A clinical study of a novel manual screw placement based on anatomical study of the 7th cervical vertebra / 中华创伤骨科杂志

Objective:To evaluate the feasibility, accuracy, effectiveness and safety of a novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction.Methods:A retrospective case series study was conducted to analyze the 35 patients with injury to the lower cervical spine or cervicothoracic junction who had been treated by a novel manual placement of cervical 7 pedicle screws at Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University from March 2015 to July 2021. There were 16 males and 19 females, with an age of (52.7±13.2) years. The core of this placement was to determine the entry point of cervical 7 pedicle screws. After the intersection of the upper edge of the cervical 7 lamina and the medial edge of the superior articular process was recorded as point A while the intersection of the lateral edge of the inferior articular process and the lower edge of the transverse process as point B, the intersection of the outer and middle 1/3 of the AB line was taken as the screw entry point, with the screw placement angle perpendicular to the lamina line or slightly inclined from 30° to 40° to the head side and outward. The length, diameter and placement angle of the cervical 7 pedicle screws were recorded and compared postoperatively between the left and right sides to explore the feasibility of this novel manual placement. According to the Rampersaud method, the screw positions were graded 1 week and 6 months after operation to evaluate the accuracy of this manual placement. The visual analogue scale (VAS) and the Japanese Orthopaedic Association (JOA) score were compared between preoperation, 1 week and 6 months after operation to evaluate the effectiveness of this placement. The postoperative complications were counted to evaluate the safety of this method. Loosening, displacement and breakage of the screws were observed by CT scanning at 6 months after operation.Results:This case series was followed up for (9.8±1.7) months. There was no significant difference in the length, diameter or placement angle of the screws between the left and right sides ( P>0.05). A total of 66 cervical 7 pedicle screws were placed. There was no change in the screw position grading at 1 week or 6 months after surgery. Grade A was achieved in 64 screws, Grade B in 2 screws, and Grade C or D in none. The VAS scores before operation, 1 week and 6 months after operation were respectively 4.4±1.7, 3.8±1.0 and 1.1±1.1, and the JOA scores respectively 6.7±2.2, 13.2±1.5 and 15.3±1.2. The VAS and JOA scores at 1 week and 6 months after operation were significantly improved compared with the preoperative values ( P<0.05). The improvement rates in JOA at 1 week and 6 months after operation were 62.7%±13.3 % and 83.9%±11.6%, respectively. There were no complications related to the placement of cervical 7 pedicle screws; there was no wound hematoma or infection. No loosening, displacement or breakage of the screws was observed by the 6-month follow-up. Conclusion:The novel manual placement of cervical 7 pedicle screws via the posterior approach of cervicothoracic junction is feasible, accurate, effective and safe.

Effects of total shoulder arthroscopy versus small-incision rotator cuff repair for rotator cuff injury / 中国基层医药

Objective:To investigate the effects of total shoulder arthroscopy versus small-incision rotator cuff repair on shoulder range of motion, postoperative pain, and complications in patients with rotator cuff injury. Methods:The clinical data of 106 patients with rotator cuff injuries treated in Yiwu Central Hospital between June 2018 and July 2021 were retrospectively analyzed. These patients were divided into an observation group and a control group according to different treatment regimens, with 53 patients in each group. The control group underwent arthroscopic small-incision rotator cuff repair. The observation group underwent total shoulder arthroscopy. Perioperative indicators, pain (Visual Analogue Scale score) before surgery and 1, 3, and 6 months after surgery, shoulder range of motion and shoulder-elbow function before surgery, and 3 and 6 months after surgery and postoperative complications were compared between the two groups.Results:Operative time in the observation group was significantly longer than that in the control group [(98.67 ± 12.31) minutes vs. (85.72 ± 10.53) minutes, t = 5.82, P < 0.01). Intraoperative blood loss, postoperative passive shoulder expansion time, and hospital stay in the observation group were (28.66 ± 3.12) mL, (5.61 ± 1.03) days, and (14.17 ± 2.26) days, which were significantly shorter than (37.68 ± 3.59) mL, (7.22 ± 1.41) days and (17.21 ± 3.04) days in the control group ( t = 13.81, 6.71, 5.86, all P < 0.01). After surgery, the Visual Analogue Scale score in each group significantly decreased compared with that before surgery (both P < 0.05). At 1, 3, and 6 months after surgery, the Visual Analogue Scale score in the observation group was (2.46 ± 0.63) points, (1.53 ± 0.42) points, and (1.03 ± 0.26) points, respectively, which were significantly lower than (3.04 ± 0.74) points, (1.84 ± 0.51) points, and (1.21 ± 0.34) points in the control group ( t = 4.35, 3.42, 3.06, all P < 0.01). At 3 and 6 months after surgery, the ranges of motion of shoulder abduction, external rotation, and internal rotation in each group significantly increased compared with those before surgery (all P < 0.05). The scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles in each group were significantly increased compared with those before surgery (both P < 0.05). After treatment, there were no significant differences in the scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles between the two groups (both P < 0.05). By 6 months after surgery, the incidence of complications in the control group was 3.77%. No obvious complications were observed in the observation group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.51, P > 0.05). Conclusion:Compared with small-incision rotator cuff repair, total arthroscopic rotator cuff repair has less invasive trauma and mild pain and is more conducive to postoperative shoulder function recovery.

Minimally invasive hybrid surgery for Stanford B aortic dissection involving the aortic arch / 中华胸心血管外科杂志

Objective:To investigate the effect and safety of one-staged hybrid surgery in the treatment of complicated Stanford B aortic dissection.Methods:246 consecutive patients who underwent one-staged hybrid technique with complicated type B aortic dissection (cTBAD) between January 2014 and July 2020 were retrospectively reviewed. The perioperative mortality and morbidity of the hybrid technique was assessed and the early results of follow up were evaluated.Results:The mean age of patients was(57.1±11.2)years old, and 175 (71.1%) were male. There were 166 cases of left common carotid artery-left subclavian artery vessels bypass + TEVAR (A group), operation time(62±8)min, post-operated hospitalization(5.2±1.3)days; 62 cases of right common carotid artery-left common carotid artery vessels bypass+ left common carotid artery-left subclavian artery vessels bypass + TEVAR (B group), operation time(88±12)min, post-operated hospitalization(6.1±1.8)days; 18 cases of debranch + TEVAR, operation time(236±36)min, post-operated hospitalization(8.8±2.1)days. 246 patients underwent hybrid procedure successfully (The technique success rate was 100%). 1 patient(0.4%)with traumatic aortic dissection (with cerebral trauma) died after operation 7 days. The average follow-up period was 5 years(30.3±7.1)xmonths. 236 patients(96%) without endoleak, 10 patients(4%)with proximal endoleak, 5 patients with regular follow-up, 5 patients with surgical treatment during one year (3 patients with re-TEVAR; 2 patients with opening operation); 25 patients(10.2%)incision hematomas, all these patients settled with closely observing and conservative treatment, and all these patients without reintervention. The rate of second intervention was 2% (5/246) the patency of bridging vessel was 99.7% (343/344). There was no paraplegia and stroke during perioperative period.Conclusion:One-staged hybrid surgery has a good short-term and med-term efficacy and safety for complicated Stanford B aortic dissection.

End-to-end bile duct anastomosis and percutaneous transhepatic cholangial drainage for iatrogenic bile duct injuries / 中华肝胆外科杂志

Objective:A novel bile duct end-to-end anastomosis and percutaneous transhepatic cholangial drainage (PTCD) were designed to treat iatrogenic bile duct injuries, and the clinical efficacy and technical advantage of this combined treatment were analyzed.Methods:Clinical data from 11 patients with iatrogenic bile duct injuries treated between February 2012 to July 2021 was retrospectively analyzed. There were 4 females and 7 males, with age of (47.5±15.3) years old. The types of bile duct injuries were: Bismuth type 1 ( n=7), Bismuth type Ⅱ ( n=1), Bismuth type Ⅲ type ( n=1), combined Bismuth type 1 and type 2 ( n=1), and Bismuth type Ⅳ ( n=1). Repair operations were performed at the time of the initial surgical procedures in 8 patients. The remaining 3 patients had their repair done 2 days, 9 days and 5 months, respectively, after the initial operations. All patients underwent successful bile duct end-to-end anastomosis and PTCD without use of T-tubes. Results:All biliary injuries were successfully repaired with no operative mortalities. Two patients who underwent end-to-end anastomosis of common hepatic duct developed anastomotic bile leakage. The amount of bile leakage was small and bile leakage resolved with conservative treatment in 1 patients 3 days after surgery, and was treated successfully by percutaneous peritoneal drainage for 2 weeks in the other patient. There were no other complications, including stricture formation or cholangitis which developed in other patients. All patients’ liver functions recovered well. The percutaneous biliary drainage tube was removed 6 months after operation in 1 patient. The remaining patients had their drainage tubes removed 3 months after operation. On follow-up, all patients had no history suggestive of cholangitis, jaundice and other symptoms. The liver functions were normal on laboratory examinations. No stricture or dilatation of intrahepatic bile ducts were detected on imaging examinations. The cure rate was 100% (11/11).Conclusion:Surgical repair of biliary tract injuries should aim to preserve sphincter of Oddi function and maintain normal physiological pathway of bile excretion. PTCD helped smooth recovery of an end-to-end anastomosis, lowered severity of physical disability of patients and minimized occurrence of medical disputes.

Predictive value of biphasic CT air trapping sign and semi-quantitative score in predicting abnormal blood gas index and progression to severe disease in COVID-19 patients / 中华放射学杂志

Objective:To explore the predictive value of low-dose biphasic (inspiratory and expiratory) CT air trapping sign and semi-quantitative score in predicting abnormal blood gas parameters and progression to severe disease in COVID-19 patients.Methods:Patients with non-severe COVID-19 who were diagnosed by nucleic acid testing and hospitalized in designated hospitals in Wuxi City from January 23 to February 29, 2020 were prospectively and consecutively recruited. All patients received low-dose biphasic CT examination on admission and repeated CT examination at regular intervals during the course. On the inspiratory phase admission of the bipolar CT, the scope of the lesion was evaluated by semi-quantitative score, and the air trapping sign on bipolar CT was assessed. The differences of semi-quantitative score, the presence of the air trapping sign and other clinical factors were compared between the patients with abnormal and the normal blood gas index, as well as between the cases progressed to severe disease and cases without disease progression using the independent sample t-test or χ 2 test. The area under the curve (AUC) of receiver operating characteristic (ROC) and the comprehensive discriminant improvement index (IDI) were used to evaluate the predictive effectiveness of the semi-quantitative scores, air trapping sign, and combination of two factors in differentiating cases with abnormal and normal blood gas indexes, as well as in differentiating cases with and without disease progression to severe COVID-19 cases. Results:In total 51 non-severe COVID-19 cases were included, with 16 cases showed air trapping sign during the first biphasic CT examination on admission. During the course of the disease, there were 13 patients with abnormal blood gas index, and 9 cases displaying air trapping sign (9/13). All 7 cases with progression to severe cases showed air trapping sign (7/7). Patients with advanced age, air trapping sign and higher semi-quantitative score were found more likely to have abnormal blood gas index ( t=3.10, χ 2=9.38, t=3.34, P<0.05); patients with advanced age, underlying diseases, air trapping sign and higher semi-quantitative score were more likely to develop into severe disease ( t=2.68, χ 2=6.65, χ 2=4.25, t=4.33, P<0.05). The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing abnormal blood gas index from normal blood gas index was 0.803, 0.754 and 0.794 respectively. The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing cases with progression to severe cases from non-progression was 0.881, 0.898 and 0.932, respectively. Air trapping sign combined with semi-quantitative score significantly improved the prediction effectiveness of disease progression, compared with semi-quantitative score or air trapping sign (IDI=0.271, 0.117). Conclusion:Air trapping sign and semi-quantitative score might be used as effective indicators to predict the progression of COVID-19 cases, and the combination of these two factors might be more helpful to predict the disease progression.

Clinical analysis of 36 children with pneumonia caused by coinfection of human adenovirus type 7 and Mycoplasma pneumoniae / 中华实用儿科临床杂志

Objective:To summarize the clinical features of children with pneumonia caused by coinfection of human adenovirus type 7 and Mycoplasma pneumoniae.Methods:A total of 36 children with pneumonia caused by coinfection of human adenovirus type 7 and Mycoplasma pneumoniae (coinfection group) diagnosed in the Wuhan Children′s Hospital from December 1, 2018 to September 1, 2019 were enrolled.Their clinical manifestations, laboratory examinations, and imaging findings were retrospectively analyzed.In the same period, 94 children with single human adenovirus type 7 infection pneumonia were selected as the single infection group.Differences between 2 groups were compared using the Student′s t-test, rank sum test and Chi- square test. Results:In the coinfection group, 25 cases were males, 11 cases were females, their mean age was 3.11 years.The main clinical manifestations included fever (97.2%) and cough (100.0%). The mean body temperature was 40.0 ℃, with the thermal peak of 4 times per day, and the mean course of fever of 11 days.The incidence of severe pneumonia was significantly higher in coinfection group (86.1%) than that of single infection group (69.1%) ( χ2=3.878, P<0.05). The common complications included myocardial damage (55.5%), heart failure (16.7%), liver function damage (25.0%), gastrointestinal bleeding (5.5%), toxic encephalopathy (11.0%), hemophagocytic syndrome (16.7%), and bronchiolitis obliterans (50.0%). The levels of cytokines like interleukin (IL)-6 [237.84(108.59, 606.36) ng/L], IL-10[31.44(12.13, 69.60) ng/L]and interferon-γ [(102.85±92.23) ng/L] were obviously elevated, and among them, IL-6 and IL-10 elevations were significantly pronounced in coinfection group than that of single infection group[148.35(57.43, 390.82); 19.67(10.96, 35.35)] ( Z=-1.984, -2.077, all P<0.05). Lung consolidation (50.0%) and pleural effusion (38.9%) were common in coinfection group, and the incidence of pleural effusion in coinfection group was significantly higher than that of single infection group (19.1%)( χ2=5.594, P<0.05). Conclusions:Most of the pneumonia caused by human adenovirus type 7 mixed Mycoplasma pneumoniae in children is severe pneumonia, which may be related to the cytokine storm.

Using plant extracts and their active ingredients to inhibit bacterial biofilms / 生物工程学报

Numerous studies have reported that the resistance of biofilm bacteria to antibiotics can be up to 10-1 000 fold higher than that of planktonic bacteria. Bacterial biofilms are reported to be responsible for more than 80% of human microbial infection, posing great challenges to the healthcare sector. Many studies have reported that plant extracts and their active ingredients can inhibit the formation and development of bacterial biofilms, including reducing biofilm biomass and the number of viable bacteria in biofilms, as well as eradicating mature biofilms. This review summarized the plant extracts and their active ingredients that are inhibitory to bacterial biofilms, and analyzed the underpinning mechanisms. This review may serve as a reference for the development of plant drugs to prevent and treat biofilm infections.

Application of fusion imaging in the treatment of complex aortic pathology / 中华胸心血管外科杂志

Objective:To explore the value of fusion imaging in the treatment of complex aortic pathology.Methods:A retrospective analysis was conducted of 29 patients with complex aortic pathology who underwent treatment with endovascular aortic repair using fusion imaging (FI+ ) technique or without FI (FI-) between June 2015 and June 2021. The perioperative outcomes and morbidity of the FI was assessed and the early results of follow up were evaluated.Results:The mean age of patients was (70.3±7.3) years old, and 24 (82.8%) males. Technical success was 96.5% (28/29). The FI+ group patients had lower procedure time[FI+ , (209±53) min vs. FI-, (306±24)min, P=0.005]and ionic contrast medium[(169±23)ml vs. (201±20)ml, P=0.040]. Contrast-induced acute kidney injury (CI-AKI)[3.4%(FI+ 0 vs. FI-6.7%, P=0.33)], and operation-related reintervention[6.9%(FI+ 0 vs. FI-13.3%, P=0.16)] were similar. There were no significant differences in blood loss, fluoroscopy time. Conclusion:FI technique improves the accuracy during positioning in complex endovascular aortic repair, could reduce aortic related reintervention rate, operation time and contrast dose. Further studies and development are needed to obtain optimal image quality and higher precision.

Involvlment of LINC01018 in the pathogenesis of colon cancer by mediating E2F1-CDK6 pathway / 中国医师杂志

Objective:To study the specific mechanism of LINC01018 involved in the pathogenesis of colon cancer.Methods:The expression of LINC01018 in colon cancer tissues and cells and normal colon tissues and cells were detected by real time fluorescence quantitative polymerase chain reaction (qRT-PCR). HT-29 cell line which overexpresses LINC01018 stably was established. RNA binding protein immunoprecipitation (RIP) assay was used to detect the interaction between LINC01018 and E2F1 protein. Dual luciferase assay was used to detect the regulatory effect of E2F1 on CDK6 promoter. The expression of E2F1 or CDK6 was up-regulated in HT-29 cell line which overexpresses LINC01018, then the proliferation, invasion and migration of HT-29 cells and the expression of CDK6 and matrix metalloproteinase-2 (MMP-2) in HT-29 cells were detected by cell counting method (CCK-8) assay, Transwell assay and Western blot.Results:The expression of LINC01018 was abnormally low in colon cancer tissues and cells. The result of RIP assay showed that LINC01018 interacted with E2F1 protein. The result of dual luciferase assay showed that E2F1 protein could enhance the efficiency of CDK6 promoter, and E2F1 had a positive regulatory effect on CDK6. Overexpression of LINC01018 could attenuate the positive regulatory effect of E2F1 on CDK6. Up-regulation of E2F1 or CDK6 expression could attenuate the effects of LINC01018 overexpression on the proliferation, invasion, migration and expression of CDK6 and MMP-2 in HT-29 cells.Conclusions:The expression of LINC01018 was abnormally low in colon cancer tissues and cells. LINC01018 may regulate the proliferation, invasion and migration of HT-29 cells through E2F1/CDK6/MMP-2 axis, and participate in the pathogenesis of colon cancer.

Establishment of LINC01018 overexpression colon cancer cell line and study on its biological characteristics / 中国医师杂志

Objective:To establish a colon cancer cell line which overexpressing LINC01018 stably and study its biological characteristics.Methods:The expression of LINC01018 in HCoEpiC and HT-29 cells were detected by real time fluorescence quantitative polymerase chain reaction (qRT-PCR). HT-29 cells were infected with LINC01018 overexpression lentivirus to screen and establish HT-29 cell lines which overexpressing LINC01018 stably. The effect of LINC01018 on the proliferation, invasion and migration of HT-29 cells were detected by cell counting kit-8 (CCK-8) assay and Transwell assay separately. The expression of CDK6 and matrix metalloproteinase-2 (MMP-2) in HT-29 cells was detected by Western blot.Results:The expression of LINC01018 in HT-29 cells was significantly lower than that in the human colonic epithelial cells (HCoEpiC). HT-29-L18 cell lines which overexpressing LINC01018 stably was screened successfully. Overexpression of LINC01018 significantly inhibited the cell proliferation, invasion and migration, and reduced the protein expression of CDK6 and MMP-2 in HT-29 cells.Conclusions:The expression of LINC01018 was decreased abnormally in colon cancer cells. Up-regulation of LINC01018 expression can inhibit the proliferation, invasion and migration of colon cancer cells, which may be related to CDK6 and MMP-2.

Tumor-derived exosomes: Nanovesicles made by cancer cells to promote cancer metastasis

Nanomedicine usually refers to nanoparticles that deliver the functional drugs and siRNAs to treat cancer. Recent research has suggested that cancer cells can also make nanoparticles that also deliver functional molecules in promoting cancer metastasis, which is the leading cause of various cancer mortalities. This nanoparticle is called tumor-derived vesicles, or better-known as tumor-derived exosomes (TEXs). TEXs are nanoscale membrane vesicles (30-140 nm) that are released continuously by various types of cancer cells and contain tumor-derived functional biomolecules, including lipids, proteins, and genetic molecules. These endogenous TEXs can interact with host immune cells and epithelial cells locally and systemically. More importantly, they can reprogram the recipient cells in favor of promoting metastasis through facilitating tumor cell local invasion, intravasation, immune evasion, extravasation, and survival and growth in distant organs. Growing evidence suggests that TEXs play a key role in cancer metastasis. Here, we will review the most recent findings of how cancer cells harness TEXs to promote cancer metastasis through modulating vascular permeability, suppressing systemic immune surveillance, and creating metastatic niches. We will also summarize recent research in targeting TEXs to treat cancer metastasis.

Research progress on the relationship between LINC01018-E2F1-CDK6 and malignant tumor / 中国医师杂志

It is known that LINC01018 and CDK6 are associated with the occurrence, progression and recurrence of malignant tumor. Our preliminary data showed that the expression of LINC01018 was down-regulated and that of CDK6 was up-regulated, which were related with the malignancy grade. Bioinformatics suggested that E2F1 binding site exist in the CDK6 promoter region, and LINC01018 might interact with E2F1. Thus we speculate that the expression of LINC01018 in malignant tumor is decreased. The interaction between LINC01018 and E2F1 activates E2F1, promotes the transcription activation of CDK6, and affects tumor proliferation, invasion and metastasis. All these are expected to reveal the effect and mechanisms of LINC01018 in the development and regulation of malignant tumor, and provide new ideas and evidences for its treatment.

Construction and clinical preliminary validation of an automaticbone age assessment model based on deep learning / 中华放射学杂志

Objective@#To build an automatic bone age assessment system based on China 05 Bone Age Standard and the latest deep learning technology, and preliminary clinical verification was carried out.@*Methods@#The left-hand radiographs of 5 000 children with suspected metabolic disorders were acquired from Wuxi Children′s Hospital. Among these cases, 2 351 patients were randomly chosen as training set, and 101 patients were randomly used as validation set. Four professional pediatric radiologists annotated the development stage according to the China 05 RUS-CHN standard with double-blind method. The mean value of the bone age assessed by experts was the reference standard which was used to train and validate the deep learning mothods based artificial intelligence (AI) model. Accuracy, mean absolute error (MAE), root mean squared error (RMSE) and time efficiency of bone age assessment were compared by using Chi-square test and t test and F test between resident doctors and AI model in the validation set.@*Results@#The MAE and RMSE was (0.37±0.35) years and 0.50 years between AI model and reference standard, respeactively. When the error range was within ±1.0, ±0.7 and ±0.5 years, the accuracy of model on the validation set was 94.1% (95/101), 89.1% (90/101), 74.3% (75/101) respectively. The accuracy between two resident doctors and AI prediction wasn′t statistical significant (P>0.05).@*Conclusion@#The AI model of bone age assessment based on deep learning is feasible and has the characteristics of high accuracy and efficiency.

Mesenchymal stem cell upregulates tumor necrosis factor-α-induced protein 8-like 2 expression in peripheral blood-derived macrophages in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the regulation of mesenchymal stem cells (MSCs) on the expression of tumor necrosis factor-α-induced protein 8-like 2 (TNFAIP8L2, TIPE2) in the peripheral blood-derived macrophages of systemic lupus erythematosus (SLE) patients. Methods The expression of TIPE2 mRNA in peripheral blood mononuclear cells (PBMCs) and macrophages from SLE patients were detected by Quantitative polymerase chain reaction (qPCR). The TIPE2 protein levels in SLE PBMCs and peripheral blood-derived macrophages were detected by western blot, flow cytometry and immunofluorescence staining, respec-tively. Data were analyzed by t test and Spearman correlation analysis. Results The TIPE2 mRNA expres-sion in PBMCs of SLE patients was significantly lower than that of healthy controls [(0.41 ±0.14) vs (1.06±0.39), t=5.376, P<0.01], as well as the TIPE2 protein level [(0.40 ±0.21) vs (1.09 ±0.26), t=2.963, P<0.05]. The expression of TIPE2 mRNA in peripheral blood-derived macrophages from SLE patients was significantly decreased [(0.56±0.24) vs (1.07±0.38), t=5.203, P<0.01). Moreover, TIPE2 mRNA level of peripheral blood-derived macrophages was negatively correlated with systemic lupus erythematosus disease activity index (SLEDAI) score (r=-0.60, P<0.01), 24-hour urinary protein (r=-0.46, P<0.05) and erythrocyte sedimentation rate (r=-0.46, P<0.05) in SLE patients. The percentage of TIPE2+cells in peripheral blood-derived macrophages (TIPE2+/CD14+)％ from SLE patients was significantly lower than that in healthy controls [(51.4 ±18.5)％ vs (82.4 ±7.5)％, t=2.679, P<0.05]. After 24 hours co-cultured with MSCs, the TIPE2 mRNA expression in SLE per-ipheral blood-derived macrophages was significantly increased [(2.2 ±0.7) vs (1.0 ±0.3), t=3.729, P<0.05). Immunofluorescence results showed the same increase of TIPE2 protein in SLE peripheral blood-derived macrophages [(0.112 ±0.020) vs (0.074 ±0.016), t=3.268, P<0.05]. Conclusion The TIPE2 level in peripheral blood-derived macrophages of SLE patients are decreased. MSCs upregulate the TIPE2 expression in vitro, suggesting that TIPE2 can be a new target for MSCs in the treatment of SLE.

Research progress in treatment of comminuted radial head fractures / 中华创伤杂志

Radial head fracture accounts for one third of the elbow joint fracture.At present,for fractures without obvious displacement,non operative treatment can achieve good results.In the case of complicated comminuted fracture of the radial head,open reduction with internal fixation and the radial head replacement have their own advantages and disadvantages.There is no exact reference for the selection of surgical procedures,and the best treatment regimen remains controversial.No matter which method is adopted,it is necessary to repair accompanied injuries.Meanwhile,postoperative standard rehabilitation exercise is also essential for the recovery of elbow function.The typing of radial head comminuted fracture and the status quo of its treatment is reviewed in this paper,so as to provide reference for better clinical treatment.

Research progress in treatment of Essex-Lopresti lesion / 中华创伤杂志

The Essex-Lopresti lesion is characterized by a fracture of the radial head with concomitant rupture of the interosseous membrane and disruption of the distal radioulnar joint. The EssexLopresti lesion is rare and serious, easily subject to missed diagnosis. However, all sorts of therapeutic methods can only yield poor results for chronic Essex-Lopresti lesion. Therefore, early and accurate diagnosis is crucial. The key to treat acute Essex-Lopresti lesion is the reconstruction of radial head and restoration of radius length, preventing the proximal move of radius. At the same time, the distal radioulnar joint should be reset and stablized, and the triangular fibrocartilage complex(TFCC) repaired, so as to restore the normal anatomic relation between radiu and ulna and to reconstruct forearm longitudinal stability. Further studies are needed on whether the forearm interosseous membrane needs repair as well as on repair method selection. The author reviews the Essex-Lopresti injury treatment methods in order to facilitate better clinical treatment.

The expression of MMP-9 in breast carcinoma and its significance / 中国医师杂志

Objective To explore the expression of matrix metalloproteinase-9 (MMP-9) in breast carcinoma and the relationship between the expression and clinical pathological characterization.Methods Specimens taken from 50 fresh resected breast carcinoma tissue and 16 normal breast tissue were selected.Tissue sections were stained by EnVisionTM imnunohistochemistry with MMP-9 as monoclonal antibody.The expression of MMP-9 in breast carcinoma and the relationship between the expression and clinical pathological characterization were studied.Results The positive rate of MMP-9 breast cancer carcinoma was 59.32％,which was significantly higher than that of normal breast tissue 9.62％,with statistical significance (P ＜ 0.01).The average rank and score of MMP-9 in the metastatic tissue of breast carcinoma were higher than that of no metastatic breast cancer tissue (P ＜ 0.01).Conclusions MMP-9 may be related to the destruction of extracellular matrix and basement membrane near the surface of breast cancer cells,thereby promoting the invasion and metastasis of breast cancer.

The expression of B7-H1 in thyroid papillary carcinoma and its clinical significance / 中国医师杂志

Objective To investigate the expression and clinical significance of B7-H1 in normal thyroid tissues adjacent to nodular goiter and thyroid papillary carcinoma.Methods Immunohistochemistry EnVisionTM two step staining method was used to monitor tumor expression of B7-H1, its relationship with clinicopathological features was analyzed.Results The positive reaction of B7-H1 material as brown granules showed positive in cytoplasm, with occasional cell nuclear staining.Positive expression of B7-H1 in papillary thyroid carcinoma tissues 58.2％ (39/67) was significantly higher than that 12.5％ (2/16) of expression of B7-H1 in the normal thyroid tissues adjacent to nodular goiter.B7-H1 in thyroid papillary carcinoma score 2.94 ± 1.843 was significantly higher than the score 0.88 ± 1.204.(P ＜ 0.01) of B7-H1 in the normal thyroid tissues adjacent to nodular goiter.The average rank of B7-H1 expression in poorly differentiated papillary thyroid carcinoma 40.92 was significantly higher than the average rank expression in papillary thyroid carcinoma with high differentiation in 27.18 and 34.67, the average rank expression in lymph node metastasis in papillary thyroid carcinoma was significantly higher than 35.93 of the average rank expression without lymph node metastasis in papillary thyroid carcinoma (18.75, P ＜0.01).Conclusions The expression of B7-H1 was significantly higher in papillary thyroid carcinoma than in normal thyroid tissue, and was positively correlated with the degree of differentiation and lymph nodes.

Clinical application of fast track surgery, laparoscopic radical resection of rectal cancer in elderly patients / 中国医师杂志

Objective To investigate the curative effect of fast track surgery laparoscopic surgery and traditional laparotomy in elderly patients over 70 years old with rectal cancer and the difference between the two groups was analyzed,and explore the practical value and the advantages in fast track surgery (FTS) laparoscopic surgery in the patients older than 70 years with colorectal cancer.Methods This study was a retrospective analysis,in accordance with the requirements of the laparoscopic group and the laparotomy group,the clinical data of 100 patients over 70 years old with rectal cancer were randomly sampled who were admitted to the second people's Hospital of Hunan province in April 2010-2016 November.Fifty patients underwent FTS laparoscopic assisted rectal cancer,which was set as the experimental group;the other 50 patients underwent conventional open surgery were set as the control group.The clinical data of two groups were compared with preoperative,intraoperative and postoperative related indicators.Results No significant difference was found in the two groups of patients in surgery (P ＞ 0.05).The operative time of experimental group was [(190 ± 35.2) min] longer than the control group [(160.5 ± 29.3) min] (P ＜ 0.05).The incidence of hypercapnia in the experimental group was higher than the control group (P ＜ 0.05).The intraoperative bleeding of the experimental group [(90 ± 40) ml] was significantly less than the control group [(130 ± 60)ml,P ＜0.05].The postoperative exhaust time of the experimental group [(3.01 ± 0.98)d] was shorter than the control group [(3.98 ± 1.38)d,P ＜0.05].The lymph node number of the experimental group (12.86 ±4.87) was not significantly different from control group (13.12 ±4.69,P ＞ 0.05).The hospitalization time of the experimental group [(15.68 ±5.10) d] was significantly shorter than the control group [(20.31 ± 6.78) d,P ＜ 0.05].The wound infection rate of experimental group was significantly lower than the control group (P ＜ 0.05).The anastomotic leakage in experimental group was not significantly different from control group (P ＞ 0.05).No significant difference in anastomotic stenosis was found between the experimental group and the control group (P ＞ 0.05).Conclusions The concept of FTS laparoscopic radical resection of rectal cancer has the advantages including less bleeding,quicker recovery,and less complications.It is safe and feasible and worthy of clinical application.

Effect of glycerin fructose combined with mannitol in the treatment of postoperative swelling of extremities fractures / 中国生化药物杂志

Objective To study the effect of glycerin fructose combined with mannitol in the treatment of postoperative swelling of extremities fractures.Methods In Yiwu Central Hospital from February 2015 to February 2017 treated 100 cases of limb fracture surgery patients as the research object in the course of the study, were randomly divided into control group and experimental group two were 50 cases each.The patients in control group were treated with mannitol after fracture surgery, and the patients in the experimental group were treated with glycerol fructose and mannitol.Comparative analysis of the experimental group and control group of patients with limb swelling degree.Results After different treatment, the experimental group of patients with adverse reactions occurred in 0 cases, the probability was 0.0%, the control group of patients with adverse reactions in the number of cases in the case of the number of patients with adverse reaction probability of 10.0%, the number of patients with adverse reactions in the control group was 5.As a result, the incidence of adverse reactions in the experimental group was significantly lower than that in the control group, with statistical difference(P<0.05).In the experimental group, 6 days after surgery, on the 7 day, the 8 day and the 9 day, the forearm circumference was significantly lower than that of the control group, with statistical difference(P<0.05).On the 8 day after surgery and after 8 days, the leg circumference of the experimental group was significantly lower than that of the control group, with statistical difference(P<0.05).Conclusion The clinical effect of glycerol and fructose combined with mannitol in treatment of limb swelling after surgery for fracture, high safety, reduce the probability of occurrence of adverse reactions to a great extent, is further applied in clinical significance.