BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were observed on 60 pelvic samples. In order to make the observation easier, 12 o'clock division mode chart of acetabulum was established, that is, a line drawn from anterior superior iliac spine toanterior inferior iliac spine, with the crossing point of its extension line and acetabular edge taken as 12 o'clock, therefore the other points should be arranged clockwise. Totally 30 patients received artificial total hip replacement by acetabular lateral-posterior approach. One week later, bilateral deep venous radiography was performed to observe the state of deep venous thrombosis in lower limbs.MAIN OUTCOME MEASURES: ① The anatomical relationship between the branches of external iliac artery and vein, femoral artery and vein and acetabulum. ② The formation rate of deep venous thrombosis in lower limbs after total hip replacement. ③ Adverse events and side effects.RESULTS: Totally 60 adult normal pelvic samples and other 30 pelvic samples of patients who received total hip replacement remained in the results analysis. ① Anatomical observation of external iliac artery and vein,as well as femoral artery and vein: the branches of femoral artery and vein: Medial and lateral circumflex femoral arteries were found running across acetabulum and entering acetabulum; the safe position for the retractor was from 12 o'clock to 3 o'clock and from 5 o'clock to 9 o'clock. However, 9o'clock to12 o'clock and 3 o'clock to 5 o'clock were taken as fragile regions. ② The incidence of deep venous thrombosis following total hip replacement: Bilateral deep venous radiography was carried out after operation and revealed that 11 patients developed deep venous thrombosis with the incidence of 37%. ③ Adverse events and side effects: Postoperative bleeding of over 1 000 mL occurred in 3 cases. In order to fully expose operative field, the retractor should be used to hold off muscles and other tissues, which contributed to long-term vascular compression and blood flow retardation.CONCLUSION: Artificial total hip replacement is liable to injure the internal wall of acetabular vessels, thereby leading to blood flow retardation and platelet aggregation, and ultimately thrombosis. In addition, the massive bleeding during operation will increase blood mucosity, which also increases the risk for thrombosis. From the mode chart of fragile regions and safe regions, we can deduce that deep venous thrombosis in lower limbs can be reduced.

BACKGROUND: At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.OBJECTIVE: To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.DESIGN: Single sample study based on the human anatomical samples.SETTING: Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.PARTICIPANTS: The study was completed in the Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University from March to May in 2003. There were 56 pelvis samples of the normal human adult cadaver, 27 males and 29 females.METHODS: The origins and the pathways of the sciatic nerves and the relation of the sciatic nerve and the acetabulum were analyzed, and the sciatic nerve injury induced by the clasp and the screw fixation in the THR was measured and analyzed.MAIN OUTCOME MEASURES: The location relation of the sciatic nerve and the acetabulum.RESULTS: The distance between the sciatic nerve and the bottom of the acetabulum was(6.00 ±0. 85) mm on the left and(6.00 ±0. 71) mm on the right. The distance between the sciatic nerve and the edge of the acetabulum was(13.00 ±0. 75) mm on the left and(14.00 ±0.06) mm on the right. The SN circumference on the edge of the acetabulum was(32.00 ± 0. 28) mm on the left and(31.00 ± 0.68) mm on the right. The distance between the bottom of the acetabulum and the greater sciatic foramen was(29.00 ±0. 36)mm on the left and(29.00 ±0.24) mm on the right.CONCLUSION: It is confirmed that the clasp and the screw fixation can be done on the safe region at the 1-3 o' clock and the 5-6 o' clock. The obsolete fracture and dislocation of the acetabulum, the unsuitable clasp location and the unsuitable location of screw fixation may induce the iatrogenic sciatic nerve injury.

Objective To investigate the inhibitory effect of curcumin on the telomerase activity of HeLa cells.Methods The growth inhibition rate of HeLa cells treated with curcumin was measured with MTT method.The expression of hTERT mRNA was studied using RT-PCR.Telomerse activity was examined by TRAP-ELISA.Results The growth of HeLa cells treated with curcumin was inhibited in concentration dependent manner and the expression of hTERT mRNA and the level of telomerase activity were down-regulated significantly.Conclusion Curcumin can inhibit telomerase activity of HeLa cells.The underlying mechanism might be related to the down-regulation of hTERT transcription.

OBJECTIVE To study the causes of recurrence and treatment methods in patients with recurrent sinonasal melanoma. METHODS From 1993 to 2003, a retrospective analysis of consecutive 11 cases with recurrent sinonasal melanoma was conducted. RESULTS Four out of the 11 cases with recurrent sinonasal melanoma were caused by misdiagnosis, while the other 7 cases recurred after operation with pathological diagnosis. Among the 7 cases, 5 were found recurrences after operation alone, and the other 2 after the operation and radiation therapy. The recurrence lesions located in nasal and paranasal sinus in 7 cases, in orbit, skull base, soft and hard palate in 1 case, in parotid gland and skin in 1 case. In face, orbit and extended skull base in 1 case. Cervical lymph node recurrence developed in 1 patient. The time of first relapse was 10 months after therapy. The 1-, 2-and 3-year survival rates after reoperation were 72.7 %, 18.2 % and 9.1 % respectively. CONCLUSION The reasonable treatment and decrease the misdignosis are the main measures to improve the cure rate of recurrent sinonasal melanoma.

Objective: To explore the value of quantitative acoustic radiation force impulse (ARFI) imaging in evaluation of liver elasticity in patients with chronic heart failure (HF). Methods: Totally 30 left HF patients (LHF group), 30 right HF patients (RHF group) and 30 healthy volunteers (control group) underwent routine ultrasound examination and biochemical examination, and then Young's modulus value of liver was detected using quantitative ARFI imaging. Correlations between Young's modulus value of liver and biochemical indexes, diameter of inferior vena cava, diameter of liver vein and oblique diameter of right lobe of liver were analyzed in patients with chronic HF. Results: Young's modulus value of liver in LHF group and RHF group were higher than that in control group (both P<0.05), and in RHF group was higher than in LHF group (P<0.05). Young's modulus value of liver in chronic HF patients positively correlated with brain natriuretic peptide, total bilirubin, gamma glutamyl transferase, alkaline phosphatase, diameter of inferior vena cava, diameter of left liver vein, diameter of middle hepatic vein and diameter of right liver vein (r=0.325, 0.382, 0.355, 0.379, 0.451, 0.445, 0.395, 0.645, all P<0.05), while no correlation was noticed between Young's modulus of liver and ejection fraction of left ventricle nor oblique diameter of right lobe of liver (all P>0.05). Conclusion: Quantitative ARFI imaging can be used to estimate the elasticity of liver in chronic HF patients. Liver elasticity is associated with the severity of heart failure.

Caveolin-1(Cav-1) is a scaffold protein of caveolae that acts as a tumor modulator by interacting with cell adhesion molecules and signaling receptors.Evidence from a variety of studies indicate that caveolin-1 exhibits the heterogeneity of Cav-1 expression in different tumors.Current research has clearly established a role for Cav-1 as a a novel prognostic marker,Future studies will undoubtedly offer novel exciting opportunities to develop anti-cancer therapies.

Objective To explore the application value of pulmonary artery monitoring program for intracranial and cervical artery angiography with dual-energy CT.Methods Sixty patients performed intracranial and cervical artery angiography with dual-energy CT were divided into two groups according to the random number table.Group A (optimization group,30 patients):the monitoring points were located in the main pulmonary artery,with threshold 150 HU,trigger delay time 8-9 s,pitch 0.9,and the iohexol (350 mg I/ml) 60-65 ml.Group B (conventional group,30 patients):the monitoring points were located in aortic arch,with threshold 100 HU,trigger delay time 5 s,and the iohexol (350 mg I/ml)60-70 ml.Patients with the body weight less than 75 kg were injected with the flow rate of 4.0 ml/s,and those weight greater than 75 kg or with body mass index (BMI) greater than 27 kg/m2 were 4.5 ml/s,following 40 ml saline solution with the same flow rate respectively.All images were transferred to Siemens Syngo workstation for further processing and analysis.The attenuation values were measured on axial images in the common carotid artery,internal and external carotid artery,vertebral and basilar artery,the horizontal segment of the middle cerebral artery,the subclavian vein of injection side,the proximal,middle and distal segment of jugular vein,the straight sinus and the superior sagittal sinus.Two experienced observers blinded independently evaluated the image quality of CTA,the impact of contrast material residues artifacts of subclavian vein of injected side and the affect of venous return factors on arterial image display.Images of volume rendering technique(VR),the maximum intensity projection (MIP),and curved planar reformation (CPR) were reconstructed using dual energy bone removal and Inspace and 3D software.The mean intraluminal attenuation of contrast material (HU),the volume of contrast material and the mean image quality scores were compared with t test between the two groups.Chi-square test was used to compare of image contrast agents residual artifacts,the absence segments of the root of the neck artery,and the degree of the jugular vein return in two groups.Results The mean CT values were 372-414 HU for each segment of artery showing no significant differences between two groups (P ＞ 0.05).In group A,the CT values of the jugular vein in proximal,middle,distal segment of the two sides were (95 ± 36),(95 ± 36),(131 ±58),(133 ± 57),(174 ± 68),and (180 ± 66) HU respectively.In group B,CT values were (135 ± 58),(137 ±59),(170 ±58),(181 ±58),(218 ±62),and (224 ±68) HU.The CT value of jugular venous in group A was significantly lower than that in group B (t =-3.30--2.54,P ＜ 0.05).Case numbers of contrast agent residual artifacts of injection side subclavian vein and the absence segments of root of the neck artery at the beginning in group A (5,11) were less than that in group B (12,24) (x2 =4.02,5.65,P ＜0.05).The degree of the jugular vein return in group A were lesser severely than that in group B (x2 =6.79,6.37,P ＜0.05).Below the level of carotid artery bifurcation:slight 5 patients,severe 1 patient in group A vs.slight 15 patients,severe 9 patients in group B.Above the level of carotid artery bifurcation:slight 9 patients,severe 6 patients in group A vs.slight 12 patients,severe 17 patients in group B.Image quality scores of group A (3.84 ± 0.40) was higher than that of group B (3.64 ± 0.63) (t =4.26,P ＜0.05).Conclusions Pulmonary Artery Monitoring combines with 60-65 ml contrast material optimization scheme for intracranial and cervical artery angiography with dual energy CT can significantly reduce the degree of jugular venous return and contrast material residues artifacts of subclavian vein of injected side.This technique is helpful to improve the work efficiency and image quality.