Objective To discuss the technique and value of preoperative reformatting with three-dimensional computed tomography technique for C_2 pedicle screw track.Methods GE Light Speed 16 Pro spinal CT scans of 15 adult dry vertebrae were loaded into an imaging station (software ADW4.2).Two methods of C_2 pedicle screw techniques were analyzed through virtual screw trajectory by VR (volume rendering) and MPR (multiple planar reformatting) techniques,in method A,screw entry point was the intersection between the media-vertical and the cranial line of C_2 inferior facet joint,in method B,the screw track was from the cranial and medial quadrant of the dorsal part of C_2 inferior facet joint.Results The screw track could be observed dynamically from any plane.Two vertebrae were ob- served with smaller height in isthmus and the medial edge of the transverse foramen since no space was a- vailable for the screw.The screw trajectories data were compared between method A and method B,which showed that the angles towards the cephalad (in sagittal plane) and midline (in transverse plane) were bigger in method A than in method B (P＜0.05,0.01),but the safe screw diameter was smaller in method A than in method B (P＜0.05),and there was no difference of the screw length between the two methods(P＜0.05 ).Conclusion In this research,the individual C_2 pedicle screw entry points, screw diameter and security screw angle can be simulated,and the screw track can be observed dynami- cally to make sure if it transits the bone structure completely.Preoperative three-dimensional computed tomography reformatting for pedicle screw track is of great value in clinical and basic researches.

OBJECTIVETo explore therapeutic effects of modified femoral prosthesis applied in the initial posterior stabilized total knee arthroplasty.

METHODSFrom April 1, 2012 to January 1, 2013, 156 patients with knee osteoarthritis underwent posterior stabilized total knee arthroplasty by the same director of orthopedic surgeon. Sixty-one patients were treated with modified femoral prosthesis, including 7 males and 54 females, with an average age of (68.34 +/- 5.41) years old; and 95 patients were treated with conventional designed femoral prosthesis, including 14 males and 81 females, with an average age of (69.92 +/- 5.11) years old. Indexes including age, body mass index, Insall-Salvati index, type of prosthesis, occurrence rate of patella click syndrome, postoperative line of force of lower extremity and postoperative function of the knee joint were observed and recorded. And American Knee Society (AKS) score was used to evaluate the clinical results.

RESULTSAll the patients were followed up, and the duration ranged from 36 to 56 weeks, with a mean of 45.31 weeks. Among patients in the conventional designed femoral prosthesis group, 7 patients had patella click syndrome, but there was no patient having patellar click syndrome in the modified femoral prosthesis group. Postoperative knee activity of patients in the modified femoral prosthesis group was (110.98 +/- 10.32) degrees, which was better than (107.05 +/- 8.61) degrees in the conventional designed femoral prosthesis group. The AKS score in the modified femoral prosthesis group was 129.79 +/- 9.63 during 21 to 28 days after operation, which was higher than 126.85 +/- 7.79 in the conventional designed femoral prosthesis group.

CONCLUSIONNew designed femoral components are effective to reduce the occurrence rate of postoperative patellar click syndrome and obtain better early functional recovery from knee surgery.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; instrumentation ; Case-Control Studies ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Incidence ; Knee Joint ; surgery ; Knee Prosthesis ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; etiology ; Retrospective Studies

Objective To study the characteristics of mismatch negativity(MMN) in patients with depression.Methods MMN was recorded from 31 patients with depression and 28 age-matched controls. Results Compared with the controls, the patients with depression had prolonged latency ([189?22] ms vs [206?26] ms, P

0.05)and significantly delayed reaction time,(305?109)ms vs(212?70)ms(P

Objective Studies show that the abnormal ex-pressions of APC and survivin play important roles in the development and progression of colon cancer .Survivin shRNA and APC double gene co-expression lentiviral vector was constructed to observe whether it could be successfully expressed in HT-29 colon cancer cells and whether it could impact on colon cancer cell apoptosis . Methods We selected the best shRNA interference fragment from the construc-tion of three pairs of complementary shRNA fragments and connected it with the effective fragment of APC ( aa1020-1698 ) to construct a double gene co-expression lentiviral vector .HT-29 cells were divid-ed into experimental group , empty loading group and blank group .HT-29 cells were observed by fluorescence microscopy after infec-tion.Survivin and APC expression levels were observed by real time PCR and western blot .Apoptosis was detected by caspase-3 activi-ty assay. Results ①We successfully constructed three pairs of shRNA sequences and proved that they had no human gene homolo -gous to the rest.Real time PCR analysis showed that the best sequence was shRNA 3.②After the sequence alignment of constructed shRNA vectors, three pairs of shRNA sequences were completely the same with the first designed sequence .Green fluorescence was observed in HT-29 cells by fluorescence microscope .The survivin content in experiment group (31.71 ±1.49) was significantly de-creased compared with empty loading group (100 ±0) and blank group(95.12 ±2.15)(P<0.05).The expression level of APC mR-NA was significantly increased compared with empty loading group (0 ±0) and blank group(0.51 ±0.15)(P<0.05).③The relative ratio of apoptosis in experiment group (0.573 ±0.050) was significantly increased compared with empty loading group (0.390 ± 0.040) and blank group(0.407 ±0.030)(P<0.05). Conclusion We have successfully constructed survivin-shRNA-APC double gene co-expression lentiviral vector which can be successfully expressed in HT-29 colon cancer cells , providing references for subse-quent gene therapy by the use of the carrier .

Objective Post-transcription RNA interference (RNAi) is more and more widely applied in multigene therapy.This study aimed to establish an subcutaneous xenotransplanted tumor (SXT) model of human HT-29 colon carcinoma in nude mice and investigate the effects of the survivin shRNA-APC double gene co-expression lentiviral vector on the growth of SXT.Methods Thirty-five nude mice were equally divided into five groups, double-gene survivin shRNA, survivin shRNA, APC, empty vector, and blank, and injected into the left anterior axillary with respective stably transfected cell lines and human HT-29 colon carcinoma cells, all at 2×106/mL, to establish an SXT model of human HT-29 colon carcinoma.The inhibition rate of tumor growth was calculated by measuring the size and weight of the SXT, the expressions of survivin mRNA and protein in the tumor tissue detected by real time PCR and immunohistochemistry respectively, and the apoptosis of the HT-29 colon carcinoma cells determined by TUNEL.Results The mean size and weight of the SXT were significantly reduced in the double-gene survivin shRNA-APC, survivin shRNA, and APC groups as compared with the blank and empty vector groups (P<0.05), though increased in the survivin shRNA and APC groups in comparison with the double-gene group (P<0.05).The expressions of survivin mRNA and protein in the tumor tissue were remarkably lower in the double-gene survivin shRNA-APC, survivin shRNA, and APC groups than in the blank and empty vector groups (P<0.05), even lower in the double-gene group than in the survivin shRNA, and APC groups (P<0.05).The apoptosis rate of the HT-29 colon carcinoma cells was markedly up-regulated in the double-gene survivin shRNA-APC ([56.72±3.17]%), survivin shRNA ([33.64±2.03]%), and APC groups ([31.19±1.79]%) as compared with the blank ([9.89±0.31]%) and empty vector groups ([10.06±0.43]%) (P<0.05), even more significantly in the double-gene than in the survivin shRNA and APC groups (P<0.05).Conclusion The survivin shRNA-APC double gene co-expression lentiviral vector can reduce the expression level the survivin gene, promote the apoptosis of colon carcinoma cells, and suppress the growth of the subcutaneous xenotransplanted tumor.

BACKGROUNDHypoxia-inducible factor (HIF) may play an important role in the process of tumorigenesis as well as tumor progression. The aim of this study was to compare the expression between HIF-1α and HIF-2α in tumor angiogenesis and the overall impact on patient prognosis in human non-small cell lung cancer (NSCLC).

METHODSIn the current work we compared the immunohistochemical expression of HIF-1α and HIF-2α in surgical specimens of 140 patients with NSCLC in a tissue microarray study. Relationships between HIF-α expression and clinicopathological or angiogenic factors, including prognosis, were analyzed.

RESULTSHigh HIF-1α and HIF-2α expression was noted in 49/140 (35.0%) and in 64/140 (45.7%) of the cases, respectively. There was no direct correlation between HIF-1α and HIF-2α expression. Patients with advanced stage tumors had frequent high expression of HIF-2α (P = 0.007), and we also found a significant correlation between HIF-2α and T or N stage (P = 0.030 and 0.043, respectively). HIF-1α showed a marginal association with T stage (P = 0.084), which showed a higher expression in early stage tumors. A significant correlation (P = 0.045) was noticed between HIF-1α and vascular endothelial growth factor (VEGF) expression while the expression levels of thymidine phosphorylase (TP), cyclooxygenase (COX)-2 and microvessel density (MVD) were significantly higher in high HIF-2α tumors (P = 0.020, 0.004, and 0.046, respectively). In addition, univariate analysis of overall survival demonstrated that HIF-2α expression, but not HIF-1α, was related to poor outcome (P = 0.001) and it retained significant in multivariate analysis (P = 0.036).

CONCLUSIONSTaken together, we conclude that HIF-1α and HIF-2α may differentially regulate the major angiogenic factors in different stages of the tumor process in NSCLC. HIF-2α may play a dominant role in tumor angiogenesis and appears to be of obvious value as a significant prognostic factor in NSCLC.

Adult ; Aged ; Angiogenesis Inducing Agents ; metabolism ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Immunohistochemistry ; Male ; Microvessels ; Middle Aged ; Multivariate Analysis ; Prognosis ; Thymidine Phosphorylase ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo determine the mechanism of pseudo-tears of the lateral meniscus caused by the transverse geniculate ligament (TL) and the miniscofemoral ligament(MFL) and to investigate a method to differentiate pseudo-tears from true tear of the lateral meniscus.

METHODSForm June 2012 to February 2014, MR examinations of 72 knees (44 left knees and 28 right knees) without tear of the lateral meniscus verified by arthroscopy were performed in the sagittal and coronal plane. There were 41 males and 31 females in the group, with an average age of 33.7 years old (ranged from 25 to 61). The MR appearance of the TL and the MFL was carefully observed.

RESULTSThere existed fatty tissue in the gap between the TL and the anterior horn of the lateral meniscus and its central tendinous attachment. On the sagittal images, the fatty tissue formed a linear high-signal cleft between the TL and the anterior horn of the lateral meniscus. This might be mistaken as an oblique tear within the anterior horn of the lateral meniscus. It was called as pseudo-tears of the anterior horn of the lateral meniscus. In sagittal plane, the MFL was identified as a circle-like or short stick-like area of low signal intensity anterior or posterior to the posterior cruciateligament. Nevertheless, a belt-shaped area of low signal intensity from the posterior horn of the lateral meniscus to lateral facet of the medial femoral condyle was identified in the coronal plane. A linear area of high signal intensity between the MFL and the lateral meniscus was found in sagittal plane, which might be mistaken as an oblique tear within the posterior horn of the lateral meniscus. It was called pseudo-tears of the posterior horn of the lateral meniscus. The occurrence rate of the TL was 34.7% (25/72). The prevaleribe of pseudo-tears of the anterior horn of the lateral meniscus was 18 cases. The shape of the anterior horn of the lateral meniscus was regular, and the course of the pseudo-tears cleft was oblique. The occurrence rate of the MFL was 73.6% (53/72), which included the anterior MFL 23.6% (17/72), the posterior MFL 70.8% (51/72) and the two ligaments coexisted 16.7% (12/72). The prevalence of pseudo-tears of the posterior horn of the lateral meniscus was 25 cases. All observed pseudo-tears had either in posteroinferiorly oblique direction (19/25) or in vertical direction (6/25).

CONCLUSIONBased on the location and direction of pseudo-tears and observation in the continuous sagittal plane and the coronal plane, pseudo-tears is easily differentiated from the true tear of the lateral meniscus

Adult ; Female ; Humans ; Knee Injuries ; diagnostic imaging ; surgery ; Knee Joint ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Menisci, Tibial ; diagnostic imaging ; surgery ; Middle Aged ; Radiography ; Tibial Meniscus Injuries

Objective: To investigate the clinical significance of serum gastrin-17, C-reactive protein (CRP) and D-dimer (D-D) levels in early diagnosis and severity evaluation of Henoch-Schölein purpura (HSP) children with abdominal symptoms. Methods: Retrospective analysis was performed in 120 children with initial HSP admitted to the Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University from December 2016 to December 2017, among them, there were 70 cases with abdominal symptoms, and 50 patients without abdominal symptoms.And 20 healthy children who underwent health consultation at the First Affiliated Hospital of Anhui Medical University were selected as a healthy control group.Serum gastrin-17, CRP and D-D levels in acute phase in the HSP children were detected, and the correlation between these parameters and purpura symptom scores was analyzed.Together with gastroscope, the severity of HSP with abdominal symptoms was evaluated. Results: (1) Serum gastrin-17 level in HSP children with abdominal symptoms were obviously lower than that of the other of type HSP group and the healthy control group [(3.12±1.64) pmol/L vs.(6.85±1.28) pmol/L and (7.15±1.03) pmol/L], and the differences were statistically significant (all P<0.001); the levels were decreased most significantly in HSP children with early gastrointestinal symptoms [(1.77±0.50) pmol/L vs.(4.01±1.51) pmol/L], and the difference was statistically significant (P<0.001); the pathological changes under gastroscope were obvious in HSP children with early gastrointestinal symptoms (χ²=8.095 2, P<0.05). (2) Serum CRP and D-D levels in the HSP children with abdo-minal symptoms were striking higher than those in the healthy control group [(18.39±4.48) mg/L vs.(3.95±1.65) mg/L; (2.53±1.17) mg/L vs.(0.59±0.41) mg/L], and the differences were statistically significant (all P<0.001), which were both increased most significantly in the HSP children with early gastrointestinal symptoms [(19.98±5.45) mg/L vs.(17.33±3.37) mg/L; (3.48±0.96) mg/L vs.(1.89±0.80) mg/L], and the diffe-rences were statistically significant (all P<0.05). (3) Serum gastrin-17 level was negatively correlated with purpura symptom scores (r=-0.907, P<0.01); serum CRP and D-D levels were both positively correlated with purpura symptom scores (r=0.974, 0.928, all P<0.01). Conclusions Serum gastrin-17, CRP and D-D levels in acute phase can be used as serological markers for early diagnosis of HSP children with abdominal symptoms, especially in HSP children with early gastrointestinal symptoms.

Objective To explore the concept,denomination and technique of miniature tissue transplantation in hand clinic. Methods In 537 cases,local skin or composite tissue defect in 756 thumbs or fingers were repaired with 4 kinds of miniature island flap and 10 kinds of miniature vascularized composite tissue.Some of them were created in clinic practice.The precess,main points and indication of the operation were expounded and compared. Results In 639 fingers covered with miniature island flap,the transferred flaps were surviverd completely in 621 fingers(97.2%),survivered partly in 11 fingers(1.7%)and necrosised in 7 fingers(1%).In 117 fingers repaired with miniature vascularized composite tissue,all the transplanted tissues were survivered.In all the injuried fingers,beautiful outlook were recovered and no fat and clumsy were found,two-point difference was 6-8 mm,effctive sensibility and good function were restored,and all the patients were satisfied. Conclusion Miniature tissue transplantation were good methods to cover the local defect in fingers or thumbs,worth of generalization and aplication in hand clinic,and have an important significance for improve the trauma repair quality and treatment level in hand surgery.