Objective To observe the effect ofJianpi-Huoxue decoction on the adrenocorticotropic hormone levels and vascular endothelial growth factor of patients with chronic nephritis.Methods 120 patients with chronic nephritis from January 2012 to December 2013 in TCM Hospital of Yanggu county were selected and recruited into a control group and a treatment group, with 40 patients in each group, according to random number table method. The control group was given oral indomethacin, 1 tablets each time, 3 times/d; intramuscular injection of methotrexate, 1 piece/time, 1 times/week. The treatment group was additionally treated by Jianpi-Huoxue decoction on the basis of the control group. Both groups were treated for 3 months. The serum adrenocorticotropic hormone and vascular endothelial growth factor levels were measured before and after the treatment,and efficacy and safety were also evaluated.Results After the treatment, the total effective rate was 72.5% (29/40) in the control group and 97.5% (39/40) in the treatment group, with significant differences (χ2=7.941,P<0.05). The ACTH levels after treatment was (13.82 ± 5.94 ng/Lvs. 8.01 ± 4.16 ng/L) in the treatment group and (18.73 ± 6.84 ng/Lvs. 8.07 ± 4.08 ng/L) in the control group, showing significant increase compared with before treatment (P<0.01). The level of VEGF was (61.92 ± 26.37 ng/Lvs. 83.72 ± 30.63 ng/L) in the treatment group and (49.36 ± 23.93 ng/Lvs.84.34 ± 33.49 ng/L) in the control group, showing significant decrease than before treatment (P<0.01). After the treatment, the increase of ACTH and the decrease of VEGF in the treatment group were better than those in the control group (t=3.427, 2.231,P<0.05).ConclusionsJianpi-Huoxue decoction combined with conventional western therapy can increase the level of ACTH in patients with nephritis, reduce VEGF, and improve clinical curative effects.

Objective To investigate the relation of a lipopolysaecharide receptor CDl4C-159T gene polymorphism to severe sepsis outcome and cytokines in postoperative severe sepsis.Methods A prospective,consecutive entry study was made among 42 postoperative sevel'e sepsis admitted in neurosurgeon department,Second People～Hospital ShenZhen between Feb.2007 to Jul.2007.The genomie DNA of peripheral blood nucleated cells WaS extracted.CDl4-159C/T gene polymorphism patients was detected by restrictive fragment length polymorphism(RFLP)analysis.The relationship between genotypes and the production of eytokines TNF-α,IL-6,IL-10 and mortality rate of severe sepsis were evaluated.Results The mortality of sepsis in patients with CDl4 homozygous for the T allete(Tr)(69.2％)was significanfly higher than those with genotype CT(23.1％)and C allete(CC)(7.7％).In addition,TNF-a and IL-6 production ofTI'homozygore were markedly higher than those of the TC and CC genetypes.while IL-10 production were the lowest of the three(P<0.05).Conclusion The single base pair pelymorphism at position-159 in the CD14 gene promoter might influence the outcome of severe sepsis and may be related to production of pro-inflammatory cytokines TNF-α,IL-6,and decrease the anti-inflanunatiry factor IL-10.

Objective To investigate the relation of a lipopolysaccharide receptor CD14C-159T gene polymorphism to severe sepsis susceptibility and outcome in postoperation.Methods A prospective,consecutive entry study WSS made among 42 postoperative severe sepsis admitted in neurosurgeon,and 50 health volunteers.The genomic DNA of peripheral blood nucleated was extracted.Typing of each patient for the CD14-159C/T gene polymorphism was performed by restrictive fragment length polymorphism(RFLP).Genotypes were then related to the susceptibility and mortality rate of severe sepsis.Results Development of postoperative severe sepsis increased in patients homozygous for the allele T(78.4%)than that of the allele C(21.6%)(P＜0.05).The mortalitv of sepsis were significantly higher in patients with CD14 homozygous for the T allete(TT)(84.6%)than those with genotype TC (15.4%)and C ailetc(CC)(O).Conclusion The single base pair polymorphism at position-159 in the CD14 gene promoter might influence the development of severe sepsis as well as outcome in postopration.

Objective To evaluate the feasibility of applying spectral CT material suppressed iodine (MSI) imaging as virtual plain CT scan to replace traditional non-contrast (TNC) CT in head and neck neoplasms. Methods A total of 52 patients with initial diagnosis of head and neck neoplasms underwent TNC CT scanning and spectrum mode enhanced scanning in the head and neck with spectral CT. With GSI Volume Viewer software from GE AW4.6 workstation, the enhanced scanning data were processed and MSI images were acquired. The CT values of different tissues (fat, erector spinae, cervical vertebrae, thyroid, and brain parenchyma) and the enhancement rate in erector spinae, carotid sinus were compared between MSI and TNC images. Image quality was objectively evaluated in noise and SNR for MSI and TNC images, while the subjective evaluation included the visibility of lesions, subjective acceptance rate, diagnostic efficacy (with/without lesions or lesion calcification, necrosis). Radiation dose including volume CT dose index (CTDIvol) and effective dose (ED) was compared between MSI and TNC. Results (1) CT values of erector spinae on MSI and TNC imaging were(52 ± 6)and(52 ± 7)HU respectively, and the difference between the two image modes was not significant(t=0.39,P>0.05). CT values on MSI and TNC Imaging were[-74 (-86,-59)HU]and[-79(-73,-61)HU]for fat (Z=-2.71, P<0.05),[139(121,196)HU]and[282 (237,336) HU,Z=-5.46]for vertebrae (Z=-5.46, P<0.05),[57(48,61)HU]and[96(74,110) HU]for thyroid (Z=-4.85, P<0.05),[35(32,39)HU]and[35(32,39)HU]for brain parenchyma (Z=-4.74, P<0.05) respectively. (2) There was no significant difference in enhancement rate of erector spinae between MSI and TNC imaging 1.15(1.07,1.20) and 1.14(1.03,1.26) respectively, Z=-5.50, P>0.05). The difference of carotid sinus enhancement rate was significant 5.75(4.70,6.73) and 4.37(3.91,5.61) respectively, Z=-5.50, P<0.05). (3) The noise of MSI[10.61(8.34,13.57) HU)]was higher than that of TNC [9.32(7.40,11.42) HU](Z=-2.52,P<0.05), and the SNR of MSI [-6.59(-8.59—-4.25)] was lower than that of TNC[-7.94(-10.25,-5.51)] (Z=-2.73,P<0.05). (4) Median scores of subjective imaging quality evaluation were 4(3.00,4.75) and 4(3.00,4.00) in MSI and TNC images respectively, and the difference was not significant(Z=-0.45,P>0.05).Unacceptable and acceptable cases in imaging quality of MSI were 3 and 49 respectively, while those were 2 and 50 in TNC group. Subjective acceptance rate between MST and TNC images was not significantly different(?2=0.01,P>0.05). (5) Diagnostic performance evaluation showed that the consistency of two observers was good in detecting lesions, necrosis and calcification between MSI and TNC image, with K value 0.93, 0.83 and 0.90 respectively (P<0.05). (6) Radiation doses between pure energy spectrum enhanced mode and conventional pre plus post contrast enhanced mode were compared. And differences of CTDIvol[11.78(10.98,17.30) mGy]and[23.89 (22.42, 29.98) mGy] respectively],ED [1.89(1.63,2.29) mSv]and[3.77(3.21,4.16 ) mSv] respectively] were significant(Z=-6.28, P<0.05). Pure energy spectrum enhanced mode reduced 39.07% of CTDIvol and 45.75%of ED respectively. Conclusions MSI imaging can be a potential substitute for TNC imaging. And it has clinical values in the diagnosis of head and neck neoplasms.

Objective To observe the interfering effect of different doses of penehyclidine hydrochloride (PHC) on the mRNA expressions of nuclear factor kappa B (NF-κB) and inducible nitric oxide synthase (iNOS) in the lung tissue of rats with traumatic shock so as to investigate the protective role of PHC in secondary long injury following traumatic shock and the underlying mechanism.Methods The traumatic shock model was established.A total of 104 Wistar rats were randomly divided into four groups:control group,shock group,low dose PHC group ( P1 group) and high dose PHC group ( P2 group).At the beginning of resuscitation,the rats in P1 and P2 groups were given transjugular intravenous injection of 2 ml/kg isotonic saline containing 0.15 mg/kg and 0- 45 mg/kg PHC respectively,while the rats in shock and control groups were injected only isometric isotonic saline.The rats in the four groups were killed at 2 h,6 h,12 h and 24 h after resuscitation respectively to detect the mRNA expressions of NF-κB and iNOS by using RT-PCR and determine the lung wet/dry weight (W/D) ratio,lung permeability index (LPI) and lung injury score (LIS).Results The mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS at all the time intervals in the shock,P1 and P2 groups were all significantly increased as compared with those in the control group (P＜0.05).Howerver,the P2 group showed significant reduction in aspects of the mRNA expressions of NF- κB and iNOS,lung W/D ratio,LPI and LIS at all time points and P1 group also had significant decrease regarding the mRNA expressions of NF-κB and iNOS,lung W/D ratio at2 h,6 h,and LPI and LIS at 2 h,6 h,12 h,as compared with the shock group.Meanwhile,P2 group showed evident decrease at 6 h concerning the mRNA expressions of NF-κB and iNOS,lung W/D ratio,LPI and LIS as compared with P1 group (P ＜ 0.05 ).Conclusions PHC,especially at a large dosage,can significantly mitigate the long injury secondary to traumatic shock,and the mechanism may be associated with the inhibition of mRNA expressions of NF-κB and iNOS.

Objective To evaluate the relationship between aged diabetes mellitus and cognitive impairment in community elders.Method 308 type Ⅱ diabetic patients, including 225 diabetes patients and 164 diabetes with hypertension patients, were random selected in our study. 225 hypertension and 186 healthy elders were random selected as controls. Mini-Mental State Examination (MMSE) was tested on each case. According to DSM-IV, all participants were classified into three groups ( normal, MCI and dementia) .Result MMSE scores in diabetes patients were lower than that in healthy controls(25. 87±3.33 vs 26. 86 ±2. 82, F = 9.62, P < 0. 01), and scores in diabetes with hypertension group (24. 68 ±4. 36 ) were much lower than that in healthy controls ( F =37. 16, P <0.01). Conclusion Senile diabetes were positive correlated with cognitive impairment. Diabetes were a risk factor of dementia in seniles. Diabetes with hypertension can increase cognitive impairment in community elders.

Objective To evaluate the efficacy of transarterial chemoembolization (TACE) and percutaneous cryosurgery sequential therapy for unresectable hepatocellular carcinoma (HCC).Methods Four hundred and twenty patients with unresectable HCC were divided into sequential TACE-cryosurgery sequential (sequential) group (n=290) and cryosurgery alone (cryoalone) group (n = 130). TACE was performed with the routine operation; the percutaneous cryosurgery was conducted 2 to 4 weeks after TACE. The patients were followed up at the first month and once every 2 to 3 month later. Liver ultrasound or both computer tomography and alpha fetal protein were examined during follow-up. Results During a mean follow-up of (42±17) months (range from 24 to 70 months), the local recurrence rate of ablated lesion was 17% for all the patients, 11% and 24% for patients in sequential group and cryoalone groups respectively (P=0. 001). The overall 1-, 2-, 3-, 4-and 5-year survival rate was 72%, 57%, 47%, 39% and 31%, respectively. The 1- and 2-year survival rates (71% and 61 % ) in sequential group were similar to those (73 % and 54 % ) in cryo-alone group (P=0.69 and 0. 147), while the 4- and 5-year survival rates were higher in sequential group (49 % and 39 % ) than those (29 % and 23 % ) in cryo-alone group (P= 0.001). Eighteen patients with large HCC (＞5 cm in diameter) in sequential group survived for more than 5 years while no one in cryo-alone group. Complication rate was 24% in all patients, 21% and 26% for the sequential and cryo-alone groups respectively (P=0. 06). The incidence of hepatic bleeding was higher in cryo-alone group than in sequential group (P=0. 02). Liver crack occurred in two patients of the cryoalone group. Conclusions Pre-cryosurgical TACE increased the cryoablation efficacy and decrease its complications, especially hepatic bleeding. TACE and cryosurgery sequential therapy may be a better treatment for unresectable HCC, especially for large HCC.

Ameloblastoma in the tibia is rare. Limb reconstruction after tumor resection is challenging in terms of selection of the operative method. Here, we report a case of radical resection of an ameloblastoma in the mid-distal tibia combined with limb salvage using a three-dimensional (3D)-printed prosthesis replacement, with 1-year follow-up results. After receiving local institutional review board approval, a titanium alloy prosthesis was designed using a computer and manufactured with 3D-printing technology. During the operation, the stem of the prosthesis was inserted closely into the proximal tibial medullary cavity. Then, the metal ankle mortise and the talus were compacted closely. Radiographic results at 1-year follow up showed that the prosthesis was well placed, and no loosening was observed. The Musculoskeletal Tumor Society (MSTS) 93 functional score was 26 points, and the functional recovery percentage was 86.7%. Computer-assisted 3D-printing technology allowed for more volume and structural compatibility of the prosthesis, thereby ensuring a smooth operation and initial prosthetic stabilization. During the follow up, the presence of bone ingrowths on the porous surface of some segments of the prosthesis suggested good outcomes for long-term biological integration between the prosthesis and host bone.
Alloys ; Ameloblastoma ; Ankle ; Ethics Committees, Research ; Extremities ; Follow-Up Studies ; Limb Salvage ; Methods ; Prostheses and Implants ; Talus ; Tibia ; Titanium

OBJECTIVETo determine the role of serine residues at position 63-84 of CITED1 in the nuclear translocation of CITED1 and osteoblast differentiation.

METHODSWe engineered all the 9 phosphorylated serine residues of CITED1 with a serine-to-alanine mutation at position 63-84. MC3T3E1 cells transfected with pCDNA3-CFP-CITED1 63-84 (9S>A), pCDNA3-CFP-CITED1, and vehicle plasmid were examined with confocal laser scanning microscopy before and after treatment with 100 nmol/L parathyroid hormone [PTH(1-34)] to observe the changes in the intracellular localization of CITED1. The transfected cells were induced for osteoblastic differentiation with mineralized solution in the absence or presence of 10 nmol/L PTH(1-34), and the changes in ALP activity and Ca(2+) concentration were measured; RT-PCR was used to detect the changes in ALP2, RUNX2, and OC gene expressions after the treatments.

RESULTSs PTH(1-34) promoted the nuclear translocation of CITED1 in MC3T3-E1 cells. The (63-84) 9S>A mutation of CITED1 obviously suppressed its translocation and increased ALP activity and Ca(2+) levels in the cells, which led to enhanced mineralization in the cells with also increased expressions of ALP2, RUNX2, and OC.

CONCLUSIONThe serine residues at position 63-84 of CITED1 play a vital role in the nuclear translocation of CITED1 and osteoblast differentiation.

Active Transport, Cell Nucleus ; Animals ; Cell Differentiation ; Cell Line ; Cell Nucleus ; Mice ; Mice, Inbred C57BL ; Mutation ; Nuclear Proteins ; metabolism ; Osteoblasts ; cytology ; Plasmids ; Serine ; metabolism ; Trans-Activators ; metabolism

Objective:To investigate the advantages and disadvantages of percutaneous compression plate (PCCP) for femoral neck fractures in the elderly patients.Methods:A retrospective study was conducted of the 31 elderly patients with femoral neck fracture who had been treated with PCCP from January 2012 to December 2018 at Orthopaedic Department, The First People's Hospital of Yancheng, Orthopaedic Department, The Ninth People's Hospital of Wuxi and Department of Orthopaedics, The People's Hospital of Wuxi. They were 16 men and 15 women, aged from 65 to 80 years (average, 70.5 years). By the Garden classification, 7 cases were type Ⅱ, 15 cases type Ⅲ and 9 cases type Ⅳ; by the Singh index, 4 cases were level Ⅲ, 11 cases level Ⅳ, 10 cases level Ⅴ and 6 cases level Ⅵ. The time from injury to operation ranged from 3 to 14 days (average, 5.8 days). The operation time, intraoperative blood loss, fracture reduction, fracture union time, complications and functional recovery of the hip were observed.Results:The operation time averaged 73.4 min and intraoperative blood loss 116.4 mL. At one week after operation, the Garden alignment index was level Ⅰ in 25 cases and level Ⅱ in 6. Superficial incision infection was noted in one case intraoperatively. Follow-ups for the 31 patients ranged from 12 to 47 months (mean, 18.9 months). All the fractures united after 4.9 months on average (from 4 to 8 months). Delayed union occurred in 2 cases, neck shortening in 12 cases, and avascular necrosis of femoral head in 3 displaced subcranial fractures 2 of which were high shear ones. The necrosis of femoral head was treated by arthroplasty in 2 and by conservative treatment in one. The Harris hip scores at the last follow-up for the 31 patients averaged 90.9 (from 75 to 100), giving 15 excellent, 12 good and 4 fair cases and an excellent to good rate of 87.1% (27/31).Conclusions:In treatment of femoral neck fractures in the elderly patients, PCCP has advantages of allowing early weight-bearing after operation, a high rate of fracture union, limited complications and quick and fine functional recovery of the hip. However, it should be used with caution in patients with severe osteoporosis, displaced subcranial or high shear fracture.