OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

OBJECTIVE: To establish the rapid PCR amplification program and system and to verify the technical indexes. METHODS: PCR multiplex and capillary electrophoresis detection of 24 autosomal STR loci and one Y-STR loci using the 6-color fluorescence marking technology, as well as A melogenin and Y-InDel. Meanwhile, sensitivity, specificity, identity, stability, mixing and a batch of sample tests were investigated, and the genotype of various routine samples and degraded, exfoliated cell samples were observed. RESULTS: The sensitivity of the system was 0.062 5 ng. In addition, the genotype could be detected accurately only around 65 min via rapid amplification. The species-specificity was high and the genotyping of all kinds of dry blood specimens of filter paper and mixed, degraded, exfoliated cell samples were accurate. CONCLUSION The rapid amplification system can significantly improve the detection rate, and obtain accurate and stable genotyping results, which may be important implications for the establishment of STR database and study on population genetics and forensic identification.
Electrophoresis, Capillary ; Fluorescence ; Genetics, Population ; Genotype ; Humans ; Microsatellite Repeats ; Multiplex Polymerase Chain Reaction/methods* ; Sensitivity and Specificity

Humans ; Membrane Glycoproteins ; immunology ; SARS Virus ; immunology ; Severe Acute Respiratory Syndrome ; prevention & control ; Spike Glycoprotein, Coronavirus ; Vaccines, DNA ; immunology ; Vaccines, Inactivated ; immunology ; Vaccines, Synthetic ; immunology ; Viral Envelope Proteins ; immunology ; Viral Vaccines ; immunology ; Virion ; immunology

【Objective】To evaluate the role of serum antimullerian hormone （AMH） concentration in predicting clinical outcomes in controlled ovarian stimulation and intrauterine insemination （IUI）. 【Methods】 A retrospective analysis of IUI data from patients with polycystic ovary syndrome and infertility in our reproductive center from January 2014 to August 2017. According to the clinical outcomes，data was divided into three groups：clinical pregnancy group，non-pregnant group，and cancellation cycle group due to multiple follicular or no dominant follicular develop. The ovarian function evaluation indexes were compared such as serum AMH，basal FSH and basal sinus follicle（AFC）. The cutoff values of the AMH to predict multi- follicular development or no dominant follicular development which IUI cycles were cancelled，and to predict obtain cumulative clinical pregnancy outcomes were calculated according to the ROC curve to cancel the cycle. 【Results】 The clinical pregnancy rates of PCOS patients were from 15.9% to 17.1% ，while the cumulative clinical pregnancy rate increased in repeat cycles （≤3 cycles） was 21.6% ，significantly higher than the average clinical pregnancy rate（16.7%）during the first cycle. AMH levels in the cancelled cycle group were significantly higher than those in the non-cancelled cycle group［（14.1±6.5）vs（10.3±4.3）ng/mL，（14.1±6.5）vs（9.3±4.3）ng/mL， P<0.025］. Compared with the clinical pregnancy group，cancel cycle group and non- pregnant group，the mean AFC of the former two groups were significantly higher［（34.5±11.4）vs（30.7±11.3），（7.8±10.8）vs（30.7±11.3），P<0.025］. In addition，we found that women′ s age，baseline FSH were negatively correlated with the cumulative pregnancy rate of repeated IUI cycles，and women′s baseline BMI，baseline LH，AFC，and AMH were positively correlated with cumulative pregnancy rates. The number of mature follicles on the HCG triggering day，as well as the value of AMH，may be the influencing factor of IUI cumulative clinical pregnancy. By ROC curve analysis，we assume that AMH is more suitable than the AFC to predict IUI cycle cancellation rate and the cumulative pregnancy rate.【Conclusion】Repeated IUI cycles can be improved cumulative pregnancy rate of PCOS infertile couples. AMH，as an important index to measure ovarian reserve function，can be used to predict the the IUI cumulative clinical pregnancy outcomes and cancelled cycle rates：as AMH increased to more than 6.56 ng/mL，the pregnancy rate increased；but when AMH ≥14.72 ng/mL，the risk of cancelled IUI cycles was increased，becasues of multi-follicular developing and absence of dominant follicle development.

【Objective】The aim of this study was to investigate the proportion of dominant follicles（PDF）on HCG day in young and aged women.【Methods】In total，3 064 cycles of GnRH agonist long protocol and 918 cycles of GnRH antagonist protocol from 2014 to 2016 were retrospectively included. Patients were divided into 3 groups（low PDF，< 20%； medium PDF，≥20% and ≤40% ；high PDF，> 40%）. The measurements regarding the ovarian stimulation characteris? tics ，clinical pregnancy rate was compared between different PDF groups stratified by age and protocol. 【Results】 In patients aged ≤30 years who received the GnRH agonist long protocol，no significant difference was found in the clinical pregnancy rate between the different PDF groups（P > 0.05）. Regarding the GnRH antagonist protocol，no significant difference was found in the clinical pregnancy rate and moderate or severe OHSS rate（P > 0.05）. In patients aged ≥40 years， the clinical pregnancy rate in the low PDF group was higher than that in the high PDF groups（40% vs. 30.88%）in GnRH agonist long protocol. Concerning the GnRH antagonist protocol，patients in the low PDF group had a significantly higher clinical pregnancy rate than those in the other two groups（27.27% vs. 9.09% ，7.40% ；P = 0.002）.【Conclusions】PDF within 20% is recommended for older patients（≥40 years），especially in those receiving the GnRH antagonist protocol.

【Objective】 To explore the differences of clinical medicine ，magnetic resonance imaging（MRI）and pathology in multifocal and multicentric breast cancer（MMBC）and unifocal breast cancer（UBC）. 【Methods】 In this retrospective analysis，55 MMBC and 68 UBC patients with pathology confirmed from April 2016 to February 2018 were enrolled，and the characteristics and difference of routine pathological types，molecular subtypes and MR enhancement types were compared. The relationships between MMBC ，UBC and the methods of clinical treatment were studied by correspondence analysis（CA）.【Results】Significant difference was observed between routine pathological types of MMBC and UBC（P < 0.001）. The high grade invasive ductal carcinoma was more frequent in maximal lesions of MMBC than in UBC lesions，whereas there was no statistical correlation between molecular subtypes，molecular subtypes and MR enhancement types（P = 0.265，P = 0.152）. However，there was statistical difference in masses enhancement（P = 0.013）. CA showed that the molecular subtypes of MMBC and UBC were the key factors for clinical treatment. In addition ，HER- 2（+）and Luminal B type breast cancer showed high correlation with treatment method，while triple-negative showed low correlation with treatment method.【Conclusions】The pathology types of the maximal lesions of MMBC were less aggressive than UBC lesions. There was significant correlation between clinical treatment and molecular subtypes of MMBC and UBC. Therefore，individualized treatments are recommended on the basis of biological characteristics in both MMBC and UBC.

Cyclodextrin can increase the solubility of poorly soluble drugs, but also decrease the permeability of poorly soluble drugs in inclusion complexes simultaneously, which partially or completely counteracts the contribution of improvement in solubility to the oral absorption of poorly soluble drugs. If a competing agent is added to the system to compete binding sites of cyclodextrins with drugs, drug permeability can be improved by increasing the concentration of free drugs in the inclusion complex system. In this paper, a rapid in vitro screening method for competing agents of cyclodextrin inclusion complex is proposed based on the principle that good drug permeability is in accord with good cell uptake. The equilibrium constants between drugs and hydroxypropyl-beta-cyclodextrin (HPCD) were determined by phase equilibrium solubility method. Cinnarizine (CN) with a high equilibrium constant was selected as a competing agent, coumarin 6 (C6) and 9-octadecyl berberine (BD) with smaller equilibrium constants were selected as model drugs. Both changes of solubility and uptake by Caco-2 and A549 cells of C6 and BD were investigated different concentrations of CN to the HPCD solution of C6 and BD. The results showed that the uptake of C6 and BD increased in a CN concentration-dependent manner, and the solubility of C6 and BD in HPCD solution decreased with the prolongation of equilibrium time. It might be due to increased free drug concentrations that resulted from the competition of CN for drug binding sites with HPCD. In our study, in vitro cell uptake method was firstly used to validate the ability of CN as a competing agent to increase drug permeability (cell uptake). This method can be used for preliminarily screening of competing agents for drug-cyclodextrin inclusion complexes.

BCS Ⅱ drugs are characterized by low solubility and high permeability. Improving their solubility is considered an important approach to improve its oral absorption. Recent strategies to increase the solubility of poorly-soluble drugs may unexpectedly result in greatly depressed permeability, ultimately leading to failure in improving oral absorption. Based on the mathematics of membrane permeability coefficient of a drug, the membrane/aqueous partition coefficient is dependent on the drug's solubility in the gastrointestinal milieu, suggesting a unique interplay between the solubility and permeability of the drug, and treating the one irrespectively of the other may be insufficient. When we focus on the increase of drug solubility and overlook the efficacy of drug permeability, the positive effect of increased solubility to drug oral absorption might be traded off by depressed permeability. To provide rational formulary designs, by optimizing excipients and evaluation, this review summarizes solubility- permeability interplay for different types of solubilizing techniques, such as cyclodextrin, surfactants-based vehicle, cosolvent, amorphous solid dispersions, other infectors such as P-gp transporters and new techniques for simultaneous evaluation of drug solubility and permeability.

OBJECTIVETo explore the clinical and physical factors that might give rise to radiation-induced esophagitis in three-dimensional conformal radiotherapy for non-small cell lung cancer.

METHODSTo collect the clinical and physical records and follow-up information of 106 NSCLC patients without undergoing surgery in our hospital. χ(2) test, linear tendency test and analysis of variance were employed to analyze the relationship between occurrence of radiation-induced esophagitis and clinical and physical treatment. Logistic analysis was also used for multivariate analysis.

RESULTSAmong the 47 cases of radiation-induced esophagitis, 31 cases were of grade I, 11 of grade II, 5 of grade III, and with a total occurrence rate of 44.3% (47/106). Radiation-induced esophagitis was correlated with Karnofsky scores, radiation sensitization and tumor location (χ(2) = 11.30, 8.45, 7.67, P < 0.05). Radiation-induced esophagitis was correlated with the length of irradiated esophagus and average dose of irradiated esophagus (F = 20.82, 83.08, P < 0.001). With the increase of the irradiated volume percentage from V20, V30, V40 up to V50, the occurrence rate of radiation-induced esophagitis was also increased, almost with a linear trend (P < 0.05). Application of all the above factors to logistic model indicated that radiation sensitization,length of irradiated esophagus, average dose and V50 were all statistically significant foactors in the occurrence of radiation-induced esophagitis (OR = 0.321, 2.850, 7.307 and 8.558, P < 0.05).

CONCLUSIONSRadiation sensitization,length of irradiated esophagus, average dose of irradiated esophagus and V50 are independent factors in the occurrence of radiation-induced esophagitis. V50 is of greater importance in the judgement of occurrence of radiation-induced esophagitis.

Aged ; Carcinoma, Non-Small-Cell Lung ; radiotherapy ; Esophagitis ; etiology ; Esophagus ; pathology ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; radiotherapy ; Male ; Middle Aged ; Multivariate Analysis ; Radiation Injuries ; etiology ; Radiation Tolerance ; Radiotherapy Dosage ; Radiotherapy, Conformal ; adverse effects ; methods ; Retrospective Studies

OBJECTIVETo investigate epidermal growth factor receptor (EGFR) gene mutations in exons 19 and 21 of patients with non-small cell lung cancer (NSCLC) and to analyze the relationship of EGFR mutations with clinicopathological features and prognosis.

METHODSThe EGFR gene exons 19 and 21 of paraffin-embedded tumor tissue were amplified by PCR, followed by direct sequencing in 282 surgically-removed specimens of NSCLC. The relationship of EGFR gene mutations in NSCLC with clinicopathological features and prognosis were analyzed.

RESULTSEGFR mutations were detected in 120 of 282 (42.6%) patients with NSCLC. There were 61 cases of the mutations in exon 19 and 66 cases of the mutations in exon 21, including 7 cases of the mutations both in exons 19 and 21. Mutations were more frequently observed in women (55.2%, 53/96) than in men (36.0%, 67/186), in 51 to 60-years-old (51.3%, 39/76) than ≤50-years-old (30.4%, 21/69) and >60-years-old (43.8%, 60/137), in non-smokers (54.3%, 69/127) than smokers (32.9%, 51/155), there was negative correlation of EGFR mutations with smoking status (P=0.000, rs=-0.216). EGFR mutations were more frequently observed in adenocarcinomas (47.8%, 64/134), bronchiolo-alveolar carcinomas (73.0%, 27/37), adenosquamous carcinomas (7/9) than squamous cell carcinomas (23.6%, 17/72) and other types (16.7%, 5/30). The EGFR mutation rate in the well differentiated, the middle differentiated, the poorly differentiated and the undifferentiated was 55.7% (68/122), 50.8% (30/59), 22.7% (17/75), 19.2% (5/26) respectively, the incidences of EGFR mutations decreased with the degrading of differentiation, there was positive correlation of EGFR mutations with differentiation of lung cancer (P=0.000, rs=0.296). The patients with EGFR mutations had better prognosis than those with wild-type EGFR (P=0.027). There was no association of EGFR mutations with clinical TNM stage.

CONCLUSIONSEGFR mutations occur frequently in females, non-smokers and adenocarcinomas, bronchioloalveolar carcinomas, and adenosquamous carcinomas. The patients with EGFR mutations have better prognosis. The results may offer a practical approach to select the patients who may benefit from anti-EGFR target therapy.

Adenocarcinoma ; genetics ; Adenocarcinoma, Bronchiolo-Alveolar ; genetics ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Carcinoma, Adenosquamous ; genetics ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Exons ; Female ; Gene Amplification ; Genes, erbB-1 ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Lung Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Mutation ; Mutation Rate ; Polymerase Chain Reaction ; methods ; Prognosis ; Receptor, Epidermal Growth Factor ; genetics ; Sequence Analysis, DNA ; methods ; Sex Factors ; Smoking ; Survival Rate