OBJECTIVETo investigate clinical outcomes of Kirschner wire as blocking screws combined with interlocking intramedullary nail internal fixation in treating tibial metaphyseal fractures (AO 43A).

METHODSFrom March 2011 to June 2012, 9 patients with tibial metaphyseal fractures were treated with blocking screws Kirschner wire combined with interlocking intramedullary nail, including 7 males and 2 females aged from 23 to 54 years old with an average of 37.4. Postoperative complications, X-ray were observed, AOFAS scoring were used to evaluate function after operation at 12 weeks.

RESULTSAll patients were followed up from 6 to 40 weeks (mean 20.1), and healed at stage I. No serious swelling, infection and skin necrosis occurred. No fracture instability and displacement appeaered at 4 and 8 week after operation. AOFAS score was (95.2±4.6) at 12 weeks after operation and 7 patients gained excellent result and 2 patients good.

CONCLUSIONKirschner wire as blocking screws with interlocking intramedullary nail for treatment of tibial metaphyseal fractures can fix well and perform simply.

Adult ; Bone Screws ; Bone Wires ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

Objective To measure the phase values of the deep gray nuclei by using susceptibility weighted imaging(SWI) in underage brains,and to investigate the correlation between the phase value and age.Methods A total of 105 healthy juveniles were examined in this study by using MRI conventional sequence and SWI.Their ages ranged from 0 to 18 years(0-＜ 1 year,60 cases; 1-＜3 years,10 cases; 3-7 years,10 cases; 7-12 years,10 cases; 12-18 years,15 cases).Phase values of deep gray nuclei were measured.The correlation between phase value and age was analyzed by Spearman correlation method.Results During 0-3 years,the phase value of caudate nucleus was the lowest within the same age group (0-＜ 1 year:left-0.0433 ± 0.0291,right-0.0369 ± 0.0215 ; 1-＜ 3 years:left-0.0369 ± 0.0215,right-0.0384 ± 0.0259),whereas the phase value of red nucleus was the highest (0-＜ 1 year:left 0.0286-0.0380,right 0.0254 ±0.0361 ; 1-＜3 years:left 0.0325 ±0.0237,right 0.0395 ±0.0270).After 3 years old,the phase value of globus pallidus was the lowest within the same age group (3-＜7 years:left-0.0967 ± 0.0656,right-0.0953 ± 0.0617; 7-＜ 12 years:left-0.1870 ± 0.0531,right-0.1724 ±0.0547; 12-＜ 18 years:left-0.2037 ±0.0492,right-0.1849-±0.0324),whereas the phase value of thalamus was the highest (3-＜ 7 years:left-0.0019 ± 0.0225,right -0.0007 ± 0.0167 ; 7-＜ 12 years:left-0.0067 ± 0.0104,right-0.0064 ± 0.0118 ; 12-＜ 18 years:left-0.0204 ± 0.0181,right-0.0172 ± 0.0133).During 0-18 years,a moderate negative correlation between phase values of bilateral caudate nucleus,globus pallidus,red nucleus,substantia nigra and age were observed (rs =-0.483,-0.497,-0.67,-0.621,-0.489,-0.43,-0.552,-0.58 respectively) A low negative correlation between phase values of bilateral putamen,thalamus and age were observed (rs =-0.272,-0.213,-0.382,-0.366 respectively).Conclusions There is a negative correlation between phase value and age in the deep gray nuclei of underage brains.And the phase value may be a useful index in the diagnosis of iron deposition related diseases.

Objective Discussion of the role/effect of an incentive mechanism in encouraging proactive reporting of adverse events in hospital.Methods Applying an incentive mechanism to encourage medical staff to report on adverse events found in their hospitals.Incentives in question include financial rewards.alleviation or cancellation of some penalties for medical defects.These measures were followed by a comparison between the number and types of proactive reporting on adverse events with those prior to such measures.in addition to typical case studies.Results Comparison of the figures during Jan.August,2007 and those during the sanqe period in 2008 after the incentive mechanism was in place found significant changes.For example,cases of proactive reporting rose from 34 to 176.Most significant changes were found in even types including medical malpractice.For medical disposal events,the number of events rose from 5 in 2007 to 10 in 2008;events in medical technical inspections from 0 to 24 cases;and that of patients identification from 2 to 14.These figures were followed by typical case analysis and improvements.Conclusion Such all incentive mechanism has significantly increased the number of proactive reporting on adverse events in hospitals,changing the types of such reporting to stand out malpractice related events,and enhancing the reporting to improve quality of care in hospitals.

Objective To investigate the contribution of single nucleotide polymorphisms (SNP)variation in folate metabolism pathway genes and its interaction with environmental risk factors to the etiology of NTD. Methods In 275 families from central China, a total of 278 aborted fetal tissues or blood samples were collected from NTD individuals, 478 maternal and/or paternal blood samples were also obtained as controls. Folate supplementation, maternal diabetes mellitus and medication before pregnancy and during the first trimester of pregnancy were investigated. SNP analyses of all samples were performed by CEQ 8800. Case-parent control study and transmission/disequilibrium tests (TDT) were performed according to environmental cofactors stratification to evaluated 28 SNP in 12 folate pathway genes associated with human NTD. Results Only gene MTHFR rs1801133 was significantly associated with NTD, and synergistic effects of environmental risk factors (no folate supplementation and maternal diabetes) were shown on the occurrence of NTD. Linkage disequilibrium between BHMT rs3733890 and NTD existed in case of no folate supplementation,whereas the genotype alone did not contribute to the etiology of NTD. Other SNP were not significantly associated with NTD. Conclusions MTHFR rs1801133 is a risk factor of NTD, but BHMT rs3733890 is not an independent risk factor. Further investigations in folate and methionine cycle genes are requird in larger scale to enclose the interactions between gene and gene, or gene and environmental factors.

Objective To investigate the expression of nucleotide-binding oligomerization domain protein 2 (NOD2)in serum of patients with hepatocellular carcinoma (HCC),and to analyse the roles of NOD2 in HCC development and its clinical diagnostic value.Methods This study including 66 patients with HCC in the hospi-tal from March 1,2013 to December 31,2014 and 61 healthy controls.Serum NOD2 levels were determined by enzyme-linked immunosorbent assay (ELISA).Analysis of significance was performed with rank sum test using SPSS statistical 16.0 software.Results Serum levels of NOD2 in HCC patients were 171 pg/ml,significantly higher than that of healthy controls(95 pg/ml,Z =-5.00,P =0.00),and the serum NOD2 levels were correla-ted with clinical stage of HCC (H=56.26,P =0.00).Compared with the serum NOD2 levels in stageⅠ,Ⅱpatients (106 pg/ml)and healthy controls (95 pg/ml),the serum NOD2 level in stage Ⅲ and Ⅳ (220 pg/ml) were significantly increased (χ2 =31.24,P =0.00;χ2 =47.23,P =0.00),but the expression of NOD2 in stageⅠandⅡwere nearly equal to that of the healthy controls (χ2 =0.36,P =0.83).The ROC analysis revealed that the best diagnostic cutoff-point of serum NOD2 levels for predicting the Ⅲ and Ⅳ stages of HCC was 148.78 pg/ml,meanwhile corresponding sensitivity was 89.1% and specificity was 77.0%.Additionally,corre-lation analysis demonstrated that there was no significant correlation between NOD2 and alpha-fetal protein (r =0.44,P =0.14).Survival curves obtained that the survival time of HCC patients with NOD2 serum concentrations≥ 200 pg/ml was significantly less than that <200 pg/ml (χ2 =15.32,P <0.05).Conclusion NOD2 is highly expressed in the serum of HCC patients,especially in advanced patients,which is possibly involved in the development of HCC and has the potential to become an effective marker used for HCC diagnosis.

Objective To structure the model of acute carbon monoxid poisoning(ACOP)in rats. Evaluate the effectiveness of the poisoning on the pulmonary function and the significance of carbon monoxide hemoglobin(HbCO)and oxygenation index in diagnosis of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS).Method Eighty healthy adult male Wistar rats were randomized into 4 groups.According to the concentration of CO,poisoning group was randomized into three groups(each group=20),group A,group B,group C.After poisoned,arterial blood was collected rapidly for arterial blood gas analysis.According to the pathological changes,the models were divided into ALI/ARDS group and non-ALI/ARDS group.Results Compared with control group,the incident rate of ALI/ARDS in group B(25%)and group C(55%)were significantly higher(P

OBJECTIVETo measure mobility of dendritic filopodia, complexity of dendritic arborization using method of live imaging in cultured rat hippocampal neurons and to analyze their morphological characters quantitatively.

METHODSVectors expressing Green Fluorescent Protein- Fibrous Actin (GFP-F-Actin) and F-GFP were co-transfected into cultured rat hippocampal neurons at 5 d in vitro (DIV 5). Neurons expressing GFP were photographed and analyzed with Metamorph software.

RESULTDendritic filopodia was observed to move actively from DIV 7 to DIV 9. The mean density of filopodia was (10.78 +/-3.78)/100 microm, (10.68 +/-2.96)/100 microm and (9.99 +/-3.67)/100 microm (P >0.05), and there were (30.18 +/-14.03)% to (87.36 +/-20.88)% filopodia were mobile (P <0.001). During DIV 7-DIV 14, the total length of dendritic branches grew from (410.74 +/-185.98) microm to (1238.21 +/-418.32)microm (P <0.001) and the number of dendritic branches increased from 18.93 +/-7.23 to 33.60 +/-10.46 (P<0.001). The density of spine was (37.17 +/-6.46)/100 microm at DIV 14.

CONCLUSIONThe combination of live imaging with quantitative analysis is a useful method to study dendritic morphological development in vitro, including indicators of dendritic filopodia, dendritic arborization and spines.

Actins ; genetics ; metabolism ; Animals ; Animals, Newborn ; Cells, Cultured ; Dendrites ; metabolism ; Green Fluorescent Proteins ; genetics ; metabolism ; Hippocampus ; cytology ; Microscopy, Fluorescence ; Neurons ; cytology ; metabolism ; Rats ; Rats, Sprague-Dawley ; Recombinant Fusion Proteins ; genetics ; metabolism ; Transfection

Objective To explore the clinical outcome of improved technique of Gamma nail in the treatment of intertrochanteric hip fracture of the elderly patients. Methods From March 2002 to October 2006.39 patients with intertrochanteric hip fracture were operated by improved technique of Gam-ma nail.There were 18 males and 21 females at average age of75.7 years(67_98 years).There were 6 patients with type A1 fracture,24 with type A2 fracture and 9 with type A3 fracture according to AO/ASIF classification.Of all.36 patients(92.3%)had osteoporosis.The operation improvements included the following points:(1)The patients were placed at the lateral decubitus position with the fractured limb on the uppermost,with flexion of knee and hip of 60°.The normal hip and knee were flexed as possible.(2)One-off indirect traction reduction was used after general anesthesia. no requirement of continuous mechanical traction.(3)C-arm image intensifier was employed to obtain normal and lateral projections.Results Of all,35 patients were followed up for a mean period of3 years and 2 months, ranging from 6 months to 5 years and 2 months.Operation data showed incision length of(4.3±1.2)cm,mean opera-tion time of(46±10)minutes,intraoperative bleeding volume of(65±26)ml and intraoperative X-ray exposure of(3.0±2.1)times.Postoperative recovery data showed survival in one-year follow up,with ambulation time of(10.5±3.6)days and fracture union time of(10.9±2.1)weeks.Mean Parker's score wag(6.9±3.2)points 6 months after operation. Conclusions Improved technique of Gamma nail can shorten operation duration,reduce operative trauma and bleeding,reduce X-ray exposure and im-prove success rate of surgery.as facilitates early pest-operative recovery and reduces the perioperative mortality rate of the elderly.

This study was designed to explore the RNA interference technique in inhibition of the expression of the mouse fibrinogen like protein 2 (mfgl2), which has been reported to be involved in the development a variety of diseases including fulminant viral hepatitis. A plasmid named p-mfgl2shRNA,complementary to the sequence of mfgl2 was constructed, while another short hairpin RNA (shRNA)which was a mutated form of the mfgl2shRNA sequences was used as a control. A plasmid named pEGFP-mfgl2 expressing the mfgl2-EGFP fusion protein was also constructed for the screening of the effect of p-mfgl2shRNA on mfgl2 expression. By cotransfection of p-mfgl2shRNA and pEGFP-mfgl2 or pcDNA3.1-mfgl2 expression construct into CHO cells or HeLa cells, the inhibition of mfgl2 expression by mfgl2shRNA was analyzed by direct observation through fluorescent microscopy, FACS, RT-PCR and immunohistochemistry staining. The experiments showed the significant inhibitory effect of p-mfgl2shRNA on mfgl2 expression at 48h post-transfection in both CHO and Hela cell lines with the inhibitory efficiency as high as 80.1%. The study demonstrated that the construct of p-mfgl2shRNA successfully interfered with the mfgl2 expression in vitro.

Objective To explore the effect of patent foramen ovale(PFO)on white matter lesions(WMLs) in migraine without aura(MwoA).Methods Thirty-five patients with MwoA were examined by contrast transcranial Doppler(cTCD)and magnetic resonance imaging(MRI).According to the results of PFO and MRI Flair data,the patients' age,sex and headache characteristics were matched,and the WMLs were compared between the PFO positive group and negative group.Results Seven cases of WMLs were recruited in PFO positive group(19 cases)and the WMLs were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 7 points.Five cases of WMLs were enrolled in PFO negative group(16 cases)and the WMLs also were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 3 points.There was no significant difference in WMLs between the groups(P＞ 0.05).Conclusion White matter lesions in migraine without aura are distributed in the frontal lobe and the parietal lobe,and these findings do not support a relationship between PFO and WMLs.