[Objective]To investigate the clinical features,reasons of missed diagnosis and treatment for ipsilateral fractures of femoral neck and shaft.[Method]Twelve cases of ipsilateral fractures of femoral neck and shaft treated from 1999 to 2005 were retrospectively reviewed.Seven cases' neck fractures were diagnosed separately before operation,2 cases' were diagnosed during operation and 3 were diagnosed after operation.Among the 12 cases,3 cases were treated with reconstructive intramedullary nail to fix both shaft and neck fractures;2 cases were treated with DHS to fix both shaft and neck fractures;1 case was treated with retrograde interlocking intramedullary nail to fix shaft fracture and with canulated screws to fix neck fracture;2 cases were treated with interlocking intramedullary nails and canulated screws;1 case combined supracondylar fracture of femur,was treated with LISS-DF to fix shaft and supracondylar fracture,canulated screws to fix the neck fracture;the neck fractures were found in 3 cases after shaft fixation with plate,then fixed with canulated screws.[Result]All cases were followed up for 1~6 years,with an average of 3.4 years.All femoral shaft fractures were united and 11 neck fractures were united,1 neck fracture was malunion,1 case was osteonecrosis of femoral head.[Conclusion]The ipsilateral fracture of femoral neck and shaft is rare,and the neck fracture is easy to miss diagnosis.The orthopaedic surgeons should consider the femoral neck fractures by analyzing the mechanism of high energy injury patient with femoral shaft fracture.Pelvic X-ray should be taken conventionally or CT scan when necessary.The surgical treatment for ipsilateral fractures of femoral neck and shaft depends on the position of femoral shaft,and the situation of femoral neck.

BACKGROUND:Many liver cancer stem cel markers have been found in liver cancer tissues and cel lines such as CD133, acetaldehyde dehydrogenase (ALDH), CD90, CD44, EpcAM, CD13, OV6, K19, c-kit and ABCG2. Of them, CD133, CD90 and CD44 have been shown to be strongly associated with the recurrence and metastasis of liver cancer. OBJECTIVE:To explore the dynamic changes of liver cancer stem cel markers and inflammatory factors during the induction of liver cancer in rats and their correlation. METHODS:Diethyl nitrosamine solution was given to Sprague-Dawley rats for 24 hours to induce rat models of liver cancer. Rats that were given common water were considered as the healthy control group. RESULTS AND CONCLUSION: Immunohistochemical staining revealed that Kupffer cels-related ED2 expression showed a gradual increase in the model group. Compared with the healthy control group, ED2 expression was significantly higher at 12, 16, 20 and 24 weeks after induction in the model group (P < 0.05). Quantitative PCR demonstrated that CD90 showed a gradualy increased trend during induction (P < 0.05). Compared with healthy tissue, CD90 increased significantly in the liver cancer tissue (P < 0.05). CD133 showed an increased trend, but one-way analysis of variance did not show significant differences (P > 0.05). During induction, no significant change was found in other liver cancer stem cel markers (P> 0.05). During the induction, tumor necrosis factor α, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly increased (P < 0.05). Compared with healthy tissue, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly higher in the liver cancer tissue (P < 0.05). Other inflammatory factors did not exhibit significant alterations during the induction (P > 0.05). Pearson correlation analysis demonstrated that MCP-1, transforming growth factor βand interleukin-6 expression levels were significantly positively correlated with CD90 expression (P < 0.05). These findings suggest that partial inflammatory factors released from Kupffer cels have a certain correlation with liver cancer stem cels. Kupffer cels can promote the occurrence of liver cancer.

Objective To evaluate three molecular methods for rapid identification of nontuberculous Mycobacterium(NTM).Methods Forty-one clinical NTM isolates were collected and 16S rRNA gene sequencing was used as the standard method for NTM identification.Meanwhile,the restriction fragment length polymorphism of hsp65 PCR-RFLP and hsp65 gene sequencing were used to identify NTM strains and compared with 16S rRNA gene sequencing.Results The results of 16S rRNA sequencing showed that there were nine Mycobacterium chelonae complex strains,seven Mycobacteriumfortuitum strains,seven Mycobacterium intracellulare strains,three Mycobacterium avium strains,three Mycobacterium kansasii complex strains, three Mycobacterium smegmatis strains, three Mycobacterium terrae strains, two Mycobacterium phlei strains,two Mycobacterium nonchromogenicum strains,one Mycobacterium scrofulaceum strain and one Mycobacterium arupense strain.Compared with 16S rRNA gene sequencing,hsp65 PCR-RFLP could identify nine Mycobacterium chelonae complexes and three Mycobacterium kansasii complexes to subspecies Mycobacterium abscessus and Mycobacterium kansasii,respectively; One Mycobacterium fortuitum strain and one Mycobacterium nonchromogenicum strain were different from 16S rRNA gene sequencing results ,but other isolates were the same.The coincidence was 95.1%.By hsp65 gene sequencing,only one identification of Mycobacterium hiberniae strain was different from 16S rRNA gene sequencing and the coincidence was 97.6%.And hsp65 gene sequencing could further identify nine Mycobacterium chelonae complexes and three Mycobacterium kansasii complexes to subspecies Mycobacterium abscessus and Mycobacterium kansasii,respectively.Conclusions All three molecular methods can identify NTM strains rapidly.Compared with 16S rRNA gene sequencing,hsp65 gene sequencing and hsp65 PCR-RFLP are easier to identify clinical common NTM strains(such as Mycobacterium kansasii and Mycobacterium abscessus),and can be widely used in clinical practice.

Carcinoma, Squamous Cell ; Epithelial Cells ; Humans ; Papilloma

Objective To observe the ultrastructure of blood-brain barrier in the nude mouse model of brain me-tastases from lung cancer by transmission electron microscopy using lanthanum nitrate tracing.Methods PC-9 cells (1 × 106/0.1 mL) in logarithmic phase were respectively injected into six nude mice ( model group) selected from eight nude mice randomly via the left ventricle, the other two mice without any treatment as the control group.The general status of the mice was observed after implantation.In the fourth week all the mice were sacrificed and brain tissue samples were taken and prepared for transmission electron microscopic observation using lanthanum nitrate tracing.besides, the lung and brain were removed and stained with HE to detect the presence of tumor metastasis.Results Mice in the model group began to lose weight almost simultaneously in the third week and became moribund slowly, and were all sacrificed at the fourth week when showing clear signs of cachexia.At autopsy, the thoraxes were clear, with normal lungs.Histology showed evidence of brain metastasis in all the six mice.The electron microscopy showed that lathanum nitrate tracer was escaped from the capillaries and diffusely or sparsely distributed in the brain tissues of the model group mice, however lathanum nitrate tracer was still confined in the capillary lumen in the mice of control group.Conclusions The diffuse lathanum nitrate tracer in the brain parenchymal tissue indicates the impairment of blood-brain barrier in the nude mouse model of lung cancer brain metastasis and the formation of these metastases is accompanied with the destruction of blood brain barrier.

Ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF/MS) was developed to identify the absorbed parent components and metabolites in rat bile, plasma and urine after oral administration of Radix Paeoniae Alba extract (RPAE). A total of 65 compounds were detected in rat bile, plasma and urine samples, including 11 parent compounds and 54 metabolites. The results indicated that glucuronidation, hydroxylation and methylation were the major metabolic pathways of the components of RPAE. Furthermore, the results of this work demonstrated that UPLC-Q-TOF/MS combined with MetaboLynx? software and mass defect filtering (MDF) could provide unique high throughput capabilities for drug metabolism study, with excellent MS mass accuracy and enhanced MSE data acquisition. With the MSE technique, both precursor and fragment mass spectra can be simultaneously acquired by alternating between high and low collision energy during a single chromatographic run.

Objective To identify non-tuberculous Mycobacterium(NTM) rapidly with HAIN molecular assay genotype Mycobacterium kit,and investigate the advantages and disadvantages of this method.Methods Seventy-four clinical NTM isolates were collected from hospitals in Zhejiang and Anhui province.Clinical strains were identified with HAIN molecular assay genotype Mycobacterium kit.16S rRNA gene sequencing was used to estimate and compare with this method.Results The results of kit showed that there were thirty-one M.intracellulare strains,twelve M.chelonae strains,eight M.fortuitum strains,six M.kansasii strains,five M.avium strains,three M.smegmatis strains,two M.phlei strains,two M.scrofulaceum strains and one M.gordon strain.Four strains were identified as Mycobacterium without further identification.Eight M.tuberculosis strains were identified correctly too.Compared with 16S rRNA gene sequencing,except for four strains identified as Mycobacterium,others 70 strains got the same results as 16S rRNA gene sequencing,the coincidence was 94.59％,and it could further identify thirteen Mycobacterium chelonae complex and eight Mycobacterium kansasii complex to subspecies M.abscessus and M.kansasii,respectively.If only to identify strains under the identification range of this kit,the coincidence reach to 100％,Conclusion The method of HAIN molecular assay genotype Mycobacterium kit is simple and accurate,the time is shorter and should widely be applied clinically.

OBJECTIVETo evaluate the in vitro cario-static effect of Galla chinesis with biofilm model.

METHODSA four-organism bacterial consortium was cultured in a biofilm model on hydroxyapatite (HA) discs in a continuous culture system and exposed to repeated solution pulsing. There were three groups with different solution pulsed in the model: negative control group was pulsed with distilled water, positive control group was pulsed with 100 mmol/L sucrose solution and experimental group was pulsed with 100 mmol/L sucrose solution containing 4.0 g/L Galla chinensis. During the experiment, the dynamic changes of pH were recorded. After 6 pulses, surface structure of the biofilm was observed with a scanning electron microscope and the population on the biofilm was enumerated.

RESULTSGalla chinesis significantly inhibited the adherence of Actinomyces naelundii to HA disc compared with the control group and facilitated the removal of acid products. It was also found that the extra-cellular polysaccharide was reduced with the pulsing of Galla chinesis.

CONCLUSIONGalla chinesis in the biofilm model can partially reduce the cario-genic response of sucrose solution.

Actinomyces ; drug effects ; physiology ; Bacterial Adhesion ; drug effects ; Biofilms ; growth & development ; Cariostatic Agents ; pharmacology ; Dental Caries ; microbiology ; Drugs, Chinese Herbal ; pharmacology ; Durapatite ; Humans ; Models, Biological ; Streptococcus mutans ; drug effects ; physiology ; Streptococcus sanguis ; drug effects ; physiology ; Sucrose ; pharmacology

OBJECTIVETo evaluate the Nidus vespae's cario-static effect on biofilm model in vitro.

METHODSA four-organism bacterial consortium was grown in a biofilm model on hydroxyapatite (HA) discs in a continuous culture system and exposed to repeated solution pulsing respectively. There were three parallel-connected flow cells in the model, so were the three groups with different solution pulsed in. Negative control group was pulsed with distilled water, positive control group was pulsed with 250 mmol/L sucrose solution as well. While 4.0 g/L Nidus vespae together with 250 mmol/L sucrose solution was pulsed in the experiment group. During the experiment, the pH responses against the pulses were recorded. After the 6 pulses, the biofilm surface structure was observed with a scan electron microscope and the population on the biofilm was enumerated.

RESULTSNidus vespae can significantly inhibit the adherence of Streptococcus mutans to HA discs compared with the control group of 250 mmol/L sucrose pulsed in, and can facilitate the remove of acid products. It is also found that the extra-cellular polysaccharide is reduced with the pulsing of Nidus vespae.

CONCLUSIONNidus vespae in the biofilm model can partially decrease the cariogenic response of sucrose solution pulsed in.

Anti-Infective Agents ; pharmacology ; Bacterial Adhesion ; drug effects ; Biofilms ; growth & development ; Dental Caries ; microbiology ; Dental Enamel ; metabolism ; Dental Plaque ; microbiology ; Durapatite ; Evaluation Studies as Topic ; Humans ; Models, Biological ; Propolis ; pharmacology ; Streptococcus mutans ; drug effects ; physiology ; Streptococcus sanguis ; drug effects ; physiology ; Sucrose ; pharmacology

Objective To investigate the safety and effectiveness of different intravenous anesthesia methods for pediatric ERCP . Methods Data of 45 children undergoing ERCP at the Affiliated Hangzhou Hospital of Nanjing Medical University from August 2013 to July 2016, including intravenous anesthesia,the procedure of ERCP, adverse reactions and the waking time were retrospectively studied. Results A total of 45 patients in two groups under intravenous anesthesia successfully underwent ERCP . Seventeen patients ( 37. 8%) whose body weights were over 20 kg and the duration of surgery was predicted less than 30 minutes received deep sedation without airway intubation. Twenty?eight patients ( 62. 2%) with an initial weight of less than 20 kg and the duration of surgery was predicted more than 30 minutes received general anesthesia with airway intubation. In patients with deep sedation, the mean time of waking was 7. 2±6. 3 minutes, body movement reaction occurred in 1 case ( 5. 9%) and with transient decreasing of pulse blood oxygen ( beyond 95%) occurred in 2 cases ( 11. 8%) . In patients receiving endotracheal anesthesia with intubation, the mean waking time was 10. 5±8. 7 minutes without adverse reactions associated with anesthesia. Conclusion Both deep sedation and general anesthesia with airway intubation are safe for pediatric ERCP. However, general anesthesia with airway intubation is an ideal method ensuring the airway safety and oxygen supply for children less than 20 kg undergoing first?time ERCP or the duration of surgery lasting over 30 minutes.