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@#[摘 要] 目的：采用基于中国人群单核苷酸多态性位点开发的同源重组缺陷（HRD）检测工具评估云南地区卵巢癌患者的HRD状态和BRCA1/2基因突变频率并探讨其临床意义。方法：共纳入2021年1月至2023年5月间在云南省肿瘤医院收治的卵巢癌患者248例，HRD状态采用基因组瘢痕评分法（GSS）（主要依据拷贝数的长度、类型、位置及基因组断片）或HRD评分法（杂合性缺失、端粒等位基因失衡及大片段移位等基因组不稳定事件的总和）进行评估，当组织样本的GSS≥50分或HRD评分≥42分者或检测到有害的BRCA1/2基因突变时HRD被定义为阳性。分析患者HRD状态与临床病理特征的关系。结果：248名卵巢癌患者中70.97%的患者HRD呈阳性，其中BRCA1/2基因突变率为30.65%。Ⅲ~Ⅵ期、高级别浆液腺癌的卵巢癌患者具有更高的HRD阳性率（均P<0.01），HRD评分更高的患者其合并其他基因突变的频率也越高（P<0.05）。HRD状态与卵巢癌的病理类型、临床分期和其他基因突变均有关联（均P<0.01）。结论：云南地区卵巢癌患者HRD阳性率较高，HRD阳性的卵巢癌患者可以从聚ADP核糖聚合酶（PARP）抑制剂治疗中获得更大的收益。
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@#Abstract: Objective To compare the diagnostic efficacy of the upgraded version of the GeneXpert automated fluorescent quantitative PCR system (GeneXpert MTB/RIF Ultra, GeneXpert Ultra) and the original version of the GeneXpert system (GeneXpert MTB/RIF, Xpert), real-time fluorescent quantitative nucleic acid detection (FQ-PCR), real-time fluorescent thermostatic amplification of Mycobacterium tuberculosis RNA (SAT-RNA), real-time fluorescent thermostatic amplification detection of DNA (thermostatic amplification method) and traditional BACTEC MGIT 960 liquid culture (culture method) for special specimens of tuberculosis, in order to analyze its application value in clinical detection. Methods Using prospective research methods, a total of 170 special specimens (including 47 pleural and ascites effusion samples, and 34 24-hour urinary sediment specimens, 49 tissue specimens and 40 fester specimens) were collected i'an Chest Hospital from January to September 2021. GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were used for detection. Clinical diagnosis was used as the standard, and sensitivity, specificity, positive predictive value, negative predictive value, coincidence rate, and Kappa value were compared among the methods. Results The sensitivities of GeneXpert Ultra, Xpert, FQ-PCR, SAT-RNA, isothermal amplification, and traditional culture were 65.18% (73/112), 49.11% (55/112), 37.50% (42/112), 19.64% (22/112), 8.04% (9/112), and 22.32% (25/112), respectively. The sensitivity of GeneXpert Ultra was higher than that of the other five methods, and the differences were statistically significant (χ2=66.25, 42.10, 28.89, 13.09, 4.92, 15.18, all P<0.05). GeneXpert Ultra result analysis showed that: 5.48%(4/73) cases had trace, that is, trace Mycobacterium tuberculosis load, 79.45% (58/73) cases were extremely low, 10.96% (8/73) cases were low, 2.74% (2/73) were medium, , and 1.36% (1/73) were high load. In 4 trace samples, the Xpert detection was negative for all. Of the 73 GeneXpert Ultra positive reports, 63 were rifampicin-sensitive, 6 were rifampicin-resistant, and 4 were rifampicin-resistant but of unclear resistance. Of the 55 Xpert positive reports, 45 were rifampicin-sensitive, 2 were rifampicin-resistant, and 8 were rifampicinresistant but of unclear resistance.. Conclusions The new generation of GeneXpert MTB/RIF Ultra has high sensitivity, specificity and drug resistance detection rate, and its advantage is even more apparent in the pathogenic diagnosis of special specimens of tuberculosis. It can be used as one of the preferred methods in samples with low bacterial load.
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BACKGROUND@#The role of sex hormones and their receptors has drawn much attention in the process of cartilage regeneration. This study aimed to investigate the effect of androgen receptor (AR) on the chondrogenic ability of articular chondrocytes and the related mechanism. @*METHODS@#Articular chondrocytes were isolated, cultured, identified by toluidine blue staining and then transduced with lentivirus carrying the AR gene. The cell viability was determined using Cell Counting Kit-8, and cell apoptosis was assessed by flow cytometry analysis. The effects of AR overexpression on the expression of cartilage-specific proteins and some signalling molecules were evaluated by real-time PCR and Western blotting. Using 24 New Zealand rabbits, the regeneration of rabbit articular cartilage defects was further investigated in vivo and evaluated histologically. @*RESULTS@#The overexpression of AR significantly reduced the apoptosis rate of chondrocytes but did not affect their proliferation. The overexpression of AR also promoted the expression of Sry-related HMG box 9, collagen II and aggrecan, decreased the expression of matrix metalloproteinase-13, and downregulated p-S6 and RICTOR. The experimental group with AR-overexpressing chondrocytes exhibited superior regeneration of cartilage defects. @*CONCLUSION@#AR overexpression can maintain the phenotype of chondrocytes and promote chondrogenesis in vitro and in vivo. mTOR-related signalling was inhibited.
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Objective@#The random forest algorithm was used to construct a rapid screening diagnostic prediction model for children with autism spectrum disorder, to provide the references for early detection, early diagnosis of ASD children, and to reduce the pressure of ASD clinical diagnosis and assessment.@*Methods@#The random forest algorithm of machine learning was applied to build the auxiliary diagnosis model. Totally 346 ASD children and 90 normal children were evaluated by Social Responsiveness Scale and Vineland Adaptive Behavior Scales. ROC curve, and accuracy was used to evaluate the models.@*Results@#Among the models, the accuracy of 13 feature factors and 7 feature factors were above 0.9, the sensitivity was up to 0.927, the specificity was up to 0.936 and the AUC was up to 0.979. The accuracy, sensitivity, specificity and AUC of the model were 0.943,0.959,0.931 and 0.978 respectively. The fitting and generalization effects of the three models were all satisfactory.@*Conclusion@#A random forest model based on the SRS Scales and Vineland Adaptive Behavior Scales can be used to diagnose ASD accurately and provide scientific basis for the development of rapid screening and diagnosis tools.
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BACKGROUND@#The role of sex hormones and their receptors has drawn much attention in the process of cartilage regeneration. This study aimed to investigate the effect of androgen receptor (AR) on the chondrogenic ability of articular chondrocytes and the related mechanism. @*METHODS@#Articular chondrocytes were isolated, cultured, identified by toluidine blue staining and then transduced with lentivirus carrying the AR gene. The cell viability was determined using Cell Counting Kit-8, and cell apoptosis was assessed by flow cytometry analysis. The effects of AR overexpression on the expression of cartilage-specific proteins and some signalling molecules were evaluated by real-time PCR and Western blotting. Using 24 New Zealand rabbits, the regeneration of rabbit articular cartilage defects was further investigated in vivo and evaluated histologically. @*RESULTS@#The overexpression of AR significantly reduced the apoptosis rate of chondrocytes but did not affect their proliferation. The overexpression of AR also promoted the expression of Sry-related HMG box 9, collagen II and aggrecan, decreased the expression of matrix metalloproteinase-13, and downregulated p-S6 and RICTOR. The experimental group with AR-overexpressing chondrocytes exhibited superior regeneration of cartilage defects. @*CONCLUSION@#AR overexpression can maintain the phenotype of chondrocytes and promote chondrogenesis in vitro and in vivo. mTOR-related signalling was inhibited.
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Objective@#To investigate knowledge, attitude and behavior related to tuberculosis prevention among primary and elementary school students in Heilongjiang province, and to provide evidence for school-based tuberculosis prevention and control.@*Methods@#A cross-sectional survey method was used to conduct a questionnaire survey among 3 033 middle and elementary school students in 10 counties (districts) of Heilongjiang province, including knowledge, attitudes and behaviors related to tuberculosis prevention and treatment.@*Results@#In the survey, 61.5% of the students understand the core information of tuberculosis. The core knowledge awareness rate was higher in primary school students (64.8%) than in middle school students(58.1%)(χ2=85.41，P<0.05). Primary and middle school students indicated that the attitude-taking rate of concerns about the tuberculosis patients was 47.5%. Primary school students had more general attitude than middle school students towards willingness to participate in publicity activities compared with primary school students(χ2=39.26，P<0.05). About 85% of students reported personal hygiene habits. The results of multiple linear regression analysis showed that tuberculosis-related knowledge was mainly associated with factors including urban and rural, parental education, health education courses in school(P<0.05).@*Conclusion@#There is a gap in tuberculosis-related knowledge among primary and middle school students between Heilongjiang province and national level. There’s a need for the improvement of tuberculosis control programs to inform a better understanding and social dissemination of TB information.
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La Candida haemulonii forma parte de la especie Candida no albicans. La candidemia por C. haemulonii es sumamente infrecuente, pero mortal, en los recién nacidos. Se informa sobre los dos primeros recién nacidos con candidemia por C. haemulonii en China tratados con fluconazol y se revisan dos artículos informados con anterioridad. Nuestro informe incrementa la sensibilización sobre la candidemia por C. haemulonii en recién nacidos críticos y resalta la importancia de un diagnóstico y un tratamiento tempranos de esta infección mortal.
Candida haemulonii forms part of the non-albicans Candida species. The candidemia caused by C. haemulonii is extremely rare but fatal in neonates. We reported the first two neonates with C. haemulonii candidemia in China which were treated with fluconazole and reviewed two papers previously reported. Our report adds further awareness on C. haemulonii candidemia in critical neonates and points out the importance of an early diagnosis and treatment of this fatal infection.
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Humans , Male , Female , Infant, Newborn , Fluconazole/therapeutic use , Catheter-Related Infections/drug therapy , Candidemia/drug therapy , Candida/isolation & purification , China , Treatment Outcome , Catheter-Related Infections/microbiology , Candidemia/etiology , Candidemia/microbiology , Antifungal Agents/therapeutic useABSTRACT
@#Objective To establish a patient-derived tumor xenograft (PDTX) model and to observe the latency and rate of tumor formation, tumor size, tumor invasion and metastasis of transplanted tumors. Methods Seven patients with chest tumor in Drum Tower Hospital from April to December 2015 were chosen. There were 5 males and 2 females with age ranging from 61-71 years, including 4 patients of esophageal tumor and 3 patients of lung tumor. PDTX model was established by surgical removal of fresh tumor tissues of these patients and transplantation in NODPrkdcem26Il2rgem26Nju subcutaneous (NCG) mice. The latency and rate of tumor formation, tumor size, tumor invasion and metastasis of transplanted tumors were observed, and pathology of HE staining and immunohistochemical testing results were compared between PDTX model and the patients. Results PDTX model was successfully established in 4 patients, and the success rate was 66.7%, including 2 patients of esophageal cancer. The PDTX model retained the differentiation, morphological and structural characteristics of original tumors. Conclusion Pathology and molecular biology characteristics of PDTX model are consistent with the original tumor, which can be an “avatar” of tumor patients for clinical pharmacodynamics screening and new drug research and development.
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·AIM: To clinical effect of 25G+ vitrectomy combined with intravitreal injection of Conbercept for severe proliferative diabetic retinopathy ( PDR) .·METHODS: A clinical case control study. A total of 35 patients (42 eyes) with severe PDR who underwent 25G+vitrectomy in our hospital from October 2014 to August 2016 were randomly divided into two groups: A and B. Among them, 18 cases (22 eyes) was given conbercept intravitreal injection combined with vitrectomy as Group A;17 cases (20 eyes) was only given vitrectomy without conbercept injection were Group B. Observation of operation duration, intraoperative complications, the incidence of vitreous hemorrhage ( RVH) , macular foveal thickness ( CFT) at 3mo after operation were observed, best corrected visual acuity ( logMAR BCVA ) , and macular foveal thickness ( CFT ) at 6mo after operation were observed too.·RESULTS: The operative time of Group A and B was 58. 23± 8. 18min and 72. 41 ± 10. 31min, the difference was statistically significant ( t = 2. 9, P = 0. 002 ). During the operation, the main complications were iatrogenic hiatus and intraoperative bleeding, Group A of 2 eyes and 1 cases, Group B of 7 eyes and 6 eyes, the difference was statistically significant (P=0. 041, 0. 027). The incidence of vitreous hemorrhage (RVH):at 3mo after operation, that in Group A was 2 eyes, and in Group B was 8 eyes, the incidence of vitreous hemorrhage was statistically significant between the two Groups (P=0. 030). The best corrected visual acuity was 0. 92 ± 0. 35 in Group A and 1. 04±0. 43 in Group B at 6mo postoperatively, but there was no significant difference between the two groups ( t=0. 241, P= 0. 212), but compared with the preoperative visual acuity improved obviously, the difference was statistically significant (t=4. 614, t=7. 355; P<0. 01). CFT:at 3mo after operation, that of Group A was 273. 42 ± 25. 21μm, Group B was 284. 58 ± 27. 44μm, there was no significant difference between the two groups ( t=0. 488, P= 0. 179 ), but there were significantly decrease, the difference was statistically significant( t=3. 152, t=4. 933;P<0. 01 ); at 6mo after operation, CFT of Group A was 238. 16 ± 16. 35μm, Group B was 247. 04 ± 17. 43μm, there was no significant difference between the two groups ( t=0. 571, P=0. 133), but there were significantly decrease, the difference was statistically significant ( t= 2. 474, t=4. 802;P<0. 01).·CONCLUSION: The 25G+ vitrectomy combined with preoperative conbercept intravitreal injection in patients with severe proliferative diabetic retinopathy can effectively improve vision and reduce macular edema, compared with simple vitrectomy, the operation time can be shortened, the incidence of complications can be reduced, and the incidence of vitreous hemorrhage in 3mo after operation can be significantly reduced.
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This study was to determine the protective effect of ω-3 polyunsaturated fatty acids (ω-3PUFAs) on MK-801-induced cognitive impairment in schizophrenia (SZ) rats and the underlying mechanism.A rat model of schizophrenia was induced by MK-801.The cognitive function of rats was assessed using a Morris water maze.The number of hippocampal neurons was measured by Nissl staining.The expression of CREB,p-CREB,BDNF,TrkB,p-TrkB,AKT,p-AKT,ERK,and p-ERK in the hippocampus of rats was detected by Western blotting.The results showed that ω-3PUFAs attenuated MK-801-induced cognitive,impairment and hippocampal neurons loss,reversed the injury of the CREB/BDNF/TrtB pathway induced by MK-801,and antagonized MK-801-induced down-regulation of p-AKT and p-ERK in the hippocampus of rats.In conclusion,ω-3PUFAs enhances the CREB/BDNF/TrkB pathway by activating ERK and AKT,thereby increasing the synaptic plasticity and decreashng neuron loss,and antagonizing MK-801-induced cognitive impairment in schizophrenic rats.
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Etanercept has been shown to be effective for the treatment of moderate-to-severe plaque psoriasis.Since most clinical trials examined etanercept in combination with other drugs,the efficacy and safety of etanercept monotherapy for moderate-to-severe plaque psoriasis have not been well established.This prospective study enrolled 61 Chinese patients with moderate-to-severe plaque psoriasis to explore the efficacy and safety of etanercept monotherapy.These patients were treated with etanercept at a subcutaneous dose of 25 mg,twice a week,for 12 weeks.All the 61 patients completed the treatment and showed significant improvement in psoriasis area and severity index (PASI) scores.At 4,8,and 12 weeks after treatment,the response rates (PASI75) were 0％,21.31％,and 40.98％,respectively.It was concluded that etanercept monotherapy is efficacious and safe for patients with moderate-to-severe plaque psoriasis.
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The sequences of ITS, matK, rbcL and psbA-trnH of 9 Gynostemma species or variety including 38 samples were compared and analyzed by molecular phylogeny method. Hemsleya macrosperma was designated as outgroup. The MP and NJ phylogenetic tree of Gynostemma was built based on ITS sequence, the results of PAUP phylogenetic analysis showed the following results: (1) The eight individuals of G. pentaphyllum var. pentaphyllum were not supported as monophyletic in the strict consensus trees and NJ trees. (2) It is suspected whether G. longipes and G. laxum should be classified as the independent species. (3)The classification of subgenus units of Gynostemma plants is supported.
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Gynostemma , Classification , Genetics , Molecular Sequence Data , Phylogeny , Plant Proteins , Genetics , Sequence Analysis, DNAABSTRACT
<p><b>OBJECTIVE</b>To clone IspE and IspH unigene from Lonicera japonica and its substitutes, and analyze their gene sequence, protein properties and transcriptional level.</p><p><b>METHOD</b>IspE and IspH unigene ware obtained from the transcriptome dataset of L. japonica. Full-length cDNA of IspE and IspH were cloned from buds of L. japonica, L. japonica var. chinensis, L. hypoglauca and L. dasystyla using RT-PCR technology, and named as LJIspE, LHIspE, LJCIspE, and LDIspE, LJIspH, LJCIspH, LHIspH and LDI-spH, respectively. And we also predicted the structure and function of IspE and IspH proteins.</p><p><b>RESULT</b>IspE contained an open reading frame that consisted of 1 221 bp, encoding one polypeptide with 422 amino acids. A complete open reading frame of IspH gene consisted of 1 380 bp and encoded 459 amino acids. Both IspE and IspH ware non-secreted proteins and localized in the chloroplast. Transcripted level of IspE and IspH in bud of L. japonica, L. hypoglauca and L. dasystyla was not significantly difference, but their transcripted level in L. japonica var. chinensis was significantly higher than that in L. japonica.</p><p><b>CONCLUSION</b>The clone of IspE and IspH will help for further research on the synthesis of terpenes, aroma and color.</p>
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Cloning, Molecular , Computational Biology , Flowers , Chemistry , Genetics , Metabolism , Lonicera , Chemistry , Classification , Genetics , Metabolism , Molecular Sequence Data , Phylogeny , Plant Proteins , Chemistry , Genetics , Metabolism , Protein TransportABSTRACT
The expression of phenylalnine ammonia lyase (LJPAL1) is closely related to the content of active compounds in Lonicera japonica. In this paper, a prokaryotic expression vector is constructed and LJPAL1 protein is expressed in E. coli. Three antigen sites were synthesized to peptide antigen and prepared polyclonal antibody of Anti-LJT-1, Anti-LJT-2 and Anti-LJT-3, separately. Antibody Anti-LJT-2 was screened using Western blotting. And indirect ELISA was built using Anti-LJT-2. The results of this study will be a base for honeysuckle chemical quality and evaluation kits.
Subject(s)
Antibodies , Allergy and Immunology , Metabolism , Antibody Specificity , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Escherichia coli , Genetics , Metabolism , Flowers , Chemistry , Gene Expression Regulation, Plant , Genetic Vectors , Lonicera , Chemistry , Phenylalanine Ammonia-Lyase , Chemistry , Allergy and Immunology , Plants, Medicinal , Chemistry , Plasmids , Protein Structure, Secondary , Protein Structure, TertiaryABSTRACT
<p><b>OBJECTIVE</b>To study the developmental phase on the growth and active compounds in Scutellaria baicalensis.</p><p><b>METHOD</b>Seeds of wild plants were collected from Laiwu and sowed in Fangshan (Beijing) and Laiwu (Shandong). Samples of aerial and underground parts were collected in five growth periods of sprouts, seedlings, flowering, seed drop and withered periods respectively. The length of taproot, fresh weight of root, diameter of taproot and the length of stem were determined. The content of active compounds and total flavonoids were determined by HPLC and ultraviolet spectrophotometry respectively. The transcripted level of PAL1, PAL2, PAL3, C4H, 4CL, CHS, GUS and UBGAT were analyzed with RT-PCR.</p><p><b>RESULT</b>The results showed that the aerial part of S. baicalensis grew quickly before flowering stage, and the underground part grew mostly between the periods of flowering and withered. In the whole growing developmental periods, the content of total flavonoids was not changed significantly, the content of baicalin was increased gradually and the content of baicalein was decreased gradually. Expression level of PAL and 4CL was the highest in withered period, CHS was increased between flowering and seed drop and decreased in withered period.</p><p><b>CONCLUSION</b>Seedlings and withered periods may be the key phase affecting the growth and active compounds in S. baicalensis.</p>
Subject(s)
Acyltransferases , Genetics , Metabolism , Chromatography, High Pressure Liquid , Coenzyme A Ligases , Genetics , Metabolism , Flavonoids , Metabolism , Flowers , Genetics , Metabolism , Gene Expression Regulation, Developmental , Gene Expression Regulation, Enzymologic , Gene Expression Regulation, Plant , Glucuronidase , Genetics , Metabolism , Glucuronosyltransferase , Genetics , Metabolism , Phenylalanine Ammonia-Lyase , Genetics , Metabolism , Plant Proteins , Genetics , Metabolism , Plant Roots , Genetics , Metabolism , Plant Stems , Genetics , Metabolism , Reverse Transcriptase Polymerase Chain Reaction , Scutellaria baicalensis , Genetics , Metabolism , Seedlings , Genetics , Metabolism , Spectrophotometry, Ultraviolet , Time Factors , Trans-Cinnamate 4-Monooxygenase , Genetics , MetabolismABSTRACT
A FatB unigene was obtained from the transcriptome dataset of Lonicera japonica Thunb. Full-length FatB cDNA was cloned from buds of Lonicera japonica Thunb., Lonicera japonica Thunb. var. chinensis (Wats.) Bak., Lonicera hypoglauca Miq. and Lonicera dasystyla Rehd. using RT-PCR technology, and named as LJFatB, LHFatB, LJCFatB and LDFatB. The results of bioinformatic analysis showed that LJFatB, LJCFatB, LHFatB and LDFatB and Arabidopsis thaliana AtFatB had a closely relationship. Nucleotide sequences and protein secondary structure of LJFatB, LJCFatB, LHFatB and LDFatB are different and their proteins had conserved FatB substrate binding sites and catalytic activity sites. Transcriptive level of LJFatB, LJCFatB, LHFatB and LDFatB in bud was not significantly different. Therefore, LJFatB, LJCFatB, LHFatB and LDFatB could have the same biological function as AtFatB.
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Amino Acid Sequence , Cloning, Molecular , Computational Biology , DNA, Complementary , Genetics , Flowers , Chemistry , Genetics , Metabolism , Lonicera , Chemistry , Classification , Genetics , Metabolism , Open Reading Frames , Genetics , Phylogeny , Plant Proteins , Genetics , Metabolism , Protein Structure, Secondary , Thiolester Hydrolases , Genetics , Metabolism , Transcriptome , GeneticsABSTRACT
The phylogenetic relationships of 15 taxa from Hystrix and the related genera Leymus (NsXm), Elymus (StH), Pseudoroegneria (St), Hordeum (H), Psathyrostachys (Ns), and Thinopyrum (E) were examined by using the Giemsa C-banded karyotype. The Hy. patula C-banding pattern was similar to those of Elymus species, whereas C-banding patterns of the other Hystrix species were similar to those of Leymus species. The results suggest high genetic diversity within Hystrix, and support treating Hy. patula as E. hystrix L., and transferring Hy. coreana, Hy. duthiei ssp. duthiei and Hy. duthiei ssp. longearistata to the genus Leymus. On comparing C-banding patterns of Elymus species with their diploid ancestors (Pseudoroegneria and Hordeum), there are indications that certain chromosomal re-arrangements had previously occurred in the St and H genomes. Furthermore, a comparison of the C-banding patterns of the Hystrix and Leymus species with the potential diploid progenitors (Psathyrostachys and Thinopyrum) suggests that Hy. coreana and some Leymus species are closely related to the Ns genome of Psathyrostachys, whereas Hy. duthiei ssp. duthiei, Hy. duthiei ssp. longearistata and some of the Leymus species have a close relationship with the E genome. The results suggest a multiple origin of the polyploid genera Hystrix and Leymus.
Subject(s)
Chromosome Banding , Genetic Variation , Poaceae/genetics , Genome , Karyotyping , PlantsABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between the operation time of femur shaft fracture with post-operation system inflammation changes and clinical outcomes for those multiple fractures.</p><p><b>METHODS</b>This investigation was designed as a prospective, nonrandomized cohort study. From April 2005 to August 2007, all 78 hospitalized patients were divided into 3 groups by an inclusion criteria: multiple fractures with opened fracture of femur shaft (group A, n = 26), multiple fractures with closed fracture of femur shaft (group B, n = 23), single closed fracture of femur shaft (group C, n = 29). In the group A, damage control orthopaedics (DCO) procedure were performed. In the group B and C, all the femur shaft fractures were performed intramedullary nail fixation early (< 24 h). From serially sampled venous blood, inflammatory reaction index were estimated by measured the concentration of IL-6, TNF-alpha surround the operation, and the conditions of multiple organs were estimated by assayed PaO2/FiO2, total bilirubin (TBIL), creatinine (Cr) levels, the postoperation complication rates were analyzed among each groups. The extent of inflammation changes, multiple organs damage conditions and postoperation complication rates were compared and analyzed among the 3 groups.</p><p><b>RESULTS</b>In the group A, the median increase values of IL-6,TNF-alpha after the secondary surgery were 59 ng/L and 85 ng/L, whereas they were 154 ng/L and 250 ng/L respectively in the group B, there was a significant difference between the 2 groups (P < 0.01). In addition, the median increase values of IL-6, TNF-alpha after the first surgery in group A and in group C were both significantly less than group B (P < 0.01). Correspondingly, the abnormal rates of PaO2/ FiO2, TBIL, Cr levels occurred in the group B were all greater than group A after the 2 surgery procedures (P < 0.05), and in the aspects of average ventilation days, ICU staying days, duration of positive fluid balance (input/output > 500 ml/24 h), the group B were all greater than group A after the second surgery ( P < 0.01). Compared with group A after the first surgery, group B showed a longer average ventilation days, but it had no significant difference in average ICU stay days and duration of positive fluid balance. In addition, for group C, all the aspects above were less than group B (P < 0.01). Concerned with the complications after surgery in each groups, fat embolism and MODS rate between group A and B had no significant difference (11.5% vs 13.0% ,P > 0.05), but higher than which of group C (P < 0.01).</p><p><b>CONCLUSIONS</b>The early intramedullary nail fixation of femur shaft fracture in multiple fractures may lead to a significant system inflammation changes, and may develop the subclinical changes of multiple organs. However, these changes are less in those surgery procedures later performed, namely intramedullary nail fixation of femur shaft fracture in multiple fractures as a primary definitive treatment has a potential risk, and should be carefully evaluated.</p>