Objective To summarize the clinical experience of operation treatment of Lisfranc fracture dislocation,and evaluate its clinical effect.Methods Thirty-nine patients with Lisfranc joint injuries (46 sides) were managed with open reduetlon as well as internal fixation with serews and Kirsehnerwlres.Results All the patients were followed up from12.0 to 42.0 months,the average was (21.1 ± 1.8) months.Evaluated the clinical effect according to the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score standard,there were 29 cases of excellent,8 cases of good,and 3 cases of aceeptable.Conclusion By Kirschner wire combining with screw fixation,open reduction and internal fixation may achieve satisfactory clinical results for the treatment of Lisfranc joint injurie.The operation is simple and fast,small trauma,less complications and can obtain good effects.

Objective To investigate if the 23 strains of highly-resistant P.aeruginosa isolated from different patients in the in- tensive care unit (ICU) have the same origin;and explore the related mechanisms of carbapenem resistance in these multidrug- resistant P.aeruginosa.MethOds Antimicrobial susceptibility testing was performed using disk-diffusion technique.The strains were genotyped by rep-PCR with the primer ERIC2 followed by electrophoresis in agarose gel.We used a previously described imipenem-EDTA double-disk test for screening MBL-producing P.aeruginosa.Polymerase chain reaction for amplification of blaOprD, blaIMP, and bla VIM were performed to detect corresponding mutants.Results The result of antimicrobial suscepti- bility testing showed that 20 of the 23 P.aeruginosa isolates were muhidrug-resistant and highly resistant to imipenem and meropenem, and at least 5 antimicrobial agents tested in this study.The analysis of the rep-PCR products indicated that all the 19 carbapenem-resistant strains had an identical band pattern, which was different from that seen in the sensitive strains.Al- though imipenem-EDTA double-disk test identified 5 MBL-producing strains, PCR found that all the 23 strains were negative for bla VIM and blaIMP.Only one OprD-deficient mutant was identified.Conclusions The 19 highly-resistant strains of P. aeruginosa derive from a common origin.More researches are needed to clarify their mechanism of carbapenem resistance.

Objective To establish a method for rapidly detecting the G-protein ?3 subunit (GNB3) 825 site single nucleotide polymorphism (SNP) and to analyse the relationship between GNB3 825 site gene SNP and obesity. Methods The real-time fluorescent PCR was employed to analyse the GNB3 825 site gene SNP of 420 samples from 21 provinces and the the frequencies of genotypes were compared with those detected by gene sequencing. GNB3 825 site genotype, body weight, body mass index (BMI) and fat content were examined from 207 subjects and the correlation between GNB3 825 site gene SNP and obesity was analysed. Results The result by real-time fluorescent PCR showed that the frequencies of 825T and 825C haploid were 46.90% and 53.10%, respectively, and the frequencies of 825TT, 825TC and 825CC genotype were 22.38%, 51.42% and 28.10%, respectively, with no other genotype detected, which was consistent with the result by gene sequencing. BMI and fat content were significantly higher in subjects with GNB3 825TT than in subjects with other genotypes. Body weight was much higher in subjects with GNB3 825TT genotype than in subjects with 825CC genotype, but not significantly different with 825CT genotype. Conclusion A new rapid method for the detection of GNB3 825 site SNP has been successfully established. There existed significant correlation between GNB3 825TT genotype and obesity.

OBJECTIVETo seek an effective drug for treatment of human hyperplastic scar through studying the effects of curcumin on fibroblast growth and collagen synthesis.

METHODSFibroblasts derived from scar tissue and from normal epidermal tissue were isolated and cultured separately with tissue-block method, their morphology were observed under invert phase contrast microscope, their growth curve was drawn respectively to determine the speed of growth. Then, fibroblasts from scar were stimulated with curcumin in different concentrations (0, 12.5, 25, 50 and 100 micromol/L) for detecting the inhibitory effect of curcumin on growth of fibroblasts using MTT methods and that on activity of procollagen alpha-1 gene transcription in fibroblast was detected by RT-PCR.

RESULTSThe cell growth curve showed that double-multiplying time was 5 days in fibroblasts from scar and 4 days in those from normal dermis, showing significant difference between them (P < 0.05). MTT showed that curcumin in 12.5 micromol/L showed a cell proliferation enhancing trend, and its absorbance value was significantly higher than that in the normal group, but the effect turned to inhibition when concentration increased to over 25-100 micromol/L, and became significant inhibition at concentration of 50 and 100 micromol/L. Besides, curcumin also showed markedly inhibition on collagen type I synthesis in fibroblasts (P < 0.01).

CONCLUSIONHigh concentration curcumin can inhibit effectively the fibroblast proliferation and collagen I synthesis in hyperplastic scar, therefore, may has therapeutic effect on the disease in human being.

Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Collagen Type I ; biosynthesis ; Curcumin ; pharmacology ; Fibroblasts ; drug effects ; metabolism ; pathology ; Humans

The graft-versus-tumor (GVT) effect of T cells induced by tumor antigen-pulsed CD8α(+) dendritic cells (DCs) in vitro was investigated in this study. Immature CD8α(+) DCs were prepared from C57BL/6 (H-2(b)) bone marrow cells by using a cytokine cocktail. On the 3rd day of culture, CD8α(+) DCs were pulsed by allogeneic (Balb/c, H-2(d)) EL9611 leukemia antigen, or RM-1 syngeneic prostate cancer antigen, with the concentration series of 0, 2.5, 5.0, 10.0, 20.0 μg/mL, respectively, then antigen-loaded immature CD8α(+) DCs were co-cultured with syngeneic T cells according to the DC/T ratio of 1:1, 2:1 and 4:1. T cell proliferation was measured by MTT assay. Cytokines including interferon gamma (IFN-γ) and interleukin-10 (IL-10) in CD8α(+) DCs and T co-culture supernatant were detected by using ELISA. Cytotoxic effect of antigen-specific T cells was tested by LDH release assay. Conventional mature DCs (mDCs) induced from C57BL/6 (H-2(b)) bone marrow cells by using granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) served as a control. The results showed that the proliferative activity of T cells stimulated by CD8α(+) DCs loaded with allogeneic or syngeneic tumor antigen was augmented with the CD8α(+) DC/T ratio increased (P<0.05). When antigen concentration ≤ 5 μg/mL and CD8α(+) DC/T ratio ≤ 2:1, the ability of CD8α(+) DCs to stimulate T cell proliferation was higher than mDC control in allogeneic tumor antigen-pulsed groups (P<0.05), but not in syngeneic tumor antigen-pulsed groups (P>0.05). The level of IFN-γ and IL-10 in CD8α(+) DCs and T cell co-culture supernatant were increased in both allogeneic and syngeneic antigen-pulsed groups (P<0.05), and the cytokine level was higher in allogeneic antigen-pulsed groups than in syngeneic antigen groups when the CD8α(+) DC/T was 1:1 or 2:1 (P<0.05). There existed a negative correlation between the level of IL-10 and T cell proliferation. T cell cytotoxicity assay showed that when CD8α(+) DCs were pulsed with allogeneic tumor antigen, the maximal T cell killing efficiency could reach (100±7.7)%, whereas syngeneic tumor antigen-pulsed group had only (65.0±3.4)%. It was concluded that syngeneic and allogeneic tumor antigen-pulsed immature CD8α(+) DCs could stimulate T cells to exert the GVT effect in vitro, and the GVT effect was more obvious with allogeneic tumor antigen than with syngeneic tumor antigen. The optimal condition was low allogeneic tumor antigen pulsation (≤ 5 μg/mL) and low CD8α(+) DC/T ratio (1:1 and 2:1).

Objective To observe the protective effects of melatonin against spinal cord injury from seawater immersion in rabbits.Methods The 120 mature and health New Zealand White rabbits,weight range from 2.6 to 2.9kg,were randomly divided into four groups (30 each):control group,ethanol group,melatonin group (100mg/kg),methylPrednisolone group (30mg/kg).The rabbit model of spinal cord injury were built by modified Allen's method taking the 10th thoracic vertebra as a center,seawater immersion for 60 minutes,and then by grouping to give the appropriate treatment.After each group was given the corresponding treatment,six rabbits in each group were randomly selected at 1,6,12,24 and 48 hours five different time points.The neurological function scores of the rabbits were evaluated by Tarlov method,the spinal cord ofT9 to T.which were obtained from all the groups were used for further study,including immunohistochemical detection of apoptosis proteins:Bax,Bcl-2,neurofilament protein 200 (NF200) and in situ end labeling (TUNEL) method to detect spinal neuronal cell apoptosis.Results Within each observation time point,the Tarlov score was higher in melatonin group and methylprednisolone group compared with control group and ethanol group (P＜0.05),there was no significant difference between melatonin group and methylprednisolone group (P＞0.05).The expressions of Bcl-2 and NF200 were significantly higher in melatonin group and methylprednisolone group compared with control group and ethanol group,while Bax expression was significantly lower (P＜0.05).There were no significant difference between melatonin group and methylprednisolone group in the expression of three proteins (P＞0.05).The TUNEL-positive apoptotic cells were fewer in melatonin group and methylprednisolone group compared with control group and ethanol group (P＜0.05),and there was no significant difference between melatonin group and methylprednisolone group (P＞0.05).Conclusion Melatonin has protective effect against spinal cord injury from seawater immersion in rabbits,no difference in efficacy exists compare with methylprednisolone.

Objective To investigate the relationship of stress hyperglycemia,cystatin C and estimated glomerular filtration rate (eGFR) with short-term prognosis in elderly patients with acute myocardial infarction.Methods 242 consecutive patients with acute myocardial infarction were divided into two groups according to age:the elderly group (n=182),and the non elderly group (n=60).The clinical data including cystatin C (Cys C),eGFR and stress hyperglycemia levels were collected.The major adverse cardiovascular events (MACE) were observed during hospitalization and 30 days after discharge.Results The incidences of stress hyperglycemia,the levels of creatinine,Cys C and brain natriuretic peptide (BNP),as well as the total MACE were higher and eGFR was lower in elderly group than in non-elderly group (all P＜0.05).Cys C level was positively correlated with age,body mass index and levels of creatinine and BNP (all P＜0.05),and negatively correlated with fasting glucose and eGFR in elderly group (both P＜0.05).The eGFR was positively correlated with body mass index (P＜0.05),and negatively correlated with age,creatinine and BNP levels in elderly group (all P＜0.05).Logistic regression analysis indicated that stress hyperglycemia [OR=1.871,95％CI:1.071-3.269,P=0.03],Cys C [OR=7.093,95％CI:2.261-22.249,P=0.00] were the independent risk factors for MACE.Conclusions Cys C level and eGFR can predict the early renal dysfunction and its prognosis in elderly patients with acute myocardial infarction.The incidence of stress hyperglycemia is higher in the elderly,and stress hyperglycemia and Cys C level are the independent risk factors for MACE.

Objective To search for the metabolites that associated with articular cartilage damage in the urine of rat model with articular cartilage destruction induced by T-2 toxin.Methods Thirty healthy male Wistar rats aged 4-5 weeks were numbered by weight,randomly divided into two groups (n =15 per group),namely the control group and the model group.The rats in the control group were fed with standard rat diets,and those in the model group were given diets contaminated by T-2-toxin (300 μg/kg).Throughout the experiment,all animals were given free access to distilled water and diets.After continuous treatment for 3 months,all the rats were sacrificed.The changes of articular cartilage in rat knee joints were observed by histopathological method,the metabolic profile of rats' urine was determined by ultra performance liquid chromatography/quadrupole time of flight-mass spectrometry (UPLC/QTOF-MS) technique.Combined with multivariate statistical analysis,database searching was applied to explore and confirm the different metabolites associated with cartilage damage.Results Light microscope showed that rats' articular chondrocytes in the control group presented cells in neat rows and eumorphism,rats' articular chondrocytes in the model group presented extensive areas of chondrocyte degeneration,necrosis and loss.In rats' urine metabolic profiles,5 different metabolites associated with cartilage destruction were detected,such as 4-hydroxynonenal (HNE),trans-4,5-epoxy-2(E)-decenal (EDE),5-methyldeoxycytidine,and 5-L-glutamyl-glycine and prolyl-valine.Compared with the control group (mass spectrum peak area:65820 ± 5200,22080 ± 3538,4292 ± 3520,3277 ± 2025,1104 ± 990),all of them increased in the model group (mass speetrum peak area:90240 ± 18863,25610 ± 5071,9702 ± 6562,6029 ± 3905,4144 ± 5322,t =-3.903,-2.209,-2.814,-2.424,-2.174,all P ＜ 0.05).Conclusions The articular cartilage destruction induced by T-2 toxin could cause the changes of related metabolites in the urine;the 5 kinds of changed metabolites in urine are related to articular cartilage destruction.

Objective Through co-culture Kupffer cells with hepatocyte in vitro,to understand the influence of Kupffer cells on the growth、morphology and metabolism of hepatocyte.Methods In-situ IV collagenase two-step perfusion method to digest SD rat liver,apply low speed centrifugalization to isolate parenchymal hepatic cells and densitygradient centrifugation by percoll fluid to isolate Kupffer cells respectively.Inoculate hepatocyte cells into 6 holes culture plate to culture alone and/or co-culture with Kupffer cells in the proportion six to one,the growth,morphous of hepatocyte are observed under the light microscope and the level of albumin and glucose in the culture supernatant are detected by automatic biochemistry meter,and compare synthesis function and metabolism of hepatocytes culture alone and coculture with Kupffer cells.Results The hepatocytes of culture alone their growth and developed to normal hepatocytes morphous quickly,2 weeks later the cells death occurs,after 21 days the hepatocytes culture alone are totaly death,when hepatocytes co-culture with kupffer cells that proliferate slower than that culture alone.The hepatocites beginning to death 48 hours later, and totally death after 10 days co-culture.The culture supernatant was collected and tested the level of albumin and glucose at 24 hours intervals.In culture alone group,the albumin level is significant higher than in co-culture group at 48h、96h、120h、144h、168h(P

Objective To evaluate different post-processing imaging techniques of multi-slice helical CT cholangiography (MSCTC). Methods Fourty-seven patients were suspected of bile duct disease by ultrasound, with no abnormality by ordinary CT. These patients then received MSCTC examination. The original images were post-processed at workstation. The result of post-processed images was compared with that of the laparotomy and surgical bile duct endoscopy. Results Procedures were successful in 45 cases. Thirty-one cases were found with choledocholithiasis. The specificity and the sensitivity of CT virtual endoscopy (CTVE) for choledocholithiasis group were high. Cholangitis and cholangiocarcinoma were detected in 3 each cases.Three cases were finally found to have gallbladder polypus, in which only CTVE provided the diagnosis. The diagnosis of bile duct disease made by ultrasound were finally excluded by CTVE. Conclusions KG1 The available post-processing methods are CTVE and X-proj, MPR is applicable for observing bile duct wall, it is valuable in the diagnosis of all kinds of bile duct disease. CTVE is better than other methods at displaying intraluminal structure.