BACKGROUND:Three-dimensional (3D) printing technology exhibits a broad future in the orthopedics,especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures.However,the related researches are few,and there is a lack of evidence-based medicine to confirm its application values.OBJECTIVE:To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of tibial plateau fractures through a meta-analysis.ME=THODS:MEDLINE,Cochrane library,Embase,CBM,CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually,to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures.Methodology quality of the trials was assessed critically and relative data were extracted,followed by analysis on Stata 11.0 (Stata Corporation,College Station,TX) software.RESULTS AND CONCLUSION:(1) Seven controlled trials involving 362 patients were included.(2) Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time (SMD=-2.411,95％C/=-2.718-2.104,P=-0.00) and less intraoperative blood loss (SMD=-1.579,95％C/=-1.842--1.316,P=-0.00) than those in the traditional surgery.The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps (P ＞ 0.05).(3) To conclude,compared with the traditional surgery,the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.

Objective To investigate the diagnosis and treatment of HELLP syndrome through analyzing the clinical data of seven patients of HELLP syndrome.Methods We reviewed the study.There were three patients in the absolute HELLP group,four patients in the partial HELLP group.The laboratory data,clinical symptom,delivery method and the outcome of the pregnant women and infants of the two groups were analyzed.Results All the seven patients had clinical presentations of PIH.Total bilirubin(TB) value in absolute HELLP group was significantly higher than that in partial HELLP group(P

AIM: To investigate the effects of protein C activator (PCA) from Agkistrondon acutus venom ( AAV) on the tension of thoracic aorta rings isolated from the rats with sepsis.METHODS:The model of sepsis was es-tablished by intraperitoneal injection of lipopolysaccharide ( LPS) .SD rats were randomly divided to 6 groups ( n=6 ):sham group, LPS group, PCA intervention group (LPS+PCA, PCA at doses of 0.1 mg/kg, 0.3 mg/kg and 0.6 mg/kg) and LPS+polymyxin B (at dose of 0.2 mg/kg) group.Using perfusion experiment in vitro, the tension of the aortic rings was measured by biological signal analytical system.RESULTS:The values of MABP, HR, LVDP and ±dp/dtmax were significantly lower in LPS group than those in sham group and LPS+PCA groups.Compared with sham group, the relaxa-tion response to acetylcholine ( ACh) and the contractile response of aorta rings induced by phenylephrine ( Phe) were sig-nificantly decreased in LPS group, which were increased significantly in PCA intervention group ( especially at dose of 0.6 mg/kg) compared with LPS group.The dose-response curve of aorta contraction with denuded endothelium induced by Phe shifted down significantly in LPS group compared with sham group, and no significant difference between LPS group and PCA intervention group was observed.Also no statistical difference was found in non-endothelium dependent relaxation of aortic rings induced by sodium nitroprusside among the groups.Pretreatment of N-nitro-L-arginine methl ester and methyl-ene blue increased the contraction amplitude of aortic rings induced by Phe.CONCLUSION:PCA from AAV effectively reverses the hypoergia of the vessels in rats with sepsis through protecting vascular endothelium, the mechanism of which may be mediated by inhibiting NO-GC-cGMP signal transduction pathway.

Objective:To investigate the role of IL-1β in regulating human placenta-derived mesenchymal stem cells (hPMSCs) to induce the differentiation of activated peripheral blood mononuclear cells (PBMCs) into CD8 + IL-10 + T cell subset in patients with rheumatoid arthritis (RA). Methods:Serum IL-1β levels in RA patients were detected by CBA kit. hPMSCs were isolated from healthy subjects by enzyme digestion. PBMCs that were isolated from RA patients and healthy subjects by Ficoll density gradient centrifugation were activated with PHA and CD3/CD28 monoclonal antibody (McAb) and then co-cultured with hPMSCs. Flow cytometry (FCM) was used to analyze the ability of hPMSCs to induce the differentiation of activated PBMCs into CD8 + IL-10 + T cell subset with the presence of programmed death ligand 1 (PD-L1) and/or PD-L2 McAb and IL-1β. Expression of PD-L1 and PD-L2 on hPMSCs under IL-1β stimulation was analyzed by RT-PCR and FCM. Results:Serum IL-1β levels were significantly higher in RA patients than in healthy subjects. After the activation by PHA and CD3/CD28 McAb, the proportion of CD8 + IL-10 + T cells in PBMCs of RA patients was significantly lower than that of healthy subjects. Moreover, the proportion of CD8 + IL-10 + T cells significantly increased after co-cultured with hPMSCs. The ability of IL-1β-treated hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells was significantly enhanced compared to untreated hPMSCs. IL-1β could up-regulate the expression of PD-L1 and PD-L2 on hPMSCs. Blocking the expression of PD-L1 and/or PD-L2 on hPMSCs significantly reduced the ability of hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells. Conclusions:IL-1β enhanced the capacity of hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells in RA patients by up-regulating the expression of PD-L1 and PD-L2.

Objective:To investigate the mechanism of IL-6 affecting the expression of CD73 on human placenta-derived mesenchymal stem cells (hPMSCs) and regulating their migration, adhesion and proliferation.Methods:Flow cytometry (FCM) and Western blot were used to analyze the effects of exogenous IL-6 or IL-6 secreted by hPMSCs on the expression of CD73 on hPMSCs. The influence of IL-6 on the phosphorylation of signal transducer and activator of transcription 3 (p-STAT3) in hPMSCs was detected by monoclonal antibody blocking test and Western blot. Real-time cellular analysis (RTCA) was used to analyze the changes in the migration, adhesion and proliferation of hPMSCs after knockdown of CD73 expression or APCP pretreatment.Results:FCM and Western blot showed that both exogenous and autocrine IL-6 from hPMSCs promoted the expression of CD73 on hPMSCs ( P<0.001, P<0.01). Moreover, CD73 expression decreased significantly with the presence of IL-6R inhibitor ( P<0.01). IL-6 could up-regulate the levels of both p-STAT3 and CD73 in hPMSCs ( P<0.05, P<0.01), while CD73 expression decreased after adding STAT3 inhibitor ( P<0.01). RTCA showed that knockdown of CD73 expression on hPMSCs significantly inhibited the adhesion and proliferation ability of hPMSCs( P<0.01, P<0.05), but promoted the migration ability of hPMSCs ( P<0.05). Similarly, inhibiting the hydrolase activity of CD73 on hPMSCs by APCP also resulted in a significant decrease in the adhesion and proliferation capacities of hPMSCs, and an increase in the migration capacity of hPMSCs ( P<0.05). Conclusions:IL-6 enhanced the expression of CD73 on hPMSCs via the JAK/STAT3 pathway, thus affecting the migration, adhesion and proliferation of hPMSCs.

Objective: To understand the antigenicity and genetic characterization of influenza B virus HA gene in B/Victoria-lineage virus (BV) in Beijing during 2017-2018. Methods: Thirty BV virus strains isolated from MDCK cell culture by 17 laboratories in Beijing were collected. The antigenicity was analyzed by comparing with the vaccine strain recommended by WHO. The total viral nucleic acid was extracted and HA gene was amplified by RT-PCR and sequenced. The phylogenetic tree was constructed by HA and mutant sites were analyzed. Results: Among 30 strains of BV, 23 strains (76.7%) were low-reactive strains, other 7 strains (23.3%) were related to the vaccine. The phylogenetic analysis showed that the HA gene of all 30 strains located in Clade 1A branch. In addition, amino acid mutations occurred in 8 sites, and 6 of them located in the antigen determining region. Conclusions There was a correlation between the high proportion of low-reactive antigenicity and 6 aa variation in antigenic determinants involved in HA region of BV influenza virus between 2017-2018, which provides an important laboratory basis for the recommendation of BV influenza vaccine.

Objective To compare and analyze the epidemiological features of adult patients with scapular fracture between eastern and western areas in China from 2010 to 2011. Methods The data of adult patients with scapular fracture who had been treated from January 2010 to December 2011 in 63 hospitals in the eastern and western areas in China were collected through the PACS system and case reports checking system. The data from the eastern 35 hospitals were classified as group A and those from the 28 western hospitals as group B. The analytic items included gender, age and AO classification. Results A total of 2, 063 cases were collected. The median age was 44 years ( interquartile range, from 33 to 56 years ) and gender ratio 3. 50:1 in Group A of 1, 376 cases; the median age was 41 years ( interquartile range, from 31 to 51 years ) and gender ratio 3. 09:1 in Group B of 687 cases. There was a significant difference between the 2 groups in median age ( Z= -3. 798, P=0. 000 ) . There was no significant difference between the 2 groups in gender ratio or constituent ratio of fracture peak age ( P > 0. 05 ) . The proportions of patients from 16 to 20 and from 31 to 40 years old in group A were significantly lower than in group B ( P <0. 05 ) . The proportion of middle-aged patients was significantly higher and that of young patients significantly lower in group A than in group B. The proportion of AO type 14-A fractures in group A ( 66. 49％) was significantly higher than in group B ( 55. 60％) while the proportion of AO type 14-C fractures was significantly lower ( 21. 37％) in group A than in group B ( 29. 55％) . Conclusions Most scapular fractures occurred in male patients. The proportion of young patients in the eastern area was lower than in the western area, but the proportion of middle-aged patients was higher in the eastern area than in the western area. The proportion of AO type 14-A fractures in the eastern area was significantly higher than in the western area while the proportion of AO type 14-C fractures in the eastern area significantly lower than in the western area.

Objective To compare and analyze the epidemiological features of Colles fractures between Eastern and Western China from 2010 to 2011.Methods The data of patients with Colles fracture treated from January 2010 to December 2011 in 63 hospitals in Eastern and Western China were analyzed retrospectively.The patients from the 35 hospitals in Eastern China were defined as group A and those from the 28 hospitals in Western China as group B.The 2 groups were analyzed and compared in terms of gender,age and laterality.Results A total of 9,255 Colles fractures were collected.The total male/female ratio was 0.82:1.Their ages ranged from 1 to 110 years,with a median age of 51 years.The Colles fractures predominated in an age range from 51 to 60 years.There were 5,006 left sides and 4,249 right sides.There were 5,639 Colles fractures in group A,accounted for 2.55％ of the total body fractures and 22.09％ of the distal ultra-radius fractures.There were 3,616 Colles fractures in group B,accounted for 3.98％ of the total body fractures and 37.55％ of the distal ultra-radius fractures.The male/female ratio was 0.72:1 in group A and 0.99:1 in group B.The median age was 54 years (from 1 to 110 years) for group A and 45 years (from 1 to 99 years) for group B.There were significant differences between the 2 groups in all the above items (P ＜0.05).The largest proportion of age group was from 51 to 60 years and the smallest proportion of age group was ≥81 years for both groups.The proportions of age groups from 1 to 10 years,from 51 to 60 years,from 61 to 70 years,from 71 to 80 years and ≥81 years in group A were larger than in group B while those from 11 to 20 years,from 21 to 30 years,from 31 to 40 years and from 41 to 50 years in group A were smaller than in group B.There were significant differences between the 2 groups in all the proportions of age group (P ＜0.05).The Colles fractures predominated on the left side in both groups,showing no significant difference between the 2 groups (P ＞ 0.05).Conclusions The Colles fractures from 2010 to 2011 predominated in the elderly and female patients in China.The proportions of Colles fractures in all body fractures and distal ultra-radius fractures in Eastern China were lower than those in Western China.There were significant differences in gender and age proportions between the 2 areas.Eastern China had a larger proportion of female patients and a higher median age than Western China.