Pelvic fractures are high energy injuries involving severe trauma and potential intra pelvic bleeding. Immediate control of hemorrhage, fixation of pelvic fractures and inter department cooperation are important for their treatment. Transcatheter angiographic embolization can be used to identify bleeding sites, control hemorrhage and improve mortality and complications, and it has been proved to be a valuable technique in the diagnosis and treatment of pelvic vascular injuries. Still there is a considerable controversy on the fracture patterns, the sequence and the timing of emergency angiography and possible embolization in these patients. In this paper, we reviewed the role of angiographic embolization and we thought more attention should be paid on angiographic embolization in the control of hemorrhage.

Objective To investigate the risk factors associated with gastroparesis syndrome after laparoscopic pancreatoduodenectomy which provide reference for clinical prevention.Methods Ninety cases of laparoscopic pancreatoduodenectomy admitted from August 2013 to December 2016 in Traditional Chinese Medicine Hospital of Guangdong Province were studied retrospectively,57 were male(63.3%),the average age was 54.6 years old.Twenty cases were diagnosed postoparative gastroparesis syndrome(22.2%).To screen out the risk factors,31 independent variables were analyzed by univariate analysis and logistic regression.Results Univariate analysis showed that malnutrition,hypoproteinemia,anemia,pylorus-preserving,extensive lymph nodes dissection,anxiety,high blood sugar before operation,delay of enteral nutrition,abdominal infection and postoperative high blood sugar were associated with postoperative gastroparesis(The value of OR were 3.143,3.587,2.852,2.889,3.231,7.071,2.889,5.359,6.000,6.263,P<0.05).Multivariate Logistic regression analysis showed that extensive lymph nodes dissection,anxiety,pylorus-preserving,abdominal infection,delay of enteral nutrition,hypoproteinemia,postoperative high blood sugar were risk factors of postoperative gastroparesis(The value of OR were 17.574,8.931,6.637,6.461,6.446,5.414,5.200;P<0.05).Conclusion Multiple risk factors can lead to gastroparesis after laparoscopic pancreatoduodenectomy,measures should be taken aimed at these risk factors during perioperative period.

ObjectiveTo study the effect of anterior decompression and autograft fusion under video-assisted thoracoscopic to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.MethodsEleven patients who suffered from lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury were treated with anterior decompression and autograft fusion under video-assisted thoracoscopic from December 2005 to May 2008.The involved vertebrae included T12 in 5cases,T11 in 4 cases,T10 in 1 case and Ts in 1 case.According to the AO classification,4 patients were A2.2and 7 were A3.According to the Frankel classification,5 patients were rated as grade A,2 as grade C,2 as grade D and 2 as grade E.ResultsEvery patient underwent successful operation.The operation time was 3.5-8 h(average,5.2±1.6).The blood loss was 600-3800 ml(average,1195±576).One patient got intercostal neuralgia after operation,which disappeared after treating with analgesic drugs for 7 days.All patients were followed up for 36-65 months (average,49.5±5.9).All patients got bony fusion according to the CT scans 24month after operation.There were no neurological function deterioration and other instrument complications happened.At the last follow-up,5 patients were rated as grade A,2 as grade D and 4 as grade E,according to the Frankel classification.ConclusionAnterior decompression and autograft fusion under video-assisted thoracoscopic is an effective method to treat lower thoracic vertebrae bursting fracture complicated with intervertebral disc injury.However,this method needs higher technology and has a long study-curve.

Objective To clarify whether the Cosmc gene down-regnhtion in lgA nephropathy (IgAN) patients is resulted from genetic disorders or external suppressions. Methods Forty IgAN patients, 16 non-IgAN glomerulonephritis patients and 21 healthy controls were enrolled in the study. Genomie DNA was extracted and then Cosmc gene was amplified and sequenced. Peripheral B lymphoeytes were isolated and cultured with RPMI-1640 alone or plus lipopolysaecharide (LPS). The Cosmc mRNA expression levels at baseline, after RPMI-1640 culture or RPMI-1640+LPS treatment were measured respectively by real-time RT-PCR. Results (1) Only 2 missense mutations and 2 silent mutations were detected in coding frame region of Cosine gene in 2 IgAN patients. (2) The baseline Cosmc gene expression level was significantly lower in IgAN patients (31% of that in healthy controls) than that in healthy controls. (3) Relative quantification PCR indicated that Cosmc mRNA expression level was significantly increased (219% of baseline) after RPMI-1640 culture, and treatment of LPS could strongly inhibit this effect. (4) The Cosmc gene expression of healthy control was not affected by RPMI-1640 or LPS. Conclusion It is not genetic disorders but external suppression to cause the down-regulation of Cosmc gene mRNA expression in IgAN.

Objective To analyze the clinical effect of pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique. Methods A total of 21 patients with multi-segmental lumbar fracture and dislocation were selected from November 2012 to November 2013. Before the screw implantation, the structure of bilateral pedicle was observed through Mimics software and the implantation parameters were measured. The position of pedicle screws by postoperative CT scan, operation time, and the satisfaction of the patients were assessed. The percentages of anterior vertebral height and Cobb′s angle were measured before operation, 2 weeks and 8 months after operation. Results All patients were satisfied with informed consent score and the way of pedicle screw and the selection of plant were more reasonable. With better screw position, shorter operative time and less blood loss and adverse reactions, pedicle screw fixation achieved good effect. Conclusion With high security and considerable clinical value, pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique has exact and good effecct.

Objective To investigate the treatment effects of Kansui root on severe acute pancreatitis (SAP) with abdominal compartment syndrome (ACS).Methods 16 cases of SAP were randomly divided into kansui root treatment group and control group according to random number table.Patients in control group received routine treatment including fasting, anti-shock, antibiotics and nutritional support.And the patients in kansui root group received routine treatment plus kansui root therapy.The clinical and laboratory parameters were determined and compared between the two groups.Results The relieving time of abdominal pain, bowel sound, the recovery time of hyperamylasemia, body temperature and leukocyte count in treatment group was (7.6±2.3)d, (6.1 ±3.1)d, (5.9±3.3)d, (5.2 ±3.2) d, (6.3 ±2.1)d, which were significantly shorter than those in control group [ ( 11.7 ± 2.1 ) d, ( 11.2 ± 2.3d, ( 10.2 ± 2.7) d, (9.2 ± 3.5 ) d, ( 11.1 ±3.3)d, P＜0.01 ) ].At the 3rd, 4th and 5th day, the intra-abdominal pressure in treatment group were also significantly lower than those in control group[ ( 19.8 ±3.1 )cmH2O vs(23.7 ±2.9) cmH2O, ( 12.3 ±2.7) cmH2O vs (21.3±1.5)cmH2O,(8.2±3.1)cmH2O vs (17.3 ±2.3)cmH2O,P＜0.05].Conclusions Severe acute pancreatitis has close relationship with Jiexiong syndrome in traditional chinese medicine.Kansui root is an effective therapy for alleviating high intra-abdominal pressure.

Objective To establish rSAG1-IgM-ELISA with purified rSAG1 fusion protein for immunodiagnosis of toxoplasmosis. Methods The rSAG1 fusion protein was purified by Ni 2+ column. The ELISA plate was coated with different concentrations of rSAG1, reacted with pooled positive and negtive human sera. Goat anti-human IgM conjugated to horseradish peroxidase was used as the second antibody. The appropriate detecting condition of the rSAG1-IgM-ELISA assay was determined by orthogonal experiment. The reproducibility, sensitivity and specificity of the assay were assessed. Thirty-five IgM-positive and 57 IgM-negative human sera detected by the imported IgM-ELISA kit were detected with the rSAG1-IgM-ELISA. Results The purity of rSAG1 was above 90%. The appropriate detecting condition was that the coated rSAG1 was 2 5 ?g/ml, the human serum was in 1∶100 dilution, and the second antibody was in 1∶4000 dilution. The coefficient of variation (CV) value of IgM-positive and IgM-negative pooled sera were 13 8% and 7 7% respectively. The inhibition rate of the assay was 62 0% The positive correspondence rate and negative correspondence rate were 82 9% (29/35) and 91 2% (52/57) respectively,the total correspondence rate was 88 0%, compared with the imported IgM-ELISA kit. Conclusions The rSAG1-IgM-ELISA has high sensitivity and specificity, and good correspondence rate with the imported IgM-ELISA kit. It indicates that rSAG1-IgM-ELISA has potential value for early diagnosis of toxoplasmosis.

OBJECTIVETo develop a novel vaccine by immobilizing interleukin-21 (IL-21) on the surface of MB49 cells and evaluate its effect in inducing specific cytotoxic T lymphocytes (CTLs) and antitumor immunity in a mouse model of subcutaneous metastatic bladder cancer.

METHODSSA-IL-21 was immobilized on the surface of 30% ethanol-fixed MB49 cells to prepare the cell vaccine. C57BL/6 mice with subcutaneous implantation of MB49 bladder cancer cells were randomized into 5 groups to receive treatments with IL-21/MB49 vaccine, soluble IL-21, GFP surface-modified MB49 cells, ethanol-fixed MB49 cells, or PBS. The tumor growth and CTL were examined to assess the antitumor efficacy of the vaccine.

RESULTSIL-21 surface-modified MB49 cell vaccine significantly inhibited the tumor growth and generated a long-lasting memory response (P<0.05). At the same effector-target (E:T) ratio, the specific CTLs induced by IL-21/MB49 vaccine showed the most potent cytotoxicity against MB49 cells (P<0.05).

CONCLUSIONWith the protein-anchor technique, IL-21 can be efficiently immobilized on the surface of MB49 cells to prepare IL-21/MB49 cells vaccine. The novel vaccine can maintain its biological activity and significantly enhance the cytotoxicity of CTLs against bladder cancer cells.

Amino Acid Motifs ; Animals ; Cancer Vaccines ; therapeutic use ; Cell Line, Tumor ; Female ; Immunotherapy ; Interleukins ; immunology ; Lymphocyte Activation ; Mice ; Mice, Inbred C57BL ; Neoplasm Metastasis ; Neoplasms, Experimental ; therapy ; T-Lymphocytes, Cytotoxic ; immunology ; Urinary Bladder Neoplasms ; therapy