Hoffa fracture is an unstable intra-articular fracture with significant redisplacement tendency. It is easy to be missed diagnosis when accompanied by distal intercondylar or supracondylar fracture of femur. CT scan is the gold standard for the diagnosis of Hoffa fracture. The treatment principles are anatomic reduction of the articular surface, reliable internal fixation, and early functional activity. At present, the main treatment is arthroscopic screw fixation. During screw fixation, the tail cap of screw should be buried, resulting in non-healing iatrogenic injury of articular cartilage. In the early postoperative functional activity of knee joint, fracture block was repeatedly subjected to backward and upward shear force under the action of the tibial plateau, which is the main reason for the failure of internal fixation. Plate assisted screw fixation could increase local mechanical stability, but it still cannot avoid the defects of iatrogenic cartilage injury. At the same time, plate molding is required during the operation due to the absence of special anatomical plates, resulting in increased surgical trauma and time-consuming surgery. The ideal fixation method for Hoffa fracture should include:(1) Avoid iatrogenic injury of articular surface cartilage. (2) With the rear anti-shear barrier plate function.(3) The internal fixator is closer to the load interface, so as to obtain greater load and better fixed strength.
Humans ; Hoffa Fracture ; Femoral Fractures/surgery* ; Tomography, X-Ray Computed ; Fracture Fixation, Internal/methods* ; Bone Plates ; Iatrogenic Disease

Humans ; Adult ; Mucormycosis ; Leukemia, Myeloid, Acute/complications* ; Acute Disease ; Antifungal Agents

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) μg/L, and 54% (14/26) of these patients had SF levels of ≥100 μg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) μg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 μg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Anemia, Iron-Deficiency/epidemiology* ; Sucrose/therapeutic use* ; Ferric Compounds/therapeutic use* ; Retrospective Studies ; Iron/therapeutic use* ; Hemoglobins/therapeutic use*

Objective: To investigate the regulatory relationship of Protein Phosphatase 2 Regulatory Subunit B"Alpha ( PPP2R3A) and hexokinase 1 ( HK1) in glycolysis of hepatocellular carcinoma (HCC). Methods: In HepG2 and Huh7 cells, PPP2R3A expression was silenced by small interfering RNA (siRNA) and overexpression by plasmid transfection. The PPP2R3A-related genes were searched by RNA sequencing. Glycolysis levels were measured by glucose uptake and lactate production. QRT-PCR, ELISA, western blot and immunofluorescence assay were performed to detect the changes of PPP2R3A and HK1. Cell proliferation, migration and invasion assay were used to study the roles of HK1 regulation by PPP2R3A. Results: RNA sequencing data revealed that PPP2R3A siRNA significantly downregulated the expression of HK1. PPP2R3A gene overexpression promotes, while gene silencing suppresses, the level of HK1 and glycolysis in HCC cells. In HCC tissue samples, PPP2R3A and HK1 were colocalized in the cytoplasm, and their expression showed a positive correlation. HK1 inhibition abrogated the promotion of glycolysis, proliferation, migration and invasion by PPP2R3A overexpression in liver cancer cells. Conclusion Our findings showed the correlation of PPP2R3A and HK1 in the glycolysis of HCC, which reveals a new mechanism for the oncogenic roles of PPP2R3A in cancer.
Carcinoma, Hepatocellular/pathology* ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Glycolysis ; Hexokinase/metabolism* ; Humans ; Liver Neoplasms/pathology* ; Protein Phosphatase 2/metabolism* ; RNA, Small Interfering/metabolism*

OBJECTIVE: To investigate the regulation of chronic myelogenous leukemia （CML） imatinib resistant genes, in order to improve the therapeutic effect of CML imatinib resistant patients. METHODS: The human CML cell line K562 and imatinib-resistant K562 cells (K562/G01) were collected, and transcriptome of the cells were achieved by RNA-seq. The sequencing data were analyzed by using standard procedures. RESULTS: Compared with K562 cells, 464 genes were significantly changed in K562/G01 cells, including 163 up-regulated and 301 down-regulated genes. The GO function annotation analysis and KEGG pathway analysis results showed that the differentially expressed genes were mainly involved in biological processes such as oxidative phosphorylation, localization to protein organelle, ribonucleoprotein complex biogenesis and so on. Gene Set Enrichment Analysis (GSEA) plots showed that 5 gene-sets were up-regulated in K562/G01 significantly, including the pathway of TGF-beta, mTOR and CML. CONCLUSION CML imatinib resistance is associated with oxidative phosphorylation, during which the pathway of TGF-beta and mTOR are significantly up-regulated.
Drug Resistance, Neoplasm ; Gene Expression Profiling ; Humans ; Imatinib Mesylate/pharmacology* ; K562 Cells ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics*

Objective To analyze the spatial epidemiological characteristics of measles in Taizhou from 2009 to 2017, so as to provide theoretical basis for measles prevention and control. Methods The spatial autocorrelation analysis and trend surface analysis of measles epidemics data from 2009 to 2017 in Taizhou were performed using ArcGIS 10.0 software. The dynamic characteristics of measles epidemics in Taizhou were analyzed. Results Among 2009-2017 years, the incidences of measles in Taizhou ranged from 0.83/1 million to 65.43/1 million. The results of global autocorrelation analysis showed that there were spatial correlations of the incidence of measles among 2012, 2013, 2015, and 2016 in Taizhou with a high-value clustering distribution. Local autocorrelation analysis indicated that the hot spots of measles incidence in Taizhou from 2009 to 2017 were mainly concentrated in the central towns of Taizhou. Trend surface analysis suggested that the measles incidence in the south towns of Taizhou was higher than that in the north in 2010, and the incidence in the central region was higher than those in other regions in 2013 and 2015. Conclusions According to the spatial analysis, autocorrelation was observed for the spatial distribution of measles incidence in Taizhou from 2009 to 2017, and there are hot spots in the central township. Targeted preventive measures should be taken based on these characteristics.

In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by a separate rating committee on a scale of 1–9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.
Area Under Curve ; Asian Continental Ancestry Group* ; Clinical Decision-Making ; Consensus* ; Coronary Artery Disease ; Echocardiography ; Electrocardiography ; Heart Diseases ; Humans ; Magnetic Resonance Imaging ; Methods ; Positron-Emission Tomography ; Radionuclide Imaging ; Tomography, Emission-Computed

BACKGROUND: Alloying can improve the corrosion resistance and slow the degradation of pure magnesium. In addition, increasing studies have shown that zinc has good antitumor effect. OBJECTIVE: To evaluate the effect of zinc-containing magnesium alloy on the proliferation and apoptosis of human osteosarcoma U2OS cells in vitro.METHODS: The corrosion resistance of pure magnesium and different zinc-containing (2%, 4%, 6%) magnesium alloys were observed and compared by the hydrogen release assay in the Hank's solution. MTT assay was used to examine the effects of different zinc-containing magnesium alloy extractions on the proliferation of U2OS cells (or MC3T3-E1 cells) after co-culture of 1, 3, 5 days. After 24-hour co-culture with pure magnesium, different zinc-containing magnesium alloys and titanium alloy extractions, the apoptotic rates of U2OS cells were analyzed by flow cytometry, and the expression of apoptosis-related proteins were detected by western blot assay.RESULTS AND CONCLUSION: The corrosion resistance of pure magnesium was improved after addition of Zn within the initial 100 hours, and the magnesium alloy containing 4% zinc exhibited the optimal corrosion resistance. Different zinc-containing magnesium alloy extractions obviously inhibited the U2OS proliferation in a zinc level-depended manner, and the cytotoxicity of different zinc-containing magnesium alloy extractions to MC3T3-E1 was graded 0-1. Different zinc-containing magnesium alloy extractions could also induce obvious apoptosis in U2OS cells in a zinc level-depended manner. Different zinc-containing magnesium alloy extractions, especially the magnesium alloy containing 4% zinc, up-regulated the expression of p53 and Bax proteins and down-regulated the expression of Bcl-2 protein in U2OS cells, leading to the disorder of Bcl-2/Bax. These findings suggest that different zinc-containing magnesium alloy extractions can inhibit the proliferation and induce apoptosis of U2OS cells in vitro.

To study the effect of Yinghua Pinggan granule (YHPG) against influenza A/H1N1 virus in vivo and on the immunologic function of infected mice. The intranasal influenza virus infection was adopted in ICR mouse to establish the influenza virus pneumonia model. At the 3rd and 7th day after the infection, the lung index and pathologic changes in lung tissues of mice were detected. Realtime PCR and flow cytometry were employed to observe the virus load in lung tissues and the levels of CD4+, CD8+, and CD4+/CD8+ in peripheral blood. The result showed that at the 3rd and 7th day after the infection, YHPG (15, 30 g x kg(-1)) can significant decrease in the lung index and virus load in lung tissues of mice infected with influenza virus, alleviate the pathologic changes in lung tissues, significantly increase the levels of CD4+ and CD4+/CD8+ ratio and reduce the levels of CD8+ in whole blood. This indicated that YHPG can inhibit the influenza virus replication, alleviate pulmonary damage and adjust the weak immunologic function of infected mice, with a certain therapeutic effect on mice infected by H1N1 virus in vivo.
Animals ; Antiviral Agents ; administration & dosage ; Humans ; Influenza A Virus, H1N1 Subtype ; drug effects ; genetics ; physiology ; Influenza, Human ; drug therapy ; pathology ; virology ; Lung ; pathology ; virology ; Male ; Mice ; Mice, Inbred ICR ; Virus Replication ; drug effects

Objective To analyze the resistance of clinically cefoxitin -non -susceptible Klebsiella pneumoniae isolates and the prevalence ofβ-lactamase.Methods WHONET 5.6 was used to analyze the resist-ance of 62 strains with non -susceptibility to cefoxitin recovered.Chi -square test was adopted to compare the resistance rates of 62 isolates with the 239 Klebsiella pneumoniae isolates susceptible to cefoxitin collected during the same period.Meanwhile, the 62 clinical isolates were further taken for preliminary screening for ESBLs and carbapenmase by disk -diffusion tests and modified Hodge tests, respectively.Further analysis for detecting the resistant genes encoding AmpC and carbapenemase was carried out by PCR and DNA sequencing.Results On the whole, cefoxin -non - susceptible Klebsiella pneumoniae isolates displayed higher resistances towards all the antimicrobial agents tested ( P <0.05), except for ampicilin.Preliminary screening test showed that 55 strains (88.7%) were ESBLs producers and 39 strains (62.9%) were carbapenemase producers.PCR and DNA sequencing showed that 8 (12.9%) produced AmpC and 39 (62.9%) strains produced KPC carbapenemase, respectively.Conclusion Most of the Klebsiella pneu-moniae isolates non - susceptibilitible to cefoxitin produce KPC carbapenemase and ESBLs, with AmpC being prevalent, posing a great challenge to clinical therapy and infection control.