OBJECTIVETo compare clinical outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) in treating distal tibial comminuted fractures at early and delayed stage.

METHODSFrom January 2006 to January 2012,66 patients with distal tibial comminuted fractures were treated by MIPPO. All patients were divided into primary group and delayed group according to operation time. There were 31 patients in primary group, including 18 males and 13 females aged 21 to 57 years old with an average of (39.0 +/- 17.8), treated by MIPPO at primary stage,according to Tscherne soft tissue injury, 18 cases were grade I ,12 cases were grade II and 1 case were grade III. Thirty-five patients were treated by MIPPO at delayed stage, including 16 males and 19 females aged 24 to 55 years old with an average of (39.5 +/- 15.2), according to Tscherne soft tissue injury, 6 cases were grade I, 26 cases were grade II and 3 cases were grade III. Operation time, blood loss, hospital stay, fracture healing time and complications of two groups were recorded and observed, Lowa scoring of ankle joint were used to evaluated therapeutic effects at final following and AP and lateral X-rays were used to evaluated fracture reduction and alignment.

RESULTSAll patients were followed up, the time of following-up of primary group was (13.5 +/- 3.5) months, (15.2 +/- 3.8) months in delayed group, there was no significant meaning between two groups (t = 1.882, P = 0.064). There was no significant differences between two groups in operation time and blood loss (P > 0.05), but hospital stay in primary group was shorter than that of delayed group(P<0.05). There was no significant meaning between primary group (5.5 +/- 2.8) and delayed group (6.2 +/- 3.1) in fracture healing time (t = 0.958, P = 0.342); there was no significant meaning between primary group (87.6 +/- 6.8) and delayed group (89.6 +/- 5.2) in Lowa scores at final following-up (t = 1.351, P = 0.182). Two cases occurred postoperative superficial inflammatory reaction around fibular incision in primary group, 1 case occurred postoperative superficial inflammatory reaction around fibular incision and 1 case occurred delayed deep incision infection in delayed group at four months after operation. There was no significant differences in incidence of postoperative soft tissue complications between primary group (6.5%) and delayed group (5.7%) (t = 0.016, P = 0.900).

CONCLUSIONFor distal tibial comminuted fractures with grade I and II of Tscherne soft tissue injury, MIPPO at primary stage can not increase incidence of soft tissue complications, also can obtain the same clinical outcomes just like delayed MIPPO.

Adult ; Bone Plates ; Case-Control Studies ; China ; epidemiology ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; etiology ; Tibial Fractures ; surgery ; Time Factors ; Treatment Outcome ; Young Adult

Objective To evaluate the long-term results of extended parietal cell vagotomy (EPCV) for the treatment of acutely perforated duodenal ulcer. Methods EPCV was performed on 239 patients. Results were analyzed retrospectively. Results Follow up was made on 203 out of 239 patients (84.9%). There was no operative mortality. Inhospital complications included injury to the spleen in 4 cases (1.7%), adhesive ileus in 6(2.5%), acute diarrhea in 3 (1.3%), and postprandial epigastric distention in 18 (7.5%). Long-term complications included epigastric pain and sour regurgitation in 16 cases(7.8%), enterolysis in 4(1.9%), duodenal bulb allaxis in 39(18.2%), chronic gastritis in 21(10.3%), and recurrent ulcer in 6(2.9%). Basic acid output, maximal acid output and peak acid output decreased by 84.7%, 60.0%, and 58.0% respectively(all P

OBJECTIVETo investigate the effects and regulatory mechanism of ILK on angiogenesis in hypertrophic scar.

METHODSThe human scar microvascular endothelial cells (HSMECs) were isolated from 6 patients' hypertrophic scar in vitro. The HSMECs with good condition in 2nd to 4th generation were selected as experimental objectives. (1) HSMECs were divided into the blank control group (treated with routine culture), negative control group (treated with only Lipofectamine 2000), LY294002 group (incubated with 50 nmol/L LY294002), ILK siRNA group (incubated with 20 nmol/L ILK siRNA). RT-PCR and Western Blot were used to detect the expression of ILK mRNA and its protein after transfecion for 48 h. (2) The digested HSMECs of four groups were resuspended with DMEM without serum and then seeded onto the upper compartment of transwell insert which contained complete medium in its lower compartment. The cell migration experiment was stopped in 10 h and then the migrated cells were counted to analyze the effects of different interventions on the migration ability of HSMECs. (3) The thawed ECMatrix was put into each well of pre-colled 48-well tissue culture plate, and then the plate was put into the incubator at 37 degrees C to make it to become gel. The HSMECs of four groups were seeded onto the surface of the ECMatrix gel and were put into incubator. Eight random view-fields per well should be valued by the sheet of pattern recognition about angiogenesis after 8 hours to evaluate the ability of angiogenesis in vitro between four groups.

RESULTS(1) The expression of ILK mRNA (ILK mRNA = 0.829 +/- 0.109, t = 13.151, P = 0.006) and protein (ILK protein = 0.096 +/- 0.049, t = 36.656, P = 0.000) were both inhibited obviously in ILK siRNA group compared with the blank control group (ILK mRNA = 0.829 +/- 0.109, ILK protein = 1). And, the expression of ILK in LY294002 group was slightly lower than that of black control group, but there was no statistical difference. (2) The number of migrated cells in ILK siRNA group (88.111 +/- 3.079) and LY294002 group (138. 667 +/- 2.404) were respectively lower than that in blank control group (322.333 +/- 3.712, P < 0. 05) in 10th hour. (3) Compared to blank control group (4.333 +/- 0.191), the ability of angiogenesis in vitro decreased significantly ILK siRNA group (2.625 +/- 0.125) and LY294002 group (3.125 +/- 0.250), in which, the vascular network structures were not formed perfectly in 8th hour (P < 0.05).

CONCLUSIONSThe ability of HSMECs' migration and angiogenesis in vitro are inhibited significantly when the expression of ILK is down-regulated. It reveals that ILK may play an role in the regulation of scar angiogenesis.

Cell Movement ; Cell Proliferation ; Chromones ; pharmacology ; Cicatrix, Hypertrophic ; enzymology ; pathology ; Endothelial Cells ; cytology ; drug effects ; Humans ; Lipids ; pharmacology ; Morpholines ; pharmacology ; Neovascularization, Pathologic ; etiology ; pathology ; Protein-Serine-Threonine Kinases ; genetics ; physiology ; RNA, Messenger ; analysis ; RNA, Small Interfering ; metabolism

AIMTo investigate the expressions of main subtypes of heat shock protein (HSP) in cervical cancer and precancerosis tissues.

METHODSAccording to the pathological diagnosis, 478 cases of cervical biopsy specimen were divided into invasive carcinoma of cervix group (63 cases), cervical intraepithelial neoplasia group (CIN, 106 cases), chronic cervicitis group (293 cases) and normal uterine cervix (16 cases).The expression levels of HSP70, HSP90a and HSP90beta3 mRNA were detected by quantitative RT-PCR with specific complex cRNA as internal control.

RESULTS(1) The expressions of HSP70, HSP90a and HSP90beta mRNA were significantly down-trended stepwise in invasive carcinoma of cervix, CIN, chronic cervicitis and normal cervix tissue (P < 0.01, respectively). (2) In the invasive carcinoma of cervix group, the expression level of HSP90beta mRNA was higher in advanced stage (FIGO II b) compared with incipient(FIGO-II a) carcinoma of the cervix (P < 0.05). (3) The expressions of HSP70 and HSP90 mRNA were each higher in poorly differentiated tumor than in well-differentiated tumor (P < 0.05, respectively). (4) The expression levels of all three HSP mRNA had no significant differences, it was observed with different histological types of cervical cancer (P > 0.05).

CONCLUSIONHeat shock protein may play some important roles in malignant transformation of cervix cell and aggravation of cervix cancer. HSP70 and HSP90alpha may promote cancer cell transition and proliferation, and HSP90beta may participate in cell differentiation.

Carcinoma ; metabolism ; pathology ; Female ; HSP70 Heat-Shock Proteins ; metabolism ; HSP90 Heat-Shock Proteins ; metabolism ; Humans ; Precancerous Conditions ; metabolism ; pathology ; Tumor Cells, Cultured ; Uterine Cervical Neoplasms ; metabolism ; pathology ; Uterine Cervicitis ; metabolism ; pathology

OBJECTIVETo examine the expressions of B7-H1 and its receptor programmed death-1 (PD-1) on circulating T cells and myeloid dendritic cells (mDCs) in patients with chronic hepatitis B virus (HBV) infection and to investigate the correlation between their expressions and their disease status.

METHODSThe expressions of B7-H1 and PD-1 on mDCs and T lymphocytes in 30 patients with chronic HBV infection and 28 healthy controls were analyzed by a fluorescence-activated cell sorter (FACS). Real time-polymerase chain reaction (RT-PCR) was used to measure the serum HBV DNA load.

RESULTSBoth B7-H1 and PD-1 were significantly upregulated on T cells and mDCs in those patients. Their expressions were positively correlated with the patients serum ALT levels and HBV DNA loads.

CONCLUSIONB7-H1 and PD-1 expressions in our patients with chronic hepatitis B are closely associated with their disease status.

Adult ; Antigens, CD ; metabolism ; B7-H1 Antigen ; Case-Control Studies ; Dendritic Cells ; metabolism ; Female ; Hepatitis B, Chronic ; metabolism ; Humans ; Male ; Middle Aged ; T-Lymphocytes ; metabolism ; Young Adult

OBJECTIVETo evaluate the stress level during parachuting training by salivary biomarker and to study the dynamic characteristics.

METHODSTwenty recruits of military parachuting training completed 8 trainings in a month. The saliva samples were collected at 2 h and 1h before boarding and at 0.5 h after landing on the 1st, 4th and 7th trainings. The levels of cortisol, chromogranin A and α-amylase in saliva samples were detected.

RESULTSThe concentrations of cortisol, chromogranin A and activity of α-amylase increased significantly from pre-boarding to landing during 3 trainings. The concentrations of cortisol, chromogranin A and activity of α-amylase at 2 h before boarding and at 0.5 h after landing decreased significantly with the training times. However, the changes of 3 biomarkers at 1 h before boarding among 3 trainings were not significant.

CONCLUSIONThe levels of stress increased significantly for 20 recruits from pre-boarding to landing during parachuting trainings. The stress levels of 20 recruits before boarding and after landing significantly decreased with parachuting training times.

Aviation ; Biomarkers ; analysis ; Chromogranin A ; analysis ; Humans ; Hydrocortisone ; analysis ; Male ; Saliva ; chemistry ; Stress, Psychological ; Young Adult ; alpha-Amylases ; analysis

OBJECTIVETo provide a basis for development and preparation of the new anti-tumor agents from Cortex A-canthopanacis senticosus (CAS), through isolating the active substances from CAS and studying the anti-tumor effect of CAS extracts in vivo and in vitro.

METHODSThe effects of CAS extracts and its isolated ingredients on tumor cell proliferation in vitro was determined by 3H-TdR incorporation; the anti-tumor component of CAS was isolated and purified by chromatography; the tumor bearing mice model was established by injecting tumor cell subcutaneously, and the model was used to observe the anti-tumor effect of CAS extract administered through gastrogavage.

RESULTSCAS extract showed obvious inhibition on tumor cell proliferation originated from multiple tissues (P < 0.01) and displayed a better dose-effect relationship. After orally taken CAS extract, the general condition of mice in the experimental group were better than that in the untreated control group, revealing a slower growth and significantly prolonged survival period (P < 0.01). A protein component, having inhibitory effect on tumor cell proliferation and the molecular weight was 64 kda, it was isolated by the thin layer gel chromatography.

CONCLUSIONCAS has not only the in vitro inhibitory effect on cell proliferation of multiple kinds of tumor, but also a good anti-tumor effect in vivo. The anti-tumor activity of CAS is correlated with a protein component with the molecular weight of 64 kda. Further isolation, purification, study on mechanism will provide scientific evidence for clinical application and development of CAS in anti-tumor effect.

Animals ; Antineoplastic Agents, Phytogenic ; pharmacology ; Cell Division ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Eleutherococcus ; Female ; HL-60 Cells ; pathology ; Humans ; Leukemia, T-Cell ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Tumor Cells, Cultured

Objective To study the clinical value of color Doppler ultrasonography in typing tuberculous epididymitis.Methods The appearances of color Doppler ultrasound and the findings on operation were analysed in 33 patients with tuberculous epididymitis.Results Of the 33 patients,epididymis appeared as diffusely and heterogeneously enlarged lesions with increased flow in 2 cases,appeared as nodular lesions in 13 cases including nodi with echofree space in 3 cases, nodi with high-level echo patches in 3 cases, and low echo-level nodi in 7 cases. Multiple lesions in scrotum were detected in 17 cases, of whom epididymis up to 11 cases appeared as diffusely enlarged heterogeneous lesions with flow increased.The sonographic appearancs of tuberculous epididymitis could be divided into 3 types:diffusion type, nodus type and complicated type. Nodus type included 3 subtypes: purulence type, calcification type, and cheese type.The accuracy rate of ultrsound diagnosis was 87.9%.Conclusions Testis is easy to be involved when epididymitis appears as diffusion type, so surgical treatments should be early.Purulence type and complicated type need surgical treatments while calcification type does not. Antituberculous drug treatments can be tried before surgical treatments in cheese type.Sonography of urinary system is helpful for the diagnosis of asymptomatic tuberculosis in urinary system when tuberculous epididymitis is first suspected on sonography.

Objective To evaluate the safety and feasibility of sphincter-preserving transabdominal-anal excision of middle-lower rectal cancer by mucosa-mucosa coloanal anastomosis. Methods There were 169 cases undergoing this procedure including 107 males and 62 females. The low margins of the tumors located between 5~9 cm from the anal verge. Histopathological examination showed adenocarcinoma in 163 cases, mucinous adenocarcinoma in 6, and adenoma with canceration in 6.According to Dukes′ classification,61 belonged to Dukes′ A,101 Dukes′B, and 7 Dukes′C. Results Postoperative complications included stomal leak in 5 cases, stomal stenosis in 3, and defecation frequency increased to 6～12 times daily in all cases during the early stage and gradually back to normal 12～18 weeks postoperation. An average follow-up of 5.8 years was made in 154 cases(91.1%).Local recurrence was 5.8%.Hepatic metastasis was 13.7%.The five year survival rate was 66.9%. Conclusion This anal-sphincter preserving procedure while fulfilling radical resection for middle-lower rectal carcinoma is both safe and feasible alternative approach.

objecfive To know and compare the intelligence level of children born in different time periods in regions with iodine deficiency disorders(IDD)in Liaoning province.Methods All 7-14 year-old children from ten schools were chosen as the subjects respectively from six villages in each of the six counties and in regions with iodine deficiency,who were respectively born at the initialization of iodinated salt supplying period(1978-1980);non-iodinated salt supplying period(1981-1990);recovery of supplied iodized salt period(1991-1995);universal iodized salt period(1996-2000),respectively.Intelligence quotient(IQ)was measured by Combined Ravens Test in China(CRT-C)and Combined Ravens Test-the Rural,in China,2nd edition(CRT-RC2).Results IQ of children during the non-iodized salt period(91.9±14.3)was significantly lower than the initial supply of iodized salt period(95.8±14.6,q=8.60,P<0.01),recovery of supplied iodized salt period(99.7±14.7)was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period(q = 9.53, 18.13, all P < 0.01 ),universal salt iodization( 104.3 ± 14.9) was significantly higher than the initial supply of iodized salt period, non-iodized salt sales period, recovery of supplied salt iodization(q = 20.00,28.00,10.46, all P < 0.01). Children's rate of mental retardation (IQ≤69) was higher in non-iodinated salt supplying period (6.7%, 88/1314 ) than the initial supply of iodized salt (4.4%, 21/471, χ2 = 3.85, P < 0.05), recovery of supplied iodized salt period(3.3%,48/1470) was significantly lower than non-iodinzed salt supplying period (χ2 = 15.37, P < 0.01), universal salt iodization period(2.7%, 36/1344) was lower than the initial supply of iodized salt period(χ2 = 4.41, P < 0.05) and non-iodinzed salt supplying period(χ2 = 26.34, P < 0.01 ). The IQ and intelligent retarded rates in children born during the initial years of iodinated salt supplying period were not different. The IQ of the children during ten years of non-iodized salt supplying period fluctuated in a "∪" curve, while the intelligent retardation rates in a "∩" curve.The children born during the period of recovery supplied iodized salt increased their IQ and lowered the retardation rates year after year. The IQ of the children in universal iodized salt period kept on increasing while intelligent retarded rates reduced to the lowest level. Conclusions The intelligence level of children born in regions with IDD during non-iodized salt supplying period is remarkably lower than that of the beginning years of iodinated salt supplying period. The intelligence level of children born after universal iodized salt period is remarkably higher than that of the initial iodinated salt supplying period and recovery of supplied iodized salt period, respectively.