OBJECTIVETo explore the methods and therapeutic effects of trans-fibular anterior-lateral approach combined with external fixation in the treatment of Gustilo III distal tibiofibula fractures.

METHODSFrom 2007 to 2010,9 patients including 7 males and 2 females with the mean age of 40 years(ranging from 29 to 51 years). All patients received internal fixation of fibula after debridement on the first phase, external fixator were used to fix tibia across ankle joint, and removed after successful skin graft; The second phase tibia was used to fix through the lateral incision used in phase I. Early functional exercise was encouraged ,the union condition and functional results of the ankle joint was evealuated. The criteria of the AOFAS Foot and Ankle Surgery was used to evaluate the effects.

RESULTSAll patients were followed up,and the duration ranged for 8 to 37 months(averaged 21 months). Nine patients were achieved bony union, the average healing time was 24 weeks. No plate rupture or screw loosening was found. According to the AOFAS Foot and Ankle Surgery evaluation system, 3 cases got excellent results, 4 good cases and 2 fair.

CONCLUSIONTrans-fibular anterior-lateral approach combined with external fixation for Gustilo III distal tibiofibula fractures can receive satisfactory reset, debond ankle joint eralier and imporove the clinical effects.

Adult ; Female ; Fibula ; Fracture Fixation ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Tibia ; Treatment Outcome

Objective To explore the changes of cognitive ability and thyroid function and mRNA level of thyroid hormone receptor α1(TRα1)in the brain tissues of rats with nonthyroidal illness syndrome (NTIS). Methods Nineteen adull male SD rats were randomly divided into normal control (n=9)and NTIS(n=10)groups.The NTIS model,its liver been fiberized was induced by intraperitoneal injecting 0.15 mL carbon tetrachloride([CCL4],[1:6,diluted by com oil])3 times per week with duration of 8 weeks.The normal control group was injected equal sodium.Morris water-maze task was employed to test the cognitive memory ability of the rats;the concentrations of T_3,T_4, FT_3,FT_4,rT_3 and TSH in the blood serum and T_3,T_4 and rT_3 in the brain tissue were detected by using radioimmunoassay(RIA);the mRNA level of TRα1 was detected by fluorescent quantitative RT-PCR. Resuits Morris water-maze task showed no significant difference in congnitive ability between NTIS and control groups (P>0.05).The concentrations of T_4,FT_3,FT_4 and T_3 in blood serum in the NTIS group were significantly lower as compared with those in the normal control group(P<0.05).Concentrations of rT3,TSH in the blood serum,the concentrations of T_4,T_3,rT_3 and the mRNA level of TRα1 in the brain tissue had no significant differences between the two groups(P>0.05). Conclusion The rats with hepatic fibrosis showed typical NTIS.Thyroid function in central nervous system of these rats is normal, so is their cognitive ability.The mRNA level of TRα1 had no significant change in brain tissue of these rats.

OBJECTIVETo investigate the clinical effects and prevent the complications of posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure.

METHODSFrom 2008 January to 2011 December, 17 patients with cervical anterior internal fixation failure were treated with posterior and anterior decompression and internal fixation. There were 12 males and 5 females, aged from 26 to 68 years old with an average of 44.1 years. The lower screw loosening was found in 6 cases, the upper screw loosening in 5 cases, titanium mesh caving in 3 cases, the upper screw breakage in 2 cases, the lower screw breakage in 1 case. Informations of bone fusion were observed by X-ray, CT, MRI. Clinical effects were evaluated by modified JOA score.

RESULTSAll the revision operations were successfully completed. One case with poor blood coagulation function before operation resulted in postoperative hematoma and occurred neurological symptoms; after hematoma removal and fresh frozen plasma infusion later, neurological symptoms of the patient disappeared. All patients were followed up from 6 to 38 months with an average of (22.4±10.0) months. Postoperative at 2 weeks, 3 months, and final follow-up, JOA score had obviously improved and respectively was 13.1±1.6, 13.4±1.6, 14.2±1.5. All internal fixation locations were good after revision,and obtained bone fusion at 10 months after operation, with an average fusion time of 6 months.

CONCLUSIONThe combined posterior and anterior decompression and internal fixation in the revision of cervical anterior internal fixation failure is safe, can achieve thoroughly decompression, maintain the cervical curvature, reconstruct the three column stability, and it may be used for the patients of cervical anterior fixation failure.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

Banana bunchy top virus (BBTV) is the pathogen of banana bunchy top disease (BBTD); it seriously disserves the banana production. This paper reviewed the separation and purification methods, classifying and taxonomy status of BBTV; the genome structure and function of each encode protein of the virus; and the present problems that should be further clarified.

BACKGROUNDPolyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.

METHODSFifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.

RESULTSPatient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.

CONCLUSIONSFish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.

Aged ; CD4 Antigens ; blood ; CD4-CD8 Ratio ; CD8 Antigens ; blood ; Colorectal Neoplasms ; blood ; surgery ; Colorectal Surgery ; Female ; Fish Oils ; therapeutic use ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Parenteral Nutrition, Total ; methods ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVETo investigate the preventive effect of interleukin-18 (IL-18) gene modified mature dendritic cells (mDC) vaccine on airway inflammation in mouse asthma model.

METHODSThe asthma model was induced by injection of ovalbumin (OVA) in BALB/c mice. IL-18 gene modified mouse mature dendritic cells (mDC) were detected by flow cytometry and its capacity of inducing allogeneic T cell responses was examined by mixed lymphocyte reaction (MLR). The OVA-induced asthmatic mice were randomly divided into 6 groups: PBS group, DXM group, mDC group, Ad-LacZ-mDC group, Ad-IL-18-mDC group and control group. The pathological changes in lung tissues were assayed by HE and AB-PAS staining. The numbers of inflammatory cells and percentage of eosinophils (EOS) in bronchoalveolar lavage fluid (BALF) were counted. The levels of IFN-γ IL-4 and IL-13 in culture supernatant of splenocytes were measured by ELISA method. The percentage of CD4(+)CD25(+)Foxp3(+) Treg was assessed by flow cytometry analysis.

RESULTThe vaccine was effective in decreasing the infiltration of EOS and accumulation of airway goblet cells in lung tissues, the numbers of inflammatory cells and percentage of EOS in BALF, and the levels of IL-4 and IL-13 in culture supernatant of splenocytes, and in increasing the levels of IFN-γ in culture supernatant of splenocytes and the percentage of CD4(+)CD25(+)foxP3(+) reg.

CONCLUSIONIL-18 gene modified mDC vaccine has a preventive effect on airway inflammation in OVA-induced asthmatic mice.

Animals ; Asthma ; immunology ; pathology ; prevention & control ; Dendritic Cells ; immunology ; Disease Models, Animal ; Genetic Therapy ; Interleukin-18 ; genetics ; Lung ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Ovalbumin ; immunology

OBJECTIVETo evaluate the effect of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients.

METHODSRandomized controlled trials (RCTs) that studied the effect of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients were searched from Pubmed, Embase, The Cochrane Library, CBM during January 1990 to June 2010. The quality of the RCTs was evaluated. Meta-analysis of timing of tracheotomy on the prognosis of prolonged mechanically ventilated patients were conducted using the methods recommended by the Cochrane Collaboration. Definition of early tracheotomy was the patients performed tracheotomy during 10 days after admission to hospital or ICU, mechanical ventilation or intubation. Late tracheotomy was defined tracheotomy performed beyond 10 days of admission to hospital or ICU, mechanical ventilation or intubation; or those mechanically ventilated through intubation all the time.

RESULTSEight hundred and twenty eight patients, 411 in early tracheotomy group and 417 in late tracheotomy group, from 6 RCTs were included in the analysis of data. The meta-analysis showed that early tracheotomy could reduce mortality of patients (RR: 0.81, 95%CI: 0.66 - 0.99, P = 0.04); but it didn't significantly alter the incidence of pneumonia (RR:0.89, 95%CI: 0.68 - 1.17, P = 0.41), mechanical ventilation days (mean difference: -2.19, 95%CI: -9.86 - 5.49, P = 0.58) and length of ICU stay (mean difference: -5.65, 95%CI: -17.11 - 5.81, P = 0.33).

CONCLUSIONSIn critically ill adult patients who require prolonged mechanical ventilation, early tracheotomy performed at an earlier stage reduces the mortality, but doesn't reduce the incidence of pneumonia and shorten the mechanical ventilation days and ICU length of stay. But more high quality RCTs are required to confirm it.

Humans ; Prognosis ; Randomized Controlled Trials as Topic ; Respiration, Artificial ; Time Factors ; Tracheotomy

OBJECTIVETo evaluate the effects of selective hepatic vascular exclusion (SHVE) on prevention of serious hemorrhage and air embolism during hepatectomy and on the liver function after operation.

METHODSFrom January 2004 to March 2007, 29 huge hepatic tumors were resected in our department. Both SHVE and Pringle maneuver were used to control the blood loss during hepatectomy. They were divided into two groups: SHVE group (15 cases) and Pringle group (14 cases). Data regarding the intraoperative and postoperative courses of the patients were analyzed.

RESULTSThere was no significant difference between the two groups regarding the age, sex, tumor size, cirrhosis, HbsAg positive rate and operating time (P > 0.05). Intraoperative blood loss was reduced significantly in the SHVE group (P < 0.05). The serum prealbumin levels on the postoperative day 1, 3 and 7 in SHVE group were significantly higher than those in the Pringle group (P < 0.05). The serum ALT value in SHVE group was significantly lower than that in the Pringle group on postoperative day 1, 3 and 7. The mean drainage volume in SHVE group was significantly less than that in the Pringle group on postoperative day 1 and 2. Liver failure occurred in two cases of the Pringle group, while no one in the SHVE group. Rupture of hepatic vein with massive blood loss occurred in 3 cases and air embolism in one case of the Pringle group, but did not occur in any case of the SHVE group.

CONCLUSIONWhen the selective exclusion of hepatic outflow and inflow is applied in hepatectomy, the resection rate of huge hepatic tumors and operative tolerance of hepatectomy are improved. It is a safe and rational operation type, and provides an optimal choice for hepatectomy.

Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Bile Duct Neoplasms ; blood ; blood supply ; surgery ; Bile Ducts, Intrahepatic ; Blood Loss, Surgical ; Carcinoma, Hepatocellular ; blood ; blood supply ; surgery ; Cholangiocarcinoma ; blood ; blood supply ; surgery ; Female ; Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Intraoperative Care ; Liver ; blood supply ; surgery ; Liver Neoplasms ; blood ; blood supply ; surgery ; Male ; Middle Aged ; Prealbumin ; metabolism ; Young Adult

The stem cell leukemia (SCL) gene is a new oncogene related with leukemogenesis. To explore the effects of antisense oligonucleotides of SCL on leukemic cells, SCL antisense phosphorothioate oligodeoxynucleotides (AS-PS-ODN) were used to treat K562 and CEM leukemic cell lines to observe the effects on proliferation, differentiation, apoptosis and SCL mRNA expression in the cells. The results showed that incubation of K562 or CEM cells with AS-PS-ODN at different concentrations led to inhibition of cell proliferation, and the inhibitory effects varied with the incubation time. The positive rate of benzidine staining in K562 cells increased significantly after the inhibition with AS-PS-ODN, compared with S-PS-ODN treatment. The characteristics of apoptosis were observed in K562 cells treated with AS-PS-ODN, but not in CEM cells. Expression of SCL mRNA in K562 and CEM cells and SIL-SCL mRNA in CEM cells decreased after incubation of AS-PS-ODN. It is concluded that SCL AS-PS-ODN inhibits specifically the proliferation of K562 and CEM cells, also decreases the level of SCL and SIL-SCL mRNA expression. AS-PS-ODN enhances erythroid differentiation and induces premature apoptosis in K562 cells.
Apoptosis ; drug effects ; Basic Helix-Loop-Helix Transcription Factors ; Cell Division ; drug effects ; DNA-Binding Proteins ; antagonists & inhibitors ; physiology ; Humans ; K562 Cells ; Oligonucleotides, Antisense ; pharmacology ; Proto-Oncogene Proteins ; antagonists & inhibitors ; physiology ; RNA, Messenger ; analysis ; T-Cell Acute Lymphocytic Leukemia Protein 1 ; Transcription Factors ; antagonists & inhibitors ; physiology

The methods to determine the total phenols, total saponins, and marker constituents salidroside, chlorogenic acid and 3, 4-dihydroxy-phenylethyl-β-D-glucopyranoside in the samples of Sargentodoxae Caulis were established to provide the evidence for the improvement and revision of the quality standard of the crude material recorded in the Chinese Pharmacopoeia (2015 Edition). The content of total phenols was determined by ultraviolet spectrophotometry, using gallic acid as a reference substance. The content of total saponins was determined by ultraviolet spectrophotometry, using 3-O-[β-D-xylopyranosyl-(1-2)-O-β-D-glucuronopyranosyl]-28-O-[β-D-glucopyranosyl] asiatic acid as a reference substance. The contents of salidroside, chlorogenic acid and 3,4-dihydroxy-phenylethyl-β-D-glucopyranoside were detected by HPLC. The linear ranges were 1.01-7.04 mg x L(-1) for total phenols, 37.7-201 μg for total saponins, 0.025 8-1.55 μg for salidroside, 0.076 2-5.44 μg for chlorogenic acid, and 0.064 9-3.47 μg for 3,4-dihydroxy-phenylethyl-βP-D-glucopyranoside, respectively. Their average recoveries were 99.12%, 99.11% 105.5%, 99.08%, and 101.6%, respectively. The contents of total phenols and total saponins were 3. 04% -11. 9% and 0. 87% -3. 63%. The contents of salidroside, chlorogenic acid and 3,4-dihydroxy-phenylethyl-β-D-glucopyranoside fluctuated from 0.018% to 0. 572%, from 0.041% to 1.75% and from 0.035% to 1.32%. The established methods were reproducible, and they could be used for the quality control of Sargentodoxae Caulis. The present investigation suggested that total phenols, salidroside, and chlorogenic acid should be recorded in the quality standard of Sargentodoxae Caulis and their contents should not be less than 6.8% for total phenols, 0.040% for salidroside, and 0.21% for chlorogenic acid.
China ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Magnoliopsida ; chemistry ; Phenol ; analysis ; Plant Stems ; chemistry ; Saponins ; analysis ; Triterpenes ; analysis