Objective To investigate the impact of Ang-1 on the septic mice′pulmonary vascular endothelial barrier function and VE-cadherin and its mechanism. Methods 80 BALB/c mice were randomly divided into NS, LPS, LPS+Ang-1, LPS+Ang-1+ Ly and Ang-1 groups (n = 16). Measure VE-cadherin, Ang-2 levels in plasma and lung permeability index (LPI).Test the total VE-cadherin of lung and the phosphorylation of VE-cadherin expression. Results Plasma Ang-2 was higher compared with NS group(P<0.01) except Ang-1 group. In LPS+Ang-1 group and LPS+Ang-1+Ly group, plasma Ang-2 was lower compared with LPS group (P <0.05). In LPS+Ang-1+Ly group, plasma Ang-2 was higher compared with LPS+Ang-1 group (P<0.01). LPI, plasma VE-cadherin and lung phosphorylation of VE-cadherin were the same with the trends of the plasma Ang-2 , but the lung total VE-cadherin showed the opposite tendency. Conclusion Through the PI3K/Akt signal transduction pathway , Ang-1 may regulate septic mice′VE-cadherin , hence the pulmonary vascular endothelial barrier function improved.

Objective To investigate the application value of the combined detection of the serum levels of tumor-associated car-bohydrate antigen 125(CA125) and human epididymis epithelial secretory protein 4 (HE4) in the diagnosis and the differentiation diagnosis of ovarian cancer .Methods Serum levels of CA125 and HE4 in 51 patients with ovarian cancer ,37 patients with benign ovarian tumor and 40 healthy females as the healthy control group were measured by chemiluminescent immunoassay (CLIA) and enzyme linked immunosorbent assay(ELISA) respectively .The detection results combined with the clinical data were performed the statistical analysis .Results The serum levels of CA125 and HE4 in the ovarian cancer group were significantly higher than those in the benign ovarian tumor group and the healthy control group (P<0 .01) .Serum concentration in the stage Ⅲ - Ⅳwere higher than that in the stage Ⅰ - Ⅱ(P<0 .01) .In the combined detection of HE4 and CA125 ,the sensitivity ,specificity and accuracy for diag-nosing ovarian cancer were 84 .6% ,83 .9% and 89 .4% respectively .Their sensitivity and accuracy were higher than those of any single marker detection ,the specificity was consistent with that in the single CA 125 detection .Conclusion The combined detection of serum CA125 and HE4 is conducive to increase the diagnosis efficiency and has certain application value in the differential diag-nosis of benign and malignant ovarian tumor .

Objective To investigate the carrying status and characteristics of Clostridium difficile isolated from infants.Methods Two hundred and thirty-eight stool specimens were collected from infant younger than 1 year old,that were hospitalized or outpatient from August to November 2015.Immunochromatography targeted GDH and toxin A&B of C.difficile was used for C.difficile screening,and those positive specimens were inoculated in CDIF and anaerobic culture.C.difficile isolates were genotyped by using slpA sequence typing (slpA ST),and tcdA,tcdB,cdtA and cdtB of C.difficile isolates were detected by PCR.Results Fifty C.difficile strains were isolated from 238 stool samples,and the isolated rates of C.difficile from <3 months,3 months to <6 months,and 6 months to 1 years old groups were 9.3%,17.6% and 27.3%(χ2=6.940,P=0.031<0.05),respectively.52.0%(26/50) of the C.difficile isolates were toxigenic,and 69.2% (18/26) toxigenic isolates harbored tcdA+tcdB+cdtA-cdtB-.Fifty C.difficile isolates were genotyped as 11 slpA STs,slpA ST fr-02 and kr-02 were the commonest genotypes in toxigenic C.difficile isolates;however,that was slpA ST xr-03 in non-toxigenic isolates.Conclusion High C.difficile carriage is found in infants younger than 1 year old,and more than half of C.difficile isolates are toxigenic.Most of toxigenic isolates harbored toxin A and B.The genotype of C.difficile isolates is different between toxigenic isolates and non-toxigenic isolates.

OBJECTIVETo establish a highly sensitive screening method for phytoestrogen active constituents and to primarily screen the phytoestrogenic active constituents from the chickpea extractions by the method.

METHODHuman ERalpha cDNA was cloned using MCF-7 total RNA as the template by RT-PCR and then was constructed into a pcDNA3 and named as pERalpha. The cell line MCF-7 was co-transfected with pERalpha and the reporter plasmid pERE-Luc which carrying the estrogen response element (ERE) plus the luciferase reporter gene. The luciferase activity was then assayed. The model was optimized by changing the ratio of two plasmids. The feasibility of the optimized model was further proved by the several known phytoestrogen compounds including fermononetin, biochanin A and genistein, et al. As an application of the model, the phytoestrogen activity of the extracts of the chickpea was assayed.

RESULTThe recombinant plasmid (pERalpha) can enhance luciferase activities of pERE-Luc transfected MCF-7 cells. The highest transfection efficiency and luciferase activity were found at the ratio of 10:1 (pERE-Luc: pERalpha), the luciferase activity was improved five times as high as the unique pERE-Luc transfection. The co-transfection screening model also indicated that fermononetin, biochanin A and genistein could induce ERE-driven luciferase activity and ICI 182,780 suppressed the induced transcription. As the application of the model, the results showed that the ethanol (70%) total extraction, the ethyl acetate extraction and the ligarine extraction of the chickpea can induce ERE-driven luciferase activity. Concurrent treatment with ICI 182,780 abolished the induced luciferase activity.

CONCLUSIONA phytoestrogen active constituent screening mode have been established based on co-transfection method. It is sensitive to assay the phytoestrogen active constituents and can be applied to screen the active component of phytoestrogens.

Cell Line, Tumor ; Cicer ; chemistry ; metabolism ; Drug Evaluation, Preclinical ; methods ; Estrogen Receptor alpha ; genetics ; metabolism ; Genes, Reporter ; drug effects ; Genetic Vectors ; metabolism ; Genistein ; chemistry ; pharmacology ; Humans ; Luciferases ; drug effects ; metabolism ; Phytoestrogens ; analysis ; pharmacology ; Plant Extracts ; chemistry ; metabolism ; pharmacology ; Plasmids ; drug effects ; metabolism ; Transfection ; methods

Objective:To explore the surgical technique and clinical results of the lateral-rectus approach (LRA) for acetabular fractures combined with ipsilateral greater sciatic notch fractures.Methods:Nine cases of acetabular fractures combined with ipsilateral greater sciatic notch fractures treated by the LRA from January 2015 to January 2021 were involved in this study, including 7 males and 2 females with age of 39.8±15.4 years (range, 25-54 years). Six cases were injured by falling and the others by traffic accidents. There were 3 cases combined with pelvic fractures, 1 combined with craniocerebral injury, 3 combined with thoracic injury, 2 combined with closed abdominal injury, and 3 combined with other fractures of the extremities. Based on the Letournel-Judet classification, the cases were all classified as double-column acetabular fractures. The fractures of the greater sciatic notch are all fractures with obvious displacement from the lower part of the sacroiliac joint through the top of the greater sciatic notch to the posterior column of the acetabulum. Pelvic X-ray and CT examination were performed after operation. The reduction quality of the acetabulum and greater sciatic foramen was evaluated by Matta's criteria. The function of the hip joint was assessed by modified Merle D'Aubigné-Postel score.Results:All 9 patients were successfully completed the operation, and followed up. The operation time was 140.4±55.2 min (range, 110-190 min). The amount of intraoperative blood loss was 770.5±430.9 ml (range, 540-1,260 ml). All cases of fractures had healed in 7.7±3.4 weeks (range, 6-12 weeks) after operation. According to Matta's reduction quality criteria, the quality of fracture reduction after surgery was excellent in 7 cases and good in 2 cases. The follow-up period was 24.8±8.8 months (range, 6-12 months). Fractures of the acetabulum and greater sciatic foramen healed well, with the healing time of 6 to 12 weeks. There were no complications such as loss of fracture reduction, failure of internal fixation, traumatic arthritis or necrosis of femoral head. Matta's modified Merle d'Aubigne-Postel hip function score was 16.2±0.6 (range, 12-18) one year after surgery. There were excellent in 6 cases, good in 2 cases, fair in 1 case, with an excellent and good rate of 89%.Conclusion:Fractures of the acetabulum and ipsilateral greater sciatic notch are serious injuries with difficulty in surgical reduction and fixation. The LRA can better complete reduction and fixation of the above fractures, obtaining satisfactory clinical outcomes.

Objective:To investigate the clinical efficacy of integrated acetabular wing-plate in the management of both column fractures with posterior wall involvement via the lateral-rectus approach.Methods:A retrospective case series analysis was performed on 43 patients with both column fractures involved with posterior wall admitted to Third Affiliated Hospital of Southern Medical University from March 2016 to June 2020. There were 35 males and 8 females, aged 19-78 years [(47.3±13.3)years]. The single lateral-rectus approach was used to expose, reduce and fix the fracture using the integrated acetabular wing-plate. Operation time, incision length, intraoperative blood loss and bone healing time were recorded. Quality of fracture reduction was assessed according to the Matta reduction criteria at postoperative 2 days, and hip function by the modified Merle d′Aubigné-Postel score at postoperative 3 months and 12 months. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(28.1±13.1)months]. Operation duration was 35-150 minutes [(84.6±26.3)minutes], with incision length of 8-12 cm [(9.4±1.0)cm] and intraoperative blood loss of 100-1 200 ml [(200(300, 500) ml]. Bone healing time was 3-6 months [(3.9±0.9)months]. According to Matta reduction criteria,the results were excellent in 32 patients, good in 7 and poor in 4 at postoperative 2 days, with the excellent and good rate of 91%. The modified Merle d′Aubigné-Postel score was 12-18 points [(16.1±1.5)points] at postoperative 3 months, and 13-18 points [(17.3±1.2)points] at postoperative 12 months ( P<0.01). According to modified Merle d′Aubigné-Postel score, the results were excellent in 3 patients, good in 34 and fair in 6 at postoperative 3 months, with the excellent and good rate of 86%; and the results were excellent in 32 patients, good in 9 and fair in 2 at postoperative 12 months, with the excellent and good rate of 95% ( P<0.01). Postoperative complications were incision fat liquefaction and infection in 1 patient, weakness of hip adduction in 5 and screw loosening with traumatic arthritis in 1. There was no sciatic nerve injury or heterotopic ossification. Conclusion:For both column fractures with posterior wall involvement, single lateral-rectus approach combined with integrated acetabular wing-plate has advantages of short operation time, minor trauma, low rate of bleeding and complications, and good hip function recovery, indicating satisfactory clinical effect.

Objective:To explore the surgical techniques and clinical effects of minimally invasive adjustable plate (MIAP) together with distraction reduction by minimally invasive anterior pelvic ring internal fixator (INFIX) in the treatment of fresh Denis type ⅡB sacral fracture with sacral nerve injury.Methods:From June 2017 to June 2020, 12 fresh Denis type ⅡB sacral fractures were treated by anterior-posterior distraction reduction and fixation with MIAP and INFIX. There were 8 males and 4 females, with an average age of 30 years (from 16 to 44 years). Preoperatively, imaging found Denis ⅡB fracture of the sacrum and magnetic resonance neurography of the lumbosacral plexus showed injury to the sacral nerve root at the sacral foramen. All patients had symptoms of S 1 nerve root injury on the affected side after injury, with 9 cases of grade M0 and 3 cases of grade M1. The time from injury to operation averaged 11 days (from 5 to 19 days). INFIX combined with MIAP was used to distract and fixate the compressed sacral fracture. The quality of fracture reduction and recovery of sacral nerve function were evaluated postoperatively. Results:According to the criteria proposed by Lindahl et al., the quality of fracture reduction was excellent in 8 cases, good in 2 and fair in 2. The 12 cases were followed up for an average of 20 months (from 12 to 36 months). All sacral fractures got united after an average of 6 weeks (from 5 to 8 months). At one-year follow-up, according to the criteria proposed by the Nerve Injuries Committee of the British Medical Research Council, the postoperative muscle strength recovery was evaluated as complete recovery in 10 cases and as partial recovery in 2 cases.Conclusion:In the treatment of fresh Denis type ⅡB sacral fracture, MIAP combined with INFIX can obtain satisfactory clinical effects because the compressed sacrum can be effectively distracted, the sacral foramen be expanded and the sacral nerve be decompressed indirectly.

Objective:To investigate the effectiveness of the modified Bikini approach in the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate.Methods:A retrospective study was conducted to analyze the data of 54 patients with acetabular fracture who had been treated at Department of Trauma Orthopedics, Orthopedic Medical Center, The Third Hospital Affiliated to Southern Medical University from May 2017 to June 2021. The patients were divided into 2 groups based on different surgical approaches: an observation group [26 cases, 6 males, 20 females; aged 40.0 (29.8, 46.8) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the modified Bikini approach, and a control group [28 cases, 10 males, 18 females; aged 34.5 (24.0, 43.5) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the lateral-rectus approach. The incision length, operation time, intraoperative bleeding, length of hospital stay, quality of postoperative fracture reduction, visual analog scale (VAS) for pain, hip function, Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) were compared between the 2 groups.Results:The differences in the preoperative general data between the 2 groups were not statistically significant, indicating comparability ( P>0.05). There were no statistically significant differences between the 2 groups either in terms of incision length, operation time, intraoperative bleeding, or hospital stay ( P>0.05). The 2 groups were not significantly different in the excellent/good rate of fracture reduction [100.0% (26/26) versus 92.9% (26/28)], VAS at 1 month postoperation [2.0(1.0, 3.0) versus 2.0(1.0, 3.0)], or the modified Merle d'Aubigné and Postel hip score at 12 months postoperation [13.5(12.3, 14.8) versus. 14.0(13.0, 15.0)] ( P>0.05). However, the VSS [4.50(4.00, 6.00)] and POSAS (29.85±10.05) at 12 months postoperation in the observation group were significantly lower than those in the control group [6.50(5.00, 8.25) and 37.11±11.75] ( P<0.05). Conclusion:In the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate, the modified Bikini approach can not only achieve as fine early clinical efficacy as the lateral-rectus approach, but also demonstrate the aesthetic advantages of smaller incision scar and more hidden incision.

Objective:To investigate the efficacy of intelligent visualization system (HoloSight Intelligent Visualization System) assisted reduction and screw fixation in the treatment of elderly pelvic fragility fracture.Methods:From January 2016 to December 2022, clinical data of 18 elderly patients aged over 75 years with pelvic fragility fractures surgically treated by our team were retrospectively analyzed. Among them, 11 cases were treated with closed reduction and hand-inserted percutaneous screw fixation to fix the posterior pelvic ring (control group), and 7 cases were treated with the assistance of the HoloSight intelligent visualization system for reduction and minimally invasive fixation (experimental group). In the control group, there were 3 males and 8 females with an age range of 75-94 years (mean age, 82±12 years). The pelvic fractures were classified as FFP type IIIa in 5 cases, IIIb in 2 cases, IIIc in 3 cases, and IV in 1 case. In the experimental group, there were 1 male and 6 females with an age range of 76-100 years (mean age. 83±14 years). The pelvic fractures were classified as FFP type IIIa in 4 cases, IIIc in 2 cases, and IV in 1 case. The surgical time, blood loss, effective intraoperative fluoroscopy times, fracture reduction quality (according to Matta standards), visual analogue scale (VAS), limb function rehabilitation (Majeed score) and postoperative complications were recorded and evaluated in both groups.Results:All patients underwent surgery successfully and were followed up for 6 months to 3 years(12 months on average), all pelvic fractures healed. Among the 7 cases of experimental group, a total of 13 screws were placed, and the adjustment times of guide pin for each screw were 3±1 times (range, 1-5 times), while 18 screws of the control group with the adjustment times of 7±2 times (range, 4-10 times), statistical difference was present ( t=6.99, P<0.001). The surgical time in experimental group (63±12 min) was shorter than that in control group 88±23 min, while effective intraoperative fluoroscopy times in experimental group (9±3 times) was less than that in control group (35±7 times), the difference were both statistically significant ( t=2.69, P=0.016; t=9.22, P<0.001). The intraoperative blood loss was 38±12 ml in the experimental group and 55±26 ml in control group, with no significant difference ( t=1.61, P=0.127). According to Matta's reduction criteria after surgery, the results of experimental group were excellent in 4 cases, good in 2, and fair in 1, while the result of control group were excellent in 5 cases, good in 3, fair in 2, and poor in 1. At the last follow-up, among the patients in experimental group, the Majeed score was 84±11, excellent in 3 cases, good in 2, and fair in 2. In control group, the score was 79±17, with excellent in 5 cases, good in 3, fair in 3. No statistical difference was observed in two groups ( t=0.69, P=0.501). The VAS was 6.4±2.6 preoperatively and 2.4±0.8 postoperatively in the experimental group, while in the control group was 6.9±3.1 preoperatively and 2.7±1.3 postoperatively, the data suggested an improvement in both groups ( t=3.89, P=0.002; t=4.14, P<0.001), while no statistical significant was observed in two groups at last follow-up ( t=0.55, P=0.593). Two cases of experimental group had loosening or withdrawal of the fixation screws in 9 and 12 months, but the fractures healed. Four cases of control group loose fixation screws in 4, 6, 9, and 12 months, two cases underwent revision surgery and other two cases healed. Conclusion:Intelligent visualization system assisted reduction and screw fixation in the treatment of elderly pelvic fragility fractures have the advantages of good reduction, accurate nail placement, less bleeding, less effective fluoroscopy, which improves the safety of surgery.

Objective:To investigate the safety and clinical efficacy of the lateral-rectus approach combined with the Pfannenstiel approach in the treatment of pelvic fractures complicated with urethral rupture.Methods:From January 2013 to June 2021, 20 patients with pelvic fracture complicated with urethral rupture were surgically managed through the lateral-rectus approach and the Pfannenstiel approach at Department of Traumatic Surgery, Center for Orthopaedic Surgery, the Third Hospital Affiliated to Southern Medical University. They were 15 males and 5 females, with an average age of 42 years (from 18 to 55 years). By the Tile classification, there were 11 cases of type B and 9 cases of type C. The first-stage urethral realignment was performed via the Pfannenstiel approach in the supine position after general anesthesia in conjunction with an urologist; at the second-stage, the lateral-rectus approach was used to reduce and fixate the acetabular or pelvic fractures. The operation time, intraoperative blood loss, fracture reduction quality, pelvic functional recovery and complications were documented.Results:In this cohort, the operation time ranged from 80 to 240 min, averaging 140.5 min; the time for simple urethral convergence ranged from 20 to 30 min; the intraoperative blood loss ranged from 400 mL to 2,000 mL, averaging 730 mL. According to the Mears andVelyvis evaluation for fracture reduction quality, anatomical reduction was achieved in 13 cases, satisfactory reduction in 6 cases, and unsatisfactory reduction in one. The 20 patients were followed up for 12 to 68 months (mean, 37 months) after surgery. One fracture got nonunited but the other fractures got united after 3.0 to 4.5 months (mean, 3.5 months). According to the Majeed scoring system, the pelvic function at 12 months after surgery was excellent in 12 cases, good in 6 and fair in 2, giving an excellent and good rate of 90% (18/20). Screw loosening was found in one patient, traction injury to the lumbosacral trunk nerve in another patient, varying degrees of dysuria which responded to periodic urethral dilation in 8 patients, urethral stricture in 3 patients and erectile dysfunction in 5 patients. No abdominal hernia or pelvic infection was observed.Conclusions:The lateral-rectus approach combined with the Pfannenstiel approach can be used effectively to reduce and fixate the pelvic and acetabular fractures, and to repair the urethral rupture in one stage as well. They are also safe due to a low incidence of such complications as abdominal wall hernia and pelvic infection.