Objective To explore the long-term effect of open reduction and internal fixation for the treatment of displaced acetabular fracture,and analyze the influence of risk factors.Methods The clinical data of 62 patients with acetabular fracture from August 2005 to February 2009 was analyzed retrospectively.All the cases were treated with open reduction and internal fixation.The long-term effect and related risk factors were analyzed.Results All the cases were followed up for 24-52(38.8 ± 2.6) months.According to the Matta standard of replacement of fracture,there were 43 cases with anatomic reduction,14 eases with satisfactory reduction,5 cases with unsatisfactory reduction.Fracture union was obtained in all the patients.Based on the modified Merled' Aubigne -Postel clinical grading system,the result was excellent and good in 50 patients,fair and poor in 12 patients,with excellent rate of 80.65％ (50/62).Postoperative complications including traumatic arthritis were seen in 7 patients,heterotopic ossification in 3 patients and femoral head avascular necrosis in 1 patient.The related risk factors of clinical results of displaced acetabular fracture were age,Letournel-Judet fracture type,operation time,cartilage surface damage of the femoral head and quality of reduction (P ＜ 0.05 ).However,gender,AO fracture type,surgical approach and hip dislocation were not affecting factors of the acetabular fracture(P ＞ 0.05 ).Conclusions Open reduction and internal fixation can result in a satisfactory clinical outcome.Age,Letournel-Judet fracture type,operation time,cartilage surface damage of the femoral head and quality of reduction are independent risk factors affecting postoperative long-term functional outcomes.

BACKGROUND:The internal structures of the colagen-heparan sulfate scaffold and human nerve are very similar. OBJECTIVE: To explore thein vivo biocompatibility of colagen-heparin sulfate scaffold. METHODS:Forty pigs were randomly divided into two groups, 20 in each group: observation group and control group. Medulo-puncture needle was inserted 1.0 cm adjacent to the midline of anterior fontanele into the subarachnoid space, and then removed gradualy. Colagen-heparin sulfate scaffold was implanted into the observation group, and no treatment was given in the control group. Brain tissues were observed under transmission electron microscope, and cel apoptosis and Caspase-3 expression were detected at days 1, 3, 7, 14 and 30 after surgery. RESULTS AND CONCLUSION:Under the electron microscope, there were some damaged neurons in the observation group with the emergence of demyelination changes in the myelinated nerve fibers; positiveexpression of Caspase-3 protein was found at the junction between the brain tissue and scaffold as wel as within the scaffold, but no positive expression was found in the surrounding tissue. There was no cel apoptosis within 30 days after surgery except for individual apoptotic neurons both in the observation group and control group. The number of apoptotic cels in the observation group was higher than that in the control group at days 1, 3, 7, 14 days after surgery (P < 0.05), but there was no difference between the two groups at 30 days after surgery (P > 0.05). Caspase-3 protein expression was at a low state in the two groups, but the protein expression of Caspase-3 was higher in the observation group than the control group at days 3 and 7 after surgery (P < 0.05). These findings indicate that the colagen heparin sulfate scaffold has good biocompatibility in the porcine brain.

Objective To study mental characteristics of children with light lead poisoning. Methods Eighty - six children with light lead poisioning and 33 control children were evaluated with WISC - R and social adaptive capacity(SAB). Results 1. Intelligence quotient( IQ)and SAB of children with light lead poisoning were lower than normal children. 2. There was also deficiency of perception factor and memory/ concentration factor among children with lead poisioning and the blood lead level had negative association with perception factor. Conclusion Light lead poisioning may affect children's IQ, especially in the perception factor and memory /concentration factor.

OBJECTIVETo investigate the optimum proportion of Mosaicplasty and genes-enhanced tissue engineering for the repair of acute osteochondral defects.

METHODSWestern blot test was conducted to detect the expression of hTGF-beta1, Col II and Aggrecan in 3 groups, including hTGF-beta1, transduction group, Adv-betagal transduction group and control group without transduction. Eighteen 6-month-old Shanghai male goats (weight: 22 to 25 kg) were used. BMSCs were isolated from the autologous bone marrow, and were subcultured to get the cells at passage 3. Thirty-six medial femoral condyles were used and divided into 6 groups named AR, AL, BR, BL, CR, and CL. Acute cylindrical defects (9 mm in diameter and 3 mm in depth)were created in the weight bearing area of the medial femoral condyle of hind limbs. In the single group, the autologous osteochondral mosaicplasty was performed to repair the defect; in the combination group, besides the mosaicplasty, the dead space between the cylindrical grafts and the host cartilage were injected with the suspension of hTGF-beta1, gene enhanced autogenous BMSCs in sodium alginate, and CaCl2 was dropped into it to form calcium alginate gels. The autologous osteochondral transplantation cover rates of group AR was 44.44% single group, AL was 44.44% combination group, BR was 33.33% single group, BL was 33.33% combination group, CR was 22.22% single group, and CL was 22.22% combination group. The goats were killed 24 weeks after operation to receive gross and histology observation, which was evaluated by the histological grading scale of O'Driscoll, Keeley and Salter. Immunohistochemistry and TEM observation were also performed.

RESULTSWestern blot test showed the expression of the hTGF-beta1, Col II and the Aggrecan in the hTGF-beta1 transduction group were significantly higher than that of the Adv-betaga1 transduction and the blank control groups. The gross and histology observation revealed that each defects of six groups had different degrees of repairing. There was no significantly difference among the BL, AR, and AL groups. But the scores of the other three groups (BR, CR, and CL) were significantly poorer than the former three groups.

CONCLUSIONMosaicplasty associated with genes enhanced tissue engineering could repair the osteochondral defects effectively. With the autologous osteochondral transplantation coverage reducing, the advantage of the combination could have a better representation.

Animals ; Blotting, Western ; Bone Diseases ; metabolism ; pathology ; therapy ; Cell Line ; Goats ; Humans ; Immunoprecipitation ; Male ; Tissue Engineering ; methods

This study was purposed to investigate the clinical significance of the amount and activated status of T cell subsets, B cells, NK cells in peripheral blood from patients with myelodysplastic syndrome (MDS). The proportion of T cells, B cells, NK cells in peripheral blood from 30 patients with MDS and their surface activation markers of CD28, CD45RA, CD45RO, CD69, HLA-DR were analyzed by flow cytometry. Twenty-two patients were in the low risk group (RA + RAS) while eight patients were in the high risk group (RAEB + RAEBT). The result showed that the amounts of T cells (CD3+ cells) in peripheral blood from patients with MDS were lower than those in control group. The amounts of naive CD4+ cells (CD4+ CD45RA+ cells) in MDS patients were lower than those in control. The expression rates of early activation marker (CD69) and late activation marker (HLA-DR) on CD3+ cells in MDS patients were significantly higher than those in control. The abnormalities of the immunologically competent cells were mainly observed in the low risk group (RA + RAS), and were characterized by the high expression rates of CD69+ and HLA-DR+ on CD3+ cells, the decrease of B cell amounts. The amount abnormalities of T cell subsets were mainly observed in high risk group (RAEB + RAEBT), and were characterized by the decrease of CD3+ cells and CD3+ CD4+ CD8- cells (Th cells) amounts without high expression of the CD69 and HLA-DR, the decrease of NK cells amounts. It is concluded that there are the abnormalities of T cell subsets and function in the patients with MDS and may change with disease progression, so the measurement of amount and activated status of T cell subsets in peripheral blood from MDS patients can have predictive role for diagnosis of disease progression and guide of therapy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; immunology ; Antigens, Differentiation, T-Lymphocyte ; immunology ; B-Lymphocytes ; immunology ; CD3 Complex ; immunology ; Female ; HLA-DR Antigens ; immunology ; Humans ; Killer Cells, Natural ; immunology ; Lectins, C-Type ; Lymphocyte Activation ; immunology ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo investigate the ability to form new bone and cartilage tissues of bone marrow mesenchymal stem cells (BMSC) derived from human condyle in vivo, to search the new source of seed cells in constructing tissue engineering condyle.

METHODSBone marrow was collected from the irrigation solution from resected human condyle, and was isolated by density gradient centrifugation and then purified by adherent separation and cultured in vitro. P3 or P4 BMSC populations were induced into osteoblasts and chondroblast under inductive medium in vitro and then seeded on porous coral scaffolds. The appearance and affinity of cells were investigated via scanning electron microscope. And then osteoblast or chondroblast/coral scaffolds composites were implanted into the dorsum of nude mice. The mice were sacrificed by anaesthesia overdose at six and nine weeks after surgery and the scaffolds were removed for analysis.

RESULTSScanning electron microscope showed that BMSC were adhering to the surface of coral and having an overlapped growth or to contact each other as net and stride over the pores. The in vivo scaffold specimens maintained the initial shape of the coral scaffold. The new formed bone tissues were clearly evident and islands of cartilage tissues were also found at nine weeks after implantation.

CONCLUSIONSThese BMSC derived from human condyle possess the ability of forming bone and cartilage tissues when being implanted in vivo, and can be used as a kind of seed cells in constructing tissue engineering condyle.

Animals ; Anthozoa ; Cartilage ; cytology ; Cell Proliferation ; Cells, Cultured ; Chondrocytes ; cytology ; Chondrogenesis ; Humans ; Mandibular Condyle ; cytology ; Mesenchymal Stromal Cells ; cytology ; Mice ; Mice, Nude ; Microscopy, Electron, Scanning ; Osteoblasts ; cytology ; Osteogenesis ; Random Allocation ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective:To investigate the clinical manifestations, auxiliary examination results, prognosis and treatment of children with typical hemolytic uremic syndrome (D + HUS). Methods:The clinical data of 36 patients diagnosed as D + HUS in the Department of Pediatrics of Nanjing Jinling Hospital from January 2001 to January 2019 were collected, and the laboratory results including blood routine, liver and kidney function, coagulation function, humoral immunity and urine were compared before and after treatment. Results:The white blood cell count[ (9.28±6.77)×10 9/L vs.(11.20±5.93) ×10 9/ L ], C-reactive protein [7.15(3.34, 29.33) mg/L vs.31.83(25.03, 39.75) mg/L], reticulocyte count [(112.49±76.25)×10 9/L vs. (206.49±147.99)×10 9/L], erythrocyte sedimentation[15.02(11.79, 22.83) mm/1 h vs.28.06(24.13, 40.52) mm/1 h] , aspartate aminotransferase[50.04(41.92, 60.11) U/L vs.62.61(54.58, 83.52) U/L], alanine aminotransferase [16.72(11.80, 24.74) U/L vs.24.54(20.30, 34.36) U/L], uric acid [(532.84±309.06) μmol/L vs.(606.64±327.23) μmol/L], serum creatinine[160.07(124.87, 221.18) μmol/L vs.200.56(160.62, 283.01)μmol/L ], blood urea nitrogen [20.74(15.77, 28.40) mmol/L vs.33.67(25.91, 45.84) mmol/L], lactate dehydrogenase [488.21(337.59, 692.82) U/L vs.1 520.68(734.24, 2 272.10) U/L ], prothrombin time [(12.14±5.89) s vs. (17.91±6.12) s ], activated partial thrombin time [(25.05±6.26) s vs.(32.38±5.49) s], fibrinogen [ (3.79±2.17) g/L vs.(5.17±3.88) g/L], D-dimer [0.92(0.30, 1.13) mg/L vs. 1.27(1.01, 1.90) mg/L ], 24-hour urinary proteinuria [ (84.05±44.19) mg/(kg·24 h) vs.(112.18±78.26) mg/(kg·24 h) ], urinary sediment [175.73(79.72, 258.66)×10 7/L vs. 160.38(118.68, 361.83)×10 7/L], N-acetyl-β-D-glucosaminidase [25.10(18.84, 33.02) U/(g·cr) vs. 41.57(29.49, 58.61) U/(g·cr)], urinary retinol binding protein [0.35(0.18, 1.33) mg/L vs 1.05(0.66, 1.68) mg/L.] in patients after treatment were significantly lower than those before treatment, and the differences were all statistically significant(all P<0.05); patients had higher levels of red blood cell count [ (4.51±1.73)×10 9/L vs.(2.43±1.40) ×10 9/L], platelet[(126.82±78.35)×10 9/L vs. (85.21±69.38)×10 9/L], hemoglobin[(118.46±18.27) g/L vs. (62.36±16.11) g/L], and complement C 3levels [(0.74±0.39) g/L vs.(0.58±0.27) g/L ] after treatment, and the differences were all all statistically significant(all P<0.05). Children with D + HUS showed multiple system injuries.Among 36 cases, 17 cases (47.22%) had fever, 31 cases (86.11%) had abdominal pain and diarrhea, 29 cases (80.56%) had nausea and vomiting, 8 cases (22.22%) had headache and dizziness, 36 cases (100.00%) had proteinuria and hematuria, 34 cases (94.44%) had renal insufficiency, and 21 cases (58.33%) had yellow staining of skin and sclera.The auxiliary examination for abnormal results mainly included renal pathology (100.00%) (mesangial proliferation endothelial cell proliferation and swelling, and shedding of renal tubular brush borders), bone marrow pathology (100.00%) (active bone marrow hyperplasia), and renal B-ultrasound (86.67 %) (kidney injury-like sound image). Conclusions:D + HUS in children shows multiple system damage.Digestive system abnormalities are the main causative factor of D + HUS in children, and the disease is dangerous.Therefore, early diagnosis and active treatment can improve the prognosis.

Elucidation of the biosynthetic pathways of natural products is not only the major goal of herb genomics, but also the solid foundation of synthetic biology of natural products. Here, this paper reviewed recent advance in this field and put forward strategies to elucidate the biosynthetic pathway of natural products. Firstly, a proposed biosynthetic pathway should be set up based on well-known knowledge about chemical reactions and information on the identified compounds, as well as studies with isotope tracer. Secondly, candidate genes possibly involved in the biosynthetic pathway were screened out by co-expression analysis and/or gene cluster mining. Lastly, all the candidate genes were heterologously expressed in the host and then the enzyme involved in the biosynthetic pathway was characterized by activity assay. Sometimes, the function of the enzyme in the original plant could be further studied by RNAi or VIGS technology. Understanding the biosynthetic pathways of natural products will contribute to supply of new leading compounds by synthetic biology and provide "functional marker" for herbal molecular breeding, thus but boosting the development of traditional Chinese medicine agriculture.

Understanding of codon usage bias of Fritillaria cirrhosa can provide theoretical basis for heterologous biosynthesis of F. cirrhosa alkaloids by genetic engineering technology. A total of 9 843 full length coding sequences (CDS) from the F. cirrhosa transcriptome data were used for the analysis of codon usage bias. The GC and GC3s contents, effective number of codons(ENC) and relative synonymous codon usage (RSCU) were calculated using the CodonW software. The results show that the codon usage bias value is low in the CDS of F. cirrhosa. A total of 15 codons, including UUG, CUU, AUU, GUU, UCA, CCU, CCA, ACU, ACA, GCA, UAU, CAU, AAU, AGA and GGA, were identified as optimal codons in F. cirrhosa. The optimal codons generally end with A/T at the third codon position. By the transcriptome annotation, we found 26 CDSs possibly involved in the biosynthesis of alkaloids in the F. cirrhosa. The proportion of rare codons of Escherichia coli and Saccharomyces cerevisiae are low in these CDSs. We also proposed a method for the codonoptimization in these target genes. Our work lays the foundation for further study on the biosynthesis of alkaloids of the F. cirrhosa in heterologous species.