Objective To compare percutaneous suturing with sponge forceps and open suturing for repair of acute closed Achilles ruptures.Methods From March 2011 to June 2014,40 patients with acute closed Achilles rupture were enrolled in this study and randomized into 2 equal groups (n =20) which were subjected to percutaneous suturing with sponge forceps or open suturing.The operative time,incisive length,blood loss,wound healing,hospitalization time and complications were compared between the 2 groups.Their ankle functions were evaluated at postoperative 3,6,and 12 months according to American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores.Results The operative time (median,60.0 min),hospitalization time (median,8.5 d) and incisive length (median,8.0 cm) in the open suturing group were significantly greater than those in the sponge forceps group (32.5 min,7.0 d and 1.5 cm) (P ＜ 0.05).The blood loss (15.1 ± 13.7 mL) in the sponge forceps group was significantly less than in the open suturing group (54.2 ± 33.9 mL) (P ＜ 0.05).The open suturing group received an average follow-up of 16.8 months (from 12 to 23 months),witnessed superficial skin infection in 3 cases,and obtained AOFAS scores of 91.2 ± 5.1,95.2 ± 2.8 and 97.8 ± 1.6 at 3,6,and 12 months postoperatively.The sponge forceps group received an average follow-up of 15.6 months (from 12 to 24 months),witnessed wound healing in all cases,and obtained AOFAS scores of 90.6 ±5.3,94.I ±2.6 and 97.0 ±2.6 at 3,6,and 12 months postoperatively.The sponge forceps group obtained insignificantly lower AOFAS scores than the open suturing group (P ＞ 0.05).No injury to the sural nerve or tendon rerupture happened in either group.Conclusions In treatment of acute closed Achilles ruptures,compared with open suturing,percutaneous suturing with sponge forceps may be relatively easier without using special equipment,and additionally,may lead to lower incidence of incision complications and better short-term efficacy.

A new method to revel RFLPs is presented. The human genomic DNAwas purified by saturatedNaCl solution and the pAW101 probe labelled with digoxigenin-dUTP. The relationships of RFLPsand genetic patterns of PGM1 (phosphoglucomutase),EsD (esterase D),GLO1 (glyoxalase)and ACP(acid phosphatase ) between the fillal generation and parental generation were detected in 15 families(among them 11 cases were aborted fetuses). The probability of paternity (w)was caculated accor-ding to Essen - Moller's formula, each w vlua was over 99. 73 %, reached the standard of incladingpaternity. An effective,rapid, and non-toxic RFLPs technique was established, which is easy to man-age in common lab oratories.

Objective To verify BMP-2 and VEGF gene activated nanobone paste can effectively enhance the vertebral bone of ovariectomized goat.Methods From January,2011 to May,2016,the goats had been neutered by ovariectomy 6 months earlier to induceosteoporosis.Then surgery to established the model of vertebral bone defected with nanobone implanting,and the operation vertebrae divided randomly into 3 groups:control group,nanobone group and double gene activated nanobone group.Three months after operation the goats were sacrificed and removed the vertebrae.Micro CT analysis of micro three-dimensional structure of trabecular bone,scanning electron microscope (SEM) analysis of the two-dimensional structure of the vertebrae,the structure of trabecular bone was evaluated by movat pentachrome staining.Results The dual gene activated nanobone group compared with the nanobone group,the bone volume fraction (BV/TV) significantly increased (85％ at 1.2 mm vs 43％ at 1.2 mm,P ＜ 0.05);the dual gene activated nanobone group compared with nanobone group,in the largest ROI (1.2 mm),TbTh increased 10.9％ (374 ± 26.2 μm vs 337 ± 22.3 μm,P ＜ 0.05);Trabecular distribution coefficient (TbPf) was significantly decreased (7.519 ± 0.184 mm-1 vs 7.529 ± 0.261 mm-1,P ＜ 0.05);In the largest ROI (0.8 mm),trabecular distribution coefficient (TbPf) was significantly decreased (283 ± 36.4 μm vs 327 ± 31.2 μm,P ＜ 0.05),In the largest ROI (0.8 mm),the trabecular bone volume (Tbn) was increased 20％(1.404 ± 0.283 mm-1 vs 1.173 ± 0.224 mm-1,P ＜ 0.05);Cortical thickness over the implantation area showed asignificant increase of 43％ in vertebrae(P ＜ 0.05);The histological analysis revealed a more extensive osseointegration of the dual gene activated nanobone group,with the presence of anabundant osteoid tissue and an osteoblastic celllining.Conclusion BMP-2 and VEGF gene activated nano bone paste can effectively enhance the vertebral bone of ovariectomized goat.

Objective To explore the effect of oxaliplatin ( OXA) on enhancing radiosensitivity in human hepatocellular carcinoma cell line HepG2 . Methods 50% inhibition concentration ( IC50 ) of HepG2 cells treated with OXA was measured by using MTT method at 6, 12, 24, 48 hours. Then clone formation assay was applied to obtain sensitizing enhancement ratio ( SER) of OXA combing IR, according to the survival fraction of three groups 10?14 days after treatments:placebo?treated group ( C) ,radiation group ( IR, single dose of 1 Gy,2 Gy,4 Gy,6 Gy,8 Gy,10 Gy) and IR synchronizing OXA group ( IR+3 mg/L OXA) . The proportions of cell apoptosis were analyzed using flow cytometry at 24 hours after treatment. At last, we semi?quantitative tested the expression of extracellular regulated protein kinase 1/2 ( ERK 1/2 ) and DNA damage repair protein Ku?70 of the C,IR and IR+OXA groups. Statistical analysis was performed by T test. Results The IC50 of OXA on HepG2 cells is 54?4 mg/L at 6 hours,29?1 mg/L at 12 hours,17?8 mg/L at 24 hours and 10?5 mg/L at 48 hours.3 mg/L was selected in clone formation assay at which 80?90% HepG2 cells survived at 24 hours. The SER ( SF2 ) is calculated as 1?59. Flow cytometry showed the proportion of survival cells in IR+OXA group is significantly lower than those of IR group ( P=0?005) ,OXA group ( P=0?008) and C group ( P=0?001) . The expressions of ERK 1/2 were inhibited in IR and IR+OXA groups compared by that of control group. But the expression of ERK 1/2 in IR group showed increasing after 48 hours which was higher than that of IR+OXA group. For Ku?70,the changes of expression were similar with that of ERK 1/2. Conclusion Oxaliplatin presented enhancing radiosensitivity in human hepatocellular carcinoma cell line HepG2 in vitro.

OBJECTIVETo screen human monoclonal Fab fragments against HIV-1 gp120 peptide binding chemokine receptor.

METHODSA synthesized polypeptide containing 23 amino acid residues of the gp120 antigen epitope binding chemokine receptor was coated as the solid-phase antigen. After biopanning from the HIV-1 phage Fab antibody library, the acquired positive clones were tested and sequenced.

RESULTSOne clone of human phage Fab monoclonal antibody against HIV-1 gp120 polypeptide was acquired. It has high affinity, specificity and inhibition rate and it belongs to IgG I subclass and kappa type. Its Vh H and V kappa were derived from Vh III and V kappa III.

CONCLUSIONSThe human phage Fab fragment against HIV-1 gp120 antigen site binding chemokine receptor was acquired.

Amino Acid Sequence ; Antibodies, Monoclonal ; genetics ; Antibodies, Viral ; genetics ; Bacteriophages ; genetics ; Cloning, Molecular ; HIV Envelope Protein gp120 ; Humans ; Immunoglobulin Fab Fragments ; genetics ; In Vitro Techniques ; Molecular Sequence Data ; Peptide Library ; Receptors, Chemokine ; metabolism ; Receptors, HIV ; immunology

miRNA-27a (miR-27a) is a member of miR-23a-27a-24 gene cluster and is abnormally expressed in gastric cancer. miR-27a plays an important role in gastric cancer cell epithelial-mesenchymal transition, proliferation, microenvironment and resistance to chemotherapy drugs by regulating SFRP1, PHLPP2, BTG2, SOCS6, FOXO1 and other tumor suppressor genes. At the same time, single nucleotide polymorphisms of miR-27a and gastric cancer have also become hotspots in recent years. A more comprehensive exploration of the relationship between miR-27a and gastric cancer is expected to provide new methods and ideas in the treatment of gastric cancer. This article reviews the research progress of miR-27a in gastric cancer.

Objective To investigate the application of percutaneous transluminal balloon dilatation (PTA) in catheter replacement within patients with catheter-related central vein disease (CVD). Methods Thirteen cases of CVD patients from Jan 2015 to Mar 2018 admitted into the First Affiliated Hospital of Zhejiang University were retrospectively analyzed. All of them underwent digital subtraction angiography (DSA) to clarify problem origin. Suitable balloons were chosen to dilate the original catheters or the occlusive veins, and then the original catheters were replaced. PTA was used to help catheter replacement and all patients were followed up for 6 months. Results Four of the 13 patients were found stuck when replacing catheters. All of them successfully had catheters removed with PTA (Hong's techniques). All patients had successfully catheter replacement with blood flow volume>250 ml/min. Among 4 patients with edema, 3 patients showed better within 6 months. Only 3 patients needed warfarin to keep blood flow volume>250 ml/min within 6 months. Conclusions PTA shows advantages of lesser trauma, better tolerance and higher success rate in patients with catheter-related CVD. It can also relieve symptoms resulting from occlusive central vein.

Vascular cognitive impairment (VCI) is a clinical syndrome with impairment of at least one cognitive domain caused by vascular risk factors or cerebrovascular diseases, and its pathogenesis is not completely clear so far. Microglia are innate immune cells in the brain. They participate in many processes such as neuroinflammation, synaptic pruning, myelin regeneration, neurogenesis and connection. They are associated with the occurrence and development of various neurological diseases such as cerebral infarction, Alzheimer's disease, Parkinson's disease, and autism. Recent studies have shown that microglia play an important role in the development of VCI. This article reviews the role of microglia in VCI.

Objective: To observe the efficacy and safety of de novo combination of Lamivudine(LAM) and Adefovir Dipivoxil (ADV) therapy counter to Entecavir (ETV) monotherapy in patients with chronic hepatitis B (CHB)- related compensated liver cirrhosis. Methods: Patients with chronic hepatitis B-related compensated cirrhosis who were initially treated with LAM and ADV for more than 1 year were randomly assigned to two groups, one half replaced with ETV monotherapy, and the other half continued LAM and ADV co-therapy. Liver biochemistry, renal biochemistry, estimated glomerular filtration rate, alpha-fetoprotein, HBV serology markers and serum HBV DNA were measured every 3 months. Urine β2-microglobulin was measured every 6 months And retinol binding protein, followed up for 3 years. The mean values of the two groups were compared with t-test, and the rate of comparison was analyzed by x2 test. Results: A total of 580 cases were collected, 290 cases were replaced with ETV monotherapy, the other 290 patients continued to LAM and ADV combination therapy. In the ETV group, the rates of HBV DNA negative conversion at 1 year, 2 years and 3 years were 77.6%, 84.5% and 94.5% respectively, while the HBV DNA negative conversion rates at 1, 2 and 3 years in the LAM and ADV combination groups were 69.3%, 73.4% and 80.3% respectively. Among them, the negative rates of HBV DNA in the second year and the third year were P < 0.05, the difference was statistically significant. The 3-year cumulative gene-resistant rate in the ETV group was 1.4%, while the combined treatment was as high as 8.6%, and the difference was statistically significant in the two groups. The estimated value of serum creatinine and glomerular filtration rate in ETV group was followed by 3 years, and the baseline level was maintained, in the same group, the serum creatinine was higher than baseline, and the estimated value of glomerular filtration rate decreased. The results showed that there were 6.2%, 12.1%, 22.1% and 0, 0.3%, 1%, respectively, in 1, 2 and 3 years for the group of consecutive treatment and the replacement of ETV Group. The estimated glomerular filtration rate decreased by more than 30% compared with the baseline. The difference was statistically significant; the proportion of serum creatinine in the 1 year, 2 years and 3 years of the combined treatment group was 1.7%, 4.5% and 6.6%, compared with the baseline rise of > 50 μmol/l, and the ETV group was replaced in the 1 year, The values of 2 and 3 years were 0,0,0.7%, of which the 2nd and 3rd years were statistically significant; the proportion of microalbuminuria and retinol-binding protein in patients with combined treatment group was also significantly higher than that of Β2-m ETV Group. Conclusion The initial combination of LAM and ADV therapy is inferior in terms of ETV monotherapy. Single therapy with ETV increase the rate of viral response, reduce the incidence of drug resistance, and also reduce the incidence of renal impairment in patients with chronic hepatitis B -related compensated liver cirrhosis.

Objective: To analyze the failure patterns of locoregional recurrence (LRR) and investigate the range of radiotherapy in T_1-2N₁ breast cancer patients undergoing modified radical mastectomy. Methods: From September 1997 to April 2015, 2472 women with T_1-2N₁ breast cancer after modified radical mastectomy without neoadjuvant systemic therapy were treated in our hospital. 1898 patients who did not undergo adjuvant radiotherapy were included in this study. The distribution of accumulated LRR was analyzed. The LR and RR rates were estimated by the Kaplan-Meier method, and the prognostic factors were identified in univariate analyses with Log-rank test. Multivariate analysis was performed using Cox logistic regression analysis. Results: With a median follow-up of 71.3 months (range 1.1-194.6), 164 patients had LRR, including supraclavicular/infraclavicular lymph nodes in 106(65%), chest wall in 69(42%), axilla in 39(24%) and internal mammary lymph nodes (IMNs) in 19 patients (12%). In multivariate analysis, age (>45 years vs.≤45 years), tumor location (other quadrants vs. inner quadrant), T stage (T₁ vs. T₂), the number of positive axillary lymph nodes (1 vs. 2-3), hormone receptor status (positive vs. negative) were significant prognostic factors for both LR and RR. Conclusions In patients with T_1-2N₁ breast cancer after modified radical mastectomy, the most common LRR site is supraclavicular/infraclavicular nodal region, followed by chest wall. The axillary or IMN recurrence is rare. The prognostic factors for LR and RR are similar, which indicates that supraclavicular/infraclavicular and chest wall irradiation should be considered for postmastectomy radiotherapy.