BACKGROUND: Abnormal hematopoietic microenvironment is an important factor causing dyshematopoiesis. However, no consensus has been reached on the sensitivity of hematopoietic stromal cells to irradiation.OBJECTIVE: To observe the changes of marrow stromal cells (MSCs) cycle and DNA content during the early stage of irradiation damage in mice, so as to further understand dyshematopoiesis due to radiation and provide scientific basis to avoid deleterious factors in hematopoietic environment.DESIGN: Completely randomized grouping and randomized controlled study based on the experimental animals.SETTING: Central laboratory of altitude military affairs medical department and altitude research institute of preventive medicine department, a military medical university of Chinese PLA.MATERIALS: This study was carried out at the Experimental Animal Center of Third Military Medical University between October 2002 and April 2003. A total of 60 healthy male Kunming mice were randomly divided into irradiation damage group and healthy control group, each having 30 mice.METHODS: The 30 mice in irradiation damage group were exposed to 60Co-γ of irradiation at a dose rate of 1.27 Gy/minutes within a distance of 4 m. Then the mice' marrow cells were harvested at day 3 and day 7 after irradiation, and were cultured in vitro for 14 days and 21 days for observation. Meanwhile the other 30 healthy mice unexposed to irradiation were considered as normal controls.MAIN OUTCOME MEASURES: Post-radiation number of MSCs colonies,cell cycle and DNA content.RESULTS: Although MSCs could grow and be adhered to walls after being exposed to irradiation of 5.0 Gy/s, the number of MSCs colonies was found significantly decreased compared to that of rnormal control group( P < 0.01 ).The colony number of the MSCs irradiated for 7 days obviously increased than that of MSCs irradiated for 3 days; however, MSCs recovered slowly and resulted in prolonged culture time, indicating the inhibited proliferation of MSCs due to irradiation damage. Results of flow cytometry showed that cells in G2+ M phase(2.60±0.41, 4.20±1.27) and DNA content (58.40±0.79,61.17 ± 1.35) in irradiation groups after 3-day and 7-day irradiation were obviously lower than those of normal control group(12.60 ±0. 75, 78.57±0. 83)(P <0.05-0.01).CONCLUSION: MSCs have relatively high sensitivity to irradiation damage and longer persisting period.

Objective To observe the clinical effects of open kinetic chain and closed kinetic chain exercise in the early period of anterior cruciate ligament reconstruction rehabilitation,provide the theoretical and clinical experiences for the early rehabilitation of the anterior cruciate ligament reconstructed knee.Methods From February 2009 to June 2010,60 patients undergoing single-bundle anterior cruciate ligament reconstructions by using hamstring tendon allograft were enrolled in the study,and were divided into two groups:open kinetic chain group(30 cases,30 knees)and closed kinetic chain group(30 cases,30 knees).In accordance with the rehabilitation procedures for six months,no statistically significant differences were found between the two groups in Lysholm scores,International Knee Documentation Committee(IKDC)scores and one-leg hop test preoperative.The active and passive range of notion,Lysholm scores,IKDC scores,one-leg hop test and KT-1000 were evaluated three and six months after surgery.Results Three months after surgery,no significant differences were found in passive range of motion,Lysholm scores,IKDC scores,but significant differences were found in active range of motion,one-leg hop test and KT-1000,and the closed kinetic chain group was significantly better than the open kinetic chain group.Six months after surgery,no significant differences were found in active range of motion,passive range of motion,one-leg hop test,Lysholm scores,IKDC scores,but significant difference in KT-1000,and the closed kinetic chain group was significantly better than the open kinetic chain group.Conclusion Closed kinetic chain exercise is benefit for recovery of muscles strength,proprioception and protect the graft in the early rehabilitation period after anterior cruciate liganent reconstruction.

Objective To evaluate the effectiveness of comprehensive prevention and control measures on coal-burning-borne endemic tluorosis in Xishui,on residents healthy behavior and situation of the disease.Methods In 2013,five towns were selected according to their location of east,south,west,north and centre.Three villages and one elementary school in each town were chosen,and 20 families' related behavior and fluorine prevention knowledge questionnaire in each village were surveyed.All the students from one class aged 8-12 of grade 3-6 in each school were selected,according to the Diagnosis of Dental Fluorosis,dental fluorosis was examined and fluorine knowledge questionnaire was surveyed.At the same time,the detection rate of dental fluorosis of children aged 8-12,information of the knowledge about prevention and cure of fluorosis and related behavior of target groups in 2007,and the urinary fluoride contents of children aged 8-12 in 2000 were collected.Analysis and comparison of the data in 2000,2007 and 2013 were done.Results After the intervention,the witting rates of students and family householders 90.95％ (11 773/12 945),84.27％ (3 792/4 500),were significantly higher than those of before the intervention [19.29％ (1 039/5 385),26.27％ (394/1 500),x2 =9 279.14,1 794.22,all P ＜ 0.01].Proper utilization rate of cooking stove was 100.00％ (37/37),iron stove utilization rate was 99.64％ (279/280),dry chili correct rate was 100.00％ (299/299) and before the intervention,these values were 3.20％ (43/1 345),90.28％ (1 207/1 337)and 62.14％ (855/1 376),respectively,and the differences were statistically significant (x2 =601.12,27.28,27.28,all P ＜ 0.01).Children's dental fluorosis detection rate was 24.21％ (206/851),compared with that of before the intervention,61.62％ (2 150/3 489),the difference was statistically significant (x2 =385.93,P ＜ 0.01).Children's urine fluoride was (0.51 ± 0.29) mg/L,and before the intervention [(1.55± 1.59) mg/L],the difference was statistically significant (t'=10.25,P ＜ 0.01).Conclusions The effect of comprehensive prevention and control measures against coal-burning-borne endemic fluorosis in Xishui are remarkable.The residents health related behavior has been formed and the condition is reduced markedly.

Objective To investigate the impact of graft position shift on anterior cruciate ligament reconstruction induced by femoral fixation of interference screw. Methods Nineteen fresh cadaveric knees were used and assigned to three groups. 1) Study of graft position shift: 5 knees were randomly selected, interference screws of 7 mm, 8 mm and 9 mm were used in autologous tendon fixation, then the graft position shift were measured. 2) Study of isometry: 7 knees were randomly divided into the isometric reconstruction group (D group). In the D group, Retrobutton, interference screw and interference screw in location-corrected bone tunnel were used respectively as fixation. The isometry of grafts was evaluated. 3) Study of tibia anterior translation: 7 knees were randomly divided into the anatomic reconstruction group (J group). In the J group,the tibia anterior translation was measured in four different conditions in the same joint: intact knee joint,knee joint without ACL, ACL anatomic reconstruction by interference screw fixation, and ACL anatomic reconstruction by interference screw fixation with corrected bone tunnel location. Results 1) With 7 mm, 8mm and 9 mm interference screw fixation, graft position shift were (2.36±0.11) mm, (2.72±0.06) mm and (3.00±0.06) mm respectively. 2) Graft length change: graft length change in Retrobutton group and corrected bone tunnel group were less than 3 mm, while graft length change in those fixed with interference screw were stretched in more than 3 mm. 3) Study of tibia anterior translation: there was no difference among the intact group, the anatomic group and the corrected group at 0° and 15°. However, the difference was found between the intact group and other groups at 30°、60° and 90° of flexion, as well as between these two reconstructed methods at 20° joint flexion (P＜0.05). Conclusion In both isometric and anatomic ACL reconstruction with interference screw, the graft is pushed tightly toward the femoral tunnel wall, which shifts the graft away from the desired position. In our study we find out that the corrected location of the femoral bone tunnel significantly improves the isometry of ACL reconstruction and anatomic reconstruction.

Objective To explore the clinical effect of percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture.Methods 63 feet of 55 patients with calcaneal fractures were involved in this study.According to Sanders fracture classification including 38 feet of Sanders Ⅱ,18 feet of Sanders Ⅲ,7 feet of Sanders Ⅳ.There were 6 to 16 days interval between the injuries and the surgeries.The patients were treated by percutaneous osteoplasty with the SKy bone expander system.The standard of operation was the satisfaction of reduction and Bohler's and Gissane's angles under X-ray.Results All of 63 feet of 55 patients were followed up for average 22 months.According to the criterion of therapeutic effect,the results were as follows:excellent in 30 cases,good in 26 cases,fair in 7cases,and no poor case.The excellent and good rate was 88.9％.Conclusion Percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture,especially in reduction and fixation of Sanders type Ⅱ and Sanders type Ⅲ,can recover Bohler's and Gissane's angles,significantly shorten the duration of illness,and has fast recovery and can possess satisfactory curative effect,and it is worth popularizing.

Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61％) were injured from falling objects.Fifty-eight patients (84％) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32％) sustained associated injuries.Twenty-nine patients (42％) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.

Objective To detect the patterns of cognitive impairment between patients with paranoid schizophrenia and patients with bipolar mania by using the Cambridge Neuropsychological Test Automated Battery (CANTAB) ,and to explore research clues for finding of cognitive endophenotype in patients with paranoid schizophrenia or bipolar mania. Methods Six CANTAB subtests and the seven subtests of the Wechsler Abbreviated Scale of Intelligence (WAIS short form) were administered to 35 patients with paranoid schizophrenia and 33 patients with bipolar mania who were drug naive experiencing an acute episode, as well as 30 healthy controls. Results Patients with paranoid schizophrenia and bipolar mania demonstrated impairments in 13 of the 15 cognitive indicators in CANTAB. After controlling IQ, both patient groups remained as significantly different from normal controls in terms of search strategy(36. 8 ±3.56,37.24 ±4. 21,30. 33 ±6.24) ,between-search errors(40. 86 ± 19.97,40.24 ± 18.92,15.4 ±17.22) on the SWM test,the proportion of hits(0.54 ±0. 18,0.56 ±0.15,0.78 ± 0.17) on the RVIP test,total errors(45.26 ±36.36,46.61 ±33.32,14 ± 11.7) and EDS errors (12.43 ±9.96, 13.18 ±8.98,4.97 ±6.09)on the IED test. Between search error in the SWM test was positively correlation with YMRS scores ( r=0.38, P=0.039) in bipolar patients. Conclusion Both patient groups demonstrated a comparable profile of cognitive impairments during active periods of their condition. The cognitive impairment index may be a discreet cognitive endophenotype overlapping the disorders.

OBJECTIVETo evaluate the value of CT common rail technique for application in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).

METHODSTwenty-seven NPC patients underwent Somatom CT scans using the Siemens CTVision system prior to the commencement of the radiotherapy sessions. The acquired CT images were registered with the planning CT images using the matching function of the system to obtain the linear set-up errors of 3 directions, namely X (left to right), Y (superior to inferior), and Z (anterior to posterior). The errors were then corrected online on the moving couch.

RESULTSThe 27 NPC patients underwent a total of 110 CT scans and the displacement deviations of the X, Y and Z directions were -0.16∓1.68 mm, 0.25∓1.66 mm, and 0.33∓1.09 mm, respectively.

CONCLUSIONCT common rail technique can accurately and rapidly measure the space error between the posture and the target area to improve the set-up precision of intensity-modulated radiotherapy for NPC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Patient Positioning ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, X-Ray Computed ; methods

BACKGROUNDTo investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis.

METHODSThirty-eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized.

RESULTSHemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured.

CONCLUSIONSBronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.

ObjectiveTo identify the metabolic alterations on prefrontal lobes and hippocampus in male patients with the first-episode mania using proton magnetic resonance spectroscopy(H-MRS).Method 18 male patients with the first-episode mania and 27 healthy subjects matched for age,gender,and years of education were included in the study.1 H-MRS was performed in two sides of the hippocampus and frontal lobes regions.The ratios of N-acetylaspartate (NAA),choline (Cho) to creatine (Cr) were measured.One-sample t test and paired-samples t test were used for statistic process.ResultsMale patients with the first-episode mania presented decreased NAA/Cr in left frontal lobe and hippocampus regions when compared to normal controls( left frontal lobe (1.68 ±0.19 vs 1.86 ± 0.19),hippocampus ( 1.32 ± 0.10 vs 1.43 ± 0.16 ),P ＜ 0.01 ),but there were no significant difference in NAA/Cr for right frontal lobe and hippocampus regions between groups ( all P ＞ 0.05 ).Two groups also showcd no significant difference for Cho/Cr in bilateral frontal lobe and hippocampus (P ＞ 0.05 ).Conclusion There is significant difference of manifestation of 1H-MRS between male patients with mania and normal controls,which reflects neuronal dysfunction in the prefrontal lobes and hippocampus.