Clinical analysis of cervical lesions in 1 337 postmenopausal women diagnosed during screening / 中华老年医学杂志

Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.

Investigatation of Rehabilitation Human Resources in Shanghai, China / 中国康复理论与实践

Objective:To investigate the rehabilitation human resources in Shanghai. Methods:Based on World Health Orgnization Rehabilitation in Health Service System: Action Guide, Rehabilitation Information Collection Template of Supporting Tools for Systematic Assessment of Rehabilitation Status was implemented by Shanghai Rehabilitation Medical Association in accordance with the requirements of Shanghai Rehabilitation Treatment Quality Control Center to investigate the number and knowledge structure of rehabilitation-related practitioners in Shanghai. Results:Totally, 311 medical institutions were investigated and 254 institutions set up rehabilitation medicine department, accounting for 82.47%. There were 1414 rehabilitation practitioners and 528 registered rehabilitation physicians, accounting for 37.34%; among them, senior, intermediate and junior professional titles were 142 (26.89%), 262 (49.62%) and 124 (23.48%), respectively. There were 2668 rehabilitation therapists, among which the senior, intermediate and junior professional titles were 11 (0.41%), 461 (17.28%) and 2196 (82.31%), respectively. There were 1614 rehabilitation nurses, among which the senior, intermediate and junior professional titles were 13 (0.81%), 476 (29.49%) and 1125 (69.70%), respectively. There were 2.17 rehabilitation physicians, 11.11 rehabilitation therapists and 6.65 nurses per 100 000 population, which is nearly 1/5 of the international level. There were 121 institutions without rehabilitation medical practitioners and 40 multi-point rehabilitation medical practitioners. Conclusion:There is a big gap in rehabilitation physicians, therapists and nurses in Shanghai, compared with the international level. Based on the imperfect occupational series and qualification certification of physiotherapists, occupational therapists, speech therapists and other specialties, it is suggested to conduct targeted job training in multiple channels and forms, especially to strengthen standardized job training and rehabilitation transformation training for rehabilitation practitioners. It is needed to promote the standardized training of resident and specialist rehabilitation practitioners more quickly to meet the needs of clinical rehabilitation work.

Functioning Evaluation for Patients with Chronic Diseases Using World Health Organization Disability Assessment Schedule 2.0 / 中国康复理论与实践

Objective:To test the reliability and validity of World Health Organization Disability Assessment Schedule (WHODAS 2.0) for assessment of functioning for people with chronic diseases. Methods:From December, 2017 to June, 2018, 346 patients with chronic diseases who received rehabilitation interventions in Huadong Hospital-Jing'an District Rehabilitation Medical Association were selected and evaluated with WHODAS 2.0, and re-evaluated after two weeks. According to the actual use of clinical rehabilitation, in order to improve the accuracy of functional measurement, the items had been added in the second domain Getting Around including Handling, Moving and Manipulating Objects, while added in the third domain Self Care including Caring for Body Parts and Toileting, and added in the fourth domain Getting Along with People including Establishing Formal Social Interpersonal Relationship, with a total of 40 items. The content reliability and structural validity of the scale with four items added were verified by internal consistency reliability, test-retest reliability and confirmatory factor analysis. Results:The Cronbach's α coefficient of the internal consistency reliability was 0.981, the Pearson coefficient of the test-retest reliability was 0.977 (P < 0.001). The final model of the scale with confirmatory factor analysis had good structural validity: the standardized factor loads between potential variables and corresponding measurement indicators were 0.710-0.960, and the standard errors were 0.023-0.066; Chi square degrees of freedom < 5, root-mean-square error of approximation < 0.1, standardized root mean square residual < 0.08, the comparatice fit index, normal of fit index, relative fit index, incremental fit index and Tucker-Lewis index all > 0.9; the reliability coefficients of the observed variables were > 0.5, the combined reliability of each potential variable > 0.6, and all the average variance extraction of each potential variable > 0.5, all P < 0.001, absolute value of the standardized residual < 3, Modification Index < 4. There was significant difference in the total score and scores of domains among the patients with different diseases (F > 10.21, P < 0.001) Conclusion:WHODAS 2.0 can be used as an assessment tool for the overall health and functioning for people with chronic diseases. Each item, including four new items added, had good content reliability and structural validity.

Clinical significance of antithrombin Ⅲ gene expression in hepatocellular carcinoma tissues / 实用肿瘤学杂志

Objective The aim of this study was to investigate the expression of antithrombinⅢ(AT3)gene in hepatocellu-lar carcinoma(HCC)and its relationship with clinical features and prognosis.Methods The profiles of gene expression and related clinical data of 214 HCC tissues were collected from the public database.Correlation analysis was conducted to investigate the associa-tion between the level of AT3 expression and clinical features,and the prognosis.Results Univariate analysis showed that with the low expression of AT3 in HCC tissues,there were a higher level of blood alpha fetoprotein(AFP)(P<0.001),a larger tumor size(P=0.015),a poorer TNM stage(P=0.001),and a higher metastasis risk(P<0.001).Survival analysis showed that tumor size was larger(P=0.023),multiple nodules(P=0.047),simultaneous cirrhosis(P=0.016),a poorer TNM stage(P<0.001),a higher metastasis risk(P=0.001),and the lower expression of AT3(P=0.005).These were the risk factors of prognosis.Multivarate Cox a-nalysis also showed a negative association between the expression of AT3 and the prognosis of HCC(HR=0.850,95% CI:0.745~0.970,P=0.016).Conclusion The expression of AT3 in HCC is associated with the clinical characteristics and prognosis of the patients.The low expression of AT3 is one of the risk factors for the prognosis of HCC.

Advance in Biomechanical Analysis of Sit-to-stand Movement in Hemiplegic Stroke Patients(review) / 中国康复理论与实践

@#Hemiplegics after stroke are often disabled in sit-to-stand(STS).This article discussed the biomechanics of STS in the hemiplegic stroke patients,in terms of kinematics,kinetics and surface electromyography,and the rehabilitation for the stroke patients with STS dysfunction.It was found that the stability,duration,symmetry of support and degree and se-quence of muscular activation were different when the patients finished the STS task in three foot positions of natural, symmetrical and unaffected foot behind.The early STS rehabilitation training or other rehabilitation may improve the function of the hemiplegic lower extremity to prevent falls and apraxia.

Association between SERPINH1 gene expression level in gastric cancer tissue with pathology and prognosis / 国际检验医学杂志

Objective To investigate the association between SERPINH1 gene expression in gastric cancer tissue with the pathology and prognosis and its action mechanism in gastric cancer.Methods The gastric cancer data in the TCGA and GEO public databases were collected,and the retrospective analysis and survival analysis were conducted on the SERPINH1 expression data of the tumor tissue samples and related clinical information;the gene set enrichment analysis(GSEA) was used to analyze the SERPINH1 expression related functional gene sets and to investigate the SERPINH1 action mechanism.Results In 421 cases of gastric cancer sample,the SERPINH1 expression level had no significant differences with the tumor grade,N stage and metastasis.However,its high expression was significantly correlated with the tumor invasion depth(T stage)(P=0.049).The higher the expression level,the preater the invasion depth.In the survival analysis,the patients with high SERPINH1 expression showed a poorer prognosis than those with low SERPINH1 expression[P<0.001,HR(95%CI):1.97 (1.61-2.41)].The gene set enrichment analaysis found that the related gene sets such as tumor signal pathway and tumor microenvironment were enriched in the SERPINH1 high expression samples.The gene expression chip data in 69 cases of gastric cancer and paracancerous tissue also suggested that SERPINH1 was highly expressed in gastric cancer (P<0.000 1) with a greater diagnostic value (AUC=0.988 1).Conclusion High expression of SERPINH1 is correlated with the occurrence and development of gastric cancer,and has a greater clinical significance.

Advance of Taiji Quan in Fall Prevention for Old People in Community (review) / 中国康复理论与实践

Fall has seriously impaired the quality of life of old people. The main risk factors for fall in the old people are concerned with balance dysfunction which is caused by ageing. Taiji Quan exercise can promote the lower limb muscle strength, proprioception, neuro-muscular reaction, gait and cognition of the old people, that plays a role in fall prevention.

Ligustrazine Promoted the Migration of Bone Marrow Mesenchymal Stem Cells by Up-regulating MMP-2 and MMP-9 Expressions / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of ligustrazine on the migration of bone marrow mesenchymal stem cells (BMSCs) and protein expressions of matrix metalloproteinase-2 and-9 (MMP-2 and MMP-9) in vitro.</p><p><b>METHODS</b>BMSCs were in vitro isolated and cultured using whole bone marrow adherent method, and phenotypes [surface positive antigens (CD29 and CD90) and negative antigens (CD34 and CD45)] identified using flow cytometry. BMSCs were divided into the blank control group, 25, 50, 100 µmol/L ligustrazine group, and the GM6001 group (100 µmol/L ligustrazine +MMPs inhibitor GM6001 ). The migration of BMSCs was tested by Transwell chamber test and wound healing assay after treated with ligustrazine for 24 h. The protein expressions of MMP-2 and MMP-9 were detected by Western blot.</p><p><b>RESULTS</b>The third passage BMSCs grew well in uniform morphology. The expression rate of CD29, CD90, CD34, and CD45 was 96.9%, 97.3%, 0.2%, and 3.0%, respectively. Compared with the blank control group, the number of migrated cells and relative distance of cell invasion increased, and the protein expressions of MMP-2 and MMP-9 were elevated in each ligustrazine group (P < 0.05, P < 0.01). Compared with 100 µmol/L ligustrazine group, the number of migrated cells and relative distance of cell invasion decreased in 25 and 50 µmol/L ligustrazine groups and the GM6001 group (P < 0.01). Protein expression of MMP-2 decreased in 25 and 50 µmol/L ligustrazine groups (P < 0.01).</p><p><b>CONCLUSION</b>Ligustrazine could promote the migration of BMSCs in vitro, and its mechanism might be related to up-regulating expression levels of MMP-2 and MMP-9 protein.</p>

Buyang Huanwu decoction promotes neuroblast migration from subventricular zone via inducing angiogenesis after ischemia / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of Buyang Huanwu decoction (BYHWD) inducing angiogenesis on the neuroblast migration from the subventricular zone and its mechanisms after focal cerebral ischemia.</p><p><b>METHOD</b>The middle cerebral artery occlusion (MCAO) was performed to mice for 30 minutes to establish the model. The rats were divided into sham group, model group, BYHWD group and endostatin group. BYHWD (20 g x kg(-1), ig) and endostatin (10 μg, sc) were administered 24 h after ischemia once a day for consecutively 14 days. At 14 d after ischemia, the density of micro-vessel and the number of neuroblasts in the ischemia border zone were determined by immunofluorescence staining. The mRNA and protein expression of cell-derived factor-1 (SDF-1) and brain-derived neurotrophic (BDNF) were examined by real-time PCR and Western blot.</p><p><b>RESULT</b>Compared with the model group, BYHWD significantly increased the density of micro-vessel and the number of DCX positive cells in the ischemia border zone (P < 0.01), and significantly increased the SDF-1 and BDNF mRNA and protein expression (P < 0.01). Compared with BYHWD group, endostatin significantly reduced the density of micro-vessel and the number of DCX positive cells in the ischemia border zone (P < 0.01), as well as the SDF-1, BDNF mRNA and protein expression (P < 0.01).</p><p><b>CONCLUSION</b>BYHWD could promote the neuroblast migration from the subventricular zone via inducing angiogenesis after cerebral ischemia, the mechanism may be correlated with up-regulating the expression of SDF-1 and BDNF.</p>

Kinematic analysis of a posterior-stabilized knee prosthesis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data.</p><p><b>METHODS</b>Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion.</p><p><b>RESULTS</b>Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis.</p><p><b>CONCLUSIONS</b>There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.</p>

Central tendon splitting combined with SutureBridge double-row technique as a surgical treatment for insertional Achilles tendinopathy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBridge double-row construct, initially used in rotator cuff repair, is probably a good choice.</p><p><b>METHODS</b>Ten consecutive patients with insertional Achilles tendinopathy underwent tendon reattachment using the SutureBridge technique through a central tendon-splitting approach. We retrospectively evaluated the surgical outcomes, which included pre- and postoperative visual analog scale (VAS), postoperative Maryland Foot Score (MFS), postoperative range of motion of the affected ankle, and related complications. Follow-up was performed in the outpatient department.</p><p><b>RESULTS</b>One patient was lost to follow-up. Nine patients (two male and seven female; 12 feet) were reviewed with a minimum follow-up of six months (range 6-30 months). The postoperative VAS pain scores were markedly lower than the preoperative scores. Postoperative MFS was 92.1±8.0 (range 74-100). No intra- or postoperative complications were found, except for one case of delayed healing incision. At last follow-up, all affected ankles achieved their normal range of motion, and patients were able to resume daily activities without any assistive device.</p><p><b>CONCLUSIONS</b>Although a randomized control trial with a larger sample may be necessary to compare the central tendon-splitting combined with the SutureBridge technique with other techniques, our results confirmed that it was a promising alternative for treatment of insertional Achilles tendinopathy.</p>

Preliminary study on features of syndrome distribution and cluster analysis for AIDS patients with pulmonary infection / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection.</p><p><b>METHODS</b>Using cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis.</p><p><b>RESULTS</b>Basic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05).</p><p><b>CONCLUSIONS</b>AIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.</p>

Randomized controlled study of integrated treatment of traditional Chinese medicine and western medicine on AIDS with pulmonary inflammation patients / 中国中药杂志

<p><b>OBJECTIVE</b>To compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation.</p><p><b>METHOD</b>A multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed.</p><p><b>RESULT</b>Twenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group.</p><p><b>CONCLUSION</b>The integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.</p>

Inhibitory effect of losartan on prostatic hyperplasia in spontaneous hypertension rats and its pathophysiological mechanism / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of losartan on prostatic hyperplasia in spontaneous hypertension rats (SHRs) and its pathophysiological mechanism.</p><p><b>METHODS</b>We randomly divided 36 male SHRs into three groups of equal number to be treated intragastrically with high-dose losartan (30 mg per kg per d), low-dose losartan (15 mg per kg per d) and distilled water (control group). After 6 weeks of intervention, we measured the body weight and tail artery blood pressure of the rats and compared them with the baseline data. We collected blood from the heart for determination of the levels of serum angiotensin II (Ang II), insulin-like growth factor-1 (IGF-1) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay (ELISA), and harvested their prostates for measurement of their weight, observation of the tissue ultrastructures under the electron microscope and detection of the expression of endothelial nitric oxide synthase (eNOS) in the prostate tissue by immunohistochemistry.</p><p><b>RESULTS</b>Compared with the control group, the low- and high-dose losartan groups showed significant decreases in systolic blood pressure ([203.75 +/- 10.28] vs [184.54 +/- 16.90] mmHg, P = 0.013; [203.75 +/- 10.28] vs [166.88 +/- 14.74] mmHg, P = 0.001) and diastolic blood pressure ([151.58 +/- 9.96] vs [136.71 +/- 14.28] mmHg, P = 0.022; [151.58 +/- 9.96] vs [122.71 +/- 11.56] mmHg, P < 0.001) of the lower tail artery after treatment, as well as in the prostate weight ([0.73 +/- 0.08] vs [0.64 +/- 0.10] mg, P = 0.011; [0.73 +/- 0.08 ] vs [0.50 +/- 0.17] mg, P < 0.001). Electron microscopy revealed edema of the basal and columnar epithelial cells, concentrated and marginated heterochromatin and widened nuclear gap of interstitial fibroblast nuclei, and reduced mitochondria and endoplasmic reticula in the low-dose losartan group, and even more obvious in the high-dose group. The level of serum Ang II was remarkably higher in the low- and high-dose losartan groups than in the control ([61.32 +/- 2.49] vs [54.85 +/- 7.20] pg/ml, P = 0.021; [65.49 +/- 6.78] vs [54.85 +/- 7.20] pg/ml, P < 0.001]) , that of serum IGF-1 was lower in high-dose losartan than in the control group ([1.50 +/- 0.11] vs [1.60 +/- 0.10] ng/ml, P = 0.03), but the serum IL-6 levels exhibited no significant differences among the three groups. The expression of eNOS in the prostate tissue was significantly higher in the losartan groups than in the controls (P = 0.022), even higher in the high-dose than in the low-dose group.</p><p><b>CONCLUSION</b>Losartan can suppress the progression of prostate hyperplasia in spontaneous hypertension rats by inhibiting RAS, IGF-1 and angiogenesis.</p>

Clinical outcome of surgical treatment of terrible triad of elbow / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical outcome of surgical treatment of the posterior dislocation of the elbow with coroniod and radial head fractures.</p><p><b>METHODS</b>From January 2004 to March 2009, 9 patients with terrible triad of the elbow were reviewed. There were 7 males and 2 females (4 left elbows and 5 right elbows), with an average age of 41.2 years, ranged from 21 to 67 years. The radial head fractures were classified according to the Schatzker-Tile criteria: 4 patients had the fractures of type I, 3 patients had type II and 2 patients had type III. The ulnar coronoid fractures were classified according to the Regan-Morrey criteria: 2 patients had the fractures of type I, 5 patients had type II and 2 patients had type III. The general approach was used to repair the damaged structures sequentially from deep to superficial, through coronoid, anterior capsule, radial head, and lateral ligament complex to common extensor origin. If there was valgus instability in the elbow after the operation, the medial collateral ligament should be repaired with nonabsorption sutures. The plaster was applied for 7 to 10 days with elbow flexion in 90 degrees and the forearm in full pronation. Unrestricted motions and rehabilitation began at the 8th week after operation. Recovery of regular occupation depended on the degree of physical activity required, and it typically took 3 months for heavy physical laborers to return to work.</p><p><b>RESULTS</b>All the patients were followed up from 6 months to 5 years, with a mean duration of (31 +/- 6) months. At the 3rd month after operation, the mean rang of motion in flexion and extension of the elbow was (102 +/- 3) degrees (ranged from 80 degrees to 110 degrees), and the mean range of motion in pronation and supination of the forearm was (135 +/- 6) degrees (100 degrees to 150 degrees). According to the criteria of the Mayo scoreing system, the results were excellent in 5 cases, good in 3 cases, and fair in 1 case. Three patients had heterotopic ossification at the 6th month after operation. Among them, 2 patients had no effects on elbow function and were not treated, 1 patient had effects on flexion-extension of the elbow and was treated with resection of heterotopic ossification through lateral approach combined with early rehabilitation, the MEP score of the patient improved from fair to good.</p><p><b>CONCLUSION</b>The key points for treating the terrible triad of the elbow are to restore the elbow normal anatomy and early rehabilitation to avoid the elbow stiff.</p>

The effects of brain-derived neurotrophic factor gene-modified neural stem cells on primary cultured dorsal root ganglion cells in vitro / 中华外科杂志

<p><b>OBJECTIVE</b>To gain stable genetic modification of neural stem cells (NSC) that constitutively secrete brain-derived neurotropic factor (BDNF) and to explore the biological role on the survival and neurite outgrowth of cultured dorsal root ganglion (DRG) neurons.</p><p><b>METHODS</b>BDNF gene fragment from human brain cDNA libraries was obtained by using PCR. With molecular cloning technique, the recombinant stem cell viral vector with report gene was constructed, which is that MSCV-BDNF-IRES(2)-EGFP vector could encode Polycistronic mRNA. Viral particle was packaged by PT67 cell line and infected neural stem cells (mouse clone: C17.2). After selection with cloning cylinder, the expression of BDNF was assessed by immunohistochemistry enzyme linked immunosorbent assay (ELISA) and reverse transcriptase polymerase chain reaction (RT-PCR). The effects of stable gene-modified neural stem cells on embryonic mouse DRG neurons were evaluated in a dual-chambered cocultivation system at 3th, 10th day.</p><p><b>RESULTS</b>RT-PCR analysis demonstrated expression of mRNA for human-BDNF. ELISA confirmed the presence of secreted BDNF 24 h after transfection and showed that the level of BDNF production by NSC-BDNF transfected C17.2 was at a rate of (14.6 +/- 0.8) ng x d(-1) x 10(-6) cells even after 3 months. With immunohistochemical analysis, compared with the control, the longer neurite outgrowth of cultured DRG cells and the more survival neurons were observed in NSC-BDNF transfected cells group.</p><p><b>CONCLUSIONS</b>BDNF gene could be stably expressed in C17.2 cell line by MSCV, and the BDNF gene-modified NSC markedly enhances the survival and neurite outgrowth of cultured DRG neurons.</p>

An experimental study on the prevention of enteral bacterial translocation in scalded rats by smectite powder / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the preventive and treatment effects of smectite powder on enteral bacterial translocation in scalded rats.</p><p><b>METHODS</b>Fifty-four Sprague-Dawley (SD) rats were randomly divided into three groups, i.e. normal control (A, n = 6), burn control (B, n = 24), and burn treatment (T, n = 24) groups. The rats in B and T groups were fed with tracing bacteria JM109, which was transfected with PUC19 plasmid in advance. The rats were subjected to 30% TBSA scald injury after the plasmid was shown to have colonized in the intestine. Smectite powder (0.6 g/day/kg) was fed to rats of T group immediately after the scalding, while those in B group received no smectite powder. Bacterial translocation in blood and mesenteric lymph nodes in all groups was observed and identified by enzyme digestion at 12 post scald hour (PSH) and on 1, 3 and 5 post-scald days (PSD). The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in rat intestinal tissue. And the degree of injury to the entire small intestine was observed pathologically. The villus height of intestinal mucosa was measured, and the rate of epithelial nuclear splitting of mucosal crypts was calculated.</p><p><b>RESULTS</b>The number of rats with positive blood bacterial culture in B group was obviously higher than that in A and T groups (P < 0.05) on 1 and 5 PSD. The bacterial quantity in mesenteric lymph nodes (MLN) in T group on 1 PSD (38 +/- 16 CFU/g) and 5 PSD (68 +/- 20 CFU/g) were obviously lower than those in B group (228 +/- 67 vs 183 +/- 29 CFU/g, P < 0.05). There was significant difference in the intestinal contents of MDA and SOD between B and T groups at each time point (P < 0.05). The rat jejunum villus height and the epithelial nuclear splitting in the small intestine mucosa in T group were evidently higher than those in B group (P < 0.05 or 0.01).</p><p><b>CONCLUSION</b>Smectite powder is beneficial to the protection of the intestinal mucosa in scalded rats, and can effectively prevent postburn intestinal bacterial translocation in rats.</p>

The study of soluble P-selectin levels and it's correlation to the severity of coronary artery lesions in coronary heart disease / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the difference of soluble P-selectin levels in different subtype of coronary heart disease and the relationship between soluble P-selectin levels with the severity of coronary artery lesions.</p><p><b>METHODS</b>Enzyme linked immuoserbent assay (ELISA) was used to measure the plasma soluble P-selectin levels in 69 patients with angiocardiography documented coronary heart disease and 19 normal coronary arteries persons without angiocardiography detectable coronary artery disease (control group). The coronary artery lesions score was recorded according to single, double and triple-vessel lesions while the American College of Cardiology and the American Heart Association proposed type A, B, C lesion and Gensini scoring system. The relationships between plasma soluble P-selectin levels and the coronary artery score (the severity of coronary heart disease) were assessed.</p><p><b>RESULTS</b>(1) The level of plasma soluble P-selectin was obviously higher in the coronary heart disease group than in the control group (180.6 +/- 60.5 ng/L vs. 145.3 +/- 21.7 ng/L, P<0.05). (2) The level of plasma soluble P-selectin was significantly higher in the acute coronary syndrome group (191.4 +/- 63.7 ng/L) than in the control group (145.3 +/- 21.7 ng/L, P< 0.01) and in the stable angina pectoris group (141.3 +/- 17.9 ng/L, P<0.01). (3) The level of plasma soluble P-selectin was high in multi-vessel coronary artery lesions group than in single-vessel group (190.1 +/- 64.2 ng/L vs. 157.2 +/- 43.4 ng/L, P < 0.05). The level of plasma soluble P-selectin was positively correlated with the Gensini score (r = 0.391, P = 0.001); the numbers of vessels lesions (rs = 0.349, P = 0.003); Type A, B and C lesions (rs = 0.358, P = 0.002).</p><p><b>CONCLUSION</b>The positive correlation between the level of soluble P-selectin and the coronary artery score may indicate that soluble P-selectin levels might reflect the severity of coronary heart disease. The elevated soluble P-selectin level in acute coronary syndrome suggested the possible relation of P-selectin to the pathogenesis of acute coronary syndrome, which may save as a potential marker of plaque unstability.</p>