Relationship between red blood cell distribution width and short-term mortality of hip fractures in the elderly / 中华老年医学杂志

Objective:To study the relationship between red blood cell distribution width(RDW)and short-term mortality in elderly patients with hip fragility fractures.Methods:The clinical data and blood routine test at admission of 205 elderly patients with brittle hip fractures who were admitted to our hospital from 2020 to 2021 and were followed up for one year were retrospectively analyzed.The comorbid conditions, RDW and cumulative mortality at 6 months and 1 year after fractures were counted, and the relationship between RDW and short-term mortality were analyzed.Results:The 6-month(6.7% and 20.8%, χ2=8.591, P=0.003)and 1-year(6.7% and 26.7%, χ2=14.818, P<0.001)mortality of patients with ≤1 comorbidity were significantly lower than those of patients with ≥2 comorbidities.Moreover, the 6-month and 1-year mortality in patients with RDW>13.5% were significantly higher than those of patients with RDW ≤ 13.5%.The proportion of RDW>13.5 % in patients with at least two comorbidities was significantly higher than that in patients with ≤1 comorbidity.Taking RDW=13.6% as the cut-off value of 6-month and 1-year mortality, the sensitivity and specificity for predicting 6-month mortality were 71.4 % and 59.9 %, respectively, and the sensitivity and specificity for predicting 1-year mortality were 64.7 % and 59.6 %, respectively. Conclusions:Red cell distribution width is associated with short-term mortality, and higher RDW is associated with a higher risk of mortality among elderly patients with brittle hip fractures.

Research progress in microRNA as a novel diagnostic marker for bone echinococcosis / 国际生物医学工程杂志

Bone echinococcosis is usually caused by Echinococcus granulosus and E. multilocularis. People become infected when they eat food or water contaminated with the eggs. Treatment of bone echinococcosis usually includes surgery and medication, but the lengthy and costly treatment imposes a heavy burden on patients. MicroRNAs (miRNA) are known to be involved in a variety of biological processes and host-host interactions, including development, cell growth and death, lifespan-related target regulation, transcription, signal transduction, and cell motility, which will help us find new strategies and targets for the treatment and control of osteonechoconiosis. For further understanding of bone echinococcosis, it is important to understand the molecular basis of E. multilocularis development in both final and intermediate hosts. The miRNA found in E. granulosus and E. multilocularis have gene and developmental stage specificity in their respective host expression regulation. In this review paper, the progress of research on miRNA as a novel diagnostic marker for osteoblastic echinococcosis is reviewed.

Preliminary experience of gasless transoral vestibular robotic thyroidectomy / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the feasibility and safety of the gasless transoral vestibular robotic thyroidectomy using skin suspension. Methods: The clinical data of 20 patients underwent gasless transoral vestibular robotic thyroidectomy in the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from February 2022 to May 2022 were retrospectively analyzed. Among them, 18 were females and 2 were males, aged (38.7±8.0) years old. The intraoperative blood loss, operation time, postoperative hospital stay, postoperative drainage volume, postoperative pain visual analogue scale (VAS) score, postoperative swallowing function swallowing impairment score-6 (SIS-6), postoperative aesthetic VAS score, postoperative voice handicap index-10 (VHI-10) voice quality, postoperative pathology and complications were recorded. SPSS 25.0 was used for statistical analysis of the data. Results: The operations were successfully completed without conversion to open surgery in all patients. Pathological examination showed papillary thyroid carcinoma in 18 cases, retrosternal nodular goiter in 1 case, and cystic change in goiter in 1 case. The operative time for thyroid cancer was 161.50 (152.75, 182.50) min [M (P25, P75), the same below] and the average operative time for benign thyroid diseases was 166.50 minutes. The intraoperative blood loss 25.00 (21.25, 30.00) ml. In 18 cases of thyroid cancer, the mean diameter of the tumors was (7.22±2.02) mm, and lymph nodes (6.56±2.14) were dissected in the central region, with a lymph node metastasis rate of 61.11%. The postoperative pain VAS score was 3.00 (2.25, 4.00) points at 24 hours, the mean postoperative drainage volume was (118.35±24.32) ml, the postoperative hospital stay was 3.00 (3.00, 3.75) days, the postoperative SIS-6 score was (4.90±1.58) points at 3 months, and the postoperative VHI-10 score was 7.50 (2.00, 11.00) points at 3 months. Seven patients had mild mandibular numbness, 10 patients had mild cervical numbness, and 3 patients had temporary hypothyroidism three months after surgery and 1 patient had skin flap burn, but recovered one month after surgery. All patients were satisfied with the postoperative aesthetic effects, and the postoperative aesthetic VAS score was 10.00 (10.00, 10.00). Conclusion: Gasless transoral vestibular robotic thyroidectomy using skin suspension is a safe and feasible option with good postoperative aesthetic effect, which can provide a new treatment option for some selected patients with thyroid tumors.

Clinicopathological features of rectal adenocarcinoma with enteroblastic differentiation / 中华病理学杂志

Objective: To investigate the clinicopathological features, immunophenotype, and genetic alterations of rectal adenocarcinoma with enteroblastic differentiation. Methods: Four cases of rectal adenocarcinoma with enteroblastic differentiation were collected at the Affiliated Hospital of Qingdao University, Qingdao, China (three cases) and Yantai Yeda Hospital of Shandong Province, China (one case) from January to December 2022. Their clinical features were summarized. Hematoxylin and eosin stain and immunohistochemical stain were performed, while next-generation sequencing was performed to reveal the genetic alterations of these cases. Results: All four patients were male with a median age of 65.5 years. The clinical manifestations were changes of stool characteristics, bloody stools and weight loss. All cases showed mixed morphology composed of conventional adenocarcinoma and adenocarcinoma with enteroblastic differentiation. Most of the tumors consisted of glands with tubular and cribriform features. In one case, almost all tumor cells were arranged in papillary structures. The tumor cells with enteroblastic differentiation were columnar, with relatively distinct cell boundaries and characteristic abundant clear cytoplasm, forming fetal gut-like glands. Immunohistochemically, the tumor cells were positive for SALL4 (4/4), Glypican-3 (3/4) and AFP (1/4, focally positive), while p53 stain showed mutated type in 2 cases. The next-generation sequencing revealed that 2 cases had TP53 gene mutation and 1 case had KRAS gene mutation. Conclusions: Rectal adenocarcinoma with enteroblastic differentiation is rare. It shows embryonal differentiation in morphology and immunohistochemistry, and should be distinguished from conventional colorectal adenocarcinoma.

Relationship between suicidal ideation, daily stress and positive mental health among college freshmem in Wuhan / 中国学校卫生

Objective@#To investigate the prevalence and influencing factors of suicidal ideation and the effects of daily stress and positive mental health on suicidal ideation among college freshmen in Wuhan. This study aims to provide a scientific basis for mental health improvement and suicide prevention among college students from the perspective of positive psychology.@*Methods@#In December 2020, a convenient sampling method was used to select 2 592 freshmen from three universities in Wuhan. Demographic information, suicidal ideation, positive mental health, and daily stress were assessed. T test and Logistic regression analysis were used to analyze the status and influencing factors of suicidal ideation among college freshmen.@*Results@#The one year prevalence of suicidal ideation was 27.5%. Freshmen with suicidal ideation had higher daily stress scores and daily stress scores in different domains than freshmen without suicidal ideation( t =-13.00--4.68)， the positive mental health scores of freshmen with suicidal ideation were lower than freshmen without suicidal ideation ( t =17.14， P <0.01). Female ( OR=1.72, 95%CI =1.44-2.05), the higher education level of the mother (OR=1.27, 95%CI=1.05-1.53) and total experience of daily stress ( OR=1.11, 95%CI =1.09- 1.13 ) were associated with risk of oneyear suicidal ideation. Positive mental health was negatively associated with suicidal ideation ( OR=0.88, 95%CI=0.87-0.90, P <0.01) and had a moderating effect on the association between daily stress and suicidal ideation.@*Conclusion@#Suicidal ideation among college freshmen is closely related to daily stress and positive mental health. It is necessary to pay close attention to daily stress of freshmen and reduce suicidal ideation by improving positive mental health.

Influence of different options of preoperative biliary drainage on perioperative complications of patients with periampullary carcinoma undergoing pancreaticoduodenectomy / 中华肝胆外科杂志

Objective:To evaluate the effect of different options of preoperative biliary drainage (PBD) on perioperative complications of patients undergoing pancreaticoduodenectomy (PD).Methods:The clinical data of patients undergoing PD for periampullary carcinoma from January 2016 to November 2021 at Third Affiliated Hospital of Naval Medical University (Shanghai Eastern Hepatobiliary Surgery Hospital) were retrospectively analyzed. The 303 patients including 199 males and 104 females, aged (64.2±8.8) years. According to PBD, the patients were divided into two groups: percutaneous transhepatic biliary drainage (PTBD) group ( n=228) and endoscopic retrograde cholangiopancreatography (ERCP) group ( n=75). PBD operation-related complications (including bleeding, biliary leakage, etc.), postoperative complications of PD (including pancreatic fistula, biliary leakage, surgical site infection, etc.) and perioperative complications (PBD operation-related complications + postoperative complications of PD) were compared between the two groups. Univariate and multivariate logistic regression analysis were used to analyze factors influencing perioperative complications of PD. Results:The incidence of PBD operation-related complications in PTBD group was 10.1% (23/228), lower than that in ERCP group 25.3%(19/228), and the difference was statistically significant (χ 2=10.99, P=0.001). The incidence of postoperative complications of PD in PTBD group was 38.2%(87/228), lower than that in ERCP group 69.3%(52/75), the difference was statistically significant (χ 2=22.09, P<0.001). The incidence of total perioperative complications in PTBD group was 44.3% (101/228), lower than that in ERCP group 73.3%(55/75), the difference was statistically significant (χ 2=19.05, P<0.001). Multivariate logistic regression analysis showed that patients with periampullary carcinoma undergoing ERCP biliary drainage and PD had increased risk of surgical site infection ( OR=2.86, 95% CI: 1.59-5.16, P<0.001) and pancreatic fistula ( OR=3.06, 95% CI: 1.21-7.74, P=0.018). Conclusion:ERCP biliary drainage is a risk factor for postoperative pancreatic fistula and surgical site infection in patients with periampullary carcinoma undergoing PD. PTBD should be recommended as the first choice for the patients underwent PD.

Intravenous Immunoglobulin to Suppress Progression in a Patient With Advanced Breast Cancer / 한국유방암학회지

Intravenous immunoglobulin (IVIG) is used to treat various diseases and has anticancer effects that suppress metastases in animal models of sarcoma and melanoma. However, these effects have been observed in a limited number of clinical cases. We report the case of a patient with metastatic breast cancer in which long-term IVIG treatment stopped disease progression in the absence of salvage chemotherapy. The patient was treated with IVIG for the treatment of immune thrombocytopenia. Surprisingly, the lung and brain metastases were stabilized, and the patient achieved a progression-free interval of 29 months. More cases are needed to investigate and confirm the efficacy of IVIG in solid tumors in the future.

Transoral robotic nasopharyngectomy for local recurrent nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the safety, efficacy, locally control and survival results of transoral Da Vinci robotic surgery for salvage treatment of locally recurrent nasopharyngeal carcinoma. Methods: This retrospective study included 33 patients with locally recurrent nasopharyngeal carcinoma (stage rT1-2, partial rT3) underwent transoral Da Vinci robotic surgery between October 2017 and January 2020. There were 20 males and 11 females, with an average age of (47.9±10.5) years. The lesions were localized in nasopharyngeal cavity in 14 cases, with extending to parapharyngeal space in 6 cases and the floor of sphenoid sinus in 13 cases. Transnasal endoscopy was used to assist surgery if necessary. SPSS 25.0 statistical software was used for statistical analysis. Results: Transoral robotic nasopharyngectomy was successfully performed in all cases without conversion to open surgery, of which 13 cases were combined with transnasal endoscopic surgery. The average operation time was (126.2±30.0) min, ranging from 90 to 180 min. The postoperative pathological margin was R0 (31 cases) and R1 (2 cases), with no tumor residue. Complications of surgery mainly included symptoms of headache, nasal dryness and velopharyngeal insufficiency without nasopharyngeal hemorrhage. Follow-up time was from 3 to 54 months. One case had tumor recurrence 11 months after operation, 1 case had ipsilateral cervical lymph node metastasis 27 months after operation, 2 cases had distant metastasis and 1 case died of nasopharyngeal hemorrhage 3 months after operation. The 1-year, 2-year and 3-year overall survival rates were 97.0%, 96.0% and 92.9%, respectively and the local recurrence free rates were 97.0%, 95.7% and 91.7%, respectively. Conclusion: Transoral robotic nasopharyngectomy is safe and feasible for local recurrent nasopharyngeal carcinoma in selected patients, with higher local control rate and quality of life.

Comparison of measurement methods of lower limb length in hip arthroplasty for femoral neck fracture / 中国骨伤

OBJECTIVE@#To compare the accuracy of three methods for measuring the length of both lower limbs in hip arthroplasty for femoral neck fracture in the elderly, and to introduce a "shoulder to shoulder" anatomical location marking method for femur.@*METHODS@#From January 2017 to January 2019, 90 elderly patients with femoral neck fracture were treated with hip replacement, including 39 males and 51 females, aged 65 to 96(78.0±7.4) years, 56 cases of total hip and 34 cases of hemi hip. According to garden classification, there were 7 cases of typeⅡ, 63 cases of type Ⅲ and 20 cases of type Ⅳ. The patients were divided into three groups according to different measurement methods:contralateral contrast method (group A) of 19 cases, shuck test method (group B) of 28 cases, and "shoulder to shoulder" anatomical marker localization method (Group C) of 43 cases. The accuracy of the three methods was compared by measuring the length difference of lower limbs in vitro and imaging.@*RESULTS@#All patients completed the operation successfully. After total hip arthroplasty, the length of lower limbs in group A was(12.9±8.6) mm, and that in group B was(10.3±4.4) mm. After hemiarthroplasty, the length of lower limbs in group A was (13.2±7.2) mm, group B was (8.7±3.5) mm, and group C was (6.3±2.8) mm; the measurement results of unequal length of lower limbs after total hip arthroplasty were(12.9±8.1) mm in group A, (9.6±4.0) mm in group B and (6.6±2.6) mm in group C. The results of factorial analysis of variance showed that the differences among the three groups were statistically significant (@*CONCLUSION@#The "shoulder to shoulder" anatomic localization marking method can reduce the length of lower limbs simply, effectively and accurately in the elderly patients with femoral neck fracture hip replacement.

Study on pathological mechanism and establishment of animal model of ICU acquired weakness / 医学研究生学报

ObjectiveThere are few animal experiments on ICU acquired weakness (ICU AW), and suitable animal models are the main constraints. The study was to explore the method of ICU AW animal model which satisfies the clinical requirements of ICU and suitable for large-scale animal trials.MethodsThirty six SD rats were randomly divided into Control group(0.9%NS at 2.5 ml/kg intraperitoneal injection once a day for consecutive 3 days), immobilization group(the left hindlimb was immobilizated for 7d, then the immobilization was removed to 14 d), sepsis group(lipopolysaccharide at 2.5 mg/kg intraperitoneal injection once a day for consecutive 3 days) and sepsis-immobilization group(the left hindlimb was immobilizated for 7d, then the immobilization was removed to 14 d and lipopolysaccharide at 2.5 mg/kg intraperitoneal injection once a day for consecutive 3 days).To determine whether the model was successful, the muscle strength of left hindlimb, gastrocnemius/body weight ratio and pathological changes of gastrocnemius were measured at 0 d( immediately after intervention), 3d, 7 d, 10 d, 14 d. To explore the possible pathological mechanism, creatinine/body weight ratio, albumin, lymphocyte, and gastrocnemius pathological scores were measured.Results7 days later, the scores of left hindlimb muscle strength and pathology in sepsis immobilization group were significantly higher than those in the sepsis group and the control group(P<0.05), contary body weight and gastrocnemius weight were lower than those in control group, immobilization group and sepsis group(P<0.05), and gastrocnmiu/body weight ratio(0.528±0.018) was significantly lower than those in control group(0.756±0.315) and sepsis group(0.813±0.040)(P<0.05). Creatinine / body weight in sepsis immobilization group(0.283±0.0268) was significantly higher than those of blank group (0.185±0.022), immobilization group (0.207±0.027) and sepsis group (0.246±0.043)(P<0.05). The lymphocyte count [(5.193±1.493) ×109/L] was significantly lower than that in the blank group[(7.005±0.702) ×109/L] and the immobilization group[(7.208±0.832) ×109/L)](P< 0.05). 14 days later, the scores of left hindlimb muscle strength, body and gastrocnemius weight in sepsis immobilization group were significantly lower than those in control group, immobilization group and sepsis group(P<0.05). Gastrocnmiu/body weight ratio in sepsis immobilization group(0.519± 1.493) was significantly lower than those in control group(0.798±0.015), immobilization group (0.570±0.022)and sepsis group(0.693±0.022)(P<0.05).ConclusionThe qualified animal model of ICU AW can be established by repeated intraperitoneal injection in low dose of lipopolysaccharide combined with limb immobilization. Immunosuppression and Hypercatabolism in ICU AW rats is an important reason that ICU AW can not to be mitigated. Thus, we supposed that it may be the mechanisms for the development of ICU AW,which needs further experimental verification.

Clinical relationships between the rs2212020 and rs189897 polymorphisms of the ITGA9 gene and epithelial ovarian cancer

To better understand the role of integrin subunit alpha 9 (ITGA9) gene polymorphism in epithelial ovarian cancer (EOC), we investigated the distribution of ITGA9 gene polymorphisms (rs2212020 and rs189897) and revealed whether these polymorphisms were associated with a curative effect in EOC. It was found that rs2212020 and rs189897 were correlated significantly with EOC incidence. The frequency of the C allele of rs2212020 was significantly higher in EOC patients than in the control group (P = 0.009, χ2 = 6.857). The population with the C allele of rs2212020 had a higher EOC risk than the population with the T allele (hazard ratio = 1.97, 95.0% CI = 1.178−3.299). Further, our results showed that the CC genotype was a risk factor for EOC. Regarding the association between ITGA9 and the sensitivity to platinum-based chemotherapy in EOC, there were no statistically significant differences in the frequencies of the rs189897 and rs2212020 polymorphisms between the chemosensitivegroup and the control group. In multivariate analysis, the patients with the TT genotype of rs189897 had longer progression free survival (PFS) than the patients without this genotype (P = 0.010, OR = 2.491). The AT genotype of rs189897 was a risk factor for PFS in EOC. These findings suggested that rs189897 and rs2212020 could play important roles in EOC diagnosis and prognosis.

Therapeutic effect of irbesartan combined metoprolol on patients with chronic heart failure complicated atrial or ventricular arrhythmia／ / 心血管康复医学杂志

To explore therapeutic effect of irbesartan combined metoprolol on patients with chronic heart failure (CHF) complicated atrial or ventricular arrhythmia .Methods : A total of 168 CHF patients with atrial or ventricular arrhythmia treated in our hospital from 2017 were randomly and equally divided into metoprolol group (re‐ceived metoprolol based on routine treatment ) and combined treatment group (received irbesartan based on metoprolol group) , both groups were treated for three months .LVEF , left ventricular posterior wall thickness (LVPWT) , interven‐tricular septal thickness (IVST) before and after treatment , therapeutic effect were observed and compared between two groups.Results : Total effective rate of combined treatment group was significantly higher than that of metoprolol group (90.5% vs.73.8%) , P＝ 0.005. Compared with before treatment , there was significant rise in LVEF [ (55.16 ± 6.52)% vs.(64.24 ± 8.72)%] , and significant reductions in LVPWT [ (14.72 ± 1.78) mm vs.(13.27 ± 1.14) mm] , IVST [ (10.18 ± 1.15) mm vs.(9.12 ± 0.64) mm] in combined treatment group after treatment , P＝0.001 all ;and compared with metoprolol group after three‐month treatment , there was significant rise in LVEF [ (56.13 ± 6.15)%vs.(64. 24 ± 8.72)%] , and significant reductions in LVPWT [ (14. 35 ± 1. 23) mm vs.(13.27 ± 1.14) mm] and IVST [(9. 88 ± 0.85) mm vs.(9. 12 ± 0. 64) mm] in combined treatment group , P＝0. 001 all.There was no signif‐icant difference in incidence rate of adverse between two groups , P＝ 0.799. Conclusion : Irbesartan combined metoprolol possess significant therapeutic effect on patients with CHF complicated atrial or ventricular arrhythmia with good safety .Inhibition on ventricular remodeling may be its main mechanism .

Minimum 2-Year Experience with Magnetically Controlled Growing Rods for the Treatment of Early-Onset Scoliosis: A Systematic Review

Magnetically controlled growing rods have been used to treat early-onset scoliosis for the last 9 years; however, few studies have been published, with only short-term follow-up. The aim of the present study is to systematically review the outcomes of magnetically controlled growing rods in the treatment of early-onset scoliosis with a minimum of 2-year follow-up. Studies were included if patients with early-onset scoliosis (scoliosis diagnosed before 10 years of age) underwent implantation of magnetically controlled growing rods with a minimum of 2-year follow-up. The literature review and data extraction followed the established preferred reporting items for systematic review and meta-analysis guidelines. Data of distraction frequency, number of distractions, distracted length, Cobb angle, kyphosis, T1–T12 length, and T1–S1 length preoperatively, postoperatively, and at final follow-up were collected. Data regarding complications and unplanned reoperations were also extracted. The mean values of these parameters were calculated, or pooled meta-analysis was performed if available. Ten articles were included in this systematic review, with a total of 116 patients and a follow-up period between 23 and 61 months. The mean preoperative Cobb angle and kyphosis angle were 60.1° and 38.0°, respectively, and improved to 35.4° and 26.1° postoperatively. At final follow-up, the Cobb and kyphosis angles were maintained at 36.9° and 36.0°, respectively. The average preoperative T1–T12 and T1–S1 lengths were 180.6 mm and 293.6 mm, respectively, and increased to 198.3 mm and 320.3 mm postoperatively. T1–T12 and T1–S1 lengths were 212.3 mm and 339.3 mm at final follow-up, respectively. The overall rate of patients with complications was 48% (95% confidence interval [CI], 0.38–0.58) and unplanned reoperation 44% (95% CI, 0.33–0.55) after sensitivity analysis. The current evidence from different countries with a minimum of a 2-year follow-up suggests that magnetically controlled growing rods are an effective technique to treat pediatric scoliosis and promote spine growth. However, nearly half of patients still developed complications or required unplanned reoperations.

Analysis of NK Cells and Receptors in Peripheral Blood of Patients with HBV Related Acute-on-chronic Liver Failure in Different Phases / 中山大学学报(医学科学版)

[Objective]To investigate the character of expression of NK cells and its receptors in peripheral blood of pa-tients with HBV-related acute-on-chronic liver failure(HBV-ACLF)in different phase.[Methods]There are thirteen pa-tients with HBV-ACLF in advanced phase group and thirty-three patients in plateau phase group,with thirteen healthy per-son in control group.The frequency of NK cells and expression of NK cell activating receptors(NKAR)including NKG2D, NKp30 and NKp46,NK cell inhibitory receptors(NKIR))cludingsd ate the character of including NKG2A,KIR2DL1, KIR2DL3 and KIR3DL1,NK cell killing function related factors including Perforin,GranzymeB and FasL in peripheral blood of all patients were detected by flow cytometry.[Results]The percentage of NK cells in advanced group was lower than plateau group and healthy control group(H=7.771,P=0.021).The expression of KIR3DL1 in healthy control group was high-er than advanced group and plateau group(Z=6.639,P=0.036)while the expression of FasL was significantly lower than ad-vanced group and plateau group(Z=22.5,P<0.001).[Conclusion]Patients in advanced group had lower frequency of NK cells,lower expression of inhibitory receptor KIR3DL1 and higher expression of FasL than patients in plateau group and healthy control group,which is associated with immune status of patients in different phase of liver failure.

Expression of Extracellular Matrix Protein Reelin in Patients with Multiple Myeloma and Its Relationship with Prognosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression of extracellular matrix protein Reelin (RELN) and its relationship with the prognosis of patients with multiple myeloma.</p><p><b>METHODS</b>The mononuclear cells were collected from bone marrows of multiple myeloma patients by Ficoll gradient density centrifugation, the CD138 cells were then purified by flow cytometry, the mRNA level of RELN was detected by real time PCR. The myeloma patients were divided into 2 groups according to the relative expression levels of RELN. Then the relationship of RELN expression level with clinical data was analyzed statistically.</p><p><b>RESULTS</b>The high expression of RELN significantly correlated with the percentage of CD138 cells, progress-free and total survival, but did not correlate significantly with DS (P>0.05) and ISS stages (P>0.05). The RELN high expression group showed higher levels of serum M protein, uric acid and serum calcium, lower hemoglobin, and more abnormal FISH results (including RB1 deletion, 1q21 amplification, IgH recombination, P53 deletion, D13S319 deletion) than those in RELN low expression group.</p><p><b>CONCLUSION</b>Reelin correlates with the progression of multiple myeloma.</p>

Impact of GOLPH3 expression in cumulus granulosa cells on outcomes of intracytoplasmic sperm injection / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the impact of GOLPH3 expression in cumulus granulosa cells on the outcomes of intracytoplasmic sperm injection (ICSI).</p><p><b>METHODS</b>A total of 119 women receiving ICSI due to male infertility at our center between April, 2012 and June, 2014 were enrolled in the study. Cumulus granulosa cells were collected from the women for detection of GOLPH3 expressions using immunocytochemistry, Western blotting, and real-time PCR. GOLPH3 expression rate was compared between women with and without clinical pregnancy following ICSI, and the associations of GOLPH3 expression with the laboratory indicators of ICSI outcomes were assessed.</p><p><b>RESULTS</b>Immunocytochemistry showed that GOLPH3 expression was located mainly in in the plasma of the cumulus granulosa cells. The rate and intensity of GOLPH3 expression in the cumulus granulosa cells differed significantly between women with and without clinical pregnancy following ICSI (P<0.05). GOLPH3 expression was found to positively correlate with the numbers of punctured follicles, grade III oocyte cumulus complex, ICSI oocytes, fertilized oocytes, cleavage, high quality embryos, blastocysts, high quality blastocysts, and frozen embryos (all P<0.01). The results of RTPCR and Western blotting revealed significant differences in GOLPH3 expressions at both the mRNA and protein levels in the cumulus granulosa cells between the pregnant and non-pregnant groups after ICSI (t=14.560, P=0.000). Western blot analysis revealed significant difference of GOLPH3 protein expression in cumulus granulosa cells between women with and without clinical pregnancy following ICSI.</p><p><b>CONCLUSION</b>GOLPH3 expression in the cumulus granulosa cells plays an important role in the development of oocytes and promotion of conception to affect the outcomes of ICSI.</p>

Clinical observation of axial offset after treatment by Ilizarov bone transport technology / 中国骨伤

<p><b>OBJECTIVE</b>To observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology.</p><p><b>METHODS</b>From January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment.</p><p><b>RESULTS</b>All patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases.</p><p><b>CONCLUSION</b>Axial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.</p>

Efficacy of Xuebijing for coagulopathy in patients with sepsis

To provide evidence of the clinical efficacy of Xuebijing [XBJ] on blood coagulation in patients with sepsis. We conducted this meta-analysis in The People's Hospital of Liaoning Province, Shenyang, China between December 2013 and May 2014. We searched a number of databases for relevant randomized controlled trials [RCTs] published before December 2013 using the keywords [Xuebijing], [coagulation] and [sepsis]. Statistical analysis was performed with Review Manager 5.2 from the Cochrane Collaboration. Fourteen RCTs involving 867 patients were included. Compared with placebo, XBJ injection significantly improved platelets [mean differences [MD] = 42.14, 95% confidence interval [CI]: 22.42 - 61.86, p<0.00001], shortened the activated partial thromboplastin time [MD = -4.81, 95% CI: -7.86 - [-1.76], p=0.002], shortened the prothrombin time [MD = -2.33, 95% CI: -4.15 - [-0.51], p=0.01], and shortened the thrombin time [MD = -2.05, 95% CI: -3.52 - [-0.58], p=0.006]. However, no significant difference was found between the XBJ injection and the placebo group for fibrinogen [MD = 0.21, 95% CI: -0.38 - 0.81, p=0.48]. Xuebijing injection may improve coagulopathy in patients with sepsis. High-quality and large sample clinical trials are needed for confirmation

Expression of progesterone-induced blocking factor in severe preeclampsia and its association with immune tolerance imbalance / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore progesterone-induced blocking factor (PIBF) expression in the placenta and blood of patients with severe preeclampsia and its relationship with immune tolerance imbalance.</p><p><b>METHODS</b>Forty-seven patients admitted between January and December, 2012 were enrolled in this study, including 25 patients with early-onset severe preeclampsia (EOPE) and 22 with late-onset severe preeclampsia (LOPE), with 25 women with normal pregnancy serving as control group. The antenatal blood and postpartum placenta were collected for immunohistochemical staining to detect PIBF expression in the placenta and for testing serum PIBF level using ELISA. Flow cytometry was used to detect the percentage of circulating Th1 and Th2 cells and the Th1/Th2 ratio was calculated.</p><p><b>RESULTS</b>PIBF was expressed in decidual cells, syncytiotrophoblasts and partial cytotrophablasts. The serum PIBF levels were 213.58 ± 44.93 ng/ml in EOPE group, 243.00∓61.19 ng/ml in LOPE group and 273.91 ± 48.57 ng/ml in control group. There were significant differences in serum PIBF, blood Th1/Th2 and placenta PIBF-IOD among the 3 groups (P<0.05). EOPE group had significantly lower serum PIBF, lower llacental PIBF quantity (PIBF-IOD) and higher blood Th1/Th2 than the control group (P<0.05). Serum PIBF in women with severe preeclampsia was positively correlated with placenta PIBF-IOD and negatively with blood Th1/Th2 ratio (P<0.05), but a negative correlation between serum PIBF and 24-hour urinary protein was found only in EOPE group (P<0.05).</p><p><b>CONCLUSION</b>The immune tolerance imbalance mediated by PIBF may participate in the pathogenesis of severe preeclampsia. PIBF, the immune suppressor secreted by lymphocytes of pregnancy women, is also a protective factor against severe preeclampsia, which is expected to be a new target in therapy.</p>

The potential role of original fracture hematoma in fracture healing / 中国组织工程研究

BACKGROUND:In closed fractures, the initial hematoma that is inclined to remove is seldom considered as the important reasons for bone healing. OBJECTIVE:To observe the mechanism and potential role of original fracture hematoma in fracture healing. METHODS:Ninety-six patients with closed fractures of the long bones undergoing open reduction and internal fixation were randomly divided into experimental group (n=48) and control group (n=48). In the experimental group, original fracture hematoma, 1.0-2.0 mL, was first taken out during the internal fixation and placed into a special sterile plastic bag; then, 3-4 pieces of hematomas were filed into the fracture site and sutured layer by layer. On the contrary, original fracture hematomas from the control group were discarded. Blood samples were extracted to detect the biochemical indicators at 1 month after internal fixation. X-ray examination was done at 1, 3, 6 months after internal fixation for observation of fracture healing. RESULTS AND CONCLUSION: X-ray films showed that the healing rate at 3 months after operation was 95% in the experimental group and 78% in the control group, and there was a significant difference between the two groups (P < 0.05). Levels of bone glaprotein, I-type precolagen carboxy terminus peptide and serum bone alkaline phosphatase were significantly higher in the experimental group than the control group (P < 0.01 orP < 0.05). These findings indicate that the original fracture hematoma can accelerate calus formation, promote bone induction, provide nutrition to the fracture site, and participate in revascularization. Therefore, the original fracture hematomas is one of the effectively therapeutic methods for union and nonunion of fractures.