OBJECTIVEThis study was to construct a geometric skull model with 3-dimension scanning and rapid-prototyping (RP) technology and also to evaluate the significance and further application of surgery simulation in the treatment of complex craniomaxillofacial malformation.

METHODSTwelve patients with complex craniomaxillofacial malformation were involved. The data obtained with CT scanning were transferred to a personal computer for surface rendering 3-dimension reconstruction. A geometric model was manufactured by selective laser sintering using rapid-prototyping device. Surgery simulation was performed both on the model and in the computer. Accordingly, a custom implant and an implant template, when needed, were constructed with the computer-aided design (CAD) and prefabricated with computer-aided manufacture (CAM) process.

RESULTSSurgery simulation made the operation shorter, the complications lower and the outcome better.

CONCLUSIONSSkull model provides great convenience in the treatment of cranio-maxillofacial malformation.

Adult ; Computer-Aided Design ; Craniofacial Abnormalities ; diagnostic imaging ; therapy ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Models, Anatomic ; Skull ; anatomy & histology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinical features of mid- and long-term acute cardiac allograft rejection to improve the long-term clinical outcomes of the patients.

METHODSFourteen recipients (11 males and 3 females) underwent orthotopic heart transplantation with standard immunosuppressive therapy protocols (3 cases) or induction therapy protocols (11 cases). Cyclosporine, azathioprine or mycophenolate mofetil, and prednisolone were applied as the maintenance immunosuppressive regimen. Acute graft rejection episodes occurred within 3 to 6 months in 1 case, within 6 months to 1 year in 3 cases, within 1 to 2 years in 3 cases, within 2 to 5 years in 6 cases, and above 5 years in 1 case.

RESULTSNo significant difference was found in the incidence of late heart rejection between the patients receiving the two immunosuppressive therapy protocols. Immunosuppressants were withdrawn or spared in 8 recipients due to different causes. Nine recipients with steroid-sensitive acute cardiac allograft rejection were treated with steroid-pulse therapy, while the other 5 were treated with a short course of polyclonal antithymocyte antibodies because of steroid-resistant acute rejection; in 11 cases, azathioprine was converted to mycophenolate mofetil. Four of the 5 late deaths occurred in the recipients with steroid-resistant rejection. The surviving recipients had a good quality of life, and no recurrent episodes of rejection or infection were observed in the follow-up period.

CONCLUSIONSLate acute cardiac allograft rejection is associated mainly with patient compliance but not with early immunosuppressive therapy protocols. The episodes are rather severe and should be timely treated with steroid pulses or polyclonal antithymocyte antibodies.

Adolescent ; Adult ; Cyclosporine ; Female ; Graft Rejection ; etiology ; prevention & control ; Heart Transplantation ; adverse effects ; Humans ; Immunosuppression ; methods ; Male ; Middle Aged ; Mycophenolic Acid ; analogs & derivatives ; Young Adult

OBJECTIVETo investigate the clinical effect of Seinsheimer type V subtrochanteric femoral fractures with dynamic hip screw and shape memory alloy bow-teeth screw.

METHODSTwelve patients with Seinsheimer type V subtrochanteric femoral fractures were retrospectively analyzed. There were 8 males and 4 females with an average age of 53 years (range 31 to 65 years). Seven cases were caused by traffic accident, 4 cases by falling from hight, 1 case by heavy object. According to the Seinsheimer classification, all the cases were type V fractures. All the cases accepted the surgical treatment with dynamic hip screw and shape memory alloy bow-teeth screw fixation.

RESULTSThe mean period of follow-up was 28 months (range 20 to 38 months). All the cases obtained bone union in average 3.3 months (from 3 to 4.5 months). There were no complications such as deep infection, deep vein thrombosis, pulmonary embolism and bone nonunion. The results of clinical evaluation according to Merle d'Aubigne scores were 16.75 +/- 1.14 and excellent in 4 cases, good in 8 cases.

CONCLUSIONApplication of dynamic hip screw and shape memory alloy bow-teeth screw as a superior option can get satisfactory reduction with reliable fixation and will be one of a better choice for fixation of Seinsheimer type V subtrochanteric femoral fractures.

Adult ; Aged ; Alloys ; Bone Screws ; Female ; Femoral Fractures ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Follow-Up Studies ; Hip ; surgery ; Humans ; Male ; Mechanical Phenomena ; Middle Aged ; Recovery of Function ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo investigate the clinical effects of PHILOS plate with injectable artificial bone for the treatment of proximal humeral fractures in elderly patients.

METHODSFrom March 2007 to March 2009,17 patients who suffered from proximal humeral fractures were retrospectively studied. There were 7 males, 10 females, with an average age of 71 years (ranged, 66 to 81 years). Nine patients were caused by falling, seven patients were caused by traffic accidents,and one patient was hit by heavy object. According to the Neer classification, 9 patients were type III and 8 patients were type IV. All the patients were treated with PHILOS plate internal fixation combined with injectable artificial bone. Assessment was based on the Constan-Murley shoulder score and percentage Constant-Murley score.

RESULTSThe mean period of follow-up was 16 months (ranged, 8 to 25 months). All the patients obtained bone union in an average of 3 months (2.5 to 3.5 months). There were no complications such as deep infection, nonunion or failure of fixation. The Constant-Murley score of the injured side was mean (86.50 +/- 10.50) (ranged, 75 to 95). The clinical outcomes were excellent in 9 cases, good in 6 cases, moderate in 2 cases.

CONCLUSIONThe treatment of proximal humeral fractures in elderly patients with application of PHILOS plate combined with injectable artificial bone can get satisfactory clinical effect especially suitable for osteoporosis and comminuted proximal humeral fractures.

Aged ; Aged, 80 and over ; Bone Plates ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Retrospective Studies ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo investigate the outcome of orthotopic heart transplantation for patient with end-stage hypertrophic cardiomyopathy.

METHODSThis retrospective review analyzed the clinical data of nine patients (7 males) undergoing orthotopic heart transplantation for end-stage hypertrophic cardiomyopathy in our center. All patients received induced therapy protocols peri-operative and standard triple maintenance immunosuppressive therapy postoperative.

RESULTSOne recipients developed acute renal failure due to renal artery embolism and allograft rejection in the early posttransplantive course, symptoms and signs were improved under continuous renal replacement therapy and steroid-pulse therapy, this patient died of sudden cardiac arrest at 32 months post transplantation. Another recipient developed demyelinating disease in frontal and parietal lobe and finally recovered with medical therapy. Eight patients survived the operation with good quality of life and there was no episode of rejection or infection or chronic graft arteriosclerosis during follow-up time. Three recipients developed left ventricular hypertrophy and there were no signs of grapg-vessel diseases in the survivals.

CONCLUSIONHeart transplantation is the best therapeutic option for selected patients with end-stage hypertrophic cardiomyopathy.

Adolescent ; Adult ; Cardiomyopathy, Hypertrophic ; surgery ; Female ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Young Adult

Adult ; Alloys ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Patella ; injuries ; physiopathology ; surgery ; Recovery of Function

OBJECTIVETo determine the clinicopathologic characteristics and the relationship between related gene expression and pathobiologic behavior of pancreatic mucinous noncystic adenocarcinoma.

METHODSAmong the 249 pancreatic carcinoma cases from the department files, 6 tumors were identified to meet the pathologic criteria of colloid carcinoma. Envision immunohistochemical staining technique was used to detect expression of p21(ras), p21(WAF1), p16, p33(ING1), p53, ATM, MDM2, PCNA, Cyclins (D1, D3, A, B and E). Intra- and extra- cellular mucin production were determined by AB-PAS staining. Clinically, all of 6 cases were followed to June, 2003.

RESULTSIn all 6 cases, the tumors were located in the head of the pancreas and all displayed similar microscopic findings. Duodenal invasion was seen in 4 cases and perineural invasion was seen in 1 case. Tumor metastasis in the liver was seen in 2 cases and in the regional lymph nodes in 2 cases. Positive immunostaining was seen in 5 cases with p21(ras), 3 cases with p21(WAF1), 1 case with p16, 4 cases with p33(ING1), 2 cases with p53, 3 cases with ATM, 3 cases with MDM2, 6 cases with PCNA, 3 cases with cyclinA, 3 cases with cyclinD1, 4 cases with cyclinD3, 4 cases with cyclinB and 6 cases with cyclinE. Both extracellular and intracellular mucin was strongly positive for AB-PAS staining. Clinical follow-up found that 2 patients died of their tumors at 14 and 20 months. Three patients were alive after 28, 49 and 87 months of follow-up. One case were lost contact.

CONCLUSIONSPancreatic mucinous noncystic adenocarcinoma has distinct morphologic features and biologic behavior. Multiple gene products including many cyclins may be involved in the pathogenesis of pancreatic colloid carcinoma. The tumor has an aggressive behavior with a high frequency of invasion and metastases, though the prognosis could be better than that of ordinary ductal adenocarcinoma of pancreas.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; secondary ; Aged ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Duodenal Neoplasms ; pathology ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms ; metabolism ; pathology ; Prognosis ; Proto-Oncogene Proteins p21(ras) ; metabolism

OBJECTIVETo explore the therapeutic strategies of the aged wounded patients evacuated from Wenchuan earthquake area.

METHODSThe characteristics of traumatic conditions and therapeutic methods of 14 aged wounded patients evacuated from Wenchuan earthquake area were retrospectively analyzed.

RESULTSAll cases accepted the effective treatment for 4 to 8 weeks and attained good recovery. There was no anesthetic and surgical complications, deep venous thrombosis, hypostatic pneumonia, pulmonary embolism, bed sore, stroke and other complications happened. When discharged, all medical disorders of the patients were under control and both psychological condition and nutritional status were improved obviously.

CONCLUSIONAssessment of traumatic condition and general status,cooperative nursing, active nutritional support, positive symptomatic treatment and necessary psychological intervention are the key to improve effectively the curative effect of the aged wounded patients in earthquake.

Aged ; Aged, 80 and over ; China ; Earthquakes ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries ; complications ; psychology ; therapy

OBJECTIVETo evaluate the outcomes of selective anterior thoracolumbar or lumbar (TL/L) fusion for adolescent idiopathic scoliosis (AIS) with PUMCIId1 curves (Lenke type 5).

METHODSThirty-five consecutive AIS patients (PUMC type IId1, Lenke type 5) with selective anterior TL/L fusion with single solid rod instrumentation were reviewed. The average follow-up was 36 months (range, 18 - 42 months). Standing anteroposterior and lateral radiographs were measured and analyzed.

RESULTSThe average preoperative Cobb angle of the TL/L curves was 45.6 degrees and corrected to 9.7 degrees postoperatively, with 79.7% curve correction. The thoracic curves decreased from 29.7 degrees preoperatively to 17.6 degrees postoperatively, with a spontaneous correction of 41.5%. There was an average 4.7 degrees and 2.5 degrees correction loss of the TL/L and the thoracic curves at the final follow-up respectively. Trunk shift deteriorated slightly from 14.0 mm preoperatively to 14.8 mm postoperatively, and improved significantly to 5.1 mm at the final follow-up. The lowest instrumented vertebra (LIV) tilt was significantly improved after surgery (from -21.8 degrees preoperatively to -1.5 degrees postoperatively) and well maintained at the final follow-up (-2.1 degrees). The coronal disc angle immediately above the upper instrumented vertebra (UIVDA) and below the LIV (LIVDA) averaged 0.5 degrees and 0.6 degrees respectively, and aggravated after surgery (0.9 degrees and 4.9 degrees, respectively). Both the UIVDA and LIVDA were significantly aggravated at the final follow-up (3.0 degrees and 7.8 degrees, respectively). The sagittal contours of T(5-12) and T(10)-L(2) were well maintained after surgery and at the final follow-up. The lumbar lordosis of L(1)-S(1) and the sagittal Cobb angle of the instrumented segments were reduced postoperatively and at the final follow-up. No pseudarthrosis or other complications were observed.

CONCLUSIONSelective anterior TL/L fusion with single solid rod instrumentation is effective and safe for AIS with PUMCIId1 (Lenke type 5) curves, above and below the fusion and larger residual thoracic curve in some cases need further evaluated.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; methods ; Treatment Outcome

OBJECTIVE: To screen multidrug resistance (MDR) related proteins in human gastric cancer using proteomics technique. METHODS: Two-dimensional electrophoresis (2-DE) was used to separate the total proteins of vincristine-resistant human gastric cancer cell line SGC7901/VCR and its counterpart SGC7901. PDQuest software was used to analyze 2-DE images, and the differential expression proteins between the 2 cell lines were identified by both MALDI-TOF-MS and ESI-Q-TOF. The differential expression level of sorcin, one of the identified proteins, was confirmed by western blot analysis. The effect of sorcin on the development of MDR of SGC7901/VCR was determined by antisense oligonucleotides (ASO) technique. RESULTS: Sorcin as a high expression protein in SGC7901/VCR was identified and the suppression of sorcin expression by sorcin ASO could enhance the vincristine chemosensitivity in SGC7901/VCR. CONCLUSION Sorcin overexpression is related to MDR in human gastric cancer cell line SGC7901/VCR.
Amino Acid Sequence ; Calcium-Binding Proteins ; analysis ; biosynthesis ; genetics ; Cell Line, Tumor ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Molecular Sequence Data ; Stomach Neoplasms ; genetics ; metabolism ; Vincristine ; pharmacology