[Objective]To investigate whether RNA interference(RNAi)could suppress the expression of HER-2 in osteosarcoma OS-732 cells.[Method]OS-732 cells were transsfected using chemically synthesized double stranded RNA(dsRNA)formulated with Lipofectamine 2000.The HER-2 gene expression inhibition was assessed by RT-PCR,Western Blot and immunocytochemistry.The chemosensitivity of transfected cells to cisplatin was determined by MTT measurement.[Result]Sequence specific siRNAs targeting HER-2 down-regulated the expression of HER-2 significantly.Currently,a range of effects on cell physiology,such as growth inhibition or apoptosis,was observed,Introduction of the siRNA into HER-2 positive tumor lines in vitro greatly reduced the expression of the HER-2 mRNA,effects lasted for 10 days,On the 9th day of interference,HER-2 protein expression was down-regulated in interference group.After RNAi,HER-2-siRNA increased thesensitivity of OS-732 to cisplatin by 10-fold.[Conclusion]Sequence specific siRNAs targeting HER-2 can suppress the expression of HER-2,and significantly inhibiting cellular proliferation,increasing the sensitivity of OS-732 to eisplatin.The successful application of HER-2 siRNA for inhibition of proliferation in HER-2 overexpressed cells extends the list of available therapeutic modalities in the treatment of human osteosarcoma.

Executive Function ; Humans ; Prefrontal Cortex ; physiology

Objective To study on the changes of the IL-6、IL-8、TNF-? in the type 2 diabetes with insulin resistance and the relation of plasma glucose or insulin resistance and cytokines. Methods (1) To assay the serum level of cytokines in 90 cases with type 2 diabetes mellitus (T2DM) and 30 normal controls. (2)To measure the level of fasting plasma glucose (FPG),hemoglohin A_1c (HBA_1c),fasting insulin(FINS),fasting C-peptide (FCP).(3) To analysis the relation of the level of FPG,HBA_1c,FINS,FCP and cytokines. Results (1) The serum levels of cytokines in T2DM group were significantly increase than in control groups,IL-6 and TNF-? in T2DM group with insulin resistance were significantly increase than in T2DM group without insulin resistance (2) There was significantly positively correlated between insulin resistance and the increasing of cytokine levels. Conclusion There is an excess activation of cytokines in T2DM,which is significantly correlated with insulin resistance. Cytokines play the important role in the occurrence and development of T2DM and insulin resistance.

Objective To evaluate the clinical manifestation and the treatment strategy of the scoliosis associated with Chiari malformation and /or syringomyelia. Methods Fifty-two cases suffered from scoliosis with Chiari malformation and /or syringomyelia were divided into three groups for surgical treatment: 1) Group 1: 18 cases had scoliosis with Chiari Ⅰmalformation and /or syringomyelia without obvious neurologic impairment, their scoliosis was corrected with posterior instrumentation, but their Chiari Ⅰmalformation and syringomyelia were left untreated surgically. 2) Group 2: 12 patients, whose scoliosis was not indicated for surgery but those Chiari malformation associated with syringomyelia, underwent posterior sub-occipital craniectomy to enlarge foramen occipital magnum, C1 posterior arch decompression, duraplasty and syrinx-subarachnoid space shunting no matter whether neurologic deficits were present or not. 3) Group 3: 22 cases in addition of correction of scoliosis, due to neurologic deficits caused by Chiari Ⅰmalformation or syringomyelia, two-stage surgery was indicated: firstly, with posterior suboccipital craniectomy to enlarge foramen occipital magnum, C1 posterior arch decompression, duraplasty and syrinx-subarachnoid space shunting 6 months later, then underwent the scoliosis correction with instrumentation. Results In 34 patients who underwent craniovertebral decompression, only 6 of the 24 cases with preoperatively neurologic deficits achieved mild improvement within 6 months postoperatively. In 40 patients who were treated with posterior correction for scoliosis, the average frontal correction was 63% and the average sagittal correction was 80% for scoliosis less than 90?, the average frontal correction was 49% and the average sagittal correction was 74% for scoliosis more than 90?. At a follow-up of 6 months to 5 years, the average loss of the frontal correction was 6%. Conclusion Scoliosis associated with Chiari malformation and /or syringomyelia can be effectively treated with the similar results, as for adolescent idiopathic scoliosis. The mainstay for diagnosis is MR imaging. Accurate diagnosis and proper treatment for Chiari malformation or syringomyelia before scoliosis surgery will improve the rate of scoliosis correction, decrease the neurological complications.

Objective To evaluate the biomechanical basis and long term clinical outcome of the offset hook-screw combined instrumentation in preventing against correction loss after it is used to treat the unstable thoracolumbar fractures. Methods Of 98 cases treated with the offset hook-screw combined instrumentation from July 1997 to December 2002, 64 with follow-up over two years were reviewed. All 64 cases received operation within average 3.2 days after injury, of which 41 were fixated with CD or CD-Horizon instrumentation and 23 with TSRH instrumentation. The long term clinical outcome evaluation included the maintenance of the vertebral height restoration, the sagittal kyphotic Cobb angle loss and the coronal Cobb angle correction loss. Results No death occurred. But after operation, there was one case with worsened neurological deficits (recovered one week after surgery) and two with deep infection. The average post-operative vertebral height and the coronal Cobb angle were restored by 89.0% and 100.0% respectively and the sagittal kyphotic Cobb angle corrected from preoperative 31?to postoperative -1? . During the follow-up for 24-62 months, no instrumentation breakage occurred. The pseudoarthrosis was affirmed in one case and suspected in two with the vertebral height loss of 8.6% and the kyphotic Cobb angle correction loss of 4?respectively. Conclusions The offset hook-screw combined instrumentation can satisfactorily restore the normal sagittal profile, effectively prevent the fixation loosening or breakage, minimize the mechanical failure of instrumentation, and particularly reduce the loss of long-term correction.

35? in 40. Risser sign was 0 in 38,Ⅰin 19,Ⅱin 13, and Ⅲ in 7. The standing AP X-ray films were obtained at intervals of 3 to 6 months. The Cobb's angle, the apical vertebral rotation and the Risser sign were measured at initial brace application and at the latest follow-up. Results With a follow-up of 24 to 60 months (mean, 30 months), 23 patients (29.9%) were judged as curve progression. Patients with double major curve were found to have the lowest percentage of curve progression, but there was no significant difference compared with other patterns of curves. The lower the Risser sign, the higher the initial brace correction rate and the percentage of curve progression. The difference of the initial brace correction rate was significant(P35?(P35?. 21 patients required surgical correction before completing bracing treatment because of curve progression, but in 13 of them, the surgical intervention was postponed about 12-20 months. Conclusion The Risser sign is a good predictor of bracing effect. Patients with double major curve have the lowest rate of treatment failure. The greater the amount of the Cobb's angle, the higher the percentage of curve progression. Bracing should be considered as successful if it can effectively reduce curve progression and postpone surgery.

Objective To compare the clinical outcomes of selective thoracic spinal fusion in adolescent idiopathic scoliosis using either iliac bone or autologous rib combined with allografts. Methods A retrospective study was made in 84 cases of idiopathic thoracic scoliosis, who were operated on with posterior instrumentation of CD, CDH or TSRH from 1999 to 2000. These patients were divided into two groups. In Group A, 34 patients, who were 12 to 20 years with a mean age of 14.5 years with a mean Cobb angle 56?(range, 40? to 82?), received autologous iliac bone grafting, and no thoracoplasty were performed. In group B 50 patients, who were 13 to 19 years with a mean age of 15.4 years with a mean Cobb angle of 54? (range, 38? to 80?), had allograft bone grafting combined with the ribs from thoracoplasty. The patients were followed up for at least 2 years with an average of 3.4 years regarding the clinical and radiographic outcomes. Results For group A, an average of 73.2% correction rate was achieved, and average 10% loss of correction and 3% of pseudoarthrosis was recorded at 2 year follow-up. The incidence of donor site morbidity was 26%, which included deep infection, hematoma, delayed healing of incision and continuous pain. For group B, an average of correction rate was 70.4% with 9% average loss of correction and 2% of pseudoarthrosis at 2 year follow-up. The complications related to thoracoplasty consisted of intraoperative tear of parietal pleural, pneumothorax, effusive pleuritis, and chest pain. Conclusion The clinical outcomes are comparable between the group of iliac bone grafing and the group of rib grafing associated with allografts in terms of fusion rate and loss of correction. If chose appropriately, allografts plus autologous rib harvested from thoracoplasty will be a good alternative to iliac crest regarding its safety, efficacy and reliability.

Objective To investigate the clinical outcome of intermittent distracting rod for the correction of juvenile scoliosis, and analyze its complications. Methods Between July 1997 through June 2002, 21 patients with scoliosis underwent posterior growing-rod instrumentation, with their age ranged from 6 to 11 years. Risser sign was 0 in all patients. Average curve magnitude was 78 degrees (62 to 94 degrees) before initial instrumentation. A pair of claw-type hooks were inserted at the upper and lower levels respectively, one rod was attached to the upper hooks and the other to the lower hooks. These two rods were allowed to overlap and were connected with a growth connector. Distraction was achieved by means of lengthening the two rods at the connector site. Repetition of lengthening was indicated by the curve deterioration larger than 15 degrees or the interval of 10 to 12 months after the previous operation. After each operation, a Milwaukee brace was worn for external support. Results The initial intraoperative correction averaged 40 degrees, but this decreased to 23 degrees of correction on average at every subsequent lengthening. The total distraction procedure of 4 times only achieved in 5 patients. The reasons for distraction ceasing were as follows: hook dislodgment in 3 patients, looseness of pedicle screw in 2, looseness of dominos connector in 2, wound infection in 1, spontaneous fusion in 2, and insufficient financial support in 6. Conclusion Curve response to correction tends to decline with consecutive distractions. A high rate of complications has been noted during the distraction procedure. The single distracting rod technique is not suitable for the correction of severe scoliosis in Chinese children.

[Objective]To investigate the clinical use of spiral CT with 3D Reconstruction for fractures of the tri-ankle joint.[Method]Fifty-six cases of tri-ankle joint fractures treated in our hospital from 1999 to 2004 were studied respectively.The ankle joint X-ray and spiral CT with 3D reconstruction were taken for all the cases preoperatively.The results were analyzed and compared with finding in operation .Scanning parameters of spiral CT were: 2 to 5mm collimation,3 to 5mm table speed and 1.5 to 3mm reconstruction interval.[Result]Fractures were demonstrated definitely by spiral CT in all the cases.Analyses of the results showed the superiority of spiral CT with 3D reconstruction in the fracture classification.Exact assessment of fragments and total agreement of the preoperative results were compared with findings in operation.[Conclusion]Operative treatment and rehabilitation may provide satisfactory fracture reduction and clinical results for ankle joint fracture.Well-timed treatment,correct fracture pattern estimation,proper internal fixation and rehabilitation are important to achieve better long term results.

[Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of scoliosis.[Method]Nine patients(7 female and 2 male)with scoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study.The etiological classification of scoliosis were idiopathic for 7,congenital for 1,neurofibromatosis(NFl)for 1.The average age was 13.5 years(ranged 11～18 years).The average preoperative Cobb's angle was 54?(ranged 48?～68?).Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation;the NFl patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation.[Result]There was no death,no infection and no neurological complication.No intra-operative fracture,no dura matter or pleuml laceration occurred.Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment.Posterior Cobb's angle averaged 20? with correction rate of 63%.The duration of follow-up averaged 23 months(ranged 20～30 months).Surgical time averaged 260 min(ranged 210～300 min)and mean EBL was 700 ml(300～1 000 ml).Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred.The loss of correction at last follow-up was 4? with 7.4% loss of correction rate.[Conclusion]The clinical results of CDH Legacy are as good as the other three generation implants,its advantage lies in lower profile,solid inter-locking,versatile implants and handy manipulation.