[Objective]To investigate curative effect for thoracolumbar burst fractures by the method of vertebral pedicle screw fixation applied in the with transpedicular bone graft,and consider its indications.[Method]Thirty cases of thoracolumbar burst fractures were treated by vertebral pedicle screw fixation combining transpedicular bone graft.Among them 22 were male and 8 were famale,age ranged 18-64.All of cases were single segment fractures.The average height of anterior border was 35% before the operation,the average of Cobb's angle was 26?,the percentage of midsagital diameter was 55%.According to Frankel's neurological function classification,preoperative neurological function was Grade A in 4 cases,B in 8,C in 5,D in 6,E in 7.[Result]All cases were followed up for 6 to 30 months.All patients' pain relieved distinctly,the average height anterior border was increased to 97%,the average of Cobb's angle was 3.5?,the percentage of midsagital diameter was 92% postoperatively,showing significant difference(P

ObjectiveTo investigate current iodine nutritional status of different groups of people in Harbin city, and to provide the basis for development of salt iodization standard and scientific iodine supplementation.MethodsThree urban districts and three surrounding counties were chosen in Harbin,2011.In each chosen urban district and county,one district office (township) was selected,and one residents committee (village) was chosen in each of the district office(township),and 30 households were selected by systematic sampling.Iodized salt,water iodine and iodine intake per capita were investigated.In each of the residents committee (village),20 adults aged 18 - 45,30 pregnant women or lactating women,and 100 school children aged 8 - 10 were selected.Urine samples were collected and urinary iodine level were tested.Salt iodine was determined by direct titration,water and urinary iodine by arsenic cerium catalytic spectrophotometry.Iodine uptake and iodine nutritional status of different populations in Harbin urban and rural areas were compared.ResultsThe edible rate of qunlified iodized salt were 93.3％(84/90) and 96.3％(156/162) in Harbin urban and rural residents,respectively,which were all greater than 90％,and the highest value of salt iodine were 38.3,46.0 mg/kg,respectively,in urban and rural areas,which all did not exceed the upper limit(50 mg/kg) of qualified iodized salt,but there were some samples of salt iodine content below the national standard(20 mg/kg).Water iodine value in urban and rural areas,even the highest value(9.40,8.40 μg/L),was failed to meet the national standard 10 μg/L; salt eaten by rural people perperson a day(8.33 g) was significantly higher than that of the urban people(7.03 g,Z=- 2.750,P ＜ 0.01); in addition to rural children aged 8 - 10,whose urinary iodine value(228.6 μg/L) was higher,the values in urban and rural adults ( 111.3,195.6 μg/L),pregnant women ( 193.0,172.9 μg/L),lactating women ( 128.4,173.7 μg/L)and urban children ( 186.8 μg/L ) were all in appropriate level.The urinary iodine medians ( 195.6,228.6 μg/L )of adults and children in rural were significantly higher than that of urban adults and children(111.3,186.8 μg/L,Z =- 2.294,- 5.434,P ＜ 0.05 or ＜ 0.01,respectively).Population composition of iodine deficiency in both urban and rural adults,lactating and pregnant women[46.7％(28/60),21.6％(13/60) ; 21.1％(19/90),21.3％ (18/89) ; 27.8％ ( 25/90 ),42.2％ (38/90) ] were significantly higher than that of the population composition with iodine excess[4.6％(4/60),5.0％(3/60) ; 16.7％(15/90),16.9％(15/89) ; 4.4％(4/90),0.0％(0/90)],but proportion of iodine excessive population in rural children [26.3％(79/300)] was significantly higher than proportion of iodine deficiency[5.6％(17/300)].ConclusionsThe natural environment of Harbin city is still in the iodinedeficient state.In addition to children in rural areas,the iodine intake and iodine nutrition level is basically appropriate; the risk of disease caused by iodine deficiency in adults,lactating and pregnant women is higher than by iodine excess,but the situation of children in rural is on the opposite.Therefore,we should strengthen the monitoring of different populations,and supplement iodine scientifically based on their need.

Diagnostic Errors ; Female ; Femoral Neck Fractures ; diagnosis ; diagnostic imaging ; Femur Neck ; diagnostic imaging ; injuries ; Humans ; Radiography ; Young Adult

BACKGROUND: There still is rarely report about the effect of glycosylphosphatidilinoditol-specific phospholipase D (GPI-PLD) on the adhesion function of leukemic cells through screening Medline and CNKI databases.OBJECTIVE: To observe the effect of GPI-PLD on the adhesion function of bone marrow mononuclear cells separated from myeloid leukemia patients, and to investigate the related mechanism. DESIGN, TIME AND SETTING: This study addressing cytology in vitro was conducted at the Hematological Laboratory of Xiangya Hospital from January to June 2004.MATERIALS: Bone marrow was collected from myeloid leukemia patients at the Department of Hematology, Xiangya Hospital, China.METHODS: The GPI-PLD activity of bone marrow mononuclear cells separated from myeloid leukemia patients was measured by using GPI-anchored placental alkaline phosphatase as substrate and Triton-X114 partition. By use of 1,10-phenanthroline, the activity of GPI-PLD was inhibited, the experiment was divided into 2 groups: treatment group adding phenanthroline to achieve a final concentration of 1 mmol/L, while control group adding the same amount of phosphate buffered saline. The adhesion rate to the fibronectin and CD24 expression of these cells were measured by MTT and immunohistochemical method, respectively.MAIN OUTCOME MEASURES: GPI-PLD activity of myeloid leukemic cells, cell adhesion rate, CD24 expression were all measured. RESULTS: The GPI-PLD activity of bone marrow mononuclear cells separated from myeloid leukemia patients was inhibited significantly after these cells were treated by 1 mmol/L 1,10-phenanthroline for 5 hours compared with control groups [(5.40±2.96)%, (42.08±7.21)%, P < 0.01]. At the same time, the adhesion rate of these cells were increased after the GPI-PLD activity was inhibited [(61.19±29.14)%, (49.78±26.73)%, P < 0.01], and the CD24 expression was also up-regulated [(18.5±11.14)%, (16.02±9.68), P < 0.01].CONCLUSION: The adhesion rate of bone marrow mononuclear cells separated from myeloid leukemia patients can be promoted by inhibiting GPI-PLD activity. At the same time, the CD24 expression of GPI-anchored proteins on bone marrow mononuclear cells is improved.

sis were given.

Objective To evaluate the outcome of unconstrained shoulder arthroplasty for severe injury of proximal part of the humerus.Methods Twelve eases were all treated with unconstrained shoul- der arthroplasty.Six patients with complex fractures of proximal humerus and four with bone tumor in the proximal part of the humerus used hemiarthroplasty and two patients with osteoarthritis were managed with total shoulder arthroplasty.Cemented prostheses were used in all the cases.Results The average age was 65 years and the follow-up was 2.3 years.Two cases of complex fractures had light pain with limited external rotation of the shoulder.No pain or prosthetic stems loosening were found,and the range of motion and the function of the shoulder were satisfactory in other cases.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe technique for severe injury of proximal humerus.

Objective To compare the effect of allograft and autograft of bone-patellar tendon- bone (B-PT-B) under arthroscopy in reconstruction of anterior cruciate ligament (ACL).Methods The injured ACL was reconstructed under arthroscopy by using autograft of B-PT-B in 30 cases and al- lograft of B-PT-B in 28 cases from January 2000 to August 2003.After over twelve months follow up,a comparison was done on rehabilitation of quadriceps femoris,knee stability,the Lysholm's score of knee and the enlargement of tunnel in both groups.Results Both groups obtained marked improvement of knee stability and symptoms after operation.But in the early time,the rehabilitation of quadriceps femoris in the ailograft group is faster than that in the autograft group.The rehabilitation of quadriceps femoris, knee stability and the Lysholm's score of knee were similar at 12th month (P＞0.05).There could be seen enlargement of tunnel in both groups,with more in the allograft group (P＞0.05).Conclusion For arthroscopic reconstruction of anterior crucial ligament (ACL),allograft of B-PT-B is good substitute, for it is characterized by effectiveness,convenience and minor side effect.

BackgroundCorneal neovascularization (CNV) is a common eye disease.The researches on the pathogenesis and treatment of CNV are focus in Ophthalmology.ObjectiveThis study was to investigate the effects of culture supernatant from human amniotic epithelial cells (AECs) on CNV in vitro and its mechanism.MethodsHuman AECs were obtained from a placenta and cultured in serum-free medium for 48 hours,and the supernatant was collected.The levels of interleukin-1 receptor antagonist (IL-1 Ra) and pigment epithelium-derived factor (PEDF) in the human AECs culture supernatant were detected by enzyme-linked immunosorbent assay (ELISA).Rabbit corneal epithelial cells (CECs) were obtained and cultured in different concentrations of human AECs culture supernatant for 48 hours,serum-free medium was used as the control group.The expression of vascular endothelial growth factor (VEGF) mRNA and basic fibroblast growth factor (bFGF) mRNA in rabbit CECs were measured by quantitative real-time PCR (QRT-PCR).Human umbilical cord vein endothelial cells (UVECs) were cultured in the three mediums above,and the proliferation of human UVECs (absorbance value,A value) was tested by the cell counting kit 8 ( CCK8 ).Migration assay was performed by the wound healing method for the human UVECs.The membrane ultra-structure of human UVECs was examined under the atomic force microscope (AFM).ResultsCultured and passaged human AECs showed a positive response for keratin.The expression of VEGF mRNA (1.00±0.22) and bFGF mRNA (1.00±0.36) in rabbit CECs was suppressed by the human AECs culture supernatant,with a significant reduction in comparison with the serum-free DMEM group (2.98±0.46,2.55±0.48 )(P=0.001,0.002).The A value was significantly lowered in the human AECs culture group for 72 hours compared with the serum-free DMEM group ( 1.941 ± 0.036 versus 2.144 ± 0.059 ) ( P =0.000 ),and the bFGF-induced migration rate of human UVECs was strongly inhibited by the culture supernatant of human AECs in comparison with serum-free DMEM.The plasma membrane of human UVECs cultured with the human AECs culture supernatant was full of bumps,and decreased intercellular connection and cellular pseudopodia were found on the AFM image.The concentration of IL-1Ra was (153.56±0.36)ng/L and that of PEDF was (70.41 ±0.68 )μ,g/L in the human AECs culture supernatant.Nothing was deteched in serum-free DMEM group.Conclusions Human AECs culture supernatant suppressed the expression of VEGF and bFGF in CECs as well as the migration and proliferation of vascular endothelial cells.The effect may be associated with IL-1Ra and PEDF secreted by human AECs.These results suggest that human AECs may be a potential therapy for the inhibition of CNV.

Background Mitomycin C (MMC) has an inhibitory effect on the growth and proliferation of human pterygium fibroblasts,however,there is little literature about its influence on plasma membrane. Objective This study was to investigate the influence of MMC on the physical and chemical features and ultrastructures of plasma membrane. Methods Human pterygium tissues were obtained during the surgery.Human pterygium fibroblasts were primarily cultured and passaged using explant cultured method and identified by Vimentin staining.The third generation of cells were incubated to 96 well plate at a density of 5 × 103 cells/well,and 0,50,100,200,300 and 400 mg/L MMC was added in the culture well respectively to act for 12 hours.Cell viability was assayed using cell counting kit-8 ( CCK-8 ),and cellular apoptosis was detected using annexin V-FICT/PI.The changes of cell membrane structure were examined under an atomic force microscope.Malondialdehyde( MDA ) content in cell supernatant and level of lactate dehydrogenase ( LDH ) in extracellular fluid were detected to assess the lipid peroxidation level and permeability of cell membrane.Intracellular Ca2+ changes and membrane surface topography were assessed by Fluo-3/AM mark and flow cytometry( FCM ).This study was approved by Ethic Commission of Affiliated First Hospital of Jinan University.Informed consent was obtained from each patient. Results A lot of cells grew with the shape of spindle 1-2 weeks after culture.Positive response was seen in cultured cells for Vimentin.Growth and proliferation of the cells reduced 12 hours after action of MMC with the increase of MMC concentrations.The apoptosis rate of human pterygium fibroblasts was 4.2％,4.2％,5.4％,19.3％ and 25.8％ in 0,50,100,200 and 300 mg/L MMC groups respectively.Different degrees of abnormalities of cells membrane were found in various concentrations of MMC groups.The elevated contents of LDH and MDA in extracellular fluid were detected in various concentrations of MMC groups compared with the control group,and the LDH and MDA levels were gradually ascended as the increase of MMC concentrations,with a significant difference between any two groups(P＜0.05).The disturbance of intracellular Ca2+ homeostasis was also been seen after MMC acted. Conclusions MMC leads to the changes of physical and chemical features in human pterygium fibroblasts at a dose-dependent manner.Cell membrane may be the acting target of MMC.

ObjectiveTo evaluate the diagnostic performance of CTCA in predicting myocardial perfusion defects through comparative analysis between MPI defects and severity of coronary stenosis on CTCA.MethodsFour hundred and seventy-eight patients who underwent CTCA and 99Tcm-MIBI MPI in the same period were analyzed retrospectively.According to the severity of coronary stenosis judged by visual evaluation of the vessel diameter,the patients were divided into five groups:no stenosis,mild stenosis,moderate stenosis,severe stenosis and total occlusion.MPI results were classified as negative or positive for perfusion defects,and the prevalence of perfusion defects in every group was calculated per-patient and per-vessel basis.The cut-off of stenotic severity for predicting myocardial perfusion defects was designated as 50％ or 75％,with MPI as standard reference.True positive,true negative,false positive and false negative statistics were thus determined separately on patient and vessel basis.The diagnostic performance for CTCA were calculated and compared.Pearson Chi-square and its partition tests or Fisher exact test were used to compare ordinal variables.ResultsFifty-eight patients showed myocardial perfusion defects.Either by patientbased or vessel-based analysis,the prevalence of myocardial perfusion defects showed an increasing trend with greater coronary artery stenosis in each group,and there were statistical differences among them (x2 =116.62 and 483.83,both P ＜ 0.05).On patient-based analysis,sensitivity ( SN),specificity ( SP),positive predictive value( PPV),negative predictive value(NPV) and accuracy (AC) for CTCA predicting myocardial perfusion defects were 62.1 ％ ( 36/58 ) and 34.5％ ( 20/58 ) (x2 =8.84,P ＜ 0.05 ),84.5％(355/420) and 97.1％ (408/420) (x2 =40.16,P ＜0.05),35.6％ (30/101) and 62.5％ (20/32) (x2 =7.19,P＜0.05),94.2％ (355/377) and 91.5％ (408/446) (x2 =2.18,P ＞0.05),81.8％ (391/478)and 89.5 ％ (428/478) (x2 =11.66,P ＜ 0.05 ) when the cutoff was set to 50％ and 75％,respectively.On vessel-based analysis,the SN,SP,PPV,NPV and AC for CTCA predicting myocardial perfusion defects were 58.8％ (40/68) and 30.9％ (21/68) (x2 =10.73,P ＜ 0.05),95.9％ (1768/1844) and 99.0％ (1826/1844) (x2 =36.72,P ＜ 0.05 ),34.5％ (40/116) and 53.8％ (21/39) (x2 =4.59,P ＜0.05 ),98.4％ (1768/1796) and 97.5％ ( 1826/1873 ) (x2 =4.14,P ＜ 0.05 ),94.6％ ( 1808/1912 ) and 96.6％ ( 1847/1912 ) (x2 =10.31,P ＜ 0.05 ),respectively.ConclusionsThe prevalence of myocardial perfusion defects correlates positively with the severity of coronary stenosis seen on CTCA.CTCA may predict perfusion defects with high SP and NPV.However,the PPV of CTCA in predicting myocardial perfusion defects is poor when the stenosis cut-off is set at 50％.It is significantly improved when the cutoff value is set at 75 ％.