Over the past several decades of innovation and development, Ilizarov technique has been widely recognized and applied in correction of limb deformity and post-traumatic sequelae with outstanding clinical outcomes, which making remarkable contributions to the development of orthopaedics. There is no doubt that tissue regeneration induced by tension-stress is the core of Ilizarov technique, and a series of biological cascades contributing to tissue regeneration could be triggered by mechanical stimulation through signal transduction including bone morphogenetic proteins regulations, inflammatory responses and immune responses, angiogenic activities, stem/progenitor cell homing and other systematic effects. One of main limitations of Ilizarov technique is slow rate of new bone mineralization. To facilitate this technique application better in clinical practices, a multitude of researches of means for promoting bone mineralization have become hot spots in this field in recent years, such as physical measures, chemicals and biological therapies. With better understanding of distraction histogenesis for promoting tissue regeneration, transverse tibial bone transport has been increasingly applied to vascular disease management in lower extremity, such as diabetic foot and thromboangitis obliterans. This review focuses on the recent advances in understanding the basic biological mechanisms of Ilizarov technique and new methods for promoting bone consolidation in distraction areas, providing evidence and ideas for further mechanism investigations and approach innovations.

Child ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy

Objective To investigate the significance of cortactin in primary liver cancer. Methods Fiftythree paraffin embedded primary liver cancer specimens were collected at General Hospital of Air Force of PLA from January 2002 to May 2008. The expression of cortactin was detected by immunohistochemistry, and the relationship between cortactin expression and clinicopathologic parameters was analyzed. All data were analyzed via Wilcoxon rank sum test and Spearman rank correlation analysis. Results There was a significant difference in cortactin expression among tumor capsule integrity, TNM staging, portal vein tumor thrombus and extrahepatic metastasis (u =2. 19, 3. 584, 2. 796, P ＜ 0.05 ). There was a positive correlation between tumor invasion and cortactin expression ( r = 0. 5794, P ＜ 0.05 ). Conclusions Overexpression of cortactin may be one of the factors enhancing the invasion of primary liver cancer. The level of cortactin expression can be used in evaluating the invasive potential of primary liver cancer.

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Radiation Dosage ; Radiosurgery ; Treatment Outcome

ObjectiveTo investigate the morphologic features of coronary sinus (CS)-left atrium muscle connections,and evaluate the function and anatomical features of coronary sinus on dual-source CT coronary angiography (DSCTCA).MethodsImages of DSCTCA of 144 patients [ control group consisted of 96 patients,and atrial fibrillation (AF) group consisted of 48 patients] were reviewed.The existence of coronary sinus-right atrium muscle connections was indirectly evaluated by measuring the cross-sectional area changes of the CS during atrial systole and atrial diastolic.The number,location,length of the CS-left atrium muscle connections andthe relationship between CS-left atrium muscle connections and CS morphological characteristics were studied.The t test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results( 1 )The anatomic course of the CS in relation to the mitral ring was straight,mild curvature and high riding of 62,16 and 18 cases in control group and 10,8 and 30 cases in AF group,respectively.There was not statistical significance between the 2 group (x2 =0.093,P=0.954). (2)The CS length was (34.1 ±9.1),(33.8 ±8.9)mm in Control group and AF group,respectively.There was no statistical significance between the 2 group ( t =- 0.486,P =0.628 ).(3) Coronary sinus-left atrium muscle connections were seen in 131 of the 144 patients (91.0％).A single connection was seen in 103 of the 144 patients,with a mean length of (22.6 ± 12.7)mm within (6.3 ± 5.8 ) mm of the coronary sinus ostium.28 patients had two connections; distal connections measured ( 13.2 ± 6.2)mm in length within (16.7 ± 6.8 ) mm of the coronary sinus ostium,and proximal connections measured ( 11.1 ± 3.6 ) mm in length within (2.1 ± 1.9) mm of the coronary sinus ostium.And there was no statistical difference the number and length of CS-left atrium connections in between Control group and AF group (P ＞ 0.05 ).(4)The CS narrowed 22.4％ (44.5/198.8 )in cross-sectional area from atrial diastolic to atrial systole in control group( t =- 21.076,P ＜ 0.01 ),while the CS had no obvious contraction in AF group(t =0.374,P ＞ 0.05).The cross-sectional area of the coronary sinus during diastole was obviously larger in the AF group than in the control group[( 230.4 ±77.0) mm2 vs (198.8 ±65.4) mm2,respectively,t =- 2.579,P =0.01 ].In control group ( n =9 ),the coronary sinus-left atrium connection was not seen,however,all showed a CS constriction during atrial systole,indicating that coronary sinus-left atrium muscle continuity is not likely the primary cause for coronary sinus contractions. Conclusions DSCTCA can clearly show the anatomical characteristics of CS,it can help to understand the length,number and location of the CS-left atrium muscle connection.

Objective To evaluate the feaibility and safety of gastrotomy in natural orifice transluminal endoscopic surgery(NOTES)using technique of percutaneous endoscopic gastostomy(PEG).Methods To retrospectively investigate and compare the success rate,complications and procedure time of gastrotomy in NOTES of dogs between PEG-like approach(PEG group,n =20)and needle knife incision(needle knife group,n =18).Results Gastrotomy was successfully performed in all animals.No mass bleeding or organ injury was observed in PEG group,while one dog in needle knife group encountered mass bleeding,and injuries to the adjacent organs were found in 3 others(0％ in PEG group vs.22％ in needle knife group,P ＜ 0.05).The procedure time of gastrotomy in PEG group was longer than that of needle knife group (15.0±3.7 min vs.6.0 ± 1.1 min,P ＜0.05).Conclusion Compared with the techniqued of needle knife incision,gastrotomy using PEG-like approach in NOTES is safe and feasible.

PurposeAlteration of the regional cerebral flow and cerebrovascular reserve (CVR) caused by cerebral artery stenosis or occlusion is an essential risk factor for ischemic stroke. This study aims to assess the CVR in patients with severe middle cerebral artery (MCA) stenosis or occlusion by using MR perfusion-weighted imaging (PWI) with CO2 inhalation stress test. Materials and MethodsPWI were performed before and after CO2 inhalation stress on 28 patients with severe middle cerebral artery stenosis or occlusion and 10 healthy volunteers. The regions of interest (ROI) were put on the affected hemisphere of the MCA blood supply area and the contralateral side in both groups. The relative cerebral blood volume (rCBV), relative mean transit time (rMTT), relative cerebral blood flow (rCBF) and CVR were measured.Results① The rCBV, rCBF and rMTT of the affected side were 149.16±33.01, 18.04±5.24, 8.65±1.81 before CO2 inhalation stress, and 156.23±21.60, 23.77±8.77, 8.72±3.01 after CO2 inhalation stress. The rCBV, rCBF and rMTT were signiifcantly increased (t=1.238, 2.561 and 2.647, P<0.05) after CO2 inhalation stress. The rCBV, rCBF and rMTT of the contralateral side were 176.22±40.12, 22.43±5.74, 8.10±3.71 before CO2 inhalation stress, and 198.54±39.87, 27.64±7.22, 8.03±2.97 after CO2 inhalation. The rCBV, rCBF was significantly increased (t=1.780 and 1.665,P<0.05) while rMTT was signiifcantly decreased (t=2.871,P<0.05) after CO2 inhalation.②The CVR of the affected side, contralateral side and control group were 18.9%, 26.8%, and 39.1%, respectively. There were significantly differences (t=1.604, 2.321 and 1.874,P<0.05) between the affected and contralateral side, the affected side and control group, the contralateral side and control group.ConclusionPWI with CO2 inhalation stress test is valuable in assessing the cerebrovascular reserve in patients with severe middle cerebral artery stenosis or occlusion.

Objective To determine the gastric emptying time for liquids in the healthy volunteers by magnetic resonance imaging (MRI) and to provide a reference for reasonable preoperative fasting time.Methods Nineteen healthy volunteers of both sexes,of ASA physical status Ⅰ or Ⅱ,aged 20-60 yr,were enrolled in the study.The volunteers were fasted from the intake of liquids or solids starting from 22:00 the night before the trial,and 12.5％ carbohydrate solution 400 ml containing 40 g maltodextrin and 10 g sucrose was given orally.MRI was performed to measure the baseline gastric fluid volume at 8:00 on the day of the trial (T0).The gastric fluid volume was measured immediately after administration of the oral solution,and then measured every 25 min until the gastric fluid volume was returned to the baseline before administration of the oral solution or to ＜25 ml,and was recorded as T25,T50,T75,T100,et al.The gastric fluid volume was drawn using a computer to obtain the curve for gastric emptying.The gastric half and total emptying time was calculated using the curves.Results The gastric half emptying time was (32± 12) min,and the gastric total emptying time was (99±22) min in the volunteers.Compared with those at Tb,the gastric fluid volume was significantly increased at T25,T50,T75,T100,and no significant change was found in gastric fluid volume at T125,T150and T175.Conclusion After oral intake of liquids,the gastric emptying time is about 2 h,indicating that the preoperative fasting time for liquids can be shortened to 2 h before anesthesia in the healthy volunteers.

Objective:To explore the application of enhanced recovery around surgery (CMERAS) by integrated Traditional Chinese Medicine & western medicine in perioperative period of laparoscopic anterior resection for rectal cancer patients.Methods:100 patients with rectal cancer who were treated by laparoscopic anterior resection in Shuguang Hospital from July 2017 to July 2019 were divided into two groups with random number table method, 50 patients in each group. The control group received enhanced recovery after surgery (ERAS) perioperative treatment and the observation group received CMERAS perioperative treatment. Both groups were treated for 7 days. The degree of intestinal cleansing during the operation and postoperative rehabilitation quality were observed of the two groups, including the time of first exhaust, hospitalization time and the incidence of complications. Serum CRP level was detected by immunoturbidimetry, serum IL-6 level was detected by chemiluminescence immunoassay and peripheral blood CD4, CD8 and CD4/CD8 were detected by flow cytometry. Adverse reactions were recorded for the two groups.Results:There was no significant difference in the degree of intestinal cleansing between the two groups during operation ( Z=-1.140, P=0.254). The first postoperative exhaust time in the observation group (29.7 ± 4.6 h vs. 36.1 ± 3.8 h, t=7.590) was earlier than that of the control group, the hospitalization time (4.2 ± 0.5 d vs. 4.7 ± 0.6 d, t=4.379) was less than that of the control group, and the incidence of complications [8.0% (4/50) vs. 30.0% (15/50), χ2=6.498] was lower than that of the control group ( P<0.01). On the third day after the operation, serum CRP (11.84 ± 4.69 mg/L vs. 23.63 ± 5.04 mg/L, t=12.106) and IL-6 (34.31 ± 5.93 ng/L vs. 44.39 ± 8.81 ng/L, t=6.714) in the observation group were lower than those in the control group ( P<0.05). CD4 levels [(37.74 ± 7.28)% vs. (33.55 ± 5.07)%, t=-3.344], CD4/CD8 ratio (1.36 ± 0.27 vs. 1.13 ± 0.22, t=-4.920) were higher than those in the control group ( P<0.01), and CD8 levels [(28.04 ± 4.68)% vs. (30.22 ± 4.04)%, t=2.487] was lower than that of the control group ( P<0.05). There were no adverse reactions in two groups during the treatment. Conclusion:CMERAS could promote the perioperative recovery of patients with rectal cancer if treated with laparoscopic anterior resection and fewer complications would occur.

Objective To evaluate the clinical application of the whole blood interferon γ(IFN-γ) release assay of QuantiFERON TB Gold in tube (QFT-GIT) in diagnosis of tuberculosis. Methods From October 2014 to October 2015, 109 patients with tuberculosis (45 cases of confirmed patients and 64 cases of clinically diagnosed patients) and 70 patients with non-tuberculosis were enrolled in Tianjin Medical University General Hospital. In order to evaluate diagnosis value between two kinds of tests, and to compare the differences between two groups, QFT-GIT test and colloidal gold anti tuberculosis antibody (TB-Ab) were employed to detect in two groups of patients. The ROC curve of IFN-γrelease quantity was analyzed in two groups. Results The sensitivity and specificity of QFT-GIT were 93.58% and 85.71% respectively. The positive rate was significantly higher in QFT-GIT than that of TB-Ab (χ2=43.68,P<0.01). The sensitivity of combined detection of the two methods decreased to 52.3% (57/109), but the specificity increased to 90.0% (63/70). The release quantity of IFN-γwas significantly higher in tuberculosis group than that in the non-tuberculosis group (U=330,P<0.05). The area under the ROC curve of IFN-γrelease quantity was 0.913 (95%CI:0.864-0.963). Conclusion The whole blood IFN-γrelease assay of QFT-GIT is a sensitive and specific assay for detecting tuberculosis infection. The combination QFT-GIT with TB-Ab can improve the specificity further, which could be a useful tool for the diagnosis of tuberculosis .