Objective To investigate the effects of metal particles produced by metal prosthesis on oxidative stress levels in human mononuclear cells . Methods Mononuclear cells obtained from peripheral blood of 15 healthy volunteers .Coculture mononu-clear cells with iron particles , cobalt particles , chromium particles , titanium particles and physiological saline , respectively .Levels of reactive oxygen species ( ROS) , malondialdehyde ( MDA) , superoxide dismutase ( SOD) and glutathione peroxidase ( GSH) were as-sessed in mononuclear cells at 6 h, 12 h, 24 h, 36 h, 48 h, respectively . Results Levels of ROS and MDA were higher in the parti-cle groups than that in the control group at 6 h, 12 h, 24 h, 36 h, 48 h, respectively (P<0.05).Levels of ROS and MDA were higher in cobalt particle, chromium particle and iron particle groups than that in the titanium particle group (P<0.05).Levels of SOD and GSH were lower in particle groups than that in the control group (P<0.05).Levels of SOD and GSH were lower in cobalt particle , chromium particle and iron particle groups than that in the titanium particle group (P<0.05). Conclusion Oxidative stress levels increased and anti-oxidant levels decreased in mononuclear cells when cocultured with metal debris .Cobalt particles , chromium parti-cles and iron particles induced higher changes than that in titanium particles .Oxidative stress may play an important role in metal deb-ris-mediated osteolysis .

Objective To explore the impact of silencing PLCε1 gene on proliferation and cell cycle of esophageal carci-noma Eca109 cells.Methods Three plasmid expression vectors (PLCε11, PLCε12 and PLCε13) were constructed to si-lence PLCε1 gene.A negative control plasmid expression vector (HK) was constructed at the same time to serve as a control .The plasmid expression vectors were transfected into esophageal carcinoma Eca 109 cells by cations liposome . The plasmid expression vector with the best interference effect ( PLCε12 ) was chosen .The study included Eca 109 group , HK group and PLCε12 group .Cell viability of Eca 109 cells was evaluated by MTT assay .The cell cycles were detected by FCM .The mRNA expression of P16 and CyclinD1 gene was measured by RT-PCR.Results The cell vi-abilitys of Eca109 cells in PLCε12 group were 80.73%and 75.88%at 48 and 72 h after transfection , which were significantly lower than that of Eca 109 cells in HK group (P<0.001).The percentage of S phase Eca109 cells in PLCε12 group was lower than that of Eca 109 cells in HK group ( P <0.01 ) , the cell cycle of PLCε12 group Eca109 cells was arrested in G0/G1 phase.The P16 gene mRNA expression of PLCε12 group Eca109 cells was higher than that of HK group Eca 109 cells ( P<0.01 ) .Conclusions Silencing PLCε1 gene may up-regulate P16 gene mRNA expression and then arrest the cell cycle at G 0/G1 phase and so inhibit proliferation of Eca 109 cells.

Objective: To explore the association of PLCε1 gene rs2274223 A/G single nucleotide polymorphism (SNP) and rs11599672 T/G SNP with susceptibility to esophageal squamous cell carcinoma (ESCC) in a population of Ci County high-incidence region in Hebei Province. Methods:The genotypes of PLCε1 gene rs2274223 A/G SNP and rs11599672 T/G SNP were determined by polymerase chain reaction–ligase detection reaction method in 527 ESCC patients and 527 healthy controls. Results:The frequency of positive family history of upper gastrointestinal cancer UGIC in ESCC patients was 48.6%, which is significantly higher than that in the healthy controls (39.3%) (χ2=9.25, P=0.002). The AA, AG, and GG genotype frequencies of PLCε1 gene rs2274223 A/G SNP were 48.0%, 43.9%, 8.1%in the ESCC patients and 57.1%, 37.5%, 5.4%in the healthy controls, respectively. Compared with AA genotype, AG, GG, and AG/GG genotypes enhanced the risk of ESCC. The age, sex, smoking status, and UGIC family history-adjusted OR were 1.41 (95%CI=1.09-1.83), 1.71 (95%CI=1.03-2.86), and 1.45 (95%CI=1.13-1.85), respectively. No significant difference was observed in the frequency of the genotype and allele of PLCε1 gene rs11599672 T/G SNP between the ESCC cases and the controls (P>0.05). PLCε1 gene rs2274223 A/G SNP and rs11599672 T/G SNP were combined for analysis using a 2LD software. Results showed that no linkage disequilibrium exists between these two SNPs (D'=0.11). Compared with the most frequent AT haplotype, the GT haplotype sig-nificantly increased the risk of ESCC (OR=1.36, 95%CI=1.08-1.71). Conclusion:PLCε1 gene rs2274223 A/G SNP might serve as a marker predicting genetic susceptibility to ESCC of the population from Ci County. The subjects with UGIC family history and the AG-or GG-genotype carriers had higher risk of ESCC and should receive periodic upper gastrointestinal fiber tests for early detection and treatment of ESCC.

Objective To study the effects of electromagnetic field (EMF) exposure on osteoporosis in ovariectomized mice. Methods Sixty 8-week-old female Kunming mice were divided into four groups at random: a sham operation group (group A), an ovariectomized group (group B), an EMF and ovariectomized group (group C) and a nilestriol and ovariectomized group (group D). Bilateral ovariectomies were performed on all mice except those in group A. The mice of group C were exposured to a 15 Hz, 1.0 mT electromagnetic field. The mice of group D were given at nilestriol 1.5 mg/kg/week. The bone mineral density (BMD) of the lumbar vertebrae was measured before the mice were sacrificed at the 12th week. Blood specimens were collected every two weeks to measure the ac-tivity of alkaline phosphatase (ALP) and the concentration of bone gamma-carboxyglutamic-acid-containing proteins (BGP), calcium and estradiol in the serum. Histological sections were taken to examine and analyze the changes in bone trabeculae in the lumbar vertebrae after 6 and 12 weeks. Results EMF at 15 Hz and 1.0 mT intensity signifi-cantly increased the activity of ALP and the concentrations of BGP and calcium in the serum. In addition, the absorp-tion of bone trabeculae in the lumbar vertebrae was significantly restrained. Conclusions EMF at 15 Hz and 1.0 mT can restrain the development of osteoporosis in ovariectomized mice.

Objective To study the effects of an electromagnetic field (EMF) on the expression of fibro-blast growth factor (FGF-2) and it' s receptor (FGFR-2) mRNA in rat bone marrow mesenchymal stem cells (BMSCs) in vitro. Methods Rat BMSCs were isolated and cultured in vitro. The subcultured cells were divided into different groups to be EMF stimulated at 1.0 mT. The expression of FGF-2 and FGFR-2 mRNA were detected by reverse transcription-polymerase chain reaction (RT-PCR). Results Different frequencies and durations of 1.0 mT EMF exposure induced FGF-2 and FGFR-2 mRNA expression in comparison to blank controls. The expression of FGF-2 mRNA reached a peak after stimulation at 15 Hz for 10 min, 50 Hz for 60 min and 75 Hz for 30 min. And the expression of FGFR-2 mRNA reached a peak after 30 minutes at all frequencies. At 1.0 mT with 30 min exposure, the expression of FGF-2 mRNA peaked after 50 Hz stimulation, and the expression of FGFR-2 mRNA peaked after stimulation at 75 Hz. Conclusions Moderate EMF stimulation can significantly increase the expression of FGF-2 and FGFR-2 mRNA in rat BMSCs in vitro.

Objective To study the effects of pulsed electromagnetic field (PEMF) in promoting tibia and fibula fracture healing in rats. Methods Thirty rats were divided randomly into two groups after establishing the animal model of artificial tibia and fibula fracture: a PEMF treated group and a control group. Radiographs were taken immediately postoperatively and once a week thereafter until being sacrificed after week 5. The blood was sampled to measure the activity of alkaline phosphatase (ALP) and the concentration of bone gamma-carboxyglutamic-acid-con-taining proteins (BGP), calcium and phosphate in serum once a week, respectively. Histological sections were taken at weeks 3 and 5 to observe the pathological change of bony callus. Results PEMF of 15 Hz and 1.0 mT could sig-nificantly increase the amount of bony callus, significantly increase the amount of bony callus, promote the disappea-ring of fracture lines and the appearance of endochondral ossification and mature bone trabecula. The amount of colla-gen in bony callus raised and the process of callus moulding accelerated in PEMF treated group. In addition, the ac-tivity of ALP(P<0.04) and the concentration of BGP(P<0.05) in serum increased. Conclusions The PEMF of 15 Hz and 1.0 mT can obviously promote fracture healing of tibia and fibula in rats.

Objective To summarize the diagnosis and treatment of epispadias with complete prepuce.Methods Between January 2007 and April 2017,clinical records were reviewed for 5 patients diagnosed as epispadias with complete prepuce.The patients were 34 to 66 months old (mean age 44.3 months),who presented with short beaked penis and nonretractile prepuce.A dorsal midline gap between corpora cavernosa could be felt on palpation.There was dorsal chordee with broad spade like glans.The preputial opening was stenosed and dorsally placed urethral opening after retraction of the prepuce.Two patients were incontinent before surgery.Epispadias were coronal type in 2 cases and penile type in 3 cases.All 5 cases were repaired by Thiersch-Duplay procedure.Results The mean follow-up time was 44.5 months (ranged 3 to 98 months).The stricture occurred in 1 patient 1 month after operation,and after dilation and indwelling catheter for a month,the problem resolved.One needed a secondary preputial plasty due to redundant ventral foreskin 8 years after operation.In 3 of 5 cases,parental satisfaction was not achieved mainly due to short length.Only 1 case was incontinent after surgery and the other four achieved urinary continence.Voiding cystourethrogram (VCUG) and ultrasonography (USG) were done in 2 patients who were incontinent before surgery.One case presented right vesicoureteral reflux of Grade Ⅱ and the other was normal.The urodynamic results of 2 patients were normal.Conclusions Epispadias with complete prepuce is extremely rare and its preoperative diagnosis remains difficult.A definitive diagnosis is based upon history,physical examination and imaging tests.Fewer complications and better continence rates were achieved in the boys with epispadias and intact prepuce.Penile length is an important factor affecting surgical outcome.

Objective To discuss the lymph node metastasis of chromophobe renal cell carcinoma (chRCC) in children.Methods One case of chRCC was reported.A eleven-year-old boy was admitted to our hospital on November 2,2017 and presented gross hematuria 4 weeks.No mass was palpable in the abdomen and he felt tenderness in the left back.The ultrasound showed a solid mass in the lower pole of the left kidney.There were a lot of tortuous blood vessels in the tumor.Contrast enhanced CT suggested a mass of 4.5 cm × 6.3 cm × 4.9 cm.The left renal artery and vein were thickened.There was no enlarged lymph nodes were seen in both examinassions.During the operation,the tumor was located in the lower pole of the kidney.The frozen section diagnosis was benign renal tumor.Nephron-sparing surgery was performed.Results The pathology showed that the tumor cells had well-defined cell borders and characteristic perinuclear halos surrounded by eosinophilic cytoplasm that was positive for Hale's colloidal iron stain.Immunohistochemical studies were positive for EMA (+),Ki-67 (5％ +),CK19 (+),CK (+),CD10 (+),CD117(+),CD56(+).Fluorescence in situ hybridization showed absence of TFE3 protein,a strong immune marker of Xp11.2/TFE renal cell carcinoma.1 year after the operation,contrastenhancement magnetic resonance showed long T1 signal near the left renal hilum and the mass showed slight enhancement.ChRCC with regional lymph node metastasis hereby was considered.Intraoperatively,an approximately 2.5 cm × 2.0 cm × 2.0 cm mass was seen near the the left renal hilum.The tumor did not involve left kidney,abdominal aorta and inferior vena cava.The mass was completely removed and introoperative fast-frozen pathology revealed chRCC.Nephron-sparing surgery was performed.Postoperative pathology report chRCC local lymph node metastasis.Follow-up at six months after resection,there was no recurrence or metastatic disease identified.Conclusions chRCC is rare in children and clinical stage is low with a good prognosis.Local recurrence and distant metastasis is rare.

Objective:To compare the efficacies of 3D-printed navigation template assisted and freehand posterior cervical screw fixation of atlantoaxial fractures.Methods:A retrospective cohort study was used to analyze the clinical data of 22 patients with atlantoaxial fractures admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2018 to December 2020. There were 13 males and 9 females, with age range of 26-68 years [(50.7±11.9)years]. All the patients underwent posterior atlantoaxial pedicle screw internal fixation and fusion, among whom 11 patients admitted from November 2019 to December 2020 were assisted with 3D printed navigation templates for the placement of pedicle screws (assisted group) and 11 patients admitted from September 2018 to October 2019 used the traditional way of placing pedicle screws (freehand group). A total of 88 pedicle screws were implanted, with 44 pedicle screws in each group. The operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency were compared between the two groups. The visual analogue score (VAS) and Japanese Orthopedic Society (JOA) score were also compared before operation, at 3 days, 3 months, 6 months postoperatively and at the last follow-up. The accuracy of pedicle screw placement was evaluated according to the Kawaguchi classification, and complications were observed.Results:All the patients were followed up for 24-30 months [(26.4±1.8)months]. The assisted group showed the operation time of (87.3±19.5)minutes and the intraoperative fluoroscopy frequency of (6.4±1.4)times, decreased compared with the freehand group [(115.5±23.0)minutes, (10.3±1.7)times] [(all P<0.01). However, no significant difference was observed in the intraoperative blood loss between the two groups ( P>0.05). Both groups demonstrated comparable VAS and JOA score before operation, at 3 days, 3 months, 6 months postoperatively and at the last follow-up (all P>0.05). Furthermore, the assisted group exhibited a significantly higher accuracy of pedicle screw placement [95.5% (42/44)] compared with the freehand group [79.5% (35/44)] ( P<0.05). Notably, there were no intraoperative vertebral artery injury, spinal cord injury, or cerebrospinal fluid leakage in either group, or internal fixation loosening, fracture, nonunion in either group after operation. Conclusion:Compared with freehand posterior cervical screw placement, 3D-printed navigation template-assisted posterior cervical pedicle screw fixation of atlantoaxial fracture can shorten the operation time, reduce the intraoperative fluoroscopy frequency, and improve the accuracy of screw placement.