Objective To analyze the MRI features of Hirayama disease(HD)with cervical natural position and its diagnostic val-ue.Methods The natural position of cervical vertebra with MRI examination was used in 1 5 patients and 40 normal people.The spe-cificity and sensitivity of MRI features were analyzed and the ratio of cervical sagittal diameter/cervical transverse diameter (CSD/CTD)of the lower cervical cord was measured.Results CSD/CTD of the patients and control group had a significant difference (t=7.99,P =0.00).The sensitivity of LOA was 86.7%,and its specificity was 88.4%.The sensitivity of atrophy of the lower cervical cord was 80.0%,and its specificity was 79.5%.The sensitivity of the cervical spine curvature abnormalities was 40.0%,and its spe-cificity was 65.2%.The sensitivity of abnormal signal in the spinal cord was 46.7%,and its specificity was 87.5%.The sensitivity of abnormal signal in the epidural outer cavity was 20.0%,and its specificity was 96.8%.Conclusion MRI features of lower cervical cord in combination with clinical symptoms and signs can be helpful for the accurate diagnosis of HD.

Objective To compare the clinical effect of vascularized fibular flap transplantation and vancomycin sulfate calcium on chronic osteomyelitis of the tibia and bone defects.Methods A total of 35 cases with chronic tibial osteomyelitis and bone defect were involved and divided into group A with 21 cases receiving anastomosis of vascularized fibular flap transplantation and group B with 14 cases recciving vancomycin sulfate calcium.Infection control rate and Enneking score were compared in both groups.Simultaneous detection of two groups preoperative,postoperative 2 weeks,1 month and 3 months of the levels of CRP and PCT were conducted.Results Postoperative CRP and PCT were under control in both groups.No statistical significance was found in the comparison of CRP and PCT preoperative and postoperative 2 weeks,1 month and 3 months.In terms of infection control rate,two groups had no signiticant difference (P ＞ 0.05) and there was statistical significance of the comparison of postoperative Enneking score (P ＜ 0.05).Conclusions The clinical results of the two methods are satisfied.The infection degree and the length of the bone defect are decisive factors in choosing the treatment method and sometimes the combination of two treatment methods may be a better choice.

Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.

Objective To study the effect of percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) in treatment of acute severe cholecystitis.Method The perioperative data of patients treated with PTGBD combined with LC and patients treated with emergency LC were analyzed.Results There were no significant difference between the two groups on surgical duration (t =0.601,P =0.551) and postoperative hospital stay (t =0.979,P =0.331).Blood loss [PTGBD + LC (79.43 ± 46.27) ml,LC (125.84 ± 64.18) ml ; t =3.641,P ＜ 0.05],peritoneal drainage time [PTGDB + LC (3.29 ± 1.58) d,LC (4.63 ± 2.31) d ; t =3.131,P ＜ 0.05] and postoperative oral intake time [PTGBD +LC (2.91 ±1.58)d,LC (4.21 ±2.22)d; t =2.669,P＜0.05] were significantly different between the two groups.The rate of laparotomy,mortality and postoperative complications in the emergency LC group were higher than those in the PTGBD combined with LC group.Conclusions PTGBD combined with LC in the treatment of acute severe cholecystitis was significantly better than emergency LC.

The cDNA coding spinach glycolate oxidase (GO) was amplified by RT-PCR using the total RNA of spinach leaves as the template, and was cloned into cloning vector pMD18-T. After the DNA sequence was determined, the go gene was subcloned into E. coli expression vector pBV220, pET-22b(+), pTIG-Trx and pThioHisC. SDS-PAGE analysis revealed that the recombinant E. coli BL21 (DE3) (pTIG-Trx-GO) and E. coli BL21 (DE3) (pET-22b(+)-GO) expressed the predicted 38 kD glycolate oxidase, and the enzyme activity was also detected.
Alcohol Oxidoreductases ; genetics ; isolation & purification ; metabolism ; Cloning, Molecular ; Escherichia coli ; Gene Expression ; drug effects ; Isopropyl Thiogalactoside ; pharmacology ; Spinacia oleracea ; enzymology ; genetics

Objective To evaluate the prognostic value of serial 18F-fluorodeexyglucose (FDG) PET/CT in patients with nasopharyngeal carcinoma (NPC).Methods Thirty-seven NPC patients who had 18F-FDG PET/CT scan before and after external beam intensity-modulated radiotherapy, were studied retrospectively.All patients were followed for five years.Correlation analysis between metabolic tumor volume (MTV)/uptake volume index (UVI) and survival was performed by Kaplan-Meier analysis, Log-rank test and multivariate Cox model.Results The 5-year overall survival (OS) and disease-free survival (DFS) rates were 70.3% (26/37) and 62.2% ( 23/37 ), respectively.Patients with a lower MTV (MTV＜30 cm3) had significantly higher 5-year OS ( 82.6% ( 19/23 ) ) and DFS (73.9% ( 17/23 )) rates than those with a higher MTV (OS:50.0% (7/14),x2 =5.28, P＜0.05; DFS:42.9% (6/14),x2 =4.84, P＜0.05).Patients with a lower UV1 (UVI＜150) had significantly higher 5-year OS( 87.5%( 21/24 )) and DFS (79.2% (19/24)) rates than those with a higher UVI (OS:38.5% (5/13),x2 =10.72, P＜0.01;DFS:30.8% (4/13), x2 =11.04, P＜0.01).Multivariate analysis showed that UVI and metabolic response (MR) were independent predictors of DFS.Conclusions Tumor volume parameters, UVI and MR, are independent prognostic factors for patients with NPC.Patients with a high UVI may benefit from more aggressive treatment.

OBJECTIVETo evaluate the clinical value of (18)F-FDG PET-CT and enhanced CT imaging for staging of regional lymph node metastasis in non-small cell lung cancer (NSCLC) patients.

METHODS122 patients with proven or suspected NSCLC underwent integrated PET-CT and enhanced CT scan before surgery. The results of lymph node metastasis diagnosed by PET-CT and CT were compared and analyzed according to the results of histopathological examination.

RESULTSPET-CT showed correctly lymph node staging in 80.3% of cases, overstaged in 13.1%, and understaged in 6.6%, while 55.8%, 26.2% and 18.0% by CT, respectively. The sensitivity, specificity, and accuracy of PET-CT for lymph node staging was 86.3%, 85.0% and 85.3%, respectively, while the corresponding data were 68.6%, 71.0% and 70.4% by CT, respectively (P < 0.01). 81.3% of false-negative and 71.6% false-positive lymph nodes by CT were interpreted correctly by PET-CT, while 57.1% of false-negative and 45.2% of false-positive lymph nodes by PET-CT were correctly diagnosed by CT. 5.9% of PET-CT-diagnosed negative lymph nodes were pathologically proven to be positive with small cancer foci and below 10 mm in diameter, while 8.2% of pathologically proven negative lymph nodes with inflammation, high FDG uptake and exceeding 10 mm (15 mm in subcarnial nodes) in diameter were false-positive on both PET-CT and CT imaging, therefore, these lymph nodes were still in the common blind area of diagnosis by both of PET-CT and CT.

CONCLUSIONCompared with enhanced CT, integrated PET-CT improves the accuracy and is helpful to correct some CT-diagnosed false-positive and false-negative lymph nodes. But CT is also beneficial supplementation to PET-CT for assessment of regional lymph node metastasis. The combination of PET-CT and CT can make up the shortage of both of them in staging of regional lymph nodes in NSCLC patients.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; pathology ; False Negative Reactions ; False Positive Reactions ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Positron-Emission Tomography ; methods ; Radiopharmaceuticals ; Tomography, Spiral Computed ; methods

Objective To investigate the effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) on autophagy and the secretion of chemokine receptor CXCR4 induced by low-dose immunosuppressive durgs.Methods Flow cytometry was used to detect the changes of hUC-MSCs surface markers after treatment with low-dose tacrolimus and rapamycin.The effect of treatment with tacrolimus and rapamycin on proliferation of hUC-MSCs was analyzed with WST-1 assay.Regular RT-PCR was applied to analyze the mRNAs expression of ligands such as LC3B,Atg5 and Beclin1 in hUC-MSCs.Western blotting was carried out to detect the expression of LC3B,Atg5,Beclin1 and p-ULK1 in hUC-MSCs after treatment with tacrolimus and rapamycin.The secretion of chemokine receptor CXCR4 in hUC-MSCs was analyzed under the state of autophay by flow cytometry.Results Flow cytometry analysis confirmed low-dose immunosuppressive drugs tacrolimus and rapamycin did not cause changes in hUC-MSCs phenotypes significantly.Low-dose tacrolimus had no cytotoxic effect on hUC-MSCs,while,rapamycin could inhibit the proliferation of hUC-MSCs after 24 h or 48 h,with survival rate being 73.66％ and 68.81％ (P＜0.05) of controls,respectively.Moreover,both tacrolimus and rapamycin could inhibit PI3K/AKt/mTOR signaling pathway to activate hUC-MSCs autophagy,and the related proteins of LC3B,Atg5 and Beclin1 increased significantly and induced the up-regulation of CXCR4 secretion.Conclusion Our results here demonstrated that low-dose tacrolimus and rapamycin induce autophagy in hUC-MSCs and promote the secretion of CXCR4.

OBJECTIVETo study the effect of different optical impression methods in Cerec 3D/Inlab MC XL system on marginal and internal fit of all-ceramic crowns.

METHODSA right mandibular first molar in the standard model was used to prepare full crown and replicated into thirty-two plaster casts. Sixteen of them were selected randomly for bonding crown and the others were used for taking optical impression, in half of which the direct optical impression taking method were used and the others were used for the indirect method, and then eight Cerec Blocs all-ceramic crowns were manufactured respectively. The fit of all-ceramic crowns were evaluated by modified United States Public Health Service (USPHS) criteria and scanning electron microscope (SEM) imaging, and the data were statistically analyzed with SAS 9.1 software.

RESULTSThe clinically acceptable rate for all marginal measurement sites was 87.5% according to USPHS criteria. There was no statistically significant difference in marginal fit between direct and indirect method group (P > 0.05). With SEM imaging, all marginal measurement sites were less than 120 microm and no statistically significant difference was found between direct and indirect method group in terms of marginal or internal fit (P > 0.05). But the direct method group showed better fit than indirect method group in terms of mesial surface, lingual surface, buccal surface and occlusal surface (P < 0.05). The distal surface's fit was worse and the obvious difference was observed between mesial surface and distal surface in direct method group (P < 0.01).

CONCLUSIONUnder the conditions of this study, the optical impression method had no significant effect on marginal fit of Cerec Blocs crowns, but it had certain effect on internal fit. Overall all-ceramic crowns appeared to have clinically acceptable marginal fit.

Ceramics ; Computer-Aided Design ; Crowns ; Dental Porcelain ; Dental Prosthesis Design ; Humans

OBJECTIVETo compare the application of HE and enzyme histochemical staining in assessing the viability of hepatocellular carcinoma (HCC) cells coagulated by microwave ablation at different temperatures.

METHODSTwo groups of mice (n=6) with transplanted homogenic HCC were treated by microwave ablation at 60 degrees C and 50 degrees C for 3 min, respectively. Before and after microwave ablation, paraffin sections and frozen sections of the tumors were prepared for routine HE staining and enzyme histochemical staining with nicotinamide adenine dinucleotide diaphorase (NADH-diaphorase), respectively, and observed under microscope.

RESULTSShortly after microwave ablation, the morphology and arrangements of the nucleus of the ablated tumor cells in the two groups showed no obvious alteration in HE stained sections, but in sections with enzyme histochemical staining, the activity of NADH-diaphorase in ablated tumor tissue at 60 degrees C disappeared, suggesting the death of HCC cells; sporadic activity of the enzyme was detected in the coagulated tumor at 50 degrees C, indicating tumor cells surviving the ablation. The ablation effect was markedly different between the two groups (P<0.01).

CONCLUSIONHE staining is not suitable for evaluation of HCC destruction immediately after microwave ablation, and detection of NADH-diaphorase activity with the enzyme histochemical method better suits this purpose.

Animals ; Catheter Ablation ; methods ; Dihydrolipoamide Dehydrogenase ; metabolism ; Female ; Histocytochemistry ; methods ; Liver Neoplasms ; enzymology ; pathology ; therapy ; Liver Neoplasms, Experimental ; enzymology ; pathology ; therapy ; Mice ; Mice, Inbred C57BL ; Microwaves ; therapeutic use ; Temperature