Clavicle ; Forensic Medicine ; Fractures, Bone ; Humans ; Skull Base

Objective To research the key technique in the virtual surgery, and to build a 3D virtual surgical system for medical imaging. Methods In VC++ platform, the volume data were segmented by using a 3D segmentation algorithm. The 3D reconstruction and virtual cutting were achieved with the help of VTK, and the performance of the varied cutting methods was analyzed. Results The interactive 3D reconstruction, virtual scalpel cutting and virtual surgical planning of the medical CT/MR images were realized. Conclusion This system offers great help for doctor to simulate the operative process, to observe the 3D models of human organs and to carry out the computer-aided surgery.

Objective To clone the gene of arginine kinase (AK) from Periplaneta americana, produce its recombinant protein and investigate its allergenicity. Method The cDNA of AK was cloned using specific primers from the total RNA of P. americana. The cloned gene was inserted into pMD18-T vector and digested by BamHI and HindⅢ. The cDNA was sequenced and subcloned into pET-28a expression vector. The cloned AK cDNA gene was expressed in Escherichia coli BL21 (DE3) by IPTG induction. The recombinant AK (rAK) was purified by metal (Ni2+) chelating affinity chromatography. Its allergenicity was examined by both Western blotting and enzyme-linked immunosorbent assay (ELISA). Result The cloned cDNA ORF sequence (Accession no. EU429466) contained 1 068 bp and encoded 365 amino acids. Its sequence homology with the published one (Accession no. AY563004) was 99.9% at nucleotide level. The allergen rAK was highly expressed in E. coli BL21 (DE3) as a soluble protein mainly with the molecular weight of about Mr 45 000 under induction of IPTG and purified by 6-His-tag purification system. Both in the non-denaturalization and denaturalization conditions, the recombinant allergen was identified as its affinity to IgE antibodies from the cockroach-allergic patient sera by Western blotting and ELISA. Conclusion The recombinant cockroach arginine kinase has been obtained with proper allergenicity.

Objective To design two-point two-line vein pricking for avoiding pain for patients and blood osmosis out of the vein caused by the high-pressure and fast-speed of the current high-pressure injector.Methods 19G butterfly-wing vein transfusion needle in the length of 19mm was used.The first point was needled with the needle tip under the skin and the first needling line was above and parallel the blood vessel in the length of 10-12mm.The second point was needled,with the second needle tip and needle line in the blood vessel,and the length of needling is 7-9mm.Results 100 persons were subjected.All the contrast medium and the physiologic saline were injected in vein in 98 persons,among which 2 had little hard tubercle in injecting area.Conclusion The two-point two-line vein pricking is safe for high pressure injector injecting in vein,and can prevent blood osmosis out of the vein.

Objective To employ intraoperative discography to determine the injured intervertebral disc segments that can not be identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53％,68％ and 76％ respectively.Mean operation time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.

Objective To investigate the relationship between leptin receptor(LEPR) gene Gln223Arg in polymorphism and serum leptin level of patients with asthma.Methods A case-control study was conducted.One hundred and ninety-two asthma patients were recruited from asthma gene library,among them 100 patients only with asthma(asthma group) and 92 patients with both asthma and metabolic syndrome(asthma complicated with metabolic syndrome group).And 108 normal people were selected as control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the polymorphism of LEPR gene Gln223Arg locus.Serum leptin levels were measured by enzyme-linked immuno sorbent assay,its relationship with asthma was analyze.Results The frequencies of genotype GG,GA,AA in asthma group,asthma complicated with metabolic syndrome group and normal control group were (83.00％ (83/100) vs.83.70％ (77/92) vs.70.37％ (76/108),15.00％ (15/100) vs.15.22％ (14/92) vs.27.78％ (30/108),and2.00％ (2/100) vs.1.08％ (1/92) vs.1.85％ (2/108) respectively).G and A alleles in asthma group,asthma complicated with metabolic syndrome group and normal control group were 90.50％ vs.91.30％vs.84.26％,9.50％ vs.8.70％ vs.15.74％ respectively.Compared with the control group,GG genotype and GA + AA genotype were different between in asthma group and asthma complicated with metabolic syndrome group.The patients with GG genotype showed 2.056 (x2 =4.599,P =0.032,OR =2.056,95％ CI =1.057-3.999) and 2.161 folds (x2 =4.907,P =0.027,OR =2.161,95 ％ CI =1.084-4.311) risk in asthma group and asthma complicated with metabolic syndrome group than that with GA + AA genotype.In terms of leptin levels,in asthma group,female were significant higher than that of control group (P =0.037,P =2.93),while in asthma complicated with metabolic syndrome group,male and female were significantly higher than control group (P =0.001,0.000 ; P =4.530,4.690).Conclusion The polymorphisms of LEPR gene locus Gln223 Arg are related with asthma.Genotype GG carrier is susceptible for the disease.In female,serum leptin is positive relationship with asthma group,especially in asthma complicated with metabolic syndrome.

Adult ; Female ; Humans ; Melanoma ; diagnosis ; pathology ; Neurocutaneous Syndromes ; diagnosis ; pathology

AIM: To determine 5 different aphrodisiacs,including apomorphine,yohimbine,vardenafil,sildenafil and alprostadil,adulterated into Chinese proprietary medicine by LC/MS(n),and build a laboratory library including MS(n) spectra and retention time. METHODS: ZORBAX SB C_18 column(150 mm?4.6 mm,5 ?m)was applied.The mobile phase consisted of acetonitrile and 0.5% formic acid changing by linear gradient elution,and the flow rate was 1.0 mL/min.The ion trap mass spectrometer with positive ion mode electrospray(ESI?) was applied. RESULTS: In the mass spectrum apomorphine,yohimbine,vardenafil and sildenafil showed abundant pseudomolecular ion +,and alprostadil showed abundant pseudomolecular ion -.All the MS(n) spectra showed characteristic product ion. CONCLUSION: It is proved that the method is simple,reliable and suitable to determin aphrodisiac adulterated to health food.

Objective To probe the advantages and characteristics of imaging on dual-energy CT boneless and digital sub- traction brain angiography through comparative analysis. Methods Siemens 64-slice dual-source spiral CT and double high pressure syringe; The 200 patients were randomly divided into dual-energy group(n=100) and DSACT group(n=100); Every patient was injected 50 ml contrast medium and 50ml normal saline, injection rate was 4ml/s. Results The groups of cere- bra-vascular imaging without interference, and completely boneless; but experimental group has more boneless defects and vascular surface definition less. The cerebral arteries were interfered by the venous shadow in dual-energy group, and the dual-energy group received low-dose radiation. Conclusion The DSACT imaging quality is superior to dual-energy CT boneless imaging. The radiation dose of the dual -energy CT is lower than DSACT.

Objective The filum terminale(FT)plays an important role in the pathophysiology of tethered cord syndrome(TCS).The study on morphology and structure of fetus FF can provide reference standard for diagnosis of TCS.Methods Ten fresh human aborted fetuses had their fila measured and removed.Transversal and longitudi nal sections of the middle,and distal thirds of FF were submitted to light microscopy analysis with four different techniques.Results The bulk of the Frr is composed of 1～5μm thick spring like longitudinal bundles of colla gen separated by 5～30μm layer intervals and 1～5μm intervals in the layer,although a small quantity of eapillar ies and other elements may be present.Collagen bundles can also be found between layers and bundles.Abundant longitudinally oriented elastic fibers ale found inside or between collagen bundles.Conclusion A complex tridi mensional structure composed by ordered arrangement of spring like fibers and small quantity of capillaries should e licit considerable elastic properties to the FI".Tts alternation of structure and element maybe involved in TCS closely.