BACKGROUND:The incidence of open fracture of the elbow joint is increased rapidly with an increased number of accidents. Fractures are often accompanied by severe soft tissue injuries. At present, a combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of open fractures has been widely reported. OBJECTIVE:To investigate the characteristics of the combined therapy of autologous skin grafting, vacuum sealing drainage, and external fixation for repair of complex and severe open fracture of the elbow joint. METHODS:A total of 41 patients with complex and severe open fracture of the elbow joint who received the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation during January 2009 to December 2013 in General Hospital of Tianjin Medical University, China were selected. Al patients were treated with routine debridement, external fixation and vacuum sealing drainage to cover wound during the first period. During the second period, autologous skin grafting or flap transfer was used to repair wound when the fresh granulation tissue covered the wound. RESULTS AND CONCLUSION:The postoperative folow-up period of these 41 patients was 8-22 months, with an average period of 13 months. External fixation period was 8-13 months with an average period of 9.8 months. The open wounds were completely healed after autologous skin grafting or skin flaps transfer. Fractures were healed in 31 patients during the first period. There were 7 cases of delayed union, 3 cases of nonunion. Al fractures were completely healed during 8-12 months after iliac bone grafting. The excelent and good rate of limb function recovery was 73.1% among 41 patients with severe open fracture of the elbow joint. The limb function of Gustilo II patients better recovered. These results suggest that the clinical effect of the combined therapy of autologous skin grafting, vacuum sealing drainage and external fixation for the treatment of complex and severe open fractures of the elbow joint is satisfactory.

Background:Tryptophan(TRP)is an essential amino acid,and can produce 5-hydroxytryptamine(5-HT)via 5-HT signal pathway and kynurenine( KYN)metabolic pathway under the catalysis of enzyme,thereby participating in the pathogenesis of visceral hypersensitivity in diarrhea-predominant irritable bowel syndrome(IBS-D). Aims:To investigate the relationship between visceral sensitivity and TRP metabolic pathway in patients with IBS-D. Methods:Thirty patients with IBS-D and 30 healthy controls from June 2012 to January 2014 at Guangdong Provincial TCM Hospital were enrolled. Score of gastrointestinal symptom rating scale( GSRS)was evaluated. Visceral sensitivity was measured by anorectal manometry. RT-PCR and Western blotting were used to detect mRNA and protein expressions of colon mucosal IDo, respectively. Serum 5-HT,5-HIAA,TRP,IDo,KYN,KYNA concentrations and IDo activity,KAT activity were determined by high performance liquid chromatography assay. Results:Compared with control group,GSRS score was significantly increased(P < 0. 05),initial perception threshold,defecation threshold,pain threshold were significantly decreased(P < 0. 05),anorectal constriction pressure was significantly increased( P < 0. 05),serum 5-HT,5-HIAA concentrations were significantly increased(P < 0. 05),mRNA and protein expressions of IDo were significantly increased (P < 0. 05),serum KYN was significantly increased(P < 0. 05),KYNA was significantly decreased(P < 0. 01),IDo activity was significantly incseased(P < 0. 01),and KAT activity was significantly decreased in IBS-D group(P < 0. 01). Correlation analysis showed that initial perception threshold,defecation threshold,pain threshold and anorectal constriction pressure were correlated with 5-HT,5-HIAA,TRP,KYN,KYNA,IDo activity and KAT activity in patients with IBS-D (P < 0. 05). Conclusions:TRP metabolic pathway is correlated with visceral hypersensitivity in patients with IBS-D.

After treatment for 3 months in the patients with impaired glucose tolerance (IGT), plasma glucose, insulin and homeostasis model assessment for insulin resistance (HOMA-IR) were decreased both in rosiglitazone therapy group and in the group treated with rosiglitazone combined with body weight control.Those parameters in the latter group were decreased more significantly than those in the former.Rosiglitazone ameliorates the insulin resistance in patients with IGT, which is further improved when combined with body weight control.

This study was aimed to investigate the effect of baicalin on the proportion of Th22 cells and the concentration of IL-22 bothin vivo andin vitro, in order to explore the immune mechanism of baicalin on inflammatory bowel disease mice model. The 3.5% dextran sodium sulfate (DSS) was used on C57BL/6 mice for the establishment of colitis mice model. Mice were randomly divided into the blank control group, model group, and baicalin group. Flow cytometry and ELISA were used in the detection of the proportion of Th22 cells and concentration of IL-22 in peripheral blood serum, respectively. The spleen lymphocytes of mice were isolated and cultured by baicalin medium (0, 10, 20, 40μM) for 48 h. Flow cytometry was used in the detection of the proportion of Th22 cells. The results showed that baicalin reduced the proportion of Th22 cells and the expression of IL-22 bothin vivo andin vitro experiments. It was concluded that baicalin can inhibit Th22 cell differentiation and expression of IL-22in vitro and DSS-induced colitis mice. It indicated that baicalin had a good treatment potential in Th22 cell-mediated inflammatory diseases.

Objective To evaluate the feasibilty of modified osteogenic culturing of goat adipose derived stromal cells(ADSCs).Methods From March,2013 to September,2014,platelet-rich plasma(PRP) was made from goat autogenous vein blood,and abodimoneal fat was aspirated,following aspetic procedure,primary and series passage of ADSCs was established.Osteoinduced ADSCs was carried out according to following group:combinative osteoinduction group(PRP+rhBMP-2 +ADSCs),growth factor group(rhBMP-2+ADSCs),conventional inductive group(dexamathasone+ascorbic acid + ADSCs) and noninductive group(blank group).Converted microscope was used to observe cellular pattern,cell activity,osteocalcin and collagen type Ⅰ level were detected at 1,3,5,7,9,13,17,21 days.Red Alazarin and Von Kossa staining were also assayed at different interval.Results Under observation of converted microscopy,remarkable cell proliferation with abundant ECM was noticed in combinative osteoinduction group,compared with other groups,level of cell activity,osteocalcin,collagen type Ⅰ [(0.82 ± 2.19)AU,(79.82 ± 1.36)U/L at,(78.51 ± 4.32)μ g/ml at]were significantly higher than other groups (P ＜0.05),and remarkable ALP expression and calcifed nodules were also seen.Conclusion PRP can enhance the inductive effect of rhBMP-2,and combinative osteoinduction procedure acts as a satisfactory culturing method.

Objective To investigate the cytokines levels in peripheral blood of ulcerative colitis (UC) patients at active stage, and to observe the effect of baicalin at various concentrations on the cytokines. Methods Quantitative polymerase chain reaction (Q-PCR) assay was used for the detection of interleukin 4 receptor (IL4R), IL6R, IL23R and RAR-related orphan receptor C (RORC) expression in single peripheral mononuclear cell of UC patients. Enzyme-linked immunosorbent assay (ELISA) was used to examine the serum levels of interferon gamma (IFN-γ), IL-4, IL-5, IL-6, IL-10, and transforming growth factor beta (TGF-β) levels in UC patients, and was applied for in-vitro detection of these indicators after baicalin intervention. Results Q-PCR results showed that IL4R, IL6R, IL23R, RORC gene expression levels in UC patients were increased to various degrees as compared to diarrhea-predominant irritable bowel syndrome (IBS-D) patients and the healthy volunteers, and then the levels were decreased to various degrees after intervention by baicalin at different concentrations, in particular at 20 and 40μmol/L. The results of ELISA showed that serum levels of cytokines of IFN-γ, IL-5, IL-6 in UC patients were increased to various degrees while IL-4, IL-10 and TGF-β1 was decreased as compared to IBS-D patients and the healthy volunteers. Baicalin at the concentrations of 20 and 40 μmol/L had an effect on decreasing IFN-γ, IL-5, IL-6 and on increasing IL-4 and IL-10. Conclusion Higher concentrations of baicalin show obvious effect on inhibiting RORC and IL23R expression, on decreasing IFN-γ, IL-5, IL-6 levels, and on increasing IL-4, IL-10 and TGF-β1 levels, which indicated that the therapeutic mechanism of baicalin in relieving ulcerative colonic inflammation is related with the regulation of immune function.

Report a case sustained Gustilo type III C open fracture of the left humerus with brachial artery injury who has limb ischemia and wound infection after operation in June, 2014. To salvage the limb, performed cross limb vessel transfer to restore blood supply at one-stage. After multiple debridement, Flow-through flap transfer was performed for definitive reconstruction of the arterial injury and repair the wound in secondary stage. In the 3rd stage, cutting the pedicle of transposition vessels. Follow-up at 1 year after surgery, the patient's left upper limb had survived with limited movement and confirmed Flow-through the vessel reconstruction using CTA.

Biopsy ; Endopeptidase K ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; pathology ; Glomerulonephritis, Membranous ; pathology ; Humans ; Kidney ; pathology ; Lupus Nephritis ; pathology ; Paraffin Embedding ; Staining and Labeling

OBJECTIVE: To evaluate the efficacy and safety of Danning Tablet (DNT) in patients with non-alcoholic fatty liver disease (NAFLD) of damp-heat syndrome type. METHODS: A multicenter, randomized, double-blinded and positive drug parallel controlled trial was performed. One hundred and thirty-five patients were enrolled into the study and divided into two groups: DNT-treated group (n=102) and ursodeoxycholic acid (UDCA)-treated group (n=33). Body mass index (BMI), principal symptoms, liver function, blood lipids, iconographic, and compositional parameters were measured before and after treatment, respectively. RESULTS: In the two groups, BMI, distress in hepatic region, fatigue, anorexia, liver function, blood lipids and iconographic parameters were significantly improved, and the improvements of BMI, distress in hepatic region were better in DNT-treated group than in UDCA-treated group. The histological study also showed that DNT had positive effect in treatment of NAFLD. CONCLUSION: DNT is an effective drug to treat patients with NAFLD of damp-heat syndrome type and is more effective than UDCA.

BACKGROUNDIt has been known that there are declines of dendritic cell (DC) count and its function in the peripheral blood of patients with non-small cell lung cancer (NSCLC), which are remarkably related to the proceeding and prognosis of NSCIC. The aim of this study is to investigate the relationship and clinical significance between the DC subsets (CD11c+DC and CD123+DC) and immunology state of patients with advanced NSCLC.

METHODSFlow cytometry was used to detect DC subsets, T cell subsets, NK cell percentage in the peripheral blood of 40 patients with advanced NSCLC and 10 healthy controls.

RESULTSThe expression of CD11c+DC (0.38%±0.18%) in the peripheral blood of advanced NSCLC patients, was decreased significantly compared with that of normal controls (0.66%±0.24%) (P < 0.01). The expression of CD123+DC in the peripheral blood of advanced NSCLC patients was (0.28±0.17)%, with no significant difference compared with that of normal controls (0.27%±0.11%) (P > 0.05). The percentage of CD3+ T cell and CD4+/CD8+ of patients with advanced NSCLC were significantly lower than those of normal controls (P < 0.01 and P < 0.05), and the percentage of CD8+ and NK cell of patients were higher than those of normal controls (P < 0.05). The correlation analysis showed that CD123+DC percentage was positively correlated to CD3+T cell percentage (P < 0.05) and negatively correlated to NK cell percentage (P < 0.01). The expression of DC subsets correlated with KPS and chemotherapy history of patients (P < 0.01).

CONCLUSIONSThe advanced NSCLC may induce significant decreasing expression of CD11c+DC and may induce significant decrease of immunology state. There are close relationship among the expression of DC subsets and the immunology state of patients as well as the clinical biological behaviors of patients with advanced NSCLC.