Objective To investigate the clinical effect of ilium grafting combined with Duhuojishengtang on the delay fracture healing and explore the effect on hemorheology. Methods Eighty patients with delayed fracture healing were randomly divided into two groups. Forty patients in control group were treated by ilium grafting and 40 patients in observation group were treated by ilium grafting combined with Duhuojishengtang. The clinical effect was observed after treatment and indexes of hemorheology were recorded after different treatment time. Results The cure rate of observation group was 62.5%, which was significantly higher than that of control group 35.0%, the effective rate of observation group was 92.5%, which was significantly higher than that of control group 72.5% (P<0.01) . There were no significant differences between two groups in indexes of hemorheology after ilium grafting (P>0.05) . After the first, second, third course, the indexes of hemorheology of observation group were better than those of control group, with statistically significant differences (P<0.05) . Conclusions Ilium grafting com-bined with duhuojishengtang can improve the indexes of hemorheology, improve the cure and effective rate and also has high security. It has high clinical value and worth of popularization and application.

Objective To investigate the factors affecting the efficacy,safety and prognosis of R0 resection in hepatocellular carcinoma(HCC)patients with portal hypertension(PH).Methods Clinical data of 600 patients with cirrhosis related HCC undergoing hepatectomy at the Dept.of Hepatobiliary Surgery were studied retrospectively.According to whether the patients with portal hypertension or not,they were divided into PH group and non PH group.Postoperative complications and mortality were compared between the two groups.Kaplan-Meier was used to analyze influencing factors of patients with R0 postoperative survival.Cox regression risk model was used to analyze the risk factors.Results The operative mortality of PH group and non PH group was 3.6%(3/84)and 0.5%(1/216),respectively.The difference was statistically significant(P<0.05).The incidence of postoperative complications in PH group was 22.6%,significantly higher than 9.7% in non PH group(P<0.05),especially the incidence rate of the liver related complications(ascites>800 ml/d,hepatic insufficiency and liver failure).Alcoholism,with PH,AFP ≥20 ng/ml,tumor size>5cm and non-solitary type HCC(all P<0.05) were important factors for overall survival.Cox regression analysis showed that tumor size>5cm and non-solitary type HCC were independent predictors for survival.Conclusion PH combined with HCC patients after R0 resection can significantly increase the incidence of complications related to liver disease and mortality,tumor size >5cm and non-isolated HCC are the risk factors for long-term survival of patients.

AIM: To study the enhancing effect of penetration enhancer on percutaneous absorption of antifungal agents. METHODS: Percutaneous penetration experiment was performed on device in vitro, and the deposit effects were observed with vivoperception. RESULTS: Combination of 1-menthol (1%) and azone (1%) showed the best effect on percutaneous absorption of cidopicox olamine, and 1-menthol (1%) had the best effect on percutaneous absorption of salysic acid. The compound penetration enhancer, consisting of 1-menthol (1%), azone (1%), propylene glycol ( 2.5%) and oleic acid ( 2.5%), had prominent action on absorption of cidopirox olamine through rabbit skins, and shorten the lag times obviously. CONCLUSION: L-menthol and azone can significantly enhance the percutaneous absorption of both salysic acid and cidopicox olamine. Combination of 1-menthol and azone can further increase the absorption.c

Electronic portal imaging device(EPID) is now been used widely.EPID was initially used for the purpose of checking set-up error.There are two ways to verify set-up errors-on-line and off-line.With advanced knowledge about the dosimetry characteristics of EPID,the use of EPID for dosimetry verification was adapted from the research study to the clinic.EPID plays an important role in quality assurance of radiotherapy accessories including multileaf collimator(MLC)that has been most studied in the past couple of years.This article briefly reviews the clinical use of EPID.

AIM: To construct a recombinant plasmid vector containing human pancreatic duodenal homeobox1(Pdx1) and neurogenic differentiation 1(NeuroD1) genes,and to detect its effective expression in eukaryocytes and the ability to induce differentiation of hepatocytes.METHODS: Using human embryo pancreas mRNA as template,Pdx1 and NeuroD1 genes were amplified by RT-PCR and cloned into the two different multiple cloning sites(MCSA and MCSB) of plasmid pIRES.The recombinant plasmid pI/Pdx1/NeuroD1 was transfected into L02 cells.The expression of Pdx1 and NeuroD1 in transfected cells was detected by immunocytochemistry,IFA,RT-PCR and Western blotting,respectively.RESULTS: The length and sequence of cloned segments were correct.Pdx1 and NeuroD1 were expressed in eukaryocytes.Furthermore,the hepatic cells were induced to express glucose transporter 2(GLUT2) and eukaryocyte transcription factor Nkx6.1,which were functionally correlated to ? cells.CONCLUSION: pI/Pdx1/NeuroD1 plasmid is successfully constructed and expressed in human eukaryocytes,with which the cells express the eukaryocyte transcription factor and GLUT2,indicating the transfected cells functionally correlates to ? cells.The results suggest that Pdx1 and NeuroD1 genes can induce the differentiation the cells from hepatic cells to pancreatic endocrine secretion cells.

Comprehensive treatment dominated by surgery is the mainstay in the treatment of hepatic cancer,and hepatectomy is still the most effective treatment method.Bile duct reconstruction after hepatectomy is still the difficult point for the treatment of hepatic cancer complicated by bile duct invasion.A 45-year-old patient with hepatic cancer and gallstone was admitted to the Affiliated Hospital of Guiyang Medical College,magnetic resonance cholangiopancreatography and enhanced computed tomography indicated that intrahepatic duct was dilated and tumor had invaded both left and right hepatic ducts.Cholecystectomy,mesohepatectomy,duct to duct anastomosis of left hepatic duct and common hepatic duct,duct to duct anastomosis of right hepatic duct and cystic duct were performed during the operation.The patient was cured 2 weeks after surgery.

AIM:To differentiate bone marrow mesenchymal stem cells(BMSCs) into functional insulin-producing cells to produce sufficient pancreatic islet cells for transplantation.METHODS:Recombinant adenovirus vectors carrying PDX1 and NKX6.1 genes were constructed and the bone marrow mesenchymal stem cells were infected by the recombinant adenovirus combined with several cytokines for differentiation.The expressions of PDX1,NKX6.1 and insulin and C-peptide in the differentiated bone marrow mesenchymal stem cells were detected by RT-PCR and Western blotting.After the differentiated bone marrow mesenchymal stem cells were transplanted into subrenal capsule of diabetic mice,cell morphology of the grafts as well as their secretion of insulin and C-peptide were detected.Besides,regulating capacities of grafts on the blood glucose level of the diabetic mice were also detected.RESULTS:BMSCs induced by recombinant adenovirus(pAdxsi-CMV-PDX1/CMV-NKX6.1) and several cytokines showed positive dithizone staining and the expressions of ?-cell related molecule such as insulin and glucose transporter 2 were detected by RT-PCR,which showed a sustaining and stable expression.The similar results were showed by Western blotting,immunohistochemical staining and indirect immunofluorescence.The insulin secretions in the cells stimulated with glucose at concentrations of 5.5 and 25 mmol/L in the experimental group were(1 240.4?109.3) mU/L and(3 539.8?245.1) mU/L,respectively,and were significantly higher than those in control group.Moreover,transplantation of the cells to STZ mice in treatment group made serum glucose recover to normal level.CONCLUSION:PDX1 and NKX6.1 gene-modified bone marrow mesenchymal stem cells differentiate into insulin-producing cells in vitro.When these cells transplanted into STZ induced diabetic mice,their serum glucose could return to the normal level and they could live well.Thus this is a promising method for diabetes treatment.

Objective To investigate the diagnosis,preoperative examination and surgical treatment of carotid body tumor(CBT).Methods From December 2008 to December 2012 80 patients of carotid body tumor were treated in our center.The average age was(43:±:12)years,33 cases were male,47 cases were female.The lesions were unilateral in 68 cases and bilateral in 12.All tumors were surgically resected.In 26 of Shamblin Ⅰ,32 of Shamblin Ⅱ and 19 of Shamblin Ⅲ tumors were simply resected.One Shamblin Ⅱ and 2 Shamblin Ⅲ cases underwent tumor resection combined with external carotid embolization.3 Shamblin Ⅱ and 8 Shamblin Ⅲ cases were treated by tumor resection combined with internal carotid reconstruction,1 Shamblin Ⅲ was done with tumor resection combined internal carotid repair.Results All of 80 patients with 92 tumors were successfully resected.There was no death case during peroperative period,while one case developed hemiplegia and 14 cases suffered cranial nerve injuries.68 cases (85％) were followed-up from 1 year to 6 years.Thera were 14 patients with cranial nerve injuries,2 of them were lost to follow-up,11 with complete or partial recovery and 1 was still doing poorly.Conclusions Tumor size and its relation to the carotid artery form the basis upon which appropriate operation is adopted.

Objective In order to improve the accuracy and efficiency of the measurement of range of motion (ROM) of human lower limbs and simplify process of ROM measurement,an automatic measurement of ROM of human lower limbs based on Kinect technique was proposed and tested in this study.Methods Fifty examinee were randomly divided into 5 groups,namely groups a,b,c,d and e,respectively,each group had 10 members.Using the human skeleton tracking technology from Kinect,the positions of the examinee's lower limbs were captured and tracked by processing the depth data of lower limbs' key joints.Then the information of ROM of hip and knee was output on human-computer interaction interface in real-time.By comparison with traditional manual measurement results,the accuracy of automatic measuring method could be verified.Meanwhile,with the aid of speech recognition and output technology,the mode of warning information transfer and the way of subject switch were optimized.Results According to the method of Grubbs-test and t-test,the ROM values | t | from the subjects' hip abduction (t =0.57,P =0.597),hip adduction (t =0.52,P =0.621),hip anteflexion (t =1.01,P =0.371),hip postextension (t =0.12,P =0.902),hip external rotation (t =0.00,P =1.000),hip internal rotation (t =0.34,P =0.753),knee flexion and extension (t =1.12,P =0.280) all were under the threshold value t0.025 (4) =2.776 on the premise of a level of significance α =0.05,which indicated that there was no significant difference between measured results and expected values(P ＞ 0.05).Conclusion The automatic measurement of ROM of lower limbs can be realized which can improve the measurement accuracy,simplify the measurement process and enhance the practicability of ROM of lower limbs measurement.