Locking compression plate(LCP)functions as an internal fixator in orthopedic surgery.It is a new screw-plate system developed by combining the traditional plating techniques with the principles of AO internal fixator.Compared with them,LCP omits pre-bending,avoids large-area exposure of fracture site,minimizes the damage to soft tissue,significantly reduces implant failure and decreases the incidence of infection and bone non-union.In addition,LCP can function as internal fixator with multiple anchor points to improve stability.All these properties of LCP accord with BO internal fixation principles and expand the application in the treatment of complex fracture.However,it is still not uncertain about the appropriate application of LCP including plate length,appearance,and type,and principles of screw application such as the number,type,sequence and position of screws.

Chronic wound has very complicated pathogenesis and is difficult to treat;the situation has been improving owing to the progress in wound healing research and the clinical application of new techniques.This article focuses on the pathogenesis of chronic wound and introduces progress in various kinds of treatment,such as skin substitute,growth factors,negative pressure treatment,etc.

Objective To study the CT features of invasive hydatidiform mole and CT value in clinical application. Methods Thirteen cases of invasive hydatidiform mole proved by clinic and pathology were examined with conventional CT and contrast CT, then the CT features were analysed . Results CT findings of invasive hydatidiform mole included : enlargement of uterus, multiple hypodense cysts of different sizes and isodense soft tissue inside uterus, hypodense cysts inside the myometrium thicken irregularly,the cyst wall and isodense soft tissue enhanced markedly and up to 30~50 HU.Conclusion The CT features of invasive hydatidiform mole are specific and CT is of important value in clinical application.

Transpedicular screw and rod internal fixation system is the common implants in spinal surgery. Multi-slice spiral CT and magnetic resonance imaging can generate section image, become routine imaging modality in the assessment of the postoperative spinal patients. Magnetic resonance imaging can evaluate the bone marrow and soft tissue, which is the first choice for examination. However, to the patients with metal implants, the existed metal artifacts can decrease the imaging quality. Therefore, multi-slice spiral CT is an important evaluation method for inserted material, os integumentale and anatomy. This article reviewed the production mechanism of metal-related artifacts, influencing factors and decreasing technique.

Bone Neoplasms ; pathology ; Chondrosarcoma, Mesenchymal ; pathology ; Dura Mater ; pathology ; Humans ; Meninges ; pathology

Objective To investigate the clinical roles of lysine methyltransferase 5A(KMT5A)in human hepatocellular carcinoma(HCC)and its functions in cell migration and invasion. Methods The expression levels of KMT5A of 60 cases were detected by immunohistochemistry(IHC). KMT5A siRNA was used to down-regulate the expression of KMT5A in SMMC-7721 cells. Cell migration and invasion were measured by wound healing assays and transwell assays,respectively. Immunoblotting was used to detect the expression of MMP-2 after siRNA trans-fection. miR-186 mimics were transfected into SMMC-7721 cells and the mRNA levels of KMT5A was detected by qRT-PCR after transfection. Results High expression of KMT5A was associated with large tumor diameter (>5 cm,P=0.047)and advanced TNM stage(Ⅲ+Ⅳ,P=0.035). The expression of KMT5A was knocked down by siRNA in SMMC-7721 cells. Down-regulation of KMT5A suppressed cell migration(P=0.031,P=0.006)and invasion(P=0.010),and impaired MMP-2 expression(P=0.040). Overexpression of miR-186 could significantly inhibit the expression of KMT5A(P = 0.007). Conclusions Over-expression of KMT5A in HCC tissues associ-ates with poor clinical features. KMT5A knockdown inhibits the migration and invasion on HCC cells.

BACKGROUND: A large amount of in vivo and in vitro experiments have confirmed that, basic fibroblast growth factor (bFGF) has been widely utilized in various tissues and cells, it can facilitate the wound healing.OBJECTIVE: To observe the efficacy and feasibility of gene gun-mediate delivery of human bFGF on the healing of deep partial thickness bum wounds.DESIGN, TIME AND SETTING: Randomized design,an observational trial was performed at the Military Central Laboratory of Changhai Hospital in the Second Military Medical University of Chinese PLA between December 2007 and October 2008.MATERIALS: SD rats of clean grade, weighing 200-250 g, irrespective of genders, ware involved in this study.METHODS: Natural human bFGF gene was recombined and optimized, then eukaryotic expression vector pCI-neo-bFGF was constructed taking pCI-neo as a vector, and transfeoted with human embryonic kidney cells 293 T cells. Dot blot and Western blot methods were utilized to determine the bFGF expression. Rat model of deep partial thickness burn wounds was processed into transgene process using gene gun technique, pCI-neo-bFGF-transfected ones served as experiment group while pCI-neo-transfected ones served as controls.MAIN OUTCOME MEASURES:Wound healing time was recorded and the efficacy was evaluated. The contents of hydroxyproline and collaganase Ⅰ in burn wound tissues were determined at 24 hours, 48 hours, 96 hours, 7 days, 10 days and 14 days following transgene process.RESULTS: the recombinant pCI-neo-bFGF was transfected with human embryonic kidney 293T cells. Dot blot and Western blot analysis have showed that, the constructed pCI-neo-bFGF expression vector could express human bFGF, and the expression of synthesized gene was remarkably higher than that of natural gene under fluorescence microscope; gene gun-mediated transgene experiment have showed that, the wound healing time was (13.00+1.31) days in the experiment group and (14.75±1.28) days in the control group, with significant differences (P＜0.05). The contents of hydroxyproline and collagenase Ⅰ reached a peak at 5 days after the injury, that is 48 hours after transfection, and then gradually decreased and maintained at a certain level. The experiment group had higher hydroxyproline levels compared with control group at different time points (P＜0.05, P＜0.01); the collagenase Ⅰ in the experiment group was notably higher than that in the control group at 48 hours and 96 hours after transfection (P＜0.01).CONCLUSION: Gene gun-mediated delivery of human bFGF can short the time of wound healing, increase the contents of hydroxyproline and collagenase Ⅰ during the healing period, accelerate the healing of deep partial thickness burn wounds.

Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cerebral Cortex ; drug effects ; metabolism ; pathology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; Male ; Malondialdehyde ; metabolism ; Nitric Oxide Synthase ; metabolism ; Nitroso Compounds ; therapeutic use ; Rats ; Rats, Wistar

Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.

Objective To explore the characteristics of ventilatory efficiency and exercise capacity during cardiopulmonary exercise testing in patients with idiopathic pulmonary fibrosis (IPF).Methods Pulmonary function test,arterial blood gas analysis and cardiopulmonary exercise testing were performed in 28 IPF patients (IPF group) from April 2012 to April 2013 and 28 healthy volunteers (control group).And the relevant parameters were measured and compared.Results No significant differences existed in age [(57.8 ±9.8) vs.(59.2 ±5.5) years],gender or body mass index (BMI) [(23.8 ±2.7) vs.(25.0 ± 2.8) kg/m2,P ＞ 0.05].The paramneters of pulmonary function test,such as forced vital capacity ％ predicted (74.8 ± 14.6 vs.101.8 ± 10.8),forced expiratory volume in 1 second ％ predicted (73.8 ± 14.6 vs.97.0 ± 10.1),maximum voluntary ventilation ％ predicted (77.5 ± 14.9 vs.95.4 ±24.5),total lung capacity ％ predicted (75.6 ± 12.4 vs.99.8 ± 5.4),residual volume ％ predicted (80.7 ± 15.4 vs.95.8 ± 11.3),diffusing capacity of lung for carbon monoxide ％ predicted (66.2 ± 13.7 vs.103.2 ± 17.3) in the IPF group,were significantly lower than those of the control group (P ＜ 0.01).The parameters of arterial blood gas analysis,such as PaO2 [(72.7 ± 7.3) vs.(92.6 ± 3.8) mmHg] and SaO2 (94.3 ± 2.1 vs.98.3 ± 0.7),were lower than those of the control group (P ＜ 0.01).Thus P(A-a) O2 in the IPF group was higher than that in the control group (33.3 ± 5.7 vs.17.8 ± 1.9,P ＜0.01).These results strongly suggested that IPF group had restrictive ventilatory dysfunction and impaired gas exchange.The IPF patients had higher VE/VCO2-slope (37.4 ± 5.3 vs.25.7 ± 2.5,P ＜ 0.01) and lowest VE/VCO2 (39.2 ±6.7 vs.30.6 ± 2.7,P ＜ 0.01) than the controls; VE/VCO2 and VD/VT during every period were significantly higher in the IPF group than those in the control group (P ＜ 0.01) ; during peak exercise,peakLoad％pred (70.4 ±±29.9 vs.104.8 ±29.7,P ＜0.01) and peakVO2％pred (68.7 ±29.8 vs.98.7 ±36.4,P =0.001) were significantly lower in the IPF group than those in the control group.In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with DLCO％pred (r=-0.589,P ＜0.01; r=-0.481,P＜0.05; r=-0.527,P＜0.05).In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with peakVO2％ pred (r =-0.548,P ＜ 0.05 ; r =-0.539,P ＜ 0.05 ; r =-0.564,P ＜ 0.05).So the exercise tolerance and ventilation efficiency of the IPF group decreased significantly.Conclusion Cardiopulmonary exercise testing reveals that the ventilation efficiency of IPF patients decreases significantly so as to seriously affect their exercise tolerance