0 05) Conclusion The cardiotoxicity of ropivacaine is related to the inhibition of sodium and calcium channels

BACKGROUND: There is lack of effective method for treating humerus nonunion, lilac plate can maintain the compact contact between fracture end and bone graft, accelerate bone union, as well as provide stability for bone union. OBJECTIVE: To evaluate the clinical effects of treating humerus nonunion by using lilac bone graft as plate combined with the external fixation.METHODS: Thirteen patients with nonunion of the humorous at Department of Orthopedic Trauma Surgery, Jinan Command General Hospital of Chinese PLA were selected, including 11 males and 2 females, aged 20 51 years, mean aged 35.5 years. All the patients were treated with Uiac bone graft and screws combined with the mono lateral external fixation. The bone healing was observed by X-ray film. Shoulder function and complications were measured by Neer score.RESULTS AND CONCLUSION: All patients were followed up for 7-64 months, mean 38 months. Bony union was achieved in all patients within 6-10 months (mean 8.1 months). The activity function of shoulder and elbow was normal; and Neer scores were 71-96 (mean 87 scores). No infection, pain, prevalent fracture or nonunion occurred. The results demonstrated that using lilac bone graft as plate combined with the mono lateral external fixation is a good salvage operation for nonunion of the humerus.

BACKGROUND:In the past, the culture and differentiation of bone marrow mesenchymal stem celsin vitrowere mostly reported in the adult or animal rather than in children.
OBJECTIVE: To explore the ability of bone marrow mesenchymal stem cels from children differentiating into neural stem cels and nerve cels.
METHODS: Bone marrow mesenchymal stem cels from children were isolated and cultured, and passage 12 cels were cultured in the pre-induction medium (DMEM culture medium containing 10% fetal bovine serum and 1 mmol/L β-mercapto ethanol) and induction medium (DMEM containing 2% dimethyl sulfoxide and 150 μmol/L butylated hydroxyanisole). Expression of nestin and β-tublin III was detected using immunocytochemistry method at 30 minutes and 7 days after induction, while RT-PCR was used to detect nestin mRNA expression at 0, 5.5, 6 days after induction.
RESULTS AND CONCLUSION: After combined induction, the cels shrank from round shape to tapered, polygonal or oval shape, and cel processes extended gradualy and became filament-like shape. Interconnected cels formed a network at 6 days after combined induction. The expression of nestin antigen was positive at 30 minutes after induction, while the expression of β-tublin was positive at 7 days. RT-PCR findings showed that positive expression of nestin mRNA was detected at 5.5 hours of induction, and then disappeared at 6 days. These findings show that the combined use of dimethyl sulfoxide and butylated hydroxyanisole can induce bone marrow mesenchymal stem cels from children to differentiate into neural stem cels and nerve cels in vitro.

Objective The purpose of the experiment is to research the effects of different kind of anti-platelet drugs and their combinations in prevention of vascular restenosis after ballon-injury, and to evaluate the best way of clinical utility of anti-platelet drugs.Methods Fifty-six male New Zealand White Rabbits were randomly assigned to 3 groups: the control group (ML) , the model group (M) , the experimental group.The experimental group was divided to 5 subgroups, the aspirin group (A), the cilostazol group (B) , the clopidogrel group (C), the aspirin plus cilostazol group (A + B) , and the aspirin plus colopidogrel group (A + C).Femoral artery stenosis model was induced by halloon injury except the control group.The rabbits were fed different drugs 3 days before operation except the normal group and the model group.On the 14th day after operation, the rabbits were sacrificed and the iliofemoral arteries were removed and made to the pathological section.We measured the internal elastic lamina, external elastic lamiua and luminal areas measured.Then calculate the area of intima, media and the ratio of intima vs.media.Results ①There is no endothelium hyperplasia in control group.Compared with the control group, we observed endothelium hyperplasia in both model group and the experimental groups.Compared with the model group, endothelium hyperplasia in all experimental groups is in a lower degree;② Cilostazol alone works better than aspirin alone and clopidogrel alone in prevention of vascular restenosis after ballon-injury.Clopidogrel combined with aspirin and cilostazol combined with aspirin both work better than aspirin alone in prevention of vascular restenosis after ballon-injury.There is no apparent difference between the effect of clopidogrel combined with aspirin and cilostazol combined with aspirin.Conclusions ① Different anti-platelet drugs and different combinations of them can prevent the happening of vascular restenosis after ballon-injury.② Cilostazol works better than aspirin and clopidogrel in prevention the happening of vascular restenosis after ballon-injury, and combination of anti-platelet drugs which contains cilostazol works better than other way of combination of anti-platelet drugs.③ Cilostazol and combination of anti-platelet drugs which contains cilostazol is potential useful in clinical uses to prevent restenosis after PTA.

Objective To investigate the value of 18F-FDG,11C-MET and 11C-CHO PET/CT in the differentiation of C6 glioma from different kinds of inflammation in experimental rat models.Methods (1) A total of 48 male SD rats were randomly divided into 6 groups by the random number table:group 1 and 2 consisted of 8 rats bearing both C6 glioma and turpentine oil-induced acute inflammation;group 3 and 4 consisted of 8 rats bearing both C6 glioma and turpentine oil-induced chronic inflammation;group 5 and 6 consisted of 8 rats bearing both C6 glioma and BCG-induced granuloma.(2) 18F-FDG and 11C-MET PET/CT were performed on rats of group 1,3 and 5;18F-FDG and 11C-CHO PET/CT were performed on rats of group 2,4 and 6.The lesion-to-muscle ratios and tumor selectivity index (SI) were calculated.(3)After the PET/CT imaging,the lesions were excised.Immunohistochemical staining was used to demonstrate the situation of Glut-1,HIF-1α and CD98.(4)Two-sample t test,Nemenyi test and nonparametric Kruskal-Wallis H test were used for statistical analyses.Results (1) 18 F-FDG and 11 C-MET uptake in C6 glioma were higher than those in different inflammatory tissues(t--1.425-3.901,all P＜0.05).The 11 C-CHO uptake among different lesions were not significant (t =0.031-3.901,all P＞0.05).In group 1 and 5 models,SIMET(4.22±2.96 and 4.89±2.08) was significantly higher than SIFDG(1.77±0.86 and 1.72±0.77;t =2.717and 2.490,both P＜0.05);but iu group 3 models,SIMET(3.84±2.71) was not significantly higher than SIFDG(2.28± 1.14;t =2.082,P＞0.05).(2) Immunohistochemical study showed that there were significant differences in the expression of HIF-1 α,CD98 among different lesions (H =17.810,26.540,both P ＜ 0.05),and no significances of expression of Glut-1 among different lesions (H=5.940,P＞0.05).Nemenyi test showed that there was significant difference for CD98 expression between C6 glioma and acute inflammation,C6 glioma and granuloma (x2=5.504,9.345,both P＜O.05),and for HIF-1α and CD98 expression between C6 glioma and chronic inflammation (x2 =-5.938,2.128,both P＜0.05).Conclusions Compared with 18F-FDG and 11 C-CHO,11 C-MET has better tumor specificity.11 C-CHO PET/CT is not suitable for the differentiation of tumor and inflammation because of its lowest specificity.

OBJECTIVE: To investigate the mechanism of Chinese herbal recipe Weichang'an (WCA) in inducing cell apoptosis of human gastric cancer grafted onto nude mice. METHODS: The high performance liquid chromatography was used for monitoring the stability of WCA. A human gastric cancer cell line SGC-7901 grafted in nude mouse was used as the animal model. The mice were divided into untreated group and two experimental groups. Animals in the two experimental groups received either WCA over a 34-day period or 5-fluorouracil (5-FU) over a 6-day period starting at the 8th day after grafting. Animals in the untreated group received normal saline on an identical schedule. Animals were killed 41 days after being grafted. To assess the effect of the treatment on tumor, the tumor weight was determined by the electron balance immediately after the animals were killed. SP immunohistochemical method was used to detect the expression of proliferating cell nuclear antigen (PCNA) in grafts. Apoptotic indices (AI) of the tumor cells were examined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate fluorescence nick end labeling (TUNEL) method. SP method was also used to detect the expressions of cleaved caspase-3, caspase-8 and caspase-9. SYBR green dye I real-time quantitative polymerase chain reaction (real-time quantitative [corrected] PCR) was used to assess the related gene alterations in mRNA level. The expressions of phospho-Stat3 (Tyr705) and bcl-2 proteins were detected by using SP method. RESULTS: Compared with the untreated group, tumor growth was significantly inhibited by treatment of WCA or 5-FU (P<0.01, respectively). The tumor inhibition rate in the WCA-treated group was 48.70% and that in the 5-FU-treated group was 60.10%. The average labeling index (LI) for PCNA in the WCA-treated group and 5-FU-treated group was significantly decreased as compared with that in the untreated group, respectively. The AI of human gastric cancer grafted in the nude mice detected by using TUNEL method was significantly increased to (9.72+/-4.51)% in the WCA-treated group, while it was (2.45+/-1.37)% in the untreated group. 5-FU-treated group was also found a significantly increased AI compared with the untreated group. The expressions of cleaved caspase-3 and caspase-9 in the WCA-treated group and 5-FU-treated group were significantly increased as compared with those in the untreated group. But caspase-8 showed no significant alteration either in the WCA-treated group or in the 5-FU-treated group. The expression levels of Stat3 (2(-)delta delta C(T))=0.16) and bcl-2 (2(-)delta delta C(T))=0.10) detected by using real-time quantitative [corrected] PCR were lower in the WCA-treated group than those in the untreated group. The expressions of phospho-Stat3 (Tyr705) and bcl-2 in the WCA-treated group were significantly decreased as compared with those in the untreated group. CONCLUSIONS: Chinese herbal recipe WCA can inhibit gastric cancer cell SGC-7901 growth in vivo, induce gastric cancer cell apoptosis and suppress the cell proliferation. WCA induces apoptosis through the caspase-9 and caspase-3 pathway in vivo. Its mechanism might be involved in the down-regulation of Stat3 and bcl-2 genes.

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot.

ObjectiveTo investigate the current status of malnutrition and its association with prognosis in hospitalized patients with decompensated liver cirrhosis. MethodsA total of 101 patients with decompensated liver cirrhosis who were treated in our department from January 2013 to December 2014 were enrolled, and according to the Nutritional Risk Screening 2002, they were divided into malnutrition risk group and non-malnutrition risk group. Serum nutritional indices, anthropometric parameters, body composition, and the incidence rates of complications and fatality within 6 months were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the non-malnutrition risk group, the malnutrition risk group had significantly lower serum levels of albumin, total cholesterol, triglyceride, and hemoglobin, body mass index, arm muscle circumference, triceps skinfold thickness, and grip strength (t=12.562, 5.967, 4.024, 14775, 4607, 7.182, 7.424, and 2.256, all P＜0.05). Compared with the non-malnutrition risk group, the malnutrition risk group had significantly lower intracellular water, total body water (TBW), protein, fat, and skeletal muscle content (t=2920, 6152, 1713, 2444, and 1.693, all P＜0.05), as well as a significantly higher extracellular water/TBW ratio (t=1.998, P＜005). Compared with the non-malnutrition risk group, the malnutrition risk group had significantly higher incidence rates of gastrointestinal bleeding, hepatic encephalopathy, portal vein thrombosis, and electrolyte disturbance and fatality (χ2=6.410, 4.436, 3.978, 4316, and 7.285, all P＜0.05). ConclusionPatients with decompensated liver cirrhosis and malnutrition have significantly increased incidence rates of complications and fatality, and it is necessary to enhance nutrition screening in the early stage of liver cirrhosis.

Objective To analyze the data from intensity-modulated radiotherapy ( IMRT) for prostate cancer guided by kilovoltage cone-beam computed tomography (CBCT), and to provide a clinical basis for selecting the optimal image registration method and reasonable target volume margins.Methods A total of 16 patients with prostate cancer who received radical IMRT were enrolled, and CBCT for online position verification was performed 214 times.The images were obtained after conventional skin marking and laser alignment, and automatic registration, bone registration, soft tissue registration, and manual registration were performed for CBCT images and planned CT images.The differences between these four registration methods were evaluated, and the margins for extending clinical target volume into planning target volume (PTV) were calculated.Results The setup errors in left-right, anterior-posterior, and cranial-caudal directions for automatic registration, bone registration, soft tissue registration, and manual registration were-0.6±2.8 mm/-0.6±4.5 mm/-0.6±3.8 mm,-0.7±2.7 mm/-0.9±4.5 mm/-0.8±4.1 mm,-0.8± 2.6 mm/-0.3±4.4 mm/-1.1±4.0 mm, and-0.6±2.9 mm/-0.7±5.1 mm/-0.9±3.9 mm, respectively. There were no significant differences between the four registration methods.The margins for extension in the left-right, anterior-posterior, and cranial-caudal directions were calculated as 4.7 mm, 5.2 mm, and 6.5 mm, respectively.Conclusions With a comprehensive consideration of various factors, a default setting of automatic registration and manual fine adjustment is appropriate for CBCT-guided radiotherapy for prostate cancer.The margins for extension in the left-right, anterior-posterior, and cranial-caudal directions are 4.7 mm, 5.2 mm, and 6.5 mm, respectively.

Objective To observe the motions of the rectum and bladder by image?guided radiotherapy ( IGRT) and to analyze their impact on treatment. Methods Eighteen patients with prostate cancer undergoing intensity?modulated radiotherapy ( IMRT) were enrolled in the study and 247 cone?beam computed tomography ( CBCT) images were obtained from this study. The clinical target volume, bladder, and rectum were contoured on all simulated CT and CBCT to examine their volume and position changes. The dose distributions were recalculated based on the data of the x?, y?, and z?axis setup errors. The doses to planning target volume ( PTV) and organs at risk were calculated in the replanning, and their impact on treatment was analyzed. Comparison of the planning and replanning results was made by paired t?test. The effects of displacements and volumes of the bladder and rectum on target doses were analyzed by Pearson correlation method. Results Great changes in the volumes of the bladder and rectum were observed during the treatment. For the planning and replanning results, PTVD95% was 7777. 37 cGy vs. 7628. 56 cGy ( P=0. 027), PTV Dmin was 87. 91 cGy vs. 83. 35 cGy (P=0. 000), and RVP was 5. 89% vs. 8. 31%(P=0. 000). There were correlations between PTVD95% and the motions of the bladder and rectum, with correlation coefficients of 0. 296 and 0. 177, respectively. The correlation coefficient between rectal volume and PTVD95% was 0. 115, indicating a certain correlation. There is a certain correlation between and PTV Dmin and bladder volume, with a correlation coefficient of?0. 128. Conclusions The recovery of the state during localization for the bladder and rectum, especially the latter, has great significance to ensure the target dose and reduce exposure of the rectum in the IMRT for prostate cancer.