Treatment of irreducible femoral intertrochanteric fractures using a wire-guided device / 中华创伤杂志(英文版)

PURPOSE@#Treatment of irreducible femoral intertrochanteric fractures often requires open reduction. However, the technique unavoidably causes patients to suffer greater trauma. As such, minimally invasive techniques should be employed to reduce the surgical-related trauma on these patients and maintain a stable reduction of the fractures. Herein, a minimally invasive wire introducer was designed and used for the treatment of femoral intertrochanteric fractures. The effectiveness of using a wire-guided device to treat irreducible femoral intertrochanteric fractures was evaluated.@*METHODS@#Between 2013 and 2018, patients with femoral intertrochanteric fractures who were initially treated by intramedullary nail fixation but had difficult reduction using the traction beds were retrospectively reviewed. Decision for an additional surgery was based on the displacement of the fracture. The patients were then divided into two groups: those in the control group received an open reduction surgery while those in the observation group received a closed reduction surgery using a minimally invasive wire introducer to guide the wire that could assist in fracture reduction. The operation time, blood loss, visual analogue scale scores, angulation, reduction, neck-shaft angle, re-displacement, limb length discrepancy, and union time were then recorded and analyzed to determine the efficiency of the wire introducer technique. Categorical variables were analyzed by using Chi-square test, while continuous variables by independent t-test and the Mann-Whitney test accordingly.@*RESULTS@#There were 92 patients included in this study: 61 in the control group and 31 in the observation group. There were no significant differences in baseline demographic factors between the two groups. All surgeries were successful with no deaths within the perioperative period. The average follow-up time for the patients was 23.8 months. However, the observation group had a significantly shorter operation time, lower visual analogue scale score, less intraoperative bleeding, and shorter fracture healing time. There were no significant differences in the angulation, reduction, neck-shaft angle, and limb length discrepancy between the two groups.@*CONCLUSION@#The minimally invasive wire guide achieved a similar effect to that of open reduction in the treatment of intertrochanteric fractures with difficult reduction. Moreover, the minimally invasive wire introducer is a good technology that accurately guides the wire during reduction. Indeed, it is an effective technique and achieves good clinical outcomes in restoration of irreducible femoral intertrochanteric fractures.

The Hypothalamo-Pituitary-Gonadal System in Men with Ischemic Heart Disease

Purpose: This Researchwas to study the functional state of the hypothalamic-pituitary gland-gonadal system in males with Ischemic Heart Disease (IHD), as well as the effect of hormonal correction of the revealed disorders on factors of pathogenesis and the course of IHD.Materials and Methods:We examined 120 males with IHD of different severity of disease, aged 20-50 years and 34 healthy males of the same age with normal body weight and with uncompromised history for diseases of the endocrine system. Among those surveyed were not included alcoholou anabolizant steroids abusers with severe somatic and inflammatory diseases of the genital organs (prostatitis, urethritis, orchitis). The body weight of patients fluctuated within ± 10% of the ideal. At the time of the examination, all the patients were married, 2 were divorced, and all had children.Depending on the age, the examinees were divided into 2 groups: the first -44 patients in the age of 20-35 years, the second -76 patients 36-50 years old.The patient was examined in Ashgabat city, Hospital with the Scientific-clinical Center of Cardiology (Turkmenistan).Results: In the I age group, 8 patients had post infarction cardiosclerosis, in which there was a slight decrease in sexual activity, in others -angina pectoris of different functional classes (there was no violation of sexual activity).The average content of Т in the fasting serum of males with IHD of I group was significantly lowered, were noted a statistically unreliable tendency to increase of FSH and a statistically significant increase in the LH/T ratio. The mean levels of LH, PRL and E2did not differ from the corresponding indices in healthy individuals.Conclusion: Patients with IHD have decreased testosterone secretion, especially at a young age

Involvement of endothelial CK2 in the radiation induced perivascular resistant niche (PVRN) and the induction of radioresistance for non-small cell lung cancer (NSCLC) cells

BACKGROUND: Tumor microenvironment (TME) plays a vital role in determining the outcomes of radiotherapy. As an important component of TME, vascular endothelial cells are involved in the perivascular resistance niche (PVRN), which is formed by inflammation or cytokine production induced by ionizing radiation (IR). Protein kinase CK2 is a constitutively active serine/threonine kinase which plays a vital role in cell proliferation and inflammation. In this study, we investigated the potential role of CK2 in PVRN after IR exposure. RESULT: Specific CK2 inhibitors, Quinalizarin and CX-4945, were employed to effectively suppressed the kinase activity of CK2 in human umbilical vein endothelial cells (HUVECs) without affecting their viability. Results showing that conditioned medium from IR-exposed HUVECs increased cell viability of A549 and H460 cells, and the pretreatment of CK2 inhibitors slowed down such increment. The secretion of IL-8 and IL-6 in HUVECs was induced after exposure with IR, but significantly inhibited by the addition of CK2 inhibitors. Furthermore, IR exposure elevated the nuclear phosphorylated factor-κB (NF-κB) p65 expression in HUVECs, which was a master factor regulating cytokine production. But when pretreated with CK2 inhibitors, such elevation was significantly suppressed. CONCLUSION: This study indicated that protein kinase CK2 is involved in the key process of the IR induced perivascular resistant niche, namely cytokine production, by endothelial cells, which finally led to radioresistance of non-small cell lung cancer cells. Thus, the inhibition of CK2 may be a promising way to improve the outcomes of radiation in nonsmall cell lung cancer cells.

Comparison of laparoscopic papillary dilation and Endoscopic sphincterotomy with small incision treating fine stones in common bile duct with stricture of oddi sphincter / 中国内镜杂志

Objective Analyze and compare the clinical data of patients with choledocholithiasis combined with benign biliary stricture and Oddi sphincter received laparoscopic percutaneous endoscopic dilation of duodenal papilla and endoscopic sphincterotomy, to explore the clinical experience and investigate the safety and superiority of laparoscopic papillary dilatation and the clinical value in extending the first phase suturing.. Methods From January 2016 to January 2017, 60 patients with choledocholithiasis combined with Oddi sphincter received laparoscopic nipple expansion (30 cases, Group L) and the others received endoscopic sphincterotomy (30 cases, Group E). All the patients clinical data was retrospectively compared and analyzed to explore the clinical experience. Results All operation were successfully performed with no perioperative deaths occurred.. By comparison of the clinical data before and after surgery, we learned that the changes of alanine aminotransferase (ALT), aspartate transaminase (AST), direct bilirubin and postoperative biliary tract bleeding has no statistically significant difference (P > 0.05), while the operation time, the changes of blood amylase and lipase, postoperative gastrointestinal symptoms, postoperative pancreatitis, gastrointestinal function recovery time has statistically significant differences (P < 0.05). There has one self-healing bile leakage case in Group L thanks to routine placement of abdominal drainage tube intraoperatively. The patients gastrointestinal function recovered quick and not suffered pancreatitis because of there's no incision of nipple sphincter. Conclusion Laparoscopic papillary dilation reflects its superiority for not increase postoperative liver function damage, DBIL abnormalities, residual stones, biliary tract bleeding and biliary stricture, while can effectively decrease the incidence of complications such as postoperative pancreatitis, bile reflux and gastrointestinal symptoms. It is safe and effective with less postoperative complications in appropriately application in treatment of fine diameter common bile duct stones with sphincter of Oddi stenosis.

Comparison of laparoscopic papillary dilation and Endoscopic sphincterotomy with small incision treating fine stones in common bile duct with stricture of oddi sphincter / 中国内镜杂志

Objective Analyze and compare the clinical data of patients with choledocholithiasis combined with benign biliary stricture and Oddi sphincter received laparoscopic percutaneous endoscopic dilation of duodenal papilla and endoscopic sphincterotomy, to explore the clinical experience and investigate the safety and superiority of laparoscopic papillary dilatation and the clinical value in extending the first phase suturing.. Methods From January 2016 to January 2017, 60 patients with choledocholithiasis combined with Oddi sphincter received laparoscopic nipple expansion (30 cases, Group L) and the others received endoscopic sphincterotomy (30 cases, Group E). All the patients clinical data was retrospectively compared and analyzed to explore the clinical experience. Results All operation were successfully performed with no perioperative deaths occurred.. By comparison of the clinical data before and after surgery, we learned that the changes of alanine aminotransferase (ALT), aspartate transaminase (AST), direct bilirubin and postoperative biliary tract bleeding has no statistically significant difference (P > 0.05), while the operation time, the changes of blood amylase and lipase, postoperative gastrointestinal symptoms, postoperative pancreatitis, gastrointestinal function recovery time has statistically significant differences (P < 0.05). There has one self-healing bile leakage case in Group L thanks to routine placement of abdominal drainage tube intraoperatively. The patients gastrointestinal function recovered quick and not suffered pancreatitis because of there's no incision of nipple sphincter. Conclusion Laparoscopic papillary dilation reflects its superiority for not increase postoperative liver function damage, DBIL abnormalities, residual stones, biliary tract bleeding and biliary stricture, while can effectively decrease the incidence of complications such as postoperative pancreatitis, bile reflux and gastrointestinal symptoms. It is safe and effective with less postoperative complications in appropriately application in treatment of fine diameter common bile duct stones with sphincter of Oddi stenosis.

The impact of tracheotomy on levels of procalcitonin in patients without sepsis: a prospective study

OBJECTIVE:Procalcitonin is a reliable biomarker of infection and sepsis. We aimed to determine whether tracheotomy influences the procalcitonin concentrations in patients without sepsis and assess whether operative duration and procedure affect the peak procalcitonin level.METHODS:A total of 38 non-septic patients who required a tracheotomy underwent either a percutaneous dilatational tracheotomy (n=19) or a surgical tracheotomy (n=19). Procalcitonin levels were measured at the beginning of the tracheotomy and at 2 h, 4 h, 8 h, 24 h, 48 h and 72 h after the procedure.RESULTS:The baseline procalcitonin concentration before the tracheotomy was 0.24±0.13 ng/mL. The postoperative levels increased rapidly, with a 4-fold elevation after 2 h, reaching a peak 4 h later with a 5-fold increase over baseline. Thereafter, the levels gradually returned to 2-fold greater than the baseline level within 72 h. The peak levels of procalcitonin showed a significant positive correlation with operative durations (r=0.710, p<0.001) and procedures (rho=0.670, p<0.001).CONCLUSION:In patients without sepsis, tracheotomy induces a rapid release of serum procalcitonin, and the operative duration and procedure have significant impacts on the peak procalcitonin levels. Thus, the nonspecific increase in procalcitonin levels following tracheotomy needs to be considered when this measure is used to evaluate infection.

Case-control study on suture-assisted locking plate for the treatment of proximal humeral fractures in elderly / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of suturing-assisted locking plate in treating elderly proximal humeral fractures.</p><p><b>METHODS</b>From January 2005 to January 2013, 55 elderly patients with three- and four-part fractures of proximal humeral fractures were divided into treatment group and control group. In treatment group, there were 31 patients including 12 males, and 19 females aged from 65 to 85 with an average of (74.00±5.42) years old, and treated with suturing-assisted locking plates; 19 patients were Neer 3-part fractures, and 12 patients were Neer 4-part fractures of proximal humerus; 23 patients were suffered from low-energy injuries and 8 patients were caused by high-energy injuries. In control group, there were 24 patients including 7 males, and 17 females aged from 65 to 85 with an average of (72.79±5.34) years old, and treated with locking plates; 16 patients were Neer 3-part fractures, and 8 patients were Neer 4-part fractures of proximal humerus; 17 patients were suffered from low-energy injuries and 7 patients were caused by high-energy injuries. Operative time, blood loss during operation, and bone healing time between two groups were observed and compared. Postoperative Neer scoring were used to evaluate recovery of shoulder joint function.</p><p><b>RESULTS</b>All patients were followed up from 6 to 24 months with an average of 16.1 months. In treatment group, blood loss was (495.806±143.150) ml, function of Neer scoring was 22.645±2.443, range of action was 18.194±2.613, anatomy was 7.935±1.504 and total score of Neer scoring was 77.161±8.335; while in control group, blood loss was (641.667±169.851) ml, function of Neer scoring was 13.958±1.989, range of action was 13.083±2.165, anatomy was 5.500±1.978 and total score of Neer scoring was 58.792±7.313. There were sigificant difference between two groups in these indexes.</p><p><b>CONCLUSION</b>Suturing-assisted locking plate for the treatment of proximal humerus fractures in elderly, has advantages of less blood loss, simple fracture reduction and rapid recovery of shoulder joint, and is a effective method.</p>

Formation of aerobic granular sludge under adverse conditions: Low DO and high ammonia.

In this study, two adverse environments: low dissolved oxygen (DO) and high ammonia concentration, were employed to investigate the morphology, interspecies quorum sensing, extracellular polymers (EPS) characterization and microbial communities in the formation of aerobic granular sludge. Results showed that low DO could promote filamentous bacterial outgrowth. Under high ammonia concentration aerobic granular sludge (AGS) could still be cultivated, although it was looser and lighter than the control group. During the early stage of the AGS cultivation process, AI-2 activity reached a peak value in all three reactors, and ultrasonic pre-treatment was not beneficial to the release of AI-2. During AGS formation, the production of polysaccharide exhibited increases from 12.2 % to 40.3 %, 49.6 %, and 29.3 %. And PS in R2 was the highest as the result of sludge bulking. PS/PN was 1.5~8 in the three reactors. Three-dimensional EEM fuorescence spectroscopy variation indicated the change of protein in EPS, and the highest intensity of Peak T1 was obtained. The location shift of Peak T1 was not obvious, and Peaks A, C, and T2 shifted toward longer wavelengths (red shift) of 5~60 nm, or shorter wavelengths (blue shift) of 10~25 nm on the emission scale and / or excitation scale in all three reactors. This provided spectral information on the chemical structure changes. Bacteria in R3 had the highest species diversity, and all bacteria in b-Proteobacteria were identified as genus Thauera, which suggested that simultaneous nitrification and denitrification occurred in R3. The filamentous bacteria in seed sludge and R2 were species-richer. There was a low abundance of filamentous bacteria in R1 and R3, which contributed to the granule structure stability.

Effects of Exogenous VEGF165b on Invasion and Migration of Human Lung Adenocarcinoma A549 Cells / 华中科技大学学报（医学）（英德文版）

Vascular endothelial growth factor 165 (VEGF165)-mediated autocrine stimulation of tumor cells enhances the progression to a malignant phenotype.VEGF165b competes with VEGF165 and binds to vascular endothelial growth factor receptor (VEGFR),resulting in inhibition of downstream signal transduction pathways.This study was designed to investigate the role of VEGF165b in the migration and invasion of human lung adenocarcinoma A549 cells.The full-length of VEGF165b was constructed and cloned into an expression plasmid (pVEGF165b),and then transfected into A549 cells.Dimethylthiazolyl-2,5-diphenyltetrazolium bromide (MTT) assay was used to detect the effect of VEGF165b on proliferation of transfected cells.Reverse transcription polymerase chain reaction (RT-PCR) was employed to examine the effect of VEGF165b on the expression of VEGF165 in transfected cells.Wound-healing assays were used to investigate the effect of VEGF165b on migration of transfected cells.Matrix metalloproteinase (MMPs) activity assay and in vitro invasion assay were used to determine the role of VEGF165b in invasion of transfected cells.There was no significant change in proliferation of A549 cells after transfection of pVEGF165b,but the expression of VEGF165,migration and invasion in A549 cells were inhibited.Furthermore,exogenous VEGF165b inhibited the activity of MMP9 in the supematant of A549 cells and the subsequent invasion capacity of those cells.We therefore conclude that exogenous VEGF165b can inhibit the expression of VEGF165,as well as the migration and invasion ofA549 cells,but has no effect on the proliferation ofA549 cells.

Anterior operative approach for the treatment of old inferior-cervical fracture-dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the choice of operative approach for old inferior-cervical fracture-dislocation and analyze the clinical effects of anterior operative approach.</p><p><b>METHODS</b>From January 2003 to May 2010, 17 patients with inferior-cervical fracture-dislocation delayed for more than 4 weeks were treated with continued closed skull traction and anterior decompression, bone graft and internal fixation with steel plate. Among the patients, 11 patients were male and 6 patients were female with an average age of 41 years (ranged from 24 to 56 years). The time between injury and operation was from 4 weeks to 3 months. According to Frankel grade, grade A was in 7 cases, B in 4, C in 2, D in 2, E in 2. Neurological function, bone fusion height of vertebral body and cervical sequence and curvature were observed.</p><p><b>RESULTS</b>The incision of 17 cases obtained primary healing. There was 1 case with hoarseness, and symptoms disappeared after 1 month. The mean time of follow-up was 23 months (ranged from 4 to 47 months). The X-ray films showed satisfactory reduction and good alignment and lordosis. The Frankel grade improved obviously at final follow-up, grade A was in 5 cases, B in 5, C in 1 , D in 3, E in 3.</p><p><b>CONCLUSION</b>Single anterior operative approach can successfully reduce old inferior-cervical fracture-dislocation of DF stage I , II and some stage III; anterior decompression, bone graft and internal fixation with steel plate is a safe, effective method for old inferior-cervical fracture-dislocation.</p>

Diagnosis and treatment of epithelioid sarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinical features, diagnosis, treatment, and prognosis of epithelioid sarcoma (ES).</p><p><b>METHODS</b>The clinical data of 13 cases with epithelioid sarcoma in the Tianjin Medical University Cancer Institute and Hospital from March 1995 to December 2009 were collected and analyzed. There were 10 males and 3 females in the group, with an average age of 41.5 years (range: 13 to 68 years). Nine patients had classic ES and 4 had proximal-type ES. Surgery was the mainstay of treatment. After the operation, four patients received radiotherapy, five received chemotherapy, and one received chemoradiotherapy.</p><p><b>RESULTS</b>Of the 13 cases, only 1 had multi-locus lesion. The average tumor size was (6.07 ± 1.34) cm. The lymph node involvement was found in 46.2% of the patients. Local and distant failure occurred in 50% and 30% patients, respectively. The most common site for dissemination was the lung. Four cases died within 3 years after initial operation. The 1-, 2-, 5-, 10-year overall survival rates of the 11 cases were 72.7%, 54.5%, 27.3% and 9.1%, respectively, with a median survival time of 27 months.</p><p><b>CONCLUSIONS</b>Epithelioid sarcoma is a rare disease. The prognosis for patients with epithelioid sarcoma is poor because of a high propensity for local recurrence, lymph node metastases, and/or distant metastases. The definite diagnosis depends mainly on the pathologic examination. Wide surgical excision is the mainstay treatment, and radiation and chemotherapy have been used occasionally as adjuvant therapy but have had limited success.</p>

Obstructive sleep apnea as an independent risk factor for stroke: possible mechanislms / 国际脑血管病杂志

Obstructive sleep apnea (OSA),the most common type of sleep disordered breathing was closely associated with the occurrence of ischemic stroke.It has been demonstrated that OSA is an independent risk factor for ischemic stroke.Its pathogenic mechanism includes atherosclerosis,coagulation abnormalities and cerebral hemodynamic changes caused by long-term periodic hypoxia hypoxemia and hypercapnia.The prognosis of ischemic stroke patients with OSA is poor.Therefore,it needs to be treated early to avoid further damage to brain tissue and reduce the mortality.

Immunological killing effect of recombicant adenovirus vector rAD-mTERT-m4-1BBL on mouse hepatoma cell line Hepa1-6 cells co-cultured with T lymphocytes / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the immunological suppressing effect of recombinant adenovirus vector rAD-mTERT promotor-m4-1BBL (rAD-mTERT) on mouse hepatoma cell line Hepa1-6 cells in co-culture with T lymphocytes.</p><p><b>METHODS</b>Adding recombinant adenovirus rAD, rAD-CMV-m4-1BBL (rAD-CMV) and rAD-mTERT to Hepa1-6 and L929 cells, respectively, to observe the effect of these adenoviruses on growth and apoptosis of these cells in co-culture with T lymphocytes.</p><p><b>RESULTS</b>Adding adenovirus significantly suppressed the growth and slightly increased apoptosis of the two types of cells (P < 0.05). rAD-mTERT promotor-m4-1BBL showed only pro-apoptotic effect on Hepa1-6 cells. When co-cultured with T lymphocytes, rAD-CMV-m4-1BBL showed promoting effect on apoptosis of the cells. Compared with that of T cells pre-co-culture, CD4(+) and CD8(+) T cells were proliferated, and the ratio of CD4/CD8 was significantly reduced (from 1.27 to 1.08).</p><p><b>CONCLUSION</b>Adding the recombinant adenoviruses only suppresses the cell growth, but not promotes their apoptosis. In co-culture with T lymphocytes, recombinant adenovirus vector rAD-mTERT promotor-m4-1BBL can targetingly suppress the growth and induce apoptosis of Hepa1-6 cells. The apoptosis is induced through the immunological killing effect of T lymphocytes.</p>

Developmental genetic analysis of fruit shape traits under different environmental conditions in sponge gourd (Luffa cylindrical (L.) Roem. Violales, Cucurbitaceae)

Analysis of genetic main effects and genotype × environment (GE) interaction effects for the fruit shape traits fruit length and fruit circumference in the sponge gourd (Luffa cylindrical (L) Roem. Violales, Cucurbitaceae) was conducted for diallel cross data from two planting seasons. A genetic model including fruit direct effects and maternal effects and unconditional and conditional variances analysis was used to evaluate the development of the fruit at four maturation stages. The variance analysis results indicated that fruit length and circumference were simultaneously affected by fruit direct genetic effects and maternal effects as well as GE interaction effects. Fruit direct genetic effects were relatively more important for both fruit shape traits during the whole developmental period. Gene activation was mostly due to additive effects at the first maturation stage and dominance effects were mainly active during the other three stages. The fruit shape trait correlation coefficients due to different genetic effects and the phenotypic correlation coefficients varied significantly for the various maturation stages. The results indicate that it is relatively easy to improve the two fruit shape traits for market purposes by carefully selecting the parents at the first maturation stage 3 days after flowering instead of at fruit economic maturation.

Study on toxicity mechanism(s) of ifosfamide in suspending cultured rat hepatocytes / 军事医学科学院院刊

Objective：To study the toxicity mechanism(s) of ifosfamide(Ifo) in suspending cultured rat hepatocytes.Methods：Hepatocytes of adult rat were isolated using two-step perfusion method and cultured suspendingly. Cell viability,intracellular enzyme leakage, contents of sulfhydryl groups and MDA contents of hepatocytes were examined 3 hours after ifosfamide was administered at 5,10,20 mmol/L. Surface and ultrastructure of hepatocytes were also observed. Results：Cell viability and TSH,NPSH,PSH contents of hepatocytes significantly declined, and LDH,AST activities in media increased due to the leakage of intracellular enzymes. The decrease in PSH content was ascribed to depletion of TSH. The higher the dose was, the more serious these changes became. However, MDA contents of the hepatocytes were not found increased at any ifo dose groups. In pathological examination, “bulla" formation was found on the surface of the hepatocytes, deformation，swelling even vacuolation of mitochondria and dilation of rough，smooth endoplasmic reticulum were also observed. Conclusions：Ifo has toxic effect on suspending cultured rat hepatocytes. The decrease in sulfhydryl groups contributes to the hepatotoxicity induced by Ifo.