Objective:To evaluate the clinical efficacy of intramedullary nailing for femoral shaft fracture in adolescents.Methods:From May 2017 to October 2019, 30 adolescent patients with femoral shaft fracture were treated at Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine. They were 20 males and 10 females, aged from 12 to 17 years (average, 14 years), with 13 left and 17 right sides affected. They were all fixated with intramedullary nailing; open reduction and internal fixation was performed in 12 cases and closed reduction and internal fixation in 18 cases. Recorded were operation time, intraoperative blood loss, and time for postoperative antibiotic use; compared were lower limb length, neck-shaft angle, femoral neck diameter (FND), articular trochanteric distance (ATD) and Harris scores between the healthy and affected sides at the final follow-up.Results:For the 18 patients undergoing closed reduction and 12 patients undergoing open reduction, respectively, the intraoperative blood loss averaged 153.2 mL and 238.0 mL, the operation time 70.5 min and 91.5 min, and the time for antibiotic use 1.5 d and 3.0 d. The 30 patients were followed up for 12 to 41 months (average, 20.3 months). Follow-up revealed no such complications as fracture nonunion, delayed union, malunion, heterotopic ossification of the hip, refracture of the femoral shaft, or developmental deformity of the proximal femur. The lower limb length, neck-shaft angle, FND, ATD and Harris scores at the final follow-up were, respectively, 133.4°±2.3°, (29.3±4.2) mm, (27.1±6.3) mm and 96.4±3.6 for the affected side, insignificantly different from those for the healthy side [132.4°±3.5°, (30.2±3.6) mm, (26.4±6.8) mm and 95.6±4.7] ( P>0.05). Conclusion:Intramedullary nailing is effective for femoral shaft fracture in adolescents, leading to positive efficacy and limited complications and impact on the development of proximal femur.

Objective To study the distribution and evolution of yiiG, a Salmonella gene encoding a candidate type secretedsubstrate .Methods Salmonella genomes were comprehensively screened for yiiG distribution with se-quence alignment strategies .The evolutionary history of yiiG was traced .Comparative genomic analysis was per-formed to study the evolutionary mechanisms of yiiG gene acquisition , loss and duplication .RNA-seq data were combined to analyzing the correlation between yiiG and other virulence factors .A variety of bioinformatic tools were used for discovering the possible type Ⅲsecretion signals .Results yiiG distributed in S.enterica subsp.enterica but variable in other subspecies of S.enterica.No yiiG was found in S.bongori.Besides Salmonella, only a part of Shigella and E.coli strains were detected with yiiG homologs .The genomic locus of yiiG and its adjacency showed conservation among all Salmonella, E.coli and Shigella strains.In most of the serovars of S.enterica subsp.enteri-ca, there was a head-to-head tandem whole yiiG repeat sequence upstream the yiiG gene, which was renamed as yiiGRrc.RNA-seq analysis showed that yiiG gene expression level was highly correlated with T 3SS-related genes . Bioinformatic prediction also indicated the T 3SS effector signals in YiiG N-terminus.Conclusions yiiG represented an ancient genomic locus , which will be a hot spot where rearrangement events frequently happened .The function of yiiG could potentially be related with Salmonella virulence.Finally, a new protein-encoding gene (yiiGRrc) was newly identified that was closely related with yiiG, providing the target for further understanding the composition , function and function variation of yiiG gene family .

Objective To develop a simple method identifying and illustrating clustered repeats in bacterial ge-nomes, and to observe the patterns of clustered repeats in Salmonella genomes.Methods Bacterial genomes were cut to be overlapped pieces of identical size with a sliding window strategy .Each piece of genome fragment was aligned against itself with BLAT integrated in PipMaker , which was further used to build collinearity figures . Collinearity figures were analyzed to identify the clustered repeats.Results With the new pipeline CRpred ( Clustered Repeat Predicter) , Salmonella typhimurium LT2 genome was screened, and in 151 clustered repeats were disclosed.Pattern analysis on these repeats indicated that there were five categories, including low-copy simple tandem repeats, high-copy simple tandem repeats, interspaced tandem repeats, reverse-complementary re-peats, and interspaced reverse-complementary repeats.Nine repeat regions in LT2 genome were discovered which could not be simply classified into the 5 categories defined above.Conclusions A new, simple and intuitive strategy is proposed to identify and show clustered repeats in genomes , providing clues for CRISPR , VNTR and oth-er repeat-related studies .

Objective To investigate the effects of pulsed magnetic fields of different intensity on carotid restenosis (CRS), post carotid endarterectomy (CEA) and the expression of matrix metalloproteinase-2 (MMP-2)in vascular smooth muscle cells (VSMC). Methods An animal model of carotid altherosclerosis was established in 50 New Zealand rabbits by using air-drying lesions combined with high fat feed. After two months, the rabbits were treated with bilateral CEA, and then divided randomly into 3 groups. Two of the groups were treated with ei-ther 0.6 or 1.0 T pulsed magnetic fields, while the third group served as an untreated blank control. Changes in the pathology of the tunica intima were observed 1, 2 and 3 months after the CEA using morphologic analysis, and the expression of MMP-2 in the VSMC was determined using immunohistochemistry. Results The histological a-nalysis showed that the total luminal area, plaque area, the maximum plaque thickness and the proportion of siena-sis in the treated groups were all significandy lower, on average, than in the control group. At all three time points the average improvements in the 1.0 T group were significantly greater than in the 0.6 T group. The average ex-pression of MMP-2 in the treated groups was significantly lower than in the control group, especially in the 1.0 T group. Conclusions Pulsed magnetic field therapy positively influences CRS and the expression of MMP-2 in VSMC. Reduced MMP-2 expression might be one of the mechanisms through which pulsed magnetic fields prevent or lessen carotid restenosis post CEA.

Objective To investigate the carotid atherosclerosis(AS) in hemodialysis(HD) patients.Methods Clinical index was measured and intma-media thickness(IMT) of extracranial common carotid artery and presence of atherosclerotic plaques were determined by high-resolution B-mode ultrasonography.Results The age,disease duration,HD duration,triglyceride(TG),low density lipoprotein(LDL),serum C-reactive protein(CRP),mean carotid artery IMT in HD with atherosclerotic plaque were significantly higher than HD without atherosclerotic plaque patients,however,the serum albumin(Alb) was significantly decreased.Mean carotid artery IMT is related to the disease duration,Alb,TG,LDL,CRP in HD patients.Conclusion The CRP,mean carotid artery IMT were increased in HD with atherosclerotic plaque.Mean carotid artery IMT is related to the disease duration,Alb,TG,LDL,CRP in HD patients.To improve malnutrition and decrease micro-inflammation,serum lipid might reduce the rate of AS in HD.

Objective To investigate the effect of different dosage of pulsed magnetic field on expression of platelet-derived growth factor-A (PDGF-A) in rabbits with carotid atherosclerosis after carotid endarterectomy (CEA). Methods Carotid atherosclerosis were modeled in 50 New Zealand rabbits with air-drying lesion combined with high fat feed. All animals were treated with double side carotid endarterectomy after 2 months, and were randomly divided 3 groups: 0.6 T group, 1.0 T group and the blank control. The expression of platelet-derived growth factor-A were detected with immunohistochemistry 1 month, 2 months and 3 months after CEA. Results The expression of PDGF-A in treated groups were lower significantly than that in controls (P<0.05) 2 month after CEA, and it was the lowest in 1.0 T group, lower in 0.6 T group 3 month after CEA. Conclusion The pulsed magnetic field therapy can decrease the expression of PDGF-A, which might be helpful to prevent the carotid from restenosis.

Aim To investigate the anti-arrhythmic effect and mechanism of ?-opioid receptor during myocardial ischemia and reperfusion in rats,and to initially determine the regulation of U50488H(U50,a selective ?-opioid receptor agonist) to angiotensinⅡ(AngⅡ),endothelin(ET) and nitric oxide(NO) in rats.Methods Rats were randomly divided into 7 groups,i.e.,control group,ischemia/reperfusion group(I/R),U50488H+I/R group,PTX group(PTX,a Gi/o proteininhibitor),Glib group(glibenclamide,a K_(ATP) channel blocker),Che group(chelerythrine,a selective PKC inhibitor),and Gen group(Genistein,a Tyrosine kinase inhibitor) respectively.The arrhythmia occurrence and score in different groups were observed and counted.The contents of AngⅡ,ET and NO in plasma of rats were also examined.Results ① Compared with I/R group,the arrhythmia score of U50+I/R group was significantly decreased.The effect of pared with I/R group,the arrhythmia score of U50+I/R group was significantly decreased.The effect of glibenclamide and chelerythrine respectively,the anti-arrhythmic effects induced by U50488H in the rats during myocardial ischemia and reperfusion were significantly attenuated or even completely blocked.③ The anti-arrhythmic effects of U50488H were not significantly affected by pretreatment with genistein.④ In comparison with normal rats,the contents of AngⅡand ET in plasma of I/R group were significantly increased,but the content of NO was decreased.With the administration of U50488H,the contents of AngⅡand ET in plasma of rats in U50488H+I/R group were significantly decreased.Meantime the content of NO was increased.Conclusions ① U50488H-induced anti-arrhythmic effects in the rats with myocardial ischemia and reperfusion are mediated by ?-opioid receptor.The signaling pathway may be related with(Gi/o,) PKC,and K_(ATP) channel.② The activation of ?-opioid receptor may elicit anti-arrhythmic effect through the down-regulations of AngⅡ or ET and up-regulation of NO in plasma of rats.

Objective To investigate the expression of BRAF-activated long non-coding RNA (BANCR) in colorectal cancer,and the influence of BANCR on the biological function of HCT116 cells.Methods Fifty-six samples of colorectal cancer specimen (including the cancer tissues and precancerous tissues) were obtained at the First Affiliated Hospital of Nanjing Medical University from March 2012 to June 2013.The expressions of BANCR in all the specimens were detected by qRT-PCR (28 cases in the BANCR-high expression group and 28 cases in the BANCR-low expression group).The relationship between the expressions of BANCR and the clinicopathological factors of colorectal cancer was analyzed.The HCT116 cells were divided into 4 groups after interfering BANCR with lentiviral-mediated shRNA-1 and shRNA-2:interference group 1 (HCT116 cells transfected with LV-shRNA-1),interference group 2 (HCT116 cells transfected with LV-shRNA-2),negative control group (HCT116 cells transfected with lentivirus vector with nonsense sequence) and blank control group (HCT116 cells cultured in RPMI 1640 medium).The proliferation,apoptosis and migration of HCT116 cells in the 4 groups were detected by CCK-8 assay,flow cytometry and Transwell assay,respectively.The comparison between the 2 groups was analyzed by u test,and multiple groups were compared by one-way analysis of variance,repeated measurement analysis of variance and LSD-t test.Multivariate analysis was done by Logistic regression model.The difference between categorical data was compared by chi-square test.Results The relative expression of BANCR in the cancer tissues was 1.6 ± 0.4,which was significantly higher than 0.9 ± 0.7 of the precancerous tissues (u =1 020.000,P ＜ 0.05).The result of univariate analysis showed that the high expression of BANCR was correlated with the lymph node metastasis and tumor stage (x2 =4.595,7.487,P ＜ 0.05).The result of multivariate analysis showed that lymph node metastasis and tumor stage (stage Ⅲ-Ⅳ) were the independent risk factors influencing the high expression of BANCR(OR =4.000,5.914,95％ CI:1.230-12.900,1.685-20.760,P ＜ 0.05).The relative expressions of BANCR of the interference group 1,interference group 2,negative control group and the blank control group were 0.25 ±0.04,0.20±0.06,0.96 ±0.04,0.98 ±0.03,with significant difference among the 4 groups (F =271.610,P ＜ 0.05).The cell proliferation rates at day 6 of the interference group 1,interference group 2 and the negative control group were 80.6％ ± 7.6％,81.2％ ± 5.1％ and 87.9％ ± 13.6％,with no significant difference among the 3 groups (F =0.559,P ＞ 0.05).The apoptotic rates of the interference group 1,interference group 2,negative control group and the blank control group were 4.7％ ± 1.7％,5.1％ ± 1.1％,3.1％ ± 0.6％ and 2.8％ ± 0.9％,with no significant difference among the 4 groups (F =2.881,P ＞ 0.05).The numbers of transmembrane cells of the interference group 1,interference group 2,negative control group and the blank control group were 135 ± 29,107 ± 18,240 ± 24 and 245 ± 22,with significant difference among the 4 groups (F =45.194,P ＜ 0.05).Conclusions BANCR was overexpressed in the HCT116 cells,and the BANCR overexpression was correlated with lymph node metastasis and tumor stage.BANCR can promote the migration of HCT116 cells.BANCR could be an important biomarker for the diagnosis and prognosis of colorectal cancer.

Objective: To compare the clinical efficacy between arthroscopic riveting with line and lateral retinacular release plus medial patellofemoral ligament reconstruction in the treatment of habitual patellar dislocation. Methods: A retrospective study was conducted of the 40 children with habitual patellar dislocation who had been treated at Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine from January 2016 to December 2016. They were divided evenly into an observation group and a control group according to the treatment methods (n=20). In the observation group which was treated by lateral retinacular release plus medial patellofemoral ligament reconstruction, there were 14 boys and 6 girls, with an age of 14.2±1.2 years and an average number of dislocations of 5.3±1.1 times. In the control group which was treated by arthroscopic riveting with line, there were 13 boys and 7 girls, with an age of 13.8±1.3 years and an average number of dislocations of 5.5±1.2 times. The 2 groups were compared in terms of visual analogue score (VAS), Q-angle, knee motion, Lysholm score and Kujala score of the knee at the last follow-ups. Results: The 2 groups were comparable due to insignificant differences in preoperative general data between them (P>0.05). The observation and control groups were followed up for 13.3±1.2 months and 12.9±1.2 months, respectively, showing no significant difference between them(P>0.05). At the last follow-ups, the observation group had a significantly lower VAS score (2.2±0.8 pints), a significantly smaller Q-angle (14.5°±1.2°), significantly larger knee motion (30.3°±3.8°), and significantly higher Lysholm (91.6±5.3 points) and Kujala scores (93.2±2.8 points) than the control group (4.3±1.1 points, 17.8°±1.6°, 23.4°±3.4°, 81.4±4.4 points and 82.0±5.4 points, respectively) (all P<0.05). Conclusion In the treatment of habitual patellar dislocation, lateral retinacular release plus medial patellofemoral ligament reconstruction can lead to improvements in knee function and clinical symptoms and better clinical outcomes than arthroscopic riveting with line.

Objective:To identify the risk factors for premature proximal femur physeal closure (PPC) in children treated surgically for femoral neck fractures.Methods:Data of 106 children with an open triradiate cartilage who were treated surgically for a femoral neck fracture were retrospectively analyzed. Age, gender, laterality, mechanism of injury, the type of fracture, initial displacement, time to reduction, fixation method, whether the implant crossed the physeal plate, reduction method, reduction quality and development of femoral head avascular necrosis (AVN) were collected. PPC of the proximal femur was assessed through postoperative 6-12 months radiographs.Results:A total of 106 patients with an open triradiate cartilage were followed up, with an average duration of 20.4±13.3 months (range, 6-86 months). The overall rate of PPC following paediatric femoral neck fractures treated surgically was 36.8% (39/106). Among the 39 patients with PPC, 25 were males and 14 were females; the average age at the time of injury was 9.7±3.6 years (range, 3-15 years); 23 patients were involved in left hips and 16 were in right; the mechanisms of injury included motor vehicle accident in 5 fractures, falling injury in 21, sports-related injury in 12 and other causes in 1 fracture; two hips were Delbet type I, and 26 hips and 11 hips were Delbet type II and III, separately; type II and III of initial displacement were involved in 26 and 13 patients, separately; the mean duration from injury to surgery was 3.3±2.8 d (range, 1-14 d); 2 hips were treated with Kirschner wires, 35 hips with screw fixation, and the remaining 2 hips underwent screw and plate fixation; 2 hips had the hardware crossing the proximal femoral growth plate, and the remaining 37 hips didn’t; 15 hips were treated by closed reduction and internal fixation, and the other 24 hips underwent open reduction and internal fixation; anatomical reduction was achieved in 14 patients, acceptable reduction in 24 hips and unacceptable reduction in 1 hip; 24 hips developed AVN at the latest follow-up and the remaining 15 hips didn’t. Statistical analysis indicated that age ( t=3.875, P< 0.001), the severity of initial displacement ( Z=-2.118, P=0.034) and the rate of AVN ( χ2=42.280, P< 0.001) in patients with PPC were significantly higher than those in patients without; Logistic regression analysis confirmed age ( OR=1.288, P=0.011) and AVN ( OR=40.336, P< 0.001) as risk factors for PPC. ROC curve analysis indicated 10 years was the cut off age to significantly increase the rate of PPC. The rate of PPC in patients aged over 10 years (63.6%, 21/33) was significantly higher than that (24.7%, 18/73) in those aged less than 10 years ( χ2=14.848, P< 0.001). Conclusion:Age over 10 years and AVN are risk factors for PPC in children with femoral neck fractures treated surgically.