circTADA2A inhibited SLC38A1 expression and suppresses melanoma progression through the prevention of CNBP trans-activation.

BACKGROUND: CircTADA2A has been demonstrated to play critical roles in the occurrence and development of human cancer. However, the expression pattern and biological mechanisms of circTADA2A in melanoma remains largely unknown. METHODS: CircTADA2A were detected by quantitative real-time RT-PCR (qRT-PCR) and validated by Sanger sequencing. Function of circTADA2A and its protein partner in melanoma cells was investigated using RNA interference and overexpression assays. Interaction of circTADA2A, CCHC-type zinc finger nucleic acid binding protein (CNBP) and solute carrier family 38 member 1 (SLC38A1) was confirmed by RNA immunoprecipitation, RNA pull-down, and dual-luciferase reporter assay. The expression of genes and proteins were detected by qRT-PCR and western blot assays. RESULTS: Data from the investigation showed that a novel circRNA (circTADA2A, hsa_circ_0043278) was markedly downregulated in melanoma cells. Functionally, circTADA2A repressed cell proliferation, migration, invasion in melanoma cells. Mechanistically, circTADA2A interacted with CNBP, acting to suppress the binding of CNBP to the SLC38A1 promoter and subsequently restrained SLC38A1 transcription, which resulting in repression of melanoma progression. CONCLUSIONS: CircTADA2A suppresses melanoma progression by regulating CNBP/SLC38A1 axis, indicating a potential therapeutic target in melanoma.

Metformin Protects Against Acute Kidney Injury Induced by Lipopolysaccharide via Up-Regulating the MCPIP1/SIRT1 Pathway.

In the present study, we aimed to explore the effect and underlying mechanism of metformin on lipopolysaccharide (LPS)-induced acute kidney injury (AKI). A total of 24 BALB/C mice were randomly divided into four groups: control group, LPS group and metformin group (50 or 100 mg/kg). The histological changes and cell apoptosis in kidney tissues were detected by hematoxylin-eosin staining and terminal-deoxynucleotidyl transferase-mediated nick end labeling assay, respectively. Enzyme-linked immunosorbent assay was applied to determine serum levels of blood urea nitrogen (BUN), kidney injury molecule-1 (Kim-1), creatinine (Cre), tumor necrosis factor-α (TNF-α), and interleukin-1ß (IL-1ß). Western blotting analysis were carried out to confirm the expressions of monocyte chemotactic protein-inducible protein 1 (MCPIP1), silent information regulator sirtuin 1 (SIRT1), and NF-κB p65 (acetyl K310). Compared with the control group, the mice in LPS group had glomerular capillary dilatation, renal interstitial edema, tubular cell damage and apoptosis. The serum levels of BUN, KIM-1, Cre, TNF-α, and IL-1ß in LPS group were significantly higher than those in control group. Moreover, LPS also elevated the expressions of MCPIP1 and NF-κB p65 (acetyl K310) but decreased the expression of SIRT1 in kidney tissues. However, metformin distinctly decreased LPS-induced renal dysfunction, the serum levels of BUN, KIM-1, Cre, TNF-α, and IL-1ß. In addition, metformin markedly increased the expressions of MCPIP1 and SIRT1 but decreased the expression of NF-κB p65 (acetyl K310) in kidney tissues. Metformin prevented LPS-induced AKI by up-regulating the MCPIP1/SIRT1 signaling pathway and subsequently inhibiting NF-κB-mediated inflammation response.

Wastewater inputs reduce the CO2 uptake by coastal oceans.

Every year a large quantity of wastewater is generated worldwide, but its influence on the carbon dioxide (CO2) uptake by coastal oceans is not well understood. Here, sea surface CO2 partial pressure (pCO2) and air-sea CO2 flux were examined in the Jiaozhou Bay (JZB), a temperate coastal bay strongly disturbed by wastewater inputs. Monthly surveys from April 2014 through March 2015 showed that surface pCO2 in the JZB substantially varied both temporally and spatially between 163 µatm and 1222 µatm, with an annual average of 573 µatm. During April-December, surface pCO2 was oversaturated with respect to the atmosphere, with high values exceeding 1000 µatm in the northeastern part of the bay, where seawater salinity was low mainly due to the inputs of wastewater with salinity close to zero. During January-March, surface pCO2 was undersaturated, with the lowest value of <200 µatm also mainly in the northeastern part because of low water temperature and strong biological production. Over an annual cycle, apparently sea surface temperature dominated the monthly variation of surface pCO2 in this shallow bay, while wastewater inputs and related biological production/respiration dominated its spatial variability. Overall, the JZB was a net CO2 source to the atmosphere, emitting 9.6 ± 10.8 mmol C m-2 d-1, unlike its adjacent western part of the Yellow Sea and most of the temperate coastal oceans which are a net CO2 sink. This was possibly associated with wastewater inputs that cause high sea surface pCO2 via direct inputs of CO2 and degradation of organic matter. Thus, from this viewpoint reducing wastewater discharge or lowering CO2 levels in discharged wastewater may be important paths to enhancing the CO2 uptake by coastal oceans in the future.

Accelerated Wound Healing in Diabetic Rat by miRNA-185-5p and Its Anti-Inflammatory Activity.

Aim: Addressing both inflammation and epithelialization during the treatment of diabetic foot ulcers is an important step, but current treatment options are limited. MiRNA has important prospects in the treatment of diabetic foot refractory wound ulcers. Previous studies have reported that miR-185-5p reduces hepatic glycogen production and fasting blood glucose levels. We herein hypothesized that miR-185-5p might play an important role in the field of diabetic foot wounds. Materials and Methods: MiR-185-5p in skin tissue samples from patients with diabetic ulcers and diabetic rats were measured using quantitative real-time PCR (qRT-PCR). The streptozotocin-induced diabetes rat model (male Sprague-Dawley rats) for diabetic wound healing was conducted. The therapeutic potential was observed by subcutaneous injection of miR-185-5p mimic into diabetic rat wounds. The anti-inflammation roles of miR-185-5p on human dermal fibroblast cells were analyzed. Results: We found that miR-185-5p is significantly downregulated in diabetic skin (people with DFU and diabetic rats) compared to controls. Further, in vitro upregulation of miR-185-5p decreased the inflammatory factors (IL-6, TNF-α) and intercellular adhesion molecule 1 (ICAM-1) of human skin fibroblasts under advanced glycation end products (AGEs). Meanwhile, the increase of miR-185-5p promoted cell migration. Our results also confirmed that the topical increase of miR-185-5p decreases diabetic wound p-nuclear factor-κB (p-NF-κB), ICAM-1, IL-6, TNF-α, and CD68 expression in diabetic wounds. MiR-185-5p overexpression boosted re-epithelization and expedited wound closure of diabetic rats. Conclusion: MiR-185-5p accelerated wound healing of diabetic rats, reepithelization, and inhibited the inflammation of diabetic wounds in the healing process, a potentially new and valid treatment for refractory diabetic foot ulcers.

Spatiotemporal distribution, source identification and inventory of microplastics in surface sediments from Sanggou Bay, China.

Microplastic pollution has become a major global environmental issue. Yet the source identification and inventory of microplastics in mariculture areas remain unclear. Here we investigated the spatiotemporal distribution, source and inventory of microplastics in surface sediments from Sanggou Bay, China. The results showed that average abundance of microplastics in the surface sediments was 1674 ± 526 items/kg dry weight, which represented a heavy level when compared with other sea areas, including coastal waters, estuaries, the open sea and other mariculture areas. Microplastics with a size of <0.5 mm were dominant throughout four seasons. The dominant shape of microplastics was granule in summer, autumn and winter, and film in spring, respectively. The most common color of microplastics was transparent. Polyethylene was the dominant polymer in summer, autumn, and winter, while polystyrene accounted for the largest proportion in spring. Approximately 57.72% of the microplastics in surface sediments originated from the plastic mariculture facilities, suggesting that mariculture makes a significant contribution to microplastic pollution in Sanggou Bay. Estimated inventory of microplastics in surface sediments of Sanggou Bay was 183.73 tons. Our results improve the understanding of risks caused by mariculture-derived microplastics to marine ecosystem and human health.

Sea surface pCO2 in an urbanized coastal system (Jiaozhou Bay, China) during summer.

Various biogeochemical processes complicate carbon dioxide (CO2) behaviour in coastal oceans. Through eight summer surveys, detailed variations in CO2 mechanisms in the urbanized Jiaozhou Bay, China, were analysed. During the rainless period, respiration and dissolved inorganic carbon input from treated wastewater made the northeastern region a strong CO2 source, while the western region with cleaner seawater was a weak source because calcium carbonate (CaCO3) precipitation exceeded primary production. Rainfall events with different intensities and locations caused significantly different effects. When rainfall occurred over the sea, enhanced primary production caused a CO2 sink; when rainfall induced little terrestrial pollutant input, CaCO3 precipitation exceeded net primary production, leading to a CO2 source. When heavy rain caused bulk runoff, the northeastern region was a strong CO2 source because rivers flowing through downtown regions inputted considerable organic matter, while in the western region, runoff through suburbs and wetlands led to a strong sink.

Variations in dissolved inorganic carbon species in effluents from large-scale municipal wastewater treatment plants (Qingdao, China) and their potential impacts on coastal acidification.

With rapid development of global wastewater treatment plants (WWTPs), acidification and enhanced CO2 release in receiving waters caused by high-CO2 treated wastewater input have raised concerns. Insights into the variations in dissolved inorganic carbon (DIC) species in treated wastewater contribute to understanding the mechanisms of the acidification process. Here, we investigated three large-scale municipal WWTPs that discharged into the coast of Qingdao, China, for variations in effluent DIC species and their control mechanisms. The results showed that the effluent DIC concentrations, with a range of 2554-5718 µmol/L, significantly exceeded the concentration in seawater and mainly increased from winter to spring and decreased from summer to autumn. The effluent DIC and its δ13CDIC showed a good negative correlation. The ratios of effluent DIC to total alkalinity (DIC/TAlk) ranged from 1.00 to 1.24, and the proportions of CO2 in DIC ranged from 0.9 to 19.7%; both sets of values significantly exceeded those in seawater. The proportions of CO32- in DIC were only ~ 0.4%. These features determined that the CO2 concentrations in effluents fluctuated from 3 to 80 times the concentration in seawater, whereas the CO32- concentrations were less than 1/15 of those in seawater. Organic matter degradation and nitrogen removal processes made important contributions to the high effluent CO2 concentrations. The increase in solubility induced by decreased temperature may be the main cause for the higher effluent CO2 concentrations during winter as well as spring months with low effluent temperatures. Correspondingly, the effluent pH values were significantly lower than the seawater pH values and showed a good negative logarithmic correlation with the DIC/TAlk values, reflecting the control of DIC species on the pH values in treated wastewater. Variations in DIC species in treated wastewater can cause changes in the affected region and the degree of the induced acidification in receiving waters.

Treated Wastewater Changes the Export of Dissolved Inorganic Carbon and Its Isotopic Composition and Leads to Acidification in Coastal Oceans.

Human-induced changes in carbon fluxes across the land-ocean interface can influence the global carbon cycle, yet the impacts of rapid urbanization and establishment of wastewater treatment plants (WWTPs) on coastal ocean carbon cycles are poorly known. This is unacceptable as at present ∼64% of global municipal wastewater is treated before discharge. Here, we report surface water dissolved inorganic carbon (DIC) and sedimentary organic carbon concentrations and their isotopic compositions in the rapidly urbanized Jiaozhou Bay in northeast China as well as carbonate parameters in effluents of three large WWTPs around the bay. Using DIC, δ13CDIC and total alkalinity (TA) data and a tracer model, we determine the contributions to DIC from wastewater DIC input, net ecosystem production, calcium carbonate precipitation, and CO2 outgassing. Our study shows that high-DIC and low-pH wastewater effluent represents an important source of DIC and acidification in coastal waters. In contrast to the traditional view of anthropogenic organic carbon export and degradation, we suggest that with the increase of wastewater discharge and treatment rates, wastewater DIC input may play an increasingly more important role in the coastal ocean carbon cycle.

Effects of aerobic respiration and nitrification on dissolved inorganic nitrogen and carbon dioxide in human-perturbed eastern Jiaozhou Bay, China.

Aerobic respiration and nitrification are important processes for dissolved inorganic nitrogen (DIN) composition change and CO2 production in human-perturbed coastal waters. On-site incubations and field investigations were conducted in the eastern Jiaozhou Bay, a high-urbanization region, from May to August 2014. Results show that aerobic respiration rates reached 15.58µmolO2L-1d-1, and NH4+ and NO2- oxidation rates were 0.53 and 0.13µmolNL-1d-1, respectively, in the human-perturbed northeastern area. The intense aerobic respiration there contributed to high-concentration NH4+, and meanwhile caused a pH decrease of 0.042units and a pCO2 increase of 166µatm per day. Moreover, the linear relationship between excess CO2 and apparent oxygen utilization suggested that the excess CO2 in the entire eastern Jiaozhou Bay was mainly from the aerobic respiration. This study may help us better understand the role of aerobic respiration in DIN composition and CO2 sink/source pattern in coastal waters.

Bioinformatics analysis of differentially expressed proteins in prostate cancer based on proteomics data.

We mined the literature for proteomics data to examine the occurrence and metastasis of prostate cancer (PCa) through a bioinformatics analysis. We divided the differentially expressed proteins (DEPs) into two groups: the group consisting of PCa and benign tissues (P&b) and the group presenting both high and low PCa metastatic tendencies (H&L). In the P&b group, we found 320 DEPs, 20 of which were reported more than three times, and DES was the most commonly reported. Among these DEPs, the expression levels of FGG, GSN, SERPINC1, TPM1, and TUBB4B have not yet been correlated with PCa. In the H&L group, we identified 353 DEPs, 13 of which were reported more than three times. Among these DEPs, MDH2 and MYH9 have not yet been correlated with PCa metastasis. We further confirmed that DES was differentially expressed between 30 cancer and 30 benign tissues. In addition, DEPs associated with protein transport, regulation of actin cytoskeleton, and the extracellular matrix (ECM)-receptor interaction pathway were prevalent in the H&L group and have not yet been studied in detail in this context. Proteins related to homeostasis, the wound-healing response, focal adhesions, and the complement and coagulation pathways were overrepresented in both groups. Our findings suggest that the repeatedly reported DEPs in the two groups may function as potential biomarkers for detecting PCa and predicting its aggressiveness. Furthermore, the implicated biological processes and signaling pathways may help elucidate the molecular mechanisms of PCa carcinogenesis and metastasis and provide new targets for clinical treatment.

[Clinical research of percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fractures of aged people].

OBJECTIVE: To investigate the feasibility of using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people. METHODS: From June 2011 to May 2013, 91 patients with closed and fresh Barton fracture were analyzed retrospectively which information was complete. According to different methods these patients were divided into three groups: 33 patients in group A were treated by simplex fixation of gypsum or splint after manipulative reduction, including 20 males and 13 females with an average age of (63.27 ± 5.83) years old; 35 patients in group B were treated by percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation, including 23 males and 12 females with an average age of (64.25 ± 4.53) years old; 23 patients in group C were treated by open reduction and internal fixation including 15 males and 8 females with an average age of (64.04 ± 4.83) years old. RESULTS: All the patients were followed up for 10 to 16 months with an average of 12 months by the method of recheckging in outpatient clinic. According Dienst scoring system: in group A, the result was excellent in 15 cases, good in 7 cases, fair in 11 cases; in group B, excellent in 25 cases, good in 6 cases, fair in 4 cases; in group C, excellent in 16 cases, good in 5 cases, fair in 2 cases. The excellent and good rate of group C was better than that of group B and A, further more group B is better than group A. According to X- ray standard, in group A, 26 patients were acceptable, 7 patients were unacceptable; in group B,28 patients were acceptable, 7 patients were uacceptable; in group C, 19 patients were acceptable,4 patients were unacceptable; there were no statistical significant difference (P > 0.05). There were 18 patients with emerging recrispation in group A, 10 patients in group B, 6 patients in group C, the result of group B and C was better than that of group A, and there was no statistically significant between group B and C (P > 0.05). CONCLUSION: Using percutaneous K-wires fixation after manipulative reduction combining with gypsum or splint fixation for treatment of the Barton fracture of aged people is an effective method, it has advantages of micro-invasived, reliable fixation, less complication, not need to fix wrist joint and early functional exercise.

[Design of the reduction fixator and its clinical application in treating fracture of lesser trochanter of femur].

OBJECTIVE: To discuss the clinical significance of the reduction and fixation for femoral lesser trochanteric fragment in treating the femoral comminuted intertrochanteric fractures. METHODS: From January 2012 to December 2013,32 patients with intertrochanteric fractures were treated by surgery, and self-designed reduction fixators were used in the patients for the fixation of lesser trochanter of femur. There were 11 males and 21 females, ranging in age from 45 to 81 years old with an average of 64 years old. According to the Evans typing, 12 cases were type II, 13 cases were type III and 7 cases were type IV. Simple lag screw fixed in 19 cases and steel wire fixed in 13 cases. Hip joint function was evaluated according Harris score and the complications such as coxa adducta,cutting of femoral head and neck,implants breakage were observed. RESULTS: Thirty-two patients were followed up from 9 to 24 months with an average of 13 months. Coxa adducta occurred in 1 case,no cutting of femoral head and neck occurred and implants breakage were found. The mean Harris score was 91.80 ± 3.05 in 32 patients. CONCLUSION: The reconstruction and fixation for the posterior medial bone cortex continuity is a key factor on affect the stability of femoral intertrochanteric fracture. Self-designed reduction fixators can effective reduce and fix the lesser trochanter of femur, it has advantage of fast reduction and fixation, and simple operation.

A three-dimensional water quality model to evaluate the environmental capacity of nitrogen and phosphorus in Jiaozhou Bay, China.

Jiaozhou Bay has recently suffered from serious problems with pollution and eutrophication. Thus, land-based pollutant load must be reduced through a national control program. In this study, we developed a 3D water quality model to determine the environmental capacity of nitrogen and phosphorus in Jiaozhou Bay. A 3D hydrodynamic model (the estuarine, coastal, and ocean modeling system with sediments) was coupled with a water quality model, which was adapted from the dynamic model of nitrogen and phosphorus for a mesocosm near Jiaozhou Bay. The water quality model is divided into seven components: dissolved inorganic nitrogen, phosphate, phytoplankton, zooplankton, detritus, dissolved organic nitrogen, and dissolved organic phosphorus. Furthermore, it was calibrated based on data collected from Jiaozhou Bay in 2003. The proposed model effectively reproduced the spatiotemporal variability in nutrient concentration, thus suggesting that a reasonable numerical representation of the prototype system must be developed for further evaluation of environmental capacity.

[Investigation of operative process in treating lumbar intervertebral disc protrusion in aged patients].

OBJECTIVE: To investigate the operative management and surgical techniques for lumber disc herniation (LDH) in aged patients (>or=65 years). METHODS: From 2005 to 2010,the data of 43 patients with LDH underwent surgical treatment were retrospectively analyzed. There were 25 males and 18 females,aged from 65 to 70 years old with an average of 67.6 years. The course of disease was from 6 weeks to 7 years with an average of 10.2 years. Fenestratiodn discectomy or extended fenestration discectomy and unilateral or bilateral fenestration were used according to the conditions of location,type of herniated macleos polposus and nerve root compression. Among the patients,the nerve root canal was enlarged,hyperplastic osteophyma and soft tissue were removed, bilateral articular process was reserved in order to maintain the stability of the lumbar segment. RESULTS: All the patients were followed up from 1.2 to 5.2 years. According to the criteria of HU you-gu, 25 cases got excellent results, 15 good, 2 fair and 1 poor. No infection or nerve injury was found. Nerve function of patients had a normal or near normal recovery. CONCLUSION: For the treatment of LDH in aged patents,it is key that reasonably choose the operative method, completely remove the hyperplasy of diseased region and enlarge the nerve root canal, thoroughly loose the nerve root.

[Transpedicular porking and grafting for the treatment of thoracolumbar spinal fracture].

OBJECTIVE: To investigate the application of transpedicular porking repositor, thread device and transpedical interbody bone grafting apparatus in the treatment of thoracolumbar spinal fracture. METHODS: From March 2008 to March 2011, 17 males and 15 females with thoracolumbar spinal fracture were treated by using self-designed transpedicular porking reposito, thread device and transpedical interbody bone grafting apparatus. The average age was 39.4 years (ranged from 25 to 65 years). All the cases were checked by X-ray and CT before and one week, one year after operation, removal of internal fixation. The angle of injured vertebral sagittal, cobbs angle and injured vertebral height were measured. RESULTS: All patients were followed up, and the duration ranged for 14 to 21 months (averaged 16 months). The content of following up included loss of ithycyphos and height of spinal, fracture healing and implant fixation. Nerve vascular complication caused by implantation didn't occurred; interverbral body fusion was good. The results preoperative, 1 week and year postoperative and 3 months after taking out the internal fixation showed injured spinal height maintained well, loss and collapse of height and angle did not occurred. CONCLUSION: Treating thoracolumbar spinal fracture can obtained satisfactory effects by using transpedicular porking repositor, thread device and transpedical interbody bone grafting apparatus. It has advantages of minimal invasive, and can promote fracture healing earlier, recover spinal height, rebuild stability of spinal, prevent loss and collapse of vertebral body height to avoid anterior lumbar surgery on the late stage.

Distribution and seasonal variation in the partial pressure of CO2 during autumn and winter in Jiaozhou Bay, a region of high urbanization.

We investigated the partial pressure of carbon dioxide (pCO(2)) in Jiaozhou Bay (JZB), which is surrounded by the economically developed city of Qingdao, during two cruises undertaken in November, 2007 (autumn) and February, 2008 (winter). Results indicated that sea surface pCO(2) in autumn varied between 315 and 720 µatm, with an average level of 418 µatm. In winter the sea surface pCO(2) ranged from 145 to 315 µatm with an average of 249 µatm, which is below atmospheric pCO(2). Despite seasonal temperature variation between autumn and winter, it was noted that biological process (production and respiration) were responsible for both spatial and seasonal variation during these seasons. We found that Jiaozhou Bay served as a net atmospheric CO(2) source in autumn (November) (2.87 mmol m(-2)d(-1)), while in winter (February) it served as a net sink (-16.22 mmol m(-2)d(-1)).

[Diagnosis of medial collateral ligament injury by stress X-ray and MRI of knee joint].

OBJECTIVE: To study the application of stress X-ray of knee joint for the diagnosis ot medial collateral ligament injury. METHODS: From January 2008 to June 2011, 46 patients with medial collateral ligament injury were reviewed. Among the patients, 32 patients were male and 14 patients were female, ranging in age from 28 to 72 years, with an average of (49.46 +/- 22.54) years. Left knee joint injuries occurred in 22 patients, and 24 patients had injuries in right knee joint. Thirty-one patients were treated with surgical method, and 15 patients were treated with conservative method including 1 patient finally received operation after 3 months treatment with conservative method without effect. The injury side and normal side were observed by X-ray under stress and non-stress, as well as MRI. Operation was used to treat patients with medial gap markedly widen and the deep layer of medial collateral ligament injury in MRI. A line (line A) was drawn from medial condyle to lateral condyle of tibia platform. The line A was translated to the inner margin of condylus medialis femoris, which was line B. The perpendicular distance was measured, which was line C. The ration of space difference (R) was calculated by (space at stress force of injured side-space at non-stress force of injured side)/(space at stress force of normal side-space at non-stress force of normal side). The relationship between R and ligament injury type were investigated. RESULTS: There were 17 patients with injuries of superficial lamella, 21 patients with injuries of deep lamella. Eight patients had associated injuries of articular capsule and posterior cruciate ligament. When R value was between 1.51 to 5.24, the injury of superficial ligament was found in 15 patients, actual injuries were found in 17 patients. When R value between 5.28 and 13.85, the injuries of bathypelagic ligament were found in 19 patients, actual injuries were found in 21 patients. When R value was between 15.61 and 26.25, the associated injuries of articular capsule and posterior cruciate ligament were found in 7 patients, actual injuries were found in 8 patients. CONCLUSION: Using the specific value as the standard of measurement can provide the quantizatily fractionation of the medial collateral ligament injury.

[Diagnosis and treatment of tarsometatarsal joint complex injury].

OBJECTIVE: To explore the diagnosis and treatment of tarsometatarsal joint complex injury (TJC). METHODS: From January 2007 to January 2009,16 patients with tarsometatarsal joint complex injury were treated with open reduction and internal fixation. There were 12 males and 4 females, ranging in age from 21 to 45 years with an average of 34.1 years. Seven cases were left and 9 cases were right and all injuries caused by direct violence. Four cases caused by traffic accident 5 by fall from high and 7 by crush injury. Intercuneiform dislocation were in 11 cases, naviculocuneiform joint dislocation in 3 cases and cuboid fracture in 2 cases. All the cases were three column injuries. According to the situation of exploring and the stability, screw fixation was used for intertarsal joint, internal and middle column tarsometatarsal joint, the Kirschner wire fixation for external column and miniature plate fixation for comminuted fracture of metatarsal bones and compressible fracture of cuboid. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional scale was used to evaluate the clinical effect. RESULTS: All the patients were followed up,the duration ranged from 6 to 18 months(averaged 12.6 months). According to the score system of AOFAS,the total score was (74.6+/-10.4 ) points, including pain items of (29.3+/-5.9), the score of functional items of (32.4+/-5.6) points, and power lines of (12.9+/-2.6). All the incisions were primarily healed without infection, skin necrosis,fixture broken or loosen. Three cases received arthrodesis due to osteoarthritis. Four cases were followed up continually because they only had the radiologic osteoarthritis without pain. CONCLUSION: Anatomical reduction and stable fixation is the key point of the treatment of tarsometatarsal joint complex injury. Open reduction and internal fixation at the first stage is good for secondary arthrodesis.

[Treatment of double injuries of superior shoulder suspensory complex].

OBJECTIVE: To explore operative method for the treatment of double injuries of superior shoulder suspensory complex (SSSC). METHODS: From January 2008 to March 2010,11 patients wiht SSSC injuries were treated, including 9 males and 2 females with an average age of 38 years (ranged from 20 to 47 years). The patients were treated with 4 methods as follows: 4 patients with fractures of neck of scapula combined with homolateral fracture of clavicle were treated with reconstituted plates; 2 patients with fractures of coracoid process or disruption of coracoclavicular ligament combined with the fracture of extremitas acromialis claviculae or acromioclavicular dislocation were treated with clavicular hook plates and cannulated compression screws; 3 patients with injuries of basilar part of acromial process combined with the glenoid cavity and acromioclavicular articulation were treated with reconstuction plates and clavicular hook plates; 2 patients with fractures of acromial process combined with acromioclavicular dislocation and the fracture of lateral third of clavicle were treated with small "T" plates and clavicular hook plates. RESULTS: Among 11 patients, 9 patients were followed up with an average duration of 9.2 months (ranged from 6 to 12 months). All the fractures were healed without bone nonunion or failure of internal fixators. The average union time was 2.6 months. The profile of articulatio capitis humeri was normal and hibateral articulatio capitis humeri was symmetrical without crispation, descensus, adduct and adtorsion of articulatio capitis humeri or other abnormity. According to the Constant-Murley evaluation system, the score ranged from 69 to 100, with an average of 89.7, which included average pain score of 10 to 15, daily activities score of 14 to 20, myodynamia score of 15 to 25, territory score of 34 to 40. CONCLUSION: The double injuries of SSSC should be treated by types to recover the integrity and constancy of SSSC.

[Treatment of tarsometatarsal joint injury combined with metatarsal fracture by open reduction and internal fixation].

OBJECTIVE: To evaluate the therapy and the key points of the tarsometatarsal joint injury combined with metatarsal fracture. METHODS: From Jan. 2006 to Jul. 2008,19 patients with tarsometatarsal joint injury combined with metatarsal fracture were treated with opened reduction and internal fixation of Kirschner wire or screws, included 13 males and 6 females with an average age of 38.1 years ranging from 21 to 56 years. The classification of tarsometatarsal joint injury showed that there were 2 cases of inner column injury, 5 cases of inner and medial column injury, 3 cases of lateral and medial column injury, 9 cases of tri-column injury. There were 8 cases of shaft fracture, 7 of neck fracture, 19 of foundation fracture. RESULTS: All the incisions were first stage healed without skin necrosis. The healing time of fracture was 11.2 weeks on average. All the patients were followed-up for 6 to 17 months with an average of 12.8 months. According to the standard of AOFAS, the average score was (84.500 +/- 8.553), the results were excellent in 4 cases, good in 9 cases, fair in 3, and poor in 3. The regular daily life was recovered after 6.4 months, 3 patients suffer from mild osteoarthritis. CONCLUSION: No matter which fixed mode was used, the anatomical reduction was the most important to rebuild arches of the foot and recover medial longitudinal and lateral arch. Rebuilding arches of the foot guaranteed the integrity of the stress point scaffold and avoided the pain and limp. The anatomical reduction of tarsometatarsal joint and metatarsal was also important to rebuild the function of foot.