The therapeutic effects of bovine hepatocytic growth factor ( BHGF ) were studied on acute hepatic failure ( AHF ) induced by D-galactosamine ( D-Gal ) in rats. The BHGF was isolated from the hepatic cytosol of newborn cow in our laboratory and its molecular is under 20 000 dalton. The results showed that. l)the survival rate of the rats with AHF was significantly enhanced after therapy with BHGF, 2 ) the 8H-TdR were highly incoporated into hepatocytic DNA of the rats, 3 ) the pathological damage of the rat liver was obviously improved, when comparied with the control. It is Suggested that BHGF could stimulate the hepatocytic DNA synthesis and be effective in the therapy of AHF in rats.

[Objective]To study the effect of sixpetal clematis root injection(WLX)on histology,collagen phenotype and ultramicrostructurc in cartilage of osteoarthritis animal model.[Method]OA model animals were randomly divided into 3 groups:group S,group D and group K.Animals in group S received WLX and animals in group D received sterilized normal saline intramuscularly,group K was control and received nothing.After the animals were killed,cartilage specimen were obtained and sections were made and stained with HE/SOFG for Mankin score;the expression level of collagen Ⅰ and Ⅱ in matrix was tested by immunohistochemistry;change of ultramicrostructure of cartilage was observed with transmission electron microscope.[Result]Mankin score in group S was better than that in group D and K at each test period;result of IHC shows that positive stain area of collagen Ⅰ was lower in group S than that in group D and K,and positive stain area of collagen Ⅱ was higher than that in group D and K at each test period;cartilage impairment degree in group S was lower than in group D and K,and impairment manifestation in group D and K was similar on the whole.[Conclusion]sixpetal clematis root injection may protect articular cartilage by maintaining and promoting the chondrocyte synthesizing proteoglycan and type Ⅱ collagen.

0.05).The titer of HBV DNA is higher in YMDD mutation group than in no mutation group at twelve month or eighteen month with(8.14?0.94)vs(7.29?0.97) and(8.28?0.77) vs(7.17?0.91) respectively.(t=2.33,P10~8copies/ml).

Objective To investigate the therapeutic effieacy and safety of 18 α-Diammonium glycyrrhizinate phosphatidylcholine complex (DGPC) in patients with chronic hepatitis B and or C with elevated aminotransferase. Methods 55 patients with chronic hepatitis B and or C, with serum alanine aminotransferase (ALT) of 2 to 10 times the upper limit of normal were randomly assigned to receive DGPC or Diammonium glyeyrrhizinate (DG) for 12 weeks. Then they were followed up for an additional 4 weeks. From week 1 to 10, DGPC or DG was given as 150 nag,three times a day (TID). At the 11th week,the drug was given as 100 mg,TID. Then 50 mg,TID for the 12th week. Results ALT was markedly decreased after receiving DGPC 4,8,12 weeks (P=0.00). ALT normalization rate at the end of therapy was similar (38.5% vs 34.5% ,P =0.76). Drug-related adverse events were similar. Conclusion DGPC can rapidly and safely decrease aminotransferase in patients with chronic viurs hepatitis.

Objective To explore the effect of the treatment for the old deltoid ligament injuries by TwinFix suture anchors fixation along with overlap suturing.Methods Totally the data of 17 patients with old deltoid ligament injury was retrospectively reviewed who received treatment from January 2007 to December 2011.There were 11 males and 5 females,with an average age of 32.1 years (range,18-58 years).All of them had ankle sprain histories with the duration ranging from 7-25 months (average,14.2 months).All patients received weight-bearing X-ray,bilateral anterior-posterior (AP) and oblique radiography,MRI and ultrasound examinations before operation.Further arthroscopic examination was performed to confirm the diagnosis and debrided the intra-articular proliferative synovial tissue as well as injured articular cartilage for the patients after they were diagnosed with deltoid ligament injury.Open surgeries were performed though an incision on the medial ankle space.Residual ligament and scar tissue were cleaned.Old avulsion fractures of medial ankle tip were removed in 2 cases.The deep layer of ruptured deltoid ligament was sutured onto the tip of medial malleolus while the superficial layer was overlapped and sutured to the periosteum of medial ankle.Anchors were then utilized to fix the ligament.The clinical outcomes were evaluated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hiodfoot score system.Results The follow-up duration of the 17 patients were 12-34 months with an average of 20.1 months.Both image evidences and intraoperative findings revealed the injury and scarring of deltoid ligament.The angle between long axis of talus and first metatarsal and the angle of hindfoot alignment in Saltzrnan view reduced from 5.4°±1.8°,8.2°± 2.6° before surgery to 4.0°±0.9° and 5.3°±1.3° after surgery respectively.The mean AOFAS hindfoot score before operation was 76.8±7.0 and increased to 94.1±3.3 at the last follow-up.There were ten cases receiving excellent effect,6 good and 1 moderate.The good and excellent rate was 94.1％ (16/17).All the 17 patients achieved paiu relief and none had recurrent injury till the last follow-up.Conclusion TwinFix suture anchor fixation along with overlap suturing was an effective way in dealing with old deltoid ligament injury cases.

Objective To evaluate the ankle stability on lateral malleolar rotational models based on three-dimensonal CT reconstruction and volume rendering technique.Methods Eighteen cadaveric specimens were utilized in the study (male 11;female 7; 68.2 years in average) and were divided into 2 groups in which the first group only cut the anterior tibiofibular ligament and defined as intact deltoid ligament group.Another group additionally cut the deltoid ligament and defined as deltoid ligament injured group.Fibular transverse osteotomy was performed at 3 cm proximal to the ankle joint and lateral malleolar rotational malunion model of 5°,10°,15° and 30° were built in every specimen.CT scanning was performed for each model then and all CT data were imported into Mimics 10.01 software.The structures of distal syndesmosis,ankle mortise as well as talus in the mortise were outlined by automatic dense identifying and manually modified later.Three-Dimensional models of these structures and their volume were outputted in the software.The volume of ankle clear space was calculated as the difference value of ankle mortise and talus in the mortise.Ankle stability was reflected by comparison of these volumes to the normal condition.Results With the rising of malrotational degree,the volume of inferior syndesmosis and mortise were increased and the volume of talus in the mortise was reduced.In the deltoid ligament intact group,10° of malrotation would significantly enlarged the volume of distal syndesmosis and ankle clear space when compared to normal condition.However,in the deltoid ligament injured group,5° of rotational deformity would significantly enlarge the volume of ankle clear space and distal syndesmosis.Conclusion The condition of deltoid ligament has significant impact on ankle stability in cases of lateral malrotional deformity.Distal syndesmosis and ankle clear space were significantly enlarged at 10° malrotation deformity.However,additional deltoid ligament injury can significantly reduce ankle stability at just 5° of distal fibular rotational deformity.

BACKGROUND: Operative correction of hallux valgus is one of the most procedures in foot and ankle department, but postoperative plaster slab immobilization often brings great inconvenience and pain. Off-loading forefoot shoes can theoretically help them to do activities off bed early, and prevent loading on the forefoot during walking. But its advantages and disadvantages compared with plaster slab are still unknown.OBJECTIVE: To compare the clinical effects of over-the-toe plaster slab and off-loading forefoot shoes after hallux valgus correction.METHODS: Patients with hallux valgus undergoing distal Chevron osteotomy or Scarf osteotomy in the Huashan Hospital of Fudan University between May 2012 and October 2013 were retrospectively reviewed. Group A patients had a below-knee and over-the-toe plaster slab while Group B had an off-loading forefoot shoe applied after surgery.Radiological assessment was done at 6 weeks postoperatively. Immobilization was removed once bone union was indicated. Clinical scales and subjective satisfaction investigation were performed at final follow-up, and complications during follow-up were noted. All values between groups were analyzed statistically.RESULTS AND CONCLUSION: Totally 125 patients (157 feet) were completely followed up, including 83 patients (95 feet) in Group A and 42 patients (62 feet) in Group B. There was no significant difference in demographics, pre-and-post operative radiological assessments, clinical scale, union time or general satisfaction rates between two groups. However,Group B patients had less chance to suffer metatarsophalangeal joint or inter-phalangeal joint stiffness, restricted ankle motion and supra-ankle pains of operated side in comparison with Group A (P < 0.05), and were more willing to accept the same treatment if they could choose again (P < 0.05). Compared with the plaster slab, the application of off-loading shoes not only maintains correction level, but also reduces such complications as stiffness or restricted motion of the joint, limb pains and so on, which makes patients more likely to accept, and should be given priority to in the rehabilitation following hallux valgus correction.

Objective To explore the outcomes of computer-assisted design of therapeutic personalized footwear for diabetic foot.Methods Fifty-eight cases of diabetic foot were included in the study.Ten items of data from theses patients were measured with methods provided by Salford University.All characteristics of the footwear were calculated with computer.Shoes were specially designed with the formula and computational method provided by Safford university.All patients had worn the shoes for 13 months.Special questionnaires were used to measure the outcomes.Results Thirty-two cases had been followed up for one month,25 cases for 2 months,25 cases for 3 months and 42 cases for 13 months.The score had improved from 67.94±15.14 before wearing the shoes to 78.13±1.44 thirteen months after wearing.The health score of the foot had improved.There was significant difference between before and after wearing the footwears.Conclusion Special-designed diabetic shoes play an important role in the prevention of ulcer for diabetic foot patients.Computational method and data model obtained from Salford university needs to be modified when applying it for Chinese.

OBJECTIVETo explore the characteristics in CFHR1 concentration and the frequency of CFHR1 gene polymorphisms of patients with type 2 diabetes mellitus (T2DM) based on the high level of complement factor H (CFH) expression among such patients and the similarity between CFHR1 and CFH in terms of sequence and functions.

METHODSFifty T2DM patients and 30 healthy controls were selected. The plasma samples were separated by pI with OFFGEL electrophoresis following solution digestion. Further separation and identification were carried out on a Nano HPLC-Chip-MS/MS system. Differentially expressed proteins were identified by comparison. Enzyme-linked immunosorbent assay (ELISA) was used to validate the result. Genomic DNA of the two groups was extracted. Polymerase chain reaction and sequencing were used to determine the single nucleotide polymorphisms in the 6 exons of the CFHR1 gene.

RESULTSThe CFHR1 level in plasma of T2DM patients were significantly higher than that of the healthy controls (P=2.78× 10). A significant difference in allelic frequencies of rs12406079 of the fifth exon of the CFHR1 gene was found between the two groups (χ=5.692, P=0.017).

CONCLUSIONThe concentration of CFHR1 and frequencies of CFHR1 gene polymorphisms among patients with T2DM differ significantly from healthy subjects. Polymorphisms of the CFHR1 gene are associated with T2DM.

Complement C3b Inactivator Proteins ; genetics ; metabolism ; Diabetes Mellitus, Type 2 ; genetics ; metabolism ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

Objective To propose a CT classification of die-punch fragments in posterior pilon fracture and to explore its significance in helping the surgery.Methods ACT scan classification of die-punch fragments in posterior pilon fracture into 5 types was proposed according to their size and location.A retrospective study was conducted of the 48 posterior pilon fractures which had been treated at Department of Orthopaedics,Huashan Hospital from January 2013 to December 2015.They involved 16 men and 32 women,aged from 20 to 87 years (average,46.5 years).According to the preoperative CT scan classification of die-punch fragments,16 cases (33.3％) belonged to type Ⅰ,2 (4.2％) to type Ⅱ,18 (37.5％) to type Ⅲ,10 (20.8％) to type Ⅳ and 2 (4.2％) to type Ⅴ.Choice of operative approach,reduction and internal fixation and removal of the fragments were guided by the CT classification of die-punch fragments.Their postoperative ankle functions were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) scoring systems.Results All the 48 cases were followed up for 11 to 21 months (average,13.7 months).Their AOFAS scores for ankle-hindfoot at the final follow-up ranged from 77 to 92 points,averaging 84.3 points;their VAS scores ranged from 0 to 1 point,averaging 0.2 point.There were no significant differences in their postoperative AOFAS scores for ankle-hindfoot or in their postoperative VAS scores between the types of die-punch fragments (P ＞ 0.05).No complications were recorded except superficial infection at the posteromedial wound of the ankle in 2 cases,tarsal tunnel syndrome in 2 cases,and sural nerve irritation in 2 cases.Conclusion It is feasible and effective to classify the die-punch fragments in posterior pilon fracture according to their size and location on the CT scan,because the classification can help choose an appropriate operative approach and manage the die-punch fragment,leading to fine clinical outcomes.