Objective To explore clinical effect of vancomycin calcium sulfate combined with internal fixation on cal-caneal beak-like fracture secondary to calcaneal osteomyelitis caused by diabetic foot.Methods From April 2018 to October 2021,a retrospective analysis was performed on 5 patients with calcaneal bone osteomyelitis secondary to diabetic foot,includ-ing 2 males and 3 females,aged from 48 to 60 years old;diabetes course ranged from 5 to 13 years;the courses of diabetic foot disease ranged from 18 to 52 days;5 patients were grade Ⅲ according to Wagner classification.All patients were treated with debridement,vancomycin bone cement implantation,negative pressure aspiration at stage Ⅰ,vancomycin calcium sulfate and internal fixation at stage Ⅱ for calcaneal beak-like fracture.Surgical incision and fracture healing time were recorded,and the recurrence of osteomyelitis was observed.American Orthopedic Foot Andankle Society(AOFAS)score and exudation at 12 months after operation were evaluated.Results Five patients were successfully completed operation without lower extremity vascular occlusion,and were followed up for 16 to 36 months.The wound healing time after internal fixation ranged from 16 to 26 days,and healing time of fractures ranged from 16 to 27 weeks.AOFAS score ranged from 65 to 91 at 12 months after oper-ation,and 2 patients got excellent result,2 good and 1 fair.Among them,1 patient with skin ulcer on the back of foot caused by scalding at 5 months after operation(non-complication),was recovered after treatment;the wound leakage complication oc-curred in 2 patients,and were recovered after dressing change.No osteomyelitis or fracture occurred in all patients.Conclusion Vancomycin calcium sulfate with internal fixation in treating calcaneal osteomyelitis secondary to calcaneal osteomyelitis caused by diabetic foot could not only control infection,but also promote fracture healing,and obtain good clinical results.

{L-End}Objective To establish a method for the simultaneous determination of dimethyltin (DMT), trimethyltin (TMT), diethyltin (DET), and triethyltin (TET) in human whole blood using high performance liquid chromatography-inductively coupled plasma-mass spectrometry (ICP-MS). {L-End}Methods The 1.0 mL of blood was added with 4.0 mL 65% aqueous solution (containing 6% acetic acid), extracted and separated by C₄ column (150 mm×3 mm×3 μm) using a mobile phase of methanol and 4% acetic acid aqueous solution (containing 0.25 mmol/L tropolone) at a volume ratio of 35∶65, and detected by ICP-MS. {L-End}Results The linear range of DMT, TMT, DET, and TET was 30.60-550.80, 29.00-522.00, 46.10-829.80, and 34.05-612.90 μg/L, respectively. All correlation coefficients were 0.999. The detection limit of DMT, TMT, DET and TET was 21.40, 20.30, 32.27 and 23.80 μg/L, respectively. The recovery rate was 81.9%-104.9%. The within-run and between-run relative standard deviation was 1.6%-6.9% and 0.1%-10.0%, respectively. The samples can be stored at -20 ℃ and 4 ℃ for at least three days. {L-End}Conclusion This method can be used for trace analysis of DMT, TMT, DET, and TET in whole blood.

Objective:To explore the long-term preservation value and repair effect of normothermic machine perfusion (NMP) on clinically discarded kidneys.Methods:A case of clinical discarded donor kidney was collected, and NMP was carried out in vitro for 9 hours with recovered blood. The dynamic changes of renal appearance, blood gas and biochemistry analysis of perfusate and renal pathology were recorded. Results:In the second to fifth hour of NMP, the appearance of renal was pink and ex vivo normothermic perfusion assessment score (EVNP) was grade Ⅰ. While, the sixth hour and beyond of NMP, the appearance of kidney turned to dark red and EVNP was grade Ⅲ. The renal perfusion blood flow maintained above 150 ml/min in the first 6 hours and decreased significantly after that, and at the end, was only 50 ml/min. During the whole process of perfusion, urine output was maintained at about 100 ml/h. PO 2 remained above 100 mmHg in the first 5 hours of perfusion and from the 6th hour, was lower than 80 mmHg and continued to decline, and was close to 0 at the end of perfusion. The results showed that although the K + concentration changes in blood and urine in the first 5 hours of NMP had a good consistency, the lactic acid level had been rising. In addition, there was no significant change in the histopathology at the fourth hour of perfusion compared with that before zero-point puncture, and the fibrinous thrombus in glomeruli was improved compared with that before perfusion. However, at the sixth hour after perfusion and before the end of perfusion, the pathological changes of renal tissue were significantly worse. There were a large of thrombosis in glomerular blood vessels, renal tubular atrophy and acute tubular necrosis. Conclusions:NMP can realize the evaluation of extended criteria donors before transplantation, and it proves the feasibility and repair potential of NMP in kidney to a certain extent. At the same time, NMP also provides a new way to expand the source of donor kidney and to pre-treat organ in vitro.

Objective: To observe the effect of modified Xiao Wuweizitang combined with massage manipulation on chronic post-infection cough (syndrome of wind-pathogenic pulmonary embedding), and immunity and inflammatory factors. Method: One hundred and thirty-five patients were randomly divided into control group and observation group by random number table. Patients (59 cases) in control group got Suhuang Zhike capsules, 1 granule/time for 3 to 6-year-old children, 2 granules/time, 3 times/days for 6 to 12-year-old children, and massage manipulation, 1 time/day. Patients (63 cases) in observation group got modified Xiao Wuweizitang combined with massage manipulation. A course of treatment was 10 days. Before treatment, and at the 5^th and 10^th day after treatment, visual analogue score of cough (VAS), cough symptom, syndrome of wind-pathogenic pulmonary embedding and leicester cough questionnaire (LCQ) were scored. And levels of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺, interleukin-8, IL-4, tumor necrosis factor-α (TNF-α), substance P (SP) and calcitonin gene related peptide (CGRP) were detected. Result: At the 5^th and 10^th day after treatment, scores of VAS, cough symptom and syndrome of wind-pathogenic pulmonary embedding in observation group were lower than those in control group (P<0.01), and the clinical efficacy was superior to that in control group (χ²=7.513,P<0.01). The disappearance rate of cough in observation group was 57.81%, which was higher than 38.98%in control group (χ²=4.356, P<0.05). And the average time of disappearance of cough was shorter than that in control group (P<0.01). Scores of LCQ questionnaire (physiology, psychology and society) and the total score were higher than those in control group (P<0.01), and levels of TNF-α, IL-8, IL-4, CGRP and SP were lower than those in control group (P<0.01). Conclusion: Modified Xiao Wuweizitang combined with massage manipulation can relieve cough symptom, shorten the cough course, increase rate of the disappearance of cough, improve the quality of life of children, regulate immune function of children, reduce airway inflammation, airway hyperresponsiveness and cough reflex sensitivity.

OBJECTIVE: To explore the feasibility of simultaneous detection of 45 kinds of common organic compounds in workplace air by solvent desorption-gas chromatography method.METHODS: A total of 45 kinds of common organic compounds such as benzene,1,2-dichloroeyhane,n-hexane and trichloroethylene in workplace air were collected with activated carbon tube and desorbed with carbon disulfide,separated by capillary chromatographic column,and detected with flame ionization detector.RESULTS: There was good linear relationship in the selected range.The correlation coefficients was 0.999 92-0.999 99.The detection limit was 0.03-0.30 mg/L and the minimum detectable concentration range was 0.01-0.20 mg/m~3( sample volume was 3.00 L).The average desorption efficiencies was 75.4%-105.7%.The within-run and between-run relative standard deviations were 0.4%-6.7% and 1.8%-7.9%,respectively.The sampling efficiency was 91.9%-100.0%.CONCLUSION: The method is simple,high sensitivity and good precision,which can be used for simultaneous detection of 45 kinds of common coexisting organic compounds in workplace air.

OBJECTIVE: To establish a methodology for simultaneous detection of chloromethyl methyl ether( CMME) and bis-chloromethyl ether( BCME) in workplace air by gas chromatography. METHODS: CMME and BCME in workplace air were collected with absorption solution which was also derivatization solution. The derivative products were extracted using n-hexane alkaline medium. The extracts were separated by capillary column and detected with electron capture detector.The quantification was performed by use of standard curves. RESULTS: The linearity ranges of CMME and BCME were2. 00-80. 00 and 1. 32-52. 80 ng,respectively. The correlation coefficients were both 0. 999 93. The minimum detectable concentrations were both 0. 030 μg / m3 and the minimum quantification concentrations were both 0. 100 μg / m3( 7. 50 L sample). The recovery rates were 99. 35%-101. 00% and 97. 99%-101. 70% respectively. The within-run relative standard deviations( RSD) were 2. 73%-4. 46% and 2. 61%-3. 82% respectively,and the between-run RSD were3. 10%-5. 50% and 3. 89%-5. 38% respectively. The sampling efficiencies were 92. 43%-96. 25% and 91. 43%-94. 03%respectively. The samples were stable at room temperature for at least 15 days. CONCLUSION: This method is suitable for simultaneous detection of CMME and BCME in workplace air.

Objective To investigate the effect of KIR-HLA receptor-ligand model on the unrelated allo-hematopoietic stem cell transplantation (Allo-HSCT) of acute lymphoblastic leukemia (ALL). Methods The KIR genotype of 23 pairs of ALL patients and their HLA-matched unrelated donors obtained from the Database of China Marrow Donor Program. KIR genotype was determined using PCR-SSP. The expression of inhibitory KIR(iKIR) was determined by flow cytometry analysis on recipients after HSCT. Results Among all 23 donor/recipient pairs, 17 donors with KIR2DL2/L3 could find corresponding HLA-Cw1, 3, 7, 8, 12, 14 ligands in their recipients. Six donors with KIR2DL1 could match with HLA-Cw6, 15 in recipients. Sixteen donors with KIR3DL1 could recognize HLA-Bw4 and 12 donors with 3DL2 could find HLA-AI1 in their corresponding recipients, respectively. Ninteen patients were successfully transplanted, and the death rate of transplantation were 33.3% (2/6)and 40.0% (2/5) in KIR receptor-ligand matched model and the graft versus leukemia(HVG) KIR ligand-mismatching pattern. The frequency of acute graft versus host disease(GVHD) was 50.0% and death rate was 12.5% (1/8) in GVH KIR ligand-mismatching. The incidence rate of activated GVHD(aGVHD) was 20.0% in the HVG KIR ligand-mismatching. Five donor/recipient pairs of KIR gene typing were the KIR-haplotype A, 2 donor/recipient pairs with KIR2DS4 * 001/002 were died, 3 donor/recipient pairs with KIR2DS4 * 003-007 were obtained the disease free survival. The expression of CD158a/2DL1 was low when the patient had no aGVHD, but became much higher when aGVHD occurred. The percentage of NK cell of the patients was decreasing since transplantation, but still higher than normal after HSCT[ (23.4 ± 3.8 ) % vs (2.04 ± 0.58) %, P < 0.05 ]. Conclusion Analysis on KIR-HLA gene loci pattern may provide a useful parameter in predicting the clinical outcome of HLA-matched unrelated allogeneic hematopoietic stem cell transplantation for leukemia patients. Moreover, it may help to increase overall survival and disease free survival after HSCT by preventing the development of GVHD.

Objective To investigate the clinical features of coronary artery spasm patients with or without myocardial bridge and explore the roles of endothelial dysfunction in these patients.Methods One hundred eighteen patients undergone acetylcholine provoking test were divided into myocardial bridge(MB)group(n=26)and non-myocardial bridge(NMB) group(n=92).The results of acetylcholine test,treadmill exercise electrocardiography,stress myocardial peffusion scintigraphy,plasma level of endothelin-1 and nitric oxide were compared between MB group and NMB group.Results Coronary artery spasm was induced in 21 patients in MB group(81%)and 52 patients in NMB group(57%,P＜0.05).Positive treadmill electrocardiography was obtained in 19 patients in MB group(73%)and 7 patients in NMB group (8%,P＜0.001).Ischemic perfusion defect in 20(77%)and 9 patients(10%,P＜0.001)and reverse redistribution in 23(88%)and 68 patients(74%,P＞0.05).Patients showed different clinical features in MB group and NMB group(more short-duration exertional angina and could not be readily released by nitroglycerine in MB group while more patients experienced long-lasting variant angina and symptoms could be readily released by nitroglycerine).Plasma endothelin-1 level was significantly higher[(132.1±6.5)ns/L vs.(108.5±8.2)ng/L,P＜0.01]while nitric oxide was significant lower[(84.7±17.5)ns/L vs.(99.8±18.2)ng/L,P＜0.05]in MB group compared to NMB group.Conclusion MB patients were prone to coronary artery spasm partly due to endothelial dysfunction.Patients with MB and coronary artery spasm also showed classic clinical symptoms and positive stress tests for ischemia.

OBJECTIVETo investigate the role of xenogenic (porcine) ADM as dermal substitute in scar treatment.

METHODSAfter scar excision, the wounds were covered with composite grafts of DR procine ADM and autologous thin split-thickness grafts in one stage or in two stages.

RESULTS22 out of 47 cases were treated in two-staged procedure. After the ADMs were applied to the wound, the autologous thin split-thickness grafts were implanted 7 days later. 25 cases were treated in one-staged procedure. The survival rates of composite grafts were (88.3 +/- 3.7)% for subcutaneous recipient bed and (89.7 +/- 3.4)% for deep fascia recipient bed in group with two-staged procedure, compared with (92.5 +/- 4.1)% and (93.2 +/- 5.2)%, respectively, in group with one-staged procedure. Early after grafts taken, the grafts had a pink colour and smooth surface. The patients were followed up for 90 days at most. The survived composite grafts were durable, elastic, smooth and soft with good function and appearance like normal skin. They could even be pinched up. The scar along the edge of the grafts was slightly hypertrophic.

CONCLUSIONSThe survival rate of composite graft is higher in patients with one-staged procedure. The elasticity and textural of the taken grafts are better on subcutaneous recipient bed than on deep fascia recipient bed, though the function has no difference. Xenogenic (porcine) ADM can be an optimal dermal substitute for wound coverage after scar excision.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Child ; Child, Preschool ; Cicatrix ; surgery ; Dermis ; cytology ; transplantation ; Humans ; Male ; Middle Aged ; Skin, Artificial ; Swine ; Transplantation, Heterologous ; Young Adult

Tetramethylpyrazine (TMP), an effective component of traditional Chinese medicine Chuanxiong, is commonly used to resolve embolism. Its possible therapeutic effect against atherosclerosis has received considerable attention recently. Angiotensin II (Ang II) is highly implicated in the proliferation of vascular smooth muscle cells (VSMCs), resulting in atherosclerosis. The mechanisms of TMP in the proliferation of VSMCs induced by Ang II remain to be defined. The present study was aimed to study the effect of TMP on Ang II-induced VSMC proliferation through detection of nuclear factor-kappaB (NF-kappaB) activity and bone morphogenetic protein-2 (BMP-2) expression. Primary cultured rat aortic smooth muscle cells were divided into the control group, Ang II group, Ang II + TMP group and TMP group. Cells in each group were harvested at different time points (15, 30 and 60 min for detection of NF-kappaB activity; 6, 12 and 24 h for measurement of BMP-2 expression). NF-kappaB activation was identified as nuclear staining by immunohistochemistry. BMP-2 expression was observed through Western blot, immunohistochemistry and in situ hybridization. The results showed that: (1) Ang II stimulated the activation of NF-kappaB. Translocation of NF-kappaB p65 subunit from cytoplasm to nucleus appeared as early as 15 min, peaked at 30 min (P<0.01) and declined after 1 h. (2) TMP inhibited Ang II-induced NF-kappaB activation (P<0.01). (3) Ang II increased BMP-2 expression at 6 h but declined it significantly at 12 and 24 h (P<0.01). (4) BMP-2 expression was also kept at high level at 6 h in Ang II + TMP group but maintained at the normal level at 12 and 24 h. (5) There was no significant difference in NF-kappaB activation and BMP-2 expression between the control group and TMP group. These results indicate that TMP inhibits Ang II-induced VSMC proliferation through repression of NF-kappaB activation and BMP-2 reduction, and BMP-2 expression is independent of the NF-kappaB pathway. In conclusion, TMP has therapeutic potential for the treatment of atherosclerosis.
Angiotensin II ; antagonists & inhibitors ; Animals ; Atherosclerosis ; drug therapy ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; analysis ; antagonists & inhibitors ; Immunohistochemistry ; Muscle, Smooth, Vascular ; cytology ; drug effects ; metabolism ; Myocytes, Smooth Muscle ; metabolism ; NF-kappa B ; analysis ; antagonists & inhibitors ; Pyrazines ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta ; analysis ; antagonists & inhibitors