Objective To discuss the anatomical and radiographic characteristics of acetabular fossa,and evaluate their value as a reference for achieving the anticipated inclination of the acetabular cup.Methods Sixteen adult normal pelvic specimens were studied.Central axis of acetabular fossa and its intersection with fossa edge and acetabular rim were marked.The radiographic appearance of the two intersections was evaluated.With radiographic templating,the relationship between the top of acetabular fossa and the central axis of acetabular cup at anticipated inclination was identified.Implantation of cementless acetabular cup was performed bilaterally on the pelvic specimens.The acetabular fossa was used as a reference for implantation on one side,and the acetabular positioning device was used on the other side.The discrepancy of acetabular inclination was recorded before and after operation in the two groups.Results Intersection of central axis of acetabular fossa with fossa top edge and acetabular rim corresponded to the most medial and lateral aspect of acetabular sourcil respectively on standard anteroposterior pelvic radiograph.There was close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40°±5°.For the group of using acetabular fossa as reference,the mean difference of inclination was 0.19°±3.14°(-6°-5°)before and after operation,and the discrepancy was 2.75°±2.89°(-2°-8°)for the control group.The difference between the two groups was statistically significant(t=-2.453,P=0.027).Conclusion In primary total hip replacement,if normal anatomy of acetabulum was found,the anticipated inclination of acetabular cup can be accurately obtained,based on the relationship between the top of acetabular fossa and anticipated inclination of acetabular cup on preoperative templating.

Objective To construct and purify the recombinant protein of platelet-activating factor acetylhydrolase (PAF-AH) isoform I , and study the enzyme activity by different substrates. Methods The (3 subunit of PAF-AH isoform I was cloned and expressed in E. coli. Exogenously expressed recombinant protein was purified to SDS-PAGE homogeneity, and its activity was identified by arylesterase detection. Phenylacetate, 1-O-hexadecyl-2-deoxy-2-thioacetyl-sn-glycero-3-phosphocholine ( 2-Thio PAF) and l-myristoy1-2-( 4-nitrophenylsuccinyl) phosphatidylcholine (the latter two were commercial plasma PAF-AH substrates) were used for the substrate identification. The plasma type PAF-AH was served as positive control. Results Recombinant protein of β subunit of PAF-AH isoform I was successfully constructed and expressed in E. coli after purification. Compared with positive control, the recombinant protein could hydrolyze phenylacetate and 2-Thio PAF, but could not hydrolyze l-myristoyl-2-( 4-nitrophenylsuccinyl) phosphatidylcholine. Conclusion Recombinant protein of β subunit of PAF-AH isoform I can be successfully constructed. There are differences in the substrate specification to the two commercial PAF substrates for PAF-AH isoform I and plasma type PAF-AH, which provides a quick method to differentiate PAF-AH isoform I from plasma type PAF-AH.

Background and purpose:Visceral pleural invasion (VPI) and vessel invasion (VI) are poor prognostic factors in patients with non-small cell lung cancer (NSCLC). The primary initial recurrence site may be local recurrence in VPI and distant metastasis in VI. The purpose of this study was to validate the prognostic impact and effect of the initial recurrence site of VPI and VI on survival outcomes for NSCLC.Methods:Two hundred and ninety patients who were diagnosed as having NSCLC and underwent lobectomy between Jan. 2007 and Dec. 2013 were retrospectively analyzed. VPI was identiifed in 51 patients as VPI group, the other 239 patients without VPI as non-VPI group. VI was identiifed in 29 patients as VI group, the other 261 patients without VI as non-VI group. Clinical characteristics, overall survival (OS), disease-free survival (DFS) were compared.Results:There were statistically signiifcant differences between VPI group and non-VPI group in tumor size, lymph node metastasis, TNM stage and initial recurrence site (P<0.05). Furthermore, there were statistically signiifcant differences between VI group and non-VI group in lymph node metastasis and TNM stage (P<0.05). The 1-, 3- and 5-year OS rates in VPI group (88.2%, 56.7% and 52.7%) were lower than those in non-VPI group (95.8%, 83.7% and 74.0%,P<0.001). The 1-, 3- and 5-year OS rates in VI group (79.3%, 56.8% and 48.7%) were lower than those in non-VI group (96.1%, 81.3% and
72.3%,P=0.001). Cox regression showed TNM stage was a significant prognostic factor for DFS, whereas lymph node metastasis and VPI were signiifcant prognostic factors in patients with NSCLC.Conclusion:The primary initial recurrence site in VPI patients is local recurrence. Patients with VPI or VI may need more postoperative therapy because of their poor prognosis.

BACKGROUND:Periosteum is considered as a source of seed cels for cel therapydue toits biological features. OBJECTIVE:To seek the optimal way to isolate and culture rabbit periosteal cels and identify their biological features. METHODS:Rabbit periosteum on facies medialis tibiae was taken out under aseptic conditions. Periosteal cels isolated through the digestion of type II colagenase with the explants culture method were cultured in DMEM/F12 complete medium. Cel ultrastructure was observedunderan inverted microscope. Periosteal cel proliferation was determined bycel counting kit-8assay. Cel surface antigensCD90 and CD105 were determined using flow cytometry. Osteogenic andlipogenic induction mediums were applied to induce periosteal cels to differentiate into osteocytes and adipocytes, respectively. After 2 weeks of induction, cels were harvestedfor alizarin red staining and oil red O staining to assay the calciumnodules and lipid droplet. RESULTS AND CONCLUSION:The digestion of type II colagenase with the explants culture method shortened the period of primary cels culture and enhanced the survival rate, which causedhigher purity and stronger reproductive activity of harvested periosteal cels. Primary cultured periosteal cels grew in form of spindle spiral or paralel. Alizarin red andOil red O staining verified the multi-directional differentiation potentiality of periosteal cels. These findings suggest that the periosteal cels with high purity,strong reproductive activity,andmulti-directional differentiation potentialitycanbe harvested in short time using digestion of type II colagenase with the explants culture method.

Objective To compare the clinical effects of closed reduction and intramedullary nailing versus open reduction and plate fixation in the treatment of displaced midshaft clavicular fractures.Methods A prospective,randomized,controlled trial was performed between July 2012 and May 2014 in 194 patients with acute displaced midshaft clavicular fracture.They were 136 males and 58 females,from 16 to 65 years of age.They were randomly divided into 2 groups to received either closed reduction and intramedullary nailing (n =98) or open reduction and plate fixation (n =96).We recorded operation time,intraoperative blood loss,hospitalization expenses,fracture healing time and complication rate.Functional assessments were conducted at 3,6 and 12 months using the Disabilities of the Arm,Shoulder and Hand (DASH) and Constant-Murley scores.The preoperative general data showed no statistical significance between the 2 groups (P ＞ O.05).Results All the 194 patients were followed up for 12 to 27 months (average,15.6 ±3.1 months).The operation time (27.7 ± 16.3 min),intraoperative blood loss (18.6 ± 14.4 mL),hospitalization expenses (12,462.0 ±3,263.4 yuan),and fracture healing time (12.1 ± 3.0 weeks) in the intramedullary nailing group were significantly better than those(62.3 ± 19.4 min,40.3 ± 17.4 mL,24,760.0 ± 3,320.4 yuan,and 16.9 ± 2.8 weeks) in the plate fixation group (P ＜ 0.05).At 3 months after surgery,the DASH (13.4 ± 3.5) and Constant-Murley (88.5 ±5.9) scores in the plate fixation group were significantly better than those (24.8 ± 6.7 and 69.1 ± 6.2,respectively) in the intramedullary nailing group (P ＜ 0.05).At 6 and 12 months after surgery,there were no significant differences in the Constant-Murley scores or DASH scores between the 2 groups (P ＞ 0.05).The complication rate in the intramedullary nailing group (25.5％,25/98) was significantly higher than in the plate fixation group (9.4％,9/96) (P ＜ 0.05).Conclusions In the treatment of displaced midshaft clavicular fractures,compared with open reduction and plate fixation,closed reduction and intramedullary nailing has advantages of less invasion,lower cost and faster fracture healing,but a disadvantage of higher complication rate.The 2 treatments may lead to similar functional recovery of the shoulder.

Objective To observe the changes of the related risk factors and the ultrasound manifestation of carotid intima on carotid atherosclerosis patients and to explore its clinical significance.Methods One thousand one hundred and fifty-two population had been selected in physical examination of the Affiliated Hospital of Hebei United University from February 2012 to June 2014.The population were divided into the normal blood pressure group(n =301),prehypertensive group (n =378) and hypertensive group (n =473).All patients were performed basic data questionnaire,blood biochemical examination,the carotid intima-media thickness (IMT),and artery plaque were measured with echocardiography.Results The differences of age,gender,waist-to-hipratio (WHR),systolic pressure (SBP),diastolic pressure (DBP),fasting blood-glucose (GLU),total cholesterol (TC),triglyceride (TG) and (low-density lipoprotein cholesterol) LDL-C among three groups were all statistically significant (F/x2 =21.54,62.228,36.2634,1846.131,415.82,3.123,43.539,17.757,P＜0.05);The IMT and plaque detection rate among three groups had significant difference (x2=196.125,P＜0.01),in pre-hypertension group was significantly higher than that in normal blood pressure group(31.2％ vs 23.3％,P＜0.001),in hypertension group was significantly higher than that of pre-hypertension group(68.9％ vs 31.2％,P ＜ 0.001).There were statistically significant differences in the ultrasonic characteristics of the atherosclerotic plaque between the three groups (x2 =32.767,P＜0.05).Multiple Logistic regression analysis showed that the formation of carotid artery atherosclerotic plaque associated with male,age,abdominal obesity,dyslipidemia and elevated systolic blood pressure (P＜0.05).Conclusion The existence of pre-hypertension associated with increased levels of risk factors,the presence of multiple metabolic abnormalities,which plays a key role in the progression of carotid atherosclerotic plaques formed.

Objecthe Children's heart valves by Dual-Source Compater Tomography(DS CT)images were enhanced and segmented in order to reconstruct 3D construction of heart valves and make motion analysis based on this model.Method,Adaptive seed-filling algorithm is proposed in this paper to segment interested region of heart based on DS CT images.Contoudet transform is used to enhance and segment heart valve based on the part-segmented image.Result With these methods,DS CT images were SUCCESS fully pro-cessed and segmented in Matlab 7.0 and clear images of mitral valves were got.Condusions The adaptive seed-filling algorithm proposed in this paper and Contourlet transform are very useful for segmentation in dif-ferent situation.The experimental result in this paper proides useful reference for doctors in their research on the motion of mitral valves and planning on surrgical operation of mitTal valves.

Objective To evaluate the effect of pediatric renal transplantation using donation after cardiac death (DCD).Methods The male DCD meeting Chinese standard Ⅲ (C-Ⅲ) was 49 years old,and the recipient with chronic renal failure was 14 years old.The right kidney of the donor was transplanted to the recipient.The renal artery and renal vein of the donor were end-to-side anastomoscd to the common iliac artery and common iliac vein of the recipient,respectively.The graft was transplanted into the fight iliac fosse.Warm ischemia time was 12 min,and cold ischemia time was 2 h.Immunity induction therapy was performed with basiliximab.Tacrolimus + mycophnolate mofetil + Pred were used as immunosuppressive regimen.Results The transplantation was done successfully.One day after operation,ALT was increased dramatically.The recipient was diagnosed as acute drug-induced liver injury.There was no occurrence of acute rejection and delayed graft function.The recipient was discharged one month after the operation,and followed up for 6 months with normal graft function.Conclusion Pediatric renal transplantation using DCD is effective and safe,even though the long-term effect still needs to be further observed.

Objective:To study the relationship between the expression of carnitine palmitoyltransferase 1α (CPT1α) and progression of renal interstitial fibrosis and chronic kidney disease (CKD), and to evaluate the value of CPT1α as a biomarker in pathological diagnosis of renal interstitial fibrosis and CKD.Methods:As a retrospective cohort study, information of CKD patients dignosed with tubulointerstitial fibrosis by renal biopsy and receiving follow-up from March 1, 2010 to July 30, 2017 in the Second Affiliated Hospital of Nanjing Medical University were collected. Renal tissues were stained by immunohistochemistry to detect the expression of CPT1α protein and then divided into three groups according to the quartile of proportion of CPT1α positive staining cells, including group Q1(>67.89%), group Q2(49.84%-67.89%) and group Q3(<49.84%). The degree of renal interstitial fibrosis was measured by Masson staining and lipid deposition was represented by Bodipy staining. Messenger RNA of CPT1α and collagen as well as other extracellular matrix genes were detected by real time-PCR. Relationships between proportion of CPT1α positive staining cells and renal interstitial fibrosis and renal function were analyzed by linear regression analysis. The relationship between CPT1α positive cell number ratio and renal function progression was measured by Pearson correlation analysis and generalized linear model. The effect of lipid-lowering medicine on renal function of CKD patients was analyzed by paired comparative analysis.Results:Ninety patients with CKD were included in this study. Renal interstitial fibrosis and lipid droplets deposition area increased in Q2/Q3 group compared with Q1 group by Masson and Bodipy staining (all P<0.05). Messenger RNA level of extracellular matrix-related proteins increased in Q2/Q3 group by real time-PCR than those of Q1 group (all P<0.05). Linear regression analysis showed that fibrosis area was negatively correlated with the proportion of CPT1α positive staining cells ( r=-0.309, P<0.01). The baseline expression of CPT1α in renal issues was negatively related with serum creatinine (Scr) ( r=-2.801, P<0.001), positively related with estimated glomerular filtration rate (eGFR) ( r=1.240, P<0.001). After a medium follow-up of 3.47 years, CPT1α positive cell number ratio was positively correlated with eGFR change rate by Pearson analysis ( r=0.220, P=0.038). Paired stratified analysis showed that taking lipid-lowering medicines attenuated the decrease of eGFR in Q2 group and Q3 group but not in Q1 group (both P<0.05). Conclusions:The decline of CPT1α in renal tissues of CKD patients is associated with the increase of Scr, the decrease of eGFR and renal interstitial fibrosis. CPT1α is a promising molecular marker to evaluate the degree of renal fibrosis and the progression of CKD.

Objective To investigate the compound donkey-hide gelatin syrup in reducing adverse reactions of qi-blood weakness patients caused by clozapine.Methods 132 patients from Psychiatric Hospital of Yunnan Province between January 2010 and June 2010 were randomly divided into a treatment group and a control group.Both groups were taken clozapine orally.On this basis,the treatment group was taken compound donkey-hide gelatin syrup and the control group was taken placebo syrup.After 8 weeks treatment for both groups,the PANSS,TESS,physical examination and experiment examination were observed to evaluate the clinical efficacy and safety.Results ① the total curative effect:the treatment group was 73.53％,the control group was 65.63％,showing statistical difference (x2=2.543,P＜0.05).② PANSS scores changes before and after the treatment:PANSS score at 2,4,6,8 weeks after the treatment of both groups were [(72.51 ±27.55),(60.54±24.03),(53.12± 15.27),(48.15± 11.88) in treatment group respectively,and (70.71 ±23.90),(58.89± 18.95),(53.06± 14.38),(48.98 ± 9.78) in the control group,respectively],both showing significant difference than the same group before the treatment [(103.99±39.12) in the treatment group,(99.78±34.35) in the control group] (P＜0.05).But there was no statistical significance between two groups (F=2.413,P＞0.05).③ adverse reactions:during the treatment liver function,blood cell analysis,dystonia,Parkinson's obstacle,akathisia,abnormal gastrointestinal reaction,heart rate,heart rate variability and blood pressure in the treatment group was significantly lower than the control group (x2=4.562,P＜0.05).Conclusion Compound donkey-hide gelatin syrup can effectively relieve adverse reactions in qi-blood weak psychosis patients after clozapine treatment and improve their drug tolerance.