Objective To investigate the clinical effect of primary internal fixation combined with flap transfer for Gustilo Ⅲ B open fracture of lower extremity with severe soft tissue defct.Methods From January,2008 to January,2013,15 patients with Gustilo Ⅲ B open fracture of lower extremity and severe soft tissue defect were treated with primary internal fixation combined with flap transfer.Among them,there were 2 cases of foot and ankle fracture,9 of lower-tibia and fibula,3 of upper-tibia and fibula and 1 of distal femur fracture.The areas of the flaps were 10 cm × 8 cm-28 cm × 16 cm.Three cases were treated by bone grafting because of bone defect.Results All patients were followed up for 6-24 months.All flaps were survived,and only small area of 2 cases with the distal necrosis were cured by changing the dressing; In 1 case,the wound was infection and healed after anti-infective and drainage treatment; 13 cases had bone union in primary stage,and the other 2 cases were achieved delayed union; the average healing time was 7.2 months,and no case of osteomyelitis was noted; the time of wound healing was 12-36 days,with an average of 18.1 days.According to lower extremity function evaluation form,the excellent and good rate was 86.6％.Conclusion It is a safe and effective strategy to treat the Gustilo Ⅲ B open fractures of lower extremity and severe soft tissue defect with primary internal fixation combined with flap transfer,which has advantages of reliable fixation,covering the wounds with satisfaction,recovering exercise early,shorten the treatment period,alleviating the suffering of patients and so on.

OBJECTIVETo study the effects of JTS, Traditional Chinese Medicine caps. treating cerebral ischemia on metabolism and antioxidant system in cerebral ischemia rat.

METHODSI.m. dexamethasone and ligating common carotid artery, the model of cerebral ischemia rats was established to investigate the effects of JTS caps. and its mechanisms through detecting substance metabolism, energy metabolism and antioxidant system.

RESULTSJTS caps. (1.78 - 3.56 g/kg) could upgrade glucose (Glu), total amino acids (T-AA), ATP, Na(+)-K(+) -ATPase, superoxide dismutase (SOD) and catalase (CAT) of brain tissue and degrade lactic acid (LD), malondialdehyde (MDA) and water content of brain tissue in cerebral ischemia rat (P < 0.05, 0.01). JTS caps. (3.56 g/kg) could also depress extenuation of rat's body weight.

CONCLUSIONJTS caps. has some protections against the cerebral ischemia in rats, and one of the mechanisms may be improving the metabolism and antioxidant system.

Amino Acids ; metabolism ; Animals ; Antioxidants ; metabolism ; Brain ; metabolism ; Brain Ischemia ; metabolism ; Catalase ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Energy Metabolism ; drug effects ; Glucose ; metabolism ; Lactic Acid ; metabolism ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Wistar ; Sodium-Potassium-Exchanging ATPase ; metabolism ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the role and possible mechanism of JWA in N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) inducing human bronchial epithelial (HBE) cells' neoplastic transformation.

METHODSJWA overexpression vector and its stable transfection HBE cells were established. The characteristics of transformed HBE cells were determined by methyl thiazolyl tetrazolium (MTT) assay and the soft agar colony formation assay. The expressions of JWA and P53 were detected by Western blot.

RESULTSThe growth rates of the HBE cells which were treated with MNNG were significantly accelerated than the JWA overexpression HBE cells and controlled HBE cells (P < 0.05). The soft agar colony formation of JWA overexpression HBE cells with and without MNNG treatment (8.06% and 10.14%) was significantly lower than that of the normal HBE cells with MNNG treatment (26.80%) (P < 0.01). After exposure of MNNG, the P53 expressions were gradually increased in HBE cells with the increased passages. However, the expression of P53 in JWA over expressed HBE cells showed a different manner. P53 reached an over expression peak at early stage (the first passage), and then with a gradually down-regulated expression spectrum with increased passages of the cells.

CONCLUSIONJWA might be a key molecule and play an important role in MNNG inducing neoplastic transformation in HBE cells through regulation of the expression of P53.

Cell Transformation, Neoplastic ; drug effects ; metabolism ; Cells, Cultured ; Epithelial Cells ; drug effects ; metabolism ; pathology ; Heat-Shock Proteins ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Methylnitronitrosoguanidine ; toxicity ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo investigate whether WASP/Verprolin homologous protein 1 (WAVE1) plays a role in the pathogenesis of childhood acute lymphoblastic leukemia (ALL).

METHODSWAVE1 mRNA and protein expression in bone marrow mononuclear cells (BMMCs) was measured by RT-PCR and Western blotting respectively in 4 children with ALL relapse, 15 children with ALL in complete remission (CR) and 40 children with newly diagnosed ALL. Ten normal bone marrow samples were used as controls. Jurkat cells were treated with different concentrations of adriamycin (ADM). The cell proliferation was detected with MTT. The apoptosis rate was measured by flow cytometry. WAVE1 mRNA and protein expression of Jurkat cells treated with ADM was detected by RT-PCR and Western blotting respectively.

RESULTSWAVE1 was not expressed or weakly expressed in BMMCs from normal controls and patients with ALL in CR. Higher WAVE1 mRNA and protein expression was found in BMMCs from patients with newly diagnosed ALL and patients with relapse ALL when compared with the controls and the patients in CR (P<0.01). ADM significantly inhibited the proliferation of the Jurkat cells and the inhibitory effect was dose-and time-dependent (P<0.05). After ADM treatment for 24 hrs, the percentage of apoptosis cells increased significantly and WAVE1 mRNA and protein expression of Jurkat cells decreased significantly when compared with the untreated controls (P<0.05).

CONCLUSIONSThe WAVE1 expression increased in children with ALL. WAVE1 may be related to the development of ALL and may be severed as a marker for the evaluation of the severity of ALL in children.

Adolescent ; Antibiotics, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Blotting, Western ; Cell Proliferation ; drug effects ; Child ; Child, Preschool ; Doxorubicin ; pharmacology ; Female ; Humans ; Infant ; Jurkat Cells ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; etiology ; metabolism ; RNA, Messenger ; analysis ; Wiskott-Aldrich Syndrome Protein Family ; analysis ; genetics ; physiology

Metastasis of renal cell carcinoma to mammary gland is rare clinically. Based on the retrospective analysis of 3 cases of metastatic clear cell renal cell carcinoma of the breast identified pathologically from January 2010 to June 2017 in Tianjin Medical University Cancer Institute and Hospital, we discussed the clinical manifestation, pathological characteristics, diagnosis, treatment and prognosis of metastatic breast cancer of renal cell carcinoma.

OBJECTIVETo investigate the clinical epidemiological characteristics and the major causes of primary liver cancer (PLC) in Xinjiang region.

METHODSThe clinical epidemiological information on the first page of case history of 3602 PLC patients, which were diagnosed in our hospital from January 2002 to December 2010, were retrospectively reviewed and analyzed.

RESULTSAmong the 3602 cases, the men/women gender ratio was 3.72:1; The proportion of Han, Uighur, Kazakh, and other nationality (Hui, Mongolian, Manchu, Xibo nationality) was 81.95%, 9.30%, 4.14%, 2.89%, and 1.72%, respectively. The comparative difference between Uighur and Han nationalities was significant (P < 0.05). The hepatitis virus detection results showed that HBs-Ag was positive in 1680 cases (59.57%), HCV-Ab was positive in 229 cases (9.41%). Virus detection was negative in 888 patients (24.65%). The hepatitis B virus positive rate in Uygur patients was 36.13% and in Kazakh patients was 40.37%, both significantly lower than that in patients of Han nationality (63.18%, P < 0.05).

CONCLUSIONSIn Xinjiang region, the infection rate of hepatitis B virus in Uygur and Kazak people is significantly lower than that in Han people. The distribution of gender and age does not differ significantly among different nationalities, compared with those in other regions. The prevalence of primary liver cancer in Xinjiang region has certain regional characteristics and features.

Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; China ; epidemiology ; ethnology ; Ethnic Groups ; Female ; Hepatitis B ; epidemiology ; ethnology ; Hepatitis B Surface Antigens ; analysis ; Hepatitis C ; epidemiology ; ethnology ; Hepatitis C Antibodies ; analysis ; Humans ; Liver Neoplasms ; epidemiology ; ethnology ; virology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate prevalence, location, negotiation and the effect of operating microscope (OM) in the treatment of the second mesiobuccal canal (MB2) in maxillary molars.

METHODS113 maxillary molars were studied. The crowns of the teeth were removed 1 mm above the chamber bottom for searching MB2 canal. Initially location and negotiation of MB2 canal were attempted without OM. Teeth in which MB2 canal were not located or negotiated were further explored under OM. Canal orifices including MB orifice, MB2 orifice and palatal orifice were filled by red gutta-percha cones, then the teeth were scanned by scanner. The images were analyzed by Image-Proplus 4.0 software to measure the relationship between MB2 canal and other canals.

RESULTSThe MB-MB2 distance is (1.47 +/- 0.54) mm, MB-P distance is (5.77 +/- 0.66) mm, the vertical distance from MB2 to MB-P line is (0.53 +/- 0.28) mm, the angle between MB-P line and MB-MB2 line is 23.07 degrees +/- 13.08 degrees. MB2 orifices were located in 70 teeth (61.9%) and negotiated in 53 teeth (46.9%) without OM. With OM, additional MB2 orifices were located in other 6 teeth, 4 were negotiated; and 2 were negotiated in which MB2 canal were not negotiated without OM.

CONCLUSIONSMB2 canal can be located in 67.3% and negotiated in 52.2% of maxillary molars. Ability to locate and negotiate MB2 canal is facilitated by OM. The MB2 canal was located less than 1 mm mesially to the MB-P line and 2 mm palatally from the MB orifice.

Dental Pulp Cavity ; anatomy & histology ; Humans ; Maxilla ; Microscopy ; Molar ; anatomy & histology

BACKGROUNDEndovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a certain percentage of missed diagnosis. Preliminary studies on contrast-enhanced ultrasound (CEUS) have shown that the sensitivity of CEUS for detecting endoleak is no lower than that of CTA. To investigate the advantages of CEUS, we conducted CEUS examinations of post-EVAR cases in which CTA failed to detect endoleak or could not verify the type of endoleak.

METHODSPost-EVAR patients, who were clinically considered to have endoleak and met the inclusion criteria were enrolled between March 2013 and November 2014. All of the patients underwent color Doppler flow imaging (CDFI) and a CEUS examination. Size, location, microbubble dispersion, and hemodynamic characteristics of leaks were recorded. Comparison between the diagnosis of CEUS and CDFI was conducted using Fisher's exact test and clinical outcomes of all patients were followed up.

RESULTSSixteen patients were enrolled, and 12 (75%) had endoleaks with verified types by CEUS. Among 12 cases of endoleaks were positive by CEUS, 10 were CDFI-positive, and the four CEUS-negative cases were all negative by CDFI. The diagnostic values of CEUS and CDFI were statistically different (P = 0.008). Six patients with high-pressure endoleaks received endovascular re-intervention guided by CEUS results. One patient with type III endoleak had open surgery when endovascular repair failed.

CONCLUSIONSCEUS is a new, safe, and effective means for detection of endoleaks post-EVAR. This technique can be used as a supplement for routine CTA follow-up to provide more detailed information on endoleak and its category.

Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal ; diagnostic imaging ; surgery ; Contrast Media ; Female ; Humans ; Male ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color

BACKGROUNDIn the process of hepatic fibrosis, the accumulation of collagen fibers is strongly related to the hepatic function. The aim of this study was to investigate the three-dimensional architecture of the collagen network in the liver of rats with hepatic fibrosis.

METHODSHealthy adult male Wistar rats (n = 32) were randomly divided into a control group (n = 16) and a hepatic fibrosis group (n = 16). In the control group, the rats were treated with peanut oil while the rats in hepatic fibrosis group were treated for 10 weeks with 60% CCl(4) diluted in peanut oil. The quantity of collagen fibers was detected by Western blotting; distribution of the collagen was detected by sirius red staining and polarized microscope; the three-dimensional architecture of collagen in the liver was observed under the scanning electron microscope after fixed tissues were treated with cell-maceration using NaOH. Statistical analysis was performed using the u test.

RESULTSThe quantity of collagen fibers increased significantly in the hepatic fibrosis group. With the aggravation of hepatic fibrosis, collagen fibers gradually accumulated. They interlaced the reticulation compartment and formed a round or ellipse liver tissue conglomeration like a grape framework that was disparate and wrapped up the normal liver lobule. The deposition of collagen fibers was obvious in adjacent hepatic parenchyma, especially around the portal tracts.

CONCLUSIONOur experiment showed the collagen proliferation and displays clearly the three-dimensional architecture of collagen fibers in rat liver with hepatic fibrosis by scanning electron microscope. It can provide a morphological foundation for the mechanisms of changed haemodynamics and portal hypertension in hepatic fibrosis.

Animals ; Blotting, Western ; Collagen ; ultrastructure ; Liver Cirrhosis, Experimental ; pathology ; Male ; Microscopy, Electron, Scanning ; Rats ; Rats, Wistar

Objective To explore the effect of metformin on learning and memory ability and hippocampal tissue structure in mice during aging induced by D-galactose, and the possible underling mechanisms. Methods Twenty-four SPF 7-month-old female ICR mice were randomly divided into three groups. Mice of the aging group and aging+metformin group were given subcutaneous injection with D-galactose on the back to induce senescence, and given intragastric gavage with 0. 9% saline or metformin. Mice of the control group were treated with 0. 9% saline. All treatments lasted for 16 weeks. The body weight and food intake were monitored, learning and memory ability and motor function were tested by Mirros water maze and shuttle box tests, HE staining was used to observe the pathology of hippocampus in the mice, and the levels of glutathione (glutathione, GSH) in hippocampus of mice were detected by colorimetry. Results Compared with the aging group, the aging+meformin group showed diverse differences:the body weight was decreased (P < 0. 05), the escape latency and swimming distance were decreased ( P < 0. 01 or P < 0. 05 ) , the swimming time in the target quadrant was prolonged (P < 0. 05) and swimming speed was accelerated (P < 0. 05) in the Morris water maze test. The numbers of active avoidance response were markedly increased in shuttle box test ( P < 0. 05 ) . The neurons with nuclear condensation and deep staining were obviously decreased in the dentate gyrus of hippocampus, however the GSH level was significantly increased ( P < 0. 05 ) . Conclusions Metformin can delay the decline of learning and memory ability, maintain the normal structure of hippocampus during the aging process in mice, which may be related to the reduction of body weight and enhancement of antioxidant levels in the hippocampus.