0.05). The length and the angle of the proximal tibial slope were (2.34?0.2) cm and (20.1?4.3)?, respectively. Conclusion The specification of entry point of intramedullary nailing must be individual because the shape of proximal tibia varies in different persons.

Glioma is a tumor with a high incidence of intracranial tumor. Because of its high degree of malignancy, strong invasiveness and high mortality, the current conventional treatment cannot achieve the desired therapeutic effect, which greatly affects the quality of life of patients. As a protein with the functions of anti-proliferation, anti-angiogenesis and anti-invasion, interferon is widely used in the treatment of all kinds of tumors in clinic. Many studies have shown that interferon plays an important role in the occurrence and development of gliomas. To explore the mechanism of interferon and its related signal pathway in the process of glioma invasion, and to study the new treatment of glioma is very necessary in clinical treatment.

Objective To evaluate the surgical procedures and clinical efficacy of endoprosthetic replacement as a salvage procedure for intertrochanteric fracture suffered failure of internal fixation.Methods The study involved 18 intertrochanteric fracture patients that suffered failed internal fixation from 2001 to 2009,including 16 patients with failed dynamic hip screw (DHS) fixation and two with failed proximal femoral nail anti-rotation (PFNA).The patients were at mean age of 76.5 years (range,58-92 years).The treatment methods included total hip arthroplasty in five patients and the bipolar hemiarthroplasty in 13.Harris score was used to evaluate the function outcome during the follow-up.Results The mean operation time lasted for 115 minutes,with intraoperative blood loss of 500 ml.Two patients presented with intraoperative complications.Of all the patients,three patients died within three months after operation and three patients were lost to follow-up.The remaining 12 patients received complete follow-up for a mean of 2.3 years ( range,1-7 years).One patient with hip joint dislocation was treated with closed reduction and distraction for three weeks.At the latest follow-up,the pain disappeared or was reduced in all the patients,including two patients with moderate pain and four with mild pain after some movements.The average Harris score was increased from preoperative 34 points to 83 points at one year after operation.Conclusions Endoprosthetic replacement is an effective salvage procedure for the failed treatment of the intertrochanteric fracture,as it can attain satisfactory pain relief and functional improvement.

Objective To compare the clinical effects of patellar resurfacing with patella reservation and patellaplasty in the total knee arthroplasty(TKA)for osteoarthritis so as to discuss appropriate management of patellas in TKA.Methods A retrospective study was conducted on 198 patients with osteoarthritis treated by TKA from January 2002 to December 2008.There were 62 patients managed by patellaplasty(patellaplasty group)and 136 patients by patellar resurfacing with patella reservation(patellar resurfacing group).The osteophytes of the patella were removed to make the articular surface of patellas similar to the primary one.Knee Society Score(KSS),Bristol patellar score,satisfaction survey and evaluation of joint range of motion(ROM)were performed during the regular follow-up.Incidence of postoperative anterior knee pain were analyzed and X-ray films were reviewed to understand the condition of the implants.Results A total of 125 patients were followed up,including 43 patients from the patellaplasty group and 82 from the patellar resurfacing group.The mean follow-up period was 51 months(range,36-80 months).Both groups showed significant improvement of each score postoperatively.No significant differences were found between the two groups regarding KSS score,patellar score and patient satisfaction in the follow-up one year later;but KSS function score in the patellar resurfacing group was superior to that in the patellaplasty group,with statistical difference.The incidence of anterior knee pain of the two groups had no statistical significance.Postoperative radiographs revealed no significant differences between the two groups concerning patellofemoral congruence,incidence of postoperative anterior knee pain or incidence of patellar related complications.Conclusion Patellar resurfacing with patella reservation for osteoarthritis in TKA can achieve satisfactory patellofemoral congruence and low incidence of intraoperative anterior knee pain,with comparable mid-term results with patellaplasty.

ObjectiveTo explore the sensitivity of cancer stem cells to chemotherapy in human pancreatic carcinoma.MethodsPANC-1 ceils were cultured in an incubator filled with 5％ CO2 at a temperature of 37℃,and were labeled with Hoechst 33342.The SP analysis and sorting were performed using a FACSVantage SE.RT-PCR was performed to detect the expression of human CD133 ABCG2 and Notch1.SP and non-SP cells from the PANC-1 cell line were treated with 5-fluorouracil (5-FU; 1,10,or 100 μg/ml) or gemcitabine (10,100,or 1000μg/ml),and the cell viability was determined using the MTT assay.The sensitivity of sorted tumor cells to chemotherapeutics was determined in NOD/SCID mice model.ResultsSP cells were found to have higher drug-resistance both in vivo and in vitro and higher levels of mRNA expression for CD133,ABCG2 and Notch1,when compared to non-SP ceils.The xenografted tumors derived from injected SP cells and treated with gemcitabine had more CD133± cells than the untreated group.ConclusionsThe SP of PANC-1 pancreatic carcinoma cells are enriched with highly gemcitabine-resistant CSCs and determine the carcinogenesis of the PANC-1 pancreatic carcinoma cells.

Objective To observe the expression of connective tissue growth factor (CTGF) in pancreas, and discuss its significance. Methods The pancreatic fibrosis model was induced by high fat diets. The rats were sacrificed 16 weeks later, and the pancreatic tissue was harvested for routine pathologic examinations. Pancreatic collagen fibrosis I was determined by HE and Sirius red staining;α-SMA and CTGF expression were detected by immunohistochemistry. Results After pancreatic fibrosis, pancreatic lobules and acinar atrophy was observed, lobules gap was widened, interstitial fibrous tissue was significantly proliferated, the synthesis of pancreatic collagen fibrosis I was significantly increased when compared with normal pancreas ( 1500.2 + 255.8 vs. 57.4 ± 23.2, P ＜ 0. 01 ), the expression of α-SMA was significantly increased when compared with normal pancreas( 1500.2 + 255.8 vs. 57.4 + 23.2, P ＜ 0. 01 ), and the expression of CTGF was significantly increased when compared with normal pancreas (2950.5 ± 431.9 vs. 382.2 + 190.8, P ＜0.01 ), and there were abundant activated PSCs. Conclusions CTGF participated in the regulation of pancreatic fibrosis development; the function of CTGF was closely related to PSCs activation.

ObjectiveTo investigate the morphological and ultrastructural characteristics of pancreatic stellate cells (PSCs) in a chronic pancreatitis murine model.MethodsSprague-Dawley rats were divided into experimental group (n=12) and control group (n=12).The experimental group was fed with a high-fat diet (HFD) for 16 weeks whereas the control group received regular rat feed.Pathologic changes in the pancreas were observed by several morphological studies including a Sirius Red staining method,as well as immunostaining for desmin and a smooth muscle actin (a-SMA).TEM and immunoelectron microscopy were performed to study the ultrastructure of the PSCs.Results The number of desmin and α-SMA positive cells significantly increased in the HFD groups compared to the control group.The quiescent and activated PSC cells both coexisted in the pancreas in the HFD group.ConclusionsThe morphology and ultrastructural study of pancreatic stellate cells may be helpful for further functional studies on chronic pancreatic fibrosis.

ObjectiveTo discover potential serum biomarkers of osteosarcoma by an integrated analysis of datasets from gene chip and surface enhanced laser desorption-ionization time-off-light mass spectrometry(SELDI-TOF-MS).Methods Gene chip was used to screen potentialbiomarkers of osteosarcoma from osteosarcoma cell lines (MG-63,Saos-2 and U-2OS),and SELDI-TOF-MS was used to screen protein peaks with statistically significant difference from serum samples (27 osteosarcoma cases and 47 healthy cases).The association between these two types of markers was constructed by link-test to get cross-validated serum biomarkers of osteosarcoma.Immunoblot analysis was performed to detect the expression of one candidate osteosarcoma protein maker in serums from osteosarcoma patients and members of the control group.ResultsSix hundred and fifty three candidate osteosarcoma gene markers were found by gene chip and 6 protein peaks were found by SELDI-TOF-MS.Thirteen differentially expressed serum markers of osteosarcoma including CYC-1 were screened by link-test analysis (12 of them were up-regulated in serum samples of the osteosarcoma patients while 1 was down-regulated ).By immunoblot,we found that CYC-1 protein was significantly up-regulated in serums from osteosarcoma patients compared to the control group.ConclusionAn integrated analysis of datasets from gene chip and SELDI-TOF-MS could accelerate the discovery,screening and identification of tumor biomarkers.A total of 13 potential serum protein markers of osteosarcoma were discovered in this study.

Objective To observe the influence of simulated microgravity on rat islet. Methods Isolated islet were assigned to flask-culture or bioreactor-culture. Gross structure and ultrastructure of islet were observed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Results Islets ultrastructure on 7th day in bioreactor closely resembled fresh islets,with well-formed secretory granules and abundant mitochondria. SEM showed under microgravity islets communicating each other with cavity-like areas. Conclusions The ultrastructure of islets cultured under microgravity closely resembled fresh islets.

Objective To introduce a new technique of navigated femoral nailing using noninvasive registration of the contralateral femur to control reduction and intramedullary nailing of femoral shaft fracture and discuss preliminary clinical results. Methods A new navigation module was employed to control femoral fracture, rotation and fixate femoral fraeture based on anteversion of the contralateral femur. In order to measure the femoral antcversion of the healthy femur intraoperatively, a non-invasive registration tech-nique was used. After minimal invasive reference arrays were fixed on the fraeture side, images of the frac-ture side were mandatory for femoral antevrsion measurements. Closed reduction and nailing was performed under computer navigation according to data of the contralteral side of the femur. Postoperative CT scanning on bilateral femur was done to observe specific anteversion and compare with intraoperative results of naviga-tion system. Results A total of 14 patients with femoral fractures obtained successful fixation and reduc-tion, with no intraoperative or postoperative complications. Postoperative CT scans were acordant with the intraoperative navigated measurements, with anteversion deviation within 3° between both sides. Conclu-sions Navigated femoral nailing using nnninvasive registration of the contralateral femur to control fracture fixation and reduction can help control anteversion measurements of the fracture site and reduce the inci-dence of femoral malrotation after closed reduction and intramedullary nailing.