Objective To study the p53 gene mutation induced by organic extract of reclaimed water used in a city. Methods The organic extract of reclaimed water was collected by C18 solid-phase extraction (SPE) and the 16 kinds of polycyclic aromatic hydrocarbons (PAHs) in the reclaimed water were analyzed using gas chromatography-mass spectrometry (GC-MS). L-02 cells were treated with the organic extract of the reclaimed water at 0.84, 1.68, 3.34 ?l/ml for 24 h. DNA samples for p53 mutation detection was extracted from the cells and subjected to DNA sequencing for detection of mutations in exon 5 of the p53 gene. Results All 16 kinds of PAHs were detected both in input water and reclaimed water. The predominant ones were fluorene and phenanthrene,then naphthalene, acenaphthene, acenaphthylene, anthracene, fluoranthene, pyrene and so on. Total PAHs concentration was 1 777.9 ng/L in the input water and 1380.1 ng/L in the reclaimed water. Mutation in exon 5 within the p53 gene was detected in L-02 cells treated with the organic extract of the water. Conclusion PAHs in water can be removed by sewage treatment technology at present, but the remaining PAHs can still induce the mutation of p53 gene, so using reclaimed water has some potential health impacts, the sewage treatment technology employed today should be improved.

Ojective To evaluate a new operation procedure for the treatment of circumferential mixed hemorrhoids. Methods 187 cases were treated by anal pad-preserving ligation resection, while 77 cases by routine procedures of stripping off the varicose masses of the external hemorrhoids and ligation the internal one as the control. Results Healing time of the operative wound were (17?4)d in the the study group and (24?4)d in the controls respectively( t =9.24, P 0.05). Postoperative urinary dysfunction: 14.4% of cases developed in the study group and 27.3% in the controls(? 2=8.42, P

Objective To investigate the technical features, postoperative complication and therapeutic regimen of immunosuppressant in pediatric and adolescent renal transplantation. Methods From February 1998 to December 2004, clinical data of 46 pediatric and adolescent patients who underwent renal transplantation were retrospectively analyzed to observe the patient and graft survival rate, growth and development of recipients and postoperative complication. Results Ten episodes of acute rejection (AR) were diagnosed in 46 cases. Four cases suffered delayed graft function (DGF), one urinary leakage and 8 drug-induced hepatic injury occurred. Eight cases suffered pulmonary infection, 3 cases suffered bone marrow depression and 2 granulocytopenia. One allograft artery stenosis and one ureteral necrosis occurred. Renal functions were returned to normal in all recipients 4 weeks after operation. The 1-year patient and graft survival rates were all 100 %, and the 3-year patient and graft survival rates were 100 % and 97.4 % respectively. Conclusions Renal transplantation is an effective treatment for pediatric and adolescent patients with end-stage renal disease. In addition to its higher AR incidence than adult, pediatric renal transplantation has especial treatment in the operation process and therapeutic regimen of immunosuppressant.

Objective To observe the impact of modified Liangge powder (MLP) on platelet activation markers and the release of proinflammatory cytokine in mice by stimulation of lipopolysaccharide (LPS). Methods 112 male mice were randomly divided into control group, model group and MLP low, middle and high dose treatment groups. The sepsis model was reproduced by injection of LPS 10 mg/kg into a mouse tail vein. In the control group, normal saline 10 mg/kg was injected into the tail vein of mouse. The MLP low, middle, and high dose groups received 0.94, 1.89, 2.84 g/mL MLP 0.02 mL/g by gavage respectively for 3 days, while the control group and model group received equal amount of normal saline by gavage for 3 days. After modeling for 24 hours and 72 hours, 8 mice in each of the three different dose MLP groups and model group were killed and their blood was taken. In the control group, after modeling for 24 hours, 8 mice were killed and their blood was taken. Platelet (PLT) was counted by blood cell analyzer, plasma interleukin-10 (IL-10), high mobility group protein B1 (HMGB1) and platelet factor 4 (PF4) were detected by enzyme-linked immunosorbent assay (ELISA). In each group after modeling for 72 hours, another 8 mice were taken, and laser scanning confocal microscopy was used to measure the platelet cytosolic Ca2+ concentration. Results Compared with the control group, the level of PLT at 24 hours(×109/L: 347.70±115.10 vs. 1 013.10±136.60) was decreased, and the levels of IL-10 (μg/L: 356.86±34.72 vs. 39.50±23.45), HMGB1 (mg/L: 16.24±4.49 vs. 10.75±1.91), PF4 (μg/L: 5.43±0.61 vs. 1.33±0.40) and Ca2+ (nmoL/L: 8.60±0.52 vs. 1.05±0.33) were elevated in model group. Compared with the model group, the levels of PLT in the MLP high, middle and low dose groups were all significantly elevated; the increase in PLT in middle dose group after modeling for 72 hours was the most remarkable (×109/L:952.13±104.02 vs. 771.50±129.30, P < 0.05); the levels of IL-10, HMGB1, PF4, Ca2+ in MLP low, middle, high dose groups were significantly decreased. The most obvious degree of decrease in level of the following indexes were as follows:IL-10 in MLP high dose group at 72 hours after modeling (μg/L:110.17±29.12 vs. 441.50±30.72), HMGB1 in MLP high dose group after modeling for 24 hours (mg/L: 10.33±3.52 vs. 16.24±4.49), PF4 in MLP middle dose group after modeling for 24 hours (μg/L:2.08±0.92 vs. 5.43±0.61) and Ca2+ in MLP high dose group (nmoL/L:2.97±0.96 vs. 8.60±0.52, all P<0.05). Conclusion MLP may possibly down-regulate the inflammatory cytokines release induced by LPS to inhibit the activation of platelet Ca2+, in turn prevent the activation of platelet and improve thrombocytopenia caused by LPS.

Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis.Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012.There were 13 males and 4 females aged 19-67 years (mean,40.9 years).Mean length of bone defect was 6.7 cm (range,2.0-18.5 cm).Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting.Clinical effect of the treatment was evaluated.Results Bone healing was detected at the 27-month follow-up (range,24-32 months).Radiographic healing was obtained 4-6 months after operation.Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement.External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change.There was one case of metal rejection,two function disorders,one clubfoot,and one ankle stiffness.Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis,especially in lone bone defect reconstruction,but limb functional complications are worth consideration during treatment.

Objective To investigate the effect of renal dysfunction on the prognosis of hospitalized patients with decompensated heart failure (DHF).Methods 191 patients with DHF hospitalized between June 2011 and June 2013 in Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled. These patients were divided into three groups according to the glomerular filtration rate (eGFR): normal renal function group (eGFR ≥ 90 mL·min-1·1.73 m-2, 63 cases), mild renal function descend group (eGFR 60 - 89 mL·min-1·1.73 m-2, 80 cases) and moderate or severe renal function descend group (eGFR < 60 mL·min-1·1.73 m-2, 48 cases). The general clinical data were recorded; the serum tumor necrosis factor-α (TNF-α) and interleukins (IL-1, IL-6, IL-8, IL-10, IL-13) were determined by enzyme-linked immunosorbent assay (ELISA). After discharge, the patients were followed-up for 1 year, and their outcomes were compared among the three groups.Results In 191 hospitalized patients with DHF, there were 67.0% with renal function impairment. Compared with normal renal function group and mild renal function descend group, the patients in moderate or severe renal function descend group were older (years: 83.4±5.1 vs. 66.2±5.4, 76.8±6.3), their cardiac functions were poorer, and their incidences of complications were higher than those in the normal renal function group [hypertension: 66.7% (32/48) vs. 42.9% (27/63), diabetes: 65.6% (31/48) vs. 41.3% (26/63), anemia: 37.5% (18/48) vs. 15.9% (10/63), acute myocardial infarction (AMI): 25.0% (12/48) vs. 9.5% (6/63), old myocardial infarction: 31.3% (15/48) vs. 11.1% (7/63), pulmonary infection: 29.2% (14/48) vs. 11.1% (7/63), allP < 0.05]. The complication incidences of hypertension [66.7% (32/48) vs. 51.3% (41/80)], diabetes [65.6% (31/48) vs. 48.8% (39/80)], anemia [37.5% (18/48) vs. 25.0% (20/80)] and pulmonary infection [29.2% (14/48) vs. 16.3% (13/80)] had no statistically significant differences between the moderate or severe renal function descend group and mild renal function descend group (allP > 0.05). The complication incidence of AMI [25.0% (12/48) vs. 10.0% (8/80)] and old myocardial infarction [31.3% (15/48) vs. 11.3% (9/80)] in moderate or severe renal function descend group was obviously higher than that in mild renal function descend group (bothP < 0.05). There were no statistically significant differences in the complication incidences of chronic obstructive pulmonary disease [COPD, 12.7% (8/63), 17.5% (14/80), 20.8% (10/48)], atrial fibrillation [30.2% (19/63), 27.5% (22/80), 29.2% (14/48)], ventricular premature beat [9.5% (6/63), 11.3% (9/80), 10.4% (5/48)] and cerebrovascular disease [20.6% (13/63), 22.5% (18/80), 22.9% (11/48)] among the three groups (allP > 0.05). Compared with normal renal function group, the levels of inflammatory cytokines in serum TNF-α, IL-1, IL-6, IL-8, IL-10, IL-13, and the mortality, the re-admission rates due to heart failure, rates of malignant arrhythmia in the two renal function descend groups were increased significantly, the increment being more remarkable in moderate or severe renal function descend group [TNF-α (ng/L): 235.8±20.9 vs. 121.6±10.7, IL-1 (ng/L): 345.9±40.8 vs. 203.5±34.7, IL-6 (ng/L): 502.8±64.2 vs. 321.9±53.8, IL-8 (ng/L): 723.9±210.3 vs. 431.5±110.5, IL-10 (ng/L): 155.4±23.5 vs. 103.1±13.2, IL-13 (ng/L): 184.5±27.3 vs. 136.8±20.2, the rate of mortality in the first time of hospitalization: 14.6% (7/48) vs. 5.0% (4/80), mortality within one year after discharge: 25.0% (12/48) vs. 18.0% (9/80), readmission rate due to heart failure: 47.9% (23/48) vs. 30.0% (24/80), rate of relapse of coronary events: 72.9% (35/48) vs. 37.5% (30/80), malignant arrhythmia rate: 39.6% (19/48) vs. 20.0% (16/80), allP < 0.05]. There were no significant differences in the rates of stroke among moderate or severe, mild and normal renal function descend groups [4.2% (2/48), 3.8% (3/80), 3.2% (2/63),P > 0.05].Conclusions The incidence of renal dysfunction in patients with DHF is relatively high, and their mortality, re-admission rate and their levels of inflammatory cytokines are high obviously. Thus, the intervention of renal dysfunction may have important significance in the improvement of their prognoses.

Long bone osteomyelitis often results from serious open fractures or some closed fractures.Its treatment is a clinical difficultly in orthopaedics.Masquelet is a new strategy for bone reconstruction,validated by surgeons in their treatment of acute bone loss,bone tumor and bone infection.It is carried out in 2 stages.At the first stage,infection was eliminated by radical debridement and placement of antibiotic bone cement into the defect,which induces a pseudomembrane to facilitate the growth of bone graft.At the second stage,reconstruction of the bone defect is performed by bone grafting in the membrance after removal of the bone cement.The unique characteristics of this technique arouse more and more attention recently.Therefore,we would like to present a review about this Masquelet technique dealing with post-traumatic osteomyelitis of long bones.

Objective To compare efficacy of procedure for prolapse and hemorrhoids (PPH) and rubber band ligation (RBL) in treatment of Ⅲ degree internal hemorrhoids.Methods One hundred patients with Ⅲ degree internal hemorrhoids were randomly divided into two groups and received PPH (42 cases) and RBL (58 cases) respectively.At once and after two weeks and two and six months the efficacy were compared.Results PPH and RBL were equally effective in controlling symptomatic prohpse (P>0.05),but RBL was associated with an increased incidence of recurrent bleeding (PPH 8/42 vs RBL 30/58,P<0.05);there was no difference in scores of patient satisfaction (P>0.05); PPH was associated with increased pain and analgesia usage at both at once and 2-week follow-up (P<0.05);the rate of complications in PPH was higber than in RBL (7/42 vs 0/58,P<0.05).Conclusion RBL can be used as treatment of first-line treatment of Ⅲ degree internal hemorrhoids.

Objective To analyze the colistin heteroresistance in Pseudomonas aeruginosa strains and their in vitro susceptibility to antibiotics used in combination.Methods Two hundred and ninety-seven carbapenem-resistant Pseudomonas aeruginosa strains were selected for this study.Broth microdilution method was used to determine the minimum inhibitory concentrations of colistin and other antimicrobials against the Pseudomonas aeruginosa strains.The colistin heterogeneity of 20 colistin sensitive strains was analyzed by using population analysis profiles.The time-kill curves of 3 randomly selected colistin heteroresistant strains were used to determine the bacteriostatic activity of colistin.Chequer-board method was used to measure the combination efficacy of colistin with other antimicrobials including imipenem,meropenem,biapenem,ceftazidime,levofloxcin,piperacillin/tazobactam and cefoperazone/sulbactam.Results The colistin sensitive Pseudomonas aeruginosa strains accounted for 99.66％ of the 297 isolates.Population analysis profiles displayed that 35％ of the 20 isolates were colistin heteroresistant and 20％ of the 20 isolates were heterogeneous.It showed that when colistin was used in combination with other drugs,they mainly had synergistic and additive effects on heteroresistant isolates,but additive and indifferent effects on non-heterogeneous isolates.Conclusion Multidrug resistant Pseudomonas aeruginosa strains were highly susceptible to colistin,but heteroresistant and heterogeneous strains were common.The efficacy of colistin against heteroresistant isolates could be enhanced by using in combination with other drugs.

Objective To investigate the expression of astrocyte elevated gene -1( AEG-1) and matrix metallopeptidase 9(MMP-9)in colorectal tissues and evaluate its correlation with clinical pathologic factors of colorectal cancer.Methods AEG-1 and MMP-9 expression in normal colorectal mucous (n=45),low-grade adenoma(n=31),high-grade adenoma(n=15)and colorectal carcinoma(n=146)were examined by immuno-histochemistry .Statistical analyses were applied to test the significance of its expression .Results AEG-1 ex-pression levels were gradually elevated in normal tissues ,low-grade adenoma ,high-grade adenoma and colorec-tal carcinoma respectively .Furthermore ,there was a similar trend for MMP -9from normal mucous to adenoma and carcinoma .Statistical analysis revealed that AEG -1 expression was markedly correlated with the UICC stage,T classification,N classification,M classification,and histological differentiation in the colorectal cancer pa-tients,but not with age,gender,tumor location and tumor size.In addition,AEG-1 expression was positively cor-related with the MMP-9 expression in colorectal cancer .Besides,those patients with high AEG-1 and MMP-9 levels had shorter survival time ( P<0 .05 ) .Conclusion AEG-1 may be involved in carcinogenesis and pro-gression of colorectal carcinoma and can be a novel prognostic biomarker in patients with colorectal carcinoma .