Objective To observe the clinical outcomes of modified posteromedial and posterolateral approaches for the treatment of posterior tibial plateau fractures.Methods Between January 2006 and October 2011,25 patients with posterior tibial plateau fracture were identified.They were 17 men and 8 women,aged from 22 to 76 years (average,46.4 years).According to the AO/OTA classification,there were 4 cases of type 41-B1,6 cases of type 41-B2 and 15 cases of type 41-B3.According to Luo's three-column classification,they were all posterior column fractures.Ten patients with posterolateral tibial plateau fracture were treated by the modified posterolateral approach and the other 15 patients with posteromedial tibial plateau fracture by the modified posteromedial approach.The posterior fractures were fixated with a buttress plate.The knee function was evaluated at the last follow-up by the The Hospital for Special Surgery (HSS) Score.Results All the 25 cases were followed up for a mean time of 13.2 months (from 10 to 24 months).By the radiological Rasmussen criteria for fracture reduction,the mean score immediately after surgery was 16.5 points (from 13 to 18 points),with 20 excellent cases,4 good cases and one fair case.All patients were pain-free with full range of motion.Radiologically,bone union was achieved in all cases after a mean time of 13.9 weeks (from 12 to 18 weeks).No surgery-related complications were found.The mean HSS score was 91 points(range,74 to 97 points) and the good to excellent rate was 100％ (17 excellent and 8 good cases) at the last follow-up.The average range of knee motion ranged from 0° to 125°.Conclusion In the treatment of posterior tibial plateau fractures,because the modified posteromedial and posterolateral approaches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating,soft tissues can be well preserved and good functional results can be expected.

Objective To investigate the expression levels of forkhead transcription factor 3 (FOXP3) and cytotoxic T lymphocyte-associated antigen-4(CTLA-4) in the peripheral blood of children with newly diagnosed type 1 diabetes mellitus(T1DM),and explore their roles in the pathogenesis of T1DM. Methods Fifty children with newly diagnosed T1DM and 30 healthy children( control group) were select-ed. FOXP3 and CTLA-4 mRNA expressions were detected using real-time PCR. Soluble FOXP3 ( sFOXP3 ) and CTLA-4(sCTLA-4) protein levels in the serum were assayed by ELISA,and the levels of diabetes anti-bodies,HbA1C and C-peptide were determined using Western blotting,high performance liquid ion-exchange chromatography,and electrochemiluminescence, respectively. Results The expressions of FOXP3 mRNA and protein in T1DM patients were lower than those in the control group[0. 95 ± 0. 48 vs. 2. 11 ± 0. 79,(6. 27 ± 1. 49) ng/ml vs. (9. 02 ± 2. 37) ng/ml,respectively,both P <0. 01],while the expressions of CTLA-4 mRNA and protein were higher than those in the control group[2. 43 ± 0. 83 vs. 1. 94 ± 0. 84,(77. 88 ± 22. 34) ng/ml vs. (65. 97 ± 12. 11) ng/ml,respectively,both P<0. 01]. In T1DM patients,the expressions of FOXP3 and CTLA-4 genes presented positive correlation with the protein expression( r=0. 758,0. 396, P<0. 05), and FOXP3 protein expression presented correlation with CTLA-4 protein expression ( r =-0. 624,P<0. 05). Conclusion There are abnormal expressions of FOXP3 and CTLA-4 genes as well as their proteins in the peripheral blood of the children with newly diagnosed T1DM,and FOXP3 regulated the expression of CTLA-4 in T regulatory cells,indicating the involvement of immune mechanisms in the devel-opment of T1DM.

ObjectiveTo observe the effect of integrated traditional Chinese medicine therapy on pelvic inflammation. Methods40 patients of chronic pelvic inflammation were as the group of integrated traditional Chinese medicine therapy and received Chinese herbal medicine treatment (by taken orally, clysis and hot compress), acupuncture, mental state therapy etc. Other 36 cases were as the control group and only received Chinese herbal medicine treatment by taken orally. Then effects of two groups were compared. ResultsIt shows that the group of integrated traditional Chinese medicine therapy got obviously better results than the control group (P<0.01). ConclusionsThe integrated traditional Chinese medicine therapy is more effective on chronic pelvic inflammation.

OBJECTIVE To investigate the status of nosocomial infection in community health services and offer a scientific basis for nosocomial infection control.METHODS Totally 5738 outpatients were investigated retrospectively for nosocomial infection in community.RESULTS The most frequently nosocomial infection sites were lower respiratory tract,and next upper respiratory tract and urinary tract(2131,1045 and 934,respectively).The major reasons of causing the nosocomial infection were irrational usage of antibacterial drugs(39.0%),invasive procedures(31.0%) and using glucocorticoids(10.0%).Most of the pathogenic bacteria of the nosocomial infection were Gram-negative and the next were Gram-positive and fungi.74.4% of the pathogens were resistant to most of antibioties.CONCLUSIONS Alzeimer′s disease patients in the community health centers are popular and susceptible to infection.

OBJECTIVETo observe the effect of Modified Yiqi Chutan Recipe (MYCR) on blood flow perfusion in treating mid-late stage non-small cell lung cancer (NSCLC) patients by using multislice CT perfusion (CTP) , and to assess the relationship between each CTP parameter and the prognosis as well.

METHODSTotally 87 mid-late stage NSCLC patients were randomly assigned to the treatment group (44 cases, Shenyi Capsule + MYCR +chemotherapy) and the control group (43 cases, chemotherapy alone) in the ratio of 1:1. And 21 days consisted of 1 therapeutic course, 4 courses in total. All of them underwent CTP of primary tumor and routine thoracic CT examination (plain CT and enhancement CT) 3 times (before therapy, after 2 and 4 cycles). CT findings were analyzed for tumor size and perfusion parameters [blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT), and time to peak (TP) before and after treatment, and relationship between perfusion parameters and prognosis was also assessed.

RESULTSIn 87 cases, 7 dropped out and 80 cases were available, 40 in the treatment group and 40 in the control group. (1) The relief rate was 47.5% (19/40) and the total stable rate was 77.5% (31/40) in the treatment group, and they were 40.0% (16/40) and 65.0% (26/40) in the control group, with no statistical difference between the two groups (χ² = 0.672, 1.227; P > 0.05). (2) Compared with before treatment group in the same group, BF and PS decreased, and MTT increased in the two groups after 2 and 4 courses (P < 0.05); BE and PS decreased, and MTT increased in the control group after 2 courses (P < 0.05). Compared with the control group after 4 courses, BE decreased more significantly in the treatment group (P < 0.05). (3) After 4 courses, all patients were assigned to the remission group (35 cases) and the non-remission group (45 cases) according to the RECIST standard. Compared with before treatment in the same group, BF, BF, and PS all decreased, and MTT increased in the remission group after treatment (all P < 0.05); BF increased in the non-remission group after treatment (P < 0.05). (4) All patients were assigned to the BE increase group (34 cases) and the BE decrease group (46 cases) according to changed BE values after treatment. Results showed the mean survival rate was 246 days in the BF increase group (the 1-year accumulative survival rate being 13.0%) and 387 days in the BE decrease group (the 1-year accumulative survival rate being 53.1%). The life span was prolonged and the 1-year accumulative survival rate was elevated in the BE increase group, with statistical difference as compared with the BE decrease group (χ² = 19.057, P < 0.01).

CONCLUSIONSShenyi Capsule plus MYCR could reduce BE in mid-late stage NSCLC patients , improve vascular permeability, showing better synergistic effect with chemotherapy. CTP could not only reflect the change of tumor size, but also reflect vascular function of the tumor. Meanwhile, changes of CTP parameters were closely associated with prognosis. Patients with post-treatment decreased BE value had better prognosis and longer life span.

Capillary Permeability ; drug effects ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Tomography, X-Ray Computed

Antigens, CD20 ; metabolism ; CD79 Antigens ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; Leukocyte Common Antigens ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Nephrectomy ; PAX5 Transcription Factor ; metabolism ; Wilms Tumor ; metabolism ; pathology

Adult ; Aged ; Coal Mining ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pneumoconiosis ; drug therapy ; immunology ; T-Lymphocyte Subsets ; drug effects

A strain of Mucor named M2,which could produce protease,was isolated from a traditional fermented soybean product.Culture conditions of proteases produced by M2 were studied therefore.The results showed that nitrogen source and carbon source preferred for protease production were soybean protein isolate and glucose,while inorganic salts preferred were KH2PO4,CaCl2 and MgCl2.The suitable culture conditions for protease production were as follows:culture temperature was 28℃,inoculation volume was 2%,liquid level was 100 mL in 300 mL triangle bottle at pH 5,rotating speed was 150 r/min and culture time was 48 h.The obtained protease activity in culture was about 4.35 U/mL.The protease produced by Mucor was analyzed with SDS-PAGE.The protease had a molecular weight of 36.4 kD.

AIM:To observe the treatment for ptosis patients with severe undercorrection after frontal muscle flap suspension surgery. · METHODS: Totally 46 patients ( 67 eyes ) were randomly divided into 2 groups: 23 cases ( 33 eyes ) in Group A were given conjoint fascial sheath ( CFS ) suspension surgery; 23 cases ( 34 eyes ) in Group B Whitnall ligament suspension. Postoperative follow-up was 6mo. Corrected rate, recurrence rate and postoperative adverse reactions were compared and analyzed. ·RESULTS:The corrected rates of the two groups were both satisfied without significant difference between the two groups (P>0. 05). the Whitnall ligament suspension surgery had less recurrence than CFS suspension surgery, but the difference was not statistically significant (P>0. 05). The rate of hypophasis after CFS suspension surgery was significantly less than that after Whitnall ligament suspension (P<0. 05). ·CONCLUSION:The two operations both have satisfied corrected rate and low recurrence rate, the Whitnall ligament suspension surgery is less damaging and more easy to operate, while CFS suspension surgery is repeatable and less rate of hypophasis.

Objective To investigate DNA methylation in the promoter region,mRNA transcription and protein expression of glutathione-S-transferases-P1 (GSTP1) gene and their relation with arsenism.Methods In endemic coal-pollution-borne arsenism area,Jiaole village of Xinren county,Guizhou province,according to the diagnostic criteria of endemic arsenism(WS/T 211-2001),123 cases with endemic arsenism were selected and divided into three groups (mild arsenism group:42 cases,moderate arsenism group:41 cases and severe arsenism group:40 cases).Forty seven residents were selected as controls in a village about 12 km away from the endemic arsenism area.With the informed consent principle,peripheral blood of all respondents was collected in order to analyze DNA methylation and check mRNA.DNA methylation of GSTP1 gene promoter region in peripheral blood was assayed by PCR,and GSTP1 mRNA expression was assayed using real-time quantitative PCR.In addition,other cutaneous specimens originated from 53 cases with arsenism that accepted surgical treatment voluntarily were taken.Of these specimens,general pathological changes were 28 cases,precancerous 20 cases and cancerous 5 cases.Skin tissues of 15 cases of non-tumor surgery patients without abnormal pathological changes were as control group.GSTP1 protein expression in the skin tissue was detected using immunohistochemistry (IHC).Results Among different groups of arsenic poisoning,the positive rate of DNA methylation of GSTP1 gene was 28.57％(12/42) in the mild group,57.10％ (23/41) in the moderate group and 65.00％ (26/40) in the severe group.Compared with the control group (6.38％,3/47),the difference was statistically significant (x2 =7.792,26.000,33.412,all P ＜ 0.01).Among different groups of arsenic poisoning diagnosed by dermapathology,the positive rate of DNA methylation of GSTP1 gene was 21.43％(6/28) in the general pathological change group,50.00％(10/20) in the precancerous group and 80.00％(4/5) in the cancerous group.Compared with the control group(6.67％,1/15),the difference was statistically significant (x2 =3.562,7.468,10.756,all P ＜ 0.05).It showed that the positive rate of DNA methylation of GSTP1 gene increased with aggravation of the disease and dermatic lesion of arsenism (tendency x2 =38.239,x2 =13.659,all P ＜ 0.01).Compared with the control group(0.184 26),the expressions of GSTP1 mRNA in peripheral blood in moderate (0.087 77) and severe arsenic poisoning groups (0.056 93) were significantly reduced(all P ＜0.01),and that of severe group was significantly lower than that of the moderate group (P ＜ 0.01) ; compared with the control group(0.338 45) and the general lesion group(0.276 74),GSTP1 mRNA expression was significantly reduced in precancerous lesion group(0.104 81) and cancerous group(0.043 70),in which the cancerous group was significantly lower than that of the precancerous lesions.The difference of skin tissue GSTP1 protein expression rate between groups was statistically significant (x2 =20.948,P ＜ 0.05),in which the difference between the precancerous lesion group(65.00％,13/20),the cancer group (40.00％,2/5) and the control group(100.00％,15/15)was statistically significant (x2 =12.183,11.778,P ＜ 0.01).Spearman correlation analysis showed that the degree of skin lesion and the level of GSTP1 protein expression was negatively correlated (r =-0.520,P ＜ 0.05).Groups were divided according to DNA methylation of GSTP1 gene,and the mRNA and protein expression of GSTP1 in methylation group(0.038 40,57.14％) was significantly lower compared with that of unmethylated group(0.187 07,95.74％; Z =9.032,x2 =23.134,all P ＜ 0.01).Conclusions Arsenism may lead to DNA methylation of human GSTP1 gene promoter region,thereby inhibiting expression of mRNA and protein.GSTP1 gene plays an important role in arsenism or carcinogenic process.