Conservative treatment of supination and external rotation for type Ⅲ and Ⅳankle fracture by bone setting / 中国骨伤

OBJECTIVE@#To explore curative effect of conservative treatment of supination-lateral rotation (SER) with type Ⅲ and Ⅳ ankle fracture by bone setting technique.@*METHODS@#From January 2017 to December 2019, 64 patients diagnosed with SER with type Ⅲ and Ⅳ ankle fracture were treated with manipulative reduction and conservative treatment (manipulation group) and surgical treatment with open reduction and internal fixation (operation group), 32 patients in each group. In manipulation group, there were 17 males and 15 females, aged from 15 to 79 years old with an average of (51.42±13.68) years old;according to Lauge-Hansen classification, there were 8 patients with supination external rotation type Ⅲ and 24 patients with type Ⅳ. In operation group, there were 13 males and 19 females, aged from 18 to 76 years old with an average of (47.36±15.02) years old;7 patients with type Ⅲ and 25 patients with type Ⅳ. Displacement of ankle fracture was measured by Digimizer software, and compared before treatment, 3 and 12 months after treatment between two groups. Lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement were measured and compared between two groups. Mazur score was used to evaluate ankle joint function.@*RESULTS@#All patients were followed up from 12 to 36 months with an average of (17.16±9.36) months. There were statistical differences in lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement in manipulation group before and after reduction(P<0.05). Compared with operation group, there were no statistically significant differences in lateral malleolus shift, lateral malleolus shift, lateral malleolus contraction shift(P>0.05), while there were statistically significant differences in lateral malleolus shift, posterior malleolus shift up and down (P<0.05). Mazur scores of ankle joint at 3 months after treatment in manipulation group and operation group were 68.84±13.08 and 82.53±7.31, respectively, and had statistical differences(P<0.05), while there was no difference in evaluation of clnical effect(P>0.05). There were no differences in Mazur score and evaluation of clnical effect between two groups at 12 months after treatment (P>0.05).@*CONCLUSION@#Bone setting technique could effectively correct lateral displacement of medial malleolus, lateral displacement of medial malleolus, lateral displacement of lateral malleolus and lateral contraction displacement of lateral malleolus in supination lateral rotation type Ⅲ and Ⅳ ankle fracture, and has good long-term clinical effect, which could avoid operation for some patients and restore ankle function after fracture.

Research progress on early stage extranodal natural killer/T cell lymphoma / 中华放射肿瘤学杂志

Extranodal natural killer/T-cell lymphoma (ENKTCL) is the subtype of non-Hodgkin lymphoma with high heterogeneity and invasiveness. Though most ENKTCL patients are present as early-stage at diagnosis, clinical prognosis significantly differs due to the limitations of clinical staging. Radiotherapy (RT) and chemotherapy (CT) are the first-line treatments for early ENKTCL patients. However, there is no consensus on the combined modalities of RT and CT, and their optimal strategy. With the continuous renewal of clinical staging and prognostic models, early-stage ENKTCL patients tend to accept risk-adapted treatment with proper stratification. In this review, the latest research progresses on clinical staging, prognostic models and treatment were retrospectively analyzed, aiming to provide references for clinical decision-making.

The outcome predicted value of enhanced MRI for prolapsed or sequestrated lumbar disc herniation / 中华骨科杂志

Objective:To analyze the predictive value of enhanced MRI in the outcome of prolapsed and sequestrated lumbar disc herniation through a retrospective analysis.Methods:A retrospective analysis of the data of 64 patients with prolapsed and sequestrated lumbar disc herniation from January 2015 to December 2018, including 38 males and 26 females; age 35.72±12.44 years (range, 22-64 years) ; 43 cases of prolapsed type, 21 cases of sequestrated type. Conservative treatment was the first choice for all patients, in case of surgical indications during the treatment, percutaneous endoscopic lumbar discectomy or fenestration discectomy will be performed. Enhanced MRI was performed at the first and last inspections, the volume of the protrusion, the thickness of rim enhancement (Tr), and the extent of rim enhancement (Er) were measured and calculated at the same time. According to the ring around the protrusion, the size of the rim-enhancement area was divided into type I-III; then compared the relationship between the rim-enhancement signal differentiation and the resorption rate of protrusions, and the correlation between Tr, Er values and the resorption rate of protrusions during the initial inspection.Results:Among the 64 patients, 42 patients completed conservative treatment, and 22 received surgical treatment. According to the rim-enhancement signal differentiation, 23 cases were treated conservatively for type I, 3 cases were treated by surgery; 16 cases were treated for type II conservatively, 7 cases were treated by surgery; 3 cases were treated for type III conservatively, and 12 cases were treated by surgery. All patients were followed up for 12 to 34 months. Among 42 conservatively treated patients, The volume of the protrusion before treatment was 2 645.67±690.86 mm 3, and the volume of the protrusion after treatment was 842.76±573.35 mm 3. The volume of protrusions before and after treatment was statistical significance ( t=11.897, P<0.001), Tr was 1.38±0.83 mm, and Er was 73.08%±34.39%, the resorption rate of protrusions was 65.10%±24.50%, and 39 cases (92.86%, 39/42) reached the standard for protrusion resorption (resorption rate ≥30%); 23 cases of type I , the resorption rate was 76.54%±18.62%; 16 cases of type II had an resorption rate of 56.81%±21.44%; 3 cases of type III had an resorption rate of 21.58%±12.19%. The resorption rate of type III were compared by single factor analysis of variance, and the difference was statistically significant ( F=12.885, P<0.001); 32 cases of both type I and II (82.05%, 32/39) had significant resorption (resorption rate ≥50%), and no case of type Ⅲ had significant resorption, comparing with type I and II, the difference was statistically significant ( P=0.010); Tr was positively correlated with resorption rate ( r=0.569, P<0.001), Er was positively correlated with resorption rate ( r=0.677, P<0.001). Conclusion:Under close clinical observation, parts of the prolapsed or sequestrated lumbar disc herniations can be conservatively treated, and the herniated disc can be resorption in many people and the clinical symptoms were alleviated. Rim-enhancement signal differentiation by enhanced MR has a better predictive value for the outcome of the herniation, type I is more prone to resorption, preferred conservative treatment, type Ⅲ is not easy to resorption, preferred surgery treatment, and the higher thickness of rim enhancement, the greater extend the rim-enhancement, the more prone to resorption phenomenon.

Mechanism of Ginsenoside Rh2 Against Liver Cancer / 中国实验方剂学杂志

Ginsenoside Rh2 is a tetracyclic triterpenoid saponin monomer containing a dammarane-type skeleton, with advantages of low toxicity, low molecular weight, good fat solubility and strong anticancer effect, and is the main anticancer effective in ginseng. In recent years, there have been emerging findings on ginsenoside Rh2, indicating an obvious anticancer activity against a variety of cancers with a high morbidity and mortality. Particularly, ginsenoside Rh2 has a significant anti-hepatocarcinoma effect, so the studies on the mechanism of action have gradually been given attention. In this paper, we have reviewed more than 100 domestic and foreign relevant literatures in Chinese and English databases in the past 20 years, such as CNKI, Wanfang Data, VIP Data, Pub Med, and conducted detailed collection, analysis and summary for the contents of the anti-hepatocarcinoma mechanism of ginsenoside Rh2. According to the findings, although there are many reports on the anti-hepatocarcinoma effect of ginsenoside Rh2, the mechanism of action of ginsenoside Rh2 against liver cancer has not been systematically elaborated. Therefore, this paper comprehensively discusses the anti-hepatocarcinoma effect of ginsenoside Rh2, clarifies that the mechanism of action of ginsenoside Rh2 against liver cancer may be related with the inhibition of the proliferation of hepatoma cells, the induction of differentiation of hepatoma cells, the promotion of apoptosis of hepatoma cells, the inhibition of invasion and metastasis of hepatoma cells, the reduction of drug resistance of liver cancer cells, and the improvement of immunity. For the first time, the mechanism of action of ginsenoside Rh2 against liver cancer was comprehensively summarized, which provided reference for researches on ginsenoside Rh2 against liver cancer, evidence and ideas for further researches on ginsenoside Rh2, new research directions for the treatment of liver cancer and new hope to patients with liver cancer.

Determination of arsenic species in Solanum Lyratum Thunb using capillary electrophoresis with inductively coupled plasma mass spectrometry.

A simple and highly efficient interface to couple capillary electrophoresis with inductively coupled plasma mass spectrometry by a microflow polyfluoroalkoxy nebulizer and a quadruple ion deflector was developed in this study. By using this interface, six arsenic species, including arsenite, arsenate, monomethylarsonic acid, dimethylarsinic acid, arsenobetaine, and arsenocholine, were baseline-separated and determined in a single run within 11 min under the optimized separation conditions. The instrumental detection limit was in the range of 0.02-0.06 ng/mL for the six arsenic compounds. Repeatability expressed as the relative standard deviation (n = 5) of both migration time and peak area were better than 2.5 and 4.3% for six arsenic compounds. The proposed method, combined with a closed-vessel microwave-assisted extraction procedure, was successfully applied for the determination of arsenic species in the Solanum Lyratum Thunb samples from Anhui province in China with the relative standard deviations (n = 5) ≤4%, method detection limits of 0.2-0.6 ng As/g and a recovery of 98-104%. The experimental results showed that arsenobetaine was the main speciation of arsenic in the Solanum Lyratum Thunb samples from different provinces in China, with a concentration of 0.42-1.30 µg/g.

[The tk gene mutation analysis in WTK1 cell line by multiplex PCR].

OBJECTIVE: To explore the tk gene mutation spectrum in spontaneous and induced WTK1 mutants. METHODS: After exposure to methyl methanesulfonate (MMS), mitomycin (MMC) or sodiam azide (NaN3), spontaneously-arising and induced mutants of WTK1 cell line were selected. The spectrum and hotspot of tk gene mutation were analyzed by multiplex PCR. RESULTS: Three chemicals used in this study induced tk mutation frequency (MF) to increase significantly in a dose-dependent manner; most of the analyzed mutants had lost exon 4 and exon 5-7. CONCLUSION: Three chemicals have mutagenic effect on WTK1 cell line, and obvious hotspot exists in tk gene mutation.

[Comparison of TK gene mutation assay in TK6 and TK6-E6 cell induced by vinblastin and colcemid].

OBJECTIVE: To compare TK gene mutation assay in human lymphoblastoid cell lines TK6 and TK6-E6 induced by vinblastin and colcemid. METHODS: Regular TK gene mutation assays were experimented to detect cytotoxicity and mutation frequency at tk locus after TK6 and TK6-E6 human lymphoblastoid cells were treated with vinblastin and colcemid for 24h. RESULTS: Relative survival (RS%) and Relative suspension growth (RSG%) of TK6 and TK6-E6 cells decreased when concentrations of vinblastin and colcemid increased. RS% and RSG% of TK6-E6 cells were higher than that of TK6 cells at the same doses. TK6 and TK6-E6 cells both were induced by vinblastin and colcemid. The TK6-E6's nature mutation frequency, induced mutation frequency and percentage of slow growth mutant (SG%) were lower than TK6' s at the same dose except group CCM 5.0ng/ml in MF and group CCM 0.625ng/ml in SC%. CONCLUSION: Both TK6 and TK6-E6 cell lines can be used in TK gene mutation assay, but TK6-E6 cell line was recommended to be used in the assay for its less quantity and doubling time.

[Analysis of loss of heterozygosity induced by vinblastine at tk locus in human lymphoblastoid cell line TK6].

OBJECTIVE: To establish TK gene mutation assay using human lymphoblastoid cell line TK6 and to study the genotoxic mechanism of Vinblastine (VBL). METHODS: TK6 cells were treated with Vinblastine at different concentrations (0.625 ng/mL, 1.250 ng/mL, 2.500 ng/mL and 5.000 ng/mL)for 24 h and TK gene mutation assay were experimented. Relative survival (RS%), relative suspension growth (RSG%), mutation frequency at tk locus and percentages of slow growth mutant (SC%) were detected and loss of heterozygosity (LOH) of mutants were analyzed. RESULTS: A decreased RS% and RSG% and an increased mutation frequency at tk locus were observed in a dose-dependent manner when the TK6 cells were treated with 0.625, 1.250, 2.500 and 5.000 ng/mL of Vinblastine respectively for 24 h. The result demenstrated that about 96.4% of Vinblastine-induced mutants were LOH. Among them, 39.3% were hemi-LOH and 57.1% were homo-LOH respectively. CONCLUSION: TK6 cell line can be used to detect the genotoxicity of Vinblastine and LOH was the major mutation events in Vinblastine-induced mutants.

[TK locus mutation assay: comparison of L5178Y and TK6 cell lines].

OBJECTIVE: To compare the advantages and disadvantages of utilizing L5178Y and TK6 cell lines in the TK locus mutation assay. METHODS: The two cell lines were used for detecting and assessing the mutability of four chemicals (MMS, EMS, MMC and KCl); the microwell method of TK locus mutation assay was adopted. RESULTS: The two cell lines brought about similar results in the study. The tolerance of TK6 to all four chemicals was lower than that of L5178Y, and all the relative mutation indices of TK6 were higher than those of L5178Y. CONCLUSION: Each of the two cell lines has its own strong points; nevertheless, the authors recommend the applications of TK6 cell in the assay system since this cell line comes from human.