BACKGROUND: The metacarpal fascial spaces of hand are the potential structure that is not virtual, so that difficulties are presented in diagnosis and treatment of diseases of the metacarpal fascial spaces of hand. In order to solve the difficulties,anatomical borderline and abut relationship of the metacarpal fascial spaces of hand have to be sufficiently understood. OBJECTIVE: The borderline and abut of the metacarpal fascial spaces of hand were detailedly observed and researched by fresh cadaveric dissection, thin sectional anatomy and computer image recognition technology, and the 3-D reconstruction technology was utilized to reconstructed the metacarpal fascial spaces in this paper, so the abut relationship of the metacarpal fascial spaces of hand could be displayed, and the detailed anatomical data of imaging diagnosis and surgical treatments of disease of the fascial spaces of hand could be provided. DESIGN: Repeated measuring design.SETTING: The 251 Hospital of Chinese PLA and Central Laboratory of the Third Military Medical University of Chinese PLA. MATERIALS: Twelve adult fresh cadaveric hands which involved six right hands and six left hands and wrist joint, had no organic damage by naked observation, provided by the Department of Anatomy, the Third Military Medical University of Chinese PLA, among one right hand and one left hand were waiting for being mill-cut and thin cross-section dissected and imaging reconstructed. Among ten hands were observed by fresh cadaveric anatomy. METHODS: The trial was carried out in the 251 Hospital of Chinese PLA and Central Laboratory and Department of Anatomy of the Third Military Medical University of Chinese PLA from May 2003 to February 2006. Based on the gross anatomy, thin cross-section anatomy, visible human and virtual human technology theory, the metacarpal fascial spaces of hand were three-D reconstructed in microcomputer.MAIN OUTCOME MEASURES: Anatomical borderline and about relation of the metacarpal fascial spaces of hand. RESULTS: Display of observation result of adjacent and dimension of the midpalmar space and the thenar space by fresh cadaveric anatomy combined with thin cross-section anatomy, computer image recognition technology, and the 3-D reconstruction technology: The anterior borderline of the MPS was the digital flexor tendons of middle finger, ring finger, little finger and the 2nd lumbrical muscle (LM), 3rd LM, 4th LM; the posterior borderline was the palmar interosseous fascia before 3rd palmar bone, 4th palmar bone, 5th palmar bone and corresponding interosseous muscles; the lateral borderline was the palmar intermediate septum; the medial borderline of the MPS was the medial intermuscular septum of palm. In addition, the distal section of the MPS which was separated into three little spaces by two septums of connective tissue, and 3rd 4th, 5th digital flexor tendon and 2nd, 3rd, 4th LM were respectively contained by the three little spaces. The proximal of this space opened to the posterior space of antebrachial flexor by the carpal canal; the distal of this space opened to 2nd, 3rd, 4th web space (WS) by 2nd, 3rd, compartment of 4th LM, and continuously the dorsal subcutaneous space and the subaponeurotic space. The anterior borderline of the TS was the 1st digital flexor tendon and the 1st LM; the posterior borderline was the fascia of abductor pollicis; the medial borderline was the palmar intermediate septum (PIMS); the lateral borderline was the tenden sheath of flexor pollicis longus and the lateral intermuscular septum of palm. The distal of this space opened to 1st WS by compartment of the 1st LM, and continuously to the dorsal subcutaneous space and the subaponeurotic space; the proximal of the TS was close.CONCLUSION: The proximal of the thenar space is close, the distal section of the metacarpal fascial spaces is separated into three little spaces, and the computerized three-D renconstruction of the fascial spaces of hand can provide some guidance for imaging diagnosis and surgical treatments.

Objective To evaluate the dose distribution of target volume and normal tissues in forward intensity modulated radiotherapy (fIMRT) and inverse intensity modulated radiotherapy (iIMRT) modes for breast cancer after radical mastectomy.Methods Both fIMRT and iIMRT plans were developed for 10 patients with breast cancer after radical mastectomy.On each patient's CT images the supraclavicular area, chest wall, and internal mammary area were delineated.The prescription dose was 50 Gyin 25fractions.In the fIMRT plan X-ray irradiation at the dose of 6 MV was adopted for the supraclavicular and the chest wall areas and electron irradiation at the dose of 9 - 12 MeV was adopted for the internal mammary area, and the doses of cold and hot spots were adjusted according to the fitting doses of these 3 regions.In the iIMRT plan the supraclavicular area, chest wall, and internal mammary area were taken asa whole target, 6 MV X-rays was used, and inverse optimal design was performed.The dose distribution oftarget volume and normal tissues, conformal index (CI) , and heterogeneous index (HI) , and acceleratormonitor unit (MU) were analyzed using dose-volume histogram (DVH)for the two intensity modulated modes.Results The maximum dose of PTV of the iIMRT plan was significantly lower than that of the fIMRT plan(t = -3.23,P ＜0.05), the minimum dose and V95% of PTV of the iIMRT were significantly higher than those of the fIMRT plan(t = 4.08, -2.69, both P ＜0.05).The CI level of the iIMRT plan was significantly higher than that of the fIMRT plan and the HI level of the iIMRT plan was significantly lower than that of the fIMRT plan (t = -3.13, 2.74, both P ＜0.05).There were not significant differences in V10, V20, V25, V30, and Dmean of the ipsilateral lung between these 2 groups.However, the V15 of ipsilateral lung of the iIMRT group was significantly lower by 4.2% than that of the fIMRT group (t= 3.2, P ＜ 0.05).There were not significant differences in the mean dose (Dmean) and V30 of heart, and Dmean of contralateral lung and contralateral breast between these 2 groups.Conclusions Compared with fIMRT, the iIMRT plan results in more PTV coverage, higher conformity index, and more homogeneous dose distribution, with lower dose upon the lung at the affected side, and better protection of the contralateral lung, heart, and breast.

Objective To investigate expression of slug and E-cadherin in pancreatic cancer tissues and determine the inhibitory effects of anti-Slug, an anti-sense plasmid, on the invasion of pancreatic cancer cell lines in vitro. Methods Slug and E-cadherin protein and mRNA was analyzed by IHP and RT-PCR in 36 cases of pancreatic cancer. Then anti-Slug plasmid was transfected into herin and Slug expression. The inhibitory effects of anti-sense Slug were also detected by Transwell motility assay and Matrigel invasion assay. Results The expression of Slug and mRNA in metastatic pancreatic cancer tissue was higher than that in non-metastatic tissue. E-cadherin and mRNA was lower in metastasis tissues(P＜0.05). The inverse relationships were further observed by transient transfection of anti-Slug into SW1990H4 cells. The downregulated expression of Slug and re-expression of E-cadherin were found. The Slug mRNA levels were 0.985±0.016,0.973±0.014, 0. 554±0. 011 after 0, 48 h of transfection of anti-sense Slug, and that of E-cadherin were 0.120±0.001, 0.360±0.002, 0. 727±0. 006, respectively. The diference was significant between different time points (P＜0.05). The Slug mRNA levels were 0. 206±0.017, 0.968±0.015, and that of E-cadherin were 0. 18±0.002,0.727±0.006 after stable transfection of anti-sense Slug, and control plasmid, respectively. The diference was significant (P＜0.05). The motility activity(393±28, 352±24, 96 ±13 )and the invasion activity (223 ± 69, 202 ± 64, 65 ±19) of1 antisense Slug transfectant cells were significantly decreased as compared with those of control cells (P＜0.05). Conclusions Higher expression of slug and lower expression of E-cadherin is related to the invasion and metastasis in pancreatic cancer. A reverse corelation of E-cadherin and Slug expression exists in pancreatic cancer. Slug is possibly a potential target for cancer gene therapy blocking invasion and metastasis in human pancreatic cancer.

Objective To explore the influence of PUMA on radiosensitivity of pancreatic cancer AsPC-1 cells after Slug gene inhibition by transfected short interferencing RNA(siRNA). Methods The AsPC-1 cells were infected with MOI 10,50,100 for 72 h, respectively. The expression of Slug and PUMA was analyzed by Western blotting and immunohistochemistry methods. The transfected and control cells were exposed to 4 Gy γ-rays. The cells inhibition rate was examined by MTT, Hoechst 33342 and IP double staining. DNA ladder and Giemsa staning was used to observe apoptosis. Results The relative value of Slug expression was 0.831 ±0.14,0. 546 ±0.12 and 0.178 ±0.08 after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly lower than that of control group ( F = 4. 992,P ＜ 0.05 ).The relative value of PUMA was 0. 325 ±0. 07,0. 593 ±0. 11 and 0. 978 ±0. 12, after AsPC-1 was infected with Slug-siRNA ( MOI 10,50,100) for 72 h, significantly higher than that of control group ( F = 4. 324,P ＜ 0. 05 ). The cell proliferation rate was ( 78.76 ± 9. 36 ) % in transfection combined with radiosensitivity group, significantly higher than that of transfection group [ ( 43.68 ± 6.71 ) % ] and radiosensitivity group alone [( 19.25 ± 3.72)% ] (F = 5.056, P ＜ 0.05). The apoptosis of transfection combined with radiosensitivity group was significantly higher than that of others. Conclusions Slug gene targeting siRNA could inhibit the expression of Slug, and consequently increase the activation of PUMA expression, and so enhance the radiosensitivity to γ-rays.

Objective To explore the influencing factors for postoperative adjuvant chemotherapy effects in elderly patients with breast cancer. Methods Five hundred and ninety female patients aged 65 years or older with invasive breast cancer were treated in our hospital, and the influencing factors for postoperative adjuvant chemotherapy effects were analyzed by chi-square test and logistic regression. Results Two hundred and thirty-one (39.2%) patients received postoperative adjuvant chemotherapy. The results showed that diabetes, age, patterns of operation and pathological characteristics of tumor had significant influences on postoperative adjuvant chemotherapy effects (χ2=4.49,88. 27,23.49 and 9.40, all P<0.05). Logistic regression analysis showed that age, tumor size, lymph node status(pN) and estrogen receptor (ER) status were related to postoperative adjuvant chemotherapy effects(χ2=68.857,15. 284,43. 540 and 7.009 ,all P<0.01). Forty-four patients (66.7%) with pN(+)/ER(-) received adjuvant chemotherapy. Conclusions Age, tumor size, lymph node status and ER status were independent predictive factors for postoperative adjuvant chemotherapy effects in elderly patients with breast cancer.

Objective To investigate radiological imaging tele-consultation in clinical application. Methods All cases of the tele-consultation analyzed retrospectively came from the Hospital′s telemedicine center from January to December of 2015. The statistical analysis covered the level of applying hospital, modality type of imaging,inspection area,as well as the timing and purpose of the consultation.Results A total of 179 medical institutions required image consultation in 2015,most of which secondary hospitals,up to 58.66%. A total of 2 454 cases were consulted,including X-ray of 278 cases (11.33%),CT of 1 353 cases (55.13%), and MRI of 823 cases (33.54%). Purposes of tele-consultation vary from differential diagnosis of 1 602 cases(65.28%),definitive diagnosis of 766 cases(31.21%),and confirmative review of 86 cases (3.51%). 90.59% of the consultation cases were finished within 24 hours. Conclusions Radiological imaging tele-consultation could offer local hospitals with diagnosis efficiently effectively. On one hand,this service saves patients'costs and gains time for treatment. On the other,it makes primary hospitals more efficient in radiological imaging diagnosis.

Objective:To develop a novel sustained-release local anesthetic microspheres and evaluate the effects on sciatic nerve block in rabbits.Methods:The magnetic lidocaine microspheres were prepared by W 1/O/W 2 compound emulsion method, investigating their external morphology, measuring the magnetic response characteristics by the VSM and draw the hysteresis loop.The encapsulation efficiency and drug-loading rate were calculated, and the cumulative release curves in vitro were drawn.Fifteen healthy rabbits (half male and half female), aged 5-6 months, weighing 3.0-3.5 kg, were selected for sciatic nerve block and divided into 3 groups ( n=5 each) using a random number table method: magnetic response lidocaine microspheres group (PL group), normal saline control group (C group) and lidocaine group (L group). Magnetic response lidocaine microsphere buffer 2 ml, normal saline 2 ml and 2% lidocaine 2 ml were injected around the rabbit sciatic nerve through a catheter in PL, C and L groups, respectively.The applied magnetic field was withdrawn at 60 h after injection.Before injection (T 0) and at 30 min and 2 , 8, 16, 24, 48, 60, 62 and 64 h after injection (T 1-9), the compound action potentials and conduction velocities of bilateral sciatic nerve trunks were measured, and block was assessed using toe reflex score and modified Tarlov score. Results:The magnetic lidocaine microspheres were brown in color and observed as monodisperse, regular spheres with a diameter of (9±3) μm, an encapsulation rate of 46.18%, a drug loading of 6.02%, and a superparamagnetic release rate of 97% in vitro at 60 h. The hysteresis loop passed through the origin and no hysteresis occurred with the absence of an external magnetic field.Compared with C group, the action potentials and conduction velocities of the sciatic nerve, toe reflex score and modified Tarlov score were significantly decreased at T 1-T 8 in PL group ( P<0.05). Compared with L group, the action potentials and conduction velocities of the sciatic nerve were significantly increased at T 1, the action potential was decreased at T 2-T 8, the conduction velocity was decreased at T 3-T 8, the toe reflex score was increased at T 1 and decreased at T 3-T 8, and the modified Tarlov score was increased at T 1 and T 2 and decreased at T 3-T 8 in PL group ( P<0.05). Conclusions:Magnetic response lidocaine microsphere is successfully developed with good magnetic responsiveness and release and can prolong the sciatic nerve block time in rabbits.

BACKGROUND:Osteosarcoma has a complex pathogenesis and a poor prognosis.While advancements in medical technology have led to some improvements in the 5-year survival rate,substantial progress in its treatment has not yet been achieved. OBJECTIVE:To screen key molecular markers in osteosarcoma,analyze their relationship with osteosarcoma treatment drugs,and explore the potential disease mechanisms of osteosarcoma at the molecular level. METHODS:GSE99671 and GSE284259(miRNA)datasets were obtained from the Gene Expression Omnibus database.Differential gene expression analysis and Weighted Gene Co-expression Network Analysis(WGCNA)on GSE99671 were performed.Functional enrichment analysis was conducted using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes separately for the differentially expressed genes and the module genes with the highest positive correlation to the disease.The intersection of these module genes and differentially expressed genes was taken as key genes.A Protein-Protein Interaction network was constructed,and correlation analysis on the key genes was performed using CytoScape software,and hub genes were identified.Hub genes were externally validated using the GSE28425 dataset and text validation was conducted.The drug sensitivity of hub genes was analyzed using the CellMiner database,with a threshold of absolute value of correlation coefficient|R|>0.3 and P<0.05. RESULTS AND CONCLUSION:(1)Differential gene expression analysis identified 529 differentially expressed genes,comprising 177 upregulated and 352 downregulated genes.WGCNA analysis yielded a total of 592 genes with the highest correlation to osteosarcoma.(2)Gene Ontology enrichment results indicated that the development of osteosarcoma may be associated with extracellular matrix,bone cell differentiation and development,human immune regulation,and collagen synthesis and degradation.Kyoto Encyclopedia of Genes and Genomes enrichment results showed the involvement of pathways such as PI3K-Akt signaling pathway,focal adhesion signaling pathway,and immune response in the onset of osteosarcoma.(3)The intersection analysis revealed a total of 59 key genes.Through Protein-Protein Interaction network analysis,8 hub genes were selected,which were LUM,PLOD1,PLOD2,MMP14,COL11A1,THBS2,LEPRE1,and TGFB1,all of which were upregulated.(4)External validation revealed significantly downregulated miRNAs that regulate the hub genes,with hsa-miR-144-3p and hsa-miR-150-5p showing the most significant downregulation.Text validation results demonstrated that the expression of hub genes was consistent with previous research.(5)Drug sensitivity analysis indicated a negative correlation between the activity of methotrexate,6-mercaptopurine,and pazopanib with the mRNA expression of PLOD1,PLOD2,and MMP14.Moreover,zoledronic acid and lapatinib showed a positive correlation with the mRNA expression of PLOD1,LUM,MMP14,PLOD2,and TGFB1.This suggests that zoledronic acid and lapatinib may be potential therapeutic drugs for osteosarcoma,but further validation is required through additional basic experiments and clinical studies.