BACKGROUND:Although there is a general consensus with regard to the treatment of Rockwood types I, II, IV, V and VI injuries, the treatment of type III injury is inconsistent. OBJECTIVE: The aim of this systematic review was to evaluate the efficacy and safety of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation. METHODS:Studies were identified from databases (PubMed, Embase, Cochrane Library, China Biological Medicine, VIP, CNKI and Wanfang Database) up to May 2015. Eligible studies that investigated and compared the effectiveness and/or complications of implant fixation and conservative treatment for Rockwood type III acromioclavicular dislocation and provided sufficient data were included. RESULTS AND CONCLUSION:In total, eight studies were included. Implant fixation (n=207) included the Bosworth technique, Clavicle Hook Plate technique, the TightRopeTM system (titanium plate and Arthrex fiber suture), Weaver-Dunn technique (coracoacromial ligament displacement, instead of coracoclavicular ligament fixation), Phemister technique (Kirschner wire fixation) and the use of a poly dioxanone sutures cord. The conservative treatments (n=137) consisted of immobilisation management with a sling, Kenny-Howard brace, or with a sling and clavicle fastening taping tape or a simple brake, or with a sling or tape. There were no significant differences in the Constant score (P=0.90) and infection rate (P=0.07) between the two groups. The rate of satisfaction with aesthetic outcomes was higher in the implant fixation group (P < 0.000 01), although the incidence of coracoclavicular ligament calcification was also higher (P=0.03) in this group. The time to resumption of normal work and normal activities was shorter after conservative treatment than that after implant fixation treatment. However, implant fixation could return to the game faster. These results indicate that both implant fixation and conservative treatments can result in satisfactory levels of shoulder function; however, the rehabilitation time was shorter after conservative treatment. Although implant fixation results in superior aesthetics, the risk of coracoclavicular ligament calcification is higher than that with conservative treatment. Time to resumption of normal work and normal activities was shorter after conservative treatment.

Acute Disease ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm, Thoracic ; complications ; Female ; Humans ; Myocardial Infarction ; etiology

Uncoupling protein 2 (UCP2) gene polymorphism was assayed by PCR in 201 diabetic patients with various degress of albuminuria. The frequency of 3′-UTR 45 bp insertion/deletion genotypes of UCP2 gene in these diabetic patients does not show any significant difference.

Objective To explore the cellular localization of chemokine (C-X-C motif) ligand 1 (CXCL1) in brain tissue and its expres-sion in brain tissue and blood in patients with severe traumatic brain injury (TBI), as well as its correlation with the injury severity. Methods From September, 2013 to October, 2015, 78 cases of TBI with craniotomy admitted to our hospital were involved as TBI group. A total of 78 peripheral blood samples and 19 brain tissue samples were studied. According to the scores of Glasgow Coma Scale (GCS) at admission, the TBI group was classified as severe TBI group (6~8, n=35) and particularly severe TBI group (3~5, n=43). Ten cases of control brain tissue were taken from patients with cerebral aneurysms or benign tumor and also undergoing craniotomy during the same time. Peripheral blood from ten healthy people were involved as the healthy control group. Immunofluorescent double staining was used to detect the cellular local-ization of CXCL1 in brain tissues, and ELISA was used to detect the expression of CXCL1 in brain tissue and blood. The relationship be-tween the level of CXCL1 in peripheral blood at different time and the score of Glasgow Outcome Scale (GOS) was analyzed with Spear-man correlation analysis. Results In normal brain tissue, CXCL1 mainly localized in astrocytes. For severe TBI, CXCL1 mainly expressed in neurons and astrocytes. The level of CXCL1 was higher in brain tissue in the particularly severe TBI group than in the severe TBI group (t=-12.58, P<0.05). In the severe TBI group, the level of CXCL1 in blood reached a peak before surgery, then gradually decreased, and was still higher than that in the healthy control group 14 days after surgery (P<0.05), however, no significant difference was found 30 days after surgery compared to the healthy control group (P>0.05). In the particularly severe TBI group, the level of CXCL1 in blood reached a peak before and one day after surgery, then gradually decreased, and was still higher than that in the healthy control group 30 days after surgery (P<0.05). The level of CXCL1 in blood was higher in the particularly severe TBI group than in the severe TBI group at all time points (P<0.05), and the level before surgery was negatively correlated with the score of GOS in the particularly severe TBI group (r=-0.351, P<0.05). Conclusion The CXCL1 protein of injury brain tissue was mainly colocalized in neurons and astrocytes in severe TBI patients, and the ex-pression was associated with injury severity and outcome.

Objective To study the changes of gastrin 17 (G17) and pepsinogen (PG) after gastric bypass surgery in gastric antrum resection, and the influences of different surgical methods on postoperative peptic ulcer. Methods Clinical data of 63 patients with gastric bypass surgery in our hospital from October 2013 to October 2015 were divided into resection of pyloric antrum group (n=33) and preserved pyloric antrum group (n=30). The values of G17, PGⅠ, PGⅡand PGⅠ/PGⅡwere detected by enzyme linked immunosorbent assay at 1 month, 6 months and 12 months after operation. The correlation between the different surgical methods and the incidence of peptic ulcer was analyzed between two groups. Results The G17 levels were significantly decreased in resection of pyloric antrum group 6 and 12 months after operation than those in preserved pyloric antrum group (P<0.05). Compared with preserved pyloric antrum group,PGⅠ and PGⅡ levels was significantly decreased 12 months after operation (P<0.05). There was no significant difference in the ratio PGⅠ/PGⅡat 1 month, 6 months and 12 months after operation between two groups (P>0.05). There was no significant difference in postoperative peptic ulcer between two groups (P>0.05). Conclusion Gastric bypass after resection of the pyloric antrum can reduce the postoperative secretion of G17, PGⅠ and PGⅡ, but which can not reduce the incidence of postoperative anastomotic ulcer.

Adult ; Brucellosis ; Humans ; Male ; Middle Aged ; Occupational Diseases

Objective To determine the gene polymorphism and serum concentration of mannose-binding lectin (MBL) in patients with psoriasis,and to analyze the relationship between MBL and psoriasis.Methods Totally,67 patients with psoriasis vulgaris and 69 healthy human controls were enrolled in this study.Venous blood samples were obtained from all the subjects.Genomic DNA was extracted,and PCR-restriction fragment length polymorphism (PCR-RELP) analysis was conducted to determine the polymorphism at codon 54 of the MBL gene.Enzyme-linked immunosorbent assay was performed to measure the serum level of MBL.A chi-square goodness-of-fit test was carried out to evaluate Hardy-Weinberg equilibrium,t test to compare the serum concentration of MBL,and chi-square test to compare the frequency of genotypes and alleles of MBL gene codon 54.Results The patients with psoriasis showed higher frequency of GGC/GAC heterozygote but lower frequency of GGC/GGC homozygote (x2 =10.36,P ＜ 0.05),together with increased frequency of GAC allele but decreased frequency of GGC allele (x2 =8.31,P ＜ 0.05),at codon 54 of the MBL gene compared with the healthy controls.The variant allele GAC at codon 54 of the MBL gene was markedly associated with psoriasis (OR =3.383,95％ CI 1.585-7.211,P ＜ 0.05).The serum concentration of MBL was (2.193 7 ± 0.816 3) mg/L in patients with psoriasis,significantly lower than that in the healthy controls ((3.269 5±1.205 8) mg/L,t=6.11,P＜ 0.05).Conclusion MBL might be associated with the pathogenesis of psoriasis to some degree.

Objective To investigate the effects of mild hypothermia on the expression of Dickkopf-1(Dkk1)in rats'brains after focal cerebral ischemia and reperfusion and to explore the molecular mechanism of any neuroprotective effects of mild hypothermia. Methods A focal cerebral ischemia and reperfusion model was established in rats by intraluminal filament occlusion of the middle cerebral artery.The adult rats were randomly divided into four groups:a sham-operation group,a sham-operation plus mild hypothermia group,a model group,and a model plus mild hypothermia group.The expression of Dkk-1 mRNA and protein in the ischemic cortex at different phases afterreperfusion were assessed using a reverse transcription polymerase chain reaction(RT-PCR),Western blotting and immunohistochemical staining.Results There was little expression of Dkk-1 mRNA or its protein in the sham-operation group or in the sham-operation plus mild hypothermia group.Expression of Dkk-1 mRNA and its protein began to increase after 2 h of cerebral ischemia and 3 h of reperfusion,with expression peaking at the 24th h after the start of reperfusion and then decreasing markedly.But expression was still stronger than in the sham-operation group at the 72nd h.At every reperfusion time point,expression of Dkk-1 mRNA and its protein were markedly less in the model plus mild hypothermia group than in the model group. Conclusion Dkk-1 probably participates in the pathologic process of injury caused by focal cerebral ischemia and reperfusion.Inhibiting the expression of Dkk-1 after focal cerebral ischemia and reperfusion is partly responsible for the neuroprotective effects of mild hypothermia.

Objective To detect the expression levels of multiple serum chemokines including IFN-inducible T cell chemoattractant (ITAC),Fractalkine,macrophage inflammatory protein (MIP)-3α,IL-8,MIP-lα,MIP-1β in patients with lung cancer and explore their association with the clinical characteristics of lung cancer as well as the correlations among these chemokines.Methods Forty newly diagnosed patients with lung cancer and thirty healthy controls were enrolled for detection of the serum levels of 6 kinds of chemokines by Luminex technology.The correlations of clinical characteristics of lung cancer with these chemokines and the correlations among these chemokines were analyzed by SPSS 17.0 software.Results The serum levels [M (QR)] of IL-8,Fractalkine and MIP-3α in patients with lung cancer were 5.16 (4.74),128.45 (141.89),10.31 (8.88) respectively,and 2.01 (0.95),61.46 (74.81),8.08 (5.87) respectively in control group,with significant differences (Z =-4.783,P ＜0.001;Z =-4.046,P ＜0.001;Z =-3.105,P =0.002).The expression of MIP-1β in lung adenocarcinoma was significantly higher than that in squamous carcinoma [18.32 (12.27) vs.13.72 (7.31),Z =-2.212,P =0.027],and of ITAC in squamous carcinoma was significantly higher than that in small cell lung cancer [24.51 (22.48) vs.9.28 (4.85),Z =-2.460,P =0.014].The expressions of MIP-3α and Fractalkine were positively correlated in the two groups (r =0.619,P＜0.001;r=0.766,P＜0.001).Conclusion The expressions of IL-8,Fractalkine and MIP-3α increase significantly in lung cancer patients,and they are may play important roles in metastatic lung cancer.