OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

Abstract: Objective　To investigate the molecular characteristics and drug resistance of non-O1/non-O139 Vibrio cholerae in Zhongshan City, and to provide laboratory basis for cholera prevention and control. Methods　The strains of non-O1/non-O139 Vibrio cholerae isolated from sporadic patients and aquatic products from 2015 to 2021 in Zhongshan city were collected. The identification and cluster analysis of the strains were analyzed by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), the ctxA virulence gene of strains were detected by real-time fluorescence quantitative PCR, the cluster analysis of the strains was analyzed by pulsed-field gel electrophoresis (PFGE), and the drug resistance of the strains were analyzed by microbroth dilution method. Results　From 2015 to 2021, 33 strains of non-O1/non-O139 Vibrio cholerae were isolated from Zhongshan City, including 28 strains from sporadic patients and 5 strains from aquatic products. Through MALDI-TOF-MS identification, 33 strains of non-O1/non-O139 Vibrio cholera can be identified to the level of species, and the identification results were all Vibrio cholerae. Among 33 non-O1/non-O139 Vibrio cholerae strains, 1 strain carried the ctxA virulence gene. The drug-resistant strains accounted for 69.7% (23/33), and the multidrug resistant strains accounted for 18.2% (6/33). A total of 7 kinds of drug resistance spectrum were produced, including 3 kinds of multidrug resistant spectrum, and showed drug resistance to 8 antibiotics, among which the resistance rates to streptomycin, cefazolin and compound sulfamethoxazole were above 30%. The 33 strains of non-O1/non-O139 Vibrio cholerae were divided into 32 PFGE fingerprints with a similarity ranging from 61.7% to 100%. MALDI-TOF-MS cluster analysis divided 33 non-O1/non-O139 Vibrio cholerae strains into two clusters. Conclusions The results of molecular typing of non-O1/non-O139 Vibrio cholerae in Zhongshan City presented diversity, and no significant correlation was found between PFGE and MALDI-TOF-MS cluster analysis. The strains demonstrated various degrees of resistance to certain antibiotics, and there were multidrug-resistant and toxigenic strains. Therefore, it is necessary to alert to the harmfulness of non-O1/non-O139 Vibrio cholerae and enhance monitoring.

Objective To assess the role of 68Ga-N,N′-bis(2-hydroxy-5-(carboxyethyl)benzyl) ethylenediamine-N,N′-diacetic acid(HBED-CC)-(Ahx)Lys-CO-Glu(PSMA-11) PET/CT on the detection of metastatic lesions from castration-resistant prostate cancer (CRPC).Methods Sixteen patients with CRPC who underwent 68Ga-PSMA-11 PET/CT between January 2015 and November 2015 were recruited in this study.Mean age of patients was (72±9) years.The PSA levels were 4-12 356 μg/L, Gleason score was 7-10.PET/CT was performed at 1 h postinjection of 68Ga-PSMA-11.Patient-based analysis and lesion-based analysis were performed.ROI analysis was used to calculate the tumor uptake (SUVmax).Final diagnosis was based on histopathology and results of other imaging examinations(99Tcm-MDP imaging, MRI).χ2 test was used to compare the diagnostic efficiencies of PET and CT.Results No adverse effects were observed in patients.68Ga-PSMA-11 PET/CT showed moderate physiologic uptake in salivary glands and proximal small intestine, with predominant tracer clearance by the kidneys.All patients were positive on 68Ga-PSMA-11 PET/CT.Bone metastasis was found in 16 patients, liver metastasis in 2 patients (5 lesions), and lymph node metastasis in 4 patients (26 lesions).The SUVmax of liver, lymph node and bone metastases were 15.06±2.77, 7.54±5.20, 19.01±16.96, respectively.The diagnostic sensitivity, specificity and accuracy on bone metastasis with 68Ga-PSMA-11 PET and CT were 96.30%(52/54) vs 61.11%(33/54), 3/3 vs 1/3, 96.49%(55/57) vs 59.65%(34/57).The sensitivities and accuracies of the two modalities were significantly different(χ2=19.943, 22.593, both P<0.01).Conclusions 68Ga-PSMA-11 PET/CT could precisely detect both primary and metastatic lesions of CRPC, suggesting that it is of great value for the clinical management and treatment.

Objective To study the correlations of VDR FokⅠgene polymorphism with type 2 diabetes in postmenopausal women of Han nationality in south Sichuan. Methods 160 patients with type 2 diabetes (T2DM) and 190 healthy cases were enrolled in the study. The VDR FokⅠgene polymorphisms were detected using RFLP-PCR and DNA sequencing. Results The FF, Ff and ff genotype frequencies were 32.5%, 47.5%and 20% in the T2DM group and 15.8%, 53.7%, 30.5% in the control group, respectively (P < 0.05). The allele frequencies were 56.3%, 43.8% in the T2DM group and 42.6%, 57.4% in the control group, respectively (P < 0.05). The risk of T2DM in the FF genotype people was 2.568 times higher than Ff/ff genotype (adjusted OR = 2.568, 95%CI = 1.246 ~ 5.292, P < 0.05). The levels of 2 h PG and HbA1C in the FF genotype people were significantly higher than those of the Ff/ff genotype people (P<0.05). Conclusions There was an association between the VDR FokⅠgene polymorphism and type 2 diabetes incidence in the postmenopausal women in south Sichuan area.

Objective To evaluate effect of PDCA circulation on incidence rate of unplanned urinary catheter removal in hospitalized patients.Methods A total of 129 hospitalized patients without PDCA circulation from April and June 2017 were selected as control group,and 110 hospitalized patients with PDCA circulation from July to September 2017 were as experimental group.The reasons of unplanned urinary catheter removal in the control group were explored and the targeted measures were formulated.The incidence rate of unplanned urinary catheter removal in two groups were compared.Results Unplanned urinary catheter removal rate was 0.91％ in the experimental group,and 6.20％ in the control group.There was a statistically significant difference between the two groups (P ＜ 0.05).Conclusion PDCA circulation can reduce incidence rate of unplanned urinary catheter,which is worthy of clinical application.

Objective To evaluate effect of PDCA circulation on incidence rate of unplanned urinary catheter removal in hospitalized patients.Methods A total of 129 hospitalized patients without PDCA circulation from April and June 2017 were selected as control group,and 110 hospitalized patients with PDCA circulation from July to September 2017 were as experimental group.The reasons of unplanned urinary catheter removal in the control group were explored and the targeted measures were formulated.The incidence rate of unplanned urinary catheter removal in two groups were compared.Results Unplanned urinary catheter removal rate was 0.91％ in the experimental group,and 6.20％ in the control group.There was a statistically significant difference between the two groups (P ＜ 0.05).Conclusion PDCA circulation can reduce incidence rate of unplanned urinary catheter,which is worthy of clinical application.

OBJECTIVETo observe the clinical efficacy and safety of Tiaozhi Yanggan Decoction (TZYGD) in treating non-alcoholic fatty liver.

METHODSOne hundred and thirty-eight patients were enrolled and randomized into two groups according to the random number table in a ratio of 3:1, with 8 cases eventually dropping out. The symptoms, signs, liver function markers, blood lipids, iconographic indices and clinical comprehensive efficacy after a 12-week treatment course were assessed in 101 patients treated with TZYGD in the treated group and 29 patients treated with Thiola in the control group.

RESULTSThe total effective rate in the treated group and the control group was 81.19% and 68.97%, respectively, showing a significant difference between the two groups with the former being significantly higher than the latter (P<0.05). Moreover, the improvements in the symptoms, signs, liver function, blood lipids and iconographic indices in the treated group were favorable with no serious adverse reactions.

CONCLUSIONTZYGD is effective and highly safe in treating non-alcoholic fatty liver.

Adult ; Body Mass Index ; Body Weight ; drug effects ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Fatty Liver ; blood ; drug therapy ; physiopathology ; Female ; Humans ; Lipids ; blood ; Liver ; physiopathology ; Male ; Medicine, Chinese Traditional ; adverse effects ; methods ; Middle Aged ; Phytotherapy ; adverse effects ; Treatment Outcome

OBJECTIVETo study the histopathological changes of livers in idiopathic portal hypertension (IPH).

METHODSLiver specimens from 29 cases with idiopathic portal hypertension were studied. Histological preparations of the livers were stained with haematoxylin eosin and Masson's trichrome; reticular fibers in the liver tissues were demonstrated. The slides were also stained using some immunohistochemistry methods, and the pathological changes of the livers were analyzed.

RESULTSThe characteristic changes found in these IPH livers were dense portal fibrosis; obliteration, with or without phlebitis, of the branches of the portal vein; dilatation of the sinusoids; atrophy and nodular hyperplasia of liver cells.

CONCLUSIONSHistopathological changes of the livers in IPH are dense portal fibrosis, portal vein branch obliteration and nodular hyperplasia of liver cells. These are the main features for a histopathological diagnosis of IPH.

Adolescent ; Adult ; Female ; Fibrosis ; pathology ; Humans ; Hypertension, Portal ; pathology ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

Lipid rafts composed of saturated phospholipids,sphingomyelin,and cholesterol are usually defined as liquid ordered microdomains located in the cell membrane. Lipid rafts are involved in many physiological and pathological processes of cells. Based on the difference in composition and distribution between lipid raft and non-raft domains,a lipid raft probe with aggregation-induced emission (AIE),cholesterol-triethylene glycol-tetraphenylethylene (TCHS-TPE),was designed and synthesized for convenient and specific imaging of lipid raft domains on cell membranes in this study. In this paper,TCHS-TPE was successfully synthesized,and the photophysical properties of TCHS-TPE were measured to evaluate its AIE characteristics. And finally the specific imaging of TCHS-TPE on the lipid raft region of B16F10 melanoma cell membrane was studied using confocal laser scanning microscopy. Compared with the existing lipid raft probe cholera toxin B (CTxB),the TCHS-TPE lipid raft probe has the advantages of simple operation and high specificity. The successful synthesis of the fluorescent probe will provide a useful tool for studying the physiological and pathological processes related to lipid raft domains,and offer a theoretical basis for the design of imaging probes for other lipid raft domains.

Objective To explore the risk factors and clinicopathologic characteristics of severe hand,foot and mouth disease (HFMD),and to provide a scientific basis for clinical interventions.Methods The clinical data of 2606 hospitalized children with HFMD in Ningbo No.2 Hospital were analyzed retrospectively from January 2010 to December 2012.Clinical characteristics were compared between two groups (regular case group and severe case group),and risk factors of severe HFMD were analyzed by Logistic regression test.The clinicopathologic features were analyzed from an autopsy case.Results Among total 2606 cases,619 cases were severe HFMD (23.7％).Logistic regression test showed that EV71 infection,poor spirit,blood glucose ＞ 9 mmol/L,high fever (temperature ≥ 39.1 ℃) lasted more than three days,younger than 3 years and abnormal neural reflex were the independent risk factors of HFMD seriousness.The results of the autopsy showed that the central nervous system,lung and intestinal were most severely.Conclusion Attention should be paid to observe the condition changes in HFMD patients with EV71 infection,younger than 3 years,nervous system symptoms,blood glucose ＞ 9 mmol/L and high fever.Targeted clinical intervention is particularly important for improving cure rate,and the protection of intestinal function can't be ignored.