Objectives To study the effect and the mechanism of peripheral blood nuclear cells (PBMC) invaded by hepatitis B virus (HBV) on the artificial immunization in newborns Methods Fifty two newborns, whose mothers were hepatitis B surface antigen (HBsAg) positive, were immunized with hepatitis B immunoglobulin and hepatitis B vaccine (HBVac), and then followed for 7 months The newborns′ serum and PBMC HBV DNA was detected by nested PCR, hepatitis B surface antibody (HBsAb) was tested with solid phase radioimmunoassay PBMC from newborn were incubated with PHA and HBsAg The supernatant interleukin 2 (IL 2) level was mesured by enzyme linked immununosorbent assay (ELISA) Results The rate of vaccination failure was higher in the infants with PBMC HBV DNA positive than those with negative ( P

Objective To investigate the surgical method and clinical curative results of acetabulum top compression fractures with sea gull sign. Methods Data of 14 patients who had acetabulum top compression fractures with sea gull sign were retrospectively analyzed and were accepted surgical therapy and followed up. There were 5 females and 9 males, aged from 28 to 71 years (average, 49.9 years). The pre-operative time was from 4 to 14 days (average, 9 days). Letournel-Judet fracture classifica-tion:eight cases for the anterior column+posterior semi-transverse, six cases for a simple anterior column. Three patients with lum-bar compression fracture, two patients with tibial plateau fracture, one patient with multiple rib fractures. All patients were accept-ed open reduction and bone graft and internal fixation through ilioinguinal approach or ilioinguinal approach+Kocher-Langenbeck approach. The quality of fracture reduction was assessed according to the Matta reduction criterion after operation. The hip func-tion was evaluated according to Matta. Results 14 patients were followed up from 6 to 60 months (average, 36 months). All pa-tients reached bone healing;healing time was from 3 months to 4 months (average, 3.4 months). According to the Matta reset stan-dard after operation, there were 6 excellent cases, 5 good cases, 2 fair cases, 1 poor case, the excellent and good rate was 78.5%(11/14). The Matta was from 10 to 18 scores (average, 16.4 scores), 5 excellent cases, 5 good cases, 3 fair cases, 1 poor case, the ex-cellent and good rate was 71.4%(10/14). Traumatic arthritis occurred in 3 patients. Pain was serious in two patients and disap-peared after total hip joint replacement. Pain was mild for one patient and disappeared after accepted non steroidal painkiller. One patient had heterotopic ossification after operation, which was not treatmented because of no obvious symptom. Conclusion The appropriate operation time of acetabular roof compression fracture with sea gull sign was from 5 to 10 days after fracture, which was no more than two weeks had best. Through ilioinguinal approach or ilioinguinal approach+Kocher-Langenbeck approach, the articular surface could be reduced excellent and got sufficient bone graft. The clinical efficacy was satisfactory after operation.

Objective To study on bioactive chemical compounds against ultraviolet irradiation in antarctic ice microalgae.Methods Four kinds of Antarctic ice microalgae were cultured under the conditions of low temperature,illumination,UV-A and UV-B irradiation.The chemical compounds were extracted by methanol and analyzed by spectrophotometer and HPLC/MS.The molecular structures were elucidated according to these data.The chemical compounds were irradated by sunshine to observe the speed of degradation and to estimate the bioactivity.Results There were five active compounds in Chlorophyceae L-4 and 7 active compounds in Diatom HF-9,in which 6 compounds belong to MAAs(mycosporine-like amino acids) and were of more bioactivity against ultraviolet irradiation.Conclusion MAAs from of Antarctic ice microalgae play an important role in resisting ultraviolet irradiation.

OBJECTIVETo study the effect and mechanism of the peripheral blood mononuclear cell (PBMC) invasion by HBV on artificial immunization in newborns.

METHODSFifty-two newborns of HBsAg positive mothers were immunized with HBIG (hepatitis B immunoglobulin) and HBVac (hepatitis B vaccine) and were followed up for 7 months. The newborns' HBV-DNA in serum and in the PBMCs was detected with nested-PCR; anti-HBs was tested with solid phase radioimmunoassay (SP-RIA). PBMCs isolated from newborn peripheral blood were incubated in the presence of PHA or purified HBsAg. Interleukin-2 (IL-2) level in culture supernatants of activated cells was detected by ELISA.

RESULTSThe failure rate of immunization was higher in infants with positive HBV-DNA in PBMCs than those with negative HBV-DNA (P < 0.05); IL-2 level in PBMC culture supernatants was lower in former than in the latter and in normal controls (P < 0.05). The level of IL-2 in the immunization failure newborns was lower than that in the successfully immunized newborns and in normal controls (P < 0.05).

CONCLUSIONSIntrauterine invasion of PBMCs by HBV is one of the important reasons for immunization failure in newborns. IL-2 production is closely related to the invasion of PBMCs by HBV, which may contribute to the failure of artificial immunization in newborns.

DNA, Viral ; blood ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B Vaccines ; adverse effects ; Hepatitis B virus ; isolation & purification ; physiology ; Humans ; Immunization ; adverse effects ; Immunoglobulins ; immunology ; Infant, Newborn ; Interleukin-2 ; biosynthesis ; blood ; Leukocytes, Mononuclear ; virology

Objective:To investigate the clinical effects of lacunar closure-assisted internal fixation in the one-stage treatment of Morel-Lavallée injury complicated with pelvic fracture.Methods:The 32 patients were retrospectively analyzed who had been treated for Morel-Lavallée injury complicated with pelvic fracture at Department of Orthopedic Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University from May 2018 to November 2020. They were 21 males and 11 females, aged from 18 to 58 years (average, 40.5 years). The injury was located at a unilateral hip in 20 cases, at bilateral hips in 6 cases, at low back in 4 cases, and at posterior thigh in 2 cases. The pelvic fractures were treated by open reduction and internal fixation while the Morel-Lavallée injuries by lacunar closure at the same time. Their wound healing, pelvic function and complications were observed regularly.Results:The hospital stay of 32 patients ranged from 14 to 28 days, averaging 19.2 days. The patients were followed up for 6 to 18 months (mean, 9.3 months). The area of Morel-Lavallée injury healed after one lacunar closure in 23 patients who obtained fine skin survival and no soft tissue necrosis or other complications; the wounds in the Morel-Lavallée injury area healed well after secondary lacunae closure in 4 patients. Superficial sensation of the skin decreased around the Morel-Lavallée injury area after wound healing in 3 patients. Wound fat liquefaction was found in the Morel-Lavallée injury area but responded to symptomatic treatment in one patient. A small amount of wound secretion found in the Morel-Lavallée injury area was cured also by symptomatic treatment in another patient whose bacterial culture was negative. All the fractures healed after 3 to 6 months (average, 3.9 months). At the last follow-up, the Majeed scores for the pelvic function ranged from 65 to 100 points, averaging 84.5 points.Conclusion:For Morel-Lavallée injury complicated with pelvic fracture, lacunar closure-assisted internal fixation can result in a satisfactory one-stage treatment.

Objective:To investigate the influential factors of patients' expectations for clinical decision-making during digestive endoscopy.Methods:A total of 120 patients who underwent digestive endoscopy were admitted to the Endoscopy Center of Zhejiang Provincial People's Hospital from January 2020 to January 2022. Their general information was collected, and their clinical decision-making expectations were evaluated using the Control Preference Scale (CPS). The influential factors of clinical decision-making expectations were determined using multiple linear regression analysis.Results:The total CPS score for 120 patients undergoing digestive endoscopy was (50.72 ± 5.48) points, including (14.12 ± 1.48) points for information needs, (25.17 ± 3.52) points for communication needs, and (11.43 ± 2.04) points for decision-making needs. Univariate analysis showed that the CPS score of patients undergoing digestive endoscopy was related to gender, age, marital status, educational level, number of children, and type of visit ( t = 2.68, 2.61, 2.82, 3.28, 3.61, 2.39, all P < 0.05). Multiple linear regression analysis showed that gender, age, educational level, and type of visit were the influential factors of clinical decision-making expectations for patients undergoing digestive endoscopy ( β = -0.71, 1.07, 0.53, -1.15, all P < 0.05). Conclusion:Gender, age, educational level, and type of visit are influential factors of patients' expectations for clinical decision-making during digestive endoscopy. Patients have a clear need for communication during clinical decision-making, and medical staff can strengthen communication with patients, correctly guiding them to participate in clinical decision-making expectations.

Objective To evaluate the clinical outcomes in patients with both column acetabular fractures involvement posterior wall using lag screw through single ilioinguinal approach.Methods Between August 2008 to August 2014,35 consecutive patients with both columns acetabular fractures and fracture also involved posterior wall and fixed by lag screws were retrospectively analyzed.There were 25 males and 10 females.The average age was 44.4+ 12.5 years (range,18-72 years).According to Letournel classifications,the acetabular fracture involved both columns and posterior wall in all cases,and 2 cases with additional seagull sign.The surgeon reduced posterior wall by pressing the fragment through a small tunnel in the soft tissue leaning against the external cortex of iliac bone and fixed the fragment using lag screws from the anterior side.Clinical and functional outcomes were assessed using the modified Merle d'Aubigné scoring system.Radiographic results were evaluated based on Matta scoring system.Results The patients were follow for an average of 44.7+ 18.9 months (range,24-96 months).The average operative time was 257.7±60.4 min (range,160-490 min).The average blood loss during the operating was 742.9±+614.5 ml (range,300-4 000 ml).Loss of reduction of the posterior wall was not found in any case.At the latest follow-up,radiographic results were excellent in 11,good in 19,and poor in 5.The average modified Merle d'Aubigné score was 16.4 (range,13-18).There were 8 cases of excellent,23 cases of good,and 4 cases of fair.Four patients developed deep venous thrombosis of the lower extremities after 3-4 days of operation.Warfarin was used for anticoagulation therapy and thrombi disappeared 6 months postoperatively.One case had superficial wound infection and was treat with vacuum sealed drainage (VSD) and anti-infection therapy.The incision healed without infection after one month.One case with poor quality of reduction and remaining seagull sign was treated with total hip arthroplasty after 35 months because of severe traumatic arthritis.The total reoperation rate was 5.7％ (2/35).latrogenic sciatic nerve injury as well as heterotopic ossification was not found in any case.Conclusion Satisfactory quality of reduction and good clinical outcomes can be achieved in patients with acetabular fractures involved both columns and posterior wall by single ilioinguinal approach and lag screw fixation for posterior wall.Iatrogenic sciatic nerve injury as well as heterotopic ossification was not found in any case.

OBJECTIVETo assess the value of ultrasonic radio frequency analysis technique for noninvasively evaluation of carotid artery intima-media thickness (IMT) and elasticity in patients with dyslipidemia.

METHODSRadio frequency quality intima-media thickness (RFQIMT) technique and radio frequency quality arterial stiffness ((RF)QAS) technique were used for measurement of IMT and pulse wave velocity (PWV) of the left carotid artery in 86 patients with dyslipidemia and 60 healthy volunteers.

RESULTSApart from the patients' age, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fasting blood glucose, IMT and PWV differed significantly between the control and case groups. IMT was positively correlated with PWV (r=0.521, P<0.05). In patients with IMT<1.0 mm (n=81), PWV differed significantly between patients with different number of other atherogenic risk factors (P=0.004), but IMT showed no such variation (P=0.079). In patients with more than 3 and those with 2 other risk factors, PWV increased significantly as compared with those with one risk factor (P=0.002). Multiple linear regression analysis showed that systolic blood pressure, age and fasting blood glucose were independently associated with PWV.

CONCLUSIONUltrasonic radio frequency analysis technique allows accurate measurement of IMT and arterial elasticity, and may thus become a valuable method for evaluating early structural and arterial functional change of the carotid artery.

Adolescent ; Adult ; Aged ; Carotid Arteries ; diagnostic imaging ; physiopathology ; Carotid Intima-Media Thickness ; Case-Control Studies ; Dyslipidemias ; diagnostic imaging ; physiopathology ; Elasticity ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To evaluate the clinical outcomes of ilioinguinal approach with short infrapectineal buttress plate fixing posterior column for patients with complex acetabular fractures. Methods Data of 29 consecutive patients (male 22, fe?male 7, age range 25-72 years, average age 53 ± 6.3 years) with complex acetabular who had operated by single ilioinguinal ap?proach with infrapectineal buttress plate from September 2008 to August 2012 were retrospectively analyzed. According to Letour?nel?Judet classifications, there were 4 cases of anterior column and posterior hemi?transverse, 11 cases of associated both?column, 4 of T?shaped and 6 with seagull sign. The acetabular fractures model was printed preoperatively by 3D printing technique for sur?gical simulation, open reduction and internal fixation through single ilioinguinal approach with a short infrapectineal plate fixing posterior column, particularly an ox horn shape K?wire sleeve was developed for drilling and screw insertion using flexible screw?driver. Clinical, radiographic, and functional outcomes assessed by the modified Merle d’Aubigné score were collected. Results Two patients were lost to follow?up, including one patient who died at 15 days postoperative because of pulmonary embolism, and the other one who had moved abroad at 12 months postoperative. The remaining 27 (93%) had a mean follow?up of 40 months (range, 24-75 months). The operating time was 180±35.5 min;the time for the fracture union was 3.5±0.9 month;blood loss during the operating was 500±43.9 ml;no case had fracture re?displacement. At the latest follow?up, radiographic grades were excellent in 17, good in 8, poor in 4, including one poor patient who had a total hip arthroplasty (3%) at 35 months after the internal fixation. The average modified Merle d’Aubigné score was 16 (range, 10-18), and categorized as excellent in 12, good in 8, fair in 5, and poor in 2. Three patients had developed deep venous thrombosis of the lower extremities, and one of them died of pulmonary embo?lism 15 days after operation; two cases of deep venous thrombosis of the lower extremity were found 3-4 days after operation. Thrombosis disappeared 6 months after anticoagulant therapy by warfarin. One case who had superficial wound infection after oper?ation was treated by anti?infection and VSD negative pressure, and incision was healed after one month. One case with poor quality of fracture reduction and seagull sign was treated with total hip arthroplasty after 35 months because of traumatic arthritis. The to?tal complication rate was 24%(7/29). Conclusion In the patient with complex acetabular fractures combining posterior column medial displacement, single Ilioinguinal approach with infrapectineal buttress plates could achieve a stable concentric hip joint, and immediate postoperative ambulation can result in reasonable clinical, radiographic, and functional outcomes.

Objective To assess the value of ultrasonic radio frequency analysis technique for noninvasively evaluation of carotid artery intima-media thickness (IMT) and elasticity in patients with dyslipidemia. Methods Radio frequency quality intima-media thickness (RFQIMT) technique and radio frequency quality arterial stiffness (RFQAS) technique were used for measurement of IMT and pulse wave velocity (PWV) of the left carotid artery in 86 patients with dyslipidemia and 60 healthy volunteers. Results Apart from the patients' age, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, fasting blood glucose, IMT and PWV differed significantly between the control and case groups. IMT was positively correlated with PWV (r=0.521, P<0.05). In patients with IMT<1.0 mm (n=81), PWV differed significantly between patients with different number of other atherogenic risk factors (P=0.004), but IMT showed no such variation (P=0.079). In patients with more than 3 and those with 2 other risk factors, PWV increased significantly as compared with those with one risk factor (P=0.002). Multiple linear regression analysis showed that systolic blood pressure, age and fasting blood glucose were independently associated with PWV. Conclusion Ultrasonic radio frequency analysis technique allows accurate measurement of IMT and arterial elasticity, and may thus become a valuable method for evaluating early structural and arterial functional change of the carotid artery.