ObjectiveTo explore the efficacy of posterior approach in treatment of crescent pelvic fracture.MethodsBetween April 2007 and January 2010, 12 patients with crescent pelvic fracture were treated via posterior approach at our department. They were 8 men and 4 women, aged from 21 to 55 years (average, 31.3 years). Six left and 6 right sides were affected. The fractures were caused by a traffic accident in 8 cases, high falling in 3 cases and heavy weight crushing in one. By Tile classification, there were 8 cases of type B2. 1 and 4 cases of B2.2. The time from injury to operation was 3 to 9 days, with an average of 6. 2 days. They were treated with open reduction and internal fixation via the posterior approach. Operation time,intraoperative blood loss, postoperative loss of pelvic ring reduction, fracture healing time and Hannover pelvic outcome scoring were documented.ResultsThe average operation time was 172.5 ± 34. 1 minutes(from 120 to 240 minutes) . The average blood loss was 412.5 ±- 128.1 mL(from 250 to 700 mL) . The average reduction gained was 11.7 ±4. 6 mm(from 6 to 21 mm). Ten patients obtained an average follow-up of 16. 3 months (from 12 to 20 months). The X-ray films showed bony healing in all patients after an average of 3. 1 ± 0. 3 months(from 3 to 4 months). There was no postoperative loss of pelvic ring reduction or implant failure.By the Hannover scoring system, 7 patients were rated as excellent and 3 as good in clinic symptoms, and complete social reintegration was obtained in 8 cases and incomplete one in 2 cases.ConclusionOperation via posterior approach is a good choice for treatment of crescent pelvic fracture.

The clinicopathological data of 173 cases of inflammatory myofibroblastic tumor (IMT)were retrospectively analyzed.Among them 125 were males and 48 females with a mean age of 47.9 y (5-78 y).The lesions of 117 cases were located in lungs,41 cases in eyes,8 in ileocecum,2 in liver,2 in spleen,1 in abdominal wall,1 in maxillary sinus and 1 in face.The average diameter of lesions were 3.5 cm,ranging from 1.0 cm to 7.0 cm.The clinical manifestations were not specific,depending on the locations of tumor.The imaging examinations were helpful for diagnosis.The prcsence of slender-spindled myofibroblasts and proliferation of fibroblast cells,with infiltration of chronic inflammatory cells were the basic histopathological features of the disease.Combined with the histological characteristics and immunohistochemical staining IMT can be differentiated from other spindle cell tumors.Appropriate surgical resection is the main treatment for IMT.

AIM To observe the effects of Wuwei Wentong Chubi Capsules (Cinnamomi Ramulus,Poria,Epimedii Folium,etc.) on autophagy proteins of Beclin-1 and LC3-Ⅱ in adjuvant-induced arthritis rats and to explore the possible mechanism of action.METHODS Sixty SD rats were randomized into six groups:normal group,model group,Wuwei Wentong Chubi Capsules (0.8,1.6,3.2 g/kg) groups and tripterygium glycosides (TPT,40 mg/kg) group.In addition to the normal group,adjuvant arthritis (AA) was induced with Freund's complete adjuvant.From the 2th day after injection of FCA,Wuwei Wentong Chubi Capsules with different doses and TPT were given by gavage once a day for 12 days.At the end of the experiment,ankle-joint samples were taken to examine the degree of AA by HE.Beclin-1 and LC3-Ⅱ mRNA were determined by real-time fluorescent quantitative PCR.Meanwhile,the protein expression levels of Beclin-1 and LC3-Ⅱ were determined by immunofluorescence histochemical staining and Western blot.RESULTS As compared with the model group,Wuwei Wentong Chubi Capsules (1.60,3.20 g/kg) not only significantly reduced histopathological injuries,but also effectively up-regulated mRNA and protein expressions of Beclin-1 and LC3-Ⅱ.CONCLUSION Wuwei Wentong Chubi Capsules has a therapeutic action on AA in rats,which might be partly associated with promoting autophagy,decreasing excessive proliferation of synovial cells,leading to the reduction of damage to articular cartilage.

Objective To summarize the clinical features, diagnosis and treatment of autoimmune pancreatitis (AIP). Methods From March 2003 to January 2008, a total of 16 cases of AIP were reviewed retrospectively. Results The ratio of male: female was 15:1, with a mean age of 61 years old (range:47-79 years old). Jaundice was the main clinical presentation in 81.2% patients. 68.8% patients presented with high serum gammaglobulin, while 66.7% with high serum IgG, 56.2% with elevated ESR, 50.0% with positive rheumatoid factor(RF), 43.7% with eosinophilia, 26.7% with positive antinuclear antigen(ANA),31.2% with elevated lipase, 18.7% with elevated amylase, and 25.0% with elevated CA19-9. 93.7%patients showed diffuse swelling of the pancreas on CT and/or endoscopic ultrasound. Stricture of the main pancreatic duct was seen in 100% patients. Distal common bile duct stricture was seen in 87.5%, while thickened wall of bile duct was seen in 50%. Histological findings of the pancreas EUS-FNA showed nonspecific results in one patient, while no tumor cell was detected in other 5 patients; lymphocytes infiltration was noted in 3 patients; pancreatic fibrosis was seen in 2 patients. 75.0% patients was found to have diabetes or abnormal sugar tolerance, enlargement of the celiac lymph nodes in 43.7%, splenic vein or inferior cava vein involvement in 42.9%, swelling of the maxillary glands in 18.7%, the lacrimal glands in 12%. Prednisone was given to 11 patients, among them 5 patients underwent endoscopic stent placement, and 10 patients responded well while 1 patient discontinued therapy due to intolerance. 2 patients underwent endoscopic stent placement alone and jaundice disappeared. 3 patients received conventional medical treatment. Steroid therapy exerted different effects on levels of the blood glucose, the enlarged maxillary and lacrimal glands improved after steroid therapy. Conclusions AIP occurred in middle aged and senior male predominantly, painless obstructive jaundice was the main clinical presentation, and patients may be accompanied with elevated levels of IgG, hypergammaglobulin, positive RF and ANA, diffuse or focal pancreatic enlargement, pancreatic duct stricture and distal common bile duct stricture. Stent placement could improve the symptoms, and steroid therapy was effective.

Objective To construct in the extracellular matrix metalloproteinase inducer (EMMPRIN)glycosylation single point mutation plasmid,and to explore its relationship with tumor cell proliferation.Methods PCR point mutantion technology was used to construct the mutantion plasimid of EMMPRIN glycosylation single point.After successful mutation, the function of mutantion plasmids were detected. Western blotting was used to detect the expression of EMMPRIN protein,immunofluorescence method was used to detemine the morphological changes of the cells,and MTT assay was performed to detect the relationship between mutantion pasmid and tumor cell proliferation.Results Confirmed by restriction enzyme digestion and sequencing,the 44th,the 152th,and the 186th Asn were successfully mutated to Gln in the sequence of EMMPRIN;EMMPRIN/GFP (N44Q), EMMPRIN/GFP(N152Q),and EMMPRIN/ GFP (N186Q)glycosylation single point mutation plasmids were constructed.Compared with wild-type,thel morphology of the cells was significantly changed,the core division of mutant-type cells was significantly reduced, the number of filopodia was reduced. The results of MTT assay showed that the survival rate of the cells in wild-type group were significantly increased compared with control group (P<0.05 );the survival rates of the cells in EMMPRIN (N44Q) group, EMMPRIN (N152Q) group and EMMPRIN(N186Q)were significantly decreased compared with wild-type group(P<0.05).Conclusion Mutant-type EMMPRIN can inhibit the proliferation of tumor cells;with the duration increasing, the inhibitory effect is weakened.There is a correlation between EMMPRIN glycosylation and proliferation of tumor cells.

Objective To discuss the clinical aesthetic effect of vermilion repair on cleft lips after using double-line reconstruction.Methods 68 children with cleft lip were repaired according to the principle of double-line reconstruction,and two contents including 7 projects,such as shapes of upper lips,vermilion borders of lips,vermilion shapes and lips,etc,were evaluated comprehensively within one month after operation for assessing the postoperative effect.Results 68 cases were followed up,with the follow-up rate of 100％,and 62 cases (91.2％) were satisfied with the vermilion repair.Six cases (8.8％) had a common effect of vermilion shapes after repair.In the 7 contents evaluated,satisfactory results were achieved in the projects except the relatively poor symmetry vermilion borders of lips.Conclusions The double-line reconstruction helps to improve the aesthetic effect of vermilion repair on cleft lips.

Objective To evaluate the effects of compound glycyrrhizin on the percentage of Th17 cells and expression of interleukin(IL)-17A in peripheral blood of patients with psoriasis vulgaris, and to explore their relationship with therapeutic effects. Methods A total of 30 patients with mild to moderate progressive psoriasis vulgaris were randomly and equally divided into two groups:group 1 treated with compound glycyrrhizin injection, antihistamines and topical drugs, group 2 treated with antihistamines and topical drugs. Twelve healthy human subjects served as the control group. Blood samples were collected from the patients 1 day before start of treatment and after 3 weeks of treatment, and from the control group. Flow cytometry and enzyme-linked immunosorbent assay (ELISA)were performed to determine the percentage of Th17 cells and expression level of IL-17A respectively in the peripheral blood samples. Results Before the treatment, the percentage of Th17 cells and expression level of IL-17A were both significantly higher in the two patient groups than in the control group (all P<0.05). After the treatment, group 1 showed significant decreases in the percentage of Th17 cells and expression level of IL-17A compared with those before the treatment (both P<0.05), while no significant differences were observed in group 2 between pre-and posttreatment IL-17A expression level or Th17 cell percentage (both P>0.05). Furthermore, both Th17 cell percentage and IL-17A expression were significantly different between the two patient groups after the treatment (both P< 0.05). Conclusion Compound glycyrrhizin may treat psoriasis vulgaris by regulating Th17 cell percentage and IL-17A expression in peripheral blood.

OBJECTIVE:To evaluate the effects of PDCA cycle management on perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department. METHODS:In retrospective analysis,512 discharge medical records, 861 ones and 1 070 ones were selected from our hospital before PDCA cycle management(Jan.-Dec. 2013,before intervention group), after first cycle of PDCA cycle management (Jan.-Dec. 2014,first intervention group) and after second cycle of PDCA cycle management(Jan.-Dec. 2015,second intervention group),respectively. The perioperative prophylactic application of antibiotics was analyzed comparatively before and after continuous intervention. RESULTS:After 2 cycles of PDCA cycle management intervention, the constituent ratio of internal fixation in orthopedics department increased significantly;utilization ratio of antibiotics,the rate of rational type,medication ratio 0.5-1 h before surgery,the rate of rational treatment course,the proportion of antibiotics use in accordance with indications increased from 50.20%,98.08%,93.77%,6.61%,82.10% to 58.41%,100%,99.04%,52.00%, 99.04%,respectively. The number of antibiotics type decreased from 4 to 2;the proportion of cephazolin increased significantly while that of clindamycin decreased significantly compared to before intervention. Postoperative prophylactic medication course decreased from(4.63 ± 2.42)d to(1.61 ± 0.75)d;the proportion of patients with medication course <24 h or ranged 24-48 h increased significantly, while those with medication course>72 h decreased significantly, with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle management improves the rational rate of perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department in our hospital. The prophylactic medication course of our hospital is not yet fully controlled within 24 h so it should be further intervened.

Objective To determine the effect of iron deficiency on hemoglobin A2(HbA2) expression in patients with β-thalassemia.Methods The participants were recruited from the out-patient clinics of the Pediatrics Department and Obstetrics Department of Affiliated Hospital of Guilin Medical College and from some β-thalassemia major families.Blood samples from the participants were used for blood smear tests and hemoglobin electrophoresis and to analyze serum ferritin (SF),3 alpha-globin gene deletions,and 17 beta-globin point mutations.Results Of the 408 individuals,304 were assigned to group A (normal controls),26 to group B (iron deficiency),56 to group C (β-thalassemia),and 22 to group D (β-thalassemia combined with iron deficiency). The results for the comparison of the mean HbA2 values among pairs of groups were as follows: group A vs group B,q=5.074 7,P<0.05; group A vs group C,q=37.650 8,P<0.05; group A vs group D,q=16.043 0,P<0.05;group C vs group D,q=7.682 9,P<0.05; Group B vs group D,q=15.806 6,P<0.05. There were no significant correlation between SF and HbA2 in all 4 groups.Conclusions Iron deficiency decreased the HbA2 level in both controls and individuals with β-thalassemia. HbA2 levels decreased significantly in individuals with both β-thalassemia and iron deficiency as compared with β-thalassemia group alone. However,they remained significantly higher than both the control and iron-deficient groups. Therefore,the elevation of HbA2 could be used to diagnose β-thalassemia reliably even in the presence of iron deficiency.

This study was purposed to investigate the feasibility to screen donor with HCV infection by means of HCV-cAg ELISA. The first and repeat assays were performed for detection of serum anti-HCV in 8677 donor's serum specimens from January 2003 to December 2005. All serum anti-HCV specimens with positive anti-HCV from first and repeat assays were finally identified by using HCV-cAg ELISA and HCV RT-PCR methods. The results showed that only 5 serum specimens were positive anti-HCV by HCV-cAg ELISA identification in 29 specimens including 15 specimens with positive ant-HCV in first assays and 14 specimens with positive anti-HCV in repeat assays, the positive rate detected by HCV cAg ELISA was 17.24%. 5 serum specimens were positive anti-HCV by HCV RT-PCR detection also in 29 specimens mentioned above, the positive rate detected by HCV RT-PCR was 17.24% too. It is concluded that sensitivity of HCVcAg ELISA is similar to HCV RT-PCR and may be useful for the early diagnosis of hepatitic C or used as a reliable method to screen donor with HCV infection in blood transfusion medicine.
Blood Donors ; Blood Transfusion ; Enzyme-Linked Immunosorbent Assay ; methods ; Hepacivirus ; isolation & purification ; Hepatitis C Antigens ; blood ; Humans ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Viral Core Proteins ; blood