Objective To evaluate more than 5-year follow-up outcome of avulsion fracture of the anterior cruciate ligament from the tibial insertion site in skeletally immature patients treated with modified arthroscopic internal fixation with cannulated screw and washer. Methods Thirty-nine patients with open physis were treated by modified arthroscopic internal fixation with cannulated screw and washer from March 2000 to November 2003. Regular X-ray plain films at AP and lateral views were conducted to detect the healing of avulsed fragments. Follow-up period of 31 patients was more than 5 years. Functional outcome before and after surgery was evaluated using the Lysholm Knee Score and the Tegner Activity Score. Angular deformity, or leg length discrepancy was assessed by clinical examination and anteroposterior-lateral radiographs of the knee. Instrumented knee laxity was performed using the KT-2000 arthrometer. Results Arthroscopic removal of implants was performed between 3 and 6 months postoperatively, when all fractures were revealed to have healed on X-ray films. No growth disturbance, angular deformation or knee instability was found in 31 patients during more than 5-year follow-up. The Lysholm score was improved from (19.2?14.8) (range 12-48) preoperatively to (98.5?3.1) (range 97-100) postoperatively, with significant statistical difference by the student-t test (t=18.395, P=0.000); The Tegner score was improved from (4.1?1.1) (range 3-5) preoperatively to (8.5?0.8) (range 7-9) postoperatively, with significant statistical difference by the student-t test (t=4.13, P=0.008). Physical examination showed Lachman test (+) in 14 of 31 patients. Instrumented knee laxity (KT-2000) showed manual-maximum side-to-side difference greater than 2 mm (range 2.1-3.8 mm) in 14 of 31 patients. Conclusion Modified arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament from the tibial insertion site with cannulated screw and washer in skeletally immature patients is a simple, safe, and effective ARIF procedure without growth disturbance.

Objective To construct a plasmid DNA encoding G glycoprotein of respiratory syncytial virus(RSV) and investigate the protective immune response against RSV infection. Methods Recombinant plasmid DNA of pcDNA3.1~G was constructed by standard RT-PCR based cloning procedure. The immunogenicity of recombinant G protein transiently expressed in HEK293 cells was detected by Western blot. BABL/c mice were intramuscularly immunized with pcDNA3.1~G. Samples of lung, sera, bronchoalveolar lavage fluid(BALF) were collected before and after RSV challenge; virus titer in lung was detected by viral titration; sections of paraffin embedding lung tissues were stained by haematoxylin and eosin(HE) for histological analyses; sera anti-RSV IgG levels were examined by ELISA; Th1/Th2 cytokine were detected by ELISA kit, the T lymphocyte subsets of BALF was determined by immunefluorescence staining followed by flow cytometry. Results Plasmid DNA of pcDNA3.1~G was successfully constructed. The expressed target protein possesses immunogenicity. After challenge, pcDNA3.1~G immunized mice presented relieved pathological changes in lung as well as reduced lung viral titers. The RSV specific IgG was detected in sera of immunized mice. There was significantly increased number of CD25~+CD4~+ T cells in mice BALF. Conclusion We constructed a pcDNA3.1~G plasmid DNA vaccination which can induce evident protective cellular immunity against RSV infection in mice with the increased number of CD25~+CD4~+ T cell subpopulation.

Objective: To systematically evaluate the effects of different forms of traditional Chinese health-preservation exercises on osteoporosis (OP) using network meta-analysis.Methods: A systematic search on Excerpta Medica Database (EMBASE), Springer Link, Allied and Complementary Medicine Database (AMED), PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang) and Chongqing VIP Database (CQVIP) targeted the randomized controlled trials (RCTs) studying traditional Chinese exercises for OP published up to January 2020. Cochrane handbook was adopted to estimate the publication bias in the included studies, and statistical analysis was performed using Stata 14.0 and GeMTC 0.14.3 when data were extracted. Results: Fifty RCTs were included in the network meta-analysis, comprising a total of 4505 OP patients. The network meta-analysis showed that in terms of visual analog scale (VAS) for pain, Tai Ji Quan (Tai Chi) was the most efficacious, followed by Yi Jin Jing (Sinew-transforming Qigong Exercises), Ba Duan Jin (Eight-sectioned Exercise), Wu Qin Xi (Five-animal Exercises), sports training, drug and blank control; in terms of bone mineral density (BMD) of femoral neck, Yi Jin Jing was the most efficacious, followed by Wu Qin Xi, Ba Duan Jin, Tai Ji Quan, sports training, blank control and drug; regarding the lumbar BMD, it was Yi Jin Jing, Tai Ji Quan, Ba Duan Jin, Wu Qin Xi, sports training, blank control and drug in the descending order of efficacy; in terms of serum alkaline phosphatase, it was Yi Jin Jing, Tai Ji Quan, sports training, Wu Qin Xi, Ba Duan Jin, drug and blank control in the descending order of efficacy. Conclusion: The evidence to date suggests that the first choice for OP amongst the traditional Chinese exercises should be Yi Jin Jing, which can not only reduce the subjective pain, but also promote bone formation and increase BMD, though this conclusion requires more high-quality large-scale RCTs for further proof.

Objective To discuss the significance of platelet rich plasma in promoting bFGF and VEGF expression in would healing of rabbit buns .Methods The 24 rabbits were randomly divided into control group and experimental group .The sulfadiazine silver paint to the wound for control group and the platelet rich plasma gel evenly spread to the wound for experimental group .At 7th ,10th ,14th day ,4 rabbits of each group were randomly selected to sacrificed after anesthesiaed ,wound healing rate was compare in 2 groups ,HE staining and testimmunohistochemistry were conducted in each group .Results At 7th ,10th ,14th day ,the wound healing rate of experimental group were higher than those of control group .At 7th d ,the focal granulation ,cells and vessels inten-sive were more significant in experimental group than in control group ,at 10th day ,the wound fibroblast cells and capillary number are more significant in experimental group ,and at 14th day ,the most of fibroblasts translate into fiber cell and the capillary number decreased ,the fibroblasts proliferation was still active and fiber cell was less in the control group .At 7th ,10th day ,the expression of bFGF and VEGF were both higher ,but experimental group is obvious higher than control group(P<0 .05) ,but at 14th day ,the ex-pression of bFGF and VEGF were gradually declined and was not obvious statistics differences in the two group (P>0 .05) .Conclu-sion The platelet rich plasma could promote the big white rabbit scald wound healing ,while the main mechanism maybe the ex-pression of bFGF and VEGF increased in the early .

Aim To study the absorption mechanism of apigenin-7-O-glucronide, 3,4-Dihydroxycinnamic acid and chlorogenic acid in Erigeron breviscapus extract ( Ebe) by Caco-2 cell monolayer model. Methods The three active ingredients were quantified by UPLC-MS/MS method, and the effect of Ebe concentrations, conveying times, pH values and P-glycoprotein inhibi-tor on the transport of three active ingredients were also investigated. Results Apigenin-7-O-glucronide and chlorogenic acid in Caco-2 cell monolayer model were time-dependent and concentration-dependent. The 3, 4-Dihydroxycinnamic acid in Caco-2 cell uptake was concentration-saturate and P-glycoprotein inhibitor was involved in the uptake process. Conclusion The mechanism of apigenin-7-O-glucronide and chlorogenic acid absorption in cells is mainly through passive trans-port, and the absorption of 3, 4-Dihydroxycinnamic acid is mainly realized by the carrier transport.

Objective To explore the effect of β-amyloid protein (Aβ) on S100β expression in rat hippocampus and its mechanisms. Methods At 7 days after bilateral stereotaxis injection of different dose of fibrillar Aβ 25-35 and interluekin-1 receptor antagonist (IL-1ra) into the rat CA1 region, the learning and memory abilities of rats were tested with passive avoidance task. Amyloid deposition was detected by using Congo red staining technique. Nissl staining and immunohistochemical techniques were used to analyze the number of neurons, and GFAP and the S100β expression in hippocampal CA1 region , respectively. Results After fibrillar Aβ injection, the step-through latency of rats was significantly shortened compared to that of the control group. The GFAP positive astrocytes were found surrounding amyloid deposition. Neuronal loss occurred in the pyramidal cell layer of CA1 region. The number of S100β positive cells in Aβ-treated group was significantly increased compared with that in the control group. After IL-1ra injection, the number of S100β positive cells was significantly decreased. Conclusion Intrahippocampal injection of Aβ 25-35 could cause similar pathologic changes of Alzheimer's disease. Aβ 25-35 was capable of up-regulating S100β expression in a dose-dependent manner. The injection of IL-1ra could attenuate the effect of Aβ on S100β expression.

Abstract: Objective To investigate the differences in epidemiological and clinical characteristics of patients with spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS). Methods A total of 86 patients with SF and 113 patients with SFTS who were laboratory-confirmed in the second-level and above hospitals in Lu'an City from January 2017 to January 2022 were selected. The basic data, epidemiological history, clinical data and laboratory test results of the two diseases were retrospectively analyzed for comparison. Results The proportion of male in SF group was 32.56% (28/86), and the proportion of male in SFTS group was 53.98% (61/113), the difference was statistically significant (χ2=9.067, P<0.01). The proportions of abdominal pain and diarrhea in the SF group were (3.49%, 3/83) and (21.24%, 24/113), which were significantly lower than corresponding (6.98%, 6/86) and (46.90%, 53/113) in the SFTS group (χ2=13.121, 37.322, P<0.01). The incidences of rash and eschar in SF group were 95.35% (82/86) and 20.93% (18/86), which were significantly higher than corresponding 1.77% (2/113) and 0.88% (1/113) in SFTS group (χ2=175.311, 22.721, P<0.01). The levels of leukocytes, platelets and C-reactive protein in the SF group were significantly higher than those in the SFTS group, and the levels of transaminase, lactate dehydrogenase and D-dimer were significantly lower than those in the SFTS group, and the differences were statistically significant (all P<0.05). Conclusions The rash and inflammatory reaction are more obvious in SF patients, while the liver function, myocardial function and coagulation function are significantly impaired in SFTS patients.

OBJECTIVETo explore the clinical application of Centerpiece titanium plate fixation in open door laminoplasty.

METHODSFrom January 2009 to December 2010,25 patients with cervical spinal stenosis were treated by open door laminoplasty with Centerpiece titanium plate fixation. There were 16 males and 9 females,with a mean age of (57.2 +/- 6.7) years (ranged, 44 to75 years). There were multilevel cervical myelopathy in 8 cases, posterior longitudinal ligament ossification in 12 cases and congenital cervical spinal stenosis in 5 cases. According to Japanese Orthopedic Association (JOA) score to evaluate nerve function and calculate improvement rate. X-ray and CT were used to evaluate postoperative spinal canal enlargement and bone fusion at the hinge side. The sagittal diameter of C5 spinal canal on the lateral X-ray was measured before operation and 6 months after operation respectively, and the expansion rate of spinal canal was calculated [(postoperative sagittal diameter-preoperative sagittal diameter)/(preoperative sagittal diameter) x 100%].

RESULTSThe operative time and intraoperative blood loss were respectively (165.5 +/- 35.6) min and (325.0 +/- 75.1) ml. All patients were followed up from 6 to 18 months with an average of (7.3 +/- 3.8) months. The JOA score increased from 9.3 +/- 1.1 before operation to 14.7 +/- 2.1 at 6 months after operation (t = 4.12, P < 0.05), and the improvement rate was (64.5 +/- 10.2)%. Radiographic data showed spinal canal enlarged perfectly, bone fusion at hinge side and no cervical spinal stenosis was found. The sagittal diameter of C5 spinal canal improved from (9.0 +/- 1.5) mm before operation to (14.3 +/- 2.0) mm at 6 months after operation (t = 7.61, P < 0.05), and the expansion rate was (67.6 +/- 11.8)%.

CONCLUSIONClinical application of Centerpiece titanium plate fixation in open door laminoplasty is safe and effective. While vertebral plate is elevated to obtain instantly stability, at the same time, the integrity of spinal canal is also recovered.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; surgery ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Spinal Stenosis ; surgery ; Titanium

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.

Objective To study the characteristics of heterotopic heart transplantation by echocardiographyand evaluate the heart function and acute rejection.Methods Five male 49-61 years old patients with heterotopic heart transplantation were studied using echocardiography pre-,intra-,post～operation and at follow-up.The anastomoses of great vessels of recipient with donor heart,chamber size,left ventricular wall thickness with wallmotion.left ventricular ejection fraction(LVEF),valvular function,pulmonary artery pressure,pericardial and pleural effusion were observed.Results All patients were end-stage coronary artery disease with NYHA class of received heterotopic heart transplantation with coronary artery bypass grafting.Some patients received mitral valvuloplasty,ventricular aneurysmectomy and stem cell transplantation simultaneously.During the operation,intra-operation transesophageal echocardiography was used to monitor and evaluate the surgical procedure with chamber sizes,anastomoses,native with donor heart ventricular and valvular function,and air bubble in chambers.The cardiac functions of donor heart backed to normal post operation,while the functions of recipient heart were increased gradually.All patients survived in 6 months and one year follow-up,with significantly improved functions of heart in situ[LVEF(44.0±15.6)%].The main reject reaction was small pericardial perfusion and pleural effusion.Conclusions Heterotopic heart transplantation has distinctive characteristics with echocardiography study,which is also an important technique in evaluation at pre-,intra-,post-operation and also at follow-up.