OBJECTIVETo analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes.

METHODSAmong 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS).

RESULTSAll the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries.

CONCLUSIONAnkle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.

Adolescent ; Adult ; Ankle Fractures ; False Negative Reactions ; Female ; Fractures, Bone ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Pronation ; Rotation ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objective:To investigate the expression of wild type estrogen receptor(wER)and the ex-on-5 deleted ER(variant ER,vER)in human hepatocellular carcinoma(HCC)samples,and thereafteranalyze the possibility of HCC treatment by endocrine therapy.Methods:The mRNA expressions of wERand vER were analysed from 28 cases of HCC by RT-PCR.The expression of ER at the protein level wasdetected by immunohistochemistry(IHC).Results:IHC results showed that 39.3% of the HCC speci-mens expressed ER.The mRNA of wER was detected in 89.3%(25/28)of the HCC specimens whilethat of vER was detected in 96.4%(27/28).Twenty four out of 28 HCC cases(85.7%)expressedboth wER and vER.One out of 28 patients(3.5%)expressed only wER whereas 3 patients out of 28(10.7%)expressed vER only.Conclusion:Ninety six percent(27/28)of the HCC patients expressedvER,which suggests that the expression of vER is an important event in the development of HCC.

Objective To observe the outcomes of intranasal endoscopic holmium laser-assisted dacryocystorhinostomy in the treatment of chronic dacryocystitis. Methods Forty-seven patients(47 eyes) with chronic dacryocystitis underwent intranasal endoscopic holmium laser-assisted dacryocystorhinostomy.The postoperative follow-up included lacrimal irrigation and intranasal endoscopic examination. Results The patients were followed up for 3 to 6 months.The cure rate was 87.2%,the improvement rate was 6.4%,and the total effective rate(cure rate+improvement rate) was 93.6%.Conclusion Intranasal endoscopic holmium laser-assisted dacryocystorhinostomy causes no scar in the face,less nasal tissue damage,shorter operation time and less hemorrhage,and does not affect the lacrimal irrigation system,which allows correction of intranasal causes of failure in traditional dacryocystorhinostomy.

Objective To construct cDNA entry library and cDNA expression library of Armillifer agkistrodontis (A.) nymphs and make a preliminary immunoscreening for the cDNA expression library.Methods The nymphs were collected from the Kunming mice infected experimentally with A.agkistrodontis eggs and the total RNA were extracted from the nymphs using TRIzol Reagent.After purifying the mRNA,the synthesized cDNAs were cloned into the donor vector pDONR222 by BP reaction of Gateway technology and the recombinants were transformed into the DH10B cells by electroporation,the cDNA entry library was obtained.Next,the expression vector pDEST17 was ligated with entry clones by LR reaction,and the recombinants were transformed into the BL21 (DE3) cells.Hence,the cDNA expression library was constructed.Then,the expression library was immunoscreened with the mixed sera of mice infected with A.agkistrodontis,and the insertions of positive clones were sequenced.After that,the open reading frame(ORF) of positive slone sequence,the homology of the screened genes and their encoded proteins were analyzed by Finder and BLAST (basic local alignment search tool) program of National Center of Biotechnology Information(NCBI),and the discovered new genes were submitted into the GenBank.Besides,the physico-chemical properties,secondary structure and B cell epitopes of encoded proteins were also analyzed by bioinformatics software.Results The average titer and total clones of the cDNA entry library were 1.45 × 105 CFU/ml(colony-forming unit,CFU) and 1.74 × 106 CFU,respectively,and the range of fragment length of the inserted cDNA was between 0.2-4.0 kb,with an average of 1.4 kb.The total clones of cDNA expression library were 1.00 × 105 CFU,and the fragment length of the inserted cDNA was between 0.3-2.2 kb,with an average of 1.0 kb.Five positive clones,coded S1,S5,A1,D1 and F1,respectively,were obtained through preliminary immunoscreening.The sequence and homology of the five positive clones were sequenced and analyzed by BLAST program.No significant similarities were found in pentastomida species,which meant that they were all novel genes of A.agkistrodontis.The gene sequences were submitted to GenBank,with the accession number from JQ180451 to JQ180455.Also,results obtained by bioinformatics software showed that the predictive encoding proteins were all potential to be valuable recombinant diagnostic antigens.Conclusions The cDNA library of A.agkistrodontis nymphs is successfully constructed,and five new genes of A.agkistrodontis are discovered.The establishment of cDNA library and the discovery of the new genes will lay a foundation for further studying the gene functions and screening the immunodiagnostic antigens.

OBJECTIVETo establish a method for the determination of gossypol in cotton root bark.

METHODSamples were extracted with acetone, and determined on a C18 column with the mobile phase (Acetonitrile-0.2% phosphoric acid, 85:15) and UV-235 nm detector.

RESULTThe recovery rate was 97.6%, RSD 1.59% (n = 5).

CONCLUSIONThis method can be used for the determination of gossypol in cotton root bark and the content of gossypol in three different species has been determined.

Chromatography, High Pressure Liquid ; Gossypium ; chemistry ; Gossypol ; analysis ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry

Veregen™ and Fulyzaq are the first two botanical drug products that were approved by the Food and Drug Administration (FDA) to market in the US in recent years. Additional herbal medicines, including Compound Danshen Dripping Pills, Fuzheng Huayu Tablets, Xuezhikang Capsule, Guizhi Fuling Capsule, Kanglaite Capsule and Kanglaite Injection, have filed the investigational new drug (IND) application to the FDA and are in phase II or phase III clinical development. In order to gain better understanding of the process of botanical drug approval in the US, this article examines the aforementioned drugs by looking at their composition, indication, prior clinical experience and clinical development process, and summarizes key features that enabled IND filing and marketing approval by the FDA.
China ; Drug Approval ; legislation & jurisprudence ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Nonprescription Drugs ; therapeutic use ; United States ; United States Food and Drug Administration

OBJECTIVETo investigate the differential expression of different types of Smads in keloids, normal scars and normal skins and its possible clinicopathological significance.

METHODSRT-PCR and Western blot methods were used to examine the expression of Smads mRNA and proteins level in 10 cases of keloid, in 10 cases of normal scar and in 10 cases of normal skin tissues and fibroblasts. Fibroblasts of keloid, normal scar and normal skin were cultured in vitro. The expression difference were compared and analyzed by t-test, there was statistical difference when P < 0.05.

RESULTSThe mRNA and protein expression of inhibitory Smad7 were significantly down regulated in keloid compared with normal scar (P < 0.05) and normal skin (P < 0.05). However, no significant difference of the mRNA and protein expression of Smad2, 3 and the protein expression of phosphorylation of Smad2, 3 in keloid, normal scar, normal skin tissues and fibroblasts.

CONCLUSIONSThe decreased expression of Smad7 in keloid might play a significant role in the increased TGF-beta1/Smads signal transduction, which can not be terminated by autologous negative feedback cycle.

Adolescent ; Adult ; Female ; Humans ; Keloid ; metabolism ; Male ; Middle Aged ; RNA, Messenger ; genetics ; Signal Transduction ; Smad Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Young Adult

OBJECTIVETo explore the mechanical behavior of lumbar spine loaded by stress and provide the mechanical basis for clinical analysis and judgement of lumbar spine fracture classification, mechanical distribution and static stress.

METHODSBy means of computer simulation method, the constructed lumbar spine three-dimensional model was introduced into three-dimensional finite element analysis by software Ansys 7.0. The lumbar spine mechanical behavior in different parts of the stress loading were calculated. Impact load is 0-8000 N. The peak value was 8000 N. The loading time is 0-40 minutes. The values of the main stress, stress distribution and the lumbar spine unit displacement in the direction of main stress were analyzed.

RESULTSThe lumbar spine model was divided into a total of 121 239 nodes, 112 491 units. It could objectively reflect the true anatomy of lumbar spine and its biomechanical behavior and obtain the end-plate images under different stress. The stress distribution on the lumbar intervertebral disc (L(3)-L(4)) under the axial, lateral flexion and extension stress, and the displacement trace of the corresponding processus articularis were analyzed.

CONCLUSIONIt is helpful to analyze the stress distribution of lumbar spine and units displacement in static stress loading in the clinical research of lumbar spine injury and the distribution of internal stress.

Adult ; Biomechanical Phenomena ; Female ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; physiology ; Sacrum ; physiology ; Stress, Mechanical

OBJECTIVETo verify the electric synchronism, mechanic synchronism and hemodynamics of selective site pacing.

METHODSPacing in the right ventricular cardiac apex (RVA), the right ventricular His bundle region (His), and the septum of right ventricular high-positioned outflow tract (RVOT), CO and CI were recorded. The electrical synchronism was assessed by observing the width and shape in a 12-lead surface ECG. The mechanical synchronism was estimated by using the VVI (vector velocity imaging) technology of the Acuson Sequia 512.

RESULTSThe results showed that CO and CI were lower while pacing in RVA, but they were not significant different (P>0.05). The QRS width: (124 +/- 5.3) ms while pacing in His, (144 +/- 7.1) ms while pacing in RVOT and (156 +/- 8.6) ms while pacing in RVA. The QRS width while pacing in His and in RVOT were narrower than in RVA and there were significant differences (P<0.01). Vector velocity imaging showed that mechanical synchronism was better while pacing in RVOT than that in RVA.

CONCLUSIONPacing in RVOT seems better than pacing in traditional RVA, and the operation was no more difficult than the traditional operation.

Adult ; Aged ; Bundle of His ; physiopathology ; Cardiac Pacing, Artificial ; methods ; Electrocardiography ; Female ; Heart Ventricles ; physiopathology ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial

OBJECTIVETo elucidate the effects of the deleted in colorectal carcinoma (DCC) gene on proliferation of ovarian cancer cell line SKOV-3.

METHODAn exogenous recombinant eukaryotic expression vector pcDNA3.1(+)-DCC, containing human DCC cDNA coding sequences, was constructed and transfected into SKOV-3 cells (SKOV-3/DCC). The pcDNA3.1 (+) transfected cells (SKOV-3/Neo) and SKOV-3 cells were used as the positive and negative controls, respectively. Expressions of DCC mRNA and protein were analyzed by RT-PCR and immunocytochemical analysis, respectively. Cell growth was detected by soft agar colony formation assay and MTT assay. Flow cytometry and transmission electron microscopy were used to assess the effects of DCC on cell cycle distribution and ultrastructure, respectively. BALB/c mice were used to evaluate the effects of DCC on tumorigenicity in vivo.

RESULTSRT-PCR and immunocytochemical analysis revealed the exogenous DCC gene was successfully transfected into SKOV-3 cell lines and obtained permanent expression. The half maximal inhibitory concentration (IC50) of SKOV-3/DCC cells was significantly lower than that of SKOV-3 or SKOV-3/Neo cells (all P<0.05). DCC expression caused SKOV-3 cells to be arrested in G1 phase (78.0%), and electron microscopic analysis showed SKOV-3/DCC cells displayed typical morphological changes of apoptosis. Two mice xenografted with SKOV-3/DCC cells showed no tumor tumorigenecity. The tumor volume of BALB/c mice bearing SKOV-3/DCC cells (3.403 mm(3)) was smaller than that of SKOV-3 cells (9.206 mm(3)).

CONCLUSIONDCC gene may play an important role in suppressing the growth of SKOV-3 cell line and inducing apoptosis.

Animals ; Apoptosis ; genetics ; physiology ; Cell Cycle ; genetics ; physiology ; Cell Line, Tumor ; Cell Proliferation ; DCC Receptor ; Female ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microscopy, Electron, Transmission ; Ovarian Neoplasms ; genetics ; metabolism ; therapy ; Receptors, Cell Surface ; genetics ; metabolism ; Transfection ; Tumor Suppressor Proteins ; genetics ; metabolism ; Xenograft Model Antitumor Assays