Objective To investigate the clinical effect of anterior internal fixation plus vacuum sealing drainage in the treatment of ulnar and radial fractures of Gustilo type Ⅲ.Methods Twenty-eight patients with open ulnar and radial fracture of Gustilo type Ⅲ were managed from April 2007 to March 2014,and were divided into four groups(n =4).Group A were managed with external fixator and conventional changing dressings.Group B were managed with internal fixation and vacuum sealing drainage.Group C were managed with external fixator and vacuum sealing drainage.Group D were managed with internal fixation and conventional changing dressings.Result Twenty-eight cases were adopted telephone follow-up for 6 to 27 months.The soft tissue recovery time of each group respectively was (20.5 ± 2.37) days,(14.7 ±2.16) days,(15.6 ±2.17) days and(19.7 ±2.18) days.The hospital stay of each group respectively was (9.7 ± 2.54) weeks,(4.7 ± 1.46) weeks,(5.2 ± 2.34) weeks and 8.6 ± 2.16) weeks.The fracture healing time of each group respectively was (19.6 ± 2.74) weeks,(13.1±1.84) weeks,(18.1 ±2.54) weeks and (14.7 ± 1.74) weeks.There was significant difference of these data between the two groups(P ＜ 0.05).Conclusions Anterior internal fixation plus vacuum sealing drainage is a better way to treat ulnar and radial fractures of Gustilo type Ⅲ.The technique has short period,less complications,less painful and less expense.

Objective To investigate the effect of super-selective intracoronary administration on acute myocardial in farction patients.Methods A total of 240 patients with ST-segment elevation myocardial infarction who received emergency percutaneous coronary intervention in our department from March 2012 to January 2014 were selected and divided into the intravenous drug administration group (n=77),the conventional intracoronary drug administration group (n=81) and the super-selective intracoronary drug administration group (n=82).Parameters,including the Thrombolysis in Myocardial Infarction (TIMI) classification,ST segment resolution after operation,peak values of creatine kinase MB (CK-MB) and troponin-I (cTn-I),left ventricular ejection fraction,left ventricular end-diastolic diameter (LVEDD),major adverse cardiovascular events and bleeding events,were compared between the groups.Results There were no significant differences in TIMI flow grade between the three groups (x2 =0.14,P=0.529).The percentage of patients with complete ST segment resolution after operation was higher in the super-selective intracoronary drug administration group than in the intravenous drug administration and conventional intracoronary drug administration groups (74.4％ vs.62.3％,61.7％,x2 =8.24,P＜0.05).Peak values of CK-MB and cTn-I were lower in the super-selective intracoronary drug administration group than in the other groups (P＜0.05).There were no significant differences in left ventricular ejection fraction and LVEDD between the three groups after operation,but left ventricular ejection fraction and the incidence of angina pectoris significantly improved in the super-selective intracoronary drug administration group than in the other groups after a three month follow-up (P＜0.05).There were no significant differences in target lesion revascularization,nonfatal myocardial infarction and druginduced thrombocytopenia between the three groups (P ＞ 0.05).Conclusions Super-selective intracoronary drug administration can significantly enhance cardiac function and alleviate angina pectoris in patients with acute myocardial infarction,and should be a recommended method.

To investigate the diversity and composition of gut microbiota in patients with lung adenocarcinoma and lung squamous cell carcinoma. A single-center and case-control study was conducted to consecutively enroll a total of 27 lung cancer patients, including 15 males and 12 females, who were seen at the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine between September 2018 to October 2020. A total of 20 cases of healthy healthy physical examiners, including 9 males and 11 females were recruited as healthy control group (HC) during the same period. Clinical data and stool samples were collected from each participants, and lung cancer patients were divided into lung adenocarcinoma group (AC, 19 patients, 8 males and 11 females) and lung squamous cell carcinoma group (SCC, 8 patients, 7 males and 1 females) according to the pathology type. Genomic DNA were extracted to amplify 16S rDNA V3-V4 region, then the Illumina MiSeq high-throughput sequencing platform and QIIME software were used for sequencing and analyzing the structure of the gut microbiota, respectively. Analysis of variance, χ 2 test, K-W test were used to analyze the differences in age, gender,α diversity, and relative abundance of microbiota among the three groups. AC, SCC, and HC were aged (58.74±9.27), (63.38±6.12), and (55.65±7.79) years old, respectively. There were no difference in gender and age among the three groups (gender and age are respectively:χ 2=5.155, P=0.076; F=2.598, P=0.086). And no significant difference in alpha diversity were found among the three groups (Chao and Shannon index were respectively: F=0.616, P=0.545; F=2.484, P=0.095), while β-diversity analysis indicated significant differences in the structure of intestinal flora among AC, SCC and HC ( P=0.001). LEfSe analysis showed that AC and SCC both have dominant bacterials. Megasphaera ( H=7.855, P=0.020) and Erysipelatoclostridium ( H=7.426, P=0.024) were enriched in patients with AC, while Enterococcus ( H=8.400, P=0.015), Veillonella ( H=9.957, P=0.007), and Eubacterium_eligens_group ( H=10.514, P=0.005) were enriched in patients with SCC. Lung cancer patients have gut microbiota imbalance, while lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference in gut microbiota diversity, but lung adenocarcinoma and lung squamous cell carcinoma have their own unique microbiota. This imbalance of the intestinal microenvironment is of great significance for studying the occurrence and development of different pathological types of lung cancer.

To investigate the diversity and composition of gut microbiota in patients with lung adenocarcinoma and lung squamous cell carcinoma. A single-center and case-control study was conducted to consecutively enroll a total of 27 lung cancer patients, including 15 males and 12 females, who were seen at the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine between September 2018 to October 2020. A total of 20 cases of healthy healthy physical examiners, including 9 males and 11 females were recruited as healthy control group (HC) during the same period. Clinical data and stool samples were collected from each participants, and lung cancer patients were divided into lung adenocarcinoma group (AC, 19 patients, 8 males and 11 females) and lung squamous cell carcinoma group (SCC, 8 patients, 7 males and 1 females) according to the pathology type. Genomic DNA were extracted to amplify 16S rDNA V3-V4 region, then the Illumina MiSeq high-throughput sequencing platform and QIIME software were used for sequencing and analyzing the structure of the gut microbiota, respectively. Analysis of variance, χ 2 test, K-W test were used to analyze the differences in age, gender,α diversity, and relative abundance of microbiota among the three groups. AC, SCC, and HC were aged (58.74±9.27), (63.38±6.12), and (55.65±7.79) years old, respectively. There were no difference in gender and age among the three groups (gender and age are respectively:χ 2=5.155, P=0.076; F=2.598, P=0.086). And no significant difference in alpha diversity were found among the three groups (Chao and Shannon index were respectively: F=0.616, P=0.545; F=2.484, P=0.095), while β-diversity analysis indicated significant differences in the structure of intestinal flora among AC, SCC and HC ( P=0.001). LEfSe analysis showed that AC and SCC both have dominant bacterials. Megasphaera ( H=7.855, P=0.020) and Erysipelatoclostridium ( H=7.426, P=0.024) were enriched in patients with AC, while Enterococcus ( H=8.400, P=0.015), Veillonella ( H=9.957, P=0.007), and Eubacterium_eligens_group ( H=10.514, P=0.005) were enriched in patients with SCC. Lung cancer patients have gut microbiota imbalance, while lung adenocarcinoma and lung squamous cell carcinoma patients have no significant difference in gut microbiota diversity, but lung adenocarcinoma and lung squamous cell carcinoma have their own unique microbiota. This imbalance of the intestinal microenvironment is of great significance for studying the occurrence and development of different pathological types of lung cancer.

Objective:To explore the clinical effect and safety of extended debridement combined with BAM bone-induced artificial bone repair in the treatment of Cierny-Mader type IV osteomyelitis.Methods:From January 2021 to December 2022, 106 patients with Cierny-Mader type IV osteomyelitis who were treated with allogeneic bone mixed with autologous bone in department of orthopedics of Sichuan Orthopedic Hospital were retrospectively selected as the study subjects. Among them, 54 patients who were combined with BAM bone-induced artificial bone mixed with autologous bone repair were included in observation group, and 52 patients who only received allogeneic bone mixed with autologous bone repair were enrolled as control group. The clinical related indicators (bone healing time, fracture healing time), clinical efficacy (Johner-Wruh tibial shaft fracture evaluation standard) at 1 year after surgery, inflammatory factors (white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin), limb function (American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AH)) and bone healing degree before surgery and at 1 year after surgery were compared between both groups. Chi-square test was used to compare the enumeration data between groups, and the independent sample t test was performed to compare the measurement data with normal distribution between groups.Results:At 1 year after surgery, the clinical healing indicators of bone healing time and fracture healing time and inflammatory factors such as WBC, ESR, CRP and procalcitonin with (21.19±2.16) weeks, (11.35±1.01) weeks, (6.15±0.73)×10 9/L, (9.10±1.05) mm/h, (8.09±1.11) mg/L and (0.05±0.01) μg/L in observation group were significantly shorter or lower than (24.32±2.39) weeks, (12.29±1.27) weeks, (7.86±0.89)×10 9/L, (10.10±1.32) mm/h, (9.26±1.23) mg/L and (0.08±0.01) μg/L in control group,and the differences were statistically significant ( t values were 7.08, 4.23, 10.83, 4.33, 5.15, and 15.44, respectively; all P<0.001). The clinical effective rate (85.19%(46/54)), AOFAS-AH score((84.83±12.17) points) and bone healing probability (94.44%(51/54)) were higher than (67.31%(35/52)), (79.17±11.25) points and 80.77% (42/52) in control group,with statistically significant differences (statistical values were χ2=4.70, t=2.48, and χ2=4.60, respectively; P values were 0.030, 0.015, and 0.032, respectively). Conclusion:Expanded debridement combined with BAM bone-induced artificial bone repair can effectively promote the bone tissue healing in patients with Cierny-Mader type IV osteomyelitis, relieve the inflammatory response, and improve the limb function, and it has good clinical efficacy and high safety.

OBJECTIVE：To observe the p rotective effects of resveratrol （Res）on LPS-induced acute lung injury （ALI）model mice，and to explore its possible mechanism based on TLR 4/NF-κB pathway. METHODS：Kunming mice were divided into normal group，model group ，positive control group （dexamethasone，0.5 mg/kg），Res low-dose ，medium-dose and high-dose groups （50， 100，200 mg/kg），with 10 mice in each group. Normal group and model group were given normal saline intragastrically ，once a day，for 7 days；positive control group were intraperitoneally injected with Dexamethasone sodium phosphate injection ，once a day，for 3 days；Res groups were given relevant medicine intragastrically ，once a day ，for 7 days. After last administration ，all the mice except the normal group were dripped LPS （5 mg/kg）into the nose to induce ALI model. The apoptosis of neutrophils in BALF was observed by Hoechst 33242 staining；the apoptosis rate of neutrophils were detected by flow cytometry. The contents of IL- 6 and TNF-α in the plasma were detected by ELISA. After wet mass to dry mass （W/D）ratio of lung was E-mail：492234709@qq.com calculated，the morphological characteristics of lung tissue were observed by HE staining. Western blotting assay was used to detect the expression o f TLR 4 and NF-κ B in lung tissue. RESULTS ：In normal group ，there were few apoptotic neutrophils in the BALF ，and the lung tissue structure was intact ， without edema，hyperemia，exudation，inflammatory cell infiltration or other inflammatory manifestations. In model group ，the number of apoptotic neutrophils in BALF increased ，and the apoptotic rate of neutrophils were enhanced significantly （P＜0.01）； edema and hyperemia of lung tissue were significantly increased ，and the red consolidation area was observed ；the contents of IL- 6 and TNF-α in plasma，the ratio of lung W/D，the relative expression of TLR 4 and NF-κB in lung tissue were significantly increased （P＜0.01）. Compared with model group ，the number of apoptotic neutrophils in BALF were increased ，and the apoptotic rate of neutrophils were enhanced significantly （P＜0.05 or P＜0.01）above symptoms of lung tissue were improved to different extents ； the contents of IL- 6 and TNF-α in plasma，lung W/D ratio as well as relative expression of TLR 4 and NF-κB in lung tissue（except for Res low-dose group ）in administration groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Res has a protective effect on ALI model mice ，the mechanism of which may be related to reducing the generation of inflammatory cytokines TNF-α and IL-6 by inhibiting TLR 4/NF-kB expression.

Objective    To compare the 5-year survival rates between two different follow-up patterns of postoperative stage Ⅰ-ⅢA non-small cell lung cancer (NSCLC) patients. Methods    Pathological stage Ⅰ-ⅢA NSCLC 11 958 patients who underwent surgical resection and received follow-up within 6 months after initial diagnosis through telephone follow-up system were included in nine hospitals from July 2014 to July 2020. The patients were divided into two groups including a proactive follow-up group (n=3 825) and a passive follow-up group (n=8 133) according to the way of following-up. There were 6 939 males and 5 019 females aged 59.8±9.5 years. The Kaplan-Meier and Cox proportional hazards regression model were used. Results    The median follow-up frequency was 8.0 times in the proactive follow-up group and 7.0 times in the passive follow-up group. The median call duration was 3.77 minutes in the proactive follow-up group and 3.58 minutes in the passive follow-up group. The 5-year survival rate was 81.8% and 74.2% (HR=0.60, 95CI 0.53-0.67, P<0.001) in the proactive follow-up group and the passive follow-up group, respectively. Multivariate analysis showed that follow-up pattern, age, gender and operation mode were independent prognostic factors, and the results were consistent in all subgroups stratified by clinical stages. Conclusion    The proactive follow-up leads to better overall survival for resected stage Ⅰ-ⅢA NSCLC patients, especially in the stage ⅢA.

Abivertinib, a third-generation tyrosine kinase inhibitor, is originally designed to target epidermal growth factor receptor (EGFR)-activating mutations. Previous studies have shown that abivertinib has promising antitumor activity and a well-tolerated safety profile in patients with non-small-cell lung cancer. However, abivertinib also exhibited high inhibitory activity against Bruton's tyrosine kinase and Janus kinase 3. Given that these kinases play some roles in the progression of megakaryopoiesis, we speculate that abivertinib can affect megakaryocyte (MK) differentiation and platelet biogenesis. We treated cord blood CD34⁺ hematopoietic stem cells, Meg-01 cells, and C57BL/6 mice with abivertinib and observed megakaryopoiesis to determine the biological effect of abivertinib on MK differentiation and platelet biogenesis. Our in vitro results showed that abivertinib impaired the CFU-MK formation, proliferation of CD34⁺ HSC-derived MK progenitor cells, and differentiation and functions of MKs and inhibited Meg-01-derived MK differentiation. These results suggested that megakaryopoiesis was inhibited by abivertinib. We also demonstrated in vivo that abivertinib decreased the number of MKs in bone marrow and platelet counts in mice, which suggested that thrombopoiesis was also inhibited. Thus, these preclinical data collectively suggested that abivertinib could inhibit MK differentiation and platelet biogenesis and might be an agent for thrombocythemia.
Acrylamides/pharmacology* ; Animals ; Blood Platelets/drug effects* ; Cell Differentiation ; Megakaryocytes/drug effects* ; Mice ; Mice, Inbred C57BL ; Piperazines/pharmacology* ; Pyrimidines/pharmacology*