[Objective]To investigate the possible etiological factors,pathogenesis,diagnostic criteria,clinic characteristics and the choice of treatment of the adolescent instability of lower cervical spine.[Method]The diagnosis,therapies and follow-up materials of the two typical cases were analyzed and researched with the available literatures.[Result]The two cases showed dissappearance of syndroms.The Roentgen film showed that the operative segments have gotten bone-fuse.Results were excellent according to Henderson-evaluation classification without any complications at 3 and 4 years follow-up.[Conclusion]The degeneration is probable one of the etiological factors causing adolescent instability of lower cervical spine.It is resemble on the pathogenesis,diagnostic criteria and the choice of treatment between the adolescent and the adult.But the each characteristic on the pathogenesis,pathologic process,clinical situation should be remarked.The growth potentiality and other correlated factors should be paid attention to for the choice of treatment.

[Objective]To comparatively analyze the clinical results of minimally invasive plate osteosynthesis (MIPO) and ORIF in treatment of intra-articular fracture of knee joint and to investigate the utilization value of biological fixation.[Method]According to the principles of conservation of the vascularity,21 cases of intra-articular fractures of knee joint underwent surgical treatment of MIPO in recent years.In accordance with the type of fracture and other anticipated factors influenced bony healing,paired-samples treated of ORIF were selected.The two groups were compared following: operation time,intra-operative blood loss,bone union time,axial malalignment radiologically of knee joint,and the ROM of knee.HSS criteria were used to evaluate the results.[Result]In MIPO group,all 21 fractures were followed up for averagely 14.2 months (range 10~16 months).The mean duration of surgery was 60.0 min (range 50~70 min) and bone grafting underwent in 2 cases.Complete fracture healing was achieved with the average time of 10.0 weeks and assessment of vallgus/varus alignment showed a deviation more than 5 degrees in 3 cases.The average HSS score was 86.67.In ORIF group,all 21 fractures were followed up for averagely 21.2months (range 12~48 months).The mean duration of surgery was 79.52 min (range 65-95 min) and bone grafting underwent in 18 cases.Complete fracture healing was achieved with the average time of 12.24 weeks and assessment of valgus/varus alignment showed a deviation more than 5 degrees in 2 cases.The average HSS score was 82.14.All patients got bony union and no patient developed infection,implant failure in both groups.There was significant difference in operation time,union time and function of knee between the two groups.[Conclusion]To the suitable cases,MIPO appears to stabilize fractures with a low intra-operative blood loss and a low incidence of bone grafting; on the other hand it offers many advantages in the aspects of operation procedures and functional recovery postoperatively.

Objective To construct recombinant Bb-Em14-3-3 vaccine of Echinococcus multilocularis and to investigate expression efficiency of Em14-3-3 antigen encoding gene in Escherichia coli BL21(DE3).Methods Em14-3-3 antigen gene was amplified by PCR.Then the gene was cloned into Escherichia coli-Bifidobacteria shuttle plasmid pGEX-1? T containing gluathione-S-transferaze(GST) gene to construct pGEX-Em14-3-3.The recombinant plasmid was electroporated into Bifidobacteria bifidum(Bb) to construct rBb-Em14-3-3 vaccine.The vaccine was identified with PCR and restriction-endonuclease digestion.The expression of pGEX-Em14-3-3 was induced with isopropyl-?-D-thiogalactopyranosid(IPTG) and fusion protein Em14-3-3/GST was examined by SDS-PAGE and Western blot techniques.Results 530 bp gene of Em14-3-3 was successfully amplified by PCR and cloned into pGEX-1? T by restriction analysis.rBb-Em14-3-3 vaccine was successfully constructed by PCR and restriction-endonuclease digestion.It was demonstrated with SDS-PAGE and Western blot that the fusion protein Em14-3-3/GST was expressed in E.coli,BL21.The expression efficiency is 23%.Conclusion rBb-Em14-3-3 vaccine of Echinococcus multilocularis was successfully constructed.The plasmid pGEX-Em14-3-3 was highly expressed in E.coli in fused form with GST and this kind of protein shows specific antigenicity.

Objective In order to investigate the changes of T lymphocytes subsets in mice immunized with recombinant Bb-Em Ⅱ/3-Em14-3-3.vaccine of Echinococcus multilocularis (Em) and challenged with Em protoscoleces.Methods BALB/c mice were immunized with recombinant Bb-Em Ⅱ/3-Em14-3-3 vaccine by subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration,Bifidobacterium (Bb) and PBS were used as controls.After 12 weeks of immunization,all the mice were challenged with 50 protoscoleces of Em by intraperitoneal injection.Eighteen weeks later,mice were killed to measure alveolar hydatid weight and spleens were taken to separate spenocytes,in which the percentages of CD4+ and CD8+ T cell subsets were determined by flow cytometry.Results Alveolar hydatid weight was (0.77 ± 0.52),(0.87 ± 0.60),(2.17 ± 0.50),(3.06 ± 0.15) g in subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration groups,respectively,which was obviously lower than that in PBS control group [(3.54 ± 0.32) g,P ＜ 0.05 or ＜ 0.01].The level of CD49 T cell subset was (28.2 ± 2.5)％,(25.0 ± 2.7)％,(24.0 ± 1.3)％,(23.0 ± 1.8)％ in subcutaneous injection,intramuscular injection,nasal mucosa inoculation and oral administration groups,respectively,which was significantly higher than that in PBS control group [(16.1 ± 2.2)％,all P ＜ 0.01].The level of CD8+ T cell subset in the immunization groups was slightly elevated,but there was no statistical significance between groups (F =1.36,P ＞0.05).The level of CD4 + T cell subset in subcutaneous injection group was higher than that in intramuscular injection,nasal mucosa inoculation and oral administration groups (all P ＜ 0.05).Conclusion CD4+ T cell subset may play an important role in the protection of mice induced by recombinant Bb-Em Ⅱ/3-Em14-3-3 vaccine and the subcutaneous injection route appears to be a better way for immunization.

To investigate the weight reduction of hydatid cyst and level of splenocyte subsets in mice immunized with recombinant Bifidobacteria bifidum (Bb) Bb-Eg95-EgA31 vaccine of Echinococcus granulosus (Eg) and challenged with Eg protoscoleces,BALB/c mice were immunized with the vaccine subcutaneously,intramuscularly,intranasally or orally.Then the mice were challenged with 50 Eg protoscoleces on 8~(th) week after vaccination and killed on 25~(th) week after infection.The weight of hydatid cyst was measured and the reduction of the weight was calculated.The spleens were collected for splenocytes preparation.CD_4~+ and CD_8~+ T cells were determined by flow cytometry(FCM),and the blank vector,Bb or MRS were set as control.The hydatid cyst weight was reduced by 45.33%,41.33%,70.67% and 62.67% respectively for the 4 immunization groups.Number of CD_4~+ and CD_8~+ subsets in the immunization groups was more than that in the control group.CD_4~+ and the ratio of CD_4~+/CD_8~+ in the intranasal or oral immunization group was much higher than that in the subcutaneous or intramuscular immunization group.It's concluded that CD_4~+ and CD_8~+T cells may play an important role in the protection induced by recombinant Eg95-EgA31 vaccine of Eg.In addition,intranasal and oral vaccinations could be the better ways for immunization.

Objective To explore the role of ureteroacopy for acute upper urinary tract obstructive anuria.Methods Clinical data of 37 cases with acute upper urinary tract obstructive anuria were analyzed.Results Among 37 cases,34 cases were successfully performed ureteroseopy or ureteroseopic lithotripsy with double-J sent incubation (successful rate was 91.9%).Renal function were recovery in 32 cases.4 Cases returned to 180μmol/L,1 case need hemodialysis periodically.Conclusion Ureteroscopy could rapidly remove the obstruction and protect renal function in management of acute upper urinary tract obstruction anuria,which was contributed to the diagnosis.It was safe,effective and the preferred method.

BACKGROUND: Previous studies have confirmed that nano-hydroxyapatite/collagen (nHAC) and mesenchymal stem cells for repair of bone defect have the ability of bone formation in vivo. OBJECTIVE: To observe the effects of vascular endothelial growth factor (VEGF) and bone marrow mesenchymal stem cells (BMSCs), nHAC composite in the repair of femoral defect in rats. METHODS: Sprague-Dawley rat models of middle part of the femur defect were established and randomly assigned to two groups. Control group was implanted with BMSCs/nHAC composite. Experimental group was implanted with VEGF/BMSCs/nHAC composite. At 2, 4 and 8 weeks postoperation, imaging and histology observation of femoral samples were performed. At 8 weeks postoperation, scanning electron microscopy was performed in new bony callus environment. RESULTS AND CONCLUSION: nHAC composite implantation in the rats did not show rejection or inflammatory reaction. Moreover, bone formed rapidly using VEGF and BMSCs, nHAC composite, which exhibited better bone regeneration capacity compared with BMSCs/nHAC composite. The way of ossification mainly was endochondral ossification. It is presumed that VEGF promoted the formation of local microvessels, differentiation and proliferation of osteoblasts, speeded up the speed of endochondral ossification, shortened bone repair time, and elevated the quality and velocity of osteanagenesis.

Objective To report therapeutic effects of patients with bladder cancer treated by intra-operative radiation and to recommend an effective method for the treatment of bladder cancer.Methods During the operation,when the tumor of bladder had been removed,a boost dose of electric beam from a linear accelerator was irridiated to the tumor bed.28 cases were follawed-up in a long period.Results Lower local recurrence was observed in patients received intra-operative radiation therapy,only 2 cases had a small recurrent tumor in the bladder during the follow-up period.26 cases had bean followed up,no tumor recurred.Conclusion The intraoperative radiation therapy is a useful treatment for the bladder cancer.

10.3969/j.issn.1000-8179.2013.12.013

Objective:To explore the predictive value of 18F-FDG PET/CT in molecular subtyping of triple-negative breast cancer. Methods:A retrospective analysis was performed on the clinical and imaging data of 227 breast cancer patients who underwent 18F-FDG PET/CT examination in the Tianjin Medical University Cancer Institute & Hospital from January 1, 2010 to December 31, 2022. Based on the expression levels of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2) in the primary breast cancer, the patients were categorized into two groups: triple-negative breast cancer (TNBC) and non-TNBC. Radiomic features were extracted from images of both groups, and a radiomic model was constructed to predict the molecular subtype of the TNBC groups. In addition, the clinical data, CT morphological features, and PET metabolic parameters of both groups were compared to determine the indicators with statistically significant differences and develop a comprehensive radiomic model combined with clinical characteristics. Results:Compared to the non-TNBC group, the TNBC groups exhibited more significant invasiveness in terms of tumor diameter, margins, ipsilateral axillary lymph node metastasis, invasion of neighboring skin or papillae, and PET metabolic parameters ( t = -3.19; χ2 = 7.30, 8.10, 5.34; t = 3.80, 3.30, 3.42, P < 0.05). The constructed 18F-FDG PET/CT radiomic model proved effective in predicting the molecular subtype of the TNBC group, and the receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.83 (95% CI 0.78-0.88), an accuracy of 75.9%, a sensitivity of 74.5%, and a specificity of 77.2%. In contrast, the constructed comprehensive radiomic model displayed an AUC of 0.86 (95% CI 0.81-0.90), an accuracy of 77.2%, a sensitivity of 78.6%, and a specificity of 75.9%. Conclusions:18F-FDG PET/CT plays an important role in predicting molecular subtypes of TNBC. The constructed radiomic model and comprehensive radiomic model can further enhance the prediction efficacy of PET metabolic parameters and accelerate the development of accurate treatment protocols in clinical practice, thus improving the prognosis of breast cancer.