Objective To observe the curative effect of internal compression in the treatment of intra-articular fracture of the calcaneus by anatomical plate with compression bolt through the sinus tarsi approach.Methods Forty-nine patients with 62 calcaneal fractures treated with anatomical plate with compression bolt through sinus tarsi approach from September 2006 to May 2009 were enrolled in the study.According to Sanders classification,there were 39 patients with type Ⅱ fractures,20 with type Ⅲ fractures and three with type Ⅳ fractures.The axial and lateral view X-ray radiographs and the axial,semi-coronal and sagittal computed tomography (CT) images of the heel were taken before and after operation.The reduction of posterior articular surface of calcaneus and calcaneal shape was observed and the width,height,length,B(o)hler' s angle and Gissan' s angle were measured on the radiographs,respectively.Partial weight bearing was allowed 12 weeks after operation and full weight beating was allowed 16 weeks after operation.The anatomical plates were removed 8-15 months after operation.The Maryland hindfoot score system was applied to evaluate the function of the hindfoot postoperatively.Results All the patients were followed up for 7.5-23 months (average 10.6 months),which showed no wound infection.The reduction of the posterior facet was nearly anatomical (less than 3 mm articular displacement) in all patients and the shape of the calcaneus was satisfactory.The width,height,length,B(o)hler' s angle and Gissan' s angle were improved significantly in all patients (P ＜0.01 ).According to Maryland hindfoot scoring system,29 feet scored 90-100 points (excellent),18 feet scored 80-90 points (good),10 feet scored 70-80 points (moderate) and 5 feet scored 60-70 points (poor).A total of 40 patients (82％) were able to return to their original occupations at mean 9.1 months ( 6.0-12.9 months ) after the injury.Conclusion The anatomical plate with compression bolt internal fixation through sinus tarsi approach is an ideal method for the treatment of displaced intra-articular calcaneus fracture.

The peripheral blood lymphocytes (PBLs) from 111 cancer patients were isolated and cultured respectively for 23 - 27 days in the medium mainly conditioned by IL-2 and PHA. With ~(125) I-UdR release method, sampling in random way, we examed the cytotoxicities of PBLs and lymphokine-activated-killer (LAK) cells in different culture periods in vitro. The statistic analysis on sufficient data gave the following results: 1. The cytotoxicity against K562 cells increased from 34.78 ?25% of the PBLs to 68.04 ?17.3% of the cells cultured for 8-13 days, afterward, kept about 70% to 23 - 27 days. The constitutional proportion patterns showed that the freshly isolated samples dispersed at a wide range of cytotoxicities (10 - 90%), and that most of the cultured samples ( ~ 85%) concentrated on the range of higher cytotoxicities (50 ~ 95% ) after 8-13 days. 2. The cytotoxicity against Raji cells rose from 8.9 ?8% of the fresh PBLs to 42.1 ?22% of the LAK cells at 8 - 13 days, and maintained about 35% in the following periods. The constitutional proportion patterns of the cytotoxicity against Raji illustrated that all the fresh PBL samples were below 25% of cytotoxicity, and that during the culture, one part of the samples ( ~ 30%) acquired the higher cytotoxicities (50 -90% ), but the other part of the samples ( - 40%) remained at lower cytotoxicities (below 35% ) . The mechanisms behind these phenomena are worth further investigating.

Objective To investigate the effects of Pinella's ingredients on the viability of cells, morphology, microstructure, cell cycle and apoptosis in human cervical cancer cell lines. Methods The β-sitosterol and/or total protein of Pinella were incubated at different concentrations with cervical cancer cell line SiHa. The effects of β-sitosterol and/or total protein of Pinella on the viability of cells were tested by MTT assay. The effects of β-sitosterol on morphology, microstructure, cell cycle and apoptosis were studied by phase-contrast microscope, electron microscope and flowcytometry, respectively. Results β-sitosterol could obviously inhibit the viability of SiHa cells in a time-and dose-dependent manner. The total protein of Pinella had no effects on SiHa cells' viability. 20 μmol/L β-sitosterol induced the accumulation of SiHa cells in S phase in the cell cycle. And the percents of apoptosis and necrosis increased. The morphology and microstructure of SiHa cells changed significantly after treated with 20 μmol/L β-sitosterol. Conclusions The total protein of Pinella had little influence on the viability of cervical cancer cells SiHa. The viability of SiHa cells could be suppressed by β-sitosterol. β-sitosterol could induce the accumulation of cells in S phase and the percent of apoptosis and necrosis. The morphology and microstructure changed significantly after treated with β-sitosterol. Therefore, β-sitosterol might be a prospect safe and low toxicity anti-cervical cancer drug.

Lateral position is a common surgical position in neurosurgery, it is also a susceptible position for pressure ulcers. The reasons not only consist of the common causes of general surgery, but also consist of unique factors due to its special position. The technique and rationality of body position placement is significant for the prevention of pressure ulcers. This article reviews the causes and preventive measures of pressure ulcers with lateral position in neurosurgery operation after consulting extensive literature. We will expound and analyze the way of body position placement, placement techniques of every part, selection of material for various body positions, and precautions of position nursing in perioperative period of lateral position surgery, etc. We hope to provide references for the prevention and management of pressure ulcers in neurosurgery operation with lateral position.

Objective? To explore the effects of new orthopedic high-waist shoes on preventing foot drop deformity among spinal cord injury patients with lower limb paralysis. Methods? From April 2016 to January 2018, we selected a total of 44 spinal cord injury patients with paralysis. All of the patients were divided into experimental group and control group according to the order of admission and random number sampling approaches. Patients of experimental group wore new orthopedic high-waist shoes from the first day after admission, while patients of control group used the square soft pillow in foot. We compared the incidence of foot drop deformity among patients two weeks after admission. Results? The incidences of foot drop deformity, pressure injury on foot as well as strephenopodia of patients in experimental group and control group were 18.2% vs. 40.9%, 4.5% vs. 18.2% as well as 27.3% vs. 59.1% respectively with statistical differences (P＜0.05). Conclusions? Early use of new orthopedic high-waist shoes can effectively prevent foot drop, protect function of ankle joint and promote the rehabilitation of neuromuscular function in limb among spinal cord injury patients with paralysis.

Objective To investigate the clinical efficacy of semi-open cancellous bone grafting for infected bone defect combined with soft tissue defect of lower limb.Methods A retrospective case control study was conducted to analyze the clinical data of 26 patients with infected bone defect combined with soft tissue defect of lower limb admitted to the Third Hospital of Hebei Medical University from March 2010 to August 2017.There were 16 males and 10 females,aged 16-65 years [(39.6 ± 12.8)years].The bone defect area before bone grafting was 1.4-6.0 cm [(3.3 ± 1.2) cm].The surface soft tissue defect of bone graft granules was 2.3 cm × 1.1 cm-8.5 cm × 5.0 cm after bone grafting.If the defect was segmental defect of more than 6 cm,the defect was firstly reduced by bone transport.When the defect was near the docking point,the bone defect was repaired by open bone grafting.If the defect was located at the metaphyseal end of the calcaneus or tibia,stage Ⅰ or stage Ⅱ open bone grafting was performed after debridement.After bone grafting,antibiotic-containing cement sheets were used to cover the wound in 14 patients (semi-open group),and vacuum sealing drainage (VSD) devices were used to cover the wound in 12 patients (VSD group).The time of granulation tissue covering bone graft granules,wound healing time,bone defect healing time,material cost and complications (wound infection and necrosis of bone graft granules) were compared between the two groups.The limb function was evaluated according to Paley score.Results All patients were followed up for 12-40 months [(19.3 ±7.2) months].In the semi-open group and VSD group,the time of granulation tissue coverage was 22.2 days (15.0-44.0) days and 20.2 days (15.0-44.0) days (P ＞ 0.05);wound healing time was 3.1 months (1.5-5.5) months and 3.1 months (1.5-6.5) months (P ＞ 0.05);bone defect healing time was (5.5 ± 2.2) months and (5.9 ± 2.4) months (P ＞ 0.05);the cost of covering wound materials was (2 056.1 ± 23.4) yuan and (5 555.3 ± 1 105.5) yuan respectively (P ＜ 0.05).No wound infection occurred in either group.Two patients in the semi-open group and one patient in the VSD group had bone graft granules surface necrosis (P ＞0.05).According to Paley's functional score,the results were excellent in 12 patients and good in two in the semiopen group,compared with excellent in 11 and good in one in the VSD group (P ＞ 0.05).Conclusion For infected bone defect combined with soft tissue defect of lower limb,semi-open bone grafting can simplify the nursing of wound,prevent wound infection,promote wound healing and fracture healing.It has similar therapeutic effect with VSD,but its treatment cost is significantly reduced.

Recent studies have shown that tumor microenvironment (TME) is significantly different from normal tissues, such as the change of abnormal enzyme expression, hypoxia, pH and so on. TME is closely related to the induced proliferation of tumor cells, angiogenesis, immune escape and the production of multidrug resistance. Cancer associated fibroblasts (CAFs) are the main stromal cell types in the TME. A variety of cytokines secreted by CAFs play an important role in tumor growth, invasion and metastasis. Understanding the role and mechanism of CAFs in the development of breast cancer is expected to provide a new target for improving the prognosis of breast cancer patients.

Objective:To explore the mechanism of Buzhong Yiqi Decoction in the treatment of retinitis pigmentosa (RP) based on network pharmacology; To verify it by in vitro experiments.Methods:The effective active components and corresponding targets of Buzhong Yiqi Decoction were screened by retrieving TCMSP database, and the RP-related targets were obtained by searching GeneCards, OMIM and other databases. The interaction network diagram of Buzhong Yiqi Decoction-RP was drawn by Cytascape3.7.1 software, and the core targets were extracted. DAVID online database was used to enrich and analyze gene ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) pathway; the FerrDb database was searched to obtain the genes that regulate ferroptosis, and finally comprehensively analyze the relationship between the active targets of Buzhong Yiqi Decoction, RP and ferroptosis and make predictions; finally, molecular docking was performed by Auto Dock software to verify the reliability of the results. In vitro experiment, rat Muller cells were used as the research object, and LPS-induced cells were used to construct model cells in vitro. The blank group, model group, Buzhong Yiqi Decoction low-, medium- and high-dosage groups were set up, and the cell proliferation was detected by CCK-8 method; the concentrations of lactate dehydrogenase (LDH), superoxide dismutase (SOD), malondialdehyde (MDA) and ferroptosis in the cells were detected by the kit method; the expressions of HIF-1α MRNA and GPX-4, FTH-1, ACSL4 mRNA levels in cells of each group were detected by RT-PCR.Results:Totally 117 effective targets were selected from Buzhong Yiqi Decoction, and IL-6, IL-1β, EGFR, ESR1, PPARG may be the targets of Buzhong Yiqi Decoction in regulating ferroptosis and anti-RP. Buzhong Yiqi Decoction could regulate ferroptosis by mediating MAPK, HIF-1, TNF, AGE-RAGE, Toll-like receptor, IL-17, PI3K-Akt and other signal pathways. Molecular docking virtual results suggested that the quercetin, kaempferol, β-Sitosterol and IL-6, IL-1β, EGFR, ESR1, PPARG and other candidate core targets had good binding activity. Compared with the model group, the cell activity, level of SOD, LDH activity, MDA content and Fe 3+ content, IL-6 mRNA, HIF1A mRNA ,ACSL4 mRNA in each Buzhong Yiqi Decoction group significantly decreased ( P<0.05), the expressions of GPX-4 and FTH-1mRNA significantly increased ( P<0.05). Conclusion:Buzhong Yiqi Decoction may play the role of anti-inflammation and anti-ferroptosis through multiple components, multiple targets and multiple molecular pathways, thus achieving the effect of prevention and treatment of RP.

Head and neck cancer is the seventh most common cancer in the world,accounting for about 10%of all malignant tumors.Radiotherapy is an important treatment for head and neck cancer.Osteonecrosis of the jaws(ORNJ)is a refractory complication after ra-diotherapy for head and neck cancer,which often manifests as osteonecrosis of the jaw and soft tissue exposure.The current pathogene-sis of ORNJ has not been fully clarified and its treatment remains challenging.The traditional treatment for this disease is partial resec-tion of necrotic jaw bone and reconstruction with osteocutaneous flap.However,in recent years,some new techniques and ideas have been used to treat the disease.For mild osteoradionecrosis of the jaw,the treatment concept tends to be conservative.This article mainly summarizes the latest research progress at home and abroad,and reviews the pathogenesis,clinical manifestations and treatment strate-gies for osteoradionecrosis of the jaws.

OBJECTIVE To identify the influence factors associated with 28-day fatality among COVID-19 hospitalizations and to analyze the interaction between the disease severity at admission and the use of hospital preparations.METHODS A retrospective review of records from COVID-19 hospitalizations aged 18 to 90 who were admitted to the Jiangsu Province Hospital of Chinese Medi-cine from December 15,2022 to January 15,2023 were conducted.Patients who died or were lost to follow-up within 48 h of admis-sion were excluded.Patients were divided into survival and death groups based on their 28-day fatality status.Descriptive statistics were used to characterize the two groups and multivariate logistic regression models were employed to identify factors influencing 28-day fatality risk.The interaction between the severity of illness at admission and the use of hospital preparations was explored through cross-over analysis and hierarchical regression analysis.RESULTS Significant differences were observed between the survival and death groups in terms of severity of illness at admission,hospital preparations usage,steroid therapy,age,platelet count,lactate dehydro-genase levels,and urea(P<0.05.Crossover analysis and hierarchical logistic regression analysis revealed a significant antagonistic interaction between the severity of illness at admission and the use of hospital formulations both before adjustment(RERI=-20.678,95%CI:-33.703～-7.652;APAI=-2.301,95%CI:-4.027～-0.575 and after adjusting for gender,age,clinical characteristics and further adjusting for laboratory parameters(RERI=-5.972,95%CI:-10.564～-1.380;APAI=-2.205,95%CI:-4.131～-0.279,and it was an antagonistic interaction both before(SI=0.279,95%CI:0.157～0.493 and after adjustment(SI=0.222,95%CI:0.095～0.523.CONCLUSION The use of hospital preparations significantly reduces the 28-day fatality risk among COV-ID-19 hospitalizations and a clear antagonistic interaction was observed between the disease severity at admission and the use of hospi-tal preparations.