Objective:To evaluate the clinical value of posterior articular screwfixation in patients with atlantoaxial instability.Methods:From January 2005 to June 2009,43 patients in our hospital with atlantoaxial instability were treated by posterior screw fixation.The clinical values were accessed by radiographic imaging,JOA and VAS score in 5 years follow-up.Results:No intraoperative complication occurred in 43 patients.Postoperative X-ray film showed anatomical reduction in 39 patients,correction of most of dislocation in 4 patients,all the internal fixation were in good position.Spinal MRI showed spinal cord compression were back to normal.After 2 to 3 months,atlanto-axial were vertebraed.After 6 months,the patient's cervical spine function(t=14.099,P=0.000)and pain conditions(t =19.335,P=0.000)were significantly improved compared with before surgery,the average improvement rate was 86.1%?5.2%.Conclusion:The posterior screw fixation in the treatment of atlantoaxial instability is effective and reliable,have less complications and can be used as an effective surgical procedure.

Objective:To detect the expression of TGF-?1 in tibia and fibula fracture with two methods of compression plate fixation and intramedullary nail fixation,and to evaluate their therapeutic effects.Methods:117 patients with non severe tibia and fibula fractures were separated into two groups.One group received pressurized plates fixation for treatment,the other received intramedullary nail fixation.On 1,7,30 and 90 days after surgery,TGF-?1 was detected by ELISA,and on 30 days after surgery the clinical efficacy were also assessed. Results:The TGF-?1 content increased on 7 days as compared with that on 1 days after surgery,and the TGF-?1 content gradually decreased at on 30 to 90 days after surgery.The TGF-?1 content in compression plate fixation group were lower than that in intramedullary nailing group every points of four days(P

China ; Humans ; Organ Transplantation ; legislation & jurisprudence ; Tissue and Organ Procurement ; legislation & jurisprudence

Cerebral small vessel diseases refer to small intracranial vascular lesions caused ischemic or hemorrhagic disease.Although researches have performed a large number of studies for its pathogenesis,it remains unclear now.This article reviews the pathogenesis of cerebral small vessel diseases from endothelial dysfunction,blood-brain barrier damage,ischemic and hypoperfusion,amyloid deposition,and genetic factor.

Background and purpose:Concurrent chemoradiotherapy followed by adjuvant chemotherapy have been administrated to locally advance nasopharyngeal carcinoma according to the NCCN guidelines.This study s pecifically evaluated the efficacy,toxicity and compliance of modified concurrent chemoradiotherapy followed by adjuvant chemotherapy in locally advanced nasopharyngeal carcinoma(NPC).Methods:From Nov.2003 to Apr. 2005,67 patients with stageⅢandⅣlocally advanced nasopharyngeal carcinoma(NPC)were enrolled in this study.A total dosage of radiation,70-74 Gy,was given in 35-37 fractions in 5 fractions per week.Two cycles of chemotherapy, consisting of cisplatin 25 mg/m2?d-1 and 5-fluorouracil 300 mg/m2?d-1 were delivered simultaneously with radiotherapy on the day 1-3 during week 1 and 5.Three cycles of adjuvant chemotherapy,consisting of cisplatin 25 mg/m2?d-1 and fluorouracil 450 mg/m2?d-1,were also given,starting on day 1-3 during week 10,13 and 16.Results:The median follow-up was 20 months(ranged from 11 to 27 months).The 2-year overall survival rate and the 2-year diseasefree survival rate were 91.75%and 81.56%respectively.The 2-year overall survival rate was 96%for stageⅢand 87.65%for stageⅣ(P=0.334).The 2-year disease-free survival rate was 92.16%for stageⅢand 69.35%for stageⅣ respectively(P=0.2358).The compliance rates were 100%for radiotherapy,47 cases(70.1%)for all chemotherapy, 56 cases(83.6%)for concurrent chemotherapy and 48 cases(71.6%)for adjuvant chemotherapy.The main grade Ⅲ/Ⅳacute toxicity events during concurrent chemoradiotherapy were neutropenia in 15 patients(21.4%),vomitting and nausea in 2 patients(3%),mucositis in 56 patients(83.6%),and gradeⅢskin reaction in 10(15%),respectively. The main gradeⅢ/Ⅳacute toxicity events during adjuvant chemotherapy were neutropenia in 13 patients(19.4%), grade 3 anemia in 2 patients(1.5%)respectively.Conclusion:The primary result showed a good compliance,lower incidences of toxicity and improved early outcome of treatments for the patients with stageⅢand stageⅣ(M0)NPC. The ultimate therapeutic ratio will be updated according to longer follow-ups.

Aged ; Aged, 80 and over ; Contraindications ; Humans ; Pacemaker, Artificial

China ; Humans ; Liver Transplantation ; methods ; mortality ; trends ; Survival Rate ; trends

China ; Humans ; Liver Transplantation ; ethics ; legislation & jurisprudence ; Tissue Donors ; Tissue and Organ Procurement ; ethics ; legislation & jurisprudence

AIM: To explore the expression of Dickkopf-1 (DKK1) in human gastric carcinoma cells, and the influences of DKK1 gene silencing on cell invasion.METHODS: The levels of DKK1 in the human gastric mucosa cell line GES-1 and gastric carcinoma cell lines MKN-45 and SGC-7901 were detected by real-time PCR and Western blot.DKK1 gene was silenced by RNA interference, which was verified by real-time PCR, Western blot and ELISA.The cell invasion ability was determined by Transwell assay, and the cell proliferation was inhibited by mitomycin C.The levels of E-cadherin, N-cadherin, vimentin and β-catenin were determined by real-time PCR and Western blot.RESULTS: The expression of DKK1 was significantly higher in MKN-45 cells and SGC-7901 cells than that in GES-1 cells, indicating that DKK1 expression was obviously increased in gastric carcinoma cells.After successful silencing of DKK1 gene in the MKN-45 cells and SGC-7901 cells, the cell invasion ability was markedly decreased in a time-dependent pattern with increased expression of E-cadherin and decreased expression of N-cadherin and vimentin, indicating that DKK1 silencing dramatically inhibited gastric carcinoma cell invasion and epithelial-mesenchymal transition (EMT).The introduction of exogenous recombinant DKK1 (rDKK1) demonstrated the promoting effect of DKK1 on gastric carcinoma cell invasion and EMT.In addition, the inhibitory effects of DKK1 silencing on gastric carcinoma cell invasion and EMT were fulfilled by down-regulating β-catenin.CONCLUSION: The expression of DKK1 is significantly increased in human gastric carcinoma cells.Silencing of DKK1 markedly inhibits gastric carcinoma cell invasion and EMT by down-regulating β-catenin.