BACKGROUND:The treatment method of tibial avulsion fractures of anterior cruciate ligament is varied;each has its advantages. OBJECTIVE:To investigate the methods and clinical effects of the treatment of avulsion fractures of tibial insertion of anterior cruciate ligament by the means of making two decussate lines and four strands of non-absorbable Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy. METHODS:From December 2014 to November 2015, 23 cases of avulsion fractures of tibial insertion of anterior cruciate ligament were treated in the Second Hospital of Inner Mongolia Medical University. Under the arthroscopy, avulsed fracture was fixed in tibial intercondylar eminence by the means of making two decussate lines of Arthrex sutures passing through. At the same time, pushlock free knotting anchor beside tibial tubercle provided a tightening of tension for Arthrex sutures, which could strengthen the fixation of avulsion fracture blocks. Knee joint Lysholm and Tegner scores were fol owed up. Knee stability was evaluated by anterior drawer test and Lachman test. Postoperative reset and healing were evaluated with X-ray films. RESULTS AND CONCLUSION:(1) Al 23 patients were fol owed up for 6 months to 1 year. (2) Lysholm scale of the knee function was (47.31±6.16) preoperatively and (94.69±1.28) postoperatively (P<0.05). Tegner score was (3.14±1.58) preoperatively and (7.74±1.69) postoperatively (P<0.05). (3) Lachman test of al cases was negative. X-ray films demonstrated that fracture healing was good. There was no repeated swel ing or cross locking of the joint. The knee was not limited by flexion or extension. No infection or deep venous thrombosis of lower extremity occurred. (4) The method of Arthrex sutures passing through two bone tunnels combined with pushlock free knotting anchor under arthroscopy has the advantages of minimal y invasive, simple operation, reliable fixation, no metal implants and satisfactory result to treat the tibial intercondylar eminence fracture of anterior cruciate ligament.

BACKGROUND:Alogeneic tendon has been frequently used to reconstruct the anterior cruciate ligament. However, there is a lack of middle- and long-term clinical evaluation. OBJECTIVE:To evaluate the middle- and long-term curative effect of alogeneic tendon reconstruction of the anterior cruciate ligament under arthroscopy. METHODS:Twenty-five patients with anterior cruciate ligament injury under alogeneic tendon transplantation were reviewed retrospectively. They were al folowed up for 3 years or more. The clinical outcomes were evaluated and compared using Lyshlom score scale, IKDC2000 and Tegner score scale. RESULTS AND CONCLUSION:Al the patients were folowed up. Lysholm scale scores on the knee function, Tegner scores and IKDC scores were significantly increased after transplantation (P < 0.05). No complications of infection and compartment syndrome occurred. Symptoms were relieved and the function of knee joint was improved. There was one case weakly positive for anterior drawer test. Both Lachman test and pivot shift test showed negative signs. Overal, the reconstruction of anterior cruciate ligament with alogeneic tendon has less trauma and complications, with good middle-term efficacy.

Objective To propose a decision tree-based early warning model so as to predict the medical equipment quantity and quality under special conditions to quantize maintenance and detection staffs allocation,components supply,emergency planning and etc.Methods A data set was established based on the verification report,data on performance parameters detection and daily management log,and then underwent pretreatment.A decision tree came into being with the algorithms of ID3,CHAID and etc.The data rule corresponding to the decision tree was transformed into a series of early warning information.The model was verified by applying it to medical equipment usage management.Results The decision tree developed was applied to analyzing a vehicle-mounted water purifying device maintenance and usage records in some logistics support vehicle,and it's found the main factors contributing to the failures included migration distance along non-paved road,ambient temperature and service time.Conclusion The decision tree-based early warning model for medical equipment quantity and quality gains high feasibility and practical values.

Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

Objective:To explore the relationship between hepatitis B virus (HBV) infection and the pathogenesis of multiple my-eloma (MM), in order to provide an epidemiological evidence for the prevention and treatment of MM. Methods:Clinical and epidemi-ological data of 185 MM patients and 182 non-tumorous patients were collected. Subjects were randomly selected from in-patients who were homeochronously admitted to the same five grade-III A hospitals, including Xi'an Central Hospital, Shaanxi People's Hospital, Xi'an Jiaotong University Xibei Hospital, and so on. MM patients were selected in terms of age and gender. Peripheral blood HBsAg was assayed by ELISA. If HBsAg was negative, the S and C-gene fragments of HBV DNA were tested using nested PCR . Fisher's ex-act test orχ2 test (SPSS statistical software) was used to compare the differences between the groups. Logistic regression was employed to examine the association between the pathogenesis of MM and HBV infection. Results:In MM patients, the HBsAg positive rate was 8.11% (15/185), the occult HBV infection (OBI) positive rate was 3.53% (6/170), and the total HBV infection rate was 11.35% (21/185). For the control group, the HBsAg positive rate was 4.40%(8/182), the OBI positive rate was 0.57%(1/174), and the total HBV in-fection rate was 4.95%(9/182). No statistical difference in HBsAg or OBI positive rate was found between the two groups (P>0.05). However, MM patients showed significantly higher total HBV infection rate than that of the controls [χ2=5.02, P<0.05;OR was 2.46 (95%CI:1.10-5.53, P<0.05)]. Additionally, the proportion of ISS stage III was significantly higher in MM patients with HBV infection than in uninfected MM patients (85.71%vs. 60.37%,χ2=5.15, P<0.05). Patients with HBV infection showed reduced albumin level (χ2=5.60, P<0.05) and aκ/λlight chain ratio (P<0.05) compared with uninfected patients. Conclusion:The risk of MM pathogenesis after HBV infection is significantly increased as OBI is included in the analyses. Furthermore, MM patients with HBV infection will develop more severe liver damage, indicating that OBI in MM patients with negative HBsAg should be screened before chemotherapy to pre-vent HBV reactivation.

A method for determination of residues of 26 β2-agonists in pork liver was developed using high performance liquid chromatography with tandem mass spectrometric ( HPLC-MS/MS ) . After enzymatic hydrolysis with β-Glucuronidase/Arylsulfatase for 12 hours, the pH of sample solution was adjusted to 1 using perchloric acid for protein precipitation. The precipitate was extracted with 0. 1mol/L perchloric acid aqueous. The extracts in the above two steps were combined and adjusted to pH 4 for the solid phase extraction ( MCX) . And then the 26 β2-agonists residues in the extracts were separated on a reversed phase HPLC column using a gradient elution program of 0. 1% formic acid aqueous solution (A) and 0. 1% formic acid in acetonitrile solution ( B) . Multiple reaction monitoring ( MRM) with positive polarity was selected to monitor qualitative and quantitative ion. Based on the optimized method, 26 β2-agonists could be analyzed in 15 min. The recoveries ranged from 64 . 0% to 112 . 7% for the 26 kinds ofβ2-agonists residues with three spiked levels of 5, 10 and 20 μg/kg. The relative standard deviations ( RSDs) were less than 15. 2%. The limits of detection (LOD) for the 26 kinds of β2-agonists were 0. 15-1. 35 μg/kg.

OBJECTIVESTo study the relationship between the mutation of Leu60Val in HBV core region and the cellular immunity in patients with chronic hepatitis B (CHB).

METHODSHBV DNA C gene mutation was confirmed by polymerase chain reaction (PCR) and sequencing the products directly. The cytokines (IFN-gamma, TNF-alpha and IL-2) levels in serum were measured by enzyme linked immunosorbent assay (ELISA). The distribution of T-lymphocyte subpopulations in peripheral blood was detected by flow cytometry (FCM).

RESULTSThe mutation of Leu60Val was found in 19 out of the 91 CHB patients. With the CHB severity, the mutation rate was getting higher, especially in the severe hepatitis group. The IFN-gamma and TNF-alpha levels were much higher in mutant strain group than those in wild strain group (t=2.584, 4.766, P<0.01), so was the ratio of CD4+/CD8+ (t=2.275, P<0.05).

CONCLUSIONThe mutant strain of 60Val may increase affinity to HLA-I molecule, or up-regulate the expression of HLA-I molecule, resulting in the activation of CTL to release the cytokines and cause immune response in liver.

Adult ; Aged ; CD4-CD8 Ratio ; Flow Cytometry ; Hepatitis B Core Antigens ; genetics ; Hepatitis B, Chronic ; immunology ; virology ; Histocompatibility Antigens Class I ; metabolism ; Humans ; Interferon-gamma ; biosynthesis ; Middle Aged ; Mutation ; T-Lymphocytes, Cytotoxic ; immunology ; Tumor Necrosis Factor-alpha ; biosynthesis

OBJECTIVETo seek a sequential method for the management of residual wounds in burn patients.

METHODSThree chronic residual wounds on each of 25 burn patients were either covered with vaseline gauze (A group), human tissue-engineered active skin (Active Skin, B group) or Active Skin after rinsing with fluid containing oxygen and vacuum assisted drainage ( C group) on wounds. The contents of (TNF)a in granulation tissue were assayed by enzyme linked immunosorbent assay (ELISA). Expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue was determined with reverse transcription polymerase chain reaction (RT-PCR). Moreover, quantity of wound bacteria in the wounds and wound healing rate were determined with usual method.

RESULTSThe quantities of wound bacteria in C group on 3,6,9, 12 post-treatment day( PTD) were (5.30 +/- 1.60), (1.30 +/-0.80) , (1.70 +/- 0. 60)and (0.60 +/-0. 10)clone formation unit/ml( CFU/ml) , respectively, which were obviously lower than those in A and B groups. The contents of TNFa and expression of metalloproteinase-13 (MMP-13) mRNA in granulation tissue in C group on 6 PTD were [ (0. 650 +/- 0. 040) ng/mg and 0. 210 +/- 0. 010,] ,respectively, and they were evidently lower than those in A group [(1.550 +/-0. 370)ng/mg,1. 040 +/- 0. 050, P <0.01] and B group (0. 810 +/- 0.080) ng/mg, 0.640 +/- 0.030, P <0.01]. Meanwhile, the contents of (TNF)a and expression of MMP-13 mRNA in B group were also obviously lower than those in A group. The wound healing ratio in C group on 15 and 30 PTD were markedly higher than those in A or B group ( P <0.01).

CONCLUSIONCovering the residual burn wounds with Active Skin after rinsing with fluid containing oxygen followed by vacuum assisted drainage can improve repairing of residual burn wounds.

Adolescent ; Adult ; Burns ; microbiology ; therapy ; Female ; Humans ; Male ; Matrix Metalloproteinase 13 ; metabolism ; Middle Aged ; Negative-Pressure Wound Therapy ; RNA, Messenger ; metabolism ; Skin, Artificial ; Therapeutic Irrigation ; Tissue Engineering ; Tumor Necrosis Factor-alpha ; metabolism ; Wound Healing ; Young Adult

OBJECTIVETo explore the relationship between neuropeptide substance P (SP) and wound healing in scalded rats.

METHODS(1) Scalded rats with different degrees of scald injury were employed as the experimental model and were sacrificed at 24 post scald hour (PSH), and on 3, 7 and 14 post scald days (PSD). The SP content in the wound was detected with radioimmunoassay method. (2) The murine granulation tissue fibroblasts (GTF) were cultured with different culture media, and divided into control, SP and Spantide (SP receptor antagonism) groups. The effects of SP and Spantide on the cellular activity and apoptotic rate of murine GTF were assessed in vitro.

RESULTSThere was significant difference of the SP content among the superficial (145 +/- 78) ng/g, partial (94 +/- 48 ng/g) and full thickness (53 +/- 27 ng/g) scald wounds at 24 PSH (P < 0.01), while the SP content in partial thickness burn wound on 3 and 7 PSD obviously increased; and that in deep partial thickness burn wound obviously increased on 7 and 14 PSD. But the SP content remained unchanged in full thickness scald wound. (2) SP could promote the activity of GTF and inhibit its apoptosis (The GTF activity in control, SP groups were 0.21 +/- 0.05, 0.36 +/- 0.07, respectively, P < 0.01). Spantide could inhibit the interaction between SP and GTF.

CONCLUSIONSP can promote GTF proliferation, and the SP content in wound is closely associated with the depth of the injury and wound healing capacity.

Animals ; Burns ; metabolism ; pathology ; Cell Proliferation ; Disease Models, Animal ; Female ; Fibroblasts ; cytology ; Male ; Rats ; Rats, Wistar ; Receptors, Neurokinin-1 ; metabolism ; Substance P ; analogs & derivatives ; pharmacology ; Wound Healing

OBJECTIVETo explore the dynamic changes in the expression of c-fos, proliferation cell nuclear antigen (PCNA) and Bax in the intestinal tissue of scalded rats before and after resuscitation.

METHODSWistar rats inflicted with 30% TBSA full thickness scald were employed as the model and randomly divided into four groups with 8 in each group, i.e. 2.0, 2.5, 4.0, 6.0 postscald hour (PSH) groups. Rats in each group received routine fluid infusion at 2 PSH, and were sacrificed at 2, 2.5, 4, 6 PSH, respectively. Then the intestinal tissue of the rats was harvested for the detection of the expression of c-fos, PCNA and Bax.

RESULTSThe expression of c-fos, PCNA and Bax at 2.0 PSH group (65.8 +/- 4.2%, 74.5 +/- 2.4%, 26.3 +/- 5.7%, respectively) significantly increased when compared with those in 2.5 PSH group (92.4 +/- 5.7%, 85.6 +/- 4.5%, 67.1 +/- 6.6%, respectively) (P < 0.01). The expression of 3 genes increased dramatically at 2.5 and 4.0 PSH, and reached the peak at 2.5 PSH. There was no obvious difference in the gene expression between 4 PSH and 2 PSH groups.

CONCLUSIONThe expression of apoptotic genes in the intestinal tissue of scalded rats increased significantly during early resuscitation stage after burn injury.

Animals ; Apoptosis ; Burns ; metabolism ; pathology ; Gene Expression ; Genes, fos ; Intestinal Mucosa ; metabolism ; Intestine, Small ; metabolism ; pathology ; Male ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; pathology ; Shock, Traumatic ; bcl-2-Associated X Protein ; metabolism