Calcaneus ; injuries ; surgery ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans

Objective To explore the diagnostic value of color Doppler ultrasonography and ultrasonography in the differential diagnosis of ectopic pregnancy.Methods 142 patients with ectopic pregnancy were given ultrasonic examination,to observe whether intrauterine gestational sac,carefully looking for recognition of ovarian masses and distinguish the relationship and structure,and were compared with pathologic diagnosis.Results Ultrasound could clearly display the uterus,ovary,failed to break the gestational sac and blood(block) mass image structure,with pathological diagnosis coincidence rate was 95.1％ (135/142),the misdiagnosis rate was 1.4％ (2/142),the missed diagnosis rate of 3.5％ (5/142).Conclusion Ultrasound was rapid,simple,noninvasive,high-accuracy,it was the preferred method for early diagnosis of the ectopic pregnancy.

Objective To evaluate the management strategy for gallbladder carcinoma found during the procedure of intended laparoscopic cholecystectomy (LC) Methods Twenty one cases of primary gallbladder carcinoma were incidently found during a period of 1996-2003, among them 17 cases of Nevin stage Ⅱ、Ⅲ and Ⅳ were divided into group A (6 cases) converted to open radical resection, and group B (11 cases) treated by LC ? 2 test and Kaplan Meier analysis were used to analyze postoperative survival rates Results (1) Two Nevin stage Ⅰ cases are still alive for 6 and 47 months at a follow up after LC; (2) For stage Ⅱ、 Ⅲ and Ⅳ patients, open surgery resulted a much longer survival ( ? 2=4 55, P =0 0328) Conclusion (1) For Nevin stage Ⅰ patients, simple LC is enough; (2) Patients of Nevin stage Ⅱ、 Ⅲ and Ⅳ should be coverted to open radical resection

Objective To evaluate the clinical value of serum MUC1(sMUC1)in the patients with multiple myeloma.Methods The enzyme linked immunosorbent assay(ELISA)was used to compare the sMUC1 levels in the 12 cases of newly diagnosed multiple myeloma.15 cases of post-chemotherapy and 46 healthy donors.Results The mean concentration of sMUC1 in the newly diagnosed patients with multiple myeloma was 33.44 U/ml(10.86～88.80 U/ml).In the patients of post-chemotherapy the mean concentration was 11.6U/ml(3.92～22.22 U/ml),and in the healthy donors the concentration was 12.81 U/ml(3.84～30.45 U/ml).The level of sMUC1 in the new diagnosed patients was significandy higher than that in the patients of post-chemotherapy(P=0.001)and healthy donors(P=0.000).There was no significant difference between post-chemotherapy and healthy donors(P=0.461).Conclusion sMUC1 may be one of the tumor markers for the diagnosis of multiple myeloma.sMUC1 could also be used as one of the indicators of prognosis and the evaluation of the chemotherapy efficacy.sMUC1 might be a potential target for the immunotherapy to the patients with multiple myeloma.

Acute Disease ; Adult ; Altitude Sickness ; blood ; pathology ; Bronchoalveolar Lavage Fluid ; chemistry ; Case-Control Studies ; Humans ; Inflammation Mediators ; metabolism ; Male

Objective To evaluate the diagnostic value of serum (1-3)-β-D-glucan detection for invasive fungal infection (IFI) in neonates. Methods Eighty-seven neonates who were suspected to be IFI cases in neonatal intensive care unit from May 2008 to January 2010 were enrolled into this study. All subjects had infection symptoms, while did no react to the antibiotics treatment. The diagnosis of IFI was made according to Invasive pulmonary fungal infection diagnostic criteria of children set by Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association and Invasive fungal infection diagnostic criteria for critical patients set by the Society of Critical Care Medicine, Chinese Medical Association. Circulating (1-3)-β-D-glucan levels were determined with GKT-5M set kinetic fungus detection kit. Levels of (1-3)-Β-D-glucan in IFI group and that in the control group were compared; optimal cut-off value was established with receiver operating characteristic (ROC) curve; and the sensitivity and specificity at the cut-off value of 20.0 pg/ml and optimal cut-off value were calculated and compared. Results Among the 87 suspected cases, 59 cases were not diagnosed as IFI and 28 cases were diagnosed as IFI finally. Five patients were confirmed to be IFI; seven cases were clinically diagnosed and 16 cases were still suspected IFI. Among the five confirmed cases, four cases were blood culture positive for Candida parapsilosis, one case Candida albicans positive and two cases both cerebrospinal fluid culture and blood culture positive for Candida albicans. The median levels of (1-3)-β-D-glucan of patients diagnosed as IFI (n=28) was 131.6 pg/ml(18.6-9999.0 pg/ml), which was higher than that of the patients without IFI (8.5 pg/ml, 5.0-34.6 pg/ml)(Z=-5.064, P<0.05). Area under ROC curve was 0.806 (95% CI: 0.725-0.886, P<0.05). The sensitivity (96.43% vs 69.49%) and specificity (72.22% vs 84.21%) for (1-3)-β-D-glucan were different as 20.0 pg/ml and 53.7 pg/ml were used as the cut-off values for diagnosing IFI. Conclusions (1-3)-β-D-glucan level could be used to diagnose IFI of neonates, but further studies are needed to evaluate false-positive rates and its cut-off value in IFI diagnosis.

AIM: To investigate the effects of transforming growth factor ?1 (TGF-?1) on murine-derived dendritic cells (DC). METHODS: Murine bone marrow cells were cultured with GM-CSF and TGF-?1 to develop TGF ?-DC. Then they were stimulated by lipopolysaccharide (LPS). Their phenotypes were assessed by flow cytometry (FCM). The allogeneic stimulating capacity of DC was measured by mixed lymphocyte reaction (MLR) using BrdU ELISA method. IL-12 p70 protein was detected by ELISA and the expressions of Toll like receptor 4 (TLR4) on DCs were measured by semi-quantitative RT-PCR and FCM. RESULTS: Compared to immature DC (imDC) cultured with GM-CSF alone, the expressions of CD_80, CD_86, I-A~b and CD_40 in TGF ?-DC were lower. The TGF ?-DC was resistant to maturation by LPS. Maturation resistance was evident from a failure to up-regulate CMs, to stimulate larger T cell proliferation and to increase secretion of IL-12 p70. Down-regulation of TLR4 expression on TGF ?-DC was also found. CONCLUSION: TGF-?1 inhibits the expression of co-stimulatory molecules on DC. It is resistant to maturation stimulus (LPS) and might be linked with TLR4 down-regulation.

A sequential extraction procedure has been proposed for the evaluation of the speciation of heavy metals including Cd,Cu,Pb and Zn in sediments from mariculture area,and the speciation of heavy metals was separated and defined as acid soluble fraction,reducible fraction,fraction bound organic matter,fraction bound sulfides and residual fraction. Matrix effects of high salinity on the determination of heavy metals in sediments were eliminated by matrix matching and internal standard methods when inductively couple plasma optical emission spectroscopy (ICP-OES) and mass spectroscopy (ICP-MS) were used,respectively. The results showed that the measured values of marine sediment reference materials were consistent with the standard values when the digestion solutions were determined after dilution. The extraction results of the prepositional extraction procedure and European Community Bureau of Reference Program (BCR) procedure were compared and the selectivity of extractants was investigated. The preliminary studies indicated that this sequential extraction procedure was applicable for evaluating the speciation of heavy metals in sediment with organic substances pollution and eutrophication,especially for fraction bound organic matter and fraction bound sulfides.

OBJECTIVETo evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.

METHODSFrom March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.

RESULTSThere was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01).

CONCLUSIONThe modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

Adult ; Arthrodesis ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Subtalar Joint ; surgery

OBJECTIVESTo provide a cumulative data about the complications of second or third generation ankle prostheses in the literature, and to provide a summary high-grade complications associated with implant failure.

METHODSA comprehensive search for all relevant articles published in English from January 1995 to December 2010 was conducted. Two reviewers evaluated each study to determine whether it was eligible for inclusion and collected the data of interest. Meta-analytic pooling of results across studies was performed for the complications and failure rate.

RESULTSThirty-five primary studies with 4395 implants were identified. The three highest complications of total ankle arthroplasty were aseptic loosening (12.51%), intra-operative bone fracture (11.97%) and bony impingement (11.27%). The three high-grade complications associated with implant failure were aseptic loosening (45.00%), infection (33.00%) and malalignment (29.00%). The pooled mean failure rate was 10.98% (95%CI: 8.80% - 13.16%), and the pooled mean failure rate of STAR implant was 14.20% (95%CI: 10.64% - 17.76%).

CONCLUSIONSIt is found that aseptic loosening, infection and malalignment are high-grade complications associated with implant failure in total ankle arthroplasty. The orthopaedic surgeons should be more careful in the operation, and the patients should coordinate with the post-operative rehabilitation plan.

Arthroplasty, Replacement, Ankle ; adverse effects ; Humans ; Joint Prosthesis ; Postoperative Complications ; Prosthesis Failure