Objective To evaluate the cardiopulmonary allograft function and to analyze key factors for long-term survival of heart-lung transplantation in a patient survived more than 5 years. Methods On December 17th, 2003 at Zhongshan Hospital of Fudan University, a homologous heart-lung transplantation was performed on a female who diagnosed with cardiopulmonary failure secondary to congenital atrial septal defect with severe pulmonary hypertension. Heart-lung allograft was preserved with 1 000 mL UW solution and 4 000 mL HTK solution.Postoperative immunosuppressive therapies were managed with Zenapax, cyclosporine A (or tacrolimus), mycophenolate mofetil and corticosteroids. Cyclosporine A maintained with serum trough levels of 100-200 μg/L and tacrolimus with serum trough levels of 8-20 μg/L. Cardiopulmonary allograft functions were evaluated by echocardiogram, pulmonary function test and thoracic CT periodically. Results The patient survived operation and experienced normal daily life with NYHA cardiac function of class Ⅰ-Ⅱ during the follow-up of 5 years and 6 months. Echocardiogram showed left ventricular ejection fraction of 65% to 86%. Pulmonary function test exhibited with nearly normal oxygen exchange, meanwhile, small airway obstruction was detected from one year after operation and keeping stable from then on. Two episodes of severe pneumonia were complicated and treated with antibiotics and fhconazob, no severe acute allograft rejection episode was experienced. Conclusions Heart-lung transplantation proves to be a reliable therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation, accurate balance of the risk between acute allograft rejection and infection, and strict preventive measures against infection are key factors for long-term survival of heart-lung transplantation.

BACKGROUND: Traditional scaphotrapeziotrapezoid limited intercarpal arthrodesis contains Kirschner wire, U-shaped nail, AO/ASIF steel plate and so on. Long-term plaster external fixation was needed following surgery. USA-designed arthrodesis apparatus is mainly suitable for European and people from USA, but not fit for Asian.OBJECTIVE: To simulate scaphotrapeziotrapezoid limited intercarpal arthrodesis, and to test the stability of the novel arthrodesis apparatus developed by the group according to anatomic form of dorsal joint fovea of Chinese scaphotrapeziotrapezoid.DESIGN, TIME AND SETTING: The observational study was performed at the Laboratory of Biomechanics of the Department of Orthopaedics, Nantong University from April 2006 to March 2007.MATERIALS: A total of 40 fresh forearm samples of corpses that were not subjected to antiseptic treatment were used for this study. Radiograph verified that these samples did not develop wrist joint affection or abnormal alinement.METHODS: The cadaver models were imitated limited intercarpal instability before scaphotrapeziotrapezoid arthrodesis used circular plate. Then, simulated flexion 50°, extenion 35°, ulnar deviation 30°, radial deviation 10° ultimate activities (50000).CT scan and 3-D reconstruction should be taken before and after motion.MAIN OUTCOME MEASURES: The index of the radial-scapho angle (RSA), radial-scapho distance (RSD), scapho length(SL), trapezium-trapezoid inclination (TTI), trapezium-trapezoid width (TTW) were measured.RESULTS: Prior to motion RSA, RSD, SL, TTW and TTI were (38.725±2.230) °, (18.988±1.216) mm, (1.686±0.191) cm,(27.360±1.571) mm and (114.975±2.293) °. Following motion RSA, RSD, SL, TTW and TTI were (38.800±2.388) °,(19.215±1.443) mm, (1.683±0.209) cm, (27.718±1.910) mm, (115.300±3.023) °. No significant difference in above-described indexes was determined before and after motion (P > 0.05).CONCLUSION: The novel STT limited intercarpal arthrodesis apparatus shows confidential stability. Thus, wrist joint can do exercises in an early stage at the range of 35 dorsal extension, 50 palmar flexion, 10 radial deviation and 30 ulnar deviation.

With the rapid development of medical genetics,online Medelian inheritance in man (OMIM) manifests a more and more important role in medical genetics teaching.Using the educational form combining ‘ classroom teaching,review writing and seminar’,‘ Query and use of OMIM ’was introduced into the education of medical genetics.Reality practice revealed that this educational practice maintained advanced and timely status of knowledge and deeply activated self-studying and independent thinking ability of students.

OBJECTIVETo explore the effects of CXCR7 knock-down by CXCR7-shRNA lentiviral vector on the proliferation and invasion of human hepatoma carcinoma cells in vitro.

METHODSCXCR7-shRNA lentiviral vector was transfected into hepatocellular carcinoma HCCLM3 cells. The changes in mRNA and protein expression of CXCR7 in the transfected cells were investigated using real-time PCR and Western blotting, respectively, and MTT assay was employed to assess the cell proliferation changes. In vitro adhesion assay and transwell chamber test were used to observe the adhesion and invasiveness of HCCLM3 cells, respectively.

RESULTSTransfection of HCCLM3 cells with CXCR7-shRNA lentiviral vector resulted in a significantly decreased expression of CXCR7 at both mRNA and protein levels (P<0.01) and obvious suppression of the cell proliferative activity (P<0.05). CXCR7-shRNA also significantly suppressed the invasiveness and adhesion of HCCLM3 cells (P<0.01).

CONCLUSIONCXCR7 knock-down can significantly inhibit the proliferation and invasiveness of human hepatoma carcinoma cells in vitro, suggesting the value of CXCR7 as a potential target for hepatoma carcinoma therapy.

Carcinoma, Hepatocellular ; genetics ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Humans ; Lentivirus ; genetics ; Liver Neoplasms ; genetics ; pathology ; RNA, Small Interfering ; genetics ; Receptors, CXCR ; genetics ; Transfection

Objective To investigate the clinical effect of dual incision and dual plate internal fixation for the treatment of tibial plateau fractures in the elderly and its impact on knee joint function.Methods Using retrospective analysis method,103 elderly patients with tibial plateau fractures admitted to Rugao Hospital affiliated to Nantong University from April 2015 to May 2021 were selected for clinical research.According to the surgical method,they were divided into two groups,52 patients in the study group were treated with double incision double plates,and 51 patients in the control group were treated with locking plate internal fixation.Perioperative indicators,knee function,knee stability Knee joint complications.Results The hospitalization time of the study group was(7.8±2.0)days,and that of the control group was(10.0±2.4)days,and the difference was statistically significant between the two groups(P＜0.05).The HSS scores at 3 months,6 months and 12 months were(66.9±5.4),(78.4±6.6)and(83.8±6.1)in the study group,and(64.2±6.1),(74.0±7.3)and(82.0±6.8)in the control group,respectively.There was statistical significance in HSS scores 3 months and 6 months after operation between the two groups(P＜0.05).The tibial migration distance 3 months after operation was(2.54±0.50)mm in the study group and(2.84±0.67)mm in the control group,and the difference was statistically significant(P＜0.05).The knee posterior inclination angles of the study group were(4.12±1.10)°,(5.03±0.96)° and(5.46±1.52)° at 3 months,6 months and 12 months after surgery,respectively,while those of the control group were(6.11±1.43)°,(6.67±1.54)° and(7.50±1.88)°,respectively.The difference was statistically significant(P＜0.05).The activity of the study group at 3 months and 6 months after surgery was(104.3±8.2)° and(117.4±7.6)°,respectively,while that of the control group was(96.8±8.9)° and(111.8±8.2)°,and the difference was statistically significant(P＜0.05).There were 3 cases of postoperative complications in the study group and 10 cases in the control group,and the difference was statistically significant(P＜0.05).Conclusion The clinical effect of dual incision and dual plate internal fixation in the treatment of tibial plateau fractures in the elderly is affirmative,which is more beneficial for promoting early recovery of knee function and maintaining stability of knee function than locking plate internal fixation.

OBJECTIVE：To improve the quality standard of M ongolian med icine Artemisia sacrorum ，and to provide scientific basis for comprehensive quality evaluation. METHODS ：The appearance and microscopic characteristics of A. sacrorum were identified；scopoletin，chlorogenic acid ，caffeic acid ，scopoletin and 3，5-dicaffeoylquinic acid were identified quantitatively by TLC；the contents of above 5 components were determined by HPLC. The water content ，total ash and extract were examined. RESULTS：The stem of A. sacrorum was cylindrical ，and its surface was purple or purple-brown or cyan-brown ；the leaves were ovate or oblong-ovate ，fragrant；the flowers were yellow ，head-shaped，subglobose or hemispherical. The powder was green or yellow-green，its pollen grain had three germination ；the parenchymal cell clusters with sharp edges and numerous threaded ducts ， occasionally having marginal pitted ducts ；its wood fibers were in bundles mostly. Results of TLC showed that the spots of the same color were found in the corresponding positions of chromatogram for 5 substance control and samples. The linear range of scopoletin， chlorogenic acid ， caffeic acid ， scopolactone and 3，5-dicaffeoylquinic acid were 85.60-428.00， 10.16-101.60， 10.20-102.00，40.84-408.40 and 40.80-408.00 μg/mL（all r＞0.999 0）. RSDs of precision ，stability，repeatability tests were all less than 3.00％（n＝6）. The average recoveries were 103.07％，99.66％，98.37％，97.78％，98.40％（all RSDs ＜3.00％，n＝6）. The contents of the above-mentioned 5 compounds in 10 batches of samples were 0.36％-1.23％，0.09％-0.51％，0.04％-0.13％， 0.61％ -1.13％ ，0.12％ -1.11％ ，respectively；the average com contents of water ，total ash and water soluble extract were 6.25％，5.86％，26.50％，respectively. CONCLU SIONS：O the basis of the original quality standard of A. sacrorum ， microscopic identification，TLC identification ，content determination and examination items of water ，total ash and extract are added. The method shows good precision ，accuracy and stability ，which can provide reference for more scientific and standardized evaluation of the quality of this medicinal material.

OBJECTIVE：To provide scientifi c evidence for improving the quality standard of Mongolian medicine Juniperus rigida. METHODS ：Totally 10 batches of J. rigida from different places were taken as samples to observe their characters and identify them by microscope ；TLC method was adopted to qualitatively identify isoquercitrin ，quercitrin，amentoflavone， podocarpusflavone A and hinokiflavone ；the contents of total ash ，acid-insoluble ash ，ethanol-soluble extract and heavy metals were determined by related method stated in 2020 edition of Chinese Pharmacopeia （part Ⅳ）. The contents of above 5 components in samples were determined by HPLC. RESULTS ：The powder of J. rigida was green or yellowish green ，polygonal tracheids ， closely arranged in longitudinal with unequal stomatal ；epidermal cells were nearly rectangular ；sclerenchyma cells were quasi rectangular and the wall beadedly thickening. Results of TLC showed that the spots of the same color were found in the corresponding positions of chromatogram for test sample and substance control. The contents of total ash ，acid-insoluble ash and ethanol-soluble extract in 10 batches of samples were 7.37％-11.18％，0.75％-2.98％，16.55％-26.42％，respectively；average contents were 8.51％，1.27％，22.35％. The contents of lead ，arsenic，cadmium，mercury and copper were 2.00-5.44，0.65-1.65， 0.044-0.100，0.034-0.160，4.59-6.79 mg/kg，respectively；average conte nts were 3.73，0.97，0.078，0.061，5.23 mg/kg. The linear ranges of isoquercitrin ，quercitrin，amentoflavone，podocarpus- flavone A and hinokiflavone were 4.98-20.02，49.99-199.96， 19.94-99.96，9.99-40.00，20.20-159.98 μg/mL（all r＞0.999 7）； com RSDs of precision ，repeatability and stability （24 h） tests were all less than 3.00％（n＝6）；the average recoveries were 话：0993-2057878。E-mail：Tanghuishz@qq.com 100.62％-102.96％，RSDs were 1.21％-1.88％（n＝6）. Average contents of the above-mentioned 5 compounds in 10 batches of samples were 0.089-0.379，1.379-4.250，1.077-2.026，0.162-0.423， 0.016 9-0.117 0 mg/g，respectively. CONCLUSIONS ：The qualitative and quantitative analysis methods of Mongolian medicine J. rigida are established. It is preliminarily proposed that the total ash content shall not exceed 10.22％，the acid-insoluble ash content shall not exceed 1.53％，ethanol-soluble extract content shall not be less than 17.88％，heavy metal lead should not exceed 5 mg/kg，arsenic should not exceed 2 mg/kg，cadmium should not exceed 0.3 mg/kg，mercury should not exceed 0.2 mg/kg，copper should not exceed 20 mg/kg.