Objective:To investigate the expression and ratio of CD4 +CD25 +Foxp3 +regulatory T cells (Tregs) to helper T cells 17 (Th17) in the peripheral blood of children with B-cell acute lymphoblastic leukemia (B-ALL). Method:54 children with newly diagnosed B-ALL in Children′s Hospital Capital Institute of Pediatrics from February 2017 to October 2019 were selected as the research subjects, with a median age of 4.9 (3.1 to 7.4) years. These children were divided into a pre-treatment group and a post-treatment group. According to the disease outcome after treatment, they were further divided into a complete remission group (45 cases), and a relapse/refractory group (9 cases). 20 healthy children were selected as the control group. Flow cytometry (FCM) was used to detect the proportions of CD4 +CD25 +Foxp3 +Treg cells and Th17 cells. The ratio of Treg/Th17 cells was calculated. Result:Before treatment, the proportion of Treg cells in the relapse/refractory group and the complete remission group (respectively 6.11±0.48, 6.20±1.16) were higher than those in the control group (4.89±1.46) (P<0.05), and the ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage and complete remission stage (respectively 8.34±2.14, 5.91±1.92) were higher than those in the control group (3.55±1.68) (P<0.05); The ratio of Treg/Th17 cells in the relapsed/refractory group was higher than that in the complete remission group (P<0.05). After treatment, the proportion of Treg cells and ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage (respectively 6.09±0.80, 7.37±1.19) were higher than those in complete remission stage (respectively 5.25±0.87, 4.22±1.50) and control group (respectively 4.89±1.46, 3.55±1.68) (P<0.05). Compared with that before treatment, children in complete remission stage after treatment had lower proportions of Treg cells and the ratio of Treg/Th17 cells, as well as higher proportions of Th17 cells in the peripheral blood (P<0.05). There were no significant differences in the proportions of Treg cells and Treg/Th17 ratio between the pre-treatment group and the post-treatment group of children in relapse/refractory stage (P>0.05).Conclusion:In peripheral blood of children with B-ALL, there is a ratio change of Treg/Th17 cells caused by the increase of CD4 +CD25 +Foxp3 +Treg cells and the decrease of Th17 cells, which tends to be normal with the remission of the disease. Regular detection of Treg and Th17 cells helps to monitor the immune status and provide prognosis of children with B-ALL, and may provide a basis for the immunotherapy of B-ALL.

Objective To discuss the application of spiral CT angiography in postoperative re-examination of lower limb artery stent implantation. Methods During the period from March 2012 to March 2014 at the Affiliated Nanjing Hospital of Nanjing Medical University, CT angiography was carried out in 67 patients who had received stent implantation for arteriosclerotic occlusion of lower limb. The diseases involved 78 lower limbs, and a total of 85 stents were employed. The volume rendering (VR), maximum intensity projection (MIP), multi-planar reformation (MPR) and curved surface reconstruction (CSR) were performed to stereoscopically display the lesion’s anatomy as well as the implanted stents, and the imaging manifestations were compared with the clinical symptoms and DSA findings. Results Successful examination was accomplished in 65 patients (81 stents in total), and clear images were obtained. Of the 81 stents, no stenosis was seen in 43, Ⅱ - Ⅳ grade stenosis in 32 and complete occlusion in 6. The results were closely correlated with the clinical symptoms. The CT angiography manifestations in 31 patients (34 stents in total) were compared with their DSA performed in two weeks, and the results showed that the stenotic degrees of three stents judged by CT angiography were not consistent with those judged by DSA. The consistent rate of CT angiography was 91.2% when taking DSA as the standard. Conclusion Lower limb arterial CT angiography examination is a safe and non-invasive technique, it can clearly display the stent inner canal. Therefore, this technique is of great value in postoperative re- examination of lower limb artery stent implantation.

Objective To investigate the role of large-conductance Ga2+-activated K+ (BKCa) channels and protein kinase G (PKG) in ketamine-induced isolated tracheal smooth muscle relaxation in rats with asthma.Methods Healthy Sprague-Dawley rats,weighing 250-300 g,were used in this study.Asthma was induced with egg albumin.Thirty-six tracheal rings of 15 rats in which asthma model was successfully established were randomly divided into 3 groups (n =12 each):ketamine treatment group (group AK),IBTX (BKCa channel blocker) +ketamine treatment group (group AKI),and KT-58232 (PKG inhibitor) + ketamine treatment group (group AKK).Tracheal rings were suspended in an organ bath filled with oxygenated Kreb's solution at 36.5-37.5 ℃.In group AK,the tracheal rings were precontracted with acetyleholine 0.1 mmol/L,and the rings were then exposed to ketamine 0.4 g/L for 15 min.In group AKI,before acetyleholine and ketamine were added to the solution,the rings were pretreated with IBTX 3μmol/L for 30 min.In group AKK,before acetyleholine and ketamine were added to the solution,the rings were pretreated with KT-5823 2μmol/L for 30 min.The tension of rings was measured by using a force-displacement transducer.Results The amplitude of relaxation of isolated tracheal smooth muscle was significantly decreased in groups AKI and AKK as compared with group AK (P ＜ 0.05).Conclusion Ketamine induces isolated tracheal smooth muscle relaxation through activating BKCa channels and PKG signaling pathway in rats with asthma.

This study was to investigate the effect of peoniflorin on the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream signal molecules in the hippocampus of Alzheimer's disease (AD) rats for exploring the mechanism of peoniflorin protecting hippocampal neurons. AD model rats were established by bilateral intrahippocampal injection of beta-amyloid(1-42) (Abeta(1-42)) and divided randomly into 3 groups: AD model group, peoniflorin low-dose (15 mg x kg(-1)) group and peoniflorin high-dose (30 mg x kg(-1)) group. The vehicle control rats were given bilateral intrahippocampal injection of solvent with the same volume. After peoniflorin or saline was administered (ip) once daily for 14 days, the hippocampuses of all animals were taken out for measuring the expressions of Nrf2, heme oxygenase-1 (HO-1) and gamma-glutamylcysteine synthethase (gamma-GCS) mRNA by reverse transcription PCR, determining the contents of glutathione (GSH), malondialdehyde (MDA) and carbonyl protein (CP) using colorimetric method, and for assaying the expressions of neuronal apoptosis inhibitory protein (NAIP) and Caspase-3 by immunohistochemical staining method. The results showed that peoniflorin markedly increased the expressions of Nrf2, HO-1 and gamma-GCS mRNA, enhanced the level of GSH and decreased the contents of MDA and CP in the hippocampus, as compared with the model group. Peoniflorin also improved the NAIP expression and reduced the Caspase-3 expression in the hippocampus neurons. In conclusion, peoniflorin protects against the Abeta(1-42)-mediated oxidative stress and hippocampal neuron injury in AD rats by activating the Nrf2/ARE pathway.

OBJECTIVETo study the mechanisms of Danggui Shaoyao San (DSS) on Alzheimer's diseases (AD) focusing on anti-inflammation.

METHODAD rats were established by intrahippocampal bilateral injection of Abeta1-42 protein. The AD rats were randomly divided into three groups: AD model group, DSS high-dose group, DSS low-dose group. Vehicle group rats were intrahippocampal bilateral injection of solvent with the same dose. The learning ability and memory of rats was investigated in step-down passive avoidance test and Morris water maze test, expression of IL-1beta, IL-6, TNF-alpha mRNA were observed by reverse transcriptase PCR (RT-PCR), levels of NO was measured by colorimetric method and neuron apoptosis in the hippocampus was investigated by tag method of TdT-mediated end-labeling of fragmented DNA (TUNEL).

RESULTDSS significantly reduced the escape latency and increased the time that rats spent in the target quadrant in Morris water maze test, shortened the responsive latency and decreased the error numbers in step-down passive avoidance test, reduced the expression of the IL-1beta, IL-6, TNF-alpha mRNA, and the level of the NO depressed the neuron apoptosis in the hippocampus.

CONCLUSIONDSS improving cognition of the rats might be related to attenuate inflammatory reaction and reduce cell apoptosis in the hippocampus.

Alzheimer Disease ; drug therapy ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hippocampus ; drug effects ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures because of its advantages including easy operation,stable fixation,good clinical results and few complications.

BACKGROUND: As reported in some literatures, articular dysfunction following limb lengthening is one of the commonest complications, but some scholars believe that the articular dysfunction after lower limb lengthening is avoidable providing appropriate technical operation and effective function prevention.OBJECTIVE: To investigate the changes of articular function of knee during limb lengthening in rabbits so as to provide a experimental basis for clinical tasks.DESIGN: A randomized controlled trial SETTING: Department of Orthopeadics, Affiliated Hospital of Some Military Medical University.PARTICIPANTS: Study was conducted in the Experimental Animal Center of the Third Military Medical University of Chinese PLA from February 2001 to June 2002. Totally 30 healthy adult New Zealand rabbits obtained from the Experimental Animal Center of the Third Military Medical University of Chinese PLA were randomly divided into lengthening group and delayed observation group(observed at 3 months after the stop of lengthening).METHODS: Every group was further divided into three sub-groups according to distraction range: 10%, 20% and 40%. Upper-tibia metaphysis distraction was adopted at the rate of 1 mm per day . Distraction and iconography changes of knee joint were observed with X-ray. The motive range of knee was investigated at the end of distraction and three months later.MAIN OUTCOME MEASURES: Articular motive range of the knee before the distraction, at the end of distraction and three months later, X-ray resutls RESULTS: ① There was no obvious radiographic change in knee at every time point in each group. ② Significant flexion disorder in knee was found in 20% distraction subgroup( P ＜ 0. 05), which was only 44. 7% of normal motive range in 40% distraction subgroup( P ＜ 0. 01) . Motive functions of knee in delayed observation group were significantly improved; thereinto,20% distraction subgroup returned to preoperative level, while 40% distraction subgroup also had significant improvement compared with that of 3 months earlier but still lower than normal level, which was only about 88.5% of normal level( P ＜ 0.05).CONCLUSION: Temporary articular dysfunction might occur during limb lengthening process, and mostly during big range of distraction. Although the dysfunction could be gradually recovered after the stop of lengthening, active prevention is still necessary.

OBJECTIVESTo summarize the experience in the treatment of 112 cases of complex bone nonunion from 1982 to 1999 in our department and introduce the technique of external skeletal fixation.

METHODSThe two fragment ends of all cases were fixed under pressure with half-ring sulcated external skeletal fixator. Those cases complicated by bone defect or limb shortening were operated on with epiphysiotomy to restore the length of the limb in the period of compressive fixation or after the occurrence of bone union according to the condition of complicated infection and the length of the limb shortened.

RESULTSThe nonunion of the 112 cases was united eventually. The infection in 34 cases was eradicated. Bone union in cases without infection took 3 approximately 7 months (average 5.2 months) and in cases with infection took 5 approximately 11 months (average 5.5 months). The length of the limb in 11 cases with bone defect was restored in the same period of compressive external fixation and another 8 cases achieved after bone union. The length between the injured and healthy limbs was balanced.

CONCLUSIONSWhen external skeletal fixation is employed to treat those troublesome cases of bone nonunion, the pins for fixation are inserted in sites far from the lesions and the non-united fragment ends are exposed only in the area without scars. Consequently, there is little interference with the blood circulation and the osteogenic potency of the fragment ends. The sclerotic bone tissue is not excised, the marrow cavity is not chased to be open and the fragment ends are only moderately modified. As a result, the stability of fixation is increased and further shortening of the limb avoided. External skeletal fixation using small pins with cross penetration results in plastic fixation and promotes bone healing. Bone lengthening with epiphysiotomy can restore the balance of the limbs.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Fracture Fixation ; Fracture Healing ; Fractures, Ununited ; Humans ; Male ; Middle Aged

Objective To use external fixator in the treatment of fracture of the olecranon of ulna. Methods Ninety four cases of olecranon fracture were treated with external fixators. The lateral medial displacement was first reduced, followed by the reduction of the proximal fragments. In some difficult cases with comminated fracture, a Kirschner wire was inserted to lever the fracture fragments to proper site. The fragments were held together by two hands, and they were fixed with an external fixator with addition of longitudinal pressure. Results The mean healing time of all the 94 cases was 35 days (5 6 weeks), and the function of the elbow joint were restored to normal. Conculsion The method as described above is an easy, economical and safe method, and can be used in out patientdinic

A new method to reconstruct a thumb was worked out in the past few years. It was achieved by inverting the skin flap of the amputated thumb stump and suturing it to an island-shaped skin flap with nerves and vessels from the dorsum of the index finger. A piece of artificial bone was inserted between the two skin flaps into the first phalanx. The operative procedure was described in detail and the indications, advantages and disadvantages of this method were discussed. It is suggested that this method be used to reconstruct a thumb since it is simple and effective.