HBsAg positive rates were found to be 0.7% - 2.9%, with an average of 1.5%, and the protective rates were 83.5% - 96.6%. Hepatitis B virus infection rates of children immunized with hepatitis B vaccine were 1.1% - 5.1%, with an average of 2.2% and the protective rates of 93.5% - 98.4%. 15 years after hepatitis B vaccination, the incidence of hepatitis B dropped from 3.27/10 000 to 0.17/10 000, a 94.8% decrease, in the group of 0 - 19 year-olds.

CONCLUSIONThe universal infant hepatitis B vaccination has proved to be effective in reducing the incidence rate of acute hepatitis B as well as the mortality of hepatocellular carcinoma.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; epidemiology ; prevention & control ; virology ; Child ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Hepatitis B ; epidemiology ; prevention & control ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization Schedule ; Infant ; Liver Neoplasms ; epidemiology ; prevention & control ; virology ; Middle Aged ; Prevalence ; Vaccination ; Vaccines, Synthetic ; immunology

BACKGROUNDAhmed glaucoma valves (AGV) has been used for decades, but there is no detailed report about the efficacy of AGV in Chinese glaucoma patients. This study aimed to compare the intraocular pressure (IOP) lowering efficacy and side effects of S-2 polypropylene and PF-7 silicone AGV implantation in Chinese refractory glaucoma patients.

METHODSPatients were divided into S-2 model AGV group and FP-7 model AGV group. The complete and qualified surgical success rate, change of IOP, number of anti-glaucoma medications used and postoperative complications were recorded and analyzed.

RESULTSAverage follow-up time was comparable between two groups. IOP was reduced from (37.9 ± 12.7) mmHg preoperatively to (17.3 ± 5.3) mmHg at the last follow-up in S-2 group and reduced from (39.9 ± 14.4) mmHg to (17.7 ± 4.9) mmHg in FP-7 group. Anti-glaucoma medications were reduced from 3.8 ± 0.2 to 1.5 ± 0.2 in S-2 group, and 3.5 ± 0.2 to 0.7 ± 0.2 in FP-7 groups. The cumulative success rates were comparable in two groups, which were 61.2% and 72.1% in S-2 group and FP-7 group respectively. When IOP reduction criteria was used, complete success rates were 30.6% and 51.2% for S-2 and FP-7 groups, and qualified success rates were 86.1% and 92.7% separately. In both groups, the major complication was hypotony, and the previous trabeculectomy of patients was the major risk factor for surgery failure.

CONCLUSIONSIn this short-term retrospective study, S-2 AGV is showed at least as effective as FP-7 AGV in IOP reduction, but associated with higher rate of complications. Previous trabeculectomy is a principle risk factor for AGV implantation failure. These clinical outcomes are important for converting use of the FP-7 silicon AGV in Chinese refractory glaucoma patients.

Adult ; Female ; Glaucoma ; physiopathology ; therapy ; Glaucoma Drainage Implants ; Humans ; Intraocular Pressure ; physiology ; Male ; Retrospective Studies

OBJECTIVEA lot of studies have suggested that a certain amount of T cells may be involved among cytokine-induced killer (CIK) cells. The aim of the present study was to prove whether an antigen-specific killing effect on tumor cells is involved during the CIKs-induced killing process.

METHODSBone marrow mononuclear cells (BMMNCs) derived from healthy subjects were separately cultured to generate dendritic cells (DC) and CIKs. A human mammary cancer cell line MCF-7/ADR, expressing P-gp antigen, was frozen-thawed and the lysate including P-gp antigen was obtained. The DC pulsed with or without tumor antigen lysate was co-cultured with CIK (pulsed-DC + CIK and DC + CIK), and CIK cultured alone was used as control. The cell phenotype of DC and CIK was analyzed by flow cytometry. The secretion of IL-12 and IFN-gamma was assayed by ELSA. The antitumor effect of the three CIK groups targeted at MCF-7/ADR cells expressing P-gp antigen and MCF-7 cells was detected by MTT.

RESULTSPulsed-DC + CIK group and DC + CIK group showed a higher expression level of DC mature phenotypes than those before co-culture with CIK, with a significant difference (P = 0.003, P = 0.001, respectively). The phenotypes (CD3, CD8, CD56) of CIK in pulsed-DC + CIK group and DC + CIK group was higher than those in CIK group (P = 0.003, P = 0.011, respectively). Among the three CIK groups, pulsed-DC + CIK group had the highest phenotypes on CD3+ CD56 (pulsed-DC + CIK vs. DC + CIK, P = 0.001; pulsed-DC + CIK vs. CIK, P < 0.001) and CD3 CD8 (P = 0.002, P = 0.002, respectively). Among the three groups, the pulsed-DC + CIK group showed the lowest CD45RA phenotype (pulsed-DC + CIK vs. DC + CIK, P < 0.001; pulsed-DC + CIK vs. CIK, P = 0.004). Among the three groups the secretion of IL-12 and IFN-gamma had the highest level in pulsed-DC + CIK group, with a value of 254 +/- 14.5 pg/ml and 3100 +/- 286 pg/ml, respectively. The antitumor killing effect on MCF-7/ADR cells had a significant difference between any two groups (pulsed-DC + CIK VS. DC + CIK, P = 0.039; pulsed-DC + CIK VS. CIK, P = 0.002; DC + CIK vs. CIK, P = 0.049). The highest was in pulsed-DC + CIK group and the lowest was in CIK group. The CIK group showed a significantly lower antitumor effect on MCF-7 cells than the other two groups (pulsed-DC + CIK vs. CIK, P = 0.007; DC + CIK vs. CIK, P = 0.048), but no significant difference between the pulsed-DC + CIK and DC + CIK groups.

CONCLUSIONIn the present study, DC and CIK cells have been successfully obtained and cultured from bone marrow mononuclear cells. After their co-culture, not only both their specific phenotypes were increased, but also the associated cytokines were secreted. An improved antitumor killing effect and some possible specific immunocytotoxicity were observed. Our findings provided a basis for experimental and clinical research on bio-immunotherapy targeted at multi-drug resistant tumor cells.

ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Breast Neoplasms ; metabolism ; pathology ; CD3 Complex ; metabolism ; CD56 Antigen ; metabolism ; CD8 Antigens ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Coculture Techniques ; Cytokine-Induced Killer Cells ; cytology ; immunology ; metabolism ; Cytotoxicity, Immunologic ; Dendritic Cells ; cytology ; immunology ; metabolism ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Female ; Humans ; Interferon-gamma ; metabolism ; Interleukin-12 ; metabolism

OBJECTIVETo study the expression of signal transducer and activator of transcription 6 and its mRNA in rat asthma model and the modulatory effect of dexamethasone (DXM).

METHODSThirty male SD rats were randomly divided into three groups: the control group, asthma group and DXM group. The rats in each group were sacrificed 24 h after the last challenge. In the experiment, the rat model of asthma was established by ovalbumin (OVA) challenge method. The lung tissue was taken from the left lung, and bronchoalveolar lavage fluid (BALF) was collected from the right lung. The total cell numbers, eosinophils (EOS) count and differentiated cell counts in BALF were performed on different count fluids. The concentrations of IL-4 in serum and BALF were measured by using sandwich ELISA. The protein expressions of STAT6 were detected with immunohistochemical techniques. The mRNA expressions of STAT6 were detected with in situ hybridization.

RESULTS(1) The total cell counts in BALF, the absolute counts of EOS, and the ratios of eosinophils to the total cell numbers (EOS%) of asthma group were all significantly higher than those of the control group (P < 0.01). The total cell counts in BALF, the absolute counts of EOS, and EOS% of DXM group were all significantly lower than those of asthma group (P < 0.01). (2) The concentrations of IL-4 in BALF and serum of asthma group [(25.7 +/- 7.4) ng/L, (34.2 +/- 10.5) ng/L] were significantly higher than those of control group [(8.6 +/- 3.0) ng/L, (12.1 +/- 2.9) ng/L] (P < 0.01). The concentrations of IL-4 in BALF and serum of DXM group were significantly lower than those of asthma group. (3) Immunohistochemistry showed that the protein content of STAT6 around the bronchus of asthma group (0.171 +/- 0.025) was significantly higher than that of the control group (0.082 +/- 0.022) (P < 0.01), while that of DXM group (0.114 +/- 0.013) was significantly lower than that of asthma group. The epithelial cells were the cells. In situ hybridization showed that the mRNA expression of STAT6 around the bronchus of asthma group (0.180 +/- 0.013) was significantly higher than that of the control group (0.091 +/- 0.012) (P < 0.01), while that of DXM group (0.114 +/- 0.010) was significantly lower than that of asthma group. (4) There was a significant correlation between the concentration of IL-4 in BALF, the content of STAT6 and STAT6 mRNA, respectively, in the epithelial cells of bronchus. There was a significant correlation between the absolute numbers of EOS and EOS% in BALF, the content of STAT6 and STAT6 mRNA, respectively, in the epithelial cells of bronchus.

CONCLUSIONSSTAT6 protein and STAT6 mRNA were found strongly expressed in rat asthma model and the epithelial cells were the chief expressing cells. Dexamethasone had an inhibitory effect on airway inflammatory cells infiltration. It significantly depressed STAT6 and mRNA expression. Which may be a key process in modulatory mechanism of asthma.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Asthma ; drug therapy ; genetics ; metabolism ; Bronchi ; cytology ; Bronchoalveolar Lavage Fluid ; cytology ; Cell Count ; Dexamethasone ; pharmacology ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; drug effects ; Epithelial Cells ; drug effects ; metabolism ; Glucocorticoids ; pharmacology ; Immunohistochemistry ; In Situ Hybridization ; Interleukin-4 ; metabolism ; Male ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; STAT6 Transcription Factor ; genetics ; immunology ; metabolism

OBJECTIVEAirway remodeling in asthma makes treatment of asthma very difficult, and study of its pathogenesis becomes very important. The present study aimed to explore the role of external signal regulated kinase (ERK) signal transduction pathway in airway remodeling in rats asthma model and regulatory effects of glucocorticoids on ERK signal transduction pathway and airway remodeling.

METHODSTotally 80 male Sprague-Dawlay rats (6-8 weeks old, weighing about 120 g) were randomly divided into control groups (30 rats), asthma groups (30 rats) and treated groups [including a group intervened with dexamethasone (DM group) and budesonide (BUD group), each had 10 rats]. The rats were sensitized for inducing asthma by intraperitoneal injection of ovalbumin and Al (OH)(3) and were repeatedly exposed to aerosolized ovalbumin for 4, 8, or 12 weeks [respectively called 4, 8 or 12 wk asthma group (A4, A8 or A12 group), each had 10 rats]; and correspondingly control rats were intraperitoneally injected with 0.9% NaCl, then were repeatedly exposed to 0.9% NaCl for 4, 8, or 12 weeks [respectively called 4, 8 or 12 wk control group (C4, C8 or C12 group), each had 10 rats]; DM group rats were repeatedly exposed to aerosolized ovalbumin for 8 wk, and BUD group rats for 12 wk. Total bronchial wall thickness (Wat) and smooth muscle thickness (Wam) were measured by an image analysis system. Concentrations of PDGF-AB in serum were measured by sandwich ELISA. Phospho-ERK (P-ERK) and c-Fos were detected by immunohistochemical technique; lung tissue extracts were analyzed for phosphorylation of ERK by Western blotting.

RESULTSWat and Wam in all asthma groups were significantly higher than those in corresponding control groups (P < 0.01, respectively), those of the treated groups were significantly lower than asthma groups (P < 0.01). The concentrations of PDGF-AB in serum of asthma groups [(228 +/- 18) pg/ml, (293 +/- 77) pg/ml, (225 +/- 66) pg/ml for A4, A8, A12 groups, respectively] were all significantly higher than those of the control groups [(160 +/- 14) pg/ml, (165 +/- 29) pg/ml and (164 +/- 27) pg/ml for C4, C8, C12 group, respectively] (P < 0.01 or P < 0.05); the value of DM group [(157 +/- 46) pg/ml] was significantly lower than that of the group A8 (P < 0.01), no significant difference was found when the values of BUD group [(208 +/- 40) pg/ml] was compared with that of A12 group (P > 0.05). Mean absorbance values (by immunohistochemistry) of P-ERK and c-Fos in asthma groups were significantly higher than those in corresponding control groups (P < 0.01, respectively), DM group had a significantly lower value than group A8 (P < 0.01), BUD group had a significantly lower value than group A12 (P < 0.01); absorbance (by Western blot) of P-ERK in A4, A8, A12 group was significantly higher than that in C4 and C8 group, the value of DM group was significantly lower than that of group A8 (P < 0.01), and that of BUD group (1.8 +/- 0.2) was significantly lower than that of group A12 (P < 0.01).

CONCLUSIONAsthmatic rats have higher concentrations of PDGF-AB in serum and phosphorylation of ERK and c-Fos; glucocorticoids inhibit phosphorylation of ERK and c-Fos in asthmatic rats, and to some extent also inhibit Wat and Wam.

Animals ; Asthma ; drug therapy ; metabolism ; Bronchi ; drug effects ; physiology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Glucocorticoids ; pharmacology ; Male ; Phosphorylation ; Platelet-Derived Growth Factor ; metabolism ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction

OBJECTIVETo analyze the clinical characteristics and long-term outcomes of patients underwent percutaneous coronary intervention (PCI) with prior ischemic stroke.

METHODSA total of 2053 patients underwent PCI in Peking union medical college hospital from January 2003 to December 2007 were included in this analysis and patients were followed up to December 2009. End-point included all-cause mortality, cardiac death, stent thrombosis, target-lesion revascularization, myocardial infarction, re-cerebral infarction. Major bleeding events were recorded during follow-up.

RESULTSThere are 1945 coronary heart disease patients were followed up and 222 patients with prior ischemic stroke. Compared patients without prior ischemic stroke, patients with prior ischemic stroke were older (P = 0.000), had higher hypertension morbidity (P = 0.000), higher diabetes mellitus morbidity (P = 0.005), higher incidence of multi-vessels disease (P = 0.000). During the follow-up of (35.0 ± 19.6) months, cardiac death rate (8.5% vs. 3.9%, P = 0.002) and re-cerebral infarction rate (5.8% vs. 1.4%, P = 0.000) were higher in patients with prior ischemic stroke than patients without prior ischemic stroke. Dual antiplatelet therapy treatment time [(13.77 ± 11.33) months vs. (13.94 ± 11.33) months, P = 0.986] and major bleeding events (5.8% vs. 3.6%, P = 0.100) were similar between the two groups and cerebral hemorrhage rate (1.8% vs. 0.5%, P = 0.028) were higher in patients with prior ischemic stroke than patients without prior ischemic stroke.

CONCLUSIONPatients with prior ischemic stroke were associated with increased rate of risk factors, multiple coronary artery disease, cardiac death and re-cerebral infarction and higher cerebral hemorrhage rate during follow-up despite similar dual-anti platelet therapy time.

Aged ; Brain Ischemia ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Stroke ; Treatment Outcome

OBJECTIVETo retrospectively analysis the treatment characteristics of the systemic situation in patients with crush syndrome after Wenchuan earthquake happened in May 12th, 2008.

METHODSForty-nine patients with crush syndrome and subsequent acute renal failure (ARF) due to the earthquake were treated in West China Hospital. All of patients had been rescued from buildings that collapsed in Wenchuan earthquake. The major associated injuries were in the low extremities and upper extremities. 49 patients developed ARF with increased concentrations of serum creatinine (mean 64 022 U/L) had underwent haemodialysis. Hyperkalaemia was seen in 9 patients and four of them underwent haemodialysis. 49 patients were administered hemodialysis.

RESULTSNo patient died. All patients who suffered from the ARF were weaned from hemodialysis after admitted 7 to 35 days. Forty-five extremities underwent amputations and 52 extremities had fasciotomy.

CONCLUSIONSCrush syndrome requires urgent recognition and prompt surgical treatment with simultaneous measures to control hyperkalemia and ARF. The authors believe that immediate intensive care therapy and multi-subjective coordination would have improved the survival rate.

Acute Kidney Injury ; etiology ; surgery ; therapy ; Adolescent ; Adult ; Aged ; Amputation ; Child ; Crush Syndrome ; etiology ; surgery ; therapy ; Decompression, Surgical ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Renal Replacement Therapy ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries ; complications