Objective To analyze factors influencing the incidence of deep venous thrombosis (DVT) and discuss the prevention and treatment of DVT in hip fracture patients. Methods The present study enrolled 531 patients who received surgery between June, 2008 to June, 2010 for hip fractures. They were 242 men with a mean age of 56. 2 years and 289 women with a mean age of 65.2 years. There were 336 femoral neck fractures, 183 femoral intertrochanteric fractures, and 12 femoral subtrochanteric fractures. The associations between DVT incidence and fracture type, plasma D-Dimer, sex, age and preoperative duration of immobilization were statistically analyzed. Inferior yens cava filters were used for patients who suffered DVT while surgery was performed. Results The total incidence of DVT was 10. 4% in this series. DVT occurred in 21 cases of femoral neck fracture, 34 cases of femoral intertrochanteric fracture and 0 case of femoral subtrochanteric fracture. All DVT events happened before surgery. DVT incidence had no significant associations with age or sex (P =0. 347 and 0. 376, respectively), but did with plasma D-Dimer, fracture type and preoperative duration of immobilization (P = 0. 002, 0. 017 and 0. 037, respectively). All the 55 DVT patients underwent a successful surgery. Conclusions The DVT incidence in hip fracture patients may have no significant associations with age or sex, but may do with plasma D-Dimer, fracture type and preoperative duration of immobilization. Inferior vena cava filters can ensure a successful internal fixation of the fracture and an uneventful postoperative rehabilitation.

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Objective To explore the interventional treatment method for complex and refractory lymphatic malformation in children.Methods The clinical data of 78 cases with complex and refractory lymphatic malformation during January 2013 to January 2016 in our department were retrospectively analyzed.The lesions involved the neck in 28 cases,maxillofacial regions in 19 cases,the chest and armpit in 8 cases,the limb in 7 cases,the pelvic cavity and retroperitoneal space in 6 cases,the superior mediastinum in 3 cases,the hypogloeeis in 3 cases and scrotum or perineum region in 4 cases.All the children underwent ultrasound or MRI imaging studies preoperatively.The interventional procedures included:(1) Percutaneous puncture of the LM for sclerotherapy.The lesions were punctured with 20 G needle under the guidance of DSA or ultrasound and the correct positions were confirmed with angiography.The liquid of the lesions was extracted as far as possible.The dosage of sclerosing agents was adjusted according to the size of lesion.The dose of Laurolacrogol injection was 1/10—1/5 of the amount of the liquid in the lesions and the maximum of Laurolacrogol foam was ≤8 ml(20 mg).The dose of Pingyangmycin was ≤ 8 mg.(2) The drainage catheter placement and sclerotherapy.Percutaneous catheter drainage under ultrasound guidance or by surgery was conducted.The liquid in the lesions was drained by retaining the catheter for 1-4 weeks,and sclerotherapy was applied for several sessions during this period.(3) Treatment for one time a week,2 times a session.The interval of every two sessions was 4 weeks.The sclerosing agents included:Laurolacrogol Injection or Pingyangmycin for the lesions with high tension,Laurolacrogol foam for the lesions with low tension,Pingyangmycin for the microcystic lesions.Statistical analysis was conducted using SPSS20.0 software.Results A total of 208 sessions of sclerotherapy for 78 LM patients were performed and average session was (3.0±0.8).Nine patients used Lauromacrogol foam,23 patients used Lauromacrogol Injection,39 patients used pingyangmycin,while combined treatment was conducted in 7 patients.Laurolacrogol injection was used in 20 cases,Pingyangmycin in 29 cases and combination therapy in 5 cases for the high tension lesions in the neck,maxillofacial,chest and armpit.The low tension lesions of pelvic cavity and retroperitoneal space in 6 cases and of superior mediastinum in 3 cases were placed with draining catheters,and treated with sclerotherapy with Laurolacrogol foam.Three cases with hypogloeeis LM was neonates,who were treated with Laurolacrogol injection.The lesions on the limb and scrotum or perineum region were almost microcystic,were treated with Pingyangmycin in 9 cases and with combination therapy in 2 cases.The total curative rate was 97.4％ (76/78),total effective rate was 100％ (78/78).Imaging examinations showed that the cavities were closed or only a small amount of residual sclerotic lesions were present.Clinical examinations showed that the surface masses almost disappeared.The follow up period was 6 months to 2 years.There were no serious complication and adverse reactions occurred.Conclusions Interventional treatment is a safe,effective,and minimally invasive treatment for the complex and refractory lymphatic malformation.In order to receive the best treatment effect,we should use targeted therapy for different region and type of LM.

Objective To explore the therapic effect of the combination of endovascular embolization and clinical hormone in treatment of Kasabach-Merritt phenomenon (KMP),and analyze the advantages.Methods Six cases with KMP from May 2010 to June 2012 were retrospectively analyzed.All the patients underwent large dose hormone shock therapy after admission for 7-10 d.Subsequently,selective endovascular embolization was performed using Seldinger technique under general anesthesia Then,the hormone therapy was continued for 2 weeks after embolization.The platelet count and the effect were recorded.If the area of the tumor reduction is less than 50％,3-4 courses of local hardening treatment was conducted for the residual tumor.The local treatment used multipoint puncturing of the tumor and injection drugs under X-ray fluoroscopic monitoring until the tension of local vascular increased.Results On DSA,the lesions of all the 6 cases showed rich blood supply with a large number of hybrid distribution of tumor blood vessels.The lesions disappeared in 4 cases after 1-2 weeks combination therapy and no recurrence for 0.5-1.0 year follow-up.Two cases whose tumor reduced less than 50％ after combination therapy received local hardening treatment,and faded after 3-4 courses.The number of platelet for all patients kept normal and the spirit of the patients showed great improvement,the bleeding tendency and local soft tissue swelling was in remission.Subcutaneous blood stasis and petechiae disappeared.There were no serious adverse reaction and complications.Conclusion Combination therapy with endovascular embolization and clinical hormone for Kasabach-Merritt phenomenon has a good curative effect.

Objective:To explore the characteristics of brain structure in patients with long-term withdrawal of methamphetamine-dependence.Methods:A total of 44 patients with withdrawal of methamphetamine-dependent for more than 14 months were recruited,who met the diagnostic criteria for substance dependence in the fifth edition of the American Mental Disorders Diagnostic and Statistical Manual (DSM-Ⅴ),and 40 healthy subjects were used as the control.In addition to the general scale of drug-relevant survey,the subjects received the 3.0T magnetic resonance high-resolution scan.The voxel-based morphometric measurements for the subject's brain gray volume were conducted.Results:There was no significant difference in age,education,smoking and alcohol consumption between the methamphetamine-dependent withdrawal group and the control group (P＞0.05).The volumes for the bilateral cerebellum,the left side of temporal gyrus and the right side of the lingual gyrus in the methamphetamine-dependent withdrawal group were increased than those in the control group.The volumes for the bilateral lingual gyrus and bilateral cuneus in the methamphetamine-dependent withdrawal group were decreased than those in the control group.The volumes of left of cuneus and cerebellum were positively correlated with the duration of abstinence.Conclusion:After long-term abstinence,although the patients still show abnormal brain structure,their behavior and cognitive function is improved.The cerebral nerve structural is recovered from long-term abstinence.

Objective To investigate the deformity of cranial base in patients with craniosynostosis and to evaluate the effect of modified fronto-orbital advancement (FOA) for craniosynostosis using three-dimensional digital technology.Methods From January 2010 to December 2016,10 cases of craniosynostosis were included in the study.All patients underwent modified FOA,we quantitatively analysed the pre-operative deformity and the surgical outcome of FOA performed in ten patients with craniosynostosis.The measurements of skull base were performed based on 3D computed tomography (CT) scan.We assessed the symmetry of skull base and the deflection of anterior cranial fossa.Results The mean patients' age at FOAs was 3.2 years.A significant asymmetry of skull base was found in all patients.The growth of anterior and middle fossae was restricted.On the follow-up CT images 23.6 months after surgery,there was prominent change (P＜0.05) between the two hemibases (CSO(-)ratio) and between the lengths and angles of anterior and middle cranial hemi-fossae (CX,CSX(-),XSM(-) ratio).Anterior cranial vault asymmetry index obviously decreased from 12.4％ to 1.05％ before surgery (P＜0.05).In addition,anterior cranial vault deflection angle proved to also be less after surgical correction (20.33°±9.19° versus 13.13°±5.28°,P＜0.05).Conclusions The asymmetry of skull base can be presented by intracranial view at over 1 year of age.FOA can correct the skeletal malformation of frontotemporal region and the asymmetry of skull base is improved after surgical treatment.

Gaining a better understanding of autoprotection against drug-induced liver injury(DILI)may provide new strategies for its prevention and therapy.However,little is known about the underlying mechanisms of this phenomenon.We used single-cell RNA sequencing to characterize the dynamics and functions of hepatic non-parenchymal cells(NPCs)in autoprotection against DILI,using acetaminophen(APAP)as a model drug.Autoprotection was modeled through pretreatment with a mildly hepatotoxic dose of APAP in mice,followed by a higher dose in a secondary challenge.NPC subsets and dynamic changes were identified in the APAP(hepatotoxicity-sensitive)and APAP-resistant(hepatotoxicity-resistant)groups.A chemokine(C-C motif)ligand 2+endothelial cell subset almost disappeared in the APAP-resistant group,and an R-spondin 3+endothelial cell subset promoted hepatocyte proliferation and played an important role in APAP autoprotection.Moreover,the dendritic cell subset DC-3 may protect the liver from APAP hepatotoxicity by inducing low reactivity and suppressing the autoimmune response and occurrence of inflammation.DC-3 cells also promoted angiogenesis through crosstalk with endothelial cells via vascular endothelial growth factor-associated ligand-receptor pairs and facilitated liver tissue repair in the APAP-resistant group.In addition,the natural killer cell subsets NK-3 and NK-4 and the Sca-1-CD62L+natural killer T cell subset may promote autoprotection through interferon-y-dependent pathways.Furthermore,macrophage and neutrophil subpopulations with anti-inflammatory phenotypes promoted tolerance to APAP hepatotoxicity.Overall,this study reveals the dynamics of NPCs in the resistance to APAP hepatotoxicity and provides novel insights into the mechanism of autoprotection against DILI at a high resolution.

The CRISPR/Cas9 gene editing technology directs Cas9 protein to recognize, bind and cleave the target site specifically by using artificial single-guide RNA (sgRNA), through non-homologous end joining or homologous end-recombinant repair mechanisms of cells, which can be engineered to knockout or knock-in of genomes. RIG-I is a pattern recognition receptor that recognizes the 5'-triphosphate-containing RNA in the cytoplasm and activates IRF3/7 and NF-κB by interacting with the downstream signaling molecule MAVS, thus initiating the expression of type I interferons and inflammatory factors. Previous studies found that influenza B virus (IBV) can up-regulate the expression of RIG-I. In the present study, to explore whether RIG-I is the major receptor for IBV to active the antiviral innate immune response and its effect on IBV replication, RIG-I gene in 293T cells was knocked out by CRISPR-Cas9 system, and a stable RIG-I knockout 293T (RIG-I(-/-) 293T) cell line was screened by puromycin pressure. The results of Western blotting showed that RIG-I was not expressed in this cell line after IBV or Sendai virus (SeV) infection, indicating that the RIG-I(-/-) 293T cell line was successfully constructed. The transcription levels of interferons, inflammatory factors and interferon-stimulated genes in RIG-I(-/-) 293T cells which were infected by IBV decreased significantly compared with those in wild-type 293T cells. Moreover, the phosphorylation of p65 and IRF3 were not detected in IBV or SeV infected RIG-I(-/-) 293T cells. It is indicated that the expression of cytokines mainly depends on the RIG-I-mediated signaling pathway at the early stage of IBV infection. Furthermore, the multi-step growth curves of IBV in the wild type and RIG-I(-/-) 293T cells showed that RIG-I inhibited the replication of IBV. Collectively, the RIG-I knockout 293T cell line was successfully constructed. We found that RIG-I is the main receptor for IBV to active the antiviral innate immune response and is critical for inhibiting IBV replication, which lays the foundation for further study of IBV infection mechanism.

H9 subtype avian influenza virus causes worldwide epidemic, resulting in enormous economic losses of poultry production. In the present study, an indirect ELISA method was established for more accurate and specific detection. The recombinant protein of the globular head domain of HA of H9 subtype avian influenza virus was used as antigen. Specific blocking buffers and dilution buffers were determined to increase the sensitivity and specificity. The sensitivity of ELISA was higher than that of hemagglutination inhibition (HI) test. The coating antigen is very specific and no cross-reactivity with positive serum against H3N2, H5N2 and H7N9 subtype influenza viruses, Newcastle disease virus, avian infectious bronchitis virus, avian infectious disease virus, and egg drop syndrome virus. Two hundred of clinical sera samples were examined. The results indicate the coincidence rate between ELISA and HI test reached 97%. In addition, there was a positive correlation between OD450 values and the logarithm of HI titer to the base 2 of an individual serum sample (R2=0.981 1).

To explore the mechanism for changes in brain microstructure in long-term abstinent from methamphetamine-dependence by using the diffusion tensor imaging (DTI).
 Methods: A total of 26 patients with long-term abstinent methamphetamine-dependence, whose abstinence time more than 14 months, and 26 normal controls all underwent cognitive executive function tests and DTI scans. We used voxel-based analysis to compare the fractional anisotropy (FA) and mean diffusivity (MD) to obtain the abnormal brain regions of DTI parameters between the two groups. Spearman correlation analysis was used to explore the correlation between FA, MD of the brain regions with abnormal parameters and cognitive executive function tests.
 Results: There were no statistical differences in the cognitive executive function tests between the two groups (P>0.05). Compared with the normal control group, the long-term abstinent from methamphetamine-dependence group showed the decreased FA in the right precuneus, right superior frontal gyrus, right calcarine, left inferior temporal gyrus and the increased MD in the right triangular part of inferior frontal gyrus, right precuneus, right posterior cingulate, right middle temporal gyrus, bilateral middle occipital gyrus, left superior parietal lobule, and lobule VIII of cerebellar hemisphere. The MD values of the right middle temporal gyrus in the long-term abstinent group were negatively correlated with the number of completions within 60 seconds (r=-0.504) and within 120 seconds (r=-0.464) .
 Conclusion: The DTI parameters in multiple brain regions from the methamphetamine-dependence patients are still abnormal after a long-term abstinence. DTI can provide imaging evidence for brain microstructural abnormalities in long-term abstinent from methamphetamine-dependence.
Amphetamine-Related Disorders ; Anisotropy ; Brain ; Diffusion Tensor Imaging ; Humans ; Methamphetamine