OBJECTIVETo investigate the clinical experiment of cortical screw in the treatment of tibiofibular syndesmosis separation together with ankle fractures.

METHODSFrom March 2008 to May 2012,42 patients with tibiofibular syndesmosis separation were treated with cortical screw, including 20 cases in the left and 24 cases in the right. All the patients had closed injury. According to Lauge-Hansen classification, there were 18 cases of supination-external rotation, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III, 6 patients with injuries belong to type IV; 14 cases of pronation-external rotation, in which 6 patients with injuries belong to type III, 8 patients with injuries belong to type IV; and 12 cases of pronation-abduction, in which 4 patients with injuries belong to type II, 8 patients with injuries belong to type III. According to injury of ankle, 4 patients had injuries in one ankle, 28 patients had injuries in 2 ankles, and 12 patients had injuries in 3 ankles. All the patients were diagnosised definitely in sight of medical history, checking-up, iconography. The clinical effects were evaluated based on Baird-Jackson score and activity degree of ankle.

RESULTSAll the patient were followed up, and the duration ranged from 11 to 23 months, with an average of 15.7 months. No postoperative wound infection, nonunion, and tibiofibular syndesmosis separation again and other complications occurred. Postoperative Baird-Jackson score exhibited 91.56 ± 6.26 (75 to 99), and 26 patients got an excellent result, 10 good, 6 poor and 2 bad. One patient had nail broken after operation,and got good function after removing broken nail without external fixation. Other 1 patient had osteoarthritis to 1 degree, and got better result with the treatment of physical therapy and intra-articular injection.

CONCLUSIONCortex screw is the effective treatment for tibiofibular syndesmosis separation. Clear diagnosis, delicate operation and postoperative reasonable functional exercise are primary factor of prognosis.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Bone Screws ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the influence of lipid metabolic markers on hip osteoarthritis (OA) and the correlation with the pain of hip.Methods In this retrospectively cross sectional analysis,393 subjects fufilling the inclusive criteria were continuously included from June 2013 to September 2014.The presentation of hip X-ray of subjects were classified into OA group and non-OA group in terms of Kellgren-Lawrence grading scale,the subjects with Kellgren-Lawrence (K-L)≥2 was classified into OA group.The average of age in total was (62±9) years.There were 183 males and 210 females,the number of patients with OA was 182.There were 210 patients with hypertension and 118 patients with diabetes while the number of smoking patients was 74.The demographic information,risk factors,blood pressure,blood glucose,lipid metabolic markers were analyzed.Differences in proportions were compared using the Chi-square test.Difterences in continuous variables were tested for statistical significance using t test analysis.VAS score was used to evaluate the severity of hip pain.Independent risk factors were confirmed by using multiple logistic regression analysis.The correlation between the risk factors and severity of hip pain was analyzed by Spearman correlation analysis.Results Statistically significance existed in age (t=-4.849),sex (x2=8.946),BMI (t=-4.794),hypertension (x2=4.751),smoking (x2=7.062),metabolic syndrome (x2=34.406),apolipoprotein A1 (t=2.352),apolipoprotein B (t=-6.870),high density lipoprotein cholesterol (t=2.519),triglyceride (t=-4.652) and ApoB/ApoA1 ratio (t=-4.901) between OA group and non OA group.Age [OR =1.060(1.033,1.086)],metabolic syndrome [OR=3.682(2.284,5.938)] and ApoB/ApoA1 ratio [OR=5.743(2.393,13.785)] were the independent risk factors.The ApoB/ApoA1 ratio had positive correlation with the severity of hip pain(r=0.379).Conclusion ApoB/ApoA1 ratio is the independent risk factor of hip osteoarthritis,and has positive correlation with the severity of hip pain.The ApoB/ApoA1 ratio should be monitored in hip osteoarthritis patients in clinical work,to get the relief of pain and improve hip osteoarthritis.

Objective To explore the expression of PRR11(Proline-rich protein 11) in human osteosarcoma and investigate the effect of PRR11 on the proliferation of human osteosarcoma cells.Methods Immunohistochemical staining was applied to detect the PRR11 expression in 75 cases of osteosarcoma and corresponding normal tissues.Western blotting was used to examine PRR11 protein expression levels in osteosarcoma cell lines.We used siRNA to knock down the expression of PRR11 and tested the effects of PRR11 down-regulation on the proliferation in SaOS2 cells.Results PRR11 was overexpressed in osteosarcoma specimens compared to their paired normal tissues,the over expression rate of PRR11 in osteosarcoma and corresponding paracancerous tissues were 76％(57/75) and 9.33％(7/75) with statistical difference(P<0.05).The high expression of PRR11 was correlated with tumor pathological grade and lymphatic metastasis(P<0.05).PRR11 was expressed in 4 osteosarcoma cell lines which were SaOS2,143B,U2OS and MG63 respectively,the expression was highest in SaOS2 cells.Silencing PRR11 inhibited cell growth as compared with control cells(P<0.05).Conclusion PRR11 is overexpression in human osteosarcoma and promotes its progression by enhancing proliferation.The increased expression of PRR11 in osteosarcoma is a new target for treatment and early diagnosis of human osteosarcoma patients.

This article, introduces setting up of reflectance confocal microscope which is divided into four parts: optical system, scanning system, detecting system and software controlling system. This reflectance confocal microscope realizes in vivo epidermis tissue imaging in mouse skin as well as disease diagnosis related cell parameters measurement.
Animals ; Diagnostic Imaging ; instrumentation ; methods ; Microscopy, Confocal ; methods ; Rats ; Skin ; Software

AIM: To analyze the correlation between levels of serum soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular cell adhesion molecule-1(sVCAM-1)and the severity of thyroid-associated ophthalmopathy(TAO).

METHODS: A total of 120 patients with TAO admitted to the hospital from August 2016 to March 2018 were selected and included in the study. According to the clinical activity score(CAS), the patients were divided into active stage group and inactive stage group. According to the severity, they were divided into mild group, moderate group and severe group. There were 90 healthy persons were selected as the control group at the same time. The general data, serum sICAM-1 and sVCAM-1 levels were compared among groups and the correlation of sICAM-1 and sVCAM-1 levels with the severity of TAO was analyzed.

RESULTS: There were no significant differences in the clinical basic data of patients in between the different clinical active stage groups and the control group, and between the different severity groups and the control group(P>0.05). The levels of serum sICAM-1 and sVCAM-1 in the active stage group were significantly higher than those in the inactive stage group and the control group(P<0.01). The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups were significantly higher than those in inactive stage patients and of control groups(P<0.01). There were no significant differences in levels of serum sICAM-1 and sVCAM-1 in inactive stage patients of different severity groups. The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups increased gradually with the severity of the disease. There was no significant correlation between levels of serum sICAM-1 and sVCAM-1 in inactive stage patients and the severity of disease(r=0.102, 0.095, P=0.135, 0.167). Levels of serum sICAM-1 and sVCAM-1 in active stage patients were positively correlated to severity of disease(r=0.695, 0.824, P=0.005, 0.002).

CONCLUSION: The levels of serum sICAM-1 and sVCAM-1 in inactive patients will not increase with the severity of the disease. However, the levels in patients with active disease will increase with the severity of the disease, which can be used for clinical diagnosis and staging of TAO and monitoring of the prognosis.

AIM: To explore the curative effect of methylprednisolone with octreotide retrobulbar injection therapy on thyroid associated ophthalmopathy.
METHODS:Fifty- one cases ( 96 eyes ) with thyroid associated ophthalmopathy were treated with methylprednisolone ( 500mg/d ) for 3d, and then retrobulbar injection of octreotide (0. 1mg/mo) for 3mo in one course. Symptoms and signs of the patients were observed before and after the treatment course.
RESULTS: Symptoms of 49 cases were improved significantly. In all cases, the mean value of exophthalmus of the patients was significantly decreased after the treatment by 3. 1 ± 1. 4mm. The height of palpebral fissure was significantly decreased after the treatment by 2. 4 ± 0. 9mm, there were statistically significant difference before and after treatment (P<0. 05).
COCLUSION: Methylprednisolone with octreotide retrobulbar injection therapy can improve symptoms and signs of the patients with thyroid associated ophthalmopathy with high safety and no obvious side effect.

【Objective】 To establish the internal quality control standard of leukocyte-depleted suspended red blood cell volume in our center, so as to guide the preparation of components, strengthen the internal quality control and improve the quality of blood preparations. 【Methods】 A total of 1 523 bags of whole blood collected using two manufacturers′ leukocyte-depleted blood bags from March to August 2023 at our center were extracted. The blood before and after filtration were weighed, and the volume of whole blood collected, the volume of filtration loss and the product volume based on the formula and measured specific gravity were calculated. According to the data distribution characteristics, the reference range of leukocyte-depleted suspended red blood cell volume was determined, and the differences of whole blood collection volume, filtration loss capacity and product capacity between the two manufacturers were analyzed. The quality control data of leukocyte-depleted red blood cells over the past year with the difference between another 100 bags of these cells and the reference interval were compared, and the effectiveness of reference interval was validated. 【Results】 The median whole blood collection volume in the sample size was 402.0 mL, with a median filtration loss of 42.4 mL, and an average volume of leukocyte-depleted suspended red blood cells at 322.5 mL. The whole blood collection volume (A: median 404.4 mL; B: median 397.7 mL, P<0.01) and the volume of leukocyte-depleted suspended red blood cell products (A: mean 331.4 mL; B: mean 312.0 mL, P<0.01) using manufacturer A′s leukocyte-depleted blood bag were both higher, with a lower filtration loss capacity (A: median 39.5 mL; B: median 46.6 mL, P<0.01). The standard deviation of the volume of leukocyte-depleted suspended red blood cell was 19.6, and the reference interval was 284.1-360.9 mL. The validation samples and quality control sampling data showed no difference from the interval samples (P>0.05). 【Conclusion】 According to the actual situation of our center, the volume standard of leukocyte-depleted suspended red blood cells in our center is determined to be 284.1-360.9 mL.

【Objective】 Toexplore the viability of preparing washed RBCs ordeglycerolized RBCs(referred as frozen RBCs)from blood containing irregular antibodies, so as to provide references for formulating processing procedures of blood containing irregular antibodiestosave blood resources and reduce blood wastage. 【Methods】 Once irregular antibodies were yielded, their type and titerwere determined.The plasma was discarded, and the suspended RBCs were prepared and processed according to the standardized washing scheme.The processing effect of blood with different titers and types of antibodies was observed, and theirfurther clinical application was followed up. 【Results】 From May 2017 to July 2019, a total of 45 blood samples containing irregular antibodies were screened in our center. The overall qualified rate reached 91.1% after processing. 100%(25/25) was qualified in IgM, and 80.0%(16/20)in IgG.4samples, initially noncom for mingdue to IgG-Dwith titerranged8~16, met the requirements after one or two additional washing processes. Among them, 23 cases were issued and appliedin clinicaland noadeverse reactions to blood transfusionoccurred. 【Conclusion】 After appropriate processing, blood containing irregular antibody can be applied to the clinical to save blood resources. When the irregular antibody is IgG-D and the titer is high, the washing times should be increased, and only when there is no residual antibodycan the samples be issued to the clinical.

OBJECTIVETo observe the intervention and mechanism of Qushi Huayu Recipe (QHR) on gene expression profiles in high lipid diet induced fatty liver rats.

METHODSFatty liver model was prepared in 20 male SD rats using single high fat diet (88% common forage +2% cholesterol +10% lard). Four weeks after modeling they were divided into the model group and the QHR group according to random digit table, 10 in each group. QHR (at 0. 93 g crude drug/100 g body weight) and distilled water was respectively to rats in the QHR group and the model group by gastrogavage while modeling, once per day. Meanwhile, 10 SD male rats were recruited in a normal group, administered with equal volume of distilled water by gastrogavage. At the end of week 8 all rats were sacrificed, and blood and livers were collected for subsequent analysis. Contents of liver triglyceride (TG) and free fatty acid (FFA) , activities of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected using biochemical assay. Pathological changes of liver tissue were observed using H&E and oil red O stain. Liver gene expressions were detected by Affymetrix gene expression profiles. Differentially expressed genes were compared between the QHR group and the model group, functions of differentially expressed genes and signal pathways involved analyzed. Ten differentially expressed genes involved in glycolipid metabolism with fold change more than 2 were selected for verification by real-time PCR.

RESULTS(1) Compared with the normal group, contents of liver TG and FFA, and serum activities of ALT and AST obviously increased in the model group (P <0. 01). Compared with the model group, contents of liver TG and FFA, and activities of ALT and AST obviously decreased in the QHR group (P <0. 05, P <0. 01). QHR could reduce high fat induced fatty degeneration of liver cells , alleviate inflammation, and improve pathological changes of liver tissue. (2) Compared with the model group, there were 80 differentially expressed genes (with fold change > 2, P < 0.05) with clear functions and appointed gene names, including 44 up-regulated and 36 down-regulated genes. Eighty genes were involved in 27 signal pathways with statistical difference, including glycerolipid metabolism, adipocytokine signaling pathway, insulin signal pathway, drug metabolism signal pathway, etc (P < 0.05). (3) RT-PCR results of 10 glycolipids metabolism regulating genes such as Gk, Scd1, Gpat2, G6pc, Irs1, and so on showed that all RT-PCR genes were completely coincide with up-regulated or down-regulated tendency in results of gene chips. 80% genes had approximate fold change.

CONCLUSIONQHR could regulate gene expressions related to fat metabolism, carbohydrate metabolism, anti-lipid peroxidation, and drug metabolism in high fat diet induced fatty liver rats, and its comprehensive pharmacological actions could be manifested.

Alanine Transaminase ; metabolism ; Animals ; Aspartate Aminotransferases ; metabolism ; Carbohydrate Metabolism ; Diet, High-Fat ; Drugs, Chinese Herbal ; pharmacology ; Fatty Acids, Nonesterified ; metabolism ; Fatty Liver ; metabolism ; Lipid Metabolism ; Lipid Peroxidation ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Transcriptome ; drug effects ; Triglycerides ; metabolism

BACKGROUND:Zinc-modified calcium silicate (CaSiO3) bioceramics coating on the titanium surface prepared in preliminary experiments has good chemical stability and antibacterial property. OBJECTIVE:To observe the effects of zinc-modified CaSiO3 bioceramics coating on osteointegration. METHODS:MC3T3-E1 cels were respectively cultured on the titanium with zinc-modified CaSiO3 bioceramics coating (experiment group), titanium with CaSiO3 bioceramics coating (control group) and pure titanium (blank control group). Then, cel adhesion, proliferation, calcification rate and the expression of type I colagen and osteocalcin were detected. The implant materials mentioned above were respectively inserted into the femurs of New Zealand white rabbits, and after 1.5 months, the osteoproliferation and osteointegration between the implants and the host were tested. RESULTS AND CONCLUSION:In vitro experiment: The number of adhesive cels at 12 hours after co-culture was significantly increased in the experimental group compared with the control group and blank control group (P < 0.05). At 14 days after co-culture, cel proliferation ability and ability of calcium nodule formation in the experiment group were significantly better than those in the other groups (P < 0.05). At 21 days after co-culture, there was no significant difference in the expression of type I colagen, but the expression of osteocalcin in the experiment group was higher than that in the control group and blank control group (P < 0.05).In vivo experiment: In the experiment group, a large amount of bone substances were detected, the coating materials directly contacted with the bone interface, new bone tissues and little fibrous tissues were observed at the interface. In contrast, there was a small amount of bone hyperplasia in the control group and almost no bone hyperplase in the blank control group. Moreover, a small part of the implant directly contacted with the bone interface and the most part was separated from bone trabeculae by fibrous tissues. These findings indicate that zinc-modified CaSiO3 bioceramics coating can enhance the ability of osteointegration between titanium implants and the host.