Adolescent ; Adult ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Tendon Injuries ; diagnostic imaging ; drug therapy ; surgery ; therapy ; Tendons ; diagnostic imaging ; drug effects ; surgery ; Young Adult

OBJECTIVETo evaluate the treatment of open Pilon fractures.

METHODSA total of 126 open Pilon fracture cases were reviewed retrospectively. The patients were treated from February 1996 to March 2009, included 72 males and 54 females with an average age of 36 years old ranging from 17 to 65 years. According to the Ruedi-Augower classification, there were 28 cases of type I, 58 of type II, and 40 of type III. Among all the cases, 31 cases were treated with external fixators combined with limited internal fixations, 80 cases were treated with open reduction and internal fixation with anatomical plates, 15 cases with open reduction and cross K-wire fixations.

RESULTSAll cases were followed-up for from 10 to 26 months with an average of 16 months. The average bone healing time was 10 weeks (from 8 to 14 weeks). According to the Mazur ankle function evaluation, the results were excellent in 89 cases, good in 26,fair in 9,poor in 2. The excellent and good rate was 91.2%.

CONCLUSIONThe "Personalized treatment principle" effectively prevents the occurrence of complications and helps to restore the joint functions.

Adolescent ; Adult ; Aged ; Female ; Fracture Fixation ; methods ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Tibial Fractures ; surgery ; Time Factors

BACKGROUND: There are plentful studies about bioreactor of tissue engineering of blood vessel, tendon, cartilage, heart valve,trachea, bladder and stern cell. OBJECTIVE: To construct small-sized tissue-engineerad blood vessels with human bone marrow stromal stem cells (hBMSCs) in improved bioreactor system.DESIGN, TIME AND SETTING: The single sample observation stuay was performed at the School of Mechanical and Power Engineering, East China University of Science&Technology, and Shanghai Tissue Engineering Research & Development Center from June 2005 to March 2008.MATERIALS: Vessel bioreactor was self-made by East China University of Science&Technology. hBMSCs were harvested from healthy volunteers. METHODS: A set of support bracket constructing tissue engineered blood vessels with the diameter of 2 mm was designed with the application of Finite Element Methods as an analysis method analyzing support bracket of tissue engineered small-sized blood vessel. Primary hBMSCs were first Collected and further cultivated exvivo. The third passage cultured cells were then seeded on the polyglycolic acid (PGA) to fabricate the cell-scaffold composite. Subsequently, this composite was subjected to dynamical culture in the blood vessel bioreactor. After cultured for 4 weeks, the composite was removed from the bioreactor.MAIN OUTCOME MEASURES: The following mentioned references were measured: composite growth; other correlation detection of the hBMSCs-PGA composite, RESULTS: Gross observation and scanning electron microscope were used at4 weeks after hBMSCs-PGA composite culture. It was observed that the tissue-engineered blood vessel had a bright color and certain elasticity. The blood vessel could rebound to its odginal shape after repeated press by the forceps.The secreted collagen matrix arrayed orderly around the cells and smooth muscle elastic acttn could also be detected in the formed tissues using immunohistochemistry. CONCLUSION: The in vivo mechanics conditions of blood vessels can be simulated using the current blood vessel bioreactor system. Using hBMSCs, the construction of tissue engineered small-sized blood vessels can be successfully achieved.

ObjectiveTo explore the expression of MRP1 and CD34 in colorectal carcinoma tissue and the relationship with clinicopathological factors.MethodsImmunohistochemical streptavidin-perosidase method was used to examine the expression of MRP1 and CD34 in 53 cases with colorectal carcinoma and normal colorectal tissue.The correlation between the levels of MRP1and CD34 expression and clinicopathological factors were analyzed.ResultsThe positive expression rates of MRP1 in the carcinoma group and normal colorectal tissue group were 49.1％ and 15.1％ respectively,and there was a significant difference of the positive expression between the two groups( x2 =14.029,P ＜ 0.01 ).The expression of MRP1 had no correlation with the degree of differentiation,the depth of invasion,the metastasis of lymph node and all the other clinicopathological factors ( P ＞ 0.05 ).CD34 value in the carcinoma group and normal colorectal tissue group were ( 35.63 ± 12.23 ) MVD/HP and ( 6.12 ± 0.97) MVD/HP,respectively,and there was a significant difference between the two groups (t =17.565,P ＜ 0.01 ).CD34 was not correlated with age,sex,tumor size,localization of the primary tumor ( P ＞ 0.05 ),but correlated with Dukes staging,lymph node metastasis,differentiation of the tumor,depth of invasion( all P ＜ 0.05).ConclusionThe overexpression of MRP1 and CD34 protein may involve in colorectal carcinogenesis;MRP1 may involve in the primary multidrug resistance in colorectal carcinoma.; CD34 may involve in the colorectal carcinoma invasion and metastasis.Investigating the expression of MRP1 and CD34 in colorectal carcinoma simultaneously can provide new referential indexes for the treatment and prognosis of colorectal carcinoma.

Objective To compare the difference in recurrence rates between the endovenous laser therapy(EVLT) combined with percutaneous continuous circumsature (PCCS) and simplex EVLT following the treatment of great saphanous vein incompetence through the introduction of propensity score matching (PSM).Methods T the baseline data of 170 patients diagnosed with great saphanous vein incompetence who were treated in Punan Hospital in Pudong New District of Shanghai from 2009 to 2014 were retrospectively analyzed,of which underwent EVLT were 87 cases as EVLT group and EVLT combined with PCCS were 83 cases as EVLT +PCCS group.The groups covariate were balanced based on the PSM function of SPSS software using 1 ∶ 1 nearest neighbor matching method.The recurrence rates of the two groups were estimated by Kaplan-Meier method and the differences between the two groups were evaluated by Log-rank test.Results Sixty-seven pairs of patients were successfully matched.No significant difference between the two matched groups in the basic clinical features.Before PSM,the 1,2,and 3 year cummulative recurrence rates were 3.5％,5.4％ and 7.3％ in the EVLT group,and 0.9％,4.7％ and 4.7％ in the EVLT+PCCS group,respectively,there were no statistically significant differences between the two groups by Log-rank test (P =0.491).After PSM,the 1,2,and 3 year cummulative recurrence rates were 5.2％,5.2％ and 7.1％ in the EVLT group,and 0％,1.0％ and 1.0％ in the EVLT+PCCS group,there were statistically significant differences between the two groups (P =0.031).Conclusion The PSM methods can effectively balanced the covariates of groups in non-randomised study.EVLT combined with PCCS can effectively reduce the recurrence rate after the treatment of great saphanous vein incompetence.

OBJECTIVEChildren with nephrotic syndrome are always associated with retardation of growth. Growth hormone (GH) administration to these children can stimulate their growth, but it plays an important role in glomerulosclerosis. Thus these children would take a risk to use it to improve their growth. This study was designed to investigate the effect of GH on the kidney of rats with adriamycin-induced nephropathy (AN) and its mechanism, and to observe the renoprotective effect of angiotensin II (AngII) receptor antagonist, irbesartan, in GH-treated AN rats.

METHODSRats were divided into the following groups: normal control rats, AN rats, GH-treated AN rats and GH plus irbesartan-treated AN rats. There were 8 developing male SD rats (120-130 g) in each group. Urinary protein was measured at weeks 3, 6 and 9. Blood pressure, serum creatinine, BUN, albumin, cholesterol, triglyceride, as well as ACE activity and AngII concentration of the kidney were detected at the end of the study. Renal pathological changes were evaluated also. Immunohistochemistry was used to examine the protein expressions of TGF beta(1), collagen IV and fibronectin in glomeruli.

RESULTSGlomerular sclerosis score of GH-treated AN rats (49.4 +/- 9.8) was significantly higher than that of AN rats (12.8 +/- 5.5, P < 0.01), and this score of GH-treated AN rats plus irbesartan (26.2 +/- 7.5) was significantly lower than the score of GH-treated AN rats (P < 0.01). The changes of urinary protein, hyperlipidemia and hypoalbuminemia in rats of each group consisted with the degree of glomerular injury in rats of each group. There was azotemia in GH-treated AN rats, but rats in the other groups did not have azotemia. ACE activity of kidney was significantly (P < 0.01) increased in GH-treated AN rats [(28.1 +/- 4.1) U/mg pro] and GH-treated AN rats plus irbesartan [(27.6 +/- 3.4) U/mg pro] compared with that in AN rats [(14.6 +/- 4.4) U/mg pro]. AngII concentrations in the kidney of GH-treated AN rats [(17.8 +/- 3.3) pg/mg pro] and GH-treated AN rats plus irbesartan [(27.3 +/- 5.1) pg/mg pro] were significantly higher than that in AN rats [(8.3 +/- 1.9) pg/mg pro] (P < 0.01). The protein expressions of TGF-beta(1), collagen IV and fibronectin in GH-treated AN rats were the most distinct in all groups. These expressions were significantly (P < 0.05) reduced in GH-treated AN rats plus irbesartan.

CONCLUSIONGH is able to exacerbate adriamycin-induced nephropathy in rats, which was partly through activating renal tissue RAS and initiating the function of the AngII-TGF beta(1)-ECM axis. Angiotensin II receptor antagonist, irbesartan, has some renal protective effects on AN rats treated with GH.

Angiotensin II ; analysis ; Angiotensin Receptor Antagonists ; Animals ; Antibiotics, Antineoplastic ; toxicity ; Biphenyl Compounds ; pharmacology ; therapeutic use ; Blood Urea Nitrogen ; Collagen Type IV ; analysis ; Creatinine ; blood ; Disease Models, Animal ; Doxorubicin ; toxicity ; Fibronectins ; analysis ; Growth Hormone ; pharmacology ; Immunohistochemistry ; Kidney Diseases ; chemically induced ; drug therapy ; Kidney Glomerulus ; chemistry ; drug effects ; pathology ; Male ; Peptidyl-Dipeptidase A ; analysis ; Proteinuria ; urine ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Serum Albumin ; metabolism ; Tetrazoles ; pharmacology ; therapeutic use ; Transforming Growth Factor beta ; analysis ; Triglycerides ; blood

Aim To observe the effects of simvastatin on PPARγ and p65 subunit of NF-κB and to invest the mechanism of simvastatin preventing hypertrophy and keeping cardiac function.Methods 24 rabbits were divided into 4 groups.Rabbits received sham operation as health control in group I. In other groups, aortic regurgitation and coarctation of ascending aorta were operated in rabbits.Rabbits received no drugs in Group Ⅱ. In group Ⅲ, rabbits were given simvastatin 5 mg·kg~(-1)·d~(-1) after the operation for 8 weeks. In group Ⅳ, rabbits were given simvastatin 5 mg·kg~(-1)·d~(-1) after 4 weeks of operation for 4 weeks. At the beginning and the end of the experiment, left ventricular end diastolic pressure (LVEDP) was measured with catheter. At the end of the experiment, heart weight (HW), left ventricular weight (LVW), body weight (BW), heart weight/body weight radio (HW/BW radio), left ventricular weight/body weight radio (LVW/BW radio) were measured.The PPARγ mRNA expression was analyzed by RT-PCR. PPARγ and p65 protein expression in cardiomyocyte nuclear were analyzed through Western blot. The activity of p65 was analyzed with EMSA.Results The HW, LVW, HW/BW were significantly decreased in the early and late treatment group than in CHF group(P<0.05,P<0.01). The LVW/BW was significantly decreased inearly treatment group than in CHF group, too (P<0.01). The LVEDP was significantly decreased in the early and late treatment group than in CHF group (P<0.01). The mRNA and protein of PPARγ significantly fell in CHF heart (P<0.01). The activity and protein expression of p65 were significantly increased in CHF heart (P<0.01). Simvastatin increased the mRNA and protein expression of PPARγ and decreased the activity and protein expression of p65 (P<0.01).Conclusions Simvastatin inhibits the cardiac hypertrophy and improves cardiac function. The mechanism of simvastatin on cardiac remodeling and function relates to the increase of PPARγ expression and preventing the NF-κB activation.

ABSTRACT:Objective To evaluate the curative effect of tension-free vaginal tape-obturator (TVT-O)and modified TVT-O in treating female stress urinary incontinence (SUI).Methods We selected 1 1 3 female patients diagnosed with SUI from January to December 2013 in our department and divided them into standard TVT-O group (group A,5 6 cases)and modified TVT-O group (group B,5 7 cases).We evaluated prospectively the safety,short-term efficacy and complications of operation in the two groups.Results The length from bilateral obturator membrane to the puncture point in the skin was greater in group A than in group B.The average intraoperative blood loss was more in group A than in group B.The median NRS score of postoperatie thigh pain in group A was higher than in group B (P<0 .0 5 ).The two groups did not differ significantly in operation duration,postoperative catheterization,mean hospital stay duration,the length and position from bilateral obturator membrane to the puncture point,or surgical efficacy (P>0.05).Conclusion Both TVT-O and modified TVT-O techniques are effective in treating female SUI.Modified TVT-O has a short path to get through the adductor muscles and less intraoperative blood loss;therefore,it can significantly reduce the complications such as postoperative pain to enhance the quality of life after operation. 

Adult ; Carcinoma, Renal Cell ; secondary ; Female ; Humans ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; Vaginal Neoplasms ; secondary

Objective:By applying moxibustion to the eight confluent points in different periods of time,to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa.Methods:A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time,i.e.Chen (7:00-9:00),Wu (11:00-13:00) and Xu (19:00-21:00).The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions (different periods of time,different genders,different acupoints and different states of the acupoints) based on Fei Teng Ba Fa.Results:Finally,thirty subjects dropped out and 438 subjects were included.The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa:latencies of the closing points and adjunct points were significantly different in different periods of time (P＜0.05);the latencies of the males were significantly longer than those of the females (P＜0.05);there was no significant difference in the latency between the left and right sides (P＞0.05);in the female group,there was a significant difference in the latency between the lower-limb points and the upper-limb points (P＜0.05).The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state:in the period of Wu (11:00-13:00),the latencies of the opening points were significantly longer than those of the closing points and adjunct points (P＜0.05);for men,their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points (P＜0.05);despite the gender,the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points (P＜0.05);in the female group,the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points (P＜0.05).Conclusion:Based on Fei Teng Ba Fa,the pain thresholds of the eight confluent points vary in different periods of time,gender,acupoint location and opening/closing state,which can be taken as the evidence of making time-based acupuncture-moxibustion prescriptions.