OBJECTIVETo explore clinical characteristics and treatment of posterior Pilon fracture.

METHODSFrom January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.

RESULTSAll patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.

CONCLUSIONPosterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.

Adult ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

To explore the correlation between the ecological factors and the contents of podophyllotoxin and total lignans in root and rhizome of Sinopodophyllum hexandrum, podophyllotoxin in 87 samples (from 5 provinces) was determined by HPLC and total lignans by UV. A correlation and regression analysis was made by software SPSS 16.0 in combination with ecological factors (terrain, soil and climate). The content determination results showed a great difference between podophyllotoxin and total lignans, attaining 1.001%-6.230% and 5.350%-16.34%, respective. The correlation and regression analysis by SPSS showed a positive linear correlation between their contents, strong positive correlation between their contents, latitude and annual average rainfall within the sampling area, weak negative correlation with pH value and organic material in soil, weaker and stronger positive correlations with soil potassium, weak negative correlation with slope and annual average temperature and weaker positive correlation between the podophyllotoxin content and soil potassium.
Berberidaceae ; chemistry ; China ; Chromatography, High Pressure Liquid ; Climate ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ecosystem ; Lignans ; chemistry ; isolation & purification ; Podophyllotoxin ; chemistry ; isolation & purification ; Soil ; chemistry ; Temperature

OBJECTIVETo explore clinical effects of Ilizarov technique at stage I for repairing tibial post-traumatic osteomyelitis with bone and skin defect.

METHODSFrom June 2010 to December 2013,44 patients with tibial post-traumatic osteomyelitis with bone and skin defect were treated with Ilizarov technique at stage I . Among them, there were 35 males and 9 females aged from 18 to 70 years old with an average of 42.5 years old. Bone defect ranged from 4 to 16 cm, skin defect ranged from 3 cm x 4 cm to 5 cm x 16 cm. The operation was performed debridement thoroughly, removed inflammatory bone section, osteotomy invasively, install circular external fixator by Ilizarow technique; screw nut were rotated at 1 week after operation, and prolonged 0.5 to 1.0 mm everyday. Wound surface, new born callus and bone healing were observed to evaluate clinical effects.

RESULTSAll patients were followed up from 11 to 36 months with an average of 18.5 months. Bone defect after osteotomy was from 6 to 22 cm with an average of 11.5 cm; the time of wound healing time ranged from 21 to 79 d with an average of 38 d; bone defect healing time was from 8 to 15 months with an average of 12.5 months. All patients were cured, no recurrent infection, refracture and shorten of calf deformity were occurred.

CONCLUSIONRepairing tibial post-traumatic osteomyelitis with bone and skin defect by llizarov technique at stage I has advantages of less trauma, low inflammatory recurrence rate, could avoid multiple complex operation, and receive definite curative effect.

Adolescent ; Adult ; Aged ; Female ; Humans ; Ilizarov Technique ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Osteotomy ; Tibia ; surgery

OBJECTIVEA hybrid operation is a joint procedure involving the interventional cardiologist and the cardiac surgeon concomitantly to optimize surgical management for complex congenital heart disease. We analyzed the feasibility and efficacy of this procedure in 20 patients with congenital heart disease.

METHODSData from 20 patients who underwent intraoperative hybrid procedures from March to October 2005 were analyzed. Two groups were identified: (1) Balloon valvuloplasty group: pulmonary atresia with intact ventricular septum in neonate (n = 3) and severe pulmonary stenosis in infants (n = 4); (2) Device closure group: atrial septum defects (ASD) in child (n = 7), adult ASD (n = 3) and multiple ventricular septum defect (VSD, n = 3). Pulmonary balloon dilation under the guidance of echocardiography together with modified Blalock-Taussig shunt procedure and PDA ligation were applied to patients in balloon valvuloplasty group. For ASD patients, the occluder was placed via right atria after opening the chest either with median sternotomy (4 case) or with submaxillary minimally invasive incision (6 cases), PDA ligation was performed in 1 patient and 2 coronary artery bypass surgeries were performed in 2 adult ASD patients complicating CHD. For multiple VSD, perimembranous VSD was closed surgically and muscular VSD closed by occluder via tricuspid valve approach under cardiopulmonary bypass.

RESULTSAll operations were successful and 1 infant received another conventional valvuloplasty due to the pulmonary restenosis after initial balloon valvuloplasty and 1 patient's muscular VSD was closed by conventional procedure after unsuccessful device closure. No device-related complications were found during follow-up (1-6 months).

CONCLUSIONOur results showed that intraoperative hybrid procedure was feasible and effective in selected patients with congenital heart disease.

Adolescent ; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

OBJECTIVETo determine whether blood lipids profile, fibrinogen and viscosity were associated with passive smoking (i. e. environmental tobacco smoke, ETS) in Chinese women who never smoke.

METHODSIn Xi'an, China, a case-control study was carried out on 115 cases of coronary heart disease (CHD) defined by coronary arteriography (CAG) and 208 non-CHD controls confirmed by CAG and/or exercise electrocardiography. Data on exposure to ETS, defined as exposure from cigarettes smoking husband or co-workers or both for at least 5 years, was obtained through standardized interviews. Standard laboratory methods were used and the lipid measurements were under US CDC quality control programs.

RESULTSIn the subjects defined by CAG, the levels of high density lipoprotein cholesterol (HDL-C), HDL2C, apolipoprotein (apo) A1 among passive smokers appeared lower than those in non-passive smokers,but the low density lipoprotein cholesterol (LDL-C), apoB, apoB/A1, fibrinogen, plasma and whole blood viscosity were higher than that in non-passive smokers. There were positive associations of the numbers of coronary arteriosclerosis with the levels of blood lipids,fibrinogen and viscosity. In the non-CHD controls, 81 subjects were not exposed and 127 were exposed to ETS. The P values of t-test for the adjusted (for age, body mass index, present diseases history) means between two groups were listed below: 0.06 (total cholesterol), 0.30 (triglyceride), 0.004 (HDL-C), <0.001 (HDL2-C), < 0.001 (apoA1), 0.009 (apoB), <0.001 (apoB/apoA1), <0.001 (fibrinogen), <0.001 (plasma viscosity), <0.001 and 0.004 [two measures (5.75/s and 230/s) of whole blood viscosity]. The correlation coefficients between cumulative exposure of passive smoking and HDL-C,HDL2-C,apoA1, apoB, apoB/apoA1, fibrinogen, plasma viscosity, and two measures of whole blood viscosity were -0.25, -0.27, -0.30, 0.24, 0.31, 0.32, 0.43, 0.51 and 0.36 (all P<0.01), respectively.

CONCLUSIONPassive smoking could affect blood lipid metabolism, fibrinogen and viscosity in the never smoking women which might contribute to the causation of coronary heart disease.

Apolipoprotein A-I ; blood ; Blood Viscosity ; drug effects ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Coronary Disease ; etiology ; Female ; Fibrinogen ; metabolism ; Humans ; Male ; Middle Aged ; Tobacco Smoke Pollution ; adverse effects

OBJECTIVETo determine the effect of composite restoration on reinforcement of weakened tooth structure and the possible mechanism.

METHODSSixty freshly extracted non-carious maxillary premolars were collected and divided into 6 groups with 10 specimen in each group. MOD cavities (buccolingual width: 2.8 to 3.2 mm; palatal cusp width: 2.0 mm; cusp height: 5.0 mm) were prepared individually. Group 1 was prepared and not restored (control). The other 5 groups were restored with silver amalgam alloy (group 2), Z250 without bonding (group 3), F2000 (group 4), Z250 (group 5) and Z350 nanocomposite (group 6) (3M ESPE) respectively. The fracture resistance of the tested teeth was determined by applying a vertical splitting load through a specially shaped steel rod at a crosshead speed of 1 mm/min. The data were analyzed by ANOVA.

RESULTSThe average fracture resistance of the 6 groups was: (245.29 +/- 39.49) N (group 1), (255.09 +/- 42.14) N (group 2), (267.34 +/- 31.56) N (group 3), (293.90 +/- 33.42) N (group 4), (337.81 +/- 32.63) N (group 5) and (349.08 +/- 32.93) N (group 6). There was no significant difference between the group 1, group 2 and group 3. The fracture resistance of group 4, group 5 and group 6 was higher than that of group 1 and group 2 (P < 0.05). Significant difference was noted between group 5 and group 3 (P < 0.01). The fracture resistance of group 4 was much lower than that of group 5 and group 6 (P < 0.01). No significant difference was found between group 5 and group 6.

CONCLUSIONSThe use of composite increased the fracture resistance of the tooth with an MOD restoration. This effect was related to the adhesive force, polymerization shrinkage stress and the elastic modulus of the composite.

Bicuspid ; Composite Resins ; Compressive Strength ; Dental Stress Analysis ; Humans ; In Vitro Techniques ; Root Canal Filling Materials ; Tooth Fractures ; prevention & control

Objective To evaluate the clinical efficacy of docetaxel +carboplatin combined with hyperthermia on treatment of advanced esopha-geal cancer and its effect on serum vascular endothelial growth factor ( VEGF).Methods Fifty patients with advanced esophageal cancer were randomly divided into treatment group (n=25) and control group (n=25). Control group was treated with docetaxel, intravenous 75 mg? m-2 , 1 h, day 1 +carboplatin, intravenous infusion 25 mg? m-2 , day 1 -3.A period of 28 days, a total of two treatment cycles.Treatment group was treated with docetaxel, intravenous 75 mg? m -2 , 1 h, day 1 +carboplatin, intravenous infusion 25 mg? m-2 , day 1 -3, combined with the same period of hyperthermia, NRL -004 tumor hyperthermia system, heat output power 900-1200 W, twice a week, a period of 28 days, a total of two treatment cycles.Short -term clinical efficacy, serum VEGF levels and quality of life scores and the incidence of adverse drug reactions were compared between the two groups.Results After treatment, the total efficacy of 84.00%in treat-ment group was significantly higher than that in control group (68.00%, P<0.05), serum VEGF levels in treatment group were significantly decreased than that in control group ( P<0.05 ) which had a slight decrease.Quality of life score of patients in treatment group ( 54.32 ± 9.42 ) was significantly higher than that in control group (42.04 ±10.51, P <0.05 ) . The main adverse drug reactions in treatment group were nausea and vomiting (48.00%) , hair loss (56.00%) and in control group they were 52.00%and 64.00%, respectively.There were of significant differences between the two groups ( P <0.05 ) .Conclusion Docetaxel +carboplatin combined with hyperthermia on the treatment of patients with advanced esophageal cancer had more significant short-term effect, and it can effectively reduce serum VEGF levels and fewer adverse drug reactions.It is recommended to be widely adpoted in clinic.

Background: and Purpose This study aimed to construct an optimal dynamic nomogram for predicting malignant brain edema (MBE) in acute ischemic stroke (AIS) patients after endovascular thrombectomy (ET). Methods: We enrolled AIS patients after ET from May 2017 to April 2021. MBE was defined as a midline shift of >5 mm at the septum pellucidum or pineal gland based on follow-up computed tomography within 5 days after ET. Multivariate logistic regression and LASSO (least absolute shrinkage and selection operator) regression were used to construct the nomogram. The area under the receiver operating characteristic curve (AUC) and decisioncurve analysis were used to compare our nomogram with two previous risk models for predicting brain edema after ET. Results: MBE developed in 72 (21.9%) of the 329 eligible patients. Our dynamic web-based nomogram (https://successful.shinyapps.io/DynNomapp/) consisted of five parameters: basal cistern effacement, postoperative National Institutes of Health Stroke Scale (NIHSS) score, brain atrophy, hypoattenuation area, and stroke etiology. The nomogram showed good discrimination ability, with a C-index (Harrell’s concordance index) of 0.925 (95% confidence interval=0.890–0.961), and good calibration (Hosmer-Lemeshow test, p=0.386). All variables had variance inflation factors of <1.5 and tolerances of >0.7, suggesting no significant collinearity among them. The AUC of our nomogram (0.925) was superior to those of Xiang-liang Chen and colleagues (0.843) and Ming-yang Du and colleagues (0.728). Conclusions Our web-based dynamic nomogram reliably predicted the risk of MBE in AIS patients after ET, and hence is worthy of further evaluation.

OBJECTIVETo analyze the capacity of personal protection on poison emergency items in Chinese disease control and prevention institutes.

METHODSEvaluation analysis based on data obtained from investigating personal protection equipments and professional knowledge quizzing about personal protection in poisoning control of 57 different level centers for disease control and prevention selected from China by a multi-stage stratified sampling.

RESULTSAll 80.70% of the institutes possessed the protection equipments, provincial, municipal, county level institutes were 100.00%, 95.24%, 66.67%, respectively, with significant statistical difference (H = 7.94, P < 0.05). The average level of the type of individual protective equipments in disease control and prevention institutes was (5.42 +/- 4.00) kinds, the average points in category of provincial, municipal, county level institutes were (11.33 +/- 3.67), (6.52 +/- 3.16), (3.47 +/- 3.10) kinds, being statistically significant (F = 17.30, P < 0.05); type difference counts of disease control and prevention institutes in economic development, secondary, less-developed regions were (6.41 +/- 4.03), (3.55 +/- 3.35), (6.45 +/- 4.07) kinds, with statistical significance (F = 3.70, P < 0.05). Protection equipments chiefly possessed were latex gloves, gauze masks and C-protective clothing. Protective clothing and respiratory protective equipments were insufficient evidently. The average points in testing personal protection basic knowledge were (71.39 +/- 12.52) points; there were no differences between different institutes with different economic regions, levels, technical posts and title degrees.

CONCLUSIONCertain advances have been achieved in recent years in personal protection capacity of institutes for disease control and prevention, but far from the actual demands, and maybe no enough effective response on emergency occurred.

China ; Emergencies ; Humans ; Occupational Exposure ; Poisoning ; prevention & control ; Protective Clothing

OBJECTIVEThis paper is to explore the DNA repair mechanism of immune adaptive response (AR) induced by low dose radiation (LDR), the changes of mRNA levels and protein expressions of p53, ATM, DNA-PK catalytic subunit (DNA-PKcs) and PARP-1 genes in the LDR-induced AR in EL-4 cells.

METHODSThe apoptosis and cell cycle progression of EL-4 cells were detected by flow cytometry in 12 h after the cells received the pre-exposure of 0.075 Gy X-rays (inductive dose, D1) and the succeeding high dose irradiation (challenge dose, D2; 1.0, 1.5, and 2.0 Gy X-rays, respectively) with or without wortmannin (inhibitor of ATM and DNA-PK) and 3-aminobenzamid (inhibitor of PARP-1). And the protein expressions and mRNA levels related to these genes were detected with flow cytometry and reverse transcription-polymerase chain reaction in 12 h after irradiation with D2.

RESULTSThe mRNA and protein expressions of p53 and PARP-1 in EL-4 cells in the D1 + D2 groups were much lower than those in the D2 groups, and those of PARP-1 in the 3-AB + D2 and the 3-AB + D1 + D2 groups were much lower than those in the D2 and the D1 + D2 groups. The percentage of apoptotic EL-4 cells in the 3-AB + D1 + D2 groups was much higher than that in the D1 + D2 groups, that in the G₀/G₁ and the G₂ + M phases was much higher, and that in the S phase were much lower. Although the ATM and DNA-PKcs mRNA and protein expressions in wortmannin + D1 + D2 groups were much lower than those in the D1 + D2 groups, there were no significant changes in the apoptosis and cell cycle progression between the wortmannin + D1 + D2 and the D1 + D2 groups.

CONCLUSIONPARP-1 and p53 might play important roles in AR induced by LDR.

Androstadienes ; Animals ; Apoptosis ; Cell Cycle ; Cell Line, Tumor ; DNA Repair ; Dose-Response Relationship, Radiation ; Gene Expression Regulation ; radiation effects ; Mice ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerases ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Radiation, Ionizing ; Tumor Suppressor Protein p53 ; metabolism