OBJECTIVETo explore clinical effects of internal fixation in treating displaced clavicle fracture combined with coracoid process.

METHODSFrom January 2005 to July 2012, 9 patients with displaced clavicle fracture combined with coracoid process were treated by internal fixation. Among them, there were 6 males and 3 females with an average age of 40.1 (ranged from 20 to 57) years old. According to Eyres classification: 3 cases were type II B, 1 case was type II A, 3 cases were type III B, and 2 cases were type V A. All patients had history of injury, and diagnosed as coracoid fracture X-ray and CT before operation. Herscovici criteria was used to evaluate function of shoulders joint after operation.

RESULTSSeven of 9 patients were followed up from 6 to 18 (averaged 11) months. The incisions were healed at stage I, coracoid process obtained bony healing, and reduction of acromioclavicular joint well. According to Herscovici criteria, 6 patients got excellent results and 1 in good.

CONCLUSIONInternal fixation for the treatment of displaced clavicle fracture combined with coracoid process could restore physiological anatomical position of coracoid process, and benefit for recovery of limb function.

Adult ; Clavicle ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Scapula ; injuries ; Shoulder Joint ; injuries

OBJECTIVETo observe the expressions of Wnt/beta-catenin and the effects of tanshinone IIA (TII A) on Wnt/beta-catenin signaling pathway in high glucose induced renal tubular epithelial cell transdifferentiation.

METHODSHuman kidney proximal tubular epithelial cells (HK-2) were divided into three groups, i. e., the normal glucose group, the high glucose group, and the high glucose plus tanshinone IIA group. The expression of beta-catenin was observed using immunocytochemical staining. The protein expression of beta-catenin, E-cadherin, and alpha-smooth muscle actin (alpha-SMA) were detected by Western blot. The mRNA levels of beta-catenin and E-cadherin were detected by RT-PCR.

RESULTSCompared with the normal glucose group, both the protein and the mRNA expressions of beta-catenin were significantly enhanced (P < 0.01), the expression of E-cadherin significantly decreased (P < 0.01), the expression of beta-catenin increased in the cytoplasm and nucleus in the high glucose group. TIIA at the final concentration of 100 micromol/L significantly reduced the ectopic expression of beta-catenin. At that concentration, the protein and mRNA expressions of beta-catenin in the nucleus significantly decreased, while the protein and mRNA expressions of E-cadherin were up-regulated. Meanwhile, the expression of alpha-SMA obviously decreased.

CONCLUSIONSWnt/beta-catenin signaling pathway participated in the high glucose induced renal tubular epithelial cell transdifferentiation. TIIA inhibited the transdifferentiation process possibly through down-regulating the activities of Wnt/beta-catenin signaling pathway, thus further playing a role in renal protection.

Cadherins ; metabolism ; Cell Line ; Cell Transdifferentiation ; drug effects ; Diterpenes, Abietane ; pharmacology ; Epithelial Cells ; cytology ; drug effects ; metabolism ; Glucose ; adverse effects ; Humans ; Kidney Tubules, Proximal ; cytology ; drug effects ; metabolism ; Wnt Signaling Pathway ; drug effects ; beta Catenin ; metabolism

Objective To observe the therapeutic action of choline on As2O3 induced electrecardiogram (ECG)QT interval prolongation and to further explore molecular biological mechanisms.Methods 40 guinea pigs were divided into 5 groups randomly with 8 rats in each group:control group intravenously injected with saline, experimental group with 0.4,0.8,1.6 ms/kg of choline and As2O3 group with 8 mg/kg choline plus 1.6 mg/kg As2O3.After a series of concentration of As2O3 was intravenously given,ECG was monitored at different time(0,10, 30,60,90,120 min),and corrected QT interval(QTc)was studied.Total RNA Wa$abstracted from the guinea pigs hearts after 6 h,and the effects of choline on altered L-type calcium channel α1c and potassium channel GPERG mRNA expression caused by As2O3 in cardiomyocytes of guinea pig were studied by the method of reverse transcription polyme,chain reaction(RT-PCR).Results In 0.8 mg/kg As2O3 group,the value of QTc at 60, 90 and 120 min respectively being 354 ±22.366± 31 and 368 ±29 waa significantly higher than that of control groups[(325±26,336 ±26 and 324 ±20)at same time] with a significant difference(P<0.05 or<0.01);the value of QTc at 90 and 120 rain was significantly higher than that of O min group(334 ±12),the difference being statistically significant(P<0.05).In 1.6 mg/kg As2O3 group,the value of QTc at 10,30,60,90 and 120 min respectively being 362±33,380±21,382±35,388±39 and 388 ±31 was significantly higher than that of control groups[(328 ±20.324 ±25,325 ±26,336±26 and 324 ±20)at same time]with a significant difference (P<0.05 or<0.01);the value of QTc at 10,30,60,90 and 120 min Was significantly higher than that of O min group(329 ±31),the difference being statistically significant(P<0.05).In choline+As2O3group,the value of qrc at 30,60,90 and 120 min was 337 ±17,341±15,344 ±22 and 343 ±19,significantly lower than that of 1.6 mg/kg As2O3 group,the difference being statistically significant(P<0.05 or<0.01).The RT-PCR results indicated that the value of L-type calcium channel α1c mRNA expression at the concentration of 1.6 mg/kg As2O3 was 1.27±0.14 vs 1.02±0.12 of control group(P<0.01),and it was 1.10 ±0.13 in choline+As2O3 group(P<0.05 Vs 1.6 mg/kg As2O3 group).The value of potassium channel GPERG mRNA expression were 1.29 ±0.11,1.22±0.12 and 1.27±0.16 at the dose of 0.4,0.8,1.6 mg/kg As2O3(P>0.05 VS 1.23±0.08 of control group).In choline+ As2O3 group,the value was 1.30±0.14(compared with 1.6 mg/kg As2O3 group,P>0.05).Conclusions Choline normalizes QTc abnormality during As2O3 application,and modulating changed calcium channel mRNA expression induced by As2O3 may be one of the mechanisms.

A large body of evidence demonstrates that dendritic cells (DC) play a pivotal role in the control of immunity by priming and tolerizing T cells. In multiple sclerosis (MS), autoreactive T cells are proposed to play a pathogenic role by secreting pro-inflammatory cytokines, but comparison studies on the effects of immature and mature dendritic cells on the cytokines profile of antigen-specific T cell lines are lacking. To evaluate the actions of dendritic cell maturation on T cell polarization, the effects of immature and mature dendritic cells derived from MS patients on in vitro proliferative responses, and cytokine production by glatiramer acetate (GA)- specific T cell lines (TCL) derived from MS patients were analyzed. The results demonstrated that it is easy to derive GA-specific TCL from MS patients with high specificity; lipopolysaccharide can efficiently induce DC maturation within 24 hours at a concentration of 5 micro g/ml; mature DC showed higher co-stimulatory capacity of GA-specific TCLs than immature DC. GA-specific TCLs produce dominantly IL-2, IL-4, IFN-gamma and IL-10, but low levels of IL-6. In contrast to immature DC, mature DC enhanced capacity to induce IL-6 and IL-10 secretion, but down-regulate IL-2, IL-4 and IFN-gamma production by GA- specific TCLs. It is concluded that DC maturation status modulating proliferation of TCL and production of cytokines may represent another focus for the study on both immuno-pathogenesis and immunotherapeutic interventions in MS.
Adult ; Cell Line ; Cytokines ; biosynthesis ; Dendritic Cells ; physiology ; Female ; Glatiramer Acetate ; Humans ; Lymphocyte Activation ; Male ; Middle Aged ; Multiple Sclerosis ; immunology ; Peptides ; immunology ; T-Lymphocytes ; immunology

To determine whether gamma irradiation influences phenotype and function of human dendritic cells (DC) in vitro, dendritic cells were induced from the peripheral blood mononuclear cells of multiple sclerosis patients with RPMI 1640 medium containing recombinant human GM-CSF (rhGM-CSF, 800 U/ml) and recombinant human IL-4 (rhIL-4, 500 U/ml). Phenotypic changes were monitored by light microscopy. Lipopolysaccharide at a concentration of 5 micro g/ml was added into the cultures after 6 days of growth for DC complete maturation, and the cells were cultured for another 24 hours. The harvested DC on day 7 were divided equally into several parts. One part was used as non-irradiated DC (naive DC) while the other parts were irradiated by gamma ray at a dose of 25 Gy and 30 Gy respectively. Cell surface molecules were analyzed by flow cytometry. The capability of DC to stimulated autologous T cell proliferation were determined. The results showed that gamma irradiation reduced expression of CD86, CD80 and HLA-DR molecules on dendritic cells, especially CD86 molecules. Dendritic cells effectively stimulated autologous T cells proliferation while irradiated DC in all groups showed profound decrease of capability to promote T cells proliferation. It is concluded that gamma irradiation of dendritic cells not only influenced phenotype of DC but also altered their function as stimulator cells in mixed lymphocyte reaction.
Antigens, CD ; analysis ; B7-1 Antigen ; analysis ; B7-2 Antigen ; Cell Division ; immunology ; Dendritic Cells ; drug effects ; immunology ; radiation effects ; Flow Cytometry ; Gamma Rays ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; HLA-DR Antigens ; analysis ; Humans ; Immunophenotyping ; Interleukin-4 ; pharmacology ; Membrane Glycoproteins ; analysis ; Multiple Sclerosis ; blood ; Recombinant Proteins ; pharmacology ; T-Lymphocytes ; cytology ; immunology

OBJECTIVETo evaluate mid-term clinical results of microendoscopic discectomy (MED) for the treatment of lumbar disc hermiation.

METHODSIn the study, 117 patients were reviewed,including 63 male and 54 female, ranging in age from 24 to 72 years,with an average of 50.6 years. Among the patients, 60 patients had simple lumbar disc herniation, 10 patients had simple lateral crypt stenosis, 32 patients had lumbar disc herniation combined with lateral crypt stenosis, and 15 patients were combined with calcified nucleus pulposus. Two patients had herniation in L3-L4, 56 patients in L4-L5, 48 patients in L5-S1, 11 patients in L4-L5 and L5-S1. The central type of lumbar disc herniation occurred in 22 patients and the lateral type of herniation occurred in other 95 patients. The Protrusion type of herniation occurred in 32 discs, ruptured type in 73 discs, and free type in 12 discs. Ninety-eight patients had lumbar and leg pain in one side, and 19 patients in double sides. MED was used to remove the nucleus and decompress the nerve root canal.

RESULTSAll the patients were followed up and the duration ranged from 48 to 84 months,with an average of 5.5 years. According to lumbar and leg pain evaluation criteria from spinal group of Chinese Orthopaedic Association, there were 93 patients got an excellent result, 16 good and 8 poor.

CONCLUSIONAppropriate control indications and skillful surgical techniques are the key points to decrease the complication and to improve the curative effect.

Adult ; Aged ; Diskectomy ; adverse effects ; methods ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged

Peripheral nerve impairment is a common complication in surgery, which repair relates directly to the recovery of motor function and sensory function. Clinical researchers always do nerve sutrure using microsurgical technique and adjuvant treatment to improve peripheral nerve regeneration. Western medicine used usually of adjuvant drugs, such as neurotrophic factors, are limited by their defects in clinical application. Traditional Chinese medicine classifies peripheral nerve impair as paralysis and arthromyodynia, considers that it is the result of defects of meridian and vessels, QI and blood, bones and muscles. So, drugs used usually are QI invigorating herbs, blood circulation promoting herbs for unblocking collaterals, and nourishing herbs, including astragali, hedysari, ginkgo leaf, angelica, danshen root, paeoniae radix, epimedium, chuanxiong, and common basic formulas, such as Buyang Huanwu decoction, Huangqi Guizhi Wuwu decoction, Huoxue Kangyuan decoction, compound radix hedysari, etc. To be ready for further study and development, we review the traditional Chinese medicine and formulas in this article.
Animals ; Chemistry, Pharmaceutical ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Medicine, Chinese Traditional ; Nerve Regeneration ; drug effects ; Peripheral Nervous System Diseases ; drug therapy ; physiopathology

OBJECTIVETo compare the short-term outcomes in patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in prone position and in left lateral position.

METHODSBetween September 2008 and September 2010, thoraco-laparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy was performed in 41 patients in prone position (group A) and other 41 patients (group B) performed by the same surgeon in left lateral position.

RESULTSPreoperatively, the endoscopic location of the tumor was in the upper third in 5 cases (2 vs. 3), the middle third in 21 cases (12 vs. 9), and the lower third in 56 cases (27 vs. 29). The median operative time was 230 (range 170-310) min in group A and 280 (range 190-380) min in group B (P=0.04). The median intraoperative blood loss was 275 (range 100-320) ml in group A and 360 (range 120-670) ml in group B (P=0.09). The median number of lymph nodes dissected was 8.4 (range 4-23) in group A and 6.9 (range 6-21) in group B (P=0.03). The postoperative complications totaled 6 (14.6%) in group A and 8 (17.1%) in group B (P=0.44). After a median follow-up period of 15.7 (range 2-28) months for group A and 16.3 (range 3-31) months for group B, 19 patients in group A died and 21 patients in group B.

CONCLUSIONSFor esophageal cancer under T3N1M0, surgical outcomes are similar between prone thoracoscopic esophageal mobilization and left lateral position. Prone position may be associated with better lymph node dissection.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prone Position ; Retrospective Studies ; Thoracoscopy ; methods ; Treatment Outcome

BACKGROUNDPrevious work has shown that optic nerve and sciatic nerve conditional medium had neurotrophic activity on neurons. In order to find if the optic nerve conditioned media (CM) had a similar activity to make PC12 cells differentiate as sciatic nerve CM did, we explored the neurotrophic activity in optic nerve CM in the same in vitro system and compared the neurotrophin expression levels in optic and sciatic nerves under both conditions.

METHODSPC12 cells were used to examine the effects of neurotrophins secreted by the sciatic nerve and optic nerve. RT-PCR and real-time QPCR showed that the sciatic nerve and optic nerve produced a range of neurotrophins including nerve growth factor (NGF), brain derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3).

RESULTSThe effects of sciatic nerve and optic nerve CM on neurite outgrowth were tested against a range of neurotrophins, and they had different neuritogenic activities. Only NGF and sciatic nerve CM had obvious neuritogenic activities, although the concentration of NGF in the sciatic nerve CM was very low.

CONCLUSIONSOur experiment showed that sciatic nerve CM had a higher neurotrophic activity on PC12 cells than optic nerve CM. These results suggested that peripheral nervous system (PNS) and central nervous system (CNS) had different expression levels of neurotrophin, which may in part explain the lack of ability to regenerate the CNS.

Animals ; Brain-Derived Neurotrophic Factor ; genetics ; pharmacology ; Cell Differentiation ; drug effects ; Culture Media, Conditioned ; metabolism ; pharmacology ; Nerve Growth Factor ; genetics ; pharmacology ; Neurotrophin 3 ; genetics ; pharmacology ; Optic Nerve ; metabolism ; PC12 Cells ; cytology ; drug effects ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Sciatic Nerve ; metabolism

OBJECTIVETo review the quality of Epimedium extract in the market.

METHODThe contents of icariin, epimedin C, sagittatoside B and total flavonoids in Epimedium extracts sold in the market were assayed by the methods of HPLC and UV respectively. HPLC fingerprintings were obtained at the same time.

RESULTThe contents of icariin in most of the extracts are closely similar with the ones labeled by the companies. 3 type chromatograms were classified in all the HPLC fingerprintings, and were corresponded with their raw materials. The contents of epimedin C, sagittatoside B and total flavonoids were different in the samples with the same content of icariin.

CONCLUSIONWe can primarily confirm the origin of raw materials by comparing the HPLC fingerprinting of extracts with the ones of materials. The difference of extracts quality mainly comes from the difference of materials. So we suggest that Epimedium extract product should be labeled the origin of materials, and assayed with more compound contents, to ensure the quality stabilization.

China ; Chromatography, High Pressure Liquid ; methods ; Ecosystem ; Epimedium ; chemistry ; classification ; growth & development ; Flavonoids ; analysis ; standards ; Plant Extracts ; analysis ; chemistry ; standards ; Plants, Medicinal ; chemistry ; growth & development ; Quality Control ; Species Specificity