Objective To observe the clinical effectiveness and prognostic factors of autologous hemopoietie stem cell transplantation on diabetic peripheral angiopathy patients under different degrees of vascular lesions. Methods Thirty-six patients with diabetic were divided into mild vascular stenosis group (group A: 20 lower extremities, vascular stenosis less than 50% ), moderate vascular stenosis group(group B :26 lower extremities, vascular stenosis of 50%-70% ) and severe vascular stenosis group (group C: 25 lower extremities, vascular stenosis greater than 70% ) according to the degree of vascular lesions. All patients were given the stem cell mobilization for 5 days, then peripheral hemopoietic stem cells were gathered on the last day and transplanted to ischemic limb by using monoeyte stem cell suspend liquid with 3 cm × 3 cm intervals.Each index of three groups was regularly observed ( 1th,12th and 18th month respectively after the operation)and comprehensive evaluated. Meanwhile,the transplantation prognostic factors (age, disease duration, post-prandial 2 hours blood glucose, glycated hemoglobin, blood pressure, triglycerides) were analyzed by multiple regression. Results Twelve months after transplantation, the ankle brachial index (ABI) and percutaneous oxygen pressure (TcPO2) of all three groups increased compared with that before the transplantation (P<0.05). In the 18th month after transplantation, the ABI still increased in group A and B (P< 0.05), and no significant changes were found in group C compared with that in the 12th month. Eighteenth month after transplantation, lower extremities of 8 patients (40%) in group A, 8 patients (31%) in group B and 6 patients (24%) in group C were examined to have neovascularizatian. Age, disease duration, blood pressure, post-prandial 2 hours blood glucose, glycated hemoglobin and triglycerides were all the important factors that affected diabetic peripheral angiopathy recurrence after transplantation. Conclusions The long-term effica-cy of stem cell transplantation on diabetic peripheral angiopathy patients at a mild to moderate degree is superior to that with severe vascular lesions. Close monitoring of blood glucose, blood pressure and triglycerides in the operation perinatal stage is required.They are the important prognostic indicators.

Objective To investigate CT image features of pleomorphic adenoma and adenolymphoma,and to improve the diagno-sis accuracy.Methods CT data of 1 3 cases of pleomorphic adenomas and 9 cases of adenolymphomas confirmed by pathology were retrospectively analyzed and compared.Results All 1 3 cases of pleomorphic adeonoma were solitary lesions,in which 1 1 cases were located in the non posterior inferior quadrant,and 1 1 cases showed persistent or delayed enhancement,with “slowly forward and slowly quit”enhancement performance.In all of the 9 cases of adenolymphoma,3 cases were multiple lesions.In total of 1 3 lesions, 9 lesions were located in the posterior inferior quadrant,and 9 lesions were significantly enhanced in the arterial phase and enhance-ment was decreased in the delayed phase,which showed “quickly forward and quickly quit”.Conclusion CT image features of pleo-morphic adenoma and adenolymphoma are different.Most of lesions can be diagnosed correctly before surgery by using image fea-tures with clinical information.

Objective:Our aim is to investigate the relationship of VEGF-C,VEGF-D and lymph node metastasis in pancreatic cancer,and to elucidate the role and significance of the cancerous peripheral lymphatic tissue.Methods: The expression of VEGF-C and VEGF-D was assayed by means of immunohistochemistry in 30 pancreatic carcinomas.Results:The positive rates of VEGF-C、VEGF-D were 73% (22/30)、57% (17/30) respectively in pancreatic cancer.The expression of VEGF-C、 VEGF-D in cancerous invasive edge was significantly higher than that in the center of cancerous tissues.There was no correlation between the expression of VEGF-C、VEGF-Dand the site,differentiation,histology types.Ⅲ~Ⅳ stages of pancreatic cancer showed strong expressions of VEGF-C、VEGF-D than that Ⅰ~Ⅱ stages of pancreatic cancer.The positive lymph node in positive VEGF-C and VEGF-D group were higher than that in the negative group.Conclusion:VEGF-C and VEGF-D induced lymphangiogenisis in pancreatic cancer,promoted the tumor cell lymph metastasis.

Objective To investigate the situation and progress in technology of brain computer interfaces (BCI) by using the bibliometric approach.Methods Literature searching was done in China national knowledge infrastructure (CNKI) database using keyword brain computer interface.Subsequent results were analyzed by using softwares concerning the periodical distribution,subjects' distribution,foundations,authors,institutes,journal types and key words.Results Overall 425 publications from 160 journals were included.The amount of the relevant articles showed an increasing trend in 2002 to 2012.The research in BCI in China was supported by a large amount of funds.There were a lot of Chinese authors and institutions participating in BCI study,and they were widely distributed across the country.However,only 32.56％ of all authors and 51.85％ of all institutions published more than 1 article.Moreover,research on BCI mainly was focused on the biomedical engineering aspect.Conclusions Research on BCI developed rapidly in the past 12 years in China and will continue to develop in the following decades.In the future studies,the focus should shift to clinical research instead of biomedical engineering,and to make this technology a useful clinical practice is the first priority.

Objective: To construct subtracted cDNA libraries of stomach tumors and normal stomach tissue using suppression subtractive hybridization(SSH).Methods: cDNA Library subtraction was performed using the protocol described in the Clontech PCR-Select cDNA Subtraction Kit. cDNA was synthesized from 2 μg of poly A+RNA from the tumor and normal tissues using AMV reverse transcriptase. The tester and driver cDNAs were digested with RsaⅠ, a four-base-cutting restriction enzyme that yields blunt ends. The tester cDNA was then subdivided into two portions, and each was ligated with different cDNA adaptor. Two hybridizations were performed. In the first, an excess of driver was added to each sample of tester. Hybridization kinetics led to equalization and enrichment of differentially expressed sequences. During the second hybridization, the two primary hybridization samples were mixed together without denaturing and thus the templates were generated from differentially expressed sequences for PCR amplification. Using suppression PCR, only differentially expressed sequences were amplified exponentially and after second PCR amplification the background was reduced and differentially expressed sequences were further enriched. The cDNAs were then directly inserted into a T/A cloning vector to generate a stomach tumor-specific subtracted cDNA library. Results: The amplified library contained 800 positive clones. Plasmid inserts were PCR amplified and showed 250－700 bp inserts. Conclusions: The successfully constructed subtracted cDNA library of gastrocarcinoma and normal tissue enables us to compare two populations of mRNA and obtain clones of genes that expressed in one population but not in the other.The characterization of these genes will allow them to be exploited for their diagnostic and therapeutic potentials.

Objective To investigate the diagnostic value of MRI in the infantile developmental dislocation of the hip.Methods Forty-five cases of preoperative hip MRI data of DDH (patient group)and 40 cases of normal hip (control group)MRI data were retrospectively analyzed.Three types were classified according to the standard of Dunn.Then the bony acetabular index (BAI),cartilaginous acetabular index (CAI)were measured on coronal MRI and all the intra-articular structures (articular cartilage,labrum, teres ligament and iliopsoas)in the acetabulum that impeded the reduction of the femoral head were observed.Results There were normal hips (80 hips)and dislocated hips (73 hips).In dislocated hips typeⅠ (30 hips),typeⅡ (20 hips),and typeⅢ (23 hips) were found.The values of BAI were (26.13±2.19)°and (35.87±4.42)°,CAI (13.84±1.07)°and (21.92±4.70)°for patient group and control group.The values of BAI were (31.80±1.74)°,(37.80±3.40)°and (39.17±4.11)°,CAI (17.20±2.68)°,(20.91±2.02)°and (27.50±2.78)°for the typesⅠ,Ⅱ,Ⅲ respectively.Differences of BAI and CAI between patient group and control group were showed (t=-11.048 and -9.188,P =0.000).Statistically significants were found among the typeⅠ,Ⅱ,Ⅲ(F=22.159 and 47.241,P =0.000).There were linear correlations for patient group ,control group,and the typeⅠ,Ⅱ,Ⅲ (r= 0.964,0.844,0.953,0.931 and 0.870,P =0.000).Some pathological changes such as varus labrum,thick teres ligament,iliopsoas spasm,articular cartilage hyperplasia,fat hyperplasia,joint effusion were observed in the type Ⅱand Ⅲ.Conclusion MRI is not only used for measuring the values of BAI and CAI,and a linear correlation among all kinds of DDH,but also some factors hindering the reduction of the femoral head can be found clearly.It can provide an important reference basis for the diagnosis and treatment of DDH.

BACKGROUND: Carbonated hydroxyapatite cement (CHC) s a new kind of biomaterial for bone defect, which is made of powder and fluid, and can be mixed to be pasty to repair various bone defects.OBJECTIVE: To observe the improvement of vertebrae height and pain in patients with osteoporosis vertebral compression fracture (VCF) after vertebroplasty by using a new kind of bone graft biomaterial, taking CHC as the filling material to reinforce the vertebral body.DESIGN: A contrast observation trial taking patients as subjects.SETTING: Department of Orthopaedics, General Hospital of Chinese PLA.PARTICIPANTS: Totally 34 patients with thoracic or lumbar osteoporosis VCF who received the treatment in the Department of Orthopaedics, General Hospital of Chinese PLA between October 2000 and August 2003. Inclusive criteria: ①Definite diagnosis by CT; ② Informed consents were obtained from the patients. Exclusive criteria: The patients with osteoporosis vertebral compression fractures who suffered vertebral posterior wall fracture. There were 6 males and 28 females, and they were aged (72±13)years; Among the patients, 27 were diagnosed as postmenopausal osteoporosis, 1 as cortical hormone-induced osteoporosis and 6 male patients weresenile osteoporosis.METHODS: ①All the patients were randomly divided into two groups: Experimental group (n =23) and control group (n=11). All the patients were performed percutaneous operation with local anesthenia. All cases were performed percutaneous operation under local anesthesia. Under the C-arm monitored, one side pedicle puncture was performed to enter the anterior column of the involved VCF. Patients of the experimental group were filled with CHC. Patients of control group were filled with polymethyl Methacrylate (PMMA) with the same way. ② Referred to McGill-Melzack scoring. Among the scale 0-100 mm (0 was no pain, 100 was acute pain), the value indicated the painful intensity and mental assault degree. ＜ 30 scores indicated good, 30-40 basically satisfied and ≥ 50 poor .③ Referred to the method from Lee et al, the preoperative height (A1) and postoperative height (A2) of compression fracture position of VCF were measured according to the lateral X-ray film. At the same time, the upper vertebral height (A3) and the inferior vertebral height (A4) were measured at the same position. The original height (A) of the involved vertebra was calculated as (A)= (A3+A4)/2,and the preoperative vertebral compression rate =(A-A1 )/A, the postoperative vertebral compression rate =(A-A2)/A, the restoring rate = (the preoperative vertebral compression rate-the postoperative vertebral compression rate)/the preoperative vertebral compression rate. ④ The wounds of the patients were observed after operation. The levels of blood routine, serum calcium and serum phosphorus were detected before, one day and one week after operation. MAIN OUTCOME MEASURES: ① Preoperative and postoperative VAS scoring. ② The vertebral compression rate and restoring rate. ③ Wounds were observed after operation. The blood routine, the serum calcium and serum phosphorus were detected before, one day and one week after operation.RESULTS: Totally 34 patients were involved in the result analysis. ①The preoperative visual analogue scale (VAS) score of experimental group were (91.5±21.7) points, and the postoperative ones were (44.5±27.2) points. The difference of VAS score reduced gradually along with the postoperative time. There was no difference of VAS score between experimental group and the control group 4 weeks after operation. ② The biocompatibility of CHC in the vertebral body was fine. The vertebral compression rate of experimental group was recovered from (43.1±21.4)％ preoperatively to (27.3± 18.5)％ postoperatively. The rate of restored heights was (27.3±18.5)％. ③ All patients obtained Ⅰ stage wound healing, and none of them had infection, inflammatory secretion and nervous symptom. There were no differences in blood routine test, serum calcium, serum phosphorus between patients in two groups. One case filled by PMMA and two cases filled by CHC presented leakage, and none had nervous symptom.CONCLUSION: As the filling materials for vertebropalsty, CHC can restore the vertebral heights and relieve pain safely and effectively, however, its efficacy to relieve pain is not significant as PMMA in the short term.

Objective To discuss the clinical characteristics and treatment of upper cervical spine injuries in the elderly. Methods A retrospective study was done on clinical data of 28 elderly patients ( > 60 years old) with upper cervical spine injuries treated from January 2003 to December 2007. There were 20 males and 8 females, at age range of 60-86 years (mean 68.1 years). Injury causes included slip in 16 patients, traffic injury in eight and fall from height in four. Atlas fractures occurred in five patients and axis ones in 15,of which there were eight patients with odontoid fractures, six with C2 vertebral arch fractures and one with C2 body fractures. Upper cervical spine injury was combined with lower cervical spine injuries in five patients. There were combined atlantoaxial injuries including odontoid fractures combined with lateral atlas fracture in one and edontoid fractures combined with anterior atlas arch fracture in one. Atlantoaxial dislocation occurred in one patient and combined spinal injury in four. Of all, eight patients were treated conservatively, eight with open surgical operation and 12 with minimally invasive surgery. Results The average hospital stay was 16.5 days, with no statistical difference be-tween conservative treatment group and open surgical operation group ( P > 0.05 ). While the average hos-pital stay in minimally invasive surgery group was shorter than that in conservative treatment and open sur-gical operation groups ( P < 0.05 ). Of all, two patients in conservative treatment group and one in open surgical operation group died and the other 25 patients were followed up for average 16.8 months (9-56 months). The satisfaction rate was 50% in conservative treatment group, 72% in open surgical operation group and 75% in minimally invasive surgery group. Complications occurred in four patients in conserva-tive treatment group, three in open surgical operation group and two in minimally invasive surgery group. Conclusions With odontoid fracture the most common injury type, upper cervical spine injuries arema-inly caused by low-energy force and characterized by low mobidity of spinal cord injuries and high possi-bility of missed diagnosis in the elderly patients. The surgical treatment especially minimally invasive surgery can bring good results compared with conservative methods.

Objective To introduce the technique and experience in reconstruction of posterior crueiate ligament-posterolateral comer(PCL-PLC)injuries with only one allograft of Achilles tendon. Methods The instable knees in 12 cases with PCL injury combined with three degree chronic PLC injury were treated with PCL reconstruction under arthroscope and PLC reconstruction through posterolateral arc incision.Single bundle grafts of PCL reconstructions in tibial and femoral tunnels were fixed by resorption screws.Fibular collateral ligament(FCL)and popliteofibular ligament(PFL)were reconstructed with reforming Larson(?)method.All reconstruction grafts only needed one Achilles tendon as donator.Total op- eration time was 130 minutes including 90 minutes of PCL reconstruction and 40 minutes of PLC recon- struction.Gradual weight loading was allowed after six weeks of bracing.Results Follow-up for mean 12 months(5-24 months)indicated that tibial“step off”reduction was 83%(10/12)and posterior drawer test of 0-1~+ 75%(9/12).Dial sign evaluated that normal external rotation angle was 75%(8/12).Nor- real varus stress test at 30?knee flexion accounted for 83%(10/12).Scores of Lysholm,Tegner and HSS were 90.5,5.1 and 84.5,respectively(P＜0.01=.Conclusion Synchronized reconstruction of PCL and PLC injuries with only one Achilles tendon can obtain satisfactory clinical result,with less expense and shorter operation time.

Aim To monitor the whole blood trough concentration of cyclosporine A (CsA) in renaltransplant recipients reciving triple therapy with mycophenolate mofetil, cyclosporine andprednisone and to establish an optimal therapeutic window of CsA. Methods Sampleswere measured by specific fluorescence polarization immunoassay. According to the timeafter operation and different therapy plan, the whole blood trough concentration of CsA ineach group was compared with that in control group.Results The optimal therapeuticwindow of CsA with MMF plan was 150~300 ?g? L-1 (less than one month after op-eration), 120~260?g?L-1 (1~