Objective To investigate the role of IFN-γ and FOXP3 expression in subpopulation distribution and functions of tumor-infiltrating lymphocytes (TILs) in the microenvironment of renal cell cancer.Methods 30 renal cell cancer tissue samples were freshly collected from the laparoscopic radical nephrectomy in the first hospital of Jiaxing.After frozen sectioning,immunofluorescent staining was conducted to detect the infiltrating CD4 positive and CDs positive cells,and the expression of FOXP3 and IFN-γ as well.In addition,TILs were isolated from the tumor tissues by density-gradient centrifugation.TILs from tumor center or tumor invasive edge were purified independently and measured for the mRNA levels of FOXP3 and IFN-γ by qRT (quantitative reverse transcription)-PCR.Results Tumor-infiltrating CD4+ and CD8+ T cells were concentrated in the invasive edge of renal cell cancer tissues.The expression of FOXP3 was found to be inversely related to that of IFN-γ from the immunofluorescent staining.The relative FOXP3 mRNA levels for the TILs from tumor center and invasive edge were 64.6 ± 9.4 and 36.2 ± 1.8,respectively,with significant difference(P ＜0.05).The relative IFN-γ mRNA levels were 631.8 ± 151.4 and 1 726.0 ± 344.1 (P ＜ 0.05).The trend of relative expression of FOXP3 was reversed in terms of IFN-γ.Conclusions The study on the renal cell cancer tissue samples suggested that the tumor-specific cytotoxic immune cells relatively concentrated in the tumor invasive edge.

OBJECTIVE: To determine the chlorpyrifos in human blood by liquid chromatography-tandem mass spectrometry and to validate its application in poisoning cases. METHODS: The samples were extracted by a simple one-step protein precipitation procedure. Chromatography was performed on a Capcell Pack C18 MGII column (250 mm x 2.0 mm, 5 μm) using an isocratic elution of solvent A (0.1% formic acid-water with 2 mmol/L ammonium acetate) and solvent B (methanol with 2 mmol/L ammonium acetate) at 5:95 V:V). RESULTS: The linear ranged from 5 to 500 ng/mL (r = 0.998 7). The limit of detection (LOD) and the lower limit of quantification (LLOQ) were 2 ng/mL and 4 ng/mL, respectively. For this method, the precision and accuracy of intra-day and inter-day were < 10% and 97.44%-101.10%, respectively. The results in stability test of long-term frozen were satisfied. The matrix effect, recovery and process efficiency were 64.97%-86.81%, 76.70%-85.52%, and 55.57%-66.58%, respectively. CONCLUSION This method can provide a rapid approach to chlorpyrifos extraction and determination in toxicological analysis of forensic and clinical treatment.
Chlorpyrifos/blood* ; Chromatography, High Pressure Liquid/methods* ; Chromatography, Liquid/methods* ; Humans ; Limit of Detection ; Poisoning ; Reproducibility of Results ; Tandem Mass Spectrometry/methods*

OBJECTIVE: To explore the change rules of peak area ratio of STR loci to Amelogenin (AMEL) locus (STR/AMEL), a sex-determining gene in DNA degradation, and to evaluate the application of STR/AMEL value in the estimation of DNA degradation degree. METHODS: DNA was extracted from iliopsoas, and the variations of STR/AMEL value (Penta E/AMEL, Penta D/AMEL, FGA/AMEL) were analyzed after the artificial degradation was made by DNase I, and the changes of these three ratios of the iliopsoas naturally degraded in an outdoor environment were also analyzed. The regression curves were analyzed using the periods of DNA degradation and outside the body as the independent variable (x) and the STR/AMEL value as the dependent variable (y) and three curve equations under two conditions were established. RESULTS: Both under the conditions of artificial and natural degradation, STR/AMEL value had a negative relationship with the degradation time. The relationship between STR/AMEL and degradation time can be well simulated by the cubic function. R2 was over 0.99 under controlled degradation condition and over 0.86 under natural degradation condition. CONCLUSION The STR/AMEL value (Penta E/AMEL, Penta D/AMEL, FGA/AMEL) is negatively related with the DNA degradation degree, which follows mathematical regression models strictly, and it might be applied to evaluate the DNA degradation degree.
Amelogenin/genetics* ; DNA Damage/genetics* ; DNA Primers ; Humans ; Microsatellite Repeats ; Regression Analysis ; Time Factors

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

Objective To determine risk factors in nosocomial infection of trauma patients during intensive care unit stay. Methods A retrospective study was carried out. A total of 1103 trauma patients admitted to the intensive care unit of five tertiary hospitals in Zhejiang Province in 2009 were reviewed. Demographic data, injury severity score and other variables related to the trauma services were collected. Univariate and multivariate analysis were processed to identify the independent risk factors of nosocomial infection in trauma patients during stay in intensive care unit. Results Overall, 171 patients( 15.5% )developed nosocomial infection during ICU stay. Of 1103 patients, 157 patients (14.2% ) died, and the 59 fatal patients were from infection group. The mortality rate in infection group was 34.7% , which was significantly higher than that in non - infection group (10.5% ). The independent risk factors of nosocomial infection in all the patients determined by using multivariate analysis included central venous monitoring, mechanical ventilation, age ≥65, the length of ICU stay > 14 days and injury severity score ≥ 16. For the severe trauma patients, central venous monitoring, mechanical ventilation, the length of ICU stay > 14 days were independent risk factors of nonsocomial infection. Conclusions The severity of injury, age, the length of ICU stay and invasive procedures were related to the nosocomial infection. To standardize the invasive procedures and to reduce the length of ICU stay may decrease the infection rate of trauma patients.

Ethyl glucuronide is a specific metabolite of ethanol. There have been plenty of articles referring its pharmacokinetics, detection and application as a specific bio-marker of alcohol intake. This article reviews various analytical methods of EtG, relationship between EtG quantification and ethanol intake, and criteria for determining chronic alcohol abuse, and origin of ethanol found in the cadavers by EtG analysis. EtG has its potential application in forensic toxicology.
Alcoholism/metabolism* ; Forensic Toxicology/methods* ; Glucuronates/urine* ; Hair/chemistry* ; Humans

This paper describes a new technique in the repair of the hand defect with digital extensor tendon injury. The anterolateral thigh flap with the thick femoral fascia has been used in the reconstruction of the composite defect of the dorsal hand, especially the defect of tendon. This technique requires short period of treatment and hence causes less damage to the donor site but shows a better recovery of the hand function. A favorable curative effect has been obtained in this patient.
Adult ; Contusions ; surgery ; Fingers ; surgery ; Free Tissue Flaps ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Tendons ; surgery ; Thigh

Focal Adhesion Protein-Tyrosine Kinases ; Humans ; Liver Diseases, Alcoholic ; enzymology ; pathology

OBJECTIVETo observe the efficacy of He-wei Jie-gu (Chinese characters) decoction on femoral intertrochanteric fractures after internal fixation in elderly.

METHODSFrom January 2010 to January 2012, 90 elderly patients with osteoporotic intertrochanteric fracture were randomly divided into two groups. The patients in experimental group were treated with open reduction and internal fixation, He-wei Jie-gu decoction and Caltrate D in oral, including 18 males and 27 females with an average age of (77.8±11.3) years old ranging from 65 to 89 years old;the time from injured to operation was 2 to 9 days with an average of (6.6±2.1) days; according to Evans-Jensen classification, 17 cases were in type I, 8 in type II, 15 in type III, 3 in type IV, 2 in type V. Meanwhile, the patients in control group were treated with open reduction and internal fixation, Caltrate D in oral, including 16 males and 29 females with an average age of (81.2±9.6) years old ranging from 67 to 91 years old; the time from injury to operation was 2 to 10 days with an average of (6.8±2.6) days; according to Evans-Jensen classification, 15 cases were in type I, 10 in type II, 14 in type III, 4 in type W, 2 in type V. The VAS score, hip BMD value before and after treatment, fracture healing and the Harris function score after operation were recorded and compared.

RESULTSAll patients were followed up from 3 to 9 months with an average of (5.6±2.8) months. Compared with the control group, the VAS score of the experimental group had an obviously reduction (F=98.138, P<0.01) after treatment; the hip BMD value at 3 months after treatment in the experimental group was higher than that of the control group (P<0.05); the fracture healing rate of the experimental group was higher than that of the control group (P<0.05); Harris score in 3 months of follow-up in the experimental group was higher than that of the control group (t=2.542, P<0.05); all the differences between two groups were statistically significant (P<0.05).

CONCLUSIONHe-wei Jie-gu decoction can reduce postoperative pain and increase bone mineral density after internal fixation of femoral intertrochanteric fracture in elderly, promote the fracture healing and functional recovery in the hip joint.

Aged ; Aged, 80 and over ; Bone Density ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Hip Fractures ; surgery ; Humans ; Male ; Osteoporotic Fractures ; drug therapy ; physiopathology ; surgery ; Pain, Postoperative ; drug therapy ; physiopathology

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.