[Objective] To investigate the effectivity and reliability of individualized method to localize the entrance point of the lumbar pedicle screws by vertebral plate borderline.[Methods]Four vertebra specimen were taken the X-ray film of anterior-posterior views as the center of L2.On the X-ray film,the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured,after applied barium at the centre-point of the pedicle,the specimen were taken the X-ray film once more,the relation of the barium to the centre-point of the pedicle was measured;the distance between the centre-point of the pedicle to the lateral and superior margins of the vertebral plate were measured on the normal lumbar X-ray film in 107 cases,the data in different sex and different projection 's center were compared;the method were applied to 40 patients of lumbar pedicle internal fixation,the information in hospital were reviewed to 30 patients of the lumbar pedicle screw localization by transverse process and transverse process.[Results]All(except L5)of lumbar plate borderline were displayed clear in the experiment,accurate rate of setpoint to be 92.5%.The principal X-ray affected scarely to the relation of the pedicle with the plate borderline of nearby two segment,but affected obviously far from three segment on the normal lumbar X-ray film;the accurate rate of one time 's setpoint in clinical application was 96%,average operation 's time being 96 minute,average lose blood being 212 ml,transverse articular process 's group showed significant difference.[Conclusion]Individualized localization of the lumbar pedicle screw entrance points by vertebral plate borderline is one of feasible method,displayed less trauma and accurate rate highly in the clinical application.

[Objective]To evaluate the radiographic and clinical results of locking compression plate and interlocking intramedullary nail in the treatment of distal tibial shaft fracture(4 to 11cm proximal to tibiotalar joint).[Method]A total of 65 cases of distal tibia shaft fractures were retrospectively reviewed from 2003 to 2007.Thirty-seven cases were treated with locking compression plate as group A,and 28 cases were treated with interlocking intramedullary nail as group B.According to AO classification system,32 cases were type A,12 were type B,21 were type C.[Result]All cases were followed up for 12-24 months(mean,16.5 months).Five cases were found delayed or nonunion,with 1 case in group A and 4 cases in group B.One case in group A and 2 cases in group B were found developed deep infection.Two cases in group A and 8 cases in group B received second operation.The good-to-excellent rates of ankle joint function were 91.9% in group A and 71.4% in group B.The good-to-excellent rates of knee joint function were 97.3% in group A and 78.6% in group B.[Conclusion]Distal tibial shaft fracture could be treated successfully with either percutaneous plates or intramedullary nails.Percutaneous locking plate is better than intramedullary nail in aspect of prevention of delayed union,malunion and second operation.

Objective To evaluate urinary vascular endothelial growth factor (VEGF) in the diagnosis of bladder cancer. Methods VEGF in urine was measured by enzyme linked immunosorbent assay in 33 cases of transitional cell bladder carcinoma,10 benign urological conditions and in 10 normal individuals. Results The mean urinary VEGF level in 33 patients with bladder cancer was ( 309.8 ? 86.6 )ng/g Cr, significantly higher than in the 20 controls which was (107.6?35.4)ng/g Cr ( P

Objective To explore the outcomes of surgery of hip fracture in elderly pafienta aged equal or greater than 80 years old.Method The data of totally 132 patients with hip fracture aged equal or greater than 80 years old were treated with surgery between January 2004 and December 2008 was analyzed retrospectively Results Of 132 cases,68 cases were femoral neck fracture,while 64 cases were intertroehanteric fracture.The average in.hospital time waft(17.2±4.6)d,and 2 cases died of cerebral embolism and respiratory dysfunction in perioperative period respectively.One hundred and eight cases were followed up for 6 months to 5 yeats,with an average of 3.2 years.According to Harris hip scores,the average score of femoral neck fracture at 1 year and at 2 years postoperatively were(77.6±10.2),(77.3±9.3)scores,respectively;while intertrochantefic fracture at 1 year and at 2 years postoperatively were(84.6±9.8),(83.9±10.1)scores,respectively.Conclusions Aged patients with hip fracture should receivesurgical treatment as early as possible.The reasonable perioperative treatment and operative method are the keys to gain good outcomes.

Objective:To produce and identify antiCK20 monoclonal antibody.Methods:Lymphocytes from the spleen of mice being immunonized by CK20 antigen were fused with the myeloma cell line(SP2/0) using PEG4000.Hybridodma cells were established by selective growth of the fusion cells in the HT medium,and the presence of antiCK20 antibody was screened by inderect ELISA,and the clonality was achieved by limiting dilution.We have incubated cloning cells into mouse abdominal cavity to produce ascitic fluid contained monoclonal antibody.Chromatography with SPA-Sepharose CL-4B affinity column were emploied to isolate the monoclonal antibody from ascitic fluid.Finally,the antibody were tested the activities and sentivities,isoforms and titer through Western blot,two directions immuning diffusion of agar and ELISA.Results:Only one hybridoma cell line,secreating McAb against CK20,had been established.The modal number of chromosome is 101(99-103).The results of identifications showed that the antibodies kept high activitis and sensitivitis in detecting sample.The titer of ascitic fluid and the McAb purified are 1∶10~6 equally.The immunoglobulin of the McAb is classified as IgG1.Conclusion:AntiCK20 monoclonal antibody have been produced succesfully with high sensitive and active and was named L20031030.

Objective To investigate the stability of lumbar single?level dynamicly fixed by socket track pedicle screws after decompression. Methods Socket track pedicle screws are made of titanium?alloy, swing like universal screw within the scope of 18° in the sagittal plane and 8° in the horizontal plane. Motion constraints were due to the hole which the screw goes through. Six pig spines (L1-5) were tested by applying a pure moment of 4.018 Nm in 3 directions of loading. The range of motion (ROM) of the following groups underwent different surgical procedures was measured:(1) intact;(2) dynamic fixation 1 (decompres?sion by total laminectomy and instrumentation with socket track pedicle screws); (3) dynamic fixation 2 (decompression by total laminectomy and bilateral facetectomy while instrumentation with socket track pedicle screws);( 4) instability resulted from decom?pression (decompression by total laminectomy plus bilateral facetectomy without any rod);(5) hybrid fixation (decompression by to?tal laminectomy and bilateral facetectomy while instrumentation with 2 socket track pedicle screws connected with 2 unilateral pedicle screws ). Results Compared with the intact specimens (in flexion, extension, lateral bending and rotation, corresponding angular displacements were 1.84°±0.75°, 1.55°±0.34°, 2.2°±1.07°, 2.06°±0.76° respectively), the ROM of segment L3, 4 of each group were significantly restricted except for axial rotation. In flexion, extension and lateral bending, the ROM was reduced to 0.71°±0.39°, 0.46°±0.18°, 0.85°±0.66° in dynamic fixation 1 group;0.79°±0.43°, 0.71°±0.20°, 1.17°±0.48° in dynamic fixation 2 group and 0.63°±0.50°, 0.37°±0.19°, 0.54°±0.60° in hybrid fixation group. The rotation ROM of dynamic fixation 1 group and hy?brid fixation group were decreased to 1.50°±0.64° and 1.22°±0.36°, whereas the ROM of dynamic fixation 2 had a non?significant reduction to 1.85°±0.67°. The extension and rotation ROM of dynamic fixation 2 increased significantly comparing to dynamic fixa?tion 1 group; the extension, lateral bending and axial rotation ROM of hybrid fixation group were reduced comparing to the state of dynamic fixation 2 group. Conclusion The dynamic instrumentation of single?level lumbar spine with socket track pedicle screws could offer stability in all directions. The flexion, extension, lateral bending and rotation ROM of spine with dynamic instru?mentation after total laminectomy and bilateral facetectomy could be reduced.

A series of adefovir mono-L-amino acid esters, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs with more potent anti-HBV activity and lower nephrotoxicity were designed and synthesized. Adefovir bis (L-amino acid) ester was used as lead compound, according to pathological and pharmacological findings that non-steroidal anti-inflammatory drugs can effectively inhibit the organic anion transporter 1 (hOAT1)-mediated adefovir phosphonic acid pairs of anion transport across tubular basement membrane thereby reducing the nephrotoxicity of adefovir. Flatten design principle was used to introducing non-steroidal anti-inflammatory drugs structural fragments to design and synthesize target adefovir mixture ester prodrugs. HepG2 2.2.15 cell line was used as in vitro anti-HBV activity evaluation model. Five compounds exhibited antiviral activity, and compound 18 showed the most potent anti-HBV activity and relatively high selective index (EC50 3.92 micromol L(-1), SI 9.97). HK-2 cell line was used as in vitro model to evaluate nephrotoxicity. Results suggested the target compounds have lower cytotoxicity than the positive control. Moreover, by analyzing the primary structure and activity relationship of these compounds, it could suggest that mono-L-amino acid ester, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs strategy has significant potential in the acyclic nucleoside phosphonates prodrug design.

Abstrate:Aim To construct HEK293 cell line with stable and high expression of sodium taurocholate cotransporting polypeptide (NTCP ) efficiently and rapidly.Method Vector expressing EGFP-NTCP fusion protein was constructed and verified by DNA sequencing.The pEGFP-NTCP expression vector was transfected into HEK293 cells by FuGENE 6 transfection reagent. The transfected cells with high expression of green fluorescent protein were selected using fluorescence microscope for screening of G418 for 14 days to obtain cell lines stably and highly expressing NTCP.NTCP expression was detected by RT-PCR,qRT-PCR, Western-blot and the uptake experiment of taurocholic acid.Re-sult RT-PCR,qRT-PCR,Western-blot and the uptake experi-ment revealed that compared to the control cells,the expression of NTCP was significantly positive (P<0.01)in stable trans-fected cells showing green fluorescence (P<0.05 ).Conclusion The HEK293 cell line with stable and high expression of NTCP has been established efficiently and rapidly,which provides a cellular model for the study of the mechanism of the uptake of bile acid derivatives.

Objective To analyze the correlation between coronary artery lesion complexity and left ventricular funotion index of patients.Methods A total of 69 patients with coronary heart disease were selected in the study and were divided into low- risk(27 cases),medium-risk(23 cases) and high-risk (19 cases) groups according to the SYNTAX score.The difference in left ventricular function among the three groups were compared by ANOVA, and the correlation between coronary artery SYNTAX score and left ventricular function index was evaluated by Spearman rank correlation analysis.Results The differences in left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV),ejection fraction(EF) and muscle mass(MM) among the groups were statistically signifcant (F=7.254,9.181, 13.004, 7.544 and 5.276,P<0.05).The coronary SYNTAX score was negatively corelated with the EF (r=-0.702,P<0.05),but positively correlated with the MM (r=0.638, P<0.05).Conclusion Coronary SYNTAX score is negatively correlated with left ventricular EF, but positively correlated with MM.

Objective To discuss the value of the posterior long segments pedicle screws fixation in surgical treatment of thoracolumbar fracture-dislocation,and summarize the experience.Method s We reviewed the clinical information of 27 cases of thoracolumbar fracture-dislocation since July 2007 to March 2010; all the cases were treated with the posterior long segments pedicle screws fixation.In these cases,20were male,7 were female.And the age ranged from 18 to 58 years old (average age was 35 years).The posterior approach was used,and the pedicle screws were inserted into the 2 vertebrae above and below the fractured vertebrae.Posterior decompression and bone grafts for fusion were also accomplished during the operation.Results Follow-up ranged from 7 to 25 months,averaging 14 months.Completely restoration of the dislocation was got in 25 cases and the spine sequence resumed to nearly normal.One case with lateral dislocation failed to complete correction; another 1 case operated 20 days after surgery failed to complete correction of forward dislocation.At the last follow-up,the mean Cobb angle loss was 3 degrees,the height of the vertebral had obvious loss compared with that of post-operation.The loosen of screw nut was found during the follow-up,but no dislocation and secondary deformity were observed after fixation.There was no death,no infection.Conclusions The technique of posterior long segments pedicle screw fixation is of great value in the clinical applications,since it has the following advantages:the operation is simple,trauma is small,the fixation is firm,good restoration of fracture and dislocations can be easily got,and most importantly,it can effectively prevent long-term vertebral height loss and the backward protruding deformity.