Objective To evaluate the therapeutic effectiveness and safety of combining chemoembolization using microspheres with iodized oil in the treatment of patients with hepatocellular cancer.Methods According to the inclusion and exclusion criteria,two reviewers independently completed the whole process of data search,selection,collection and quality assessment.The Medline,Cancer Lit,PUBMED,EMBASE,Cochrane Library,CNKI,CBM,VIP,Wanfang Data and Grey literature were searched for randomized controlled trails (RCTs) on combining chemoembolization using microspheres with iodized oil in the treatment of liver cancer.The search was from January 2005 to December 2012.The software package Rev Man 5.1 (the Cochrane collaboration) was used to conduct the Meta-analysis and to analyze the data.Results Of the 159 trials selected out from January 2005 and December 2012 for review,only five RCT involving 471 patients were finally included into the analysis.When compared with chemoembolization by iodized oil alone,the combination treatment significantly improved the therapeutic effectiveness (CR + PR).However,there was no obvious difference between the two methods of treatment in the incidence of adverse reaction.Conclusions Combining chemoembolization using microspheres with iodized oil for patients with hepatocellular cancer was effective in controlling liver cancer progression.There is still a need to reduce the incidence of adverse reaction in future.

Endothelial progenitor cells(EPCs)are the precursor cells of vascular endothelial cells.EPCs are in bone marrow,peripheral blood and cord blood.They participate in the process of angiogenesis after birth.The stimulation of exogenous and endogenous factors mobilizes bone marrow-derived EPCs into peripheral blood,and participates in the revascularization of ischemic tissue and the process of re-endothelialization of the injured blood vessels.The decreased mmahers and quality of EPCs in blood circulation are one of the most important factors of unfavourable prognosis after ischemic stroke.The transplantation of EPCs may provide a novel therapeutic strategy for the treatment of ischemic cerebrovascular disease.

Objective To construct recombinant Bb-Em14-3-3 vaccine of Echinococcus multilocularis and to investigate expression efficiency of Em14-3-3 antigen encoding gene in Escherichia coli BL21(DE3).Methods Em14-3-3 antigen gene was amplified by PCR.Then the gene was cloned into Escherichia coli-Bifidobacteria shuttle plasmid pGEX-1? T containing gluathione-S-transferaze(GST) gene to construct pGEX-Em14-3-3.The recombinant plasmid was electroporated into Bifidobacteria bifidum(Bb) to construct rBb-Em14-3-3 vaccine.The vaccine was identified with PCR and restriction-endonuclease digestion.The expression of pGEX-Em14-3-3 was induced with isopropyl-?-D-thiogalactopyranosid(IPTG) and fusion protein Em14-3-3/GST was examined by SDS-PAGE and Western blot techniques.Results 530 bp gene of Em14-3-3 was successfully amplified by PCR and cloned into pGEX-1? T by restriction analysis.rBb-Em14-3-3 vaccine was successfully constructed by PCR and restriction-endonuclease digestion.It was demonstrated with SDS-PAGE and Western blot that the fusion protein Em14-3-3/GST was expressed in E.coli,BL21.The expression efficiency is 23%.Conclusion rBb-Em14-3-3 vaccine of Echinococcus multilocularis was successfully constructed.The plasmid pGEX-Em14-3-3 was highly expressed in E.coli in fused form with GST and this kind of protein shows specific antigenicity.

Objective To improve the accuracy of X-ray diagnosis of the deltoid ligament injury by evaluating the influence of plantar flexion on the diagnosis.Methods Twenty-four patients with ankle supination-extemal rotation fracture which was distal fibula fracture but no medial malleolus fracture were treated from February 2010 to December 2010.All the patients were taken Mortise radiograph with the ankle in four positions of plantar flexion(0°,15°,30° and 45°)applied with rotational stress and the deltoid ligament injury was identified with MRI.The medical clear space(MCS)and the superior clear space(SCS)on each radiograph were measured.The results were tested by a one-way analysis of variance model(ANOVA),based on the following criteria:(1)the MCS≥ 4 mm and MCS ＞ SCS,or when MCS≥5 mm and MCS ＞SCS.The MRI examination was taken as the gold standard to compare the influence of X-ray diagnosis of the deltoid ligament injury with different plantar flexions and different standards.Results The average MCS in four positions of plantar flexion(0°,15°,30°,and 45 °)with rotational stress were(4.10 ±0.79)mm,(4.55 ±0.72)mm,(4.99 ±0.56)mm and(5.71 ±0.86)ram,with statistical difference(P ＜0.05).The average SCS in four positions of plantar flexion(0°,15°,30°,and 45°)were(3.56 ±0.41)mm,(3.50 ±0.43)mm,(3.71 +0.44)mm and(3.93 ±0.51)mm,with no statistical difference in the four groups(P ＞0.05).With the MSC≥4 mm and MSC ＞ SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 50.0％,66.7％,88.9％ and 94.4％ respectively.With the MSC≥5 mm and MSC ＞SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 5.6％,11.1％,38.9％ and 77.8％ respectively.Condusions Different plantar flexion angle is an important factor for X-ray diagnosis of deltoid ligament injury of the ankle joint.The prevalence of false-positive findings of deltoid injury increases with the increase of plantar flexion.

Objective To evaluate the effect of pronator teres tendon reconstructing the forearm interosseous membrane(IOM)central band on restoring the longitudinal stability of the forearm after Essex-Lopresti injury.Methods A total of ten fresh-frozen adult cadaveric forearms were loaded axially through the humeral and the distal radius.Each forearm was tested as following six steps:radial head excision,radial head plus excision of triangular fibrocartilage complex(TFCC),radial head plus TFCC plus excision of IOM central band,reconstructing central band with pronator teres tendon,metallic radial head prosthesis replacement,central band reconstruction plus radial head prosthesis replacement.The difference of the load exerted to displace the radius to the proximal for 5 mm was compared at different steps by using single-factor analysis of variance.Then,the effect of each step on restoring the forearm longitudinal stability of the forearmwas evaluated.Results There was statistical difference upon load for the radial displacement to the proximal for 5 mm in all six steps,ie,(74.51±15.17)N,(49.23±6.14)N,(17.83±4.73)N,(27.40±3.56)N,(140.25±25.39)Nand(164.21±28.26)N,respectively(P＜0.01).With migration of the radius to proximal for 5 mm,the load for pronator teres reconstruction was 55.66% of radial head plus TFCC,and the load for pronator teres reconstruction plus radial head prosthesis replacement was 559.31% of IOM reconstruction step and 333.56% of radial head excision.Conclusions Reconstruction of the central band with pronator teres tendon is insufficient to restore the longitudinal stability of the forearm after Essex-Lopresti injury.Reconstruction of the central band in combination with metallic radial head prosthesis replacement are beneficial to restoring the longitudinal stability of the forearm.

Objective To investigate the role of transforming growth factors(TGF-?1 and ?2) in the pathogenesis of scleroderma(SD). Methods The mRNA expression of TGF-?1 and ?2 in the skin lesions from 17 patients with SD and skin from 10 normal controls were detected with in situ RT-PCR technique. Results A higher positive rate and stronger expression of TGF-?1 mRNA in SD skin lesions were seen, compared with those in controls(P0.05).The higher positive rate and stronger expression of TGF-?1 mRNA than TGF-?2 mRNA in SD were seen(P

n of IL-6 and TNF-alpha,alleviate the inflammation of ANP.

Objective To evaluate and compare the clinical outcome of coracoclavicular screw and double Endobutton plate in treatment of acromioclavicular dislocation ( Rockwood Ⅲ-Ⅴ ). Methods Twenty-eight patients with Rockwood Ⅲ-Ⅴ acromioclavicular dislocation were subjected to surgical reconstruction from January 2008 to October 2009. The coracoclavicular screw was performed in 14 patients and the double Endobutton plate in the other 14 patients. Clinical evaluation was performed by using Constant score and subject should value (SSV) in both groups, and the preoperative and postoperative radiographs, curative effects and complications were compared. Results The patients in two groups were followed up for a range of 6-25 months (average 12.6 months) , which showed higher postoperative Constant score and SSV score than preoperation in both groups (P＜0.05). But the postoperative Constant sore and postoperative SSV score in the double Endobutton group were (89.8 ±8.3) points and (85.7 ±7. 3) points respectively, significantly better than (78. 0 ± 10. 3) points and (71. 8 ±9. 7) points respectively in the coracoclavicular screw group ( P ＜ 0.05). The radiologic measurement showed no significant difference in regard of the coracoclavicular distance three months after operation in two groups (P＞0.05). Conclusions The double Endobutton plate can attain significantly superior clinical outcomes for Rockwood Ⅲ-Ⅴ acromioclavicular dislocation compared with the coracoclavicular screw. The surgical technique of reconstructing the coracoclavicular ligament through anatomical approach will be the future trend in treatment of the acromioclavicular joint dislocation.

Objective To evaluate correlation of radial head fracture with forearm interosseous membrane (IOM) injury.Methods Twenty-six patients with radial head fractures were studied prospectively between September 2007 and June 2010.There were 15 men and 11 women,with an average age of 37.6years (range,21-53).According to the Mason classification,there were 7 cases of type Ⅰ,9 cases of type Ⅱ,10 cases of type ⅢL All patients were subjected to forearm X-ray,CT scans and the MR within a week.Clinical and radiographic data of all the patients were collected.Spearman rank correlation statistical analysis was used to analyze the correlation between the radial head fracture and the IOM injury.Results The radial head fractures and IOM injury were directly related.The IOM injury was noted in all type of radial head fracture.The more severity radial head fracture had,the more IOM injury happened.In Mason Ⅰ-Ⅲ fractures,IOM injury was found in 2,4 and 7 cases respectively.The different degree of radial head fracture caused different effects on IOM injury.The severity of radial head fracture was correlated with damage degree of IOM.In Mason type Ⅰ and type Ⅱ fractures,the IOM injury were just partial disruption with distal part of the IOM and did not reach the biomechanically essential central band.In type Ⅲ fractures,central band disruption was found in 3 cases.Conclusion Mason Ⅰ-Ⅲ radial head fractures are associated with forearm IOM injury.There was a positive correlation between radial head fractures and IOM injury.If IOM lesions are suspected,magnetic resonance imaging should be performed,especially Mason Ⅲ fractures.

Objective To determine the morphology, bacteria and endotoxin content of bio-films on the inner surface of PVC tubes in hemodialysis water treatment system. Methods We dissolved biofilms of segments before and after reverse osmosis machine for bacterial count and identification. We studied biofilm structure of segments before and after reverse osmosis machine with eyes and scanning electron microscope. Biofilms of all 7 segments were dissolved for qualitative and quantitative assay of endotoxin. Results The inner surface of segment before reverse osmosis machine was homogeneously distributed with activated carbon powder deposition. The segment after reverse osmosis machine was normal. With scanning electron microscope, biofilm with successive surface and sandwich was found on the inner surface of segment before reverse osmosis machine, formed by clustering bacillus, activated carbon powder and some coccus. Bacteria of the same shape and length were found on segment after reverse osmosis machine, but fewer and looser. Bacterial culture and identification showed the former was mostly gram-negative bacillus, the latter was only a few micrococcus. Endotox-in of biofilm was between 2. 0 EU/mL and 4. 0 EU/mL. Quantitative assay showed: segment after softener (2.821 ±0. 807) EU/mL; segment after active charcoal canister(3. 635 ±0. 427) EU/ mL; segment before reverse osmosis machine (3.687 ±0.271) EU/mL; segment after reverse osmosis machine (2. 041 ±0. 295) EU/mL; exit of power pump (1. 983 ±0. 390) EU/mL; the 1st dead space (2. 373 ± 0. 535) EU/mL; and the 2nd dead space (2. 858 ± 0. 690) EU/mL. Conclusion Biofilms are found on the inner surface of segment before and after reverse osmosis machine . Endotoxin level from high to low is as follows: segment before reverse osmosis machine, segment after active charcoal canister, the 2 nd dead space, segment after softener, the 1 st dead space, segment after reverse osmosis machine, exit of power pump. The character of the bacteria and endotoxin of the biofilm can help us find better ways to control them.