[Objective]To discuss the surgical extension and clinical effects of CAD custom-made hemipelvic for treating malignant pelvic tumors.[Method]The pelvis model was generated with its CT data by rapid prototyping.Simulated bone resection and prosthesis design were performed on the models.Surgical extension and made hemi-pelvic were designed.Nine patients received resection of pelvic tumor and reconstruction by individualized hemi-pelvic from June 2003 to June 2007.The series comprised three males and six females,four were diagnosed having giant cell tumor,two having chordoma,two having chondrosarcoma and one having osteosarcoma.According to Enneking's division,region Ⅱ(n=3),the region Ⅱ and Ⅲ(n=5),involved region Ⅰ,Ⅱand Ⅲ(n=1).[Result]The resection of tumor the implantation of prosthesis was easily accessible.The amount of bleeding was 5700 ml on an average.One patient suffered from infection and recovered after debridement.All patients began non-weight bearing walk with double crutches 4～6 weeks after operation and gradually abandoned crutches in 4 months.Three patients had local relapse,one osteosarcoma patient died of lung metastasis at 18 months after operation,one chondrosarcoma patient relapsed locally at 13 months after operation and died at 17 months after operation.One chordoma patient relapsed locally at 6 months operation and received the second operation.It was relapsed again at 6 months after the second operation and died at 3 months.Bolt was loosened in one patient,but the patient can walk with one crutch.No loosening was found in the 5 patients.The position of bilateral hips was symmetric.[Conclusion]The surgical extension of tumor designed by computer aided technical makes thorough resection possible.The custom-made hemi-pelvic is highly similar to the pelvis of patient in appearance,which makes the operation easy and produces good clinic results.The custom-made hemi-pelvic offers a good promise for the reconstruction of pelvic malignant tumors.

BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL reconstruction using B-TP-B autograft, B-TP-B allograft and semitendinosus tendon graft (P > 0.05); 10° flexion limitation was found in 3 cases of B-TP-B autograft, 5° flexion limitation in 1 case of B-TP-B allograft and flexion limitation in 2 case of semitendinosus tendon graft. There was no significant difference in the ratio of knee joint flexion limitation among three groups. No synarthrophysis, wound infection, implant disrupture, screw loose, patellar fracture or vascular nerve injury was observed in three groups of patients; There were 12 cases presenting anterior knee pain in the B-TP-B autograft group and 5 cases presenting posterior knee pain in the semitendinosus tendon graft group. The difference of peal-knee pain incidence was statistically significant among three groups (P=0), the highest in B-TP-B autograft group, then semitendinosus tendon graft group and the lowest in B-TP-B allograft group. The time of post-operative fever in B-TP-B autograft group was earlier than that in the B-TP-B allograft and semitendinosus tendon graft groups (P=0). There was no significant difference between allogreft group and semitendinosus tendon autograft group (P=0.844). The rejections appeared in 4 cases of B-TP-B allograft with the manifestations of the sustained jam-like liquid outflow from tibial tunnel. After dressing, hormones or indomethacln, the rejection was healed. CONCLUSION: The arthroscopic B-TP-B autograft, B-TP-B autograft and semitendinosus tendon autograft have the same clinical curative effect in PCL reconstruction.

Objective To observe the inhibition of vascular endotheilal growth factor (VEGF) gene transcribition and translation with antisense VEGF165 adenovirus vector transfection. Method To transfect the synovial cells with antisense VEGF165 adenovirus and detect the gene translation level with northern-blot method. Result The Northern-blot showed that: the transcription of VEGF gene were inhibited markedly after the antisense VEGF165 gene transfection for 3 days and the inhibition efficiency was obivious in 4th day. In the 5th day, the VEGF translation signal was hardly detected. Conclusion The antisense VEGF165 adenovirus gene transfection can inhibite not only the transcription but the translation of VEGF gene in synovial cells. Thus it can inhibit the secretion of VEGF in synovial cells with high efficiency.

BACKGROUND: Lateral collateral ligaments play an important role in maintaining knee stability.Motion reduction of knee joint can be realized and the changes laws of medial and lateral collateral ligaments' length after anterior cruciate ligament(ACL)injury during weight-bearing flexion can be obtained via 2D/3D image registration technique.OBJECTIVE: To study in vivo stability of length changes of the medial and lateral collateral ligaments of ACL injury knee during weight-bearing flexion.METHODS: Eight volunteers with unilateral ACL rupture and contralateral normal knees,was captured CT images and 2orthogonal images of the knee at 0,15°,30°,60°,and 90° of weight-bearing flexion.These orthogonal images were used to recreate the in vivo knee positions at each of the targeted flexion angles by the method of 2D/3D image registration.Through the bone insertion of medial and lateral collateral ligaments,the elongation changes of medial and lateral collateral ligaments were obtained.RESULTS AND CONCLUSION: At 0°,15° and 30°,the length of medial collateral ligament of ACL injury knees was longer than normal knees,but the lateral collateral ligaments length of ACL injury knee was shorter than that of normal knees.All the differences have statistical significances(P < 0.05).The findings demonstrated that,at 0°,15° and 30°,the medial collateral ligament length of ACL injury knees was longer than normal knees,but lateral collateral ligaments length of ACL injury knees was shorter than normal knees.

BACKGROUND:Bone tumors around the Ⅱ section of pelvis are difficult to treat due to complicated anatomic structures.Using computer-aided technique,the excision range and prosthesis preparation can be individualized,which may obtain notable therapeutic efficacy in treating pelvic fractures in the clinic.OBJECTIVE:To discuss the application and the clinic effect of computer-aided technique in bone tumors therapy around the Ⅱsection of pelvis.METHODS:The pelvis model was generated with its CT data by rapid prototyping.Simulated bone resection and reconstruction were performed on the models.Then we designed surgical extension and made hemi-pelvic.Eight cases received resection of pelvic tumor and reconstruction based on computer-aided technique.RESULTS AND CONCLUSION:The resection of tumor and implantation of prosthesis were easily accessible.Two cases relapsed and 1 case loosened at 2 years after operation.According to Harris scoring criteria after total hip replacement,the scores of cases were well.The simulated resection and reconstruction of bone tumors around the Ⅱ section of pelvis based on computer-aided technique makes the operation easy and reconstruction precise,which produces good clinic results and offers a good promise for the application.

Aim To investigate the brain targeting of ginkgolide B prodrug (PGB ) and its mechanism. Methods The liquid chromatography tandem mass spectrometry (LC-MS /MS)method was applied to in-vestigate the pharmacokinetics of PGB in rat brain tis-sue after intravenous injection of PGB.Also the brain targeting was evaluated on the basis of the pharmacoki-netic parameter of PGB.The incomplete cerebral is-chemia model was induced in mouse,the effect of PGB on cerebral capillary permeability was observed by Ev-ans blue method.High performance liquid chromatog-raphy (HPLC)was used to determine the partition co-efficients (logP)of PGB in octanol-water system.PGB and P-glycoprotein (P-gp)was docked by using Mole-gro Virtual Docker (MVD)software to predict its bind-ing abilities with P-gp.The interaction of PGB with ATPase activity of human P-gp membrane was esti-mated by measuring inorganic phosphate liberation. Results The brain targeting of PGB was evaluated by treatment effective (TA ) and drug targeting index (DTI),the calculated value were 6.87 and 4.1 4 re-spectively.Preventive medication of PGB could signifi-cantly decrease cerebral capillary permeability (P <0.05).The lipo-hydropartition coefficient of PGB was higher than that of GB,their logP data were 1 .03 and 0.61 respectively.PGB displayed the stronger binding affinity with P-gp than GB according to the molecular docking calculations,their MolDock Score toward P-gp were -1 43.36 and -1 1 6.40KJ·mol -1 respectively. ATP-hydrolisis showed that PGB increased ATPase activity with a Km of approximately 237.75 μmol · L -1 ,however GB with a Km of approximately 841 .24μmol·L -1 .PGB might interact with P-gp with a high-er affinity and exhibit more effect than GB.Conclu-sion PGB is characterized by its brain targeting. Higher liposolubility of PGB results in good blood-brain permeability,which is advantageous to its brain targe-ting.Besides,PGB can effectively inhibit the efflux effect of P-gp to GB because of its increased P-gp AT-Pase activity.

OBJECTIVETo study mosaicplasty a as method of autogenous osteochondral transplantation in the treatment of cartilaginous defects.

METHODSThe technique involves obtaining small cylindrical grafts from the non-weight bearing periphery of the femur at the patellar femoral joint, and transporting them to the prepared recipient site by arthroscopy.

RESULTSFifteen patients with defects cartilaginous received mosaicptasty osteochondral grafting. Follow up for 12 to 21 months (mean 15 months) showed good results.

CONCLUSIONThe treatment is indicated for patients with focal cartilaginous defects under the age of 45.

Adult ; Arthroscopy ; Bone Transplantation ; methods ; Cartilage, Articular ; injuries ; transplantation ; Female ; Follow-Up Studies ; Humans ; Male