Objective:To investigate the effects of cortical comminution on therapeutic outcomes and postoperative complications in young patients with femoral neck fracture after fixation with femoral neck system (FNS).Methods:A retrospective study was conducted of the 86 patients with femoral neck fracture who had been treated by FNS fixation from January 2020 to December 2020 at Department of Hip Orthopaedic Trauma, Tianjin Hospital. Of them, 41 had cortical comminution at the fracture ends of the femoral neck. They were 16 males and 25 females with a mean age of 53.0 (40.5, 57.0) years. The other 45 patients had intact cortical bone at the fracture ends of the femoral neck. They were 21 males and 24 females with a mean age of 55.0 (44.5, 62.5) years. The 2 groups were compared in terms of incidence of postoperative complications, Harris hip score, Barthel index and visual analogue scale (VAS) pain score after 6-month follow-up.Results:There were no statistically significant differences between the 2 groups in baseline data or reduction mode except for fracture classification, showing comparability between groups ( P>0.05). In the cortical comminution group, the incidences of nonunion [17.1%(7/41)] and femoral neck shortening [29.3%(12/41)] were significantly higher than those in the cortical intact group [0% (0/45) and 11.1% (5/45)], the Harris hip score and Barthel index [82.0 (72.5, 91.5) points and 100.0 (90.0, 100.0)] at 6 months postoperatively were significantly lower than those in the cortical intact group [94.0 (88.0, 98.0) points and 100.0 (100.0, 100.0)], the VAS pain score [1.5 (0, 4.5) points] was significantly higher than that in the cortical intact group [0 (0, 1.0) points] (all P<0.05). However, there was no significant difference between the 2 groups in osteonecrosis of the femoral head or internal fixation failure ( P> 0.05). Conclusions:Cortical comminution following femoral neck fracture is a major risk factor for post-operative complications after FNS fixation, because it may seriously affect the recovery of hip function and quality of life in young patients.

OBJECTIVETo investigate the molecular genetics basis for HLA novel allele HLA-DRB1*1212 in Chinese population.

METHODSGenomic DNA was extracted from whole blood by salting-out method. HLA-DRB1 gene exon 2 was amplified by PCR with group-specific primers from genomic DNA. PCR products were cut back from agarose gels and purified to sequence directly. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSO) was performed to confirm the mutations which were detected by sequencing in this study.

RESULTSThe sequencing results showed HLA-DRB1 alleles of the proband as DRB1*090102 and the novel allele. The sequences of the novel allele have been submitted to GenBank (AY899825). Through BLAST analysis, the novel allele was found to be different from DRB1*120101 at position 199A-->C in exon 2, that results in an amino acid change from Ile to Leu at codon 67.

CONCLUSIONThis allele is a novel and has been officially named as DRB1*1212 by the WHO Nomenclature Committee.

Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; ethnology ; DNA ; analysis ; Ethnic Groups ; Female ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Sequence Analysis

The aim of this study was aimed to investigate the molecular genetic basis for a novel HLA allele, HLA-B*4061, in Chinese population. DNA was extracted from whole blood by salting-out method. The HLA-B exons 1 - 8 of the proband was amplified and the amplified product was cloned using TOPO TA cloning sequencing kit to split the two alleles apart. Both strands of exons 2, 3 and 4 of chosen colonies were sequencing. The PCR-SSP was performed to confirm the mutations detected by sequencing. The sequencing results showed HLA-B alleles of the proband as B*4601 and the novel allele. The sequences of the novel allele have been submitted to GenBank (DQ089628, DQ089629, DQ089630). After HLA blast analysis, the novel allele showed a single nucleotide mismatch with B*400101 in exon 2 at position 272 C-->A, as the results, changing amino acid from Ser to Tyr at codon 67. It is concluded that this allele is a novel one and has been officially named B*4061 by the WHO Nomenclature Committee.
Alleles ; Amino Acid Substitution ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; HLA-B Antigens ; genetics ; immunology ; Histocompatibility Testing ; Humans ; Molecular Sequence Data ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid

AIM To study the chemical constituents from Inonotus sanghuang.METHODS The ethyl acetate extract from Inonotus sanghuang fermentation broth was isolated and purified by silica,Sephadex LH-20 column and HPLC,then the structures of obtained compands were identified by spectral data.RESULTS Twelve compounds were isolated and identified as (2Z,4E)-γ-ionylideneacetic acid (1),p-hydroxyphenethyl (2),5-hydroxymethyl-2-furancarboxaldehyde (3),2-hydroxy-5-hydroxymethyl furan (4),cyclo (D)-proline-(D)-leucine (5),cyclo (D)-proline-(D)-isoleucine (6),cyclo (D)-proline-(D)-valinel (7),cyclo (D)-proline-(D)-phenylalanine (8),cyclo-glycine-(D)-proline (9),cyclo-(D)-serine-(D)-proline (10),cyclo-(L)-alanine-(D)-proline (11),cyclo-(D)-alanine-(D)-proline (12).CONCLUSION All the compounds are isolated from Inonotus sanghuang for the first time.

ObjectiveTo study the regulatory effect of microRNA-124（miR-124） on the expression of Apelin（APLN） in epileptic neurons and its effect on neuronal injury. Methods Epileptic model of neurons was established by low magnesium extracellular medium. Dual-luciferase reporter gene system was used to verify the regulatory effect of miR-124 on APLN. Quantitative real-time PCR（qRT-PCR） was used to examine mRNA expression of miR-124 and APLN gene. Western blotting was employed to detect the expression of APLN，Bax，Bcl-2，and Caspase 3 proteins. Flow cytometry was utilized to determine the apoptosis of neurons. 〖WTHZ〗Results〖WTBZ〗Although no significant difference was reached，the luciferase activity was lower in miR-124+APLN gene wide-type group than that in control group. Both qRT-PCR and western blotting showed that up-regulation of miR-124 could promote the expression of APLN，and down-regulating miR-124 expression could inhibit APLN mRNA expression. Furthermore，up-regulating miR-124 expression could promote the apoptosis of epileptic neurons. The underlying mechanisms involved up-regulation of pro-apoptotic protein Bax and caspase 3，and down-regulation of anti-apoptotic protein Bcl-2. Conclusion The results of this study suggested that miR-124 might positively regulate APLN expression，and miR-124 might lead to neurons deaths by regulating other gene expression other than APLN gene.

This study was aimed to detect the gene expression profile changes between human acute leukemia cell line HL-60 and VCR-resistance HL-60, and to investigate the underlying mechanisms of MDR by using genechip technology. In experiments, mRNA were harvested using TrizoL reagent from these two cell lines, through RT-PCR, the biotinylated nucleotide were incorporated into the cRNA during the in vitro transcription reaction. The high quality RNA was hybridized to the gene expression array--human genome U133A developed by Affymetrix. It was scanned by G2500A GeneArray Scanner and the acquired image was analysed by a series of softwares. The results showed that 5,507 genes were differentially expressed between human acute leukemia cell line HL-60 and VCR-resistant HL-60. Compared with HL-60, 3,100 genes were up-regulated and 2,407 genes were down-regulated in VCR-resistant cell line. These genes were involved in different cell activities such as growth regulation and signal transduction. Among the genes with remarkable differential expression between the two cell lines, 435 were up-regulated and 605 were down-regulated. It is concluded that many different kinds of genes are involved in the mechanism of MDR and there is an intricate molecular network that controls the sensitivity of leukemia cells to the chemotherapeutic agents. Genechip is an efficient tool for parallel gene expression analysis.
Drug Resistance, Neoplasm ; genetics ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Genome, Human ; HL-60 Cells ; Humans ; Oligonucleotide Array Sequence Analysis ; Vincristine ; pharmacology

OBJECTIVETo investigate the effect of low-dose carvedilol combined with candesartan in the prevention of acute and chronic cardiotoxicity of anthracycline drugs in adjuvant chemotherapy of breast cancer.

METHODSForty patients were randomly divided into two groups: the experimental group with chemotherapy plus low-dose carvedilol combined with candesartan (20 cases) and control group with chemotherapy alone (20 cases). The same chemotherapy was given to the two groups. All the 40 patients had no contraindication for carvedilol and candesartan. Patients of the experimental group received low-dose carvedilol from 2.5 mg orally twice a day at first cycle to 5 mg twice a day gradually if no side reactions, and candesartan 2.5 mg orally once a day. Electrocardiogram, ultrasonic cardiogram, arrhythmia, troponin and non-hematologic toxicity were recorded and compared after the second, forth and sixth cycle of chemotherapy. Each cycle included 21 days.

RESULTSLVEF was decreased along with the prolongation of chemotherapy in the experimental group and control group. LVEDD and LVESD showed no significant changes in the experimental group, but gradually increased in the control group. After four and six cycles of chemotherapy, LVEF were (57.00 ± 5.13)% and (45.95 ± 3.68)%, respectively, in the control group, significantly lower than that of (67.00 ± 5.13)% and (57.50 ± 2.57)%, respectively, in the experimental group (P < 0.05). After six cycles of chemotherapy, LVEDD and LVESD were (50.00 ± 10.48) mm and (35.01 ± 2.99) mm, respectively, in the control group, significantly higher than those before chemotherapy (P < 0.05) and experimental group (P < 0.001). The rate of ST segment and T wave abnormalities was 80.0% in the control group after six cycles of chemotherapy, significantly higher than that of 25.0% after four cycles of chemotherapy (P = 0.001) and 10.0% after two cycles of chemotherapy (P < 0.001). The reduction of QRS voltage, arrhythmia and abnormal troponin were 55.0%, 45.0% and 45.0%, respectively, in the control group, significantly higher than those in the experimental group (20.0%, P < 0.05), (10.0%, P = 0.010) and (10.0%, P < 0.05), respectively. The rate of abnormal expression of troponin was 45.0% in the control group, significantly higher than the 10.0% in the experimental group (P < 0.05).

CONCLUSIONSThe use of low-dose carvedilol combined with candesartan can reduce the acute and chronic cardiotoxicity of anthracycline drugs, and with tolerable toxicities. This may provide a new approach to prevent cardiotoxicity of anthracycline drugs in adjuvant chemotherapy of breast cancer.

Adrenergic beta-Antagonists ; administration & dosage ; pharmacology ; Adult ; Aged ; Angiotensin II Type 1 Receptor Blockers ; administration & dosage ; pharmacology ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Arrhythmias, Cardiac ; chemically induced ; Benzimidazoles ; administration & dosage ; pharmacology ; Breast Neoplasms ; drug therapy ; surgery ; Carbazoles ; administration & dosage ; pharmacology ; Chemotherapy, Adjuvant ; Cyclophosphamide ; adverse effects ; therapeutic use ; Electrocardiography ; drug effects ; Epirubicin ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Mastectomy, Radical ; Middle Aged ; Propanolamines ; administration & dosage ; pharmacology ; Stroke Volume ; drug effects ; Tetrazoles ; administration & dosage ; pharmacology ; Troponin ; metabolism

OBJECTIVETo assess serum levels of endogenous endostatin in patients with clear cell renal cell carcinoma (CCRCC) and to determine the relationship of these levels to tumor stage, grade.

METHODSFrom March 2004 to October 2008, preoperative serum were obtained from 138 consecutive patients with CCRCC (73 patients in T1, 39 patients in T2, 20 patients in T3, and 6 patients in T4) and 40 healthy controls. Serum levels of endostatin were measured by sandwich-ELISA. Associations between circulating endostatin levels and clinicopathologic factors and clinical outcome were determined.

RESULTSEndostatin levels did not differ significantly between the patients with CCRCC (93.1 microg/L) and healthy controls (78.9 microg/L, P > 0.05). Serum levels of endostatin were significantly higher in the T2-4 CCRCC patients (107.2 microg/L) than those of the T1 patients (80.4 microg/L, P < 0.01). No significant difference was found in the endostatin levels among the T2-4 patients, or between healthy controls and the T1 patients. The serum endostatin concentration was significantly higher in the metastasis group (118.4 microg/L) than in the no metastasis group (89.5 microg/L, P < 0.05), but there was no significant difference between patients with distant metastasis group (122.0 microg/L) and lymph nodes metastasis (110.0 microg/L, P > 0.05). Patients with G3-4 tumors had significantly higher endostatin levels (111.8 microg/L) than those of patients with G1 (80.4 microg/L) and G2 tumors (86.2 microg/L, P < 0.01), but endostatin levels did not differ significantly between the two groups (P > 0.05).

CONCLUSIONPreoperative serum levels of endostatin elevated in patients with CCRCC and associated with higher stage and grade.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; blood ; pathology ; Endostatins ; blood ; Female ; Humans ; Kidney Neoplasms ; blood ; pathology ; Male ; Neoplasm Staging ; Prognosis

BACKGROUND: An association has been reported between CYP2C19 polymorphism and the altered antiplatelet activity of clopidogrel. We investigated this association using the newly introduced platelet function analyzer (PFA)-200 (INNOVANCE PFA-200 System; Siemens Healthcare, Germany) P2Y test. METHODS: Polymorphisms of CYP2C19*2, *3, *17 and the degree of inhibition of platelet function were determined in 83 patients. Three different platelet function tests were used to evaluate the degree of platelet inhibition and to check the association with genotype. RESULTS: The post-procedure PFA-200 values of extensive metabolizers (EM) patients (285.3+/-38.8) were higher than those of intermediate metabolizers (IM) and poor metabolizers (PM) patients (227.7+/-98.3 and 133.7+/-99.2, respectively; P=0.024). Light transmittance aggregometry (LTA) and the VerifyNow system showed that the post-procedure values for EM patients were lower than those of IM and PM patients (LTA: 24.4+/-15.7, 34.1+/-17.6, and 42.2+/-16.9, respectively, P<0.001; VerifyNow: 133.2+/-60.5, 171.5+/-42.6, and 218.7+/-59.3, respectively, P<0.001). The high residual platelet reactivity (HPR) rates were significantly different among the EM, IM, and PM groups using PFA-200 (PM:IM:EM=82.4:40.6:11.8, P<0.001). CONCLUSIONS: Approximately, 59.0% of Korean patients with cardiovascular disease receiving clopidogrel had CYP2C19 loss-of-function genotypes classified as IM or PM, and the frequency was similar to the data from Asian people. The PFA-200, LTA, and VerifyNow platelet function tests revealed evidence of a significant association between the efficacy of clopidogrel and CYP2C19 genotypes.
Aged ; Cardiovascular Diseases/blood/*drug therapy ; Cytochrome P-450 CYP2C19/*genetics/metabolism ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Phenotype ; Platelet Aggregation Inhibitors/*therapeutic use ; Platelet Function Tests/instrumentation ; Polymorphism, Genetic ; Ticlopidine/*analogs & derivatives/therapeutic use

BACKGROUND AND OBJECTIVES: The aim of this study was to confirm the predictive cut-off values for P2Y12 reaction units (PRU) and aspirin reaction units (ARU) and to evaluate the clinical impact of VerifyNow(R) assays. SUBJECTS AND METHODS: From November 2007 to October 2009, 186 eligible patients were prospectively recruited. Post-treatment platelet reactivity was measured by VerifyNow(R) assays within 12 to 24 hours after intervention, followed by standard dual maintenance dose therapy for 1 year. All patients had scheduled clinical follow-ups at 1, 3, 6, and 12 months. RESULTS: The rate of low responders to clopidogrel, aspirin, and both drugs were 41.4%, 10.2%, and 3.8%, respectively. The predictive factors for low responsiveness to clopidogrel (PRU > or =240) were female sex, age, and non-use of cilostazol medication in our univariate analysis and age > or =65 years and non-use cilostazol in the multivariate analysis. The predictors of low responsiveness to aspirin (ARU > or =550) were male sex and age in both univariate and multivariate analyses. There was no significant difference in the clinical event rate with a cut-off value of PRU > or =240 or ARU > or =550 for 30 days and 1-year (p>0.05). CONCLUSION: Hyporesponsiveness to antiplatelet agents (namely aspirin and clopidogrel) was identified in about half of the patients. The cut-off point of PRU > or =240 or ARU > or =550 did not confer predictive value for 30-day or 1-year clinical event rates in patients who had undergone coronary intervention with drug-eluting stents.
Aspirin ; Blood Platelets ; Coronary Artery Disease ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Multivariate Analysis ; Platelet Aggregation Inhibitors ; Platelet Function Tests ; Prospective Studies ; Stents ; Tetrazoles ; Ticlopidine