OBJECTIVETo investigate characteristics of treating dislocation and fracture of sacroiliac joint through anterior and posterior approaches.

METHODSBetween January 2006 and September 2012, 39 patients with dislocations and fractures of sacroiliac joint were treated with operation. There were 28 males and 11 females, aged 12 to 64 (mean, 41.3) years old. Seventeen cases were chosen through anterior approach, 13 cases through posterior and 9 cases were combined with anterior and posterior approaches. The anterior approach were made with supine position, performed open reduction, and two plates with 4 holes were used as internal fixation for arthrodesis of sacroiliac joint after reduction; while posterior approach prone position, close or open reduction was performed, and one or two partial thread lag screws, which with 7.3 mm in diameter and 60 to 75 mm in length, were penetrated via sacroiliac joint for fixation under X-ray. Postoperative complications were observed, Matta and Majeed scoring were used to evaluated currative effects.

RESULTSAll patients were followed up from 6 to 36 months. The patient could sit on the bed 2 to 4 weeks after surgery and walk with a crane 6 weeks' later. No breakage or loosening of screw occurred during follow-up. In all but one case with old sacral iliac fractures reducted poor, others obtained good opposition. According to Matta's criteria, 30 cases got excellent results, 8 good and 1 fair. According to Majeed's funtional standard, 14 patients got excellent results, 20 good 4 fair and 1 poor.

CONCLUSIONTreating dislocation and fracture of sacroiliac joint through anterior and posterior approaches can obtain good effects. However, anatomic location, fracture types, degree of displacement, the rate of preoperational reduction, vulnerability assessment of operation and fixation strength should be considered.

Adolescent ; Adult ; Bone Screws ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sacroiliac Joint ; injuries ; surgery ; Young Adult

Objective To evaluate the economic effect of new strategy for preventing poliomyelitis in Zhejiang Province. Methods Based on the population of Zhejiang Province in 2016, cost-effectiveness ratio (CER) , benefit-cost ratio (BCR), and net benefit (NB) were applied to calculate the health economic difference for the new strategy and the original strategy as compared to no vaccination strategy. Univariate sensitivity analysis was used to assess the robustness of results with main parameters; including burdens of poliomyelitis, cost of vaccines, and the vaccination program itself, and the discount rate. Results CERdisease, CERdeath, BCR and NB for the new strategy were 1:52700 RMB Yuan per case, 1:1813700 RMB Yuan per case, 12.26 and 796.6622 million and CERdisease, CERdeath, BCR and NB for the original strategy were 1 :32900 RMB Yuan per case, 1 :1133900 RMB Yuan per case, 19.58 and 823.1753 million, respectively. The results of the univariate sensitivity analysis with main parameters were robust. Conclusion The new strategy for preventing poliomyelitis is necessary for this period of the global polio eradication. Though the new strategy appears not as good as the original strategy on economic evaluation, its health economic benefit is significant.

Adult ; Aged ; Anthracosis ; diagnostic imaging ; therapy ; Bronchoalveolar Lavage ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Radiography

Objective To evaluate the quality of the hepatitis B report data on a pilot surveillance in Zhejiang Province from 2013 to 2015.Methods Hepatitis B report data of 6 pilots in Zhejiang Province from 2013 to 2015 were extracted from national notifiable infectious disease reporting system,including reported cases of hepatitis B,classification of hepatitis B cases and supplementary card information etc. To evaluate the accuracy of hepatitis B classification,information of supplementary cards was used to make classification diagnose for hepatitis B.Results A total of 3214 hepatitis B cases were reported in 6 pilot surveillance counties in Zhejiang Province between 2013 and 2015. Excluded 32 duplicated cases within the year and between years,3182 hepatitis B cases were actually reported,hepatitis B cases repeated reporting rate was 1%. A total of 2717 hepatitis B cases were correctly classified,and the accuracy rate of classification was 85.39%,showing an increasing trend (P<0.05). The proportion of accurate classification of reported hepatitis B by referring to the results of positive time of HBsAg and ALT from the supplementary card were 80.86% and 97.29% respectively. Among those reported acute hepatitis B cases,90.43% of them filled with anti-HBc IgM positive in supplementary card. The proportion of accurate classification of reported hepatitis B by referring to the information for liver puncture and the HBsAg and anti-HBs transform during the recovery period in supplementary cards were 0.19% and 5.13% respectively. Among those reported acute hepatitis B cases,0.69% of them were chronic or undetermined. Among those reported chronic hepatitis B cases,13.92% of them were acute,undetermined or HPV carrier. Five out of 3182 cases were unclassified,accounting for 0.16%.Conclusion The quality of classification diagnosis for hepatitis B should be improved in Zhejiang Province. Filling in the supplementary card is very beneficial for the classification of hepatitis B.

Objective To study the effects of maca extract on exercise endurance and blood hormone levels in the rats. Methods Wistar rats treated with maca extract (2. 0, 4. 0, 8. 0 g/kg body weight) were freely swimming in the cir-culating water flow daily for 15 days. On the 16th day of experiment, the exercise endurance and blood noradrenaline (NA), estradiol (E2), and testosterone (T) levels of the rats were determined. Results The rats administered with maca extract at the doses of 2. 0, 4. 0, 8. 0 g/kg body weight for 15 d showed that the swimming time before sinking was in-creased by 32. 51%, 60. 04%, 106. 52%, the total swimming time was extended by 16. 99%, 56. 50%, and 101. 73%respectively ( P<0. 01 ); while the number of sinking was decreased by 18. 89%, 35. 89%, and 58. 06%, respectively (P< 0. 01), compared with those swimming rats without maca extract treatment. The noradrenaline level in the blood of rats treated with maca extract 2. 0, 4. 0, 8. 0 g/kg body weight was increased by 3. 30%, 6. 60%, and 16. 50%, respec-tively, compared with the control group, and increased by 42. 49%,47. 05%, and 60. 70%, respectively, compared with the swimming rats without extract treatment;the E2 level was increased by 132. 83%,102. 72%, and 62. 26% (P<0. 01) respectively, compared with the control group, while decreased by 23. 88%, 33. 72%, and 46. 95% (P<0. 01) respec-tively, compared with the swimming rats without extract treatment. The blood testosterone level was increased by 5. 11%, 37. 65%, and 123. 16% (P<0. 01) respectively, compared with the control group, and increased by 28. 98%, 68. 92%, and 173. 85%, (P<0. 01) respectively, compared with the swimming rats without extract treatment. Conclusions The results of this study demonstrate that maca extract has effect to resist fatigue and enhance exercise capacity in rats. The mechanism is associated with reduced blood E2 , and increased noradrenaline and testosterone levels in the blood of rats.

BACKGROUND: Epigenetics, especially DNA methylation, plays an important role in the pathogenesis of primary Sjogren syndrome (pSS). Our study aimed to reveal the role of DNA methylation in peripheral monocytes of pSS patients. METHODS: A total of 11 pSS patients and five age-matched healthy controls (HCs) were included in this study. Monocytes were isolated from peripheral blood mononuclear cells using magnetic microbeads. DNA methylation profiles were generated using Human Methylation 850K BeadChips. RESULTS: In monocytes from pSS patients, we identified 2819 differentially methylated positions (DMPs), comprising 1977 hypomethylated- and 842 hypermethylated-DMPs, corresponding to 1313 unique genes when compared with HCs. IFI44L, MX1, PAARP9, and IFITM1, which influence the interferon (IFN) signaling pathway, were among the genes hypomethylated in pSS. Functional analysis of genes with a minimum of two DMPs showed involvement in antigen binding, transcriptional regulation, cell adhesion, IFN-γ pathway, type I IFN pathway, antigen presentation, Epstein-Barr virus infection, human T-lymphotropic virus type 1 virus infection, and metabolic disease-related pathways. In addition, patients with higher serum IgG levels exhibited enrichment in Notch signaling and metabolic-related pathways. Upon comparing monocytes with salivary gland epithelial cells, an important overlap was observed in the cell cycle, cell senescence, and interleukin-17 signaling pathways. The differentially methylated genes were more enriched in the ribosome- and AMP-activated protein kinase signaling pathway in anti-Ro/SSA and anti-La/SSB autoantibodies double-positive patients. CONCLUSION Genome-wide DNA methylation profiling revealed significant differences in DNA methylation in monocytes isolated from patients with pSS.
DNA Methylation/genetics* ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Humans ; Leukocytes, Mononuclear ; Monocytes ; Sjogren's Syndrome/genetics*

Objective The aim of this study was to demonstrate the immunogenicity and safety of diphtheria, tetanus, pertussis (acellular, component) , poliomyelitis (inactivated) vaccine (adsorbed) and Haemophilus influenzae type b conjugate vaccine (DTaP-IPV//PRP-T) combined vaccine compared with commercially available DTaP (diphtheria, tetanus and pertussis), Haemophilus influenzae type b (Hib), tetanus conjugate and IPV monovalent vaccine. Methods Subjects were randomly divided into three groups, Group A and Group B were DTaP-IPV//PRP-T combined vaccine (PENTAXIMTM) vaccinated at 2,3,4 months of age or 3,4, 5 months of age respectively; Group C was commercially available DTaP. Hib tetanus conjugate (Act-HIBTM) and IPV (IMOVAX PolioTM) vaccines vaccinated at 3,4, 5 months of age. All groups received booster dose at 18 to 20 months of age, with antibody titers tested. Non-inferiority analysis was demonstrated in terms of seroprotection / seroconversion rates between Group A, Group B respectively and Group C. Safety information was collected after each vaccination to assess the safety of investigational vaccines. Results The non-inferiority of DTaP-IPV//PRP-T combined vaccine vaccinated at 2,3,4 or 3,4, 5 months of age versus DTaP, Hib tetanus conjugate and IPV vaccine was demonstrated for all vaccine antigens in both primary and booster phases in terms of seroprotection/seroconversion rates. DTaP-IPV//PRP-T combined vaccine was well tolerated. The rate of solicited/unsoliciated severe adverse reactions was very low and similar to the control vaccines. Conclusion DTaP-IPV//PRP-T combined vaccine was highly immunogenic with good safety profile in Chinese infants, which was comparable to the commercially available control vaccines.

Blunt bowel injury (BBI) is relatively rare but life-threatening when delayed in surgical repair or anastomosis. Providing enteral nutrition (EN) in BBI patients with open abdomen after damage control surgery is challenging, especially for those with discontinuity of the bowel. Here, we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3. Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed. Postoperatively, the patient was transferred to our trauma center for septic shock and hyperbilirubinemia. Following salvage resuscitation, damage control laparotomy with open abdomen was performed for abdominal sepsis, and a temporary double enterostomy (TDE) was created where the anastomosis was ruptured. Given the TDE and high risk of malnutrition, multiple portions EN were performed, including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube. Besides, chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube. Hyperbilirubinemia was alleviated with the increase in chyme reinfusion. After 6 months of home EN and chyme reinfusion, the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet. For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen, the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.
Male ; Humans ; Middle Aged ; Enteral Nutrition ; Intestines/surgery* ; Intestinal Diseases ; Abdomen/surgery* ; Anastomosis, Surgical ; Abdominal Injuries/surgery*

Objective To investigate the changes of mitochondrial metabolic functions of macrophages following Echinococcus multilocularis infections, so as to provide insights into the pathogenesis of alveolar echinococcosis. Methods Two groups were assigned according to different treatment methods. In the culture group, mouse leukemic monocyte macrophage RAW264.7 cells were cultured with 2 000 E. multilocularis at a ratio of 500∶1, while RAW264.7 cells in the control group were given no treatment. Then, both the culture and control groups were further divided into the 24 h and 72 h subgroups. Mitochondria were stained with MitoTracker^® Deep Red FM and the mean fluorescence intensity of macrophage mitochondria was measured with the Cytation 5 Cell Imaging Multi-Mode Reader. The mitochondrial DNA copy number was quantified using the quantitative real-time PCR (qPCR) assay, and the mitochondrial energy metabolism was monitored using the Seahorse XF assay. In addition, the mitochondrial reactive oxygen species and mitochondrial membrane potential were detected using flow cytometry. Results The mean fluorescence intensities of macrophage mitochondria were significantly lower in the 24 h (15 341 ± 2 532 vs. 17 823 ± 3 429; t = 6.379, P < 0.01) and 72 h (18 102 ± 3 505 vs. 21 511 ± 5 144; t = 17.680, P < 0.01) culture subgroups than in the corresponding control subgroups, and lower mitochondrial DNA copy numbers were measured in the 72 h culture subgroup than in the 72 h control group [(3.23 × 10⁹ ± 1.78 × 10⁷) vs. (4.39 × 10⁹ ± 3.70 × 10⁷); t = 8.85, P < 0.001]. The oxygen consumption rates were significantly greater in the 24 h [(241.70 ± 73.13) pmol/min vs. (69.05 ± 52.30) pmol/min; t = 7.89, P < 0.01] and 48 h culture groups [(249.50 ± 42.06) pmol/min vs. (60.28 ± 40.66) pmol/min; t = 8.64, P < 0.01] than in the corresponding control groups, and a higher extracellular acidification rate was seen in the 48 h culture group than in the 48 h control group ([ 111.6 ± 17.49) mpH/min vs. (35.05 ± 7.57) mpH/min; t = 16.90, P < 0.01]. In addition, flow cytometry detected higher mean fluorescence intensity of mitochondrial reactive oxygen species (58 264 ± 10 087 vs. 4 307 ± 97; t = 12.930, P < 0.01) and lower mitochondrial membrane potential (9.833% ± 2.285% vs. 2.667% ± 0.208%; t = 6.645, P < 0.01) in the 72 h culture group than in the control group. Conclusions E. multilocularis infection may impair mitochondrial functions and inhibit oxidative phosphorylation of macrophages, resulting in increased macrophage glycolysis. It is speculated that the alteration of macrophage metabolic states may contribute to the mechanisms underlying the development and progression of alveolar echinococcosis.

ObjectiveTriple-negative breast cancer (TNBC) is the breast cancer subtype with the worst prognosis, and lacks effective therapeutic targets. Colony stimulating factors (CSFs) are cytokines that can regulate the production of blood cells and stimulate the growth and development of immune cells, playing an important role in the malignant progression of TNBC. This article aims to construct a novel prognostic model based on the expression of colony stimulating factors-related genes (CRGs), and analyze the sensitivity of TNBC patients to immunotherapy and drug therapy. MethodsWe downloaded CRGs from public databases and screened for differentially expressed CRGs between normal and TNBC tissues in the TCGA-BRCA database. Through LASSO Cox regression analysis, we constructed a prognostic model and stratified TNBC patients into high-risk and low-risk groups based on the colony stimulating factors-related genes risk score (CRRS). We further analyzed the correlation between CRRS and patient prognosis, clinical features, tumor microenvironment (TME) in both high-risk and low-risk groups, and evaluated the relationship between CRRS and sensitivity to immunotherapy and drug therapy. ResultsWe identified 842 differentially expressed CRGs in breast cancer tissues of TNBC patients and selected 13 CRGs for constructing the prognostic model. Kaplan-Meier survival curves, time-dependent receiver operating characteristic curves, and other analyses confirmed that TNBC patients with high CRRS had shorter overall survival, and the predictive ability of CRRS prognostic model was further validated using the GEO dataset. Nomogram combining clinical features confirmed that CRRS was an independent factor for the prognosis of TNBC patients. Moreover, patients in the high-risk group had lower levels of immune infiltration in the TME and were sensitive to chemotherapeutic drugs such as 5-fluorouracil, ipatasertib, and paclitaxel. ConclusionWe have developed a CRRS-based prognostic model composed of 13 differentially expressed CRGs, which may serve as a useful tool for predicting the prognosis of TNBC patients and guiding clinical treatment. Moreover, the key genes within this model may represent potential molecular targets for future therapies of TNBC.