OBJECTIVETo evaluate the clinical effect of 3D printing-assisted minimal invasive surgery on pelvic fracture by plate internal fixation through a small incision lateral to the rectus abdominis.

METHODSThis retrospective study was conducted among 50 patients with pelvic fracture undergoing anteromedial plate internal fixation between September, 2013 and June, 2015. Thin-layer computed tomography scan data of the patients were input into Mimics software in DICOM format for 3D editing and virtual surgery before the operation. The pelvic model was created by 3D printing. Simulated operation was performed to design the optimum location of the plate screw, prelflex of the plate, screw length measurement and screwing approach. Diaplasis and internal fixation were performed through the extraperitoneal space with a small incision lateral to the rectus abdominis. Matta standard was employed for diaplasis evaluation, and Majeed assessment was used for function evaluation 6 months after the operation.

RESULTSAccording to Matta standard, excellent and good diaplases were achieved in 96% of the cases, as compared with 94% according to Majeed assessment. Radiographic examination showed a good consistency between the internal fixation and simulated operation. No screw entry into the hip joint cavity occurred in these cases. The mean operation time was 127 min in these cases with a mean intraoperative blood loss of 728 mL and a mean incision length of 8.4 cm. Based on the postoperative VAS score, 12 patients reported severe pain, 28 reported moderate pain and 10 reported mild pain. All the patients were advised for early functional exercise after the operation and clinical healing was achieved in a mean of 8 weeks.

CONCLUSIONS3D printing with simulated operation can improve the accuracy and safety of the operation. Preoperative simulation of plate preflex and screw length measurement can shorten the operation time. A small incision lateral to the rectus abdominis allows minimally invasive operation for pelvic fractures.

Blood Loss, Surgical ; Bone Plates ; Bone Screws ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Minimally Invasive Surgical Procedures ; Operative Time ; Pelvic Bones ; injuries ; surgery ; Printing, Three-Dimensional ; Rectus Abdominis ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo investigate effect of lung protective ventilation on respiration and circulation in elderly patients receiving spinal operation performed in the prone position.

METHODSSixty patients undergoing elective spinal surgery were randomized control group [with VT of 10 mL/kg (PBW) and RR of 10-12 /min] and test group [with VT of 6 mL/kg +RMs+PEEP: 5 cmH(2)O (PBW) and RR of 12-18 /min]. Recruitment maneuver was performed once every 30 min. HR, MAP, P(peak), P(Plat), PaO(2)/FiO(2), SpO(2), PaCO(2), WBC, NEUT%, CRP, VAS, pulmonary complications risk score, and clinical pulmonary infection score were recorded before the operation, upon entry in the operation room, at 5 min before and 30 min, 1 h, and 3 h after changing into the prone position, and at 1 day and 3 days after the operation.

RESULTSPulmonary complications risk score, HR, MAP, WBC, NEUT%, and PaCO(2) were all comparable between the two groups (P>0.05). P(peak) and P(plat) of the test group were lower than those of the control group after entering the operation room and at 5 min before and 30 min, 1 h, and 3 h after changing into the prone position (P<0.05). Compared with those in the control group, the oxygenation index at 1 day after the operation was significantly higher and CRP and postoperative clinical pulmonary infection score at 1 day and 3 days after the operation were significantly lower in the test group (P<0.05).

CONCLUSIONSLung protective ventilation can reduce the risk of barotrauma, reduce lung inflammation, and improve postoperative oxygenation in elderly patients undergoing spinal surgery in the prone position without affecting intraoperative hemodynamics or causing CO(2) retention.

Aged ; Blood Gas Analysis ; Hemodynamics ; Humans ; Lung Diseases ; prevention & control ; Neurosurgical Procedures ; Pneumonia ; prevention & control ; Postoperative Complications ; Prone Position ; Respiration, Artificial ; Spine ; surgery

OBJECTIVETo explore the molecular mechanism by which Biejiajian pills inhibit hepatocellular carcinoma in a nude mouse model bearing HepG2 cell xenograft.

METHODSThe inhibitory effect of Biejiajian pills on the growth of HepG2 cell xenograft in nude mice was observed. Immunohistochemical method was used to examine proliferating cell nuclear antigen (PCNA) expression in HepG2 cell xenograft, and TUNEL method was employed to detect the cell apoptosis; the expression levels of β-catenin and Tbx3 were measured by Western blotting.

RESULTSBiejiajian pills significantly suppressed the growth of HepG2 cell xenograft in nude mice. The tumor-bearing mice treated with a high and a moderate dose of Biejiajian pills showed significantly increased apoptosis rate of the tumor cells [(22.9±1.220)% and (14.7±0.50)%, respectively] compared with the control group [(5.5±0.90)%, P<0.05]. Treatment with Biejiajian pills significantly decreased the expressions of PNCA, β-catenin, and Tbx3 in the cell xenograft (P<0.05).

CONCLUSIONSBiejiajian pills can inhibit the growth of HepG2 cell xenograft in nude mice and promote tumor cell apoptosis possibly by inhibiting PNCA expression and the Wnt/β-catenin signaling pathway.

Animals ; Apoptosis ; Carcinoma, Hepatocellular ; drug therapy ; metabolism ; Cell Proliferation ; Drugs, Chinese Herbal ; pharmacology ; Hep G2 Cells ; Humans ; Liver Neoplasms ; drug therapy ; metabolism ; Mice ; Mice, Nude ; Proliferating Cell Nuclear Antigen ; metabolism ; T-Box Domain Proteins ; metabolism ; Wnt Signaling Pathway ; Xenograft Model Antitumor Assays ; beta Catenin ; metabolism

OBJECTIVETo investigate the correlation between a diverse of clinical factors and bone metastases of prostate cancer.

METHODSThe clinical data of 80 patients with prostate cancer were collected and analyzed. The correlations of age, alkaline phosphotase (ALP), prostate specific antigen (PSA), erythrocyte sedimentation rate (ESR), Gleason score, and expressions of androgen receptor (AR) and Ki-67 with bone metastases were analyzed by one-way ANOVA and Logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated.

RESULTSForty-five of the 80 patients (56%) were found to have bone metastasis, who had significantly older age and higher levels of ALP, PSA, ESR, Gleason score, and expressions of AR and Ki-67 than those without bone metastasis (P<0.05). Logistic regression analysis identified PSA, Gleason score and AR expression as independent factors correlated with bone metastasis with OR (95% CI) of 1.005 (1.001, 1.009) (P=0.008), 5.356 (1.431, 20.039) (P=0.013), and 18.594 (2.460, 140.524) (P=0.005), respectively. The cutoff values of PSA, Gleason Score and AR were 67.1 ng/ml, 7.5, and 2.5, respectively; their sensitivities were 55.6%, 75.6%, and 84.0% for predicting bone metastasis with specificities of 97.1%, 82.9%, and 91.4%, respectively.

CONCLUSIONOf the factors analyzed, PSA, Gleason score and AR expression, but not age, ALP, PSA, ESR, or Ki-67 expression, are the predictive factors of bone metastasis of prostate cancer.

Alkaline Phosphatase ; metabolism ; Bone Neoplasms ; diagnosis ; secondary ; Humans ; Male ; Neoplasm Grading ; Predictive Value of Tests ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; pathology ; Receptors, Androgen ; metabolism ; Sensitivity and Specificity

OBJECTIVETo evaluate the effect of different designs of marginal preparation on stress distribution in the mandibular premolar restored with endocrown using three-dimensional finite element method.

METHODSFour models with different designs of marginal preparation, including the flat margin, 90° shoulder, 135° shoulder and chamfer shoulder, were established to imitate mandibular first premolar restored with endocrown. A load of 100 N was applied to the intersection of the long axis and the occlusal surface, either parallel or with an angle of 45° to the long axis of the tooth. The maximum values of Von Mises stress and the stress distribution around the cervical region of the abutment and the endocrown with different designs of marginal preparation were analyzed.

RESULTSThe load parallel to the long axis of the tooth caused obvious stress concentration in the lingual portions of both the cervical region of the tooth tissue and the restoration. The stress distribution characteristics on the cervical region of the models with a flat margin and a 90° shoulder were more uniform than those in the models with a 135° shoulder and chamfer shoulder. Loading at 45° to the long axis caused stress concentration mainly on the buccal portion of the cervical region, and the model with a flat margin showed the most favorable stress distribution patterns with a greater maximum Von Mises stress under this circumstance than that with a parallel loading. Irrespective of the loading direction, the stress value was the lowest in the flat margin model, where the stress value in the cervical region of the endocrown was greater than that in the counterpart of the tooth tissue. The stress level on the enamel was higher than that on the dentin nearby in the flat margin model.

CONCLUSIONSFrom the stress distribution point of view, endocrowns with flat margin followed by a 90° shoulder are recommended.

Bicuspid ; Crowns ; Dental Stress Analysis ; Finite Element Analysis ; Humans ; Stress, Mechanical

OBJECTIVETo explore the role of SIRT3 in regulating the proliferation of hepatocellular carcinoma (HCC) cells in vitro.

METHODSThe protein expression of SIRT3 in 2 normal liver tissues, 2 immortalized hepatocyte lines, and 3 HCC cell lines was determined with Western blotting. SIRT3 overexpression and knockdown in HCC cells were induced by transfection with a vector expressing SIRT3 and a siRNA construct targeting SIRT3, respectively. The efficiency of SIRT3 overexpression and knockdown was detected by Western blot and qRT-PCR, respectively. The proliferation of the transfected HCC cells was examined using Trypan blue exclusion assay, and the cellular DNA synthesis was tested using EdU incorporation assay. The colony-forming ability of the cells was analyzed by colony formation assays.

RESULTSSIRT3 expression was significantly lower in the 3 HCC cell lines than in immortalized hepatocytes and normal liver tissues. SIRT3 overexpression in HCC cells significantly lowered the cell proliferation by 51%-61% (P<0.001), reduced cellular DNA synthesis by 57% (P<0.05), and inhibited colony formation of the cells. SIRT3 knockdown significantly increased the proliferation of HCC cells by 51%-61% (P<0.01) and enhanced DNA synthesis by 137%-149% (P<0.01).

CONCLUSIONSSIRT3 plays a inhibitory role in regulating the proliferation of HCC cells in vitro.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Gene Knockdown Techniques ; Hepatocytes ; metabolism ; Humans ; Liver Neoplasms ; metabolism ; pathology ; RNA, Small Interfering ; Sirtuin 3 ; metabolism ; Transfection

OBJECTIVETo explore the value of detecting bacterial 16S rRNA with 23S rRNA in the diagnosis of periprosthetic joint infection (PJI).

METHODSA prospective study was conducted among 67 patients with previous total hip arthroplasty (THA) undergoing a reoperation for infection (23 patients) or aseptic loosening (44 patients). Bacterial 16S rRNA and 23S rRNA in the interface membrane were detected by real-time PCR and their value in diagnosis of PJI was assessed.

RESULTSThe 16S rRNA and 23S rRNA showed no significant difference in their power in the diagnosis of PJI. The detection of 16S rRNA/23S rRNA showed a higher sensitivity and a greater negative predictive value in PJI diagnosis than the detection of 16S rRNA+23S rRNA (95.7% vs 52.2%, P<0.01; 97.6% vs 79.6%, P=0.01). The specificity, positive predictive value, and accuracy of the 4 diagnostic strategies were not significantly different.

CONCLUSIONSThe diagnostic power of 16S rRNA and 23S rRNA was similar in detecting PJI. Compared with the diagnostic strategy with 16S rRNA+23S rRNA, 16S rRNA/23S rRNA is more sensitive in detecting PJI.

Arthritis, Infectious ; diagnosis ; microbiology ; Arthroplasty, Replacement, Hip ; Humans ; Prospective Studies ; Prosthesis-Related Infections ; diagnosis ; microbiology ; RNA, Bacterial ; isolation & purification ; RNA, Ribosomal, 16S ; isolation & purification ; RNA, Ribosomal, 23S ; isolation & purification ; Real-Time Polymerase Chain Reaction ; Reoperation ; Sensitivity and Specificity

OBJECTIVETo investigate the role of ROG, GATA3 and T-bet in the progression of chronic hepatitis B (CHB).

METHODSThe mRNA levels of ROG, GATA3 and T-bet in peripheral blood mononuclear cells (PBMCs) from 135 patients with CHB (including 45 mild cases, 42 moderate cases, and 48 severe cases) and 15 healthy control subjects were detected by real-time quantitative PCR.

RESULTSThe levels of T-bet mRNA in the PBMCs were significantly higher in CHB patients than in the healthy controls (P<0.05), and also differed significantly between the 3 groups of CHB patients (P<0.05). ROG mRNA levels were significantly higher in severe cases of CHB than in the healthy controls and mild and moderate CHB cases (P<0.05), but were similar among the latter 3 groups (P>0.05). The mRNA level of GATA3 in the PBMCs were significantly higher in moderate and severe CHB cases than in the healthy controls and mild CHB cases (P<0.05). The T-bet/GATA3 ratio was significantly greater in the 3 CHB groups than in the control group (P<0.05) but comparable between the 3 CHB groups (P>0.05). ROG levels were not correlated with GATA3 levels or T-bet/GATA3 ratio in the CHB cases.

CONCLUSIONSThe mRNA levels of ROG, GATA3 and T-bet in the PBMCs are obviously up-regulated in CHB patients and these 3 genes may participate in the progression of CHB. ROG plays an important role in correcting and maintaining the new balance of Th1/Th2.

Case-Control Studies ; GATA3 Transcription Factor ; metabolism ; Hepatitis B, Chronic ; metabolism ; Humans ; Leukocytes, Mononuclear ; metabolism ; RNA, Messenger ; metabolism ; Real-Time Polymerase Chain Reaction ; Repressor Proteins ; metabolism ; T-Box Domain Proteins ; metabolism ; Up-Regulation

OBJECTIVETo compare the osteogenic differentiation potential and osteoclast capacity between stem cells from human exfoliated deciduous teeth (SHED) in the physiological root resorption period and dental pulp stem cells (DPSCs).

METHODSSHED and DPSCs were isolated, purified and cultured in vitro. The two stem cells were examined with ALP staining at 14 days and with alizarin red staining at 21 days of osteogenic induction, and the expressions of the genes associated with osteogenesis and osteoclastogenesis were detected using real-time PCR.

RESULTSThe isolated SHED and DPSCs both showed an elongate spindle-shaped morphology. After osteogenic induction of the cells, Alizarin red staining visualized a greater number of mineralized nodules in SHED than in DPSCs (P<0.05), and SHED also exhibited a stronger ALP activity than DPSCs (P<0.05). RT-PCR test results showed that the two stem cells expressed RANKL,OCN, ALP, OPG and Runx2 mRNA after osteogenic induction, but the expression levels of Runx2, OCN and ALP were lower in DPSCs than in SHED (P<0.05), and the ratio of RANKL/OPG was significantly higher in SHED (P<0.05).

CONCLUSIONSCompared with DPSCs, SHED has not only the ability of osteogenic differentiation but also an osteoclast capacity, which sheds light on the regulatory role of SHED in physiological root resorption bone remodeling.

Alkaline Phosphatase ; metabolism ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Dental Pulp ; cytology ; Humans ; Osteoclasts ; cytology ; Osteogenesis ; Osteopontin ; metabolism ; RANK Ligand ; metabolism ; Real-Time Polymerase Chain Reaction ; Stem Cells ; cytology ; Tooth, Deciduous ; cytology

OBJECTIVETo construct a breast cancer gene-drug network model for extracting and predicting the correlations between breast cancer-related genes and drugs.

METHODSWe developed an algorithm based on the ABC principle and the association rules to obtain the correlations between the biological entities. For breast cancer, we constructed 3 different correlations (gene-gene, drug-drug and gene-drug) and used the R language to implement the associated network model. The reliability of the algorithm was verified by ROC curve.

RESULTSWe identified 185 breast cancer-associated genes and 98 associations between them, 97 drugs and 170 associations between them. The breast cancer genes-drugs network contained 127 genes and 77 drugs with 384 associations between them.

CONCLUSIONSWe identified a large number of different correlations between the breast cancer-related genes and drugs and close correlations between some biological entity pairs that have not yet been reported, which may provide a new strategy for experimental design for testing personalized breast cancer treatment.

Algorithms ; Antineoplastic Agents ; pharmacology ; Breast Neoplasms ; genetics ; Female ; Gene Regulatory Networks ; Genes, Neoplasm ; Humans ; ROC Curve ; Reproducibility of Results