Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor(rhG-CSF)in treatment of different leukopenia.Methods A total of 50 patients were divided into 4 groups:aplastic anemia(AA)group(n=10),myelodysplastic syndromes(MDS)group(n=10),drug-induced leukopenia group(n=20)(subdivided into hyperplasia group and hypoplasia group by the degree of cellularity)and iron deficiency anemia group(control group,n=10).The concentrations of G-CSF of peripheral blood were measured by ELISA method.The ratio of CD34+ cells and G-CSFR expression in blood marrow mononuclear cells(BMMNC)were measured by flow cytometry.Granulocyte colony-forming units(CFU-G)of MNC were cultured.Clinical efficacy of rhG-CSF to all patients were determined.Results The concentrations of G-CSF were higher in AA and drug-induced leukopenia groups than those of MDS and control groups(P0.05).Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups(P0.05).The ratio of CD34+ cells was lower in AA group than that of other groups(P0.05).Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups(P0.05).The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group,and superior in MDS group than in AA group(P

Objective To explore the clinical effect of arthrolysis and a hinged external fixator for treatment of posttraumatic elbow stiffness.Methods From April 2007 to April 2012,26 cases of posttraumatic elbow stiffness patients were treated with arthr o lysis and a hinged external fixator after operation,and the effect was observed.Results After operation,26 patients were followed up for 15(8-24) months,the ranges of elbow joint motion increased from (42 ± 17) ° to (119 ± 17) ° after operation.There was significant difference (t =152.85,P＜ 0.05).The MEPS scores increased from (36 ± 13) points to (82 ± 14) points after operation,15 cases were excellent,5 cases were good,3 cases were fair and 3 cases were poor,the rate of excellent and good cases was 76.9％ (20/26).Twenty-three cases (88.5％,23/26)elbow function improved.Postoperative infective complication occurred in 1 case,postponed incision healing occurred in 1 case and 1 patient had cubital nerve paralysis,the symptom disappeared after 3 months and the patient showed no instability in elbow joint.Conclusion Arthrolysis and a hinged external fixator can deep stabe the elbow and its specific position,allowing early rehabilitation to promote functional recover of the elbow.

Objective To explore the effects of ginsenoside Rg3 on the expression of P27 in human erythrol-eukemia cell line K562 and cell proliferation. Methods Human erythroleukemia cell line K562 cells were cultured to exponential phase, then K562 cells were treated with different concentrations of Rg3 (6.25, 12.5, 25, 50, and 100 μg/mL) as Rg3 group, and cells treated without Rg3 (0 μg/mL) were take as control group. After 3 days, K562 cells were observed by Wright-Giemsa staining with microscopy , the proliferation of K562 cells were examined by tetrazolium salt (MTT) assay, and the expression of P27 mRNA were detected by fluorescent quantitative RT-PCR assay. Results MTT assay showed that after treatment with Rg3,the inhibition rate (IR) of proliferation of cells in Rg3 groups were increased gradually , and the differences were significant compared with the control group (P < 0.05). The results of fluorescent quantitative RT-PCR showed the levels of P27 mRNA expression in 25,50 and 100 μg/mL Rg3 groups were significant higher than that of control group (P < 0.05). Conclusion The ginsenoside Rg3 can inhibit the proliferation of K562 cells by inducing the expression of P27.

OBJECTIVETo explore clinical characteristics and treatment of posterior Pilon fracture.

METHODSFrom January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.

RESULTSAll patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.

CONCLUSIONPosterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.

Adult ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Acquired Immunodeficiency Syndrome ; microbiology ; Female ; Humans ; Mycoses ; diagnosis ; Young Adult

Objective To assess the outcomes of the surgical treatment of supination external rotation trimalleolar fractures,comparing the techniques of lateral plating and antiglide plating as described previously.Methods This is a retrospective review.A total of 31 patients meeting our inclusion criteria,with supination external rotation trimalleolar fractures surgically treated between 2009 and 2011,were studied.17 patients were treated with antiglide plating,whereas the remaining 14 patients underwent traditional lateral plating.They were followed up by a period ranging from 14 to 38 months(average,26 months).The functional results were evaluated with olerud and molander scoring system described previously.All the data including time to surgery,operating room time,tourniquet time,hospital stay and ankle joint function scores,were respectively analyzed in accordance with the complete randomized design t-test.Results There was no statistically significant in time to surgery,operating room,tourniquet time,hospital stay and ankle joint functional scores.Conclusions The outcome of the surgical management of supination external rotation trimalleolar fracture is comparable with both techniques.Our data do not support one technique over the other.

10.3969/j.issn.2095-4344.2013.25.007

Objective To study the causes and nursing points of re-operation after orthotopic liver transplantation (OLT). Methods The clinical data of 241 patients who underwent OLT in the past three years were analyzed, and the causes and nursing of re-operation were summarized. Results In the 241 patients,30 cases underwent re-operation. The incidence of re-operation was 12.4%. The causes included: intra-abdominal bleeding in 14 cases with the incidence of 46.7%, biliary complications in 8 cases with the incidence of 26.6%, 4 cases infection in different organs with the incidence of 13.3%, wound dehiscence in 2 cases with the incidence of 6.7% and recurrence of carcinoma in 2 cases with the incidence of 6.7%. 7 patients died after re-operation with the mortality rate of 13.3%. Conclusions The causes of re-operation after OLT were various, intra-abdominal bleeding and biliary complications were the main factors. Knowing the causes and taking rational nursing helped to raise the survival rate and quality of life after OLT.

Objective To compare the efficacy of weight loss,metformin and rosiglitazone in women with polycystic ovary syndrome(PCOS).Methods A randomized controlled trial(RCT)was carried out in Peking Union Medical College Hospital(PUMCH),one hundred and six women with PCOS were assigned to three intervention groups:weight loss,weight loss and metformin,weight loss and rosiglitazone group.Patients were treated with weight loss(diet and exercise),weight loss and mefformin (500 mg three times daily),weight loss and rosiglitazone(4 mg once daily)for three months.Sixty patients completed treatments.Basal body temperature(BBT),total testosterone as well as fasting serum insulin levels and lipid were measured and compared in all patients before and after weight loss.Results No significant differences were found in the baseline characteristics among three groups.In weight loss group 51%(22/43)patients completed treatment,and 23%(5/22)patients resumed ovulation.In weight loss and mefformin group 58%(21/36)patients completed treatment,and 43%(9/21)patients resumed ovulation.In weight loss and rosiglitazone group 63%(17/27)patients completed treatment,and 59% (10/17)patients resumed ovulation.Ovulation rate was significantly higher in weight loss and rosiglitazone group than in weight loss group.There was no significant difference among three groups in body mass index (BMI),waist circumference,waist-hip ratio(WHR),sex hormone,serum fasting insulin and lipid level after treatment.Conclusion Weight loss,metformin and rosiglitazone all can improve ovulation each.

Objective To explore the operative indication operation time and post-operative care for infants with large ventricular septal defects (VSD).Methods Eighty-eight infants who suffered from large VSD were selected,male 53 cases,female 35 cases,aged from 3 to 18 months[average (7.5-±2.9) months],weight from 5 to 13 kg [average (7.9 ± 1.9) kg].All patients underwent VSD repair and other accompanied anomaly corrections under cardiopulmonary bypass.Fifty-eight cases were operated through right atrium,14 cases through pulmonary artery and 16 cases through right ventricle.Patch repairs were done in all patients,78 cases given bovine pericardium patches,10 cases given self pericardium patches treated by Glutaral.Patients were sent to the intensive care unit after surgery,vasoactive drugs were used as a routine method.Antibotics were selected based on their sputum cultures postoperatively.Nutritional support was given in the earlier stage.Results There were no hospital death,average hospitalization days were (15.2 ± 5.9) days (from 11 to 32 days).The main complication were pneumonia (5 cases),bad coalesce of incision (4 cases),atelectasis (3 cases),minimal residual shunt of VSD (3 cases).All patients were discharged from hospital,76 cases were followed up from 1 to 12 months,2 cases had residual shunt of VSD,the residual shunt of the other case disappeared;76 patients had no clinical symptom,28 patients body weight returned to normal after 6 months of operation.There was no other complication and death.Conclusion Early surgical treatment for infants with large VSD is a safe and effective way with a better prognosis.