0.05).Six patients(6/23)in the Gln group developed mucositis and 11 cases(11/11)in the standard group(P

Objective To observe the therapeutical effect of posterior vertebral column resection on chronic thoracolumbar tuberculosis with secondary paraplegia and to provide a safe and effective method for the treatment of chronic thoracolumbar tuberculosis with secondary paraplegia.MethodsFrom Aug.2007 to Mar.2010,12 cases with chronic thoracolumbar tuberculosis and secondary paraplegia were surgically treated by posterior vertebral column resection and Titanium net support for bone graft and internal fixation operation treatment.Cobb angle was measured,and conditions of internal fixation were observed before and after the operation by X-ray films.Neurological status were evaluated by Frankel grades.ResultsThe follow-up periods was 6- 18 months( on average 11 months).Operations eased all patients' back and chest pain.Frankel grade increased from C preoperatively to grade D or E postoperatively in 6 cases,from grade D to E in 4 cases and from grade B to C in 1 case.No obvious improvement of Frankel grade was observed in the other patient of grade B.The average Cobb angles were(76.0 ± 23.4) ° before surgery,( 15.5 ± 6.3 ) ° at one week after surgery and ( 16.0 ± 8.2) °at the last follow-up.The difference in the Cobb angle before and at one week after treatment was significant( t =3.41,P ＜ 0.01 ).No difference was found in the Cobb angle between at one week after treatment and at the last follow-up (t =1.58,P ＞ 0.05 ).All patients got bony fusion with Titanium net.No complications occurred with internal fixation.Conclusion Posterior vertebral column resection is a feasible method for the treatment of chronic thoracolumbar tuberculosis with secondary paraplegia.It achieves neurological decompression with high correction rate and minor injury,and no anterior surgery is needed.

Objective To observe the therapeutical effect by using pedicle screw and interbody fusion cage,and compare with posterior interbody simple autogenous bone graft. Methods From August 2006 to January 2009,46 cases of lumbar spondylolisthesis patients were treated by using pedical screw internal fixation system, including 24 cases of cage-graft (group A), 22 cases of interbody simple autogenous bone graft (group B), efficacy evaluation using JOA evaluation standard, and measured lumbar olisthe reset rate, relative intervertebral space height and lumbosacral angle of recovery and observed fusion rate through the preoperative and postoperative follow-up X-ray films. Results All the patients' waist pain symptoms relieved after operative reduction. At 18 months of follow-up , group A of lumbar olisthe reset rate was 94.7%, relative intervertebral space height was (74.93 ± 7.85)% ,lumhosacral angle was 36.6° ± 3.6° ,meanwhile group B was 89.9%, (68.72 ± 12.40)%,39.3°± 5.6°. There were significant differences between two groups (P<0.05). Bone graft fusion rate in group A was 95.83% (23/24), in group B was 90.91%(20/22), there was significant difference between two groups (P < 0.05). Conclusion Pedicle screw system and interbody cage-graft in treatnent of lumber spondylolisthesis can effectively prevent the loss of reduction,mid and long-term effects are satisfactory,it is a stable and reliable method.

Objective To investigate mesenchymal stem cells genetically modified by nerve growth factor to repair acute spinal cord injury in rats. Methods Fifty six Wistar rats of inbred strain were randomly divided into sham operation group cell transplantation group and simple injury group. The spinal cord injury model was prepared according to the modified Allen's method. NGFβ (hNGFβ) and GFP genes were transfected into MSCs by replication-deficient recombinant adenovirus vector (Ad-hNGFβ) and replication-deficient recombinant retrovirus vector (Rt-GFP) respectively. GFP positive MSCs were transplanted into intradural space of injured spinal cord at 7 days after spina coral injury. Spinal cord was dissected at 24 h, 1 and 2 weeks after transplantation. To observe the expression of GFAP and nestin and the distribution of MSCs after transplantation following the spina corol injury. Results MSCs migrated to the injured parenchyma In transplantation group, the expression of GFAP and NGF protein was higher than in the control group (P<0.05), the BBB score in transplantation group was higher than that in the control group (P<0.05). Conclusion The MSCs transplantation repaired the injured spinal cord to some extent.

Objective To investigate the effect of medial collateral ligament (MCL) repair and coronoid process fracture fixation on stability of the Terrible Triad of the elbow. Methods CT and MRI scan images of elbow joints from one healthy 28-year-old male volunteer were used to establish three elbow models. Model A: normal model. Model B: repair of coronoid process fractures, without MCL repair. Model C: repair of MCL, without repair of ulnar coronoid processes. Longitudinal loads were applied on the three models to analyze the displacement and stress distributions of the elbow joint under different working conditions and compare the stability of the elbow joint. Results The displacement and stress distributions of the three models were similar. The maximum displacement and maximum stress of the articular surface were located at the ulna pulley notch, while the minimum displacement was located at the coronoid process and its medial side. The minimum stress was located at the lower lateral side of the coronoid process. There were no statistical differences in the maximum displacement and stress among the three models (P>0.05). Conclusions When the lateral column is stable, the effect of repairing the MCL and fixing the fracture block of ulnar coronoid process is similar.

Objective To investigate the differences in biomechanical properties of 3 internal fixation patterns(the lateral plate and screw group, the rear plate and screw group, and the front and rear lag screw group) for treating posterolateral tibial plateau fracture under different axial loads. Methods Based on CT data of the tibial plateau, the entity model of 1/2 and 1/4 posterolateral tibial plateau fracture with 3 internal fixations were established and meshed to analyze force status of the fracture models with 3 internal fixations under different axial loads. ResultsUnder the axial load of 1 kN, for the 1/2 posterolateral tibial plateau fracture model, the displacements of the fracture fragments in the lateral plate and screw group, the rear plate and screw group, and the front and rear lag screw were 552.082, 67.964, 54.085 μm, respectively, and the stresses on the fixation device were 306.745, 231.844, 73.047 MPa, respectively. For the 1/4 posterolateral tibial plateau fracture model, the displacements in the three groups above were 416.072, 302.107, 150.639 μm, respectively, and the stresses on the fixation device were 306.673, 208.467, 73.607 MPa, respectively. Both the displacements of the fracture fragments and the stresses on the fixation device increased correspondingly under the axial load of 1.5 kN, and the trend of the data was similar to that under the axial load of 1 kN. Conclusions The results from the fracture models with 3 internal fixation patterns show that the front and rear lag screw group has a superior biomechanical stability under two different axial loads, and the similar mechanical properties can be achieved in the rear plate and screw group. Therefore, the front and rear lag screws will be preferred to treat posterolateral tibial plateau fracture with less obvious displacement in clinic.

Objective To investigate the effects of GW4064,one FXR agonist,on the leptin and OB-Rb during the differentiation of 3T3-L1 preadipocytes and on the OB-Rb in the HepG2 cells. Methods The mRNA relative expression of leptin , OB-Rb and the protein of leptin on the day of 0 , 2 , 4 , 6 , 8 during the differentiation of 3T3-L1 preadipocytes after interfered with GW4064 were detected by fluorescent real-time PCR and ELISA , respectively. Meanwhile , the mRNA relative expression of OB-Rb of HepG2 cells after treated with GW4064 0 h , 12 h,24 h,48 h were also examined. Results The mRNA relative expression of leptin in the 3T3-L1 preadipocytes and OB-Rb in the HepG2 cells after treated with GW4064 were significantly increased compared with the controlgroup. Also, the protein level of leptin was similar with the mRNA expression. The all differences were statistically significance (P<0.05). However, there was no significant difference on OB-Rb in 3T3-L1 preadipocytes cells (P>0.05). Conclusions GW4064 is able to upregulate the expression of leptin in the 3T3-L1 preadipocytes and OB-Rb in the HepG2 cells. Now the role of leptin in the NAFLD is still unkown, however, the low expression of OB-Rb is related with the leptin resistance in the pathogenesis of NAFLD. So we hypothesize that FXR agonist may treat NAFLD through upreglating the expression of OB-Rb and improving leptin resistance.

BACKGROUND: There is no consistently effective therapy for patients with steroid-refractory acute graft-versus-host disease (GVHD). A variety of alternative approaches have been tested, including antithymocyte globulin, mycophenolate mofetil (MMF), pentostatin, and monoclonal antibodies; however, these treatments have been only modestly successful. OBJECTIVE: To further evaluate the efficacy of human adipose-derived stem cells (ASCs) as the salvage therapy for steroid-refractory acute GVHD. DESIGN: A clinical trial.SETTING: Department of Haematology, Henan Institute of Haematology, Henan Tumor Hospital.PARTICIPANTS: The clinical trial was performed at the Henan Institute of Haematology from September 2002 to August 2005. Eight patients were treated with ASCs for grades Ⅲ-Ⅳ steroid-resistant acute GVHD. The study was approved by the Ethics Committee at Henan Tumor Hospital and informed consent was obtained from patients and ASCs donors before they enrolled.METHODS: Eight patients with steroid-refractory grades Ⅲ-Ⅳ acute GVHD received intravenous infusions of ASCs. The ASCs dose was 1.0×106/kg. Seven patients were treated once and one patients twice. Four patients received ASCs from haplo-identical family donors and four from unrelated mismatched donors. MAIN OUTCOME MEASURES: The efficacy of human ASCs as the salvage therapy for steroid-refractory acute GVHD. RESULTS: No side effects were noted after the ASCs infusions. Acute GVHD disappeared completely in seven of eight patients and six of these seven patients are still alive after the median follow-up of 30 months (range 11-90 months) after the initiation of ASCs therapy. All four surviving patients were in good clinical condition and in remission of their hematological malignancy. Two patients died-one with no obvious response to ASCs died of multiorgan failure and one of relapse of leukemia. CONCLUSION: These results suggest that ASCs is a very promising treatment for severe steroid-resistant acute GVHD.

BACKGROUND: The treatment of chronic myelogenous leukemia (CML) is revolutionized by the tyrosine kinase inhibitor imatinib mesylate (imatinib). However, resistance to imatinib is increasingly recognized as a clinical problem, the prognosis of patients who develop imatinib resistance is poor, particularly in acute transformation phase of leukemia.OBJECTIVE: To characterize a novel CML cell line and to further elucidate the mechanisms of resistance to STI571.DESIGN: An observational comparative experiment.SETTING: Henan Institute of Haematology, Henan Tumor Hospital.MATERIALS: Thirty female BALB/c nu/nu mice with 5 weeks old were purchased from Animal Center, Chinese Academy of Medical Sciences. STI571 was kindly provided by Novartis (Nuremberg, Germany). VP-16 was purchased from Bristol-Myers Squibb (Munich, Germany); anti-P-gp from Santa Cruz Company, USA; anti-ab1 from BD Biosciences Company, USA. The disposal of experimental animal was coincidence with the ethical standard.METHODS: The experiment was performed in the Henan Institute of Haematology from September 2003 to November 2005. A novel K562 cell line (K562/VP16) was achieved after exposure of the K562 cells to VP16. A small subpopulation (SP K562/VP16) that was capable of excluding Hoechst 33342 in the K562/VP16 cell line was isolated by flowcytometry sorting. The rest of the K562/VP16 cells were classified as non-SP K562/VP16. In order to elucidate the mechanisms involved in K562/VP16 SP cells which became resistant to STI571, the expression of multidrug-resistant gene 1 (MDR1), Bcr-Abl and P-gp was detected in K562, non-SP K562/VP16, or K562/VP16 SP calls, respectively. Furthermore, one thousand cells of K562, K562/VP16 SP and non-SP cells were injected,respectively, intraperitoneally into the right flanks of ten 5-week-old female BALB/c nu/nu mice. The same experiment was repeated twice.MAIN OUTCOME MEASURES: Comparison of STI571 resistance and oncogenicity of non-SP K562/VP16 and K562/VP16 SP cells.RESULTS: The MDR-1 gene expression of the Mr 170 000 P-gp was detected in K562/VP16 non-SP and K562/VP16 SP cells but not in K562 cells. The expression levels of P-gp in the two K562/VP16 cell lines were similar (P ＞ 0.05).The levels of Bcr-Abl and Abl proteins were similar in the K562 cell line and in non-SP K562/VP16 and K562/VP16 SP cells (P ＞ 0.05). Compared with non-SP K562/VP16, the K562/VP16 SP cells were more resistant to STI571, and this resistance could hardly be reversed by many multidrug resistance inhibitors. In addition, in vivo study showed that the K562/VP16 SP cells induced oncogenicity in mice, while the K562/VP16 non-SP cells failed to do so.CONCLUSION: Bcr/abl gene amplification and MDR1 overexpression may not be an important clinical mechanism in the diversity of resistance development to imatinib treatment, and the development of drug resistance by leukemia cells may be at least partly due to a rare SP cells which drives leukemia occurrence and maintenance. So, these SP cells need to be targeted for effective cancer therapy.

Objective To study the relationship between the imaging patterns of microvasculature change and histological diagnosis.MethodsOne hundred and thirty-seven patients with esophageal mucosa roughness,erosion,plaque,abnormal color and indentation in conventional endoscopy and thirty healthy volunteers were enrolled in this study.The magnifying endoscopy images were graded as four patterns by intraepithelial papillary capillary loop(IPCL) changes by NBI .The biopsies underwent pathologic evaluation.The imaging patterns of endoscopy and histological diagnosis were compared and statistically analyzed.Results137 patients were diagnosed by narrow-band imaging system with magnifying endoscopy combined miniprobe sonography.Among these patients,27 cases were pathologically diagnosed as squamous cancer including 15 cases of early esophageal cancer,21 cases were high grade intraepithelial neoplasia,23 cases were low grade intraepithelial neoplasia,66 cases were chronic inflammation.100% esophageal carcinoma and high grade intraepithelial neoplasia were Ⅳ,Ⅲ type IPCL,56.52% low grade intraepithelial neoplasia was Ⅲ type IPCL,43.48% wasⅡtype IPCL,90.91% esophagitis wasⅡtype IPCL.100% esophageal normal mucosa wasⅠtype IPCL.The difference was significant among esophageal carcinoma,high grade intraepithelial neoplasia and esophagitis,esophageal normal mucosa (P＜0.05).ConclusionsThe imaging patterns of microvasculature change under NBI magnifying endoscopy were crucial in the diagnosis and identification of benign and malignant of esophageal disease.