Objective:To analyze the clinic effects of arthroscopic partial trapeziectomy and suture button suspensionplasty in the treatment of first carpometacarpal joint (CMCJ) Eaton stage II/III arthrosis.Methods:A retrospective study was conducted on a total of 15 cases (16 hands) of patients including 5 males (1 bilateral) and 10 females with CMCJ stage II/III arthrosis who underwent surgical treatment at the first affiliated hospital of Shenzhen university from January 2020 to June 2022, with mean age of 56.7±6.4 years (range, 46-75 years). The duration from pain to treatment was 7.8±3.2 months (range, 4-14 months). X-ray showed narrowing of CMCJ with osteophytes and distal radial subluxation. All the patients were treated with arthroscopic partial trapeziectomy and suture button suspensionplasty. The preoperative and last postoperative follow-up radiographs, visual analogue scale (VAS), thumb's Kapandji scores, disabilies of the arm, shoulder, and hand (DASH) scores, grip and pinch strength and time to return to work were compared.Results:All cases were followed up for 19.6±6.3 months (range, 11-36 months). The postoperative X-ray showed all the CMCJs were reduced with a normal height of first metacarpal. The mean time for patients to return to their daily activities was 18.69±3.70 d and the mean time to return to work was 24.63±4.91 d. The average VAS score decreased from 6.56±1.15 preoperatively to 1.00 (0.75, 1.25). The preoperative Kapandji's score was 8.00±0.82 and the postoperative Kapandji's score was 8.00 (7.25, 9.00). The average DASH values improved from 24.06±3.19 to 4.00 (3.00, 5.00). The were significant differences except for Kapandji score ( Z=-4.905, P<0.001; Z=-0.121, P=0.905; Z=-4.846, P<0.001). The mean grip and pinch strength showed improvement from an average of 16.4 (14.13, 18.68) kg and 1.70±0.35 kg to 26.14±3.27 kg and 3.58±0.91 kg with significant difference ( Z=-4.617, P<0.001; t=-7.669, P<0.001). Conclusion:Arthroscopic partial trapeziectomy and suture button suspensionplasty is a minimally invasive surgery for the treatment of first CMCJ Eaton stage II/III arthrosis. By this technique, the patients' existing instability and pain problems can be solved.

Objective:To investigate the clinical efficacy of wrist arthroscopic transosseous footprint repair technique for treating triangular fibrocartilage complex (TFCC) injury.Methods:A retrospective case series study was conducted to analyze the clinical data of 56 patients with TFCC injury admitted to Shenzhen Second People′s Hospital from July 2017 to September 2020, including 38 males and 18 females, aged 17-45 years [(33.5±3.6)years]. All patients had unilateral injury. Physical examination showed instability of the distal radioulnar joint, and MRI and arthroscopy confirmed deep ligament injury of TFCC. All patients underwent repair of deep insertion of the TFCC by using wrist arthroscopic transosseous footprint. The operation time, intraoperative blood loss, wound healing and postoperative complications were recorded. The flexion and extension range of motion of the wrist, radial and ulnal deviation of the wrist, rotation range of motion of the forearm, patient related wrist evaluation (PRWE) score, modified Mayo wrist score, visual analogue scale (VAS), and percentage of grip strength between the affected side and unaffected side were compared preoperatively, at 3 months postoperatively and at 1 year postoperatively.Results:All patients were followed up for 12-18 months [(13.4±5.2)months]. The operation time was (61.3±8.9)minutes, with the intraoperative blood loss of (2.4±1.2)ml. All wounds were healed by first intension. There was no wound infection or ulnar nerve irritation symptom after operation. Four patients experienced clicking on the ulnar side of the wrist in a short period of time post-operation, with spontaneous disappearance of the symptom. At 3 months postoperatively, the radial and ulnar deviation of the wrist was decreased from (52.5±5.9)° preoperatively to (42.6±5.9)°, and rotation range of motion of the forearm was decreased from (94.9±8.4)°preoperatively to (84.6±5.9)° (all P<0.01). The flexion and extension range of motion of the wrist was (93.1±17.4)° preoperatively, with insignificant difference compared with (89.4±5.8)° at 3 months postoperatively ( P>0.05). At 1 year postoperatively, the flexion and extension range of motion of the wrist, radial and ulnar deviation range of motion of the wrist, and rotation range of motion of the forearm were significantly increased to (101.3±13.6)°, (52.4±6.6)°, and (116.4±16.4)° when compared with those at 3 months postoperatively (all P<0.01). At 3 months postoperatively, the PRWE score was increased to (17.1±3.8)points from (10.6±3.2)points preoperatively ( P<0.01), modified Mayo wrist score was decreased to (70.3±6.7) points from (78.1±12.7)points preoperatively ( P<0.01), VAS was decreased to (4.4±1.7)points from (6.2±1.5)points preoperatively ( P>0.05), and percentage of grip strength between the affected side and unaffected side was decreased to (55.7±8.7)% from (74.4±15.2)% preoperatively ( P<0.01). At 1 year postoperatively, the PRWE score was increased to (2.0±0.9)points, modified Mayo wrist score was increased to (94.8±3.3)points, VAS was decreased to (2.1±1.1)points, and percentage of grip strength between the affected side and unaffected side was increased to (93.2±8.7)% when compared with those at 3 months postoperatively (all P<0.01). Conclusion:Wrist arthroscopic transosseous footprint repair technique can effectively treat deep ligament injury of TFCC, with advantages of significantly improving postoperative joint range of motion and functional score, relieving the pain on the ulnar side of the wrist and enhancing grip strength.

Objective:To analyze the changes of serum 25-hydroxyvitamin D 3[25-(OH)D 3] expression in diabetic patients and its correlation with macrovascular complications. Methods:Two hundreddiabetic patients admitted to Cangzhou Central Hospital from February 2018 to November 2019 were divided into macrovascular complications group (87 cases) and without macrovascular complicationsgroup (113 cases). According to the degree of 25-(OH)D 3 deficiency, 32 cases were divided into 25-(OH)D 3 normal group, 94 cases were mild deficiency group and 74 cases were moderate and severe deficiency group. At the same time, 168 outpatients were selected as control group. The levels of serum 25-(OH)D 3 were compared between diabetic group and control group, macrovascular complications group and without macrovascular complications group, and the correlation between the level of serum 25-(OH)D 3 and carotid intima-media thickness (IMT) was analyzed. Results:The level of serum 25-(OH)D 3 in diabetic group was lower than that in control group: (24.79 ± 3.02) μg/L vs. (39.18 ± 4.38) μg/L, the difference was statistically significant ( P<0.05). The level ofserum 25-(OH)D 3 in diabetic patients with macrovascular complications group was lower than that in without macrovascular complications group: (21.08 ± 2.64) μg/L vs. (27.65 ± 3.31) μg/L; while the IMT was higher than that without macrovascular complications group: (1.29 ± 0.13) mm vs. (0.93 ± 0.10) mm, the differences were statistically significant ( P<0.05). The incidence of macrovascular complications in 25-(OH)D 3 moderate and severe deficiency group was higher than that in 25-(OH)D 3 mild deficiency group and 25-(OH)D 3 normal group: 60.81%(45/74) vs. 40.43%(38/94), 12.50%(4/32), the difference was statistically significant ( χ2 = 21.896, P<0.05). The level of serum 25-(OH)D 3 in patients with diabetic macrovascular complications was negatively correlated with IMT ( r = -0.513, P<0.05). Conclusions:The level of serum 25-(OH)D 3 in diabetic patients is decreased, and the change of its concentration is related to the occurrence of macrovascular complications.

Objective: To analyze the clinical effects of arthroscopic autologous bone grafting and percutaneous fixation in treating scaphoid nonunion. Methods: From May 2013 to August 2017, a total of 25 cases of patients including 20 males and 5 females with unilateral scaphoid fractures and nonunion were reviewed, with mean age of 35.80±2.41 years (18-65 years). The duration from injury to treatment was averaged 11.70±1.90 months (5-18 months). All of the cases sustained waist and proximal end fractures. X-ray and CT scan showed sclerosis and bone resorption without any callus at the fracture sites. However, there were no serious deformities and wrist arthritis. The patients suffered pain and weakness at the radial side of the wrist. The type of the fractures were Slade-Geissler's III-VI, including grade III 4 cases, grade IV 13 cases, grade V 7 cases and grade VI 1 case. The patients were treated with arthroscopic debridement of the sclerotic bone, autologous bone grafting, percutaneous screw (9 cases) or K-wires fixation (16 cases) and immobilization by plaster for 3 weeks after operation, followed by functional rehabilitation training. Bone union was assessed by serial plain radiographs and CT scan regularly. The functional effects were evaluated by comparing the modified Mayo wrist score with the visual analogue scale (VAS) for pain, range of motion (ROM) and the grip strength, which were measured before operation and at 18 months after operation. Results: All cases were followed up. Bone union was achieved in all of 25 nonunion. The average radiological union duration was 10.24±2.10 weeks (6-20 weeks). The average VAS score decreased from 6.75±1.10 preoperatively to 1.33±0.21. The mean ROM of wrist was improved to 168.48°±12.41° (92.90% of that of the normal side), compared to that of 135.24°±17.47° preoperatively (79.80% of that of the normal side). The mean grip strength showed improvement from an average of 35.68±3.81 kg (80.46% of that of normal side) preoperatively to 48.75±4.42 kg (90.65% of that of normal side). The average modified Mayo wrist score improved from 61.52±6.32 preoperatively to 85.88±8.37. Conclusion Arthroscopic autologous bone grafting with percutaneous cannulated screw and K-wires fixation is an effective and minimally invasive treatment for scaphoid nonunion, which could protect the blood supply of the fracture sites, decrease the surgical complications, promote bone healing and lead to a faster recovery.

Objective To analyze clinical characteristics and gene mutation of two patients diagnosed with P450 oxidoreductase deficiency(PORD). Methods Clinical data of 2 patients with PORD was collected from Ruijin hospital. POR gene mutation was analyzed by PCR-Sanger sequencing. A retrospective analysis of literatures concerning PORD was performed. Results Patient 1, female, 16 years old, with 46,XX karyotype, presented with anorectal anomalies, clitoral hypertrophy at birth and irregular menstruation; Patient 2, female, 32 years old, with 46,XX karyotype, showed irregular menstruation and infertility, both without obvious skeletal deformity. Genetic test of POR gene mutation revealed that patient 1 carried a homozygous missense mutation (R457H) and patient 2 carried a heterozygous mutation (R223X/ Y607C). The two mutations (R223X and Y607C) are reported for the first time in China. Conclusion P450 oxidoreductase deficiency which caused by mutations in POR gene has a variety of clinical manifestations, including abnormal steroid hormone synthesis with or without Antley-Bixler syndrome. The affirmative diagnosis should rely on steroid hormone measurement and POR gene analysis.

Objective To explore the feasibility of bletilla striata polysaccharide as a drug delivery material .Method With hydrophobic cholesterol succinyl bletilla striata polysaccharide (CHSB) as the carrier ,the model drug paclitaxel (PTX) loaded nanoparticles were prepared via dialysis method .The morphology of nanoparticles was observed by Transmission Elec-tron Microscope (TEM) .The particle size ,distribution and zeta potential were characterized by Dynamic Light Scattering in-strument (DLS) .The entrapment efficiency ,drug loading and in vitro release were determined by high performance liquid chromatography (HPLC) .Differential Scanning Calorimetry (DSC) was used to confirm the drug form in the drug loaded nan-oparticles .The in vitro antitumor activity of nanoparticles was assayed by MTT .The uptake of nanoparticles by QGY-7703 liver cancer cells was observed by fluorescence labeling method .Results The prepared nanoparticles had spherical shape with uniform particle size distribution .The drug was loaded in the interior of the nanoparticles .Drug loading and encapsulation effi-ciency were affected by the CHSB in certain range .The cytotoxicity of drug loaded nanoparticles on liver cancer cells was stron-ger than the free drug .The fluorescence of Rhodamine B labeled drug nanoparticles were observed in the cells .Conclusion Cholesterol succinyl bletilla striata polysaccharide (CHSB) is highly feasible as an insoluble drug carrier .It can be used as a po-tential Nano carrier material .

Objective To establish a simple and sensitive method for the determination of plasma drug concentration in rats after intragastrical and intravenous administration of paclitaxel loaded nanoparticles and to evaluate its pharmacokinetic characteristics .Methods AgilentTC-C18 column (250 mm × 4 .6 mm ,5 μm) was used for HPLC at the flow rate 1 ml/min with ketoconazole as internal standard and methanol acetonitrile water (45:20:35) as the mobile phase .The statistical mo-ment method was applied to calculate the pharmacokinetic parameters and to evaluate pharmacokinetic characteristics .Results There was a good liner relationship (r=0 .9997) when rat blood concentration of Paclitaxel ranged from 0 .5 to 20μg /ml .The accuracy and precision were in line with the requirements of biological sample analysis .The t1/2 were 3.86 ,3.76 ,3.35 and 2 .62 h after intravenous injection of three lab-made paclitaxel nanoparticles and paclitaxel solution via rat tail vein .The t1/2 were 5 .28 and 3 .72 h respectively after intragastrical administration of lab-made paclitaxel nanoparticles and paclitaxel suspen-sion .Conclusion This method can be used for the pharmacokinetic study of paclitaxel nanoparticles in rats .The paclitaxel loaded nanoparticles exhibited significantly longer in vivo retention time than paclitaxel injection and paclitaxel suspension .

AIM: To investigate the influences of microRNA-126 on the curative effect of chemoradiotherapy and radiosensitivity of SGC-7901 cells.METHODS: The patients of gastric cancer (n=60) were selected in this study including 32 males and 28 females with the average age of (51±7) years.All patients received similar chemoradiotherapy strategy.The tissue and blood samples were collected during treatment.The short-term curative effect was evaluated by the Response Evaluation Criteria in Solid Tumors (RECIST), and the patients were divided into sensitive group and insensitive group.The microRNA-126 levels were detected by RT-qPCR.The SGC-7901 cells were maintained in vitro and transfected with microRNA-126 mimic.The plate colony formation assay was used to determine the enhancement effect of microRNA-126 on radiosensitivity of the SGC-7901 cells.The apoptotic rate of the SGC-7901 cells induced by microRNA-126 was analyzed by flow cytometry.RESULTS: According to the RECIST, 28 cases were defined as sensitive patients and 32 cases were the insensitive patients.Compared with the sensitive patients, the microRNA-126 levels both in blood and tissue samples were lowered in the insensitive patients, and the relative fold changes were 0.72±0.04 and 0.48±0.03, respectively (P<0.05).After transfection with microRNA-126 minic, the SF2 and D0 in the SGC-7901 cells were decreased with the SER of 1.74.Furthermore, microRNA-126 induced apoptosis of SGC-7901 cells and enhanced their radiosensitivity.CONCLUSION: The patients with low microRNA-126 level may suffer a poor curative effect of chemoradiotherapy on the gastric cancer.MicroRNA-126 has an enhancement effect on the radiosensitivity to the SGC-7901 cells.

Objective To study the anti‐microbial activity and strength of allicin on Campylobacter jejuni .Methods Disc diffusion method (K‐B) was used to determine the diameter of the bacteriostatic ring .The minimal inhibitory concentra‐tion (MIC) of allicin ,ciprofloxacin and erythromycin were detected by constant broth dilution method ,respectively .The mini‐mal inhibitory concentrations and bacteriostatic rate of allicin ,ciprofloxacin and erythromycin were compared .Results The anti‐microbial activity on Campylobacter jejuni of allicin (MIC 12 .8 μg/ml ,bactetiostatic rate 90 .40% ) was better than that of ciprofloxacin (MIC 20 .48 μg/ml ,bactetiostatic rate 90 .21% ) and erythromycin (MIC 35 .84 μg/ml ,bactetiostatic rate 90 . 33% ) .Conclusion Allicin has anti‐microbial activity on Campylobacter jejuni in vitro .

Objective To study the pharmaceutical quality of the thermos sensitive insulin anal liquid suppository .Meth-ods Orthogonal test method was used ,the forming of a gelatum time ,gel strength ,bio-adhesive force ,viscosity ,gelation temperature were taken as the evaluation index ,the prescription of poloxamer 407 and poloxamer 188 ,the proportion of chi-tosan and pH were investigated ,in order to determine the best optimized prescription and measure what was the best choice of the gel strength ,biological adhesion force ,suppository viscosity ,gelation temperature for the final prescription of liquid sup-pository .Result The best combination of the prescription were 15% of poloxamer 407 ,25% of poloxamer 188 and 0 .4% of chitosan with the pH of 5 ± 0 .2 .Conclusion The test proved to be equitable with the good intensity and bio-adhesive force of the liquid suppository .