During the healing of diabetic wounds,prolonged inflammation,difficulty in angiogenesis,and decreased epithelialization ability of keratinocytes often appear,which lead to delayed wound healing.Autophagy is a catabolic pathway that degrades intracellular proteins,promotes cell survival,and maintains cellular biological functions.Recent studies have shown that autophagy affects the healing of diabetic wounds through various mechanisms.This article reviews the potential mechanism of autophagy in diabetic wound healing:autophagy may delay wound healing by causing a decrease in the phagocytic ability and polarization of macrophages,a decrease in the angiogenesis ability of endothelial progenitor cells,a decrease in the migration ability and proliferation of keratinocytes,and an increase in the apoptosis of fibroblasts,which may provide new ideas for finding therapeutic targets for diabetic wound healing.

Objective A rat model of cerebral small vessel disease(CSVD)was established by unilateral injection of a single dose of sodium laurate into the internal carotid artery.The effectiveness of the model was assessed by behavior scoring and analysis of serum-related indicators,cerebral infarction volume,cerebral microvascular density,hemodynamics,brain histopathology and the expression of blood-brain barrier(BBB)-related proteins.Methods SPF-grade male SD rats were divided randomly into a control group and a model group(n=6 per group).The model group received a single injection of 100 μL of sodium laurate(2 g/L)via the internal carotid artery,while the control group underwent the same surgical procedure but received an equal volume of saline.Neurobehavioral assessments were conducted using the Longa score and postural reflex test.Serum homocysteine(HCY)levels were measured by enzyme-linked immunosorbent assay.Cerebral infarction volume was detected by magnetic resonance imaging and changes in cerebral vascular density were observed by cerebrovascular imaging.The resistance index(RI)and perfusion index(PI)were measured by ultrasonography.Histopathological changes in brain tissue were evaluated by hematoxylin and eosin(HE)staining.Expression of the cerebral microvascular marker CD31 and tight junction proteins ZO-1 and Occludin in brain cortex tissue were detected by immunohistochemical staining.Results The Longa score,postural reflex score(P＜0.05),and cerebral infarction volume were significantly increased(P＜0.05)while the cerebral vascular density was decreased in the model group compared with the control group.Serum HCY levels,carotid RI,and PI values were all significantly increased in the model group(P＜0.05).HE staining revealed solidified neuronal nuclei and enlarged perivascular spaces in the brain cortex in the model group.Immunohistochemical staining revealed that CD31,ZO-1,and Occludin expression were significantly reduced in the brain cortex in the model group compared with the control group(P＜0.05).Conclusions A rat model of CSVD can be established rapidly and effectively by a single unilateral injection of high-concentration sodium laurate via the internal carotid artery.This model is characterized by neurobehavioral abnormalities,cerebral infarction,insufficient cerebral blood supply,reduced vascular density,and disruption of the BBB,suggesting that it may serve as an effective rat model for the study of CSVD.

Objective A rat model of cerebral small vessel disease(CSVD)was established by unilateral injection of a single dose of sodium laurate into the internal carotid artery.The effectiveness of the model was assessed by behavior scoring and analysis of serum-related indicators,cerebral infarction volume,cerebral microvascular density,hemodynamics,brain histopathology and the expression of blood-brain barrier(BBB)-related proteins.Methods SPF-grade male SD rats were divided randomly into a control group and a model group(n=6 per group).The model group received a single injection of 100 μL of sodium laurate(2 g/L)via the internal carotid artery,while the control group underwent the same surgical procedure but received an equal volume of saline.Neurobehavioral assessments were conducted using the Longa score and postural reflex test.Serum homocysteine(HCY)levels were measured by enzyme-linked immunosorbent assay.Cerebral infarction volume was detected by magnetic resonance imaging and changes in cerebral vascular density were observed by cerebrovascular imaging.The resistance index(RI)and perfusion index(PI)were measured by ultrasonography.Histopathological changes in brain tissue were evaluated by hematoxylin and eosin(HE)staining.Expression of the cerebral microvascular marker CD31 and tight junction proteins ZO-1 and Occludin in brain cortex tissue were detected by immunohistochemical staining.Results The Longa score,postural reflex score(P＜0.05),and cerebral infarction volume were significantly increased(P＜0.05)while the cerebral vascular density was decreased in the model group compared with the control group.Serum HCY levels,carotid RI,and PI values were all significantly increased in the model group(P＜0.05).HE staining revealed solidified neuronal nuclei and enlarged perivascular spaces in the brain cortex in the model group.Immunohistochemical staining revealed that CD31,ZO-1,and Occludin expression were significantly reduced in the brain cortex in the model group compared with the control group(P＜0.05).Conclusions A rat model of CSVD can be established rapidly and effectively by a single unilateral injection of high-concentration sodium laurate via the internal carotid artery.This model is characterized by neurobehavioral abnormalities,cerebral infarction,insufficient cerebral blood supply,reduced vascular density,and disruption of the BBB,suggesting that it may serve as an effective rat model for the study of CSVD.

Objective To analyze and compare epidemiological characteristics of adult single metatarsal fractures between the east and west areas in China from 2010 through 2011.Methods Thirty-five hospitals in the east area (group A) and 28 hospitals in the west area (group B) participated in this epidemiological investigation of adult single metatarsal fractures treated from January 2010 through December 2011.Data concerning gender,age and fracture location and type were documented and compared between groups A and group B.Results There were 4,779 fractures in group A and 1,708 in group B,accounting for 21.28％ (4,779/22,455) and 26.88％ (1,708/6,354) of the adult foot fractures,and 2.48％ (4,779/192,991) and 2.10％ (1,708/81,143) of all the adult fractures,respectively,showing significant differences between the 2 groups (P ＜ 0.05).The ratio of male to female was 1.21:1 in group A and 1.48:1 in group B,showing a significant difference (x2 =11.768,P =0.001).The median age of group A (43 years) was significantly older than that of group B (40 years) (Z =-6.275,P ＜ 0.001).The proportions of the patients aged from 21 to 30 years (19.02％) and of those aged from 31 to 40 years (18.62％) in group A were significantly lower than those in group B (22.66％ and 21.60％),but the proportion of the patients aged from 51 to 60 years in group A (21.09％) was significantly higher than that in group B (14.64 ％) (P ＜ 0.05).The proportions of type 87-A (40.18％) and type 87-C (5.52％) in group A were significantly lower than those in group B (44.38％ and 8.20％),but the proportion of type 87-B in group A (54.30％) was significantly higher than that in group B (47.42％) (P ＜ 0.05).There was no significant difference between the 2 groups in the distribution of fracture locations (P ＞ 0.05).Conclusions The most common single metatarsal fracture was that of the fifth metatarsal bone and the fractures of proximal metatarsal bone accounted for the largest proportion in both the cast and west areas.The west area had higher proportions of male patients and single metatarsal fracture than the east area.

Objective To investigate the epidemiological features and trends of humeral intercondylar fractures at our hospital from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the patients with humeral intercondylar fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender,fracture site and AO classification were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 303 humeral intercondylar fractures were recorded,accounting for 5.29％ of the distal humeral fractures,3.39％ of the elbow fractures and 0.24％ of the total fractures at the same period.They involved 197 males and 106 females,with a male/female ratio of 1.86∶ 1.The high-risk age group was adolescent and middle-aged adults,accounting for 63.70％.The high-risk type was type 13-C2,accounting for 44.00％.There were 171 and 132 cases in group A and group B,accounting for 5.40％ and 5.17％ of the contemporary distal humeral fractures,3.72％ and 3.05％ of the contemporary elbow fractures,and 0.26％ and 0.22％ of all the contemporary fractures,respectively,showing no significant differences between the 2 groups(P ＞ 0.05).In groups A and B respectively,the male/female ratios were 1.44∶1 and 2.67∶ 1,the proportions of adolescents and the middle-aged 58.48％ and 70.45％,the proportions of type 13-C1 35.83％ and 18.10％,and the proportions of type 13-C3 14.17％ and 44.76％,showing significant differences between the 2 groups in all the above comparisons (P ＜ 0.05).Conclusion The humeral intercondylar fractures were common in the adolescent and middle-aged patients,with a male predominance (about twice more in males).Compared with the first five years,the latter 5 years witnessed increased proportions of males,adolescent and middle-aged patients,and type 13-C3 but a decreased proportion of type 13-C1.

Objective To investigate the epidemiological features and trends of adult fractures at the base of the first metacarpal bone in The Third Mfiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system.Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups,group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012.Comparison and analysis was done with analytic items of gender,age and fracture type.Results A total of 378 adult fractures at the base of the first metacarpal bone were included,accounting for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures involved 311 males (82.28％) and 67 females (17.72％).The youth group had 254 fractures with the highest constituent ratio (67.20％).The right side was involved in 286 cases (75.66％) and the left side in 92 (24.34％).There were 198 cases of extra-articular fracture with the highest constituent ratio (52.38％).Group A had 200 fractures,a male to female ratio of 6.14∶ 1,a median age of 34 years,the highest constituent ratio in youth (73.50％) and in type A1 fractures (53.50％);group B had 178 fractures,a male to female ratio of 3.56∶ 1,a median age of 40 years,the highest constituent ratio in youth (60.11％) and in type A1 fractures (51.12％).Compared with group A,group B had a higher constituent ratio of females,older ages,a higher constituent ratio of elderly patients,a lower constituent ratio of youth,and a lower constituent ratio of type C1 fractures.All these differences between the 2 groups were statistically significant (P ＜ 0.05).Conclusions During the 10 year,the adult fractures at the base of the first metacarpal bone accounted for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures occurred mostly in men and in the age range of 16 to 44 years.About 3/4 of them occurred on the right side.Compared with the first 5 years,the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type C1 fractures.

Objective To investigate the epidemiological features and trends of adult carpal fractures at The Third Affiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the adult patients with carpal fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender and fracture type were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 1,181 carpal fractures were collected,accounting for 5.99％ (1,181/19,712) of the hand fractures and 1.10％ (1,181/107,648) of the total fractures in the same period.They involved 967 males and 214 females,with a male/female ratio of 4.52∶ 1.The high-risk age group was from 21 to 30 years (33.28％);the high-risk type was scaphoid fracture (72.99％).In group A of 453 cases,the male/female ratio was 6.68∶1,the median age 29 years and the high-risk type scaphoid fracture (83.89％).In group B of 728 cases,the male/female ratio was 3.70∶ 1,the median age 34 years and the high-risk type also scaphoid fracture (66.21％).Group B had a significantly lower male/female ratio,a significantly lower proportion of scaphoid fractures and a significantly older median age than group A (P ＜ 0.05).Conclusions In the 10 years at our institute,adult carpal fractures accounted for 5.99％ of the hand fractures and 1.10％ of the total fractures in the same period.They mostly occurred in males and during the age from 21 to 30 years.Of all the carpal bones,the scaphoid was the most often fractured.The latter 5 years witnessed significantly increased median age,proportion of females and proportion of scaphoid fractures compared with the former 5 years.

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.

Objective To compare and analyze the epidemiological features of fractures at the base of the first metacarpal bone between East and West China.Methods We retrospectively analyzed the clinical data of the patients with fracture at the base of the first metacarpal bone who had been treated from January 2010 to December 2011 in 63 hospitals in the east and west areas of China.The data from 35 hospitals in East China were classified as group A while the data from 28 hospitals in West China as group B.The analytic items included gender,age,age distribution and fracture classification.Results A total of 890 cases were collected.The total male/female ratio was 4.56∶ 1.The youth accounted for the highest proportion and the high-risk type of fracture was type Ⅲ (44.49％,396/890).The male/female ratio was 4.59∶1 in group A of 621 patients and 4.49∶1 in group B of 269 patients,showing no statistic between-group difference (P ＞ 0.05).The median age in group A was 39 years,significantly older than that in group B (35 years) (Z =-3.687,P ＜ 0.001).In both groups,the youth accounted for the highest proportion and there were more right-side fractures than left-side ones.Group A had a significantly lower proportion of the youth and a significantly higher proportion of the middle-aged than group B (P ＜ 0.05),but there was no statistic difference in proportions of the children and the aged (P ＞ 0.05).Type Ⅲ was the high-risk type in both groups;group A had significantly more fractures of type Ⅰ and significantly fewer fractures of type Ⅱ than group B (P ＜ 0.05),but there was no statistic difference in proportions of type Ⅲ and type Ⅳ between the 2 groups (P ＞ 0.05).Conclusions Fractures at the base of the first metacarpal bone mostly occurred in the young males.There were more fractures at the right side than at the left side.The most frequent type was type Ⅲ.The proportion of type Ⅰ fractures in East China was higher than in West China while the proportion of type Ⅱ fractures in East China lower than in West China.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.