Objective:To investigate the efficacy of an additional augmentative locking compression plate combined with bone graft for aseptic subtrochanteric fracture nonunion after intramedullary nailing.Methods:From October 2016 to October 2019, 32 patients (25 males and 7 females) were treated at Department of Orthopedics, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University for aseptic subtrochanteric fracture nonunion after intramedullary nailing. Their ages ranged from 27 to 68 years (average, 50.5 years) and their nonunion time from 9 to 24 months (average, 12.2 months). According to the Weber-Cech classification for nonunions, 9 cases belonged to the highly vascular type and 23 to the ischemic type. With the original intramedullary nails retained, all patients were fixated with an additional augmentative locking compression plate before simultaneous autologous iliac bone grafting. All patients were followed up regularly for fracture union, function of the affected hip and complications.Results:The 32 patients were followed up for 6 to 24 months (average, 12.9 months). All nonunions obtained clinical and imaging union. The clinical union time ranged from 3 to 8 months (average, 5.2 months), and the imaging union time from 6 to 10 months (average, 7.4 months). At the last follow-up, the therapeutic efficacy was evaluated as excellent in 28 cases and as good in 4, giving a good to excellent rate of 100%(32/32), according to the Sanders scoring for post-traumatic hip joint; the efficacy was evaluated as excellent in 21 cases, as good in 10 cases and as fair in one, giving a good to excellent rate of 96.9%(31/32), according to the Harris hip scoring. No such complications occurred as infection or loosening or breakage of internal fixation.Conclusion:An additional augmentative locking compression plate combined with bone graft is a reliable and effective treatment for aseptic subtrochanteric fracture nonunion after intramedullary nailing.

Objective:To investigate the effects of Origin-Preserving Decoction on the proliferation of marrow hematopoietic cells in aplastic anemia mice. Methods:Based on experimental AA models induced by Benzene and 60Co radiation in mice, the experiments including semi-solid colony culture (CFU-GM、CFU-E、BFU-E) and liquid culture (MTT Assay) were undertaken to investigate the effects of Origin-Preserving Decoction on the proliferation of marrow hematopoietic cells in AA mice. Results:Origin-Preserving Decoction (3g/kg) (ig.) could improve the outputs of CFU-GM, CFU-E and BFU-E in AA mice damaged by benzene and 60Co radiation: MTT assay showed that Origin-Preserving Decoction could stimulate the hematopoeisis of bone marrow of AA mice radiated by 60Co. Conclusions: Origin-Preserving Decoction has a good future for AA therapy.

Objective To investigate the association of chlamydia pneumoniae infection with ankylosing spondylitis (AS).MethodsSerum samples were obtained from 33 AS patients and 22 healthy controls.Enzyme-linked immunosorbent assay (ELISA) was applied to mearsure serum anti-Chlamydia pneumoniae antibodies (IgM/IgG),while immunofluorescence assay (IFA) was used to detect Chlamydia pneumoniae LPS antigen,and polymerase chain reaction (PCR) was used to amplify Chlamydia pneumoniae DNA in peripheral blood cells. Immunohistochemistical technique was applied to examine Chlamydia pneumoniae LPS antigen in synovial tissue from another 9 AS patients who received total hip replacement and 13 patients with comminuted femoral fractures.ResultsThe positive rates of Chlamydia pneumoniae IgM,LPS antigen and chlamydia pneumoniae DNA were higher in AS patients than those in healthy controls (78.8％ vs 22.7％,x2 =16.867,P =0.000; 66.7％ vs 31.8％,x2 =6.431,P =0.011; 33.3％ vs 9.1％,x2 =4.298,P =0.038).Chlamydia pneumoniae DNA positive rate was correlated with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels (Z =-2.774 and -2.829,P =0.004).In synovial tissues,chlamydial LPS-containing inflammatory cells were observed in 77.8％(7/9) AS patients,while those in fracture patients was 30.8％ ( 4/13 ) ( P =0.08 ).Conclusion Chlamydia pneumoniae infection is common in blood circulation and joint cavity of AS patients and may be associated with the pathogenesis of AS.

Objective To explore the effect of the clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for undergraduate nursing students.Methods Totally 87 undergraduate nursing students were enrolled and divided into the experimental group (n=44) and the control group (n=43).The experimental group received clinical scenario-based simulation communication education based on Calgary-Cambridge Guide for communication.The control group received traditional class-based education for communication.The chnical communication skills questionnaire and Communication Observing Questionnaire were administered before and after the training.The testing results of both groups were compared.Results After participating in the education project,six dimensions of clinical communication competence and the total score were significantly improved after training compared with those before training in the experimental group.After training,the experimental group was better than the control group in establishment of harmonious relationship,confirming patients' problems,efficient information transfer,validation experience and communication competence,t values were 2.64,2.32,2.19,2.20 and 4.36,P＜ 0.05.In testing of integrated cases,scores of six aspects such as case design,information collection,explaining behavior,relationship development,conflict coordination and service behavior in the experimental group were significantly higher than those of the control group,t values were 2.15,2.10,3.26,2.84,2.14 and 2.61,P＜0.05.Conclusions The clinical scenario-based simulation education based on the Calgary-Cambridge Guide can improve communication competence of nursing students.

β-carotene has a wide range of application in food, pharmaceutical and cosmetic industries. For microbial production of β-carotene in Saccharomyces cerevisiae, the supply of geranylgeranyl diphosphate (GGPP) was firstly increased in S. cerevisiae BY4742 to obtain strain BY4742-T2 through over-expressing truncated 3-hydroxy-3-methylglutaryl-CoA reductase (tHMGR), which is the major rate-limiting enzyme in the mevalonate (MVA) pathway, and GGPP synthase (GGPS), which is a key enzyme in the diterpenoid synthetic pathway. The β-carotene synthetic genes of Pantoea agglomerans and Xanthophyllomyces dendrorhous were further integrated into strain BY4742-T2 for comparing β-carotene production. Over-expression of tHMGR and GGPS genes led to 26.0-fold increase of β-carotene production. In addition, genes from X. dendrorhous was more efficient than those from P. agglomerans for β-carotene production in S. cerevisiae. Strain BW02 was obtained which produced 1.56 mg/g (dry cell weight) β-carotene, which could be used further for constructing cell factories for β-carotene production.
Basidiomycota ; enzymology ; Farnesyltranstransferase ; genetics ; metabolism ; Hydroxymethylglutaryl CoA Reductases ; genetics ; metabolism ; Metabolic Engineering ; Polyisoprenyl Phosphates ; Saccharomyces cerevisiae ; metabolism ; beta Carotene ; biosynthesis

AIM:To investigate the relationship between polyamine metabolism and hypoxia /ischemia ( H/I)-induced cell apoptosis and to determine the mechanisms by which exogenous spermine protects cell apoptosis against AMI in rats .METHOD:The left anterior de-scending coronary artery ( LAD) of the Wistar rats were ligated , and neonatal rat cardiomyocytes were placed under hypoxic conditions for 24 h to establish the model of AMI (or H/I).Exogenous spermine was administered by intraperitoneal injection (2.5 mg/kg daily for 7 days) in vitro and subjected to the cell medium at 5μmol/L as a pre-treatment therapy.RESULTS:AMI (or H/I) induced an increase in polyamine catabolized enzyme SSAT and a decrease in polyamine biosynthesis enzyme ODC , which result in endogenous spermine and spermidine decrease and putrescine increase .At the same time, AMI ( or H/I) lowered cardiac function , increased cTnI and CK-MB concentrations , aggravated myocardial infarct size , cardiomyocyte damage and apoptosis , raised ROS generation , increased the expression of cleaved caspase-3, cleaved caspase-9 and endoplasmic reticulum stress (ERS)-related proteins, promoted the release of cytochrome C and mPTP opening , down-regulated Bcl-2 expression and the phosphorylation of ERK 1/2, PI3K, Akt and GSK-3β, and activated PERK and eIF 2αphosphorylation .Spermine pre-treatment reversed the above-motioned changes .CONCLUSION:AMI ( or H/I ) could induce cardiomyocyte apoptosis and polyamine metabolism disorder .Exogenous spermine attenuates cardiac injury through scavenging the ROS and inhibiting mPTP opening and ERS injury .These findings provide a novel target for the prevention of apoptosis in the setting of AMI .

Objective To explore the strategy of surgical therapy for breast carcinoma . Methods The clinical data of 258 patients with breast carcinoma were analysed retrospectively. Results (1)136 patients with stage Ⅰ～Ⅱ breast carcinoma were subjected to modified radical mastectomy, overall survival(OS) was 100%, and relapse free survival(RFS)92.6%.(2)Partial mastectomy and axillary dissection were performed on two patients with stage Ⅱbreast carcinoma,one relapsed in 5 months after operation. (3)In patients with stage Ⅲ breast carcinoma,there was no statistical difference in OS and RFS between 88 patients subjected to modified radical mastectomy and 20 radical mastectomy.(4)The radical operation showed a better efficacy in 5 patients with stage Ⅳ breast carcinoma.(5)Using special breast cutter and electrotome,the rate of surgical blood transfusion was 3.5%,postoperative hematocele 2.7%,flap necrosis 7.4%, effusion under skin 18.6%,and edema of affected limb 4.3%. Conclusions (1)The modified radical mastectomy is the major operation for stage Ⅰ～Ⅲ breast carcinoma patients. (2)Using special breast cutter and electrotome could cut down surgical blood transfusion and operation time.(3)Rational axillary lymph node dissective could reduce postoperative complications.

Biochemical indexes and blood composition in early lactation health,ketosis and hypocalcemia dairy cows were analyzed to make sure the milk composition characteristics with related diseases,the correlation analysis between early lactating dairy milk composition and blood biochemical were also make in order to provide support for the cattle health assessment.According to theblood index,72 Holstein cows 7-21 d postpartum,were divided into group subclinical hypocalcemia,ketosis test group and control group,24 heads each group.The blood and milk of cows were collected and used to analyze the correlation between blood biochemical indexes and milk composition.The results showed that ketosis and hypocalcemia induced the level of milk protein and non fat milk solids decreased,while the content of citric acid in milk increased.The correlation equation between citric acid in milk and serum NEFA,BHBA and GLU was y=3.192x-0.802,(R2 =0.363),y=4.594x-0.793,(R2 =0.320),y=1.228x+0.775,(R2 =0.261),in which x was the content of citric acid in milk.The results showed that the content of citric acid in milk had positively related to blood NEFA,which could be used as an early marker for the diagnosis of negative energy balance.The levels of BUN and ALB in blood can be used to evaluate the levels of milk protein and urea.

The objective of this study was to determine the concentrations of calcium,phosphorus and magnesium in blood and compare the differences in seven areas of Heilongjiang province,and then estimate calcuim-phosphorus metabolism of beef cattle in seven beef cattle farms to provi detheoretical foundation for the prevention of calcium phosphorus metabolism diseases of beef cattle.Seven beef cattle farms of Daqing,Shuangyashan,Jiusan and Mudanjiang in Heilongjiang province were selected as the survey sites,which were recorded as group A (both grazing and stall-feeding in Shuangyashan),group B (stall-feeding mode in Shuangyashan),group C (stall-feeding mode in Daqing),group D (grazing mode in Jiusan),group E (both grazing and stall-feeding in Daqing),group F (both grazing and stall-feeding in Daqing) and group G (stall-feeding mode in Mudanjiang).Then the concentrations of Ca,Mg,P,free fatty acid (NEFA),glucose (Glc) and β-hydroxybutyric acid (BHBA) in the blood were compared to estimate the calcuim-phosphorus metabolic states.Results showed that the concentrations of calcium,magnesium and phosphorus in the plasma of 65 beef cattle in seven survey sites were within the normal range,and there was no significant difference in calcium concentration among seven sites.The P contents in group C and G were significantly higher those that in group A and B(P＜0.01),which in group C was significantly higher than those in group D,E and F (P＜0.01),which in group G was significantly higher than those in group D,E and F(P＜0.01).NEFA content in group B was significantly higher than that in group D (P＜0.05),and there was no difference among other groups.The concentration of Glc in group A was significantly higher than that in group E (P＜0.05),which in group B was significantly higher than those in group A and D,and was very significantly higher than those in group E,F and G (P＜0.01),which in group C was very significantly higher than those in group A,D,E,F and G (P＜0.01),which in group C was significantly higher than those in group A,D,E,F and G (P＜0.01),which in group D was significantly higher than that in group E (P＜0.05),and which in group F was significantly higher than that in group E (P＜0.05).The concentration of BHBA in group C,D and E were significantly higher than that in group A (P＜0.01),which in group C was significantly higher than that in group B (P＜0.05),which in group D and E was significantly higher than that in group B (P＜0.01),which in group C was significantly higher than that in group G (P＜0.01),which in group D was significantly higher than those in group F and G (P＜0.01),and in group E was highly significantly higher than that in group F and G (P＜0.01).Overall,there were not calcuim-phosphorus metabolic disorders within the seven beef cattle farms which were selected,but it is also necessary to strengthen feeding management and health care to prevent the occurrence of nutrition and metabolic diseases.

Objective:To investigate the clinical effects and indications of tibial condylar valgus osteotomy (TCVO) in treating varus unicompartmental knee osteoarthritis.Methods:A retrospective analysis was conducted in 32 patients (45 knees) who suffered from varus unicompartmental knee osteoarthritis and underwent TCVO from June 2016 to June 2018. These patients were aged 65.8±8.3 (range from 52 to 79) years, including 12 males (18 knees) and 20 females (27 knees). All enrolled individuals presented obvious expansion of the lateral joint space with joint line convergence angle (JLCA) of 7.19°±2.69°. Based on the full-length standing X-ray imaging of the lower limbs at before and 2 years after surgery, the percentage of mechanical axis (%MA), femorotibial angle (FTA), hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured and analyzed to evaluate the improvements of lower extremity alignments. The medial tibial plateau depression (MTPD), posterior proximal tibial angle (PPTA), JLCA and joint space width (JSW) were measured and analyzed to evaluate the congruency of the knee joint and shape of the tibial plateau based on positive and lateral radiographs of knee joint. In addition, visual analogue scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score were evaluated to assess the clinical effects of TCVO pre-operatively and at 1 year or 2 years after surgery.Results:All patients were followed up for 33.4±7.4 (range from 25 to 40) months. Comparing to the preoperative radiological data, %MA at 2 years after surgery increased from 3.78%± 14.34% to 66.16%±9.90%, FTA from 185.41°±4.45° to 170.81°±2.87°, HKA from 169.69°±1.70° to 181.16°±2.39°, MPTA from 83.03°±3.20° to 90.84°±3.67° all with statistical significance ( P<0.05). There was no significant difference for PPTA between before (89.22°±1.52°) and 2 years (88.97°±1.57°) after surgery ( t=0.638, P=0.526). MTPD improved from -7.81°±3.27° to 5.78°±2.19° ( t=19.218, P<0.001). However, there was no significant difference for PPTA between before (81.63°±3.28°) and 2 years (82.25°± 2.21°) after surgery ( t=0.881, P=0.382). JLCA reduced from 7.19°±2.69° to 0.22°±2.09°. The medial and lateral JSW were corrected from 2.45±0.23 mm and 5.86±0.25 mm to 3.73±0.27 mm and 4.68±0.34 mm ( P<0.05), respectively. Additionally, VAS and WOMAC scores improved from 6.46±2.21 and 52.66±16.69 preoperatively to 2.94±1.72 and 19.31±14.87 at 1 year after surgery, and to 1.39±1.45 and 13.66±15.44 at 2 years after surgery, respectively ( P<0.05). Conclusion:Satisfactory early therapeutic outcomes could be achieved by TCVO in varus unicompartmental knee osteoarthritis with subluxated lateral joint and increased JLCA. TCVO can correct intra-articular varus deformity, adjust mechanical axis and relieve knee joint pain and dysfunction.