Objective To study the correlations between bone fracture types and healing time in patients with osteofluorosis. Methods Thirty-seven patients with osteefluorosis and long tubular bone fracture were diagnosed in accordance with radiogram retrospectively. The fractures were divided into two groups: sclerotic and osteoporotic. Twenty four fractured patients with non osteofluorosis were included in the study as controls. All of the patients had operation(open reduction and nickelclad internal fixation). Fracture healing in patients with sclerotic and osteoporotic groups was compared with the control group after operation. Results There were notable differenees(F=4.30,P< 0.05) in term of fracture healing time among the three groups [sclerotic group:(18.4±5.3)weeks; osteoporotic group: (24.5±5.1)weeks; control group: (17.6±3.8)weeks]. Notably, there were significant differences between the osteoporotic and control groups(q=2.34,P<0.05), and between sclerotic and osteoporotic gronps(q=2.51, P<0.05). The healing time of the osteoporotic group was longer than that of sclerotic group. The constituent ratios of fracture healing in sclerotic, osteoporotic and control groups were 73.1% (19/26) ,54.5% (6/11),75.0% (18/24) respectively, and the differences among the three groups were statistically significant(X2=3.67,P<0.05). The healing rate of the osteoporotic group was lower than that of sclerotic and control groups(X2=3.12, 3.36, all P< 0.05). The constituent ratios of healing in the sclerotic, osteoporotic and control groups were 26.9% (7/26),45.5% (5/11),25.0%(6/24), respectively, and there differences among the three groups were statistically significant (X2=4.07 ,P<0.05). The delayed healing rate of the osteoperotic group was higher than those of the sclerotic and control groups(X2= 3.87,3.95, all P<0.05). Conclusions Fracture healing time of osteoporotic osteofluorosis after fracture is longer than normal, and the cause might be the loss of bone mass.

OBJECTIVETo investigate the protective effect of soyasaponins on acute liver injury induced by D-galactosamine (GalN) and lipopolysaccharide (LPS) in mice.

METHODThe mice were randomly divided into five groups: the normal control, the model group, the silymarin (positive control) group, and soyasaponins high and low-dose groups. They were administered with drugs once every day for 7 days. At the end of the experiment, GalN and LPS were injected intraperitoneally to all of the groups except for the normal group to establish the acute liver injury model. The pathological changes were detected with hematoxylin & eosin (HE) staining, tumor necrosis factor-alpha (TNF-alpha) was detected by ELISA method, and the alanine aminotransferase (ALT), aspartate aminotransferase (AST), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST), reduced glutathione (GSH), malondialdehyde (MDA), nitric oxide (NO), and the activation of Caspase-3 and Caspase-8 were detected by the colorimetric method.

RESULTSoyasaponins could reduce the activities of serum ALT and AST, the acute hepatic injury induced by GalN/LPS, serum TNF-alpha level, hepatic NO and MDA contents, and the Caspase-3 and Caspase-8 activations of liver tissues, and increase the hepatic CAT, GPx, GST and GSH levels.

CONCLUSIONSoyasaponins shows the protective effect on acute liver injury induced by GalN and LPS in mice, which may be related to its antioxidative ability and anti-liver apoptosis.

Alanine Transaminase ; blood ; Animals ; Antioxidants ; metabolism ; Apoptosis ; drug effects ; Aspartate Aminotransferases ; blood ; Caspases ; metabolism ; Chemical and Drug Induced Liver Injury ; metabolism ; pathology ; prevention & control ; Galactosamine ; toxicity ; Lipopolysaccharides ; toxicity ; Liver ; pathology ; Male ; Mice ; Saponins ; pharmacology ; Soybeans ; chemistry

OBJECTIVETo compare differences between Crowe IV developmental dysplasia of the hip (DDH) with secondary acetabulum and Crowe IV DDH without secondary acetabulum,and determine whether it is necessary to divide Crowe IV DDH into two subtypes.

METHODSFrom June 2007 to May 2015,145 hips of 112 Crowe N patients who underwent total hip arthroplasty (THA) using S-ROM stem were divided into two groups: secondary acetabulum formaton group (group A) and no secondary acetabulum formaton group (group B). In group A,there were 12 females, 96 males,with an average age of (39.38 ± 11.19) years old. In group B, there were 2 females, 35 males, with an average age of (38.19 ± 10.92) years old. All the patients were evaluated by using Harris Hip Score. Radiographic evaluations were made preoperatively and during follow up. The differences between two groups were compared on dislocation height, canal flare index (CFI), subtrochanteric shortening osteotomy (SSTO) usage, pre- and post-operation Harris scores, complications.

RESULTSThe dislocation height for group A was (4.74 ± 1.57) cm, while the dislocation height for group B was (3.12 ± 1.15) cm. Significantly difference was detected between two groups. The CFI for group A was 2.69 ± 0.68, while the CFI for group B was 3.42 ± 0.79, and the significantly difference was detected between two groups. Harris scores were totally improved from 58.18 ± 15.67 preoperatively to 91.20 ± 3.79 post-operatively and the difference was significant. Pre-operative Harris scores was 58.1 ± 15.3 in group A, 58.3 ± 16.9 in group B. Post-operative Harris scores was 91.0 ± 4.1 in group A, 91.0 ± 5.1 in group B. No significant difference was found on Harris scores between A and B preoperatively and post-operatively. Complications of 4 cases peri-prosthesis fracture, 4 cases dislocation and 4 cases nerve injury occur in group A; While only one case dislocation and one case nerve injury occur in group B. No statistical significance was detected.

CONCLUSIONCrowe IV DDH with secondary acetabulum is significantly different from Crowe IV DDH without secondary acetabulum on dislocation height and femoral morphology, which causes the different selections of surgical techniques (SSTO usage or not). These important differences in fundamental parameters indicate the necessity to further divide Crowe IV DDH into IVA and IVB two subtypes.

Adolescent ; Adult ; Aged ; Female ; Hip Dislocation, Congenital ; classification ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy

Objective To achieve detailed genomic characterization and investigate the antibiotic-resistant mechanisms of plasmid pA1137 carrying the aminoglycoside resistance gene aacC2.Methods Antibiotic-resistant genes were deter-mined by PCR.Conjugation experiments were performed to verify the transferability of plasmid pA 1137.The minimum in-hibitory concentration(MIC)values of bacterial strains were tested with microdilution method.The genetic background, mobile elements and antibiotic resistance mechanisms of pA 1137 were determined using a whole genome sequencing meth-od.Results Both carbapenem-resistant gene blaIMP-8and aminoglycoside-resistant genes aacC2 and aacA4 were carried by A1137 isolated from Enterobacter cloacae(ECL).aacC2 was located in plasmid pA1137 while the other two resistant genes were observed in chromosomes.Plasmid pA1137 was an IncFⅡplasmid,whose total length was 68.97 kb,and GenBank accession number was MF190369.Plasmid pA1137 contained multiple replicons and intact conjugative transfer regions,so it could be transferred into ECL through conjugation experiments and confer corresponding antibiotic resistance to the transconjugant A1137-EC600.Conclusion IncFⅡ plasmid pA1137 has a single accessory region, the first reported Tn5403-based aacC2-tmrB-related region,which can cause stable inheritance and mediate the resistance to aminoglycoside antibiotics in ECL A1137.

BACKGROUNDIntra-articular fractures of the fingers are common problems to emergency physicians and hand surgeons. Inappropriate management of these injuries may result in chronic pain, stiffness, deformity, or post traumatic arthritis. Ideal treatment necessitates the restoration of a stable and congruent joint that will allow early mobilization. The purpose of this study was to investigate the results of intra-articular fracture of the fingers by mini external fixator combined with limited internal fixation.

METHODSFrom May 2005 to May 2007, a total of 26 patients with intra-articular fracture of the fingers were treated by mini external fixator combined with limited internal fixation. Of the 26 cases, 11 involved in metacarpophalangeal joint, and 15 interphalangeal joint in proximal interphalangeal. Kirschner wire, mini wire and absorbable suture were used for limited internal fixation. All patients were followed up and patients were accomplished with total active motion (TAM) of fingers.

RESULTSAll patients were reviewed by an independent observer. The mean follow up was 13 months (range 9 to 24 months). Subjective, objective and radiographic results were evaluated. X-ray films revealed fracture union and the average radiographic union time was 7 weeks with a range of 5 - 12 weeks and the phalange shortening or rotation in 2 cases, joint incongruity (less than 1 mm) and joint space narrowing in 3 cases respectively. Phalangeal shortening or rotation was observed in 2 cases and joint incongruity or joint space narrowing was observed in 3 cases. An artificial implant was performed on one case for traumatic arthritis 1.5 years after surgery. Based on TAM the overall good-excellent rate of joint motion function was 80.8%.

CONCLUSIONMini external fixator combined with limited internal fixation is a reliable and effective method for treatment of intra-articular fracture of the fingers.

Adolescent ; Adult ; External Fixators ; Female ; Finger Joint ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Intra-Articular Fractures ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

In the face of the worldwide threat of severe acute respiratory syndrome (SARS) to human life, some of the most urgent challenges are to develop fast and accurate analytical methods for early diagnosis of this disease as well as to create a safe anti-viral vaccine for prevention. To these ends, we investigated the antigenicity of the spike protein (S protein), a major structural protein in the SARS-coronavirus (SARS-CoV). Based upon the theoretical analysis for hydrophobicity of the S protein, 18 peptides were synthesized. Using Enzyme-Linked Immunosorbent Assay (ELISA), these peptides were screened in the sera from SARS patients. According to these results, two fragments of the S gene were amplified by PCR and cloned into pET-32a. Both S fragments were expressed in the BL-21 strain and further purified with an affinity chromatography. These recombinant S fragments were confirmed to have positive cross-reactions with SARS sera, either by Western blot or by ELISA. Our results demonstrated that the potential epitope regions were located at Codons 469-882 in the S protein, and one epitope site was located at Codons 599-620. Identification of antigenic regions in the SARS-CoV S protein may be important for the functional studies of this virus or the development of clinical diagnosis.
Antigens, Viral ; immunology ; Chromatography, High Pressure Liquid ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Enzyme-Linked Immunosorbent Assay ; Genetic Vectors ; Humans ; Mass Spectrometry ; Membrane Glycoproteins ; genetics ; immunology ; metabolism ; Molecular Weight ; Peptide Fragments ; chemistry ; Recombinant Proteins ; genetics ; immunology ; SARS Virus ; genetics ; immunology ; metabolism ; Spike Glycoprotein, Coronavirus ; Viral Envelope Proteins ; genetics ; immunology ; metabolism

The qualitative analysis method of RRLC-Q-TOF-MS/MS was established for determine the chemical constituents in Qige Keli. Kramosil C₁₈ column (4.6 mm×150 mm, 3.5 μm) was used at the temperature of 30 °C. The mobile phase was 0.2% formic acid and acetonitrile by gradient elution, with a flow rate at 1.0 mL·min⁻¹, and the injection volume was 10 μL. The high-resolution quadrupole time-flight mass spectrometry was used as detector with electrospray ion source in both positive and negative models. On the basis of medicinal materials, reference materials, literature reports, and mass spectrometry data, the chemical composition in the Qige Keli was identified. A total of 44 compounds were identified, including 3 flavonoids, 21 flavonoid glycosides, 8 organic acids, 6 lactones, and 3 saponins. The results laid the foundation for the quality control of Qige Keli and the further research on pharmacodynamic materials.
Acids ; analysis ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; analysis ; Glycosides ; analysis ; Lactones ; analysis ; Phytochemicals ; analysis ; Saponins ; analysis ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

OBJECTIVETo report the authors' experience with adult-to-adult living donor liver transplantation using right lobe liver grafts performed by a modified technique.

METHODSFrom March to June 2005, 13 patients underwent living donor liver transplantation using right lobe grafts. Among these, one patient received two left lobes from his two elder sisters, one received a right lobe from his mother and a left lobe from a cadaveric donor. All patient underwent a modification designed to improve the reconstruction of right hepatic vein, the reconstruction the tributaries of the middle hepatic vein by interpositioning a vein grafts, and the anastomosis of the hepatic arteries and bile ducts.

RESULTSThere were no severe complications and deaths found in donors. Four complications occurred in recipients including hepatic artery thrombosis (n = 1), bile leakage (n = 1), left subphrenic abscess (n = 1) and pulmonary infection (n = 1). The patient with pulmonary infection died of multiple organ failure (MOF). All patients underwent direct anastomosis of right hepatic vein and inferior vena cava (IVC), 5 cases plus the reconstructions of right inferior hepatic vein, and the other 5 cases plus the reconstruction of the tributaries of the middle hepatic vein by interpositioning a vein graft to provide sufficient venous outflow. The graft and recipient weight ratio (GRWR) were between 0.72% and 1.24%, among these, 9 cases < 1.0% and 2 cases < 0.8%, and there was no "small-for-size syndrome" occurred.

CONCLUSIONSWith modifications of surgical technique, especially the reconstruction of hepatic vein to provide sufficient venous outflow, living donor liver transplantation in adults using right lobe liver grafts can become a relatively safe procedure and prevent the "small-for-size syndrome".

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Transplantation, Homologous

OBJECTIVETo evaluate the safety of donors of right lobe graft.

METHODSWe retrospectively studied 13 living donors of right lobe graft from January 2002 to June 2005. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein. Liver transection was done by using an ultrasonic dissector without inflow vascular occlusion. The standard liver volume and the ratio of left lobe volume to the standard liver volume were calculated.

RESULTSThe mean blood loss was 490 ml. The mean blood transfusion was 440 ml. In the perioperative period the mean albumin administered was 85 g. One donor had portal vein trifurcation, two had a right posterior bile duct and a right anterior bile duct draining into the left bile duct, respectively. One had bile ducts from left lateral and left internal segment and right duct draining into common hepatic duct. On postoperative day 1 the donors' liver functions were found impaired to some extent, but all the indices rapidly returned to the normal level at the end of the first week. Postoperative complications included 1 case of abdominal bleeding, 2 wound steatosis and 1 chyle leak. There was no donor mortality. All donors are well and have returned to their previous occupations.

CONCLUSIONSThe donation of right lobe graft for adult living donor liver transplantation is safe provided that the patency of the remnant hepatic vasculature and bile duct is ensured, the volume of the remnant liver exceeds 30% of the total liver volume, and there is no injury to the remnant liver.

Adult ; Female ; Follow-Up Studies ; Humans ; Liver ; blood supply ; surgery ; Liver Function Tests ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Transplantation, Homologous

BACKGROUNDIt is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.

METHODSA retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.

RESULTSNo deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepatic vein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1), left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.

CONCLUSIONSThe multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.

Adolescent ; Adult ; Female ; Hepatic Veins ; surgery ; Humans ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Treatment Outcome