Establishment of a Patient-Derived T-Cell Acute Lymphoblastic Leukemia Xenograft Model in Novel Immunodeficient NCG Mice / 中国实验血液学杂志

OBJECTIVE@#The leukemia cells from patients with T-cell acute lymphoblastic leukemia (T-ALL) were inoculated into NCG mice to establish a stable human T-ALL leukemia animal model.@*METHODS@#Leukemia cells from bone marrow of newly diagnosed T-ALL patients were isolated, and the leukemia cells were inoculated into NCG mice via tail vein. The proportion of hCD45 positive cells in peripheral blood of the mice was detected regularly by flow cytometry, and the infiltration of leukemia cells in bone marrow, liver, spleen and other organs of the mice was detected by pathology and immunohistochemistry. After the first generation mice model was successfully established, the spleen cells from the first generation mice were inoculated into the second generation mice, and after the second generation mice model was successfully established, the spleen cells from the second generation mice were further inoculated into the third generation mice, and the growth of leukemia cells in peripheral blood of the mice in each group was monitored by regular flow cytometry to evaluate the stability of this T-ALL leukemia animal model.@*RESULTS@#On the 10th day after inoculation, hCD45+ leukemia cells could be successfully detected in the peripheral blood of the first generation mice, and the proportion of these cells was gradually increased. On average, the mice appeared listless 6 or 7 weeks after inoculation, and a large number of T lymphocyte leukemia cells were found in the peripheral blood and bone marrow smear of the mice. The spleen of the mice was obviously enlarged, and immunohistochemical examination showed that hCD3+ leukemia cells infiltrated into bone marrow, liver and spleen extensively. The second and third generation mice could stably develop leukemia, and the average survival time was 4-5 weeks.@*CONCLUSION@#Inoculating leukemia cells from bone marrow of patients with T-ALL into NCG mice via tail vein can successfully construct a patient-derived tumor xenografts (PDTX) model.

Surveillance of malaria vector Anopheles in Guizhou Province from 2005 to 2019 / 中国血吸虫病防治杂志

Objective To understand the density, populations and habitats of malaria vector Anopheles in Guizhou Province from 2005 to 2019, so as to provide the evidence for formulating the countermeasures to tackle the risk of local transmission of imported malaria in the province. Methods The malaria vector Anopheles density and populations were monitored using human bait trapping and light trapping techniques in Guizhou Province from 2005 to 2019, and all captured Anopheles was morphologically identified and counted. In addition, the distribution of Anopheles habitats was investigated. Results During the period from 2005 through 2019, the malaria vector Anopheles density increased from early June in Guizhou Province, peaked on early July and then declined, which appeared a single peak. The greatest Anopheles density was seen on early August, 2018 [57.34 mosquitoes/(person-night)], and the lowest density was found on late October, 2009 [1.29 mosquitoes/(person-night)]. The annual mean Anopheles density slowly reduced from 17.91 mosquitoes/(person-night) in 2005 to 12.34 mosquitoes/(person-night) in 2012, with a 38.02% reduction (χ2trend = 115.04, P < 0.01), while the annual mean Anopheles density showed a tendency towards a rise from 2017 to 2019 (χ2trend = 420.00, P < 0.01). The malaria vector Anopheles was captured during the period between 19 : 00 and 7 : 00 of the next day in Guizhou Province from 2017 to 2019, with the overall density appearing a tendency towards a rise followed by a decline, and the Anopheles activity was highly frequent during the period between 19 : 00 and 21 : 00. The malaria vector Anopheles was monitored for 938 times using the light trapping method in Guizhou Province from 2005 to 2019, and a total of 52 781 Anopheles mosquitoes were captured, including 49 705 An. sinensis, 804 An. minimus, 238 An. anthropophagus, and 2 034 other Anopheles mosquitoes, with a significant difference seen in the Anopheles composition (χ2 = 165.68, P < 0.01). From 2017 to 2019, a total of 24 557 Anopheles mosquitoes were captured in human housings, outdoors and livestock housings in Guizhou Province, with 67.65% captured in livestock housings and 12.01% in human housings, and there was a significant difference in the number of Anopheles mosquitoes captured from the three types of habitats (χ2 = 55.04, P < 0.01). An. sinensis, An. minimus and An. anthropophagus were captured form all three types of habitats, in which 98.07% was An. sinensis, and 0.09% was An. anthropophagus. Conclusions The population structure of malaria vector Anopheles has changed in historically malaria-endemic areas of Guizhou Province, and An. sinensis has replaced An. minimus and An. anthropophagus to become the predominant malaria vector. The malaria vector Anopheles density has shown a tendency towards a rise in Guizhou Province during the recent years, and there have been a rise in the type and number of Anopheles mosquitoes, leading to a potential risk of local transmission of imported malaria. Long-term, persistent and extensive surveillance of malaria vectors is recommended in Guizhou Province.

Preparation and in vitro evaluation of fused deposition modeling 3D printed verapa-mil hydrochloride gastric floating formulations / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility of preparing gastric floating formulations by fused de-position modeling (FDM) 3D printing technology, to evaluate the in vitro properties of the prepared FDM 3D printed gastric floating formulations, and to compare the influence of different external shapes of the formulation with their in vitro properties.@*METHODS@#Verapamil hydrochloride and polyvinyl alcohol (PVA) were used as the model drug and the excipient, respectively. The capsule-shaped and hemisphere-shaped gastric floating formulations were then prepared by FDM 3D printing. The infill percentages were 15%, the layer heights were 0.2 mm, and the roof or floor thicknesses were 0.8 mm for both the 3D printed formulations, while the number of shells was 3 and 4 for capsule-shaped and hemisphere-shaped formulation, respectively. Scanning electron microscopy (SEM) was used to observe the morpho-logy of the surface and cross section of the formulations. Gravimetric method was adopted to measure the weights of the formulations. Texture analyzer was employed to evaluate the hardness of the formulations. High performance liquid chromatography method was used to determine the drug contents of the formulations. The in vitro floating and drug release behavior of the formulations were also characterized.@*RESULTS@#SEM showed that the appearance of the FDM 3D printed gastric floating formulations were both intact and free from defects with the filling structure which was consistent with the design. The weight variations of the two formulations were relatively low, indicating a high reproducibility of the 3D printing fabrication. Above 800.0 N of hardness was obtained in two mutually perpendicular directions for the two formulations. The drug contents of the two formulations approached to 100%, showing no drug loss during the 3D printing process. The two formulations floated in vitro without any lag time, and the in vitro floating time of the capsule-shaped and hemisphere-shaped formulation were (3.97±0.41) h and (4.48±0.21) h, respectively. The in vitro release of the two formulations was significantly slower than that of the commercially available immediate-release tablets.@*CONCLUSION@#The capsule-shaped and hemisphere-shaped verapamil hydrochloride gastric floating formulations were prepared by FDM 3D printing technology successfully. Only the floating time was found to be influenced by the external shape of the 3D printed formulations in this study.

Analysis of 6 cases ERCP-related Ⅲ Stapfer perforation in the bile duct successfully treated by placement of covered metal stents joint nasobiliary drainage / 中国内镜杂志

Objective To summarize the efficacy and safety of covered metal stents joint nasobiliary drainage in treated with ERCP-related Ⅲ Stapfer bile duct perforation. Method Covered metal stent were immediately placed with patients for ERCP-related III Stapfer bile duct perforation. Then, nasobiliary drainage were placed. The stents were removed after 2 ～ 4 weeks. Result 6 patients were all improved, and no surgical patients. The effective rate was 100.00％. No stent related complications occurred. The symptoms of abdominal infection occurred in 1 patient during hospitalization, the rate was 16.67％. Conclusion The method of treatment for ERCP-related III Stapfer bile duct perforation was safe and effective, it was worthy of clinical popularization and application.

Clinical Significance of Additional Chromosomal 8 Clonal Evolution in CML Progression / 中国实验血液学杂志

OBJECTIVES@#To explore the clinical significance of clonal evolution of additional chromosomal 8 in CML progression.@*METHODS@#An unusual case with the clonal evolution from trisomy 8 to tetrasomy 8 accompanied by 2 time of CML blast crisis (BC) was reported.@*RESULTS@#This patient suffered from 2 time of CML blast crisis and the additional chromosome 8 aberrations were accompanied. Trisomy 8 and tetrasomy 8 were detected at first CML blast crisis and second CML blast crisis, respectively. After tetrasomy 8 was developed, the c-Myc was over-expressed and the central nervous system leukemia happened in this case. Only high dose Ara-C and MTX regimen could induce remission for a short period.@*CONCLUSION@#These findings suggested that additional chromosome 8 aberrations are important marker for poor prognosis of CML patients and contribute to a poor prognosis.

Electronic Medical Record in TCM Field-An Analysis Based on Scientific Knowledge Visualization / 中国中医药信息杂志

ObjectiveTo assess China’s newly evolved hot spots and novelty of structural electronic medical record in TCM field.Methods Articles about electronic medical record in TCM field were retrieved from CNKI from January 2000 to December 2015, focusing on researchers, research institutes, and key words for bibliometric analysis. Then visualization software CiteSpace was used to establish co-occurrence network.ResultsThe top 3 productive authors were LIU Bao-yan (13 articles), ZHANG Run-shun (8 articles), XIE Qi (7 articles), and ZHOU Xue-zhong (7 articles). Institutes highly cooperated with others included China Academy of Chinese Medical Sciences, Information Engineering College of Hubei University of Chinese Medicine and The First Affiliated Hospital of Henan University of Chinese Medicine. The major clusters were TCM diagnosis (#0), China’s TCM information (#1), artificial intelligence (#2), medical record management (#3), and medical laboratory department (#4). The representative keywords involved electronic medical record, TCM hospital, data mining, telemedicine, and artificial intelligence. ConclusionIn the field of TCM electronic medical record, cooperation is not sufficiently facilitated among researchers and institutes. Research hot spots are not formed and novelty is not obvious, which is probably because of the overall status quo for China’s TCM information construction.

Minimally invasive percutaneous fixation with cannulated compression screw for young patients with femoral neck fracture / 中国组织工程研究

BACKGROUND: Screw fixation is mainly used in the treatment of femoral neck fractures in the youth; therefore, how to reduce surgical trauma, retain sufficient blood supply and reduce postoperative complications becomes so important. OBJECTIVE: To study the efficacy of minimal invasive percutaneous fixation with cannulated compression screws for young patients with femoral neck fracture and its impact on the length of bilateral lower limbs and hip joint function. METHODS: Thirty patients with femoral neck fracture admitted in the Shanghai Pudong Hospital Affiliated to Fudan University from January 2009 to December 2012, were selected as experimental group, followed by subjected to minimal invasive percutaneous traction bed-assisted closed reduction with cannulated compression screws. Meanwhile, 28 cases of femoral neck fracture admitted from January 2006 to December 2009, were given open reduction with square muscle grafting and cannulated screw fixation (control group). The efficacy, intraoperative blood loss, operation time, hospital stay, fracture healing time and incidence of complications were observed. Additionally, the length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively were compared between two groups. RESULTS AND CONCLUSION: (1) All patients were followed up for 24-60 months. (2) The excellent and good rate in the experimental and control groups was 90% and 93%, respectively, which showed no significant difference between two groups (χ2=0.007, P > 0.05). (3) The intraoperative blood loss, operation time, and hospital stay in the experimental group were significantly less than those in the control group (P < 0.01); while, the fracture healing time, incidence of complications as well as length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively did not differ significantly between two groups (P > 0.01). (4) These results suggest that the minimal invasive percutaneous fixation with cannulated compression screws applied in the treatment of young patients with femoral neck fracture exhibits satisfactory efficacy, good reduction, less trauma and rapid postoperative recovery, which is available for all types of young femoral neck fracture.

EFFECT OF SECOND TOE-TO-HAND TRANSFER ON THE PLANTAR PRESSURE DISTRIBUTION OF THE DONOR FOOT

ABSTRACT Objective: To investigate the effect of second toe-to-hand transfer on the plantar pressure distribution of the donor foot. Methods: Twelve normal fresh-frozen cadaveric foot specimens were subjected to an axial load of 600 N. An F-Scan plantar pressure analysis system was used to measure the forefoot plantar pressure. The testing was performed under the conditions of intact second toe, second toe removal with the second metatarsal head reserved, and second toe removal in combination with the distal one-third of the second metatarsal, respectively. Results: The peak pressure of the second metatarsal head was greater than other four forefoot plantar regions. There was no statistically significant change in the forefoot plantar pressure distribution after the second toe was removed (p > 0.05). When the second toe and the distal one-third of the second metatarsal were removed, the forefoot plantar pressure distribution changed significantly (p < 0.05). Conclusions: An intact second metatarsal is essential for the normal distribution of plantar pressure. Removal of the second toe with the second metatarsal head reserved had little influence on the plantar pressure distribution of the donor foot. Removal of the second toe and distal one-third of the second metatarsal resulted in abnormal plantar pressure distribution. Level of Evidence II, Experimental Study.

Isoquercitrin suppresses the expression of histamine and pro-inflammatory cytokines by inhibiting the activation of MAP Kinases and NF-κB in human KU812 cells / 中国天然药物

Mast cells and basophils are multifunctional effector cells that contain abundant secretory granules in their cytoplasm. Both cell types are involved in a variety of inflammatory and immune events, producing an array of inflammatory mediators, such as cytokines. The aim of the study was to examine whether isoquercitrin modulates allergic and inflammatory reactions in the human basophilic KU812 cells and to elucidate its influence on the phosphorylation of mitogen-activated protein kinase (MAPK) and nuclear factor (NF)-κB activation. The KU812 cells were stimulated with phorbol-12-myristate 13-acetate plus the calcium ionophore A23187 (PMACI). The inhibitory effects of isoquercitrin on the productions of histamine and pro-inflammatory cytokines in the stimulated KU812 cells were measured using cytokine-specific enzyme-linked immunosorbent (ELISA) assays. Western blotting analysis was used to assess the effects of isoquercitrin on the MAPKs and NF-κB protein levels. Our results indicated that the isoquercitrin treatment of PMACI-stimulated KU812 cells significantly reduced the production of histamine and the pro-inflammatory cytokines, such as interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α. The treated cells exhibited decreased phosphorylation of extracellular signal-regulated kinase (ERK), revealing the role of ERK MAPK in isoquercitrin-mediated allergy inhibition. Furthermore, isoquercitrin suppressed the PMACI-mediated activation of NF-κB in the human basophil cells. In conclusion, the results from the present study provide insights into the potential therapeutic use of isoquercitrin for the treatment of inflammatory and allergic reactions.

Relationship between Migration and HIV Risky Behavior: a Comparative Study of Returning Migrants and Non Migrants Based on Rural Out-of-school Youth in Jilin, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China.</p><p><b>METHODS</b>A cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China.</p><p><b>RESULTS</b>58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse (4.3% for males and 5.5% for females, P<0.01), multiple sexual partners (24.1% for males and 44.1% for females, P<0.01), and HIV knowledge rate (35.2% for males and 25.5% for females, P<0.001). While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration.</p><p><b>CONCLUSION</b>Among rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.</p>

Analysis on Serum Trace Element Levels of Echinococciasis Patients in Garze Tibetan Autonomous Prefecture in Sichuan, China, 2011 / 生物医学与环境科学（英文）

In Garze Tibetan autonomous prefecture in Sichuan province, China, 41 echinococciasis patients who had received surgical treatment were recruited in the study, and 82 health persons who had lived in Garze for at least 10 years were selected as controls. The serum levels of Zn, Se and Cu of the cases and controls were detected. The results showed that most echinococciasis cases were distributed in Shiqu county (17.1%, 7/41), and only 1 case was distributed in Yajiang county (2.4%). The male to female ratio of the cases was 1:1.56. The echinococciasis patients were mainly aged 30-39 years (36.59%, 15/41). And, the cases aged 20-49 years accounted for 68.29% (28/41). Compared with health controls, the serum levels of Zn and Se of the cases significantly declined. However, the serum level of Cu of the cases had no significantly change. It was confirmed that the serum levels of Zn and Se were interrelated with the prevalence of echinococciasis.

Advances in biomechanical research on syndesmosis / 医用生物力学

Each of the syndesmotic ligaments has different biomechanical effects. Minimal movement occurs in the syndesmosis during the motion of the ankle joint, and the syndesmotic injury is associated with the ankle position and the patterns of external forces. Controversy still exists with respect to the optimal fixation of the syndesmosis. Malreduction of the syndesmosis would lead to abnormal pressure distribution on the ankle joint. Therefore, the flexible fixation might more accord with the physical movement of the syndesmosis. In this article, the biomechanical studies on syndesmosis are reviewed to provide the reference for proper treatment method for syndesmotic injury.

Outcome comparison of lisfranc injuries treated through dorsal plate fixation versus screw fixation

O objetivo deste estudo prospectivo foi testar se o tratamentode lesões de Lisfranc com redução aberta e fixação da placadorsal teria os mesmos resultados funcionais, ou melhores, do quetratamento padrão com fixação com parafuso transarticular. Métodos:Sessenta pacientes com lesão articular de Lisfranc foram tratadospor redução aberta e fixação da placa dorsal ou pelo método padrãopor fixação de parafusos. Os pacientes foram acompanhados por,em média, 31 meses. A avaliação foi realizada com base na queixaprincipal dos pacientes, exame clínico, radiografia, e escala AOFAS.Resultados: Trinta e dois pacientes foram tratados com redução abertae fixação da placa dorsal, e vinte e oito pacientes foram tratadoscom redução aberta e fixação com parafuso. Depois de dois anos deacompanhamento, a média do escore AOFAS foi de 83,1 pontos nogrupo de fixação da placa dorsal e 78,5 pontos no grupo de fixaçãocom parafusos (p <0,01). Do grupo de fixação com placa dorsal, aanálise radiográfica revelou redução anatômica em vinte e nove pacientes(90,6%, 29/32) e redução não anatômica em três pacientes.Do grupo de fixação com parafuso, a análise radiográfica revelou reduçãoanatômica em vinte e três pacientes e redução não anatômicaem cinco pacientes (82,1%, 23/28). Conclusões: A redução abertae fixação com placa dorsal para lesão de Lisfranc deslocada têmmelhor resultado a curto e médio prazo e uma taxa de reoperaçãoinferior do que a técnica padrão de redução aberta e fixação interna(RAFI) com parafuso. Em nossa experiência, recomendamos o usode placa dorsal em RAFI nas lesões de Lisfranc deslocadas. Nívelde Evidência II, Estudo Prospectivo Comparativo...

The objective of this prospective study was to testwhether the treatment of Lisfranc injuries with open reductionand dorsal plate fixation would have the same or better functionaloutcomes as treatment with standard trans-articular screwfixation. Methods: Sixty patients with primarily isolated Lisfrancjoint injury were treated by open reduction and dorsal platefixation or standard screw fixation. The patients were followedon average for 31 months. Evaluation was performed with patients’chief complaint, clinical examination, radiography, andAOFAS Midfoot Scale. Results: Thirty two patients were treatedwith open reduction and dorsal plate fixation, and twenty eightpatients were treated with open reduction and screw fixation.After two years follow-up, the mean AOFAS Midfoot score was83.1 points in the dorsal plate fixation group and 78.5 points inthe screw fixation group (p<0.01). Of the dorsal plate fixationgroup, radiographic analysis revealed anatomic reduction intwenty-nine patients (90.6%, 29/32) and nonanatomic reductionin three patients. Of the screw fixation group, radiographicanalysis revealed anatomic reduction in twenty-three patientsand nonanatomic reduction in five patients (82.1%, 23/28).Conclusions: Open reduction and dorsal plate fixation for adislocated Lisfranc injury do have better short and median termoutcome and a lower reoperation rate than standard screw ORIF.In our experience, we recommend using dorsal plate in ORIF ondislocated Lisfranc injuries. Level of Evidence II, ProspectiveComparative Study...

Open reduction and internal fixation of posterior pilon fractures with buttress plate

Objective: Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. Method: In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score). Results: Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively. Conclusion: Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study. .

Treatment of essential thrombocytosis with Buyang Huanwu Decoction plus hydroxyurea:an effectiveness evaluation / 中国生化药物杂志

Objective To observe the effectiveness of treating essential thrombocytosis(ET) with Buyang Huanwu Decoction plus hydroxyurea. Methods 120 patients with ET were randomly divided into observation group(OG) and control group(CG). Patients from OG were treated with Buyang huanwu decoction plus hydroxyurea, while those from CG were given hydroxyurea. After 6 months, the treatment effectiveness indexes including symptoms in a sense of chinese medicine, cell counts and saffy were observed. Results Total effective rate of OG was higher than that of CG(P<0.05). TCM symptoms remission in OG group was better than that of CG(P<0.05). After treatment, blood platelet count and megakaryocyte count were decreased in two groups(P<0.05), and the difference between two groups was signiifcan(P<0.05). Conclusion The therapy combined Chinese and western medicine deals with ET is better than simple western medicine treatment.

Desfechos clínicos de tratamento cirúrgico de más uniões ou não consolidadas do tálus / Clinical outcomes of surgical treatment for talar malunions and nonunions

Objetivo: apresentar nossas experiências no tratamento de más uniões ou não consolidações talares. Método: entre janeiro de 2000 e setembro de 2009, 26 pacientes com má união ou nãounião depois de fraturas do tálus foram submetidos a tratamento cirúrgico de acordo com os diferentes tipos de deformidade talar. Os desfechos do tratamento foram avaliados pela escala tornozelo-retropé da AOFAS, assim como por radiografias simples. Resultados: 20 pacientes ficaram disponíveis para acompanhamento por 30 (24 a 60) meses. Não houve problema de cicatrização ou infecção das feridas e foram obtidas uniões sólidas em todos os pacientes. As uniões radiológicas foram atingidas em tempo médio de 14 (faixa de 12 a 18) semanas. O tempo médio para concluir o apoio de carga foi 16 (faixa de 14 a 20) semanas. O escore AOFAS médio aumentou significantemente de 36,2 (27 a 43) para 85,8 (74 a 98). Conclusão: as intervenções cirúrgicas das fraturas mal-unidas ou não consolidadas dos tálus podem produzir resultados satisfatórios e o procedimento apropriado deve ser adotado, de acordo com diferentes tipos de deformidades pós-traumáticas. Nível de Evidência: IV, Estudo Retrospectivo.

Objective: To present our experiences of treating talar malunions and nonunions. Method: between January 2000 and September 2009, 26 patients with malunions or nonunions after talar fractures underwent surgical treatment according to different types of talar deformities. The treatment outcomes were evaluated using AOFAS ankle-hindfoot scale as well as plain radiographs. Results: 20 patients were available for follow-up for 30 (range, 24 to 60) months. No wound healing problems or infections occurred and solid unions were achieved in all patients. Radiological unions were achieved at a mean time of 14 (range, 12 to 18) weeks. The mean time to complete weight-bearing was 16 (range, 14 to 20) weeks. The mean AOFAS score increased significantly from 36.2 (range, 27 to 43) to 85.8 (range, 74 to 98). Conclusion: surgical interventions for malunions and nonunions after talar fractures can bring about satisfactory outcomes, and the appropriate procedure should be adopted according to different types of posttraumatic deformities. Level of Evidence: IV, Retrospective Study.

injuries to the fourth and fifth tarsometatarsal joints: a review of the surgical management by internal fixation, arthrodesis and arthroplasty

The surgical management to the injuries of the fourth and fifth tarsometatarsal [TMT] joints is controversial. We briefly review the anatomical characteristics to the injuries, the diagnosis, as well as the individualized treatment of the injuries of the fourth and fifth TMT joints by open reduction and internal fixation, TMT arthrodesis and arthroplasty. We conclude that open reduction and internal fixation is the recommended option for acute injuries, while arthrodesis can be used in cases of malunion of the fourth and fifth TMT joints with gross pain or arthritic changes and obvious structural deformity. Arthroplasty is an effective salvage operation mainly used in high-demand patients with severe TMT arthritis. Finally, we propose a recommended treatment algorithm [based on the literature and our experience], taking into account the specific indications for internal fixation, TMT arthrodesis and arthroplasty to optimize the individualized treatment

Data sources /Study selection: Data from survey reports, descriptive, cross-sectional and longitudinal studies published from 2002 to 2012 on the topic of the injuries to the fourth and fifth tarsometatarsal joint on human and radiography studies were included

Data Extraction: The data was extracted from online resources of American Orthopaedic Foot and Ankle Society, American Academy of Orthopaedic Surgeons, US National Library of Medicine, The MEDLINE

Conclusion: It is important to comprehend the specific anatomical characteristics and grasp the strict indications, advantages and disadvantages of the ORIF, TMT arthrodesis and arthroplasty to optimize the individualized treatment of the fourth and fifth TMT joints injuries in a maximum extent

Genetic characteristics and its prognostic significance for 217 adult patients with acute lymphoblastic leukemia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To evaluate cyto- and molecular genetic characteristics of adult patients with acute lymphoblastic leukemia (ALL) and its prognostic significance.</p><p><b>METHODS</b>Two hundred and seventeen adult patients with ALL were analyzed for cyto- and molecular genetic characteristics with combined conventional cytogenetics, fluorescence in situ hybridization (FISH), real-time quantitative PCR (qPCR) and nested PCR. Significance of genetic findings for prognosis was evaluated.</p><p><b>RESULTS</b>t(9;22)(q34;q11)/BCR-ABL has been the most frequent abnormality found in the cohort (56.3%). And 22.4% of cases with BCR-ABL detected by FISH was negative by cytogenetic analysis. Ratio of patients in high-risk group increased with age; Patients with B-ALL had a higher risk group than the average-risk group (98.40% vs. 65.70%, P=0.000). The overall survival (OS) rates at 3-month (67.30% vs. 85.10%, P=0.042), 6-month (55.1% vs. 80.4%, P=0.008), 12-month (34.0% vs. 59.1%, P=0.017) and 24-month (13.0% vs. 36.6%, P=0.010) were lower in high-risk group than in average-risk group, with medium OS time (11 months, 95% CI 8.0-13.9) being significantly shorter compared with the average-risk group (19 months, 95%CI 10.8-27.1).</p><p><b>CONCLUSION</b>Adult patients with ALL have unique cyto- and molecular genetic characteristics, which has important value for prognosis and guiding treatment. Moreover, combined cytogenetic and molecular genetic techniques can precisely define sub-groups of ALL patients.</p>

Detection of HOXA3 gene expression and apoptosis in myocardial tissues of children with tetralogy of fallot / 中华实用儿科临床杂志

Objective To explore the potential role of HOXA3 gene in children with tetralogy of fallot (TOF) by detection the expression of HOXA3 mRNA and protein levels,as well as the apoptotic cardiomyocytes in the developing heart tissues.Methods Twenty-two surgical samples from sporadic cases of TOF determined by prenatal color Doppler ultrasound and autopsy [gestational age(25.67 ± 7.68) weeks,TOF group] were examined with quantitative real-time PCR and Western blot to evaluate the expression of HOXA3 gene.Twelve age-matched autopsies without heart structural abnormalities [gestational age (26.55 ± 6.36) weeks,control group] were also included.Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling(TUNEL) assay was performed to clarify the apoptosis of cardiomyocytes.The difference between the 2 groups and the correlation analysis of HOXA3 level and the apoptotic cardiomyocytes were performed with SPSS 13.0 software.Results Compared with control group,HOXA3 mRNA expression of the outflow tract of the right ventricle from the TOF group was significantly reduced(P ＜ O.01).Western blot also confirmed that the HOXA3 protein was accordingly reduced(P ＜0.01).The proportion of apoptotic cardiomyocytes in samples of TOF group was significantly greater than that of control group (P ＜ 0.01).The proportion of apoptotic cells was strongly correlated with the mRNA and protein expression of HOXA3 (r =-0.566,-0.759,all P ＜ 0.01).Conclusions Reduction of HOXA3 gene expression and the increase of apoptotic cardiomyocytes at the crucial stage during heart development may play a potential role in the onset of TOF.