Dihydromyricetin Alleviates H9C2 Cell Apoptosis and Autophagy by Regulating CircHIPK3 Expression and PI3K/AKT/mTOR Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate the effect and potential mechanism of dihydromyricetin (Dmy) on H9C2 cell proliferation, apoptosis, and autophagy.@*METHODS@#H9C2 cells were randomly divided into 7 groups, namely control, model, EV (empty pCDH-CMV-MCS-EF1-CopGFP-T2A-Puro vector), IV (circHIPK3 interference), Dmy (50 µ mol/L), Dmy+IV, and Dmy+EV groups. Cell proliferation and apoptosis were detected by cell counting kit-8 assay and flow cytometry, respectivley. Western blot was used to evaluate the levels of light chain 3 II/I (LC3II/I), phospho-phosphoinositide 3-kinase (p-PI3K), protein kinase B (p-AKT), and phospho-mammalian target of rapamycin (p-mTOR). The level of circHIPK3 was determined using reverse transcriptase polymerase chain reaction. Electron microscopy was used to observe autophagosomes in H9C2 cells.@*RESULTS@#Compared to H9C2 cells, the expression of circHIPK in H9C2 hypoxia model cells increased significantly (P<0.05). Compared to the control group, the cell apoptosis and autophagosomes increased, cell proliferation rate decreased significantly, and the expression of LC3 II/I significantly increased (all P<0.05). Compared to the model group, the rate of apoptosis and autophagosomes in IV, Dmy, and Dmy+IV group decreased, the cell proliferation rate increased, and the expression of LC3 II/I decreased significantly (all P<0.05). Compared to the control group, the expressions of p-PI3K, p-AKT, and p-mTOR in the model group significantly reduced (P<0.05), whereas after treatment with Dmy and sh-circHIPK3, the above situation was reversed (P<0.05).@*CONCLUSION@#Dmy plays a protective role in H9C2 cells by inhibiting circHIPK expression and cell apoptosis and autophagy, and the mechanism may be related to PI3K/AKT/mTOR pathway.

Influencing factors of the adverse outcome of pulmonary tuberculosis among adolescents in Hangzhou City between 2005 and 2020: a school-based retrospective cohort study / 中华预防医学杂志

Objective: To explore the influencing factors of the adverse outcome of pulmonary tuberculosis (PTB) among adolescents in Hangzhou City between 2005 and 2020. Methods: A retrospective cohort study was used to collect the information of adolescent PTB patients with the onset of PTB occurring from January 1, 2005 to December 31 in 12 designated tuberculosis hospitals in Hangzhou, mainly including demographic, epidemiological, clinical manifestations, bacteriological characteristics and other data, through the China Management Information System for Infectious Disease Surveillance and Reporting and the follow-up survey. All patients were followed up and the end time was December 31, 2021. Multivariate Cox regression model was used to analyze the factors affecting the adverse outcome of these patients. Results: The mean age of 4 921 adolescent PTB patients was (18.9±3.6) years old, and the number of male and female patients were 3 074 and 1 847 respectively. The adverse outcome accounted for 14.7% (725) of all patients. Multivariate Cox regression model showed that eight risk factors, including management model from patients themselves or family members (HR=5.87, 95%CI: 4.55-7.64), molecular biology examination positive for PTB (HR=4.62, 95%CI: 2.98-7.19), the number of sputum smears-positive≥1 (HR=3.72, 95%CI: 2.87-4.83), non-standardized therapy regimens of PTB (HR=3.69, 95%CI: 2.95-4.64), history of retreated PTB (HR=2.22, 95%CI: 1.46-3.36), migrant adolescents (HR=1.89, 95%CI: 1.54-2.34), the number of chest X-ray scan (HR=1.83, 95%CI: 1.65-2.04), and severe PTB (HR=1.38, 95%CI: 1.02-2.05), were associated with the adverse outcome of adolescent PTB patients. Age (HR=0.94, 95%CI: 0.92-0.96), as the only protective factor, was associated with the adverse outcome of these patients. Conclusion: The management mode, molecular biological examination, chemotherapy program, history of tuberculosis, sputum smear examination, severity of tuberculosis, household residence, chest X-ray examination and age are associated with the adverse outcomes of adolescent PTB patients in Hangzhou.

Mucus-penetrating nonviral gene vaccine processed in the epithelium for inducing advanced vaginal mucosal immune responses

Establishment of vaginal immune defenses at the mucosal interface layer through gene vaccines promise to prevent infectious diseases among females. Mucosal barriers composed of a flowing mucus hydrogel and tightly conjugated epithelial cells (ECs), which represent the main technical difficulties for vaccine development, reside in the harsh, acidic human vaginal environment. Different from frequently employed viral vectors, two types of nonviral nanocarriers were designed to concurrently overcome the barriers and induce immune responses. Differing design concepts include the charge-reversal property (DRLS) to mimic a virus that uses any cells as factories, as well as the addition of a hyaluronic acid coating (HA/RLS) to directly target dendritic cells (DCs). With a suitable size and electrostatic neutrality, these two nanoparticles penetrate a mucus hydrogel with similar diffusivity. The DRLS system expressed a higher level of the carried human papillomavirus type 16 L1 gene compared to HA/RLS in vivo. Therefore it induced more robust mucosal, cellular, and humoral immune responses. Moreover, the DLRS applied to intravaginal immunization induced high IgA levels compared with intramuscularly injected DNA (naked), indicating timely protection against pathogens at the mucus layer. These findings also offer important approaches for the design and fabrication of nonviral gene vaccines in other mucosal systems.

Expression of miR-106b-5p in children with primary immune thrombocytopenia and its correlation with T cells / 中国当代儿科杂志

OBJECTIVES@#To study the expression level of plasma miR-106b-5p in primary immune thrombocytopenia (ITP) and its correlation with the levels of T helper 17 cell (Th17) and regulatory T cell (Treg) and the Th17/Treg ratio.@*METHODS@#A total of 79 children with ITP (ITP group) and 40 healthy children (control group) were selected as subjects. According to the treatment response, the 79 children with ITP were divided into three groups: complete response (n=40), partial response (n=18), and non-response (n=21). Quantitative real-time PCR was used to measure the expression level of miR-106b-5p. Flow cytometry was used to measure the frequencies of Th17 and Treg, and the Th17/Treg ratio was calculated. The correlation of the expression level of plasma miR-106b-5p with the frequencies of Th17 and Treg and the Th17/Treg ratio was analyzed.@*RESULTS@#Compared with the control group, the ITP group had significantly higher levels of miR-106b-5p, Th17, and Th17/Treg ratio (P<0.05) and a significantly lower level of Treg (P<0.05). After treatment, the ITP group had significant reductions in the levels of miR-106b-5p, Th17, and Th17/Treg ratio (P<0.05) and a significant increase in the level of Treg (P<0.05). Compared with the partial response and non-response groups, the complete response group had significantly lower levels of miR-106b-5p, Th17, and Th17/Treg ratio (P<0.05) and a significantly higher level of Treg (P<0.05). The correlation analysis showed that in the children with ITP, the expression level of plasma miR-106b-5p was positively correlated with the Th17 level and the Th17/Treg ratio (r=0.730 and 0.816 respectively; P<0.001) and was negatively correlated with the Treg level (r=-0.774, P<0.001).@*CONCLUSIONS@#A higher expression level of miR-106b-5p and Th17/Treg imbalance may be observed in children with ITP. The measurement of miR-106b-5p, Th17, Treg, and Th17/Treg ratio during treatment may be useful to the evaluation of treatment outcome in children with ITP.

Awareness of the Three Level Social-psychological Service in Zhejiang Province / 预防医学

Objective@#To learn the awareness of the Three Level Social-psychological Service in Zhejiang Province and its influencing factors, so as to provide the basis for promoting the construction of social-psychological service system.@*Methods@#The counties (cities, districts) in Zhejiang Province were divided into three levels: high, medium and low, according to economic development. The residents are selected by multistage stratified random sampling method. A questionnaire survey was conducted to collect the general information of residents and their awareness of the Three Level Social-psychological Service.The influencing factors for the awareness were analyzed by multivariate logistic regression model. @*Results @#Of 7 114 questionnaires sent out, 6 577 valid ones were recovered, with the response rate of 92.45%. The overall awareness rates of the Three Level Social-psychological Service and service sites was 63.02% and 59.91%, respectively. The multivariate logistic regression analysis showed that the age of 40-<50 years ( OR=1.376, 95%CI: 1.077-1.758 ), permanent residence ( OR=1.474, 95%CI: 1.319-1.647 ), being the national pilots ( OR=1.200, 95%CI: 1.079-1.334 ) and having the experience of seeking mental health services before 2018 (OR=1.323, 95%CI: 1.191-1.469) were the influencing factors for the awareness of the Three Level Social-psychological Service; under 50 years old ( OR: 0.610-0.768, 95%CI: 0.423-0.991 ), permanent residence ( OR=1.571, 95%CI: 1.407-1.755 ), being the national pilots ( OR=1.368, 95%CI: 1.232-1.519 ) and having the experience of seeking mental health services before 2018 ( OR=0.733, 95%CI: 0.661-0.812 ) were the influencing factors for the awareness of the Three Level Social-psychological Service sites. @*Conclusions@#It is necessary to improve the awareness of the Three Level Social-psychological Service among Zhejiang residents. Age, permanent residence, being the national pilots, seeking mental health service experience before 2018 are associated with the awareness of the Three Level Social-psychological Service.

Effects of Sacral Nerve Root Magnetic Stimulation Combined with Solifenacin on Refractory Overactive Bladder in Women / 中国康复理论与实践

Objective:To investigate the clinical efficacy of sacral nerve root magnetic stimulation combined with Solifenacin in women with refractory overactive bladder (OAB). Methods:From January to December, 2017, 120 women with refractory OAB were randomly divided into sacral nerve root magnetic stimulation group (group A, n = 40), Solifenacin group (group B, n = 40), and combined treatment group (group C, n = 40). Before and after treatment, they were assessed with the urine diary (number of daily urination, number of nightly urination, single urine output, number of urgent urination), urodynamic index (initial urinary bladder capacity, maximum bladder capacity) and Overactive Bladder Symptom Score (OABSS). Results:Two patients from group A, one from group B and one from group C were dropped out. The number of daily urination, the number of nightly urination, the single urine output, the number of urgent urination, the initial urinary bladder capacity and maximum bladder capacity, and OABSS were better in group C than in groups A and B (P < 0.05). Conclusion:Sacral nerve root magnetic stimulation combined with Solifenacin is effective and better than anyone alone on women with refractory OAB.

Correlation between Plasma D-dimer Count and Features of Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#More and more patients with small pulmonary nodules (SPN) can be found along with the developing of chest low-dose computed tomography (LDCT). With current examinations not all the SPN can be diagnosed to be benign or malignant and not all the malignant nodules can be diagnosed to be lymphatic metastasis. We need to study the correlation between plasma D-dimer count of patients before surgery with pathology features of non-small cell lung cancer (NSCLC).@*METHODS@#The study comprised 567 highly suspected lung cancer patients. Preoperative plasma D-dimer were qualified, and the relationship between plasma D-dimer with pathology features including benign or malignant nodules, tumor size and involvement of lymph nodes was examined using Kruskal-Wallis test and Spearman correlation coefficients.@*RESULTS@#The median plasma D-dimer values were statistically higher in NSCLC patients than in those who suffered from benign lung nodules (P112.5 ng/mL) and malignant lymph node involvement in stage T1 lung cancer.@*CONCLUSIONS@#The plasma D-dimer maybe useful for early diagnosis, staging and prognosis of the patients with NSCLC. The plasma D-dimer can be one of the indicator to identify what kind of patients need mediastinal lymph node cleaning.

Acute and subchronic toxicity and the evaluation of safety pharmacology of Chinese herbal compound preparation "Shikuqin"

"Shikuqin" [SKQ] powder consists of three Chinese herbs: Punica granatum L, Sophora flavescens Ait, and Fraxinus rhynchophylla Hance. SKQ has been used for the treatment of diarrhea. In order to provide a comprehensive understanding of toxicity, the acute and sub-chronic toxicity and safety pharmacology of SKQ were evaluated in the present study. The result of the acute toxicity revealed that the LD50 of the valve was 28,379mg/kg.b.w, which was more than 5,000 mg/kg b.w. The 30-day sub-chronic toxicity test results revealed that compared with the control group, the clinical signs, hematology parameters and body weight of rats in each group had no significant differences. The viscera coefficient and histopathological examination results revealed that the SKQ powder could cause kidney and liver damage. In the safety pharmacology test, SKQ did not exhibit any toxicity to the central nervous system, cardiovascular system and respiratory system. In conclusion, SKQ powder could be considered safe for veterinary use

Influence of Common Exercise Methods on Static Balance Ability in Elderly Women / 医用生物力学

Objective To explore the differences in the static balance ability of elderly women performing Tai Chi, square dance, and fitness walking as long-term exercises. Methods A total of 128 healthy elderly women were selected as the subjects. The subjects were classified into the Tai Chi, square dance, fitness walking, and control groups based on their daily main fitness items. The average swing speed (avg.v) of the subjects, swing angle, outer area (area), and total length of the swing (TL) were measured by a balance tester during double-feet standing with eyes closed and right-foot standing with eyes opened, and the test time was 10 s. Results There were significant differences in the values of each balance index of the Tai Chi, square dance, fitness walking, and control groups during double-feet standing with eyes closed and right-foot standing with eyes opened(P<0.05). There were significant differences in the avg.v, TL, and area index values of the Tai Chi and square dance groups (P<0.05) in case of right-foot standing with eyes opened. In both the states,the four balance indices of the Tai Chi group were significantly smaller than those of the fitness walking group (P<0.05).There were significant differences in the area, TL, and avg.v index values of the square dance and fitness walking groups (P<0.05) for the right-foot standing with eyes opened. Conclusions The static balance abilities of elderly women performing Tai Chi, square dance, and fitness walking over a long term were better than those in the absence of regular exercises. The elderly women associated with long-term Tai Chi exercises exhibited a better static balance ability than those performing square dance and fitness walking exercises, and elderly women associated with long-term square dance exercises showed a better static balance ability than those with fitness walking exercises.

Progress and prospects on treatment of primary pulmonary carcinoid / 中国肿瘤临床

Primary pulmonary carcinoid tumors are a group of relatively rare lung neoplasms.In the 2015 World Health Organization classification of lung tumors,lung carcinoid tumors(including both the classical and atypical types)were included in the category of pulmonary neuroendocrine tumors along with large cell neuroendocrine carcinomas and small cell lung carcinomas.Due to the low in-cidence and lack of specific clinical manifestations,the diagnosis and management of pulmonary carcinoid tumors remain relatively challenging.Current consensus supports surgery as the only curative option for localized,resectable pulmonary carcinoid tumors.How-ever,some inconsistencies exist between the guideline recommendations for systemic therapies that have resulted in a lack of consen-sus in regard to the standardized treatment for the metastatic or unresectable disease.This review intends to summarize the latest rec-ommendations for the diagnosis and multidisciplinary treatment of pulmonary carcinoid tumors.

A new recombined porcine reproductive and respiratory syndrome virus virulent strain in China

Porcine reproductive and respiratory syndrome (PRRS) is one of the most important swine diseases worldwide. In the present study, a new virulent strain of PRRS virus (PRRSV), GDsg, was isolated in Guangdong province, China, and caused high fever, high morbidity, and high mortality in sows and piglets. The genome of this new strain was 15,413 nucleotides (nt) long, and comparative analysis revealed that GDsg shared 82.4% to 94% identity with type 2 PRRSV strains, but only 61.5% identity with type 1 PRRSV Lelystad virus strain. Phylogenetic analysis indicated that type 2 PRRSV isolates include five subgenotypes (I, II, III, IV, and V), which are represented by NADC30, VR-2332, GM2, CH-1a, and HuN4, respectively. Moreover, GDsg belongs to a newly emerging type 2 PRRSV subgenotype III. More interestingly, the newly isolated GDsg strain has multiple discontinuous nt deletions, 131 (19 + 18 + 94) at position 1404–1540 and a 107 nt insertion in the NSP2 region. Most importantly, the GDsg strain was identified as a virus recombined between low pathogenic field strain QYYZ and vaccine strain JXA1-P80. In conclusion, a new independent subgenotype and recombinant PRRSV strain has emerged in China and could be a new threat to the swine industry of China.

Early diagnostic value of multi-slice spiral CT for cystic mediastinal tumor / 中国基层医药

Objective To evaluate the value of multi-slice spiral CT in the early diagnosis of cystic mediastinal tumors.Methods 60 cases with cystic mediastinal tumor were collected.All patients were examined by multi-slice spiral CT,and the CT findings of all patients with various types of mediastinal tumors were statistically detected.Results (1) CT manifestations of thymic cyst showed clear boundary of the circular or oval or triangular mass,thin cyst wall,uniform density,internal watery density,no enhancement,the diagnostic accuracy rate was 90.48％.(2)CT manifestations of thymoma sac variable showed round or oval,cystic wall smooth,uniform density of the inner edge of the center for low density cystic variable.Enhanced scan showed uniform or mild enhancement of the inhomogeneous enhancement,the diagnostic accuracy rate was 93.75％.(3)CT manifestations of teratoma showed round and similar to the round or irregular in shape,the thickness of cystic wall,fuzzy edge,different density,enhancement,the diagnostic accuracy rate was 100.00％.(4)CT manifestations of bronchogenic cyst showed round or oval mass,clear boundary,thickness of cystic wall,uniform density,internal watery density,cyst wall strengthening,lesions no enhancement,the diagnostic accuracy rate was 90.00％.Conclusion Cystic mediastinal tumors can be diagnosed by CT,which has guiding significance for clinical.

Relevant research of PD-1, PD-L1 protein expression and K-RAS gene mutations in lung adenocarcinoma / 临床与实验病理学杂志

Purpose To investigate the association of the PD-1 and PD-L1 protein expression with K-RAS gene mutations in lung adenocarcinoma.Methods The protein expression of PD-1 and PD-L1 was detected by immunohistochemical EnVision two-step staining,the K-RAS mutation was examined by realtime fluorescent quantitative PCR.Results The positive rate of PD-1 and PD-L1 was higher in lung adenocarcinoma than benign lung disease (P ＜ 0.01).There was no relationship between PD-1 and PD-L1 protein expression with the gender,age,smoking condition,differentiation,lymph node metastasis and TNM stages (P ＞ 0.05).The K-RAS gene mutations were detectable in 8 patients (22.2％) among 36 lung adenocarcinoma,there was no association between K-RAS gene mutation with the gender,age,smoking condition,differentiation,lymph node metastasis and TNM stages (P ＞ 0.05).The correction analysis showed that there was no relationship between PD-1 and PD-L1 protein expression with K-RAS mutation (P ＞ 0.05).Conclusion The positive rate of PD-1 and PD-L1 is higher in lung adenocarcinoma than benign lung disease,but there is no relationship among PD-1 and PD-L1 protein expression with its clinal pathological characteristics and K-RAS mutation in lung adenocarcinoma.

New outpatient mode based on mobile internet for pregnancy nutrition / 医疗卫生装备

Objective To explore a new outpatient mode for pregnancy nutrition to adapt to digital hospital.Methods The outpatient management mode and methods were analyzed for pregnancy nutrition.A new outpatient mode combining the technologies of mobile internet and remote monitoring was developed with consideration on standardization,and the effect of the new mode was discussed on pregnancy nutrition outpatient.Results Mobile internet technology and remote monitoring technology contributed to enhancing the efficiency of pregnancy nutrition outpatient,and facilitated the nutrition service of common pregnant women as well as the precision and individualized nutrition management of high-risk ones such as those with gestational diabetes mellitus.Conclusion The new outpatient mode enhances the doctor's efficiency and pregnancy care,and thus is worthy promoting practically.

Role of autophagy in renal disease / 中华实用儿科临床杂志

Autophagy is the cell biology process in which cytoplasmic components are degraded in lysosomes to maintain cellular homeostasis,it is involved in the pathophysiology of several kidney diseases (podocytopathies,IgA nephropathy,diabetic nephropathy,hereditary kidney disease),but its specific effect is still controversial.Most studies suggest that autophagy plays a protective role in kidney diseases,in the future,it may become a new target for the prevention and treatment of kidney disease.

Expressions of glutathione S-transferase P1 and 4- hydroxynonenal and the progression of prostate cancer / 中华男科学杂志

Objective@#To investigate the expressions of glutathione S-transferase (GSTP1) and tetra-hydroxynonenal (4-HNE) in prostate cancer (PCa) and their clinical significance.@*METHODS@#We determined the expressions of GSTP1 and 4-HNE in 40 patients with PCa and another 42 with benign prostatic hyperplasia (BPH) by immunohistochemistry and analyzed their relationship with Gleason grades.@*RESULTS@#The expression rate of GSTP1 was 92.9% in the BPH tissue, and those in the highly, moderately, and lowly differentiated PCa tissues were 58.3%, 20.0%, and 16.7%, respectively, significantly higher in the BPH than in the PCa group (P <0.01). However, the positive rate of 4-HNE was only 5.0% in the BPH tissue, markedly lower than 91.6%, 100.0%, and 100.0% in the highly, moderately, and lowly differentiated PCa tissues (P <0.01). There was a negative correlation between the expression of GSTP1 and that of 4-HNE in the PCa tissue (r = －2.73, P <0.01).@*CONCLUSIONS@#Expression deletion of GSTP1 and high expression of 4-HNE may play an important role in the progression of prostate cancer.

Effect of Chuanmingshen violaceum polysaccharides and its sulfated derivatives on immunosuppression induced by cyclophosphamide in mice / 中国免疫学杂志

Objective:In oder to investigate the effect of Chuanmingshen violaceum polysaccharides ( CVP) and Solfated Chua-nmingshen violaceum polysaccharides ( SCVP) on immunosuppression induced by cyclophosphamide ( CY) in mice.Methods: CY were used to induce immunosuppression in mice;Spleen and thymus indexes were used to evaluate the immune organs indexes;the [3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltet-razolium bromide,MTT] method was used to detect the proliferation of spleen lymphocytes of each group;the concentrations of IFN-γand IL-2 were assayed by ELISA kit.Results: SCVP and CVP could resist immunosuppression by promoting lymphocyte proliferation, increasing the contents of IFN-γ and IL-2, promoting immune organs development in immunosuppressive mice induced by CY.Conclusion:SCVP and CVP exhibited the potential to used as immunopotentiator.

Effect of cellular repressor of E1A stimulated genes (CREG1) on cardiac function injury induced by angiotensin Ⅱ in mice / 解放军医学杂志

Objective To investigate the effect of cellular repressor of E1A stimulated genes (CREG1) on cardiac function in mouse with myocardial fibrosis. Methods CREG1 knockout mice (CREG1+/-) and CREG1 wild-type mice (CREG1+/+) were used to reproduce the model of myocardial fibrosis by subcutaneous pump burying of angiotensin Ⅱ (AngⅡ). After being stimulated with AngⅡ for 14 days, myocardial fibrosis was verified by HE staining and Masson trichrome staining. Western blotting and immunohistochemistry were used to detect the expression of CREG1 in myocardium before stimulation and 3, 7, 14 days after the AngⅡ stimulation. The cardiac function was evaluated by echocardiography after AngⅡ stimulation for 14 days. The CREG+/+ mice were given AngⅡ for 14 days, and at the same time recombinant CREG1 protein [respectively 15, 30, 60 and 300μg/(kg.d), intraperitoneal (IP) injections] (treatment group) and NaCl (control group) were administered for treatment, and then cardiac function and myocardiac apoptosis were examined. Results Western blotting and immunohistochemistry showed that the expression of CREG1 in heart tissue was significantly lower in CREG+/-mice than in CREG+/+ mice (P<0.05). After AngⅡ stimulation for 3, 7 and 14 days, the expression of CREG1 in heart tissue declined significantly in both CREG+/-and CREG+/+ mice (P<0.05), especially in CREG+/-mice (P<0.01). With HE and Masson staining, it was also found that CREG1 deficiency aggravated myocardial fibrosis and cardiac function deterioration in response to AngⅡ stimulation (P<0.05). Conversely, exogenous infusion of recombinant CREG1 protein significantly inhibited the occurrence of myocardial apoptosis (P<0.05), thus ameliorated cardiac function (P<0.05). Conclusions CREG1 deficiency may aggravate the deterioration of cardiac function in mouse with myocardial fibrosis induced by AngⅡ stimulation. The deterioration of cardiac function can be improved by administration of exogenous recombinant CREG1 protein.

Case-control study on different fixation methods for the treatment of tibial fractures in 96 patients / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effects of limited excision and locking plate fixation, interlocking intramedullary nailing and external fixation in treating tibial fractures.</p><p><b>METHODS</b>From May 2007 to May 2011, 96 patients with tibial fractures were divided into three groups (Group A, Group B and Group C) and were treated with three kind of fixations including limited excision and locking plate fixation (36 cases in Group A, including 24 males and 12 females), interlocking intramedullary mailing (38 cases in Group B, including 22 males and 16 females) and external fixation (22 cases in Group C, including 12 males and 10 females). Operative time, healing time, weight-bearing time and complications were observed. Johner-Wruhs scoring was used to evaluate the function of lower limbs.</p><p><b>RESULTS</b>All patients were followed up from 3 months to 30 months with an average of 13 months. In Group A, the operative time was (85.01 +/- 12.2) minutes; the healing time was (143.0 + 12.3) days; the weight-bearing time was (114.3 +/- 12.2) days; Complications occured in 3 patients. According to Johner-Wruhs scoring, the results were rated as excellent in 21 cases, good in 12 cases, moderate in 2 cases, and poor in 1 case; In Group B, the operative time was (90.0 +/- 14.6) minutes; the healing time was (132.0 +/- 14.6) days; the weight-bearing time was (46.0 +/- 12.2) days; Three patients occurred complications. According to Johner-Wruhs scoring,the results were rated as excellent in 24 cases, good in 11 cases, moderate in 2 cases, and poor in 1 case. In Group C, the operative time was (70.0 +/- 10.2) minutes; the healing time was (121.0 +/- 13.5) days; the weight-bearing time was (108.2 +/- 8.9) days; Two patients underwent complications. According to Johner-Wruhs scoring, the results were rated as excellent in 16 cases, good in 5 cases, moderate in 0 case, and poor in 1 case. There were no significant significance among three groups in operative time, healing time, complications and the lower limbs function recovered (P > 0.05). But weight-bearing time in interlocking intramedullary nailing was better than in limited excision and locking plate fixation and external fixation (P < 0.05).</p><p><b>CONCLUSION</b>Different fixation methods have different advantages. Limited excision,closed reduction with locking plate fixation is an ideal method to treat the tibial fracture.</p>

The effect of high voltage alternating electric field therapy on fracture healing / 中华物理医学与康复杂志

Objective To explore the effect of high voltage alternating electric field therapy on fracture healing in rats. Methods An animal model of cortical bone defect was successfully established in the unilateral proximal tibia of 41 rats.They were then randomized into an experimental group (21 rats) and a control group (20 rats).The animals in the experimentsl group were given high voltage alternating electric field therapy for 30 minutes daily,while those in the control group only had sham exposure to the high voltage alternating electric field therapy.Rats in each group were sacrificed at days 7,14,21 and 28 post-operation.After blood collection,the operated tibias of the rats were resected with muscle and other soft tissue removed.Bone mineral density (BMD) of the callus at the fracture point was measured using dual energy X-ray absorptiometry (DEXA).The calluses were then cut down and fixed,decalcificated and sliced for histological observation.At the same time serum osteocalcin ( OC ) and bone alkaline phosphatase (RAP) were also detected by ABC-ELISA. Results The BMD examination showed that callus BMD in the experimental group was significantly higher than in the control group at days 14 and 28.Serum OC and RAP in the experimental group were also higher at days 14 day 21,and OC was still significantly higher in the experimental group at day 28.Histological examination showed that in the early stages of bone healing hematoma absorption and organization appeared earlier in the experimental group than in the control group,with remarkable osteoblast and chondroblast proliferation.While at the later stage,bone trabeculas connection and mineralization also appeared earlier in the experimental group than in the control group. Conclusions High voltage alternating electric field therapy may promote fracture healing by accelerating hematoma absorption and organization,elevating osteoblast proliferation and differentiation as well as promoting extracellular matrix secretion and mineralization.The underlying therapeutic mechanism might be related to the increased expression of OC and RAP caused by exposure to the high voltage alternating electric field.