Objective:To evaluate the precise guidance of intraoperative ultrasound for closed reduction and fixation with intramedullary titanium elastic nail (TEN) in the treatment of clavicle fractures.Methods:The data of 40 patients with fresh clavicle fracture were retrospectively analyzed who had undergone closed reduction and TEN fixation under precise guidance of intraoperative ultrasound at Department of Emergency Trauma, Shandong Wendeng Osteopathic Hospital from January 2017 to March 2019. They were 25 males and 15 females, aged from 25 to 68 years (average, 52.1 years), with 27 cases on the left side and 13 on the right. Reduction and fixation of the fracture was monitored during operation to avoid iatrogenic injuries to the subclavian brachial plexus nerve, subclavian artery and vein and thoracic cavity. The Neer scoring was used at the last follow-up to assess shoulder joint function and complications were recorded.Results:Closed reduction and TEN fixation was completed uneventfully in all the 40 patients under precise guidance of intraoperative ultrasound. The operation time ranged from 20 to 56 min, averaging 36 min; the blood loss from 10 to 35 mL, averaging 22 mL. No injury occurred to the subclavian brachial plexus, subclavian artery or vein, or thoracic cavity. The 40 patients were followed up for 4 to 6 months (average, 4.8 months). All fractures achieved bony union, with no displacement or breakage of internal fixation, or fracture malunion. At the last follow-up, the shoulder joint function was good, with Neer scores ranging from 85 to 95 points (average, 93.1 points).Conclusion:The precise guidance of intraoperative ultrasound improves surgical accuracy and safety, making the closed reduction and TEN fixation a safe and minimally invasive treatment for clavicle fractures.

Objective To investigate the manifestations and features of CT for glandular cystitis as well as cystic cystitis.Methods Clinical manifestations and CT imaging features of 39 cases with biopsy-proved glandular cystitis or cystic cystitis were analyzed retrospectively.Results Among 39 cases,33 were glandular cystitis and 6 were cystic cystitis.Two out of the 33 cases with glandular cystitis had a negative CT scan,and 31 had a positive CT scan among which 4 cases with extensive lesions showed diffuse thickening of the bladder wall,and 27 were with localized lesions.Furthermore,19 out of the 27 cases showed localized thickening of the bladder wall with smooth edge,which was a continuation of surrounding normal bladder wall;8 showed nodular lesions.17 of the 33 cases with glandular cystitis underwent contrast-enhanced CT scan which showed mildly enhancement consistent with or slightly stronger than the normal bladder wall in 15 cases and moderate uneven enhancement in 2 cases.The 6 cases with cystic cystitis showed diffuse thickened rough bladder wall.There were cystic shadows of various sizes in the inner wall of the bladder partially protruding into the bladder,which presented as a"beaded shape"manifestation.Conclusion The characteristic manifestations of glandular cystitis as well as cystic cystitis on CT scan are of great significance in diagnosing both of the diseases.

Objective To investigate the expression levels of connective tissue growth factor(CTGF)and hepatocyte growth fac-tor(HGF)in the serum of patients with nephropathy and the relationship with renal fibrosis.Methods Levels of serum CTGF, HGF,blood urea nitrogen(BUN),creatinine(Cr)and Cystatin C(SCys C)in 87 patients with chronic nephropathy and 40 healthy persons(control group)were determined by enzyme-linked immunosorbent assay(ELISA)and the automatic biochemical analyzer. The correlation of indexes like serum CTGF with glomerular sclerosis and renal tubule interstitial fibrosis score in patients with chronic nephropathy was analyzed by Pearson correlation analysis.Results The levels of serum BUN,Cr and Cys-C and in patients with grade Ⅲ and grade Ⅳ chronic nephropathy were significantly higher than those in the control group(P<0.05).The levels of serum CTGF and HGF in patients with grade Ⅱ,grade Ⅲ and grade Ⅳ chronic nephropathy were significantly higher than those in the control group(P<0.05).For patients with gradeⅢ - Ⅳ chronic nephropathy,the levels of Cys-C and serum CTGF increased with the increase of grade(P<0.05).Pearson correlation analysis showed that serum CTGF,HGF,BUN,Cr and Cys-C were signif-icantly positively correlated with glomerular sclerosis score and renal tubule interstitial fibrosis score(P<0.05).Conclusion Serum CTGF and HGF may be involved in the occurrence and renal fibrosis of chronic nephropathy.

Toxoplasma gondii, an intracellular protozoan parasite that infects one-third of the world’s population, has been reported to hijack host cell apoptotic machinery and promote either an anti- or proapoptotic program depending on the parasite virulence and load and the host cell type. However, little is known about the regulation of human FHs 74 small intestinal epithelial cell viability in response to T. gondii infection. Here we show that T. gondii RH strain tachyzoite infection or ESP treatment of FHs 74 Int cells induced apoptosis, mitochondrial dysfunction and ER stress in host cells. Pretreatment with 4-PBA inhibited the expression or activation of key molecules involved in ER stress. In addition, both T. gondii and ESP challenge-induced mitochondrial dysfunction and cell death were dramatically suppressed in 4-PBA pretreated cells. Our study indicates that T. gondii infection induced ER stress in FHs 74 Int cells, which induced mitochondrial dysfunction followed by apoptosis. This may constitute a potential molecular mechanism responsible for the foodborne parasitic disease caused by T. gondii.