AIM: To analyze and screen humoral bioactive factors associated with accelerated fracture healing after traumatic brain injury. METHODS: A computer-based online search of Chinese Journal Full-text Database and Pubmed database was undertaken to identify related articles. After the first trial, only articles about the effect of humor changes after brain trauma or humoral factors on fracture healing were selected, and those published in recent five years and published in a authoritative journal were preferred. Repetitive research was excluded. RESULTS: Fracture healing can be accelerated, especially for people with traumatic brain injury. Brain injury, spinal cord injury, different parts of the spinal cord injury, and nerve injury have different influences on fracture healing. There are cell active factors in humour of patients after traumatic brain injury, which can induce karyogenetic division and proliferation of bone marrow-derived stroma cells. Bone morphogenetic protein (BMP) is a very important factor in fracture healing, but it seems not one of factors that are associated with accelerated healing mechanism. Transforming growth factor-? (TGF-?) is correlated with brain injury and bone healing. It is likely to be one of cell factors that can promote fracture healing. Basic fibroblast growth factor (bFGF) has an early expression in traumatic brain injury patients, which can promote osteoblast by stimulating vascular endothelial growth factor (VEGF) and TGF-? expressions. VEGF is only a member of various factors in the network in fracture healing. The action mechanism of single factor needs further exploration. Growth hormone has a high concentration in patients with traumatic brain injury, and can promote fracture healing through interaction with insulin-like growth factor. However, the mechanism is still uncertain. Nerve growth factor, prolactin and melantonin concentration significantly change after traumatic brain injury. They may be the humoral factors that influence bone healing, but the mechanism has not yet been identified. CONCLUSION: Accelerated fracture healing associated with traumatic brain injury is influenced by systemic and local bioactive factors. Currently, the researches about the association of some humoral factors such as BMP, TGF-? and bFGF with fracture healing have been conducted, but others need to further study.

Given the limited sources of autogenic tendon and the difficulties of the tissue engineering tendon to clinical application, the allograft tendon transplantation was a good way for tendon repairing defects. The domestic and foreign scholars have done a lot of studies on the acquisition, preservation, immunological characteristics, clinical application and prognosis of allograft tendon transplantation technology. The allograft tendon transplantation has been more and more used to repair the tendon tissue defects, but there still were some problems to be solved, such as the preservation, immunological characteristics, mechanical strength and postoperative adhesions.

Objective To evaluate the clinical characteristics,treatment,outcome and complications of child and adolescent nasopharyngeal carcinoma (NPC). Methods From January 1970 to April 1997, the records of 145 NPC patients younger than 21 years of age were reviewed. The clinical stages according to 92'Chinese NPC Staging System were :stageⅠin 1, Ⅱin 8, Ⅲ in 79 and Ⅳ in 57. All patients were treated with external beam radiotherapy. Before 1988, parallel opposed lateral pre-auricular portals were chiefly used in 75 patients and after 1988, parallel opposed lateral facio-cervical portals were adopted in 70. The radiation dose to the primary tumor ranged 45-80?Gy: 70?Gy in 50 cases and 32 of them also received chemotherapy. Results Distant metastasis developed in 26 cases, while local and/or regional recurrence in 14. The actuarial overall survival rates of 1-, 3-, 5, and 10-years were 96.3%, 79.9%, 76.5% and 69.4%, respectively. Among 45 dead cases, 16 did so of metastasis, 11 of local and/or regional recurrence and 18 of other reasons. Univariate analysis suggested that clinical stage, size and site of involved lymph nodes, skull base involvement were significant prognostic factors of survival, whereas sex、age、dose、therapeutic method and chemotherapy were not. Conclusions 1. Even though the majority of pediatric and adolescent NPC were advanced, it signifies a relatively good survival. 2. As the normal tissue of pediatric and adolescent patients tolerates radiation poorly, prudence should be meticulously practiced in deciding the radiation dose and radiotherapeutic fields.

Objective To study the effect and toxicity ofgefitinib combined with selected radiotherapy in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Methods From March 2006 to February 2009,10 of 13 advanced NSCLC patients who got benefit from gefitinib were enrolled to treatment group (gefitinib concurrent selected radiotherapy) and control group (gefitinib only), with 5 cases in each group. The response was evaluated as progression free survival (PFS) and overall survival (OS).Results No patient got complete remission (CR). Ten of 13 patients got partial remission (PR) and stable disease (SD). The 1 year and 2 years survival rate was 53.8%(7/13) and 46.2%(6/13) respectively. The median PFS in treatment group and control group was 24 months and 8 months respectively(P= 0.0019). The median OS was 32 months and 10 months respectively (P= 0.0062). The main toxicities were reversible skin rash and diarrhea,and 3 patients developed asymptomatic radiation pulmonary fibrosis. Conclusions Gefitinib combining with selected radiotherapy is effective and tolerated in patients with advanced NSCLC. It may prolong PFS and OS. It may be a rational choice for the standard and individualized treatment of NSCLC.

Objective To probe the precision of the magnetic resonance spectroscopy (MRS)in assessing the fat content in the vertebral bone marrow and the changes at different vertebrae.Methods A total of 46 female volunteers were recruited in this study. After routine MRI examination,single voxel (SV)was chosen for the 1 H-MRS acquisition at L1 -L4 vertebral body.Thirty subjects were scanned twice to evaluate the precision of MRS.The fat fraction (FF%),unsaturation index (UI)and coefficients of variation (CV) were calculated by amplitude and area under the peak respectively.The changes of fat content in marrow at L1 -L4 vertebrae was further evaluated.Results The CV related to peak amplitude was 1.7% in quantification of vertebral FF%,while the CV related to peak area was 6.3%.In quantification of vertebral UI,the CV related to amplitude and area was 2.4% and 7.8% respectively.The FF% was ascended from L1 to L4,while UI of bone marrow declined.A significant correlation was observed between FF% and UI (r=-0.714,P <0.01).The correlation of FF% among L1 -L4 were also significantly observed (r =0.612 -0.923,P <0.01). Conclusion MRS at 3.0 T provides reliable measurement for marrow fat content with a good precision associated with amplitude. Meanwhile,there is a preferential increase in saturated lipids compared to unsaturated lipids from L1 to L4.There is a high correlation of FF%among L1-L4.MRS is a valuable tool for providing complementary information on osteoporosis research.

Objective:To learn the prevalence and correlated factors of hyperuricemia in the middle-and-old aged inhabitants of Nanjing. Methods:5 423 inhabitants in the districts of Nanjing were selected by random cluster sampling. The levels of uric acid, creatine, total cholesterol, triglycerides, blood glucose in the serum were measured,and the diet was also investigated. Results:The prevalence of hyperuricemia in the middle-and-old aged inhabitants was 15.0%, with 20.1% for males and 10.6% for females. The prevalence for males and females increased after 50 years old, and maintained at a high level afterwards. The concentration of uric acid, creatine, total cholesterol, triglycerides, blood glucose, the blood pressure and BMI in the inhabitants with hyperuricemia were higher than those in the inhabitants without hyperuricemia. The risk factors for hyperuricemia included higher BMI and hypertension, while the protective factor was favorite for hot-food. Conclusion:For the inhabitants over 45 years old in Nanjing, hyperuricemia was common among the adults over 50 years old. Higher BMI and hypertension were the risk factors, while favorite for hot food was the protective factor.

The research aimed to investigate the therapeutic effects and mechanisms of Opuntia dillenii Haw polysaccharide (OPS) on atherosclerosis of rats. First atherosclerotic rat models were established by high-fat and high-calcium diet. Thirty days later, the rats were treated with low dosage of OPS (0.2 g x kg(-1) x d(-1)) or high dosage of OPS (0.4 g x kg(-1) x d(-1)) by intraperitoneal injection for 60 days continuously. At the end of treatment, thoracic aorta rings were prepared and vasorelaxation of rat thoracic aorta in different experiment groups were determined by using 620M multi wire myograph system in vitro. Blood and livers of rats were collected. Then plasma levels of total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL) of rats were separately determined using whole automatic biochemical analyzer; protein level of hepatic apolipoprotein B (ApoB) and that of hepatic diglyceride acyltransferase (Dgat1) were measured by Western Blot technique. Results showed that the ability of rat thoracic aorta to relax decreased markedly in the model group compared with that in the normal group, and significant differences existed in vasorelaxation ratios induced by different concentrations of carbamylcholine chloride (Carb) between these two groups (P < 0.01). After OPS treatment, the ability of rat thoracic aorta to relax improved markedly, the vasorelaxation ratios induced by Carb at 5 and 10 μmol x L(-1) were respectively 0.34 ± 0.08 and 0.62 ± 0.15 in the group treated with low dosage of OPS, while the ratios induced by Carb at 1 and 5 μmol x L(-1) were respectively 0.54 ± 0.08 and 0.98 ± 0.02 in the group treated with high dosage of OPS, which were all significantly different with those in the model group (P < 0.01). Plasma contents of TC, TG and LDL reduced significantly by the treatments both with low and high dosages of OPS compared with those in the model group (P < 0.01). Protein level of hepatic ApoB and that of hepatic Dgat1 decreased significantly after the treatment with high dosage of OPS compared with those in the model group (P < 0.01). These results indicate that OPS can markedly improve the vasorelaxation of thoracic aorta of atherosclerotic rats and has significant anti-atherosclerotic effect; inhibiting the expression of ApoB and Dgat1 and thus decreasing the amounts of TC, LDL and TG serving as one of the molecular mechanisms of its antiatherosclerosis effect.

Objective To investigate the change of gastroesophageal reflux including acid reflux,duodenogastroesophageal reflux (DGER) and its effect on expression of COX-2 and TNF-α in the remnant esophagus in different period after esophagectomy for cancer.Methods Thirty-two patients who underwent esophagectomy for cancer were selected randomly.Twentyfour-hour pH and spectrometric bilirubin monitoring,endoscopy were periodically performed.Esophageal mucosa samples were obtained by endoscopic biopsy.Expression of COX-2 and TNF-α within remnant esophageal mucosa was detected using immunohistochemical assay.Results ( 1 ) The incidence of reflux esophagitis and extent of acid reflux gradually increased over time after surgery for cancer ( P ＜ 0.05 ).(2) Very low level of COX-2 and TNF-α expression was detected in normal esophageal squamous mucosa.The expression of COX-2 and TNF-α was observed in cytoplasm of basal cell of esophageal epithelium after esophagectomy for cancer.High intensity of COX-2 and TNF-α expression was detected in the metaplastic columnar mucosa.The level of TNF-α expression in the remnant esophagus where reflux esophagitis occurred was higher than that in the normal remnant esophagus ( P =0.0274 ).There was no significant difference in level of COX-2 expression in the remnant esophagus between reflux esophagitis occurred and not ( P =0.7403 ).Conclusion ( 1 ) The extent of acid reflux and incidence of esophagitis gradually increases over time.(2) The expression of COX-2 and TNF-α may represent an early change associated with gastroesophageal reflux.The expression of COX-2 may serve as a molecular marker of gastroesophageal reflux occurred.( 3 ) The durative expression TNF-α is likely involved with the pathogenesis of chronic reflux esophagitis.

Objective To investigate the effect of different operative approaches on perioperative respiratory and cardiac function of patients with gastric cardia carcinoma. Methods The perioperative changes of SpO2 ,Breath Rate (BR) and Heart Rate(HR) of patients with gastric cardia carcinoma underwent surgical therapies through transthoracic ( n = 30 ), transabdominal ( n = 37 ) or trans-thoracoabdominal ( n = 10 )approaches were compared respectively. Results On the postoperative 1st,2nd,4th and 7th day,the changes of BR in transthoracic (5. 20 ± 0. 96,5. 17 ± 1. 58,3.93 ± 1.53,2. 63 ± 1.25 )/min and trans-thoracoabdominal (5.80 ±0. 79,6. 10 ± 1.20,4. 80 ± 1.32,3.00 ± 1.49)/min approach groups were significantly greater than that of transabdominal group (4. 35 ± 1.06,3.89 ±0. 99,2. 24 ± 1.30,1.16 ±0. 65)/min (Ps ＜0. 05). At the meanwhile, the changes of SpO2 at 2nd, 4th postoperative day of transthoracic ( [ 8. 30 ± 1.95 ] %, [ 7.23 ±2. 01 ] % ) and trans-thoracoabdominal ( [ 8.60 ± 1.43 ] %, [ 7. 70 ± 2. 11 ] % ) approach groups were significantly greater than that of transabdominal group ( [ 7. 08 ± 1.82 ] %, [ 6.24 ± 1.88 ] % ) ( Ps ＜ 0. 05 ), but there were no significant differences observed among three groups on the postoperative 1st,7th day. On the postoperative 1 st,2nd and 4th day, the changes of HR of transthoracic ( 18.00 ± 3.79,13.47 ± 4. 42,8. 60 ±4. 13 )/min and trans-thoracoabdominal ( 19. 80 ± 4. 96,14. 80 ± 3.33,8.70 ± 3.47)/min approach groups were significantly greater than that of transabdominal group ( 13.62 ± 4. 00,10. 84 ± 4. 16,6. 32 ± 2. 53 )/min, too (Ps ＜0. 05) ,but no differences were observed among three groups on the postoperative 7th day (Ps ＞0. 05).Coniclusion Transthoracic,transabdominal and trans-thoracoabdominal approachs resulted in different effects on respiratory and cardiac function in patients with gastric cardia carcinoma.

Objective To observe the effect of Zusanli acupoint injection of Astragalus Membranaceus Injection on patients with tumor leukopenia after radiotherapy and chemotherapy and its influence on cellular immune function.Methods According to clinical case of random table,60 cases of malignant tumor patients in Hubei province Xiangyang city hospital from March 2010 to August 2011 were randomly divided into two groups of 30 patients in each group.The treatment group was treated with Zusanli acupoint injection of Astragalus Injection therapy,while the control group was taken Leucogen,vitaminB4,batyl alcohol orally.Venous blood and peripheral white blood cell were taken in both groups before and after treatment.Direct immunofluorescence staining and flow cytometry were used for the detection of peripheral blood T lymphocyte total number and its subsets.Results ① clinical efficacy:Total effectiveness was 77.5％in the treatment group,and 52.5％ the control group,the difference was statistically significant between the two groups (x2=8.027,P＜0.05).Comparison of the white blood cell count and T lymphocyte subsets of peripheral blood:the white blood cell count was (3.56～4.21) × 109/L in the treatment group,and (2.89～3.39) × 109/in the control group,there was significant difference between two groups (t=2.435,P＜0.05); there was significant elevation of CD3 +,CD4+,CD4+/CD8 + [(62± 1.63) ％,(43 ± 0.80) ％,(1.48 ± 0.23) in the treatment group after the treatment comparing with (48± 1.25)％,(31 ± 0.74)％,(0.93± 0.12) before the treatment (P＜0.05 or 0.01),while there was no such changes in the control group.Conclusion Zusanli acupoint injection of Astragalus Injection may modulate the cellular immune function of patients with cancer.It is effective in the treatment of leukopenia after radiotherapy and chemotherapy.