Dislocation of the acromioclavicular joint is a common injury seen by surgeons.Although many orthopaedic surgeons hold that injuries of Rockwood types Ⅰ and Ⅱ are usually treated nonoperatively and injuries of types Ⅳ to Ⅵ surgically,there is no consensus with regard to the treatment of type]Ⅲ injuries.There are mainly 2 disputes in the management of AC joint dislocations of Rockwood type Ⅲ concerning operative versus nonoperative treatments and different operative techniques.In this paper,we will outline the current progress in the management of acromioclavicular joint dislocation of Rockwood type Ⅲ.

Objective To investigate the role of 8 iso PGF2a in patients with chronic obstructive pulmonary disease(COPD).Methods Level of serum 8 iso PGF2a and lung function were studied in 38 patients with acute exacerbation of COPD(AECOPD),23 patients with stable COPD and 18 health subjects.Results The serum 8 iso PGF2a level was significantly higher in patients with AECOPD[(6.84?1.70)?g/L]as compared to those in the controls[(4.64?1.24)?g/L]and in patients with stable COPD[(5.82?1.72)?g/L](P

Objective To explore the dynamic changes of glutamate in the cortex of cynomolgus monkeys during cerebral ischemia.Methods Proximal M1 segment of middle cerebral artery (MCA) was occluded for 1 h in 3 young cynomolgus monkeys (7.3 ± 1.5 years old) to induce cerebral ischemia.Magnetic resonance imaging and neurologic deficit scoring were used to evaluate the ischemia and observe the manifestations,respectively.Fast Analytical Sensing Technology (FAST) was applied to record the content of cortex glutamate in the same site of ipsilateral primary motor cortex in the periods of pre-,during,and post-occlusion,and at 1 and 2 weeks after surgery.Results Compared with pre-occlusion,the content of glutamate was increased significantly in the process of occluding in the MCA M1 (P =0.003);No significant difference was observed in the content during occluding and post-occlusion (P--0.877).The content in the first week was decreased obviously as compared with post-occlusion (P--0.004),but it showed no statistical difference with that in the second week (P =0.085).Conclusion Cerebral ischemia may potentially accelerate the extra-cellular glutamate release in the cortex,but reperfusion may ameliorate or balance off the glutamate release.

Objective To survey the frequency of H deficient phenotype in blood donor population and analyze the serological and genetic characteristics of these individuals.Methods The H deficient phenotype was screened with anti-H monoclonal antibody.The ABO type was screened with serological method and with sequence specific primer polymerase chain reaction(PCR-SSP).FUT1 and FUT2 gene sequences were analyzed with direct sequencing of PCR products and gene cloning products.Result Of 85 390 blood donors,ten individuals were identified to be para-Bombay phenotype.Four h alleles were found in 14 para-Bombay phenotype individuals,h1(nt547-552?ag),h2(nt880-882?tt),h3(nt658c→t),and h_(new-2)(nt328g→a).The FUT1 genotypes of these para-Bombay individuals were h1/h1(6 individuals),h1/h2(7 individuals) and h3/h_(new2)(1 individual),and the frequency of 4 allele were 67.85%(h1),25%(h2),3.57%(h3),and 3.57%(h_(new-2)),respectively.FUT2 gene was analyzed in 12 para-Bombay phenotype individuals,and a mutation of nt357c→t was detected in all FUT2 gene,another mutation of nt716g→a were heterozygous in 5 individuals with h1/h2 genotype.No null FUT2 gene was detected.In serological analysis,all atypical anti-A or anti-B antibody of 14 para-Bombay individuals were inactive at 37℃,7 individuals had active anti-H antibody at 37℃.Conclusion The frequency of H deficient phenotype in Fujian population is about 1:8 500.The h1 and h2 alleles are predominant in Fujian H deficient individuals on h1-Se~(357) and h2-Se~(357,716) haplotype background.

Objective To investigate the therapeutic efficacy of truly anatomic reconstruction of the coracoclavicular ligament with two Endobutton devices for acute acromioclavicular joint dislocation of Rock-wood type Ⅴ.Methods From May 2013 to October 2015,25 patients with acromioclavicular joint dislocation of Rockwood type Ⅴ underwent truly anatomic reconstruction of the coracoclavicular ligament using two Endobutton devices.They were 15 men and 10 women,from 18 to 67 years of age (mean,43.0 years).All the dislocations were unilateral,involving 14 left and 11 right sides.The visual analog scale (VAS) and the Constant scoring were used at 3,6,12,18 and 24 months postoperatively for assessments of pain and shoulder function.The coracoclavicular distances on the healthy and affected sides were measured on their anteroposterior X-ray films of bilateral shoulders.Results The 25 patients were followed up for 24 to 48 months (mean,34.0 months).Their VAS score were decreased significantly from preoperative 5.0 ± 0.9 points to 0 ±0.5 points at 24 months after surgery,their Constant score increased significantly from preoperative 45.0 ± 5.6 points to 95.0 ± 2.9 points at 24 months after surgery,and their coracoclavicular distances at the affected side restored significantly from preoperative 23.0± 5.4 mm to 8.0 ± 0.9 mm at 24 months after surgery (all P ＜ 0.05).There was no significant difference in the coracoclavicular distance between the affected and the healthy sides at 24 months after surgery (P ＞ 0.05).No serious complications like acromioclavicular joint re-dislocation or clavicular condylar fracture occurred in any patient.Conclusions Truly anatomic double Endobutton reconstruction of the coracoclavicular ligament is a safe,reliable and creative surgical technique that may yield good to excellent clinical and radiological outcomes in the treatment of acute acromioclavicular joint dislocation of Rockwood type Ⅴ.

Objective To explore the predictive value of contrast-enhanced echocardiography com-bined with serum levels of CD137 and insulin-like growth factor binding protein 6(IGFBP-6)for cardiovascular adverse events(MACE)in elderly patients with stable coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods A total of 108 elderly patients with stable CHD(CHD group)who visited Department of Cardiology of Changsha First Hospital from March 2020 to March 2022 were recruited in this study.They were grouped into a non-MACE group(81 cases)and a MACE group(27 cases)according to whether MACE occurred after PCI.Another 100 healthy individuals who taking physical examination during the same period served as control group.Their serum CD137 and IGFBP-6 levels were detected,and the contrast agent filling speed(β value)and maximum number of microbubbles(A value)were calculated based on the results of contrast-enhanced echocardiography.Their general clinical data were col-lected.ROC curve analysis and multivariate logistic regression analysis were used to analyze the data.Results The serum levels of CD137 and IGFBP-6 were significantly higher,while the β value and A value were obviously lower in the CHD group than the control group(P＜0.01).And the serum levels were notably higher,and the β value and A value were remarkably lower in the MACE group than the non-MACE group(P＜0.01).The AUC of cardiac ultrasound parameters βvalue and A value combined with serum CD137 and IGFBP-6 to predict MACE after PCI in CHD patients was 0.930,which was significantly higher than the AUC value of every single indicator(P＜0.01).β value,A value,CD137 and IGFBP-6 levels were all risk factors for the occurrence of MACE in CHD patients after PCI(P＜0.01).Conclusion Contrast-enhanced echocardiography,serum CD137 and IGFBP-6 levels have certain predictive value for MACE in elderly CHD patients after PCI,and combined detection has higher predictive value.

OBJECTIVETo screen for KIT gene mutations in two Han Chinese pedigrees affected with Piebaldism.

METHODSClinical data of the pedigrees was collected. Genomic DNA was extracted from blood samples collected from the pedigrees and 120 unrelated healthy controls. All coding exons of the KIT gene were subjected to PCR amplification and direct sequencing.

RESULTSTwo missense mutations, c.1861G>A(p.Ala621Thr) and c.1872G>A(p.Met624Ile), were identified respectively in the two pedigrees. Neither mutation was found among healthy members from the respective pedigree and the 120 unrelated healthy controls. c.1872G>A is a novel mutation.

CONCLUSIONMutations of the KIT gene may affect the structure and function of the transmembrane receptor KIT, which lead to the disease.

Objective:To explore the application of 16-words formula " resection surrounding the proximal part of seminal colliculus, lateral tunnel, plane extending and bladder neck preservation" in transurethral enucleation resection of prostate with plasma rod electrode (TUERP).Methods:The clinical data of 88 patients with benign prostatic hyperplasia (BPH) admitted to our department from May 2018 to July 2019 were retrospectively analyzed. The age of patients was (67.0±8.6)years, and the volume of prostate was (51.0±27.3)ml. All patients were treated with TUERP using transurethral plasma rod electrodes according to the above 16-words formula. The perioperative clinical data and follow-up results at the 3rd month postoperation were statistically analyzed.Results:All operations were successfully completed. The operation time was (49.7±17.7)min, including gland enucleation time (16.8±6.7)min, tissue resection time (33.0±12.3)min, enucleated tissue weight (45.5±24.4)g, intraoperative blood loss (10.2±2.9)ml, postoperative continuous bladder irrigation time (1.9±0.8)d, postoperative hospital stay (4.1±0.7)d. There were no significant changes in hemoglobin and sodium concentration at 2 hours after operation ( P>0.05). The International Prostate Symptom Score (IPSS), quality of life score (QOL), maximum urinary flow rate (MFR) and residual bladder urine were significantly improved at 3 months after operation ( P<0.05). The patients were followed up for 3 to 14 months (average 6.8 months). There were 6 cases of Clavien grade Ⅰ complications, 1 case of Clavien Ⅱ complications, 1 case of Clavien Ⅲ complications, and no Clavien Ⅳ-Ⅴ complications occurred. Conclusions:The TUERP with plasma rod electrode according to the 16-words formula is an ideal choice for BPH treatment, which has the advantages of simple operating, high efficiency of enucleation, less blood loss, fast recovery and satisfied improvement of urination symptom.

【Objective】 To investigate the active ingredients of Zizyphi Spinosae Semen (ZSS) in relieving benzodiazepine (BDZ) dependence and its molecular mechanism based on the integrated Traditional Chinese Medicine and chemical drugs idea of "enhancing effect and reducing toxicity" via the approach of network pharmacology and the technique of molecular dynamics simulation. 【Methods】 First, literature search was undertaken to find the main components of ZSS. Then, the major effective constituents of ZSS in relieving BDZ dependence and its target of action were explored on the basis of network pharmacology and molecular docking. Finally, the relationship between core components of ZSS and key proteins was further verified through the technique of molecular dynamics simulation. 【Results】 After literature search, a total of 24 chemical components in ZSS were found to act on 731 targets. Through establishing the network of "ingredients-targets-pathways" , topology analysis was performed to obtain nine core components such as linoleic acid, palmitic acid, oleic acid, tetradecanoic acid, spinosin, oleanolic acid and jujuboside A, as well as five key targets including AR, PTGS2, PPARG, RXRA and CYP19A1. Bioinformation enrichment analysis was made to obtain critical pathways such as calcium signaling pathway, cAMP signaling pathway, IL-17 signaling pathway and TNF signaling pathway. The results of molecular docking revealed that there was a good combination between core components of ZSS and key targets, and it was mainly dominated by hydrogen bonding. Furthermore, the molecular dynamics simulation experiments indicated that the combinations between jujuboside A and RXRA, oleanolic acid and RXRA, spinosin and PPARG were stable, and these three active ingredients played an important role in improving BDZ dependence. 【Conclusion】 The active components in ZSS may exert multi-target and multi-pathway intervention effects on BDZ dependence by means of processes such as immunoregulation, anti-anxiety, and anti-insomnia.