Objective To investigate MR imaging features of femoral marrow in treated ?-thalassemia major.Methods MR imaging of the proximal femoral marrow was performed in 35 cases of ?-thalassemia major and 45 age-and sex-matched normal children as control.Coronal images of femoral marrow with the techniques of spin echo and fast field echo(FFE)were obtained.On T_1-weighted imaging the red and yellow femoral marrow were judged and marrow distribution was classified into five groups.The hemosiderosis of marrow was judged on the basis of signal intensity of marrow on FFE imaging.The marrow distribution classification and the hemosiderosis on MR imaging were correlated with clinical features.Results On FFE,marrow hemosiderosis occurred in 15 patients with a marked hypo-intensity signal and was related to the age(P=0.032).On T_1-weighted imaging,the femoral marrow in 35 patients was classified as groupⅢand IV,while the marrow distribution was groupⅠorⅡin all normal children,there was statistically significant difference(P

OBJECTIVETo present a method of quantitative diagnosis of craniofacial skeleton deformities based on three-dimensional computed tomography (3D CT).

METHODS20 cases with facial asymmetric deformities underwent 3D CT and the 3D images were reconstructed by Mimics 10.0 (Belgium). Anatomical landmarks were located and the coordinate of the landmarks obtained. Axial images of 1 patient with Romberg disease was used as representative case. The differences in the distance between the right landmarks and the left were calculated and analyzed.

RESULTSThe measurement results were not significantly different between two stages with an interval of 4 weeks ( P > 0.05), showing a reproducible resutls. The deviation of landmarks at facial midline increased gradually from upward to downward, reaching (2.63 +/- 0.54) mm at menton point. Paired landmarks showed asymmetry in three dimensions, especially gonion point on the left side, which was deviated 10.21 mm inward, 9.26 mm forward, 6.30 mm upward, compared to the opposite side.

CONCLUSIONSThe method of 3D CT quantitative analysis can provide precise information in the diagnosis and treatment planning of facial asymmetry deformity.

Anatomic Landmarks ; diagnostic imaging ; Cephalometry ; Craniofacial Abnormalities ; diagnostic imaging ; Facial Asymmetry ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; methods ; Tomography, X-Ray Computed ; methods

Objective To evaluate the clinical effect and complications of total hip replacement (THR) in novel femoral neck fracture,old femoral neck fracture, aseptic necrosis of femoral head and coxa degenerative osteoarthropathy. To provide instructions to surgical indications and treatment effects analysis.Methods One hundrde and four patients were divided into 4 groups by disease type: novel femoral neck fracture group (n = 32 ), old femoral neck fracture group (n = 22) ,aseptic necrosis of femoral head group (n =34) and coxa degenerative osteoarthropathy group (n = 16). These patients were followed-up for 12 - 144 months after THR, their Harris standard score and complications data, before and after operation, were analyzed retrospectively. Results After operation, the Harris standard scores were 92. 6 ± 5.8,90. 1 ± 5. 2,86. 3 ± 4. 6,81.9 ±4. 1 in novel femoral neck fracture,old femoral neck fracture,aseptic necrosis of femoral head and coxa degenerative osteoarthropathy groups respectively, which were significantly higher than the scores before operation (25.6±1.8,36.7±2.6,52.9±4.3,42. 1 ±3.8,Ps ＜0.05). Conclusion THR has good effects in the four types of diseases. Short length of stay and high healing rate are marked characteristics of THR. More attention shoud be paid to the complications of THR.

OBJECTIVETo evaluate the clinical features, pathologic diagnosis and laboratory test of otologic manifestation in Wegener's granulomatosis (WG).

METHODSFourteen eases of WG with ear involvement were reviewed. The clinical course, method of treatment and outcomes in all cases were evaluated. Diagnosis of WG was made when the patients had clinical findings, clear histologic findings and a positive titer of antineutrophil cytoplasmic autoantibodies (ANCA). RESULTS In all 14 cases, the most frequent finding was chronic otitis media Sensorineural hearing loss was present in 1 case and facial nerve paralysis was present in 2 cases separately. There were 5 patients whose otologic manifestations were the primary involvement of WG. Fourteen cases had positive histologic diagnosis of WC while 13 cases were confirmed positive for ANCA. All patients were treated with glucocorticoids, immunosuppressive drugs, and finally got marked improvement.

CONCLUSIONSWG should he included in the differential diagnosis in cases of atypical inflammatory states of the ear, facial nerve paralysis and sensorineural hearing loss. Early diagnosis was made basing on the histologic findings and a positive titer of ANCA. Appropriate treatment were important to improve the otologic manifestations of WG.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Facial Paralysis ; etiology ; Female ; Granulomatosis with Polyangiitis ; complications ; Hearing Loss, Sensorineural ; etiology ; Humans ; Male ; Middle Aged ; Otitis Media ; etiology ; Retrospective Studies ; Young Adult

Objective To study the clinical effect of adjacent flap on immediate breast repair in conserving surgery for upper inner quadrant breast cancer.Methods A total of 100 women with breast cancer treated in our hospital from August 2012 to August 2016 were selected as the study subjects.According to the different surgical methods,46 cases were divided into control group and 54 cases in observation group.The patients in the control group were treated with modified radical mastectomy for breast cancer.The patients in the observation group were treated with adjacent flap for immediate repair of breast defect in breast conserving surgery.The quality of life,the follow-up results and between the two groups were compared.The cosmetic effect of the observation group was evaluated.Results At 6 months after operation,the physiological function,affective function,physical pain,social function,physiological limitations,vitality,mental health and overall health score of the observation group were higher than those of the control group,the difference was statistically significant(P ＜ 0.05).There was no significant difference in local recurrence rate,distant metastasis rate,non-survival rate,loss of follow-up or mortality between the two groups (P ＞0.05).The excellent and good rate of breast cosmetic effect was 96.3％ after surgery in observation group.The satisfaction rate of observation group was 92.59％ (50/54),the control group was 45.46％ (21/46),the difference was statistically significant (x =26.582,P =0.000).Conclusion The clinical effect of repairing breast defect by using adjacent flap transfer is very effective in improving the quality of life and reducing the risk of local recurrence and distant metastasis.

[Objective]To discuss the microsurgical approaches of 30 patients with tentorial meningiomas and conclude their treatment experiences.[Methods]A retrospective analysis of clinical data was performed on 30 patients underwent microsurgical approaches from July 2004 to September 201 1.The pathology of these patients was confirmed after operation.The outcome and follow-up were evaluated.[Results] The meningiomas were totally removed in 19 patients subtotally in 6,and partially in 5.All the patients received 8 months to 5 years of follow-up:no mortality or death were found;no surgical related complications were noted.[Conclusion] Appropriate approaches according to the size and site of the tumors,intraoperative protection of venous sinus,facial and acoustic nerves and brain stem are the key points to improve the therapeutical outcomes and the post-operative quality of patients with infra and supra tentorial menmingiomas.

OBJECTIVEBone marrow stromal cells (bMSCs) of rabbits transferred with mammalian hBMP-4 expression plasmid were used to construct tissue-engineered bone. Gene therapy combined with tissue-engineering technique was explored to further improve osteogenesis.

METHODSpEGFP-hBMP-4 plasmid was constructed by subcloning technique. bMSCs were then transferred with either pEGFP-hBMP-4, pEGFP plasmid by lipofectamine or left uninfected in vitro. The cells from the 3 groups were combined with natural non-organic bone (NNB) to construct tissue-engineered bones, which were subcutaneously implanted into nude mice (6 implants per group) for 4 weeks. Specimens were evaluated through histological and computerized new bone formation analysis.

RESULTSpEGFP-hBMP-4 plasmid was successfully constructed. bMSCs could attach and proliferate on the surface on NNB. In vivo experiment showed that new bone formation in pEGFP-hBMP-4 group was higher than those of the control groups.

CONCLUSIONSTissue-engineered bone using hBMP-4 gene modified bMSCs might be an ideal alternative for the repair of bone.

Animals ; Bone Morphogenetic Protein 4 ; Bone Morphogenetic Proteins ; genetics ; Genetic Therapy ; Humans ; Mice ; Mice, Nude ; Osteogenesis ; Rabbits ; Tissue Engineering

Acute-Phase Proteins ; metabolism ; Animals ; Female ; Hepatitis, Autoimmune ; immunology ; metabolism ; pathology ; Interleukin-17 ; metabolism ; Lipocalin-2 ; Lipocalins ; metabolism ; Liver ; pathology ; Mice ; Mice, Inbred BALB C ; Oncogene Proteins ; metabolism

OBJECTIVETo investigate the effect of rat mesenchymal stem cells (MSCs) transfected with different oncogenes differentiate into hepatocellular carcinoma (HCC) in vitro.

METHODSMSCs, transfected with different oncogenes c-myc, K-ras, c-myc and K-ras and amplified in vitro, were infused into rats via vena portae. The recipient rats were divided into the hepatic impairment group, which were fed with tetrachloromethane and the healthy control group. At day 7, 14, 21, 28 and 42 following grafting, the complete livers were obtained and examined using fluorescence detection, conventional pathology and immunohistochemistry detection of GFP, c-kit and AFP to study the colonization and distribution of stem cells in rat liver.

RESULTSNo immunological rejection occurred after grafting of allogenic MSCs. The infused MSCs colonized in the recipient rat liver. Liver tumors were present in 6 rats grafted with MSCs that were transfected with K-ras, K-ras and c-myc, and the protein expression of AFP was detected using immunocytochemistry at day 7. Rats grafted with MSCs that were transfected with c-myc gene had no obvious tuberosity or tumor. Small oval cells were found microscopically in the periphery of vena portae, and immunohistochemistry staining of AFP was negative. Immunohistochemical staining of c-kit was positive in all livers of rats that were transfected with MSCs.

CONCLUSIONSHepatocellular carcinoma may derive from genetically mutated MSCs.

Animals ; Bone Marrow Cells ; cytology ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Differentiation ; Cells, Cultured ; Female ; Genes, myc ; genetics ; Genes, ras ; genetics ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Liver ; metabolism ; pathology ; Liver Neoplasms, Experimental ; metabolism ; pathology ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Microscopy, Fluorescence ; Rats ; Rats, Sprague-Dawley ; Transfection

OBJECTIVETo analyze the relationship between genotype and phenotype of homozygous hemoglobin Constant Spring (Hb CS) in Guangxi province, and to explore the reasons of missed diagnosis and the methods for screening and diagnosing.

METHODSScreening Hb CS by acetate fibrous membrane electrophoresis with benzidine staining. Gene mutation of homozygous Hb CS by polymerase chain reaction (PCR) and DNA sequencing.

RESULTSOut of the 9 patients, 4 had no clinical symptoms, 2 showed mild anemia and splenomegaly, 3 were jaundice. Hemoglobin levels were normal or mild anemia. MCVs were normal or reduced. Peripheral blood smear of all the patients displayed hypochromia, anisocytosis, poikilocytosis and target cells. The quantities of HbA(2) + Hb CS were 4.3% - 6.72%, while HbA(2) < 2%. Gene analysis confirmed the diagnosis of homozygous Hb CS.

CONCLUSIONThere was quite different in clinical symptoms, hematological parameters and hemoglobin quantifications for patients with homozygous Hb CS. They might have no clinical and hematological signs and looked like the phenotype of Hb H disease. Homozygous Hb CS was very easy to miss diagnosis. Gene analysis can be helpful.

Adult ; Child ; Child, Preschool ; Female ; Hemoglobins, Abnormal ; genetics ; Humans ; Male ; Mutation ; alpha-Thalassemia ; genetics