Objective To investigate the clinical efficacy of anterior pelvic plating plus percutaneous lumbo-iliac rod/screw fixation in the treatment of pelvic fractures which are vertically and rotationally unstable and combined with unilateral sacral fracture of Denis type Ⅱ.Methods From January 2008 to November 2012,19 patients were treated for compound injury to the anterior and posterior pelvic rings complicated with sacral fracture of unilateral Denis type Ⅱ using anterior pelvic plating plus posterior percutaneous fixation of lumbo-ilium with screws.Their improvement in neurological function,reduction outcome and clinical effectiveness were evaluated by comparing preoperation and 2 years postoperation in terms of visual analogue scale (VAS),Japanese Orthopaedic Association (JOA) score for lower back pain,MOS Item Short-form health survey (SF-36 comprehensive scale),modified Roland-Morris Disability questionnaire (RDQ),Oswestry disability index (ODI),Gibbons overall scale,Majeed total score,sacral kyphosis abnormity,bias of sagittal/coronal vertical axis (SVA/CVA),pelvic incidence,pelvic tilt,lumbar lordosis,vertical displace,and leg length discrepancy.Results The differences respectively reached statistical significance for the aforementioned clinical and imaging parameters between preoperation and 2 years postoperation (P ＜ 0.05).By Majeed scoring,13 cases were rated as excellent,4 as good and 2 as fair.By Tometta/Matto scoring postoperatively,the fracture reduction was rated as excellent in 12 cases,as good in 6 and as fair in one.The complications of incision infection or necrosis,secondary neurovascular damage,implant failure or mal-union was not observed.Perfect nerve functional recovery and sufficient imaging reduction were achieved in all but one patient who had to receive decompression and release for sacral canals or foramens.According to Mohammad criteria,15 patients were engaged in the jobs with the same intensity and property as their pre-injury ones.Conclusions The simultaneous hybrid performance of anterior reconstruction plating combined with unilateral lumbar/sacral pedicle and iliac screwing may be a safe,reliable and satisfactory treatment for pelvic fractures of AO/Tile C1 type which involve unilateral sacral Denis type Ⅱ.

With the current accumulation of metagenome data, it is possible to build an integrated platform for processing of rigorously selected metagenomic samples (also referred as "metagenomic communities" here) of interests. Any metagenomic samples could then be searched against this database to find the most similar sample(s). However, on one hand, current databases with a large number of metagenomic samples mostly serve as data repositories but not well annotated database, and only offer few functions for analysis. On the other hand, the few available methods to measure the similarity of metagenomic data could only compare a few pre-defined set of metagenome. It has long been intriguing scientists to effectively calculate similarities between microbial communities in a large repository, to examine how similar these samples are and to find the correlation of the meta-information of these samples. In this work we propose a novel system, Meta-Mesh, which includes a metagenomic database and its companion analysis platform that could systematically and efficiently analyze, compare and search similar metagenomic samples. In the database part, we have collected more than 7 000 high quality and well annotated metagenomic samples from the public domain and in-house facilities. The analysis platform supplies a list of online tools which could accept metagenomic samples, build taxonomical annotations, compare sample in multiple angle, and then search for similar samples against its database by a fast indexing strategy and scoring function. We also used case studies of "database search for identification" and "samples clustering based on similarity matrix" using human-associated habitat samples to demonstrate the performance of Meta-Mesh in metagenomic analysis. Therefore, Meta-Mesh would serve as a database and data analysis system to quickly parse and identify similar
Cluster Analysis ; Computational Biology ; methods ; Databases, Genetic ; Humans ; Metagenome ; Metagenomics ; methods

Objective To verify the daily delivery accuracy of volumetric-modulated arc therapy (VMAT) and achieve the process quality control (PQC) of linac using statistical process control (SPC)technology.Methods The log files of all treatments were taken out from the linac system.An in-house software which created by Matlab 7.14 was used to analyze the daily parameters accuracy and the mechanism and dose delivery accuracy of the linac for each VMAT,and an daily evaluation report was automatically created for the linac.The stability of the linac and the deviation of the delivery accuracy for various cancer sites were also analyzed.To achieve the process quality control of hnac using SPC technology,the control limit of each parameter was calculated by Johnson alternation and the single value control charts were drawn.Results 76 patients mainly with nasopharyngeal carcinoma,cervical carcinoma,rectal cancer and laryngeal cancer,got the treatment daily with VMAT technology,and a total of 2 446 arcs were delivered by the linac in continuous 16 days.The gantry angle error,y and x collimator position error,MLC leaf position error and dose delivery error were 0.49°,0.09 mm,0.38 mm,0.31 mm,0.05 MU,respectively.Compare to the nasopharynx,uteri,rectal and larynx cancer,it can be seen that the variation factors of dose delivery and gantry angle errors for various cancer sites were higher,which was 8.10％ and 4.54％,respectively.Through the process quality control of the linac,it was found that all the parameters were in control.While some abnormal points arose (the error was greater than UCL),and the ratio of the gantry angle which was out of control (0.45％) was the highest in all parameters.Conclusions linac delivery accuracy could be monitored and verified during the whole VMAT treatment for each patient,and the daily running condition of linac could be monitored.Through the introduction of SPC technology and the control charts,the process quality control of linac in VMAT could be achieved.It is a financial and valid method for the daily quality assurance of linac.

Objective To evaluate the image quality and registration accuracy of a three?dimensional ( 3D ) dynamic phantom in four?dimensional computed tomography ( 4DCT ) and four?dimensional cone?beam computed tomography ( 4DCBCT) . Methods The Computerized Imaging Reference Systems Dynamic Thorax Phantom Model 008A was scanned to get 4DCT and 4DCBCT images. Two balls with different diameters ( ?= 1 cm and ?= 2 cm) were used to simulate tumors with different sizes. The motion mode of the balls was 3D sinusoidal motion at 0?25 Hz ( the amplitudes along the x, y, and z axes were ±1?0 cm, ±0?4 cm, and ±0?2 cm, respectively). Gross target volumes (GTVs) from 10?phase bins, internal gross target volumes (IGTV), and target volumes on maximum intensity projection (MIP) and mean intensity projection (MeanIP) images were contoured and calculated. Target volumes on 4DCT or 4DCBCT images were compared with the static and dynamic volumes of the balls ( VS and VD ) . The matching index ( MI) of target volumes between the 4DCT and 4DCBCT images was analyzed after rigid image registration. Results The GTV in each phase of the image was larger than VS . The difference between the average GTV derived from 10 phases of 4DCT or 4DCBCT images and Vs of the small ball was larger than that of the large ball ( 35?03% vs. 22?66%;32?62% vs. 17?00%) . All the IGTVs and target volumes on MIP images were slightly larger than VD , but target volumes on MeanIP images were smaller than VD . The average MI of 10?phase bins of the small ball was smaller than that of the large ball ( 66?76% vs. 82?21%) . Moreover, MIs of IGTV,MIP, and MeanIP of the small ball were also smaller than those of the large ball ( 77?39% vs. 90?29%;75?90% vs. 89?28%;74?47% vs. 82?74%) . Conclusions In the case of a relatively small tumor volume and a relatively large motion amplitude, 4DCT and 4DCBCT should be used with caution for comparison of image registration.

Objective To study CT numbers correction of kilo?voltage cone?beam CT (KV?CBCT) images for dose calculation. Method Aligning the CBCT images with plan CT images, then obtain the background scatter by subtracting CT images from CBCT images. The background scatter is then processed by low?pass filter. The final CBCT images are acquired by subtracting the background scatter from the raw CBCT. KV?CBCT images of Catphan600 phantom and four patients with pelvic tumors were obtained with the linac?integrated CBCT system. The CBCT images were modified to correct the CT numbers. Finally, compare HU numbers between corrected CBCT and planning CT by paired T test. Evaluate the image quality and accuracy of dose calculation of the modified CBCT images. Results The proposed method reduces the artifacts of CBCT images significantly. The differences of CT numbers were 232 HU, 89 HU, 29 HU and 66 HU for air, fat, muscle and femoral head between CT and CBCT respectively (P= 0?? 39,0?? 66,0?? 59,1).The differences of CT numbers between CT and CBCT was reduced to within 5 HU. And the error of dose calculation with corrected CBCT images was within 2%. Conclusions The CT numbers of corrected CBCT are similar with plan CT images and dose calculations based on the modified CBCT show good agreement with plan CT.

Objective: To select suitable conditions for prokaryotic expression and purification of rhIL-17. Methods: rhIL-17 was expressed in E. coli host under heat induction. After compared among the expression amounts in different media under different heat induction time, the most suitable conditions was selected. The target protein was present in the form of inclusion body. The precipitate of inclusion was obtained and purified after 6M guanidine solublization or 2% SDS solublization. Results: Either protocol could yield rhIL-17 with high purity and stable activity. The SDS solublization mehthod gives rise to much more higher productivity than the guanidine solublization method. Conclusion: rhIL-17 were expression in E. coli system and purified to homogenicity by SDS solublization methods with high productivity.

Objective To compare the clinical efficacy of anteroposterior approach (APA) versus anterior approach (AA) for decompression,fusion and fixation for single-level unstable thoracolumbar vertebrae fractures concomitant with incomplete neurologic symptoms and injury to posterior ligament complex (PLC).Methods From February 2006 to June 2012,55 patients were treated for single-level unstable thoracolumbar vertebrae fractures.Of them,27 were treated by only anterior decompression and lateral screw-rod instrumentation and 28 by anterior decompression and fusion combined with open posterior pedicle fixation of one to two segments above and below the fracture position.The 2 groups were compared at postoperative 3 and 12 months in terms of visual analogue scale (VAS),overall score of short-form health survey (SF-36),Japanese Orthopaedics Association (JOA) score of lower back,Oswestry disability index (ODI),loss ratio of anterior margin of vertebral height,endplate angle of kyphotic deformity of superior-inferior adjacent vertebrae,wedge angle of fractured vertebra via radiographic measurement and canal compromise rate.The neurologic functional recovery was analyzed using the American Spine Injury Association (ASIA) evaluation system at postoperative 12 months.Results There were no significant differcnces in operative time,amount of blood loss or postoperative drainage between the 2 groups (P ＞ 0.05).At postoperative 3 months,the VAS and JOA scores in the APA group were significantly better than those in the AA group (P ＜ 0.05).At 12 months after surgery,the VAS,kyphotic angle of adjacent vertebra,wedge angle of fractured vertebra and the ASIA improvements in the APA group were significantly better than those in the AA group (P ＜ 0.05).There were no significant differences between the 2 groups in the other indexes at postoperative 3 or 12 months (P ＞ 0.05).All the comparative indexes were significantly improved than the preoperative values in all the patients in the 2 groups at both 3 and 12 months (P ＜ 0.05).Conclusions Compared with the merely anterior approach,the combined antero-posterior approach may have advantages of better immediate and persistent reduction,steadily rebuilding fractured alignment,continuously maintaining injured biomechanical stability,and obviously improving neurological function.As the antero-posterior approach allows for combination of posterior auxiliary reduction and fixation with anterior definitive support and decompression,it may lead to a safe and effective treatment of unstable single-level thoracolumbar fracture concomitant with incomplete neurologic and PLC impairments.