Objective To explore the diagnosis and operative treatment of spinal tumor. Methods Clinical symptom, diagnosis and operative treatment of 22 patients with spinal tumor in our institution from August 1987 to August 2002 were analysed retrospectively. Results Combining with patients' clinical symptoms and results of corresponding examination, all cases were diagnosed before operation. After operation, all the patients recovered with different outcome except 3 patients died. There were 18 cases nearly cured. Conclusion The clinical symptoms of the patients with spinal tumor have some specialty. The preoperative diagnosis mainly depends on MRI. The various operative modes should be taken according to tumor localization.

Objective To investigate the association of endothelial nitric oxide synthase (eNOS) polymorphisms and avascular necrosis of femoral head (ANFH),to explore possible relationship between the ANFH incidence and 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7.Methods Totally 125 atraumatic ANFH patients and 126 healthy controls without hip trauma history were enrolled.Gene polymorphisms in 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 were determined.Medical history was collected for etiology analysis.Results In between-group comparison,the frequency of b/a genotype intron 4 in ANFH group was significantly higher than that in healthy control group [19/125 (15.2％) vs 6/126 (4.8％),P =0.0001,OR =4.501],and the result of G/T genotype exon 7 in the ANFH group also indicated a statistical significance with the healthy control group [30/125 (24.0％) vs 17/126 (13.5％),P =0.0094,OR =3.804].In subgroup analysis,genotype b/a and G/T were especially higher in the idiopathic group than that in the healthy control group.Conclusions eNOS gene polymorphisms might be a risk factor of ANFH,there is underlying relevance of eNOS and the disease.Both 27-bp repeat polymorphism in intron 4 and G894T polymorphism in exon 7 are associated with ANFH incidence.

Objective To explore the effect of rifampin liposome in treatment of tuberculosis in mice.Methods Sixty KM mice were infected by H37Rv to prepare tuberculosis model.Rifampin liposome was prepared by thin film dispersing method.Mice were randomly divided into 4 groups(15 mice each):group of normal control,empty liposome control,rifampin(10mg/kg body weight/day) and rifampin liposome(7mg/kg body weight/day).Rifampin and rifampin liposome were put into drinking water,respectively.Mice were sacrificed after one month of oral treatment to analysize the difference of lung weight and to homogenize lung,spleen,liver tissues to test bacteria burden(cfu).Results Lung weight was significantly different in rifampin and rifampin liposome groups when compared with normal control,empty liposome control groups respectively(P0.05) in two drug groups.Things were the same when compared bacteria cfu in lung,spleen and liver tissue.Conclusion Rifampin liposome may become a promising preparation in the treatment of tuberculosis which make it possible to reduce the clinical dose and thus weaken side effects of rifampin.

Objective To observe the short-term effect of radial head replacement for the treatment of terrible triad of the elbow.Methods In the period between June 2011 and June 2012,the radial head replacements were carried out in six patients with terrible triad of elbow.There were five acute elbow fracture-dislocation cases and one old fractnre case.All cases underwent open reduction and fixation coronoid fracture with screws or nonabsorbable sutures,radial head replacement,repair of lateral ligament complex and repair or reconstruction of annular ligament.All patients initiated the rehabilitation program under supervision within 5-7 days after surgery.The X-ray and Computed tomography of elbow was used to evaluate the posi tion of radial head prosthesis.Functional outcome of elbow was assessed by Mayo Elbow Performance Score (MEPS) and complications.Results All patients were participated in follow-up for 10-24 months and the mean duration of follow-up was 16.8 months.The MEPS was from 85 to 95 points and the mean MEPS was 91.7 points.The outcome of MEPS was excellent in 5 cases,good in 1 case.The range motion of elbow flexion was from 82 to 95 degrees and the average of elbow flexion was 87 degrees; the range motion of extension was from 15 to 32 degrees and the average of elbow extension was 21 degrees.The range motion of fore-ann pronation was from 82 to 90 degrees with 86 degrees in average.The motion range of supination was from 45 to 80 degrees with 56 degrees in average.All cases got persistent stability in elbow with painless movement.None of patient suffered traumatic arthritis and infection.The motion range of elbow was restricted due to the unfit relative position of radial head prosthesis and capi tellum in one case,characterized by decreasing radiocapitellar joint space.Two cases developed into heterotopic ossification in elbow without hampering the motion range of elbow.Conclusion The outcome of the radial head replacement on the treatment of radial head fracture in the elbow terrible triad was satisfactory.However,the longer duration of observation was essential to verify the favorable effect of radial head replacement on dealing with terrible triad in elbow.

Objective To establish phage splitting method for Mycobacterium tuberculosis and explore its application in the diagnosis of pulmonary tuberculosis.Methods Two hundred and fifteen sputum specimens were tested by L-J medium culture method,fluorescent microscopy method and phage splitting method concurrently.Results Comparing with L-J medium method,the sensitivity and specificity of phage splitting method were 71.0%,97.9%,respectively,however for routine microscopic method,the sensitivity and specificity were 55.7% and 91.2%.Conclusion With very high specificity and comparatively better sensitivity,phage splitting method can rapidly detect Mycobacterium tuberculosis and can be used in the rapid diagnosis of pulmonary tuberculosis.

Objective To evaluate the feasibility and clinical results of one-stage total knee arthroplasty in patients with extra-articular deformity and osteoarthritis of the knee. Methods From June 2006 to April 2010, 9 patients with osteoarthritis of the knee and extra-articular deformity underwent one-stage total knee arthroplasty, including 2 males and 7 females with an average age of 51 years (range, 34-69). These deformities were in the tibia in 4 patients and in the femur in 5. The deformity resulted from fracture malunion in 8 cases and dysplasia in one. There were 6 uniplanar and 3 biplanar deformities. The average angle of the femoral deformities was 13.3° in the coronal plane (ranged from 8° to 22°) and 11.3° in the sagittal plane (ranged from 6° to 15°). One femur had a 10° deformity of external rotation. The average angle of the tibial deformities was 16° in the coronal (ranged from 11° to 22°), One was 21° in the sagittal plane. Results The mean follow-up period was 29 months (range, 7-54) after surgery. The average HSS score improved from 18.7 points preoperatively to 89.8 points at the time of the last follow-up. The average arc of knee motion improved from 46.7° preoperatively to 100.6° postoperatively. The average deviation of mechanical axis of knee was improved from 11.8° of excursion preoperatively to 1° of excursion at the time of the last follow-up. One patient had an unsatisfactory clinical result from delayed union at the esteotomy site. No complications such as infection, DVT, ligament instability, patella problem or component loosening. Conclusion One-stage total knee arthroplasty is a technically difiicult but effective treatment for patients with osteoarthritis of the knee and extra-articular deformity. We recommend that if feasible total knee arthroplasty with intra-articular bone resection and soft-tissue balancing for these patients.

Objective To study the indication,surgical technique and clinical results of the uncemented hip arthroplasty for unstable intertrochanteric fractures in elderly patients.Methods Twenty-three elderly patients with unstable interthochanteric fractures were treated with uncemented hip arthroplasty,including 6 males and 17 females with an average age of 77.6 years (range,73-95 years).According to the Evans-Jensen classification,there were 2 cases of type ⅡA,9 of type ⅡB,and 12 of type Ⅲ.Osteoporosis was classified according to the Singh index,there were 2 cases of Ⅳ,8 of Ⅲ,12 of Ⅱ and 1 of Ⅰ.Results All patients were followed up with an average of 31 months (range,12-64 months).The average Harris score improved from 33.1 1±6.58 points preoperatively to 87.12±5.05 points at the time of the last follow-up.Radiologically,there were 16 cases of fixation by bone ingrowth; nonunion of lesser trochante fracture was noted in 3 cases; proximal displacement of greater trochante was found in one patient.Intraoperative proximal femoral fracture was encountered in two cases; deep venous thrombosis was found in three cases and one case died of pulmonary embolism.One case who experienced acute left ventricular failure recovered by medical treatment.There was no aseptic loosening,peri-prosthetic infections,dislocation or ectopic ossification.Conclusion The short-term results of uncemented hip arthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.

AIM:To investigate the effect of inhibiting Mcl-1 gene expression on apoptosis of mouse peritoneal macrophages infected with different virulence of Mycobacterium tuberculosis using a technique of RNA interference .METH-ODS:The BALB/c mice were infected with prepared bacterium of the virulence strains of Xinjiang , H37Rv, H37Ra and BCG.Mcl-1-shRNA was applied to the mouse model of infection , and the control groups were set up .On 1 d, 3 d, 5 d and 7 d, the mouse peritoneal macrophages were collected .The expression of Mcl-1 at mRNA and protein levels was deter-mined by real-time PCR and Western blot .The apoptotic rate of peritoneal macrophages was analyzed by flow cytometry . RESULTS:The expression of Mcl-1 at mRNA and protein levels was up-regulated in the peritoneal macrophages from the mice infected with different virulence of Mycobacterium tuberculosis, and the cells from the mice infected with virulence strains of Xinjiang and H37Rv expressed higher level of Mcl-1 than the uninfected control cells (P<0.05).The expres-sion of Mcl-1 at mRNA and protein levels was reduced by RNA interference as compared with control group ( P<0.05 ) . Inhibition of Mcl-1 expression induced apoptosis of peritoneal macrophages in the mice .CONCLUSION: The Mcl-1 ex-pression at mRNA and protein levels in mouse peritoneal macrophages infected with different virulence of Mycobacterium tu-berculosis was effectively suppressed by Mcl-1-shRNA, which can induce macrophage apoptosis .

Objective:To transfect Mcl-1shRNA into Raw264.7 cells,and screen out specific shRNA eukaryotic expression plasmids with the most significant effect of silent Mcl-1 gene to figure out the effect of shRNA on Mcl-1 expression in murine macrophage cell line Raw 264.7.Methods: Specific shRNA was transfected into murine macrophage cell line Raw 264.7 via lipofectamine.Semi-quantitative RT-PCR and Western blot were respectively employed to test the changes in Mcl-1 mRNA level and Mcl-1 protein expressions 24 h and 48 h after the transfection ,and the silencing effects of the three pairs of specific shRNA fragments corresponding to different sites were analyzed.Results: Specific shRNA fragments at 24 h and 48 h could effectively reduce Mcl-1 mRNA and protein level ,with higher silencing effects than those of the normal group ,the lipofectamine group and the negative control group.There were statistically significant differences among them ( P<0.05 ).Among the three pairs of specific shRNA fragments corre-sponding to different sites ,Mcl-1 shRNA3 showed the most significant inhibiting effect on Mcl-1 mRNA and proteins.Conclusion:RNA interference can downregulate the level of Mcl-1 mRNA in murine macrophage cell line Raw 264.7 and greatly downregulate the expression of Mcl-1protein.Specific shRNA eukaryotic expression plasmids with the most significant effect of silent Mcl-1 gene have been screened out successfully.

Objective To study the expressions of myeloid cell leukemia-1 (Mcl-1 ) gene in mouse macrophages Raw264.7 and human macrophages THP-1,to screen out the cell lines with high levels of expression as the experimental cells,and based on the screening results to construct the short hairpin RNA(shRNA)eukaryotic expression plasmid targeting mice Mcl-1 gene for transfection and further screen out the shRNA expression plasmid with the most obvious effect in silencing Mcl-1 gene.Methods Semi-quantitative PCR method was used to detect the expression of Mcl-1 mRNA in the two kinds of macrophages.Western blotting was adopted to detect the expressions of Mcl-1 proteins in the two kinds of macrophages.Three different gene loci for Mcl-1 shRNA fragments were designed with small molecules interfering RNA (siRNA)software.Eukaryotic expression plasmid Mcl-1 shRNA 1-3 carrying the shRNA fragments was constructed by a company.And the eukaryotic expression plasmid vector was transfected into scavenger cells Raw264.7 mice via through the liposome.The transfection results 24 h and 48 h after transfection were observed under the inverted fluorescence microscope;Mcl-1 mRNA and protein expression were detected by real time quantitative PCR and Western blot,respectively.Results The relative expression levels of Mcl-1 mRNA and protein in mouse macrophages Raw264.7 were significantly higher than those of human macrophages (P <0.05).The shRNA expression vector constructed within 24 h and 48 h could decrease Mcl-1 mRNA and protein levels in Raw264.7 cells,especially with the most obvious silencing effect at 48 h.The 48-h transfection group differed significantly from normal group,liposome group and negative control group (P <0.05).Compared with Mcl-1shRNA1and Mcl-1shRNA2,Mcl-1shRNA3 had the strongest effect in silencing Mcl-1mRNA and protein.Conclusion We have successfully screened out experimental Raw264.7 cells and Mcl-1 shRNA eukaryotic expression plasmid which has an obvious silencing effect targeting on Mcl-1 in mice macrophages Raw264.7.