Adult ; Arsenic Poisoning ; etiology ; Arsenicals ; Humans ; Male ; Skin ; injuries ; Skin Absorption ; Wounds and Injuries

Objective To discuss the clinical effects of treatment of femoral intertrochanteric fracture by DHS internal fixation. Methods 42 cases with femoral intertrochanteric fracture were treated by DHS internal fixation. According to AO classification, there were 16 cases of type A1,14 A2,and 12 A3. Results 36 patients were followed up for 6 to 18 months, with an average of 10 months. Their results were satisfactory. Conclusion Treatment of femoral intertrochanteric fractures with DHS internal fixation is an effective method.

Objective To investigate endometrium receptivity in patients with luteinized unruptured follicle(IUF)by measuring the expression of estrogen receptor(ER),progesterone receptor(PR)and integrin αVβ3 in the endometriunm Methods From May 2007 to Nov.2007,17 infertile women with LUF were selected as LUF group matched with 13 infertile cases with normal ovulation as control group.They all underwent frozen-thawed embryo transfer in Reproductive Medicine Center.Renmin Hospital of Wuhan University.Endometrial tissue in anterior and posterior wall of uterus of LUF group and control group were biopsied by a small curettage between 7 and 11 days after luteinizing hormone(LH)surge.The expression of ER,PR and integrin αVβ3 in endometriam were detected by immunohistochemistry staining.The level of estrogen and progesterone were measured by chemiluminescence assay.Then,the relationship between αVβ3 expression in endometrium and the level of estrogen/progesterone were analyzed in LUF patients.Results (1)There was no remarkable difference in the level of estrogen between LUF [(656±299)pmol/L]and control group[(727±275)pmol/L,P>0.05].However,the level of progesterone were(23±8)nmol/Lin LUF group and(35±10)nmol/L in control group,which reached statistical difference(P<0.01).(2) The expression of ER,PR in endometrium of LUF patients were 183.9±2.4 and 168±3.which were significantly higher than 109.4±6.3 and 106±4 in control group(P<0.01).The expression of integrin α Vβ3 in endometrium of 115±11 in LUF group were significantly lower than 191±9 in control group(P< 0.01).(4)In LUF group,the expression of αVβ3 in endometrium waft correlated positively with the level of progesterone(r=0.77,P<0.01)and irrelevant with the level of estrogen(r=0.01,P>0.05).Conclusion The higher expression of estrogen and progesterone and lower expression of integrin αVβ3 misht confer impaired receptivity of endometrium and interfere with embryo implantation.

Objective To investigate the distribution and drug resistance of pathogens isolated from urine culture in 2013 and provide basis for clinical treatment .Methods MicroScan WalkAway 96 PLUS bacterial identification system was used to identify the pathogens and drug susceptibility testing .The data were analyzed by WHONET 5 .6 software .Results A total of 231 strains of pathogens were isolated from urine cultures ,including 51(22 .1% ) strains of gram‐positive bacteria ,170(73 .6% ) strains of gram‐negative bacteria ,and 10(4 .3% ) strains of fungi;Escherichia coli ,the coagulase‐negative Staphylococcus ,Klebsiella pneumoniae and E .faecalis were ranked the top four species of pathogens ,accounting for 48 .9% ,13 .0% ,9 .5% ,5 .2% ,respectively .MRCNS among CNS were 73 .6% .Staphylococcus had 100 .00% sensitivity to vancomycin and linezolid ;the antimicrobial resistance rate of E .fae‐calis to ampicillin was 8 .3% .E .faecalis had 100 .00% sensitivity to vancomycin and linezolid .the detectable rates of Escherichia co‐li ,Klebsiella pneumoniae of ESBLs were 52 .2% and 50 .0% ,and the strains had 100 .00% sensitivity to imipenem and meropenem . Conclusion Escherichia coli is a major pathogen in urine culture ,Bacterial resistance is serious .

Objective:To evaluate the effect of the occlusal surface height of a mandibular posterior implant-supported single crown on stress in bone tissues.Methods:Three-dimensional finite element models of the implant-supported single crown replacing the missing right lower second premolar,mesial and distal natural teeth,periodontal membrane,alveolar bone,loaded rigid body and analog food of almond were established.Using the Federation Dentaire International (FDI)system,the first premolar, the second premolar and the first molar were represented with 44,45,46.Three occlusal surface heights of the crown were studied:(1 )normal height;(2)1 5 μm reduction in height;(3)30 μm reduction in height.The models were loaded by independent loading with maximal occlusal force(44 by 280 N,45 by 360 N,and 46 by 480 N)and average occlusal force(44 by 1 40 N,45 by 1 80 N,and 46 by 240 N)on the single crown;combined loading (maximal occlusal force transformed into uniform load of 3 .7 MPa on top of rigid body,in contact with points on the occlusal surface),and analog almond-like food loading (average occlusal force transformed into uniform load of 1 .67 MPa in simulated food chewing,in contact with points on the occlusal surface).Results:For maximal biting force under independent loading,Von Mises stress peak values in bone tissues around 44,45,and 46 were 82.57 MPa,45.26 MPa and 27.79 MPa;For average biting force,peak values were 41 .28 MPa,22.63 MPa and 1 3.89 MPa.Under com-bined loading,compared with the normal occlusal surface height group,Von Mises stress peak values de-creased 4.6 MPa,by 0.84%;increased 7.52 MPa,by 20.04%,and decreased 1 .8 MPa,by 5.84%, for 45,46,and 44 in the 30 μm infra-occlusion group,respectively.Under food loading,Von Mises stress peak values decreased 0.34 MPa,by 1 .62%;increased 1 .1 1 MPa,by 2.66%;and increased 0.06 MPa,by 0.54%,and for 45,46,and 44 in the 30 μm infra-occlusion group,respectively.Con-clusion:Within the limitation of this study,within 30 μm reduction of the occlusal surface height of im-plant-supported single crown,no significant difference of the peak values was observed.

Objective To investigate the drug resistance tendency of Klebsiella pneumoniae isolated from the clinical samples during 2012-2014 to provide reliable evidence for clinical treatment .Methods The Klebsiella pneumoniae strains isolated from the submitted specimens were collected and identified according to the national clinical test procedures ,and the drug sensitivity test was performed by using MIC method .The confirmation test of ESBLs was conducted by using K‐B method and the phenotype of carbap‐enemases producing was confirmed by using the improved Hodge test .Results Totally 410 strains of Klebsiella pneumoniae were i‐solated ,55 .87% of which were derived from sputum ,and the rest was derived from pus(9 .53% ) ,secretion(9 .47% ) and blood (8 .78% );Klebsiella pneumoniae was mainly originated from ICU ,respiration department and oncology department ,accounting for 16 .10% ,9 .02% and 7 .80% respectively ;the resistance rates of Klebsiella pneumoniae against imipenem was 0 .74% ,the resist‐ance rates of Klebsiella pneumoniae against ampicillin/sulbactam ,cafazolin ,cefepime ,cefotaxime ,cefatriaxone ,ceftazidine ,compound sulfamethoxazole were decreased year by year ,while which against amoxicillin/clavulanic acid showed the increasing trend as a whole .Conclusion Timely conducting the identification and drug susceptibility analysis on local Klebsiella pneumoniae and tracking its drug resistance trend can guide the rational and standardized use of antibacterial drugs ,reduces the pressure for selecting anti‐bacterial drugs in order to reduce the generation of drug resistant strains .

Objective To detect the expression of vascular endotheilal growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), and its receptor CXCR-4 in the retinopathy of diabetic rats, and to explore the relationship between those factors and diabetic-retinopathy(DR). Methods Diabetes was induced in 40 rats with a single intraperitional injection of streptozotocin(STZ). Experimental rats were randomly divided into M1 (diabetic for 1 month), M3 (diabetic for 3 months), and M5 (diabetic for 5 months) groups, and another 10 rats served as a normal control group (NC). Retinal vascular status was observed by transmission electron microscope. After retinal stretched preparation, VEGF, SDF-1α and CXCR-4 immunohistochemistry were done. Retinal VEGF, SDF-1α, and CXCR-4 mRNA were detected by semi-quantitative RT-PCR. Protein expression was measured by Western blot. Results Under transmission electron microscope, change in vascular status was found in M1 to M5 groups, but not in the NC group. The changes became increasingly serious with the prolongation of the disease. By immunohistochemistry, we found the expression of VEGF, SDF-1α, and CXCR-4 on the retina increased gradually. It increased after injecting STZ for 1 month and increased significantly after 5 months.VEGF, SDF-1α, and CXCR-4 mRNA expression increased obviously after injecting STZ for 1 month and increased significantly after 5 months. Western blot showed that protein of VEGF, SDF-1α, and CXCR-4 had no change after injecting STZ for 1 month. It began to increase in the M3 group and increased most in the M5 group. Conclusion The expression of VEGF, SDF-1α, and CXCR-4 on the retina in retinopathy of diabetic rats increases gradually with the prolongation of the disease. It is an important factor for diabetic retinopathy.

Objective To analyze the relationship between the JAK2V617F mutation and the expressions of phosphorylated Janus kinase 2 (p-JAK2), suppressor of cytokine signaling 1 (SOCS1), and SH2-containing protein tyrosine phosphatase 1 (SHP1) in JAK2V617F mutation positive myeloproliferative neoplasm (MPN) tissues, and to investigate the effects of JAK2 inhibitor ruxolitinib on regulating the proliferation of JAK2V617F mutation positive human erythroleukemia cell lines HEL and the expressions of SOCS1 and SHP1 in HEL cells. Methods A total of 48 patients with JAK2V617F mutation positive MPN (MPN group) and 24 patients with anemia (control group) in Hebei General Hospital and The First People’s Hospital of Baoding from Jul. 2012 to Aug. 2016 were enrolled in this study. The protein expressions of p-JAK2, SOCS1 and SHP1 in bone marrow biopsies (BMBs) were detected by immunohistochemistry. The correlations between JAK2V617F mutation level and the protein expressions of SOCS1 and SHP1 were analyzed by Spearman rank correlation analysis. HEL cells were treated with ruxolitinib at different concentrations (50, 100, 250, 500 and 1 000 nmol/L), and the viability of cells was determined by CCK-8 assay. The JAK2V617F mutation levels in MPN tissues and HEL cells and the mRNA expressions of JAK2, SOCS1 and SHP1 in HEL cells were detected by qPCR. The protein expressions of JAK2, SOCS1 and SHP1 in HEL cells were detected by Western blotting analysis. Results The ratio of JAK2V617F/JAK2 was (57.33±20.82)% in the MPN group and was zero in the control group. The protein expressions of p-JAK2, SOCS1 and SHP1 in BMBs of MPN patients were significantly different from those in the control group (all P0.01). The protein expressions of SOCS1 and SHP1 were negatively correlated with the mutation level of JAK2V617F (r＝－0.648, －0.692; P0.05). The expressions of SOCS1 and SHP1 in MPN patients with JAK2V617F/JAK250% were significantly higher than those in MPN patients with JAK2V617F/JAK2≥50% (P0.01), while the expression of p-JAK2 was significantly lower than that in MPN patients with JAK2V617F/JAK2≥50% (P0.01). After treatment with 250 nmol/L ruxolitinib for 24 h, 48 h, and 72 h, the viabilities of HEL cells were (60.06±3.87)%, (52.05±2.88)%, and (36.43±2.01)%, respectively. With the increase of ruxolitinib concentrations, the mRNA and protein expressions of JAK2 and the protein expression of p-JAK2 were gradually decreased (P0.01, P0.05), while the mRNA and protein expressions of SOCS1 and SHP1 were gradually increased (all P0.01). Conclusion Ruxolitinib can inhibit the expressions of JAK and the phosphorylation of JAK in HEL cells, enhance the expressions of SOCS1 and SHP1, and reduce the viability of HEL cells.

Objective To study the anatomic features of surface vasa vasorum on longissimus in thoracolumbar segments,and its protection function during the internal fixation for thoracolumbar fracture via Wiltse approach.Methods From March 2010 to October 2012,a total of 97 patients with thoracolumbar fractures underwent posterior internal fixation with pedicle screw system.The trend and distribution of surface vasa vasorum on longissimus in thoracolumbar segments were observed in the operation,and the vessels were protected during the surgical procedures by using specific devices and techniques.Operative time and intra-operative blood loss were recorded.Visual analogue scale (VAS) values were evaluated after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation.MRI images of longissimus in thoracolumbar segments were compared after preoperative and postoperative 6 months.Results Surface vasa vasorum distribution on 194 longissimus and 402 inter-pedicle areas of 97 patients were observed.In 402 areas,94.3％ of surface vasa vasorum presented sarciniform,while only 5.7％ of surface vasa vasorum presented tube shape.In 379 areas of sarciniform distribution,9.8％ of blood vessel bundles were located in vertebral pedicle area;76.0％ of blood vessel bundles were located in the upper inter-pedicle areas;12.4％ of blood vessel bundles were located in middle inter-pedicle areas;1.8％ of blood vessel bundles were located in lower inter-pedicle areas.In 379 areas,87.3％ of blood vessel bundles could be completely retained;12.7％ of blood vessel bundles were treated by electro coagulation and burning.Intra-operative blood loss was 21±9.3 ml.VAS values after 3 days,1 month,6 months postoperatively,and 1 month after the removal of internal fixation were 3.3± 1.6,2.1± 1.4,1.2±0.7 and 1.1±0.7.The longissimus treated with electro coagulation demonstrated pimelosis change on MRI after postoperative 6 months.Conclusion Surface vasa vasorum on longissimus in thoracolumbar segments are generally of sarciniform,and most of them are located in upper inter-pedicle areas.The protection of vasa vasorum can reduce the intra-operative lesion and postoperative pimelosis change of longissimus.

Objective: To analyze the risk factors of acute kidney injury (AKI) after isolated heart valve prosthesis implantation (HVPI) in relevant patients. Methods: We retrospectively studied 400 patients who received isolated HVPI in our hospital. The demographic characteristics and pre-, intra-, post-operative information were collected to conduct uni- and multi-variantanalysis. Results: The pre-operative serum creatinine level in 400 patients was 85.0 (72.0, 98.0) μmol/L and post-operative level was 104.5 (80.0, 146.3) μmol/L, the elevation was 20.9% (1.6%, 57.9%),P<0.05. Multi Logistic regression analysis indicated that age>50years (OR=2.12, 95% CI 1.13-3.95),hypertension history (OR=4.07, 95% CI1.23-13.47), cardiopulmonary bypass time>180 minutes (OR=5.38, 95% CI 1.63-17.77), post-operative hemoglobin<70 g/L (OR=0.20, 95% CI 0.06=0.74), serum glutamic-pyruvic transaminase>100 u/L (OR=12.10, 95% CI 2.28-64.23), pleural fluid drainage at the day of operation> 500 ml (OR=2.12, 95% CI 1.13-3.95), extubation after 24 hours of operation (OR=3.94, 95% CI 2.07-7.52), combining low cardiac output syndrome (OR=4.64, 95% CI 1.06-20.29) were the independent risk factors for AKI occurrence in patients after HVPI, allP<0.05. Conclusion: Post-HVPI AKI was associated with many factors. At prior operation, it was mainly related to the age and hypertension; during theoperation, it was mainly related to cardiopulmonary bypass time; at post-operation, it was mainly related to delayed extubation, low cardiac outputsyndrome, anemia, increased pleural lfuid drainage and serum glutamic-pyruvic transaminase.