ObjectiveTo investigate the accuracy of percutaneous iliosacral screw fixation in sacroiliac joint fracture-dislocation with minimally invasive guider with CT-guided.MethodsFrom January 2011 to May 2011,8 patients with sacroiliac joint fracture-dislocation were treated using percutaneous iliosacral screw fixation assist with minimally invasive guider in CT-guided,which included 5 males and 3 females,with the average age of 32 years (ranged from 26 to 56 years).All patients suffered with vertically unstable pelvic fractures.Bone traction was used in femoral condyle for 6 cases which displaced more than 2cm in sacroiliac joints.Patients were prone position on the CT bed.First sacroiliac joint CT-scan was performed,then marked the needle position on affected side buttocks after measure the best position and track of needle that expected on CT computer screen.According to the data of CT-scan,the angle of the devices was adjusted,which could control 3D direction of the minimally invasive guider,then insert the Kirschner wire into sacroiliac joint guided with the front end of the sleeve of the minimally invasive guider,confirmed the track of needle was excellent with CT-scan (3D),then the guider was moved out and put the hollow screw (dia 7.3 mm Synthes) into the sacroiliac joint along the Kirschner wire.ResultsAll 8 patients were successfully insert the Kirschner wire.The operation time was from 10 to 20 min(mean,14 min).All screws were in the position expected before surgery,no cut out of bone with the CT-scan immediately after operation,the shape of sacroiliac joint was restored satisfied and the fixation was stable.No numbness and radiation-like pain appeared among the operation in the lower limb for all patients,no case had vascular and neurological complications postoperative.ConclusionThe minimally invasive guider can improve the accuracy,security and simplicity of the percutaneous iliosacral screw fixation with CT-guided,and also avoid the deviation of needle insertion angle that determined by operator himself.

Objective To establish and improve the acute hepatic failure model in pigs induced with D-galactosamine (D-gal),and explore the feasibility of evaluating preclinical artificial liver devices.Methods Nineteen Duroc breeding pigs were divided into 4 groups.Fifteen unanesthetic Duroc breeding pigs out of 19 (5 of each group) received intravenously administration of D-gal at a dose of 1.0,1.25 and 1.5 g/kg body weight,respectively.The remaining 4 pigs which received the same volume of 5% dextrose in water served as controls. Clinical data and survival time of pigs were recorded.Blood samples were collected for dynamic testing of plasma ammonia,prothrombin time,liver and renal functions,blood glucose and L-lactate;liver tissues were sampled for pathological examination.The differences between groups were compared using t test and F test.The survival time of pigs was compared by Kaplan-Meier survival analysis and Log Rank test.Results Twelve hours after administration of D-gal,all pigs presented as acute hepatic failure characterized by progressive increases of levels of plasma ammonia,aspartate aminotransferase (AST),total bilirubin (TBil) and L-lactate,the level of blood glucose marked decreased and prothrombin time prolonged (F= 32.33,F=27.817,F=50.097,F=88.382,F=8.211,F=21.227;all P＜0.01);especially in the pigs which received D-gal at a dose of 1.5 g/kg.Except 2 pigs survived for 168 h,the other 3 pigs which received D-gal at a dose of 1.0 g/kg died within 68-84 h,while all pigs which received D-gal at a dose of 1.25 and 1.5 g/kg died within 33-89 h and 23-47 h,respectively.All pigs presented coma before death and liver histopathological examination indicated massive hepatic necrosis with severe hemorrhage.Conclusions D-gal induced acute hepatic failure model in unanesthetic Duroc breeding pig appears potential reversibility and high reproducibility,which has proper therapeutic window.Thus,this model could be applied to evaluate the therapeutic effects and safety of artificial liver devices.

Objective To explore the short?term functional outcomes of the reconstruction of the proximal humerus by re?verse shoulder arthroplasty after tumor rescetion. Methods 8 patients who underwent reverse shoulder arthroplasty after tumor resection between January 2013 and December 2014. 5 were female and 3 were male, mean aged was 38 years old (25-61). 2 chon?drosarcomas and 6 giant cell tumors. Enneking stageing of 2 cases with chondrosarcoma were stageⅠB and stageⅡB. 6 giant cell tumors were Campanacci stage 3, meanwhile 3 cases had pathological fractures. The deltoid and axillary nerve were intact in all patients by image analysis before the operation. The proximal humerus was resected according to Malawer typeⅠresection. Then reverse shoulder arthroplasty reconstruction and bone graft was performed. The follow?up was scheduled, and the patient received X?ray examination of the shoulder. The range of motion of the shoulder was measured, the Constant?Murley score and musculoskel?etal tumor society(MSTS) score was recorded. Results The mean duration of the operation was 2.7 h (2-3.5 h). The bleeding in the operation was 510 ml (300-850 ml). The mean length of humerus resection was 8 cm (6-10 cm). The allografts were used in 7 cases and reimplantation after tumor bone deactivation was used in one. The latissimus dorsi transfer were performed in 2 cases. The rotator cuff were resected 1-1.5 cm from the great and lesser tubercles. The follow?up was 13 months (3-26 months). No infec?tion, dislocation, or loosening of prosthesis was found by the last follow?up. The X?ray showed the case who received reimplanta?tion after tumor bone deactivation had achieved bone union 1 year postoperation,7 cases received allograft had still nonunion at the host?graft junction. Bone resorption were found in all cases in different extent but the prosthesis were stable. No local recur?rence of the tumor was found. At last follow?up, active abduction was 155° (100°-175° ) and active forward elevation was 150° (115°-170°) and Constant?Murley score was 76%(68%-87%). The MSTS score was 92%(87%-97%). Conclusion The func?tional outcomes of the reconstruction of the proximal humerus by reverse shoulder arthroplasty after tumor rescetion was satisfied in early period. The reverse shoulder arthroplasty can be used in younger patient, but long?term results need further study.

AIM:To investigate the expression of up-regulated gene 11 ( URG11 ) in prostate cancer cell line and the effect of URG11 siNRA on the proliferation and invasion of human prostate cancer LNCaP cells.METHODS:The mRNA and protein levels of URG11 in prostate cancer cell lines and normal prostate epithelial cell line were evaluated by real-time PCR and Western blot.LNCaP cells were transfected with designed siRNA using the liposome method.The prolif-eration, apoptosis, migration and invasion abilities of the LNCaP cells were evaluated by MTS assay, flow cytometry, wound-healing assay and Transwell assay.RESULTS:The expression of URG11 at mRNA and protein levels in the DU145, PC3, LNCaP cell lines was significantly higher than that in RWPE-1 cell line.Compared with the control group, the proliferation of LNCaP cells with URG11 siRNA was stagnant in G1/S phase and induced apoptosis.The proliferation of LNCaP cells at 0 h, 24 h, 48 h and 72 h was inhibited after URG11 expression was down-regulated (P<0.05).Transwell assay showed that migration (P<0.05) and invasion (P<0.05) were also inhibited.CONCLUSION:URG11 is highly expressed in prostate cancer.Silencing of URG11 significantly inhibits the proliferation and invasion and induces apoptosis of LNCaP cells.

Objective To establish normally immortalized porcine hepatocyte lines by ectopic expression of simian virus 40 large T (SV40LT) antigen and the human telomerase reverse transcriptase(hTERT). Methods Primary porcine Hepatoeyte cells were transfeeted with recombinant retrovirus containing SV40LT or hTERT respectively. Subsequently drug resistant cell clones were screened and expanded for further studies. Immortalized porcine hepatocyte was confirmed by examination. Results The morphological phenotype of the transfected cells was similar to the primary porcine hepatocyte. One clone, HepLP, has been maintained in cultue for half year, and expanded by more than 60 passages. SV40 LT and hTERT could be detected in transfected porcine hepatocyte. Pig albumin mRNA was also detected by RT-PCR. No tumor formation occurred when HepLP cells were injected into Balb/c nude mice. Conclusions The immortalized, nontumorigenic, porcine hepatoeytes maintained the properties of porcine primary hepatocytes such as the albumin secretion. This generation of immortalized porcine hepatocyte may be helpful for bioartifical liver support system, hepatocytes transplantation, drug/toxicological studies, and liver biologic studies.

OBJECTIVETo explore the hematopoietic and immunologic reconstitution and transplantation-related complications of HLA one locus mismatched unrelated umbilical cord blood transplantation for the treatment of hematological malignancies.

METHODSTwo children with acute lymphoblastic leukemia received HLA-mismatched unrelated umbilical cord blood transplantation. The conditioning regimens were BU-CTX (case 1) and BU-CTX plus BCNU (case 2). GVHD prophylaxis regimen consisted of cyclosporine (CsA) and mycophenolate mofetil (MMF). The patients received 14.6 x 10(7) nucleated cells/kg with 7.24 x 10(5) CD(34)(+) cells/kg and 16.24 x 10(7) nucleated cells/kg with 21.11 x 10(5) CD(34)(+) cells/kg, respectively.

RESULTSThe two recipients, ANC > 0.5 x 10(9)/L occurred at day 27 and day 17, BPC > 50 x 10(9)/L at day 53 and day 46, the peripheral blood counts normalization at day 60 and day 52, the immune function normalization at day 134 and day 122 and the DNA fingerprinting showing engraftment at day 19 and day 17, respectively. The donor-recipient pair of case 1 was male to female, and the chromosome karyotype of recipients bone marrow and peripheral blood cells showed 100%, 46, XY cells at day 49. Grade II acute graft versus host disease (aGVHD) occurred at day 26 (case 1) and day 21 (case 2). The two recipients have survived for 353 days and 256 days.

CONCLUSIONThe hematopoietic and immunologic reconstitution in umbilical cord blood transplantation were earlier and more durable. The transplantation-related complications were less and aGVHD were milder.

Child, Preschool ; Cyclosporine ; therapeutic use ; DNA Fingerprinting ; DNA, Neoplasm ; genetics ; Female ; Fetal Blood ; cytology ; immunology ; Graft Survival ; drug effects ; immunology ; Graft vs Host Disease ; immunology ; prevention & control ; HLA Antigens ; immunology ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Immunosuppressive Agents ; therapeutic use ; Infant ; Male ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; immunology ; therapy ; Transplantation Conditioning

OBJECTIVETo investigate the correlation of neurochemical metabolism in hippocampus with memory function in young adult patients with first-episode depression.

METHODSTwenty patients with first-episode depression (patient group) and fifteen health subjects (control group) were enrolled in the study. The neurochemical metabolism, including the levels of N-acetylaspartate (NAA), Choline (Cho), Creatine (Cr), Myoinositol (mI) were measured by proton magnetic resonance spectroscope (1H-MRS) in bilateral hippocampus. Wechsler Memory Scale (WMS) were used to examine the memory function in both groups.

RESULTSThe memory quotient (89.15 ±6.62) of patient group was significantly lower than that of controls (P <0.01),the scores of long-term memory,short-term memory and immediate memory in patients were also lower than those of controls (P<0.05 or 0.01). In patient group, the ratio of NAA/Cr (1.34 ±0.08) in the left hippocampus was significantly lower than that of control group (P<0.01); and the ratio of mI/Cr in the bilateral hippocampus [(0.63 ±0.13) in left and (0.6 ±0.1) in right] was significantly higher than those in control group (P<0.05). In patient group,the ratio of NAA/Cr in the left hippocampus was positively correlated with WMS scores (P<0.01), and the ratio of mI/Cr in the left hippocampus was negatively correlated with WMS scores (P<0.05).

CONCLUSIONThe memory deficit and abnormal metabolism function of neuron cell in hippocampus coexist in young adult patients with first-episode depression, and the lower NAA/Cr and higher mI/Cr ratio in the left hippocampus may result in the memory deficit.

Adolescent ; Adult ; Aspartic Acid ; analogs & derivatives ; metabolism ; Case-Control Studies ; Creatine ; metabolism ; Depressive Disorder ; metabolism ; physiopathology ; Female ; Hippocampus ; metabolism ; Humans ; Inositol ; metabolism ; Magnetic Resonance Spectroscopy ; Male ; Memory ; Neuropsychological Tests ; Young Adult

Objective To establish immortalized human hepatocyte lines for studies of bioartificial liver,hepatocyte transplantation,and drug metabolism in vitro.Methods Primary human hepatocytes were isolated by 4-step perfusion technique with collagenase and transfected with recombinant retrovirus containing Simian virus 40 large T antigen(SV40 LT).Subsequently,immortalized human hepatocytes were evaluated by analysis of gene expression and functional characteristics in vitro.Results Two immortalized human hepatocyte lines,HepLi2 and HepLi3,were obtained after primary human hepatocytes being infected by SV40 LT containing recombinant retrovirus for 3-4 weeks.The immortalized human hepatocytes showed classical appearance of hepatocyte observed by phase contrast microscope.The protein expression of SV40 LT in HepLi2 and HepLi3 cells were detected by Western blotting.The mRNA expressions of albumin(Alb),glutathione S-transferase(GST-p),human blood coagulation factor X(HBCF-X)and β-actin in HepLi2 and HepLi3 cells were detected by reverse transcription polymerase chain reaction(RT-PCR),and the mRNA expressions of cytochrome(CY)450 subtypes(CYP3A5,CYP2E1,CYP2C8-19 and CYP3A4)in HepLi2 and HepLi3 cells were also observed by RT-PCR.Levels of alanine transaminase (ALT),lactate dehydrogenase(LDH)and Alb were detected in the supernatant of immortalized human hepatoeyte culture.Conclusions The immortalized human hepatocyte lines have the biological characteristics of primary human hepatocytes and have the CYP450 functions of hepatocytes,which may be heIDful for the studies of bioartificial liver,heoatocvte transplantation and drug metabolism in vitro.

Objective To explore the personalized treatment options and clinical results obtained by our hospital for different parts of bone destruction of different degrees of bone giant cell tumor.Methods Retrospective analysis from January 2005 to December 2014,according to the giant bone cell tumor diagnosis and treatment procedures used in thehospital to take wide resection or intralesional curettage and adjuvant therapy for the treatment of primary limb long bone giant cell tumor 281 cases.There were 150 males and 131 females,with overall age from 14 to 71 years and an average of 35.10 yearsold.The distal ulna was 9 cases.The distal radiuswas 26 cases.The proximal humerus was 19 cases.The distal humerus was 2 cases.The proximal femur was 38 cases.The distal femur was 95 cases.The proximal tibiawas 59 cases.The distal tibiawas 10 cases.There were 19 proximal fibula cases,3 distal fibula cases and 1 case of multiple giant cell tumor of bone.We chose curettage and/or adjuvant therapy or wide resection,then with bone cement,allograft or autograft,prostheses to reconstructionaccording to tumor site,the degree of destruction,pathological fractures.The x2 test and Cox regression analysis were used to detect the statistic differences.The KaplanMeier survival analysis was used to count the disease-free survival.The relationship between tumor location,destruction degree,Campanacci grading,pathological fractures,treatment methods at different stages and recurrence were analyzed.Results A total of 281 patients with long bone giant cell tumor were included in the follow-up study,including 37 pathological fracture and 244 non-fracture.According to the author's giant cell tumor diagnosis and treatment process,122 patients received a wide resection,159 cases were treated with curettage ± adjuvant therapy.23 patients had postoperative recurrence,the recurrence rate was 8.19％.The recurrence time after operation ranged from 9 to 75 months (average 30.95 months).There was no significant difference between the recurrence rate of lesions around the knee and other parts (x2=0.370,P=0.240).In the non-pathologic fracture group,the recurrence rate was significantly lower in the large section compared with curettage surgery (x2=9.393,P=0.002).Of the patients with intralesional surgery,126 patients reconstructed with cement and 28 patients reconstructed with autograft/allograft bone to rebuild mechanical stability.There were 14 recurrence cases (14/126,11.11％) in the bone cement group and 8 recurrence cases (8/28,28.57％) in the bone graft group.The recurrence rate in the bone cement group was significantly lower than that in the simple bone graft group (x2=5.846,P=0.017).The patients with lesion less than 50％,4 had recurrences (4/55,7.27％),12 recurrences occurred (12/76,15.79％) in more than 50％ and less than 75％ of the cross-sections,and if the lesion was more than 75％ cross-sectional area,4 cases of recurrence (4/113,3.54％).There was no significant difference in the proportion of bone destruction between different cross-sections in affecting tumor recurrence.The recurrence rate of Campanacci Grade Ⅲ patients was significantly higher than that of Campanacci Grade Ⅱ patients with curettage surgery (x2=9.909,P=0.002).Only 1 of the patients with pathological fracture had recurrence (1/37,2.70％),the recurrence rate was significantly lower than that the curettage group (x2=11.972,P=0.001).Among the early patients,79 cases (63.71％) were cured by surgery and 17 cases were relapsed,while in the last 5 years 80 cases (50.96％) were cured by surgery and 6 cases were relapsed,In two different periods,the curettage recurrence rate was significantly decreased (x2=9.246,P=0.003).Conclusion By selecting personalized treatment options for different patients,it is possible to increase the proportion of patients who maintain their knee joints while reducing the local recurrence rate,providing doctors and patients with a choice of treatment options.

Objective To evaluate the local recurrence rate,limb function and complications of soft tissue sarcoma of thigh after muscle group resection.Methods Between January 2009 and August 2016,twenty-threepatients who were diagnosed as soft tissue sarcoma for the first time in our hospital,receiving thigh quadriceps muscle group resection,adductor muscle group resection or posterior compartment of the thigh resection were incorporated into this study.Patients who had received surgery of this lesion before,suffered from recurrent soft tissue tumor,had tumor involved multiple muscle groups which could not be resected completely,had sciatic nerve or femoral artery or vein affected by tumor or had distal metastasis were excluded.This retrospective study consisted of 12 male and 11 female.The age ranged from 20-80 with the average of 52.All the patients received CT and MRI of thigh to figure out the size of tumor,the invaded extension of the lesion and the specific muscle group involved.Chest CT scan and ultrasound of bilateral inguinal lymph nodes were arranged to exclude the tumor metastases.After all these examinations were done,needle biopsy with the guidance of CT scan was performed for the pathological diagnosis.The pathology included undifferentiated pleomorphic sarcoma (7 cases),rhabdomyosarcoma (2 cases),primitive neurotodermal tumor (1 case),synovial sarcoma (1 case),leiomyosarcoma (3 cases),fibrosarcoma (5 cases) and liposarcoma (4 cases).Sixpatients received quadriceps muscle group resection,eightpatients received adductor muscle group resection and the other 9 patients received posterior compartment of the thigh resection.Patients with undifferentiated pleomorphic sarcoma,leiomyosarcoma,primitive neurotodermal tumor and synovial sarcoma received postoperative adjuvant chemotherapy.None of patients received radiotherapy.After surgery,drainage tube of negative pressure was placed until the volume of drainage was less than 50 ml within 24 h.The affected thigh was bound up tightly.Intravenous antibiotics were used for 3 days to prevent from postoperative infections.Patients received quadriceps muscle group resection stayed in the bed for 4 weeks.After that they could walk with the protection of orthosis with unbending position.Other patients got out of bed after 2 weeks.All the complications after surgery were recorded.Reexaminations were arranged in 3,6,12 and 24 months after surgery separately.After that,reexamination was arranged every half a year.Chest CT scan was used to detect lung metastasis and ultrasound or MRI was arranged for local recurrence.Lower limb function after surgery was evaluated by MSTS scores.Results All the surgeries of muscle group excision were successfully completed.The duration of surgery ranged 1.5-3.5 h with the average of 2.2 h.The bleeding volume during surgery ranged 100-1 100 mL with the average of 313 mL.The follow-up was a mean of 41 months (range,17-108 months).None was lost to follow-up.The local recurrence rate was 4.3％ (1/23).One patient with undifferentiated pleomorphic sarcoma had positive surgical margin,who received posterior compartment of the thigh resection.Local recurrence occurred 6 months after surgery.Then he received expanded resection.Six patients had distant metastases,five patients for lung metastases,one patient for lung and inguinal lymph node metastases.Of these,five patients had died and one lived with the metastasis.The median MSTS score was 26.3 points (range,14-30 points).Specifically,the median musculoskeletal tumor society (MSTS) score was 28 points (range,21-30 points) for 9 patients with posterior compartment of the thigh resection,twenty-nine points (range,27-30 points) for 8 patients with adductor muscle group resection,and 20.3 points (range,14-24 points) for 6 patients with quadriceps muscle group resection.Five patients had complications,including local recurrence (1 case),hematoma (2 cases) and cutaneous necrosis (2 cases),all of which were settled by reoperation.The rate of complication was 21.7％.Conclusion Muscle group resection is an effective surgical treatment for soft tissue sarcoma of thigh,which could reduce the risk of local recurrence,apart from quadriceps muscle group resection,the other two muscle group resections have limited impact on lower limb function,additionally,thigh muscle group resection is a safe procedure with few complications.