BACKGROUND: The treatment of large-segment bone defect has always been a major problem in clinical orthopedics. The treatment of large-segment bone defect is characterized by long treatment time, high difficulty and high cost. Therefore, it is of great clinical value and significance to study the treatment of large-segment bone defect. OBJECTIVE: To review the current methods of repairing large-segment bone defect and their advantages and disadvantages. METHODS: PubMed, CNKI and Wanfang databases before April 2020 were retrieved by the first author with the keywords of “bone defect, bone repair, bone graft, intramedullary nail technology, Masquelet, bone transport, vascularized bone graft, bone tissue engineering” in English and Chinese, respectively. Forty eligible articles were included to systematically summarize the repair methods and their advantages and disadvantages in the treatment of large-segment bone defect. RESULTS AND CONCLUSION: (1) Currently, the scope of large bone defects is not clearly defined. In clinical practice, long bone defects with poor healing ability and difficult healing by traditional fixation and autogenous bone graft can be regarded as large-segment bone defect according to experience. (2) There are many repair methods, and different methods can play their unique advantages in the treatment process. However, the disadvantages and related complications of different methods should be paid attention to when choosing the treatment method, so as to improve the bone healing rate. (3) It is still necessary to improve and standardize the existing treatment technology of large-segment bone defect to obtain a more satisfactory treatment effect.

Objective To study the clinical effects of tearing pediatric diarrhea with traditional Chinese and western medicine.Methods Altogether 520 patients with pediatric diarrhoea were recruited into three groups:the group treated with combined traditional Chinese and western medicine,the group treated with Chinese medicine and the group treated with western medicine.Observe clinical effects of each group.Results In 175 cases of the group treated with combined traditional Chinese and western medicine,66 cases show significant effects,64 cases are effective,45 eases are ineffective,and the effective rate is 74.30%;In 171 cases of the group of treated with traditional Chinese medicine,32 eases show significant effects,42 eases are effective,97 cases are ineffective,and the effective rate is 43.30%;In 174 eases of the group of treated with western medicine,35 eases show significant effects,43 eases are effective,96 eases are ineffective,and the effective rate is 44.80%.The effective rate of the group treated with combined Chinese medicine and western medicine was significantly better than the other two groups (P＜0.01).Conclusion Combined Chinese and western medicine is more effective in treating the patients with pediatric diarrhea,and it is worthy of spread.

Objective To discuss the experience of antegrade radical retropublic prostatectomy. Methods Thirty cases of prostate cancer were treated by antegrade radical retropublie prostateeto-my. The mean age of patients was 64 years. There were 8 cases of T_1, 15 cases of T_2, and 7 cases of T_3. The surgery included following procedures: Firstly the vesical neck was divided. Then the seminal vesicle and the prostate were freed from above downward. After the urethra was separated from the prostatic apex, the proximal end of urethra was sutured to the new vesical neck. Results All the 30 laparoscopic surgeries were accomplished successfully. The mean operative time was 2.5 hours. The mean blood loss was 350 ml in the operation. No ureteral injury, rectal injury and other severe compli-cation was observed. Histopathologic study showed prostate cancer for all the cases. Four cases had positive surgical margins. All cases were followed up from 6 to 48 months (average 25 months) with-out dysuria and permanent incontinence. No death occurred. Sexual function recovered in 7/13(54%) cases after the operation. Conclusions Antegrade radical retropublic prostatectomy provides low complication, tittle bleeding and positive surgical margins. It is an effective and sale procedure to treat prostate cancer.

Objective Vascular mild cognitive impairment(VaMCI) refers to mild cognitive impairment caused by or associated with vascular causes.This study aims to investigate the characteristics of the cognitive impairment in patients with vascular mild cognitive impairment (VaMCI).Methods Seventy-five patients with VaMCI(VaMCI group) and 38 healthy old subjects whose age, sex and education level match the VaMCI group patients(control group) were recruited from the department of Neurology, Beijing Chaoyang Hospital, Capital Medical University between Jan 2016 and June 2016.The neuropsychological examinations were used to evaluate the severity of cognitive impairment, specifically including the Minimum Mental State Examination(MMSE), Montreal cognitive assessment scale(MoCA), Clinical Dementia Rating(CDR), Activity of Daily Living Scale(ADL), Hachinski ischemic score table, Hamilton Depression Scale(HAMD) and Auditory Verbal Learning Test(AVLT).The Fazekas scale was used to assess the severity of white matter lesions, and the medial temporal lobe atrophy rating scale(MTA) was used to evaluate the atrophic severity of medial temporal lobe.Results The overall cognitive function score in VaMCI group was significantly lower than the control group [MMSE [25.7±2.3 vs 28.4±2.0] MoCA [22.8±3.9 vs 26.3±3.7]], the differences was statistically significant(P<0.05);as well as the AVLT-I [5.1±1.0 vs 8.9±1.9], AVLT-D [3.7±1.0 vs 9.8±1.5] and AVLT-R [7.6±1.9 vs 12±1.5] scores in VaMCI group was significantly lower than the control group, the differences was statistically significant(P<0.05), which suggested patients with VaMCI have overall cognitive impairment, especially memory impairment.But Fazekas and MTA scores in VaMCI groups were higher than the control group, the differences was statistically significant(P<0.05).Correlation analysis showed that the scale of medial temporal lobe atrophy had a negative relationship with the performance of MoCA (r=-0.434,P=0.002).Conclusion Our findings demonstrate patients with VaMCI have significant cognitive impairment, especially memory impairment, which may be correlated to the severity of the white matter lesions and the medial temporal lobe atrophy.

Objective To investigate telomerase activity in patients with psoriasis. Methods The telomerase activity in the skin lesions of patients was detected by TRAP (Telomeric repeat amplification protocol)——ELISA which is based upon PCR amplification of the initial telomerase product and detected by ELISA. Results Telomerase activity was detected in the lesions of psoriatic patients, but the level of it was lower in comparison with that in tissues of malignant tumor and K562 cell line. Conclusion These findings support that the increase of telomerase activity may be linked to the pathogenesis of psoriasis and that the telomerase activity can be detected not only in malignant tumors but also in nonmalignant skin diseases.

Retinitis pigmentosa (RP) is a large group of common hereditary eye diseases with highlyheterogeneous genetic background. Over forty genes with diverse functionalities are associated with RP and they include a set of ubiquitously expressed genes. These include five genes involved in the precursor messenger RNA( premRNA) splicing. Recent progress in disease gene identification for RP has established the involvement of pre-mRNA splicing as one important mechanism in the disease etiology and has shed light on the splicing process itself, a fundamental biological process. To this date, studies in this field have been focused on two major issues. First, how do the mutations of the adRP associated splicing factors (adRP-SF) affect the splicing function? Second, how do the mutations in these ubiquitously expressed genes lead to specific retinopathy? The two topics fit with the two continuous important steps of the disease pathogenesis. Recently, researchers have made a dramatic progress in the first topic. The identification of the SNRNP200 gene,the fifth adRP-SF and its relevant functional study has shown significance to the progress in the study of RP. Numerous investigations are also being carried out in addressing the second issue.Generation of a variety of models led to a better description of the pathological process of the disease. However, in respect to the key pathogenic mechanism,researchers are still puzzled with a number of confusing questions. In this commentary,the results from the latest investigations were summarized, and in particular,the difficulties in studying the molecular mechanism by which the pre-mRNA splicing deficiency causes RP were detailed.

BACKGROUND:Staphylococcal infections and its biofilm formation can occur when orthopedic implants or wound is healing, and are regulated by bacterial population sensing mechanism. RNAIII inhibiting peptide intervenes the quorum-sensing system of staphylococcal and blocks the signal transduction among staphylococcal cells, and inhibits staphylococcal biofilm formation, and then prevents staphylococcal infections.
OBJECTIVE:To investigate the influence of RNAIII inhibiting peptide on the adhesion of staphylococcus epidermis to the Hela cells.
METHODS:The Hela cells were cultured in vitro. There were four groups in this study. In the blank group, saline with dimethyl sulfoxide was added in each wel . In the RNAIII inhibiting peptide group, dimethyl sulfoxide solution containing RNAIII inhibiting peptide was added. In the levofloxacin group, levofloxacin was added. In the combination group, the dose was in accordance with above methods. Using intergroup control method, the adhesion of staphylococcus epidermis to the Hela cells was compared under the effects of saline, RNAIII inhibiting peptide and levofloxacin and their combination.
RESULTS AND CONCLUSION:In the blank group, abundant bacterial adhered to Hela cells. The number of adhered bacteria was significantly lower in each medicine group than in the blank group (P<0.001). The spot count was significantly lower in the levofloxacin group than in the RNAIII inhibiting peptide group (P<0.05). In the combination group, the number of bacteria adhered to Hela cells was decreased (P<0.01). Results verified that RNAIII inhibiting peptide effectively suppressed the adhesion of staphylococcus epidermis to the host cells, and showed synergistic effects on antibiotics.

Chinese materia medica (CMM) has double complexity in bioactive ingredient and its mechanism. It is difficult to explain by the modern biomedicine theory So it seriously restricts the modernization of CMM The modern CMM should have the high quality standard to meet the needs of international standard It can be guaranteed by spreading the GAP for Chinese medicinal materials and GMP for standard production The mechanism depends on using the DNA microarray to set up “the gene expression difference chart”, to study on the combination of CMM and gene expression difference chart Meanwhile, we can establish a totally new method of screening modern CMM based on the gene expression difference chart, it can really make the modernization and internationalization of CMM

BACKGROUND:It has been known that there exists a close relationship between leptin and obesity.Then,how are serum leptin and insulin related to obesity-related hypertension(ORH)? OBJECTIVE:To study the changes of serum leptin and insulin in elderly men with ORH,and investigate the relationship between leptin resistance and ORH in elderly men. DESIGN: Retrospective controlled study based on diagnosis. SETTINGS:The Department of Neurology and the Department of Nuclear Medicine,Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS: Altogether 62 elderly male inpatients or outpatients aged from 60 to 82 years in the Affiliated Union Hospital of Tongji Medical College from October 2001 to June 2002 were selected.The diagnosis of hypertension was based on the diagnostic criteria established by the WHO in 1999:systolic blood pressure(SBP) ≥ 140 mm Hg(1 mm Hg=0.133 kPa) and(or) diastolic blood pressure(DBP) ≥ 90 mm Hg. INTERVENTIONS:The content of serum leptin and insulin in 41 hypertensive and 21 normotensive elderly men was determined by the method of radioimmunoassay. MAIN OUTCOME MEASURES:Blood pressure,body mass index (BMI),serum leptin and insulin level. RESULTS:The content of serum leptin and insulin in the hypertensive obese men were increased significantly by 1.8 μ g/L and 2.7 mIU/L,respectively,as compared with that in the normotensives (t=2.212,2.395,P< 0.01). The level of serum leptin and insulin in the ORH patients was increased by 2.7 μ g/L and 4.7 mIU/L,respectively,as compared with that of the normotensives with significant differences (t=3.348,5.113,all P< 0.001). The level of serum leptin in the hypertensive patients older than 70 years was significantly increased by 1.7 μ g/L compared with that of those aged 60 to 70 years(t=2.767,P< 0.05). CONCLUSION:Resistance to leptin and insulin exists in obesity-related hypertension of elderly men and leptin is closely associated with obesity-related hypertension.

Objective To study expression and significance of keratin 17 and 19 in psoriatic lesion.Method The expression of keratin 17 and 19 in 30 psoriatic lesion and 10 normal skin was measured by immunohistochemistry method.Results The expression level of keratin 17 in the psoriatic lesion was higher than that in the normal skin,the expression level of keratin 19 in the psoriatic lesion was lower than that in the normal skin,there were significant differences in the expression of keratin 17 and 19 between them(P ＜0.05).The optical density level of keratin 17 in the psoriatic lesion was obviously raised compared with the normal skin(5.81 ± 1.42 vs.0,P＜ 0.01).The optical density level of keratin 19 in the psoriatic lesion was obviously decreased compared with the normal skin(0.49 ±0.03 vs.2.03± 1.08,P＜0.05).The optical density level of keratin 17 and 19 showed negative correlation in the psoriatic lesion(r =-0.479,P＜ 0.01).Conclusion Keratin 17 and 19 may play a role in the pathogenesis of psoriasis.