OBJECTIVETo investigate application of the bone flap pedicled on the retrograde branch of radial artery for treatment of old scaphoid bone fractures of type AO-B.

METHODSFrom October 2007 to October 2011,41 patients with old scaphoid bone fractures of type AO-B were treated by transplantation of the bone flap pedicled on the retrograde branch of radial artery including 26 males and 15 females with an average of (27.3±4.5) years old ranging from 16 to 43 years old. The courses before operation ranged from 6 to 22 months with an average of 11 months. All fractures belonged to the type B of AO classification, that is old wrist fracture of scaphoid bone. All patients' wrist function (pain, function, motion, grip strength) were evaluated by Cooney's modifiedwrist scoring system before and 6 months after operation,and the conditions of bone healing were observed during the follow-up time.

RESULTSAmong them, 36 patients were followed up from 4 to 15 months with an average of 8.3 months. The wounds were healed well without other complications as infection appearing. X-rays or CT confirmed that all fractures were healed completely. The Cooney wrist score was improved from preoperative 53.61±13.97 to postoperative 81.81±8.71 (P<0.01).

CONCLUSIONThe operation of transplantation of the bone flap pedicled on the retrograde branch of radial artery is an effective method to treat old scaphoid bone fractures,which is scientific and has curative effects, and valuable for clinical application.

Adolescent ; Adult ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Radial Artery ; injuries ; surgery ; Scaphoid Bone ; blood supply ; injuries ; surgery ; Surgical Flaps ; Wrist Injuries ; surgery ; Young Adult

OBJECTIVE:To study the bioequivalence of Alendronate Sodium Tablets in healthy volunteers. METHODS:According to a paired and cross-over design,a bioequivalence test was performed on two different alendronate sodium tablets,10 mg (Group 1) and 70 mg (Group 2). Then each group was subdivided into two groups,i.e. test preparation and reference preparation. The urine concentrations of alendronate at different time point within 48 h were determined by HPLC and the urine excretion rate -time curve was drawn,and the DAS software was used to compute the pharmacokinetic parameters and the relative bioavailability of the tested formulation. RESULTS:The 90% confidence intervals of urine excretion rate of the tested formulations were 82.4% ～122.6% (Group 1) and 85.4% ～124.6% (Group 2),respectively and the maximum excretory rates were 80.3% ～131.5% (Group 1) and 82.3～136.5% (Group 2),respectively,compared with the reference formulations. CONCLUSION:The two different Alendronate Sodium Tablets and their respective reference formulations were proved to be bioequivalent in healthy volunteers.

Adult ; Female ; Herbicides ; poisoning ; Humans ; Paraquat ; poisoning ; Poisoning ; therapy

Objective To investigate the association between the presence of cerebral microbleeds and chronic kidney disease in patients with ischemic stroke.Methods Patients with ischemic stroke within 1-6 months were consecutively recruited.Cranial MRI was taken within two weeks after recruitment.Cerebral microbleeds were assessed using Microbleed Anatomical Rating Scale on gradient echo MRI.Demographics including sex,age and risk factors were obtained.Chronic kidney disease was defined and classified according to National Kidney Fundation-Kidney Disease Outcome Quality Initiative Guideline.Glomerular filtration rate (GFR) was estimated by using the abbreviated Modification of Diet in Renal Disease equation.Results Of the 636 patients included,mean age was (59.8 ± 10.1) years,435 (68.4％) were male.Sixty-six had decreased estimated GFR (eGFR; ＜ 60 ml · min-1 · 1.73 m-2).Two hundred and one (31.6％) patients had cerebral microbleeds,which were most commonly located in deep or infratentorial location (133/201,66.2％).The presence of cerebral microbleeds was much higher in patients with decreased eGFR than the others (48.5％ (32/66) vs 29.6％ (169/570),x2 =9.709,P =0.002).Age,history of hypertension and decreased eGFR were associated with the presence of cerebral microbleeds in univariate analysis.In multivariate analysis,decreased eGFR was independently associated with the presence of cerebral microbleeds in deep or infratentorial location (OR =1.457,95％ CI 1.044-2.034,P =0.027),but not associated with the presence of cerebral microbleeds in pure lobe.Conclusion Impaired kidney function is associated with the presence of cerebral microbleeds in deep or infratentorial regions in patients with ischemic stroke.

Objective To study the inhibition of tumor necrosis factor-alpha(TNF-α)cytokine expression of BV-2 cells induced by hypoxia-reoxygenation injury by siRNA targeting TLR4 gene via the RNAi mechanisms.Method BV-2 mouse microglial cell line was cultured in six-well plates and randomly divided into group N(nor-mal group),group H(hypoxia-reoxygenation),group T(hypoxia-reoxygenation+TLR4-siRNA transfected group),group C(hypoxia-reoxygenation+pEGFP-H1/control-siRNA transfected group)and group B(hypox-ia-reoxygenation+pEGFP-H1 transfected group).Group H,group T,group C and group B were cultured in hy-poxia condition for 3 h followed by reoxygenation for 24 h.The plasma was transfected into BV-2 cells mediated by lipofectamine 2000.The efficiency of transfection were detected by flow cytometry to observe the expression of EGFP.RT-PCR method was used to detect the level of mRNA of TLR4 or NF-кB p65.Westem blot methed was used to test the expression of TLR4 protein.and ELISA was used to test the level of TNF-α in the supernatants.Analysis of variances was used for statistical analysis.Results The expression of EGFP gene waa;(67.58±7.16)% after transfection by flow cytometry analysis.Compared to group N,the TLR4 mRNA,NF-кB p65 mR-NA,TLR4 protein level and the TNF-α quantity in group H,group T,group C and group B increased after the hy-poxia-reoxygenation treatment(P＜0.01).While the expression of the TLR4 mRNA,NF-кB p65 mRNA,TLR4 protein level and the TNF-α quantity in the group T down-regulated compared to group H,group C and group B(P＜0.01).And there were no changes in group C,group B and group H about observation index(P＞0.05).Conclusions The siRNA targeting TLR4 mRNA could inhibit the inflammatory reaction released by BV-2 cells in-duced by hypoxia-reoxygenation stimulation.

Objective To explore the relationship among the sense of coherence,empowerment and self-efficacy in peritoneal dialysis patients.Methods General information,the Sense of Coherence Scale,the Peritoneal Dialysis Empowerent Scale-Short Form and the Self-Efficacy for Managing Chronic Disease Scale were used to investigate a total of 160 peritoneal dialysis patients in a third-class hospital in Tianjin from March to June,2015.Results The mean score of the sense of coherence,empowerment,self-efficacy were (62.01±11.94) points,(4.09±0.68) points and (6.08±2.19) points.Both the sense of coherence and empowerment could positively influence the self-efficacy of peritoneal dialysis patients directly (r=0.429-0.571,P ＜ 0.01),and the sense of coherence could also indirectly influence the self-efficacy through the mediation of empowerment (β decreased from 0.429 to 0.172,P ＜ 0.01),the mediation effect accounted for 60.1％ of the total effect.Conclusions Medical staff should take different actions to improve the sense of coherence and empowerment to improve the self-efficacy of peritoneal dialysis patients.

Objective To study the expression of S100A8 and the relationship between S100A8 and Toll-like receptor 4 (TLR4) in focal cerebral ischemia reperfusion (I/R) injury.Methods C3H/HeJ mice with TLR4 gene mutation (n =30) and C3H/HeN with normal TLR4 gene mice (n =30) were divided into 4 groups at random (random number),namely C3H/HeJ model group (n =18),C3H/HeJ control group (n =12),and C3H/HeN model group (n =18).C3H/HeN control group (n =12).Middle cerebral artery was occluded to make I/R model in mice by using thread embolism method.Brain tissues were collected after ischemia for one hour and reperfusion for 12 hours.Stroke outcome was evaluated by determination of infarct volume of brain tissue and assessment of neurological scores.And brain injury after cerebral I/R was observed by optical microscope after TTC and HE staining.The immunofluorescence technique and RT-PCR were used to determine the protein level and expression of S100A8 mRNA in damaged brain tissues.Results Compared with C3H/HeN model mice,TLR4-deficient model mice (C3H/ He J) had lower infarct volumes and better outcomes of neurological function after resuscitation for 12 hours.Compared with control groups,the expression of S100A8 mRNA and level of S100A8 protein increased greatly in damaged brain tissues of model mice after I/R injury.In addition,model mice with lacked TLR4 (C3H/HeJ) had lower expression of I/R-induced S100A8 mRNA than C3H/HeN mice in model group,indicating that the close relationship between the levels of S100A8 and TLR4.Conclusions S100A8 interaction with TLR4 might be involved in brain damage and in inflammation triggered by I/R injury.

Objective To study the influence of carboxymethyl-chitosan (CM-chitosan) on phenotype and proliferation of chondrocytes stimulated by recombinant human interleukin-1? (rhIL-1?), and explore its mechanism. Methods Chondrocytes were isolated and cultured. 10 ng/ml IL-1? with or without CM-chitosan of varied concentrations were added into the culture medium. After 24 h, changes of proliferative ability of chondrocytes were tested by MTT and flow cytometry. Proteoglycan synthesis was measured by incorporation of Na235SO4 into chondrocytes, nitric oxide (NO) production was detected by Greiss reaction, mRNA expression of typeⅠ、Ⅱcollagens, Aggrecan and inducible NO synthase (iNOS) were examined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Results CM-chitosan could significantly antagonize IL-1?-induced inhibitory effect on proliferation of chondrocytes, restore proteoglycan synthesis of chondrocytes, decrease NO production of IL-1?-induced chondrocytes, increase the mRNA expression of typeⅡcollagen and Aggrecan, but decrease the expression of typeⅠcollagen and iNOS. The effects of CM-chitosan were in a dose-dependent manner. Conclusion CM-chitosan can maintain the proliferation and phenotype of IL-1?-induced chondrocytes.

In order to investigate the role of Toll-like receptor 4 (TLR4) in cerebrocardiac syndrome (CCS), the partial cerebral ischemia/reperfusion (I/R) models in mice with different TLR4 genotypes were established in the present study. TLR4 wild-type (C3H/HeN) and mutant (C3H/HeJ) mice of 6-8 weeks of age were divided into 4 groups at random: C3H/HeN sham group (n=10), C3H/HeJ sham group (n=10), C3H/HeN model group (n=10) and C3H/HeJ model group (n=10). Partial cerebral I/R was caused by the middle cerebral artery occlusion (MCAO) to duplicate CCS models in mice. After the operation, the electrocardiogram (ECG), the level of tumor necrosis factor-alpha (TNF-α) in myocardial tissue and the cardiac pathological changes were observed in each group. It was shown that the brain infarct volume in C3H/HeN model group was larger than that in C3H/HeJ model group (P<0.01). The ST segment change and T wave inversion occurred frequently in model groups. Moreover, the TNF-α level in C3H/HeN model group was higher than that in C3H/HeJ model group (P<0.01). The myocardial injury was aggravated in C3H/HeN group as compared with C3H/HeJ group. It was concluded that TLR4 was implicated in the development of CCS.

Objective To investigate the surgical efficacy for the treatment of ruptured anterior communicating artery aneurysms with different dome projections in acute phase via supraorbital lateral approach.Methods From January 2014 to March 2017,the clinical data of 79 patients with acute ruptured anterior communicating artery aneurysm with different dome projections in acute phase treated via supraorbital lateral approach in the First Affiliated Hospital of Soochow University were retrospectively analyzed.The operative efficacy was analyzed.The Glasgow outcome scale (GOS) score was used to evaluate the prognosis at 3-36 months after procedure.Results In the 79 patients,34 were superior dome projections,37 was inferior dome projections,and 8 were complicated dome projections.All the anterior communicating artery aneurysms were successfully clipped.The patients were followed up for 3-36 months after procedure.GOS showed good prognosis in 70 cases (88.6％),of which 26 were superior dome projections,36 were inferior dome projections,and 8 were complicated dome projections;9 suffered mild disability (11.4％),of which 8 were superior dome projections and 1 was inferior dome projection.There were no severe disability,persistent vegetative state,and death.The prognosis in patients with inferior dome projection was better than that of superior dome projection (97.3％ [36/37] vs.76.5％ [26/34]).The difference was statistically significant (χ2=5.19,P<0.05).Conclusions The lateral supraorbital approach is an effective option for treating ruptured ACoAA with different dome projections in acute phase.The prognosis in patients with inferior dome projection is better than that of superior dome projection.