Objective To evaluate the value of serum procalcitonin (PCT ) in the diagnosis of liver cirrhosis complicating sponta‐neous bacterial peritonitis (SBP) .Methods The patients with cirrhosis were divided into non‐SBP group and complicating SBP group according to whether complicating SBP ,and the patients with common hepatitis served as the control group .Serum expres‐sion levels of PCT ,CRP and IL‐6 were detected by electrocheniluminescence and Immunoturbidimetry methods .The receiver operat‐ing characteristic curve (ROC) curve was drawn for evaluating the diagnostic efficiency of each indicator .Results The levels of ser‐um PCT ,CRP and IL‐6 in the complicating SBP group were significantly higher than those in the non‐SBP group and control group , the differences were statistically significant (P<0 .01);The ROC curve analysis showed that the diagnostic value of PCT at the op‐timum threshold value of 0 .51 ng/mL for diagnosing cirrhosis complicating SBP was superior to CRP and IL‐6 ,the sensitivity of se‐rum PCT for diagnosing SBP in 3 groups was 62 .68% ,the specificity was 76 .59% and the accuracy was 80 .01% .Conclusion The serum PCT level has an important value for the early diagnosis of liver cirrhosis complicating SBP .

Objective To observe the effects of thymosin alpha-1 on T cell subsets and gastricintestinal reac-tion of patients with gastricintestinal tumor. Methods Twenty patients with gastricintestinal tumor were divided into two groups, observe group(n = 10) received thymosin alpha-1 during chemotherapy, and control group(n = 10) only received chemotherapy, T cell subsets and gastricintestinal reaction were observed. Results Before chemotherapy, CD+4,CD+8 and CD+4/CD+8 of observe group were(43.7±7.5),(27.3±2.8) and (1.5±0.1), and control group were (39.4±6.3), (30.9±2.5) and (1.2±0.6). There was significant difference between them (P < 0.05). After chemotherapy, CD+4, CD+8 and NK cell were (40.6±6.8)、( 29.7±2.6) and (19.1±2.7), control group (35.9±5.7), (33.4±2.4) and (18.6±2.3). There was significant difference between them (P < 0.05). Effec-tive ratio of nausea and vomit of observe group were 72.5% and 60.0%, control group 40.0% and 33.3%, There were significant differences between them(P <0.05). Conclusion Thymosin alpha-1 may ameliorate the function of T cell subsets and gastricintestinal reaction of patients with gastricintestinal tumor.

Objective To study the prevention and cure effect of immunoregulation therapy on postoperative infectious complications of calculous obstructive jaundice.Methods Prospective,randomized,blind and controlled clinical analysis of 40 patients conforming to the standard of calculous obstructive jaundice was carried out.The patients were divided into two groups at random.One was control group (n=20) with regular therapy,and the treatment group (n=20) with ulinastatin plus thymosin-α1 on the base of regular therapy for 1 week.The immunological indexes were determined before and after therapy on the 1st,3rd,5th、7th and 14th day,including the changes in lymphocyte count,CD14+ monocytes human leukocyte antigen (locus) DR (HLA-DR),and the incidence of postoperative infection were observed.Results The incidence of postoperative infectious complications in treatment group (10％) was remarkable lower than that in control group (30％,P＜0.01).There was significant difference between two groups (P＜0.05).After the 3rd,up to 14th day of therapy,the counts of lymphocyte and CD14+ monocytes HLA-DR were significantly higher than those in control group (all P＜0.05).Conclusions Immunoregulation therapy can improve the prognosis of obstructive jaundice patients in a period of 14 days of observation,and lymphocyte counts and CD14+monocytes HLA-DR were increased significantly,showing that immuno suppression can be ameliorated.Immunoregulation therapy could effectively prevent infectious complications of calculous obstructive jaundice.

Objective To evaluate effect of combined corpeetomy for multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).Methods Fifteen patients with CSM or OPLL,including 9 males and 6 females,were treated with combined corpectomy which is characterized by C4 and C6 corpectomy,excision of osteophyma,protruded disc and/or ossified posterior longitudinal ligament on basis of preservation of C5 vertebral body,structural bone grafting in C3-5 and C5-7,and anterior cervical plate fixation at C3,C5,and C7.The clinical results were evaluated with Japanese Orthopaedic Association (JOA) score.X-rays and CT scans were taken to evaluate vertebral fusion,and MRI was used to access spinal canal decompression and condition of spinal cord.Results All patients were followed up for 9 to 42 months (average,26.7 months).Bony fusion was achieved in all 15 patients.The JOA score improved from preoperative 13.44±2.81 to postoperative 16.16±2.19 (P=0.0354).The cervical lordosis improved from preoperative 1.16°±11.74° to immediately postoperative 14.36°±7.85° (P=0.00217),and 12.92°+6.17° at the final follow-up (P=0.00292).The complications included temporary hoarseness in 2 cases,dysphagia in 1 case.Conclusion The combined corpectomy for treating CSM and OPLL can obtain reliable and satisfactory results.In operation,the preservation of C5 vertebral body can provide an additional screw anchoring force and strengthen stahility.

OBJECTIVE: To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture. METHODS: Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically. RESULTS: All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover. CONCLUSION Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; classification ; complications ; surgery ; Fractures, Compression ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Multiple Trauma ; classification ; Spinal Fractures ; classification ; complications ; surgery ; Sternum ; injuries ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

【Objective】 To analyze the status of HBV infection in blood donors reactive to jointed NAT but non-reactive to primary discriminatory tests (NRR), so as to provide suggestions and data support for subsequent studies on NRR samples. 【Methods】 HCV RNA and HIV RNA repeat differential detection, HBV DNA viral load detection and HBV pgRNA copy volume detection were performed in the plasma of 60 blood donors with negative ELISA results in routine blood screening and NRR in NAT. HBsAg, HBsAb, HBcAb, HBeAg and HBeAb serological tests were performed on the NRR samples with positivity in HBV DNA viral load and HBV pgRNA virus copy detection, so as to analyze the serological infection status and occult hepatitis B (OBI) infection. 【Results】 The HCV RNA and HIV RNA repeat discrimination results of 60 NRR samples were negative. The quantitative detection results of HBV DNA in 60 NRR samples were positive in 9 cases (15%), and the HBV DNA concentration was less than 10IU/mL. Nine cases (15%) were positive for HBV pgRNA quantitative detection, and the virus copy volume ±SD was (289±58.25) copies/mL. Two NRR samples (3.33%) were HBV DNA positive and HBV pgRNA positive. Among the 9 HBV-DNA positive samples, the highest positive rate of HBcAb was 66.67%, and 7 (77.78%) of them were confirmed to be seropositive for OBI. Among the 9 HBV pgRNA positive samples, the copy amount of pgRNA in HBcAb positive samples was slightly higher than that in negative samples, while the copy amount of pgRNA in HBsAb and HBeAb positive samples was lower than that in corresponding negative samples. In recent 6 years, the proportion of NRR samples in the single NAT system of the center fluctuated from 0.09% to 0.13%. 【Conclusion】 HBV DNA and HBV pgRNA exist in NRR samples. HBV DNA and/or HBV pgRNA positive samples can be detected in the relevant serological infectious markers. NRR samples have a certain potential risk of OBI infection. HBV DNA detection plus HBV pgRNA can better confirm the status of virus infection in NRR and improve the safety of blood transfusion.

Objective To investigate the relationship between serum fatty acid binding protein(FABP)1,FABP2 and diabetic kidney disease(DKD)in patients with type 2 diabetes mellitus(T2DM)and its diagnostic value.Methods A total of 170 patients with T2DM diagnosed and treated in this hospital from January 2020 to December 2022 were selected as the research objects.According to urinary albumin to creatinine ratio(UACR),they were divided into non-DKD group(UACR<30 mg/g,72 cases)and DKD group(UACR≥30 mg/g,98 cases).A total of 60 healthy people in the same hospital during the same period were selected as the control group.Pearson correlation analysis was used to analyze the correlation between serum FABP1,FABP2 and renal function related indicators.Multivariate Logistic regression was used to analyze the influencing fac-tors of DKD.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of serum FABP1 and FABP2 for DKD.Results The DKD group had significantly higher serum levels of FABP1 and FABP2 than the non-DKD group and the control group(P<0.05),and the non-DKD group had significantly higher serum levels of FABP1 and FABP2 than the control group(P<0.05).Compared with the non-DKD group,the DKD group had a significantly lower eGFR and significantly higher UACR,serum creatinine,blood urea nitrogen,and serum uric acid levels(P<0.05).Serum FABP1 and FABP2 levels were positively correla-ted with UACR,serum creatinine,blood urea nitrogen,and negatively correlated with eGFR(P<0.05).In-creased serum FABP1 and FABP2 levels were independent risk factors for DKD.The serum FABP1,FABP2 joint detection diagnosis efficiency was better than that of serum FABP1,FABP2 detection alone(Z=4.712,4.363,P=0.001,0.002).Conclusion The serum levels of FABP1 and FABP2 are increased in patients with DKD,and they are related to the degree of renal function damage,which are independent risk factors for the occurrence of DKD in patients with T2DM.The combined detection of FABP1 and FABP2 has a high diagnos-tic efficiency for the occurrence of DKD in patients with T2DM.

BACKGROUND:Abnormal extracellular matrix accumulation and excessive proliferation of fibroblasts are the main manifestations of pathological scars.Excessive proliferation of fibroblasts leads to the production of large amounts of collagen-based extracellular matrix.Therefore,to investigate the role of fibroblast fibrosis in the formation of pathological scar will provide a new idea for revealing the mechanism of pathological scar and biological therapy. OBJECTIVE:To investigate the effect of RAS-selective lethal small molecule 3(RSL3)on the fibrosis of human pathological scar fibroblasts. METHODS:Then cases of pathological scar tissue and normal skin tissue samples from the same individuals,provided by the Department of Burn Plastic Surgery,General Hospital of Ningxia Medical University,were collected.Fibroblasts of human pathological scar and human normal skin were extracted and used in the following experiments.The general condition of the pathological scar tissue and the normal skin tissue was detected by hematoxylin-eosin staining.The appearance of fibroblasts from pathological scar and normal skin were observed by inverted microscope.The fibroblasts were verified by immunofluorescence assay.The cells were treated with different concentrations of RSL3(1,3,5,7,9,11,13 μmol/L).The inhibitory concentration of RSL3 on fibroblasts was detected by cell counting kit-8.Control group(without treatment)and RSL3 intervention group(treated with 7 μmol/L RSL3 for 24 hours)were set up.The mRNA and protein expressions of glutathione peroxidase 4,type Ⅰ collagen,type Ⅲ collagen and α-smooth muscle actin were detected by Qrt-PCR and western blot,respectively.Level of malondialdehyde in cells was detected.The residual scratch area was measured by cell scratch test after 24 hours to calculate the percentage of residual scratch area. RESULTS AND CONCLUSION:The expression of glutathione peroxidase 4 in the pathological scar group was higher than that in the normal skin group(Mrna:t=3.252,P<0.01;protein:t=5.075,P<0.01).The expression of glutathione peroxidase 4 in the pathological scar fibroblast group was higher than that in the normal skin fibroblast group(Mrna:t=10.32,P<0.01;protein:t=26.22,P<0.01).Compared with the control group,the expression of glutathione peroxidase 4 was decreased(Mrna:t=2.798,P<0.05;protein:t=4.643,P<0.01),the content of malondialdehyde was increased(t=2.917,P<0.05),the expression of type Ⅰ collagen(Mrna:t=15.84,P<0.01;protein:t=4.610,P<0.01),type Ⅲ collagen(Mrna:t=28.86,P<0.01;protein:t=7.713,P<0.01)and α-smooth muscle actin(Mrna:t=2.671,P<0.05;protein:t=7.417,P<0.01)were decreased in the RSL3 intervention group.Compared with the control group,the migration ability was weakened in the RSL3 intervention group(t=14.06,P<0.01).To conclude,RSL3 can inhibit the expression of glutathione peroxidase 4 and then inhibit the ability of fibrosis and migration of pathological scar fibroblasts.

Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.

ObjectiveTo investigate the effects of modified Chunzetang on urinary retention in rats with spinal cord injury （SCI） and the c-Jun N-terminal kinase/p38 mitogen-activated protein kinase （JNK/p38 MAPK） signaling pathway. MethodBefore modeling， 10 of the 70 female SD rats were randomly selected to assign to the blank group， and 10 to the sham group. The remaining 50 rats were used to prepare a SCI-induced urinary retention model using the spinal cord transection method. The model rats were randomly divided into model group， low-dose modified Chunzetang group， high-dose modified Chunzetang group， and inhibitor group. After modeling， the blank group， sham group， and inhibitor group were given 2 mL of saline by gavage. The high-dose and low-dose groups of modified Chunzetang were given modified Chunzetang at 28.8 g·kg^-1 and 14.4 g·kg^-1 by gavage， respectively. The inhibitor group was injected intraperitoneally with the JNK inhibitor SP600125 twice a week at a dose of 15 mg·kg^-1. All rats were gavaged for a total of 28 days. Urodynamic and bladder muscle tension tests were conducted to evaluate bladder function. Hematoxylin-eosin （HE） staining was performed to observe the morphology of bladder smooth muscle tissue. Enzyme-linked immunosorbent assay （ELISA） was used to measure the levels of JNK， phosphorylated （p）-p38 MAPK， B cell lymphoma-2 （Bcl-2）， and cysteinyl aspartate-specific proteinase-3 （Caspase-3）. Western blot was used to detect the expression levels of p-JNK， p-p38 MAPK， ETS-like protein-1 （ELK-1）， and activator protein-1 （AP1） in the detrusor muscle. Immunofluorescence was used to detect the expression levels of p-JNK， p-p38 MAPK， and AP1. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling （TUNEL） assay was conducted to measure cell apoptosis. ResultCompared with blank group and sham group， the model group showed a significant increase in maximum bladder capacity and bladder compliance， and a significant decrease in leak point pressure. The minimum contraction force was increased， and the contraction frequency was significantly decreased （P<0.01）. The structure of bladder smooth muscle was disordered， with a large number of vacuolar cells， tissue edema， mononuclear cell infiltration， obvious hemorrhage， and a trend towards fibrosis in connective tissue. TUNEL positive cells increased significantly. The protein expression levels of p-JNK， p-p38 MAPK， AP1， and ELK-1 were significantly increased （P<0.01）. Compared with model group， all intervention groups showed significant improvement in urodynamic and bladder muscle contraction tests. In the low-dose modified Chunzetang group， the levels of p-p38 MAPK and Caspase-3 was decreased （P<0.05，P<0.01）. The levels of JNK, p-p38 MAPK and Caspase-3 in the high-dose group were significantly decreased （P<0.01）， and the level of Bcl-2 was significantly increased （P<0.01）. The expression levels of p-JNK， p-p38 MAPK， and AP1 proteins were significantly reduced （P<0.01）， and ELK-1 protein expression was decreased （P<0.05）. The positive rate of p-JNK and AP1 receptors was significantly decreased （P<0.01）. The positive cell rate was significantly decreased （P<0.01）. The high-dose modified Chunzetang group was positioned between the low-dose group and the inhibitor group， with no significant difference compared to the inhibitor group. ConclusionModified Chunzetang can improve urinary retention in SCI and enhance the contraction force of bladder smooth muscle. This effect is related to the inhibition of the JNK/p38 MAPK signaling pathway activation， thereby reducing apoptosis of bladder smooth muscle cells.