ABSTRACT
Objective:To compare the clinical effectiveness between arthroscopic hollow screws combined with a suture anchor, hollow screws and proximal humerus internal locking system (PHILOS) in the treatment of split-type fractures of humeral greater tuberosity.Methods:A retrospective study was conducted to analyze the 54 patients with split-type fracture of humeral greater tuberosity who had been admitted to Department of Joint Surgery, Hospital of Traditional Chinese Medicine, Affiliated to Southwest Medical University from May 2015 to August 2020. There were 17 males and 37 females with an age of (58.4±12.1) years. According to different treatment methods, they were divided into 3 groups. Group A of 18 cases was treated with arthroscopic hollow screws combined with a suture anchor, group B of 18 cases with hollow screws, and group C of 18 cases with PHILOS. The length of surgical incision, and range of shoulder motion, visual analogue scale (VAS), and American Shoulder and Elbow Surgeons (ASES) score at the last follow-up were recorded and compared between the 3 groups.Results:There was no statistically significant difference in the preoperative general information between the 3 groups, indicating the 3 groups were comparable ( P>0.05). The surgical incision in group A [(0.7±0.1) cm] was the shortest, followed by (5.0±1.4) cm in group B, and (12.8±2.1) cm in group C, showing statistically significant differences in pairwise comparison ( P<0.05). In the 3 groups at the last follow-up, respectively, the shoulder forward flexion was 159.7°±13.4°, 154.9°±16.2°, and 160.5°±12.9°, and the shoulder abduction 149.6°±11.3°, 142.4°±12.0°, and 145.1°±10.4°, showing no statistically significant difference among the 3 groups ( P>0.05); the external rotation was 41.1°±8.1°, 38.1°±7.8° and 43.7°±6.2°, showing a statistically significant difference between groups B and C ( P<0.05); the dorsal extension was T 12 (L 5 to T 6), T 12 (L 5 to T 7), and T 12 (L 3 to T 6), showing no statistically significant difference among the 3 groups ( P>0.05). There was no statistically significant difference among the 3 groups in the VAS score or ASES score at the last follow-up ( P>0.05). Respectively, there were 2, 6, and 4 patients in groups A, B and C who developed complications, showing statistically significant differences between the 3 groups ( P<0.05). Conclusions:In the treatment of split fractures of humeral greater tuberosity, arthroscopic hollow screws combined with a suture anchor, hollow screws and PHILOS can all relieve pain and restore joint function of the shoulder. However, arthroscopic hollow screws combined with a suture anchor are the most recommendable due to their advantages in minimally invasiveness and reduction in complications.
ABSTRACT
Objective:To establish a model of epiphyseal plate injury in juvenile rabbits and explore the effect of periosteum flap with saphenous artery on preventing the formation of bone bridge after epiphyseal plate injury.Methods:From July 2017 to January 2018, 30 young New Zealand immature rabbit were randomly grouped into 3 groups (group A, B and C, with 10 rabbits per group). The blood vessels of knee joint were dissected and a periosteum flap with saphenous artery were designed. A model of distal femoral epiphyseal plate injury was established in immature rabbits with a 3.0 mm Kirschner wire on one side of the distal femoral epiphyseal plate as experimental side, and the other side of the distal femoral epiphyseal plate was assigned as control side. The injured epiphysis were prepared and described as follow: in experimental side of group A, a piece of periosteum with the same size as that in group C was resected and discarded. In experimental side of group B, a periosteal flap without vascular pedicle was filled in the injured area. And in experimental side of group C, a periosteum flap with saphenous artery was filled in the injured area. The length and varus angle of femur specimens of length and varus angle of femur specimens wihthin groups were measured at 24 weeks after surgery to evaluate the effect on bone growth in epiphyseal plate injury. The effect of the periosteum flap with saphenous artery on preventing a formation of bone bridge was assessed by section view of decalcified specimens, HE staining and toluidine blue staining. The measured data were expressed as Mean and standard deviation (Mean±SD), and data were compared within and between the groups using one-way analysis of variance (ANOVA). P<0.05 was considered as statistically significant. Results:The femur of experimental side of group A and B showed obvious short with valgus deformity compared with that of control side, and the difference of length and varus angle of femur specimens wihthin groups was statistically significant ( P<0.05). There were no significant differences in the length and valgus angle of the femur between experimental side and its control side in group C ( P>0.05). In experimental side of group A, there were bone bridges in the epiphyseal lesion area, with a clear boundary to the surrounding epiphyseal plate. In experimental side of group B, the periosteum flap in the injured area was absorbed, accompanied by the formation of a few pale white bone tissue, and with a clear boundary to the surrounding epiphyseal plate. In experimental side of group C, the lesion area was filled with milky white cartilage tissue with the same colour as the epiphyseal plate, and with an unclear boundary with the epiphyseal plate. HE stain and toluidine blue staining showed that the injured area of group A was filled with a large number of bone tissue, but no obvious cartilage tissue was observed. In group B, the area of lesion was filled mainly with fibrous tissue, with a small amount of bone tissue. In group C, a large number of hyaline cartilage tissues were formed along the tunnel of the injury area, and closely connected with the normal epiphyseal plate. Conclusion:Filling a periosteum flap with saphenous artery after epiphyseal plate injury can prevent the formation of bone bridge and prevent the affected limb form shortening and angulation.
ABSTRACT
Objective@#To explore the effects of prenatal exposure to polybrominated diphenyl ethers (PBDEs) on placental size and birth outcomes.@*Methods@#Based on the perspective Wenzhou Birth Cohort, this nested case-control study included 101 fetal growth restriction (FGR) and 101 healthy newborns. Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry. The basic information of mother-newborn pairs was collected from questionnaires, whereas the placental size and birth outcomes of newborns were obtained from hospital records.@*Results@#A total of 19 brominated diphenyle ether (BDE) congeners were detected in maternal serum samples. Higher concentrations of BDE-207, -208, -209, and ∑ @*Conclusion@#A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes. Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Case-Control Studies , China/epidemiology , Fetal Growth Retardation/epidemiology , Halogenated Diphenyl Ethers/blood , Incidence , Placenta/physiology , Risk FactorsABSTRACT
Antiretroviral therapy (ART) can effectively inhibit human immunodeficiency virus-1 (HIV-1) replication, but is not curative due to the existence of a stable viral latent reservoir harboring replication-competent proviruses. In order to reduce or eliminate the HIV-1 latent reservoir, characteristics of the latently infected cells need to be intensively studied, and a comprehensive understanding of the heterogenous nature of the latent reservoir will be critical to develop novel therapeutic strategies. Here, we discuss the different cell types and mechanisms contributing to the complexity and heterogeneity of HIV-1 latent reservoirs, and summarize the key challenges to the development of cure strategies for acquired immunodeficiency syndrome (AIDS).
Subject(s)
Humans , CD4-Positive T-Lymphocytes , HIV Infections/drug therapy , HIV-1 , Viral Load , Virus Latency , Virus ReplicationABSTRACT
OBJECTIVE： To evaluate the influential factors for drug-induced liver injury （DILI） caused by routine lung cancer chemotherapy plan and the rationality of hepatoprotective drugs. METHODS： The information of lung cancer patients receiving routine chemotherapy in our hospital from Feb. 1st， 2018 to Jan. 31st， 2019 were selected. The occurrence of DILI induced by different routine chemotherapy plans， the correlation of each influential factor with DILI and the rationality of hepatoprotective drugs were analyzed retrospectively. RESULTS： A total of 325 patients were involved in this study， among which 126 patients （38.77％） suffered from DILI， involving 109 first-level cases （33.54％） and 17 second-level cases （5.23％）. Routine chemotherapy plan included etoposide+cisplatin， gemcitabine+cisplatin， docetaxel+platinum， pemetrexed disodium+platinum. The clinical classification of DILI included hepatocyte injury type 44 cases （14.52％）， cholestasis type 38 cases （12.54％） and mixed type 37 cases （12.21％）. Totally 174 patients （53.54％） received hepatoprotective drugs during chemo-therapy， among whom 49 patients （28.16％） suffered from first-level DILI and 6 patients （3.45％） second-level DILI， with total incidence of 31.61％. Among patients without hepatoprotective drugs， 60 patients （39.74％） suffered from first-level DILI， and 11 patients （7.28％） suffered from second-level DILI， with total incidence of 47.02％. The incidence of DILI in patients without hepatoprotective drugs was significantly higher than those with hepatoprotective drugs （P＜0.05）. Among patients with hepatoprotective drugs， 23 patients （13.22％） used hepatoprotective drugs unreasonably， including 5 patients （2.87％） received 3 kinds or more hepatoprotective drugs； 3 patients （1.72％） received drugs with same mechanism repeatedly； 11 patients （6.32％） received 3 kinds or more drugs and drug with same mechanism repeatedly； 4 patients （2.30％） used drugs contrary to contraindication. Influential factor correlation analysis showed that there was a positive correlation between DILI and the dosage of chemotherapeutic drugs， treatment course and KPS before chemotherapy （P＜0.05）. CONCLUSIONS： KPS before chemotherapy， dosage of chemotherapeutic agents and treatment course are the main factors of DILI. There is still unreasonable use of drugs such as repeated use， unreasonable drug combination， violation of drug contraindications. The use of hepatoprotective drugs during chemotherapy can reduce the risk of DILI occurrence. Clinicians should be more aware of the methods and indications of hepatoprotective drugs in order to improve the effectiveness and safety of drug use.
ABSTRACT
PLCζ is a new isoenzyme of the PLC family which plays an important role in activating mammalian oocytes. In recent years, large-scale expression and purification of active PLCζ protein in vitro for structural biology research has not been successful. In this study, the recombinant human PLCζ protein was expressed and purified in the baculovirus expression system. First, the full length of human PLCζ gene was cloned into the pFastBac-HTA plasmid to form the recombinant donor plasmid that was further transformed into DH10Bac Escherichia coli cells to construct the recombined bacmid by the site-specific transposition that was screened by resistance and blue-white spots. Then the bacmid was transfected to Sf9 insect cells via cellfectin to package the recombinant baculovirus. After the amplification of the recombinant baculovirous, the recombinant protein was expressed from the cells transduced by the recombinant baculovirus and was purified by Ni-NTA resin. Purified protein was identified by Western blotting and time-of-flight mass spectrometry and the enzyme activity was determined. The results showed that the recombinant PLCζ protein in the Sf9 cells was achieved at 72 hours after baculovirus infection and expressed in secreted form in cell culture medium. The recombinant protein purified by Ni²⁺ affinity column was identified as PLCζ by Western blotting and ionization time-of-flight mass spectrometry and the enzyme activity was up to 326.8 U/mL. The experimental results provide a reference for the large-scale production and biological application of recombinant human PLCζ protein.
Subject(s)
Animals , Humans , Baculoviridae , Genetic Vectors , Recombinant Proteins , Sf9 Cells , SpodopteraABSTRACT
To explore the value of the third generation dual-source computed tomography (CT) convolution kernel in display of pulmonary ground-glass nodule (GGN) in transverse image reconstruction. Methods: A total of 52 lung adenocarcinoma patients with lung CT data were selected from February 2018 to January 2019 for this study. The pulmonary CT data were reconstructed by convolutional nucleus B157, Br54, and Br49. The signal-to-noise ratio (SNR), the contrast-to-noise ratio (CNR), and the standard deviation (SD) of the image at the GGN were used as the objective evaluation standard of image quality. Subjective image quality was scored by 2 radiologists from 3 aspects (overall image quality, noise, and lesion outline). Results: Objective image quality evaluation, SNR and CNR of reconstructed convolution kernel Br49 (SNR: 11.36±5.39, CNR: 7.19±4.29), Br54 (SNR: 8.30±3.35, CNR: 5.09±2.86) are greater than those of Bl57 (SNR: 4.18±2.10, CNR: 3.25±1.78; all P<0.01). SD of reconstructed convolution kernel Br49 (61.80±20.17) and Br54 (80.45±20.31) is smaller than that of Bl57 (137.92±31.11, both P<0.01). In the subjective image quality evaluation, the overall image quality score 5.0(4.5, 5.0) of Br54 was higher than that of all other images [Br49: 3.0(3.0, 4.0), Bl57: 3.0(3.0, 3.5); both P<0.05]. The Br54 image showed that the lesion contour ability score 5.0(4.0, 5.0) was higher than all other images [Br49: 4.0(4.0, 5.0), Bl57: 3.0(3.0, 3.0); both P<0.05]; Br49 image noise score 3.0(3.0, 3.0) is the lowest one [Br54 4.0(4.0, 4.0), Bl57 5.0(5.0, 5.0); both P<0.05]. Conclusion: The reasonable selection of CT convolution kernel plays an important role in the subjective and objective image quality of GGN. It is suggested that Br54 should be used as the reconstruction of convolutional kernel in pulmonary ground glass nodules, which is helpful for doctors to find and diagnose GGN.
Subject(s)
Humans , Algorithms , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted , Signal-To-Noise Ratio , Tomography, X-Ray ComputedABSTRACT
Objective To discuss the clinical value of IL-6 combined with CA125 and HE4 as a new association marker in the diagnosis of early ovarian cancer.Methods The expression of IL-6, CA125 and HE4 in 21 cases of early ovarian cancer (stageⅠ-Ⅱ), 36 cases of advanced ovarian cancer (stageⅢ-Ⅳ), 40 cases of benign ovarian tumor and 40 healthy women were measured by the Roche automatic chemiluminescence analyzer (electrochemiluminescence).The sensitⅣity, specificity, positive predictive value, negative predictive value and ROC curves were used to evaluate the diagnostic value.Results The serum levels of IL-6, CA125 and HE4 in patients with ovarian cancer were significantly higher than those in the benign ovarian tumor and the healthy control (P＜0.05).The sensitⅣity, specificity, positive predictive value and negative predictive value of IL-6 combined with CA125 and HE4 were respectively 85.7％, 90％, 81.8％, 92.3％in the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients and respectively 94.4％, 97.5％, 97.1％and 95.1％for advanced ovarian cancer (stageⅢ-Ⅳ) patients.For IL-6 combined with CA125 and HE4, the ROC AUC was respectively 0.955 4 and 0.974 0 for early ovarian cancer (stageⅠ-Ⅱ) patients and advanced ovarian cancer (stageⅢ-Ⅳ) patients.It performed significantly better than any single test of IL-6, CA125 and HE4 and the 2-marker combination of CA125+HE4.Conclusion The marker panel, IL-6, CA125 and HE4, shows higher sensitⅣity, positive predictive value and ROC AUC.It is an ideal serum marker combination for the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients, which can improve the diagnostic efficiency of early ovarian cancer.
ABSTRACT
Objective To investigate the surgical outcomes of one-stage repair of the ankle fracture combined with grade Ⅲ injury to the lateral ligament.Methods From April 2015 to December 2017,23 patients with ankle fracture and lateral ligament injury were treated at Department of Traumatic Reconstruction Surgery/Foot and Ankle Surgery,Zhongnan Hospital.There were 15 males and 8 females,aged from 18 to 65 years (average,37.8 years).After intraoperative treatment of their fractures,22 ruptures of the ligamentous insertion were repaired with suture anchor and one rupture of the middle ligament with Internal Brace.Routine postoperative X-rays,physical examination and Sefton grading system were used to evaluate the stability of the ankle joint and the subtalar joint.The Karlsson-Peterson and American Orthopedic Foot and Ankle Society (AOFAS) scores were used to evaluate the function and pain of the ankle.Results The follow-up for this cohort ranged from 12 to 24 months (average,13.9 months).The bone union time ranged from 6 to 24 weeks,averaging 10.1 weeks.There was no chronic instability of lateral ankle or subtalar joint in all the cases.Two cases developed osteochondral lesion of the medial talus which was treated with micro-fracture surgery one year after injury;one case suffered subtalar arthritis which was treated by subtalar arthrodesis 14 months after injury.Their Karlsson-Peterson scores averaged 84.6 points and AOFAS ankle-hindfoot scores 93.7 points with 19 excellent and 4 good cases.The Sefton grading system gave 9 cases of grade Ⅰ and 14 ones of grade Ⅱ.Conclusion One-stage repair of the ankle fracture combined with grade Ⅲ injury to the lateral ligament can lead to the stability of the ankle joint and the subtalar joint and improved function of the ankle.
ABSTRACT
Objective@#To investigate the factors associated with the anastomotic leakage after anterior resection in rectal cancer.@*Methods@#From January 2014 to January 2017 471 patients underwent Dixon procedure for rectal cancer in The Affiliated Hospital of Qingdao University. The data of those patients was collected and reviewed retrospectively. Inclusion criteria included: 1) rectal cancer confirmed by preoperative electron colonoscopy; 2) the standard of total mesorectal excision followed by the surgeon during the surgery; and 3) elective surgery. Exclusion criteria included multi-primary rectal cancer, secondary surgery for tumor recurrence, palliative surgery, Miles procedure, Hartmann procedure, hormone drugs used, presence of rheumatic and immune diseases, and distant metastasis of rectal cancer. The variables, including demograpic characteristics, ASA score, diabetes mellitus, preoperative radiochemotherapy, histopathologic grade, pathological T stage, laparoscopic or open surgery, distance of the tumor from the anal verge ≤5 cm, were analyzed to identify the risk factors for anastomotic leakage.@*Results@#Of 471 patients, 285 and 186 were men and women, respectively, with a mean age of 61 years (range, 31-92) years. Symptomatic clinically anastomotic leakage occurred in 31 patients (6.6%, 31/471) after Dixon procedure for rectal cancer. On univariate analysis, the occurrence of anastomotic leakage was associated with diabetes (χ2 = 10.972, P = 0.001) , serum albumin level < 35 g/L (χ2 = 9.784, P = 0.002) , neoadjuvant chemoradiotherapy (χ2 = 6.867, P = 0.009) , distance ≤5 cm between the tumor and anal edge (χ2 = 5.993, P = 0.014) , preventive colostomy (χ2 = 5.630, P = 0.018) , and the use of double-perfusion cannula for abdominal flushing (χ2 = 4.232, P = 0.040) . Multivariate analysis revealed that diabetes (OR = 3.632, 95%CI: 1.620-8.145, P = 0.002) , neoadjuvant chemoradiotherapy (OR = 3.177, 95%CI: 1.283-7.867, P = 0.012) and distance ≤5 cm between the tumor and anal edge (OR = 2.444, 95%CI: 1.172 - 5.059, P = 0.017) were independent risk factors for anastomotic leakage, while preventive colostomy (OR = 0.138, 95%CI: 0.056 - 0.345, P = 0.000) and the use of double-perfusion cannula for abdominal flushing (OR = 0.223, 95%CI: 0.086 - 0.575, P = 0.002) were independent protective factors for anastomotic leakage.@*Conclusions@#For patients with rectal cancer with diabetes, undergoing neoadjuvant chemoradiotherapy, or distance ≤5 cm between the tumor and anal edge, anastomotic leakage after anterior resection of rectal cancer must be paid attention. When necessary, preventive colostomy or use of double-perfusion cannula for abdominal flushing should be considered.
ABSTRACT
Objective To compare internal fixation with hallow compression screws combined vascularized bone graft(observation group) with only three hallow compression screws(control group) in young patients' Garden III and IV femoral neck fractures. Methods The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and mid-dle-aged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery;280 patients were treated by closed reduction with 3 hallow com-pression screws. Results Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no sta-tistical difference(P>0.05). It was 0.7％of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6％, and incidence of femoral neck shortening was 8.8％. In the control group, inci-dence of avascular necrosis of femoral head was 14.6％, nonunion incidence rate was 4.6％, and incidence of femoral neck shortening was 22.5％. The differences between two groups was statistically significance( P<0.05). Conclusion The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures.
ABSTRACT
Objective To investigate the clinical efficacy of three-stage Masquelet technique in the treatment of infective bone defects of foot and ankle.Methods A retrospective case series study was conducted on the clinical data of 19 patients with infective bone defects of foot and ankle admitted to Zhongnan Hospital of Wuhan University from December 2014 to October 2017.There were 15 males and four females,aged 18-68 years [(39.6 ± 12.3)years].Among the patients,16 patients were infected with bacteria and three patients were infected with Mycobacterium tuberculosis.The infection involved humeral end,talus and surrounding joints in 14 patients,internal hemorrhoids in two patients,midfoot and interphalangeal joints in one patient,and humerus and metatarsophalangeal joints in two.The operation included three stages:the first stage was thorough debridement,supplemented with negative pressure closed drainage (VSD) and continuous washing to clarify the pathogenic bacteria;the second stage was to fill the bone defect with targeted antibiotic bone cement to prevent or treat infection;in the third stage,after filling the antibiotic bone cement for 3 months with no sign of local wound infection,the bone cement was taken out,and the bone reconstruction operation was performed by means of internal fixation and bone grafting.The flap survival and wound healing were observed,and the time of fracture healing was recorded.The American Orthopaedic Foot and Ankle Society (AOFAS) score and the Visual Analogue Score (VAS) were used to evaluate the improvement of the function of the foot and ankle before operation and at the last follow-up,and the bone healing was evaluated according to the radiographic union scale in tibial (RUST) fractures.Results The patients were followed up for 9-12 months [(11.1 ±1.0) months].Two patients with soft tissue defects caused by preoperative infection and necrosis received posterior tibial artery perforator flap and anterolateral thigh flap repair in the second stage,and the flaps all survived.The postoperative bone healing time was 3 7 months [(3.5 ± 1.4)months].Nineteen patients underwent three-stage surgery,and the ankle and foot wound or sinus tract were all healed,with no infection recurrence during follow-up.At the last follow-up,the AOFAS score was improved significantly from preoperative (36.3 s-12.1) points to (71.4 ± 5.7) points (P ＜ 0.05).The VAS was decreased significantly from preoperative (5.3 ± 1.2) points to (1.4 ± 0.9) points (P ＜ 0.05).The RUST bone healing score at the last follow-up was 8-12 points [(10.2 ± 1.1) points].Conclusion In treating the infective bone defects of foot and ankle,the three-stage Masquelet technique can effectively control infection,facilitate wound healing,promote bone union,and improve foot and ankle function.
ABSTRACT
Objective To set up a living mice colonoscopy platform to establish an orthotopic model of colorectal cancer in mice under direct vision,and to observe its biological behavior such as metastasis.Methods Eighteen-week-old male C57/BL mice were anesthetized,and the intestinal lumen of the mice was examined by a self-developed living mice colonoscopy and Olympus URF-P5 ureteroscopy,respectively.The imaging effects of the two methods were compared.Human colon cancer HT-29 cells were injected into the colonic mucosa of BALB/c-nu mice under direct vision.The colonoscopy was performed on the 3rd,7th and 15th day after the injection to observe the tumor formation in the intestinal lumen.The mice were sacrificed when the body weight decreased significantly or cachexia appeared,and then the abdominal cavity was examined including the tumor formation and metastasis.Results The self-developed living mice colonoscopy platform can provide clear vision of enteric cavity,and no mice died in the colonoscopy examination.In vivo subcutaneous injection of HT-29 cells in mice was performed with a perforation rate of 15％,a mortality rate of 33.3％,a tumor formation rate of 62.5％,an abdominal metastasis rate of 60％,a liver metastasis rate of 25％,and an abdominal wall transfer rate of 25％.Conclusion The self-developed mice colonoscopy platform can be used for the study of colorectum in living mice.The imaging effect is no less than that of Olympus URF-P5 ureteroscopy.In addition,an orthotopic colorectal cancer model can be established by this platform combing with submucosal injection technology.
ABSTRACT
Objective To identify the intracellular host factors necessary for the hepatitis C virus (HCV) infection process so as to provide a scientific basis for the discovery of new antiviral targets.Methods In total 1×108 human liver cancer cells Huh7.5 were infected with a CRISPR Cas9 lentiviral small guide RNA (sgRNA) library which covers 19 050 human genes.Cell clonal populations with genes knockout were screened using blasticidin and puromycin resistance markers,and then were infected with HCV JFH1 strain (multiplicity of infection of 0.30).By comparing the infection levels with the unknocked Huh7.5 cells (control group),the cell populations with significantly reduced infection levels were screened and obtained.Finally,the cloned gene sequence of cell clonal populations was obtained by Illumina sequencing,and the single gene was separately verified by short hairpin RNA (shRNA) technology to identify the intracellular host factor necessary for HCV infection.Results The gene knockout cell populations by CRISPR-Cas9 library were successfully screened by blasticidin and puromycin resistance markers.Cell populations with significantly decreased HCV infection levels compared with the control group were obtained by immunofluorescence assay.These populations were sequenced by Illumina and the results suggest that there are at least 10 genes that may be associated with a reduction in HCV infection.The shRNA knockdown single gene verification results showed that compared with the unknocked Huh7.5 cells,the HCV infection rates were decreased in MTCP1 or RPS14 genes knockout Huh7.5 cells,and the differences were statistically significant (all P＜0.05).That indicates that MTCP1 and RPS14 are two intracellular host factors essential for HCV infection.Conclusion A new method for identifying intracellular host factors essential for HCV infection was established.The two intracellular host factors essential for HCV infection,MTCP1 and RPS14,were screened.This study lays a foundation for further studies on related action mechanism,and also provides a scientific basis for discovering new antiviral targets.
ABSTRACT
Objective To investigate the clinical effectivity of the muscular flap transposition and induced membrane technique in the emergency treatment for the limb salvage of Gustilo type Ⅲ B/C open fracture of lower leg. Methods From July, 2015 to December, 2017, 10 cases of Gustilo type Ⅲ B/C fracture of lower leg with bone defects were performed limb salvage surgery. Induced membrane technique was used to fill the bone defects in the emergency room.The gastrocnemius and/or soleus muscular flaps were transposed to cover the bone cement or ex-posed bone simultaneously in emergence treatment. After the wound healed completely, traditional bone grafting was used to repair the bone defects. There were 4 cases of Gustilo type Ⅲ B and 6 cases of Gustilo type Ⅲ C. The aver-age length of bone defect was (5.25±1.70) cm ranging from 3.0 cm to 11.0 cm. The gastrocnemius medial head flaps were performed in 5 cases, the combined application with the gastrocnemius medial head flaps and the medial hemimuscular flaps of soleus were performed in 2 cases, and medial hemimuscular flaps of soleus were transposed in 3 cases. Results The wounds in 6 cases were healed at one stage, but 2 cases healed by dressing because the exudate after skin grafting.In 1 case, the cross-leg flap was used to cover the exposed bone cement due to the necro-sis of soleus flap. The other 1 was performed the transposition of the lateral gastrocnemius flaps because the exposure of bone cement after the necrosis of the upper and lateral muscles in lower leg. In the second-stage, the bone defects were reconstructed by traditional bone grafting. The average healed time of bone was 7.2 months ranging from 5 months to 9 months. At the last followed-up time, all patients recovered their function of weight-bearing. The Paley's score of the adjacent joints: excellent in 8 cases and good in 2 cases. Conclusion The combination with induced membrane technique and local muscular flap transposition in emergency surgery is an effective method to limb salvage for the Gustilo type Ⅲ B/C open fracture of lower leg.
ABSTRACT
Objective To evaluate the effectiveness of spectral CT with multiple parameters on the diagnosis of ovarian cancer. Methods The data of 22 patients with spectral CT enhanced scan were analyzed retrospectively.The patients were divided into two groups:ovarian cancer group (n=11)and benign tumor group (n=11),according to the pathologic results.CT values at 40 keV,iodine concentration (IC),water concentration(WC)and spectral curve slope (λHU)of arterial phase and venous phase in the tumors of two groups were measured with gemstone spectral imaging(GSI)post-processing software.The independent samples t test was used to compare these multiple parameters above between two groups.Interobserver agreement with regard to various parameters was assessed using Cohen’s Kappa . For the parameters which showed statistically different,the receiver operating characteristic(ROC)curves were further generated to calculate their diagnostic effectiveness respectively.Results CT values at 40 keV,IC andλHUmeasured in arterial and venous phases were higher in ovarian cancer group than those in benign tumor group.There were significant differences between these two groups(P<0.05). While WC had no significant difference in these two groups (P>0.05).Interobserver agreement with regard to various parameters was excellent (Kappa>0.80).CT values at 40 keV,IC andλHUhad high effectiveness on the diagnosis of ovarian cancer according to ROC curves.The optimal parameter among them was IC in arterial phase with AUC of 0.90.Using 10.92 (100 μg/cm3)as a threshold value,the sensitivity and specificity for diagnosis were 90.9% and 90.9%.Conclusion Spectral CT with multiple parameters,including CT values at 40 keV,IC and λHUhave significant differences between benign and malignant ovarian tumors.IC in arterial phase has the highest effectiveness on the diagnosis of ovarian cancer.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effectiveness and safety of acupuncture in patients with post-stroke dysphagia by an update meta-analysis.</p><p><b>METHODS</b>Potentially eligible RCTs aimed to evaluate the effects of acupuncture vs. non-acupuncture treatments, such as rehabilitation training or routine medication on the swallowing difficulty after stroke were searched from PubMed, Cochrane Library, China National Knowledge Infrastructure, and other database from the earliest record to June 2016. Patient demographics, regimens for acupuncture, type of controls, methods of randomization, and measurements of the clinical symptoms of dysphagia were retrieved. The relative risk (RR) and 95% confidence interval (CI) of effective rate of dysphagia was calculated after intervention performed following admission. Subgroup analyses and a metaregression analysis were performed to describe the heterogeneity.</p><p><b>RESULTS</b>Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Acupuncture therapy provided a higher effective rate compared with nonacupuncture treatments [RR=1.33, 95% confidence interval (CI), 1.25 to 1.43]. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs.</p><p><b>CONCLUSIONS</b>Our meta-analysis provides a new evidence supporting the efficacy and safety of acupuncture in treatment to post-stroke dysphagia in short-term compared with rehabilitation or medication. More high-quality and large-scale research studies are needed.</p>
ABSTRACT
To assess the value of noise-optimized virtual monoenergetic imaging (VMI+) reconstruction technique on objective and subjective image quality in patients with inflammatory bowel disease (IBD) undergoing abdominal dual-energy computed tomography (DECT). Methods: Datasets from 32 patients (22 men, 10 women) with IBD, who underwent abdominal DECT, were reconstructed by using the standard linearly blended (M_0.6), traditional monoenergetic (VMI) and VMI+ algorithms in 10-keV intervals from 40-100 keV. Attenuation in IBD lesions was measured to perform objective evaluation using signal-to-noise (SNR) and contrast-to-noise ratios (CNR). Subjective evaluation was performed by 3 independent blinded radiologists using 5-point Likert scales. The overall image quality, image sharpness, lesion delineation, and image noise were analyzed. Results: Mean SNR and CNR peaked at 40 keV VMI+ series (SNR 8.28±2.34, CNR 5.10±2.10) and they were significantly higher than those in linearly blended (SNR 5.82±1.44, CNR 1.53±0.86) and all VMI series (all P<0.01). Subjective image parameter was the highest for the 50 keV VMI+ series regarding overall image quality (mean 4.80, all P<0.01). The highest image sharpness scores were observed at 40 and 50 keV VMI+ reconstructions (mean 4.14 and 4.25, respectively; P=0.415). VMI+ series at 40 keV provided the highest lesion delineation (mean 4.52, all P<0.01). Image noise was low at the 100 keV VMI+ and VMI series (mean 4.58 and 4.40, respectively; P≥0.11). Conclusion: Low-keV VMI+ reconstructions improves SNR, CNR, and subjective image quality significantly in patients with IBD.
Subject(s)
Female , Humans , Male , Inflammatory Bowel Diseases , Diagnostic Imaging , Radiographic Image Interpretation, Computer-Assisted , Radiography, Dual-Energy Scanned Projection , Methods , Reproducibility of Results , Retrospective Studies , Signal-To-Noise Ratio , Tomography, X-Ray Computed , MethodsABSTRACT
Objective To explore the clinical application value of S100B and vWF:Ag levels in ischemic cerebral apoplexy disease.Methods The plasma and clinical data from 85 cases of patients with ischemic cerebral apoplexy were collected,extracted 38 cases of volunteer blood plasma from a random sample of the general population and quantitative detected S100B levels by ELISA method,using Sysmex CA-7000 automatic blood coagulation instrument to detect plasma vWF:Ag levels.The carotid artery diameter and intima-media thickness of all the participants were detected by GELOGIC9 color doppler ultrasonic diagnostic instrument.Results The levels of plasma vWF:Ag in the CS group,the NCS (％) group and the control group were 176.8±56.3,128.9±37.6 and 93.7±30.1,which of plasma S100B (μg/L) were 2.8±1.3,1.9±0.9 and 1.3 ±0.7.Stroke patients could be divided into CS group and NCS group,compared with control group,observed the changes and the relationship of ischemic stroke disease for plasma S100B and vWF:Ag levels.The levels of plasma vWF:Ag and called S100B in the two case groups were increased compared with those in controls,the differences had statistical significance (F=125.9,89.3,P＜0.01).In CS and NCS group,vWF:Ag and S100B were comparative differences and statistically significant (F=125.9,89.3,P＜0.01),the levels of the two markers in the CS group were higher than in replication group.In CS group,the plasma levels of vWF:Ag and S100B were positively correlated (r=0.836,P＜0.01).In CS group,plasma levels of vWF:Ag were associated with carotid artery diameter and intima-media thicknes (r=-0.853,0.923,P＜0.01 and r=-0.783,0.823,P＜0.01),which of S100B did so (r=-0.820,0.833,P＜0.01).Conclution Detection of the levels of vWF:Ag and S100B can predict the degree of danger of ischemic cerebral apoplexy disease and estimate the development of the disease.
ABSTRACT
Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry (MALDI-TOF-IMS) can analysis unknown compounds in sections and obtain molecule imaging by scanning biological tissue sections,which has become a powerful tool for the research of biomarker,lipid distribution and drug metabolism,etc.This article reviews the application of this technique in protein identification,clinical application,drug discovery,lipid research and brain injury.