OBJECTIVETo investigate the effect of augmentative locking compression plate combined with bone graft in treating aseptic femoral shaft nonunion after intramedullary nailing.

METHODSTwenty-one cases with aseptic femoral shaft nonunion after intramedullary nailing from January 2007 to January 2013 were treated,including 18 males and 3 females with a mean age of 37.7 years (ranged from 23 to 64 years). The mean period of nonunion after surgery was 23.9 months (ranged from 9 to 62 months). According to Weber-Cech classification,10 of those 21 cases were hypertrophic nonunion,7 were atrophic, and 4 had oligotrophic fracture nonunion. All patients retained the original intramedullary nail, and applied with augmentation plating of 6 to 8 holes locking compression plate, unicortical fixation with 2 to 3 locking screws in the proximal or distal end, with simultaneous autologous iliac bone grafting. After treatment,all patients were allowed to partial weight-bearing until full weight-bearing according to the radiological results. All patients were followed up and were evaluated with clinical and imaging results.

RESULTSAll patients were followed up from 8 to 24 months, averaged (13.5±3.5) months,which showed clinical union at 4 to 8 months, averaged (6.0±1.0) months and radiological solid union at 7 to 12 months, averaged (9.1±1.5) months. No such complications as infection,hardware loosening or breaking were found.

CONCLUSIONAugmentative locking compression plate(LCP) combined with bone graft for aseptic femoral shaft nonunion after intramedullary nail has a satisfied clinical efficacy. It's an useful and simple method.

Adult ; Bone Nails ; adverse effects ; Bone Plates ; Bone Transplantation ; Female ; Femoral Fractures ; complications ; surgery ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; adverse effects ; Fractures, Ununited ; complications ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Treatment Outcome ; Young Adult

Objective:To study the inhibitory effect of retinoblastoma 94(Rb94) gene combined with radiotherapy ionizing radiation on the growth of esophageal carcinoma cells of tumor-bearing nude mice, and to clarify the synergistic effect of Rb94 gene and radiotherapy in inhibiting the growth of tumor cells.Methods:The models of tumor-bearing BALB/c-nu nude mice were built by inoculating the K150 cells.The model mice were divided into five groups:blank control(no any treatment), Ad-LacZ(control adenovirus including LacZ gene but not Rb94 gene, Ad-LacZ was transfered into tumor xenograft on 0, 3, 7 d separately), Ad-Rb94(tumor xenograft was transfected with Ad-Rb94 on 0, 3, 7 d separately), radiation (tumor xenograft was irradiated with 4 Gy γ-radiation on 1, 4, 8 d separately) and Ad-Rb94 combined with radiation(combination group, tumor xenograft was irradiated with 4 Gy γ-radiation after transfected with Ad-Rb94) groups.The volumes and the weights of esophageal carcinoma and the inhibitory rates of tumor growth of the mice in various groups were detected.The expression levels of ABL and JNK kinase in tumor tissue of the mice in various groups were measured,and the pathological changes of tumor tissue were investigated.Results:The speeds of tumor growth of the nude mice in Ad-RB94, radiation, and combination groups were slower than that in control group.The volume of esophageal carcinoma in combination group at day 15 after treatment was markedly smaller than those in Ad-RB94 and radiation groups,and there were significant differences compared with control group and Ad-LacZ group (F=26.7,23.8;P<0.01).The tumor weight of the nude mice in combination group was the lightest at the end of treatment;the inhibitory rate of tumor growth in combination group reached 81.16% and was significantly higher than those in Ad-Rb94 group(57.84%)and radiation group(38.20%)(P<0.01).The expression levels of ALB and JNK kinase in tumor tissue of the mice in combination group was markedly higher than those in control group(P<0.01).Compared with other groups, the tumor cells in combination group had fewer karyokinesis and lower level of nuclei hyperchromasia.Conclusion:Rb94 gene combined with radiotherapy shows synergistic effect in inhibiting the growth of tumor of tumor-bearing nude mice.

Objective To study the correlation between the coagulation factor Ⅶ (F Ⅶ) and progressive hemorrhage after brain contusion in mice and provide the experimental evidence for the clinical application of recombinant human FⅦa.Methods Twelve male BALB/c mice were given liposomeencapsulated FⅦsiRNA via tail vein at doses of 1,3,5 and 10 mg/kg with 3 mice per dosage.The other 3 mice received equivalent volume of normal saline as controls.Two days after the injection,mice blood sampling was used to detect FⅦ mRNA expression in liver using real-time PCR,level of plasma FⅦ using ELISA method,and activity of plasma FⅦ using chromogenic substrate assay.The optimal dose at which F Ⅶ expression was inhibited was determined.Thirty BALB/c male mice were assigned to two groups (n =15 per group) according to the random number table:FⅦ-suppressing group,mice were injected with FⅦsiRNA at the optimal dose and control group,mice were injected with same volume of negative control vector.The model of brain contusion was established in both groups.Volume of hemorrhage following brain contusion was measured at 3,24 and 72 h postinjury,and hematoma volume at 24 and 48 h postinjury.Results Liposome-encapsulated siRNA delivery down-regulated FⅦ expression in the mouse liver.Level and activity of plasma FⅦ were also reduced significantly.The optimal siRNA dose was 3 mg/kg.At 3,24 and 72 h postinjury,relative volume of brain hemorrhage in FⅦ-suppressing group was 1.46 ± 0.10,1.82 ± 0.23 and 2.28 ± 0.15 respectively,significantly higher than that in control group (1.00 ± 0.25,1.20 ± 0.31 and 1.20 ± 0.22 respectively) (P ＜ 0.05).At 24 and 48 h postinju-ry,volume of hematoma in FⅦ-suppressing group was (6.7 ± 1.5)mm3 and (9.8 ± 1.0) mm3,significantly higher than that in control group [(5.2 ± 1.2) mm3 and (5.5 ± 1.5) mm3] (P ＜0.01).Conclusions Level of FⅦ in vivo relates closely to the progressive hemorrhage of brain contusion in mice.Administration of FⅦ is effective to reduce the incidence of progressive hemorrhage.

Objective To investigate the specific silencing of connective tissue growth factor (CTGF) in a nude mouse keloid model,using RNA interference (RNAi) technique,and to provide the basis for gene therapy of keloid.Methods The nude mouse keloid model was established,and then transfected in vivo with well-amplifiating plasmid.The mRNA expression levels of CTGF mRNA and type Ⅰ collagen mRNA were detected with reverse transcription-polymerase chain reaction (RT-PCR).The distribution and protein expression levels of CTGF and type Ⅰ collagen were determined quantitatively using immunohistochemistry.Results The expression of CTGF at mRNA and protein levels was decreased in the experiment group,and the expression of type Ⅰ collagen at mRNA and protein levels was also decreased after transfection,as compared with negative control group and blank group,with significant difference between groups (P＜0.05).Moreover,the expression of type Ⅰ collagen and CTGF was positively correlated (r=0.979).Conclusions Keloid type Ⅰ collagen can be decreased through in vivo inhibiting CTGF expression.The transfection of CTGF gene in vivo may have effects on type Ⅰ collagen generation,and thus inhibit the keloid growth.

OBJECTIVETo study effects of body mass index (BMI) on postoperative outcome in patients with osteoarthritis after total knee arthroplasty (TKA).

METHODSThe data of 148 patients with osteoarthritis who underwent TKA from June 2006 to May 2009 in our hospital and had complete follow-up data were analyzed restrospectively, including 29 males and 119 females, ranging in age from 39 to 89 years old, with an average age of 71.2 years old. According to BMI classification standard, all the patients were divided into 4 groups: non-obese group (BMI ≤ 25.0 kg/m2), had 38 patients (45 knees), including 9 males and 29 females, with a mean age of (70.0 ± 8.2) years old; overweight group (BMI 25.1 to 27.0 kg/m2), had 40 patients (48 knees), including 10 males and 30 females, with a mean age of (72.6 ± 7.4) years old; obesity group (BMI 27.1 to 30.0 kg/ m2), had 30 patients (43 knees), including 7 males and 30 females, with a mean age of (70.4 ± 6.0) years old; morbidly obesity group (BMI > 30.0 kg/m2), 33 patients (39 knees), including 3 males and 30 females, with a mean age of (71.7 ± 6.4) years old. The index such as Knee Society Score (KSS), anterior knee pain and patella cartilage damage during surgery were recorded before surgery and at the time of follow-up.

RESULTSPostoperative KSS increased significantly compared to preoperative KSS, and the good rate reached to 97.1%. In the knee score, preoperative KSS and postoperative KSS had no significant differences among the four groups (preoperative P = -0.789; postoperative P = 0.133). However, compared with other groups, obesity group got the lowest preoperative function score (preoperative P = 0.036; postoperative P = 0.225). While the incidence of anterior knee pain was 9.7% (17/175), including 14 grade I and 3 grade II. There were no significant differences in incidence of anterior knee pain among four groups (χ2 = 0.764, P = 0.862). The average BMI of the patients with anterior knee pain was (27.4 ± 3.6) kg/m2, while the others' BMI was (27.5 ± 4.4) kg/m2. There was no statistically difference between two groups (t = -0.061, P = 0.951). There were no significant differences in patella cartilage damage among groups (χ2 = 7.070, P = 0.314).

CONCLUSIONThe KSS increases in all the different groups. Those patients get the benefit from TKA, and the obese patients can receive a similar postoperative outcome as the non-obese ones.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; Body Mass Index ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; physiopathology ; surgery ; Retrospective Studies ; Treatment Outcome

Aim To observe the intervention effects of sodium aescinate on acute lung injury model of rats induced by oleate. Methods Fifty four male SD rats were randomly divided into five groups: normal control group, sodium aescinate control group (without oleate) , oleate model control group,medrol interventional group and sodium aescinate interventional group. Acute lung injury models of rats were made by injecting oleate (OA, 0. 1 ml · kg~(-1) ) through caudal veins, and then rats were observed and killed to detect correlated in-dice. The observation indice were the histomorphology of lung, the wet and dry weights of lung ( W/D), score of injury of lung under light microscope (IQA ) , partial pressure of oxygen in artery ( PaO_2) , the levels of SOD and MDA in blood plasma and lung tissue. Results ① Histomorphology of lung: Lung surface hyperemia relieved obviously and pink secretion from trachea of rats in sodium aescinate interventional group and medrol interventioal group decreased significantly compared with oleate model control group. Under light microscope , compared with oleate model control group, effusion of inflammatory cells in alveolar space of rats in sodium aescinate interventional group and medrol interventional group decreased. ② The wet and dry weights of lung ( W/D ) ; W/D of rats in oleate control model group increased obviously compared with those in normal control group, W/D of rats in sodium aescinate interventional group and medrol interventional group decreased obviously compared with those in oleate model control group. ③ Score of injury of lungs under light microscope (IQA) ; IQA of rats in oleate model control group advanced obviously compared with that in normal control group. IQA of rats in sodium aescinate interventional group and medrol interventional group lowered significantly compared with that in oleate model control group.④ Partial pressure of oxygen in artery (PaO_2) : PaO_2 of rats in oleate model control group lowered significantly compared with that in normal control group. PaO_2 of rats in sodium aescinate interventional group and medrol interventional group improved significantly compared with that in oleate model control group. ⑤ The levels of SOD and MDA in blood plasma and lung tissue:The levels of SOD in plasma and lung tissue of rats in oleate model control group lowered significantly compared with those in normal control group. SOD in plasma and lung tissue of rats in sodium aescinate in-terventional group and medrol interventional group increased significantly compared with that in oleate model control group. The levels of MDA in plasma and lung tissue of rats in oleate model control group lowered significantly compared with those in normal control group. MDA in plasma and lung tissue of rats in sodium aescinate interventional group and medrol interventional group increased significantly compared with that in oleate model control group. Conclusion Sodium aescinate can improve W/D, IQA and PaO_2 by adjusting oxidization of the acute lung injury model of rats, which may provide a possible path for treating acute lung injury in clinical practice.

Objective:To investigate the impact of obstructive sleep apnea(OSA)on cardiac structure and function in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a case-control study.Elderly patients with T2DM aged 65 years and above at the Department of Geriatrics of Tianjin Medical University General Hospital were consecutively enrolled in this study, and eventually 61 patients with complete general information were included.All patients were examined with polysomnography(PSG). They were divided into the T2DM group and the T2DM+ OSA group based on whether there was concurrent OSA.Differences in cardiac structure and function were compared between the two groups and between patients with mild OSA and those with moderate-severe OSA.The correlation of OSA with cardiac structure and function in T2DM patients was analyzed by using Pearson correlation and multiple linear regression analysis.Results:The left ventricular ejection fraction(LVEF)was lower in the T2DM+ OSA group than in the T2DM group(52.38±4.70 % vs.56.34±5.92%, t=2.892, P=0.005). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness increased in the T2DM+ OSA group compared with the T2DM group(21.50±1.49 mm vs.20.55±1.05 mm, 10.21±0.88 mm vs.9.52±1.04 mm, 10.42±0.83 mm vs.9.83±0.83 mm, t=-2.670, -2.770 and -2.716, P=0.010, 0.007 and 0.009). LVEF was lower in patients with moderate-severe OSA than in those with mild OSA group(50.58±3.55% vs.55.83±4.83%, t=3.813, P=0.001). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness were greater in patients with moderate-severe OSA than in those with mild OSA(21.86±1.39 mm vs.20.79±1.46 mm, 10.48±0.82 mm vs.9.69±0.75 mm, 10.68±0.80 mm vs.9.92±0.64 mm, t=-2.231, -2.871 and -2.943, P=0.032, 0.007 and 0.006). Pearson correlation analysis showed that the Apnea Hypopnea Index(AHI)was correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( r=-0.425, 0.340, 0.458 and 0.473, P=0.001, 0.007, <0.001 and <0.001). After adjusting for age, body mass index, systolic blood pressure and triglycerides, multiple linear regression analysis showed that AHI was also correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( β=-0.385, 0.520, 0.604 and 0.388, P=0.036, 0.011, 0.001 and 0.039). Conclusions:OSA aggravates cardiac remodeling and systolic insufficiency in T2DM patients and may be related to the severity of intermittent hypoxia.

Objective To evaluate the effectiveness and safety of terazosin in the treatment of Chinese benign prostatic hyperplasia (BPH) patients. Methods A multicenter prospective postmarketing observational study was conducted from June 2007 to March 2008 in 32 urologic centers.Patients were given terazosin for 4 weeks according to the routine medical care procedures following instructions. Effectiveness evaluation included the primary endpoint focusing on the changes in IPSS total score at the end of 2nd and 4th week compared with the baseline. The secondary endpoints were the changes in Qmax and QOL at the end of 4th week, diastolic and systolic blood pressures at the end of 2nd and 4th week compared with the baseline and the discontinuation rate of terazosin within the four weeks. Safety was assessed by adverse events. Results There were 1006 patients included in this study (FAS) and 992 patients (PP) completed the study. Among them, there were 344 patients having hypertension. The total IPSS score reduced from 22.32±6. 13 at baseline to 16. 98±5.92 at the end of the 2nd week and to 14.00±5. 52 at the end of the 4th week in FAS population (P＜0. 01).The total IPSS score changed from 22.32±6.15 at baseline to 16. 96±5.93 at the end of the 2nd week and to 13. 95±5.52 at the end of the 4th week in the PP population (P＜0.01). The efficacy rate was 26.54% at the 2-week treatment and 60.64% at the 4-week treatment, which was defined as obtaining improvement by 30% compared with the baseline. Patient's IPSS in different age groups with different prostatic hyperplasia levels and patients combined with or without 5-α reductase inhibitors were all decreased significantly(P＜0.01). With 4-week treatment of terazosin, Qmax and QOL were improved significantly by 32% and 45% (P＜0.01). Terazosin decreased BPH patient blood pressure with untreated or uncontrolled hypertension (P＜0.05), but had little influence on normal blood pressure of those under control. The incidence of adverse reactions was low. The most common adverse event was dizziness (3.68%). At the end of the study, 960 subjects (95%) were taking drug continuously.Conclasions Terazosin can significantly improve the symptoms and quality of life in Chinese BPH patients with good safety and compliance.

OBJECTIVETo evaluate the alterations in calcium metabolism of the vascular smooth muscle of rat thoracic aorta in the late phase of sepsis and to investigate the involvement of nitric oxide (NO)/cyclic-GMP(cGMP) signal transduction pathway in the sepsis-induced vascular hyporeactivity.

METHODSMale Sprague-Dawley rats were subjected to sepsis by cecal ligation and puncture (CLP). Eighteen hours post CLP, rat aortic rings were removed for measurement of contractile responses to vasoconstrictors by using organ bath technique.

RESULTIn endothelium intact aortic rings from CLP rats, concentration-contraction curves to phenylephrine (PE) and high KCl were significantly decreased when compared with those from control rats. The transient contraction induced by PE in calcium-free Krebs solution and the concentration-dependent contraction to CaCl(2)in KCl-depolarized medium were also markedly reduced. The hyporeactivity to vasoconstrictors was completely reversed by pretreatment either with aminoguanidine (AMG), a selective inducible nitric oxide synthase inhibitor, or with 1H [1,2,4] oxadiazolo[4,3-a] quininoxalin-1-one(ODQ), an inhibitor of NO-sensitive guanylyl cyclase.

CONCLUSIONA generalized impairment in calcium handling in vascular smooth muscle,including the calcium influx through the voltage-operated and receptor-operated channels and calcium release from intracellular calcium stores, is involved in vascular hyporeactivity during the late phase of sepsis. The NO/cGMP signal transduction pathway might be involved in this defect in vascular smooth muscle.

Animals ; Aorta ; metabolism ; Calcium ; metabolism ; Cyclic GMP ; physiology ; Homeostasis ; In Vitro Techniques ; Male ; Muscle, Smooth, Vascular ; metabolism ; Nitric Oxide ; physiology ; Rats ; Rats, Sprague-Dawley ; Sepsis ; metabolism ; Signal Transduction ; physiology

OBJECTIVEThe forensic DNA databases are very important for individual identification. In order to evaluate the genetic markers used for a forensic DNA databases and the compatibility between the manual DNA typing system and the automatic DNA typing system, a testing DNA database should be constructed. Also, constructing a testing DNA database can increase our understanding of the issue for forensic DNA databases.

METHODSA total of 1000 specimens, including samples of blood, blood stains, salvia stains, semen stains, mixture stains and muscle tissues, were collected from the public security bureau of Chengdu. The DNA of each specimen was extracted by Chelex method and analyzed using Amp-FLP technique. A total of 8 STR loci, including D3S1358, D9S1118, vWA, D5S818, D16S539, D8S1179, CSF1PO and D20S161 were chosen and employed for DNA typing. Each STR locus was amplified by the polymerase chain reaction PCR and the PCR products were typed with the polyacryamide gel electrophoresis. Typing DNA was carried out by comparing with a human allele ladder. A total of 8 human allele ladders for D3S1358, D9S1118, vWA, D5S818, D16S539, D8S1179, CSF1PO and D20S161 were made in-house. Managing software of the testing DNA database was designed using Microsoft Access.

RESULTSThe results of DNA typing in 1000 specimens showed that the total discrimination power of 8 STR loci was over 0.99999999.

CONCLUSIONThis study show that a forensic DNA database should be useful for search purpose. The total discrimination power over 0.99999999 imply that in principle there is no identical genotype at whole 8 STR loci between two persons from a population with 10000000 individuals. This means that 8 STR loci used in this study are suitable to construct forensic DNA databases in Chengdu of China. The result of DNA typing can be repeated and the data have compatibility between the manual DNA typing system and the automatic DNA typing system. The data search in our testing DNA database can be carried out using only some loci of the set of 8 STR markers. Also, the volume of our testing DNA databases could be enlarged easily. The implication from this study is that the legislation should not be negligent before establishing a forensic DNA database. This DNA database provides a model for establishing the forensic DNA databases in China.

Adolescent ; Adult ; Alleles ; Crime ; DNA ; chemistry ; genetics ; Databases as Topic ; Female ; Forensic Medicine ; statistics & numerical data ; Gene Frequency ; Genotype ; Humans ; Male ; Microsatellite Repeats ; Middle Aged ; Prisoners ; statistics & numerical data ; Sequence Analysis, DNA ; Tandem Repeat Sequences ; genetics