Objective To explore the hepatotoxicity of Dioscoreae Bulbiferae Rhizoma and its molecular mechanism using transcriptomics.Methods Totally 40 SPF-grade male Kunming mice were randomly divided into the normal control group and Dioscoreae Bulbiferae Rhizoma low-,medium-and high-dosage groups,and were orally administered with the decoction of Dioscoreae Bulbiferae Rhizoma for 14 days.Serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)contents were detected,HE staining was used for morphology examination of the liver and scoring,transcriptomic analysis was conducted to detect the gene expression of liver tissue,differentially expressed genes were subjected to GO and KEGG pathway enrichment analysis,serum alkaline phosphatase(ALP)and total bile acid(TBA)content in liver tissue were detected,Western blot was used to validate key targets.Results Compared with the normal control group,Dioscoreae Bulbiferae Rhizoma high-dosage group showed an increase in serum ALT and AST contents(P<0.05),with hepatic cell edema,increased volume,dilated hepatic sinusoids,necrosis in some areas,and elevated pathological score(P<0.05).Transcriptomic analysis revealed that after intervention with Dioscoreae Bulbiferae Rhizoma,differentially expressed genes in liver tissue were mainly enriched in cholesterol metabolism process,steroid metabolism process,cholesterol biosynthesis process,and signaling pathways such as steroid biosynthesis,cholesterol metabolism,bile secretion and primary bile acid biosynthesis.The experimental verification results showed that serum ALP and liver tissue TBA content in Dioscoreae Bulbiferae Rhizoma high-dosage group increased(P<0.05),as well as HMGCS1 and CYP51A1,the expressions of CYP27A1 and CYP7A1,which promoted cholesterol conversion to bile acids in liver tissue increased(P<0.05,P<0.01),while the expression of multidrug resistance protein 4(MRP4),which promoted bile acid excretion decreased(P<0.05).Conclusion Dioscoreae Bulbiferae Rhizoma inducing liver toxicity is related to promoting cholesterol synthesis and conversion into bile acids,while inhibiting bile acid excretion.

Objective To explore the hepatotoxicity of Dioscoreae Bulbiferae Rhizoma and its molecular mechanism using transcriptomics.Methods Totally 40 SPF-grade male Kunming mice were randomly divided into the normal control group and Dioscoreae Bulbiferae Rhizoma low-,medium-and high-dosage groups,and were orally administered with the decoction of Dioscoreae Bulbiferae Rhizoma for 14 days.Serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)contents were detected,HE staining was used for morphology examination of the liver and scoring,transcriptomic analysis was conducted to detect the gene expression of liver tissue,differentially expressed genes were subjected to GO and KEGG pathway enrichment analysis,serum alkaline phosphatase(ALP)and total bile acid(TBA)content in liver tissue were detected,Western blot was used to validate key targets.Results Compared with the normal control group,Dioscoreae Bulbiferae Rhizoma high-dosage group showed an increase in serum ALT and AST contents(P<0.05),with hepatic cell edema,increased volume,dilated hepatic sinusoids,necrosis in some areas,and elevated pathological score(P<0.05).Transcriptomic analysis revealed that after intervention with Dioscoreae Bulbiferae Rhizoma,differentially expressed genes in liver tissue were mainly enriched in cholesterol metabolism process,steroid metabolism process,cholesterol biosynthesis process,and signaling pathways such as steroid biosynthesis,cholesterol metabolism,bile secretion and primary bile acid biosynthesis.The experimental verification results showed that serum ALP and liver tissue TBA content in Dioscoreae Bulbiferae Rhizoma high-dosage group increased(P<0.05),as well as HMGCS1 and CYP51A1,the expressions of CYP27A1 and CYP7A1,which promoted cholesterol conversion to bile acids in liver tissue increased(P<0.05,P<0.01),while the expression of multidrug resistance protein 4(MRP4),which promoted bile acid excretion decreased(P<0.05).Conclusion Dioscoreae Bulbiferae Rhizoma inducing liver toxicity is related to promoting cholesterol synthesis and conversion into bile acids,while inhibiting bile acid excretion.

BACKGROUND:At present,the use of a locking bone plate combined with steel wire or steel cable for the treatment of periprosthetic femoral fracture often adopts monocortical fixation,which is not stable and the proximal end of the bone cannot be achieved anatomically fitted by plate.The customized anatomical plate system can effectively solve this problem. OBJECTIVE:To explore the biomechanical strength of a customized anatomical plate system in fixation of Vancouver BI periprosthetic femoral fracture. METHODS:CT thin layer scanning data of normal femurs of 1 006 cases were selected and input into the MIMICS 21.0 software to establish the three-dimensional reconstruction model of the femur,which was set as the three-dimensional reconstruction group.56 complete human femoral specimens were selected as the femoral specimen group.The measured results of the two groups for femoral anatomical appearance were compared.If there was no significant difference between the two groups,the approximate appearance of a customized anatomical plate system was designed based on the measurement results in MIMICS 21.0 software and NX11.0 software.The customized anatomical plate system was designed and prepared according to the above measurement results.Eight pairs of frozen human femurs were selected to make Vancouver BI periprosthetic femoral fracture,which of the left were thin layer scanned by dual-source CT to obtain data.The data were transferred to determine the customized anatomical plate system model by the above design software.Eight sets of customized anatomical plate systems were ultimately produced,relying on the instrument company.The eight pairs of models were numbered 1-8.The left side was fixed with the customized anatomical plate system(customized anatomical plate system group);the right side was fixed with a metal locking plate system-large locking plate(claw plate group).L1-L4 and R1-R4 were subjected to vertical short-cycle loading test and vertical loading test.L5-L8 and R5-R8 were subjected to horizontal short-cycle loading test and four-point bending test.The vertical loading test and four-point bending test were used to collect bending load,bending displacement,and bending strain.Two short cycle loading tests were used to collect strain displacement to compare the maximum load,maximum displacement,bending stiffness,and short-period displacement resistance of the two kinds of bone plates. RESULTS AND CONCLUSION:(1)There were no significant differences in all indexes between the three-dimensional reconstruction group and the femoral specimen group(P>0.05).Individual customized anatomical plate system was designed based on the measurement results combined with digital software.(2)In the vertical loading test,the maximum load was higher(P=0.015),the maximum bending displacement was smaller(P=0.014),and the bending stiffness was higher(P=0.005)in the customized anatomical plate system group compared with the claw plate group.(3)In the four-point bending test,the maximum load was higher(P=0.023),the bending stiffness was higher(P=0.005),and the maximum bending displacement was not significant(P=0.216>0.05)in the customized anatomical plate system group compared with the claw plate group.(4)In the vertical short-cycle loading test,the average level of bending displacement in the customized anatomical plate system group(0.23±0.10 mm)was significantly lower than that in the claw plate group(0.44±0.02 mm)(P<0.05).(5)There was no significant difference in the average level of bending displacement between the two groups in the horizontal short cycle loading test(P>0.05).(6)It is concluded that the customized anatomical plate system has personalized anatomical characteristics,and the fixation of Vancouver BI periprosthetic femoral fracture is more stable,which has certain significance for clinical treatment.

BACKGROUND:Considering the risk of lack of bone in revision and the bone coverage of component,it is advisable to use bone grafting to increase bone stock in patients with adult Crowe type Ⅲ developmental dysplasia of the hip (DDH) in the first total hip arthroplasty (THA).OBJECTIVE:To investigate the effectiveness of impaction bone grafting with morselized bone and bone paste for acetabular defects of adult Crowe type Ⅲ DDH in THA.METHODS:Forty cases (45 hips) of Crowe type Ⅲ DDH were enrolled,including 8 males and 32 females,aged 31-68 years.All the components were reconstructed at the anatomic acetabulum combined with deepening acetabulum and putting the centre of rotation medially and distally during THA procedures.The patients were all followed up and evaluated with Harris score,limp length,displacement of the centre of rotation,cup coverage,and postoperative complications.RESULTS AND CONCLUSION:The average follow-up was 32.7 months.Acetabular rotation centers of all the cases were recovered (near) to normal.The incisions healed by first intention and there was no complication such as infection,dislocation,prosthesis loosening.The acetabular cup prosthesis did not displace and was covered well by bone at the last follow-up,the grafted bone particles got radiological osseointegration and the bone sclerosis zone disappeared.No radiolucent lines and screw fracture were detected.The Harris scores of affected hips at the last follow-up were significantly higher than those before surgery(P=0).The average leg length was increased (2.31 ±0.18) cm.The mean cup coverage was 78.1％.The postoperative horizontal and vertical distance of the hip center were shorter than those before surgery (P=0).Reconstructing the acetabulum with autogenous morselized bone graft impaction can effectively restore the acetabular coverage,maintain the stability of acetabular cup and provide better relative bone stock in THA for Crowe type Ⅲ DDH in adult,and moreover,the short-term effect is satisfactory.

BACKGROUND:Legacy posterior stabilized prosthesis has advantages in theoretic design,in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes for vaglus knee deformity are better than Legacy constrained condylar knee prosthesis. OBJECTIVE:To explore the midterm folow-up effect of Legacy posterior stabilized prosthesis in total knee arthroplasty in patients with valgus knee deformity. METHODS: From February 2006 to November 2013 in Department of Bone and Joint Surgery, Affiliated Hospital of Luzhou Medical Colege, total knee arthroplasty was used to treat valgus knee deformity in 33 cases (35 knees). Parapatelar medial approach was used. Precise osteotomy was utilized to correct limb alignment. Lateral soft tissue received selective release. Finaly, an equal type of Legacy posterior stabilized prosthesis (Zimmer, USA) was implanted and fixed with antibiotic bone cement. The differences in hospital for special surgery knee score, range of motion of knee, femoral tibial angle, and maximum flexion and extension angle, as wel as X-ray film results were compared and analyzed before and after replacement. The complications including deep vein thrombosis, peri-prosthetic infection, patelar clicking, unstable knee, and common peroneal nerve injury were recorded after surgery. RESULTS AND CONCLUSION: Al patients were folowed up for 24-50 months. The incision was healed in one-stage. No complications such as peri-prosthetic infection appeared. Three patients suffered from common peroneal nerve palsy, which was cured at half a year after surgery by expectant treatment such as trophic nerve. Two cases suffered from knee instability after replacement, which was improved at 1 month after external fixation with a brace. One case experienced deep vein thrombosis in the lower extremity, which was improved after treatment with low molecular weight heparin anticoagulation. During final folow-up, hospital for special surgery knee score increased from (51.85±4.15) preoperatively to (85.77±2.50) postoperatively (P < 0.01). There were excelent in 20 knees, good in 11 knees, with an excelent and good rate of 89%. X-ray films showed that hindlimb alignment was apparently corrected, prosthetic position was good, no loosening occurred. These data indicate that total knee arthroplasty, using parapatelar medial approach, obtained good correction outcomes through the accurate amputation to correct hindlimb alignment and selective release of the soft tissue with Legacy posterior stabilized prosthesis in the treatment of valgus knee deformity.

Objective To explore changes of levels of interferon‐γ(IFN‐γ) ,interleukin‐32(IL‐32) and interleukin‐6(IL‐6) in pe‐ripheral blood and the correlation between peripheral IFN‐γ,IL‐32 ,IL‐6 and liver function level and hepatitis B virus(HBV) DNA load in HBV carriers .Methods Sixty HBV carriers ,including 39 cases of chronic HBV carriers and 21 cases of inactive hepatitis B surface antigen(HBsAg) carriers ,and 50 healthy individuals were collected .Serum levels of IFN‐γ,IL‐32 and IL‐6 ,the amount of HBV DNA and liver function were detected ,and clinical correlations were analysed .Results Compared with the control group ,ser‐um levels of IFN‐γ,IL‐32 and IL‐6 of chronic HBV carriers and inactive HBsAg carriers were significantly increased (P<0 .05) . Compared with chronic HBV carriers with low amount of HBV DNA loads and high amount of HBV DNA loads ,chronic HBV car‐riers with medial HBV DNA loads had higher serum levels of IFN‐γ,IL‐32 and IL‐6 ,but no statistically significant differences were observed(P>0 .05) .There was positive correlation between IL‐32 level and ALT level (r=0 .32 ,P<0 .05) ,and negative correla‐tion between IL‐32 level and ALB level(r= -0 .27 ,P<0 .05) .Conclusion IFN‐γ,IL‐32 and IL‐6 may play important roles in chro‐nic HBV infection ,the levels of IFN‐γ,IL‐32 and IL‐6 could be used as important indicators to assess the severity of inflammation in HBV carriers .

Objective To investigate the value and clinical significance of CD4+CD25+ regulatory T cells (Treg) ,inteleukin‐18 , interferon‐γand transforming growth factor‐βin patients with hepatitis B virus (HBV) infection .Methods A total of 175 patients with HBV infection were divided into chronic type B hepatitis (CHB) group and chronic asympotomatic HBV carrier (ASC) group , which were further divided into hepatitis B e antigen (HBeAg) positive and negative groups .CD4+ CD25+ Treg ,cytokines levels and liver function were measured .Healthy subjects were enrolled into control group .Results Proportion of CD4+CD25+ Treg were without significant difference among healthy controls ,HBeAg(+ ) and HBeAg(-) ASC groups ,and HBeAg(+ ) and HBeAg(-) CHB groups (P>0 .05) .Compared with control group ,cytokines levels were significant higer in CHB and ASC group (P<0 .05) . CD4+CD25+ Treg level was significant positive correlation to alanine aminotransferase and ratio of aspartate aminotransferase to plateles in HBeAg(+ )ASC group (P<0 .05) .Conclusion CD4+CD25 + Treg and related cytokines could play important roles in the course of CHB ,while CD4+CD25+ Treg expressing might be correlated with inflammatory degree of hepatitis .

Objective To investigate the correlation between the liver fibrosis markers laminin(LN),hyaluronan acid(HA),col-lagen Ⅳ(CⅣ)and procollagen type Ⅲ N-terminal peptide(PⅢNP)with the replication of hepatitis B virus(HBV)DNA in the pa-tients with chronic HBV in Lanzhou.Methods Real-time PCR and chemiluminescent immunoassay(CLIA)were used to quantita-tively measure serum HBV-DNA and liver fibrosis markers in 724 cases of HBV infection in Lanzhou with the different clinical classifications and the natural history stage as the background.Results The values of the liver fibrosis indicators and HBV-DNA level in all clinical types were higher than normal levels,and reached to maximum in the liver cirrhosis goup;CⅣ and PⅢNp were highest in the HBeAg (+)CHB group;according to the hepatitis B natural history stage,the PⅢNP and CⅣ values reached the peak value in the immune clearance phase,moreover the CⅣmean value in the HBeAg and HBV-DNA (+)group was higher than that in the HBV-DNA and HBeAg (-)group.4 indicators in the HBeAg (+)CHB group were higher than those in the HBeAg (-)CHB group,but only HA had statistical difference(P <0.01 ).Conclusion There is certain correlation between CⅣ with HBV-DNA and HBV-M,indicating that which can indirectly reflect the degree of liver damage and viral replication level.

Objective To investigate the relationship between HBV DNA load with the serological markers(HB-M)HBsAg, HBeAg,HBeAb,HBcAb in the persons infected by chronic hepatitis B virus (HBV)in Lanzhou.Methods The real-time fluores-cent quantitative PCR was used to detect the HBV DNA load and the double antibody sandwich chemiluminesent immunoassay was used to measure the serum HBsAg,HbeAg,HbeAb and HbcAb levels in 724 cases of HBVinfection.Results The HBsAg level was positively correlated with the HBV DNA load in chronic HBV infection in Lanzhou area(r=0.342,P <0.05),there was an ob-vious positive correlation between HBeAg and HBV DNA load(r=0.463,P <0.05),the HBeAb level and HBV DNA load had the negative correlation (r=-0.227,P =0.001),the HBcAb level and HBV DNA load had no significantly correlation (r=-0.062, P =0.366).Conclusion There is obvious positive correlation between HBV DNA load with HBsAg,HBeAg in chronic HBV infec-tion in Lanzhou area,which indicating that the observation by combining HBsAg and HBeAg with HBV DNA can judge the infec-tious degree of the patients more accurately.