Adenocarcinoma ; surgery ; therapy ; Combined Modality Therapy ; Humans ; Pancreatic Neoplasms ; surgery ; therapy ; Practice Guidelines as Topic ; Prognosis

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

Multi-stage countercurrent extraction technology, integrating solvent extraction, repercolation with dynamic and countercurrent extraction, is a novel extraction technology for the traditional Chinese medicine. This solvent-saving, energy-saving and high-extraction-efficiency technology can at the most drive active compounds to diffuse from the herbal materials into the solvent stage by stage by creating concentration differences between the herbal materials and the solvents. This paper reviewed the basic principle, the influence factors and the research progress and trends of the equipments and the application of the multi-stage countercurrent extraction.
Countercurrent Distribution ; methods ; Drugs, Chinese Herbal ; isolation & purification ; Particle Size ; Plants, Medicinal ; chemistry ; Solvents ; chemistry ; Technology, Pharmaceutical ; instrumentation ; methods ; Temperature ; Time Factors

OBJECTIVETo screen the differential expression gene profile in nasal mucosa of seasonal allergic rhinitis (SAR) and SAR with asthma, oligonucleotide microarray (Affymetrix HG-U133-plus2) was employed to analyze the changes of gene expressions with GeneSpring software.

METHODSInferior turbinate mucosa was obtained from five SAR patients and four SAR with asthma patients. Total RNA was extracted from the nasal mucosal biopsies and pooled into one SAR control pool and one SAR with asthma patient pool, and biotin-labeled cRNA probes were hybridized with Affymetrix HG-U133-plus2 array. The hybridization results were confirmed by RT-PCR analysis. The analysis of differential expression profiles were performed by GeneSpring software 7.3.

RESULTSOut of 47,000 analysed transcripts, 1,900 genes were differentially expressed at least 2-fold in which 849 genes were up-regulated and 1,051 genes were down-regulated in nasal mucosa of SAR with asthma patients compared with that in SAR patients. These genes were involved in cell metabolism, gene transcription, cell proliferation, signal transduction, immune response, enzyme activity, transmembrane receptor activity, cytoskeletal protein binding, and many other aspects. Pathway analysis displayed 161 groups, of which including more than 20 genes were as follow: cytokine-cytokine receptor interaction, focal adhesion, cell adhesion molecules (CAMs), regulation of actin cytoskeleton, cell communication, gap junction, MAPK signaling pathway, calcium signaling pathway, leukocyte transendothelial migration, and purine metabolism.

CONCLUSIONSThe data suggested that multigentic expression and regulation changes were involved in the development of SAR and SAR complicated with asthma, whose molecular mechanisms might be elucidated by identification of these differential genes.

Adolescent ; Adult ; Asthma ; complications ; genetics ; Female ; Gene Expression Profiling ; Gene Expression Regulation ; Humans ; Nasal Mucosa ; metabolism ; Oligonucleotide Array Sequence Analysis ; Rhinitis, Allergic, Seasonal ; complications ; genetics ; Young Adult

BACKGROUNDAdvanced glycation end products (AGEs) play a critical role in the development of diabetic nephropathy. Reactive oxygen species (ROS) may play a critical role in AGEs induced growth factor expression. In this study, the effects of AGEs on transforming growth factor beta1 (TGF-beta1), connective tissue growth factor (CTGF) and fibronectin (Fn) mRNA expression and oxidative stress in cultured NRK-49F cells were examined.

METHODSNRK-49F cells were incubated with medium containing different doses of AGEs (50, 100 or 200 microg/ml) for 24 hours, or with AGEs 100 microg/ml for different times (0, 12, 24 or 48 hours). Cells in the serum-free medium or medium containing 25 mmol/L glucose were controls. Cells were treated with 25 mmol/L glucose and 100 microg/ml AGEs for 24 hours to determine the effects between AGEs and glucose. We clarified the role of antioxidant by pretreating cells with N-acetylcysteine (10 mmol/L), ginkgo biloba extract (50 or 100 mg/L) for 24 hours and with 100 microg/ml AGEs for further 24 hours. Alamarblue dye assay was used to analyze cell growth; intracellular ROS generation was measured by flow cytometry; intracellular glutathione by fluorescence spectrophotometry; expressions of TGF-beta1, CTGF and Fn mRNA by semiquantitative RT-PCR.

RESULTSAGEs significantly increased the expressions of TGF-beta1, CTGF, Fn mRNA and intracellular ROS generation, and decreased the glutathion level in NRK-49F cells in dose- and time-dependent manners. High glucose and AGEs together significantly increased the expression of TGF-beta1, CTGF and Fn mRNA, compared with AGEs and high glucose separately. Preincubation with N-acetylcysteine or ginkgo biloba extract increased GSH level, suppressed AGEs-induced oxidative stress and TGF-beta1, CTGF and Fn mRNA overexpression.

CONCLUSIONSAGEs can significantly increase expression of TGF-beta1, CTGF, Fn mRNA in NRK-49F cells through enhancement of oxidative stress. The accumulation of AGEs may play a pivotal role in the pathogenesis of tubulointerstitial fibrosis in diabetic nephropathy. Suppression of AGEs induced TGF-beta1, CTGF and Fn mRNA overexpression in renal fibroblasts through inhibition of oxidative stress may be a mechanism underlying effect of ginkgo biloba extract in diabetic nephropathy. In addition, antioxidant therapy may help prevent AGEs accumulation and its induced damage.

Antioxidants ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Connective Tissue Growth Factor ; Diabetic Nephropathies ; etiology ; Fibronectins ; genetics ; Fibrosis ; Glutathione ; analysis ; Glycation End Products, Advanced ; pharmacology ; Humans ; Immediate-Early Proteins ; Intercellular Signaling Peptides and Proteins ; Kidney ; drug effects ; metabolism ; pathology ; Oxidative Stress ; drug effects ; Transforming Growth Factor beta1 ; genetics

Objective:To evaluate the early clinical and radiographic outcome of scaphoid non unions treated with Acu-trak headless compression screw. Methods:From January 2008 to July 2011,21 patients with scaphoid non union were treated in our department. There were 18 males and 3 females with a mean age of (23.6±4.6) years;12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification,there were 10 cases with type D1,7 cases with type D2,3 cases with type D3,and 1 case with type D4. The mean time from injury to operation was (12.4±2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation,15 cases received 1 screw fixation,and Matti-Russe bone grafting was applied in 7 cases). The carpal height,the scaphoid index and changes of the scapholunate an-gle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE). Results:Average duration of follow up was (21.3±3.6) months. All the patients attained radiological union in a mean time of (13.3±2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61±0.13 and the pre-operative mean scapholunate angle of (59.4±6.8)° to be improved to 0.69±0.10 and(44.3±8.2)° postoperatively,respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 ±4.7 was improved to 76.1 ±5.2 postoperatively. All patients returned back to the original work ,the average time from surgery to work was (6.0±1.1) months. Conclusion:For scaphoid non unions,Acutrak headless compression screw fixation can provide anatomical reduction,provide satisfactory results with a high union rate,well return of function and minimal complica-tions in the early stage.

Objective To investigate the efficacy of antibiotic cement column combined with iliac bone graft in the treat-ment of open fracture with bone defect of distal femur.Methods From October 2014 to March 2021,16 patients of open frac-ture bone defect of distal femur were treated with antibiotic bone cement column and iliac bone graft,including 12 males and 4 females.The age ranged from 28 to 68 years old.There were 11 cases of traffic accident injury,5 cases of falling injury,3 cases as Gustilo type Ⅰ,5 cases as type Ⅱ and 8 cases as type Ⅲ A.AO classification was used:9 cases of C2 type and 7 cases of C3 type.The time from injury to final bone grafting ranged from 4 to 119 days.The length of bone defect ranged from 2 tol0 cm.Fractures healing time,complications and knee function Merchan score were recorded.Results All the 16 patients were fol-lowed up from 9 to 29 months.The incisions of 16 patients healed in one stage without postoperative infection,plate fracture,limb shortening and valgus and varus deformity.The healing time randed from 4 to 10 months.Knee joint function according to the Merchant scoring standard,showed that 8 cases were excellent,4 cases were good,3 cases were fair,and 1 case was poor.Conclusion The use of antibiotic bone cement column combined with iliac bone graft in the treatment of open and complex bone defects of distal femur is an effective surgical method to prevent infection,assist fracture reduction,increase fixation strength and significantly reduce the amount of bone grafting.

BACKGROUNDChronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Pulmonary rehabilitation (PR) is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China.

METHODS AND DESIGNA multicenter, randomized, controlled trial will be conducted. A total of 464 patients meeting the inclusion criteria will be enrolled into this study with 232 patients in each of the trial group and the control group. Based on patient education, patients in the trial group will receive pulmonary Daoyin and continue with their usual therapy for three months. In the control group, patients will continue with their usual therapy. The primary outcome measures are exercise capacity assessed by the six-minute walking distance test and lung function. Secondary outcomes include dyspnea and quality of life. Measurements will be taken at baseline (month 0) and after the study period (month 3).

DISCUSSIONIt is hypothesized that pulmonary Daoyin will have beneficial effects in improving exercise capacity and psychosocial function of patients with stable COPD, and will provide an alternative form of exercise training that is accessible for the large number of people with COPD.

TRIAL REGISTRATIONThis trial has been registered in ClinicalTrials.gov. The identifier is NCT01482000.

Adolescent ; Adult ; Aged ; Breathing Exercises ; China ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; rehabilitation ; therapy ; Research Design ; Young Adult

OBJECTIVETo compare the differentiation ability difference of hematopoietic, mesenchymal and endothelial potential between CD41⁺ cells derived from the mouse aorta-gonadmesonephros (AGM) region, yolk sac (YS) and embryonic circulating blood (CB).

METHODSCD41⁺ cells were sorted from AGM, YS and CB. The CD45 and c-kit expression were studied in CD41⁺ cells by flow cytometry. IL-3 and bone morphogenetic protein 4 (BMP-4) treatment together with semi solid culture were used to assess hematopoietic potential difference of CD41⁺ cells. Immunofluorescence staining of α-SMA was used to assess mesenchymal potential difference. The endothelial cell induction system was used to assess endothelial potential difference.

RESULTSThe proportions of CD45+ cells in CD41⁺ population were 51.9% (AGM), 45.8% (YS) and 22.2% (CB), respectively, while those of c-kit⁺ cells were 40.0% (AGM), 39.6% (YS) and 36.2% (CB), respectively. After stimulated by IL-3 factor, the number of total colonies increased in all three groups-derived CD41⁺ cells compared to that of unstimulated group[(14.1±1.9) vs (1.2±0.2), (32.4±1.1) vs (18.4±2.2) and (41.8±0.9) vs (10.4±1.8)], (P<0.01). After stimulated by BMP-4 factor, compared to unstimulated group, CFU-Mix colony number in CD41⁺ cells from AGM region and YS were significantly decreased[(0.5±0.6) vs (3.2±0.8), (1.3±0.7) vs (7.4±1.7)](P<0.01), but there was no difference in CB group[(2.5±0.5) vs (3.9±1.5)](P>0.01). The mesenchymal marker α-SMA was highly expressed in CD41⁺ cells from AGM region and YS, but lowly expressed in CD41⁺ cells from CB.

CONCLUSIONThere are some differences between CD41⁺ cells in AGM region, YS and CB on hematopoietic cell surface marker expression, hematopoietic colony formation with IL-3 and BMP-4 stimulation.

Animals ; Aorta ; cytology ; Bone Morphogenetic Protein 4 ; pharmacology ; Cell Differentiation ; Gonads ; cytology ; Interleukin-3 ; pharmacology ; Mesonephros ; cytology ; Mice ; Platelet Membrane Glycoprotein IIb ; metabolism ; Proto-Oncogene Proteins c-kit ; metabolism ; Yolk Sac ; cytology

OBJECTIVETo investigate the clinical effects of arthroscopic repair and arthroscopic-assisted small incision repair for the treatment of rotator cuff injury.

METHODSThe clinical data of 86 patients with rotator cuff injury from January 2012 to January 2015 were analyzed retrospectively. All the patients were divided into two groups: arthroscopic assisted small incision repair group(group A) and arthroscopic repair group(group B). There were 46 patients in group A, including 25 males and 21 females, with an average age of (52.8±7.8) years old. And there were 40 patients in group B, including 23 males and 17 females, with an average age of (53.2±9.5) years old. Several indexes such as shoulder joint activity, muscle strength and ASES, UCLA and VAS scores were examined before and after operation to compare therapeutic effects between these two groups.

RESULTSAll the patients were followed up, and the mean time was 20.8 months (ranged, 18 to 35 months). The results of patients in group A as follows: range of abduction motion of shoulder joint was (131.4±18.8)°, external rotation was (64.9±8.8)°, and internal rotation was(63.7±7.3)°. Results of patients in group B as follows: range of abduction motion of shoulder joint was(132.3±16.9), external rotation was(65.1±9.4)°, and internal rotation was(64.4±8.1)°. All the patients had better shoulder mobility than those before operation, but there were no significant differences between two groups after operation. Postoperative scores of patients in group A: ASES was 88.4±8.9, UCLA score was 29.6±3.6, VAS was 1.4±0.3; and in group B, the above scores were 89.5±9.6, 30.8±4.1 and 1.3±0.4 respectively. All the patients had better scores than those before operation, but there were no significant differences between two groups after operation.

CONCLUSIONSArthroscopic repair and arthroscopic-assisted small incision for repair of rotator cuff injury has clinical curative effects to some extent, and these two methods could improve the safety and reliability of surgical treatment.