Objective To evaluate the clinical effects and experiences of short stem ceramic-on-ceramic total hip arthroplasty in the treatment of young and middle-aged patients with femoral head necrosis.Methods From December 2009 to March 2011,40 patients with femoral head necrosis were treated primarily with short stem ceramic-on-ceramic hip arthroplasty (43 hips) through posterior-lateral or anterior-lateral approach.There were 23 males,17 females； with the mean age of 40.5 years (range,27-55 years).All cases were stage Ⅳ or more according Steinberg stage.The patients were followed up at the 3,6,12 months after operation,and then once each year.Standard X-ray films were taken at the follow-ups.Femoral prosthesis subsidence was assessed through X-ray films.Harris scores system and WOMAC Osteoarthritis Index were recorded before and after operation to evaluate clinical effects of surgery.Results Thirty-eight patients (41 hips) were followed up for 21-36 months,with an average of 31.3 months.The femoral stem subsided 0.68±2.90 mm at the last follow-up.After operation,hip pain of patients was relieved obviously.The Harris score improved from 38.7±12.1 (15-66) preoperatively to 95.2±4.49 (83-100) postoperatively,WOMAC Index from 66.7±12.0 (49-94) to 12.8±5.6 (0-24).During follow-up period,there was no serious complication such as femoral neck fracture,infection of wound,pulmonary embolism,et al.No dislocation,implant prosthesis failure and infection were observed.Conclusion The short stem hip arthroplasty preserves bone stock to a great extent.The short stem implant showed a good stability and osseous integration.The wear rate of ceramic-on-ceramic bearing surface is extremely low.Short stem hip arthroplasty plus ceramic-on-ceramic bearing surface might be a good option for the young and middle-aged patients with femoral head necrosis.

Objective To investigate the effectiveness and safety of bilateral lobar lung transplantations (LLTx) in thoracic cavity size mismatching patients with end-stage lung diseases and analyze its prognosis.Method Clinical data of 34 patients receiving LLTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2012.LLTx were performed on 14 male and 20 female patients,with a mean age of 37.0 ± 6.3 years (ranging from 15 to 56 years).Indications for LLTx were idiopathic pulmonary fibrosis (n =24),idiopathic pulmonary hypertension (n =2),Eisenmenger syndrome (n =3),bronchiectasis (n =2) and lymphangiomyomatosis (n =3).Amongst them 26 patients received LLTx under extracorporeal membrane oxygenation (ECMO) support and 3 on ECMO as a bridge to transplantation.Twenty-four middle/lower right lobes with left lower LLT,4 bilateral lower LLT,2 bilateral superior LLT and 4 split left lung LLT were performed.Ischemic time was 4.4± 1.2 h for the first lobe and 6.3 ± 1.4 h for the second.Result The mortality in postoperative prophase (30 days) was 23.5％.The 1-,2-,3-and 5-year survival rate after LLTx was 70.9％,60.8％,50.6％ and 36.2％ respectively.The main causes of mortality included primary graft dysfunction,acute rejection,multiple organ failure,bronchiolitis obliterans and sepsis.Lung function test was performed on 23 cases after transplantation and forced expiratory volume in first second,maximal voluntary ventilation accounting for the predicted value was (74.23 ± 4.86)％ and (72.0 ± 3.64)％,respectively.Conclusion This study demonstrates that for thoracic cavity size mismatching patients,LLTx are safe and effective in the treatment of end-stage lung diseases,which can ameliorate the lung function and prognosis.

Objective To investigate the effectiveness and safety of bilateral lung transplantation with simultaneous lung volume reduction surgery in the treatment on end-stage lung disease and analysis its prognosis.Methods Clinical data of 79 patients with end-stage 1ung diseases receiving BLTx in our hospital were retrospectively analyzed between Sept.2002 to Dec.2012.Bilateral lung transplantations were performed on 48 male and 31 female patients, with a mean age of(57.0 ± 6.3) years (ranging from 15 to 75 years).Amongst them 56 patients received LTx under circulation support,including 1 cases of cardiopulmonary bypass(CPB) support and 55 cases of extracorporeal membrane oxygenation(ECMO) support.34 patients accepted lung volume reduction surgery, other 45 patients receive standard BLTx.The Patients were divided into lung volume reduction group(group Ⅰ)and control group(group Ⅱ).Differences in various clinical parameters such as Pulmonary function, postoperative complications, and prognosis between the two groups were compared.Results The 1、2、3 and 5-year survival rate after LTx was 80.5％ 、71.4％ 、58.2％ and 43.5％.The mean survival time post-transplant in size reduction group and control group were(38.54 ±4.72) months and(42.19 ±6.64) months repectively.The main causes of mortality included primary graft dysfunction(PGD) ,acute rejection(AR) , multiple organ failure(MOF) , bronchiolitis obliterans(BOS) and sepsis.No tendency of increase in mechanical ventilation, chest tube drainage time, volume of chest drainage were observed.Compared clinical parameters between the two groups, none had significant differences(P ＞0.05).Lung function test was performed on 63 cases after transplantation.There was no significant difference in FEV1 improvement after lung transplantation between the two groups[(74.23 ±4.86)％, (72.0 ±3.64)％, P ＞0.05].Conclusion This study demonstrates that BLTx with simultaneous lung volume reduction surgery is safe and effective, which have the same outcome and prognosis compare with standardbilateral lung transplantation.

In this study, we present a constructive algorithm for training cooperative support vector machine ensembles (CSVMEs). CSVME combines ensemble architecture design with cooperative training for individual SVMs in ensembles. Unlike most previous studies on training ensembles, CSVME puts emphasis on both accuracy and collaboration among individual SVMs in an ensemble. A group of SVMs selected on the basis of recursive classifier elimination is used in CSVME, and the number of the individual SVMs selected to construct CSVME is determined by 10-fold cross-validation. This kind of SVME has been tested on two ovarian cancer datasets previously obtained by proteomic mass spectrometry. By combining several individual SVMs, the proposed method achieves better performance than the SVME of all base SVMs.

OBJECTIVETo investigate the methylation of p16(INK4a) and RB gene, and the expression of p16(INK4a) in meningiomas.

METHODSMethylation-specific polymerase chain reaction (MSP) was used to detect the methylation of p16(INK4a) and RB in 50 cases of meningiomas, and immunostaining was performed to analyze the protein expression of p16(INK4a) in 25 of those cases.

RESULTSNo methylation was found in the benign meningiomas, whereas methylation of p16(INK4a)or RB occurred in 6(37.5%) cases of grade II tumors and 4(28.6%) cases of grade III tumors, and among these cases, an atypical meningioma showed methylation of both genes. Thirteen cases showed p16(INK4a) positive expression, but none of them was methylated.

CONCLUSIONThe methylation of p16(INK4a) or RB is related with the tumorigenesis and progression of atypical and anaplastic meningiomas, and a probable mechanism is that methylation causes the loss of expression and leads to dysfuncation of the p16(INK4a)/cyclin D1/CDK4/RB pathway.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cyclin D1 ; genetics ; Cyclin-Dependent Kinase 4 ; Cyclin-Dependent Kinases ; genetics ; DNA Methylation ; Female ; Genes, Retinoblastoma ; Genes, p16 ; Humans ; Male ; Meningeal Neoplasms ; genetics ; Meningioma ; genetics ; Middle Aged ; Proto-Oncogene Proteins

OBJECTIVETo study the potential relationship between the expressions of c-jun and c-fos oncogenes and the prognosis of medulloblastoma.

METHODSThe specimens from 70 cases of medulloblastoma of the posterior fossa and 10 cases of normal cerebellar tissues were collected to determine c-jun and c-fos expressions by immunohistochemical staining in formalin fixed paraffin-embedded sections.

RESULTS(1) It showed that c-fos and c-jun protein expression was negative in 10 normal cerebellar tissue, while positive c-fos, c-jun immunoreactivity was found in 70 medulloblastoma specimens. The positive rate of c-jun and c-fos was 80% and 77%, respectively. There was high expression of c-jun and c-fos protein in medulloblastoma tissues. (2) There were positive correlations and strong co-operativity between c-jun and c-fos expression (r = 0.493, P < 0.01). (3) Correlative analysis indicated that expression of c-jun, c-fos were significantly correlated with survival time (c-jun: r = -0.447, P < 0.01; c-fos: r = -0.590, P < 0.01). The higher the expression level of c-jun and c-fos protein was, the worse the prognosis was in medulloblastoma patients.

CONCLUSIONSHigh expression of c-jun and c-fos protein could be noted in medulloblastoma tissues. The two transcription factors show positive correlation and strong co-existence between c-jun and c-fos expressions. The expression levels of c-jun as well as c-fos are negatively correlated with the mortality rate and life expectancy of patients with medulloblastoma. In addition, the co-expression of c-jun and c-fos could serve as an indicator for judging the prognosis of medulloblastoma.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Immunohistochemistry ; Infant ; Male ; Medulloblastoma ; metabolism ; mortality ; pathology ; Proto-Oncogene Proteins c-fos ; analysis ; Proto-Oncogene Proteins c-jun ; analysis ; Survival Analysis ; Survival Rate

Objective To analyze usage and development trend of TCM decoction pieces in First Hospital of Zhangjiakou City (hereinafter referred to as "our hospital") from 2014 to 2016; To provide the basis for making reasonable purchase plan, reserving TCM decoction pieces and guaranteeing clinical medication.Methods Computer medicine management system was used to conduct statistical analysis on the prescription or order number, dosage, sales, and top 10 TCM decoction pieces among annual consumption and sales of TCM decoction pieces from 2014 to 2016.Results The results showed that the prescription and the order, dosage and sales of TCM decoction pieces decreased year by year. The top 10 TCM decoction pieces in the three years were the same with nine kinds, namely Astragali Radix, Poria, Angelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, Ophiopogonis Radix, Coicis Semen, Citri Reticulatae Pericarpium, and Lycii Fructus. Conclusion The usage of TCM decoction pieces in our hospital is reasonable and the structure of medication is stable.

OBJECTIVETo test whether the tumor vessel density (TVD) from the enhanced spiral CT can preoperatively predict nodal status and distant metastasis of colorectal cancer.

METHODSForty cases of colorectal cancer patients who received surgical treatment were included in this study. The three dimensional tumor vessels were reconstructed by an enhanced CT 64-slice spiral CT and its AW4.4 image processing platform. The TVD was measured by the 1000 high-resolution color graphics pathological analysis system. The TVD level was compared between different tumor size, classification, and TNM stage. The postoperative pathological staging was taken as golden standard.

RESULTSThe sensitivity, specificity and accuracy for direct prediction of lymph node metastasis by the enhanced CT 64-slice spiral CT was 74.1%(20/27), 53.8%(7/13) and 67.5%(27/40) respectively. The TVD from the reconstructed three dimensional tumor vessels in the group with lymph node metastasis was significantly higher than that without metastasis(0.070±0.046 vs. 0.037±0.013, P<0.05). The TVD in the distant metastasis group was significantly higher than that without distant metastasis (0.130±0.032 vs. 0.049±0.030, P<0.01). No difference of TVD was found between different tumor size, invasion depth, and differentiation type.

CONCLUSIONTVD level from the reconstructed three dimensional tumor vessels can indicate lymph node and distant metastasis of colorectal cancer.

Colorectal Neoplasms ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Staging ; Tomography, Spiral Computed

BACKGROUNDVascular endothelial growth factor (VEGF) is well known as a hypoxia-induced protein. That it markedly increased expression of VEGF and improvement of rat motor function after spinal cord injury suggested that VEGF could play a neuroprotective role in ischaemic tolerance. This study investigated whether vascular endothelial growth factor has direct neuroprotective effects on rat spinal cord neurons.

METHODSWe employed primary cultures of embryonic rat spinal cord neurons, then administrated different concentrations of VEGF164 in the culture medium before hypoxia when the number of neurons was counted and the cell viability was detected by MTT. The neuronal apoptosis and expression of VEGF and its receptor genes were evaluated by terminal deoxynucleotidyl transferase mediated dUTP nick-end labelling (TUNEL) and immunohistochemistry. The VEGFR2/FLK-1 inhibitor, SU1498, was used to confirm whether the neuroprotective effect of VEGF was mediated through VEGFR2/Flk-1 receptors.

RESULTIn hypoxic conditions, the number and viability of neurons decreased progressively, while the number of TUNEL-positive cells increased along with the prolongation of hypoxic exposure. When the concentration of VEGF in cell culture medium reached 25 ng/ml, the cell viability increased 11% and neuronal apoptosis reduced to half, this effect was dose dependent and led to an approximately 25% increase in cell viability and about threefold decrease in TUNEL-positive cells at a maximally effective concentration of 100 ng/ml. In normal conditions, VEGF/Flk-1 but not VEGF/Flt-1 gene expressed at a low level: after hypoxia, the expression of VEGF/Flk-1, but not VEGF/Flt-1 was significantly increased. The protective effect of VEGF was blocked by the VEGFR2/Flk-1 receptor tyrosine kinase inhibitor, SU1498.

CONCLUSIONSVEGF has direct neuroprotective effects on rat spinal cord neurons, which may be mediated in vitro through VEGFR2/Flk-1 receptors.

Animals ; Cell Hypoxia ; Cells, Cultured ; Cinnamates ; pharmacology ; Female ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; drug effects ; Vascular Endothelial Growth Factor A ; pharmacology ; Vascular Endothelial Growth Factor Receptor-2 ; physiology

OBJECTIVETo establish a LC-MS/MS method for determining the concentration of tanshinone IIA, salvianolic acid B and paeoniflorin of refined coronary cataplasm in rabbit plasma, in order to determine the concentration of the three main ingredients in blood after transdermal administration and calculate their pharmacokinetic parameters.

METHODRabbits were given refined coronary cataplasm on the basis of 15 g x kg(-1) by transdermal administration to detect the plasma concentration of the three main ingredients using LC-MS/MS. Winnonlin software was used to calculate their major pharmacokinetic parameters.

RESULTTanshinone IIA, salvianolic acid B and paeoniflorin showed good linearity (r>0.999) at 1-100, 50-1 000, 10-1 000 microg x L(-1) respectively in plasma, with average recovery rate of 96.57%, 91.90%, 95.93%, respectively. The RSD within day were less than 15%. After transdermal administration of refined coronary cataplasm in rabbits, the main pharmacokinetic parameters of tanshinone IIA, salvianolic acid B or paeoniflorin were as follows: Cmax (20.85 +/- 12.68), (636.25 +/- 386.91), (787.80 +/- 395.64) microg x L(-1); Tmax (0.49 +/- 0.28), (0.44 +/- 0.27), (0.46 +/- 0.30) h.

CONCLUSIONThe LC-MS/MS method is highly selective and sensitive to determine the concentration of samples in rabbit plasma. The pharmacokinetic characteristics of tanshinone IIA, salvianolic acid B and paeoniflorin are suitable to assess the percutaneous absorption of refined coronary cataplasm.

Animals ; Benzoates ; administration & dosage ; pharmacokinetics ; Benzofurans ; administration & dosage ; pharmacokinetics ; Bridged-Ring Compounds ; administration & dosage ; pharmacokinetics ; Chromatography, Liquid ; methods ; Coronary Disease ; drug therapy ; Diterpenes, Abietane ; administration & dosage ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; pharmacokinetics ; Glucosides ; administration & dosage ; pharmacokinetics ; Humans ; Male ; Monoterpenes ; Rabbits ; Tandem Mass Spectrometry ; methods