OBJECTIVE:To observe the effect of the side-hole hollow bone cement nail on promoting bone fracture healing. METHODS:This experiment was performed in the Third Hospital of Hebei North College from July 2006 to December 2008. Femoral neck samples were obtained from 60 adult corpses of which the patients were dead one year at most with the mean age of 70 years. X-ray examination showed a significant osteoporosis,but no other abnormalities. Hollow nail was provided by Sanyou Medical Apparatus Co.,Ltd.,Shanghai; self-cohesion methyl methacrylate bone cement was provided by Dental Material Factory,the Second Medical University of Shanghai. In the maximal axial pulling-out force group,the hollow nails were directly implanted into 10 femoral neck samples after drilling at the axial center. The polymethyl methacrylate bone cement was inserted into other 10 femoral neck samples after drilling at the axial center,and the side-hole hollow nail were then implanted. The pulling out experiment was performed by AGS-10KN material testing machine to measure the maximal axial pulling-out strength of hollow nail and the maximal loading when the nail was loose during anti-bending cycle experiments. RESULTS:① The maximal axial pulling-out force of 10 femoral neck samples implanting the hollow nail was 471.5-1 070.5 N,with the mean value of (855.0 ? 207.5) N; the maximal axial pulling-out strength of femoral neck samples implanting the side-hole hollow nail added by poly-methyl methacrylate bone cement was 2 023.7-3 572.1 N,with the mean value of (2 943.3 ? 535.8) N. The maximal axial pulling-out strength in the combined group was significantly greater than hollow nail implantation group (P

Purpose:During the malignant transformation, most tuomr cells will become resistant to anoikis (the apoptosis induction upon loss of anchorage), thereby gaining an important growth advantage and providing the basis for tumor spread, growth at distant places, and formation of metastasis.The present study focus on the role of soluble fibronectin, integrin and their signal transduction in the process of tumor cells anoikis apoptosis.Methods:Flow cytometry detected integrin subunits' expression on the human squamous cell carcinoma cell (HSC 3) surface. Establish anoikis induction model. The role of different integrin subunits during anoikis induction were detected by antibody blocking method, p53 and Bcl 2/Bax expression were measured during this anoikis process.Results:There is no or low expression of integrin av on the normal epithelial cells, whilst it expresses relative higher on the surface of HSC 3 cells. The treatment of soluble fibronectin decreased p53 expression, increased the ratio of Bcl 2/Bax and then protected HSC 3 cell from anoikis. Anti integrin ?v blocking antibody resumed the anoikis that was inhibited by soluble fibronectin evidently. Conclusions:We now provide the evidence that the binding of integrin ?v and soluble fibronectin protected HSC 3 cells from anoikis apoptosis, via decreasing the expression of p53, increase the ratio of Bcl 2/Bax.

Objective To investigate the medium-and long-term clinical efficacies of superficial needling therapy for lumbodorsal myofacial pain syndrome.Method Three thousand two hundred and fifty-one patients with lumbodorsal myofacial pain syndrome were randomly allocated to a superficial needling group of 1753 cases and an acupuncturegroupof 1498 cases.Seventy-threepatients in the superficial needling group and 105 patients in the acupuncture group did not complete the required courses of treatment and were lost to follow-up.The others in the two groups completed therequiredcourses of treatment and were followed up.After three courses of treatment, the clinical therapeutic effects were compared using the pain score at the end of treatment and at three and six months and one year after.Thereturn visit rates were also compared.Result There was a significant difference in the pain score (NRS score) between the two groupsat the end of treatment (P<0.01), which was significantly lower in the superficial needling group than in the acupuncturegroup, and a difference between the twogroupsat three months after.There was no significant difference in the pain score between the two groupsat six months after and no difference between the two groupsat one year after.There were no differences in clinical the rapeutic effect and the return visit rate between the two groupsat six months and one year after.Conclusion A clinical observation with a large sample shows that superficial needling has a good short-term therapeutic effect on lumbodorsal myofacial pain syndrome and is a safe and effective method, but its medium-and long-term the rapeutic effects are notgood enough.

Stray light is a physical phenomenon that degrades visual quality when light scattering occurs in the human eye.It is a main cause of the disabling glare.Stray light originates in cornea,iris,sclera,lens and retina,and these ocular tissues contribute to the total amount of stray light in a normal eye.The light scattering intensity increases when the transparency of any optical element mentioned above reduces.Stray light can be measured by several different methods,but the measurements still lacks a standardized procedure and outcome.Further clinical study is necessary to quantify and standardize the measuring method of stray light.This article aims to introduce the concept,source and clinical significance of stray light,and to provide its advanced measurement techniques and methods.

BACKGROUND: Glutamine (Gln) supplementation is known to decrease oxidative stress and inflammatory response, enhance resistance to infectious pathogens, shorten hospital stay, and decrease medical costs of patients. This study was undertaken to evaluate the relationship between the effect of early parenteral glutamine (Gln) supplement on acute liver injury (ALI) and heat shock protein 70 (HSP-70) expression in critical patients. METHODS: Forty-four patients who had been admitted to the emergency intensive care unit (EICU) of Nanjing First Hospital Affiliated to Nanjing Medical University were randomly divided into a control group (n=22) and a Gln group (n=22). The patients of the two groups received enteral and parenteral nutrition. In addition, parenteral Gln 0.4 g/kg per day was given for 7 days in the Gln group. Serum HSP-70 and Gln were measured at admission and at 7 days after admission. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBiL), serum levels of HSP-70 and Gln, mechanical ventilation (MV) time, ICU stay, peripheral blood of TNF-α, IL-6, CD3, CD4 and CD4/CD8 levels were also measured in the two groups. RESULTS: In the Gln group, the levels of serum HSP-70 and Gln were significantly higher after Gln treatment than those before the treatment (P<0.01). HSP-70 level was positively correlated with the Gln level in the Gln group after administration of parenteral Gln (P<0.01). The levels of serum ALT, AST, TBiL and TNF-α, IL-6 were lower in the Gln group than in the non-Gln group (P<0.01). MV time and ICU stay were significantly different between the two groups (P<0.05). The levels of CD3, CD4 and CD4/CD8 were significantly higher in the Gln group than in the control group after treatment (P<0.05). CONCLUSION: Parenteral Gln significantly increases the level of serum HSP70 in critically ill patients. The enhanced expression of HSP70 is correlated with improved outcomes of Gln-treated patients with acute liver injury.

BACKGROUND:Over the past 10 years, scholars have proposed the tubular stomach as an alternative to the whole stomach for digestive tract reconstruction; however, its occurrence rate of postoperative complications has been controversial. OBJECTIVE:To evaluate the clinical efficacy of tubular stomach versus whole stomach for digestive tract reconstruction in the resection of esophageal carcinoma. METHODS: The randomized controled trials about tubular stomach for digestive tract reconstruction in the resection of esophageal carcinoma were searched from PubMed, OVID, CNKI, EBSCO, Science online, Wangfang, Super Star Digital Library, CMB, Baidu and Google search engines. Two searchers screened studies based on the included criteria strictly. Literature quality and bias risk were assessed according to the criteria of Cochrane Colaboration, GRADEprofiler3.6.1 software was used for evaluation of the quality grade, and Revman5.3 for data management and statistical analysis. RESULTS AND CONCLUSION:Totaly 12 randomized controled trials including 4 137 patients were enroled. Compared with the whole stomach group, in the tubular stomach group, the incidences of reflux esophagitis and thoracic stomach syndrome were significantly lower, but there was no difference in the incidences of anastomotic leakage and anastomotic stenosis between the two groups. These findings indicate that the tubular stomach as a substitute of the whole stomach for digestive tract reconstruction in the resection of esophageal carcinoma is a safe and effective. However, the literatures included are only in English and Chinese, and there is publication bias and smal sample size. Therefore, the large-sample high-quality clinical randomized controled trials are stil needed for further confirmation.

Medical image segmentation is a classical puzzle for researchers.Image segmentation is the method to delineate anatomic structures or other interested regions automatically or semi-automatically,which is helpful to diagnosis and plays a crucial role in many medical imaging applications.In this article,a rather complete survey to medical image segmentation methods and their characteristics are given,especially to the new methods or improvement of the classical methods which was put forward recently.The prospects and the challenge of medical image segmentation is discussed.

Objective To study whether clinical variables could be used to predict the presence of esophageal varices(EV). Methods One hundred and twenty-six patients with decompensated liver cirrhosis were enrolled. Upper endoscopy was performed to identify the EV. The spleen vein (SV), portal vein(PV), spleen index(SI), ascites was determined by ultrasenography. Platelct count(Pt), prothrombin time(PT) and liver function was determined. Results Ninety-five patients with EV, and 42 patients with severe EV. Patients with EV had significant larger SI and lower Pt. Pt and SI were predictive factors for the presence of EV. When SI≥66.9 cm2 and Pt≤89.0×109/L, they had a positive predictive value of 97.4% and 96.5%, and a negative predictive value of 55.4% and 59.8%, respectively. SI was the only predictive factor for the presence of severe EV. When SI≥82.6 cm2, it had a positive and negative predictive value of 89.2% and 75.4%. Conclusions Pt and SI are predictive factors for the presence of EV. SI is the only predictive factor for the presence of severe EV. Non-invasive factors SI and Pt can be used to predict the EV in patients with decompensated liver cirrhosis.

OBJECTIVE: To evaluate the clinical outcomes of medical supporting bone graft following posterior approach and bone cement implantation in the hip joint in treating intertrochanteric fracture.METHODS: A computer-based online search of Science Direct, Ei databases was performed for English articles published between January 1960 and October 2009, with the key words "bone cement, intertrochanteric fracture". In addition, CNKI and CBM were searched for related Chinese articles published between January 1994 and October 2009, with the key words "intertrochanteric fracture, coxa vara, posterior approach of hip joint, bone cement implantation in major screw hole". Moreover,related books were manually searched. Treatment of intertrochanteric fracture, basic and clinical experiment of intertrochanteric fracture treated by bone cement was included.RESULTS: Intertrochanteric fracture treatment includes lateral or anterior approach for dynamic hip plate system, dynamic hip screw, and femoral proximal intramedullary screw internal fixation. Dynamic hip screw is standard internal fixation to treat intertrochanteric fracture, with strong anti-rotation function, and meets the biomechanical requirements. However, screw loosening,extraction and breakage frequently occur. Cancellous bone screw track enhanced by bone cement increases screw retention force,benefits screw compression, enhances bone-screw interface to transfer the stress to screw-bone regions, which significantly increases the anti-flexion and anti-torsion strength of dynamic hip screw and improves fracture stability. The mechanism involves the integral formation of cancellous bone, bone cement and screw by the micro-interlocking of bone trabecula and surrounding cancellous bone.CONCLUSION: Dynamic hip screw filled by bone cement significantly enhances the anti-flexion and anti-torsion strength of internal fixation and improves fracture stability.

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