[Objective]To observe the clinical effect of the treatment of hyperplastic nonunion of the tibia with interlocking intramedullary nailing,fascia pedicled callus flap and bone grafting.[Method]Twelve cases of nonunion of the tibia were treated with intramedullary interlocking nailing,fascia pedicled callus flap and bone grafting,and there were 8 males and 4 females.The patients age ranged from 26 to 64 years,with an average of 45 years.[Result]All cases were followed-up for an average of 48 months and achieved a solid union within 4～6 months.[Conclusion]Intramedullary interlocking nailing,fascia pedicled callus flap and bone grafting have the design of the reasonable biomechanics,the function of untispinning and unticurtailing,less partial blood decompose.The fascia pedicled callus flap and iliac bone grafting could result in solid union and it is a recomment method for promoting bone-healing up after grafting and forming.

Objective To evaluate the clinical efficacy and safety of tapering the dosage of recom-binant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc) combined with DMARDs in the treatment of peripheral joints involvement of ankylosing spondylitis. Methods Sixty patients who met the classification criteria of ankyloding spondylitis were enrolled. Meanwhile, all patients had one or more of the following joint involvement: hip, knee, ankle, and shoulder. Their BASDAI was higher than 4, joint pain VAS≥4, ESR ≥30 mm/1 h and CRP≥8 mg/L. Tuberculosis, hepatitis B, hepatitis C infection or other microorgan-isms infections were excluded. All enrolled patients had no serious heart,liver,kidney, or other internal organ involvement. During the first stage (The first eight weeks patients were matched by age and, disease activity, then randomly divided into the rhTNFR-Fc (the control group) treatment group in which patients were treated with 25 mg rhTNFR-Fc subcutaneous injection twice per week for 4 months) and rhTNFR-Fc dosage tapering group in which 25 mg rhTNFR-Fc were subcutaneously injected once per week for 4 weeks and then followed by 12.5 mg per week for 4 weeks, then once every 10 days for 6 times. Then the dosage of rhTNFR-Fc dosage of the dosage tapering group (the experimental group) was changed to 12.5 mg subcutaneous injection once every 15 days for another 4 times combined with methotrexate 7.5 mg per week and Salfasalazine 2 g daily and thalidomide 100 mg per night. The second stage started from week 9 to 24. In addition to the 30 cases at the first stage, 42 cases were included based on the same inclusion criteria for stage one. Patients' clinical and laboratory parameters were evaluated at week 0, 4, 8, 16 and 24. Results During the first four weeks, all patients of both control group and experimental group reached ASAS20, 97% (29/30) patients reached ASAS50 in the control group, 83% (25/30) patients reached ASAS50 in the experimental group. At week 8, patients in both groups maintained at 100% ASAS20 improvement, 100% (13/13) patients in the control group reached ASAS50, and that of the experimental group was 97% (29/30), the differences between the two groups were not statistically significant (P>0.05). In the second stage, 72 cases (100%) could achieve ASAS20, 63 cases (88%) achieved ASASSO at week 16. At week 24, 72 cases (100%) remained to achieve ASAS20, 71 cases (99%) achieved ASAS50. The safety and compliance of the two groups were good. Two cases developed infection, one patient had mild elevation of serum transaminase. Conclusion Tapering the dosage combined with DMARDs is an effective and safe approach in the treatment of peripheral joints involvement of ankylosing spondylitis. The compliance of this strategy is good and only few patients have serum transaminase elevation. But attention should be paid to the increased rate of infection.

ObjectiveTo establish rabbit knee joint cartilage injury models to evaluate effects of the type Ⅱ collagen sponge in repair of the articular cartilage.MethodsThe type Ⅱ collagen sponge was prepared according to previous method and the pore size of the sponges was measured based on the collagen autofluorescence characteristics.The type Ⅱ collagen sponge was transplanted into the injury lesions of the animal model for experimental study.The regeneration of the cartilage defects was observed by using MRI, histologic HE staining, Safranin O, sirius red polarized light staining, areas determination of the newly grown cartilage and immunohistochemistry of type Ⅱ collagen.ResultsAutofluorescent images of confocal microscope layer scanning showed that the pore size was (93.26 + 38.40) μm in diameter, suitable for chondrocyte growth.Comparison between MRI and H&E staining results showed quicker effusion absorption in the treatment groups than that in the control group, while the level of inflammatory response in the treatment group was lower than that in the control group.The sporadic cartilage signals first appeared at the 6th week.The newly formed cartilage with the expression of glycosaminoglycan and type Ⅱ collagen matrix was confirmed by Safranin O staining and immunohistochemical analysis.The sirius red polarized light staining showed that areas of the newly formed cartilage were significantly larger in the treatment group than that in the control group (P ＜ 0.01).Conclusion The type Ⅱ collagen sponge developed from purification can effectively repair the damaged cartilage tissues of the rabbit knee joints, as has been verified either by MRI or histology.

Objective To compare the suture bridge (SB) and conventional double-row (DR) suture in the repair of full-thickness rotator cuff tear.Methods From May 2013 through July 2016,48 patients with full-thickness rotator cuff tear were randomly divided into 2 even groups (n =24).SB group was repaired using the SB technique while DR group using conventional DR technique.The 2 groups were compared in terms of operation time,postoperative shoulder function scoring and incidence of re-tear.Results All the patients were followed up for 8 to 24 months (average,15.3 months).In DR group,the visual analogue scale (VAS) scores decreased from preoperative 6.3 ± 2.3 to 1.0 ± 0.4 at the last follow-up,the America Shoulder and Elbow Surgeons (ASES) scores increased from preoperative 49.3 ± 8.5 to 90.0 ± 2.5 at the last follow-up,and the Constant scores increased from preoperative 58.7 ± 12.5 to 88.1 ± 4.0 at the last follow-up.In SB group,the VAS scores decreased from preoperative 6.0 ± 1.9 to 0.9 ± 0.8 at the last follow-up,the ASES scores increased from preoperative 50.2 ± 6.2 to 89.5 ± 3.4 at the last follow-up,and the Constant scores increased from preoperative 57.3 ± 7.5 to 90.0 ± 3.2 at the last follow-up.All the comparisons showed a significant difference between preoperation and the last follow-up (P ＜ 0.05),but an insignificant difference between the 2 groups (P ＞ 0.05).SB group used significantly less operation time (74.5 ± 19.0 min) than DR group (86.5 ± 21.0 min),and reported significantly lower incidence of re-tear (4.2％) than DR group (25.0％) (P ＜ 0.05).Conclusions In arthroscopic repair of full-thickness rotator cuff tear,SB technique shows few therapeutic advantages over conventional DR technique,but the former needs less operation time and leads to lower incidence of re-tear.

Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.

OBJECTIVETo study the inhibitory effect of CD133 monoclonal antibody labeled with ¹³¹I (¹³¹I-CD133mAb) on Huh-7 human liver cancer cell line overexpressing CD133 antigen in vitro and in mouse models bearing the tumor cell xenograft.

METHODS¹³¹I-CD133mAb was prepared by chloramines-T method and evaluated for its stability. Flow cytometry and immunohistochemistry were used to detect the expression of CD133 in Huh-7 cells and in Huh-7 cell-derived tumors, respectively. Huh-7 cells treated with ¹³¹I-CD133mAb plus cisplatin (DDP), ¹³¹I -CD133mAb, DDP, or no treatment (blank control) were examined for cell proliferation suppression by MTT assay with the IC₅₀ calculated. BALB/c mice bearing subcutaneous Huh-7 cell xenograft in the right forelegs were treated with ¹³¹I -CD133mAb, DDP, or both every two days for two weeks. The tumor size and volume were measured twice a week, and pathological examination of the tumor was carried out after the treatments. The tumor inhibition rate was calculated and tumor cell apoptosis observed with HE staining.

RESULTSThe labeling ratio of ¹³¹I-CD133mAb was 90.25% and the radiochemical purity was 97.78%. Huh-7 cells showed obviously higher CD133 expression than HepG2 cells. ¹³¹I-CD133mAb combined with DDP group resulted in a significantly higher tumor inhibition rate than other treatments in the tumor-bearing mice.

CONCLUSION¹³¹I-CD133mAb can inhibit the growth of liver cancer cells with a high CD133 expression both in vivo and in vitro.

AC133 Antigen ; Animals ; Antibodies, Monoclonal ; pharmacology ; Antigens, CD ; immunology ; Apoptosis ; Carcinoma, Hepatocellular ; drug therapy ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Cisplatin ; pharmacology ; Glycoproteins ; immunology ; Hep G2 Cells ; Humans ; Liver Neoplasms ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Peptides ; immunology ; Xenograft Model Antitumor Assays

Objective:To establish a method for correction of tail vein extravasation based on PET images and to improve the accuracy of SUV.Methods:The simulation method was established by phantom on Nano PET/CT and images were reconstructed by a three-dimensional ordered-subsets exception maximum algorithm. PET images were analyzed by using the Interview Fusion 1.0 software. The optimal scanning time and the ROI delineated method were found. The accuracy of the simulation method was verified by comparing the activity of simulation method with the mice tail activity measured by the dose calibrator directly on Kunming (KM) mouse ( n=11). Using the simulation method, the impact of extravasation on SUV was proved. Independent-sample t test was used to analyze data. Results:Ten minutes was selected as the optimal scanning time and SUV max 42% threshold was selected as the ROI delineated method. The specific correction formula was as follows: actual activity=image activity/(4.48× V+ 77.05)×100 (0.3 MBq/ml≤leakage concentration<6.5 MBq/ml); actual activity=image activity/(6.65× V+ 71.10)×100 (6.5 MBq/ml

Objective To study the inhibitory effect of CD133 monoclonal antibody labeled with 131I (131I-CD133mAb) on Huh-7 human liver cancer cell line overexpressing CD133 antigen in vitro and in mouse models bearing the tumor cell xenograft. Methods 131I-CD133mAb was prepared by chloramines-T method and evaluated for its stability. Flow cytometry and immunohistochemistry were used to detect the expression of CD133 in Huh-7 cells and in Huh-7 cell-derived tumors, respectively. Huh-7 cells treated with 131I-CD133mAb plus cisplatin (DDP), 131I-CD133mAb, DDP, or no treatment (blank control) were examined for cell proliferation suppression by MTT assay with the IC50 calculated. BALB/c mice bearing subcutaneous Huh-7 cell xenograft in the right forelegs were treated with 131I-CD133mAb, DDP, or both every two days for two weeks. The tumor size and volume were measured twice a week, and pathological examination of the tumor was carried out after the treatments. The tumor inhibition rate was calculated and tumor cell apoptosis observed with HE staining. Results The labeling ratio of 131I-CD133mAb was 90.25% and the radiochemical purity was 97.78%. Huh-7 cells showed obviously higher CD133 expression than HepG2 cells. 131I-CD133mAb combined with DDP group resulted in a significantly higher tumor inhibition rate than other treatments in the tumor-bearing mice. Conclusion 131I-CD133mAb can inhibit the growth of liver cancer cells with a high CD133 expression both in vivo and in vitro.

Objective To study the inhibitory effect of CD133 monoclonal antibody labeled with 131I (131I-CD133mAb) on Huh-7 human liver cancer cell line overexpressing CD133 antigen in vitro and in mouse models bearing the tumor cell xenograft. Methods 131I-CD133mAb was prepared by chloramines-T method and evaluated for its stability. Flow cytometry and immunohistochemistry were used to detect the expression of CD133 in Huh-7 cells and in Huh-7 cell-derived tumors, respectively. Huh-7 cells treated with 131I-CD133mAb plus cisplatin (DDP), 131I-CD133mAb, DDP, or no treatment (blank control) were examined for cell proliferation suppression by MTT assay with the IC50 calculated. BALB/c mice bearing subcutaneous Huh-7 cell xenograft in the right forelegs were treated with 131I-CD133mAb, DDP, or both every two days for two weeks. The tumor size and volume were measured twice a week, and pathological examination of the tumor was carried out after the treatments. The tumor inhibition rate was calculated and tumor cell apoptosis observed with HE staining. Results The labeling ratio of 131I-CD133mAb was 90.25% and the radiochemical purity was 97.78%. Huh-7 cells showed obviously higher CD133 expression than HepG2 cells. 131I-CD133mAb combined with DDP group resulted in a significantly higher tumor inhibition rate than other treatments in the tumor-bearing mice. Conclusion 131I-CD133mAb can inhibit the growth of liver cancer cells with a high CD133 expression both in vivo and in vitro.

Objective To investigate the molecular epidemiology and clinical characteristics of human bocavirus in children with acute respiratory tract infection in Shanghai,China.Methods Between January 2012 and December 2012,271 nasopharyngeal aspiration (NPA) samples were collected from children who had been hospitalized for acute respiratory tract infection at Shanghai,China.HBoV NS1 gene was detected by the nested polymerase chain reaction.In the further,other common respiratory viruses (HRV,RSV,ADV et al) was screened in HBoV positive samples,All PCR positive products were sequenced and phylogenetic analysis.Results The overall frequency of HBoV,infection was 11.4％.21of 31 HBoV positive sample tested were mix-infection.HBoV was detected from all over year.Children with HBoV varied in age from 4 months to 4-years (median age,17 months).The clinical diagnoses of HBoV positive patients included acute upper respiratory tract infection and lower respiratory tract infection.The clinical presentations of HBoV positive children included fever,cough,sputum production,diarrhea,vomiting;pharynx engorgement,crackles,wheezing.There being a statistically significant difference in the detection rates of HBoV between the outpatients and inpatients.The HBoV NS1 gene sequences phylogenetic analysis revealed that 29 HBoV1 NS1 sequences shared 99％-100％ nucleotide identity with the human bocavirus strain,whereas the amino acid identity was 96％-100％.The two HBoV2 NS1 sequences shared 99％ nucleotide sequence identity with HBoV2 strain FJ170282 respectively.Conclusions Human bocavirus was distributed in Shanghai region,HBoV1 was dominant and HBoV2 was detected at the first time.The symptom and clinical diagnoses has no specificity with patients with other common respiratory viruses.