OBJECTIVETo investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.

METHODSFrom September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.

RESULTSFive patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.

CONCLUSIONFor the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo observe the therapeutic effects of steel plate fixation after the failure of arthrodesis of ankle by screw fixation.

METHODSFrom August 2001 to October 2011, 15 patients were with steel plate fixation after failure of arthrodesis of ankle by screw fixation. Among patients, 9 cases were males and 6 cases were females,ranging age from 40 to 65 years old with the average of 56 years old. Ten cases were in left and 5 cases were in right. Screws were removed and steel plate was fixed intraoperatively, and plaster external fixation for postoperation. Clincal effect were evaluated according to AOFAS scoring system from pain, waliking ability and aligment before and after operation, and X-ray was used to evaluate joint fusion after operation.

RESULTSAll patients were followed up, and the duration ranged from 4 months to 4 years with an average of 2 years. The incison were healed in stage I. No ankle pain,injury of blood vessel and nerve,infection and farilure of internal fixation occuerred. The AOFAS score increased from 36.86 +/- 8.32 preoperatively to 85.09 +/- 4.65 (t = -26.366, P = 0.000).

CONCLUSIONSteel plate fixation after the failure of ankle arthrodesis of screw fixation has the advantages of rigid stability, simple manipulation and high success rate, less pain, perfect recovery.

Adult ; Aged ; Ankle Joint ; diagnostic imaging ; surgery ; Arthrodesis ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Steel ; Tomography, X-Ray Computed ; Treatment Failure

Acupuncture Therapy ; Chest Pain ; therapy ; Female ; Humans ; Middle Aged ; Stroke ; therapy

[ ABSTRACT] AIM:To investigate the expression relevance of transcription factors GATA-1 and GATA-2 in the bone marrow CD71 +cells of a high-altitude polycythemia (HAPC) rat model.METHODS:Male SD rats (n=48) were randomly divided into normal control group and HAPC model group .HAPC model was established at an altitude of 4 300 m in the natural environment and verified by the morphology and quantity of the bone marrow cells and hematologic parameters detection .A relative change in the trend of bone marrow CD 71 +cell numbers was detected by flow cytometry analysis .The expression of GATA-1 and GATA-2 at mRNA and protein levels in the CD 71 +cells was examined by RT-qPCR and West-ern blot .CD71 +cells were cultured under hypoxic condition and transfected with the optimal interference sequence of GA -TA-1shRNA1 for 96 h.The expression of GATA-1 and GATA-2 at mRNA and protein levels was detected by RT-qPCR and Western blot .RESULTS:The establishment of the animal model with HAPC was successful as the bone marrow smears and the hematologic parameters showed compared with the control .The quantity of the bone marrow CD 71 +cells of HAPC rats were significantly increased and the expression of GATA-1 at mRNA and protein levels in the CD 71 +cells were higher than those of the control .The expression of GATA-2 at mRNA and protein levels was similar to that of the control .The correla-tion analysis showed that the expression of GATA-1 was negatively correlated with that of GATA-2 in the control, while no obvious correlation between them was observed in the HAPC rats .The expression of GATA-1 at mRNA and protein levels in HAPC group was lower than that in control group after interfered by GATA-1 shRNA1 for 96 h, but no obvious diversity of GATA-2 expression between the 2 groups was observed .CONCLUSION:GATA-1 and GATA-2 are abnormally expressed and their negative correlation is destroyed in HAPC , which may be one of the pathogenesis of HAPC .

Objective To study the role of lipase in inflammation in patients with acute pancreatitis.Methods Acute pancreatitis patients (n =200) were enrolled in the study.The patients were examined by computerized tomography and the severity of AP is determined by Blathazat Score.We assess the muhivariate-adjusted association of amylase and lipase with inflammatory markers of AP.We identified that lipase was more specifically correlated with AP progression than amylase,lactate dehydrogenase and creatitine kinase.Results We demonstrated that in AP patients,a doubling of lipase excretion was associated with 6.8％ increase of white blood cells (95％ CI,3.06％-10.5％,P ＜ 0.01),10.3％ (95％ CI,5.7％-14.9％,P ＜ 0.01) increase of neutrophil number but 14.8％ (95％ CI,2.3％-27.3％,P ＜0.05) decrease of lymphocytes in the blood,respectively.By contrast,amylase has no association with these cells.Both amylase and lipase had no relationship with triglyceride level in AP patients.Conclusions Lipase serves as an indicator for the severity and treatment of AP.

The known members of inhibitor of growth (ING) gene family are considered as candidate tumor suppressor genes. ING4, a novel member of ING family, is recently reported to regulate brain tumour angiogenesis through transcriptional repression of NF-?B-responsive genes, induce G2/M arrest by the increased p21 expression in a p53-dependent manner, suppress the loss of contact inhibition and represses activation of the hypoxia inducible factor, which plays an important role in the progression of tumorigenesis. However, seldom studies about ING4 inducing tumor cells apoptosis were reported.The C6 cells (mouse glioma cells) were infected respectively with the blank adenovirus carrying GFP (Ad) and the recombinated Ad-hING4-His, then RT-PCR assay was used to detect the transcriptions of hING4, as well Western-blotting assay was ued to detect the expressions of hING4. The effects of hING4 expression upon C6 cells were observed, and the growth curve was drawed and tumor control rates were calculated. The C6 cells, which were affected by blank Ad and Ad-hING4-His, were respectively observed by LSCM (laser scan confocal microscope) and transmission electron microscope (TEM), detected by flow cytometry; and the genomic DNA of both groups were extracted and electrophoresised in agarose gel to examinate the DNA fragments. The results showed hING4 can significantly inhibit the growth of C6 cells by promoting the cell’s apoptosis, which probably is the first one to prove this property of ING4.The experimental and theoretical foundation for gene therapy for gliomas with ING4 in the future was established.

Objective:To study the role of indocyanine green(ICG)fluorescence imaging in laparoscopic partial splenectomy (LPS).Methods:The data of 4 patients who underwent ICG fluorescence imaging technology for LPS at Beijing Luhe Hospital Affiliated to Capital Medical University from May 2017 to May 2020 were retrospectively analyzed. There were 3 females and 1 male, aged 46, 41, 27 and 12 years respectively. The extents of spleen preservation were compared between ICG fluorescence imaging with ordinary white light during operation. The residual splenic remnants were tested with fluorescence imaging after splenectomy, which showed fluorescence fading indicating good vascular perfusion.Results:ICG fluorescence imaging was performed on 4 patients. The operation time ranged from 180.0 to 250.0 min, and the intraoperative blood loss ranged from 40.0 to 200.0 ml. The postoperative hospital stay ranged from 4 to 14 days. There were no serious complications. Postoperative histopathology showed: splenic cyst ( n=1), splenic hemangioma ( n=2), and splenic laceration ( n=1). Conclusions:ICG fluorescence imaging technology had a significant role to play in partial splenectomy. This study showed this technique to improve safety of laparoscopic partial splenectomy.

Objective: To study the phenotypes and functions of dendritic cells (DCs) derived from peripheral blood monocytes of chronic hepatitis B (CHB) patients with different traditional Chinese medicine (TCM) syndrome types, and to explore the relationship between TCM syndrome type and DC functions. Methods: Sixty CHB patients were included in this study. All the CHB patients were divided into spleen deficiency and liver stagnation, spleen deficiency and dampness-heat and deficiency of both spleen and kidney groups according to TCM syndrome diagnosis standard. There were 20 cases in each group, and ten healthy people were included as normal control. The volunteer's peripheral blood was collected for monocyte separation, biochemical test and hepatitis B virus DNA loads detection. DCs were induced and isolated from peripheral blood monocytes, and then the expressions of surface markers CD80, CD86, CD1a and HLA-DR were detected by flow cytometric analysis method. Interleukin-10 (IL-10) production of the DCs was quantified by enzyme-linked immunosorbent assay. Results: The proliferation of DCs in the CHB patients was slower than that in the healthy volunteers (P<0.05). The expressions of DC surface molecules such as CD80, CD86, and CD1a were obviously decreased in the CHB patients as compared with those in the healthy volunteers (P<0.05). More over, expressions of DC surface molecules were different among CHB patients with different TCM syndrome types. The positive expressions of CD80, CD1a, and HLA-DR in the CHB patients with spleen deficiency and liver stagnation were obviously higher than those in the CHB patients with deficiency of both spleen and kidney (P<0.05), and the CD1a expression in the CHB patients with spleen deficiency and dampness-heat was higher than that in the CHB patients with deficiency of both spleen and kidney (P<0.05). In DC culture supernatant, the IL-10 concentration of the CHB patients with deficiency of both spleen and kidney was higher than that of the CHB patients with spleen deficiency and liver stagnation (P<0.05), and the IL-10 concentrations of the CHB patients with different TCM syndrome types were higher than that of the healthy volunteers (P<0.05). Conclusion: During the pathogenic course of CHB, the phenotypes and functions of DCs are different in CHB patients with different TCM syndrome types. It suggests that there is a correlation between TCM syndrome type and body immunity function.

Objectives To investigate the clinical features of pneumonia in children with elevated alanine aminotransferase(ALT). Methods Clinical and laboratory data of 3 979 children with pneumonia admitted to the hospital were collected and retrospectively analysed, and ALT was detected in all cases. Results In 3 979 children with pneumo-nia, elevated ALT (13.78%) was found in 548 cases, most of which had mildly elevated ALT and were infants less than 6 months. The average age in elevated ALT group was less than that in normal ALT group (P=0.000). Apart from the symp-toms of pneumonia, most of them had non-specific clinical symptoms, 169 cases (30.84%) with anorexia or feeding dif-ficulties. 22 cases (4.01%) with poor spirit or weak, 10 cases (1.82%) with crying or abdominal pain;6 cases (1.09%) with dark urine; 4 cases (0.73%) with skin and/or sclera jaundice, 2 cases (0.36%) with bleeding tendency. Children in mildly elevated ALT group recovered faster than in moderate-to-severe elevated ALT group. Conclusions Mildly elevated ALT was most common in pneumonia with elevated ALT which was more likely to occur in younger age group. Clinical mani-festations were often non-specific with good outcomes.

Objective To explore the effect of flexible ureteroscope in treatment of retained kidney calculi after percutaneous nephrolithotomy.Methods Thirty-six patients with retained kidney calculi after percutaneous nephrolithotomy who were treated with flexible ureteroscope were selected,and clinical data of the patients were retrospectively analyzed.Results In the 36 patients,26 patients were through the percutaneous nephroscope channel,and 10 patients were through the ureter channel.Except for 1 patient who stopped the operation because of poor visibility caused by active bleeding in percutaneous nephroscope channel lithotripsy 7 d after percutaneous nephrolithotomy,other patients did not appear severe complication.All the patients were rechecked plain abdominal radiograph the second,seventh and fourteenth day after this operation,and the eradication rates of calculi were 13.9％ (5/36),69.4％ (25/36) and 94.4％ (34/36).Two patients still had less than 0.4 cm retained calculi in lower renal calices and were followed up.Conclusions The retained kidney calculi after percutaneous nephrolithotomy can be effectually treated by flexible ureteroscope,and it can avoid secondary percutaneous nephrolithotomy or multichannel percutaneous nephrolithotomy,and inprove the eradication rate of complex kidney calculi by percutaneous nephrolithotomy.The method is economical,safe,simple and with little injury,and it is the effective supplement protocol of percutaneous nephrolithotomy.