Objective To study the effect of serum leptin in “two hits” of nonalcoholic fatty liver disease (NAFLD).Methods Fasting serum leptin(LEP) ,malondialdehyde(MDA) ,hyaluronic- acid(HA) ,type Ⅲ procollagen ( PCⅢ), laminin ( LN), and type Ⅳ collagen ( Ⅳ-C ) were detected in 43 simple nonalcoholic fatty liver( NAFL ) patients ,41 NASH patients and 40 healthy subjects. Insulin resistance was estimated by HOMA value and its relatio nship with leptin level in NAFLD was analyzed. The severity of lipid peroxidation was estimated by MDA and its relationship with leptin level in NAFLD was analyzed. The relationship of serum fibrosis markers with leptin level in NAFLD also was analyzed. Results Serum leptin, HOMA value in NAFLD were higher than those of healthy controis. MDA,PC Ⅲ 、Ⅳ-C 、LN 、HA in NASH were higher than those of healthy controls or simple NAFL patients. ,HOMA value, in NAFLD positively correlated with leptin. MDA, PC Ⅲ、 Ⅳ-C 、LN、HA in NASH positively correlated with leptin. Conclusion Serum leptin closely correlated with insulin resistance which results in “First hit” of NAFLD. There was certain relationship of leptin with “Second hit” of NAFLD. Leptin should be one of the factors which result in liver fibrosis.

Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

Objective To evaluate the clinical efficacy of universal self-locking anatomical plate for acetabulum and pelvis (USAPAP) in the treatment of posterior acetabular fractures.Methods Data of 55 patients with posterior acetabular fractures who were treated with the USAPAP from January 2014 to January 2016 were retrospectively analyzed.There were 39 males and 16 females with an average age of 38.5 years old (range,17-82 years).There were 35 fractures on the left side while the other 20 fractures were on the right side,including 52 fresh cases and 3 old cases.According to Letournel-Judet classification,there were 32 cases of posterior wall,9 cases of transverse and posterior wall,5 cases of anterior column and posterior wall,2 cases of posterior column,2 cases of transverse,2 cases of two columns,1 case of anterior column and posterior hemitransverse,2 cases of Pipkin type Ⅳ.All patients were managed operatively by the USAPAP,which allows simultaneous fixation for two columns and quadrilateral surface fractures through a single Kocher-Langenback approach.The quality of reduction was assessed by Matta's score system.The mean follow-up period was 18.5 months (range,12-24 months).Average operation time was 95 min,and average blood loss was 350 ml.Average operation time of plate and screws fixation was 19 min,and average fluoroscopy times in the surgery was 2 times.The mean time of bony union was 4.3 months.According to the criteria described by Matta,the excellent and good rate of radiological score was 92.7％ (51/55),including 39 cases excellent,12 cases good and 4 cases poor.The excellent and good rate of Merle d'Aubigne-Postel score was 87.3％ (48/55),including 35 cases of excellent,13 cases of good,5 cases of fair,and 2 cases of poor.Heterotopic ossification occurred in 1 patient (Brooker type Ⅱ) at three months postoperatively.One case with Pipkin type Ⅳ fracture underwent total hip arthroplasty due to femoral head necrosis at seven months postoperatively.Complications including wound infection,sciatic nerve injury,screw invade joint,redisplacement of the fracture,avascular necrosis of bone fragment,hardware failure,nonunion or malunion was not found in any case at the latest follow-up.Conclusion The USAPAP through the single posterior Kocher-Langenback approach provides strong and stable fixation for complex acetabular fractures associated with posterior region including posterior wall,both columns and quadrilateral surface.Satisfactory clinical results can be achieved by the use of this method.

OBJECTIVETo evaluate the results of manipulative reduction and percutaneous pin fixation for the treatment of severely displaced proximal humeru fracturess in children.

METHODSFrom January 2006 to December 2010, 43 patients with severely displaced proximal humeru fractures were treated with manipulative reduction and percutaneous pin fixation. There were 28 boys and 15 girls,ranging in age from 3 to 17 years,with an average of 11.1 years. Preoperative diagnoses were confirmed by the X-ray films as Neer-Horwitz type III or IV fractures. All the patients were close fractures without nerve or vascular injuries. Under C-arm X-ray machine, anatomical reduction was achieved by manipulative reduction according to the bone fracture type. The fractures were fixed by percutaneous pinning. Postoperative X-ray confirmed anatomical reduction. Follow-up index were recorded: intra-operative and postoperative complications, postoperative radiographic examination, upper extremity length and range of shoulder motion. Neer score system was used to evaluate shoulder function.

RESULTSAll the patients were followed up, and the duration ranged from 3 to 37 months with an average of 20.4 months. The mean Neer score of the injured side was (95.0 +/- 4.3) (ranged, 85 to 100). Thirty-eight patients got an excellent result, 5 good. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. All the patients could participate in the normal physical activities and had a normal range of motion and excellent strength of the shoulder joint.

CONCLUSIONThe method of manipulative reduction and percutaneous pin fixation is relatively reliable treatment for severely displaced proximal humerus fractures in children.

Adolescent ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Internal Fixators ; Male ; Treatment Outcome

OBJECTIVETo investigate the ion channel genes related with the genesis and development of heart failure after myocardial infarction through analyzing the differential gene expressions in non-infarcted myocardial tissues of post-myocardial infarction heart failure (PIHF) rat model, and that of normal rat, and the bio-informatics Stc-GO analysis on them.

METHODSRat model of PIHF was established by left anterior descending coronary artery ligation in six SD rats, and a control group with six sham-operative rats was set. Myocardial samples were taken in two batches from them (three rats in each group) at the heart failure formation stage and the stable stage (10 days and 8 weeks after operation) respectively. Total RNA extraction, probe preparation with reverse transcription, hybridization with double-channel cDNA microarray of rat's ion channel genes, and computerized differential gene expression screening were conducted, and Stc-GO functional clustering analysis was performed on the outcomes obtained to search out the GO sort of significance in them.

RESULTSAt 10 days after operation, 319 common differential expressed genes were found from the 746 target genes, all of them were up-regulated. At 8 weeks after operation, in the 276 differential expressed genes, 274 were up-regulated while the other two down-regulated. The up-regulated genes were those concerning receptors of various hormones, cytokines, neuro-hormones, growth factors and nuclear receptor, protein phosphorylase, G protein, various ion channels mediated by ligand or voltage, transport protein, receptor interfering protein, etc. The down-regulated genes concerning the potassium channel and transport protein, etc. Stc-GO analysis found that the six genes concerning adrenergic receptor kinase beta 1 (betaARK1), amiloride-sensitive cation channel 2 neuronal (Accn2), voltage-dependent calcium ion channel gamma subunit 1 (Cacng1), cyclic nucleotide gated channel alpha 1 (Cnga1), Glutamate receptor ionotropic kainite 2 (Grik 2) and neurotrophic tyrosine kinase receptor type 2 (Ntrk 2), were all the significantly up-regulated differential genes of the model group related with the sham-operative group, and all showed a down-regulating trend as time goes on, and four genes in them were validated by the RT-PCR test.

CONCLUSIONIon channel genes concerning Accn2, Grik2, Ntrk2 and Cacng1 were up-regulated in PIHF, and its mechanism is waiting for further study.

Animals ; Heart Failure ; etiology ; genetics ; metabolism ; Ion Channels ; metabolism ; Male ; Myocardial Infarction ; complications ; genetics ; metabolism ; Oligonucleotide Array Sequence Analysis ; Rats ; Rats, Sprague-Dawley ; Transcriptome

OBJECTIVETo explore the effective skills of reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus in order to avoid postoperative complications of joint instability and great tubercle displacement.

METHODSFrom June 2002 to June 2006, 25 patients with Neer four-part fracture of the proximal humerus were adopted in the study which included 15 females and 10 males, with the mean age of 66 years (ranged from 56 years to 80 years). They were treated with humeral head replacement and should joint reparation simultaneously by modified operation approach and reconstruction and balance skills of soft tissue.

RESULTSThe mean duration of follow-up was 2.3 years (ranged from 1 to 4.5 years). No infection, nerve damage and prosthesis loosing were found in all cases. Two cases of infra-forward dislocation or subluxation occurred due to affected limb placed on abduction splint postoperatively. One case occurred prosthesis upward displacement due to early active abduction exercise but no complains. Neither joint instability nor displacement and malunion of great tubercle were found in other patients. According to Neer scoring system, 6 cases were rated as excellent, 15 as good and 5 as fair. The good and excellent rate was 84%.

CONCLUSIONIn hemi-shoulder replacement for patients with Neer four-part fracture the modified operation approach and reconstruction and balance of soft tissue skills combined with rational rehabilitation exercise can prevent postoperative shoulder joint instability and displacement and malunion of great tubercle.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement ; methods ; Connective Tissue ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Shoulder Fractures ; surgery ; Shoulder Joint ; surgery

OBJECTIVETo explore the therapeutic efficacy and safety of batroxobin in patients with primary hepatic carcinoma (PHC) and the advantages of transcatheter arterial perfusion of batroxobin combined with transcatheter arterial chemoembolization (TACE).

METHODS40 patients with PHC were randomized into experimental group (transcatheter arterial perfusion of batroxobin combined with TACE treatment, 20 patients) and control group (TACE alone group, 20 patients). The patients were followed up and the data were recorded, compared and analyzed.

RESULTS(1) Compared with the control group, the FIB level in the experimental group was significantly decreased at the first month after treatment (P < 0.05). (2) The baseline of the tumor was shortened in both groups after the treatment. There was a significant difference between the two groups at different time intervals (P < 0.05). (3) After the treatment, there was a significant difference of PFS levels between the two groups (t = 2.877, P < 0.05).(4) The incidence of metastasis were 5.0% (1/20) in both groups at 6 months after treatment, and that after one year was 10.0% (2/20) in the experimental group and 25.0% (5/20) in the control group. However, the difference was not significant (chi(2) = 0.693, P > 0.05).

CONCLUSIONBatroxobin can rapidly and effectively decrease the FIB level. Therefore it may be used as an effective and safe adjuvant drug for the the treatment of primary hepatic carcinoma. Transcatheter arterial perfusion of batroxobin combined with TACE therapy has advantages in comparison with TACE alone. It could be taken as a new therapeutic regimen in the PHC treatment.

Adult ; Aged ; Batroxobin ; therapeutic use ; Carcinoma, Hepatocellular ; blood ; pathology ; therapy ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Fibrinogen ; metabolism ; Fibrinolytic Agents ; therapeutic use ; Follow-Up Studies ; Humans ; Liver Neoplasms ; blood ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Metastasis

OBJECTIVETo study the chemical constituents in the rhizome of Elaeagnus bockii.

METHODCompounds were isolated by silica gel and Sephadex LH-20 chromatography. Their structures were elucidated by means of spectral analysis.

RESULTSeven compounds were isolated from the rhizomes of E. bockii, and their structures were identified as angelicin (1), psoralen (2), vanillic acid (3), bakuchiol (4), oleanolic acid (5), ursolic acid (6) and beta-sitosterol (7 ).

CONCLUSIONAll these compounds were obtained from E. bockii for the first time.

Elaeagnaceae ; chemistry ; Ficusin ; chemistry ; isolation & purification ; Furocoumarins ; chemistry ; isolation & purification ; Phenols ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Vanillic Acid ; chemistry ; isolation & purification

Fusarium graminearum (sexual stage: Gibberella zeae) is the causative agent of Fusarium Head Blight (FHB), which is one of the most destructive plant disease of cereals, accounting for high grain yield losses, especially for wheat and maize. Like other fungal pathogens, several extracellular enzymes secreted by G. zeae are known to be involved in host infection. Among these secreted lipases, G. zeae lipase (GZEL), which is encoded by the FGL1 gene, was demonstrated to be crucial to G. zeae pathogenicity. However, the precise mechanism of GZEL remains unclear due to a lack of detailed structural information. In this study, we report the crystal structure of GZEL at the atomic level. The structure of GZEL displays distinct structural differences compared to reported homologues and indicates a unique "double lock" enzymatic mechanism. To gain insight into substrate/inhibitor recognition, we proposed a model of GZEL in complex with substrate and the lipase inhibitor ebelactone B (based on the reported structures of GZEL homologues), which defines possible substrate binding sites within the catalytic cleft and suggests an "anti sn-l" binding mode. These results pave the way to elucidating the mechanism of GZEL and thus provide clues for the design of anti-FHB inhibitors.
Amino Acid Sequence ; Catalytic Domain ; Crystallography, X-Ray ; Gibberella ; enzymology ; Lactones ; chemistry ; Lipase ; chemistry ; metabolism ; Models, Molecular ; Molecular Sequence Data ; Oleic Acid ; chemistry ; Protein Binding ; Protein Structure, Secondary ; Protein Structure, Tertiary ; Sequence Alignment ; Sequence Homology, Amino Acid ; Substrate Specificity ; Surface Properties

Objective To explore the risk factors of cardiovascular disease in adolescents with a family history of hypertension.Methods A cross-sectional study was conducted in 3874 adolescents ages 13-18 years,with normal BP in 3724 people.Based on family history of hypertension (FH),the cohort of adolescents were dichoto- mized as postive family history (FH~+,n=1145) and negative (FH~-,n=2579).Height,weight,waist circum- ference,hip circumference,blood pressure and fasting plasma glucose(FPG),total cholesterol(TC),triglyceride (TG) and high-density lipoprotein cholesterol(HDL-C) were determined.Results FH~+ adolescents had signifi- cantly higher levels of body mass index(BMI),waist circumference,WHR,FPG,TC and LDL-C(P