Objective:To investigate the clinical therapy of one-stage internal and external fixation combined with early perforator fiap for treatment of ankle fracture dislocation with soft tissue defects of Gustilo types Ⅲ.Methods:A retrospective study was conducted of the 20 patients with ankle fracture dislocation of Gustilo type Ⅲ who had been treated from May 2014 to July 2017 at Deparment of Traumatic Orthopaedics, the Second Hospital of Tangshan. There were 14 males and 6 famales among the patients, aged from 18 to 58 years (average, 40 years). There were 5 cases of Gustilo type ⅢA, 12 cases of type ⅢB, and 3 cases of type ⅢC; AO classification of ankle fractures: 4 cases of type A, 7 cases of type B, and 9 cases of type C; The wound size ranged from 4 cm×3 cm to 20 cm×9 cm. All patients were treated by primary internal and external fixation plus secondary transfer with a perforator flap. The times from injury to initial surgery ranged from 1 to 8 h (average, 5.5 h), the period from injury to secondary flap transfer ranged from 7 to 21days (average, 12 days). Among them, 11 cases of posterior tibial artery perforator flap, 5 cases of fibular artery perforator flap, 1 case of anterior ankle flap, and 3 cases of posterior tibial artery perforator flap combined with fibular artery perforator flap.Results:All 20 cases of limb preservation were successful, and there were no amputees. 9 patients showed superficial infection, no deep infection and osteomyelitis occurred. All 19 cases of flap survived, 1 case of distal part of posterior tibial artery perforator flap was necrosis, and the skin graft was cured later. All patients were followed up for 6 to 18 months (average, 12 months). The flap healed well. There was no sinus tract and bone exposure. The sensory recovery was S1 in 2 fiaps, S2 in 12 flaps, S3 in 6 flaps. The fracture healing time vanged from 4 to 10 months (average, 6.5 months), no bone disunion in patients. According to the American foot ankle surgery scoring system, the efficacy was assessed: 4 excellent cases, 11 good cases, 3 fair cases, 2 poor cases, yielding an excellent to good rate of 75%.Conclusions:One-stage internal and external fixation combined with early perforator fiap transfer is an effective strategy for treatment of ankle fracture dislocation with soft tissue defects of Gustilo types Ⅲ, due to its advantages of shortened treatment period, possibility for early rehabilitation, decreased complications and satisfactory functional recovery.

Objective:To investigate the effects of IL-18BP blockade on apoptosis of synovial cell in IL-18 induced Collagen-induced-arthritis(CIA) in mice and its possible mechanism.Methods: CIA mice were established by freund′s complete adjuvant,and divided into 5 groups:normal group,CIA model group,IL-18-CIA group,MTX group and IL-18BP group,each for 10,total 50 mice.The expression of Fas and FasL in the synovial tissue of the left posterior ankle joint taken from each group were detected by immunohistochemistry analysis.Results: IL-18BP group compared with the model group,the mice of joint swelling was inhibited,the expression level of Fas and FasL increased significantly,the difference was statistically significant (P<0.01);IL-18BP group has a significant curative effect and basically recovered to normal level(P<0.05).Conclusion: IL-18BP can promote the apoptosis of synoviocytes by regulating the expression of apoptosis genes Fas and FasL,which is helpful for the treatment of rheumatoid arthritis.

Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.(Chin J Lab Med, 2015, 38:595-599 ) Objective To investigate the diagnostic value and monitoring application of anti-phospholipase A2 receptor antibodies ( PLA2R ) in patients with idiopathic membranous nephropathy ( IMN) .Methods A retrospective study was used .48 patients were diagnosed as idiopathic membranous nephropathy by puncturing kidney from January of 2013 to June of 2014 in the Hospital of Liaoning Traditional Chinese Medical University and Shengjing Hospital of China Medical University were included. 43 patients were diagnosed as non-idiopathic membranous nephropathy ( NIMN ).35 healthy volunteers were selected as control groups.Serum PLA2R were detected by indirect immunofluorescence.The intensity of antibodies fluorescence and the level of urine protein in 24 hours(24 h PRO) ,serum UREA ,serum CYSC, serum UA,GFR were compared in each groups.Measurement data was shown as mean ±standard deviation;Count data was shown as frequency or composition, t test andχ2 test were used as statistical method.Results (1) Among 48 cases with IMN,37 cases showed positive PLA2R (positive rate 77.08%).All of cases were negative in NIMN group.The sensitivity and the specificity of serum PLA2R were 77.08%and 100%.(2) Compared with control groups, the levels of UREA, CYSC and UA were found statistically significant differences in patients with IMN ( P <0.05 ) .( The levels of UREA in control groups and IMN groups respectively:4.12 ±1.25,6.02 ±2.28, t =4.446,P=0.00;UA:262 ±49,331 ±112,t =2.577,P =0.017;CYSC:0.78 ±0.21,1.16 ±0.27,t=4.63,P=0.00.) Compared with control groups, the levels of main items in patients with NIMN had statistically significant differences (P<0.05).(The levels of UREA in control groups and Allergic purpura nephropathy subgroups respectively:4.12 ±1.25,5.43 ±1.84,t=3.606,P=0.000 2;UA:262 ±49, 299 ±51, t=1.050,P=0.03;CYSC:0.78 ±0.21, 1.06 ±0.31, t=1.672,P=0.02.The levels of UREA in control groups and lupus nephropathy subgroups respectively:4.12 ±1.25, 5.90 ±2.20,t=4.225,P=0.00;UA:262 ±49, 342 ±92,t=2.409,P=0.026;CYSC:0.78 ± 0.21,0.92 ±0.24, t =1.674, P =0.00.The levels of UREA in control groups and IgA nephropathy subgroups respectively:4.12 ±1.25,6.69 ±2.87,t=4.756,P=0.00;UA:262 ±49,361 ±52,t=4.598, P=0.00;CYSC:0.78 ±0.21, 1.30 ±0.36,t=4.752,P=0.00.The levels of UREA in control groups and tumor associated nephropathy subgroups respectively: 4.12 ±1.25, 5.02 ±1.70, t =3.626, P =0.002;UA:262 ±49, 289 ±92,t=0.05,P=0.01;CYSC:0.78 ±0.21, 0.98 ±0.20,t=1.1,P=0.01.) There was no statistically significant differences between IMN group and NIMN ( P >0.05 ) . ( 3 ) Positive correlation were found between 24 h PRO(r=0.877,P=0.00),serum UA (r=0.766,P=0.00 ) with the level of PLA2R antibodies fluorescence intensity.( 4 ) There were no correlation between serum PLA2R antibody with IMN pathology aging (r=0.087,0.194,0.182;P=0.598,0.399,0.667).PLA2R positive rate(Ⅰstage:37.50%,Ⅱstage:84.85%, Ⅲstage 85.71%) may increases with the increasing of illness severity.Conclusion Serum PLA2R antibody would be a new laboratory diagnosis standard in patients with IMN.

Methane monooxygenases (MMO), regarded as "an amazing biomolecular machine", catalyze the oxidation of methane to methanol under aerobic conditions. MMO catalyze the oxidation of methane elaborately, which is a novel way to catalyze methane to methanol. Furthermore, MMO can inspire the biomolecular machine design. In this review, we introduced MMO including structure, gene and catalytic mechanism. The history and the taxonomy of MMO were also introduced.
Catalysis ; Methane ; metabolism ; Methanol ; metabolism ; Oxygenases ; metabolism

Objective To explore the relationship between physical activity ( PA) in college students and self?efficacy,and provide guarantee for improving health education in colleges. Methods International physical ac?tivity questionnaire( IPAQ) ,scales of physical behavior,scales of stage of change in physical exercise behavior,and scales of self?efficacy were used to test 504 students from some of colleges in Zhejiang province. Results Signifi?cantly more males (38.52%) than females (27.27%) were in the high activity tertile (P<0.01); the amount of PA per week in males and females were (4608±872.07)MET and(4361±674.03)MET(P<0.01); the scores of males and females were (3.32±0.44) and(3.04±0.36),(P<0.01). The number of males (35.5%) in maintenance period and period of action is greater than that of females (28.9%). Males had higher self?efficacy and more scores of behavior than females (P<0.05) . There were significant characteristics of PA in their self?efficacy,score of be?havior and stages of change( F=18.38, F=15.08, F=34.71, P<0.01),and a significant correlation between PA and self?efficacy,stages of change and physical exercise behavior ( r=0.336, r=0.36, r=0.46, P<0.01).Conclu?sion Self?efficacy may have important effect on the level of PA. Stages of change and scores of behavior may ex?plain difference of PA between males and females.

BACKGROUND: Matrix metalloproteinase (MMP) degrades extracellular matrix, which is a necessity of joint destruction in rheumatoid arthritis patients. MMP-2 and MMP-9 can evaluate rheumatoid arthritis and serve as an index to predict progressive destruction of the joint. OBJECTIVE: To observe heterogenous allogeneic umbilical cord blood stem cell (UBSC) transplantation on MMP-2 and MMP-9 expression in the spleen of mice with type Ⅱ collagen-induced arthritis. METHODS: Fetus cord blood was sterilely obtained and cord blood stem cells were separated. The C57BL/6(H-2b) mice were assigned to five groups (n=10). Except normal control group, models of collagen-induced arthritis were established using complete Freund's adjuvant + type Ⅱ collagen. Mice from the methopterin group were intragastrically administered methopterin suspension 0.017 5 g/kg, once every 5 days. Other groups used caudal vein injection. Mice from the model and normal control groups were injected with saline. Mice from the mono-UBSCs group and double-UBSCs group were injected with 2×106/kg UBSCs from one and two parents. At 42 days following injection, animals were sacrificed and the ankle joint was obtained for histopathological detection. MMP-2 and MMP-9 mRNA expression in the spleen was examined using reverse transcription-polymerase chain reaction. RESULTS AND CONCLUSION: Double-UBSC transplantation could significantly inhibit inflammatory cell infiltration in synovial tissue of mice with type Ⅱ collagen-induced arthritis, repaired impaired cartilage tissue. The repair effect was better than that in methopterin group and mono-UBSCs group. MMP-2 and MMP-9 mRNA expression in the spleen was significantly lower in the double-UBSCs group than the mono-UBSCs group (P < 0.01). These suggest that heterogenous allogeneic double-UBSCs transplantation participated in pathological changes in rheumatoid arthritis cartilage and in synthesis of cartilage extracellular matrix and effectively treated rheumatoid arthritis by regulating MMP-2 and MMP-9 mRNA expression.

Objective To compare the differences in physical activity (PA), self-efficacy, stages of change and physical exercise behaviour in college students. Methods International physical activivty questionnaire( IPAQ), scales of self-efficacy, questionnaire of stage of change in physical exercise behaviour, and scales of physical behaviour were used to make a study on college students from Zhejiang province. Results The rate of males (40.43%) was signficant higher than that of females (26.09%) MET in the high activity tertile. There was significantly more energy expenditure in males (( 3462.79 ± 976.31 ) MET) than in females (( 3118.63 ±944.29 ) MET) (P ＜ 0.05 ). The rate of males (44.68 % ) was more than females (25.00%) in maintainanee period and period of action. PA characteristics were shown significant defferences in different stages (F= 31. 380, F=6.012, P ＜ 0.01 ). Characteristics in stages of change were shown high in behaviour score (F= 13.071, F= 7. 461,P ＜0. 01 ). Four factors as attitude,cognitive controls, behavior disposition and self-efficacy in males were entered into regression model of MET( t = 2.138 ～ 3. 789, P ＜ 0.05 ), while in females only the factor of behaviour attitude was entered. Conclusion There is significant difference in PA, stages of change, behaviour characteristics, and self-efficacy between male and female college students.

Radiofrequency thermocoagulation (RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia (CTN). In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia (MTN). Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009. Thirty patients had CTN, and 27 had MTN. Outcomes were measured by using the visual analog pain scale (VAS) and patients' reports of quality of life (QOL), medication usage, and complications over a follow-up period of up to 3 years. Our results showed that the patients with MTN were younger, tended to have bilaterial involvement of the first division, and were unresponsive to treatment. All surgeries were completed smoothly. About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT. The VAS scores were significantly higher in the CTN group than in MTN group (P<0.05). Kaplan-Meier curves showed that 1-year, 2-year, and 3-year pain relief rates were 76.7%, 73.3%, and 73.3% in the CTN group and 46.6%, 41.4%, and 41.4% in the MTN group, respectively. The rates of pain relief for both groups leveled off at 2 years. Complications included numbness, dysesthesia, and anesthesia dolorosa. RFT did not cause any deaths and complications were low. The treatment was very effective for CTN and, to some degrees, effective for MTN. If numbness, dysesthesia, and anesthesia dolorosa are limited to the trigger area, QOL will be greatly improved.

Radiofrequency thermocoagulation(RFT)of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS)and patients' reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.

Objective To clarify the mechanism of lipoprotein (a) ［Lp (a)］ metabolic disorder in patients receiving maintenance hemodialysis (MHD), and to offer theoretical basis for seeking for modus operandi of disorder control.Methods The apolipoprotein (a)［apo(a)］ isoforms were identified by high-resolution SDS-agarose gel electrophoretic method followed by immunobloting in 61 patients receiving maintenance hemodialysis (MHD group), 51 patients with end-stage renal disease (ESRD group) and 62 healthy controls (healthy control group). The influential factors for elevated serum level of lipoprotein (a) in MHD group were analyzed by applying statistical method.Results No statistical difference of Lp (a) median level was found between MHD group and ESRD group in LWM isoforms, but their level was significantly higher than that of healthy control group. In MHD group, the concentrations of serum creatine(Crea),cystatin C(CysC) and C-reactive protein(CRP) were significantly higher (P<0.05), while the concentrations of albumin(Alb) and Hb were lower than those of healthy control group (P<0.05). The concentration of LDL-C had no significant difference between MHD group and healthy control group. Compared with those of ESRD group, the levels of Crea, CRP and CysC were not significantly increased (P<0.05) in MHD group. There was no difference in the level of Lp (a) between the MHD and the ESRD patients with LMW-apo (a) isoforms (P>0.05), but compared with healthy control group, the serum levels of Lp (a) in the two groups were remarkably increased (P<0.05). The level of Lp (a) with LMW-apo (a) were significantly correlated with Alb and CysC respectively (P<0.05). The level of Lp (a) with HMW-apo (a) of MHD patients were higher than that of ESRD patients (P<0.05). The patients in the two groups had higher levels of Lp (a) as compared with those of healthy control group. The positive correlation of Lp (a) level with CRP and CysC was observed in patients with HMW-apo (a) (P<0.01). As MHD group as concerned, Lp (a) level was associated with Alb and CysC (P<0.01); regression analysis showed that apo (a) isoforms, Alb and CysC were listed in the regression equation, and the determinate coefficient (r2) was 0.348, in which the respective r2 of apo (a) isoforms, Alb and CysC was 0.121, 0.178 and 0.049.Conclusion Multiple factors may contribute to the high level of Lp (a) in MHD patients. Moreover, Lp (a) with different isoforms of apo (a) had different influencing factors. The corresponding therapeutic measure should be taken according to apo (a) isoforms in order to acquire better therapeutic efficacy for MHD patients.