The authors designed to separate, purify and determine the monosaccharide composition of the polysaccharide from Cordyceps militaris, and study its effect on reverse cholesterol transport in vivo by isotope tracing assay. Polysaccharides were separate and purify by ion exchange column Q-sepharose Fast Flow and size exclusion column Sephacryl S200HR; the molecular weight and monosaccharide composition of the polysaccharides were determined by high performance gel permeation chromatography and high performance liquid chromatography coming with pre-column derivation, respectively. Finally, three purified polysaccharides CMBW1, CMBW2 and CMYW1 were obtained, their total carbohydrate contents were 87%, 89%, 95%, respectively; their protein contents were 6.5%, 1.3%, 2.8%, respectively; their molecular weights were 772.1, 20.9, 13.2 kDa, respectively; CMBW1 was composed of mannose, glucosamine, rhamnose, glucuronic acid, glucose, galactose and arabinose with a molar ratio of 7.25: 0.17: 1.29: 0.23: 6.30: 11.08: 0.79; CMBW2 was composed of mannose, glucosamine, galactose and arabinose with a molar ratio of 2.40: 0.16: 2.92: 0.24; CMYW1 was composed of mannose, glucosamine, glucuronic acid and glucose with a molar ratio of 0.59: 0.57: 0.45: 25.61. Polysaccharide at 50 mg x kg(-1) could significantly improve the transport of 3H- cholesterol to blood and excretion from feces. All of the three purified polysaccharides CMBW1, CMBW2 and CMYW1 were heteropolysaccharide; and they could improve reverse cholesterol transport in vivo, the underlying mechanisms are being studied.
Animals ; Biological Transport ; drug effects ; Cholesterol ; metabolism ; Chromatography, High Pressure Liquid ; instrumentation ; methods ; Cordyceps ; chemistry ; Mice ; Monosaccharides ; analysis ; isolation & purification ; Polysaccharides ; chemistry ; isolation & purification ; pharmacology ; Tritium

Objective To evaluate the clinical application of our self-designed ultradistal locking tool in the intramedullary nailing for tibial fractures.Methods From January 2014 to May 2016,175 patients with tibial fracture were treated at our department.They were 119 men and 56 women,from 19 to 73 years of age (average,46.3 years).They were divided into 2 groups according to the different targeting devices used in the intramedullary nailing.Conventional locking tools were used in the 83 patients from January 2014 to January 2015 and our self-designed new ultradistal locking tools in the 92 patients from February 2015 to May 2016.The 2 groups were compared in terms of operation time,frequency of intraoperative fluoroscopy,and successful rate of one-time locking.Results There were no significant differences between the 2 groups in general clinical data(P ＞ 0.05),showing similarities of the 2 groups.The operation time(59.8 ±4.3 min),frequency of intraoperative fluoroscopy(11.0 ± 2.1 times),and rate of one-time successful locking[94.4％ (238/252)] in the ultradistal locking group were significantly better than those in the conventional locking group [73.6 ± 5.3 min,23.0 ± 3.8 times and 85.7％ (180/210),respectively] (P ＜ 0.05).Conclusions Our new ultradistal locking tools are superior to the conventional ones in that they lead to shorter operation time,less intraoperative fluoroscopy and higher successful rate of one-time locking.Additionally,the new locking tools are easy to handle and incur no extra costs.

Objective To explore the application of 3D-printing rapid prototyping in classification of acetabular fractures and education of young surgeons.Methods The data of 20 patients with acetabular fracture were reviewed in this study who had been treated between January and June 2016.Three junior orthopedic surgeons and 3 senior ones were chosen as observers.The conventional radiographs (X-ray films of the pelvis and acetabulum,CT scans and 3D reconstruction images of the pelvis) and 3D-printing rapid prototyping models of the 20 patients(1∶ 1) were randomly numbered.All the observers were asked to make Letournel-Judet classification of each radiograph and 3D-printing model independently in the first assessment.Four weeks later in the second assessment,all the observers were asked to make the same classifications after all the conventional radiographs and 3D-printing models were randomly numbered again.The kappa statistics was used to evaluate inter-and intra-observer agreements among the recorded results.Results At the first assessment,the inter-observer agreement was 0.887 and 0.962 respectively for conventional radiographs and 3D-printing models in senior surgeons while 0.659 and 0.849 in junior surgeons.The second assessment showed the intra-observer agreement was 0.906 for radiographs and 0.925 for 3D-printing models in senior surgeons while 0.696 and 0.849 in the junior ones.Conclusions Compared with conventional radiographs,since 3D-printing models can effectively enhance the reliability of acetabular fracture classification,they may be more helpful for young surgeons in understanding acetabular fractures.

OBJECTIVETo investigate the efficacy and safety of adding pravastatin (Pra) on top of standard therapy in non-ischemic heart failure patients.

METHODSA total of 61 patients hospitalized in our hospital from Jan 2005 to Jul 2006 were randomly divided into pravastatin group (Pra 20 mg/d on top of standard therapy, n = 30) and control group (standard therapy, n = 31) and followed 6 months. The changes on cardiac function, flow-mediated vasodilatation (FMD) of brachial artery, plasma TNF-alpha level, liver and kidney function were observed.

RESULTSIn Pra treated patients, FMD of brachial artery significantly increased after 3 months treatments and NYHA stage significantly improved, plasma BNP, TNF-alpha levels and left ventricular end-diastolic dimension significantly decreased, LVEF significantly increased significantly 6 months post therapy compared to baseline (all P < 0.01). In control group, the patients' NYHA stage also significantly improved (P < 0.05) and LVEF tended to be higher (P = 0.052) while FMD, plasma BNP and TNF-alpha levels remained unchanged at 6 months post therapy compared to baseline. In Pra group, the level of TC (P < 0.05) and LDL-C (P = 0.051) also significantly decreased while HDL-C remained unchanged 6 months post therapy. One patient in Pra group discontinued the study drug because of anaphylaxis. No event on liver and kidney dysfunction was noticed.

CONCLUSIONPravastatin was effective and safe in treating non-ischemic heart failure patients and can significantly improve left ventricular remodeling, endothelial and cardiac functions as well as reduce the levels of inflammatory factors.

Adult ; Female ; Heart Failure ; drug therapy ; etiology ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Pravastatin ; therapeutic use ; Ventricular Function, Left

OBJECTIVETo explore the therapeutic effects of arthroscopy for post-traumatic chronic wrist pain.

METHODSFrom February 2007 to June 2010, 12 patients with post-traumatic chronic wrist pain treated with arthroscopy were reviewed. Among the patients, 9 patients were male and 3 patients were female, ranging in age from 19 to 47 years, with a mean of 35.6 years. After physical examinations or MR abnormal findings, all the patients underwent wrist arthroscopic examination and treatment. Eight patients with tear in the central area of the triangular fibrocartilage complex (TFCC) underwent endoscopic partial resection. Two patients with relaxation of inter-carpal ligament after injury underwent radiofrequency shrinkage. One patient with distal radioulnar joint instability was treated with Kirschner fixation through distal radius and ulna in the neutral forearm rotation after clean-up of wrist joint, and also fixed with long arm cast immobilization for 6 weeks. One patient with ulnar impaction syndrome was treated with wrist clean, border modeling of triangular cartilage plate, partial resection of distal ulna.

RESULTSAll the patients were followed up with an average duration of 10 months. Modified Mayo wrist score were evaluated from preoperative mean of (51.67 +/- 15.27) ( 25 to 75 scores) to postoperative mean of (77.92 +/- 10.54) (65 to 95 scores). Eleven patients recovered to normal work.

CONCLUSIONArthroscopy is an effective method for patients with post-traumatic chronic wrist pain which can diagnosis and cure the injuries under arthroscopy.

Adult ; Arthroscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Pain ; surgery ; Wrist Injuries ; pathology ; surgery ; Wrist Joint ; pathology ; surgery ; Young Adult

OBJECTIVETo study the clinicopathologic features of uterine papillary serous carcinoma (UPSC) and the roles of adjuvant therapy.

METHODSSixty-one cases of UPSC with operation done and followed up for a period of 4 to 9 years were enrolled into the study. The histology of slides specimens were reviewed and immunohistochemical study was performed. The follow-up and survival data were analyzed.

RESULTSAll of the 61 patients were post-menopausal, with a median age of 68 years. The clinical presentations included abnormal vaginal bleeding, abdominal symptoms and abnormal Pap smears. The median size of the tumors was 7.5 cm (range=1.2 to 14.8 cm). There were 27.9% cases in FIGO stage I (8.2% in stage IA, 14.8% in stage IB and 4.9% in stage IC), 9.8% in stage II, 32.8% in stage III and 29.5% in FIGO stage IV. The histologic features were similar to those of the ovarian counterpart, with tumor cells containing the high-grade nuclei and arranged in complex papillae. Psammoma bodies were identified in 24.6% of the cases. Immunohistochemical study showed that the tumor cells demonstrated diffuse and strong nuclear staining for p53 and Ki-67. They were negative for estrogen receptor and progesterone receptor. Fifteen of the 61 cases (24.6%) showed no evidence of myometrial invasion. However, ten of the 15 cases had extrauterine disease, with peritoneal (6/15) and nodal (9/15) involvement. Tumors with deep myometrial invasion, lymphovascular permeation and nodal metastasis were associated with worse prognosis by univariate analysis. Fifty-six patients received adjuvant therapy. The number of patients receiving adjuvant chemotherapy alone, adjuvant radiotherapy alone and combined adjuvant chemotherapy/radiotherapy were 42, 24 and 10, respectively. The median survivals of the chemotherapy group and non-chemotherapy group (with or without radiotherapy) were 66.4 months and 32.8 months, respectively.

CONCLUSIONSUPSC has distinctive clinical and pathologic features. The tumor stage, lymph node status, lymphovascular permeation and depth of myometrial invasion were important prognostic factors. Adjuvant chemotherapy for stage III/IV tumors or recurrent UPSC may have survival benefit.

Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Papillary ; drug therapy ; pathology ; radiotherapy ; surgery ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Cystadenocarcinoma, Serous ; drug therapy ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Menopause ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Paclitaxel ; administration & dosage ; Radiotherapy, Adjuvant ; Survival Rate ; Uterine Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery

OBJECTIVETo evaluate the clinical efficacy of implanted biliary metallic stents in the management of malignant obstructive jaundice (MOJ).

METHODSPercutaneous transhepatic cholangiography and stent insertion were performed in 241 consecutive patients to treat malignant biliary obstruction between December 1998 and February 2009. The study end point was patient death. All patients were followed-up until death or until February 2010. The therapeutic efficacy was determined by statistical analysis of life span and pre- and post-operative laboratory indices.

RESULTSAll 241 patients were successfully stented. The level of bilirubin descended obviously within four weeks of implantation (P less than 0.05), and the early mortality rate was 4.56% (11/241). Two-hundred-and-two patients were followed-up (range: 8-193 weeks post-transplantation) and showed a median survival of 43.55 weeks. The survival rates at 13, 26, 39 and 52 weeks post-transplantation were 87%, 66%, 56%, and 41%, respectively. The stent patency rates at 13, 26, 39 and 52 weeks post-transplantation were 70%, 46%, 36% and 24%, respectively; the mean stent patency was 27.57 weeks. Cox regression analysis identified the strong predictors of improved survival as an initial bilirubin level of less than 221 mumol/L (P = 0.01) and a stent-induced bilirubin reduction of more than 50% (P = 0.002).

CONCLUSIONTranshepatic metallic biliary stenting is a safe and effective therapeutic intervention for malignant biliary obstruction. Significant periods of survival and palliation of jaundice can be achieved with this method. Hyperbilirubinemia and a stent-induced bilirubin reduction of less than 50% are independent predictive factors for the survival of MOJ patients.

Adult ; Aged ; Aged, 80 and over ; Biliary Tract Surgical Procedures ; Bilirubin ; metabolism ; Female ; Humans ; Jaundice, Obstructive ; surgery ; Male ; Metals ; Middle Aged ; Stents ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the expression of annexin I in esophageal squamous cell carcinoma (SCC) and carcinomas of other histological types in order to analyze the correlation between the expression of annexin I and carcinogenesis.

METHODSFirst, a set of tissue microarray was established, which consisted of SCC from the esophagus (208 cases), lung, larynx, cervix, and external genital organs; adenocarcinomas from the lung, stomach, colon and rectum, liver, pancreas, breast, thyroid and kidney with 30 cases in each group, meanwhile, the corresponding normal tissue was also obtained for control. Immunohistochemistry was used to detect the expression of annexin I in different types of carcinomas and the corresponding normal controls from different organs. The correlation between the expression of annexin I and the clinicopathological feature was analyzed and compared, which included age, gender, differentiation grade and lymph node metastasis.

RESULTSIt was found that the expression of annexin I was decreased in esophageal SCC, when compared with normal esophageal squamous epithelia (P < 0.001), the similarity was also found in SCC of the lung, larynx and cervix. However, though negative in normal epidermis, annexin I expression was detected in some cases with SCC from external genital organs. Annexin I was found to be overexpressed in adenocarcinomas of the lung, stomach, colon and rectum, liver, pancreas, breast, thyroid and kidney, particularly very strong expression of annexin I was seen in lung adenocarcinoma, uterine endometrioid adenocarcinoma and ovarian serous adenocarcinoma. Interestingly, it was found to be positive in all thyroid papillary carcinomas, but negative in all normal thyroid glands. However, annexin I expression was found to be negative in all hepatocellular carcinoma and normal hepatocytes; and it was only detected in myoepithelium of normal breast tissue, but not in ductal luminal cells, and rarely in infiltrating ductal adenocarcinoma. In SCC, annexin I expression was stronger in well differentiated ones than that in the poorly differentiated ones. However, contrasting with SCC, in the adenocarcinomas from different organs, annexin I expression was much stronger in poorly differentiated ones than that in the well differentiate ones, especially in the adenocarcinomas from stomach, colon and rectum, pancreas, ovarian and kidney.

CONCLUSIONAnnexin I expression is quite different among different types of carcinomas, and is correlated with histopathological type and differentiation grade. Further study is needed to investigate its role in the carcinogenesis.

Adenocarcinoma ; metabolism ; pathology ; Annexin A1 ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Differentiation ; Endometrial Neoplasms ; metabolism ; pathology ; Epithelium ; metabolism ; Esophageal Neoplasms ; metabolism ; pathology ; Esophagus ; metabolism ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology

Objective:To evaluate short-term clinical efficacy of femoral neck system (FNS) for treatment of femoral neck fractures in young and middle-aged patients.Methods:A retrospective analysis was conducted of the 70 middle-aged and young patients who had been surgically treated for femoral neck fractures at Department of Trauma Orthopaedics, Honghui Hospital from January to November 2020. Of them, 32 cases were fixated by FNS; they were 16 males and 16 females, with an age of (49.4±11.0) years, including 10 cases of type Ⅱ, 12 cases of type Ⅲ and 10 cases of type Ⅳ by the Garden classification. The other 38 patients were fixated by cannulated compression screws (CCS); they were 19 males and 19 females, with an age of (48.8±10.1) years, including 12 cases of type Ⅱ, 15 cases of type Ⅲ and 11 cases of type Ⅳ by the Garden classification. The 2 groups were compared in terms of operation time, intraoperative blood loss, fracture reduction, fracture union time, weight-bearing time, complications, Barthel index at 3 months after surgery, and hip function at 6 months after surgery.Results:There was no statistically significant difference in preoperative general information or follow-up time between the 2 groups, showing comparability between groups ( P>0.05). There was no significant difference in operation time, intraoperative blood loss or fracture reduction quality between the 2 groups ( P>0.05). In the FNS group, weight-bearing time [(11.4±3.4) weeks] and fracture healing time [(3.1±0.9) months] were significantly shorter than those in the CCS group [(16.4±3.9) weeks and (3.6±0.9) months], rate of complications (12.5%, 4/32) was significantly lower than that in the CCS group (34.2%, 13/38), Barthel index at 3 months after operation (98.1±2.8) and Harris hip score at 6 months after operation (96.8±4.0) were significantly higher than those in the CCS group (93.8±4.1 and 93.6±6.7) ( P<0.05). Conclusion:In the treatment of femoral neck fractures in young and middle-aged patients, compared with CCS fixation, FNS fixation can obtain better short-term curative effects, due to its advantages of shorter bone union and weight-bearing time, a decreased rate of complications and early functional recovery of daily activities.

Objective:To observe multiple locus variable-number tandem repeat analysis (MLVA) typing of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province, and to explore the relationship between the strains and strains previous isolated from Qinghai Province. Methods:Blood samples of Himalayan marmot were collected in Qinghai-Tibet Plateau of Qinghai Province from March 2019 to October 2020. Pathogens were isolated and cultured from Brucella antibody positive samples identified by using the rose bengal test (RBT). Conventional biological methods and molecular biological methods (BCSP31-PCR and AMOS-PCR) were used for strain identification. At the same time, MLVA method was used to genotype the isolated strains, and cluster analysis was used to analyze the genetic relationships between the strains based on the genotype of 70 Brucella isolated from different hosts in Qinghai Province. Results:A total of 1 466 blood samples of Himalayan marmot were collected from Qinghai-Tibet Plateau. Two strains of Brucella were isolated and cultured from 64 RBT-positive samples, named QH2013054 and QH2013062, respectively. They were identified as Brucella ovis biotype Ⅲ by conventional and molecular biological methods. The MLVA genotyping results showed that QH2013054 and QH2013062 were different at the Bru16 locus, indicating different MLVA genotypes. Cluster analysis showed that strain QH2013054 had the same MLVA genotype as 7 strains, among which 6 strains were from 3 farmers and 3 sheep from the same family in Gonghe County, and 1 strain was from a farmer in Menyuan Hui Autonomous County. The strain QH2013062 had the same MLVA genotype as 4 strains, including 3 strains from 3 farmers in Menyuan Hui Autonomous County and 1 strain from a farmer in Tu Autonomous County of Huzhu. Conclusions:The strains of Brucella isolated from Himalayan marmot in Qinghai-Tibet Plateau of Qinghai Province have the same MLVA genotype as some strains of Brucella isolated from humans and sheep in Qinghai Province. It is speculated that the host humans, sheep and Himalayan marmot in Qinghai-Tibet Plateau may have a common source of infection.