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Objective To study the biological behaviors and effects of immunoglobulin-like transcript-4 (ILT4) expression in mononuclear cells on the prognosis of sepsis.Methods ILT4 +/+ (WT) and ILT4-knockout mice (ILT4-/-) male BALB/c mice were used for sepsis modeling using cecal ligation puncture (CLP).Flow cytometry was used to measure the levels of expression of ILT4 and major histocompatihility complex class Ⅱ molecules (MHC-Ⅱ) in mononuclear cells of peripheral blood 24 h after CLP.ELISA was used to measure the concentrations of interleukin-6 (IL-6) and serum tumor necrosis factor-alpha (TNF-α) in different groups of mice at 0 h,6 h,12 h,and 24 h after CLP to monitor the survival and prognosis over the course of 168 h.Results ILT4 was highly expressed in mononuclear cells of the peripheral blood of septic mice 24 h after CLP in comparison with that before CLP (1292.00 ± 143.70) vs.(193.50 ± 52.54),P ＜ 0.05.MHC-Ⅱ expression in mononuclear cells of the peripheral blood in ILT4-/-mice was significantly higher than that in WT mice (49.38 ± 5.66)％ vs.(24.25 ± 6.76) ％,P ＜ 0.05).Serum IL-6 was significantly elevated 24 h after CLP compared with that before CLP (470.75 ± 88.03) vs.(54.25 ± 20.04),P ＜ 0.05.The serum IL-6 concentration was much lower in ILT4-/-mice thanthatin MT mice (241.25 ± 45.10)vs.(470.75 ± 88.03),P ＜ 0.05;whereas,there was no significant difference in TNF-α expression between two groups of mice (50.88 ± 6.38) vs.(53.13 ± 5.49),P ＞ 0.05.The survival rate of ILT4-/-mice was significantly higher after CLP compared with WT mice (P ＜ 0.05).Conclusion The high level of ILT4 expression in mononuclear cells were observed in peripheral blood during sepsis and it was found to be associated with high serum IL-6 levels and low MHC-Ⅱ expression in mononuclear cells,leading to increased mortality.
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ObjectiveTo investigate the clinical effects of minimally invasive incision in anterior traverse approach for Gartland type Ⅲ humeral supracondylar fractures in children.Methods Forty-two patients with Gartland type Ⅲ displaced supracondylar fractures of the humerus were treated through anterior traverse approach between January 2008 and April 2011.The fractures were fixed using two Kirschner wires from the medial and lateral epicondyles placed crossing each other.There were 31 males and 11 females,at age of 2.6-12 years (average 5.7 years).Three patients were with open fractures.Seven patients were combined with other fractures,four with radial nerve injury and one with median nerve injury,with time from injury to hospitalization for a range of 1 hour to 3 days.Of all the patients,30 patients were with fractures on the right side and 12 with fractures on the left side.All fractures were treated by minimally invasive incision in anterior traverse approach,when the neurovascular and muscular probing and repair were performed. Results Forty patients were followed up for 3-32 months ( average 13 months),which showed incision healing at one stage,with fracture healing time for 3-4 weeks (average 3.6 weeks).No cubitus varus or incision scar were found after operation.According to Flynn' s criteria,the effect of treatment three months after operation were excellent in 32 patients,good in four and fair in four,with excellence rate of 90％.ConclusionsThe minimally invasive incision of anterior traverse approach is characterized by minor trauma,small incision,nil scar and convenient neurovascular and muscular exploration and hence is a safe and reliable treatment for open reduction of Gartland type Ⅲ humeral supracondylar fractures in children.
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Objective To investigate the biological effect of GM-CSF on splenic dentritic cells (DCs)when used to treat severe sepsis and the influence on the prognosis.Methods All 160 male Kunming mice were randomly(random number)divided into four groups:control group(n =50),the mice didnt receive special treatment; CLP group(n =42),the mice underwent cecal ligation and puncture;conventional treatment group(n =34),the mice received intraperitoneal injection of 5 mg/kg ceftriaxone at 12,24,36,48,60,72 and 84 h after surgery; GM-CSF treatment group(n =34),the mice received hypodermic injection of 20 μg/kg GM-CSF besides ceftriaxone at 12,36,60,and 84 h after surgery.The mice were sacrificed at 0,12,24,48 and 72 h after CLP by cervical dislocation.The amount of splenic DCs and apoptosis rate were measured by flow cytometry,and the serum concentrations of IL-12 were detected by ELISA in each group.Meanwhile the survival prognosis was observed at 96 h.Results At every time point,the apoptosis of splenic DCs increased and the amount markedly reduced in severe sepsis(P ＜0.05),the serum concentration of IL-12 increased on an one-way curve type(P ＜0.05).The treatment of cephalosporin exacerbated the loss of DCs(P ＜ 0.05),while hadnt any effect on IL-12(P ＞ 0.05).GMCSF treatment increased the amount of DCs(P ＜ 0.05),and decreased IL-12 concentrations(P ＜ 0.05).The OR of GM-CSF was 0.079 computed by Logist regression analysis.Conclusions GM-CSF treatment severe sepsis can increase the amount of splenic DCs,decrease serum levels of IL-12,and improve prognosis.
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Objective To evaluate the clinical effect of long incision and reticular incision in the treatment of osteofascial compartment syndrome(OCS)in children.Methods The study involved 56 children with OCS who met failure of the conservative treatment.The injury sites included mainly the forearm and the leg.All the children underwent decompression by a small reticular incision procedure from January 2000 to May 2009.The fractures were treated with one stage reduction and fixation or second stage open reduction.Meanwhile,the study involved another 21 children(including 13 earthquake victims)who were treated with long incision for open decompression in the other hospitals before admission.All the wounds were healed by direct suture or dermatoplasty after 1-5 weeks of infection control.Bacterial culture was performed in all the wounds.The fractures were treated with secondary open reduction and fixation.Bacteria culture was done in all wounds.Results The reticular incisional wounds of 56 patients were healed free from dermatoplasty,with no infection or sensory dysfunction.Among 21 patients treated with long incision,the bacteria culture was positive in 16 patients(including 13 earthquake victims)and verve injury found in five patients(including two with radial nerve injury and three with peroneal nerve injury).Four patients with partial or complete cut-off of the verves were improved after repair by secondary operation.Direct suture of incisions was done in nine patients and skin graft performed in 12,with average healing time for three weeks.The patients were followed up for mean 5.6 years,which showed no claw hands,with overall satisfactory rate for about 98% and 95% respectively in two groups according to the probation standard of amputated finger function evaluation from the Hand Surgery Plant of Chinese Medical Association.Conclusions Both long incision and reticular incision procedures can be used early in the treatment of pediatric OCS,while the reticular incision procedure is more convenient and simple,with less complications.
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Objective To investigate the effect of intramedullary stabilization of lower limb fractures with titanium elastic nails (TENs) in children.Methods From June 2004 to October 2010,278 children were stabilized with TENs in our hospital,including 181 boys and 97 girlsat average age of 7.6 years (range,3.0-14 years).There were 162 patients with femoral fractures,of which 35 underwent open reduction and the rest closed reduction.There were 116 patients with tibial fractures,which was treated with closed reduction.Postoperative fixation lasted for 3-4 weeks.The mean hospital stay was seven days.Of all the patients,272 patients received the removal of the TENs six months after operation and 242 received more than one year of follow-up to have a further observation on the limb length,hip and knee mobility and gait condition in children.Results All the patients were followed up for 6-66 months (mean,33 months).All fractures were healed in good alignment without severe complications.There were no intraoperative complications like infections,delayed union,nonunion,TEN broken and femoral or tibial epiphysis injuries.Ten patients suffered from swell and skin irritation in the nail' s position 3-4 months after operation,and the nails were removed in advance.Nineteen patients showed unequal lengths ( within 1 cm) of the lower limbs,with normal function of the lower limb joint but with no obvious limp.According to the Flynn evaluation standard,the excellent and good rate was 100％.Conclusions Characterized by good stability,rapid healing,small incision,anatomic reduction,unimpaired periosteum,short hospital stay and few complications,intramedullary stabilization with titanium elastic nails can achieve effective fixation in the treatment of lower limb fractures in children.
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BACKGROUND:There are numerous studies on bone marrow mesenchymal stem cells(BMSCs)from small animals such as rats and rabbits,but no few reports addressing BMSCs from big animals.OBJECTIVE:To observe in vitro cultured goat BMSCs,and to understand its biological properties.METHODS:A healthy Chinese goat aged ten months was obtained to extract 5 mL fresh bone marrow from the posterior superior iliac spine by puncture following anesthesia.Using the whole bone marrow method,the samples were incubated in a sterile plastic culture flask and added with DMEM/F12 containing 10% fetal bovine serum.Following 80% 90% confluence,cells were digested by trypsin.Cells at passage 3 in logarithmic phase were collected and frozen,and then recovered.Changes in cell morphology were observed using an inverted microscope.Cell growth curve was measured using MTT assay.The potential of osteogenic differentiation was examined utilizing Von Kossa's staining.RESULTS AND CONCLUSION:The primary cultured BMSCs were cultured with adherent growth.The cells were spindle form.Cell morphology following passage 3 was similar,showing long spindle shape.Following freezing and recovery,cell adherence was slower compared with subculture cells,and no significant difference was detected in cell morphology and viability compared with subculture cells.Growth cycle was similar in passage 3-passage 5 cells.BMSCs entered lag phase at days 2 and 3,logarithmic phase at day 3,and platform phase at days 6 and 7,and then growth speed was slow.Goat BMSCs were positive for Von Kossa's stain at 3 weeks following osteogenic induction.Results verified that cultured goat BMSCs showed strong genetic stability and proliferation ability,and differentiated into osteoblasts.
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[Objective]To discuss the tissue engineering method of treating bone defects through rabbit bone marrow mesenchymal stem cells(MSCs)'culture in vitro and make composite grafts with anti-extracted bovine cancellous bone(BCB).The composite grafts were implanted into segmental radial defects in rabbits was compared on the curative effect of repairing segmental bone defects in rabbits with the composite grafts.[Method]The purified,culture-expanded MSCs were combined with BCB in vitro according to condition of cell culture.The composite grafts were tested by scanning electron microscope.An bone defect(15mm in length) was created at two radii in each rabbit.The composite grafts were implanted into segmental radial defects in rabbits through open operation.The curative effect was evaluated by radiographic examination,histologic analysis,biomechanical test after surgery in experimental groups and control's and blank's.[Result]Roentgenographically,the bone defects that had been treated with grafts exhibited new bone formation increased with time.But the result of experimental groups were apparently superior to that of the control groups′s at 2、4、8、12、16 week after operation(P
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Objective To study the effects of vitamin A deficiency(VAD)and its supplementation on the skeletal growth in rats.Methods Eighteen female Wistar rats were randomly divided into VAD(Vit A 400 IU/kg diet,n=3),supplement(n=9)and control groups(normal diet Vit A 6 500 IU/kg,n=6).The supplement groups were randomly divided into 3 sub-groups,and their diet was changed to Vit A 6 500 IU/kg diet from 14 d after pregnancy,0 d and 4 weeks after birth respectively until they were 7 weeks age old.When they were 0 day,4 and 7 weeks old,their body weight,the length of the tibia,serum Vit A level were measured,and the histology of growth plate was also observed.Results At every measuring times,the serum Vit A level was significantly lower,and the tibial length was shorter in VAD group than in the control(P
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Objective To analyze the clinical outcomes after different treatments for the Monteggia's fracture in children. Methods From January 1991 to December 2001, a total of 128 children with Monteggia's fracture were reviewed, there were 91 males and 37 females, the average age was 7.4 years (range, 2-14 years). According to the Bado classification system: 73 of typeⅠ( extension type) accounted for 57.0%; 20 of type Ⅱ (flexion type), 15.6%; 33 of type Ⅲ (adduction type), 25.8%; 2 of type Ⅳ, 1.6%. 50 patients received conservative treatment, all belonged to the fresh fractures (within 1 week after injury); the other 78 patients were operated, including 30 fresh fractures after failure of closed reduction and 48 old fractures. The conservative patients received manipulation and plaster immobilization. In the operative group, 45 patients (16 fresh and 29 old fractures) were fixed with single Kirschner wire after reduction of the radiohumeral joints, and the ulnas were free of fixation; 33 children (14 fresh and 19 old fractures) were fixed with double wire both for the radiohumeral joints and fractured ulnas. In the fresh Monteggia's fractures, the annular ligament was repaired simply without reconstruction, but in the old fractures, neither reparation nor reconstruction was needed. The plaster was kept for 4-6 weeks postoperatively. Results All patients were available at the final follow up with a mean of 5.6 years (range, 1-10 years). According to the Lihan Ming's scoring system for the motion function in children: the conservative patients were classified as 42 excellent, 4 good, 2 fair and 2 poor, the excellent and good rate was 92%; and in the single wire group, there were 31 excellent, 5 good, 2 fair and 1 poor, the excellent and good rate was 93.3%; finally in the double wire group, 22 excellent, 7 good, 2 fair and 2 poor, the excellent and good rate was 87.9%. Conclusion The closed reduction should be selected first for the fresh Monteggia's fracture in children, the operation is only indicated for the special fresh or old fractures, in which neither the anatomic reduction was satisfactory nor the reduction can be kept without internal fixation. The operative technique, including the open reduction of the radiohumeral joint and fixation both with Kirschner wire and plaster,is reliable to improve the clinical results.