Objective To present a method to treat soft tissue defects with bone exposure after the distal tihial fracture.Methods Twenty-six patients who had suffered from the distal tibial fracture complications leading to exposure of the bone or fixation material sought medical help in our department.The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases.Five of the 26 cases were treated using a free microvascular muscle flap and the mesh skin graft by one stage.Twenty-one of them were re- paired with the same method by two-stage.Results Follow-ups were 10 to 24 months.The microvascular re- construction was successful in 22 patients.Two of the 26 cases had partial necroses of the skin graft,and the other two cases had delayed wound healing.All the fractures united.Conclusion Microvascular free muscle flap re- construction of the leg is regarded as a reliable method to treat legs with massive soft-tissue defects or defects with bone exposure and chronic infection or fistulation at the distal leg.

Objective To explore the role of CD 30 on CD4 + T lymphocyte and T lymphocyte subset activation in asthma pathogenesis.Methods Twenty seven asthma active attack patients,16 acute upper respiratory infection patients and 19 control children were randomly selected. Direct immunofluorescence flow cytometry was used to detect the CD 30 positive percentage on CD4 +cell; ELISA was used to detect the levels of interleukin(IL) 4 and IL 13 in culture supernatants of peripheral blood mononuclear cells(PBMC) and plasma total immunoglobulin E(IgE) level.Results Compared with control group and acute upper respiratory infection group, in asthmatic children the CD4 +CD 30 + percentage on CD4 + cell was elevated significantly; 2.The levels of IL 4 and IL 13 in supernatants of cultured lymphocyte were increased significantly, the plasma total IgE level was increased significantly;3.There was a significant positive correlation of CD4 +CD 30 + cell percentage with the levels of IL 4 and IL 13 in culture supernatants and plasma total IgE.Conclusions The cell that could produce Th2 derived cytokine may consist of CD 30 +cell;When CD 30 L combined with CD 30 on CD4 + cells ,it might result in Th2 cell proliferation ,develop and release Th2 derived cytokine; IL 4 and IL 13 could induce B cell production and secrete more IgE. It is suggested that CD 30 and imbalance of Th2 subset may play an important role in asthma pathogenesis.

Acute Disease ; Adult ; Animals ; Brucellosis ; transmission ; Cattle ; blood ; Female ; Food Handling ; Humans ; Male ; Middle Aged ; Occupational Diseases ; etiology ; Sheep ; blood

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

The gene of mutated TNF-?D4 gene was amplified by overlap PCR and cloned into the prokaryotic expressive vector pBV220.TNF-?D4 contains two changes:substitutions of Pro8Arg,Ser9Lys,Asp10Arg,Ile157Phe,Leu29Ser,Arg31Val and a deletion of the N terminal four amino acids.The recombinant vector pBV220-TNF-?D4 was transformated into E.coli strain DH5?,and the high expression strain was obtained by screening monoclones.The level of expression was about 45% of total cell protein.After purification,the purity of fusion protein was above 90% by HPLC and relative ability was 8 ?107.TNF-?D4 was modificated by mPEG-ButyrALD。After purification,the purity of mPEG-TNF-?D4 was above 85% and relative ability was 8.6?107.The in vivo systemic toxicity of mPEG-TNF-?D4,which is indicated by LD50,is lower than that of rhTNF-?.These results strongly supported for the further study and exploitation of TNF-antitumor drug.

Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as 'index cases', including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route (74.9%, or 143/191 ), followed by homosexual transmission ( 19.4%, or 37/191 )and injection drug use (5.8%, or 11/191 ). These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 (47.3%) tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases (45.6%, or 47/103) and malesex partners of HIV-infected men having sex with men (MSM) (60.0%, or 12/20). Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.

Background:Accumulating studies on computational fluid dynamics (CFD) support the involvement of hemodynamic factors in artery stenosis.Based on a patient-specific CFD model,the present study aimed to investigate the hemodynamic characteristics of transplant renal artery stenosis (TRAS) and its alteration after stent treatment.Methods:Computed tomography angiography (CTA) data of kidney transplant recipients in a single transplant center from April 2013 to November 2014 were reviewed.The three-dimensional geometry of transplant renal artery (TRA) was reconstructed from the qualified CTA images and categorized into three groups:the normal,stenotic,and stented groups.Hemodynamic parameters including pressure distribution,velocity,wall shear stress (WSS),and mass flow rate (MFR) were extracted.The data of hemodynamic parameters were expressed as median (interquartile range),and Mann-Whitney U-test was used for analysis.Results:Totally,6 normal,12 stenotic,and 6 stented TRAs were included in the analysis.TRAS presented nonuniform pressure distribution,adverse pressure gradient across stenosis throat,flow vortex,and a separation zone at downstream stenosis.Stenotic arteries had higher maximal velocity and maximal WSS (2.94 [2.14,3.30] vs.1.06 [0.89,1.15] m/s,256.5 [149.8,349.4] vs.41.7 [37.8,45.3] Pa at end diastole,P =0.001;3.25 [2.67,3.56] vs.1.65 [1.18,1.72] m/s,281.3 [184.3,3 64.7] vs.65.8 [61.2,71.9] Pa at peak systole,P =0.001) and lower minimal WSS and MFRs (0.07 [0.03,0.13] vs.0.52 [0.45,0.67] Pa,1.5 [1.0,3.0] vs.11.0 [8.0,11.3] g/s at end diastole,P =0.001;0.08 [0.03,0.19] vs.0.70 [0.60,0.81] Pa,2.0 [1.3,3.3] vs.16.5 [13.0,20.3] g/s at peak systole,P =0.001) as compared to normal arteries.Stent implantation ameliorated all the alterations of the above hemodynamic factors except low WSS.Conclusions:Hemodynamic factors were significantly changed in severe TRAS.Stent implantation can restore or ameliorate deleterious change of hemodynamic factors except low WSS at stent regions.

Objective To explore the changes of tumor necrosis factor-?(TNF-?) in serum and cerebrospinal fluid(CSF) of children with acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia(AML) and its clinical significance.Methods TNF-? in serum and CSF were measured by radioimmunoassay and CSF samples were obtained from 31 cases of childhood acute leukemia before treatment, on complete remission(CR), and continuous CR.Results Serum TNF-? was in ALL and AML before treatment [(24.35?4.84) pmol/L and(28.65?5.12) pmol/ L],which were significantly higher than those of healthy controls[(11.2 8? 1.69) pmol/L, P

Integration of "5+3" training mode is to accelerate the construction of standardization of clinical medical personnel training system,and the establishment of the new training mode.The training goal is to make the students become the high-level clinicians with the ability of clinical thinking and clinical practice,and scientific research and teaching,who can independently and pro-fessionally prevent and treat the related common disease.Therefore,guided by the general training goal of our students,we designed and practiced a teaching mode centered on "immune disease mechanism analysis" in the teaching of medical immunology,aiming at improving students'ability of clinical thinking,self learning and team coorperation.