Objective To investigate the feasibility of the lower cervical spine (C3 -C7 ) laminar screw technique for fixing adult posterior cervical spine .Methods We chose 9 formalin fixed moist adult cervical specimens ,which consist of male 6 and female 3 of the age 38 to 63 years old .The average age is 51 .9 years old and the average height is 165 .6 cm .Then we measured the thickness and heightof C3 -C7 lamina ,the lamina length of L1 ,L2 ,and the lamina of axis and the sagittal plane angle .Results The thickness and height of C3 -C7 lamina ,and the lamina length of L1 and L2 of adult male is bigger than adult women .There was statistical sig-nificance between the thickness ,height ,lamina length difference of different genders lamina (P<0 .05) ,but no significant difference between the left and the right (P> 0 .05) .The average lamina thickness of C2 ,C3 ,C4 ,C5 ,C6 ,C7 were respectively 4 .70 ,3 .87 , 3 .30 ,3 .84 and 5 .16 mm .The lamina thickness which was more than 4 .00 mm accounted for 54 .4% .The lamina thickness of C3 , C4 ,C6 ,C7 which was more than 4 .00 mm accounted respectively for 77 .8% ,61 .1% ,33 .3% ,and 88 .9% .Conclusion Crossing laminar screws in cervical spine is feasible in anatomy .The operation can make under direct vision ,and can accurately estimate the screw path length and entry angle .Patients with anatomic abnormalities can be used as an alternative fixation technique or as fixed in the fixed mode fails .So the results can provide a reference for clinical application .

Objective To research the effect of GGCX gene on MMP13 in rabbit osteoarthritis cartilage cells and investigate its effect on osteoarthritis cartilage degeneration.Methods Six Japanese big ear rabbits weighted (2.0±0.2)kg were randomly di vided into three groups,each group seted a rabbit as control.Anterior cruciate ligament transection method was used to build osteoarthritis cartilage degeneration model at second,forth,sixth week.Articular cartilage was separated successfully after the model were built,cartilage cells were divided from articular cartilage and cultured in 6-well cell culture plate.Cartilage cells were divided into blank group,negative control group and transfection group.PCR method and Western blot were conducted to detect GGCX and MMP13 expressed at the level of mRNA and protein.Results Compare with blank group and negative control group,the expressin level of GGCX incresed,while the MMP13 expression level dcresed(P＜0.05).Conclusion Over expression of GGCX gene can ob viously decrease the expression of MMP13,it provide experimental basis for osteoarthritis of the in vitro gene therapy.

Objective To investigate the cachexia morbidity among hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.Method By analyzing the clinical data of 5 118 hospitalized patients with digestive system cancer in Zhongshan Hospital,Fudan University from January 2012 to December 2013,we investigated the cachexia morbidity and compared the clinical outcome between cachectic patients and noncachectic patients.Results The overall cachexia morbidity of hospitalized patients with digestive system cancer was 15.7％ (803/5 118).The highest cachexia morbidity was 34.0％ (89/173),found in patients with pancreatic cancer.In cachectic group and non-cachectic group,the overall completion rate of radical resection was 67.1％ (539/803) and 74.5％ (3 214/4 315),respectively (P =0.000).Compared to the non-cachectic group,the cachetic group had significantly longer postoperative hospital days [(11.5 ±6.2) d vs (9.4 ±4.9) d,P =0.003],slower postoperative recovery of bowel function [(3.4 ±0.9) d vs (3.2 ±0.8) d,P =0.013],longer postoperative time to intake semifluid [(4.4 ± 1.5) d vs (3.9 ± 1.3) d,P =0.002],and more postoperative complications in 28 days after surgery [8.9％ (48/539) vs 5.8％ (186/3 214),P=0.006].After surgery,131 patients in the cachectic group were transferred to the ICU,and 646 patients in non-cachectic group transferred to the ICU (24.3％ vs 20.0％,P=0.026).Compared to the non-cachecic group,the reoperation rate [3.2％ (17/539) vs 1.5％ (48/3214)],ventilator support rate [8.0％ (43/539) vs 5.7％ (184/3 214)],and mortality [2.4％ (13/539) vs 1.1％ (35/3 214)] of the cachectic group were all significantly higher (P =0.006,0.042,0.011).Conclusions Cachexia is common in hospitalized patients with digestive system cancer,especially in patients with pancreatic cancer.Cachexia has negative impact on the clinical outcomes.

Objective To study the clinical,imaging and pathological features of hepatic angiomyolipoma,and to investigate methods in improving the preoperative diagnosis rate.Methods The imaging features and treatment experience of 73 patients with hepatic angiomyolipoma who had been admitted to the Eastern Hepatobiliary Surgery Hospital from 2000 to 2007 were retrospectively analyzed.All patients were classified according to the imaging features and corresponding treatments were applied.Results Of all patients,7 were diagnosed preoperatively.The diagnostic rate of B ultrasound,computed tomography and magnetic resonance imaging were 0,13%(7/56)and 6% (2/33),respectively.According to the results of imaging examination,6 patients were with the type of hemangioma,17 with the type of lipoma,4 with the type of leiomyoma and 46 with mixed type.One patient was treated by radiofrequeney ablation and 72 by surgical resection.Twenty-four patients were presented with pulmonary infection,pleural effusion,ascites or slight hepatic dysfunction.Postoperative immunohistochemical assay demonstrated that HMB45 had the highest positive expression rate,then followed by smooth muscle actin,vimentin,proliferating cell nuclear antigen,CD34,polyclonal carcinoembryonic antigen,CD18,CD19 and p53.One patient died of postoperative tumor recurrence.Conclusions Hepatic angiomyolipoma is easy to be misdiagnosed,while imaging classification is helpful in the diagnosis.Surgical resection is beneficial to patients with hepatic angiomyolipoma.