Objective To discuss the clinical results of lateral locking plate combined with bone grafting in the treatment of distal femoral fractures in the elderly.Methods Between January 2006 and December 2013,112 senile patients with distal femoral fracture were treated at our department by lateral locking plate combined with bone grafting.They were 16 men and 96 women,aged from 67 to 85 years (average,76.1 years).By AO classification,48 cases were type 33-A1,11 type 33-A2,3 type 33-A3,7 type 33-B1,4 type 33-B2,32 type 33-C1,and 7 type 33-C2.All of them had a previous history of osteopenia.By the Singh index classification,22 cases were rated as grade Ⅰ,74 as grade Ⅱ,13 as grade Ⅲ,and 3 as grade Ⅳ.Postoperatively,the patients conformed to regular follow-up,accepted functional rehabilitation and continued medication for osteopenia.Radiographic examinations were conducted to observe fracture healing.At the last follow-up,the function of involved knee was assessed according to the criteria by Karlstrom and Olerud.Results All the 112 patients completed their follow-ups,ranging from 10 to 48 months (average,16 months).All fractures united primarily after an average of 4.2 months (range,from 3.5 to 5.0 months).According to the criteria by Karlstrom and Olerud,93 cases were rated as excellent,10 as good and 9 as fair,giving a good-to-excellent rate of 92.0％.No such complications as nonunion,malunion,plate breakage,or screw loosening were observed during the follow-ups.Conclusion Lateral locking plate combined with bone grafting is effective for the treatment of distal femoral fractures in the elderly,if followed by postoperative anti-osteopenia therapy and early functional exercises.

Objective To evaluate the safety and efficacy of intra-arterial infusion neoadiuvant chemotherapy in local advanced bladder cancer. Methods Nineteen cases with T2-T4a bladder cancer were enrolled in this study.Intra-arterial infusion chemotherapy with Gemcitabine and Cisplatin (GC)were performed for 1 to 3 cycles before radical cystectomy.Postoperative values of hematological parameters,maximum diameter of tumors,TNM(tumor,node and metastasis)stages and pathological grades were compared with preoperative parameters of the same case. Results Compared to the values before GC chemotherapy,WBC count showed no significant change post-operative,(6.63±2.58)×109/L vs(5.12±2.91)×109/L(P=0.13);RBC(4.41+0.52)×1012/L vs(3.92±0.42)×1012/L(P=0.00)and platelet count(220.50±59.86)×109/L vs(157.05±56.72)×109/L(P=0.001)showed significant decrease;ALT did not show significant decrease(20.00±8.31 vs 26.88±17.04 U/L,P=0.08);Creatltme also showed no significant change(95.82±14.57 vs 88.04±17.76μmol/L,P=0.06);Maximum diameter of tumors decreased significantly(3.72±1.23 vs 2.80±1.29 cm,P=0.02).Compared with clinical TNM stages,pathological TNM stages demonstrated significant decrease in 9 cases;While cell differentiation did not show decrease. Conclusions Intra-arterial infusion with GC regimen can reduce tumor size,decrease TNM stages,while not causing significant adverse impact to radical cystectomy.Bladder-spare treatment is an option for chemotherapy-sensitive cases.

OBJECTIVETo study the effect of peroxisome proliferator activated receptor γ (PPAR-γ) agonist on the angiotensin converting enzyme 2 (ACE2) mRNA expression in monocyte-derived macrophages of essential hypertensive patients.

METHODSTotally 57 essential hypertensive patients were randomly divided into three groups: conventional treatment group (n=18), telmisartan group (n=19), and benazepril group (n=20); 20 patients with normal blood pressure were also selected as the control group. Monocyte-derived macrophages were isolated from blood samples of patients in all four groups. The expression of ACE2 mRNA in monocyte-derived macrophages was detected by RT-PCR before treatment and 4 and 12 weeks after treatment.

RESULTSFour and 12 weeks after treatment, the systolic pressure and diastolic pressure of telmisartan group and benazepril group were significantly lower than that of the conventional treatment group (all P<0.01), and the systolic pressure and diastolic pressure of telmisartan group were significantly lower than that of the benazepril group(both P<0.01) .The expression of ACE2 mRNA in monocyte-derived macrophages were significantly lower in essential hypertensive patients than that in control group (P<0.01). After having been treated for 4 weeks and 12 weeks, the expression of ACE2 mRNA in monocyte-derived macrophages of hypertensive patients in telmisartan and benazepril groups were significantly higher than that in conventional treatment group (all P<0.01), and the expression of ACE2 mRNA in telmisartan group was significantly higher than that in benazepril group (both P<0.01).

CONCLUSIONPPAR-γ agonist could increase the ACE2 mRNA expression in monocyte-derived macrophages of essential hypertensive patients.

Aged ; Benzazepines ; pharmacology ; Benzimidazoles ; pharmacology ; Benzoates ; pharmacology ; Female ; Humans ; Hypertension ; drug therapy ; enzymology ; Macrophages ; enzymology ; Male ; Middle Aged ; PPAR gamma ; agonists ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; RNA, Messenger ; genetics

OBJECTIVETo explore the association of gene polymorphism of organophosphate insecticides (OPs) metabolic enzymes with intermediate myasthenia syndrome (IMS) following acute OPs poisoning.

METHODSThirty six of 147 acute OPs poisoning patients developed IMS one to four days after poisoning. Peripheral blood samples were collected from all the patients and whole blood cholinesterase (ChE) activity was determined by DTNB spectrometry. The genetic polymorphism of CYP2E1 (1091C-->T) and GSTP1 (313A-->G) were analyzed by polymerase chain reaction (PCR)-restrict fragment length polymorphism, CYP1A1 (4889A-->G), GSTM1 and GSTT1 by allele-specific PCR, and PON1 at 55 codon (55L-->M) by PCR-single strand conformation polymorphism.

RESULTSThe whole blood ChE activity in IMS patients was not significantly different from non-IMS patients at admission (38.22 +/- 17.56)% and (42.49 +/- 16.23)%, respectively, P > 0.05, but recovered much slower in IMS patients than that in non-IMS patients. The frequencies of heterozygote and variant homozygote of PON1 at 55 codon, GSTM1 null, and both GSTM1 and GSTT1 null were higher in IMS patients than those in non-IMS patients (P < 0.05), with odds ratios and their 95% confident intervals of 2.48 (1.06 - 5.78), 11.23 (2.95- 42.76), 2.53 (1.14 - 5.61) and 2.68 (1.20 - 5.97), respectively.

CONCLUSIONSPatients of OPs and its mixture poisoning with genotype of variant allele at 55 codon of PON1, GSTM1 null and both GSTM1 and GSTT1 null probably had higher risk for IMS.

Adult ; Cholinesterases ; metabolism ; Cytochrome P-450 CYP2E1 ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Glutathione Transferase ; genetics ; Homozygote ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Myasthenia Gravis ; chemically induced ; genetics ; Organophosphorus Compounds ; Point Mutation ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Syndrome

In order to construct a pichia pastoris expression vector containing the extracellular domain of human Jagged1 and the Fc fragment of human IgG1 fusion gene, or containing only the Fc fragment of human IgG1 and to express them in pichia pastoris. The extracellular domain of human Jagged1 gene was cloned from normal human bone marrow cells. After DNA sequencing, the extracellular domain of Jagged1 gene was inserted into pIC-Fc vector constructed previously, which is Pichia pastoris expression vector containing only the Fc fragment of human IgG1. The constructed plasmid was transformed into yeast GS115 by means of electroporation. The recombinant transformants with a high copy number of the plasmid were selected on MD plate with G418. The expression of protein was induced by addition of methanol. Then, protein expression was analyzed by SDS-PAGE. The results indicated that the extracellular domain of human Jagged1 gene was effectively amplified. The DNA sequencing result showed that the constructed plasmid containing hJagged1(ext)-Fc fusion gene was the same as designed. The fusion protein was successfully expressed in Pichia pastoris. It is concluded that the hJagged1(ext) gene has been successfully cloned and expressed, which provides a new fusion protein for further experiments, the hJagged1(ext)-Fc fusion protein can be used as a new stimulator for proliferation of hematopoietic stem/progenitor cells in vitro.
Calcium-Binding Proteins ; biosynthesis ; genetics ; Genetic Vectors ; genetics ; Humans ; Immunoglobulin Fc Fragments ; biosynthesis ; genetics ; Immunoglobulin G ; biosynthesis ; genetics ; Intercellular Signaling Peptides and Proteins ; biosynthesis ; genetics ; Jagged-1 Protein ; Membrane Proteins ; biosynthesis ; genetics ; Pichia ; genetics ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; Serrate-Jagged Proteins ; Transfection

OBJECTIVE: To evaluate the clinical efficacy of medicinal penetration on acupoint combined with medication for histiocytic necrotizing lymphadenitis (HNL) of heat-toxin syndrome, and to explore the methods of improving the clinical effect. METHODS: A total of 72 cases with HNL with heat-toxin syndrome were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with oral administration of prednisone tablets for 40 days (first 5 days: 10 mg, three times a day; since then, reduced by 5 mg every 7 days). In the observation group, on the basis of the medication in the control group, the patients were treated with acupoint application and ultrasonic drug penetration therapy, once a day for 14 days. The acupoints of Waiguan (TE 5), Fengchi (GB 20) of affected side and points were selected. The changes of target lymph node swelling, visual analogue score (VAS), axillary temperature and total score of symptoms and signs were evaluated before treatment and 7, 14, 28 and 40 d into treatment; the changes of white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and lactic dehydrogenase (LDH) were evaluated on 14 d and 40 d into treatment; the patients were followed-up for half a year. RESULTS: ① Fourteen days into treatment, the clinical cured rate in the observation group was 38.9% (14/36), which was superior to 16.7% (6/36) in the control group (<0.01); the clinical cured rates were both 100% in the two groups on 40 d into treatment. ② The VAS score, axillary temperature and the total score 7 d into treatment, as well as node swelling, VAS score, axillary temperature and the total score 14, 28 and 40 d into treatment in the two groups were significantly improved (<0.01); the total score and VAS score of 7 d into treatment, target lymph node swelling, VAS score and total score of 14 d into treatment in the observation group were significantly improved than those in the control group (<0.01). ③ Compared before treatment, WBC, CRP, ESR in the two groups were significantly improved 14 d and 40 d into treatment (<0.01), and LDH in the two groups were decreased 40 d into treatment (<0.01), but there was no significant difference between the two groups (>0.05). ④ The recurrence rate in the observation group was 5.6% (2/36), which was similar to 16.7% (6/36) in the control group (>0.05). CONCLUSION The medicinal penetration on acupoint as adjunctive treatment could effectively relieve the discomfort symptoms of HNL patients with syndrome of heat and toxin, improve the clinical cured rate, and provide the research direction for shortening the course of medication.
Acupuncture Points ; Acupuncture Therapy ; Histiocytic Necrotizing Lymphadenitis ; therapy ; Humans ; Medicine, Chinese Traditional ; Prednisone ; therapeutic use ; Treatment Outcome

OBJECTIVE: To compare the posterior cruciate ligament(PCL) index with six different measurement methods, and analyze and verify its clinical diagnostic value in anterior cruciate ligament (ACL) injury. METHODS: The Magnetic resonance imaging (MRI) data of 225 knee joints in our hospital from May 2018 to March 2022 were retrospectively analyzed, aged from 18 to 60 years old, with a median of 32 years old. On the sagittal MRI images of 114 patients with ACL injury and 111 patients with intact ACL, Measure the straight-line distance (A) between the femoral attachment point and the tibial attachment point of the PCL on the MRI sagittal image and the maximum vertical distance (B) between the straight line and the arcuate mark point of the PCL on the sagittal image, calculate the PCL index and evaluate the diagnostic value of the PCL index for ACL injury. RESULTS: The PCL index of the ACL normal group and the ACL injury group were statistically described. There was no significant difference in PCL index 1, 2, 3 and 6 between the two groups(P>0.05). The difference of PCL index 4 and 5 between the two groups was statistically significant (P<0.001). This study only found that the PCL index 2, 6 in the ACL normal group had a negative correlation with the patient's age (correlation coefficient=-0.213, -0.819;P<0.05), and the PCL index 5 in the ACL injury group was significantly correlated with the patient's body mass index(BMI)had a negative correlation (correlation coefficient=-0.277, P<0.05). CONCLUSION The change of PCL index is helpful for the diagnosis of ACL injury, PCL index 4 and 5 can be used as effective reference indexes for diagnosing ACL injury in clinic.
Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Posterior Cruciate Ligament/diagnostic imaging* ; Anterior Cruciate Ligament Injuries/diagnostic imaging* ; Anterior Cruciate Ligament ; Retrospective Studies ; Knee Joint ; Magnetic Resonance Imaging/methods*