BACKGROUND: Fixation of bone fracture is one of the fundamental methods for bone fracture healing. The technique of AO has a lot of defects, such as negative effect induced by "stress dodging". Recently, the technique of CO is praised highly by national and international scholars. OBJECTIVE: To observe the influence of external fixation of small splint on healing of long bone fracture of rabbit, and compare to the internal fixation of steel plate.DESIGN: Randomized and controlled animal trial. SETTING: Research Institute of Orthopedics, Hubei College of Traditional Chinese Medicine.MATERIALS: The experiment was performed at the Laboratory of Orthopedics, Hubei College of Traditional Chinese Medicine from April 2006 to April 2007. Thirty rabbits were randomly divided into small splint fixation group and steel plate fixation group with 15 rabbits in each group. Small splint was self-made of fir-barks with good elasticity, and composed of exterior, interior, front and back splints. The upper part of the splint was wide and the lower part was narrow. We sting an eyelet in the small splint that is used in front and behind part. A hole was drilled in the front and back splints close to the tubercle of tibia. Steel plate was provided by Jiangsu Golden Deer Group (Type HA2.0). METHODS: The standard models of transverse fracture of 3 mm in the meta-infer 1/3 of left tibia were established. In small splint fixation group (SSF group), the fracture was fixed by plaster stone, and 5 days later, replaced by external fixation of small splint. The steel fixation group (SF group) was fixed by steel plate with 4 holes. Animals were executed 14, 24, and 34 days after surgery, respectively. The growth condition of bony callus in fracture sites was observed, and the histomorphology of bony callus and bone cell production during fracture healing was observed. MAIN OUTCOME MEASURES: Macroscopic observation of rabbit tibial bony callus, and histomorphology of bony callus and bone cell formation. RESULTS: In SSF group, the bony callus formed early, and there were plentiful and active osteoblast. Thirty-four days after surgery, bony union was observed in fracture sites. In SF group, there was little fibrous bony callus in the fracture ends 14 days after surgery, accompanied by granulation tissue. Twenty-four days after surgery, sparing cartilage synostosis was observed. On day 34 days, bony callus span the fracture ends, but fracture ends did not connect completely yet. Compared with the SF group, the quantity of bony callus and the speed of fracture healing were superior in SSF group. CONCLUSION: The external fixation of small splint can promote osteoblastic differentiation and proliferation, absorption of hematoma, calcification of the bony callus, and the growth and rebuilding of bone trabecula.

Adult ; Angiomatosis ; immunology ; pathology ; surgery ; Antigens, CD ; metabolism ; Diagnosis, Differential ; Female ; Hemangioma ; immunology ; pathology ; Humans ; Hyperplasia ; Spleen ; immunology ; pathology ; Splenectomy ; Splenic Diseases ; immunology ; pathology ; surgery ; Splenic Neoplasms ; immunology ; pathology

Adenomatous Polyposis Coli Protein ; genetics ; Chromatography, High Pressure Liquid ; methods ; Codon ; genetics ; DNA Mutational Analysis ; Fibromatosis, Aggressive ; genetics ; pathology ; Humans ; Mutation ; Polymerase Chain Reaction ; beta Catenin ; genetics

OBJECTIVE:To improve the electronic prescription prior-review mode and increase the rate of qualified prescrip-tions. METHODS:The electronic prescription prior-review mode of our hospital was established by setting up outpatient and emer-gency electronic prescription review team,review evidence and enforcement measures. Aimed at these problems as low review effi-ciency at initial stage,non-unified standards and untimely feedback,quality control circle and internet tools WeChat were used to improve the mode and evaluate its effects. RESULTS:The electronic prescription prior-review mode of our hospital was improved by optimizing system settings,unifying review standard,one-to-one feedback and communication with WeChat public platform, etc. Average time of prescription prior-review had reduced from 50 s to 30.58 s;the rate of qualified prescriptions had increased from 86.77% to 95.30%;prescription review efficiency and the rate of qualified prescriptions had been improved significantly. CONCLUSIONS:The implementation and continuous improvement of electronic prescription prior-review mode can reduce the rate of unqualified prescriptions and promote rational drug use in outpatient and emergency department.

OBJECTIVE: To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor. METHODS: Short hepatic veins were ligated and divided followed by the dissection, and isolation of the inflow and outflow vessels of the tumor-bearing lobe, which were completely devascularized after the occlusion of these vessels. The blood loss volume, postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases. RESULTS: Main hepatic veins were dissected and isolated exo-hepatically in 65 cases. In the other 3 cases, the main hepatic veins were blocked by Satin skin clamp applied longitudely along the inferior vena cava. Hepatic pedicle was routinely excluded.The amount of blood loss was from 400 to 1200 (600+/-200) mL and 26 (65%) cases didn't receive transfusion.There was no operative mortality and liver function failure. Surgical complications included subphrenic abscess in 2 cases and bile leakage in 2 cases, which were cured conservatively. CONCLUSION Highly-selective regional exclusion of hepatic blood flow during the risk hepatectomy is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.
Adult ; Aged ; Female ; Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Liver ; blood supply ; surgery ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Vena Cava, Inferior ; surgery

Adult ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; Cerebral Ventricle Neoplasms ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Fourth Ventricle ; Ganglioglioma ; metabolism ; pathology ; surgery ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Magnetic Resonance Imaging ; Nerve Tissue Proteins ; metabolism ; Oligodendrocyte Transcription Factor 2 ; Rosette Formation ; Synaptophysin ; metabolism ; Young Adult

Objective To evaluate the effects of different interventios on insulin resistance and ?-cell function in population with impaired glucose tolerance(impaired glucose tolerance,IGT).Methods The total of 382 cases of IGT were divided into five groups according to interventions:control(C),diet plus exercise group(D+E),Acarbose Group(A),Metformin(M)and traditional Chinese medicine Group(TCM),with each group making the appropriate intervention programmes.BMI,FPG,2hPG,F-Ins,P-Ins,F-CP and P-CP were determined before intervention and yearly during the follow up,and BMI,HOMA-IR,HOMA-? were calculated.Results By the end of the study,insulin,F-CP,IR Group D+E and FPG,2hPG,insulin,C-peptide,IR in the other groups were significantly lower than before the intervention(P

Objective To analyze the local control rate and the desimetric patterns of local recurrence in nasopharyngeal carcinoma(NPC)patients having been treated with standardized conventional radiotherapy and to evaluate the delineation of rational target volume.Methods From Jan.2000 to Dec.2000,476 patients with untreated NPC were treated by standardized conventional radiotherapy alone at the Sun Yat-sen University Cancer Center.The radiation ports were designed on a X-ray simulator.The nasopharyngeal lesion demonstrated by CT scan and the subclinical spread regions adjacent to the nasopharynx were defined as the target volume.Kaplan- Meier method was used to calculate the cumulative local recurrence rate.For patients with locad recurrence,the primary and recurrent local tumor volumes(V_(nx),V_(recur))were delineated with three-dimensional treatment planning system(3DTPS),and the dataset of radiation ports and delivered prescription dose to the 3DTPS were transferred according to the first treatment.The dose of radiation received by V_(recur)was calculated and analyzed with dose- volume histogram(DVH).Local recurrence was classified as:1.“in-port”with 95% or mere of the recurrence volume((recur)_V_(95))was within the 95% isedase;2.“marginal”with 20% to95% of _(recur)V_(95)within the 95% isedese; 3.“outside”with only less than 20% of _(recur)_V_(95)within the 95% isodose curve.Results With the median follow- up of 42.5 months(range 8～54 months),52 patients developed local recurrence.The 1-,2-,3 and 4-year cumulative local failure rate was 0.6%,3.9%,8.7% and 11.5%,respectively.Among the 42 local recurrent patients who could be analyzed by 3DTPS,52% were in-port,40% were marginal and 7% were outside.For most of the marginal recurrence and all the outside recurrence patients,the main reason of recurrence were related to the unreasonable design of the radiation port and inaccuracy in the interpretation image findings.Conclusions The outcome of better local control rate and the dosimetric pattern of local recurrence show that the target volume is reasonable for NPC in Sun Yat-sen University Cancer Center.Enhancing the capability of correct interpretation of images,accurate design of the radiation pouts and making most useful molecular or functional imaging techniques to escalate the local radiation dose are promising ways to improve the local control further and better.

BACKGROUNDOur previous study confirmed that oligodendrogliomas had higher frequency of chromosome 1p/19q deletion. In order to improve the diagnostic criteria and to predict the prognosis of oligodendroglioma patients, the status of chromosome 1p/19q deletion, the methylation of O(6)-methylguanine-DNA methyltransferase (MGMT), and the expression of p53 protein were evaluated and investigated in relation to patients' outcomes.

METHODSMethylation of MGMT in 73 cases was analyzed by nested methylation-specific PCR (MSP). The levels of MGMT and p53 protein were tested with immunohistochemistry. Pearson's chi-square test and Fisher's exact test were used. Multivariate and Kaplan-Meier analysis were performed to determine patients' outcomes.

RESULTSBoth oligodendrogliomas and astrocytic gliomas exhibited frequent methylation of MGMT. However, the results of MSP did not completely correspond to that of the immunohistochemical staining for MGMT. The expression of p53 protein was more frequently observed in patients without a 1p or 19q deletion in anaplastic oligodendrogliomas (P = 0.032, 0.025). In low-grade oligodendrogliomas, methylation of MGMT was more frequent in patients with 1p/19q deletion than in patients with 1p/19q intact (P = 0.038). Patients with oligodendrogliomas with 1p/19q loss of heterozygosity and p53-negative showed a longer progression-free survival.

CONCLUSIONDetection of chromosome 1p/19q status combined with p53 protein immunohistochemistry might be beneficial to improve the pathological diagnosis and to determine the prognosis of patients with oligodendrogliomas.

Adolescent ; Adult ; Aged ; Astrocytoma ; genetics ; Brain Neoplasms ; diagnosis ; genetics ; mortality ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 19 ; DNA Methylation ; DNA Modification Methylases ; genetics ; DNA Repair Enzymes ; genetics ; Disease-Free Survival ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Loss of Heterozygosity ; Male ; Middle Aged ; Oligodendroglioma ; diagnosis ; genetics ; mortality ; Prognosis ; Tumor Suppressor Protein p53 ; analysis ; Tumor Suppressor Proteins ; genetics

OBJECTIVETo study the clinicopathological and genetic features of desmoid-type fibromatosis, and to investigate the feasibility of detecting trisomy 8 in formalin fixed, paraffin embedded (FFPE) tissue by fluorescence in-situ hybridization (FISH).

METHODSA total of 96 cases were included in this study. All patients had clinical information. Histopathologic and immunohistochemical evaluations were available in 69 cases, and ultrastructural evaluation was done in 2 cases of desmoid-type fibromatosis. FFPE tissue sections were available in 20 tumors for the trisomy 8 detection by FISH.

RESULTSThere were 20 male and 76 female patients with ages ranging from 8 to 86 years (mean 35.3 years). Clinically, there were 44 extra-abdominal tumors, 28 abdominal wall tumors and 23 intra-abdominal lesions mostly involving the mesentery. Most cases presented with nodular or funicular masses with white firm cut surfaces, measuring 0.6 to 24.0 cm (mean 8.4 cm) in size. Histologically, desmoid-type fibromatoses showed longitudinal fascicles of spindle fibroblasts and myofibroblasts in a predominantly collagenous background. The tumor cells stained positive for vimentin, alpha-smooth muscle actin, desmin, and beta-catenin (47.8%, 33/69). Ultrastructurally, most tumor cells had features of fibroblasts, including rich endoplasmic reticulum and Golgi apparatus. Some tumor cells were myofibroblast-like cells exhibiting intercellular junctions, fibronexous junctions and stress fibers. Trisomy 8 was detected in 6 of 20 cases of desmoid-type fibromatosis including 5 of the 8 recurrent tumors but only one of the 12 primary tumors. The latter tumor also recurred three years later.

CONCLUSIONSDesmoid-type fibromatosis is an intermediate (locally aggressive) tumor that occurs predominantly in young females. The lesion consists of fibroblasts and myofibroblasts with the latter showing characteristic features including stress fibers and fibronexous junctions. Trisomy 8 can be detected in FFPE tissue by FISH, and its presence serves as a useful predictor of tumor recurrence and may define a subtype of desmoid-type fibromatosis with high recurrence rate.

Actins ; analysis ; Adult ; Aged ; Aged, 80 and over ; Child ; Chromosomes, Human, Pair 8 ; genetics ; Desmin ; analysis ; Feasibility Studies ; Female ; Fibromatosis, Abdominal ; genetics ; metabolism ; pathology ; Fibromatosis, Aggressive ; genetics ; metabolism ; pathology ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Male ; Mesentery ; Middle Aged ; Muscle, Smooth ; chemistry ; Neoplasm Recurrence, Local ; Peritoneal Neoplasms ; genetics ; metabolism ; pathology ; Trisomy ; Vimentin ; metabolism ; beta Catenin ; analysis