Objective To study the correlation between bone marrow edema (BME), the amount of joint fluid and clinical symptoms in order to strengthen further understandings about clinical significance of BME in osteonecrosis of the femoral head (ONFH). Methods Fifty-seven patients (91 hips) with ONFH proved by clinical follow-up or pathology were examined by conventional radiography, 1.5 T MRI, and radionuclide imaging. BME, necrotic area, and joint fluid were analyzed respectively in ONFH with pre- or post-collapse of the femoral head and different MR signal intensities within necrotic area.Results ①The characteristic “line-like sign” appeared on MRI in 88 of 91 affected hips, and BME was seen in the distal zone away from line(s) in 61 hips, extending to the femoral neck and intertrochanteric region. ②The ratio of the occurance of BME in the collapse was greater than that in noncollapse, and in mixed signals within necrotic area without collapse greater than pure fat-like signal (P0.05), and both were greater than noncollapse without BME (P

Objective To establish regression m odel betw een craniofacial lines and body height by m ea-suring craniofacial lines in Southw est H an m ales using C Tand to accum ulate data for the study of foren-sic anthropology. Methods H ead C Tdata of 273 H an m ales in Southw est w ere collected and 7 cranio-facial lines w ere determ ined. M ultiplanar reconstruction and volum e rendering w ere perform ed by im age post-processing softw are and the selected lines w ere m easured. The relationship betw een each m easuring indicator and body height w as analyzed using SPSS 21.0 softw are. The regression equation of body height estim ation w as established and 50 sam ples w ere selected again and put into the m athem atics m odels to verify its accuracy. Results The linear regression equations of 7 lines w ere established (P<0.05). The correlation coefficients of the unary linear regression equations w ere 0.190-0.439 and the standard errors of the estim ate (SEE) w ere 4.597-5.023 cm . The correlation coefficients of the m ultiple linear regression equation w ere 0.494-0.524 and the SEEw ere 4.418-4.458 cm . The return tests show ed that the highest ±1SEEaccuracy of the m ultiple regression equation:y=83.959+3.589 x6+2.573 x2, w ere 30%;and the highest ±2SEEaccuracy of the m ultiple regression equation: y=72.646+3.316 x6+1.586 x2+1.553 x4+2.211 x3, w ere 92% . Conclusion There is significant linear correlation betw een 7 selected lines and the stature in this study, and the plural linear regression equation established could be applied for estim ating the stature of Southw est H an m ales.

Objective To study the clinical, radiologic and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma for further improving the diagnostic ability.Methods The data of 10 patients with histologically proved telangiectatic osteosarcomas were retrospectively reviewed, and the clinical, radiologic and pathologic characteristics were further analysed in combination with the literature.All 10 patients were examined with X-ray and MRI, and 2 patients with CT.Results Telangiectatie osteosarcomas originated from inferior femur in 5 patients, femur neck in 1 patients, superior humerus in 2 patients and superior segment of tibia in 2 patients.The lesions showed osteolytic bone destruction on X-ray films (n = 10) and CT images ( n = 2), with mild bone expansion in 4 patients.The majority of the edge of the destroyed bone areas was unclear but without sclerotic rim.There were Codman's triangle and soft tissue mass in each patient but no obvious neoplastic bone forming.On MRI, all the lesions were mostly or completely constituted by the multiple cysts with periostnal reaction, and several scatteredly smaller liquid-liquid levels were found within cystic cavity in 7 patients.In all 10 cases, there were pathologic hemocoele similar to aneurysmal bone cysts (ABC), but malignant tumor cells and some neoplastic bones were found in cystic walls or septations.Only a small number of neoplastic bone tissue were seen by microscopy in 6 patients.Conclusions The radio-pathologic characteristics of telangiectatic osteosarcoma include the similar imaging findings of ABC, the common growth patterns of malignant tumors,and the pathologic hemocoele, malignant tumor cells within cystic wails or septations.The comprehensive analysis of clinical, radiologic and pathological data may help clinicans to make a correct diagnosis for telangiectatic nsteosareoma.

Objectiye To measure longitudinal (T1) and transverse (T2 ) relaxation time of metabolites in m. soleus (SOL) and m. tibialis anterior TA of healthy volunteers at 3.0 T through 1H-MRS and optimize measurement protocols. Methods Altogether 24 healthy volunteers were recruited in the study. All subjects signed a letter of informed consent. After divided into 2 groups randomly by the table of random number, 1H-MRS measurements with stimulated echo acquisition mode (STEAM) sequence were undertaken in SOL and TA separately. Progressive saturation method was used for T1 measurement. Spectra with 8 different TRs (770,900,1000, 1100,1200,1500,2000 and 3000ms ) were acquired with TE=20 ms.T2 time was measured by changing TE. Altogether 8 TEs (20,30,45,60,90,135,200 and 270 ms) were used with TR = 3000 ms. Metabolites' concentration was calculated through T1 and T2 correction using water as internal reference. The t test was used for statisties. Results Altogether 22 groups of data were gained ( 12 for SOL, 10 for TA ) . T1 value of water, Creatine-CH3 ( Cr3 ), Trimethyl amonium ( TMA ),extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) in SOL were ( 1384. 0 ± 36. 9 ),( 1064. 0 ± 167.0), (964. 2 ± 144. 0 ), ( 373.0 ± 46. 8 ), ( 374. 7 ± 20. 6) ms respectively and T2 value were (26.5 ±1.2), (100.2±19.3), (149. 1 ±32.7), (81.4±5.2), (84.7±4.2) ms. InTA T1 value of water, Cr3, TMA, EMCL, and IMCL were ( 1307. 0 ± 24.4), (945.7 ± 132. 0), (968.3 ± 127. 0),(372. 7 ± 39. 2), (412. 8 ±80. 2) ms respectively and T2 value were (27. 1 ± 0. 9), (135.3 ± 18. 2 ),(62.1 ± 6. 0), ( 84. 3 ± 4. 0 ), ( 90. 7 ± 3.2 ) ms. After corrected by the calculated relaxation times, the concentrations of Cr3 in SOL and TA were (33. 1 ± 3.7) and (31.7 ± 3. 1 ) mmol/kg respectively, TMA (35.2±3.2) and (32.9 ±5.2) mmol/kg, EMCL (12.2 ±5.0) and (8.9 ±4.9) mmol/kg, IMCL (9. 0 ± 2. 4) and (3.0 ± 0. 8 ) mmoL/kg. IMCL in TA was much lower than SOL with statistical significant ( t = 8. 044, P < 0. 01 ), the difference between other metabolites were not statistically significant( t = 0. 926,1. 264, 1. 542, P > 0. 05 ) . Conclusions Accurate relaxation time was measured at 3.0 T of the metabolites in skeletal muscles of healthy adult human. After corrected by the relaxation times, the absolute concentrations calculated were consistent with the reported results. Quantitative knowledge of muscle NMR relaxation time was a prerequisite for absolute quantification of metabolites using the 1H-MRS and also was useful for optimizing measurement protocols.

Objective To identify the mutation of trafficking protein particle complex 2 (TRAPPC2) gene in a large Chinese pedigree with X-linked spondyloepiphyseal dysplasia tarda by the PCR-based capillary electrophoresis methods.Methods The blood samples were collected from a large Chinese pedigree of three generations with six affected persons with X-SEDT.Four exons comprising the TRAPPC2 gene open reading frame as well as their exor/intron boundaries were analyzed by argrose electrophoresis and bidirectional direct sequencing of PCR products.Fluorescence labeled fragment analysis was performed by capillary electrophoresis.Results A 5-bp deletion mutation of TRAPPC2 gene in exon 5,c.262_266delGACAT (D88del; I89fX12),was identified in the proband and his unaffected mother(a heterozygote) in the Chinese family with X-SEDT,but no other sequence change occurring in exons 3,4 and 6 was detected.The old sister of proband was determined being carriers because she carries the deletion fragment allele of exon 5 PCR product and the young sister being normal individuals because she carries the wild allele of TRAPPC2 gene.Conclusions The mutation c.262_266delGACAT (D88del; I89fX12) of TRAPPC2 gene was firstly reported in Chinese people.The mutation of c.262_266delGACAT (D88del; I89fX12) in TRAPPC2 gene may be the pathologic cause of the patients in the X-SEDT pedigree.Fragment analysis combined with DNA sequencing by capillary electrophoresis method is effective laboratory test in the small deletion mutation analysis and carriers screening in X-SEDT family.

Objective To explore the function and clinical effect of automatic nerve retractor in micro-endoscopic discectomy.Methods From August 2009 to December 2010,350 patients with lumbar disc hemiation were treated by micro-endoscopic discectomy,including 196 males and 154 females,aged from 17 to 68 years (average,42 years).Three cases were at L1-2,8 at L2-3,12 at L3-4,186 at L4-5 and 141 at L5S1.The automatic nerve retractor was used in all micro-endoscopic discectomy.The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate clinical outcomes.Results All patients were followed up for 6 to 16 months (average,9 months).The mean VAS score decreased from preoperative 8.79±1.15 to 3.80±1.14 3 months after operation and 3.65±1.14 6 months after operation.The mean ODI score decreased from preoperative 78％±1.71％ to 28％±1.72％ 3 months after operation and 28％±1.88％ 6 months after operation.Postoperative VAS and ODI scores decreased significantly compared with those before operation.The VAS and ODI scores 6 months after operation were not significantly improved compared with those 3 months after operation.No spinal cord and nerve root injury and epidural hematoma formation occurred in all cases.Conclusion In micro-endoscopic discectomy,the automatic nerve retractor can help the operator obtain effective exposure,protect nerves from injury,alleviate workload of the operators,therefore it has a great clinical application value.

Objective To establish the linear regression equation between body height and com bined length of manubrium and mesosternum of sternum m easured by CTvolum e rendering technique (CT-VRT) in southw est H an population. Methods One hundred and sixty subjects, including 80 m ales and 80 fem ales w ere selected from southw est H an population for routine CT-VRT(reconstruction thickness 1 m m ) ex-am ination. The lengths of both manubrium and mesosternum w ere recorded, and the com bined length of manubrium and mesosternum was equal to the algebraic sum of them . The sex-specific linear regression equations between the com bined length of manubrium and mesosternum and the real body height of each subject w ere deduced. Results The sex-specific sim ple linear regression equations between the com bined length of manubrium and mesosternum (x3) and body height (y) w ere established (m ale:y=135.000+2.118x3 and fem ale:y=120.790+2.808x3).Both equations show ed statisticalsignificance (P<0.05) w ith a 100% predictive accuracy. Conclusion CT-VRTis an effective m ethod for m easurem ent of the index of sternum . The com bined length of manubrium and mesosternum from CT-VRTcan be used for body height estim ation in southw est H an population.

Objective The aim of the present study was to monitor the plasma levels of atrial natriuretic peptide(ANP) in patients accepting minimally invasive ablation.Methods The demographic and clinical data were collected from 26 consecutive patients with paroxysmal atrial fibrillation.Two milliliter of peripheral blood was harvested before operation,7 days and 3 months post-operation followed by ANP assay using ELISA kit.The repeated measurements were performed for each sample and One-way ANOVA was used for statistical analysis.Results Before operation,the ANP levels in plasma was (2.86 ± 1.47) pg/ml.No significant changes of this ANP levels were observed 7 days and 3 months after operation,which were(2.83 ± 1.08) pg/ml and(2.75 ±0.87) pg/ml,respectively.The Pvalue of sphericity Mauchly test was 0.008 for repeated measurements and for correction coefficient,P =0.801.Conclusion These findings suggest that the minimally invasive ablation and left appendage excision in patients with atrial fibrillation has no significant effect on atrial ANP secretion.

BACKGROUND:Transplantation of mesenchymal stem cels to prevent and treat degeneration of the intervertebral disc is a feasible method. Mesenchymal stem cels co-transfected by SRY-related high mobility group-box gene 9 (SOX-9) and growth differentiation factor-5 (GDF-5) can differentiate into nucleus pulposus cels, in order to obtain greater effect of induction and proliferation of nucleus pulposus cels. OBJECTIVE:To investigate the effect of SOX-9 and GDF-5 co-transfection on the differentiation of rabbit bone marrow mesenchymal stem cels into nucleus pulposus cels. METHODS: We separated and cultured bone marrow mesenchymal stem cels from the bone marrow of rabbit aged 4 months. Passage 3 cels were divided into five groups andin vitro induced to differentiate into nucleus pulposus cels: non-transfected group, empty vector transfection group, SOX-9 transfection group, GDF-5 transfection group, SOX-9 and GDF-5 co-transfection group. At 14 days after transfection, RT-PCR was employed to assay SOX-9, GDF-5 and colagen type II mRNA expressions in bone marrow mesenchymal stem cels. The marker of nucleus pulposus cels-KRT19 expression was also detected by immunohistochemical staining. RESULTS AND CONCLUSION:In the co-transfection group, the mRNA expressions of SOX-9, GDF-5, and colagen type II were significantly higher than those in the SOX-9 transfection group, GDF-5 transfection group, and both these two groups, respectively (P < 0.05). Cels were positive for KRT19 in the SOX-9 and GDF-5 groups, and strongly positive for KRT19 in the co-transfection group. These findings indicate that double gene-transfected bone marrow mesenchymal stem cels are better than single gene-transfected cels with regard to differentiation into nucleus pulposus cels and secretion of extracelular matrix.

Objective To observe the expression of AdipoQ in Sj?gren's syndrome (SS) mice and its role in inflammation was investigated by recombinant gene transfection study in vivo. Methods As spon-taneous SS mice model, a total of 30 NOD mice were divided into 3 groups randomly: recombinant adenovirus (rADV-AdipoQ) group, normal saline control and simple adenoviruses (control group). The submandibular gland morphology, histopathological grading and the level of serum tumor necrosis factor-α (TNF-α), AdipoQ was compared between the three groups. The expression of AdipoQ on mice submandibular gland was assessed by means of semi-quantitative reverse transcriptase polymerase chain reaction. Results The submandibular glands of the mice of the control group were destructed, with focal lymphocytic infiltration and acinus atrophy. Compared with control model groups, the serum TNF-α and salivary gland AdipoQ expression was significantly down-regulated in the rADV-AdipoQ group [(248 ±30) vs (162 ±73) ng/ml] (P<0.05). Conclusion AdipoQ gene transfected SS mice can significantly improve the morphological features of tissues and decrease the concentration of TNF-αin serum, in addition, it can effectively inhibit inflammation, decrease the degree of protein and AdipoQgene expression. So the AdipoQ may be the protective gene in SS mice.