OBJECTIVETo investigate the selection of operative methods,timing of operation and the effect of hige-energy distal tibia Pilon fracture.

METHODSFrom July 2006 to December 2009, 29 patients with hige-energy distal tibia Pilon fractures were treated, including 23 males and 6 females with an average age of 36.8 years old ranging from 21 to 54 years. According to Ruedi-Allgower classification on Pilon fractures, there were 3 cases of type I, 16 of type II and 10 of type III. The type I patients were fixed by screws and Kirschner wires and the cases of type II and III were fixed by filmy clover steel plates closed up tibia medial border or tibia lateral anatomical steel plates. All patients were evaluated by the tumid algesic level of ankle joint, gait,the activity of ankle joint according to Mazur score.

RESULTSNone of patients occurred complications such as deep infection, fractured internal fixation and prolapsed internal fixation. All patients were followed up from 6 to 42 months (averaged 28 months). The time of fracture healing was from 10 to 32 weeks (means 15 weeks). According to the ankle score of Mazur, the results were excellent in 15 cases,good in 10 cases,fair in 3 cases, poor in 1 case.

CONCLUSIONThe step-by-step delayed open reduction and internal fixation for hige-energy distal tibia Pilon fracture is an effective method with fewer complications and good function after the recovery of soft tissue injury. The method can not only mitigate the level of soft tissue injury, but also is beneficial to the early joint motion with rigid fixation.

Adult ; Female ; Follow-Up Studies ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Tibia ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Time Factors ; Tomography, X-Ray Computed ; Young Adult

Objective:To investigate the reference value of ultrasonography (US) image features, elastography and serum thyroid stimulating hormone (TSH) levels in preoperative diagnosis of differentiated thyroid carcinoma (DTC).Methods:Retrospective analysis was conducted to collect clinical data of patients undergoing thyroid surgery in the Fourth Affiliated Hospital of Harbin Medical University from September 2018 to January 2020. All patients underwent conventional ultrasound, elastography examination and serum TSH level measurement before surgery; patients were divided into benign group and DTC group according to the results of pathological results of the operation, and the US image features and elasticity score were analyzed by chi-square test and multivariate logistic regression to evaluate the causes of DTC; a multivariate logistic regression model was established and the receiver operating characteristic curve (ROC) was drawn with the regression model, by analyzing the area under the ROC curve (AUC), sensitivity, specificity and accuracy, the reference value of US image features, elastography and serum TSH levels in the preoperative diagnosis of DTC were judged.Results:Clinical data of 81 patients were collected, including 17 men and 64 women, aged (48.72 ± 10.58) years. In benign group, there were 37 cases, including 10 men and 27 women, with age of (53.24 ± 9.59) years; there were 44 patients in DTC group, including 7 men and 37 women, with age of (44.91 ± 9.95) years old, the age difference between benign group and DTC group was significant ( t = 3.822, P < 0.05), while the gender difference was not statistically significant (χ 2 = 1.498, P > 0.05). There were significant differences in the number, size, echo level, microcalcification, aspect ratio and elasticity score between benign group and DTC group (χ 2 = 49.000, 4.457, 32.111, 5.444, 4.457, 49.926, P < 0.05); multivariate logistic analysis showed that hypoecho, microcalcification, aspect ratio > 1 and elasticity score were risk factors for DTC ( OR = 8.042, 4.787, 4.160, 2.380, P < 0.05), the ROC curve of the multivariate logistic regression model showed that the AUC was 0.841 (95% CI = 0.743 - 0.939), sensitivity was 90.91%, specificity was 72.97%, and accuracy was 82.72%; the AUC of serum TSH level prediction of DTC showed that the AUC was 0.721 ( P < 0.05), sensitivity was 72.70%, specificity was 64.90%, accuracy was 54.30%, and TSH best cut-off value was 2.215 μU/ml. Conclusion:In the preoperative diagnosis of DTC, US image features, elastography and serum TSH levels are of important clinical reference value for diagnosis of DTC, and the establishment of multivariate logistic regression model is conducive in improving the clinicians prediction of the occurrence of DTC.

ObjectiveTo explore the efficacy and safety of risperidone and haloperidol in treating Tic disorder.Methods78 patients with Tic disorder were randomly divided into the risperidone group and haloperidol group with 39 cases in each group and treated with risperidone and haloperidol respectively for 8 weeks. All patients of two groups were assessed with the Clinical Global Impression Scale (CGI) and Treatment Emergent Symptom Scale (TESS) before treatment and at the end of the 2nd, 4th and 8th week after treatment. Dosages of patients of two groups were recorded.ResultsAfter 8 weeks treatment, the average maximum dosage of risperidone was (1.4±0.34)mg, and that of haloperidol was (7.3±0.52)mg. The total effective rate of risperidone group was 82% and that of haloperidol group was 82.3 %. There was no significant difference between two groups ( P>0.05). The incidence of adverse reactions in risperidone group was 28.2%, and that in haloperidol group was 76.9%. There was a significant difference between two groups (P<0.01), especially at the end of 2nd week after treatment.ConclusionRisperidone and haloperidol both are effect on Tic disorder, but safety and compliableness of risperidone are higher.

OBJECTIVE: To introduce the design of customized pelvic prosthesis, to evaluate the biomechanical property under three load conditions of customized pelvic prosthesis under three load cinditions. METHODS: A titanium alloy prosthesis for reconstruction of pelvic tumors was designed by CAD software. The strength and stiffness of the custom prosthesis under static and slow gait conditions were analyzed and evaluated by finite element method. RESULTS: The results of the finite element analysis suggested that the maximum von Mises stress in the pelvic under three load conditions were 39.0, 202.8 and 42.4 MPa; the maximum displacement were 0.199, 0.766 and 0.847 mm. The maximum von Mises stress in the prosthesis under three load conditions were 62.3, 318 and 468 MPa. The maximum Von Mises stress in the Ti-alloy prosthesis and pelvic was far smaller than the yield strength of Ti-alloy. CONCLUSIONS The study can design the size and shape of prosthesis accurately according to patient's condition. The finite element method can reduce the bone stress level and fracture risk, prolong the service life of prostheses, and ensure the safety and stability of the postoperative patients under normal gait.
Biomechanical Phenomena ; Finite Element Analysis ; Fractures, Bone ; Gait ; Humans ; Prostheses and Implants ; Prosthesis Design ; Stress, Mechanical

This study was aimed to examine the effect of ovariectomy on visceral fat, serum adiponectin levels and lipid profile. Forty-five female Sprague Dawley rats were divided into three groups (n=15 each): ovariectomized group (OVX), ovariectomized plus estrogen-treated group (OVX+E2), and sham-operated group (SHAM). Body weight, abdominal adipose tissues, serum adiponectin and lipid profile were measured and compared among the groups after three-month feeding post-surgery. Significant increases in body weight and visceral fat were found in ovariectomized rats when compared with sham-operated ones and significant increases were also observed in serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in ovariectomized rats. Body weight, visceral fat and serum adiponectin levels were profoundly reduced in OVX+E2 group as compared with OVX group. It was concluded that ovarian hormone deficiency induced by ovariectomy leads to significant increases in body weight and visceral fat, along with increased serum adiponectin, triglyceride and very low density lipoprotein cholesterol levels in rats. Attenuation in these changes can be achieved by estrogen supplementation.
Adiponectin ; blood ; Animals ; Cholesterol, LDL ; blood ; Female ; Intra-Abdominal Fat ; metabolism ; Ovariectomy ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; blood

OBJECTIVETo evaluate the activity and genotype of thiopurine methyltransferase (TPMT) and the concentration of thioguanine nucleotides (TGNs) as parameters for individualizing mercaptopurine (6-MP) therapy.

METHODSErythrocyte TPMT activity was measured by means of radiochemical assay. Sequence specific primer (SSP) PCR and restriction fragment length polymorphism (RFLP) were used to determine the mutations in TPMT genomic DNAs. Erythrocyte TGNs concentration in acute lymphoblastic leukemia (ALL) patients after 6-MP treatment was detected by high-performance liquid chromatography (HPLC).

RESULTSThe erythrocyte TPMT activity in Han population was 16.6 +/- 4.5U/ml pRBCs (man 16.8 +/- 5.0 U/ml pRBCs, woman 16.5 +/- 4.4 U/ml pRBCs), the activity in 8.1% of the samples was lower than 10 U/ml pRBCs. There was no difference for TPMT activity by gender, age, and between healthy donors and ALL patients. For TPMT genotypes, there were 5 cases of TPMT * 2, 4 TPMT * 3A, 6 TPMT * 3B, 10 TPMT * 3C and 5 unknown in 30 subjects who had low TPMT activity. In children with ALL, the TGNs level did show a negative correlation with TPMT activity at diagnosis and 7 approximately 14 days after 6-MP therapy and with WBC count 14 days after the determination of TGNs.

CONCLUSIONDetection of TPMT activity before 6-MP therapy and TGNs level during 6-MP therapy may be helpful for preventing side effects from antipurine metabolic drug overdose, and individualizing 6-MP chemotherapy in children with ALL.

Adolescent ; Adult ; Aged ; Antimetabolites, Antineoplastic ; therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Chromatography, High Pressure Liquid ; Erythrocytes ; metabolism ; Female ; Genotype ; Humans ; Male ; Mercaptopurine ; therapeutic use ; Methyltransferases ; genetics ; metabolism ; Middle Aged ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy ; metabolism ; Purine Nucleotides ; metabolism ; Time Factors

OBJECTIVETo investigate the gene polymorphism of human leukocyte antigen (HLA)-A, B, DRB1 loci in the population of Beijing region, and research on the application feasibility of polymerase chain reaction sequence-based typing (PCR-SBT) method.

METHODSPCR-SBT method was applied to determine HLA- A, B, DRB1 genotypes of 618 unrelated healthy individuals of Beijing region.

RESULTSA total of 84 different alleles and 199 genotypes of HLA-A, 143 alleles and 366 genotypes of HLA-B, 122 alleles and 286 genotypes of HLA-DRB1 were detected.

CONCLUSIONThe results showed the characteristics of HLA-A, B, DRB1 distributions, and provided more comprehensive and accurate gene data that may serve as normal reference values for all of Beijing people.

Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Female ; Genetics, Population ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Population

OBJECTIVETo investigate the frequencies distribution of human leukocyte antigen (HLA)-B27 subtypes in unrelated healthy Chinese.

METHODPolymerase chain reaction sequence-based typing (PCRSBT) was used to determine HLA high-resolution genotypes of 825 unrelated healthy Chinese.

RESULTSA total of 25 HLA-B27-positive individuals and 8 HLA-B27 subtypes were detected. These subtypes and their corresponding frequencies were B * 2704 (30.77%) , B * 2705 (23.08%), B * 2707 (19.23%), B * 2711 (7.69%), B * 2712 (7.69%), B * 2701 (3.85%), B * 2713 (3.85%) and B * 2721 (3.85%).

CONCLUSIONThe data obtained through PCR-SBT method may serve as important reference for the research of relationship between HLA-B27 subtypes and some diseases such as ankylosing spondylitis.

Adult ; Asian Continental Ancestry Group ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; HLA-B27 Antigen ; classification ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Spondylitis, Ankylosing ; genetics

Objective To investigate the effect of early postoperative abnormal blood glucose on the short-term prognosis of non-small cell lung cancer(NSCLC),and to analyze the clinical characteristics and risk factors related to poor early prognosis.Methods A total of 897 patients with NSCLC who underwent thoracoscopic surgery in Huadong Hospital,Fudan University from Jan 2020 to Aug 2021 were divided into hyperglycemia(HG)group(>7.8 mmol/L)and normal blood glucose(NG)group(≤7.8 mmol/L and≥3.9 mmol/L)according to the early postoperative blood glucose values.Additionally,the patients were divided into higher blood glucose fluctuation group(≥4 mmol/L)and the group with lower blood glucose fluctuation(<4 mmol/L)basing on the fasting blood glucose.Using Logistic regression models,column line charts,ROC curves and other methods,we aimed to clarify the impact of early postoperative blood glucose abnormalities on short-term prognosis,explore clinical characteristics associated with poor short-term outcomes,identify other high-risk factors,and establish relevant risk prediction models.Results Compared with the NG group,the incidence of postoperative pneumonia,thromboembolism,ICU admission rate,total length of hospital stay and hospital cost were significantly higher in the HG group(P<0.05).Higher blood glucose fluctuation group had a greater risk of ICU admission(P=0.003).Logistic regression analysis showed that age,preoperative fasting glucose,white blood cell count and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)were risk factors for postoperative hyperglycemia(P<0.05).Contrary to the effect of BMI,diabetes,male patients,higher blood glucose fluctuation,white blood cell count and age were the risk factors for postoperative adverse events(P<0.05).The AUC of the column line chart model was 0.661(95%CI:0.624-0.698),indicating good discriminative ability for predicting poor short-term prognosis postoperatively.Calibration curves also demonstrated good consistency between predicted and actual probabilities.Conclusion Early postoperative blood glucose fluctuations independently impact the short-term prognosis of thoracoscopic NSCLC patients.Blood glucose combined with gender,BMI,white blood cell count,age and diabetes history can serve as predictive factors for poor short-term prognosis postoperatively.Additionally,a column line chart constructed based on these factors may aid clinicians in early intervention for NSCLC patients with indications.

Objective To evaluate the efficiency of a recombinase-aided amplification (RAA) assay for the detection of Schistosoma japonicum infections in Oncomelania hupensis snails. Methods A group test was employed. Fifty Oncomelania snails were collected as a detection sample. The detection samples without infected snails were designated as negative specimens, while the detection samples that contained different numbers of infected snails were designated as positive specimens. A total of 10 negative specimens, 10 positive specimens containing 1 infected snail, 20 positive specimens containing 2 infected snails and 10 positive specimens containing 3 infected snails were assigned. Following random grouping, 40 specimens were subject to the florescent RAA assay using a blind method. The miradium shedding method served as a gold standard, and the sensitivity, specificity, Youden’s index and coincidence rate of the florescent RAA assay were estimated. In addition, 20 samples consisted of 5 negative specimens and 15 positive specimens with 1, 2 and 3 infected snails respectively were grouped randomly. The same specimens were detected using the crushing method and fluorescent RAA assay with the blind method in a paired-design manner. Then, the test results were compared and analyzed. Results Florescent RAA assay detected 29 positives in the 30 specimens containing different numbers of infected snails, with a sensitivity of 96.67%, and 8 negatives in the 10 detection specimens without infected snails, with a specificity of 80.00%, showing a Youden’s index of 0.77. The coincidence rate was 100% among 10 repeated assays for a detection specimen. In addition, there was no significant difference in the detection of infected snails between the florescent RAA assay and the crushing method (χ² = 0, P > 0.05), and the actual coincidence rates of the florescent RAA assay and crushing method were 95.00% (19/20) and 90.00% (18/20) with the real results, respectively. Conclusion Fluorescent RAA assay has a favorable efficiency for the detection of S. japonicum infections in Oncomelania snails, which shows a potential in screening of S. japonicum-infected Oncomelania snails.