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Li Y.,Shanghai University | Jiang X.,85th Hospital of PLA | Guo Q.,Shanghai University | Zhu L.,Shanghai University | And 2 more authors.
International Orthopaedics | Year: 2014

Purpose: A few studies focused on the methods of treatment for displaced distal tibial shaft fractures have been published, all of which compared two different methods. In this randomized, prospective study, we aimed to compare minimally invasive plate osteosynthesis, locking intramedullary nail stabilization and external fixation combined with limited open reduction and absorbable internal fixation for distal tibial shaft fractures by assessing complications and secondary procedures. Methods: From November 2002 to June 2012, 137 skeletally mature patients with displaced distal tibial shaft fractures with or without fibula fracture were randomized to be treated by minimally invasive plate osteosynthesis (group A, n=46), locking intramedullary nail (group B, n=46) or external fixation combined with limited open reduction and absorbable internal fixation (group C, n=45). Age, gender, mechanism of injury, fracture pattern and presence of open fracture were equally distributed among the three groups. Indexes for evaluation included hospital stay, operative time, time to radiographic union, union status, infection and the incidence of re-operation.Mazur ankle score was introduced for functional evaluation. Statistics Analysis System (SAS) 9.2 was used for analysis. Results: A total of 121 patients were included in the final analysis (group A 42, group B 40 and group C 39) and evaluated after a mean of 14.8 months follow-up. There was no significant difference (P>0.05) in hospital stay, time to radiographic union and the incidence of union status among the three groups. Although group C was associated with less secondary procedures versus groups A and B, it was related with more pin tract infections (15.4%). Anterior knee pain occurred frequently after locking intramedullary nailing (37.5%) and the irritation symptoms were more frequently encountered in group A (59.5%). There was no difference in ankle function between the three methods after operation (P>0.05). Conclusions: We consider that the minimally invasive plate osteosynthesis, locking intramedullary nail stabilization and external fixation combined with limited open reduction and absorbable internal fixation techniques are all efficient methods for treating distal tibia fractures. With its wide indications, external fixation combined with limited open reduction and absorbable internal fixation leads to minimal soft tissue complication, good functional result and no local soft tissue irritation or implant removal. © Springer-Verlag 2014. Source


Wang L.,85th Hospital of PLA | Lang L.-L.,Shanghai University | Wang Y.,Shanghai University | Shi S.,85th Hospital of PLA | Liu L.,Shanghai JiaoTong University
Ophthalmic Research | Year: 2013

Aims: To investigate the differences of gene expression in rat retinal Müller glial cells after basic fibroblast growth factor (bFGF) treatment, and to explore the function of prostaglandin E2 (PGE2) in the proliferation and dedifferentiation of rat retinal Müller glial cells. Materials and Methods: A gene expression profile in rat retinal Müller glial cells after bFGF treatment, matching untreated cells, was conducted using gene array technology. The candidate gene selection was performed on GenMAPP/MAPPFinder. The functional effects of PGE2 on the proliferation and dedifferentiation of Müller cells were further investigated. Results: Gene array analysis identified that 298 genes were upregulated and 293 genes were downregulated. The GenMAPP/MAPPFinder results showed that the PG biosynthetic process had the highest correlation (Z score 8.803) with the stem cell characteristics of Müller cells. The quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) results showed that PGE2 can significantly upregulate the expression of cyclin D1 in Müller cells. Also, the bromodeoxyuridine and flow cytometry results showed that PGE2 can significantly increase the proportion of Müller cells in S phase. Furthermore, qRT-PCR showed that the expressions of nestin (a marker of neural stem/precursor cells) and Pax6 (a marker of retinal stem/precursor cells) were significantly upregulated by PGE2 stimulation, and similar results were obtained by immunofluorescence staining. Conclusion: PGE2 may enhance the proliferation, dedifferentiation, and stem-like properties of rat retinal Müller glial cells in vitro. © 2012 S. Karger AG, Basel. Source


Pu H.,85th Hospital of PLA | Yin J.,85th Hospital of PLA | Wu Y.,85th Hospital of PLA | Zhang D.,85th Hospital of PLA | And 4 more authors.
Molecular Biology Reports | Year: 2013

Monocyte differentiation antigen CD14 is considered an important cell-activating mediator of inflammatory responses that may result in atherosclerosis, coronary heart disease (CHD), thrombus formation, and myocardial infarction (MI). A common C-260T polymorphism in the promoter of the CD14 gene, the trans-membrane receptor of lipopolysaccharides, has been inconsistently associated with CHD. To investigate this inconsistency, we performed a meta-analysis of 28 studies involving a total of 13,335 CHD cases and 7,979 controls for C-260T of the CD14 gene to evaluate the effect of CD14 on genetic susceptibility for CHD. An overall random effects odds ratio of 1.24 (95 % CI: 1.12-1.36, P < 10-5) was found for T allele. Significant results were also observed using dominant (OR = 1.34, 95 % CI: 1.17-1.54, P < 10-4) or recessive genetic model (OR = 1.25, 95 % CI: 1.10-1.41, P = 0.0004). There was strong evidence of heterogeneity (P < 10 -5), which largely disappeared after stratification by ethnicity. After stratified by ethnicity, significant results were found in East Asians; whereas no significant associations were found among Caucasians and other ethnic populations in all genetic models. In the stratified analysis according to sample size, CHD endpoints, and HWE status, significantly increased risks for the polymorphism were found in all genetic models. In conclusion, our results indicate that the CD14 C-260T polymorphism is a risk factor of CHD, especially in East Asians. However, additional very large-scale studies are warranted to confirm our results. © 2012 Springer Science+Business Media Dordrecht. Source

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