目的 探讨三关节截骨矫形融合术治疗成人僵硬性高弓足的临床效果.方法 回顾性分析2018年1月至2020年1月应用三关节融合(距下关节、跟骰关节、距舟关节)治疗10例成人僵硬性高弓足患者;患者行三关节融合术的同时联合跟腱Z行延长及跖筋膜松解作为辅助术式改善足部功能,同时保证术后踝关节的功能位,采用美国足踝外科协会(AOFAS)踝-后足评分、视觉模拟疼痛评分(VAS)及患者术前术后的主观满意度,末次随访时通过影像学分析对比跟骨倾斜角(Pitch角)、距骨第一跖骨角(Meary角)等.结果 术后10例患者全部获得随访,随访时间为15～36个月,平均23.4个月,患者均未出现手术切口感染,且术后患者的外观、症状、步态等方面均有明显的提高,末次随访时满意度评价:非常满意7例,满意2例,一般1例,不满意0例.术后AOFAS评分高于术前,VAS评分低于术前,Meary角、Pitch角及第一跖楔关节高度较术前明显改善,差异有统计学意义(P<0.05).结论 三关节截骨矫形融合治疗成人僵硬性高弓足可以显著纠正关节畸形,解除足部疼痛,提高患者的生活质量,但三关节融合术主要应用后足僵硬型高弓足,因其限制了足部部分功能,故应严格把握手术适应证.

Objective To study the effect of astaxanthin (ASTA) on morphological structure,oxidative stress level,induding content of reactive oxygen species (ROS) and malondialdehyde (MDA),and content of 2,3-diphosphoglycerate (DPG) in suspended red blood cells without leukocyte during early storage.Methods From May to June 2013,6 bags of suspended red blood cells without leukocyte which were prepared at Hebei Blood Center were collected as research objects in this study by random sampling method.Then the suspended red blood cells without leukocyte of each bag were randomly divided into four groups.The ASTA was added into preservation solution of 3 groups,and the final content of ASTA was 5,10 and 20 μmol/L,respectively,and these 3 groups were then enrolled into 5 μmol/L ASTA group,10 μmol/L ASTA group and 20 μmol/L ASTA group.As the last group,only equivalent volume of dimethyl sulfoxide (DMSO) was added into the reservation solution,and this group was enrolled into control group.The suspended red blood cells without leukocyte of four groups were stored at 2-6 ℃.On day 7 and 14 of storage,the morphological structure of suspended red blood cells without leukocyte was observed by scanning electron microscopy.The content of ROS in suspended red blood cells without leukocyte was detected by fluorescence microplate reader.The content of MDA in suspended red blood cells without leukocyte was detected by thiobarbituric acid method.The content of 2,3-DPG in suspended red blood cells without leukocyte was detected by ultraviolet test method.The content changes of ROS,MDA and 2,3-DPG in suspended red blood cells without leukocyte on day 7 and 14 of storage were analyzed by statistical methods.Results ① On day 7 and 14 of storage,the percentages of double concave disc suspended red blood cells without leukocyte in 5,10 and 20 μtmol/L ASTA group were all higher than that in control group,and the percentages of suspended red blood cells without leukocyte with spines were all lower than that in control group,and all the differences were statistically significant (F=25.170,61.376;P =0.000).The percentage of double concave disc suspended red blood cells without leukocyte in 10 μmol/L ASTA group was higher than those in 5 and 20 μmol/L ASTA group,and the percentage of suspended red blood cells without leukocyte with spines in 10 μmol/L ASTA group was lower than those in 5 and 20 μmol/L ASTA group,and all the differences were statistically significant (P＜0.05).On day 7 of storage,the percentages of double concave disc suspended red blood cells and suspended red blood cells without leukocyte with spines in 5,10,20 μmol/L ASTA group and control group were 77.4％ and 22.6％,83.6％ and 16.4％,76.9％ and 23.1％,73.8％ and 26.2％,respectively.On day 14 of storage,the percentages were 59.4％ and 40.6％,70.8％ and 29.2％,58.3％ and 41.7％,52.8％ and 47.2％,respectively.②On day 7 and 14 of storage,the contents of ROS in suspended red blood cells without leukocyte of four groups were compared,and both the differences were statistically significant (F=13.530,27.515;P=0.000).On day 7 and 14 of storage,the contents of ROS in suspended red blood cells without leukocyte of 5,10 and 20 μmol/L ASTA group were all significantly lower than that of control group,and the content of ROS in suspended red blood cells without leukocyte of 10 μmol/L ASTA group was also significantly lower than those of 5 and 20 μmol/L ASTA group,and all the differences were statistically significant (P＜0.05).There was no significant difference in the content of ROS in suspended red blood cells without leukocyte between 5 and 20 μmol/L ASTA group (P＞0.05).On day 7 and 14 of storage,thecontents of ROS in control group were (204.3±28.7) relative fluorescence intensity/mgHb and (245.2± 15.8) relative fluorescence intensity/mgHb,respectively,and both of them were the highest among four groups.And the contents of ROS in 10 μmol/L ASTA group were (148.1 ±5.5) relat ive fluorescence intensity/mgHb and (156.0± 13.8) relative fluorescence intensity/mgHb,respectively,and both of them were the lowest among four groups.③On day 7 and 14 of storage,the contents of MDA in suspended red blood cells without leukocyte of four groups were compared,and both the differences were statistically significant (F=20.698,21.398;P =0.000).On day 7 and 14 of storage,the contents of MDA in suspended red blood cells without leukocyte of 5,10 and 20 μmol/L ASTA group were all significantly lower than that of control group,and the content of MDA in suspended red blood cells without leukocyte of 10 μmol/L ASTA group was also significantly lower than those of 5 and 20 μmol/L ASTA group,and the content of MDA in suspended red blood cells without leukocyte of 5 μmol/L ASTA group was also significantly lower than that of 20μmol/L ASTA group,and all the differences were statistically significant (P＜ 0.05).On day 7 and 14 of storage,the contents of MDA in control group were (23.6±5.1) μmol/mgHb and (33.0±4.4) μmol/mgHb,respectively,and both of them were the highest among four groups.And the contents of MDA in 10 μmol/L ASTA group were (7.3 ± 2.6) μmol/mgHb and (15.5±3.2) μmol/mgHb,respectively,and both of them were the lowest among four groups.④On day 7 and 14 of storage,the contents of 2,3-DPG in suspended red blood cells without leukocyte of four groups were compared,and the difference was statistically significant (F=15.376,17.443;P=0.000).On day 7 and 14 of storage,the contents of 2,3-DPG in suspended red blood cells without leukocyte of 5,10 and 20 μmol/L ASTA group were all significantly higher than that of control group,and the content of 2,3-DPG in suspended red blood cells without leukocyte of 10μmol/L ASTA group was also significantly higher than those of 5 and 20 μmol/L ASTA group,and all the differences were statistically significant (P＜0.05).There was no significant difference in the content of 2,3-DPG in suspended red blood cells without leukocyte between 5 and 20 μmol/L ASTA group (P＞0.05).On day 7 and 14 of storage,the contents of 2,3-DPG in control group were (517.1±-106.2) μg/L and (417.6±62.9) μg/L,respectively,and both of them were the lowest among four groups.And the contents of 2,3-DPG in 10 μmol/L ASTA group were (789.1± 48.2) μg/L and (677.5±90.8) μtg/L,respectively,and both of them were the highest among four groups.Conclusions During early storage,ASTA could delay the change speed of morphological structure and slow down the decreasing progress of 2,3-DPG content in suspended red blood cells without leukocyte by decreasing the oxidative stress level.But whether 10 μtmol/L is the best treatment content of ASTA in suspended red blood cells without leukocyte reservation solution,it still needs further study to confirm.

Objective To investigate the risk of storage lesion of suspended erythrocyte membrane without leukocyte with prolonged storage time.Methods From May to June 2013,6 bags of suspended erythrocyte without leukocyte which were prepared at Hebei Blood Center were collected as research objects in this study by random sampling method.Onday 7,14,28 and 42 of storage,the ultrastructure changes of suspended erythrocyte without leukocyte were observed by scanning electron microscopy.Four views were selected randomly to count double concave disc suspended erythrocyte and suspended erythrocyte with spines.The mean corpuscular volume (MCV) of suspended erythrocyte without leukocyte was detected with blood cell analyzer,and the content of free hemoglobin (FHb) outside suspended erythrocyte without leukocyte was detected with chemical colorimetry.Correlation analysis between MCV,FHb concentration outside of suspended erythrocyte without leukocyte and storage time was carried out by statistical methods.Results The changes of suspended erythrocyte without leukocyte were as followed.①With the extension of storage time,the number of double concave disc suspended erythrocyte without leukocyte reduced gradually,but the number of suspended erythrocyte with spines increased gradually.②On day 7,14,28 and 42 of storage,MCV of suspended erythrocyte without leukocyte showed a significant increasing trend.And the MCV of suspended erythrocyte without leukocyte on day 42 was significantly higher than that on day 7,14 and 2 8 (P＜0.01,0.01,0.05).There was a positive correlation between the MCV of suspended erythrocyte without leukocyte and its storage time (r=0.899,P＜0.01).③On day 7,14,28 and 42 of storage,FHb concentration outside suspended erythrocyte without leukocyte showed a significant increasing trend,FHb concentration outside suspended erythrocyte without leukocyte on day 42 was significantly higher than that on day 7,14 and 28 (P＜0.01).There was a positive correlation between the FHb concentration outside suspended erythrocyte without leukocyte and storage time (r=0.969,P＜0.01).Conclusions With the extension of storage time,the normal morphology of most of the suspended erythrocyte without leukocyte disappear gradually,the MCV and extracellular FHb concentration increase significantly.This shows that the damage degree of suspended erythrocyte membrane without leukocyte increase gradually with the extension of storage time.

Aims: Several studies have shown associations between the composition of polyunsaturated fatty acids (PUFAs) in various tissues and type 2 diabetes mellitus (T2DM) development in European populations. Genetic variants of fatty acid desaturase (FADS) contribute to the variations of PUFA composition. Here we have explored whether similar correlations are also true among Chinese Han people.Methods: A case-control study was employed to examine this correlation in Han Chinese people. The study included 421 healthy adults and 331 T2DM patients.Results: The ratio of arachidonic acid/linoleic acid (AA/LA), which reflects D6 desaturase activity, was significantly increased in T2DM patients. Furthermore, the ratio of eicosapentaenoic acid/a-linolenic acid (EPA/ALA), which reflects D5 desaturase activity, was markedly decreased in T2DM patients. Importantly, among four single nucleotide polymorphisms (rs174545, rs2072114, rs174602 and rs174616) in the FADS1-FADS2 gene cluster, only minor allele (T) of rs174616 was associated with decreased risk of T2DM in both codominant and dominant models after adjustment for age, gender and BMI. Furthermore, the ratio of AA/LA in both controls and T2DM was reduced in T carriers while an increased proportion of LA was seen in T2DM patients compared with control patients.Conclusion: These data suggest that in northern Han Chinese people, the minor allele (T) of rs174616 in the FADS1-FADS2 gene cluster is associated with a decreased conversion rate of LA to AA, which may contribute to decreased reduced risk of developing T2DM. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Objective To investigate the changes of reactive oxygen species (ROS) concentration and malonaldehyde (MDA) concentration in suspended red blood cells without leukocyte during storage.Methods From May 2013 to June 2013,6 bags of suspended red blood cells without leukocyte which were prepared at Hebei Blood Center were collected in this study by random sampling method.On day 0,day 7,day 14,day 28 and day 42 of storage,the expression of ROS in suspended red blood cells without leukocyte were observed by fluorescent probe 2',7'-dichlorofluorescin diacetate (DCFH-DA) incubation method,the ROS concentration and MDA concentration in suspended red blood cells without leukocyte were also detected.Correlation analysis between the ROS concentration,MDA concentration in suspended red blood cells without leukocyte and storage time was carried out,respectively.Correlation analysis between the MDA concentration and ROS concentration in suspended red blood cells without leukocyte after storage was carried out.Results ① With the extension of storage time,fluorescence intensity of suspended red blood cells without leukocyte incubated with fluorescent probe DCFH-DA was significantly enhanced.② On day 0,day 7,day 14,day 28 and day 42 after storage,ROS concentration in suspended red blood cells without leukocyte showed a significant increasing trend.Concentration of ROS in suspended red blood cells without leukocyte on day 42 was significantly higher than that of day 0,day 7,day 14 and day 28 (P＜0.01,0.05,0.05,0.05).There was a positive correlation between the ROS concentration in suspended red blood cells without leukocyte and storage time(r=0.898,P＜0.01).③ On day 0,day 7,day 14,day 28and day 42 after storage,MDA concentration in suspended red blood cells without leukocyte showed a significant increasing trend,MDA concentration in suspended red blood cells without leukocyte on day 42 was significantly higher than that of day 0,day 7,day 14 and day 28 (P＜0.01,0.01,0.01,0.05).There was a positive correlation between the MDA concentration in suspended red blood cells without leukocyte and storage time (r=0.930,P＜0.01).④ On day 0,day 7,day 14,day 28 and day 42 after storage,there was a positive correlation between the ROS concentration in suspended red blood cells without leukocyte and MDA concentration of corresponding time respectively (r=0.877,0.872,0.823,0.786,0.907; P＜0.05).There was also a positive correlation between the mean of ROS concentration of each day and the mean of MDA concentration on day 0,day 7,day 14,day 28 and day 42 after storage (r=0.981,P＜0.01).Conclusions Concentration of ROS and MDA in suspended red blood cells without leukocyte were significantly increased during storage,and oxidative stress reaction was enhanced in red blood cells.This was the important cause leading to the storage lesions of suspended red blood cells without leukocyte.

OBJECTIVETo explore the effect of astaxanthin (ASTA) on oxidative stress of intra- and extra- red blood cells during stored period and the protective function for cell membrane.METHODSThe blood of volunteers was collected to prepare suspended red blood cells without leukocytes. Then the red blood cells were randomly divided into group A, group B, group C and group D. The ASTA was added into MAP preservation solution of group B, group C and group D, the final concentration of ASTA was 5, 10 and 20 µmol/L respectively. Group A was used as control group, in which only the dissolved liquid DMSO of ASTA was added. The red blood cells were stored in refrigerator at 2 °C-6 °C. On day 7, 14, 28 and day 42 of storage, the content of reactive oxygen species (ROS) in red blood cells was detected by fluorescence microplate reader. The content of malondialdehyde (MDA) was detected with TBA method. The content of hydrogen peroxide (H2O2) outside cell was detected with spectrophotometric method. The mean corpuscular volume(MCV) was detected with blood cell analyzer. The content of free hemoglobin(FHb) was detected with chemical colorimetry.RESULTSThe ROS, MDA, FHb and H2O2 levels in B, C and D groups were lower than those in control group during the stored period. On day 7 and 14 of storage, among group B, group C, group D and group A, the MCV showed no difference in comparison with control group. On day 28 and 42 of storage, the MCV in B, C and D groups was lower than that in control group.CONCLUSIONThe ASTA can reduce the oxidative stress level of stored red blood cells inside and outside, relieve the peroxidation damage of cell membrane.

Objective To analyze the distribution of voluntary blood donors in Shijiazhuang area and varied trend from 2004 to 2014,thus providing reference basis for establishing scientific and reasonable donor recruitment measures to ensure adequate blood supply.Methods From 2004 to 2014,the data of voluntary blood donors in Hebei Blood Center were chose as study objects which were collected through SHINOW information management system of Tangshan.The gender,engaged in occupation,age and education level distribution of voluntary blood donors and varied trend of donation proportion from 2004 to 2014 were analyzed by SPSS statistical software.Results ①There were 1 355 476 voluntary blood donors in Shijiazhuang area from 2004 to 2014,the number of voluntary blood donors increased year by year.The proportion of male voluntary blood donors (63.38％) was significantly higher than that of female (36.62％).In occupation distribution analysis,the donation proportion of freelancers was highest (29.66％),followed by student (19.79％),the donation proportion of cadres was lowest (9.26％).In age distribution analysis,the donation proportion of aged 18 to 30 years was highest (57.29％),the donation proportion of over 45 years old was lowest (9.57％).In education level analysis,the donation proportion of college education level or above was highest (39.12％),while the donation proportion of junior middle school education level or below was lowest (24.14％).②During the period of 2004 to 2014 years,the proportion of male voluntary blood donors showed an upward trend,but reverse in female,and both the differences were significantly different (P＜0.01).The donation proportion of students,cadres and workers also decreased,but the donation proportion of peasant increased from 2004 to 2014,and both the differences were significantly different (P＜0.01).The donation proportion of staff increased first and then decreased,and the donation proportion of freelancers increased first and then decreased and then increased again,the donation proportion had obvious volatility.The donation proportion of aged 30 to 45 and over 45 years old showed an increasing trend,hut that of aged 18 to 30 gradually decreased,and both the differences were significantly different (P＜0.01).The donation proportion of junior middle school education level or below showed an increasing trend,but that of college education level or above showed an decreasing trend,and both the differences were significantly different (P＜0.01),while the donation proportion of high school (including technical secondary school) education level varied from 33.86％ to 39.52％.Conclusions The distribution of voluntary blood donors in Shijiazhuang area,such as gender,profession,age and education level,has its own distribution characteristics.The donation proportion of voluntary blood donors from different population shows great volatility,so we should strengthen the blood donation propaganda to different population according their different characteristics,in order to establish a stable team of voluntary blood donors and ensure enough blood supply.

<正>巨噬细胞,包括中性粒细胞和树突状细胞,因为其特有的吞噬能力被认为是体内主要的固有免疫效应细胞。近年研究表明巨噬细胞在维持机体代谢平衡的过程中也起着重要作用,它们广泛存在于各种组织,对代谢信号做出应答、产生抗炎因子及其前体因子,从而对代谢过程进行调节。这些充分表明,由于营养过剩引起的代谢应激会使巨噬细胞和免疫系统调节失衡,并且恶性循环,最终导致炎症不可控制,产生代谢紊乱,比如胰岛素抵抗、脂肪肝、动脉粥样硬化与高脂血症等。

BACKGROUND:There is overwhelming evidence that dietary supplementation with n-3 polyunsaturated fatty acids (PUFAs), mainly EPA (C20:5n-3) and DHA (C22:6n-3), has cardiovascular protective effects on patients with type 2 diabetes mellitus (T2DM) but not on healthy people. Because the T2DM heart increases fatty acid oxidation (FAO) to compensate for the diminished utilization of glucose, we hypothesize that T2DM hearts consume more n-3 PUFAs and, therefore, need more n-3 PUFAs. In the present study, we investigated the changes in cardiac n-3 PUFAs and peroxisomal beta-oxidation, which are responsible for the degradation of PUFAs in a high-fat diet (HFD) and low-dose streptozotocin- (STZ) induced type 2 diabetic rat model.METHODS AND RESULTS:The capillary gas chromatography results showed that all the n-3 (or omega-3) PUFAs, especially DHA (~50%) and EPA (~100%), were significantly decreased, and the n-6/n-3 ratio (~115%) was significantly increased in the hearts of diabetic rats. The activity of peroxisomal beta-oxidation, which is crucial to very-long-chain and unsaturated FA metabolism (including DHA), was significantly elevated in DM hearts. Additionally, the real-time PCR results showed that the mRNA expression of most peroxisomal beta-oxidation key enzymes were up-regulated in T2DM rat hearts, which might contribute to the reduction of n-3 (or omega-3) PUFAs.CONCLUSION:In conclusion, our results indicate that T2DM hearts consume more n-3 PUFAs, especially DHA and EPA, due to exaggerated peroxisomal beta-oxidation.