Objective To investigate the effects of internal plating with high and low moduli of elasticity on the stress and its distribution on the femoral shaft fracture. Methods A femur from a normal Chinese adult male was scanned by 64-detector row helical CT at 0. 5 mm interval. The CT images were used to establish a finite element model of the femur by software. The mid-femoral fracture was simulated in the model and fixated by eight-hole plates of Ti-6Al-4V (high modulus group, E = 110 GPa) and of Ti2448 (low modulus group, E = 30 GPa). When the femur was in axial compression, flexion and torsion loads, the stress and its distribution on the bone fracture site were analyzed to compare the biomechanics of the plates with high and low moduli. Results Under axial compression load, the contact stress between fracture ends in the low modulus group was larger than that in the high modulus group, while the max stress at the hole (11.47MPa) was smaller than that in the high modulus group (13.89 MPa) . Under four-point bending load, the contact stress in the low modulus group was still larger, while the bending movement was smaller. Under the torsion load, stress on the femur was well-distributed in both groups, but the max stress at the hole in the low modulus group (11.47 MPa) was smaller than that in the high modulus group (31.24 MPa). Conclusions Under internal fixation by plates of low modulus, the stress stimulus at the fracture site may be increased,while the stress concentrated at the hole may be decreased. The stress shielding of the low modulus plate may also be modified.

Objective To observe the therapeutic effects of ganciclovir(GCV)with differentInjection methods on experimental acute retinal necrosis(ARN).Methods The right eyes of 41pigmented rabbits were infected by herpes simplex virus(HSV-1)(COS strain)to establish ARN animalmodel.After 24 and 72 hours,GCV was given by intravitreal injection(10 eyes),intravenous injection(11 eyes)and the intravitreal+intravenous injection(10 eyes);intravitreal injection of GCV anddexamethasone(6 eyes)was also included.Four eyes were not treated as the control.The dosage of GCVin intravitreal and intravenous injection was 800 μg and 5 mg/kg weight,respectively.Retina necrosis wasobserved and the grade was recorded 1-21 days after injection according to the grade standard ofretinopathy.The maximum grades of retinal necrosis in different groups were compared.Results Thegrade of retinal necosis was 3.8 in the control group,and 0.2,0.4,0.8,and 2.2 in intravitreal iniection,intravitrcal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenousrejection,respectively,24 hours after the model was set up.The effects of the first 3 groups wereobviously better than the Iast group(P=0.003,0.011,0.045);while the difference among the first 3groups were not significant(P=0.881,0.054,0.107).Seventy-two hours after the mode J was set up,thegrades of retinal necrosis were above 1.4 in 4 groups,and the differences among the 4 groups were notapparent(P=0.214).Conclusions In the animal model of ARN,intravitreal injection with GCV caneffectively decrease the grade of retinal necrosis.The difference among intravitrealinjection,intravitreal+intravenous injection,intravitreal injection with GCV and dexamethasone,and intravenous injection is notsignificant.

Objective To establish the rabbit model for acute retinal necrosis(ARN) and investigate the possible route of the virus migrates from one eye to the other. Design Experimental study. Participants 41 chinchilla rabbits. Methods HSV-1 COS strain was inoculated into subretina in 41 rabbits to establish ARN animal model. Ganciclovir was used to treat by intraocular and/or intravenous injection 1 day or 3 days after virus inoculation. PCR test of blood samples was performed for HSV detection. Histopathological examinations were also conducted in some eyeballs, optic nerves and brains of the rabbits. Main Outcome Measures Results of blood PCR and histopathology. Results 10 rabbits appeared bilateral retina necrosis (10 to 18 days after virus inoculation) and 15 rabbits appeared central nervous system damages. PCR samples of 5 rabbits obtained before and after the contralateral retina damages appeared (9 to 19 days after virus inoculation) had all negative results. Histopathological damages were found in bilateral eyeballs, optic nerves and brains. Conclusion The ARN model can be established by injection of HSV-1 into subretina of rabbits. Blood samples PCR don't support the hypothesis of virus transmission through circulation system in bilateral ARN cases. Trans-optic chiasm transmission may be a possible route.

Objective To evaluate the long-term clinical outcomes between laparoscopic gastrectomy and open gastrectomy with D2 lymph dissection for advanced gastric cancer.Methods Clinical studies that compared clinical outcomes of laparoscopic gastrectomy and open gastrectomy for advanced gastric cancer were searched from PubMed,EMBASE,Medline,Cochrane Library,WanFang,CNKI,CMCC and VIP database with the Gastric neoplasms Laparoscopy Gastrectomy Long-term outcomes Meta-analysis between Jan.2002 and Oct.2016.Data of long-term survival and recurrence were analyzed by using of RevMan 5.2 software.Survival data were present by the odds ratio(OR) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Fifteen studies including 4,053 cases were enrolled.There were 2,091 patients in LG group and 1,962 patients in the open gastrectomy group.There was no significant difference in the 3-year overall survival rate(OR =1.00,95％ CI:0.83-1.20,P =0.98),5-year overall survival rate (OR =1.14,95％ CI:0.95-1.36,P =0.15),5-year disease-free survival rate(OR =1.13,95％ CI:0.93 ～ 1.39,P =0.22)and cancer recurrence rate (OR =0.96,95％ CI:0.79 ～ 1.18,P =0.71)between the patients treated with laparoscopic gastrectomy,or open gastrectomy (P ＞ 0.05).Conclusion Laparoscopic gastrectomy with D2 lymph dissection for advanced gastric cancer has similar long-term outcomes as compared to open gastrectomy.

AIM:To investigate the roles of microRNA-134 (miR-134) in the cisplatin resistance of lung ade-nocarcinoma cells.METHODS:miRNA microarray was applied to compare the miRNA expression profile between A549/CDDP and A549 cells.Real-time PCR was used to confirm the expression of miR-134.miR-134 mimics and inhibitors were transfected into A549/CDDP and A549 cells, respectively.MTT assay was used to detect the sensitivity of lung cancer cells to cisplatin.Western blot was applied to test whether miR-134 regulated forkhead box protein M1 ( FOXM1 ) and multi-drug-associated protein 1 ( MRP1 ) expression.RESULTS: Based on the data of miRNA microarray, 13 miRNAs were found to be differentially expressed in A549/CDDP cells compared with A549 cells, among which miR-134 was the most significantly down-regulated one.Compared with control group, A549/CDDP cells transfected with miR-134 mimics showed greatly enhanced sensitivity to cisplatin as indicated by IC50 values (P<0.01).In contrast, suppression of the miR-134 level in the A549 cells resulted in a decreased sensitivity to cisplatin (P<0.01).FOXM1 siRNA down-regulated the pro-tein levels of FOXM1.A549/CDDP cells transfected with si-FOXM1 showed enhanced sensitivity to cisplatin (P<0.01). In addition, the result of Western blot showed that miR-134 repressed MRP1 protein expression.CONCLUSION: miR-134 effectively increases the sensitivity of lung adenocarcinoma cells to cisplatin, and this effect of miR-134 may be partly due to its regulation of FOXM1 and MRP1 expression.

Objective To investigate the role and the mechanism of Apr-1 gene on cholangiocarcinoma QBC939 cell lines proliferation and cell cycle regulation. Methods Apr-1 gene was transfected into QBC939 cells by using liposomes to establish a QBC939 cell model ( QBC939-Apr-1 ) stably expressing Apr-1 gene. Apr-1 mRNA expression and the changes in cell cycle and cell growth of QBC939 cells were analyzed by RT-PCR, flow cytometry ( FCM ) and growth curve before and after transfection. The regulatory effect of Apr-1 gene on the expression of cell cycle-related genes was investigated in QBC939 cells before and after Apr-1 transfection using cell cycle gene microarrays. Results Significant suppression of cell growth was observed with the cell model stably expressing Apr-1 gene. Apr-1 over-expression caused cell arrest from 9% to 13% (P ＜0. 01 ) increase in G2 population. Cell cycle gene microarrays demonstrated that the expression of Skp2 、UBE1 was up-regulated, while the expression of MRE11A 、CKS2 、CDK8 、CDC45 was down-regulated by more than 3 folds. Conclusions Apr-1 gene suppresses QBC939 cell proliferation in vitro, QBC939 cells presented with differences in the expression of cell cycle-related genes after Apr-1 gene transfection.

ObjectiveTo study the injuries of liver after ischemia-reperfusion of small intestine of the rat.MethodsModels of ischemia-reperfusion of small intestine was made with rats. At 0 min, 30 min, 1h, 2h, 1d, 3d,7d after reperfusion, the concentration of nitric oxide(NO), superoxide dismutase (SOD) in the serum was examed and the expression of Bax, Bcl-2 and p53 in the liver was observed by the immunohistochemical SP method.ResultsThe concentration of NO increased apparently 0 min after reperfusion, but decreased 2 h after, then increased gradually to a peak at 7th day. But for SOD, the concentration decreased 0 min after reperfusion, increased 2 h after,and decreased to the lowest level at 7th day. The immunohistochemical SP positive cells were observed in sinus endothelial cells and hepatocytes. The ratio of positive cells of Bax,p53 and Bcl-2 began to increase 0 minute after reperfusion and increased continuously 30 min after, while that of Bcl-2 was higher than that of Bax(P<0.01). It decreased apparently 2h after, and then increased till 7d after reperfusion,while the ratio of Bax positive cells was higher than that of Bcl-2(P<0.01).ConclusionThe change of concentration of NO, SOD and the expression of positive cells of Bax, Bcl-2 and p53 might play a important role in apoptosis and injuries of the liver after ischemia-reperfusion of small intestine of rat.

Objective To establish a method for amplification of immature dendritic cells(DC) from murine bone marrow in vitro and investigate correlations between maturation degree of DC and varying dosages of granulocyte-macrophage-colony stimulating factor(GM-CSF).Methods Dendritic cells from murine bone marrow were cultured with different dosages of rm GM-CSF.The suspension cells were examined with scanning electronic microscope,and the non-sensitized T lymphocyte proliferation was observed by mixed lymphocyte reaction.Results DC cultured in lower dosage of rmGM-CSF(GMlow DC) exhibited typical characteristics of DC,and had immature characteristics in cell phenotype and cell functions with high expression of CD11c and low expression of CD80,CD86 and MHC II on the surface of the cells.The ability of GmlowDC to stimulate the proliferation of non-sensitized T lymphocyte in vitro was weaker than that of GmhighDC.Conclusions The methods of immature DCs culturing establised by allthors was feasible.The dosage of rm GM-CSF has a direct relationship with the maturation degree of DC.

ObjectiveToinvestigatetheriskfactorsforunfavorableoutcomeinpatientswithminor ischemic stroke. Methods Patients with minor ischemic stroke were enroled prospectively. The modified Rankin Scale ( mRS ) w as used to assess the clinical outcome at day 90 after onset, and mRS 0-2 w as defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group w ere compared. Multivariate logistic regression analysis w as used to identify the independent risk factors for early poor outcome in patients w ith minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enroled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95%CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95%CI 1.177-2.347; P=0.004), limb movement disorder ( OR 2.430, 95%CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95%CI 1.188-7.221;P=0.020), early neurological deterioration ( OR 50.994, 95%CI 17.659-147.258; P<0.001), infarct diameter ( OR 1.279, 95%CI 1.075-1.521; P=0.005), non-responsible vascular stenosis ( OR 2.518, 95%CI 1.145-5.536;P=0.022), and large artery atherosclerotic stroke ( OR 2.010, 95%CI 1.009-4.003; P=0.047) w ere the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated w ith age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided.

Objective This study was to compare surgical safety and oncologic adequacy of laparoscopy-assisted gastrectomy (LAG) versus open gastrectomy (OG) for advanced gastric cancer.Methods 120 consecutive AGC patients undergoing LAG with D2 lymph node dissection between September 2005 to December 2009 were compared with 120 AGC patients undergoing OG during the same period.In each group,50 underwent distal gastrectomy,70 for total gastrectomy.Results There was no conversion to open surgery in LAG.The operative time was significantly longer in LAG than OG [(307 ± 84) min vs.(203 ± 52) min,t'=11.556,P ＜ 0.01].The estimated blood loss was significantly less in LAG group than OG group [(258 ± 78) ml vs.(318 ± 89) ml,t =5.550,P ＜ 0.01].The number of lymph nodes retrieved was(17 ±11) in LAG,(16 ±10)in OG (t =0.723,P＞0.05).All margins were tumor free in both groups.9 patients had the postoperative complication in LAG,8 patients in OG (P ＞ 0.05).Length of postoperative stay was significantly shorter in LAG than OG [(10.6 + 4.7) vs.(14.3 ± 2.9) days,t' =7.339,P ＜0.01].There was no mortality in both groups.The 5-year recurrence-free survival rate were comparable (47.6％ in LAG vs.42.8％ in OG,x2 =0.577,P ＞ 0.05) between the two groups.Conclusions This study suggested that laparoscopy-assisted gastrectomy is safe and feasible in terms of surgical outcome and oncologic adequacy for advanced gastric cancer.