0.05).Conclusion Vitrectomy significantly alters the stability of tear film.The tear film function returned to preoperative conditions in 3 months after operation.

Objective To observe the therapeutic effect of pericarpium zanthoxylum oil on experimental hyperlipemia in mice. Methods Hyperlipemia model was reproduced in mice, and then pericarpium zanthoxylum oil was garaged for 4 weeks. Blood samples were obtained from retro-ocular vessel. The levels of blood lipids were determined, the hemorrheology parameters were determined by hemorrheometer, and the pathological changes in the liver of mice were observed microscopically. Results Zanthoxylum oil could obviously reduce contents of TC, TG, LDL-C (P

Objective To construct an RNA interference vector to down-regulate X-linked inhibitor of apoptosis(XIAP)gene and study the RNA interference effect on the cell cycle and growth of ovarian cancer.Methods Oligonucleotides of 64 base pairs for hairpin RNA targeting XIAP were designed, chemically synthesized,annealed,and cloned into the pSUPER vector.After identification by restriction digestion,the correct vectors were transiently transfected into SKOV3 cells,a human ovarian cancer cell line.The XIAP mRNA was detected by RT-PCR.The proteins were detected by western blot and indirect immunofluorescence staining.Flow cytometry(FCM)analysis and methyl thiazolyl tetrazolium(MTT)assay method were applied to measure cell cycle,cell growth and sensitiveness to cisplatin.Results SKOV3 cells had a high level expression of XIAP.The vector of RNA interference,which can interfere with XIAP gene was successfully constructed.After transient transfection,the expression of XIAP protein was significantly decreased in SKOV3 cells and the value of relative density was 3584?124,2138?65,1973?80 and 110 ?12,respectively(P=0.0334).At the same time,the expression of XIAP mRNA was decreased accordingly and the value of relative density was 6674?274,4532?107,2322?57 and 1864?78, respectively(P=0.0127).The FCM results showed that,the vector could increase the number of cells in G_1 phase compared with parent cells and compared with the cells transfected with pSUPER(P

Objective To explore the effect and mechanism of local administration of thymosin β4 (Tβ4) on bone regeneration in a distraction osteogenesis model of rat fenur.Methods Sixty Sprague-Dawley rats were randomly divided into groups A,B and C in this study.A distraction osteogenesis model was established in the left femur after osteotomy.At the end of distraction period,the bone regeneration area in group A was subjected to no treatment,that in group B to injection of phosphate buffer saline (PBS),and that in group C to injection of Tβ4.On days 22,29 and 43 postoperatively,the rats from each group were randomly sacrificed and processed for observation of bone regeneration in the distraction osteogenesis area using radiography,Micro-CT,histology and immunohistochemical staining.RT-PCR was used to detect the expression of related genes as well.Results Radiography revealed that the bone regeneration in group C was superior to that in groups A and B on days 22,29 and 43 postoperatively.Micro-CT examination showed significantly increased bone volume (BV),bone mineral density (BMD) and ratio of bone volume to tissue volume (BV/TV) in group C on days 22,29 and 43 postoperatively,and significantly decreased ratio of bone surface area to bone volume on postoperative day 43 in comparison with groups A and B(P ＜ 0.05).HE staining indicated that local capillary density was significantly higher in group C than in groups A and B after local administration of Tβ4 in the distraction osteogenesis.Immunohistochemical staining showed that the capillary density and osteoblasts in group C were higher than in groups A and B.RT-PCR results revealed significantly higher expression of eNOS and Osterix mRNA in the local callus in group C on postoperative day 22 than in groups A and group B (P ＜ 0.05).Conclusion Local administration of thymosin β4 may promote bone formation,which is probably related to the increased expression of eNOS and Osterix.

The incidence of venous thromboembolism after spinal cord injury is high, and its diagnosis and prevention received much attention in clinical research in recent years. Because of the special characteristics, the prevention of venous thrombosis should be combined with basic prevention, physical prevention and drug prevention. According to the different situations of venous thromboembolism in patients with spinal cord injury, the prevention methods need to adjust to carry out multidisciplinary comprehensive treatment.

Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.

Objective To evaluate the clinical value of real-time 3 dimensional echocardiography (RT-3DE) for measurement of right ventricular function in the repaired tetralogy of Fallot (TOF) compared to cine magnetic resonance imaging (c-MRI).Methods Thirty-seven randomly selected patients with repaired TOF from Jan.2000 to Jun.2007 in Children's Hospital,Fudan University underwent both RT-3DE and c-MRI for the data of right ventricular enddiastolic volume (RVEDV),right ventricular end-systolic volume (RVESV),right ventricular ejection fraction (RVEF),which were compared to evaluate the reproducibility and correlation of two ways on right ventricular function.Results All the patients completed both RT-3DE and c-MRI on the same day.The correlation for RVEDV,RVESV,RVEF measured by 2 methods was high (r =0.933,0.943,0.911,P =0.000,0.000,0.105),and it showed that consistency existed in RVEF,as difference was only (1.2 ± 4.5) ％.Comparison with c-MRI,RVEDV and RVESV measured by RT-3DE was underestimated,in which difference was (-17.4 ± 16.9) mL,(-9.3 ± 10.5) mL.Conclusions RVEF with RT-3DE can be assessed with acceptable accuracy,but it is not so good for RVEDV and RVESV.Further study needs to be performed to make sure the value of RT-3DE on the assessment of right ventricular function in repaired TOF.

Axillary reverse mapping (ARM) is a technique used to map and preserve arm lymphatic drainage during axillary lymph node dissection (ALND) and/or sentinel lymph node dissection (SLND). As a result, the risk of arm lymphedema is reduced. ARM is an emerging technology for breast cancer surgery and currently in the clinical trial phase. In this article, related clinical trials conducted in recent years were reviewed and the displaying methods of ARM lymph nodes and lymphatic vessels were analyzed. The feasibility of retained ARM lymph nodes and lymphatic vessels was also evaluated. Furthermore, the clinical significance of ARM was evaluated in terms of the reduction of the incidence of upper extremity lymphedema after breast cancer surgery.

BACKGROUND: Interlocking nail implantation exhibits great stability and preventory effect on fracture shortening or rotation.OBJECTIVE: To evaluate the reasons and countermeasures for the complication after interlocking nail implantation in treating femoral fracture.DESIGN, TIME AND SETTING: The case analysis was performed at Department of Orthopedics, Changhai Hospital of Second Military Medical University of Chinese PLA from April 1987 to April 2008.PARTICIPANTS: 352 patients underwent femoral interlocking nail implantation, including 289 male and 63 female with an average age of 35.9 years (range 18-84 years).METHODS: 127 patients were treated with close interlocking nail implantation, of which 30 cases were subjected to minimal incision to assist nail insertion; 24 were treated with dynamic interlocking nail implantation; 321 with static interlocking nail implantation, and 38 with interlocking nail implantation for femoral reconstruction.MIAN OUTCOME MEASURES: Complications post-implantation; limb joint function recovery during long-term follow-up.RESULTS: 331 cases were followed-up for over 60 months, and the longest follow-up lasted for 252 months. Complications were found in 16 cases, including deformity union in 2, femoral neck fracture in 1, exit of the nail in 2, infection in 2, breakage in 8 (nonunion in 3), and perineal nerve injury in 1. Except 2 with deformity union and recovered by secondary surgery, all patients developed bone union. During the followed-up, no pain or knocked pain was found with normal pseudoarthrosis activities and functional activities. The excellent function recovery in joints and limbs was 91.2%.CONCLUSION: Nail breakage is the main complication after interlocking nail implantation. Therefore, we should select longer and thicker interlocking nail as the first choice. In addition, the interlocked screws should be distal to fracture site. For the patients with severe trauma, the interlocking nail implantation in early stage of fracture would not increase complications.

BACKGROUND: With the advanced progress of prostheses manufacture and surgical technique, early loosening of hip articulation prostheses and femoral neck fracture tend to reduce after hip surface arthroplasty. Meanwhile hip articulation activity has been improved.OBJECTIVE: To discuss the biocompatibility between the implants and the hosts in patients underwent hip surface arthroplasty and observe the functional recovery of hip articulations.DESIGN, TIME AND SETTING: Retrospective case analysis was carded out in the Department of Orthopaedics, Changhai Hospital Affiliated to the Second Military Medical University of Chinese PLA (Shanghai, China) from January 2006 to August 2007.PARTICIPANTS: Fifty-two patients with hip articulation diseases, including 25 females and 27 males, underwent sixty-three hip surface arthroplasties, and eleven cases of them were subjected to bilateral arthroplasty. Their average age was 47.6 years.METHODS: Hip resurfacing prostheses were offered by Zimmerm Company (Huntington, Indiana, USA). Hip resurfacing was performed using 4-mm-thick cement-less acetabular bone (metal acetabular cup of 3.7-ram thickness was coated with 0.3-mm plasma titanium). Acetabular cup exhibits large diameter and arch shape (165°), is coated with 0.3-ram plasma titanium and fixed with cement less. By means of posterolateral approach, acetabular prostheses were implanted to the central position of hip articulation with regards to anatomy. Acetabular prostheses were covered more than 90% area.MAIN OUTCOME MEASURES: Subsequent to the arthroplasty, biocompatibility between the implant materials and the hosts was recorded, such as dislocation and infection. Functional recovery of the patients was assessed with Harris hip score at 1, 3, 6 and 12 months after operation and annually thereafter. Radiological evaluation was conducted to record radioactive permeability in the areas of 1 ram around acetabular cup in the DeLee and Charnley zone.RESULTS: All patients were involved in the follow-up. There were no cases of dislocation, deep venous embolism, deep infection or neurovascular complications that required further treatment. The mean Harris score was 38 points before operation and significantly increased to 90 points after operation. Two patients appeared a 2-mm crevice below acetabular prostheses, which disappeared 6 months after arthroplasty. Acetabular or femoral prostheses removal, or local osteolysis was detectable.CONCLUSION: Metal-on-metal hip surface arthroplasty has excellent early effects on young and active patients. The arthroplasty potentially offers the ultimate bone preservation and better restoration of hip articulation function in patients, without specific biocompatibility.