Objective To evaluate bone cement longer handle artificial femoral head replacement treatment the clinical effect of the treatment of femoral fractures between rotor-instability.Methods There were 98 patients with fracture of instability-between the femur rotor ,women 60 cases,38 cases,male,aged 75 to 94 years old,average 83.5 years.Fractured by Tronzo-Evans type III 56 cases,type IV 42 cases.All use of bone cement longer handle arti-ficial femoral head replacement therapy ,to observe clinical therapeutic effect .Results All cases of postoperative X-ray showed both fracture reduction and fixation well between the rotor and prosthesis position is good .96 cases of post-operative for 6 to 24 months followed-up,the average 15 months.Harris score was 85.4%.Conclusion Bone cement longer handle artificial femoral head replacement has quick postoperative functional recovery ,weight-bearing activities earlier,which can avoid the advantages of long-term complications in bed ,instability is treatment of older femoral frac-tures between rotor reasonable operation method .

Objective To study low frequency ultrasound combined with microbubbles to promote the transfection of P53 gene in human prostate cancer cells mediated by liposome.Methods Ultrasound equipment was used with a frequency of 21 kHz and intensity was 46 mW/cm2 and the working time was controlled at 20% (i.e.,2 s “on”time and 8 s “off”time)lasting 5 minutes.The human prostate cancer cell line PC-3 suspension was prepared,the cell concentration was adjusted to 1 × 10 5 cell/ ml,and cells were divided into 8 groups:control group,single microbubbles group,single ultrasound group,ultrasound combined with microbubbles group,single liposome group,liposome combined with microbubbles group, liposome combined with ultrasound group,liposome combined with ultrasound and microbubbles group. Each microbubbles group was added SonoVue 200 μl and the wild type P53 plasmid,plasmid∶liposome is 1 ∶2.At 24 hours after irradiation,Western-blot and RT-PCR were used to detect the gene transfection efficiency,CCK-8 was used to detect cell proliferation,then cell survival rate was calculated,cell apoptosis was detected by flow cytometry.Results After transfection,compared with single liposome group and control group,liposomes combined with ultrasound and microbubbles group can significantly improve expression of the human wild type p53 gene and protein (P <0.001).After transfection,the apoptosis rate of human prostate cancer PC-3 cells in liposomes combined with ultrasound and microbubbles group was significantly higher than that of the liposome group and control group (P <0.001).And after transfection, cell survival rate of liposome combined with ultrasound and microbubble group decreased significantly than those of single liposome group and control group (P <0.001).Conclusions Low frequency and low energy ultrasound combined with microbubbles can promote the transfection of human wild-type P53 gene mediated by liposome.

Objective To explore the indications and curative effect of minimally invasive pedicle screw fix-ation in the treatment of thoracolumbar fractures .Methods 10 patients with thoracolumbar fractures without neuro-logical damage and the need for vertebral lamina decompression were selected .Under the C arm,the disease vertebral and adjacent vertebral arch spikes were positioned ,four 2.5cm long incisions were done ,fixation and restoration were completed within four small incisions .Results All patients restored vertebral body height and protrusion deformity after correction.The operation time was about 2h,blood loss was 100~150mL.Conclusion The minimally invasive pedicle screw fixation in the treatment of thoracolumbar fractures is suitable for simple thoracolumbar fractures without neurological damage ,the need for patients with vertebral lamina decompression ,it has advantages of small trauma ,fas-ter postoperative recovery .

Objective:To study the effects of tamoxifen on proliferation and ER expression of human hepatocellular carcinoma cells.Methods:HepG2 cells were treated with tamoxifen at different concentration and different action time.MTT was used to determine the suppression rate of human hepatocellular carcinoma cell.The effects of tamoxifen on human hepatocellular carcinoma cell ER performance were observed by immunohistochemistry.Results:Tamoxifen inhibited the proliferation of human hepatocellular carcinoma cells and suppressed human hepatocellular carcinoma cell ER performence.Conclusions:Tamoxifen may suppress human hepatocellular carcinoma cell proliferation ER performance.

Objective To investigate the effect of 20 kHz low-intensity ultrasound combined with microbubbles on autophagy of both PC3 cells and DU145 cells. Methods Ultrasound with a frequency of 20 kHz and intensity of 80 mW in continuous wave mode was used. Both PC3 cells and DU145 cells were divided into four groups, including control group (A), microbubbles group (B), ultrasound group (C) and ultrasound combined with microbubbles group (D). Twenty-four hours after treatment, the acid vesicular organelles were detected by acridine orange lfuorescence staining, and transmission electron microscopy (TEM) was used to observe autophagosomes. Results Acridine orange lfuorescence staining showed formation of acid vesicular organelles (AVOs) in the cytoplasm with normal nucleus in both PC3 cells and DU145 cells in group D, while in group A cells were basically normal. Lots of autophagosomes with double-membrane structure were detected by transmission electron microscope in group D. Conclusions Low-frequency and low-intensity ultrasound combined with microbubbles can induced autophagy in both PC3 cells and DU145 cells.

Objective To study whether ultrasound combined with microbubbles induces suppress invasion in androgen-independent prostate cancer cells PC-3 and to identify the probable mechanism.Methods Ultrasound with a frequency of 21 kHz and intensity of 46 mW/cm2 in continuous wave mode was used.Ultrasound combined with microbubbles (200 μl SonoVue) was used to treat androgen-independent human prostate cancer PC-3 cells for 30 seconds.PC-3 cells were divided into three groups:control group,ultrasound group and ultrasound combined with microbubbles group.Twelve hours after treatment,cell growth curve we drawn,and transwell chamber model was used to do cell invasion experiments in vitro.Real-time PCR was used to measure the expression matrix metalloproteinase-2 and matrix metalloproteinase-9 messenger ribonucleic acid.Results Twelve hours after treatment,cell growth was not significant difference among three groups (P ＞ 0.05).Twelve hours after treatment,ultrasound combined with microbubbles could significantly inhibit the invasion of human prostate cancer cells (P ＜0.05).Treatment with ultrasound combined with microbubbles down-regulated the expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 messenger ribonucleic acid.Conclusions Ultrasound combined with microbubbles inhibited the invasion in human androgen-independent prostate cancer cells through down-regulation of matrix metalloproteinase-2 and matrix metalloproteinase-9.

Objective To investigate the application of fusion imaging in the initial prostate biopsy.Methods Retrospective analysis was made on 40 patients who underwent initial ultrasound-guided prostate biopsy in Shanghai Jiao Tong University Affiliated 6th People's Hospital from August 2014 to May 2015.All patients underwent preoperative magnetic resonance imaging (MRI) scans one week prior to surgery and the results showed that all patients had suspicious positive prostate cancer lesions,while there were no positive findings in the same area in sonography.All patients with prostate cancer have been confirmed by pathologic examination.Image fusion technology was used to guide the biopsy of lesions which were suspected as prostate cancer by MRI,and then the prostate underwent systematic biopsy by 10 needles under the guide of ultrasound.R× C Chi-square test was used to compare the positive ratio among imaging fusion biopsy,systematic biopsy and combined method in the diagnosis of prostate cancer.Fourfold table Chi-square test was used to compare to undetected rate between fusion imaging biopsy and systematic biopsy in the diagnosis of prostate cancer.The differences of detection rate in the Gleason score more than 7 points of prostate cancer between fusion imaging biopsy and systematic biopsy was compared by Fisher exact test.Results In this group of 40 patients with prostate biopsy,14 cases (35.0％) were diagnosed prostate cancer by systematic biopsy,19 cases (47.5％) were diagnosed prostate cancer by image fusion biopsy,and 22 cases (55.0％) were diagnosed prostate cancer by systematic biopsy combined with image fusion.The difference of diagnostic positive rate among combined method of biopsy,image fusion biopsy and systematic biopsy had not statistically significant (P ＞ 0.05).Three cases (13.6％,3/22) of prostate cancer patients were missed in image fusion method group,and 8 cases (36.4％,8/22) of prostate cancer patients have not been diagnosed by systematic biopsy,which indicated the umdetected rate of systematic biopsy is higher than that of image fusion biopsy in prostate cancer diagnosis,and there was a statistical difference between the two groups (x2=8.338,P=0.005).Among 19 cases of prostate cancer patients who were diagnosed by image fusion biopsy method,Gleason score were greater than 7 points in 15 cases (78.9％,15/22).Among 14 cases of prostate cancer patients who were diagnosed by systematic biopsy method,Gleason score were greater than 7 points in 6 cases (42.9％,6/14).The positive rate of Gleason score ≥ 7 points in fusion imaging biopsy was higher than that of systematic biopsy,which had a statistical difference (Fisher exact probability method,P=0.039).Conclusion Image fusion method can be used to reduce the tndetected rate of prostate cancer and improve the detection rate of the high-grade prostate cancer.

Objective To explore the clinical effects of three nail and plate systems in treating femoral intertrochanteric fracture.Methods The clinical data of 75 patients with femoral interochanteric fiactures treated by internal fixation were analyzed.According to different treatment methods,75 patients were divided into three groups:DHS group(treated with dynamic hip screw) 26 cases,PFN group(treated with proximal femoral nail) 15 cases,LCP group (treated with anatomical proximal femoral locking plate) 34 cases.Fracture union time,complications and hip function scores according to Harris's scoring were recorded.Results All patients were followed up for 18 to 36 months.Four patients appeared coax vara in DHS group and one case appeared coax vara in PFN group,three case appeared coax vara in anatomical proximal femoral locking plate (LCP.) There was no significant difference in fracture union time and the excellent and good rate of hip function scores among the three groups (F =2.25,χ2 =0.032,all P ＞ 0.05).Conclusion The effects of three nail and plate systems in treating femoral intertrochanteric fracture is similar,but they have their own characteristics and indications.And the reasonable treatment should be selected according to different fracture types.

Objective To investigate the feasibility of low-frequency ultrasound combined with microbubbles improving transfection of enhanced green lfuorescent protein plasmid (pEGFP) to subcutaneously transplanted prostate cancer in nude mice, and to optimize the parameters of intensity. Methods The model of nude mice of subcutaneously transplanted prostate cancer were built. Then they were divided into 2 groups including low-frequency ultrasound group and low-frequency ultrasound combined with microbubbles group, each group with 15 mice. Then 250μl of mixture of saline and pEGFP (50μg) were co-injected in low-frequency ultrasound group and 250μl of mixture of SonVue and pEGFP (50μg) were co-injected in low-frequency ultrasound combined with microbubbles group through tail vein. According to intensity, they were divided into 3 subgroups respectively, including group 1 W/cm2, group 2 W/cm2 and group 3 W/cm2, each group with 5 mice. Ultrasound was applied at 80 kHz input frequency with 50%duty cycle for 10 minutes after pEGFP injection. The tumors were collected on the third day after treatment. The expression of pEGFP in tumor was examined by laser scanning confocal microscope (ISCM) and the average lfuorescence intensity were estimated. At the same time, routine pathological examination was performed. The mean lfuorescence intensity of low frequency ultrasound group and low frequency ultrasound combined with microbubble group were compared with one-way ANOVA and those of any two groups were compared by SNQ-q test. Results TThe mean lfuorescent light in low-frequency ultrasound combined with microbubbles group were 23.75±2.54, 30.25±1.67 and 59.60±2.03, which were obviously stronger than those of low-frequency ultrasound treatment group (14.04±1.35, 14.66±0.98 and 14.32±1.20), the difference was statistically signiifcant (the value of q were 18.26, 14.12 and 13.88, P<0.05). The rate of gene transfection increased along with the enhancement of the ultrasound intensity (the value of q were 15.33, 17.81 and 13.79, P<0.05). Histology analyses performed by HE staining showed that there was no damage to the tumor tissues in all groups, tumor tissues were intact and without infection. Conclusions Low-frequency ultrasound combination with microbubbles can significantly enhance pEGFP transfecting into subcutaneously transplanted prostate cancer in nude mice. In certain range, improving the ultrasound intensity can increase the rate of gene transfection.

Objective To explore the duration of blood blocking effect and recovery process induced by low-frequency ultrasound combining microbubbles (USMB) on prostate cancer xenografts.Methods A total of 88 nude mice undergoing USMB was studied.Contrast enhanced ultrasound,Hemotoxylin and eosin staining,and modified Martius-Sarlet-Blue staining were used to compared the average peak intensity(API),time to peak intensity(TP) and histological alteration before and after treatment.Results Immediately after the treatment,the tumor contrast perfusion completely disappeared,API dropped from 68.63±5.25 to 18.01±2.73 (P<0.001,vs pre-treatment) and TP increased from (32.28±6.18)s to (72.63±7.47)s (P<0.001,vs pre-treatment).At 30 minutes and 1 hour after treatment,the tumor perfusion remained defect.At 2 hours after treatment,rarely dotted enhancement was showed.The differences among the three groups in API and TP at 30 minutes,1 hour and 2 hours after treatment were not significant (all P>0.05).From post-3 hours after treatment ,the tumor perfusion began a process of perfusion recovery,and showed nodular or large patch of heterogeneous enhancement.API at 3 hours after treatment was 51.99±6.20 (P<0.001,vs post treatment immediately),and TP decreased to (50.41±6.51)s (P<0.001,vs post treatment immediately).At 4 hours,5 hours,6 hours,12 hours and 24 hours after treatment ,CEUS showed homogeneous and rich enhancement,and there was no significant difference in both API and TP,compared with those pre-treatment (all P>0.05,vs pre-treatment).Histological examinations showed that,immediately after treatment,microvessels severely dilated,ruptured and intravascular and extravascular thrombi formed.At 30 minutes,1-hour and 2-hour after treatment,extravascular thrombi and hematomas gradually disappeared.From 3-hour after treatment,vessel dilation was lessened,and intravascular thrombi gradually shrank.At 12-hour after treatment,microvessels had almost fully recovered as pre-treatment.Conclusions USMB could block blood perfusion of prostate cancer xenografts in nude mice for 2 hours.The blood reperfusion is probably mainly caused by thrombolysis in microvessels.