Objective: To confirm that the antiserum induced by short peptide in the region of AA 448-477 at HPV16 L1 C-terminal can respond with many types of HPV L1. Methods: This sutdy synthesized a short peptide containing the conserved sequence of HPV L1 and immunized animal with the synthetic peptide to obtain the polyclonal antiserum. The type of HPV in clinical specimens, such as cervical cancer and condyloma acuminatum tissues, was identified by PCR. ELISA, Western blotting, and inummohistochemistry were used to determine whether the anti-serum of the short peptide could react with different types of HPV-positive specimens. Results: ELISA assay showed that the reaction between antigen and antibody was positive in HPV6, 11, 16, and 18 and other HPV-positive clinical specimens. Western blotting revealed that there was a strip at 56 kDa in all types of HPV-positive clinical specimens, but there was no strip in HPV-negative clinical specimens. Immunohistochemistry analysis demonstrated that the histological reaction had varying features in different clinical specimens. The positive-reaction appeared only in the epithelium tissues, which was regional and had apparent borders. Conclusion: This study confirms that the common conserved sequence really has HPV L1 common epitope. Its anti-serum can respond with many types of HPV L1. These findings provide an important basis for further researching a broad-spectrum HPV L1 vaccine or publicizing broad-spectrum HPV detection kits.

Objective To study the value of insulin like growth factor binding protein-1 of cervicovaginal secretion in the delayed pregnancy termination. Methds Phosphorylated isoforms of IGFBP-1 in cervicovaginal secretion of 202 delayed pregnant women were measured by immmmunochromatography. Results In the IGFBP-1 positive group. The rate of successful pregnant termination in three days was 91 2%, while in IGFBP-1 negative group, the rate of that was 41 8%..There was statistically significant diference in the rate of successful pregnant termination between the two groups(P

Objective To probe the imaging diagnostic characteristics of skull base-type pituitary adenoma (SBPA). Methods CT, conventional MRI, dynamic MRI, and pathological data of 16 patients with SBPA were analyzed. The manifestations of both CT and conventional MRI, the dynamic time-signal curve, time of peak enhancement, and average enhancement rate were compared between SBPA in the 16 patients and chordoma of the skull base (CSB) in another 9 patients. Results The CT appearances of both tumors were quite similar, offering no differential value. Both tumors were slightly hypointense on T 1 weighted images, but SBPA was mildly hyperintense and CSB was markedly hyperintense on T 2 weighted images. The T 2 weighted signal intensity between both tumors differed significantly (P5 min, (40?5) /min for CSB, respectively (P

Objective To summarize the types and imaging features of periosteal anomaly in osteosarcoma.Further to seek the feature of genesis and advancement of periosteal anomaly and its clinical significance.Methods One hundred and twenty-eight patients with osteosarcoma were enrolled in this study,which consisted of 76 males and 52 females aging from 5 to 66 years old with an average of 19 years.Both x-ray plain film and MR images were obtained in all patients.and DWI were done in 23 patients.CT scanning was conducted in 48 patients.which included post-contrast scanning done in 36.The pathological gross specimen,macrosection and point-to-point microsection were obtained in each of 14 cases to correlate the imaging findings of periosteal anomaly to the pathological outcome.Results The imaging and pathological finding:(1)Periosteodema,occurring in 96 patients.The sign was merely demonstratable on MR image and presented as loosened periosteal structure with no tumoral infiltration pathologically.(2)Periosteal lift and thickening,demonstratable on both CT and MR image,including 13 noted on CT and 42 on MR image.Pathologically,non-tumoral infiltration was noted in the thickened periosteum.(3)Periosteal destruction,occurring in 48 patients.Periosteal destruction was merely demonstratable on MR image and presented as localized or generalized tumoral infiltration of the periosteum.(4)Linear periosteal neo-bone formation,demonstrated in 42 cases on plain films,13 cases on CT and 22 on MR images,respectively.The linear periosteal neo-bone formation was pathologically regularly arranged periosteal neo-bone.(5)Laminar periosteal neo-bone fomarion,demonstrated in 21 cases on plain films,6 cases on CT and 21 on MR images,respectively.Pathologically,it appeared as multi-layer arrangement.(6)Radiated and spiculate periosteal neo-bone formation,demonstrated in 13 cases on plain films,7 cases on CT and 14 on MR images,respectively.On both plain film and CT,the closer to the center of the tumor,the longer and denser the spicule was.The interspiculate structure was tumoral tissue pathologically.(7)Periosteal neo-bone formation of mixed type,demonstrated in 7 cases on plain films,4 cases on CT and 8 on MR images,respectively.It was composed of 2 types or more of periosteal neo-bone.Conclusions (1)Multiform periosteal anomaly can be induced by osteosarcoma,and difierent periosteal anomaly possesses different imaging findings and different pathological basis.(2)The pathologically-based classification of periosteal anomaly generalizes the 3-modality imaging findings of various periosteal pathological alterations.(3)MR imaging enables to demonstrate periosteal anomaly more early,and periosteodema and periosteal destruction without neo-bone formation can only be demonstrated by MR imaging.MR imaging is more sensitive than CT in displaying periosteal thickening.

Objective To investigate the effect of femoral head replacement for the treatment of intertrochanteric frac -tures among elderly patients .Method There were 38 cases that received intertrochanteric fracture hemiarthroplasty and 35 patients were treated with open reduction and dynamic hip screw ( DHS) plate internal fixation .After follow-up, their opera-tion duration,blood loss, postoperative drainage flow , postoperative ambulation time , hospitalization time were compared according to the Harris score to assess the effect of postoperative follow-up.Results After the mean follow-up time of 18 months (12 to 36 months),the hemiarthroplasty group was superior to the open reduction and DHS plate fixation group ,as shown by the earlier postoperative ambulation time , fewer complications , and better fracture reduction , with an excellent rate of 94 .7%.Conclusion For patients with intertrochanteric fractures , hemiarthroplasty surgery is effective and can re-duce the incidence of postoperative complications .

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.

Objective:To investigate the normal sonographic anatomic characteristics of the pectoralis major and the clinical value of ultrasound in diagnosing the extent and location of the pectoralis major tears.Methods:High frequency transducer was used in scanning the pectoralis major.The ultrasono-graphic images of 40 normal pectoralis major were obtained from 20 healthy volunteers with both sides. Longitudinal and transversal views were performed and stored.The distal tendon was identified in the transverse plane coursing superficially to the long head of the biceps brachii tendon inferior to the level of the subscapularis tendon.Eighteen cases of pectoralis major tears were analyzed retrospectively,with MRI,surgical and ultrasound follow-up results correlation respectively.Results:High-frequency ultra-sound could clearly show the anatomic orientation of the normal pectoralis major.The fibers converge was like a fan into three laminae that twisted upon each other at 90°before coalescing into a single tendon of insertion.In the study,1 8 patients of pectoralis major muscle tears [average age:(37.2 ±1 5.6)years] sustained injuries during weightlifting,basketball and impact.Three of the eighteen patients had MRI re-sults;nine had surgical correlation;six were followed by ultrasound.Eleven were injured on the left side,and 7 on the right side.Seven were involved in the distal tendon (1 in sternal head,2 in clavicular head,4 in both sternal and clavicular head),five were involved the musculotendinous junction,6 were involved muscle belly.Twelve cases were partial-thickness petoralis major tears(4 in the distal tendon, four in the muscle tendon junction,4 in the muscle belly),with the partial fiber intact,echogenicity de-creased and the internal structure disordered;6 cases (3 in the distal tendon,1 in the muscle tendon junction,2 in pectoralis major muscle belly)were completely disrupted,with fiber fracture and retrac-tion,accompanied with or without hematoma formation.Conclusion:High-frequency ultrasound can clearly show the anatomic structure of the pectoralis major.Ultrasonography can diagnose the pectoralis major tears with the extent and location of injuries,and can be used to help the clinical treatment.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .

Objective To compare DHS(dynamic hip screw )with PFNA(proximal femoral nail antirotation) treatment for intertrochanteric fractures and to analyze their postoperative complications .Methods A total of 107 patients with inter-trochanteric fractures were treated with DHS and PFNA fixation respectively .The type of fracture , postoperative complica-tions and overall efficacy were compared .Results After the follow-up of 28(24 to 36) months.DHS group had a higher overall incidence of postoperative complications than the PFNA group and the difference was statistically significant ( P<0.05).Conclusion In order to reduce the intertrochanteric fracture fixation complications , the type of fracture, osteoporo-sis and biomechanical fixation characteristics need to be considered when selecting surgical procedures .Postoperative func-tional rehabilitation is to be improved .The curative effect of PFNA is better than that of DHS .

AlM:To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema ( DME) .METHODS:Totally 60 eyes ( 60 patients ) with DME were randomly divided into 2 groups: 30 eyes of simple injection group underwent intravitreal injection of ranibizumab, and 30 eyes of combined treatment group underwent intravitreal injection of ranibizumab and macular grid photocoagulation 1wk later. The best corrected visual acuity ( BCVA ) , central macular thickness ( CMT ) measured by optical coherence tomography ( OCT ) and postoperative complications were observed.
RESULTS:ln simple injection group, the BCVA after operation were separately 0. 390 ± 0. 075 (4wk), 0. 367 ± 0. 088 (8wk) and 0. 319 ± 0. 064 (12wk), the CMT after operation were separately 221. 63 ± 112. 34μm (4wk), 337. 73±99. 56μm (8wk) and 432. 92 ± 100. 46μm (12wk), which were much better than pre-operation. But during follow-up, the BCVA presented down trend and the CMT was on the rise slowly. ln combined treatment group, the BCVA after operation were separately 0. 385 ± 0. 036 (4wk), 0.382±0.079 (8wk) and 0.377±0.097 (12wk),the CMT after operation were separately 249. 77 ± 106. 55μm (4wk), 270. 40 ± 92. 88μm (8wk) and 275. 84 ± 97. 34μm (12wk ), which were satisfactory and steady during follow-up, better than simple injection group (P<0. 05).CONCLUSlON:lntravitreal injection of ranibizumab can effectively improve visual acuity and decrease central foveal thickness for patients with DME, combining with macular grid photocoagulation can ensure therapeutic effects steady and permanent.