Objective To explore the relationship between the serum level of leptin,growth hormone(GH),insulin like growth factor-1(IGF-1),insulin like growth factor binding protein-3(IGFBP-3)and those modulatine effects on fetal growth.Methods One hundred and thirty-five cases of newborns were divided into 4 groups according to the relationship between born weight and gestational age.Group A:premature infants small for gestational age(SGA),n=30.Group B:premature infants appropriate for gestational age(AGA),n=36.Group C:mature infants small for gestational age,n=32.Group D:mature infants appropriate for gestational age,n=37.All infants were measured se-rum leptin,GH,IGF-1 and IGFBP-3 level with radiommunosassay(RIA).Results There were significant difference in the levels of leptin,GH,IGF-1,IGFBP-3 as group C0.05).There were positive correlation between levels of leptin,IGF-1 and IGFBP-3 in group A,B and C,while,there was positive correlation between only level of IGF-1 in group D.Conclusions Leptin,IGF-1 and IGFBP-3 may play an important role in the fetal growth regulation of premature infants and IUGR infants.IGF-1 also regulate intrauterine growth of group D.Another side,in group D,Leptin,GH,IGF-1 and IGFBP-3 don't regulate fetal growth.

Objective To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults.Methods MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed.Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR).The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and anteroposterior diameter of the foramen magnum (FMD) were measured on sagittal images in 52 patients and 100 normal adults.Independent-sample student's t test was used to compare the differences between patients and normal adults.Results The results of PCFV, PCFH, CL, SL,FMD and CG, male of control group were (168.2 ±12.3) cm~3, (38.2 ±1.2), (47.1 ±2.8), (41.1 ±1.8), (36.6 ±4.9) mm, (51.5±3.6)°, female of control group were (157.5 ±10.2) cm~3, (36.5 ±1.4), (46.2 ±2.2), (39.7 ±1.3), (35.2 ±3.8), (49.6±3.1)° ;diseased group were (128.7 ±11.7) cm~3, (30.6 ±1.9), (36.2 ±1.4), (37.3 ±0.9), (33.9 ±3.5)mm, (44.5 ±2.8)° .There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t =4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant(t=1.97,P>0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively,P<0.01) ; the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively,P<0.01) ;but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96,2.07, P> 0.05).Conclusions The overcrowding of PCF can be accurately measured by MCST.As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF.

Objective To evaluate the mid-term tollow-up results of cervical artificial disc replacement (CADR) for cervical degenerative disc disease,and to explore whether it can reduce the occurrence of adjacent segment degeneration (ASD).Methods A prospective comparative study of 93 patients who underwent CADR or anterior cervical decompression and fusion (ACDF) for cervical degenerative disc disease were conducted.All patients were followed up for more than 6 years.The Japanese Orthopaedic Association (JOA) score,neck disability index (NDI),Odom's scale,X-rays and magnetic resonance imaging (MRI) were used to evaluate the clinical and radiologic results.Results Twenty eight patients who underwent CADR and 35 patients who underwent ACDF had complete follow-up data.At final follow-up,the JOA score and NDI improved significantly in both groups.Between the two groups,there was no significant difference in terms of JOA score,NDI and Odom's scale.The sagittal alignment was well maintained in both groups.The total cervical spine range of motion (ROM) had no significant change for the CADR group,whereas,it significantly decreased for the ACDF group.The ROM at the replacement level of CADR patients decreased from 9.5° ± 3.7° before operation to 7.0° ± 3.0° 3 months after operation,and it was maintained to 6.6° ± 4.1° at final follow-up without significant decrease.Lateral radiographs and T2-weighted MRI showed the incidence of ASD in CADR group was significantly lower than that in ACDF group.Conclusion The six-year follow-up results of CADR are basically satisfactory.Compared with ACDF,it could better preserve physiological motion and biomechanics of cervical spine,and reduce the incidence of ASD.

OBJECTIVE: Osteoblasts are essential for osteogenesis and bone metabolism, the in vitro culture of osteoblasts is the foundation for studies on bone metabolism and osteogenetic mechanism. Therefore, it is of great significance to study the related factors affecting it.DATA SOURCES: Related literature about the influencing factors of in vitro culture of osteoblasts were searched for in Medline from January 1980 to December 2004 with retrieval words of "osteoblasts, culture in vitro, in fluencing factors", with the language limited to English. Meanwhile, it was also searched in the CBM between January 1995 and December 2004 with the retrieval words of "osteoblasts, in vitro culture, influencing factors",with the language of the articles limited to Chinese.STUDY SELECTION: After preliminary examination, literature that met the need of this study was searched for the full text. Inclusion criteria: Factors influencing the in vitro culture of osteoblasts included ① physical factors; ② microelements; ③ growth factors; and ④ hormones.Reviews were removed from this study because of summary or repetitive research.DATA EXTRACTION: A total of 105 articles related to the influencing factors of the in vitrocul ture of osteoblasts were obtained, articles of repetitive and similar researchwere removed; thereby 17 articles were included in the study.DATA SYNTHESIS: ① Physical factors: Ionizing radiation, microgravity,external force, and oxygen pressure. ② Microelements: microelement deficiency would hinder the skeletal growth, or even lead to malformation. Osteoblastic proliferation is closely related to some microelements, mainly including zinc, aluminum, fluorine, copper, manganese, calcium, and magnesium. ③ Growth factors closely related to osteogenesis mainly consist of bone morphogenetic protein, platelet-derived growth factor, fibroblast growth factor, transforming growth factor-beta, insulin like growth factor,and osteogenic growth peptide (OGP). ④ Hormones capable of promoting the proliferation and differentiation are growth hormone, estrogen, thyroxine, parathyroxine, and glucocorticosteroid.CONCLUSION: Multiple factors are involved in the in vitro culture of osteoblasts. It is helpful to understand these influencing factors to seek an effective way for the in vitro culture ofosteoblasts that is applied in tissue engineering.

Objective To identify differentially expressed N-linked glycoproteins between hepatocellular carcinoma ( HCC) and adjacent non-tumorous liver tissues .Methods N-linked glycoproteome was extracted by multi-lectin affinity chromatography comprising concanavalin A (ConA), lentil lectin (LCH), and snowdrop lectin (GNA) and subsequently subjected to two-dimensional electrophoresis ( 2DE ) and mass spectrometry ( MS ) for identification of differential glycoproteins between 10 pairs of HCC and adjacent non-cancer tissue .Western blotting was used to verify different expression of human liver carboxylesterase 1 (hCE1), haptoglobin (HP)and cathepsin D (CD).Invasion potential in vitro was examined after si-RNA mediated CD gene scilencing .Results LC-ESI-MS/MS identified a total of 28 differentially expressed glycoproteins (14 up-regulation and 14 down-regulated).Western blotting detected consistent down-regulation of hCE1 and HP, and up-regulation of pro-cathepsin D (pCD) in HCC.Up-regulation of ConA-binding CD (ConA-CD), however , was verified in HCC only after ConA-CD enrichment by ConA chromatography .Down-regulation of CD expression mediated by CD-siRNA markedly inhibited the in vitro invasive potential of SNU449 and SNU473.Conclusion Dysregulation of HP , hCE1 expression and alteration of glycans linked to CD may play crucial roles in pathogenesis of HCC.

Objective To observe the outcome of uncemented hip arthroplasty for failed internal fixation of intertrochanteric fracture.Methods Seventeen patients admitted from Februaty 2010 to January 2014 were reviewed retrospectively in this study.The patients aged 67.2 years (range, 41-80 years) composed 6 males and 11 females.There were 15 patients with intertrochanteric fracture and 2 intertrochanteric and subtrochanteric fracture.The primary internal fixation method was dynamic hip screw (DHS) fixation in 2 patients, proximal femoral nail anti-rotation(PFNA) fixation in 12 patients and intramedullary nailing in 3 patients.Arthroplasty with a prosthetic hip was performed for 15 patients and with a prosthetic femoral head was done for 2 patients 3-48 months after the internal fixation.Harris score was used for evaluation of the results of hip arthroplasty.Preoperative Harris score was (32.6 ± 6.8)points.Results All the patients were followed up for 6 to 48 months.One patient with intraoperative femoral fracture experienced early subsidence and dislocation of femoral stem following allogeneic bone plate and titanium cable fixation and had further revision surgery.One patient had secondary subsidence of the femoral stem without pain and limitation of motion.One patient had primary infection recurrence after arthroplasty, but the infection remained uncured even after a series of treatments like repeated debridements, sustained vacuum drainage, prosthesis removal, debridement and temporary spacer implantation.Sixteen patients showed postoperative pain relief and good hip function recovery characterized by the ability to care for themselves and no prosthetic loosening.Harris hip score signficantly improved to (79.2 ± 15.9) points at the final follow-up (P ＜ 0.01).Conclusions Uncemented hip arthroplasty is an effective method for the failed internal fixation of peritrochanteric fracture.The procedure achieves satisfactory function recovery, early weight-bearing exercise and early recovery of self-care ability,and avoids the complications of bone cement use.

Objective To investigate gene transfer efficiency of a novel target non-viral vector GE7 and effects of herpes simplex virus thymidine kinase (HSV 1-tk)/ganciclovir(GCV) mediated by it in vitro. Methods The epidermal growth factor receptor (EGF-R) target gene delivery system GE7 was constructed.Human ovarian cancer cell line CAOV3 was transfected in vitro with ?-galactosidase(?-gal) as reporter gene and HSV 1-tk gene as therapeutic gene using this gene delivery system.By means of the assay of X-gal staining, Northern blotting, cell growth-inhibiting curve and so on,the transferring efficiency of exogenous genes and killing effects are observed. Results It showed that gene transfer efficiency is over 80%.When 10 mg/L GCV was put into ovarian cells transfected with HSV 1-tk gene, 95% of cells were killed, and the apoptosis ratio reached up to 30. Conclusions The GE7 gene delivery system is an effective and safe delivery system.GE7/ HSV 1-tk /GCV therapeutic gene system is appraising for ovarian cancer.

Objective To detect the expression of IL-17 in renal transplant recipients by Luminex and evaluate the relationship between the level of serum IL 17 and early acute renal allograft rejection.Methods 38 kidney transplant recipients and healthy controls (HC,healthy volunteers,n =20) were selected in this study from January 2009 to October 2011.All patients were divided into two groups according to their allograft outcome as acute rejection group (ARG,n-18) and non-rejection group (NRG,n=20).The expression of serum IL-17 was detected by Luminex technique in two groups of kidney transplant recipients and HC.To evaluate the correlation between the level of serum IL-17 and early acute renal allograft rejection.Results The mean level of IL-17 in all renal transplant recipients 1.3 ± 1.9 pg/ml at the pre-transplantation was significantly lower than that in HC (6.9± 8.5 pg/ml,t=3.968,P＜0.001).The results highlighted that the level of serum IL-17 in ARG 3.4±5.8 pg/ml was significantly higher than that in NRG (0.5±0.4 pg/ml) on the 7th days post Kidney transplantation (post KTx,t=2.242,P =0.031).Kaplan-Meier survival analysis showed that the probability of rejectionfree survival in the higher levels group of IL-17 on the 7th days post-KTx was significant lower than that in the lower levels group (P＜0.001).The results of receiver operating characteristic curve showed that the sensitivity and specificity of the combined IL-17 to predict acute rejection were 66.67％ and 100％,respectively.Conclusion The serum IL-17 levels in renal transplant recipients on the 4th and 7th post-KTx days can predict early renal transplant rejection.

Objective To evaluate the effect of pregnancy and delivery after renal transplantation (RT)on recipients,graft and offspring.Methods Clinical data of 6 pregnancies in 5 recipients were retrospectively studied and literature was reviewed.Results Among them,6 pregnancies and 4 deliveries occurred in 5 female RT recipients.The mean age at pregnancy was 31.1 years,with a mean interval between RT and pregnancy being 3.6 years.Preeclampsia developed in two pregnancies and hyperlipemia in one pregnancy.One RT recipient who discontinued immunosuppressant following pregnancy on her own exhibited subsequent renal failure.She underwent a second RT and delivered a healthy baby two years following the second RT.One RT recipient decreased the immunosuppressant dose to half after the pregnancy on her own and developed renal failure thereafter.Four patients underwent a Cesarean section at 38 th,35 th,35 th,and 38 th week,respectively.The mean birth weight was 3262.5 g with all Apgar scores of 10.Conclusion Our data coupled with prior reports suggest that for the recipients with normal renal function,successful pregnancy is achievable if immunosuppressant was taken correctly,but the pregnancy is at high risk,and careful monitoring is needed.

ObjectiveTo evaluate the clinical effect of MSCT measurements in the pre- and postoperational osteal posterior cranial fossa for the adult patients of basilar invagination.Methods We reviewed the images of a cohort of 31 adult patients with basilar invagination,which were treated by surgical operation.According to the presence of atlantoaxial dislocation,the patients were divided into groups A and B.The basion-dens interval (BDI),atlanto-dental interval (ADI),space available of the spinal cord ( SAC),clivus-canal angle( CCA),Highly index( HI),and Chamberlian line(CBL) of the posterior cranial fossa were obtained in all the patients.Independent-sample Student's t test was used to compare the differences between groups A and groups B.Spearman correlations were analyzed between CT measurement data and effects of operations.ResultsIn Group A,the BDI,ADI,SAC,CCA,HI,CBL before and after surgery were 12.6 mm,8.3 mm,4.5 mm,3.3 mm;18.2 mm,20.8 mm,138.3°,150.4°,28.7 mm,43.4 mm,6.3 mm,3.3 mm respectively.There were significant differences ( t = 5.603,2.323,3.124,5.531,4.278 and 2.375,respectively,P ＜0.05 ).Preoperative JOA score in groups A was 10 points,and was 14 points after surgery.There was significant difference between the JOA scores before and after surgery ( t = 3.526,P ＜ 0.05 ).There were 7 effective cases and 4 stable cases after surgery in group A.Before and after surgery,JOA score and BDI,ADI,SAC,CCA,HI,CBL were significantly correlated( r = -0.667,- 0.673 ; - 0.571,- 0.619 ; 0.642,0.513 ; 0.525,0.558 ; 0.587,0.511 ; - 0.532,- 0.596,respectively,P＜0.05).The SAC,CCA,and CBL before and after surgery in group B were 18.3 mm,19.6 mm,146.8°,150.2°,2.7 mm,1.8 mm.The difference was statistically significant after operation ( t = 5.359,4.126,0.769,P ＜0.05).The BDI,ADI,and HI before and after surgery in group B were 7.2 mm,6.6 mm,2.4 mm,2.1 mm,39.3 mm,41.5 mm.And there were no significant differences (t = 1.482,2.374,0.153,P＞0.05).The preoperative JOA score in groups B was 11 points,and the postoperative score was 16 points.JOA scores before and after surgery were significantly different (t =2.874,P ＜0.05).There were 14 effective cases and 6 stable cases after operation in group B.The JOA score before and after surgery and BDI,ADI,and HI had no correlation (r =0.341,0.387;0.154,0.182; 0.192,0.167,P ＞0.05),and CBL,SAC and CCA were correlated (r = -0.756,-0.728;0.651,0.672; 0.726,0.695,P ＜0.05).ConclusionMSCT measurements for basilar invagination before and after surgery are helpful for understanding changes of osteal posterior fossa anatomy and comprehensive evaluation of surgical treatment.