In this paper, we propose a new active contour algorithm, i. e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Models, Theoretical ; Tomography, X-Ray Computed

Objective To evaluate the effect of mental intervention combined with simple brachial plexus anesthesia in children' upper extremity operation. Method 80 cases of8 ～ 12 years old children were selected after strict evaluation and screening,of who needed upper extremity operation(fractures internal fixation not included) ,and the surgery time less than 120 minutes. All the operations were completed under the simple brachial plexus anesthesia, and combined with mental intervention preoperatively and intraoperatively. The changes of HR and BP intraoperatively the psyche condition after the operation completed were observed and followed up the mental change postoperatively. Result All the operation were completed. The HR and BP were stable intraoperation (P ＞ 0. 05), the psyche was quiet after the operation completed,and no mental disorder was happened postoperative. Conclusion The mental intervention combined with simple brachial plexus anesthesia was safe in 8 ～ 12 years old children' upper extremity operation, and it deserved to spread and apply.

BACKGROUND: A latest research indicates that γ~δ T cells following touching with microbe products show characteristics as dendritic cells and antigen-presenting cells (APC) and induce intensive immune response of CD4~+ CD8~+ γ~δ T cells.OBJECTIVE: To verify APC-like functions of γ~δ T cells during transplantation rejection, investigate a simple and effective method to amplify γ~δ T cells in vitro, and to infect γ~δ T cells with FasL retrovirus system.DESIGN, TIME AND SETTING: An animal experiment was performed at Central Laboratory of the First Affiliated Hospital of the Fourth Military Medical University of Chinese PLA from August 2007 to August 2008. MATERIALS: A total of 60 healthy adult Wistar rats of clean grade and weighing 200-320 g were used to establish donor and receptor models with segmental heterotopic small intestine transplantation.METHODS: Models of segmental heterotopic small intestine transplantation were established using three sleevelet vascular anastomosis. γ~δ T cells were obtained using flow cytometry and its function was demonstrated. Mononuclear cells were routinely separated and amplified with Mtb-Ag. MAIN OUTCOME MEASURES: Cell proliferation was observed; percentage of γ~δ T cells for lymphocytes was detected using TCRγ~δ magnetic beads kit; γ~δ T cells following transfection were detected using pLXSN FasL retrovirus system. RESULTS: Activated γ~δ T cells showed dendritic cell-like adhesion function and APC-like functions during transplantation rejection. γ~δ T cells accounted 4.5% for mononuclear cells, the purification of γ~δ T cells was up to 72.2% on the 10~(th) day after activated by Mtb-Ag, and the purification of γ~δ T cells was up to 99.1% through positive magnetic sorting. 285 bp FasL fragment demonstrated that the gene integration was observed in PA317 cells. The ration of FasL+ cells was 97.3% after infected by pLXSN FasL retrovirus system.CONCLUSION: This study demonstrated APC-like functions of γ~δ T cells during transplantation rejection. γ~δ T cells were successfully amplified in vitro. PA317/ pLXSN2FasL+ retrovirus system was successfully constructed and γ~δ T cells were modified by FasL retrovirus system.

Objective:To investigate appropriate accommodation of nutrition after living-related small bowel transplantation.Methods: According to the function of allograft and general body state,TPN was used and gradually transferred to PN+EN,finally to TEN.The clinical and laboratory nutrition markers in 4 recipients were observed.Results: 2 recipients survived over 4 years,various kinds of nutrition markers were normal,and the health status was good.One recipient died of acute pulmonary infarction at 19 days.Another recipient died of multiple system organ infection at 5 months.Conclusion: EN cand promote restoration of allograft function.

Objective:To examine the expression of CLC-3 in colorectal tissues and the effect of CLC-3 on the viability and invasion of colorectal cancer (CRC) SW480 and SW620 cells. Methods:The mRNA levels of CLC-3 in CRC cell lines were determined by RT-PCR. CLC-3 expression was inhibited by adding DIDS or NPPB to the CRC cells. Subsequently, cell viability and invasion were assessed by CCK-8 assay and Transwell assay, respectively. In addition, the effects of DIDS and NPPB on the Wnt orβ-catenin signaling pathways were de-termined by Western blot analysis. Results:The mRNA level of CLC-3 was remarkably increased in the CRC tissues compared with that in normal colorectal tissues (P<0.05) and was positively correlated with the T stage of CRC. The blockade of CLC-3 inhibited the viability and invasion of CRC cells (P<0.05). The expression ofβ-catenin, C-myc, cyclin D1, Ki-67, and survivin were evidently reduced by the in-hibition of CLC-3 (P<0.05). Conclusion:The inhibition of CLC-3 decreases the cell viability and invasion of CRC cells by reducing the ex-pression of the proteins related to the Wnt orβ-catenin signaling pathway.

Objective:To observe the effects of hydrogen on osteogenic capacity of human periodontal ligament cells(hPDLCs)stim-ulated with P.g-LPS.Methods:hPDLCs were cultured and divided into 4 groups:control(C)group,osteogenic induction(OI) group,OI +1 00 ng/ml LPS(OILPS)group and OIPLS +3%H2 (H2 OIPLS)group,and treated respectively.Alizarin red staining (ARS)was carried out 3 weeks after treatment.ALP and OC mRNA expression of the cells was examined by RT-PCR after 7-d treat-ment.Results:LPS decreased A value of ARS(P <0.01 ),ALP mRNA expression(P <0.001 )and OC mRNA expression(P <0.001 )of the cells.H2 increased the A value(P <0.05),ALP mRNA expression(P <0.01 )and OC mRNA(P <0.01 )of the cells treated by LPS.Conclusion:High concentration of P.g-LPS can inhibit osteogenic capacity of hPDLCs,while hydrogen can impair the P.g-LPS induced suppression of hPDLC's osteogenesis.

BACKGROUND:Pedicle screw fixation is the mainstream type of spine operation currently. The key point of the fixation is to make the screw pass through the center of pedicle. The angle of pedicle screw implantation is a key factor for repair quality. In previous literatures, angle of pedicle screw is determined according to the patient body, and is easily disturbed by factors such as position of the body. OBJECTIVE:To determine the inserting angle of pedicle screw of lower lumbar spine taking local anatomic landmark as a reference using digital technology. METHODS:3D-CT data of 100 patients were selected. The fourth and fifth lumbar vertebrae received three-dimensional reconstruction, and the operation was simulated using digital technology to achieve optimal placement. After simulation, the angle of pedicle screw was measured. The angle of the planes of the midline of the screw and the midline of the spine served as coronal angle. The angle of the planes of the midline of the screw and the upper surface of the vertebral body served as sagittal angle. RESULTS AND CONCLUSION:Measure results suggest that each angle was bigger than the angle in previous studies, which might be induced by different reference markers. Standard deviation of each angle was also big. These findings verify that the anatomical differences of pedicles were apparent. Thus, we should insert the pedicle screws individual y. Method of locating reference using anatomic landmarks of a single vertebral body can maximize to avoid interference posture. The combination with preoperative three-dimensional reconstruction is more in line with the requirements of pedicle screw, and can effectively improve the accuracy of pedicle screws.

BACKGROUND:Pancreatic stelate cels transforming growth factor β1/Smads signaling pathway activation is probably a main molecular mechanism of pancreatic fibrosis. If this pathway can be blocked, the progression of fibrosis of tissues with chronic pancreatitis wil be inhibited. OBJECTIVE:To study the inhibitory effect of colchicine on transforming growth factor β1/Smads pathway in chronic pancreatitis rat models. METHODS:Healthy male Sprague-Dawley rats were randomly divided into colchicines-treated group and chronic pancreatitis group. After successful establishment of rat models of chronic pancreatitis, the rats in the colchicines-treated group were intraperitonealy injected with colchicine 150 μg/kg daily. The rats in the chronic pancreatitis group were intraperitonealy injected with equal volume of physiological saline daily. Pancreatic tissues were colected after 3 months. Hematoxylin-eosin staining was used to observe histopathological changes of pancreatic tissue. Immunohistochemical staining was used to detect the expressions of transforming growth factor β1 in pancreatic tissue. Western blot assay was utilized to detect the expressions of P-Smad2, P-Smad3 and α-SMA protein in pancreatic stelate cels. RESULTS AND CONCLUSION: Hematoxylin-eosin staining results revealed that compared with the colchicines-treated group, glandular tissue had reduced, while fibrous connective tissue and inflammatory cels had increased obviously and replaced the pancreatic gland tissue in the chronic pancreatitis group. Immunohistochemical staining results demonstrated that the expression levels of transforming growth factor β1 and the index of positive cels were significantly lower in the colchicines-treated group than those in the chronic pancreatitis group (P < 0.05). Western blot assay results revealed that the results of P-Smad2/β-actin, P-Smad3/β-actin andα-SMA/β-actin in pancreatic stelate cels were significantly lower in the chronic pancreatitis group than those in the colchicines-treated group (P < 0.05). Results suggested that colchicine could inhibit the activity of transforming growth factor β1/Smads pathway and pancreatic tissue fibrosis in chronic pancreatitis rats. Therefore, colchicine can be used as a new candidate therapeutic scheme for chronic pancreatitis fibrosis.

Objective To observe and evaluate the clinical effect of submental island myocutaneous flap(SIMF) and free skin graft(FSG) for the reconstruction of buccal defect resulted from the buccal carcinomas .Methods Forty-four aged aging patients di-agnosed with the buccal carcinomas were operated by the total dissection of primary tumor and selective neck dissection and recon-structed simultaneously with SIMF(19 cases) and FSG(25 cases) .The degree of postoperative cheek shape ,limitation of mouth o-pening ,speech sound ,and function of chewing were observed and analyzed .Results Eighteen SIMFs were completely survived .The residual muscle flap had a good blood supply after the debridement of skin island in one case ,the successful rate of flaps was 94 .7%(18/19) while 100% (25/25) .The donor site of SIMF was sutured directly .Follow-up was taken in 12 months for all patients .In SIMF group ,the degree of postoperative cheek shape ,limitation of mouth opening ,speech sound ,and function of chewing were bet-ter than those of FSG group in FSG group(P<0 .05) .There was no significant difference between 2 groups in the field of recur-rence and metastasis although the recurrence adjacent to the primary tumor had happened in FSG group in 5 months after operation (P>0 .05) .Conclusion The submental island flap is an excellent choice for the reconstruction of cheek defects in aging patients af-ter resection of buccal carcinoma .With acceptable cosmetic ,functional results and reasonable oncological saftety ,SIMF has a prom-ising prospect in head and neck surgery .

Objective To explore the association between rs7049105, rs647188, rs1333035 of chromosome 9p21 and the LAS among Chinese Han population of Changsha;to explore the association between rs7049105, rs647188, rs1333035 and the LAS among patients with evidence of cephalic and cervical vessel atherosclerosis. Methods The present study com?prised 229 LAS patients and 233 healthy controls. The 233 controls which we defined control group 1. In the controls, 150 (64.38%)controls with evidence of atherosclerosis were defined as control group 2, 83(35.62%)controls without evidence of atherosclerosis were defined as control group 3. The sample genotyping was detected using MALDI-TOF-MS. Results There was no polymorphism of rs647188 among case group and control group 1. There was no significant difference in the polymorphism distribution of rs7049105 and rs1333035 between the case group and control group 1 and 3 (P>0.05). There may be no significant different in the polymorphism distribution of rs7049105 between the case group and control group 2 . The rs1333035 was associated with risk of LAS among patients with evidence of cephalic and cervical vessel atherosclerosis (χ2=6.502,P=0.039). Conclusions The rs10757274 and rs7049105 polymorphism in the chromosome 9p21 may not be as?sociated with risk of LAS among Han population of Changsha. There may be no polymorphism of rs647188 among Han popu?lation of Changsha. The rs1333035 polymorphism may be associated with plaque rupture and thrombosis.