Objective To investigate the clinical outcome of post-traumatic tibial osteomyelitis treated by induced membrane technique combined with the antibiotic cement-coated locking plate.Methods A restrospective case series analysis was made on 71 cases of post-traumatic tibial osteomyelitis treated by induced membrane technique from September 2014 to September 2014.There were 55 males and 16 females, aged 18-60 years(mean, 37.4 years).Mean length of bone defect following debridement was 4.5 cm(range, 4-11 cm).Antibiotic cement-coated locking plates were used to provide the stability of the bone defects after one-stage debridement.Bone grafting and exchanging the plates with ntramedullary nails were done during the second-stage surgery.Parameters were monitored dynamically after operation to evaluate infection recurrence and bone healing, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), clinical features(sinus formation, redness and swelling, warmth and pain) and X-ray films of the involved limbs.Results All patients were followed up for 13-25 months (mean, 19.5 months).There was no sign of recurring infection and CRP and ESR were normal in all cases after the first stage surgery.However, four cases (6%) had recurrent infection with sinus exudates and their CRP and ESR were abnormal after the second stage surgery, and further treatments were carried out on these patients.Follow-up showed bony union in all patients within mean 5.5 months (range, 4-6 months).Conclusion Induced membrane technique with antibiotic cement-coated locking plates for treatment of post-traumatic tibial osteomyelitis can shorten bone healing time and decrease infection recurrent rate without obvious impact on osteogenic activity.

Objective To investigate the results of Cierny-Mader type Ⅳ posttraumatic long bone infection treated by en bloc resection combined with induced membrane technique.Methods A retrospective case series analysis was made on 36 patients with posttraumatic long bone infection treated by en bloc resection combined with induced membrane technique from January 2013 to January 2015.There were 30 male and 6 female patients between 21 and 68 years (mean,41 years).Infection control,bone union,function activity and complications were detected after operation.Results After debridement in the first stage,a segmental bone defect of 5.5 cm in length (range,2-10.9 cm) was seen in all patients.Seven patients needed a local flap transfer to cover the wound and five patients had a second debridement.Mean duration of systemic antibiotic use was 2 weeks (range,1-6 weeks) and mean time interval of second-stage bone grafting was 12 weeks after debridement (range,6-36 weeks).Mean follow-up was 29.5 months (range,24-45 months).One patient had recurrence and was cured with radical debridement and a permanent acrylic spacers insertion,with the cure rate of bone infection of 97％ (35/36).All patients achieved bone union with a mean duration of 5.9 months (range,4-8 months),and were able to walk independently.Thirty patients returned to work or pre-operative physical labor.No pain and re-fracture occurred.Six patients had adjacent joint stiffness.Conclusion En bloc resection combined with induced membrane technique is associated with radical debridement,decreased recurrence rate and limb salvage,indicating a simple and effective method for Cierny-Mader type Ⅳ posttraumatic long bone infection.

The sources of clinical efficacy of slow needle insertion is discussed. From the basic factors of slow needle insertion, the requirements of this manipulation, main points of 4 steps (to straight the needle, to press softly, to twirl the needle and to hold without brute force), keys of operation and its significance are analyzed. Slow needle insertion is not only beneficial to the management and regulation of Shen (spirit) and induction of qi in the process of the spirit unity of doctor and patient, but also accumulates the needling sensation among three levels of the superficial, middled and deep layers of an acupoint, which could promote the curative effect.
Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, 20th Century ; History, 21st Century ; History, Ancient ; Humans ; Medicine in Literature ; Needles

OBJECTIVETo study the effect and the mechanism of Xuesaitong drop pills (total saponins in Radix Notoginseng; XDP) on experimental thrombosis, thrombolysis and blood theology.

METHODFirst, the rats were randomly divided into five groups: control, XDP (90, 30, 10 mg x kg(-1)), Xuesaitong tablet (XP) 30 mg x kg(-1). Then the effect of the drugs on thrombus and thrombosis was studied after the ratsthrombosis was induced by the arteriovenous shunt. Second, the rats were randomly divided into seven groups: model, XDP (90, 30, 10 mg x kg(-1)), XT (90, 30 mg x kg(-1)), lumbrukinase capsule. Then the effect of the drugs on thrombus and thrombosis was studied after the rats'thrombosis was induced by the electrical stimulation of common carotid artery. Third, the rats were randomly divided into six groups: control, model, XDP (80, 40 mg x kg(-1)), XT (40, 20 mg x kg(-1)). Then the effect of the drugs on blood circulation promoting was observed after the rats'acute blood stasis induced by adrenalin and icy water.

RESULTXDP 90, 30 mg x kg(-1) could notably lighten the wet-weight and dry-weight of thrombus in the arteriovenous shunt model in rats in a dose-dependent manner (P < 0.01). XDP 90 mg x kg(-1) with intragastric administration for 3 days had the satisfactory effect on thrombolysis after the rat's thrombosis was induced by the electrical stimulation of common carotid artery (P < 0.01). XDP 80, 40 , 20 mg x kg(-1) reduced significantly erythrocyte aggregation (P < 0.01) and decreased the whole blood viscosity at low shear rate (P < 0.05). XDP 80, 40 mg x kg(-1) reduced the whole blood viscosity at high shear rate and plasma viscosity (P < 0.05). XDP 80 mg x kg(-1) decreased the whole blood viscosity at high shear rate (P < 0.05).

CONCLUSIONXDP can significantly inhibit the thrombosis and has the satisfactory effect on thrombolysis. One kind of the mechanism is related to the effect on blood rheology.

Animals ; Blood Viscosity ; drug effects ; Carotid Artery Thrombosis ; blood ; drug therapy ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; therapeutic use ; Erythrocyte Aggregation ; drug effects ; Erythrocyte Deformability ; drug effects ; Female ; Fibrinolytic Agents ; pharmacology ; therapeutic use ; Male ; Panax notoginseng ; chemistry ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Saponins ; isolation & purification ; pharmacology ; therapeutic use ; Thrombolytic Therapy

Objective To investigate the relationship between hemoglobin and blood pressure of pregnant women in Zhoushan islands, so as to provide scientific evidence for the etiological study of gestational hypertension. Methods A retrospective study was conducted among 1 383 pregnant women who received perinatal care in Zhoushan Maternal and Child Health Hospital of Zhejiang Province from January 2017 to June 2018. Pregnant women were monitored for hemoglobin content and blood pressure in the early, middle and late pregnancy. The multivariate linear regression was used to analyze the relationship between hemoglobin content and blood pressure in different pregnancy. Results The incidence of anemia in early, middle and late pregnancy was 7.74%, 25.45% and 15.76% respectively. The multivariate linear regression showed that hemoglobin levels during pregnancy had effects on systolic blood pressure in early, middle and late pregnancy, and the earlier hemoglobin levels were monitored, the more obvious the effect on systolic blood pressure was.With the increase of hemoglobin level, systolic blood pressure increased, such as the effect of hemoglobin on systolic blood pressure in early pregnancy, mid-pregnancy and late pregnancy. Hemoglobin of first trimster had the greatest effect (β=0.10, P<0.001), Hemoglobin of second trimester had no obvious effect, and that of third trimester had the second effect (β=0.04, P=0.027).Hemoglobin levels and diastolic blood pressure levels were similar to their relationship with systolic blood pressure. Conclusions Hemoglobin levels during pregnancy have significant effects on systolic and diastolic blood pressure in first, second and third trimsters of pregnancy. Regular measurement of hemoglobin levels during pregnancy can improve the health of pregnant women.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; China ; Disasters ; statistics & numerical data ; Earthquakes ; Female ; Fractures, Open ; psychology ; surgery ; Humans ; Leg Injuries ; psychology ; surgery ; Male ; Middle Aged

OBJECTIVESTo evaluate the expression of synuclein-γ (SNCG) and metalloproteinase 9 (MMP-9) both in the invasive ductal breast cancer samples and T47D and T47D(SNCG)- cell lines, to investigate the correlation between SNCG and MMP-9.

METHODSTotally 96 invasive ductal breast cancer samples (female, mean age of (56 ± 8) years) were collected between June 2009 and June 2012. The expressions of SNCG and MMP-9 were investigated by immunohistochemistry. T47D and SNCG knock down T47D(SNCG)- cell lines were established and SNCG and MMP-9 protein expression were investigated by Western blot and gene expression by real-time PCR.

RESULTSAmong 96 samples, 26 (27.1%) of them co-expressed SNCG and MMP-9, 30(31.2%) of them expressed neither SNCG nor MMP-9. The expression of SNCG was correlated with the expression of MMP-9 (r = 0.655, P = 0.000).SNCG mRNA level of T47D cell line was 13.5 fold of T47D(SNCG)- cell line and SNCG protein expression was 2.1 fold. While MMP-9 mRNA level of T47D cell line was 7.3 fold of T47D(SNCG)- cell line and MMP-9 protien expression was 1.6 fold.When SNCG was knocked down, the expression of MMP-9 decreased.

CONCLUSIONSSNCG and MMP-9 are significantly correlated with each other in breast cancer. SNCG may promote the invasion and metastasis of breast cancer mediated by up-regulating the expression of MMP-9.

Aged ; Breast Neoplasms ; metabolism ; Female ; Gene Expression ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Neoplasm Proteins ; metabolism ; RNA, Messenger ; genetics ; Real-Time Polymerase Chain Reaction ; gamma-Synuclein ; metabolism

OBJECTIVETo explore the influence factors of salt-sensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.

METHODSEssential hypertensive patients from Beijing Jinzhan second community were included in this study. Salt-sensitivity was determined via the improved Sullivan's acute oral saline loading and furosemide volume-depletion tests. Binary logistic regression analysis was applied to explore influence factors of salt-sensitive hypertension. Acute oral saline loading induced changes on blood pressures and urinary sodium and potassium excretion were observed.

RESULTSSixty-three salt-sensitive hypertensive patients were classified out of a total of 342(18.4%) essential hypertensive patients. Salt-sensitive patients were elder than the non-salt-sensitive patients (P < 0.05) . Binary logistic regression analysis showed that age (OR = 1.744, 95%CI:0.922-3.300, P > 0.05) , gender (OR = 0.728, 95%CI:0.374-1.415, P > 0.05) , total cholesterol level (OR = 1.168, 95%CI:0.882-1.547, P > 0.05) and 24-hour urinary sodium (OR = 0.998, 95%CI:0.995-1.002, P > 0.05) were not influencing factors of salt-sensitivity among essential hypertensive patients. Bivariate general linear models for repeated measures showed that there were significant statistical differences on blood pressures and urinary electrolytes concentrations between the beginning of trials, 2 hours after acute saline loading and 2 hours after furosemide volume-depletion(all P < 0.01). There was a greater blood pressures change in salt-sensitive patients than in non-salt-sensitive patients(all P < 0.01) while urinary electrolytes concentrations change was similar between two groups(all P > 0.05).

CONCLUSIONSAge, gender, total cholesterol level and 24-hour urinary sodium are not influencing factors of salt-sensitivity among essential hypertensive patients in this study. Impaired pressure natriuresis during acute oral saline loading and furosemide volume-depletion tests is presented in salt-sensitive essential hypertensive patients.

Adult ; Aged ; Aldosterone ; blood ; Blood Pressure ; drug effects ; Electrolytes ; urine ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; Male ; Middle Aged ; Potassium ; urine ; Sodium Chloride, Dietary ; administration & dosage ; urine

OBJECTIVETo evaluate the accuracy and precision of 2 kinds of anti-treponema pallidum (anti-TP) ELISA reagents in our laboratory for detecting the anti-TP in voluntary blood donors, so as to provide the data support for use of ELISA reagents after introduction of chemiluminescene immunoassay (CLIA).

METHODSThe route detection of anti-TP was performed by using 2 kinds of ELISA reagents, then 546 responsive positive samples detected by anti-TP ELISA were collected, and the infections status of samples confirmed by treponema pallidum particle agglutination (TPPA) test was identified. The confirmed results of responsive samples detected by 2 kinds of anti-TP ELISA reagents were compared, the accuracy of 2 kinds of anti-TP ELISA reagents was analyzed by drawing ROC and comparing area under curve (AUC), and precision of 2 kinds of anti-TP ELISA reagents was compared by statistical analysis of quality control data from 7.1 2016 to 6.30 2017.

RESULTSThere were no statistical difference in confirmed positive rate of responsive samples and weak positive samples between 2 kinds of anti-TP ELISA reagents. The responsive samples detected by 2 kinds of anti-TP ELISA reagents accounted for 85.53%(467/546) of all responsive samples, the positive rate confirmed by TPPA test was 82.87%. 44 responsive samples detected by anti-TP ELISA reagent A and 35 responsive samples detected by anti-TP ELISA reagent B were confirmed to be negative by TPPA test. Comparison of AUC showed that the accuracy of 2 kinds of anti-TP ELISA reagents was more high, the difference between 2 reagents was not statistically significant. The coefficient of variation (CV) of anti-TP ELISA reagent A and B was 14.98% and 18.04% respectively, which met the precision requirement of ELISA test.

CONCLUSIONThe accuracy and precision of 2 kinds of anti-TP ELISA reagents used in our laboratory are similar, and using any one of anti-TP ELISA reagents all can satisfy the requirements of blood screening.

Blood Donors ; Enzyme-Linked Immunosorbent Assay ; Humans ; Syphilis Serodiagnosis ; Treponema pallidum

Zexietang is a Chinese herbal compound prescription with a long history， which consists of Rhizoma alismatis and Atractylodes macrocephala. Zexietang comes from "Synopsis of Golden Chamber"， as "there is a drink under the heart， and its people are bitter and dizzy". Zexietang has the effect of removing water from drinking water and invigorating spleen for diuresis. Modern pharmacological studies have shown that its lipid-lowering and anti-inflammatory effects are very significant. It can be used to treat hyperlipidemia， anti-atherosclerosis and non-alcoholic fatty liver disease. With the continuous development of molecular biology， the research on the pharmacological effects of Zexietang， extracts and their monomers has deepened to the molecular level gradually， and the relevant mechanism of action has also been continuously elucidated. In terms of lipid-lowering effect of Zexietang， the levels of cytokines or receptors such as 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGCR）， cholesterol 7α-hydroxylase （CYP7A1）， and liver X receptors （LXR） are affected. It is widely involved in adenosine 5'-monophosphate-activated protein kinase （AMPK） and peroxisome proliferators-activated receptors （PPAR） pathways， while Zexietang's anti-inflammatory effect mainly affects inflammatory factors such as interleukins （IL） and tumor necrosis factors （TNF）， and simultaneously nuclear factor κB （NF-κB）， toll-like receptors （TLR） and other cytokines or receptor-related pathways. In order to promote the further research and clinical application of Zexietang and contribute to the development of modernization of traditional Chinese medicine， the studies of the past 15 years on molecular mechanism of the lipid-lowering and anti-inflammatory effect of Zexietang， Alisma and Atractylodes extract as well as their monomer components were reviewed.