Cells, Cultured ; Flutamide ; pharmacology ; Human Umbilical Vein Endothelial Cells ; cytology ; drug effects ; metabolism ; Humans ; Proto-Oncogene Proteins c-myb ; metabolism ; Sp1 Transcription Factor ; metabolism ; Testosterone ; antagonists & inhibitors ; physiology ; Transcription Factors ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Biopsy ; Histological Techniques ; instrumentation ; methods ; Humans ; Indicators and Reagents ; Paraffin Embedding ; Ultrasonics

BACKGROUND:Routine posterior cruciate ligament(PCL)reconstruction can improve posterior stability of the knee joint.But the wear between graft and outlet of tibial tunnel always reduces graft mechanical strength or enlarges tunnel,resulting residual laxity.OBJECTIVE:To explore the clinical application of fluoroscopy-based navigation technique for assisting tibiai tunnel placement in arthroscopic PCL reconstruction and to investigate the efficacy and feasibility of the technique.DESIGN,TIME AND SETTING:Case analysis was performed at Beijing Jishuitan Hospital between August 2006 and March 2007.PARTICIPANTS:of 15 eases with compound ligament injury,14 underwent allograft,and 1 underwent autograft bone-1/3 of patellar tendon-bone.METHODS:The navigation system consisted of tibia tracker fixed into the proximal tibia and tool tracker attachcd with PCL tibial drill guide.With registration and calibration,the navigation system identi fied and captured the infrared signals actively from the two trackers.The computer calculated the 3D-position of the knee joint relative to the PCL tibial drill guide and then the virtue tibial tunnel was imposed into the interactive images formed by the intraoperative C-aim images.The virtue tunnel was precisely adjusted according to the intraoperative planning protocol until the ideal position achieved.In the standard anteroposterior view,the centre of the outlet of tunnel should be in the midpoint between the medial and lateral eminence and 1.5 cm from the articular surface.In sagittal plane,with the intact posterior wall,the tibial tunnel should be as close as to the posterior proximal tibial cortex to get a maximum angulation.MAIN OUTCOME MEASURES:Fluoroscopy time and times,postoperative standard anterior and lateral X-ray,outlet of tibial tunnel,angle between graft and tunnel,attachment of tunnel to posterior cortex,and integrity of posterior wall.RESULTS:Among 15 patients,14 succeeded without navigation related complications and 1 failed.The frequency of intraoperative fluoroscopy reduced from 2-10 times to 2-4 times and the exposure time for fluoroscopy shortened 10-30minutes.The tibial outlet in all success cases was located within the tibialinsertion area of posterior cruciate ligament.The average angulation between the tibial tunnel and the graft was 123.3°;all cases showed close spatial relationship between tunnel and posterior proximal tibial cortex within 2 mm,with intact posterior wall in 10 cases and slightly broken in 4 cases.CONCLUSION:With high accuracy and time-saving features,fluoroscopy-based navigation system is a feasible technique in assisting tibial tunnel placement in arthroscopic PCL reconstruction surgery.

Objectiye To introduce the surgical technique of arthroscopy assisted anatomical posterolateral corner (PLC) reconstruction,including popliteal ligament,popliteofibular ligament and lateral collateral ligament,and evaluate the results of this technique.Methods From August 2008 to April 2010,34arthroscopic posterior cruciate ligament (PCL) and PLC reconstruction surgeries were performed.The average age of the patients was 34.1 (15-52) years.There were 32 males and 2 females.The average time period from injury to surgery was 10.7 months.All patients were chronic injuries and combined ligament injuries,including PCL and PLC injuries.Some cases had other ligament injury,including 6 patients of anterior cruciate ligament (ACL) injury (17.6%),2 of ACL combined medial cruciate ligament (MCL) injuries (5.9%),and 5 of MCL injuries (14.7%).According to Fanellis classification,for type A posterolateral rotation instability,we performed arthroscopic popliteal ligament reconstruction or popliteal ligament combined popliteofibular ligament reconstruction.For type C posterolateral instability,we performed arthroscopic PLC anatomical reconstruction.Results During the follow-up period,14 patients had undergone a second look arthroscopic examination and removal of hardware.The average follow-up time was 18.5 months (13-25 months).At the final follow-up,physical examination,stability evaluation with KT-1000 and Telos stress view,and dial test were performed.The posterior displacement of the knee had decreased from 15.56 mm preoperatively to 5.16mm postoperatively.The external rotation instability had decreased from 14.92° preoperatively to -0.22°postoperatively.The average limitation of knee flexion was 4.23° and no knee extension was limited.Conclusion With the surgical technique of arthroscopy assisted anatomical PLC reconstruction,we can restore the external rotation stability of knee.This technique can be performed combine with PCL reconstruction.

Objective To discuss the clinical features of neonatal shock retrospectively.Methods Totally 144 neonates were enrolled in this retrospective study from Sep.2006 to Sep.2012 in NICU of Beijing Children's Hospital.Clinical data were collected from our database,including the primary disease,manifestation,laboratory findings,treatment and prognosis.Results According to the severity of shock,28 cases were mild,85 were moderate,31 were severe.Regarding to the type of shock,71 cases were cardiogenic shock,22 cases were hypovolemic shock,51 cases were septic shock.About 69.4％ patients were cured,only 9 cases died.Eight of them died of septic shock.Totally 33 cases in pH ＜7.15 group,2 of them died.In pH≥7.15 group,111 cases were involved,7 of them died.There was no significant difference of mortality between two groups (P =0.959).Conclusion Neonatal shock mostly occurred within 3 days after birth,and cardiogenic shock were dominating.Septic shock increased with age,and were responsible for death.

Fibroblast growth factor 21 (FGF21) is a peptide hormone predominantly secreted by the liver and plays a crucial role in maintaining whole-body energy metabolism and regulating insulin sensitivity. A large number of clinical studies have demonstrated that serum FGF21 levels are increased in obese patients with non-alcoholic fatty liver disease (NAFLD), and high circulating FGF21 is a sensitive biomarker for predicting the onset and progression of NAFLD. Injection of exogenous FGF21 can effectively alleviate pathological process in both animal models and NAFLD patients. This review aims to describe the molecular mechanism underlying the hepatoprotective effects of FGF21; to summarize the current data and challenges of the clinical trials on FGF21 analogs and receptor agonists in the treatment of NAFLD and nonalcoholic steatohepatitis (NASH); and to speculate the future directions of FGF21 as a diagnosis and treatment for NAFLD.

AIMTo investigate the +Gz protection provided by tilt-back seat and GZ-2 anti-G suit.

METHODS6 subjects were exposed to centrifuge and onset rate is 3 G/s. First, their relaxed +Gz tolerances were determined while using tilt-back seat of 13 degrees. Secondly, it was their +Gz tolerance provided by pressurized GZ-2 anti-G suit and tilt-back seat of 13 degrees. Finally, their +Gz tolerances while using pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees were determined. The difference between the first and the third result was the +Gz protection that pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees offered.

RESULTS+Gz protection of pressurized GZ-2 anti-G suit and tilt-back seat of 13 degrees was 3.06 G, and +Gz protection of pressurized GZ-2 anti-G suit and tilt-back seat of 45 degrees was 4.13 G, which had an increase of 1.06 G.

CONCLUSIONTilt-back seat of 45 degrees can greatly enhance +Gz tolerances of human.

Adolescent ; Aerospace Medicine ; instrumentation ; methods ; Centrifugation ; Gravity Suits ; Humans ; Hypergravity ; Male ; Posture ; Protective Clothing ; Young Adult

Objective To quantitatively detect circulating DNA levels in the plasma of patients withcervical lesion and to determine the value for diagnosis of cervical lesion and cervical cancer . Methods Preoperative blood samples were collected from 53 cases of low-grade lesions, 49 cases of high-grade lesions, 44 cases of cervical invasive cancer and 70 cases of healthy women. Plasma DNA was extracted by magnetic bead method (BILATEST DNA kit). The quantity of plasma DNA was determined by duplex real-time quantitative PCR. Results Median plasma DNA level of invasive cervical cancer patients was 61. 59 mg/L (32. 06 - 162. 16 mg/L) , which was significantly higher than that of healthy women [16. 35 mg/L(11. 98 -22.71 mg/L), P < 0.01]. Among invasive cervical cancer patients, median plasma DNA level of squamous carcinoma patients was slightly higher than that of adenocarcinoma (50. 43 versus 47. 31 mg/L,P>0. 05). Median plasma DNA level of stage I patients was lower than that of stage Ⅱ- Ⅲ patients (46. 02 versus 71. 35 mg/L, P <0. 05). Conclusion Quantitatively detecting plasma circulating DNA may be with some application prospect in the diagnosis of cervical diseases.

ObjectiveTo investigate the incidence and risk factors in retinopathy of prematurity (ROP) at matched gestational age.Methods Data collected by the medical records of neonates from November 2007 to December 2010 in our neonatal database were analyzed.Patients'information was recorded from birth to discharge from NICU.Data included age after birth (hours),gestational age,body weight at birth,treatment,and maternal demographics.The statistical study was carried out by SPSS version 13.0 software.Mann - Whitney U test was used for numerate data.Fisher's exact probability test and Pearson's chi - square test were used to compare quantitative variables between independent groups.P values were considered significant when they were less than 0.05 ( two - sided).ResultsThe incidence of ROP was 5.38％.Gestational age of ROP group and control group was matched ( P =0.387 ),but difference in body weight at birth was significant ( P =0.045 ).Age after birth was significantly different ( P =0.013 ).Apnea and anemia were significantly different between two groups (P ＜ 0.01). The differences in duration of hospitalization,NCPAP and use of antibiotics between two groups were significant ( P ＜ 0.002,0.000 and 0.000,respectively).ROP group differed from control group greatly in hospitalization expenses.Multiple stepwise logistic regression analysis showed that oxygen supplenentation ( P =0.0237 ) and infection ( P =0.0118) were risk factors of ROP. ConclusionsThe incidence of ROP in NICU in Beijing Children's Hospital was 5.38％.Inhalation of oxygen supplementation and infection were risk factors of ROP.

Objective:Position emission tomography/computed tomography(PET/CT) is a new bio-imaging system which is combined metabolic with anatomic imaging.This study was to compare the accuracy of conventional staging methods(including computed tomography,ultrasound,magnetic resonance imaging,and detection of bone marrow) with that of PET/CT for lymphoma staging and re-staging. Methods:A total of 42 patients with lymphoma diagnosed by operation or biopsy,received conventional and PET/CT staging.The accuracy of these two methods and their impact on lymphoma staging were compared.Results:The accuracy of PET/CT scan was 95.2%(40/42),and that of conventional staging was 78.6%(33/42).The detection rates of internal lymph node were 97.1%(66/68) and 88.2%(60/68),respectively.The detection rates of outer lymph node were 91.7%(22/24) and 58.3%(14/24),respectively.Compared with conventional staging methods,7 cases were up-staged and 2 cases were down-staged by PET/CT,which led to the change of therapy in 8 cases.Conclusion:PET/CT scan is more sensitive and accurate than conventional staging methods in staging and restaging of lymphoma.