Objective To determine the dynamic change of serum procalcitonin (PCT) level after traumatic brain injury and the rclated clinical significance.Methods Serum levels of PCT and adrenocorticotropic hormone (ATCH) in 137 patients with traumatic brain injury and 20 normal volunteers were measured by electrochemiluminescence assay.Correlation between serum PCT level and severity of traumatic brain injury was evaluated.Results Percentage of serum PCT level at low inflammatory-risk threshold detected from day 1 to day 14 after admission was descended from 80.3％ to 63.5％.Meanwhile,the percentage of serum PCT level at high inflammatory-risk threshold was a rising-fall-rising trend,but the percentages of serum PCT level at median and definite inflammatory-risk thresholds showed sustained increase from 13.9％ to 27.0％ and 0.7％ to 3.7％ separately.Based on the Glasgow Coma Scale (GCS),the dynamic change of serum PCT level demonstrated a distinct bimodal pattern in severe injury group,a gradual falling after rising mode in middle injury group which was significantly and positively correlated with GCS (r =0.463,P ＜ 0.05),and a rising-falling-slight rising tendency in minorinjury group.In addition,the GCS in each group only closely related to the positive detections of serum PCT level detected at days 3 and 7 (x2 =10.32,16.31 respectively P ＜ 0.01).Serum ATCH level at day 1 was far higher than that at day 14 in severe injury group and was significantly higher in severe injurygroup compared with minor and middle injury groups (P ＜ 0.01 or 0.05).Conclusions Positive serum PCT may be predictive of the traumatic brain injury and injury degree within 3-7 days after the injury.The dynamic change of serum PCT is associated with the specialized mechanism of traumatic brain injury and neuronendocrine response,and it may be a useful parameter to assess posttraumatic stress response and prognosis.

AIM: To Screen and identify human single-chain variable fragment (ScFv) specific to hepatitis B virus core protein and determine its gene sequence. METHODS: The recombinant phages were panned by HBcAg coated in a 96-pore plate and 48 clones were identified specific to HBc after three rounds of panning. The specificity of ScFv from the positive clone was determined by ELISA. Then, the soluble ScFv was expressed in E.coli. HB2151 and secreted in the supernatant. Subsequently, SDS-PAGE and dot blot were performed to identify the ScFv in the supernatant and cell lysate. The gene of ScFv specific to hepatitis B virus core protein was sequenced. RESULTS: The ScFv screened from phage antibodies has a specific combination character with hepatitis B virus core antigen. Soluble ScFv was confirmed to express in E.coli. HB2151 and secrete in the supernatant. The sequence of ScFv gene conformed to that of heavy chain and kappa chain of human immunoglubulin. CONCLUSION: Human ScFv specific to hepatitis B virus core protein has been identified by means of the phage display technology, and its gene sequence has been determined.

98%. In the pDOR-myb infected HSCs, c-myb expression levels, the cell proliferation, and ? 1-Ⅰ collagen mRNA expression were repressed significantly. CONCLUSIONS: c-myb plays a key role in the activation and proliferation of HSC. c-myb antisense RNA can inhibit cell proliferation and ? 1-Ⅰ collagen mRNA expression in the infected HSC. These data suggest that inhibition of c-myb gene expression would be a potential way for the treatment of liver fibrosis.

Objective To introduce the experience of improved posterolateral mini-incision total hip urthroplasty(THA)in treatment of femoral neck fractures.Methods Of 199 patients(207 hips)treated with preliminary THA from October2002 to January 2005,them were46 patients(46 hips)with femoral neck fractures including31 fresh fractures and 15 old ones,which were then treated with posterolateral mini-incision THA.An observation was done on length of incision,operation time,volume of blood loss,drainage volume,hospital stays,postoperative complications,functional recovery and Harris score.Results All patients were followed up for 14-26 months(mean 17.2 months).The final Harris score during follow-up was(84.1±8.6)points in the fresh fracture group and(85.8±7.6)points in the old fracture group.Pestoperative X-ray showed sound position of the prosthesis.There was no statistical difference upon length of incision,operation time,blood loss,drainage volume and hospital stays between fresh fracture group and old fracture group(P＞0.05).Dislocation occurred in one patient in each group.Conclusion Posterolateral mini-incision THA is proved to be successful in reducing surgical trauma,accelerating rehabilitation and decreasing blood loss and complications for patients with femoral neck fractures.

Objective To study the mechanism of Liangruntongluo Recipe in improving gastrointestinal function on DM rats induced by STZ. Methods Forty male Wistar rats were divided into four groups randomly: group A as model control group,group B as Liangruntongluo group,group C as Cisapride group,and group D as normal control group. There are 10 rats in each group. After the establishment of DM animal model with Wistar rats,the animals were raised for 6 weeks without any hypoglycemic agents. And then medicines were intragastric administrationed for another 6 weeks. In the 12th week motile and cholecystokinin in blood and tissue were tested. Result By the time of the twelfth week,the rats with DM presented the disorder of gastrointestinal hormone. Liangruntongluo Recipe affected the excretion and releasing of hormone in blood,stomach,and duodenum. With a wide target range,effect of Liangruntongluo Recipe is superior to Cisapride. Conclusions Chinese herbal medicine Liangruntongluo recipe has the superiority in improving the obstacle of the gastrointestinal function of diabetes mellitus.

OBJECTIVETo discuss the diagnosis and operative technology of acetabular fracture.

METHODS41 cases of displaced acetabular fractures were enrolled. CT and 3D-CT were performed before operation to understand the classification of fractures and to determine operative regimen. All cases were fixed by reconstruction plates and screws through the best approach.

RESULTS39 cases were followed up for 1 - 4 years, with an average of 1.5 years. Curative outcomes were assessed by Matta's criteria. Clinically, 16 (53.3%) 30 fresh fractures were excellent, 11 (36.7%) good, 3 (10%) fair. The rate of excellence and goodness was 90%. In 9 cases of old fractures, 2 were excellent, 3 good, 2 fair and 2 poor. The rate of excellence and goodness was 55.6%. Complications consisted of sciatic never injury, necrosis of the femoral head, and heterotopic ossification.

CONCLUSIONSThe time of operation, degree of injury, and quality of reduction of fracture are important factors affecting the postoperative function of the hip. The key to enhance the outcome is to verdict the type of fracture, select the proper approach before operation, and precise reduction and appropriate internal fixation during operation.

Acetabulum ; injuries ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVETo examine the change of epidermal growth factor (EGF) concentration in saliva of recurrent aphthous ulcer (RAU) patients during the ulcerous and interval period and epidermal growth factor receptor (EGFR) in ulcer biopsy samples.

METHODSECF data of the samples, which were 27 saliva samples from RAU gained not only in the ulcerous period but also in interval period and 33 ones from normal persons, were acquired through enzyme linked immunosorhent assay (ELISA) and EGF standard curve. ECFR-RNA date of RAU biopsies, which were 31 biopsy samples from RAU got during the ulcerous period and 35 ones from normal persons, were surveyed by QF-RT-PCR. All RAU samples were obtained under the same level, which were the whole patients were minor aphthous ulcers and their ulcers occurred not over the first four days. All patients and normal persons were selected seriously under the rule of physical situations without any other diseases and histories of using medicines.

RESULTSThe EGF concentration of saliva in RAU group at ulcer occurrence was higher than that in the interval period and the normal control with a significant test (F = 3.24, P < 0.05). The EGF concentration of saliva in RAU group during the interval period was lower than that in the control, which was significant on statistics (t = 2.73, P < 0.05). The EGFR-RNA in RAU group at ulcer occurrence was higher than the normal control with a significant test (t = 3.15, P < 0.05).

CONCLUSIONIt was suggested that the ulcer occasion of RAU patients could be related with the decreasing of EGF in saliva during interval period, and that the ulcer sell-cure of RAU patients would be contributed to

Adult ; Biopsy ; EGF Family of Proteins ; Female ; Humans ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; Saliva ; Stomatitis, Aphthous

Objective To investigate the outcome of a new designed extramedullary femoral osteotomy module and to compare with conventional intramedullary system in clinical study.Methods The extramedullary femoral osteotomy module was designed with the extramedullary alignment rod connecting with the T type rod at right angle,and it had a 5°-7° adjustable valgus design.The positioning module fixation screw was parallel with the epicondylar axis.The coronal plane of the distal femur bone cut was orientated by the extramedullary alignment rod pointing to the inguinal midpoint,and the sagittal plane was orientated by the extramedullary alignment rod keeping parallel with the distal femoral medullary cavity.The terminal distal femoral bone cut was conducted with suitable osteotomy after the orientation.Sixty patients who underwent unilateral total knee arthroplasty (TKA) from October 2015 to March 2016 were randomly divided into intramedullary and extramedullary group for prospective controlled study.Blood loss,drainage and the incidence of deep vein thrombosis (DVT) were evaluated at one week postoperatively.Knee valgus angle and femoral prosthesis flexion angle were analyzed at two weeks postoperatively.Moreover,the extramedullary femoral osteotomy module was used in 273 patients (78 males and 195 females) with an average age of 68.7 (range,57-82 years old) who underwent unilateral TKA from April 2016 to January 2017.Blood loss,operation duration and lower limb ultrasonography preoperatively and at one week postoperatively were recorded.Knee valgus angle and femoral prosthesis flexion angle were measured at 2 weeks postoperatively.Range of knee motion and Hospital for Special Surgery (HSS) knee score at six weeks postoperatively were also reported.Results In the randomized controlled trial,blood loss and drainage in extramedullary group was less than that in intramedullary group (t=-3.330,P=0.004).There was no significant difference in the incidence of DVT at 1 week postoperatively (x2=2.269,P=0.132) and the knee valgus angle and femoral prosthesis flexion angle at 2 weeks postoperatively within the two groups.In the clinical application,operation time was 60.13± 13.69 min,and blood loss and drainage was 109.11±70.73 ml.There were four cases of popliteal vein thrombosis,nine cases of posterior tibial vein thrombosis,and seventeen cases of muscular venous thrombosis at one week postoperatively.The incidence rate of DVT was 11.0％.There was no symptomatic pulmonary embolism at three months postoperatively.Knee valgus angle was 7.34°±0.69°,and 211 knees accounting for 77.3％ were in the range of ±3° error.Femoral prosthesis flexion angle was 6.43°±1.59°,and 273 knees were all in the range of ±10° error.Range of knee motion improved from 54.52±5.96 preoperative to 86.20±4.92 at six weeks postoperative.HSS knee score improved from 100.88°±7.51° preoperative to 110.42°±7.08° at six weeks postoperative.Conclusion The new designed extramedullary femoral osteotomy module used in distal femoral osteotomy during TKA can significantly reduce the risk of bleeding and the incidence rate of DVT postoperatively.Furthermore,patients can obtain as excellent prosthesis position and limb alignment as conventional intramedullary system.

OBJECTIVETo identify the predictors of the positive results of transrectal ultrasound (TRUS)-guided biopsy for prostate cancer.

METHODSWe performed univariate and multivariate logistic regression analyses on the relevant data on 385 male patients that underwent TRUS-guided biopsy for prostate cancer, including such potential predictors as age, body mass index (BMI), symptoms, results of digital rectal examination (DRE), tPSA, fPSA, free/total PSA ratio (f/tPSA), prostate volume (PV), and PSA density (PSAD) for identification of the risk factors related to the positive rate of biopsy. Then we constructed a scoring system as a tool for predicting prostate cancer in repeat biopsies and determined the sensitivity of the system by calculating the false positive rate using the receiver operating characteristic curve.

RESULTSAmong the 385 patients, 139 (36.1%) were diagnosed with prostate cancer. On multivariate analysis, age (P < 0.01), DRE (P < 0.01), tPSA (P < 0.01), fPSA (P < 0.01), f/tPSA (P < 0.01), PV (P < 0.01), and PSAD (P < 0.01) were all significant predictors of prostate cancer. Multivariate logistic regression analysis showed age, tPSA, f/tPSA, PV, and PSAD to be independent predictors, with ORs and 95% CIs of 1.07 (1.05-1.16), 1.05 (1.02-1.15), 0.97 (0.86-0.99), 0.98 (0.87-0.96), and 1.79 (1.48-2.06), respectively. Moreover, patients with the risk score of 3-5 had a significantly higher rate of prostate cancer than those with 0-2 (64% vs 11%, P < 0.001).

CONCLUSIONThe scoring system on the key predictors of prostate cancer can help urologists to identify the men in need of prostatic biopsy.

Aged ; Digital Rectal Examination ; Humans ; Image-Guided Biopsy ; methods ; Logistic Models ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; chemistry ; pathology ; ROC Curve ; Risk Factors ; Ultrasonography, Interventional ; methods

OBJECTIVETo evaluate the clinical efficacy of sufentanil and fentanyl at equivalent dose for patient-controlled intravenous analgesia (PCIA) after thoracotomy.

METHODSSixty ASA I-II patients (20-60 years of age) undergoing radical operation for lung or esophageal cancer were randomly divided into sufentanil intravenous analgesia group (group S, with sufentanil 1 microg/ml) and fentanyl intravenous analgesia group (group F, fentanyl 10 microg/ml). PCIA was administered with background infusion of 2.5 ml/h, bolus injection of 2.5 ml and lockout time of 15 min. The pain intensity according to visual analogue scale (VAS), cumulative analgesic consumption (CAC), sedative scores and side effects at 24 and 48 h after administration were recorded. SpO(2), respiratory rate (RR), blood pressure (BP) and ECG were continuously monitored.

RESULTSThere were no significant differences in CAC between the two groups, but he VAS was lower in group S than in group F (P<0.05) and the sedative efficacy was superior in group S (P<0.05). The incidence of nausea and vomiting in group S was lower than that in group F (P<0.05). No significant differences were observed in SpO(2), RR, heart rate and mean arterial pressure between the two groups.

CONCLUSIONPCIA with sufentanil provides better efficacy of analgesia and sedation with lower incidence of nausea and vomiting than with fentanyl in postoperative patients with thoracotomy.

Adult ; Analgesia, Patient-Controlled ; Esophageal Neoplasms ; surgery ; Female ; Fentanyl ; administration & dosage ; adverse effects ; Humans ; Infusions, Intravenous ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Nausea ; chemically induced ; Pain, Postoperative ; drug therapy ; Sufentanil ; administration & dosage ; adverse effects ; Thoracotomy ; Vomiting ; chemically induced