Objective To investigate outcomes of different surgical approaches for treating cases of fracture and dislocation of the lower cervical spine.Methods The study involved 26 cases of fracture and dislocation of the lower cervical spine treated surgically from December 2002 to January 2012,including 19 males and 7 females with age ranging from 27 to 62 years (average 39 years).According to the AO classification,there were 12 cases of type B3.1,three of type B3.2,two of type C2.1,three of type C3.1,and six of type C3.2.Preoperative spinal cord function graded by Frankel criteria was six cases of grade A,five of grade B,seven of grade C,six of grade D,and two of grade E.Conventional skull traction was done for all patients before operation.Vertebral cannal decompression and interbody fusion through anterior,posterior or anterior-posterior approaches were determined according to type of fracture dislocation and severity of spinal cord injury.Radiography was performed regularly after operation to review the correction of dislocation,restoration of vertebral height,and interbody fusion.Spinal cord function was also evaluated postoperatively.Results No large blood vessel injury or aggravation of spinal cord injury occurred intraoperatively.There were no complications of incision infection,leakage of cerebrospinal fluid,herniation of bone graft or implant breakage postoperatively.All cases obtained successful correction of fracture and dislocation of the lower cervical spine as well as the recovery of cervical sequence,physiological curvature,and vertebral height in the 12 to 24 months of follow-up (average 16 months).Bony fusion was obtained for all cases at postoperative 3-6 months (average 3.5 months).Spinal function evaluated by Frankel criteria at the latest follow-up showed was grade A in six cases,grade B in three,grade C in five,grade D in five and grade E in seven,with different degree of improvement for all cases.Conclusions Operative approaches should be selected according to the specific status of fracture and dislocation of the lower cervical spine.Anterior approach can be performed for vertebral or intervertebral disc injury straightly and the procedure handles cervical instability immediately.Posterior surgical approach can be used to settle dislocation and interlocking of the articular process directly,but the intervertebral disc injury should be ruled out simultaneously in order to avoid further injury of spinal cord during the reduction process.Combined anterior and posterior surgical approach can be applied to treat fracture and dislocation of lower cervical spine and intervertebral disc injury concurrently but has high risk and large operation wound.

OBJECTIVE To study multiple factors on bone graft healing of mandibular reconstruction. METHODS Patients were divided into two groups: healing group(31 cases) and healing delayed group(10 cases).By comparison between two groups,the factors on wound healing after bone grafting were studied. RESULTS In patient′s age and sex,bone graft type and size,and history of operation on bone graft done,there were no differences between two groups.Extraoral and intraoral passage was the important factor to two groups,P=0.000. CONCLUSIONS It is important for us to treat wound carefully while bone graft is carried with extraoral and intraoral passage.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) are easily isolated and amplified, and facilitate the exogenous gene transfer and expression. In the human medicine, it is believed that BMSCs are ideal therapeutic cells and target cells in the gene therapy.OBJECTIVE: To investigate liposome-mediated cytosine deaminase (CD) gene transfecting rabbit BMSCs and its gene expression. DESIGN: A single sample observation. SETTING: Dalian Research and Development Center for Stem Cell and Tissue Engineering; Department of Biochemistry, College of Basic Medical Science, Dalian Medical University.MATERIALS: This study was performed at in the Dalian Research and Development Center for Stem Cell and Tissue Engineering; Department of Biochemistry, College of Basic Medical Science, Dalian Medical University from March 2006 to June 2007. New Zealand big-ear white rabbits of either gender, weighing 2.0-2.5 kg, with the age of 5 months old, were included in this study. METHODS: The CD gene was obtained from E.coli JM109 DNA by polymerase chain reaction (PCR). The fragment was cloned into pMD19-T vector. After restriction enzyme BamHI/XhoI digestion analysis and DNA sequence analysis, pIRES2-AcGFP1-CD eukaryotic expression plasmid was constructed. Meanwhile, BMSCs were harvested, cultured and identified. After enzyme digestion of eukaryotic expression plasmid, the rabbit BMSCs were transfected by Lipofectamine 2000-mediated method. Twenty-four hours after transfection, expression of green fluorescent protein was observed under an inverted fluorescent microscope. MAIN OUTCOME MEASURES: Construction of eukaryotic expression plasmid and identification of CD gene-transferred BMSCs. RESULTS: CD gene was cloned and connected to eukaryotic expression plasmid with green fluorescence. Twenty-four hours after transfecting rabbit BMSCs, it was found under an inverted microscope that under the excitation of 488 nm blue light, green fluorescence appeared in the pIRES2-AcGFP1-CD and pIRES2-AcGFP1 empty-plasmid transfected BMSCs, but not in the non-transfected ones. It indicates that CD gene successfully transferred BMSCs. CONCLUSION: BMSCs are ideal vectors in the CD gene therapy.

Objective To evaluate the efficacy and safety of levetiracetam (LEV) monotherapy on children with epilepsy.Methods Forty-one children (26 cases were male,15 cases were female) with epilepsy aged 7 months to 13 years were treated with LEV as monotherapy.These patients were selected from Department of Neurology ,Wuhan Children′s Hospital, from Aug.2007 to Aug.2009.The starting do-sage of LEV was (13.6?4.7) mg?kg-1?d-1,twice daily,and its objective dosage was (25.7?7.5) mg?kg-1?d-1,twice daily.LEV monotherapy was investigated by a self-controlled and open-label research,and the follow-up period ranged from 6 months to 2 years.Results The effective rate was 68.3% (28 cases),with 39.0% (16 cases) achieving seizure freedom in LEV monotherapy of children with epilepsy.Thirteen patients (31.7%) had poor efficacy in reduction of seizures,7 patients (17.1%) discontinued LEV monotherapy due to either an inadequate seizure control or aggravated seizures.Fifteen patients (36.6%) had the therapy-related adverse events in LEV monotherapy,including gastrointestinal dysfunction (5 cases),irritability (5 cases),dizziness (2 cases) and somnolence (2 cases).The adverse effects appeared in 2-4 weeks of early LEV therapy and were spontaneously disappeared in 1 week to 1 month of continuing therapy.Conclusions The LEV monotherapy is effective and safe for the control of partial and generalized seizures in children with epilepsy.LEV appears to be a broad-spectrum,first-line anti-epileptic drug in treatment of children with epilepsy.

The 1.23 kb DNA fragment encoding the early protein EP0 of pseudorabies virus (PRV) Ea strain was amplified by PCR technique and cloned into pBluescriptII sk+.Three sequencing plasmids containing the partial fragment of the EP0 gene were constructed and the sequences were obtained by Sanger's sequencing technique. Compared with PRV InFh strain, there were multipile site-mutations and a deleted-mutation in the EP0 gene of PRV strain Ea，and the diversity of amino acid residues also existed.Then, the EP0 gene was inserted into an expression vector, pET-28a, fused into the downstream of the 6ΧHis-Tag in frame, to yield the expression plasmid pETEP0. After induction by IPTG, a high expression of fusion protein was obtained, SDS-PAGE analysis and Western blotting showed that the fusion protein was 62kD and the protein was specific to antisera against PRV Ea strain. This indicated that the EP0 gene be expressed in BL21(DE3) and the expression products have immuno-genicity.

Background Oxidative stress is thought to be responsible to diabetes-complicated cataract.Our previous study demonstrated that as an iron chelator,deferiprone can protect lens from oxidative damage.Objective This further study aimed to investigate the role of deferiprone on the formation of diabetic-complicated cataract.Methods Forty 6-week-old Wistar rats were included in the study and randomized into 4 groups.Eight of them were used as the normal control group.Diabetes mellitus animal models were established in 22 rats by the carbonhydratediet and fat diet and the intraperitoneal injection of 40 mg/kg streptozocin (STZ).The deferiprone of 50 mg and 100 mg were intragastrically given in 8 model rats respectively after 3 days once a day for 8 weeks.The opacification of lenses was examined under the slit lamp weekly after treatment.The animals were sacrificed and the lenses were obtained at the eighth week of deferiprone injection.The concentrations of water-soluble protein ( WSP),urine-soluble protein (USP) and alkali-soluble protein (ASP) in rat lens suspension were detected by Bradford method.The super oxide dimutese (SOD),malondialdehyde (MDA) and glutathione (GSH) were determined spectrometically using xanthine oxidase,thiobarbituric acid,dithio bis-nitrobenzoic acid.Results No evidently differences were found in the content of the WSP,USP and ASP among the these groups( F=1.73,0.18,0.09,P＞0.05).The contents of MDA in 50 mg deferiprone group and 100 mg deferiprone group were ( 1.05 ± 0.10 ) mmol/g and ( 1.05 ± 0.22 ) mmol/g respectively,showing a significant decline in comparison with diabetic model group (P＜0.05).The SOD and GSH contents in lens were (321.29±16.57) U/mg,(322.07±22.16) U/mg and (7.83±0.65 ) mg/g,(7.70±0.77 ) mg/g respectively in 50 mg deferiprone group and 100 mg deferiprone group and were considerably elevated in comparison with ( 298.70± 14.69 ) U/mg and ( 5.47 ± 1.01 ) mg/g of diabetic model groups ( P＜0.05 ).No significant differences were found in the indexes mentioned above between 50 mg and 100 mg deferiprone groups(P＞0.05).Conclusions Deferiprone can reduce oxidative stress and improve the energy metabolism of the lens in diabetic rats.

Objective To evaluate the therapeutic value of endoscopic band ligation in gastric stromal tumors.Methods Twenty-nine patients with small gastric stromal tumors(diameter<12mm)underwent endoscopic band ligation,and were followed up with routine endoscopy and EUS.Results Twentyeight patients recovered completely,with the surface healing up 4-6 weeks(average 4.8 weeks)thereafter.The neoplasm did not slough off in one patient,so he underwent a second ligation.Hemorrhage occurred in one patient three days after ligation,but was successfully managed with hemoclips.Other patients showed no complications.All the patients were followed up for 36 to 51 months,and there was one case of recurrence.Conclusion Endoscopic band ligation is an effective and safe treatment for small GISTs of less than 12 mm.

Objective To discuss and analyze the imaging features of extramedullary hematopoiesis (EMH).Methods Imaging data of EMH in 7 patients with 85 lesions confirmed by clinical and pathological results were retrospectively analyzed.Results CT or MRI showed thoracic paravertebral multiple tumor-like soft tissue masses in 6 patients accompanied with pleural mass in 1,with liv-er mass in 1 and spleen mass in 1,and the masses in the distal ileum and in front of the inferior vena cava in 1.Thoracic paraverte-bral and pleural masses presented isodensity on plain CT and moderate enhancement on post-contrast CT.Among the 6 liver mas-ses,CT showed uniform density in 5 and small area of necrosis in 1.The only one spleen mass also appeared inner necrosis and mul-tiple small calcifications.The mass in the ileum presented thickened bowel wall with moderate enhancement,meanwhile the mass in front of vena cava presented obvious edge enhancement.MRI in 2 patients showed the masses with low signal on T1 WI and high sig-nal on T2 WI.Conclusion EMH has certain specific imaging characteristics,which may be helpful for correct diagnosis of EMH when combined with the clinical data.

Objective To examine cardiotoxicity of anthracyclines and trastuzumab in patients with breast cancer by two dimensional speckle tracking imaging. Methods Fifty-eight human epidermal growth factor receptors-2 (HER2) positive patients with breast cancer treated by anthracyclines and trastuzumab were monitored by echocardiography before treatment (Group A), after completion of anthracyclines (Group B), and at follow-up of 3 months (Group C) and 12months (Group D) after using trastuzumab. LVEDD, IVSTD, PWTD, LVEDV, LVESV were measured in the apical four- and two-chamber views. Left ventricular ejection fraction (LVEF) was measured using a modified Simpson's biplane method. Global longitudinal strain (GLS) and longitudinal strain rate (LSR) were calculated via Qlab8.0 analysis software off-line. Results LVEDDs in A-D groups were (47.95 ±4.12), (48.45 ±4.02), (48.91 ±3.83) and (49.98 ±3.72) mm, respectively, and LVEDVs were (108.70 ±21.26), (111.90 ±20.91), (113.50 ±20.25) and (119.20 ±20.02) ml, respectively. LVEDD, PWTD [(9.14 ±0.76) mm vs. (9.00 ±0.82)mm], LVEDV, LVESV [(54.60 ±14.58) ml vs. (50.97 ±14.35) ml] were increased in group B compared with those in A group (all P<0.05). LVEDD and LVEDV were increased in group C(P<0.05) compared with those in group B. CLVEDD, LVEDV, LVESV [(59.18±13.88) ml vs. (55.23± 13.81) ml] were increased in group D compared with group (P<0.05). Differences of LVEF between group C and group D were statistically significant[(59.48±2.62) % vs. (62.00±1.40) %, P<0.001]. Differences of GLS [(-21.16±2.33)%, (-19.76±1.98) %, (-19.22±1.89) % and (-18.74±1.79) %, respectively, P<0.001] and LSR [(-1.27±0.11), (-1.22±0.09), (-1.17±0.07) and (-1.14±0.06) /s, respectively, P<0.001] among four groups had all statistically significant. Conclusions Longitudinal left ventricle systolic function are impaired in patients with breast cancer treated by anthracyclines and trastuzumab. GLS and LSR of myocardium traced by two dimensional speckle tracking imaging would be useful for early evaluation of the severity.

Objective To observe the correlation between cardiac two-dimension global strain-speckle tracking imaging (2D-STI) and coronary artery disease index (CADi) scores in patients with acute myocardial infarction(AMI). Methods Eighty patients with AMI were chosen and given myocardial motion analysis using 2D-STI. The global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) was calculated. All patients were given scoring according to CADi scores standard by coronary angiography. The correlations between 2D-STI indexes and CADi scores were analyzed. The area under curve(AUC) of the receiver operating characteristic curve (ROC) of critical coronary stenosis was calculated. Results GLS, GRS and GCS was all correlated to CADi scores (r=0.670, -0.621, 0.525, all P < 0.01). The sensitivity, specificity and AUC of GLS for critical coronary stenosis was 82.35%, 80.43% and 0.831. The sensitivity, specificity and AUC of GCS for critical coronary stenosis was 76.47%, 76.09% and 0.797. The sensitivity, specificity and AUC of GRS for critical coronary stenosis was 97.06%, 78.26% and 0.880. The AUC of GLS and GRS was larger than that of GCS, and the sensitivity, specificity for critical coronary stenosis was larger. Conclusions 2D-STI indexes have correlation with CADi scores. GLS and GRS has correlation with coronary artery stenosis.