RNAs specifically affect gene expression in a length,position and sequence dependent manner

We aim to explore if RNA regulating gene expression is affected by length, sequence and position of RNA. HeLa cells were co-transfected with modulator plasmids (derived from pcDNA3.1 vector containing different length regulating sequences that produce RNAs) and reporter plasmids (derived from pEGFP-C1 vector); In addition, HeLa cells were transfected with plasmids that possess different sequences of downstream or adjacent genes of GFP reporter gene. We found that long inserting sequences of modulator plasmids induced stronger GFP gene activation than short inserting sequences. Changing of downstream sequences of GFP gene induced significant effects on GFP gene expression. Short sequences of adjacent genes of GFP activated GFP gene. Bioinformatics analysis of genes which is highly expressed in differentiating cells (thymocyte cells, germinal center B-cells) and quiescent cells (T cells, B cells) shows that differentiating cells produce longer RNA than quiescent cells. These findings demonstrate that the length, sequence and producing position of RNAs are important factors for RNA regulating gene expression.     

双层人工真皮移植在关节深度烧伤创面的早期修复效果

目的 探讨双层人工真皮早期应用于关节深度烧伤创面的治疗效果。 方法 选择40例伴关节部位深度烧伤的特重度烧伤患者作为研究对象,按治疗方式随机分为观察组和对照组（各20例）,观察组关节深度烧伤创面于受伤后3~5 d行切/削痂术后植入Lando双层人工真皮覆盖创面,待真皮血管化良好后去除硅胶层,植入自体刃厚皮片。对照组关节部位深度烧伤创面于伤后3~5 d行切/削痂术后自体刃厚皮片移植术。记录两组自体刃厚皮植入后7 d皮片成活率、21 d创面愈合率。创面愈合后指导康复性训练,统计关节部位水泡、疼痛、瘙痒发生率,随访并评估关节部位瘢痕增生及烧伤后患者生活质量。 结果 植皮术后7 d换药时,观察组皮片成活率高于对照组,术后21 d,观察组创面愈合率高于对照组,观察组水泡、疼痛、瘙痒发生率低于对照组,差异有统计学意义（P＜0.05）。随访12个月,根据温哥华瘢痕量表量表评分,观察组瘢痕增生情况好于对照组,根据BSHS-B评分,观察组烧伤后生活质量情况优于对照组,差异有统计学意义（P＜0.05）。 结论 双层人工真皮早期移植修复关节部位深度烧伤创面,植皮成活率高,创面不良事件发生率低,关节部位瘢痕增生不明显,烧伤患者生活质量高。     

P53基因治疗药联合中药治疗原发性肝癌的疗效观察

目的观察P53基因治疗药联合中药治疗原发性肝癌的临床疗效。方法将40例原发性肝癌患者随机分为联合组20例和对照组20例。对照组给予速溶表柔比星+今又生处理,联合组在对照组的基础上加用中药艾迪注射液治疗。定期分析2组患者肿瘤标志物、肝功能恢复情况,并监视肝癌肺部转移病灶和肝内肿瘤个数及大小情况。结果联合组治疗6个月和1 a的甲胎蛋白、癌胚抗原含量均低于对照组,肝功能好于对照组;治疗后1 a的肝内肿瘤个数和大小均好于对照组;治疗后1 a联合组Child-Pugh评分明显低于对照组。结论艾迪注射液联合今又生治疗原发性肝癌效果好,可增强P53基因治疗的效果。     

CD109在基底细胞样乳腺癌中的表达及意义

目的 探讨CD109在基底细胞样乳腺癌(basal-like breast cancer,BLBC)中的表达及意义.方法 采用免疫组织化学(S-P法)检测86例基底细胞样乳腺癌和90例浸润性乳腺癌中CD109的表达情况.结果 CD109在基底细胞样乳腺癌和浸润性乳腺癌中的阳性表达率分别为61.6％、8.9％,两组差异具有统计学意义(P＜0.01);CD109在基底细胞样乳腺癌中的高表达与患者年龄、肿瘤大小、肿瘤的组织学分级和淋巴结累及情况均无关.CD109表达阳性乳腺癌中组织学Ⅲ级比例明显高于阴性组,Spearman等级相关分析显示CD109表达与肿瘤组织学分级呈正相关(r =0.365,P＜0.01).结论 CD109是基底细胞样乳腺癌新的特异性标志物,CD109的表达可能与肿瘤的侵袭性有关;鉴于CD109是一种细胞表面蛋白,其有可能成为治疗乳腺癌的一个潜在分子靶点.     

移位跟骨关节内骨折手术方法的进展与选择

<正>跟骨骨折是临床较为常见的后足损伤,多为高处坠落所致,占全身骨折的1%～2%^[1],占足踝部骨折的60%,分为关节内骨折和关节外骨折,其中75%为关节内骨折^[2]。目前研究表明,移位的关节内骨折手术治疗是适当的,虽然文献中关于跟骨骨折的最佳治疗方法存在许多争议,但毫无疑问的是,成功的关节复位和重建正常的跟骨结构对良好的临床疗效至关重要^[3]。     

Clinical significance of anterior humeral line in supracondylar humeral fractures in children

IntroductionAnterior humeral line (AHL) location is commonly used to evaluate sagittal alignment after fracture reduction in children with supracondylar humeral fractures. However, the position of the AHL for acceptable fracture reduction has not been validated by clinical outcome. The purpose of this study was to investigate the relationship between the location of AHL and range of elbow motion.Patients and methodsWe retrospectively reviewed 101 children who underwent closed reduction and percutaneous pinning for Gartland type III supracondylar humeral fractures between January 2009 and June 2014. There were 67 boys and 34 girls, with a mean age of 7 years. The children were classified according to the location of the AHL three months postoperatively into five groups: anteriorly loss (n = 6), anterior third (n = 25), middle third (n = 47), posterior third (n = 21), and posteriorly loss (n = 2). Range of elbow motion was measured by attending paediatric orthopaedic surgeons with a goniometer. Clinical and radiographic outcomes were compared among the five groups.ResultsThe mean elbow extension angle was not significantly different among the groups (p = 0.21). However, children with AHL anterior to the capitellum had less elbow flexion angle (125.8° vs. 131.2°, p = 0.046) and less total range of elbow motion (128.3° vs. 135.7°, p = 0.048) than children with AHL crossing the capitellum. When the AHL crossed the capitellum, the elbow flexion angle and total range of elbow motion were significantly decreased in children with AHL crossing the anterior third of the capitellum. The Flynn criteria were not significantly different among the central three groups (p = 0.131). However, the Flynn criteria were significantly worse in children whose AHL missed the capitellum (p < 0.001). The mean Baumann angle measured 3 months postoperatively was not significantly different among the groups (p = 0.12).ConclusionsThese findings demonstrate that children with AHL crossing the middle and posterior thirds of the capitellum appear to have slightly better early elbow flexion and total range of elbow motion. AHL crossing the anterior third of the capitellum can be an underreduction that has similar elbow motion as AHL anterior to the capitellum. AHL posterior to the capitellum is a warning sign of overreduction and should be avoided.     

The outcome of unstable proximal femoral fracture treated with reverse LISS plates

BackgroundThe Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates.DesignA retrospective studySettingThe study was conducted at a Level III trauma center in Taiwan.MethodsTwenty-five consecutive patients presenting with a Russel-Taylor type 2B fracture were enrolled. All cases were treated with reverse LISS plates. A Modified Radiographic Union Scale for Femur (RUSF), Radiographic parameters, functional scores, and complications were assessed.ResultsUnion occurred in 21 cases at an average of 18.8 weeks. The average immediate postoperative neck-shaft angle was 130° (range: 122–135°) compared with 139° (range: 135–141°, p = 0.05) on the contralateral side. Two cases had complications of proximal screws cutting out and two cases had broken implants. Finally, all 4 cases required repeated surgeries (16%). Malunion occurred in 4 patients and early mechanical failure (proximal screws cut out) occurred in 2. There was a significant difference in the purchase index of the proximal screws between cases with redisplacement and those without (26.4 mm and 98.6 mm, p = 0.01).ConclusionsThe use of reverse LISS plate appeared to be an alternative procedure for the specific pattern in the present study. We recommend using this reverse locking plate to treat unstable proximal femoral fractures with meticulous techniques of placing plates. Adequate purchase of the proximal locking screws might decrease the risks of complications.     

MicroRNA-9-3p 在2 型糖尿病合并不稳定型心绞痛患者血浆中的表达分析

目的 检测microRNA-9-3p（miR-9-3p）在2 型糖尿病（T2DM）患者以及T2DM 合并不稳定型心绞（T2DM+UA）痛患者血浆中的表达水平,分析miR-9-3p 对于T2DM 以及T2DM+UA 的诊断价值。方法 选取2012 年1 月-2013 年6 月唐山市工人医院就诊的单纯T2DM 患者50 例为T2DM 组,T2DM+UA患者50 例为T2DM+UA 组,健康体检人员30 例为对照组。抽取患者外周静脉血,提取microRAN（miRNA）,应用实时荧光定量聚合酶链反应（qRT-PCR）,以miR-423-5p 为内参,检测3 组血浆中miR-9-3p 表达水平,应用受试者工作曲线（ROC）统计分析其对于T2DM 以及T2DM+UA 的诊断价值。结果 3 组血浆miR-9-3p表达水平比较,差异均有统计学意义（P <0.05）,T2DM 组及T2DM+UA 组均高于对照组,T2DM+UA 组高于T2DM 组;miR-9-3p 对于T2DM 的诊断价值AUC=0.723（95%CI ：0.610,0.837,P <0.05）,miR-9-3p对于T2DM+UA 的诊断价值AUC=0.972（95%CI ：0.963,0.981,P <0.05）。结论 miR-9-3p 在T2DM 以及T2DM+UA 患者血浆表达水平升高,miR-9-3p 有望作为T2DM 以及T2DM+UA 早期诊断的分子标志物。