Objective To study the clinical effects of the artificial vertebral body of the biomimetic nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite for the structural reconstruction and the height restoring of the vertebral body in the thoracolumbar fractures by the anterior surgical procedures. Methods From December 2003 to January 2006, 42 patients with thoracolumbar fractures received the anterior surgical procedures to decompress and reconstruct the spinal vertebral structure with the artificial vertebral body of the n-HA/PA66 composite. Among the patients, there were 28 males and 14 females, aged 17-67 years, averaged 43.6 years. The thoracolumbar fractures developed at T12 in 5 patients, at L1 in 17, at L2 in 14, and at L3 in 6. The height of the anterior border of the vertebral body amounted to 29%-47% of the vertebral body height, averaged 40.6%. The Cobb angle on the sagittal plane was 21-38° averaged 27.6°. According to the Frankel grading scale, the injuries to the nerves were as the following: Grade A in 7 patients, Grade B in 19, Grade C in 8, Grade D in 6, and Grade E in 2. Results All the 42 patients were followed up for 6-25 months. Among the patients, 36 were reconstructed almost based on the normal anatomic structure, and 6 were well reconstructed. The mean height of the anterior border of the vertebral body was 40.6% of the vertebral body height before operation but 91.7% after operation. And the reconstructed height of the vertebra was maintained. The mean Cobb angle on the sagittal plane was 27.6°before operation but 13.4° after operation. All the patients had a recovery of the neurological function that had a 1-grade or 2-grade improvement except 7 patients who were still in Grade A and 2 patients who were in Grade D. The implant was fused 3-5 months after operation. No infection, nail break, bar/plate break or loosening of the internal fixation occurred. Conclusion The artificial vertebral body of the biomimetic n-HA/PA66composite can effectively restore the height and the structure of the vertebra, can be fused with the vertebral body to reconstruct the spinal structural stability effectively, and can be extensively used in the clinical practice.

Objective:To evaluate the effect of post-conditioning in brain injury induced by myocardial I/R on inflammatory factor and GFAP.Methods:Male Sprague-Dawley rats were randomly allocated into 3 groups (n=8):group Sham,group IR,group IPost.Myocardial IR was induced by occlusion of the anterior descending branch of the left coronary artery for 30 min.group IPost received 3 cycles of 10 s reperfusion followed by 10 s ischemia at the end of myocardial ischemia.The rats were sacrificed at 120 rain of reperfusion and the brains were removed for microscopic examination,inflammatory factors and GFAP.Results:Compared with group Sham,IL-6,IL-8 were significantly increased,IL-10 was down-regulated in group IR(P＜0.01).Post-conditioning can decrease IL-6,IL-8 and up-regulated IL-10(P＜0.01).When compared with group Sham,the expression of GFAP was higher in group IR(P＜0.05),however,the GFAP in group IPost is the most among these three groups(P＜0.01).Conclusion:Post-conditioning could protect brain by decreasing inflammatory factors,increasing GFAP,which both from brain injury induced by myocardial ischemia reperfusion.

Objective To assess the feasibility and clinical efficiency of laparoscopic Madigan enucleation of the prostate for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From Nov.2008 to Jan.2010,24 eases of BPH patients with large prostate ( ＞90 g) were treated in our institute by laparoscopic Madigan enucleation.The average patient's age was 65.2 yrs,the average prostate weight were 132.3 ± 21.9 g,preoperative residual urine was 143.2 ± 23.2 ml,average IPSS was 28.6 ± 3.8,average QOL was 5.5 ± 2.4 and average MFR was 5.4 ± 2.3 ml/s.All patients accepted the laparoscopic Madigan enucleation of the prostate.The pre-surgery and three months post-operative IPSS,QOL,and MFR were compared and analyzed.Results All 24 patients successfully completed the surgery.The resected prostate tissue weight was 104.7 ± 23.3 g,blood loss was 112.5 ± 47.8 ml,postoperative hospital stay was 3.5 ± 0.8 d,bladder irrigation time was 1.3 ± 0.9 d,drainage time was 2.3 ± 0.5 d and catheterization time was 3.1 ±0.4 d.Three months after surgery,patient's IPSS was 4.5 ± 1.8,QOL was 19.9 ±3.1,and MFR was 18.5 ±2.9 ml/s.All the parameters significantly improved compared with the pre-surgery data ( P ＜ 0.05 ).Conclusions Laparoscopic Madigan enucleation of the prostate is a safe and effective method in the treatment of BPH with large prostate volume.

BACKGROUNDAdrenocorticotrophin (ACTH)-secreting pituitary adenomas account for approximately 7% - 14% of all pituitary adenomas, but its pathogenesis is still enigmatic. This study aimed to explore mechanisms underlying the pathogenesis of ACTH-secreting pituitary adenomas.

METHODSWe used fiber-optic beadarray to examine gene expression in three ACTH-secreting adenomas compared with three normal pituitaries. Four differentially expressed genes from the three ACTH-secreting adenomas and three normal pituitaries were chosen randomly for validation by reverse transcriptase-real time quantitative polymerase chain reaction (RT-qPCR). We then analyzed the differentially expressed gene profile with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway.

RESULTSFiber-optic beadarray analysis showed that the expression of 28 genes and 8 expressed sequence tags (ESTs) were significantly increased and the expression of 412 genes and 31 ESTs were significantly decreased. Bioinformatic and pathway analysis showed that the genes HIGD1B, EPS8, HPGD, DAPK2, and IGFBP3 and the transforming growth factor (TGF)-β signaling pathway and extracellular matrix (ECM)-receptor interaction pathway may play important roles in tumorigenesis and progression of ACTH-secreting pituitary adenomas.

CONCLUSIONSOur data suggest that numerous aberrantly expressed genes and several pathways are involved in the pathogenesis of ACTH-secreting pituitary adenomas. Fiber-optic beadarray combined with pathway analysis of differential gene expression appears to be a valid method of investigating tumour pathogenesis.

ACTH-Secreting Pituitary Adenoma ; etiology ; genetics ; Adenoma ; etiology ; genetics ; Adult ; Disease Progression ; Expressed Sequence Tags ; Extracellular Matrix Proteins ; physiology ; Female ; Fiber Optic Technology ; Gene Expression Profiling ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; methods ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; physiology ; Transforming Growth Factor alpha ; physiology

Objective To investigate the feasibility and role of single-dose three-dimensional dynamic contrast-enhanced magnetic resonance angiography(SD 3D DCEMRA)in evaluating soft-tissue hemangioma of limbs.Methods The transit time(TT),signal intensity of peak enhancement(SPE)and duration of peak enhancement(DPE)of the femoral,popliteal and anterior tibial arteries at the level of the middle section were assessed in 30 healthy volunteers after intravenous bolus injection of single-dose contrast media at the rate of 3 ml/s.Forty-five patients with soft-tissue hemangioma and 9 patients with schwannoma of the extremities underwent both conventional MRI and SD 3D DCEMRA.The acquisition time of SD 3D DCEMRA ranged from 10 to 12 s,and early arterial,late arterial and venous phases of SD 3D DCEMRA images were acquired consecutively.The conventional MRI and SD 3D DCEMRA findings of the 45 patients with hemangioma were observed and compared with those of the 9 cases of sehwannoma.Results(1)The TT,SPE and DPE of the femoral,poplitcal and anterior tibial arteries were(15?5)s,(400?50),(11.9? 2.6)s;(19?7)s,(320?45),(16.8?3.6)s and(27?10)s,(270?39),(22.0?6.6)s respectively. The comparison of TT(F=6.91,P0.01).The tumoral feeding artery was visualized in all cases(100%).(3)Two cases of hemangioma missed on conventional MRI were correctly diagnosed on SD 3D DCEMRA owing to the visualization of both the tumoral mass and the feeding artery.(4)For schwannoma,neither the dynamic visualization of tumoral mass nor the feeding artery was demonstrated on SD 3D DCEMRA.Conclusion SD 3D DCEMRA is technically feasible to evaluate the limb soft-tissue hemangioma.Dynamic visualization of tumoral mass and demonstration of the tumoral feeding artery are the characteristic features of the tumor on SD 3D DCEMRA.

Objective To investigate the clinical features,diagnosis and treatment of prostate sarcoma. Methods19 cases of prostate sarcoma had been treated in our hospital from Oct 1995 to Sep 2010,aged from 16 to 48 years (mean,36 years).They were hospitalized due to different degrees of difficulty in urination,6 cases with bladder irritation,3 cases with gross hematuria,3 cases with blood clots in urination,3 cases with difficult defecation,2 cases with urinary tract infection,and 1 case with low back pain.Digital rectal examination showed prostate volume increased significantly in 16 cases,of which 6 cases prominent into bladder,and 3 cases touched hard nodules and tenderness.B ultrasound examination showed prostate neoplasms with internal echo uneven.Pelvic MRI in 12 cases indicated irregular soft tissue density in prostate with unclear edge,a high-low mixed signal inside,and mass protruding outward,among which 7 cases with significantly enlarged prostates and unclear bladder boundaries,6 cases with unclear boundaries with rectum,and 1 case with solid and cystic change. Pelvic CT in 10 cases showed irregular prostate tumors,among which 5 cases with tumor violation of bilateral seminal vesicle,2 cases with tumor invasion of unilateral seminal vesicle,and 3 cases with lymph node enlargement.Chest X-ray in 2 cases showed widespread metastatic lung. Results Different treatments were used according to different conditions:6 cases with full cystoprostatectomy,8 cases with radical prostatectomy,1 case with skin routine ureter fistulization and rectal fistulization,1 case with bladder fistulization,1 case with chemotherapy after prostate biopsy,and 2 cases with prostate biopsy alone. Pathological diagnosis showed 6 cases of leiomyosarcoma,6 cases of rhabdomyosarcoma,2 cases of malignant mesenchymal tumor,1 case of phyllodes sarcoma,1 case of granulocytic sarcoma,1 case of phyllodes sarcoma,1 case of malignant fibrous tissue sarcoma,and 1 case of poorly differentiated muscle induced sarcoma. Immunohistochemical examination in 19 cases of paraffin specimens stained with SP showed vimentin was positive,smooth muscle actin and myoglobin in leiomyosarcoma and rhabdomyosarcoma were positive respectively,and desmin in two kinds of afore-mentioned sarcoma expressed in different level.CD117 and S-100 were weakly positive in 1 patient with undifferentiated component and 1 patient with liposarcoma of the malignant mesenchymoma.Peroxidase was positive in granulocytic sarcoma,p63 was positive in lobulated sarcoma,and CD34 was positive in malignant fibrous histiocytoma.14 patients were given chemotherapy,among which 6 cases were combined with radiotherapy.19 cases were followed up for 4 -30 months (mean 13 months).4 patients survived for 24 -30 months without recurrence,while 15 cases died within 18 months after diagnosis. Conclusions The prostate sarcoma is a clinically rare malignant tumor with high degree of malignancy and unspecific clinical manifestations.The diagnosis relies on biopsy and immunohistochemistry,and early diagnosis and radical surgical excision are helpful for increasing survival rate.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

Objective To study the stability of micro-implant orthodontic anchorage(MA)with different pitch in the case of immediate loading.Method Employing 3D finite element analysis method,the stress and dis-placement distribution on the bone interface of MIA with different pitch(0.3 mm、0.5 mm、0.7 mm and 1.0 mm,respectively),which was 1.47 N loaded vertically in the major axis direction,were analyzed.Result The pitch affected the stress distribution significantly,because the maximum stress increased with the pitch decreasing and the impact of pitch on stress distribution on neck and central locations of MIA were different;to decrease the pitch could reduce the max displacement of the jaw,but the impact of pitch on displacement distribution of MIA was not significant.Condusions In the case of immediate loading.MIA with pitch 0.5 mm-0.7 mm is suggested to be selected as orthodontic anchorage in the clinic.

OBJECTIVETo investigate the expression of the Pim-1 gene in the LNCaP cells of the animal model of orthotopically implanted prostate cancer by surgical castration simulating androgen-deprivation therapy.

METHODSWe equally allocated 32 male BALBc-nu mice into 4 groups, androgen-dependent prostate cancer (ADPC), androgen-deprivation therapy (ADT) , castration-resistant prostate cancer (CRPC) and blank control, and established the models of orthotopically implanted tumor using human prostate cancer LNCaP cells. We detected and ,compared the expressions of Pim-1, PSA, and androgen receptor (AR) in the tumor tissues of different groups by RT-PCR. qRT-PCR, ELSIA and immunohistochemistry.

RESULTSThe relative gray scales in the ADPC and CRPC groups were 0.59 ± 0.01 and 1.14 ± 0.02, with statistically significant differences from 0.62 ± 0.03 in the ADT group (P < 0.05), and the Δ Ct values of Pim-1 were 6.15 ± 0.34 and 4.56 ± 0.23 in the former two groups, also with significant differences from 5.11 ± 0.21 in the latter (P < 0.05). The results of 2-ΔΔ Ct relative quantification analysis showed that the amplification products of Pim-1 in the ADT and CRPC groups increased 2.05 and 3.01 times respectively that of the ADPC group. The concentration of PSA was significantly higher in the ADPC ([480 ± 25] pg/ml) and CRPC ([870 ± 23] pg/ml) than in the ADT ([170 ± 32] pg/ml) and blank control groups (0 µg/L) (P < 0.01). The mean optical densities of Pim-1 and AR proteins were 0.017 ± 0.002 and 0.032 ± 0.009 in the ADPC group and 0.024 ± 0.002 and 0.040 ± 0.011 in the CRPC group, both with significant differences from those in the ADT group (0.018 ± 0.001 and 0.019 ± 0.006) (P < 0.01).

CONCLUSIONPim-1 is highly expressed in nude mice with prostate cancer receiving androgen-deprivation therapy and plays an important role in the progression and metastasis of prostate cancer.

Androgen Antagonists ; therapeutic use ; Animals ; Disease Progression ; Gene Expression ; Heterografts ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasms, Hormone-Dependent ; metabolism ; Prostate-Specific Antigen ; metabolism ; Prostatic Neoplasms, Castration-Resistant ; genetics ; metabolism ; therapy ; Proto-Oncogene Proteins c-pim-1 ; metabolism ; Receptors, Androgen ; metabolism

By inquiring the medical students under the background of grouping teaching between the mainland students and the oversea Chinese students,we have got something about their attitude toward the credit system.The result will help us to improve the teaching renovation in medical education.The questionnaire including implementing of credit system,standard credit system, grouping teaching,curriculum,tutor system of the undergraduates,the administration of education,and so on.Then we analyze and get the result.