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Objective:To investigate the behavior and emotion of trainees (residents) in the standardized residency training under the novel coronavirus pneumonia (NCP) epidemic, and adjust the training plan and mode of standardized residency training during the NCP epidemic according to the survey results.Methods:A real-name closed questionnaire survey was conducted among 40 residents (27 ultrasound majors and 13 other majors) in ultrasound department using the "Questionnaire Star" WeChat applet, including basic personal information, questions related to NCP, behavioral change survey, behavioral attitude survey and emotional status survey. All the collected data were further statistically analyzed by Chi-square test and rank sum test using SPSS 19.0Results:There were forty valid questionnaires and the participation rate was 100.0%. The accuracy of 24 NCP-related questions was not significantly different between residents majoring in ultrasound and other specialties [92.0%(596/648) vs. 93.6%(292/312), P>0.05]. All the residents had a good understanding of NCP. The main behaviors of going out were significantly reduced, while various behaviors of being at home were significantly increased. Their interest in learning declined. When the epidemic happened (or possibly) in the community or village they lived in, their negative emotions, such as nervousness, fear pessimism and depression, were obviously expressed. Network teaching and evaluation through WeChat public number were adopted and we guided residents to adjust their home behaviors and emotions according to the survey results. Conclusion:Under the NCP epidemic, the behaviors and emotions of residents had been extensively changed. The training center should adjust the teaching plan and mode of training in time, and provide more counselling service in psychology and learning for residents during the epidemic.
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Objective:To investigate the efficacy of fixation with cannulated screws alone via the Kocher approach in the treatment of adult humeral capitulum fractures.Methods:From August 2016 to August 2020, 16 patients with humeral capitulum fracture were treated at Department of Upper Limb Orthopedics, Zhengzhou Orthopaedic Hospital. They were 10 males and 6 females, aged from 36 to 62 years (average, 45 years). The left side was affected in 10 cases and the right side in 6. According to the Ring classification, 3 cases were type Ⅰ, 3 cases type Ⅱ, 6 cases type Ⅲ, and 4 cases type Ⅳ. All patients were treated with the Kocher approach on the lateral side of the elbow. After reduction under direct vision, the fractures were fixated temporarily with Kirschner wires and finally with cannulated screws. On the second postoperative day, the patients started active flexion and extension of the elbow joint and took indomethacin orally to prevent heterotopic ossification. At the last follow-up, the curative efficacy was evaluated according to the Mayo elbow performance score (MEPS). The flexion and extension of the elbow joint and the rotation of the forearm were also recorded.Results:All patients were followed up for 10 to 19 months (mean, 14.3 months) after surgery. Bony union was achieved after 7 to 12 monthes (average, 11.3 monthes) in all the 16 patients, 2 of whom developed heterotopic ossification. By the MEPS evaluation at the last follow-up, 8 cases were excellent, 6 good and 2 fair, scoring an average of 89.5 points (from 73 to 95 points). At the last follow-up, the elbow flexion ranged from 80° to 130° (averaging 113°), extension from 5° to 30° (averaging 15°), forearm pronation from 62° to 75° (averaging 67°), and forearm supination from 50° to 90° (averaging 75°).Conclusion:When the fracture ends are exposed through the lateral Kocher approach, the fracture fragments fixated with cannulated screws only, and the patients encouraged to start elbow joint exercises in the early stage, the treatment of adult humeral capitulum fractures can result in satisfactory curative effects.
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Objective:To evaluate the clinical efficacy of the axillary approach in the treatment of scapular glenoid fracture.Methods:A retrospective analysis was performed of the 12 patients who had been treated for scapular glenoid fracture from November 2019 to April 2021 at Department of Upper Limb Orthopaedics, Zhengzhou Orthopaedic Hospital. They were 4 males and 8 females, aged from 30 to 75 years (mean, 53.5 years). According to the Ideberg classification, there were 2 cases of type Ⅰa, 9 cases of type Ⅱ and one case of type Ⅴa. All cases were treated through the axillary approach. Two patients complicated with anterior shoulder dislocation were treated with manual reduction under anesthesia before operation and the other 10 cases with special plate fixation through the axillary approach. The 3 patients complicated with fracture of greater tuberosity were fixated with a special plate through the lateral shoulder split deltoid approach. Constant-Murley score, visual analogue scale (VAS) and Hawkins grading were used at the last follow-up to evaluate shoulder function, pain and stability after operation.Results:All patients were followed up for 9 to 20 months (mean, 14.4 months). The operation time ranged from 55 to 110 min (mean, 76.3 min), intraoperative bleeding from 60 to 160 mL (mean, 103.8 mL), and hospital stay from 8 to 14 d (mean, 11.1 d). All incisions healed primarily and all scapular glenoid fractures got united 6 months after operation. The last follow-up showed no shoulder instability, neurovascular injury or internal fixation failure. At the last follow-up, the range of motion of the shoulder was 159.2°±26.1° in forward bending, 156.7°±29.6° in abduction, 48.3°± 15.3° in external rotation (neutral position), and 73.3°±12.3° in internal rotation (neutral position), and the Constant-Murley score was (94.0±5.3) points. The range of motion of the shoulder and Constant-Murley score were significantly improved compared with those before operation (10.8°±11.6°, 7.5°±11.4°, 5.8°±10.0°, 42.5°±16.0° and 4.9±4.0, respectively) (all P<0.05). The VAS score was 0 in 11 patients and 2 in one patient at the last follow-up. Conclusion:The axillary approach is feasible for the treatment of scapular glenoid fracture, because it is hidden and less invasive, leading to good clinical outcomes.
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To obtain chicken CD40L protein, the cDNA was prepared from chicken splenic cells and used as a template to clone and amplify CD40L by PCR. The target gene was cloned into pFastBac vector to construct a pFastBac-chCD40L donor plasmid. Recombinant plasmid was transformed into DH10Bac and recombinant Bacmid-chCD40L was obtained. The Bacmid-chCD40L plasmid was transfected into sf9 insect cells to obtain His-chCD40L protein. In addition, the target gene was cloned into pQM01 vector to construct a pQM01-chCD40L plasmid, recombinant plasmid was transfected into HEK 293T cells to obtain Strep-chCD40L protein. The chCD40L protein was purified by affinity chromatography, and the concentration of purified chCD40L protein was determined to be 0.01 mg/mL. Primary cells were isolated from the bursal tissue of 3-week old SPF chickens, and the chCD40L protein was added to the culture medium to stimulate cells. The chCD40L could bind to CD40 on B cells as examined by Western blotting, indirect immunofluorescence assay and flow cytometry, suggesting that chCD40L protein is biologically active. We successfully obtained chicken CD40L protein of biological activity, which laid the foundation in the in vitro culture of primary B lymphocytes for the isolation and diagnosis of virulent IBDV.
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Animals , Baculoviridae/genetics , CD40 Ligand/genetics , Chickens , Cloning, Molecular , Genetic Vectors/genetics , Recombinant Proteins/geneticsABSTRACT
Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.
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Objective@#To explore the treatment strategy for traumatic posterior dislocation of shoulder joint with concomitant reverse Hill-Sachs lesion on the humeral head.@*Methods@#Data of 8 consecutive traumatic posterior shoulder dislocations with concomitant compression on anteromedial portion of the affected humeral heads (reverse Hill-Sachs lesion), which resulted from the collision between the posterior rim of the glenoid and anterior portion of the humeral head, who had undergone treatment in our department since July 2015 to June 2018 were retrospectively analyzed. Seven males and 1 female have been included in the case series, with the age between 30-70 years (mean 44.5±12.3 years), 6 on the right shoulder and 2 on the left. 7 were acute injuries and 1 chronic. One patient received closed reduction under brachial plexus block anesthesia, and the rest cases underwent open surgeries. Modified Judet approach was performed in one case due to the concomitant fracture on the postero-inferior glenoid. The other 6 patients received modified delto-pectoral approach. 4 concomitant rotator cuffswere found during the procedures, including1 full thickness tears 3 partial. One patient received McLaughlin surgery, allograft and anchor suture fixation. 2 underwent cannulated screw fixation. Allograft and PHILOS fixation was placed on 4 cases. All 8 patients were required maintaining in mild abduction and external rotation the affected arms, with the protection of the casts. All patients were followed up for 20.6±8.4 months (range, 9-36 months). Constant-Murley scores and visual analogue score (VAS) were used to evaluate the clinical outcomes at the latest follow-up.@*Results@#Infection occurred in 1 case, the humeral head has been resected subsequently and antibiotic cement spacer was inserted for further arthroplasty. Necrosis of the humeral head has been observed in one CT follow up 9 months after surgery, with no limitation of the range of motion of the shoulder. Stage 1 wound closure and bony union were witnessed on the rest 6 patients. No neuromuscular injures or re-dislocations on the affected shoulders was found. The range of motion of the affected shoulder has been recorded at the latest follow-up: 123.8°±30.1° (90°-180°) in flexion, 124.4°±34.2° (80°-180°) in abduction, 36.9°±20.9° (0°-70°) in external (neutral position), 58.8°±10.9° (50°-80°) in internal rotation (neutral position) and 83.5±12.1 (70-95) in Constant-Murley score. Among the 8 patients, 7 patients were at the rank of VAS 0-3, and 1 of 4-6.@*Conclusion@#Optimal treatment options should be chosen based on the humeral head defect status, in case of traumatic posterior shoulder dislocation with concomitant reverse Hill-Sachs lesion. Closed reduction can be tried on < 20% humeral head defect with the help of anesthesia, and surgical option is the optimal one for the defect between 20%-40%.
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Objective To explore the treatment strategy for traumatic posterior dislocation of shoulder joint with concomitant reverse Hill-Sachs lesion on the humeral head.Methods Data of 8 consecutive traumatic posterior shoulder dislocations with concomitant compression on anteromedial portion of the affected humeral heads (reverse Hill-Sachs lesion),which resulted from the collision between the posterior rim of the glenoid and anterior portion of the humeral head,who had undergone treatment in our department since July 2015 to June 2018 were retrospectively analyzed.Seven males and 1 female have been included in the case series,with the age between 30-70 years (mean 44.5±12.3 years),6 on the right shoulder and 2 on the left.7 were acute injuries and 1 chronic.One patient received closed reduction under brachial plexus block anesthesia,and the rest cases underwent open surgeries.Modified Judet approach was performed in one case due to the concomitant fracture on the postero-inferior glenoid.The other 6 patients received modified delto-pectoral approach.4 concomitant rotator cuffswere found during the procedures,including1 full thickness tears 3 partial.One patient received McLaughlin surgery,allograft and anchor suture fixation.2 underwent cannulated screw fixation.Allograft and PHILOS fixation was placed on 4 cases.All 8 patients were required maintaining in mild abduction and external rotation the affected arms,with the protection of the casts.All patients were followed up for 20.6±8.4 months (range,9-36 months).Constant-Murley scores and visual analogue score (VAS) were used to evaluate the clinical outcomes at the latest follow-up.Results Infection occurred in 1 case,the humeral head has been resected subsequently and antibiotic cement spacer was inserted for further arthroplasty.Necrosis of the humeral head has been observed in one CT follow up 9 months after surgery,with no limitation of the range of motion of the shoulder.Stage 1 wound closure and bony union were witnessed on the rest 6 patients.No neuromuscular injures or re-dislocations on the affected shoulders was found.The range of motion of the affected shoulder has been recorded at the latest follow-up:123.8°±30.1° (90°-180°) in flexion,124.4°±34.2° (80°-180°) in abduction,36.9°±20.9° (0°-70°) in external (neutral position),58.8°± 10.9° (50°-80°) in internal rotation (neutral position) and 83.5±12.1 (70-95) in Constant-Murley score.Among the 8 patients,7 patients were at the rank of VAS 0-3,and 1 of 4-6.Conclusion Optimal treatment options should be chosen based on the humeral head defect status,in case of traumatic posterior shoulder dislocation with concomitant reverse Hill-Sachs lesion.Closed reduction can be tried on ＜ 20％ humeral head defect with the help of anesthesia,and surgical option is the optimal one for the defect between 20％-40％.
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Objective To investigate the clinical effects of headless double-threaded compression screws plus microplate for treatment of capitellar fracture of Ring type Ⅱ.Methods In the period from March 2015 to February 2018,12 capitellar fractures of Ring type Ⅱ were treated at Department of Upper limb Orthopedics,Zhengzhou Orthopaedics Hospital.There were 8 men and 4 women,aged from 25 to 57 years (average,35.4 years).There were 5 left and 7 right fractures.The fractures were exposed and reduced through the posterolateral elbow approach in 6 patients and through the lateral elbow approach in the other 6 ones.Fixation of all the fractures was conducted with headless double-threaded compression screws plus microplate.At the final follow-up,the elbow function was evaluated by the Mayo elbow performance score and the severity of traumatic arthritis by the Broberg & Morrey imaging criteria.Results All the patients were followed up for 9 to 36 months (average,23 months).The fracture healing time ranged from 9 to 12 weeks (average,10.6weeks).The final follow-ups revealed fine stability of the affected elbow joint in all the patients,and no loss of reduction,loosening or breakage of internal fixators or ischemic necrosis in any case.At the final follow-ups,the elbow inflection angles ranged from 90° to 130° (average,114.3°),the elbow extension angles from 0° to 20°(average,12.4°),the forearm pronation angles from 50° to 85° (average,70.5°) and the forearm supination angles from 45° to 80° (average,64.3°).The Mayo elbow performance scores at the final follow-up averaged 93.2points (from 85 to 100 points),yielding 8 excellent and 4 good cases.According to the Broberg & Morrey imaging criteria,10 patients showed no regressive change and 2 patients change by one grade.Conclusions A proper surgical approach should be chosen according to the preoperative imaging findings.The fracture of articular surface can be firmly fixated by head-less double-threaded compression screws and the integrity of the distal lateral column of the humerus can be restored with a microplate to achieve a strong biomechanical fixation.Fine clinical outcomes can be obtained by early functional exercise.
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Objective To investigate the clinical effect of the V-Y advancement flap based on double perfo-rators of the posterior tibial artery for reconstruction of small-area tissue defect in the achilles tendon. Methods From June, 2014 to June, 2017, a total of 8 patients with small-area tissue defect in the achilles tendon were repaired by the V-Y advancement flap based on double perforators of the posterior tibial artery. The size of defects ranged from 1.5 cm ×3.5 cm to 3.5 cm ×5.0 cm, and the size of flaps ranged from 2.0 cm ×8.0 cm to 4.0 cm ×12.0 cm. The donor area was directly sutured. Eight cases were followed-up, and the appearance, quality, color and elasticity was raorded. Results All V-Y advancement flaps based on double perforators of the posterior tibial artery survived, and all donor sites were directly sutured. Followed-up for 3 to 12 months. All V-Y advancement flaps were flat with the sur-rounding tissue. The appearance, quality, color and elasticity of flaps were good. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS), the results of 8 patients were ex-cellent in 6 cases, and good in 2 cases. The patients had a high degree of satisfaction. Conclusion Application of the V-Y advancement flap based on the double perforators of the posterior tibial artery is an ideal method to repair the small-area tissue defect in the achilles tendon. This kind of surgery is simple, safe and has minimal donor site mor-bidity.
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To develop monoclonal antibodies (McAbs) against chicken interleukin 4 (chIL-4), we subcloned the mature chIL-4 gene into prokaryotic expression vectors pET-28a and pGEX-6P-1, then expressed and purified the recombinant proteins. We immunized BALB/c mice with the purified His-chIL-4 protein and fused the murine splenocytes with SP2/0 after 4 times of immunization. We used the GST-chIL-4 protein as a coating antigen to establish an indirect ELISA to screen positive clones. After screening and 3 rounds of cloning process, we obtained 3 hybridomas that stably secreted McAbs against chIL-4, and named 1G11-3B, 2E5-3D, and 1G11-5H. The isotypes of these McAbs were all IgG1 and the dissociation constant (Kd) of these McAbs were 1.79×10⁻⁹, 1.61×10⁻⁹, and 2.36×10⁻⁹, respectively. These McAbs specifically bound to chIL-4 expressed by either prokaryotic or eukaryotic system as determined by Western blotting and indirect immunofluorescence assay. The binding domains of chIL-4 recognized by 1G11-3B, 2E5-3D, and 1G11-5H were located between aa 1-40, 80-112, and 40-80, respectively, as determined by Western blotting. These McAbs would help to detect chIL-4 and to elucidate the biological roles of chIL-4 in immune responses.
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Objective To investigate the effect of restraint stress on liver injury in mice induced by D-galactosamine and lipopolysaccharide (D+L).Methods Normal BALB/c (B/c) mice were randomly divided into normal control, stress control, D+L group, and D+L+stress group.The mice of normal control group were bred routinely.The stress group was giv-en stress regularly and quantitatively.Mice in the D+L group were injected intraperitoneally with mixed solution of D-galac-tosamine and lipopolysaccharide at final concentration of 30 mg/mL and 2μg/mL, respectively, once every two days.The D+L+stress group was given equal stress as stress group after injection of D-galactosamine and lipopolysaccharide mixed solution. Eight weeks later, blood samples were collected to test serum aminotransferase (ALT) and aspartate aminotransferase (AST), liver tissue samples from all animals were collected to evaluate the degree of liver fibrosis by HE and Masson staining.Results At the 8th week, the ALT and AST values in the D+L+stress group were significantly reduced( P＜0.01) and AST/ALT value was significantly increased(P＜0.01)compared with that in the D+L group.For HE and Masson staining, disordered structure of hepatic lobules, nodular hyperplasia, and necrosis of epithelial cells were present in animals of the D+L group.However, no obvious pathological changes were observewd in the D+L+stress group.For fibrosis scores, the fibrosis grade in the D+L+stress group was significantly decreased than that of the D+L group (P＜0.05).Conclusions Constraint stress presents pro-tective effect on D-galactosamine and lipopolysaccharide induced liver injury in mice.
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Objective To investigate the association of leiomyoma with death receptors(DR) and the mechanisms underlying the development of leiomyoma.Methods The semi-quantitative RT-PCR was employed to examine the mRNA expression of apoptosis-associated death receptors in the Leiomyoma tissue samples collected from 20 clinical cases.Results It was found that the mRNA expression of DR4 in leiomyoma tissue was dramatically decreased as compared to that of normal tissue controls (P<0.001),but no difference was found between leiomyoma and normal tissue controls in terms of DcR1,DcR2,DR5,TNFR1A,TNFR1B and Fas mRNA expressions (P>0.05).Conclusion It is highly possible that DR4 expression might be involved in the development of leiomyoma.More efforts will be required to elucidate the exact mechanisms underlying the development of leiomyoma.
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In order to study the pathogenesis of Listeria monocytogenes (LM), we cloned listeriolysin gene into prokaryotic expression vector PET21a. The expression vector was transformed into Escherichia coli BL21 for expression of listeriolysin O (LLO). LLO-His tag fusion protein was purified with a Ni-NTA affinity column and was used as an immunogen to vaccinate BALB/C mice. Hybridomas were developed by fusing mouse myeloma cells Sp2/0 and splenocytes from the immunized mice and screened with purified LLO. Three hybridomas secreting antibodies against listeriolysin O were obtained and named anti-LLO1, anti-LLO2 and anti-LLO3, respectively. Western blotting analysis showed that all of them could specifically bind to the LLO secreted by the LM. The titers of anti-LLO monoclonal antibodies in the supernatants of three hybridomas cultures were 1:3.6 x 10(4), 1:6.4 x 10(4) and 1:1.6 x 10(4), respectively, and the titers of ascites from the hybridoma-injected mice were 1:2 x 10(7), 1:2 x 10(7) and 1:1 x 10(7), respectively, based on ELISA test. The isotypes of the monoclonal antibodies were determined to be IgG1. The dissociation constants (Kd) of these three monoclonal antibodies were determined to be 6.18 x 10(-11), 7.50 x 10(-11) and 6.27 x 10(-11) respectively. These data and reagents will be of great assistance to elucidate the pathogenesis of Listeriosis.
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Animals , Mice , Antibodies, Monoclonal , Allergy and Immunology , Bacterial Toxins , Genetics , Allergy and Immunology , Cloning, Molecular , Escherichia coli , Genetics , Metabolism , Genetic Vectors , Genetics , Heat-Shock Proteins , Genetics , Allergy and Immunology , Hemolysin Proteins , Genetics , Allergy and Immunology , Listeria monocytogenes , Genetics , Virulence , Mice, Inbred BALB C , Recombinant Fusion Proteins , Genetics , Allergy and ImmunologyABSTRACT
Objective: To identify the related psychosocial risk factors of emotional disorders in children. Methods:To use case-control approach in which. Diagnosis was made by clinical interview according to ICD-10 criteria. Eighty eight cases and controls separately filled out general condition inventory. The results were put into Logistic regression model for analysis. Results: The children with timid personality, without kindergarten education, or with parents who were administrative or technical personnel, were apt to have emotional disorders. The children who were usually counseled by their mothers had less emotional disorders than those were beaten. Conclusion: The emotional disorders were the results of multiple factors. Prevention of children's emotional disorders should be focused on the children's personality and family education.