OBJECTIVETo explore the clinical outcomes of open reduction and internal fixation with calcaneal locking plates in treating Sanders type II and III calcaneal fractures.

METHODSFrom January 2010 and October 2012, 38 calcaneal fractures with Sanders type II or III were treated with open reduction and internal fixation with calcaneal locking plate. According to the Sanders classification, 15 fractures were classified as type II, 23 fractures as type III. The patients were divided into two groups (group A and B) according to the different fixed methods. Sustentaculum tali was fixed with one screw in group A, including 13 males and 5 females, with a mean age of (38.56±8.03) years old (ranged, 25 to 55). And sustentaculum tali was not fixed in group B, including 16 males and 4 females, with a mean age of (42.35±8.29) years old (ranged, 29 to 53). Clinical effects were evaluated according to the changes of Böhler's angle and the Maryland Foot Score and VAS score.

RESULTSAll patients were followed up from 12 to 20 months with a mean of 14 months. Böhler's angles and subtalar joints obtained satisfactory reconstruction in all patients. One year after operation, the mean Maryland Foot Score was 88.61±7.59 in group A; and was 82.40±9.24 in group B; Maryland Foot Score of group A was higher and foot functional rehabilitation was better than group B. The mean VAS score was 13.39±11.47 in group A; and was 22.50±13.10 in group B; VAS score of group A was lower and foot pain was less than group B.

CONCLUSIONSustentaculum tall screw fixation has advantages of strong fixed strength, high stability, less postoperative pain, rapid functional recovery in treating Sanders type II and III calcaneal fractures.

Adult ; Bone Plates ; Bone Screws ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function

Objective：To observe the inhibitory effects of pr obucol on nuclear factor-κB （NF-κB）-like activity of vascular smooth mus cle cells(VSMCs). Methods:The effects of probucol and H2O2 on NF-κB-like activity of VSMCs were investigated by electrophoretic mobility shift assay(EMSA). Results:NF-κB activation of VSMCs could be induced by H2O2 or new born calf serum(NCS) for 72 h, the gray-measure of the protein bindings measured through computer scanning was 63.9 and 46.6 respe c tively. NF-κB activity of VSMCs stimulated by H2O2 or NCS might be prevent ed by 100 μmol/L probucol, the inhibitory rate was 37.1%, 14.8% respectively. Conclusion:probucol can inhibit NF-κB activity of VSMCs stim ulated by NCS or H2O2. These effects of probucol might help to re duce development of atheroclerosis and restenosis after percutaneous transluminal coronary angioplasty.

OBJECTIVETo study the therapeutic effect of agonistic CD40 monoclonal antibody combined with tumor specific cytotoxic T lymphocyte (CTL) on B lymphoma.

METHODSHuman B lymphoma cell line, Daudi cells, were cultured with CD40 mAb (5C11) for 24 and 48 hours, respectively. Annexin V/PI-binding assay was employed to analyze apoptosis, and FCM to analyze Fas (CD95) expression. Human peripheral monocyte-derived DC were loaded with apoptotic Daudi cells and stimulated by SC11 for further maturation. Tumor specific CTL were generated in vitro by co-culture of mature DC with autologous T lymphocytes. DNA fragmentations of Daudi cells treated with 5C11, CTL or 5C11 combined with CTL were determined by JAM assay. To establish the B lymphoma model, Daudi cells were subcutaneously injected into humanized SCID mice (hu-SCID). 1 or 3 weeks after tumor transfer. tumor-bearing mice were respectively treated with SC11, CTL, 5C11 combined with CTL by intraperitoneal injection. Tumor volume in differently treated mice was measured every week after therapy, and the survival of tumor-bearing mice was recorded.

RESULTS5C11 significantly up-regulated FAS expression in Daudi cells, but had no significant effect on apoptosis rate of Daudi cells. Tumor-specific CTL could effectively kill Daudi cells. Fragmentation of Daudi cells co-cultured with CTL was remarkably enhanced by combination with SC11. Tumor growth in hu-SCID mice was apparently delayed by treatment with SC11, CTL, or SC11 combined with CTL. Moreover, minimal tumor burden mice got 30.0% or 70.0% complete remission (CR), respectively, when received CTL treatment or combination treatment of SC11 with CTL, and the lifespan of tumor bearing mice was also prolonged significantly.

CONCLUSIONSC11 may enhance the sensitivity of Daudi cells to apoptosis by up-regulation of Fas expression and promote cytotoxicity of CTL in vitro and therapeutic effect in vivo.

Animals ; Antibodies, Monoclonal ; immunology ; therapeutic use ; Apoptosis ; immunology ; CD40 Antigens ; immunology ; Cell Line, Tumor ; Coculture Techniques ; Female ; Flow Cytometry ; Humans ; Immunotherapy, Adoptive ; methods ; Lymphoma, B-Cell ; immunology ; pathology ; therapy ; Mice ; Mice, SCID ; Remission Induction ; Survival Analysis ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; Xenograft Model Antitumor Assays ; fas Receptor ; immunology

Traumatic tricuspid valve insufficiency (TTVI) is a relatively uncommon disease. To summarize the experience in the diagnosis and treatment of TTVI, we have analyzed the clinical data of 3 patients with TTVI who were admitted to the department of cardiac surgery of our hospital between April 1997 to April 2002. Relevant literatures have also been reviewed.
Accidents, Traffic ; Adult ; Cardiac Surgical Procedures ; methods ; Electrocardiography ; Follow-Up Studies ; Heart Injuries ; diagnosis ; surgery ; Heart Valve Prosthesis ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; physiopathology ; Risk Assessment ; Sampling Studies ; Treatment Outcome ; Tricuspid Valve Insufficiency ; diagnosis ; surgery

Objective To evaluate contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging in the detection of leptomeningeal lesions.Methods Seventeen patients with a variety of leptomeningeal lesions were analyzed.The MRI protocol included un-enhanced and contrast-enhanced FLAIR images and contrast-enhanced T_1WI,Comparisons between contrast-enhanced FLAIR images and T_1WI and between un-enhanced and contrast-enhanced FLAIR images were made to determine which sequence better depicted the lesions.Results Leptomeningeal lesions showed as either diffusely or locally abnormal hyper-intensity along sulci or cistern on three sequences.Comparison between contrast-enhanced FLAIR and T_1WI showed that only contrast-enhanced FLAIR revealed the abnormalities in 7,both revealed the abnormalities but the former was superior in 2 ,and both were conspicuous in 7. In 1 patient of tuberculous meningitis,diffuse abnormalities of sulci were shown only on contrast-enhanced FLAIR, abnormalities of cisterns were shown on both sequences but the former was superior.Comparison between un- enhanced and contrast-enhanced FLAIR showed that only contrast-enhanced FLAIR revealed the abnormalities in 9,both revealed the abnormalities but the former was superior in 3,and both were conspicuous in 4. In 1 patient of tuberculous meningitis,abnormalities of cisterns were shown only on contrast-enhanced FLAIR,diffuseabnormalities of sulci were shown on both sequences but the former was superior.Conclusions Contrast-enhanced FLAIR images were superior to un-enhanced FLAIR images and contrast-enhanced T_1WI in the detection of leptomeningeal lesions. Contrast-enhanced FLAIR images are helpful and should be considered when findings on un-enhanced FLAIR images and/or contrast-enhanced T,WI are inconclusive.

Health self-management group adopts the mode of chronic disease self-management and offers a series of courses for community residents in order to help them carry out health self-management. For healthy people, the program aims at disease prevention by means of improving health literacy, acquiring health knowledge and skills, and developing a healthy lifestyle.While for patients, the program aims to prevent or slow the progression of diseases by means of helping them deal with their condition, achieving disease self-management. By nearly ten years of exploration and practice in Shanghai communities, with the program a working system had been established which was dominated by patriotic health campaign committee office at the levels of city and district, and technologically supported by centers for disease control and prevention with support and cooperation of the town government.The program was implemented by community health service centers and neighborhood ( village ) committee.A large-scale and whole-society promotion had been really achieved in community residents with health self-management. By the end of 2015, health self-management groups had covered all of the city's streets ( town ) and neighborhood ( village ) committee, 26 thousand groups set up and nearly 440 thousand community residents participated in group activities.

OBJECTIVETo study the impact of an agonist anti-CD(40) monoclonal antibody 5C11 on the induction and biological characteristics of leukemic dendritic cells.

METHODSCombinations of 5C11 and different cytokines were used to induce differentiation of leukemic blasts into dendritic cells. Morphology was observed by light microscopy. Surface antigens of the induced cells were analyzed by fluorescence-activated cell sorting (FACS), the yields of dendritic cell by cell counting, the levels of IL-6 and IL-12 by ELISA, T cell proliferating activity by allo-mixed lymphocyte reaction (MLR) in vitro. Allogeneic T cells were stimulated with leukemic dendritic cells and T-cell cytotoxicity was measured by MTT assay.

RESULTSWhen cultured with combinations of 5C11 and different cytokines, the leukemic cells isolated from the patients could differentiate into dendritic cells. The morphology showed typical features of dendritic cells, which expressed high levels of CD(40), CD(80) and CD(86). In comparison with the original leukemia cells, the leukemic dendritic cells secreted less IL-6 but more IL-12 (P < 0.05). The leukemic dendritic cells were potent to stimulate the proliferation of allogeneic T cells, and the latter was able to lyse the original leukemia cells.

CONCLUSIONLeukemic blasts could be induced to differentiate into functional dendritic cells. It may be of great value in the adoptive immunologic therapy of leukemia.

Antibodies, Monoclonal ; immunology ; CD40 Antigens ; physiology ; Cell Differentiation ; Dendritic Cells ; immunology ; Humans ; Immunophenotyping ; Immunotherapy ; Interleukin-12 ; biosynthesis ; Interleukin-6 ; biosynthesis ; Leukemia ; immunology ; pathology ; therapy

Objective To study the role of abnormally changed migration of vascular smooth muscle cells (VSMCs) induced by low shear stress (LowSS) in vascular remodeling during atherosclerosis as well as the molecular mechanism involved in this process. Methods By using comparative proteomic analysis with two-dimensional electrophoresis combined with mass spectrometry, differential protein expression profiles of cultured vascular tissues under normal shear stress (NSS) (1.5 Pa) and LowSS (0.5 Pa) were studied. Using endothelial cells (ECs) and VSMCs co-cultured parallel plate flow chamber system, two levels of shear stress i.e. LowSS and NSS, were applied, respectively. Western blot was used to detect the protein expressions of Rab28 and phosphor-ERK. Transwell system was used to detect the migration ability of VSMCs. After using RNA interference and ERK inhibitor PD98059 to decrease the expressions of Rab28 and phosphor-ERK, respectively, the migration ability of VSMCs was observed again. Results The expression of Rab28 in the cultured rat aorta was significantly up-regulated by the LowSS (0.5 Pa) application in comparison with the NSS (1.5 Pa). The migration, expressions of Rab28, and phosphorylation of ERK in VSMCs were significantly increased by the LowSS application. Target RNA interference of Rab28 significantly decreased the migration of VSMCs, but had no specific effect on the phosphorylation of ERK. Target inhibitor of ERK, PD98059, significantly decreased both the migration and Rab28 expression in VSMCs. Conclusions The LowSS may increase the phosphorylation of ERK and then increase the expression of Rab28 in VSMCs, which subsequently modulate VSMC migration during vascular remodeling. The investigation on the role of Rab28 and its signal path in LowSS-regulated VSMCs as well as the molecular mechanism might provide a biomechanical reference for understanding the pathogenesis of vascular remodeling during atherosclerosis and finding the therapeutic target of new drugs.

OBJECTIVEThe aim of this study was to evaluate the recognition and defibrillation efficiency of a newly developed automated external defibrillator (AED).

METHODVentricular tachycardia (VT)/ventricular fibrillation (VF) was induced by alternating current (50 Hz) through an electrode placed on apex of right ventricle in 23 anesthetized swine and recorded, recognized and defibrillated by a newly developed AED.

RESULTSA total of 96 VF was induced and 145 defibrillations were recorded. We analyzed available 167 electrocardiosignal with a total length of 103,740 seconds. The accuracy, sensitivity and the specificity of the AED on VT/VF recognition are 99.5%, 98.2% and 99.6%, respectively. The success rate of defibrillation was 33.4% which increased in proportion to defibrillation energy. The defibrillation threshold of energy is 29.10-116.91 (78.75 +/- 35.64) J, the defibrillation threshold of electric quantity is (0.11 +/- 0.04) C and the defibrillation threshold of voltage is (1216.67 +/- 260.87) V.

CONCLUSIONSThis newly developed AED has high sensitivity and the specificity on recognizing VT/VF. The lower success rate of defibrillation of this AED is associated with the low defibrillation energy during defibrillation which needs to be improved on further development.

Animals ; Defibrillators ; Disease Models, Animal ; Electric Countershock ; Equipment Design ; Sensitivity and Specificity ; Swine ; Ventricular Fibrillation ; therapy

BACKGROUND/AIMS: Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. METHODS: This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score. RESULTS: Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. CONCLUSIONS: The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.
Blood Component Removal* ; China* ; Colitis, Ulcerative* ; Cytokines ; Granulocytes* ; Humans ; Inflammation ; Leukocytes ; Monocytes* ; ROC Curve ; Sensitivity and Specificity ; Treatment Outcome ; Ulcer*