OBJECTIVETo study clinical effects of the over-articular external fixator combined with limited internal fixation for the treatment of Pilon fractures caused by high energy.

METHODSFrom September 2003 to April 2011, 36 patients with Pilon fractures caused by high energy were treated with the over-articular external fixator combined with limited internal fixator. There were 25 males and 11 females, ranging in age from 16 to 72 years old,with an average of 38 years old. The diagnoses of all patients were determined by conventional X-ray examination or three-dimensional spiral CT examination. The AOFAS scoring criteria was used to evaluate the therapeutic effects. The patients with comminuted fractures were treated with screw or Kirschner wire fixation without uncovering periost so as to enhance stability between fracture end and bone blocks,followed by the fixation with over-articular external fixators.

RESULTSAll the patients were followed up, and the duration ranged from 4 to 27 months, with an average of 13 months. Thirty-two patients got wound healing at the first stage. And the bone union duration ranged from 2 to 6 months, with a mean of 3 months. According to the AOFAS ankle-hindfoot subjective scoring standard, 13 patients got an excellent result, 20 good and 3 fair, with an score of 88.2 +/- 3.6. Twelve patients had infections at pinhole, 5 patients had pinhole pain. One patient had the fixator broken induced by over loading, who was cured after treatment. There were no complications such as nerve or vascular injuries, or osteomyelitis.

CONCLUSIONThe over-articular external fixation combined with limited internal fixation for the treatment of Pilon fractures caused by high energy is an ideal method, which has such advantages as reliable fixation, simple operation, coincidence with principles of biomechanical fixation, and benefit for fracture healing.

Adolescent ; Adult ; Aged ; Ankle Injuries ; diagnostic imaging ; surgery ; Ankle Joint ; diagnostic imaging ; surgery ; External Fixators ; Female ; Fracture Fixation ; Fracture Fixation, Internal ; Humans ; Internal Fixators ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the expression and clinical implication of receptor for activated C kinase 1 (RACK1) in mononuclear cells and coronary atherosclerotic plaques from patients with coronary artery disease.

METHODSmRNA and protein expressions of RACK1 were detected in mononuclear cells from 29 patients with stable angina pectoris (SAP), 41 patients with acute coronary syndrome (ACS) and 30 healthy volunteers. RACK1 protein expression was also detected by immunohistochemistry in 17 coronary atherosclerotic plaques and 6 normal autopsy coronary samples.

RESULTS(1) mRNA expression of RACK1 was significantly upregulated in mononuclear cells from patients with ACS compared with those from patients with SAP (18.71 ± 5.45 vs. 12.18 ± 4.14, P < 0.05), and the latter was also significantly higher than in healthy controls (12.18 ± 4.14 vs. 3.65 ± 1.57, P < 0.05). (2) Similar changes were observed for protein expression of RACK1 for the three groups. (3) Increased expression of RACK1 was found in atherosclerotic plaques, especially in unstable plaques, positive RACK1 stain was evidenced in foam cells, inflammatory cells, smooth muscle cells and endothelial cells.

CONCLUSIONSThe expression of RACK1 is significantly upregulated in mononuclear cells from patients with coronary artery disease, especially in patients with ACS, and in coronary atherosclerotic plaques, especially in unstable plaques. Our results thus suggest that RACK1 might play an important role in the development and progression of coronary artery disease.

Adult ; Aged ; Case-Control Studies ; Coronary Artery Disease ; blood ; genetics ; pathology ; Female ; Gene Expression ; Humans ; Leukocytes ; metabolism ; Male ; Middle Aged ; Receptors for Activated C Kinase ; Receptors, Cell Surface ; genetics ; metabolism

Aged ; Genital Neoplasms, Male ; pathology ; Humans ; Male ; Neurilemmoma ; pathology ; Scrotum

Aged ; Aged, 80 and over ; Female ; Fracture Fixation, Internal ; adverse effects ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

Objective To observe the clinical effect of therapy of strengthening Qi, resolving phlegm and dissipating mass for middle-late non-small cell lung cancer. Methods Sixty patients with middle-late non-small cell lung cancer were randomly divided into 3 groups according to the results of intention-to-treat and genetic test. All of the 3 groups were given fundamental supportive and asymptomatic treatment, and additionally Group Ⅰ was mainly given oral use of Jinfuan Decoction with the actions of strengthening Qi, resolving phlegm and dissipating mass based on syndrome differentiation, group Ⅱ was treated with molecular targeted therapy with Gefitinib Tablets and /or Erlotinib Hydrochloride Tablets, and groupⅢ was only given the fundamental supportive and asymptomatic treatment. The 3 groups were treated for 3 cycles(84 days), and then we compared the tumor size, clinical symptoms, quality of life, distant metastasis, and the toxic and adverse effect in each group. Results (1) GroupⅠand group Ⅱhad stronger effect on relieving cough, shortness of breath and lassitude than groupⅢ(P<0.05); groupⅡand groupⅢwere more effective on relieving bloody sputum and chest pain than groupⅠ(P<0.05); groupⅠand groupⅢwere more effective on relieving fever than groupⅡ(P < 0.05). (2) In aspect of quality of life, KPS scores of groupⅠand group Ⅱwere much increased after treatment (P < 0.05), but the scores of group Ⅲ showed no obvious increase (P > 0.05). The improvement of KPS scores in groupⅠand groupⅡwas superior to that in groupⅢ(P<0.05). (3) GroupⅡhad a higher effective rate on stabilizing tumor size, the rate arrived to 65.0％, and was superior to that in groupⅠand groupⅢ(P <0.05) , and the effective rate in group Ⅰ was superior to that in group Ⅲ(P < 0.05). Group Ⅰ and group Ⅱhad a higher stabilizing rate than group Ⅲ(P < 0.05) , but the difference between group Ⅰ and group Ⅱ was insignificant (P>0.05). (4) GroupⅠhad less adverse reaction and higher safety. (5) The distant metastasis rate in groupⅠand groupⅡwas obviously lower than that in groupⅢ(P<0.05), but the difference of distant metastasis rate beetween group Ⅰ and group Ⅱ was insignificant (P > 0.05). Conclusion Therapy of strengthening Qi , resolving phlegm and dissipating mass is effective on relieving tumor-related symptoms , improving the quality of life, stabilizing the tumor, and controlling the distant metastasis in middle-late non-small cell lung cancer patients.

BACKGROUNDEmbryonic stem (ES) cells poss unlimited self-renewal capacity and the ability to differentiate into cell of all three germ layers in vitro. Induced differentiation of ES cells to neural lineage cells has great potential in basic study of neurogenesis and regeneration therapy of neurodegenerative diseases. Histone deacetylase (HDAC) inhibitors enhance histone acetylation so that globularly activate gene expression and may initiate multilineage differentiation. In this study, we aimed to develop a method to induce the differentiation of ES cells to neural cells combining HDAC inhibition and neural cell selection.

METHODSIn this study, we used HDAC inhibitor sodium butyrate (NaB) to induce the differentiation of mouse embryonic stem cells to neural cells through monolayer culture. After differentiation initiation by histone deacetylase inhibitor sodium butyrate, neural cells were induced and selected with a serum free culture system.

RESULTSHomogeneous neurons without glial cells demonstrated by molecular marker expression were differentiated with the method. The resultant neurons were excitable.

CONCLUSIONThe method combined differentiation induction effect of HDAC inhibitors and selective culture system to derive neural cells from ES cells, and implied the involvement of epigenetic regulation in neural differentiation.

Animals ; Butyrates ; pharmacology ; Cell Adhesion ; Cell Cycle ; drug effects ; Cell Differentiation ; drug effects ; Cells, Cultured ; Embryonic Stem Cells ; cytology ; drug effects ; Fibroblast Growth Factor 2 ; pharmacology ; Histone Deacetylase Inhibitors ; pharmacology ; Mice ; Neurons ; cytology ; physiology

OBJECTIVEWith the objective of discovering novel putative chromosomal regions and special genes involved in the carcinogenesis, progression and metastasis of laryngeal squamous cell cancer (LSCC).

METHODSDNA copy profile of LSCC were obtained and analyzed by comparative genomic hybridization (CGH) and a computerized digital image analysis system. cDNA microarray of LSCC was performed and the profile was analyzed by Hierarchical clustering.

RESULTSCGH analysis showed average-12.9 gains and losses of chromosomes in LSCC. Relatively high frequencies of gains were found at 3q15-21 (14/18), 5p12-13 (11/18), 8q22-24 (6/18), 11q12-13 (8/18), 15q21-23 (7/18) and 18p11 (8/18), while those of losses at 1p13-21 (8/18), 3p21-23 (14/18), 5q21-22 (14/18), 9p12-pter (11/18) and 13q21-31 (8/18). Hierarchical clustering analysis showed that the differentially expressed genes were segregated into three groups. Three genes differentially expressed in process I (normal tissue to cancer) and process II (cancer to lymph node metastasis), and the Cy5/Cy3 ratios of twelve genes were either higher than 5.0 or lower than 0.2 in process I or process II. The fifteen special genes were first reported possibly to be the relationships with LSCC. In particular, 4 genes of them, which were cytochrome C oxidase Va, PPBP, EPHX2 and PON1, were first reported to correlate with tumorigenesis. SH3GL2, which was one of the 15 special genes, was located at one of the special chromosome regions, 9p12-pter.

CONCLUSIONThe important genes and special chromosomal aberrances might provide us a clue for further investigation of carcinogenesis, progression and metastasis in LSCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; genetics ; pathology ; Chromosome Aberrations ; DNA, Neoplasm ; analysis ; Disease Progression ; Female ; Gene Expression ; Humans ; Karyotyping ; Laryngeal Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Metastasis ; Nucleic Acid Hybridization ; Oligonucleotide Array Sequence Analysis

OBJECTIVETo study the correlation between morphological variation and gentiopicroside content in cultivated Gentiana manshurica roots and to investigate the feasibility of breeding new varieties of high effective constituent content.

METHODGentiopicroside was determined in 5 morphological types of cultivated G. manshurica roots by HPLC, which are normal (or wild) type, white-flowered type, thick-rooted type, broad-leaved type I and broad-leaved type II.

RESULTAmong different types gentiopicroside content is the highest in the roots of thick-rooted type, the contents decrease as following order: normal type, broad-leaved type I white-flowered type and broad-leaved type II, and the gentiopicroside contents in the same type root system are a positive correlation with root ages, as 3-years-age roots > 2-years-age roots > 1-year-age varied with roots.

CONCLUSIONThe contents of effective constituent vary with the morphological variation in cultivated G. manshurica. It is feasible to breed a new variety with high effective constituent with the morphological character as a selecting index.

Genetic Variation ; Gentiana ; anatomy & histology ; chemistry ; classification ; Glucosides ; analysis ; Iridoid Glucosides ; Iridoids ; analysis ; Plant Roots ; anatomy & histology ; chemistry ; Plants, Medicinal ; anatomy & histology ; chemistry ; classification ; Pyrans ; analysis ; Species Specificity

The aim of this study was to investigate the feasibility of the human cord blood adult stem cells (ASCs) to differentiate into hepatocytes in vitro induced by combined stimulation with hepatocyte growth factor (HGF), stem cell factor (SCF) and leukemia inhibitory factor (LIF). The adult stem cells were obtained through density gradient centrifugation and magnetic activated cell sorting (MACS). The adult stem cells were cultured in DMEM with HGF (10 ng/ml)+SCF (10 ng/ml)+LIF (10 ng/ml) in induced group I. In induced group II the enriched cells were cultured in DMEM with SCF (10 ng/ml)+LIF (10 ng/ml) and the undifferentiated cells acted as the control group without the factors. The morphology of cells was observed by the inverted phase contrast microscopy; the expression of albumin (Alb), human hepatocyte cytokeratin (CK18) and alpha-fetoprotein (AFP) were detected by immunofluorescence, immunohistochemistry and RT-PCR assay in the 21-day culture. Alb secreted by hepatocytes in the medium was determined by radioimmunoassay (RIA) at day 7, 14, 21, 23 and 25. The results showed that the shapes of ASCs changed and their sizes and number increased in the course of culture in group I. After being induced for three weeks, the cells turned round and resembled hepatocyte-like cells. The mRNA for Alb could be detected by RT-PCR in the differentiated adult stem cells in group I, and the mRNA for AFP was poorly detected by RT-PCR at day 21. Alb and CK18 were positive through immunofluorescence and immunohistochemistry at day 21, compared with group II and the control group. In group I, Alb in the medium significantly increased, compared with control group, and reached the highest level at day 21, then decreased at day 23. It is concluded that under some definite inducing conditions, human cord blood adult stem cells can differentiate into hepatocyte-like cells and HGF plays a critical role during the course.
Adult Stem Cells ; cytology ; Cell Differentiation ; physiology ; Cells, Cultured ; Fetal Blood ; cytology ; Hepatocyte Growth Factor ; pharmacology ; Hepatocytes ; cytology ; Humans ; Leukemia Inhibitory Factor ; pharmacology

OBJECTIVETo summarize our experience on the diagnosis and treatment of pancreatic serous cystadenoma.

METHODData from 20 patients with pancreatic serous cystadenoma in Peking Union Medical College Hospital from 1994 to 2004 were analyzed retrospectively.

RESULTSUltrasound test was a good choice for primary diagnosis, while computed tomography scan and endoscopic retrograde cholangiopancreatography (ERCP) were better choice for the suspected cases. Most tumors (60%) were located in the body and tail of pancreas. The distal pancreatectomy was the commonest operation procedure. The main complications were pancreatic leakage (35%). The symptoms were resolved after surgical treatment.

CONCLUSIONSThe treatment of pancreatic serous cystadenoma depends on the accurate diagnosis. Ultrasound and computed tomography are useful diagnostic methods. Surgical operation is the treatment of choice. Long-term follow-up has shown satisfactory outcomes if the tumors are resected completely.

Adult ; Aged ; Aged, 80 and over ; Cystadenoma, Serous ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms ; diagnosis ; diagnostic imaging ; surgery ; Pancreaticoduodenectomy ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography