Objective:For further exploring the feasibility,we have treated the middle and infe- rior femoral bone fracture nonunion by the transplantation of bone flap with ascending and transvers branch of the lateral femoral circumflex vessels.Method:The technique,on the basis of anatomical study have been designed to treat the femoral bone fracture nonunion by the transplantation of bone flap with ascending and transvers branch which pedicle was descendant branch of the lateral femoral circumflex vessel.Results:8 cases of middle and inferior femoral fracture nonunion had been treated by this method.At follow-up of 1 year 5 months to 4 years 6 months,the results have been satisfacto- ry.Conclusions:The method of the transplantation of the bone flap with ascending and transvers branch of the lateral femoral circumflex vessel for the treatment of middle and inferior femoral fracture nonunion has the adventages of simplicity,easiness,reliability.

Neuroendocrine tumors of the epiglottis were extremely rare. Patients normally had no obvious symptoms and signs of early stage. Epiglottis lingual except (without) tubercle of epiglottis, and hyperplastic mass were observed by using laryngoscopy and also confirmed by biopsy and immunohistochemistry. Immunohis- tochemical studies showed that Syn, a broad spectrum endocrine marker, and CgA, a specific marker of endocrine tumor, were both positive. Which is consistent with the diagnosis of neuroendocrine carcinoma.
Carcinoma, Neuroendocrine ; pathology ; Epiglottis ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; pathology ; Laryngoscopy

Objective To investigate the effects of therapeutic hypercapnia on acute pulmonary allograft rejection induced by macrophages in rats.Methods Twenty-four adult male Wistar rats and 12 adult male Sprague-Dawley rats,weighing 250-280 g,were used in this study.The recipient rats were randomly divided into 3 groups using a random number table (n =6 each):syngraft group (group S),allograft group (group A) and therapeutic hypercapnia group (group H).In group S,Wistar rats served as donors and recipients,while in A and H groups,Sprague-Dawley rats served as donors and Wistar rats served as recipients.Orthotopic left lung transplantation was performed using the cuff technique.After transplantation,the rats inhaled 50％ N2-50％ O2 for 90 min during reperfusion in S and A groups,while in group H the rats inhaled N2-O2-CO2 for 90 min during reperfusion and PaCO2 was maintained at 80-100 mm Hg and O2 concentration in inspired air at 48％-50％ by adjusting the concentrations of the three gases.At 7 days after operation,the arterial blood sample was collected for blood gas analysis and for determination of serum concentrations of tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ)by ELISA.The oxygenation index was calculated.Then the rats were sacrificed,and the transplanted lungs were removed for microscopic examination and for detection of infiltration of macrophages (by immunohistochemistry)and cell apoptosis (by using TUNEL) in lung tissues.The rejection was scored and apoptotic index was calculated.Results Compared with group S,PaCO2,serum concentrations of TNF-α and IFN-γ,rejection score,the number of macrophages and apoptotic index were significantly increased,and oxygenation index was decreased in group A (P ＜ 0.05).Compared with group A,pH value and oxygenation index were significantly increased,and serum concentrations of TNF-α and IFN-γ,rejection score,the number of macrophages and apoptotic index were decreased in group H (P ＜ 0.05).Conclusion Therapeutic hypercapnia can reduce macrophage-induced acute pulmonary allograft rejection possibly through inhibiting the inflammatory responses and cell apoptosis.

Objective:To explore the effect of bifidobacterium tetravaccine tablets combined with low-dose erythromycin on the efficacy and motilin (MTL) levels in the treatment of children with functional dyspepsia (FD).Methods:One hundred and fifty children with FD admitted to Shanghai Public Health Clinical Center from January 2019 to June 2020 were selected and were divided into two groups by random number table, with 75 cases in each group. The control group was treated with bifidobacterium tetravaccine tablets, and the observation group was treated with low-dose erythromycin on the basis of control group. The clinical efficacy and the disappearance time of the clinical symptoms of the two groups were compared. The changes in the frequency of gastric antrum contraction (ACF), the amplitude of gastric antrum contraction (ACA), the gastric antral movement index (MI) were detected by ultrasonic developing-out unit before and after treatment. The levels of 5-hydroxytryptamine (5-HT), nitric oxide (NO), gastrin (GAS) and MTL were detected before and after the treatment using enzyme linked immunosorbent assay. The incidence of adverse reactions was counted. The recurrence rate was recorded after 6 months of the treatment.Results:The total effective rate in the observation group was higher than that in the control group:93.33% (70/75) vs. 78.67% (59/75), and the difference was statistically significant ( χ2 = 6.700, P<0.05). The disappearance time of symptoms of nausea and vomiting, loss of appetite, abdominal distension, and abdominal pain in the observation group were shorter than those in the control group: (2.58 ± 0.45) d vs. (3.22 ± 0.68) d, (3.56 ± 0.62) d vs. (4.10 ± 0.70) d, (2.54 ± 0.46) d vs. (3.24 ± 0.69) d, (2.66 ± 0.56) d vs. (3.40 ± 0.67) d, and the differences were statistically significant ( P<0.05). The levels of ACF, ACA and MI in the observation group after the treatment were higher than those in the control group: (4.32 ± 0.90) times/min vs. (3.58 ± 0.83) times/min, (0.34 ± 0.12) vs. (0.30 ± 0.10) mm, (1.33 ± 0.42) vs. (1.14 ± 0.30), and the differences were statistically significant ( P<0.05). The levels of 5-HT and NO in the observation group after the treatment were lower than those in the control group: (164.77 ± 30.34) mg/L vs. (184.45 ± 28.90) mg/L, (38.27 ± 10.20) mmol/L vs. (46.54 ± 9.48) mmol/L; and the levels of GAS and MTL were higher than those in the control group: (115.23 ± 15.70) ng/L vs. (98.50 ± 14.29) ng/L, (266.67 ± 32.76) ng/L vs. (238.40 ± 28.97) ng/L, and the differences were statistically significant ( P<0.05). Conclusions:The treatment of pediatric FD with bifidobacterium tetravaccine tablets combined with low-dose erythromycin can significantly improve the efficacy, quickly improve the clinical symptoms of children, promote physical recovery, and regulate MTL levels to improve gastric motility. The recurrence rate is low.

Objective We conducted a case-control study to verify the association of rs2070045 SOLR1 polymorphism with PD in the northern Han Chinese population from mainland China.Methods A total of 215 unrelated Han Chinese healthy people and 377 PD patients were included in the study.According to the onset age,the PD patients were divided into 2 groups:early onset PD group (onset age ≤ 50 years old) and late onset PD group (＞50 years old).Clinical data was collected and peripheral blood genomic DNA was extracted using MALDI-TOF-PEX technology.The correlation of rs2070045 SOLR1 with Parkinson's disease was analyzed.Results Genotypic frequencies of rs2070045 SNP were investigated through the data from a total of 592 subjects including 377 PD patients and 215 control participants.Genotypes of TT,TG and GG were found in 52,182 and 143 PD patients respectively and in 31,13 and 71 Healthy controls.No significant differences were found in the genotype and allele frequency for rs2070045 between PD group and healthy control (HC) groups.The genotype for rs2070045 in the early-onset PD group was significantly different from that in the HC group (P=0.036).There were no significant differences in genotype and allele frequency between late-onset PD and HC groups.Moreover,carriers of the G-allele (genotype GG/ TG) of rs2070045 showed a significantly decreased risk of early-onset PD compared to non-carriers according to the Logistic regression analysis.Onset age of carriers (genotype GG/ TG) in late-onset PD group was lower compared to non-carries (P=0.001).Other clinical features such as gender,Hoehn-Yahr stage and disease duration had no statistical difference between carriers and non-carriers of PD patients.Conclusion We have found that rs2070045 SNP of SORL1 was associated with early-onset Parkinson's disease in the northern Han Chinese population.G-allele of rs2070045 SNP decrease the risk for early-onset PD,suggesting G-allele might be a protecting factor of early-onset PD.The influence of SORL1 gene polymorphism on Parkinson's disease warrants further investigation.

Objective To investigate the clinical manifestations,laboratory findings and genetic characteristics of two cases with simple virilizing (SV)21-hydroxylase(21OHD). Methods Clinical manifestations and laboratory data were obtained. The promoter and coding areas of CYP21A2 gene were directly sequenced. In silico analysis were used to predict the function of mutations. Results Two patients presented severe virilism. The laboratory examinations showed that plasma ACTH,aldosterone,androstendione and testosterone were significantly increased compared with normal individuals. VCT scan showed hyperplasia of bilateral adrenal. Direct sequencing of CYP21A2 gene showed two complex mutations-H62L/V69L and I2g/10InsL,which were not reported previously. In silico analysis(Polyphen)showed the novel mutation V69L could probably damage the function of CYP21A2 protein. Conclusion The combined mutations,H62L/V69Land I2g/10InsL,could be associated with SV type 21-OHD phenotype.

Objective To analyze the difference among antigens of Angiostrongylus cantonensis in different developmental stages and identify dominant diagnostic antigen for angiostrongyliasis. Methods Antigens of A.cantonensis in different developmental stages were analyzed by SDS-PAGE and immunoblot. Results The protein bands of all developmental stages were similar on SDS-PAGE. The Mr 40 000 , 50 000 , 66 000 and 80 000 antigens reacted not only with the sera of rats infected by A.cantonensis but also with the sera of normal rats. The Mr 104 000 antigen could be discerned by sera of rats infected with A.cantonensis for 2 weeks. The Mr 32 000 antigen could be recognized by sera of rats 2 weeks after infection, and the reaction became stronger with the infection continued. Conclusion The Mr 40 000 , 50 000 , 66 000 and 80 000 antigens might result in the unspecific reaction in the immunodiagnosis of angiostrongyliasis using the crude antigen of A.cantonensis. The Mr 104 000 of larva, Mr 33 000 of adult females and Mr 32 000 of the worms might be used as candidate antigens in early diagnosis and epidemiological survey of angiostrongyliasis.

Objective To evaluate the risk factors for surgical site infection(SSI)following ankle joint and Pilon fracture surgery,and provide theoretical basis for the prevention of postoperative SSI.Methods Clinical data of pa-tients who underwent ankle joint and Pilon fracture surgery in a hospital between June 2005 to May 2013 were sur-veyed retrospectively,risk factors for SSI were analyzed.Results Among 356 patients with ankle joint and Pilon fracture surgery,22 developed 25 times of SSI,SSI rate was 6.18%,case infection rate was 7.02%.Univariate analysis showed that elderly patients (> 60 years old),history of diabetes,pre-operative calcaneal traction, perioperative irrational antimicrobial use,incision type,and long duration of operation (>3 h)were risk factors for SSI following ankle joint and Pilon fracture surgery (all P <0.05).Multivariate logistic regression analysis showed that the independent risk factors for SSI were incision type(OR,3.58[95%CI ,3.24-12.07]),history of diabetes (OR,2.75[95%CI ,1 .54-4.75]),duration of operation(OR,2.15[95%CI ,1 .32-3.64]),and patients age(OR, 1 .68[95%CI ,1 .25-2.37]).Conclusion Occurrence of SSI following ankle joint and Pilon fracture surgery is related to multiple factors,corresponding prevention and control measures should be taken to reduce the occurrence of SSI.

Objective To systematically evaluate the clinical efficacy and safety of Danshen Chuanxiongqin Injection (DCI) in the treatment of angina pectoris. Methods Randomized controlled trials (RCTs) regarding DCI in the treatment of angina pectoris were searched in CNKI, VIP, Wanfang Database, CBM, PubMed, Embase and Cochrane Library by Feb. 2014. Two researchers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a meta-analysis was conducted with Review Manager 5.2 software. Results A total of 12 RCTs with 1145 participants were included. The meta-analysis indicated that the combined use of DCI and conventional treatment with western medicine was more effective in the outcomes of the total clinical effective rate [RR=1.27, 95%CI (1.19,1.35), P<0.000 01], the total effective rate of ECG [RR=1.34, 95%CI (1.23,1.46), P<0.000 01], and decrease of plasma viscosity [MD=-0.15, 95%CI (-0.25,-0.05), P=0.004] and fibrinogen [MD=-0.96, 95%CI (-1.14,-0.78), P<0.000 01]. And there were no adverse drug reaction reports. Conclusion Based on this systematic evaluation, DCI combined with conventional therapy is effective and relatively safe in treating angina pectoris, but it still needs larger samples, multi-center, and high quality RCT to verify.