The treatment of lower extremity chronic refractory ulcers requires a long time but with poor prognosis. Thus, many patients end up with amputations. The treatment of lower extremity chronic and recalcitrant ulcers and limb salvage has been a challenge worldwide. The Ilizarov technique based on the law of "tension-stress" brings a new hope in treating lower limb chronic and recalcitrant ulcers. The Ilizarov technique and distraction osteogenesis not only induce bone formation but also lead to angiogenesis and improved microcirculation. The Ilizarov technique consists of longitudinal distraction of long bone and tibia trans-verse transport (TTT) (proximal tibial corticotomy followed by transverse distraction). These two techniques have their own advantages and disadvantages with different indications in clinical application. Longitudinal distraction of long bone is mainly used for bone formation, such as large bone defects, osteonecrosis or bone infection (with or without soft tissue loss or ulcers). Because of only a partial osteotomy in TTT, the trauma is minor and their effects on limb instability are limited. Moreover, the procedure is simple with only a few minor complications. Thus, it is ideal in treating lower limb ischemic ulcers, such as diabetic foot ulcers, thromboangiitis obliterans (Buerger's disease), ulcers caused by atherosclerotic occlusion, arterial or venous ulcers, and trauma wounds. Several studies reported that TTT achieved high healing and limb salvage rates in treating severe diabetic foot ulcer. However, TTT could achieve lower recurrent rate. Thus, it is the most successful application in treatment of chronic ulcers. TTT also improves healing and limb salvage in treatment of thromboangiitis obliterans. However, the overall effects are limited than those in treating diabetic foot ulcer. For lower limb atherosclerosis occlusion, TTT induces regeneration of microvessles and consequently leads to ulcer healing. The effects are better than other conventional treatments. A combination therapy with vascularization is emphasized to attain the optimal long-term effects. The effects of TTT on lower limb recalcitrant ulcers still need to be validated in randomized control trial with larger sample size. Further, the mechanism of treatment needs to be explored by pilot studies which could show that this may be related to the formation of pro-angiogenetic factors and a rebalance of the inflammatory microenvironment during TTT.

OBJECTIVESTo investigate the clinical effect of sequential therapeutic intervention Yupei Qisun [compensating for weakness by invigorating Kidney (Shen) and Spleen (Pi) in advance] in Chinese medicine (CM) and hysteroscopic endometrial mechanical stimulation on the treatment of infertile patients with repeated implantation failure (RIF); and to study the differences in patients' endometrial thickness and type on the day of embryo transfer, serum hormone levels on embryo transfer day and clinical pregnancy outcomes.

METHODSIn the clinical study, 168 frozen-thawed embryo transfer (FET) cycles for couples with RIF conforming to the research protocol were randomly divided into three groups: a CM group with 56 cycles (CM combined with FET), a hysteroscopy group with 55 cycles (hysteroscopic endometrial mechanical stimulation), and a control group with 57 cycles (conventional FET). Differences in endometrial thickness on the embryo transfer day, levels of serum estradiol (E2) and progesterone (P) on the embryo transfer day, the E2/P ratio on the embryo transfer day, biochemical and clinical pregnancy rates, implantation rate, abnormal pregnancy rate and other indices were compared among the three groups.

RESULTSEndometrial thickness, E2 and P levels, and the E2/P ratio on embryo transfer day and other factors had no significant differences among groups. The biochemical pregnancy, clinical pregnancy, and implantation rates of the CM and hysteroscopy groups were significantly higher than the control group (P<0.05), and there were no significant differences between these two groups. The abnormal pregnancy rate had no significant difference among the three groups.

CONCLUSIONSSequential therapy of Yupei Qisun could significantly improve the clinical outcomes of rif-fet cycles, being equivalent to hysteroscopic endometrial mechanical stimulation, and provided a reliable method to treat such infertile couples.

Abortion, Habitual ; therapy ; Adult ; Embryo Implantation ; Embryo Loss ; therapy ; Embryo Transfer ; Endometrium ; pathology ; physiopathology ; Female ; Humans ; Hysteroscopy ; Infertility, Female ; pathology ; therapy ; Medicine, Chinese Traditional ; methods ; Physical Stimulation ; methods ; Pregnancy ; Retreatment ; statistics & numerical data

Objective:To investigate the effect of miR-21 on the proliferation and apoptosis of leukemia cell line K562 and the regulation of PI3K/AKT signaling pathway.Methods:K562 cells were divided into control group,miR-21 NC group and miR-21 interference group,the first group without treatment,the two groups after using cationic liposome transfection of LipofectamineTM2000 miR-21 inhibitor and miR-21 negative control.After transfection 48 h,the expression of miR-21 mRNA in cells was detected by Real-time fluorescence quantitative (qRT-PCR),MTT assay was used to test the effect of miR-21 on cell proliferation,flow cytometry was used to detected the effect of miR-21 on cell cycle apoptosis rate,the protein expression of PI3K,AKT and p-AKT in PI3K/AKT signaling pathway after miR-21 transfection were detected by protein immunoblotting (Western blot).Results:The expression level of miR-21 mRNA and the survival rate of cells in the miR-21 interference group were significantly lower than those in the control group and the miR-21 NC group;compared with control group and miR-21 group NC,flow cytometry detected the cells accounted for proportion of G0/G1 phase in miR-21 interference group increased significantly,the proportion of cells at S phase significantly decreased,and apoptosis rate increased significantly.Western blot test results show that the expression levels of p-AKT in miR-21 inter-ference group were significantly lower than those in the control group and miR-21 NC group,but the expression levels of PI3K and AKT protein were not changed significantly.Conclusion:Down-regulation of miR-21 can inhibit the proliferation and promote apoptosis of leukemia K562 cells,and its mechanism may be related to the inhibition of PI3K/AKT signaling pathway.

Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mucin-2 ; Mucin-6 ; Mucins ; analysis ; Neoplasms, Cystic, Mucinous, and Serous ; chemistry ; Pancreatic Neoplasms ; chemistry

OBJECTIVETo investigate the secretion patterns of glucose-dependent insulinotropic polypeptide (GIP) after different dietary loads in subjects with normal glucose tolerance (NGT) and their relation to insulin secretion and plasma glucose levels.

METHODSFourteen subjects with normal glucose tolerance underwent 75 g glucose tolerance test(OGTT) followed by mixed meal tolerance test(MMT) one week later. Blood glucose, insulin, and GIP were measured in the fasting state and at 0, 15, 30, 60, 90 and 120 min after glucose load or mixed meal load.

RESULTSThe first peak value of GIP after glucose load occurred at 15 min (45.09∓4.67 pmol/L). After a brief decline, GIP continued to increase till reaching 59.66∓11.73 pmol/L at 120 min after the load. After the mixed meal load, GIP secretion presented with two peaks: the first peak appeared at 15 min (71.69∓14.19 pmol/L) with a level significantly higher than that at 15 min following glucose load (P<0.05), and the second occurred at 90 min (55.35∓13.19 pmol/L). The area under curve of GIP showed no significant difference between the two loads (P>0.05). Compared with glucose load, mixed meal load resulted in an increase of the first GIP peak and an earlier insulin peak (30 min vs 60 min), but a significant decrease of blood glucose at 15 min (P<0.05).

CONCLUSIONCompared with glucose load, mixed meal (containing fat) can strongly stimulate GIP release and cause earlier occurrence of the insulin peak, which might be an important reason for the lower blood glucose after mixed meal.

Adult ; Blood Glucose ; metabolism ; China ; ethnology ; Diet ; Energy Intake ; Female ; Gastric Inhibitory Polypeptide ; secretion ; Glucose Tolerance Test ; Humans ; Insulin ; secretion ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the clinical efficacy in the treatment of allergic rhinitis (AR) of lung qi deficiency and cold syndrome between Jin's three-needle therapy and western medication.

METHODSSixty-six patients were randomized into an acupuncture group and a western medication group, 33 cases in each one. In the acupuncture group, acupuncture was applied at three-nose points [Yingxiang (LI 20), Shangyingxiang (EX-HN 8) and Yintang (GV 29); Cuanzhu (BL 2) was added for frontal headache] and three-back points [Dazhu (BL 11), Fengmen (BL 12) and Feishu (BL 13)], once every day. Ten treatments made one session. Two sessions of treatment were required. In the western medication group, desloratadine oral suspension was prescribed, 5 mg each time, once a day, for 20 days. The scores of the symptoms and physical signs in AR patients as well as the clinical efficacy were observed between the two groups.

RESULTSThe total effective rate was 93.9% (31/33) in the acupuncture group, which was better than 72.7% (24/33) in the western medication group (P < 0.05). After treatment, the scores of AR symptoms and physical signs as well as the total score were all reduced compared with those before treatment in the two groups (all P < 0.01). The score of every item in the acupuncture group was lower than that in the western medication group after treatment (score of symptoms: 4.70 +/- 2.07 vs 6.55 +/- 2. 69, score of physical signs: 0.85 +/- 0.67 vs 1.45 +/- +0.62, total score: 5.36 +/- 2.70 vs 8.00 +/- 2.91, all P < 0.01).

CONCLUSIONJin's three-needle therapy achieves superior efficacy on AR of lung-qi deficiency and cold syndrome, which is better than desloratadine oral suspension.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Child ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Needles ; Qi ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; physiopathology ; therapy ; Young Adult

Objective To study mental characteristics of children with light lead poisoning. Methods Eighty - six children with light lead poisioning and 33 control children were evaluated with WISC - R and social adaptive capacity(SAB). Results 1. Intelligence quotient( IQ)and SAB of children with light lead poisoning were lower than normal children. 2. There was also deficiency of perception factor and memory/ concentration factor among children with lead poisioning and the blood lead level had negative association with perception factor. Conclusion Light lead poisioning may affect children's IQ, especially in the perception factor and memory /concentration factor.

Background: (Introduction): Zika virus (ZIKV), a mosquito-borne flavivirus, causes the outbreaks of Latin America in 2015 - 2016, with the incidence of neurological complications. Sunitinib malate, an orally bioavailable malate salt of the tyrosine kinase inhibitor, is suggested as a broadspectrum antiviral agent against emerging viruses like severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2. Materials and Methods: This study investigated the antiviral efficacy and antiviral mechanisms of sunitinib malate against ZIKV infection using cytopathic effect reduction, virus yield, and time-of-addition assays. Results: Sunitinib malate concentration-dependently reduced ZIKV-induced cytopathic effect, the expression of viral proteins, and ZIKV yield in supernatant with 50% inhibitory concentration (IC 50 ) value of 0.015 μM, and the selectivity index of greater than 100 against ZIKV infection, respectively. Sunitinib malate had multiple antiviral actions during entry and post-entry stages of ZIKV replication. Sunitinib malate treatment at entry stage significantly reduced the levels of ZIKV RNA replication with the reduction of (+) RNA to (-) RNA ratio and the production of new intracellular infectious particles in infected cells. The treatment at post-entry stage caused a concentration-dependent increase in the levels of ZIKV (+) RNA and (-) RNA in infected cells, along with enlarging the ratio of (+) RNA to (-) RNA, but caused a pointed increase in the titer of intracellular infectious particles by 0.01 and 0.1 μM, and a substantial decrease in the titer of intracellular infectious particles by 1 μM. Conclusion The study discovered the antiviral actions of sunitinib malate against ZIKV infection, demonstrating a repurposed, host-targeted approach to identify potential antiviral drugs for treating emerging and global viral diseases.

OBJECTIVESTo explore the feasibility of DC being in vitro induced from AML cells with cytokine cocktails and their biological properties.

METHODSAML cells were cultured in either presence or absence of cytokine cocktails. DC were studied for morphology, and cytochemical and immunofluorescent staining. Functions of DC were examined by MLC, FITC-conjugated dextran uptake test, and LDH release assay. RT-PCR and FISH were used to analyze the specific fusion genes of culture-derived DC.

RESULTSClassical DC morphological changes occurred in all 15 cultured AML cells. DC-associated surface molecules such as CD(1a), CD(80), CD(86), CD(106), CD(83) and HLA-DR were upregulated (P < 0.05). The allostimulatory abilities of culture-derived DC were significantly higher than those of AML cells uncultured or cultured in the absence of cytokines (P < 0.05). Culture-derived DC only in the presence of GM-CSF + IL-4 have phagocytotic activities. CTL assay was performed in 5 of the 15 samples. At effector/target ratio of 20:1, auto-T lymphocytes primed with the culture-derived DC exhibited no more killing activity to auto-AML cells than those stimulated by IL-2 or uncultured AML cells. Culture-derived DC presenced the native AML-specific aberrant karyotype and related fusion gene.

CONCLUSIONSCytokine cocktails could in vitro induce AML cells into DC with classical morphology, immunophenotype and function. DC maturity induced by different cytokine cocktails could be variable. Culture-derived DC were originated from the native AML cells. AML cells could make the auto-T lymphocyte anergy.

Adolescent ; Adult ; Aged ; Cell Differentiation ; drug effects ; Cytokines ; pharmacology ; Dendritic Cells ; cytology ; Drug Synergism ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; In Vitro Techniques ; Interleukin-4 ; pharmacology ; Leukemia, Myeloid, Acute ; immunology ; pathology ; Male ; Middle Aged ; Monocytes ; cytology ; drug effects ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo establish a new staging system based on analysis of several presently used clinical staging systems for carcinoma of nasal cavity.

METHODSThe data of 122 patients treated from 1985 to 1997 in the cancer center of Sun Yat-sen University were analyzed, and a new clinical staging system was established using computer optimizing and screening combined with the clinical results. The survival analysis was performed by Kaplan-Meier estimates, and the multivariate analysis was achieved by Cox proportional hazard model.

RESULTSThe flaws in the presently used clinical staging systems proposed by Zhuang, Qiu, Department of Head and Neck of Cancer Center of Sun Yat-sen University and University of Florida and the AJCC'2002, were as follows: insufficient consideration of the modern tomography resulting in indefinite location of the tumor in clinical practice, the uneven distribution of patients in different stages, being unable to separate survival curves of different stages, and not containing of all necessary clinical staging information in some staging systems. However, based on our new staging system, the cases distributed in T1, T2, T3 and T4 was 16, 32, 42 and 32, and the 5-year survival rate was 78.8%, 64.6%, 49.9% and 30.0%, respectively. The cases distributed in stage I, II, III and IV was 16, 26, 45 and 35, and the 5-year survival rate was 78.8%, 68.4%, 51.3% and 29.0%, respectively. The overall 5-year survival rate was 61.6%.

CONCLUSIONCompared to the presently used clinical staging systems, the new staging system may have more advantages in various parameters for the clinical staging in the carcinoma of nasal cavity, and may be worth to be widely and clinical used.

Adenocarcinoma ; mortality ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; mortality ; pathology ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Neoplasm Staging ; standards ; Nose Neoplasms ; mortality ; pathology ; Proportional Hazards Models ; Reference Standards ; Survival Analysis