Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa,and to guide clinical treatment.Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled.The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa.According to the wound healing time,they were divided into wound healing group (26 cases,healing time ≤ 3 months) and wound un-healing group (23 cases,healing time ＞ 3 months).The general information,clinical indicators and treatment between two groups were compared,and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis.Results Compared with those in wound un-healing group,the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher:(43.59 ± 2.71) ml/min vs.(23.14 ± 5.39) ml/min,76.9％ (20/26) vs 47.8％(11/23),and the urinary micro-albumin was lower:(67.01 ± 3.32) mg/L vs.(234.03 ± 6.71) mg/L.There were significant differences (P ＜ 0.05 or ＜ 0.01).Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was-5.551,P =0.001),urinary micro-albumin (regression coefficient was 0.127,P =0.007) and negative pressure attraction (regression coefficient was-2.244,P =0.042).Conclusion The blood flow volume of dorsal artery of affected foot,urinary micro-albumin,negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa.

Objective To discuss the feasibility of positioning the acetabular center,fixing acetabular implant correctly and reconstructing hip rotation center according to Harris fossa and the remaining anatomical markers of acetabular notch in revision hip arthroplasty.Methods Twenty-eight patients underwent revision hip arthroplasty from April 2007 to June 2009.Based on Paprosky type,3 cases with type Ⅰ were treated with biological fixed acetabular component;8 cases with ⅡA and ⅡB were reconstructed with using of morselized bone grafting and large diameter cemented acetabular prosthesis;17 cases with type ⅡC,ⅢA and ⅢB were treated with using of morselized bone grafting and fixation of acetabular reinforcement ring.Among them,5 patients with massive bone loss in acetabular wall were reconstructed with the use of the structural and morselized bone grafting.The center of the original acetabulum was believed to be in the lunate cartilage surface which was closed to Harris fossa.During the operation,the center was located in the site which was 25-28 mm above in line with perpendicular bisector of acetabular notch connecting line.The acetabular center was the point of positioning acetabular prosthesis (Ⅰ type) or making new acetabulum by impaction bone grafting.Acetabular reinforcement ring (Ⅱ,Ⅲ type) was fixed in accordance with proper transverse angle and anteversion angle.The vertical distance from hip rotation center to teardrop connection and the horizontal distance from hip rotation center to teardrop were measured on preoperative and postoperative radiograph.And the outcomes of reconstruction of rotation center were evaluated.Results The vertical distance was changed from (14.22±3.39) mm preoperatively to (32.64±4.51) mm postoperatively.The difference was statistically significant (t=3.65,P＜ 0.05).The horizontal distance was changed from (25.13±3.46)mm preoperatively to (32.87±4.73) mm postoperatively.The difference was statistically significant (t=2.72,P＜0.05).Conclusion Using residual Harris fossa and acetabular notch as the anatomical markers in revision hip arthroplasty,the restoration of the anatomical hip center has shown to be favorable.

Objective To assess the effectiveness of pedicled iliac periosteal flap graft for treatment of old femoral neck fracture in adolescents.Methods Between June,2005 and December,2013,15 patients (15 hips) of old femoral neck fracture in adolescents treated with vascular pedicled iliac periosteal.There were 11 males and 4 females with an average age of 15.8(range 12 to 18) years.Based on the location of fracture,there was 5 cases of subcapital,8 cases of transcervical and 2 cases of basal.6 cases were treated with lower limb traction,3 cases with internal fixation and 6 just without any treatment.The average duration from injury to the second operation was 4.8 (range 1 to 19) months.There were 2 cases of femoral head necrosis after femoral neck fracture.Open reduction,pedicled iliac periosteal flap grafting and cannulate screw fixation were performed.Results All incisions healed by first intention.All patients were followed up 12 to 90 months (mean,46 months).The HHS was increased from (48.7 ± 8.3) pre-operation to (91.3 ± 6.1) at last followed-up,indicating a significant difference between before and after operation (P ＜ 0.01).One patient underwent total hip arthroplasty at 10 months after operation because of fracture nonunion and femoral head necrosis.Fracture healed successfully in 14 cases and the average time of fracture healing was 4 (range 3 to 6) months.Certain extent of remodelling and bulge of the head were observed in 2 cases of collapsed heads.Conclusion Pedicled iliac periosteal flap graft can provide good osteogenesis and vascular reconstruction for femoral head and promote fracture healing in treatment for old femoral neck fracture in adolescents.

Objective To discusses the clinical significance of XRCC1 399 and TYMS 5'-translation section enhancement subsequence polymorphism in guidance the postoperative individual chemotherapy for patients with resected non-small cell lung cancer.Methods Retrospectively analyze the results of 150 cases from February 2010to June 2014.Statistical analysis with SPSS 21.0.Results Three of the most common gene type of XRCC1 399 is Arg/Arg(58.7％),Arg/Gln(36.7％) and Gln/Gln(4.6％),respectively.Three of the most common gene type of TYMS is 3R/3R (70.7％),2R/3R (25.3％) and 2R/2R (4.0％),respectively.Conclusion In resected non-small cell lung cancer,XRCC1 399 Arg/Arg genotype is the most common,followed by Arg/Gln type.At the sarne time,TYMS gene type 3R/3R accounted for more than 70％,especially higher percentage of in adenocarcinoma.Neither of these two gene polymorphism is recommended as marker to guide the postoperative individual chemotherapy.

Objective To explore the effect of traumatic brain injury on the fracture healing and its related mechanism by observing the expression of platelet-derived growth factors (PDGF) in serum and bone callus in rats with bone fracture and cerebral trauma.Methods One hundred and forty-four SD rats were randomized into 4 equal groups (n =36) which were subjected respectively to:no treatment (group N),traumatic brain injury (group TBI),bone fracture (group F) and bone fracture and cerebral trauma (group TBI + F).The animals were sacrificed at 3 days,1,2,3 and 4 weeks after modeling.In all the 4 groups,ELISA was used to detect the expression of PDGF in serum.In groups F and TBI + F,the callus growth was observed at the right tibial fracture site by X-ray,the callus growth and morphology were also observed by HE staining,the expression of PDGF in the callus tissue was measured by immunohistochemieal analysis,and the expression of PDGF mRNA in the callus tissue was measured by RT-PCR.Results X-ray showed that fracture healing was accelerated in group TBI + F compared with group F.The serum expression of PDGF in group TBI + F was significantly higher and the peak time was significantly earlier than in the other 3 groups (P ＜ 0.05).H-E staining showed that osteoblastic activity at the fracture ends in group TBI + F was stronger than in group F.Inmunohistochemica[staining showed that the expression of PDGF in the local callus was significantly higher at 3 days and 1 week in group TBI + F and the peak time was significantly earlier than in group F (P ＜ 0.05).RT-PCR showed that the expression of PDGF mRNA in the local callus was significantly higher at 3 days and 1 week in group TBI + F than in group F (P ＜0.05).Conclusions Traumatic brain injury can promote fracture healing in rats,which is probably related to increased expression of PDGF after cerebral trauma.

ObjectiveTo investigate the correlation between the methylation status of HLA class Ⅰ genes(HLA-A, -B and -C) in psoriatic epidermis and disease severity in patients with psoriasis vulgaris. MethodsDNA specimens were obtained from the lesional and nonlesional epidermis of 46 patients with psoriasis vulgaris and from the normal skin of 28 human controls. Methylation specific PCR (MSP) was conducted to detect the methylation status of CpG islands in the promoter region of HLA-A, -B and -C genes. The severity of psoriasis was evaluated by psoriasis area and severity index(PASI) scores. ResultsThe percentage of promoter methylation of HLA-B and HLA-C genes was 4.35％(2/46) and 21.74％(10/46), respectively in nonlesional epidermis, 4.35％ (2/46) and 4.35％ (2/46), respectively in lesional epidermis from these patients. No methylation was observed for the promoter of HLA-A, -B or -C gene in the normal control epidermis or for that of HLA-A gene in the nonlesional or lesional epidermis from the patients. The frequency of HLA-C gene promoter methylation in the nonlesional epidermis was significantly higher than that in the lesional epidermis and control epidermis, but was uncorrelated to the disease severity. No significant difference was observed for the methylation frequency of HLA-A or -B gene promoter among the three groups of specimens. Conclusion Abnormal methylation of HLA-C gene promoter is observed in patients with psoriasis vulgaris.

Objective To establish a diagnostic scoring system for coronary artery disease(CAD)in patients with diabetic foot(DF)and evaluate its application efficiency. Methods The clinical data of 445 DF inpatients were analyzed retrospectively in this case?control study. These patients were divided into the CAD group(n=372,DF with CAD)and the control group(n=73,DF without CAD)according to the presence or absence of CAD. Risk factors were screened from related clinical factors examined through multiple logistic regression analysis for CAD in patients with DF and were assigned according to odds ratio(OR)to establish the scoring system for diagnosis of CAD in patients with DF. Application efficiency of the di?agnostic scoring system was tested by calculating area under the receiver operating characteristic(ROC)curve. Results The multiple logistic re?gression analysis showed that risk factors for CAD in patients with DF were age,male sex,the duration of diabetes≥10 years,the ankle?brachial in?dex(ABI)≤0.9,body mass index(BMI)≥25 kg/m2 and chronic renal insufficiency. According to ORassigned age(<50 years=0,50?64 years=1,≥65 years=2),sex(female=0,male=2),the duration of diabetes(<10 years=0,≥10 years=3),ABI(>0.9=0,≤0.9=2),BMI(<25 kg/m2=0,≥25 kg/m2=3)and chronic renal insufficiency(absent=0,present=3)scores. Area under the ROC curve of the diagnostic score scheme was 0.758(0.682?0.835),the standard error was 0.039,and the point of the diagnosis of CAD was 7. Conclusion The scoring system established in the study is efficacious,simple and practical,which provides an important reference for CAD in patients with DF.

Objective:To investigate the feasibility of real-time screening and diagnosing fundus diseases with Wild Field Imaging System (WFIS SW-8000) in the eyes with dense cataract patients.Methods:A series of case-observational study was carried out.Ninety-six dense cataractous eyes of 90 patients with suspected fundus diseases were included in Affiliated Hospital of Nantong University from April to July 2019.Lens phacoemulsification combined with intraocular lens implantation was performed after the opacity lens was removed, and fundus examination was performed with WFIS SW-8000.Super field lens, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) was used to verify the fundus findings after surgery, which were compared with WFIS SW-8000.This study protocol was approved by Ethics Committee of Affiliated Hospital of Nantong University and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:Among 96 eyes, fundus diseases were detected in 40 eyes with the detection rate of 41.67% by WFIS SW-8000 examination, including dry age-related macular degeneration (AMD) in 2 eyes, wet AMD in 3 eyes, polypoidal choroidal vasculopathy (PCV) in 1 eye, high myopia retinopathy (HMR) in 7 eyes, central retinal vein occlusion (CRVO) with macular edema (ME) in 1 eye, mild non-proliferative diabetic retinopathy (NPDR) in 12 eyes, moderate NPDR in 7 eyes, severe NPDR in 4 eyes and proliferative diabetic retinopathy (PDR) in 3 eyes.Fundus diseases were detected in 45 eyes with detection rate of 46.88% after surgery by a super field lens, OCT and FFA.The detectable rate of digital retinal camera examination and super field lens, OCT and FFA showed no significant difference between intraoperation and postoperation (χ 2=0.528, P=0.468). Twenty-two eyes with fundus neovascular disease or macular edema requiring drug intervention were identified intraoperatively, and intravitreal anti-inflammatory and/or anti-vascular endothelial growth factor (VEGF) drugs were injected in 11 eyes during the operation. Conclusions:WFIS SW-8000 is a useful tool for the accurate and convenient method in real-time fundus examination during phacoemulsification, which is feasible and helpful for timely intervention in and treatment of fundus diseases.

OBJECTIVETo investigate the frequency of microsatellite instability (MSI) and loss of heterozygosity (LOH) at human leucocyte antigen(HLA) class I loci in cervical carcinoma and the detailed deletion mapping in this region.

METHODSLOH and MSI of HLA class I genes were analyzed in 30 paired blood and tumor samples by PCR based single-stranded length polymorphism (PCR-SSLP).

RESULTSOf the 30 cases, 23(76.7%) showed LOH at one or more loci. Higher frequencies of LOH were found at four loci: C3_2_11 (50%), C1_4_4 (37%), C1_2_5 (36.7%), D6S276 (48.3%). MSI was found in 20 out of 30 cases (66.7%).

CONCLUSIONThe data suggest that the LOH and MSI of HLA class I gene might participate in the carcinogenesis of cervical carcinoma. Meanwhile, the minimal deletion region might be defined between C1_2_5 and C3_2_11, thus providing the evidence for cloning the tumor suppressor genes associated with cervical carcinoma.

Adult ; Aged ; Female ; Histocompatibility Antigens Class I ; genetics ; Humans ; Loss of Heterozygosity ; genetics ; Microsatellite Instability ; Middle Aged ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms ; genetics

OBJECTIVEThe effect of the different fertilizing levels on yields and main active components of Pinellia ternata from Sichuan was studied under the cultivated condition, in order to provide theoretical basis for the standardized cultivation.

METHODUsing one of the wild populations of P. ternate from Sichuan as tested material, the experiment was performed with orthogonal designing methods L25 (5(3)). During growth and development period, agronomic traits such as number of sprouting, inflorescence and bulblets were counted. After harvesting, main chemical compositions, growth and proliferation rates were determined.

RESULTIn different fertilizing levels, the P. ternata from Sichuan showed the same growth rhythm, though there were significant difference (P < 0.05) among the average emergence rate,whereas extremely significant difference (P < 0.01) were detected among the average ratio of bolting, the average bulbils, individual growth rate, individual proliferation rate, beta-sitosterol and alkaloid content under different fertilizing levels. Nitrogenous fertilizer that affected the content of alkaloids and beta-sitosterol were extremely significant (P < 0.01), whereas phosphate and potassium fertilizer had no significant effect. The effect of fertilizer factor and inter effects on beta-sitosterol showed no significant effect, but have influence on other indexes.

CONCLUSIONThe optimum fertilizer composition was 315 kg x hm(-2) of nitrogen, 225 kg x hm(-2) of P2O5 and 270 kg x hm(-2) of K2O.

Alkaloids ; analysis ; Fertilizers ; Nitrogen Compounds ; analysis ; Phosphates ; analysis ; Phosphorus Compounds ; analysis ; Pinellia ; chemistry ; growth & development ; Potassium Compounds ; analysis ; Sitosterols ; analysis