[Objective]To investigate the clinical use of spiral CT with 3D Reconstruction for fractures of the tri-ankle joint.[Method]Fifty-six cases of tri-ankle joint fractures treated in our hospital from 1999 to 2004 were studied respectively.The ankle joint X-ray and spiral CT with 3D reconstruction were taken for all the cases preoperatively.The results were analyzed and compared with finding in operation .Scanning parameters of spiral CT were: 2 to 5mm collimation,3 to 5mm table speed and 1.5 to 3mm reconstruction interval.[Result]Fractures were demonstrated definitely by spiral CT in all the cases.Analyses of the results showed the superiority of spiral CT with 3D reconstruction in the fracture classification.Exact assessment of fragments and total agreement of the preoperative results were compared with findings in operation.[Conclusion]Operative treatment and rehabilitation may provide satisfactory fracture reduction and clinical results for ankle joint fracture.Well-timed treatment,correct fracture pattern estimation,proper internal fixation and rehabilitation are important to achieve better long term results.

Many microbial pathogens,including those responsible for major enteric infections,exploit oligosaccharides that are displayed on the surface of host cells as receptors for toxins and adhesins. Blocking crucial ligand receptor interactions is therefore a promising therapeutic strategy. One approach is to express molecular mimics of host receptors on the surface of harmless recombinant bacteria that can survive in the gut. These recombinant probiotics bind bacterial toxins in the gut lumen with very high avidity,thereby preventing disease.

Fermentation property and kinetic analysis of the inhibition of in vitro growth of pathogenic Escherichia coli K88, O138 by Lactobacillus intestinalis isolated from porcine intestine mucus were investi-gated. The results of fermentation showed that L1 result in a pH of 3.90 within 12 h and a large amount of lactic acid production, with the concentration of 104.08 mmol/L. Kinetic analysis of the antibacterial activity of L1 metabolic product toward K88, O138 showed that CFUS display strong antibacterial activity toward K88, O138; the antibacterial activity of L1 CFUS was higher than the lactic acid control samples and was mainly due to the production of lactic acid; K88, O138 had the tolerance property toward pH 4.5.

Objectives To explore the clinical relationship between different degrees of Alzheimer's disease(AD) and trace elements and to provide information for control and prevention of AD.Methods From January 2015 to December 2015,125 AD patients in psychiatric hospital of the same city were randomly selected and divided into mild (n =28),moderate(n =42),and severe (n =55) AD group according to dementia degree.40 volunteers were recruited as healthy control group.The fasting contents of serum copper,iron and zinc were measured,and the data were statistically analyzed.Results Compared with healthy control group,the content of serum copper was(16.32 ±6.54)g/L in control group,(16.90±6.37)g/L in mild group,(20.31±6.74)g/L in moderate group,and(21.29 ± 6.92)g/L in severe AD group,increasing gradually in mild,moderate,and severe AD groups versus control group (F=6.318,P＜0.001).Serum copper levels howed significantly differences (P＜ 0.05) in severe AD group versus healthy control group or the mild AD group.The content of serum iron was (9.17 ± 4.71) g/L in control group,(7.82 ± 4.67) g/L in mild AD group,(7.71 ± 4.42) g/L in moderate AD group and (7.28 ± 4.19)g/L in severe AD group,decreasing significantly in mild,moderate and severe AD groups versus healthy control group(F=3.331,P =0.021).The content of serum zinc was (100.67 ± 9.78) g/L in control,(81.78 ± 9.91) g/L in mild,(66.48 ± 9.37) g/L in moderate,and(71.55± 8.97)g/L in severe AD group,decreasing significantly in mild,moderate and severe AD group versus the control group(F=123.168,P＜ 0.001).Serum copper,iron and zinc contents showed statistically differences in mild,moderate and severe AD groups versus in healthy control group (P ＜ 0.05).There was no interaction between dementia degree and serum iron concentration.In patients with moderate dementia and serum copper concentrations close to 20.31 mmol/L(F=10.098,P=0.000),or in patients with moderate dementia and serum zinc concentrations close to 66.48 mmol/L(F =7.433,P =0.001),behavioral and psychological symptoms were most obvious.Conclusions The serum levels of trace elements in patients with different degrees of AD may change differently.The content of serum copper is increased gradually,while the contents of serum iron and zinc are significantly decreased along with increased AD degree.

Objective To investigate the clinical features of hidden horizontal tears of the posterior horn of the medial meniscus and clinical efficacy of arthroscopic partical meniscectomy. Methods A total of 14 cases of hidden horizontal tears of posterior horn of the medial meniscus from May 2011 to May 2013 were enrolled.The knee arthroscopy was carried out through anteromedial and anterolateral approaches.The lesion of tears was exposed after the inner edge of posterior horn of the meniscus was bitten away.The bottom of the posterior horn of meniscus was found instable during the operation, which was then removed to conduct a partial meniscectomy.Afterwards the arthroscopic meniscus plasty of the posterior horn was performed. Results Arthroscopic photographs showed normal appearance in 6 cases and tears underside meniscus in 8 cases, all of which were confirmed to be horizontal medial meniscus posterior horn tear during operation.The mean time of operation was 32 min (range, 26-40 min), and the mean hospitalization time was 6 days ( range, 3-8 d) .There was no complications, such as infections or stiffnesses.All the patients were followed up for 2 -3 years.Subjective symptoms improved significantly after arthroscopic partial meniscectomy.According to the Lysholm knee scoring scale, the scores were (71.1 ±6.6) points preoperatively and (92.0 ±3.4) points postoperatively, with significant difference (t=10.530, P=0.000). Conclusion Diagnosis of hidden horizontal tears of the medial meniscus posterior horn is often difficult, because most patients have osteoarthritic knees.Careful physical examination and MRI are critical for making a correct diagnosis.Arthroscopic partial meniscectomy can help patients obtain better results.

Objective To understand the situation of oxidative stress among diabetic nephropathy (DN) patients and observe the antioxidative effect of losartan at increasing dose in DN patients. Methods Thirty type 2 DN patients who neither smoked and nor took antioxidants were selected. The study began with an initial 4-6 weeks screening-treatment. Eligible patients then received losartan 50 mg/d daily for 8 weeks followed by losartan 100 mg/day daily for an additional 8 weeks. Blood glucose and blood pressure were closely monitored over the whole study period. All patients were followed up every other weeks, their 24-hour urine samples,fresh urine and venous blood sample were collected to measure urinary protein and creatinine excretion, urinary 8-OHdG, SOD, TAOC and MDA excretion , serum SOD, TAOC , MDA and other blood biochemistry parameters. Urinary 8-OHdG was determined by capillary electrophoresis and liquid phase chromatography. Results The total 24 hours urinary 8-OHdG excretion and the serum MDA concentration were higher than the normal values. The serum and urine SOD concentrations were lower than the normal values. There was an improvement in urinary 8-OHdG,serum and urine SOD, serum and urine MDA levels with losartan therapy. Compared with losartan 50 mg/d, the antioxidative effect of losartan 100 mg/d was more noticeable. Obvious decrease in 24-hour proteinuria on exposure to losartan was found, without severe adverse effect. Conclusions Oxidative stress damage is active in DN patients. Losartan has antioxidative effect on DN patients. Compared with losartan 50 mg/d, the antioxidative effect of losartan 100 mg/d is more marked, without increasing side effect. Losartan's antioxidative effect may be involved in its beneficial mechanisms on DN.

Objective To evaluate the effect of popliteal fossa fixed method to reduce the setup errors in patients with postoperative cervical carcinoma by CBCT of TrueBeam Linear accelerator.Methods 30 cases of postoperative cervical cancer patients were randomly divided into two groups,group A with popliteal fossa fixed method by trapezoidal fixation,group B with traditional vacuum pad fixation.CBCT was used to record both setup errors and rotational errors,Stroom extension formula was used to calculate the PTV expansion value coming from the two different fixation methods.Results There was significant difference in setup errors between group A and group B.The setup errors in the left-right direction (X),cranial-caudal direction (Y) and anterior-posterior direction (Z) were (0.19±0.14) cm,(0.17±0.12) cm and (0.13±0.11) cm in group A,respectively.On the contrary,the setup errors in X,Y and Z were (0.24±0.19) cm,(0.25±0.21) cm and (0.22±0.18) cm in group B,respectively.The rotational errors were 0.05°±0.02° in group A,comparing with 0.5°±0.21° in group B (P =0.00).The PTV expanded margin in group A was 0.56 cm in X direction,0.51 cm in Y direction,0.40 cm in Z direction,in comparing with 0.73 cm,0.78 cm and 0.67 cm in group B,respectively.Group A remarkably reduced the PTV,pelvis,small intestine,bladder and rectum irradiated volumes [(1 167±271) mm3 vs (1 379±297) mm3,(84±12) mm3 vs (130±17) mm3,(81±51) mm3 vs (117±64)mm3,(62±40) mm3 vs (75±47) mm3,(21±16) mm3 vs (31±21) mm3].Conclusion Popliteal fossa fixed method can reduce setup errors and improve the stability of positioning,more suitable in precise radiotherapy for postoperative cervical cancer patients,which has the value of further validation.

Objective To study whether the uremic toxins accumulated long-term in uremia patients may be involved in oxidation of protein by forming advanced oxidative protein products (AOPPs). Methods Malonylaldehyde (MDA), hippuric acid (HA) and p-cresol were used as the representatives of uremic toxins. Human albumin serum (HSA), plasma specimens from normal or uremia patients were incubated respectively with MDA (10 retool/L), HA (20 mmol/L) and p-cresol (10 retool/L) or PBS (20 retool/L, pH 7.4, as control groups) at 37℃ for 30 minutes or 24 hours, respectively. Those indices such as AOPPs, protein thiol groups (Pt-SH) and dityrosine were used as biomarkers of protein injury. High performance liquid chromatography (HPLC) was employed to identify the aggregation and cross-links of modified proteins. Results AOPPs levels in all groups containing poison compounds were significantly increased by 121.5%(P<0.05) compared to that in control groups. Uremic toxins also resulted in over 14.7% loss in Pt-SH (P< 0.05) and 119.2% increment in dityrosine, respectively (P<0.05). Meanwhile, the formation of HMW-AOPPs in a time-dependent manner was observed by HPLC and cross-linked protein levels were significantly increased by 148.45%～333.3% in comparison with control groups. Conclusion Uremic toxins can directly mediate the damage of proteins by inducing the formation of HMW- AOPPs in a time-dependent manner, which is also one of the mechanism of AOPPs production in vivo besides the activation of the myeloperoxidase-H2O2-Cl pathway.

Objective To investigate the methods of isolation,culture,identification and labeling of mesenchymal stem cells(MSCs) in vitro and lay a foundation for further study on intervention of MSCs on immunologic rejection of organ transplantation. Methods MSCs were isolated and cultivated by adherent methods . The expressions of CD90 and CD45 of cells were analyzed by using flow cytometry in order to identify MSCs.The third generation of MSCs were labeled by DAPI,the labeling efficiency was detected.Results Primary cultured MSCs adhered to plastic surface within 48 h and reached 90% confluence within 7-10 d .Flow cytometry showed that the positive rates of CD90 and CD45 of MSCs at third generation were 99.8% and 6.8%. MSCs expressed CD90 but no CD45.All of the MSCs after labeling by DAPI showed blue fluorescence by immunofluoroscope. DAPI labeling was sensitive and highly efficient to MSCs.Conclusion Adherent method is simple and easy to isolate and cultivate MSCs and it can serve as a routine method.DAPI labeling can be used as a efficient method to label MSCs.

Objective To design a method to characterize AOPPs. Methods Carbonyl groups were used as an oxidative index to link AOPPs and oxidized protein. Plasma-AOPPs were obtained by a series of preparation as follows. The native plasma was first determined for its protein contents followed by AOPPs level evaluation. Specimen was then washed with PBS and ultrafiltrated with an ultrafilter (10 000 cut-off membrane) to obtain clean plasma-AOPPs. A size-exclusion HPLC technique was used to verify which protein was oxidatively damaged. Fractions resulted from delipidation were also examined. Results The levels of AOPPs and total carbonyl groups in patient plasma were significantly higher than those in controls; both in native/delipidated plasma and CHC13-resulted precipitate. HPLC revealed that serum albumin presented highest carbonyl levels. It was an exclusive protein with statistically significant difference between controls and patients (patients vs. controls in nmol carbonyl/mg protein: HSA: 1.510?0.067 vs. 0.791?0.048, P