OBJECTIVE:To discuss the relationship between the changes in pla sma endotoxin levels and use of antibiotics in patients with serious traumatic injury before and after operation.METHODS:The plasma bacterial endotoxin levels were dynamically detected by kinetic turbidimetric assay in20patients with severe traumatic injury used with different antibiotics before and after operation,at the same time the normal control group was established.RESULTS:Plasma endotoxin levels in patients with severe traumatic injury increased remarkably before and after operation,as compared with the normal control group(P0.05).CONCLUSION:Intestine-borne endotoxin induced in a stress condition can strengthen the pathological reaction of the body ,therefore dy?namic detection of plasma endotoxin can provide guidance for clinical therapy.

Objective: To investigate the expression of interleukin (IL)-1α, IL-1β and IL-1 receptor antagonist (IL-1RN) in cervical cancer and its correlation with clinical feature and prognosis of cervical cancer. Methods: The data of 4 databases were collected and analyzed on April 28, 2019. The Cancer Genome Atlas (TCGA) database was used to analyze the relationship between IL-1α, IL-1β and IL-1RN mRNA expression and prognosis in cervical cancer tissues (292 cases). The GEPIA (Gene Expression Profiling Interactive Analysis) database (http://gepia.cancer-pku.cn) was used to analyze the correlation between IL-1α, IL-1β and IL-1RN mRNA expression and prognosis in cervical cancer tissues (292 cases), the LinkedOmics database (http://www.linkedomics.org) was used to analyze IL-1α, IL-1β and IL-1RN mRNA expression in different pathological types of cervical cancer tissues (226 cervical squamous cell carcinoma tissues and 47 cervical adenocarcinoma tissues), and the STRING database (https://string-db.org) was used to analyze protein interaction networks of IL-1α and IL-1β. Results: The expressions of IL-1α, IL-1β and IL-1RN mRNA in cervical cancer tissues were significantly higher than those in normal cervical tissues (1.54 vs. 0.04, 4.82 vs. 0.46 and 73.53 vs. 0.67), and there were statistical differences (P<0.01); Kaplan-Meier survival curve analysis showed that high expression of IL-1α and IL-1β mRNA suggested poor prognosis (HR=1.7 and 1.7, P=0.021 and 0.028), and IL-1RN mRNA expression was not associated with prognosis (P>0.05). The expressions of IL-1α, IL-1β and IL-1RN mRNA were correlated between any two indexes (P<0.01), and the correlation between IL-1α and IL-1β was stronger (r=0.87, P<0.01); Kaplan-Meier survival curve analysis showed that the assessment prognosis value of IL-1α combined with IL-1β was the highest (HR=2.0). The expressions of IL-1α, IL-1β and IL-1RN mRNA in cervical squamous cell carcinoma tissues were significantly higher than those in cervical adenocarcinoma tissues (6.535 vs. 2.936, 7.382 vs. 5.588 and 11.170 vs. 8.639), and there were statistical differences (P<0.01). The associated proteins with IL-1α and IL-1β included IL-1 receptor type 1 (IL-1R1), IL-1 receptor type 2 (IL-1R2), IL-10, IL-4, IL-18, IL-1 receptor accessory protein (IL1RAP), tumor necrosis factor (TNF), caspase 1 (CASP1) and IL-8; IL1R1 mRNA expression in cervical cancer tissues was significantly lower than that in normal cervical tissues (9.56 vs. 40.961), the expressions of TNF, CASP1, IL1RAP, IL-18 and IL-8 mRNA were significantly higher than those in normal cervical tissues (1.51 vs. 0.06, 33.70 vs. 12.61, 11.12 vs. 3.02, 24.59 vs. 3.54 and 20.01 vs. 0.48), and there were statistical differences (P<0.01 or <0.05); high expression of IL-8 mRNA suggested poor prognosis (HR=2.9, P<0.01). Conclusions Overexpression of IL-1α, IL-1β and IL-1RN plays an important role in the proliferation of cervical cancer. IL-1α and IL-1β can prompt the inflammatory response and prognosis of cervical cancer, and provide a theoretical basis for the early diagnosis and prognosis of cervical cancer.

BACKGROUND:Traditional core decompression and al ograft fibula supporting can reduce the stress load within femoral head and improve mechanical properties of femoral head. However, it cannot provide supports for maintaining the stability of five pathological areas fol owing femoral head necrosis. OBJECTIVE:To observe the clinical effect of fan-shaped decompression and al ograft fibula supporting internal fixation in treatment of early femoral head necrosis in adults, taking al ograft fibula grants as the control. METHODS:Forty patients with early femoral head necrosis were randomly divided into treatment group and control group, receiving fan-shaped decompression plus al ograft fibula supporting internal fixation and traditional decompression plus al ograft fibula grafting, respectively. The therapeutic effects in two groups were observed and compared. After treatment, patients were detected by bilateral hip anteroposterior films, Harris scoring and X-ray ARCO staging to evaluate the col apse severity and restoration of necrosis. RESULTS AND CONCLUSION:At the last fol ow-up, Harris scores in the treatment group were significantly higher and the repairing effect was better than control group (P<0.05). In treatment group, 18 hips restored wel (72%) and 7 hips delayed or failed to restore (28%);in control group, 9 hips restored wel (60%) and 6 hips delayed or failed to restore (40%). Our findings indicate that, fan-shaped decompression plus al ograft fibula supporting internal fixation yields a more complete decompression, a higher stability of femoral head and a more reliable supporting, compared with traditional decompression plus al ograft fibula grafting.

Objective To investigate the relationship between the expression patterns of fibronectin (Fn) and its receptors-α5β1 and αVβ3 integrins and angiogenesis after cerebral ischemia in aged mice. Methods Both young (2 months) and aged (18 months) C57BL6 male mice were subject to middle cerebral artery occlusion. The brain endothelial cells (BECs) proliferation was assessed by using dual-immunofluorescent staning (IF) for Ki67 and CD31 and the vessel density was quantified by counting the number of CD31-positive vessels per field of view. The expression patterns of Fn,α5β1 and αVβ3 on blood vessels was assessed by using dual-IF for CD31/ɑ5,CD31/β3 and CD31/Fn. Results The number of CD31/Ki67 dual-positive cells in the penumbra at day 7 after cerebral ischemia of was significantly lower in the aged mice than in the young mice (4.7±0.8/field, P<0.05). The number of CD31-positive vessels in the penumbra at day 7 and 14 of was both significantly lower in aged mice than in the young mice (38.3±3.9/field, 45±4.4/field, both P<0.01). Furthermore, the expression of Fn, α5 and β3 on blood vessels in the penumbra at day 7 after cerebral ischemia was significantly lower in age mice than in the young mice (P<0.05). Conclusions The cerebral angiogenesis after ce?rebral ischemia is impaired in the aged stroked mice, which is associated with the low expression of fibronectin and its receptors-α5β1 andαVβ3 integrins on blood vessels.

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.

Objective To study the expressions of S100A4 and urokinase plasminogen activator(uPA) in pancreatic cancer cells and their correlation with patients prognosis.Methods The expressions of S100A4 and uPA were examined in 63 surgical specimens of primary pancreatic carcinoma by suing immunohistochemistry PV methods,and correlation of their expressions and prognosis of pancreatic cancer was analyzed.Results ( 1 ) Positive immunostaining for S100A4 and uPA was observed in 74.6％ (47 cases) and 65.1％ (44 cases) of 63 pancreatic cancer samples respectively.(2) The positive expressions of S100A4 and uPA were significantly correlated in pancreatic cancer( P =0.000,r =0.567 ).( 3 ) The expression of S100A4 significantly correlated with TNM stages( P =0.002 ),lymph node metastasis ( P =0.002 ) and distant metastasis ( P =0.007 ).The expression of uPA had a significant correlation with TNM stages ( P =0.002),lymph node metastasis ( P =0.001 )and differentiation(P =0.003).(4) Kaplan-Meier survival analysis showed that the median survival (21 months) of patients with S100A4 ( - ) was significantly longer than the median survival ( 9 months) of the patients with S100A4( + )(P=0.000) ;the median survival(9 months) of patients with uPA( + ) was significantly shorter than the median survival ( 18 months) of the patients with uPA ( - ) ( P =0.000) ; the median survival(23 months)of 13 patients with S100A4( - )/uPA( - )was significantly longer than the median survival of other cases ( Log-rank test,x2 =54.444,P =0.000).( 5 ) Cox regression model ( x2 =53.974,P =0.000 )analysis suggested:the differentiation(P =0.004),lymph node metastasis(P =0.017) 、S100A4( + ) expression ( P =0.000) and uPA ( + ) expression ( P =0.001 ) were independent prognostic factors for pancreatic cancer.Conclusion S100A4 and uPA are highly expressed in pancreatic cancer cells,and S100A4 expression has positive correlation with uPA expression,which indicates that the overexpression of S100A4 and uPA maybe poor prognosis factors for pancreatic cancer patients.S100A4 maybe promote extracellular matrix and basement membrane degradation by up-regulation of uPA protein expression,and ultimately promote tumor invasion and metastasis,which is not favorable to prognosis.They may be potential indicators of metastasis and predictors for prognosis of pancreatic cancer.

Objective To study the experiences of severe acute pancreatitis (SAP) treated by combmation of traditional Chinese and western medicine.Methods Two hundred and forty patients with SAP were divided into A and B groups randomly,140 patients of group B were treated by combination of traditional Chinese and western medicine;100 patients of group A were treated by western medicine.Results After treatment in group B, the serum and urine amylase, and c-reactive protein,signiflcantly decreased.The complication rate of group A and group B was 55.00 % and 12.86 %(P

Objective To evaluate the clinical efficacy of monosegmental pedicle instrumentation in management of thoracolumbar burst fractures. Methods A total of 67 patients with traumatic thora-columbar burst fractures (type A3.1 and A3.2) were treated with monosegmental pedicle instrumentation in our department from October 2003 to February 2008. Imageologic effect was observed by measuring sagittal index and wedge index via X-ray and clinical outcomes evaluated by using low back outcome score. Results All operations were performed successfully, with average operation duration of 93 mi-nutes and average intraoperative blood loss of 157 ml. Of all, 65 patients were followed up for 4-27 months (average 19.8 months), which showed that all the patients achieved bony fusion, with no implant failure except for one with screw loosening. The sagittal index and wedge index were 13.06°and 42.9% preoperatively and 4.47° and 21.78% postoperatively, with statistical difference (P <0.01). The final follow-up showed no significant correction loss except for two patients (P < 0.05). The low back outcome scores of all patients at follow-up were improved significantly (P < 0.05). Conclusions Monoseg-mental pedicle instrumentation has advantages of minimal invasion, short operative duration, less blood loss and less vertebral motion segment loss and hence is an effective and reliable operative technique for thoracolumbar burst fractures.

BACKGROUND:Hydroxyapatite (HA) artificial bone,as bone grafting substitute,would not cause inflammatory reaction or immunological rejection and possesses good biocompatibility after transplantation into human body.It is a novel implant material with bone conduction ability.OBJECTIVE:To investigate the efficacy of HA artificial bone in bilateral open-door posterior cervical expansive laminoplasty and to make a comparison with autogenous bone.DESIGN,TIME AND SETFING:A retrospective case analysis was performed at the Department of Spine Surgery,Hungpuyuan Branch,the First Affiliated Hospital of Sun Yat-sen University from March 2001 to December 2008.PARTICIPANTS:Seventy patients with cervical spondylosis complicated by compression in 3 or more segments or by cervical stenosis and additional fifteen patients with cervical stenosis complicated by cervical trauma were included in this study.METHODS:A bilateral open-door posterior cervical expansive laminoplasty was performed,in which,23 patients received autogenous bone transplantation (autogenous bone group) and 62 patients underwent HA artificial bone transplantation (HA group).MAIN OUTCOME MEASURES:① Japanese Orthopaedic Association (JOA) score pdor to and after surgery,surgery time,and intraoperative bleeding.② HA artificial bone-host biocompatibility.RESULTS:All eighty-five patients were followed up for more than 3 months.There was no significant difference in JOA scores no matter prior to or after surgery between the autogenous bone and HA groups (P＞0.05).The surgery time averaged 85.2 minutes (range 65-110 minutes) in the HA group and averaged 116.4 minutes (range 75-150 minutes) in the autogenous bone group.The intraoperative bleeding averaged 210 mL (range 130-400 mL) in the HA group and averaged 260 mL (range 170-500 mL) in the autogenous bone group.There were no material-host response and other severe complications found in each group,except HA artificial bone fragmentation in 3 patients from the HA group.CONCLUSION:HA artificial bone yields good efficacy and causes fewer complications in bilateral open-door posterior cervical expansive laminoplasty;in addition,it requires less time for surgery and causes less bleeding.

BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.