Objective To investigate the diagnosis,operation characteristics and clinical effect of anterior Pilon fracture.Methods A retrospective analysis was carried out to analyze 13 patients who had been treated for anterior pilon fracture from September 2012 to March 2014.All had fresh closed fracture.Mean age was 39.8 years (range,18-61 years).Injury resulted from high falls in 11 patients and falls in 2 patients.According to the preoperative imaging manifestations and four column fracture classification,the fracture type was mainly anterior column fracture.All underwent open reduction and internal fixation with buttress plates,and allograft bone was performed in 8 patients.At the last followup,American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale(VAS) were employed for clinical evaluation.Results Mean period of follow-up was 15.7 months (range,12-30 months).Mean AOFAS score was 91.38 points (range,74-100 points).Excellent results were found in 10 patients,good in 2 and fair in 1,with the excellent-good rate of 92％.Mean VAS score was 1.08 points (range,0-3 points).Traumatic arthritis occurred in 1 patient.Skin necrosis occurred in 1 patient,and was cured by dressing change.There were no complications such as infection,refracture or implant failure.Conclusions Mechanism of injury in anterior pilon fracture is vertical violence when the foot in dorsiflexion position.Imaging findings are mainly characterized by the compression in anterior articular surface of the distal tibia,which is often implicated in the anterior medial malleolus but in part is combined with lateral malleolus fracture.The fracture is the result of high energy injury,and can be diagnosed by mechanism of injury and imaging manifestations.Through anterior approach,open reduction and internal fixation with buttress plates plus allogenic bone grafting obtain satisfactory outcomes.

Objective To study the effect of three different modes of non-invasive positive pressure ventilation on cardiac indices of premature infants with respiratory distress syndrome (RDS).Method From January 2014 to October 2015,preterm infants who had RDS received intubation-pulmonary surfactantextubation in the neonatal intensive care unit of the Hospital were randomly assigned (by random number table) to three groups based on the primary mode of ventilation:nasal continuous positive airway pressure (NCPAP),bi-level positive airway pressure (BiPAP),and synchronized bi-level positive airway pressure (SBiPAP).The mean airway pressure (MAP) were about 6 cmH2O in the three groups.The level of plasma B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI),and correct QT intervals dispersion (QTcd) were monitored before and 42-54 h after non-invasive ventilation.Result There were 173 cases in our study,59 of which in NCPAP group,56 in BiPAP group,and 58 in SBiPAP group.The plasma BNP level at 42-54 h after non-invasive ventilation in the three groups were all higher than that before non-invasive ventilation [NCPAP group:(247.9 ± 137.9) ng/L vs.(182.5 ± 1 10.7) ng/L,P =0.007;BiPAP group:(258.5 ± 131.2) ng/L vs.(182.6 ± 105.0) ng/L,P ＜ 0.001;and SBiPAP group:(260.9 ± 159.7) ng/L vs.(177.5 ± 101.5) ng/L,P =0.002].After 42-54 h non-invasive ventilation,there were no significant changes of plasma cTnI level and QTcd in all the three groups (all P ＞ 0.05).The level of plasma BNP,cTnI,and QTcd among the three groups before and after 42-54 h non-invasive ventilation all showed no significant differences statistically (all P ＞ 0.05).Conclusion Longer duration (42-54 h) of non-invasive positive pressure ventilation (MAP:6 cmH2O) in preterm infants with RDS may lead to increased plasma BNP level,and may affect their cardiac function.However,it may not lead to serious myocardial damage and abnormality of ventricular repolarization.There were no significant differences in cardiac indices of premature infant with RDS among NCPAP,BiPAP,and SBiPAP group with the same MAP.

Objective To evaluate the accuracy of the transcutaneous bilirubin (TcB) at different sites including the chest (covered and uncovered),forehead and scapula,compared with total serum bilirubin (TSB) before and after phototherapy.Method Neonates who underwent blood test of TSB together with the average TcB at chest over 6 mg/dl from September 2015 to July 2016 in our Hospital were enrolled in our study.TcB measurements were done by the transcutaneous bilirubinometer (JH20-1 C) at the sites of the chest,forehead and scapula within 30 minutes after venous or arterious blood sampling for testing TSB after admission.An area of 2 cm diameter over the left chest was covered during phototherpy.TSB was tested immediately and within 12 ～ 24 hours after phototherapy,while TcB was measured within 0.5 hour after blood sampling at the covered sites over the left chest,right chest,forehead and scapula.IBM SPSS 20.0 software was used for data analysis.Data were compared via Pearson correlation analysis,ANOVA of repeated measurement data,student's t test and Bland-Altman analysis.Result A total of 437 data were collected from 364 neonates were enrolled in our study.Before phototherapy,the values of TcB at different sites were highly correlated and consistent with TSB (P ＜ 0.05),especially taken from the chest (the difference value of TcB and TSB-1.2 ± 2.3 mg/dl).Immediately and within 12 ～ 24 hours after the phototherapy,the values of TSB and TcB taken from the covered left chest showed the highest consistency (-1.2±2.3 mg/dl and-0.5 ± 1.6 mg/dl).When TSB exceeded 15 mg/dl before phototherapy,the difference between TSB and TcB taken from chest was 1.5 ± 1.6 mg/dl,while if TSB was below 15 mg/dl,the difference was-1.9 ± 1.9 mg/dl.They were significantly different (P ＜ 0.001).And difference between TSB and TcB taken from chest was not affected by gender gestational age,birth weight,days of birth and different measurements.When TcB taken from the covered or uncovered chest was less than the TSB threshold value of 3.3 mg/dl for phototherapyl,or the TcB of the left covered sternum lower than the threshold value of 2.6 mg/ml for cessation of phototherapy,97.5％ of the TSB would not exceed the corresponding value.Conclusion The TcB values of both uncovered chest before phototherapy and covered chest after phototherapy were highly consistent with TSB,and could be applied in the replacement of TSB in the assessment and management of neonatal jaundice.

The effect of obesity on idiopathic central precocious puberty (ICPP) girls is still under discussion.The relationship between body mass index (BMI) and sexual hormone levels of gonadotropin-releasing hormone (GnRH) stimulation test in ICPP girls is controversial and the underlying mechanism is unclear.This study aims to further explore the independent effect of excess adiposity on peak luteinizing hormone (LH) level of stimulation test in ICPP girls and the role of other related factors.A retrospective cross-sectional study was performed on 618 girls diagnosed as having ICPP,including 355 cases of normal weight,99 cases of overweight and 164 cases of obese.The results showed that obese group had more progressed Tanner stage and no significant difference (P=0.28) in LH peak was found as basal LH value was used as a covariate.The obese group had higher total testosterone (TT),adrenocorticotrophic hormone (ACTH),17-α hydroxyprogesterone (17-αOHP) and androstendione (AN),with significantly increased fasting insulin (FIN) and homeostasis model of assessment for insulin resistance index (HOMA-IR).Stratified analysis showed inconsistency of the relationship between BMI-standard deviation score (BMI-SDS) and LH peak in different Tanner stages (P for interaction=0.017).Further smoothing plot showed linear and non-linear relationship between BMI-SDS and LH peak in three Tanner stages.Then linear regression model was used to analyze the relationship between BMI-SDS and LH peak in different Tanner stages,with and without different confounding factors being adjusted.In B2 stage,BMI-SDS was negatively associated with LH peak.In B3 stage,when BMI-SDS ＜1.5,as BMI-SDS increased,the level of LH peak decreased (model Ⅰ:β=-1.8,95％ CI=-4.7 to 1.1,P=0.214).When BMI-SDS ≥1.5,BMI-SDS was significantly positively associated with LH peak (model Ⅰ:β=4.5,95％ CI=1.7 to 7.4,P=0.002).In B4 stage,when BMI-SDS ＜1.5,BMI-SDS was negatively associated with LH peak (model Ⅰ:β=-11.6,95％ CI=-22.7 to-4.5,P=0.049).When BMI-SDS ≥1.5,BMI-SDS was positively associated with LH peak (model Ⅰ:β=-4.2,95％ CI=-3.3 to 11.7,P=0.28).It is concluded that there is an independent correlation between BMI-SDS and LH peak of stimulation test in ICPP girls,their relationships are different in different Tanner stages,and the effect of BMI-SDS can be affected by adrenal androgens,estradiol and glucose metabolism parameters.

Objective To research the effect mechanism of ultrashortwave in the correlation of ultrashortwave and the tail replantation, provide the experiment basis of clinical practice of prevention and cure for the vascular crisis after micromodule anastomosis. Methods Eighty Sprague-Dawley(SD) rats of clean grade were 3-month-old,female,and were divided into four groups:control group (group 0),model group (group 1 ),contrast group (group 2),ultrashortwave (USW) group (group 3).The preparation of tail replantation model was cut off soft tissue except for caudal veins on both sides of the tail. The coccyx was not broken away from tail.At last,the audal artery under abdominal main centre ditch was anastomosed.In experiment process, the USW group was divided into high dosage group (group 3A) and low dosage group (group 3B). The caudal arterys were ligated and not anastomosed in the group 0. Caudal arterys in other groups were anastomosed.Rats in the group 0 and group 1 received no treatment,normal management after the operation. Rats in the group 2 were given abdominal cavity injection of papaverin liquid immediately,then once a day to 5 days after the tail replantation.Rats in the group 3 were immediately given USW therapy of twenty minutes on the anastomosis section,and then once a day for 5 days after the tail replantation.The USW dosage of group 3A was 3th grade and 50mA. The USW dosage of group 3B was 2th grade and 28mA.The survival rate of the rat tails was observed after the tail replantation for 10 day.Before being grouped,it was measured that the tail skin temperature diference between near and far side of anastomosis section.After the tail relpantation, the temperature diference was inspected daily for 10 postoperative days hence. Before rats were grouped and the eighth hour after the tail replantation, rats were collected blood plasma specimens and measured contents of nitric oxide with destination colorimetric mathods of nitric oxide.Results Carrying out comparison of survival rate of every group,the output weve:between tail cutting off group (group 0,0) and tail replantation group (group 1,2,3,43.94％) to compare P ＞ 0.05; between each group of the tail replantation groups (1,2,3A,3B group) to compare P＞ 0.05,group 3B ＜ 2 ＜ 1 ＜ 3A; between group 3B and group 1 to compare P ＞ 0.05; between group 2 and group 1 to compare P ＞ 0.05. Each group were compared with the change daily between postoperative and preceding operative the skin temperature diference,single-factor analysis of variance (One-Way ANOVA) analysis:Postoperative 1 day,group 3A ＜ 1,P ＜ 0.05.Postoperative 6 day:3A ＜ 3B ＜ 1 ＜ 2,P ＞ 0.05.Postoperative 7 day:group 3B ＜ 1 ＜ 3A ＜ 2,P ＜ 0.05.Each group were compared with the change of the content of nitric oxide between postoperative 8 hour and preceding operative,with rank-sum test:group 3B ＞ 3A ＞ 2 ＞ 1 ＞ 0,H =33.760,P ＜ 0.05,shows statistically significant.Conclusions USW therapy,especially USW low-dose therapy,can reduce vascular crisis and improve the survival rate of replanted rat tails,after the postoperative 1,6,7 days,reduce skin temperature,improve blood supply,improve nitric oxide at postoperative eighth hour,prevent vascular crisis.Rat tail replantation model in this experiment is feasible.

Objective To understand the clinical features of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) complicated by cytomegalovirus (CMV)viremia.Methods The clinical data of 249 cases of HIV/AIDS patients hospitalized in Beijing Ditan Hospital from Oct 2008 to Nov 2009 were analyzed retrospectively,in which 43 HIV/AIDS patients were diagnosed with CMV viremia.The symptoms and signs,cerebrospinal fluid (CSF)tests,and pathological detections by bronchoscope,gastroscope and fibercoloscope were collected.The database was set up using Excel software.The association between cellular immunity and CMV DNA level was determined by SPSS12.0 software.Results Forty-three patients (17.3%)were diagnosed with CMV viremia by positive results of CMV pp65 antigen and CMV DNA tests; 14 patients manifested retinal bleeding or infiltration and 4 patients displayed retinal fibrosis; 1 patient was diagnosed with CMV pneumonitis by pathological results of bronchoalveolar lavage fluid.Low level of CD4+ T lymphocytes and CMV DNA levels were positively correlated.Conclusions CMV pp65 antigen and CMV DNA should be detected in HIV/AIDS patients with CD4+ T lymphocytes less than 100 × 106/L and anti-CMV treatment should be given according to the results.Ophthalmologic examination and bronchoalveolar lavage fluid pathological detection are effective methods in diagnose of CMV retinitis and pneumonitis.

Objective To investigate water fluoride content and the current status of water-improving project in Jining,Shandong Province in 2005.Methods Water fluoride content and the status of water-lmprovlng project were havestigated in Bencheng Ditrict,Liangshan and Jiaxiang Couties of Jining City.The fluoride content in drinking warer was assessed by F-ion selective electrode.Results Water fluoride contents of 671 fluorosis villages were determined.One hundred and seventy villages had water fluoride content less than or equal to 1.00 mg/L(accounting for 25.34%)and 501 villages water fluoride content higher that 1.00 mg/L(accounting for 74.66%),with the highest being 11.33 mg/L.Four hundred and ninty.seven projects were surveyed,in which 161 Projects were discarded (accounting for 32.39%),334 projeets worked well(accounting for 67.20%),and 2 pmjects worked fitfully(accounting 0.40%).Two hundreds and eighty-one projects had water fluoride content≤1.00 ms/L and 55 projects had water fluofide cantent>1.00 mg/L(aceounting for 26.82%),with the highest being 4.28 ms/L.Conclusions The situation of endemic fluorosis control is still serious in Jining City.Countermeasures for endemic fluorosis must be carried out as sppm as possible and surveillance of water-improving and defluoridation projects must be strevIsthend.

Objective To explore the effect of T140 on SDF-1 and MMPs levels through targeted blocking SDF-1/CXCR4 signaling pathway , and to investigate the function of T140 to prevent from cartilage degeneration. Methods Thirty-six 9-month-old male healthy Hartley guinea pigs were divided into three groups: experimental group(group A,n = 12),experimental control group(group B,n = 12) and blank control group (group C,n = 12). In the 2nd,4th,6th,8th,10th,12th week, the levels of SDF-1 in serum were quantified with ELISA. In the 12th week, mRNA levels of MMP-3,MMP-9 and MMP-13 in articular cartilages were measured with RT-PCR. Results The serum levels of SDF-1 of the group A decreased gradually but increased in group B and C. Group A had a statistical significance compared with group B and C at the same time point (P< 0.05).The mRNA levels of MMPs in group A were lower than group B and C (P < 0.05). Conclusion T140 could block the SDF-1/CRCR4 signaling pathway and decrease the secretion of SDF-1 and mRNA expression levels of MMPs and reduce the cartilage degeneration.

AIM:To investigate the effect and mechanism of osthole on increasing the cytotoxicity of doxorubi -cin(DOX)to prostate cancer cells.METHODS:MTT assay was performed to evaluate the viability of LNCaP cells trea-ted with osthole and DOX.The protein expression of silent information regulator 1(SIRT1),p53,acetylated p53 and Pu-ma,as well as release of cytochrome C and activation of caspase-9 and caspase-3 in the LNCaP cells treated with osthole and DOX were determined by Western blot.The apoptosis of the LNCaP cells treated with osthole and DOX was analyzed by flow cytometry.RESULTS:Osthole significantly increased the cytotoxicity of DOX against p 53-wildtype prostate cancer cell line LNCaP.Osthole significantly inhibited the expression of SIRT 1 in the LNCaP cells.Transfection with SIRT1 plas-mid decreased the cytotoxicity of osthole and DOX co-treatment against LNCaP cells.Combination with osthole and DOX significantly induced the over-expression and acetylation of p53.Transfection with p53 siRNA significantly decreased the synergistic effect of osthole on cytotoxicity of DOX-treated LNCaP cells.Combination with osthole and DOX significantly in-duced the release of cytochrome C into the cytoplasm from mitochondria,followed by activation of caspase-9 and its down-stream molecule caspase-3,thus leading to cell apoptosis in the LNCaP cells.CONCLUSION:Osthole promotes the p53-dependent apoptosis in DOX-treated prostate cancer LNCaP cells by down-regulating the expression of SIRT1.

OBJECTIVETo observe the cytotoxic effect of cisplatin with proteasome inhibitor on osteosarcoma cells.

METHODSCell survival was tested by MTT, apoptotic morphology was observed by electron microscopy, apoptotic rate was analyzed by flow cytometry, the transcription level of excision repair cross complementation-1 (ERCC-1) was tested by reverse transcription polymerase reaction.

RESULTSCompared with cells treated with cisplatin alone, cells treated with cisplatin and proteasome inhibitor showed a decreased survival rate, more typical apoptotic morphology, higher apoptotic rate [(14.37 +/-2.37)% vs. (50.93 +/-4.84)%, P<0.01)], and lower transcription level of excision repair cross complementation-1.

CONCLUSIONProteasome inhibitor could increase the cytotoxic effect of cisplatin on osteosarcoma cells and promote cisplatin-induced osteosarcoma apoptosis. These effects may be associated with the decreased transcription of excision repair cross complementation-1.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Bone Neoplasms ; pathology ; Cisplatin ; pharmacology ; Drug Synergism ; Oligopeptides ; pharmacology ; Osteosarcoma ; pathology ; Rats ; Tumor Cells, Cultured