OBJECTIVETo typing of tibial plateau fracture based on spiral CT reconstruction and to explore effect of the typing method for treatment.

METHODSA hundred and twenty-six cases with tibial plateau fracture (male 95, female 31, age from 23 to 58 years old), the fractures were classified based on reconstruction image of spiral CT. Including central compression type in 13 cases, split type in 8, split compression type in 79, comminution type in 26. According to the different typing the suitable incision of operation and fixed method for fracture were select.

RESULTSA hundred and twenty-six cases were followed up for 0.5-4 years with an average of 1.2 years. According to Hohl system score to knee joint function, there were statistical significance in the pain,active movement,active range of motion between before and after operation (P < 0.01) and there were no statistical significance in stability and self-evaluation (P < 0.01).

CONCLUSIONTyping of tibial plateau fracture based on spiral CT reconstruction helpful to choose operative approach, reduction and fixed method and obviously improve clinical effect.

Adult ; Female ; Follow-Up Studies ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tibial Fractures ; diagnostic imaging ; surgery ; therapy ; Tomography, Spiral Computed ; Treatment Outcome

Background Asthma is a complex disease involving genetic and environment interactions.Atopy is a strong risk factor for asthma.The airway epithelium not only forms a physical barrier but also provides immune defense against harmful materials.To explore the effects of airway epithelium on asthma,we hypothesized that environmental injuries could act on bronchial epithelial cells and damage the physical barrier,which might facilitate allergens to stimulate immunoreactions and play an important role in the pathogenesis of asthma.Methods Thirty eight-week-old male Wistar rats were randomly divided into five groups with six rats in each group:control group,asthma group,ovalbumin (OVA)+OVA group,lipopolysaccharide (LPS) group and LPS+OVA group.In the control group,0.9％ saline was injected intraperitoneally on day 1.Fourteen days later,the rats were exposed to aerosolized 0.9％ saline.In the asthma group,the rats were sensitized with an injection of 10 mg of OVA,followed by an aerosolized 2％ OVA challenge14 days later.The OVA+OVA group was sensitized by an inhalation 2％ OVA,20 minutes a day,from day 1 to day 7,and then OVA challenged in the same way as the asthma group.In the LPS group,LPS (200 μl,1 μg/μl) was given by airway on day 1 and day 3,with a simultaneous aerosol inhalation of 2％ OVA for 20 minutes a day from day 1 to day 7.Fourteen days later,the rats were challenged with saline as in the control group.While in the LPS+OVA group,LPS (200 μl,1 μg/μl) was given by airway on day 1 and day 3,with a simultaneous aerosol inhalation of 2％ OVA for 20 minutes a day from day 1 to day 7.Fourteen days later,the rats were challenged with OVA as in the asthma group.The expression of interleukin (IL)-4,interferon-gamma (IFN-y) and thymic stromal lymphopoietin (TSLP) in the lungs was detected by reverse transcription polymerase chain reaction (RT-PCR) and the pulmonary pathological changes were also observed.The level of IL-4,IFN-γ and IgE in plasma was detected by enzyme-linked immunosorbent assay (ELISA).Bronchoalveolar lavage fluid (BALF) was collected to conduct differential cell counts.Flow cytometry analysis was also used to count Th1 and Th2 cells.Results The pathological changes in the LPS+OVA group were similar to the asthma group,while in other groups,the pathological changes were not obvious.The ratio of lymphocytes in BALF,IL-4/IFN-γ in plasma and the expression of the TSLP and IL-4 in the asthma and LPS+OVA groups were higher than in the control group and the OVA+OVA group (P ＜0.05).The level of IgE was higher in the asthma,LPS and LPS+OVA groups than in the control group and the OVA+OVA group (P ＜0.05).By flow cytometry analysis,the Th1/Th2 ratio was lower in the LPS+OVA and asthma groups than in other groups (P ＜0.05).Conclusions The experiment results show that the injury to the bronchial epithelial layer may be the initial event of allergic responses.This finding implies that a rational approach to therapeutics would be to increase the resistance of the airways to environmental injuries rather than concentrating on suppressing inflammation.

Abstract: Objective　To evaluate the influence of coronavirus disease 2019 (COVID-19) prevention and control measures on the transmission and epidemic of influenza in Chongqing, so as to provide references for formulating targeted influenza prevention and control strategies. Methods　The influenza surveillance data, during the year 2018 to 2020, were collected through the "China Influenza Surveillance Information System", and the seasonal characteristics of influenza epidemic were analyzed. The percentage of influenza like cases (ILI%) and influenza virus positive rate between 2020 and 2018-2019 were compared, so as to evaluate the impact of COVID-19 prevention and control measures on influenza epidemic characteristics. Results　The annual proportions of ILI cases in Chongqing were respectively 3.53%, 2.23% and 1.2% from 2018 to 2020, while the positive rates of influenza virus were respectively 13.97%, 23.81% and 2.65%. The distribution trend of ILI% from 2018 to 2019 fluctuated were similar, but it continued to drop and remain at a low level since February 2020. The positive rate of influenza virus showed an epidemic peak from December to March in 2018-2019, also peaked from November 2019 to January 2020, but decreased to 0 in March. ILI% was positively correlated with the positive rate of influenza virus (r=0.404 8, P<0.05). In 2020, compared with the same period of 2018-2019, the growth rate of ILI% was -66.09% and -46.32%, respectively. The positive rate of influenza virus in 2020 decreased by 81.03% and 88.87% compared with the same period of 2018-2019, respectively. The growth rates of influenza virus positive rate in January 2020 were decreased with a small rate of about 39.87%, and with a significantly decline of more than 93.65% from February. No influenza epidemic was found after March. Conclusions　Since COVID-19 prevention and control measures were implemented in January 2020 in Chongqing, the ILI% and the positive rate of influenza virus in sentinel hospitals decreased significantly. In the season of high incidence of respiratory infectious diseases, personal protection and other measures can effectively reduce influenza virus infection.

OBJECTIVETo analysis the early complications of tibial fracture and its related factors, and propose a solution.

METHODSFrom December 2003 to December 2013,38 patients with early complications of tibial plateau fracture after operation were retrospectively analyzed. There were 35 males and 3 females, aged from 37 to 69 years old (averaged 42.3 years). According to Schatzker classification, 3 cases were classified as type II, 2 cases as type III, 2 cases as type IV, 19 cases as type V, 12 cases as type VI. The intervals between injury and operation ranged from 9 hours to 9 days, 26 cases within 3 days. Fifteen cases were treated with internal fixation of plates and 23 were treated by plate fixation and bone transplantation. Early complications included skin necrosis in 15 cases, infection in 6 cases, osteofascial compartment syndrome in 3 cases, common peroneal nerve injury in 2 cases, the superficial peroneal nerve injury in 3 cases, popliteal artery injury in 2 cases, loss of reduction in 7 cases.

RESULTSThe wound of 14 cases healed at the first stage and 24 cases healed delay. Hospitalization days ranged from 7 to 67 days (averaged 25.6 days). All patients were followed up for 12 to 36 months with an average of 16.4 months. The fracture healing time ranged from 3 to 9 months (averaged 6.9 months). According to Merchant knee function evaluation criteria, the results were excellent in 19 cases, good in 12, fair in 5 and poor in 2.

CONCLUSIONEarly complications of tibial fracture after operation is closely associated with the severe fracture complexity and related with preoperative preparation, surgical timing, operation incision selection and surgical technique. Early detection and timely processing reduce damage.

Adult ; Aged ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Tibial Fractures ; surgery

Objective To explore the effects of potassium iodate (KIO3) on the proliferation, cell cycle, and the mRNA/protein levels of cyclin D 1 and Ki67 of SW579 cells, a human thyroid squamous carcinoma cell line . Methods The effects of different doses of KIO3(0,10-6,10-5,10-4,10-3,10-2,10-1 mol/L)on SW579 cell prolifer-ation were assessed by CCK8 method.SW579 cells were then treated with 0 (control), 10-6 or 10-2 mol/L KIO3 for 48 h.The cell cycle was measured by flow cytometry .The mRNA and protein levels of cyclinD 1 and Ki67 were re-spectivelyanalyzedbyreal-timePCRandWesternblot.Results 10-6and10-2mol/LofKIO3respectivelyexhibi-ted the most promoting and suppressive effect on SW579 cell proliferation.G1 phase of cells in 10-6 group short-ened significantly( P<0.05) , and S phase prolonged significantly( P<0.05); while each phase of cells in 10-2 mol/L group changed in the opposite way( P<0.05) .KIO3 at the dose of 10-6 mol/L significantly up-regulated the mRNA levels of cyclin D1 and ki67 in cells( P<0.05) ;whereas, the mRNA and protein levels of cyclin D1 and Ki67 were significantly down-regulated in cells treated with 10-2 mol/L KIO3( P<0.05) .Conclusions Different doses of KIO3 affect the proliferation and cell cycle of SW579 cells probably by regulating the levels of cyclin D1and Ki67 .

OBJECTIVETo investigate the distribution features of Chinese medical constitutions in hypertension complicated diabetes patients.

METHODSRecruited were 251 primary hypertension inpatients at the Department of Neurology and the Department of Cardiology, Mindong Hospital of Ningde City from October 2010 to March 2011. They were assigned to two groups according to whether they were complicated with diabetes, i.e., the primary hypertension complicated diabetes (as the case group, 78 cases) and the primary hypertension without complicated diabetes (as the control group, 173 cases). The constitution types were investigated by questionnaire. The constitution type distribution was compared between the two groups. The data including gender, age, and the distribution of the constitution type were compared between the two groups. The levels of TG, TC, LDL-C, Hb, FPG, and ALB were detected on the 2nd day after admission. The levels of TG, TC, LDL-C, Hb, and ALB were compared be- tween the two groups in patients of yin deficiency constitution, phlegm dampness constitution, and qi deficiency constitution.

RESULTSThere was no statistical difference in the hypertension grading, the disease course, and chronic disease complications between the two groups (P > 0.05). The main constitution types were yin deficiency (accounting for 26.0%), phlegm dampness (accounting for 19.1%), and qi deficiency (accounting for 19.1%) in the control group. The main constitution types were yin deficiency (accounting for 32.1%), phlegm dampness (accounting for 30.8%), and qi deficiency (accounting for 17.9%) in the case group. The ratio of phlegm dampness type in the case group was higher than that in the control group with statistical difference (P = 0.041). There was no statistical difference in the constitution distribution in the same gender between the two groups (P > 0.05). There was no statistical difference in the constitution distribution in those younger than 80 years between the two groups (P > 0.05). Compared with those older than 80 years in the control group, the ratio of phlegm dampness was higher, and the ratios of yang deficiency, yin deficiency, qi deficiency, and dampness heat were lower in the case group with statistical difference (P = 0.020). There was no statistical difference in the constitution distribution among different age stages in the case group (P > 0. 05). But there was statistical difference in the constitution distribution among different age stages in the control group (P < 0.05). The yin deficiency and qi deficiency constitutions were dominated in thinner patients of the control group, while yin deficiency constitution was dominated in thinner patients of the case group, showing no statistical difference between the two groups (P > 0.05). There was no statistical difference in the distribution of constitution type in overweight patients between the two groups (P = 0.458). Compared with those of gentle type constitution in the same group, the levels of TC and LDL-C increased in those of phlegm dampness constitution in the two groups (P < 0.05). The level of TC increased in those of qi deficiency constitution in the case group. The level of Hb decreased in those of qi deficiency constitution in the control group (P < 0.05). Compared with those of qi deficiency constitution in the same group, the levels of TC and Hb obviously increased in those of phlegm dampness constitution in the control group (P < 0.05). The level of ALB increased in those of yin deficiency constitution in the case group (P < 0. 05). Compared with the control group, the level of FPG of those of each constitution increased in the case group (P < 0.05) ,.and the level of TC increased in those of qi deficiency constitution (P = 0.007).

CONCLUSIONSThe main constitution types of hypertension complicated diabetes patients were yin deficiency, phlegm dampness, and qi deficiency. The ratio of phlegm dampness was higher in hypertension complicated diabetes patients than hypertension without complicated diabetes patients. The levels of TC and LDL-C were higher in those of phlegm dampness constitution type. The level of TC was higher in hypertension complicated diabetes patients of qi deficiency constitution.

Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Diabetes Complications ; diagnosis ; Diabetes Mellitus ; diagnosis ; Essential Hypertension ; Female ; Humans ; Hypertension ; complications ; diagnosis ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Surveys and Questionnaires

OBJECTIVEto study the clinicopathological features, imaging characteristics, immunophenotypes and differential diagnosis of giant cell angioblastoma (GCAB).

METHODSa case of GCAB in the left middle-upper tibia and fibula was studied by light microscopy, X-ray and CT imaging, immunohistochemistry.

RESULTSX-ray and CT imaging showed a clearer lesion in the left middle-upper tibia than in the ipsilateral fibula with enlarged ostealleosis and increased inhomogeneously medullary cavity density, irregular thickening of cortical bone, local cortical default at the inner edge, soft tissue swelling around the abnormal bone. Histologically, tumor tissue was located between the bone trabeculae by nodular, linear and plexiform aggregates of oval-to-spindle cells, large mononucleate cells and multinucleate giant cells with prominent nucleoli and abundant granular eosinophilic cytoplasm. Some aggregates had uncentain amount of discernible lumens, either empty or containing few erythrocytes. A concentric arrangement of oval-to-spindle Cells around small-caliber vascular structures together with collagen fiber contributed to a so-called 'onion-skin' arrangement. The background showed a loose mesenchymal stroma formed of some inconspicuous spindle-fibroblast-like cells, stellate-shape mesenchymal cells, a moderate mononuclear inflammatory cell infiltrate and scattered mast cells. Immunophenotype showed the tumor cells and giant cells strongly positive for vimentin. A good many oval-to-spindle cells stained markedly for CD31 and CD34, but weakly for FVIII, while the giant cells are highlighted instead by CD68, occasionally, very few giant cells showed positive focally for FVIII, a-SMA decorated notedly the cells surrounding the endothelium-like cells but weakly positive in some other tumor cells.

CONCLUSIONGCAB is a rare, locally infiltrative but slow growing neoplastic angiogenesis with unique morphological characteristics during infancy, which may occur not only in the skin, mucosa, subcutis and deep soft tissue but also in the bone.

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Dermatofibrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibula ; Giant Cell Tumor of Bone ; diagnostic imaging ; metabolism ; pathology ; surgery ; Hemangioblastoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Hemangioendothelioma ; metabolism ; pathology ; Hemangioendothelioma, Epithelioid ; metabolism ; pathology ; Hemangioma, Cavernous ; metabolism ; pathology ; Humans ; Infant ; Kasabach-Merritt Syndrome ; Male ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Kaposi ; metabolism ; pathology ; Skin Neoplasms ; metabolism ; pathology ; Thrombocytopenia ; metabolism ; pathology ; Tibia ; Tomography, X-Ray Computed ; Vascular Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism

OBJECTIVETo study clinical effects of minimally invasive, effective and economic operational method for the treatment of medial malleolus fractures.

METHODSFrom March 2008 to August 2010, 19 patients (12 males and 7 females, ranging in age from 17 to 42 years, averaged 31.7 years) with medial malleolus fractures were reviewed. Closed reduction and percutaneous internal fixation were applied, with a hollow compression screw inserted at the centre and perpendicularly to the fracture surface. A Kirschner wire was inserted through the cortical bone of opposite side and in accordance with the axis of inner malleolus. Postoperative therapeutic effect was evaluated by Kaikkonen sprained ankle scoring system and imageology examination.

RESULTSAll the patients got primary healing of incisions and were followed up, the duration ranged from 6 to 30 months, with an average of 18.7 months. All the patients obtained bone union. Clinical healing time ranged from 2.6 to 3.8 months, averaged 3.2 months. According to Kaikkonen scoring system, the results were rated as excellent in 5 cases, good in 10 cases, moderate in 3 cases, and poor in 1 case.

CONCLUSIONIt is a minimally invasive, effective and economic method to treat medial malleolus fractures by closed reduction and percutaneous internal fixation with hollow compression screw and Kirschner wire.

Adolescent ; Adult ; Ankle Joint ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Young Adult

OBJECTIVETo explore the feasibility, effect, and clinic value of total laparoscopic gastric resection in patients with benign gastric disease.

METHODSThe clinical materials of 50 cases underwent total laparoscopic gastric resection (LG group) and 104 cases open surgery (OG group) between January 2002 and June 2006 were compared. The operation time, intraoperative blood loss, mean time of stay in hospital and postoperative complications were studied.

RESULTSAll operations in LG group were successfully preformed with laparoscopic technique, and the mean operation time was 105 min, mean intraoperative blood loss was 50 ml, and mean hospital stay was 7 days. Incisional wound infection occurred in 2 cases and no serious complications occurred in this group. In OG group, the mean operation time was 118 min, mean intraoperative blood loss was 108 ml, and mean hospital stay was 12 days. Wound infection occurred in 7 cases, disorder of gastric emptying was found in 3 cases, fistula of anastomotic stoma happened in 1 case and bowel obstruction occurred in 1 case. There was significant difference in operation blood loss and hospital stay between the two groups (P < 0.05).

CONCLUSIONSLaparoscopic gastric resection is a safe and feasible minimally-invasive surgery, it brings less pain, less bleeding, shorter hospital stay.

Adult ; Aged ; Feasibility Studies ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Diseases ; surgery ; Treatment Outcome

OBJECTIVETo investigate the clinical characteristics of primary valve tumors and the late surgical results of their resection.

METHODSWe reviewed our clinical experience with the surgical treatment of ten primary valve tumors at Fuwai Hospital between November 1983 and November 2002.

RESULTSIn this series, cardiac valve tumors constituted 2.65% (10/378) of all primary cardiac tumors, and the incidence of primary valve tumors was roughly one in 4000 cardiac operations. There were 5 male and 5 female patients aged 2 to 66 years (mean age, 30 years). The clinical presentations included exertional dyspnea in 7 patients, neurological symptoms in 2, and cyanosis at rest in 1 patient. The diagnosis was established by preoperative echocardiography in 8 patients, and in the other 2, it was confirmed by the findings at operation. All of the tumors were resected. Eight of the ten tumors were benign, and two were malignant. All patients survived the operation and recovered eventfully. Late outcomes were known for all patients. There were three late deaths. One patient with a benign tricuspid valve died 2 months postoperatively of an electrolyte disorder. The other 2 patients with a malignant mitral valve tumor died within 1 year postoperatively. The 7 survivors, all with a benign valve tumor, were followed up for an average of 5.7 years (range, 8 months to 19 years), and all were in functional Class I. Exercise tolerance improved to normal levels. The latest follow-up echocardiography showed no evidences of the local recurrence in any patients.

CONCLUSIONExcellent early and late surgical results can be obtained in patients with benign valve tumors. The prognosis for the patients with a malignant valve tumor is poor.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Heart Neoplasms ; diagnosis ; surgery ; Heart Valves ; pathology ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome