Objective To provide a new method for sacral fracture fixation by means of 3D recon-struction and reverse engineering technique. Methods Pelvis images of 3D CT scan were obtained from patients with sacral fracture. The digital data were transferred into a computer workstation. 3D models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. The 3D fracture models were imported into Imageware 10.0 software. Different situations of reduction (total reduction, half reduction and no-reduction) were simulated using Imageware 10.0 software. The extract locations and the best directions of inserting iliosacral lag screws were defined using Reverse Engineering according to the 3 situations to before navigation templates were designed according to the posterior anatomic features of the ilium and the insertion channels. Exact navi-gational templates were manufactured by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist surgical navigation and placement of iliosacral lag screws. Results Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation templates were found to be helpful and highly accurate. Conclusion The navigation template may be a useful method for mini-invasive fixation of sacroiliac joint fracture.

Adult ; Coloring Agents ; adverse effects ; Diagnosis, Differential ; Humans ; Lymphadenitis ; chemically induced ; Male ; Melanoma ; secondary ; Tattooing ; adverse effects

Objective To investigate the safety and effectiveness of ultrasound-guided paravertebral anaes-thesia combined with propofol in the thoracoscopic sympathectomy. Methods Total 63 male and 59 female patients with hyperhidrosis were recruited. The patients were equally divided into two groups:group A and C. Patients in group A received ultrasound-guided paravertebral anaesthesia combined with propofol. Patients in group C received general intravenous anesthesia with endotracheal intubation. The heart rate (HR),mean arterial pres-sure(MAP)and the oxygen saturation(SpO2)at the time of entering the operating room(T0),completing anesthe-sia(T1),incising the skin(T2),cutting the T4 sympathetic trunk(T3),completing the operation were record-ed. The awake time after operation ,VAS score after operation and postoperative throat discomfort were also record-ed. Results The two groups successfully completed the surgery. There were no significant differences of the HR , MAP and SpO2 at T0-T4 between the two groups. There were significant differences of the awake time after opera-tion,postoperative feeding time and hospitalization expenses. The VAS score after operation of group A were better than group C(P<0.05)at T2 h,T4 h,T8 h,and T12 h. There was no significant difference of VAS score at T24 h between the two groups. Conclusion Ultrasound-guided paravertebral anaesthesia combined with propofol can pro-vide a safe and effective approach for patients receiving the thoracoscopic sympathectomy.

Objective To investigate the relationship between alteration of gene in cyclic adenosine monophosphate(cAMP) signal transduction system in rats after myocardial damage and changes of cardiac function and ventricular remodeling. Methods Twenty eight male Wistar rats weighing 220 g to 250 g were randomly divided into three groups: acute myocardial damage group(AMD, n = 10), chronic myocardial damage group (CMD,n = 9 ) and sham-operation group (control, n = 9). Animal model of acute myocardial damage was established by ligation of rats left coronary artery in the AMD and the CMD groups. Rats in control group were treated similarly, except that the coronary suture was not tied. Hemodynamics and echocardiography were measured before rats were sacrificed 24 hours after operation in control and AMD groups but those in CMD groups were sacrificed 8 weeks later. Cadiocyte apoptosis were estimated by TUNEL method, cAMP levels in heart were tested by radioimmunity and the mRNA expressions for inducible cAMP early repressor (ICER), cAMP response element binding protein (CREB), phosphodiesterase 3A (PDE3A) and bcl-2 were assayed by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results The difference of left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic pressure(LVEDP), maximal rising and falling rate of ventricular pressure,left ventricular systolic pressure (LVSP), eject fraction (EF) and fraction shortening (FS) were statistically significant among the three groups(F = 285.9, 196.8, 83.2, 80.4, 54.9, 196.6, 95.2, all P ＜ 0.01). LVEDD[(7.03 ±0.28), (8.20 ± 0.27)mm] and LVEDP[(11.19 ± 2.89), (19.76 ± 3.34)mmHg] in AMD and CMD groups were significantly increased, compared with those in control group[ (5.05 ± 0.30)mm, (- 5.62 ± 3.01 )mmHg, all P ＜0.01 ]. While maximal rising rate[ (2964 ± 449), (2214 ± 434)mmHg/s] and falling rate[(- 2617 ± 441),(- 1891± 424)mmHg/s] of left ventricular pressure, LVSP[ (94.19 ± 4.03), (85.85 ± 6.39)mmHg], EF[ (41.6 ±5.9)%, (35.9 ± 4.1 )%] and FS[ (36.9 ± 4.6)%, (23.1 ± 4.9)%] of left ventricular in the two groups were lower than those in control[(4759 ± 406)mmHg/s, (- 4327 ± 388)mmHg/s, (116.29 ± 8.25)mmHg, (80.9 ± 5.6)%,(53.1 ± 4.3)%, all P ＜ 0.01 ]. These changes in CMD group were more significant than those in AMD groups(P ＜0.05 or P ＜ 0.01 ). The difference of apoptotic index, cAMP and expression of ICER, CREB, PDE3A mRNA and bcl-2 mRNA were statistically significant among the three groups(F= 172.5, 141.0, 540.8, 246.8, 165.1, 563.9,all P＜ 0.01 ). Apoptotic index[ (32.8 ± 4.2)‰, (18.4 ± 3.9)‰] and cAMP in heart[ (9.95 ± 0.30), (5.60 ± 0.25)nmol/kg] in AMD and CMD groups were increased compared to control group[ (3.9 ± 1.7)‰, (2.48 ± 0.29)nmol/kg,all P ＜ 0.01 ], and those in CMD group were lower than in AMD group(all P ＜ 0.01 ). Expression of ICER mRNA (1.434 ± 0.093, 0.942 ± 0.076) and CREB mRNA(5.70 ± 0.50, 2.64 ± 0.51) in AMD and CMD groups were higher, and expression of PDE3A mRNA(48.98 ± 8.14, 16.68 ± 8.46) were lower than those in control group (0.154 ± 0.063, 1.08 ± 0.35, 105.94 ± 12.61, all P ＜ 0.01 ). The three genes in CMD group were fewer than those in AMD group(all P ＜ 0.01 ). bcl-2 mRNA was up regulated in AMD group(4.55 ± 0.27) and was down regulated in CMD group(0.35 ± 0.15) compared to control(2.18 ± 0.30, all P＜ 0.01). Conclusions There is PDE3A-ICER positive-feedback loop leading to myocyte apoptosis and heart failure after myocardial damage. The downregulation of PDE3A mRNA observed in chronic myocardial damage may play a causative role in the progression of ventricular remodeling and heart failure, in part, by inducing ICER mRNA and promoting cardiac myocyte dysfunction.

OBJECTIVETo discuss the diagnosis and treatment interstitial cystitis (IC).

METHODSThe clinical date of 10 cases of IC (all women) were analyzed. Their age ranged from 31 to 63 years, with a mean of 41 years. Their courses ranged from 1.5 to 7 years, with a mean of 3.4 years. The symptom criteria of the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) was met for IC and no patients had Hunner's ulcer. Potassium sensitivity tests (PST) were performed in all cases. Eight were positive. The O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) was used as treatment outcome measures. ICSI score was from 9 to 20 (mean, 14 +/- 4) at baseline. All the patients were treated with hydrodistention initially. Efficacy was evaluated at 1 month after hydrodistention. The patients who failed to respond to the treatment and recurrence after the treatment were treated by oral or intravesical therapy.

RESULTSThe 10 cases were followed up for 3 to 26 months (mean, 7.8 months) after hydrodistention. Five patients obtained symptom relief. Among them, symptom significantly relieved or disappeared in 2, with the score decreased > 7; symptom partially relieved in 3, with the score decreased > 3. Five cases failed to respond to the treatment. Two cases had recurrence 3 and 6 months after the treatment. The effective rate was 50%. The ICSI score was decreased to 11 +/- 6 at 1 month (t = 4.394, P < 0.05) after the treatment. Those who failed to respond or recurrence after hydrodistention were treated by other methods. Two case were treated with oral Pentosan Polysulfate, effective. Three cases were treated with amitriptylin, 2 effective. Three cases were treated with intravesical Dimethyl sulfoxide plus heparin plus dexamethasone, all effective.

CONCLUSIONSThe diagnosis of IC should meet the symptom criteria of the NIDDK. PST has significant high positive rate in IC patient, which can be used not only for diagnosis but also for instruction. There are a lot of strategies in the management of patients with IC. Hydrodistention is the first choice.

Adult ; Combined Modality Therapy ; Cystitis, Interstitial ; diagnosis ; therapy ; Dilatation ; methods ; Drug Therapy, Combination ; Female ; Humans ; Middle Aged ; Retrospective Studies

OBJECTIVETo optimize the formula of Glycyrrhiza flavonoid and ferulic acid cream and set up its quality control parameters.

METHODReflect-line orthogonal simplex method was used to optimize the main factors such as amount of Myrj52-glyceryl monostearate and dimethicone, based on the appearance, spreadability and stability of the cream.

RESULT9.0% Myrj52-glyceryl monostearate (3:2) and 2.5% dimethicone were chosen in prescription. The prepared cream presented a good stability after being placed 24 h at 5 degrees C, 25 degrees C and 37 degrees C respectively,and its spreadability suited with the property of semi-fluid cream.

CONCLUSION[corrected] The formula of Glycyrrhiza flavonoid and ferulic acid cream is suitable, and its quality is stable. The reflect-line orthogonal simplex method is suitable for the formula optimization of cream.

Coumaric Acids ; chemistry ; Dosage Forms ; Drug Compounding ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; chemistry ; Glycyrrhiza ; chemistry

OBJECTIVETo investigate the effects of tacrolimus (FK506) on behavioral function and heat-shock proteins (HSP70) expression in nervous tissues of acrylamide (ACR)-induced rats.

METHODSTotally 40 health Wistar rats were randomly divided into control group, model group, low and high doses of FK506 groups. All four groups were treated five times per week for four weeks. Gait score was measured every week. And rats were sacrificed on day 28, the cerebrum, spinal cord and sciatic nerve were dissected, and homogenized in ice bath, then the levels of HSP70 and Bcl-2, Bax were analyzed by western bloting.

RESULTSCompared with the ACR model group, the gait score in low and high doses of FK506 groups decreased by 30.1% and 47.7% respectively in the 4th week. In the cerebrum and sciatic nerve pellet, the level of HSP70 in the FK506 groups increased by 11.6%, 33.3% and 56.3%, 58.5% (P < 0.01), but no significant changes existed in spinal cord. The level of Bcl-2 in the sciatic nerve pellet increased by 39.1% (P < 0.01) but no significant changes existed in the cerebrum and spinal cord from low dose of FK506 group. And the level of Bax in the spinal cord pellet markedly increased by 46.8% but not in cerebrum and sciatic nerve pellet; Whereas in the tissues mentioned above, the levels of Bcl-2 were enhanced remarkably by 16.3%, 14.8% and 56.0% (P < 0.01) in the high dose of FK506 group. And the level of Bax in the cerebrum and spinal cord pellet markedly increased by 16.4% and 40.2% but not in sciatic nerve. The values of Bcl-2/Bax in low and high doses of FK506 groups clearly increased by 15.9%, 33.3%, 36.9% and 30.1%, 49.1%, 60.1% (P < 0.01).

CONCLUSIONThe administration of FK506 has dramatically neuroprotective effects against the development of ACR neuropathy, which may be related to up-regulating the expression of HSP70 and Bcl-2 with down-regulating the expression of Bax.

Acrylamide ; poisoning ; Animals ; HSP70 Heat-Shock Proteins ; metabolism ; Male ; Nerve Tissue ; drug effects ; metabolism ; Neuroprotective Agents ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Wistar ; Tacrolimus ; therapeutic use ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo investigate the dynamic changes of neurofilaments (NFs) proteins in spinal cords of hens with phenylmethylsulfonyl fluoride (PMSF) pretreatment for exploring the mechanism of tri-o-cresyl phosphate (TOCP)-induced delayed neuropathy (OPIDN).

METHODAdult Roman hens were randomly divided into three groups, control, TOCP and PMSF + TOCP. Birds in PMSF + TOCP set were pretreated with PMSF, 24 hours later, hens in both TOCP group and PMSF + TOCP group were administrated with TOCP at a single dosage of 750 mg/kg. Then all animals were sacrificed on the corresponding time-points of 1, 5, 10, and 21 days respectively after dosing of 750 mg/kg TOCP. The spinal cords were dissected, homogenized, and centrifuged at 100,000 x g. The levels of high molecular neurofilament (NF-H), medium molecular neurofilament (NF-M) and low molecular neurofilament (NF-L) in both pellet and supernatant fractions of spinal cords were determined by SDS-PAGE and Western-blotting.

RESULTSThe hens in TOCP group showed paralysis gait at the end of 21-day experimental period. The levels of NFs proteins in spinal cords changed obviously. Compared with control, the NFs in pellet showed a dramatic decrease on day 10 and then followed by a recovery. In the supernatant, the NFs proteins showed similar changes, which decreased significantly on day 10 and almost recovered control on day 21. Such as, NF-L, NF-M and NF-H decreased by 51%, 86% and 38% on day 10. The OPIDN signs were not observed in PMSF + TOCP group, and imbalances of NFs were obviously alleviated. Compared with control, only NF-M in pellet increased by 21% (P < 0.05) on day 21, others remained no changes; The levels of NF-H and NF-M in supernatant respectively increased by 19% and 35% on day 21, others were no significant statistical differences.

CONCLUSIONTOCP may induce imbalance of NFs levels in progress of OPIDN, and PMSF pretreatment may protect animals from OPIDN by reducing above changes, which may explain that TOCP-induced imbalance of NFs may be connected with the occurrence and development of OPIDN.

Animals ; Chickens ; Female ; Neurofilament Proteins ; drug effects ; Phenylmethylsulfonyl Fluoride ; pharmacology ; Protein Subunits ; drug effects ; Spinal Cord ; drug effects ; metabolism ; pathology ; Tritolyl Phosphates ; toxicity

OBJECTIVETo study the selective effect to tumor cells mediated by a recombinant adenoviral vector carrying E2F-1 promoter.

METHODSThe AdEasy-1 adenoviral vector system was used in this experiment. Several recombinant adenovirus with tumor-targeting E2F-1 promoter were constructed and then the E2F-1 promoter gene was checked by PCR and sequencing. The two adenovirus expressing GFP gene which is regulated by E2F-1 promoter or CMV promoter were used to respectively transfect tumor cells and non-proliferating normal cells, then observed and analyzed the different results caused by different promoters. Vpr gene was cloned into the targeting recombinant adenovirus. The new adenovirus named rvAdE2F-1/vpr was used to transfect tumor cells SMMC-7721, LS174T and non-proliferating normal cells H292, L-02. The surviving rate of each group was registered; the level of E2F-1 protein expressed in normal and tumor cell lines were checked by Western Blot.

RESULTE2F-1 promoter can regulate the downstream gene GFP selectively expressed in LS174T and its activity in LS174T was similar with CMV promoter's; Vpr gene regulated by E2F-1 promoter can suppress the proliferation of tumor cells and no toxicity to normal cells; In all of the tumor cells, a much higher level of E2F-1 was expressed compared with normal cell lines. E2F-1 promoter's activity correlated well with E2F-1 protein levels.

CONCLUSIONSE2F-1 promoter can control a selective cell killing to cancer cells, with no effect to normal cells. The system of E2F-1 promoter is a useful method for tumor-targeting gene therapy.

Adenoviridae ; genetics ; Blotting, Western ; Cell Line ; Cell Line, Tumor ; Cell Proliferation ; E2F1 Transcription Factor ; genetics ; metabolism ; Gene Products, vpr ; genetics ; physiology ; Genetic Therapy ; methods ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Neoplasms ; genetics ; pathology ; therapy ; Promoter Regions, Genetic ; genetics ; Recombinant Fusion Proteins ; genetics ; metabolism ; Transfection

OBJECTIVETo study the clinical application value of middle segment pancreatectomy in the treatment of benign tumors of the amphi-neck of the pancreas.

METHODSFifteen cases were retrospectively analyzed treated from November 2005 to June 2009. There were 3 male and 12 female aging from 30 to 50 years. They all received middle segment pancreatectomy for benign tumors of the amphi-neck of the pancreas.

RESULTSThere was no death during perioperative period. All the 15 patients received middle segment pancreatectomy. Fourteen of them received the closure of broken ends of pancreatic head, pancreaticojejunostomy (mono-anastomosis) and the rest one received dipl-anastomosis. Postoperative pathology showed that in the 15 patients, 1 got solid-pseudopapillary tumor of the pancreas, 3 got non-functional islet cell tumor, 11 got cystadenoma of pancreas. Three of them got pancreatic fistula and were self cured in 3 months. Follow-up visits to all the patients kept in the following 2 to 45 months. There was no death. No patients got new-onset diabetes and pancreatic pseudocyst. And their tumors were not relapsed.

CONCLUSIONSThere is an exact therapeutic effect of middle segment pancreatectomy for benign tumors of the amphi-neck of the pancreas. The treatment has little function damage to patients' endocrine and external secretion. The incidence rate of pancreatic fistula in middle segment pancreatectomy is higher than that in pancreaticoduodenectomy. As long as the drainage is kept unobstructed, most of the pancreatic fistula can be self cured.

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; surgery ; Retrospective Studies