[Deltoid ligament augmentation and repairing in ankle fracture associated with deltoid ligament injury and syndesmosis diastasis]

Objective: To evaluate the outcome of the deep component augmentation and superficial component repairing and syndesmosis screw fixation in treating ankle fracture associated with deltoid ligament injury and syndesmosis diastasis. Methods: From January 2014 to December 2017, 16 patients with ankle fracture combined with deltoid ligament injury and syndesmosis diastasis were treated with the deep component augmentation and superficial component repairing in Beijing Jishuitan Hospital.Of the patients, 13 were males and 3 were females, with an average age of (38±10) years (21-57 years). Nine cases were athletic injuries, 4 cases were daily-life injuries and 3 cases were traffic injuries.According to the Weber classification, 6 cases were type B, 10 cases were type C. According to the Lauge-Hansen classification, 6 cases were supination external rotation Ⅳ injury, 9 cases were pronation external rotation Ⅳ injury, 1 case was pronation abduction Ⅲ injury.The surgical treatment method was rigid fixation of the lateral malleolus and deep deltoid ligament augamentation instead of syndesmosis screw fixation.The effect of the surgical method was observed. Results: The average follow up was (24±12) months (6-40 months). The mean degree of dorsiflexion was 17.8°±6.8° (5°-30°), with 3.8°±6.0° (0°-15°) less than that in normal side, the mean degree of plantar flexion was 46.9°±7.9°, with 1.9°±3.9° (0°-10°) less than that in normal side.The mean Philips and Schwartz score was 96.8±5.1 (82-100), the American Orthopaedic Foot and Ankle Society (AOFAS) Score was 97.4±4.6 (84-100). Conclusion: In the treatment of ankle fracture associated with deltoid ligament injury and syndesmosis diastasis, the deep component augmentation and superficial component repairing and proper rehabilitation can benefit the functional recovery.

[Diagnostic value of protein markers in plasma exosomes of lung squamous cell carcinoma]

Objective: To investigate the tumor-associated protein molecules carried by plasma exosomes of patients with lung squamous cell carcinoma before treatment and analyze their value as clinical markers. Methods: Exosomes from 2 patients with lung squamous cell carcinoma before treatment and 2 healthy controls were collected by ultracentrifugation. Proteomics was applied to analyze the protein expression profiles of exosomes. Candidate molecules were verified in another 30 exosomes samples from lung squamous cell carcinoma and healthy controls using enzyme-linked immunosorbent assay (ELISA). Results: Electron microscopy and particle-counting assay showed that high-quality exosomes were collected. The number of exosomes distributed from 45 to 135 nm in 2 cases of lung cancer patients were 7.89×10(11)/ml and 9.71×10(11)/ml, respectively, significantly higher than 2.76×10(11)/ml and 1.41×10(11)/ml in healthy controls. Proteomic analysis showed that proteins of exosomes in lung squamous cell carcinoma patients were very different from those of healthy controls, and some proteins are related to important functions in tumor progression. 14-3-3ζ from exosomes was selected and further verified as a marker, and the area under the receiver operating characteristic curve (ROC) was 0.68. The sensitivity and specificity of 14-3-3 ζ from exosomes were 60.0% and 80.0%, respectively, suggested that it could be used as a diagnostic marker for lung squamous cell carcinoma. Conclusion: The exosome counts in plasma and the protein molecules from exosomes, such as 14-3-3ζ, are closely related to the tumorigenesis, which can be used to assist clinical diagnosis of lung squamous cell carcinoma patients.

[Risk factors analysis and prognosis of renal pelvis dilatation in high-risk infants in monocenter]

Objective: To explore the prognosis and risk factors of pyelectasis in high-risk infants. Methods: This was a retrospective study. Totally 960 high-risk infants, who accepted type B ultrasonic examination for fetus at 28th week of gestation and for newborns in 48 hours after birth, were included in the study in departments of obstetrics and eonatology, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital during May 2012 to April 2013. The degree of pyelectasis was classified using Grignon grade and the paients were followed up for 3 years. The factors of epidemiology, high risk pregnant women, fetus and high-risk newborns that relate to pyelectasis were summarized. High-risk factors were analyzed by using logistic multivariate regression analysis. Results: Of 960 high-risk infants, 103 had abnormal urinary ultrasound results, 87 (9.1% of high-risk infants) were diagnosed with pyelectasis, 16 (1.7% of high-risk infants) were diagnosed with congenital anomalies of the kidney and urinary tract. According to the degree of pyelectasis, 68 infants were Grignon grade Ⅰ, male:female ratio=5.8∶1, left side:right side ratio=1.91∶1; 19 infants were Grignon grade Ⅱ, male:female ratio=5.33∶1, left side:right side ratio=2.12∶1. Postnatal follow-up results showed that pyelectasis disappeared in 48 cases (55% of pyelectasis cae), 40 infants were Grignon grade Ⅰ (59% of all Grignon grade Ⅰ patients), 8 infants were Grignon grade Ⅱ (42% of all Grignon grade Ⅱ patients); The result of risk factors analysis showed that the risk of pyelectasis in males was 4.368 times that of females (95%CI: 2.33-8.189, P<0.05); the risk of pyelectasis in low birth weight infants was 22.434 times that of non low birth weight infants (95% CI: 5.883-85.547, P<0.05). Conclusion: The incidence of pyelectasis in high-risk infants was 9.1%. The mitigation rate of pyelectasis in Grignon grade Ⅰ to Ⅱ in fetal or newborn period is high. Patients in Grignon grade Ⅲ and above in fetal or new born period had high risk of congenital anomalies of the kidney and urinary tract. The risk of pyelectasis of male was higher than that of female; the risk of pyelectasis of low birth weight infant was higher than appropriate for gestational age infants.

Production of recombinant human tektin 1, 2, and 4 and in vitro assembly of human tektin 1

Proteins predicted to be composed of large stretches of coiled-coil structure have often proven difficult to crystallize for structural determination. We have successfully applied EPR spectroscopic techniques to the study of the structure and assembly of full-length human vimentin assembled into native 11 nm filaments, in physiologic solution, circumventing the limitations of crystallizing shorter peptide sequences. Tektins are a small family of highly alpha helical filamentous proteins found in the doublet microtubules of cilia and related structures. Tektins exhibit several similarities to intermediate filaments (IFs): moderate molecular weight, highly alpha helical, hypothesized to be coiled-coil, and homo- and heteromeric assembly into long smooth filaments. In this report, we show the application of IF research methodologies to the study of tektin structure and assembly. To begin in vitro studies, expression constructs for human tektins 1, 2, and 4 were synthesized. Recombinant tektins were produced in E. coli and purified by chromatography. Preparations of tektin 1 successfully formed filaments. The recombinant human tektin 1 was used to produce antibodies which recognized an antigen in mouse testes, most likely present in sperm flagella. Finally, we report the creation of seven mutants to analyze predictions of coiled-coil structure in the rod 1A domain of tektin 1. Although this region is predicted to be coiled-coil, our EPR analysis does not reflect the parallel, in register, coiled-coil structure as demonstrated in vimentin and kinesin. These results document that tektin can be successfully expressed and assembled in vitro, and that SDSL EPR techniques can be used for structural analysis.

Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies

To summarise evidence about the effectiveness of home blood pressure telemonitoring (HBPT) and identify the key components of intervention. We comprehensively searched PubMed, EMBASE and the Cochrane Library for relevant studies. The authors were contacted for additional information. Two authors independently extracted the data and assessed the risk of bias. 46 randomised controlled trials including a total of 13 875 cases were identified. Compared with usual care, HBPT improved office systolic blood pressure (BP) and diastolic BP by 3.99 mm Hg (95% confidence interval (CI): 5.06-2.93; P<0.001) and 1.99 mm Hg (95% CI: -2.60 to -1.39; P<0.001), respectively. A larger proportion of patients achieved BP normalisation in the intervention group (relative risk (RR): 1.16; 95% CI: 1.08-1.25; P<0.001). For HBPT plus additional support (including counselling, education, behavioural management, medication management with decision, adherence contracts and so on) versus HBPT alone (or plus less intense additional support), the mean changes in systolic and diastolic BP were 2.44 mm Hg (95% Cl, 4.88 to 0.00 mm Hg; P=0.05) and 1.12 mm Hg (95% CI, -2.34 to 0.1 mm Hg; P=0.07), respectively. For those surrogate outcomes, low-strength evidence failed to show difference. In subgroup analysis, high strength evidence supported a lower BP with HBPT that lasted for 6 or 12 months and was accompanied with counselling support from study personnel. HBPT can improve BP control in the hypertensive patients. It may be more efficacious when a proactive additional support is provided during the intervention process.

[Minimally invasive plate osteosynthesis for treatment of proximal humeral fractures through anterolateral acromial approach]

OBJECTIVE

To investigate the feasibility, surgical technique and effect of osteosynthesis for proximal humerus fractures through the minimal incision anterolateral acromion.

METHODS

In this study, 32 patients of proximal humeral fractures were selected and treated through the minimal incision antero-lateral acromion between January 2012 and October 2014. Of these patients, there were 19 males and 13 females, with mean age 46 years old (range: 22-78 years). The mechanism of injury was a trauma of simple fall for 21 patients and motor vehicle accident for 11 patients. According to Neer classification, 18 cases had two-part fractures, 12 had three-part fractures, and 2 had four-part fractures. All patients were sustained operation of open reduction and internal fixation. The average delay between trauma and surgery was 4 d (0.5-10.0 d). The operations were performed in invariable operating room with general anesthesia. The fractures were reduced and immobilized with anatomical locking plate through the minimal incision anterolateral acromion during operation. Patients were received passive motion after operation.

RESULTS

All the 32 cases were followed up ranging from 3 to 34 months with an average of 11 months. All the fractures were healed. There was neither failure of internal fixation nor incision infection case. The functional results of the shoulder, according to Constant-Murley score was on an average 86 (range: 69-100).

CONCLUSION

The treatment for proximal humeral fractures through the minimal incision anterolateral acromion approach is a feasible and effective method, which shows good results for treating proximal humerus fractures with correct indication. There are several advantages compared with conventional deltopectoral approach. They are minimal soft tissue disruption, minimal blood loss and easily to manipulate technique. But it required selection of indication strictly and surgeon's experience.

Association between miR-499 rs3746444 and the susceptibility of hepatocellular carcinoma

Considering the inconsistent association between miR-499 rs3746444 and the risk of hepatocellular carcinoma (HCC), it is critical to carry out a meta-analysis in order to produce a precise result. Therefore, a meta-analysis was performed. All of the potential eligible studies were screened based on the following databases, including PubMed, EMBASE, Medline and China National Knowledge Internet (CNKI) up to December 2015. The associations between miR-499 rs3746444and HCC susceptibility was quantified using odds ratios (ORs) with its 95% confidence intervals (CIs). Nine case-control articles were included in the analysis. A total of 2593 cases and 3259 controls were included. The pooled OR was 1.27 (95% CI: 1.10 - 1.48, P = 0.002) which suggested thatmiR-499 rs3746444 was significantly associated with an increased the risk of HCC. Subgroup analysis was performed by ethnicity, miR-499 rs3746444 was significantly associated with an increased the risk of HCC in Asians (OR = 1.31, 95% CI = 1.10-1.55; P = 0.002). However, no significant result was found in Caucasians (OR = 1.10, 95% CI = 0.84-1.44; P = 0.49). In addition, miR-499 rs3746444 was significantly associated with an increased the risk of HCC in subjects with HBV infection OR = 1.31, 95% CI = 1.09-1.58; P = 0.004). This study suggested that miR-499 rs3746444 might play an important role in the development of HCC.

Effects of polymorphisms of serotonin transporter promoter (5-HTTLPR) and brain derived neurotrophic factor gene (G196A rs6265) on the risk of major depressive disorder in the Chinese Han population

OBJECTIVE

The etiology of Major depressive disorder (MDD) is multifactorial but the genetic risk is an important factor. Previous studies have shown a significant interaction between serotonin and brain-derived neurotrophic factor (BDNF) in brain function. The serotonin transporter protein promoter polymorphism (5-HTTLPR) and BDNF (rs6265) are two of the most studied candidate gene polymorphisms in relation to MDD. However, the effect of 5-HTTLPR-BDNF (rs6265) interaction on MDD-risk is not consistent.

PATIENTS AND METHODS

This study recruited 459 patients with MDD and 412 healthy volunteers in a Chinese Han population. Polymerase chain reaction (PCR)-based genotyping was used to detect polymorphisms. Logistic regression was applied to estimate the effect of polymorphisms of 5-HTTLPR, BDNF (rs6265), and their interaction.

RESULTS

We observed a significant correlation between the heterozygous genotype of 5-HTTLPR and MDD [odds ratio (OR) = 1.42, 95% CI: 1.05~1.91; p = 0.02]. The BDNF (rs6265) polymorphism showed that there is no correlation with MDD. When interaction with BDNF was modeled, for individuals with BDNF (rs6265), genotype GG, cases in the heterozygous group had even higher odds of MDD than those in the combined homozygous group of 5-HTTLPR polymorphism (OR = 2.92, 95% CI: 1.43-5.95; p = 0.003).

CONCLUSIONS

Our results suggested that 5-HTTLPR, may be associated with the susceptibility of MDD in an overdominant mode, and there may be a significant interaction between 5-HTTLPR and BDNF (rs6265) polymorphisms in relation to MDD.

Ghrelin inhibits oxLDL-induced inflammation in RAW264.7 mouse macrophages through down-regulation of LOX-1 expression via NF-κB signaling pathway

Oxidized low-density lipoprotein (oxLDL) is one of the many causes of the initiation and progression of atherosclerosis, which can subsequently promote the uptake of oxLDL by macrophages and lead to inflammation in the blood vessels. In the present study, we evaluated the protective effects of ghrelin on oxLDL-induced RAW264.7 mouse macrophages. Ghrelin was able to inhibit the release of several pro-inflammatory cytokines including tumor necrosis factor (TNF)-α and interleukin (IL)-6. In addition, ghrelin also inhibited the expression of Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) in oxLDL treated macrophages. Furthermore, we demonstrated that ghrelin could inhibit the expression of p-IκBα, and the inhibitory effects could be blocked by BAY 117082. Taken together, ghrelin possesses anti-inflammatory effects on oxLDL-induced inflammation in macrophages, suggesting that it can prevent or treat atherosclerosis, and deserves to be further studied and developed to be potent drug for treating atherosclerosis.

Nanoparticle analysis of cancer cells by light transmission spectroscopy

We have measured the optical properties of cancer and normal whole cells and lysates using light transmission spectroscopy (LTS). LTS provides both the optical extinction coefficient in the wavelength range from 220 to 1100nm and (by spectral inversion using a Mie model) the particle distribution density in the size range from 1 to 3000nm. Our current work involves whole cells and lysates of cultured human oral cells in liquid suspension. We found systematic differences in the optical extinction between cancer and normal whole cells and lysates, which translate to different particle size distributions (PSDs) for these materials. Specifically, we found that cancer cells have distinctly lower concentrations of nanoparticles with diameters less than 100nm and have higher concentrations of particles with diameters from 100 to 1000nm-results that hold for both whole cells and lysates. We also found a power-law dependence of particle density with diameter over several orders of magnitude.

Effect of estrogen deficiency on the fixation of titanium implants in chronic kidney disease mice

We established a chronic kidney disease (CKD) mouse model with estrogen deficiency and inserted titanium implants into the femur of such mice to investigate the fixation of the implants. Both the histomorphometry and implant resistance indicated that estrogen deficiency impaired the fixation of titanium implants inserted into such mice.

INTRODUCTION

CKD has been regarded as a worldwide public health problem. Estrogen is a critical factor for both renal protection and bone remodeling. A previous study demonstrated that CKD impairs the early healing of titanium implants. However, the combined effect of estrogen deficiency and CKD on the fixation of titanium implants is largely unknown.

METHODS

Forty 9-week-old female C57BL mice were randomly divided into sham, ovariectomy (OVX), CKD, and CKD + OVX groups. Uremia and estrogen deficiency were induced by 5/6 nephrectomy and OVX, respectively. Experimental titanium implants were inserted into the distal end of the femur. Bone-implant contact (BIC) ratio and bone volume (BV/TV) around the implants were histomorphometrically analyzed. The fixation strength of the implant was measured by a biomechanical push-in resistance test.

RESULTS

Serum measurement confirmed a significant increase in serum blood urea nitrogen (BUN) in the CKD group, which was further increased by OVX. Estrogen deficiency led to significant decreases in the BIC ratio, BV/TV, and the push-in resistance in CKD animals. There was a significant interaction between the effects of OVX and CKD, with OVX exacerbating the effects of CKD on BIC ratio and push-in resistance.

CONCLUSIONS

The results indicated that estrogen deficiency exerts a synergistic effect with CKD and further impairs the fixation of titanium implants in CKD mice.

Pharmacokinetics of doxycycline after a single intravenous, oral or intramuscular dose in Muscovy ducks (Cairina moschata)

1. The pharmacokinetics of doxycycline in ducks were investigated after a single intravenous (IV), intramuscular (IM) or oral (PO) dose at 20 mg/kg body weight. 2. The concentrations of doxycycline in plasma samples were assayed using a high performance liquid chromatography method, and pharmacokinetic parameters were calculated using a non-compartmental model. 3. After IV administration, doxycycline had a mean (±SD) distribution volume (Vz) of 1761.9 ± 328.5 ml/kg and was slowly eliminated with a terminal half-life (t₁/₂λz) of 21.21±1.47 h and a total body clearance (Cl) of 57.51 ± 9.50 ml/h/kg. Following PO and IM administration, doxycycline was relatively slowly absorbed - the peak concentrations (Cmax) were 17.57 ± 4.66 μg/ml at 2 h and 25.01 ± 4.18 μg/ml at 1.5 h, respectively. The absolute bioavailabilities (F) of doxycycline after PO and IM administration were 39.13% and 70.71%, respectively. 4. The plasma profile of doxycycline exhibited favourable pharmacokinetics characteristics in Muscovy ducks, such as wide distribution, relatively slow absorption and slow elimination, though oral bioavailability was low.