Objective To report our clinical outcomes of treating tibial defects combined with soft tissue defects using Ilizarov technique.Methods From May 2010 to February 2015,52 patients with combined bone and soft tissue defects of the tibia were treated at our department.They were 41 males and 11 females,aged from 19 to 65 years (average,37.7 years).By Gustilo classification,49 cases were type ⅢB and 3 type ⅢC.The areas of soft tissue defect ranged from 7 cm ×3 cm to 28 cm × 15 cm,and the tibial defects ranged from 5 cm to 15 cm in length (average,12.6 cm).The schemes of Ilizarov technique depended on the location and size of the tibial defects.Open wound dressing combined with bone transport was adopted in 21 cases,limb shortening followed by bone lengthening with compression at the fracture ends in 12 cases,and tissue flap transplantation combined with bone transport or lengthening in 19 cases.Results The follow-up time of the 52 patients ranged from 13 to 61 months (average,27.1 months).The distance of bone transport or lengthening ranged from 5.0 cm to 13.6 cm (average,10.8 cm);the bone transport speed averaged 0.81 mm/day.The tibiae united in all the 52 patients;the time for external fixation ranged from 13 to 21 months (average,15.3 months);the external fixation index was 2.3 months/cm.According to the Paley functional criteria,23 cases were excellent,19 good,9 fair,and one poor,yielding an excellent to good rate of 80.7％.Conclusion According to the location and size of the bone and soft tissue defects of the tibia,the 3 schemes of Ilizarov technique can be rationally chosen to obtain fine clinical outcomes.

AIM To prepare D-α-tocopherol polyethylene glycol 1000 succinate (TPGS)-modified artesunate liposomes and to investigate the in vitro anti-tumor activity.METHODS The liposomes prepared by thin-film dispersion method were characterized by transmission electron microscopy and particle size analyzer,and the encapsulation efficiency was determined by ultrafiltration centrifugation.The liposomes' cytotoxicity to human hepatoma HepG2 cells was evaluated by MTT method.RESULTS The average particle size,PDI,Zeta potential,encapsulation efficiency,drug loading of the liposomes were 126.7 nm,0.182,-10.1 mV,78.8％ and 18.38％,respectively.The liposomes displayed a significant inhibition on HepG2 cells with the IC50 value of 0.034 μmol/mL.CONCLUSION Compared with non-TPGS-modified artesunate liposomes,the TPGS-modified artesunate liposomes prepared by this method afford smaller vesicle size,better stability and higher encapsulation efficiency with stronger in vitro anti-tumor activity.

Objective To study the effects of using jaw tracking technique with Smart LMC algorithm on the absorbing dose of planning target volume (PTV) and organs at risk (OARs) in dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods Field fluencies of 10 cases of NPC patients were optimized using DVO algorithm on Eclipse TPS (11.0),and according to the same optimal fluence,MLC operation files were calculated using jaw tracking technique and jaw fixing technique respectively,dose distribution was calculated with AAA algorithm and jaw tracking IMRT plan (JT-IMRT) and jaw fixing IMRT plan (JF-IMRT) were generated respectively.Collimators' position at the plan implementation was observed,and the total number of plans' monitor units (MU),the dose of PTV,the absorb dose of OARs,and the actual fluence verification pass rate were compared.Results The collimators' opening gap distances in 166 control points of the JT-IMRT reduced in both X and Y directions in the field,compared to that of the JF-IMRT.Total number of the JT-IMRT's MU increased by 3.59％-11.63％.There was no statistical significant difference between the doses of the PTV.Statistical significance was found in the differences between maximum dose (Dmax) of brainstem,spinal cord,crystal,optic nerve,the mean dose (Dmean) and D50％ of parotid and their decreased values after therapy (t=5.70-8.66,P＜0.05).The actual fluence verification pass rate of the JT-IMRT was higher than that of the JF-IMRT.There was a significant difference between the results (t=5.18,P＜0.05).Conclusions The JT-IMRT plan of the smart LMC algorithm is more tolerant to the radiation leakage between inter-and intra-leaf.The dose of OARs is lower,while the dose calculation precision and the verification pass rate are higher,the actual radiation dose is more accurate and reliable.Therefore it is more suitable for clinical applications.

Objective To compare the functional and radiographic outcomes of modified dual plating and less invasive stabilization system(LISS)in treatment of patients with complex tibial plateau fractures.Methods From November 2003 to November 2004,84 patients with complex tibial plateau fracture were treated with modified dual plating or LISS fixation.Their functional and radiographic outcomes were reviewed to compare the differences in bone union time,full weight-bearing time,knee joint's HSS(The Hospital for Special Surgery)scores,complications, tibia plateau angle(TPA)and posterior slope angle(PA).Results The 84 cases had complete follow-up records and a mean tollow-up of 16.2 months(range,12 to 23 months).Nine complications occurred in the modified dual plating group.The mean full weight-bearing time and radiographic bone union time were 16.8 and 15.1 weeks respectively for this group which had a mean HSS score of 87.4 points.Six complications were found in the LISS group.The mean full weight-bearing time and radiographic bone union time were 14.1 and 13.8 weeks respectively for this group which had a mean HSS score of 89.6 points.There were no significant differences between the two groups in changes of TPA and PA.Conclusion LISS can provide as good fixation as modified dual plating can for most complex tibial plateau fractures,but additional medial plate fixation may be necessary for some special cases.

Adult ; Asthma ; metabolism ; physiopathology ; Basic-Leucine Zipper Transcription Factors ; genetics ; physiology ; Fanconi Anemia Complementation Group Proteins ; genetics ; physiology ; Female ; Glutamate-Cysteine Ligase ; metabolism ; Humans ; Inflammation ; metabolism ; pathology ; Male ; NF-E2-Related Factor 2 ; genetics ; physiology ; RNA, Messenger ; genetics ; metabolism ; Sputum ; cytology

At present, most clinical thrombolytic drugs are plasminogen activators, which are highly dependent on the plasminogen level of the patient. Therefore, the efficacy of those drugs is restricted. Unlike the conventional thrombolytic plasminogen activator drugs, fibrinolytic drugs have direct fibrinolytic activity. Thus, fibrinolytic drugs can directly dissolve the thrombus, and its thromlysis efficacy is not restricted by the patients' plasminogen. This is a new type of thrombolytic drug with higher thrombolytic efficiency and safety, and has become one of the research hotspots at present. Although more and more agents that can be used as fibrinolytic drugs have been discovered, only a few of them can successfully be applied in clinical practice. The mainly underlying reason is the risk of bleeding. In this paper, based on the latest research progress of fibrinolytic drugs, the bleeding mechanisms and coping strategies of fibrinolytic drugs were systematically reviewed, five types of bleeding mechanisms of fibrinolytic drugs were summarized, and three types of coping strategies were proposed. We hope our work can provide theoretical basis for the development of safer and more efficient fibrinolytic drugs.

Objective To assessed the distribution of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in Xinjiang Uygur and Han nationality populations,and to investigate correlation and the incidence of all cases of macrovascular disease (coronary artery disease,carotid atherosclerosis and peripheral arterial disease)and analysis of risk factors.To further study the correlation between the incidence of two single nucleotide polymorphism (SNP)loci (rs2383206.rs10757278)on chromosome 9p21 in type 2 diabetes melli-tus(T2DM)of Han and Uygur ethnic and the incidence of all cases vascular disease,then to analysis the risk factors. Methods 497 adults with T2DM who were treated in the Endocrinology department in hospital from May 2012 to April 2014 were involved in this study,including 298 Uygur patients and 199 Han patients.215 non -T2DMpatients who were treated in the Cardiology department in hospital were also involved in the study,including 93 Uighur patients and 122 Han patients.Then the total 712 patients were detectedby using PCR -SNP Stream technology to analyse rs2383206.rs10757278 loci SNP genotyping.The relevant results were compared with t test,two different genotype distribution and allele frequency were compared with χ2 test,multiple factors analysis were calculated by Logisitic regression.Results The distribution of genotype with two SNP loci had no significant difference between the patients in Uygur group and Han group (rs2383206χ2 =5.570,P =0.062;rs10757278 χ2 =2.721,P =0.257 ),and there's no significant difference between the patients with macrovascular disease and non -macrovascular disease in all patients(rs2383206χ2 =0.120,P =0.950;rs10757278 χ2 =1.027,P =0.598).Logisitic regression analysis showed that the incidence of macrovascular was significantly associated with increasing age(χ2 =28.820,P =0.000)and fatty liver(χ2 =5.210,P =0.020)in Uighur group with type 2 DM.In Han group with type 2 DM,the macrovascular was significantly associated with the increase of age (χ2 =19.980,P =0.000),elevated fasting blood glucose (FPG)(χ2 =4.070,P =0.044)and poor controlled with glycosylated hemoglobin (χ2 =4.280,P =0.040). Conclusion This study found that there's no correlation between two single nucleotide polymorphisms (SNPS)loci (rs2383206.rs10757278)on chromosome 9 p21 large with macrovascular in Uygur group and Han group.Increasing age,higher FPG and poor controlled with glycosylated hemoglobin combined with fatty liver were the risk factors for macrovascular.

AIMTo investigate the effects of protein tyrosine kinase on the inflammation and airway remodeling in lung of guinea pigs with bronchial asthma.

METHODS30 adult male guinea pigs were randomly divided into 3 groups (n=3): control group (C group), asthmatic group(A group)and genistein group (B group). Asthmatic model was established by ovalbumin intraperitoneal injection and ovalbumin inhalation. The total cell and the proportion of inflammatory cell in bronchial alveolar lavage fluid(BALF), inflammatory cell infiltration and index of remodeling of bronchiole were measured, respectively. The expression of p-tyrosine in lung tissue was examined by immunohistochemistry.

RESULTSThe total cell and proportion of eosinophil in BALF of A group were significantly higher than that of C group (P < 0.01), but compared with A group, the total cell and proportion of eosinophil in BALF of B group were much lower (P < 0.01). The number of eosinophile and lymphocyte of bronchiole in A group were significantly higher than that of C group (P < 0.01), but compared with A group, the number of eosinophile and lymphocyte in bronchiole of B group were much lower (P < 0.01). Compared with A group, the remodeling of bronchiole of B group was significantly relieved (P <0.01), there was no difference between B and C group (P > 0.05). Immunohistochemistry indicated that in A group the p-tyrosine was more positively expressed at the bronchial smooth muscle, bronchial epithelium, smooth muscle of vessel and inflammatory cell, especially at smooth muscle of bronchi and vessel and inflammatory cell than that of C group (P <0.01), there was no difference between B group and C group (P > 0.05).

CONCLUSIONPTK played a key role in inflammation and bronchial remodeling in lung of guinea pigs with bronchial asthma. The Protein tyrosine kinase inhibitor genistein could prevent and inhibit the inflammation and bronchial remodeling in lung of guinea pigs with bronchial asthma.

Airway Remodeling ; physiology ; Animals ; Asthma ; physiopathology ; prevention & control ; Genistein ; pharmacology ; Guinea Pigs ; Inflammation ; prevention & control ; Male ; Ovalbumin ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; physiology ; Random Allocation

Objective To evaluate the setup errors for lower neck with cone beam CT (CBCT) in breast cancer patients immobilized by breast bracket,and to probe the margins from supraclavicular clinical target volume (CTV) in 3 directions.Methods A total of 14 breast cancer patients with supraclavicular lymph node radiation were enrolled.All patients were immobilized by breast bracket,and each patient would undergo CBCT at the first,tenth and twentieth treatment after positioning,respectively.Then these CBCT images were registered to the planning CT to determine setup errors in translational and rotational direction,and evaluated correlation between them.At last,CTV margins were calculated from the systenatic and random errors.Results The setup errors on x (left-ring),y (superior-inferior),z (anterior-posterior) translational directions were (2.89 ±.2.52),(3.96 ±2.97),(4.21 ±2.24) mm and on θ (pitch degree),φ (roll degree),Ψ (yaw degree) rotational direction were (2.38 ± 1.97)°,(1.60±1.63) °,(1.91 ±1.54)°,respectively.The margins from CTV were 8.08,8.13,6.30mminx,y and z direction.On y and z directions translational errors were correlated significantly with φ and Ψ degree rotational errors(Pearson =-0.515,-0.509,P ＜ 0.05).In inter-fraction only on z direction the setup changes were considered as correlative with Ψ degree (Pearson =-0.583,P ＜ 0.05).Conclusions For supraclavicular region irradiation breast cancer patients immobilized with breast bracket,the margins from CTV were recommended as not less than 8.08,8.13,6.30 mm in x,y,z directions,respectively.The position immobilized method and the positioning workflow should be further improved in order to reduce the influence of the neck rotational on setup errors.

Objective To compare the efficacy and complications of Chinese Shang Ring circumcision with conventional circumcisiom Methods Clinical data of 479 cases of Chinese Shang Ring circumcision and 354 cases of conventional circumcision with complete follow-up were analyzed.Comparisons were made between the two groups on operation time,pain score,blood loss,postoperative complications,postoperative satisfaction with penile appearance,wound healing time and treatment costs. Results There was no statistical difference in age and foreskin status between the two groups (P＞0.05).For the Shang Ring group,the operation time was(5±1)rain,blood loss was (0.98±1.14)ml,pain score during operation was 0.25±0.54,24-hour pain score after operation was 1.63±0.87,the postoperative complication rate was 6.89% (33/479),wound healing time was (20±5)d,the satisfaction rate of appearance was 99.79% (478/479),and treatment cost was (871±52) yuan.For the conventional group,the operation time was (27±5) min,blood loss was (8.30±3.60)ml,pain score during operation was 3.29±1.57,24-hour pain score after operation was 5.56±1.42,the postoperative complication rate was 13.28%(47/354),wound healing time was (13±2)d,satisfaction rate of appearance was 92.37% (327/354),and treatment cost was (554±46) yuan.Compared with the conventional group,the Shang Ring group had a shorter operation time,less blood loss,less pain score,higher appearance satisfaction rate and a lower complication rate (P＜0.05).But wound healing time was longer and treatment cost was higher in the Shang Ring group (P＜0.05). Conclusions Chinese Shang Ring circumcision is simpler and an improved approach over conventional circumeision with shorter operative time,less blood loss,less pain,relatively lower complication rate and higher satisfaction and acceptability.