Objective To investigate the concentration of homocysteine (Hcy) and related factors of hyperhomocyste-inemia (hHcy,Hcy≥15μmol/L) among non-hypertensive people aged between 40-70 in Tianjin. Methods Non-hyperten-sive community residents aged 40-70 years were enrolled randomly from May 2011 to December 2012 in six districts in Tian-jin. Plasma Hcy was assessed by enzyme cycling method. Factors related to hHcy were analyzed in multivariate logistic re-gression models. Results Our study included 874 participants (mean age is 57 ± 6 years, 25.5%of all are males) and the con-centration of Hcy was 12.0 μmol/L. The OR (odds ratio)(95%CI; P)for hHcy were 1.048(1.015,1.083; P=0.004), 4.191 (2.359,7.448;P<0.001), 1.280(0.896,1.829;P=0.175), 0.460(0.259,0.816;P=0.008)respectively for age, male, smoking, exercise, and the odd ratio for hHcy were 0.290(0.179, 0.469;P<0.001), 0.168(0.092,0.309;P<0.001)for consumption of vegetable and fruits 250-500 g/d and>500g/d, compared with<250 g/d. Conclusion Male and age were adverse factors for hHcy, consumption of vegetable and fruits, and exercise were positive factors.

Objective Schistasoma japonicum(S.japonicum)lysophospholipase gene(Sjl539)from cDNA of S japonicum adult worms was amplified and subcloned into eukaryotic expression vector pcDNA3.1(+)for expression of recombinant antigen and immunogenicity analysis.Methods Total RNA of S.japonicum was extracted to generato cDNA by RT-PCR.The Sj1539 gent was amplified.The DNA fragment was subcloned into eukaryofic expression vector pcDNA3.1(+)following insertion and amplification in pGEM-T.The recombinant plasmid was transfected into human cervical carcinoma cell strain(Hela cells)and expression products were identified by Western blotting.Results The size of PCR product was approximately 684 bp.It was confirmed that Sj1539 gene had been inserted successfully by the recombinant plasmid digested with two enzymes and PCR.It was verified that the expression product could react with S.japonicum-infected rabbit serum by Western blotting and the molecular weight was approximately 25×103.Conclusions The eukaryotie expression vector carrying Sj1539 gene has been established and the expression product has been obtained.

OBJECTIVETo investigate the clinical effects of plate and xenogenic bony plate for the treatment of nonunion of femoral shaft fracture after initial fixation with locked intramedullary nailing.

METHODSFrom February 2006 to June 2013, 21 cases with nonunion of femoral shaft fracture after initial fixation with locked intramedullary nailing were treated with femoral plate and contralateral xenogenic bony plate. There were 12 males and 9 females with an average age of 34.8 years old (ranging from 18 to 62 years). The time of nonunion was 9 to 18 months (averaged 12.8 months). The clinical outcomes of the treatment were evaluated by Merchan assessment.

RESULTSAll of the patients were primary healing, and on complications such as infection,fat embolism, internal fixation breaking or rotational deformity, shortening were occurred. All the cases were followed up for 13.2 months (ranging from 8 to 24 months). Nineteen cases were bone healed,the time of union averaged 6.2 months (ranging from 4 to 9 months). Two cases appeared delayed union and gained bony union after 7 to 13 months' observation. According to the criterion of Merchan,the results were excellent in 13 cases, good in 6 cases, poor in 2 cases.

CONCLUSIONTreatment of nonunion of femoral shaft fracture after initial locked intramedullary fixation with plate and xenogenic bony plate has advantages of high curative rate and low complications, good postoperative function recovery, it is a reliable treatment to elevate the stability of fixation and promote the osteogenesis.

Adolescent ; Adult ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged

Objective To investigate the significance of early diagnosis and intervention in cases with severe hand-foot-mouth disease. Methods Nine severe cases were chosen from 220 hospitalized children with hand-foot-mouth disease for retrospective analysis, including onset, disease progression, the blood and cerebrospinal fluid tests, electroencephalogram data, patients' treatment responses and prognosis. Pearson X2 test and t test were utilized for statistical analysis. Results All cases showed nervous systems involved symptom, including meningeal irritation sign and (or) other pathological signs of nervous system (9 cases), drowsy (7 cases), trembling (6 cases), voiding dysfunction (3 cases), hypersensitivity(3 cases), autonomic nervous system disorders (2 cases), ataxia (1 case), left leg mild paralysis (1 case) and early stage of pulmonary edema (1 case). Early intervention, such as high dose gamma globulin, methylprednisolone, mannitol treatment restriction of fluid input, started before the development of heart and lung failure. No case died but one patient with encephalomyelitis showed hobbling left leg, which didn't recover until 6 weeks later. One case with brainstem encephalitis still showed abnormal electroencephalogram after 8 weeks follow-up but without clinical symptom. Conclusions Enterovirus 71 can cause severe hand-foot-mouth disease complicated by encephalitis, meningitis and pulmonary edema. Early active intervention before the development of neurogenic pulmonary edema can improve the prognosis and reduce the mortality.

Objective To study the blood concentration of hydroxychloroquine in patients with systemic lupus erythematosus (SLE) treated with different doses, and analyze the relationship between blood concentration of hydroxychloroquine and disease activity, and evaluate its safety.Methods Forty SLE patients were randomly divided into 2 groups, each group contained 20 cases.The patients in group A were treated with hydroxychloroquine (0.4 g, qd), while patients in group B were treated with hydroxychloroquine (0.2 g, qd).The treatment lasted more than six months in every patient.The blood concentrations of hydroxychloro-quine were detected by high performance liquid chromatography.The clinical and laboratory indices were collected.The systemic lupus erythematosus disease activity index (SLEDAI) score was recorded.The doses and varieties of combined hormone, immunosuppressant were recorded.The correlation of blood concentration of hydroxychloroquine and disease activity was analyzed.The significance was determined by Student's t test and Pearson correlation analysis.Results In SLE patients, the average blood concentration of hydro-xychloroquine was (402±190) ng/ml in group A and (150±60) ng/ml in group B (t=7.471, P＜0.01).The disease activities of patients in the two groups showed no significant difference (t=-0.172, P＞0.05).The platelet counts of patients in group A were significantly higher than those in group B[(188±88)×109/L vs (158 ±87) ×109/L] (t=4.375, P＜0.05).However, the other laboratory parameters showed no significant difference between the two groups (P＞0.05).Conclusion The results of this study indicate that the blood concentrations of hydroxy-chloroquine are significantly different in different dosages.The high dose of hydroxy-chloroquine is related to high platelet number in lupus patients.These findings suggest that hydroxychloroquine is safe and effective for SLE patients.

Objective To evaluate the effect of lipoxin A4 receptor agonist BML-111 on acute lung injury induced by hemorrhagic shock and resuscitation in rats.Methods Thirty-two healthy male Sprague-Dawley rats,aged 6-8 weeks,weighing 200-250 g,were randomized into 4 groups (n =8 each) using a random number table:sham operation group (S group),hemorrhagic shock/resuscitation group (HSR group),BML-111 group,and BML-111 plus BOC-2 (lipoxin A4 receptor antagonist) group (BOC-2 group).The animals were anesthetized with 2％ pentobarbital sodium 80 mg/kg,tracheostomized and mechanically ventilated.Left common carotid artery was cannulated for blood-letting and fluid infusion.Hemorrhagic shock was induced according to the method described by Kochanek et al.MAP was reduced to 35-45 mmHg and maintained at this level for 30 min.The animals were then resuscitated for 30 min with infusion of the blood withdrawn and lactated Ringer' s solution 2 times the volume of blood withdrawn.In BML-111 and BOC-2 groups,BML-111 (1 mg/kg) was injected intraperitoneally at the beginning of resuscitation.In BOC-2 group,BOC-2 (50 μg/kg) was injected intraperitoneally before blood-letting.The rats were sacrificed at 2 h after completion of resuscitation.Bronchoalveolar lavage fluid (BALF) was collected for determination of neutrophil count.Lungs were excised for microscopic examination of the pathological changes and for determination of wet/dry lung weight ratio (W/D ratio),contents of interleukin-1 (IL-1β) and IL-6,and phosphorylation of mitogen-activated protein kinase (MAPK).Results Compared with group S,the neutrophil count in BALF,W/D ratio,contents of IL-1β and IL-6,and phosphorylation of MAPK were significantly increased in HSR group (P ＜ 0.05).The neutrophil count in BALF,W/D ratio,contents of IL-1β and IL-6,and phosphorylation of MAPK were significantly lower in BML-111 group than in HSR group,and higher in BOC-2 group than in BML-111 group (P ＜ 0.05).Conclusion BML-111 can attenuate acute lung injury induced by hemorrhagic shock and resuscitation in rats and inhibition of activation of MAPK pathways and reduction of inflammatory responses in lung tissues are involved in the mechanism.

ObjectiveTo assess the diagnostic value of ultrasonography in the diagnosis and pathological classifi cation of appendicitis with pathological results.MethodsThe study included 111 cases who confi rmed by surgery and pathology in the Six Affi liated Hospital of Sun Yat-sen University from June2012 to December 2013. The image characteristics of ultrasonic images performed before surgery were analyzed retrospectively. The cases were divided into five groups based on the pathology: 6 acute simple appendicitis, 45 acute suppurative appendicitis, 15 acute gangrenous appendicitis, 33 chronic appendicitis, and 12 acute attack of chronic appendicitis. The length, width and wall thickness of the appendicitis measured by preoperative ultrasound between various pathological type were compared with Kruskal-Wallis statistical methord, and also used the same method to compared the one which had statistically signifi cance between the fi ve groups. As in the above case, Fisher Exact Test was used to compare the characters′ of ultrasonography included gradations of the appendix, the tube cavity expansion, stercorolith, the appendiceal abscess, mergering lymph node enlargement and the appendix around effusion, if there was statistically signifi cance, the same methord was used to the further comparison between thefi ve groups.ResultsTotally 90 of 111 cases of were reminded appendicitis by preoperative ultrasound, the diagnostic accuracy rate was 81.08%, including acute suppurative appendicitis 91.11% (41/45), acute gangrenous appendicitis 93.33% (14/15), acute simple appendicitis 83.33% (5/6), chronic appendicitis 60.61% (20/33), chronic appendicitis onset acute 83.33% (10/12). There were no statistical differences of preoperative ultrasound measured between various pathological type of appendicitis in length, while the appendix width measured by preoperative ultrasound of acute gangrenous appendicitis was wider than the acute simple group and chronic group, and there were statistically signifi cance between them (P<0.05), in the aspect of wall thickness, the acute suppurative appendicitis and the acute gangrenous appendicitis groups were thicker than the chronic group, and these differences had statistically signifi cance (P<0.05). The stercorolith, lymph node enlargement and the appendiceal abscess in different types of appendicitis had no statistical difference. There were statistically differences (P<0.05) between the acute suppurative goup, acute gangrenous group and the chronic group respectively, both in gradations of the appendix and the tube cavity expansion. Also there were statistically difference (P<0.05) between the acute gangrenous appendicitis group and the chronic group in the aspect of the appendix around effusion.ConclusionsUltrasound is valuable in the diagnosis of appendicitis, especially for acute gangrenous appendicitis and acute purulent appendicitis. The measurement of appendix with wide diameter, wall thickness by ultrasond preoperatively, and the characteristics of the wall layers, lumen expansion degree and the appendix around effusion are valuable in identifying chronic appendicitis, acute suppurative appendicitis, and acute gangrene appendicitis; The ultrasonic measurement of appendix wide diameter could identify acute gangrenous appendicitis and acute simple appendicitis. Ultrasound had limited value in identifying acute suppurative, acute gangrenous appendicitis, acute simple appendicitis, chronic appendicitis, and chronic appendicitis onset acute.

Objective To study the effect of injection ganciclovir in infants with rotavirus disease.Methods According to age (6 months to 2 years) and typical clinical symptoms in combination with etiologic evidence of rotavirus, 76 patients within 2 days after onset were selected as study subjects. These young children were randomly assigned to two groups according to the hospitalized order.Treated group received intravenous administration of ganciclovir 5～10 mg/(kg?d) once daily for 3 days while control group didn′t receive any antivirus drugs. Rotavirus testing by ELISA on stool samples was performed for every patient on admission and the third day after treatment. Stool sample was collected to a clear box every day in patients with positive results until the reaction was negative.Results The total effective rate after treatment was 88.1% and 61.8% in treated group and the controll group, respectively. There was significant difference between these two groups(?2=20.42 P

Objective To study the design and fabricating method of orthosis for patients with leg length discrepancy. Methods Ischial weight bearing orthosis with prosthetic feet was made through efforts from weight,beauty and durabili-ty.The fabrication process included taking a negative plaster cast,modifying the positive model,forming,align-ment,and fitting the device to the patients. Results The orthosis was compensated for the patients'height with good appearance and convenience wearing. Conclusion Ischial weight bearing orthosis with prosthetic feet can help patients reconstruct walking function,therefore can be recommended.

To identify the active constituents in vitro and blood-absorbed ingredients in vivo from Yin Chen Hao decoction provides scientific evidence for probing its prevention and treatment mechanism on acute liver injury. An ultrahigh performance liquid chromatography quadrupole-time of flight-mass spectrometry (UPLC-QTOF/MS) method was applied for analysis of Yin Chen Hao decoction and the serum samples of mice with con-A induced acute liver injury after preventive oral administration for 14 days (the use of all laboratory animals in this study was approved by the Ethics Committee of the Naval Medical University, 19YF1459400). A total of 90 chemical constituents were identified from Yin Chen Hao decoction, mainly were flavonoids, terpenoids, tannins, quinones. 5 prototype compounds were identified in the serum, including chrysophanol, deoxyrhapontin-8-O-gallate, mussaenosidic acid, herniarin, emodin. The established UPLC-QTOF/MS method could efficiently and sensitively identify the constituents in vitro and blood-absorbed ingredients of Yin Chen Hao decoction, primarily clarify the material basis of its hepatoprotective effect, and provided a scientific basis for the quality marker selection and the pharmacodynamic material basis research on the decoction.