BACKGROUND: There are many kinds of suturing methods for curing hand extensor tendon rupture. But different methods present different clinical effects and the adhesion of tendon following operation is still a clinical difficulty. OBJECTIVE: To make a comparative study on the biomechanical properties and histological differences of 3 tendon suturing methods. DESIGN, TIME AND SETTING: A comparative observational animal experiment was completed in the Centralab of the First Clinical Collage of Harbin Medical University from April to June 2008. MATERIALS: A total of 45 Wistar rats were randomly divided into 3 groups, namely, Tang method group, upgraded Kessler method group and Bunnell method group. METHODS: Under germ free condition, posterolateral achilles tendons of hide limbs of rats were cut open in S shape and their subcutaneous tissues were separated. Then, sharp transsection was performed to the achilles tendons of rats. At hour 24, week 1 and week 3 postoperatively, tendons of rats in the three groups were sutured with their corresponding methods, namely Tang method, upgraded Kessler method and Bunnell method. The sampling objects were the hind limbs of each rat, with the right ones undergoing biomechanical test and the left ones undergoing histological detection. MAIN OUTCOME MEASURES: The tensile strength (TS) and the histological change of the tendon rupture. RESULTS: At hour 24, week 1 and week 3, the TS of the three groups changed in the same direction, regardless of the tendon suturing method used, i.e. the TS of each group weakened during the early period and strengthened gradually during the later period. However, the tendon sutured by Tang method presented greater TS than the other two groups at hour 24 and week 1 postoperatively. At week 3, there is no difference of significance in TS among the three groups. In addition, the histological detection with HE staining showed pathological sections of great difference to the three groups at week 1 postoperatively, i.e. more granulation tissues formed in the group sutured with Tang method than in the other two groups, with more new vessels, less inflammatory cells and completely-expanded lumen of blood vessels in these granulation tissues. CONCLUSION: The Tang tendon suturing method results in faster healing and greater TS to the broken ends of tendons than the other two. Accordingly, it is more suitable for early functional exercise.

BACKGROUND:It is possible to change the normal structure of lumbar intervertebral disc,even worse,to accelerate the degeneration in the procedures of comprehensive treatment for degeneration of intervertebral disc.OBJECTIVE:To observe the pathological and imaging changes of lumbar intervertebral disc degeneration after Ad/CMV-Sox9 transduction.DESIGN,TIME AND SETTING:The randomized controlled experiment based on genes was performed in the Center Laboratory of the First Clinical College,Harbin Medical University between October 2005 and March 2006.MATERIALS:Ad/CMV-Sox-9 and Ad/CMV-green fluorescent protein were supplied by the Vector Gene Technology Co.,Ltd(Beijing,China).METHODS:Thirty New Zealand white rabbits,which had been created lumbar intervertebral disc degeneration models,were divided into 2 groups by the random number table.20 rabbits in the Ad/CMV-Sox9 group were exposed lumbar intervertebral disc,and injected Ad/CMV-Sox-9 20 ?L in each segements of L2-3,L3-4,L4-5 after pricking with 0.1 mL syringe.10 rabbits in the expression of green fluorescent protein group were injected isodose Ad/CMV-GFP.MAIN OUTCOME MEASURES:The expression of mRNA collagen II was evaluated at 2,4,8 weeks after transfected with Sox-9.?-actin was served as blank control to observe pathological and imaging changes of lumbar intervertebral disc degeneration.RESULTS:The Ad/CMV-Sox-9 was transfected with intervertebral disc degeneration successfully.The expression of mRNA collagen II was obvious higher than that in the blank control group(P

Objective To investigate the expression and prognostic significance of p27kip1 in patients with stage I and Ⅱ colorectal carcinoma ( CRC). Methods We retrospectively analyzed the expression of p27kip1 by immunohistochemistry in paraffin-embedded specimens from 114 consecutive patients operated for stage I and Ⅱ CRC. Statistical analysis was done with SPSS10. 0 package. Results The rate of p27kip1 over-expression in stage I and ⅡCRC was 85. 1 % (97/114). The expression of p27kip1 was statistically associated with TNM stage and histologic grade, while there was no significant relationship between p27kip1 expression and patient's age, tumor location. The 5-year disease free survival rate of the patients with p27kip1 over-expression was significantly higher than those with p27kip1 low-expression (88. 4% vs. 52. 9% , P

Objective To investigate biomechanical analysis of poly DL-lactic acid (PDLLA)biodegradable fusion cage of the lumbar vertebrae in vivo degradation. Methods Forty-eight healthy adult porcine were divided into experimental group and control group at randomly. PDLLA cage full of autogenous bone and bone block with the same size were planted in L45 intervertebrae respectively. At the 1st, 3rd, 6th,9th, 12th, and 18th month postoperatively, the animals were sacrificed and the surgical spinal segment was observed. The range of motion (ROM) was measured. Results The ROMs had no statistical differences at all motion directions between the two froups at the 1st month postoperatively. But the ROMs of experimental group were greater than those of control group at extension direction at the 3rd and 6th month postoperatively. The ROMs of extension was the greatest while the ROMs of right rotation was the least in both groups. At the 9th month postoperatively: the ROMs of experimental group greater than those of control group except at rotation. The ROMs of right rotation was the least in both groups. The greatest ROMs was at extension in experimental group and at right bending in control group. ALL ROMs tended to decrease and the ROMs of extension had comparability between tow groups. At the 12th month postoperatively, experimental group had greater ROMs at extension and left bending and less ROMs at other directions. Likewise statistical differences showed only at extension. 18th month postoperatively all ROMs were close between two groups. Conclusion After PDLLA cage is planted, the first 3 months is autologous stable stage. The period of 3rd to 6th months is easily released stage. The operative segments are stable from 9th to 12th months and acquired.Critical period between stability and instability is from 6th to 9th months. Bone fusion is from 12th to 18th months postoperatively.

Objective:To investigate the role of transforming growth factor β1 (TGFβ1) in the development of Helicobacter pylori ( H. pylori)-associated non-metaplastic atrophic gastritis. Methods:The expressions of TGFβ1, CD68 and smooth muscle actin(SMA) were detected immunohistochemically in 10 patients with mild non-atrophic gastritis, 30 patients with mild non-metaplastic atrophic gastritis, and 32 patients with severe non-metaplastic atrophic gastritis having H. pylori infecion. Meanwhile, three cases of mild non-atrophic gastritis and 4 cases of severe non-metaplastic atrophic gastritis were observed with electron microscope. Results: The count of TGFβ1 positive cells per high-power field (HPF) in severenon-metaplastic atrophic gastritis group (53±22 ) was significantly higher than that in mild non-atrophic gastritis group(22±/HPF) and mild non-atrophic gastritis group(0-3/HPF, P＜0.01). The count of CD68 positive cells in severe non-metaplastic atrophic gastritis group (23±7/HPF) was significantly higher than that in mild non-atrophic gastritis group (13±/HPF) and mild non-atrophic gastritis group (0-3/HPF, P＜0. 01). Correlation analysis showed that the expressions of TGFβ1 and CD68 had a moderate correlation in each group ( r = 0. 634, P＜ 0. 01; r = 0. 699, P＜ 0. 01). Compared with mild non-atrophic gastritis, SMA-positive myofibroblasts and smooth muscle cells in the lamina propria increased in mild and severe non-metaplastic atrophic gastritis. Ultrastructurally, the proliferation of fibroblasts in gastric lamina propria was observed in mild non-atrophic gastritis, while the proliferation of fibroblasts and presence of myofibroblasts could be observed in mild non-metaplastic atrophic gastritis, and there was a parallel phenomenon between myofibroblasts and fibroblasts, as well as smooth muscle cells.Conclusion: Our findings indicate that TGFβ1 expression increases with severity of H. pylori-associated non-metaplastic atrophic gastritis, suggesting that TGFβ1 might play an important role in the development of non-metaplastic atrophic gastritis.

Objective To observe the enhancement pattern of focal liver lesions in cirrhotic patients and to evaluate the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of dysplastic nodule with hepatocellular carcinoma(DN-Ca). Methods One hundred and forty-one cirrhotic patients with 163 focal liver lesions with the size of 1 - 3 cm were included in this study. All the nodules were examined using CEUS with SonoVue and underwent biopsy. The biopsies were performed using 18G needles in the different parts of enhancement. The enhancement patterns of DN-Ca, HCC and regenerative nodule(RN) were analyzed.Results Twenty-one lesions were diagnosed as DN-Ca by biopsy,45 lesions as hepatocellular carcinoma (HCC) and 97 lesions as RN. All the 21 lesions of DN-Ca presented partial enhancement during arterial phase or portal phase and wash-out during the late phase; the other areas of the lesions presented delayed or simultaneous enhancement during arterial phase and 23.8 % (5/21 ) slight wash-out in the late phase. Of the 45 lesions of HCC,82.2 % (37/45) presented global enhancement during arterial phase or portal phase, and 17.8% (8/45) presented inhomogeneous enhancement with no-enhancement in the central area during arterial phase, 100% (45/45) presented wash-out during the late phase. In 97 RNs, 96.9% (94/97)presented delayed or simultaneous enhancement during arterial phase, 3.1% (3/97) presented slightly enhancement during arterial phase;25.8% (25/97) showed wash-out and 74. 2% (72/97) showed no washout during the late phase. The pathological diagnosis was HCC in the enhanced area and hepatocytes regeneration in the un-enhanced area in the 21 DN-Ca. Conclusions CEUS is helpful in predicting the progress from RN to HCC by analyzing the hemodynamics. CEUS can improve the diagnostic accuracy of biopsy by providing more accurate information.

Objective:To evaluate the association between RUNX3 expression and Helicobacter pylori(H.pylori)-associated precancerous gastric lesions.Methods: A population-based study was conducted in Linqu County,Shandong Province,a high-risk area of gastric cancer in China.RUNX3 expression was determined by immunohistochemistry analysis in 1 026 H.pylori infected subjects with different gastric lesions.Results: Among 1 026 subjects,359(35.0%,359/1 026) was positive.The prevalence rates of RUNX3 expression decreased steadily with severity of gastric lesions,65.6%(40/61) among those with superficial gastritis /normal(SG/N),and 22.4%(60/268) among those with dysplasia(DYS)(P

Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.

OBJECTIVETo investigate spontaneous metastasis, micrometastasis and genetic stability in human breast carcinoma xenografts in nude mice.

METHODSIntact tissue from surgical specimens from breast carcinoma patients was xenografted into nude mice and transplanted from generation to generation. Cells from the xenografts were cultured in vitro and retransplanted into nude mice. Microsatellite DNA in the genome of human breast carcinomas, xenotransplanted tumors and metastases in nude mice were analyzed at three microsatellite loci.

RESULTSThe tumorigenicity of orthotopic xenotransplantation was 88.6% (31/35), with a metastatic rate of 41.9% (13/31). Cells from xenotransplants were successfully cultured in vitro. The taking rate of retransplantation into nude mice and the spontaneous lung metastasis rate were both 100% (10/10). Microsatellite DNA sequences in the genome of xenotransplanted tumors and metastases in nude mice were identical with that of the original human breast carcinoma at three microsatellite loci.

CONCLUSIONSTumorigenicity and metastatic potential can be improved in human breast carcinoma xenografts using intact fresh tumor tissue and orthotopic grafts. Xenotransplanted tumors and tumors after serial passage maintained the genetic stability. The detection of microsatellite DNA may identify micrometastases in a nude mouse model.

Aneuploidy ; Animals ; Breast Neoplasms ; genetics ; pathology ; Cell Division ; Female ; Humans ; Mammary Neoplasms, Experimental ; genetics ; pathology ; Mice ; Mice, Nude ; Microsatellite Repeats ; Neoplasm Metastasis ; Neoplasm Transplantation ; Time Factors ; Transplantation, Heterologous ; Tumor Cells, Cultured

Dose verification is carried out on the individualized three-dimensional phantom based on 3D printing technology, which simulates the anatomical structure of human body, contour shape, tumor anatomical structure and other dangerous organs to the greatest extent, and produces a reasonable and effective dose validation phantom. According to the need to obtain effective patient data, import Mimics software to reconstruct the parts of the body and its surrounding tissues and organs that need to be measured, and make them into three-dimensional shell components. The 3D printing is used to assemble and fill the equivalent tissue, and then the body phantom is made. The phantom was scanned by CT and the data was transmitted to TPS system. The previously completed treatment plan was transplanted to the phantom. The phantom was placed according to the patient's location information, irradiated and measured data. The three-dimensional shell assembly is completely reconstructed according to the patient's data, and the contour difference is not significant. The shell is filled with tissue radiation equivalent material whose CT value is the same as the average CT value of the shell volume. The CT image data show that the radiation equivalence of the phantom is similar to the actual tissue of the patient, and the equivalent dose distribution conforms to the conventional treatment range. It can provide a reliable means of dose verification for the accurate design of intensity modulated radiation therapy.
Humans ; Phantoms, Imaging ; Printing, Three-Dimensional ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated