BACKGROUND:Compared with the fixation of bone cement prosthesis,the fixation of cementless femoral prosthesis does not have the folowing worries,including cement-prosthesis separation,cement sheath rupture,and cement debris-induced osteolysis.Long-term outcomes are good,and the survival rate is high.OBJECTIVE: To observe the preliminary clinical results and complications of total hip arthroplasty with Accolade TMZF cementless femoral stem.METHODS:From February 2010 to July 2012,67 patients (70 hips) underwent primary total hip arthroplasty with cementless femoral stem.Al patients were treated with Accolade TMZF Biological hip prosthesis system.Femoral component was treated with the same Accolade TMZF cementless femoral stem.Acetabular component was treated with Secure-fit HA and Trident PSL HA.The first mortar joint friction surface was treated withceramic-ceramic composite in 49 hips,ceramic-polyethylene composite in 19 hips and metal-polyethylene composite in 2 hips.After replacement,hip imaging data were utilized to assess biological fixation of femoral stem prosthesis,osteolysis surrounding the prosthesis,and prosthesis subsidence,and to observe hip function,thigh pain and complications.RESULTS AND CONCLUSION:Al cases were folowed up for more than 2 years.The mean Harris hip score was (32.7±6.2) preoperatively,and improved to (89.2±5.1) during final folow-up.During final folow-up,four patients (6％) suffered from slight pain.No moderate and severe pain or extremely severe pain occurred.None of the patients needed second operation due to failure for various reasons.X-ray films showed that no prosthesis displacement or loosening.Bone fixation surrounding the prosthesis was visible at the femoral side.Only one hip had subsidence of less than 2 mm,and the remaining did not experience subsidence.No blood vessels or nerve injury appeared during the surgery.During prosthesis placement,femoral calcar cleavage fracture occurred in 4 hips,so wire cerclage was used.Deep vein thrombosis in the lower limb or fractures surrounding the prosthesis was not found after placement.These results indicated that the preliminary clinical results of primary total hip arthroplasty with Accolade TMZF cementless femoral stem are encouraging,can effectively improve the function of hip joint.But the folow-up time is shorter,mid-term long-term curative effect should be further observed.

Objective To explore the preliminary study of the four-dimensional CT-based respiratory gating applications in the IGRT treatment of lung cancer .Methods 38 patients′ were scanned with 4D-CT ,and could got 10 images:0-90% each one ,and then two kinds of radiation treatment plans :Plan-3D and Plan-4D were used ,respectively .Treatment of the patients in the IGRT mode with Plan-4D and following up were done in two months after treatment to evaluate the efficacy and complication probability . Meanwhile evaluation of the two plans by the volume histogram was done .Results The displacement of lung tumor respiratory mo-tion was different in three dimensions ,especially in the Vertical direction ,about(9 .1 ± 2 .2)mm .Accuracy of the distance was 2 .6 mm .The Plan-4D′s CTV was bigger than Plan-3D ,but its PTV was less than the Plan-3D significantly ,at the same time its lung V20 ,MLD were both less than the Plan-3D ,and the difference was statistically significant(P< 0 .05) .The total efficiency(CR+PR)was 77 .78% (28 case);the incidence of 1 ,2 ,3 acute radiation-induced lung injury were 86 .11% ,11 .11% ,2 .78% ,respectively ;the incidence of 1 ,2 acute radiation esophagitis injury were 80 .56% ,8 .33% .Conclusion The respiratory gating techniques based on 4D CT applied in image guided radiotherapy of lung cancer in clinical is feasible ,and it can reduce the volume of the planning tar-get volume ,and help to improve the accuracy of radiotherapy .The degree of respiratory motion is significantly different in individu-als ,and expanding outside the target ranges should be individualized .

Objective To study the iso-center point coincidence of two accelerators with treatment planning system (TPS) based on γ passing rates of intensity-modulated radiotherapy (IMRT) plan verification.Methods Twenty-one IMRT plans were verified by Varian accelerator and twenty by Elekta accelerator with a gamma criterion of 3 mm/3％.The passing rates were measured when the iso-center point of TPS had-2,-1,0,1,and 2 mm shift in the x or y direction.A binomial curve of γwas fit to figure out the values of the two accelerators on the x and y axes when γ value reached the maximum.The γ pass rate difference was analysed by x2 test.Results The mean values of γ-2,γ-1,γ0,γ1,and γ2 in the x direction were (92.56±3.27) ％,(96.53± 1.82) ％,(96.13± 1.41) ％,(90.14± 2.87) ％,and (82.28± 4.69) ％ for Varian accelerator,and (94.82± 2.04) ％,(97.05± 2.02) ％,(98.38± 1.33) ％,(97.96± 1.44) ％,and (94.49±2.34)％ for Elekta accelerator.There was no significant difference in the mean value of γ0between the two accelerators (P=0.332).When γvalue reached the maximum,the values on the x and y axes were0.65 and-0.30 mm for Varian accelerator and 0.01 and 0.30 mm for Elekta accelerator,respectively.Conclusions In the same TPS,different accelerators have different degrees of coincidence of the actual field center point with the iso-center point of TPS,to which more attention should be paid in clinical practice.

BACKGROUND:Total knee arthroplasty has matured in clinical treatment. LPS-Flex Mobile Bearing System (Zimmer, USA) artificial knee prosthesis is the high-flexion rotating platform type knee prosthesis. The time of its clinical application in China is short, so its advantages have not been reported. OBJECTIVE:To investigate the preliminary clinical outcome of the total knee arthroplasty with LPS-Flex Mobile Bearing system artificial knee prosthesis (Zimmer, USA), and to assess the biocompatibility of artificial prosthesis and host using range of motion of knee and function after replacement. METHODS:We retrospectively analyzed 37 patients (42 knees) undergoing total knee arthroplasty using Zimmer LPS-Flex Mobile Bearing prostheses (high-flexion rotating platform type knee prosthesis) in The First Hospital Affiliated to Soochow University from February 2012 to March 2014, including 9 males (10 knees) and 28 females (32 knees), aged 47-78 years, averagely 63.7 years. Bone cement fixation was used, and the patel a was not treated with replacement. Postoperative complications were observed. Ranges of motion of knee joint preoperatively and postoperatively were compared. The recovery of knee joint function was evaluated using Hospital for Special Surgery Knee Score. RESULTS AND CONCLUSION:A total of 34 cases (38 knees) were fol owed up for 6-28 months. Range of motion of knee joint improved from 88.5° before operation to 124.2° after operation on average. Hospital for Special Surgery Knee Score improved from 52.5 before replacement to 91.1 after replacement, showing significant differences (P<0.01). Therapeutic effects were assessed according to Hospital for Special Surgery Knee Score:excel ent in 20 cases, good in 16 cases, average in 2 cases, with an excel ent and good rate of 95%. The incidence of various complications was low. These data suggested that short-period clinical outcomes of high-flexion rotating platform type knee prosthesis replacement are satisfactory. This prosthesis has advantages in its design, which is more close to the physical structure of knee joint, but its long-period outcomes deserve further investigations.

BACKGROUND: Cell-based therapies for treating bone defects require a source of stem cells with osteogenic potential. There is evidence from pathologic ossification within muscles that human skeletal muscles contain osteogenic progenitor cells. However, muscle samples are usually acquired through a traumatic biopsy procedure which causes pain and morbidity to the donor. Herein, we identified a new alternative source of skeletal muscle stem cells (SMSCs) without conferring morbidity to donors. METHODS: Adherent cells isolated from human orbicularis oculi muscle (OOM) fragments, which are currently discarded during ophthalmic cosmetic surgeries, were obtained using a two-step plating method. The cell growth kinetics, immunophenotype and capabilities of in vitro multilineage differentiation were evaluated respectively. Moreover, the osteogenically-induced cells were transduced with GFP gene, loaded onto the porous β-tricalcium phosphate (β-TCP) bioceramics, and transplanted into the subcutaneous site of athymic mice. Ectopic bone formation was assessed and the cell fate in vivo was detected. RESULTS: OOM-derived cells were fibroblastic in shape, clonogenic in growth, and displayed phenotypic and behavioral characteristics similar to SMSCs. In particular, these cells could be induced into osteoblasts in vitro evidenced by the extracellular matrix calcification and enhanced alkaline phosphatase (ALP) activity and osteocalcin (OCN) production. New bone formation was found in the cell-loaded bioceramics 6 weeks after implantation. By using the GFP-labeling technique, these muscle cells were detected to participate in the process of ectopic osteogenesis in vivo. CONCLUSION: Our data suggest that human OOM tissue is a valuable and noninvasive resource for osteoprogenitor cells to be used in bone repair and regeneration.
Alkaline Phosphatase ; Animals ; Biopsy ; Extracellular Matrix ; Fibroblasts ; Humans* ; In Vitro Techniques* ; Kinetics ; Methods ; Mice ; Mice, Nude ; Muscle Cells ; Muscle, Skeletal ; Muscles ; Ossification, Heterotopic ; Osteoblasts ; Osteocalcin ; Osteogenesis* ; Regeneration ; Stem Cells* ; Tissue Donors

Objective To analyze the effect of needle arrangement on the lung dose in interstitial brachytherapy for lung cancer. Methods For 15 patients undergoing interstitial brachytherapy for lung cancer, a virtual radiotherapy plan in which needle arrangement was not restricted by the ribs was designed and compared with the original plan. For the two plans, V5, V20, V30, and mean lung dose(MLD)of the whole lung were determined when the prescribed doses were 10,30, 60, and 120 Gy, respectively. The data were analyzed by Wilcoxon signed-rank test. Results The lung V5,V20, V30, and MLD were significantly smaller in the virtual plan than in the actual plan(all P<0.05). Conclusions Irregular needle arrangement prevents a further reduction in the lung dose in interstitial brachytherapy for lung cancer. In the implantation surgery, therefore, the needles should be arranged as regularly as possible.

AIM: To investigate the role and possible mechanism of gastrodin combined with dexamethasone in myocardial cell injury induced by oxygen-glucose deprivation. METHODS: Oxygen-glucose deprivation (OGD) model was established. The cells were divided into 5 groups: normal control group, OGD group, DEX group, GAS group and DEX+GAS group. The activity of myocardial cells was detected by CCK-8 test in each group. The activity of LDH was detected by colorimetry in each group. The apoptosis of myocardial cells was detected by TUNEL method in each group. The ELISA assay was used to detect the inflammatory factors in culture medium of myocardial cells in each group. Western blot was used to detect the expression of Notch1, Bax, Bcl-2 and Beclin1 in myocardial cells in each group.RESULTS: The results showed that GAS combined with DEX could significantly increase the activity of myocardial cells and decrease the apoptosis, reduce production of TNF-α, IL-6, IL-1β and promote production of IL-10, decrease the release of LDH significantly of myocardial cells induced by OGD. The results of Western blot showed that GAS combined with DEX increased the expression of Notch1, Bcl-2 and autophagy-related gene Beclin1, but decreased the expression of Bax of myocardial cells induced by OGD. CONCLUSION: The combination of GAS and DEX may promote autophagy and increase cell activity, inhibit apoptosis and inflammatory reaction by activating Notch signaling pathway, thereby reducing OGD-induced myocardial cells damage.

【Objective】 To investigate and analyze the current situation of the human resources as well as blood collection and supply of blood banks of Zhejiang Province, so as to understand the problems existing in the development of human resources and put forward suggestions. 【Methods】 Questionnaires were issued to Blood Center of Zhejiang Province, municipal central blood stations, and county-level central blood banks to investigate the relevant data in 2015 and 2019. Meanwhile, some data were obtained through the Zhejiang Blood Management Information System (BIS3.0), symposiums, and querying medical service data. Statistical analysis was carried out. 【Results】 Among the 28 blood banks, filled the questionnaires, 927 personnel were in accordance with the authorized strength, accounting for 62.26% (927/1 489), and 1069 health technicians, accounting for 71.519% (1 060/1 489). From 2015 to 2019, the annual growth rate of human resources in blood banks was 2.02%, lower than the annual growth rate of whole blood collection volume 4.83% and the annual growth rate of clinical blood supply (red blood cell) 4.82%, lagging behind the annual growth rate of 6.55%, 8.71% and 12.36% in the number of diagnoses, inpatients and surgeries in the hospitals across the province. The average annual growth rate of doctors and nurses in blood banks was 0.17% and 1.67%, lower than that of licebsed doctors and registered nurses of the province, which was 6.78% and 8.27%, respectively. 【Conclusion】 With the development trend of blood collection and supply, the personnel allocation and the proportion of health technicians of blood banks across Zhejiang Province is insufficient. It is suggested to establish a manpower allocation standard suitable to the business volume, give priority to properly solvement of the current employment, strengthen training, and improve the efficiency of physical examination consultation, testing and phlebotomy positions.

Breast cancer is a systemic malignant tumor caused by multiple pathogenic factors， and its pathological mechanism is complex and has not been clarified so far. It has gradually become the largest killer threatening women's life. The common method for the treatment of breast cancer is lesion resection combined with radiation and chemical therapy， endocrine therapy， or targeted therapy. However， due to the limitations of western medicine therapies， there are still considerable breast cancer patients with poor disease control and high tumor recurrence rate in clinical practice. At the same time， the side effects and complications produced by these therapies affect the quality of life of patients. Therefore， it is urgent to develop new drugs or find safe and effective alternative therapies against breast cancer. Volatile oil （VO）， as a unique volatile component of Chinese herbal medicines， has anti-inflammatory， antiviral， and anti-tumor activities. It has been applied in the treatment of breast cancer and has demonstrated good efficacy by exerting the unique effects of strengthening healthy Qi， eliminating pathogenic factors， moving Qi， resolving stasis， warming Yang， soothing liver， and relieving depression. The recent studies have confirmed that VO and its chemical components can prevent and treat breast cancer via multiple mechanisms， while there is a lack of systematic review. The relevant literature published in recent years has demonstrated that VO can inhibit the occurrence and development of breast cancer by regulating the level of estrogen， inhibiting the proliferation and inducing the apoptosis of cancer cells， enhancing immunity， resisting inflammation， and regulating emotions. We introduced the pathogenesis of breast cancer， as well as the mechanisms and advantages of VO in the prevention and treatment of breast cancer， aiming to provide new ideas for the research on VO in the treatment of breast cancer.