Objective To perform anatomic study on percutaneous cannulated-screw fixation of symphysis pubis diastasis in human cadaveric pelvic specimens so as to provide a basis for clinical practice of the technique.Methods Fifteen adult pelvic cadaveric specimens were dissected to expose pubic symphysis,peripheral major vascular nerve,spermatic cord and round ligament of the uterus.Thickness of pubic symphysis and distance between the outer edge of pubic tubercle and spermatic funicle or round ligament of uterus were measured respectively.Distances were measured respectively from entry and exit points to the above-mentioned structures in the direction of guide pin.Entry depth and angles of guide pin with the coronal plane and cross section of the human body were measured.Surgery was simulated to prove the surgery effect through post-surgery filming and CT.Results Thickness of symphysis pubis was gradually reduced from up to down.Pubic tubercle part was the most thick and it could accommodate a 7.3 mm cannulated-screw.Entry and exit points of cannulated-screw were in certain distances with the important nervusvascularis and spematicfunicle (or round ligament of uterus) in the periphery,which were invulnerable to damages in the process of surgery.Proper lengths of cannulated screws were (73.6 ± 1.3) mm for males and (72.4 ± 1.7)mm for females (t =3.146,P ＜ 0.05).Screw thread was completely embedded in pubic tubercle.Angles of guide pin with coronal plane and cross section of human body were (7.3 ± 1.1) °and (6.4 ± 1.0) ° for males (6.9 ± 1.5) ° and (6.1 ± 0.6) ° for females.Radiography and CT findings confirmed that all pin tracks were in the bone substances with angle and length of screws staying within the scope of experiment.Conclusion Percutaneous cannulated screw fixation is reliable and safe for symphysis pubis diastasis.

Objective To explore the value of MRI in the diagnosis of fetal aortic arch anomalies. Methods We retrospectively collected 10 fetuses with aortic arch anomalies indicated by prenatal ultrasound and underwent MR examination and were subsequently proven by autopsy or post-birth follow-up from 320 pregnant women. We focused on the observations of the location of the aortic arch and brachiocephalic artery anomalies, the locations of the liver and stomach in the abdominal cavity, and the large vessels in abdomen. The above-mentioned finding were compared with prenatal ultrasound and follow-up findings. Results Of 10 cases, right aortic arch with aberrant left subclavian artery was seen in 7 cases, right aortic arch with the mirror branch, left aortic arch with aberrant right subclavian artery, right aortic arch with aberrant left subclavian artery combined with cervical aortic arch and double aortic arch was seen in 1 case, respectively. All aortic arch anomalies detected by MRI were consistent with post-birth or autopsy findings. Ultrasound misdiagnosed aortic branch malformation in 5 places, which included right aortic arch but misdiagnosed aberrant left subclavian artery in 2 cases, right aortic arch never diagnosed mirror branch anomaly in 1 case, right aortic arch with left subclavian artery misdiagnosed cervical aortic arch in 1 case, left atrial isomerism but misdiagnosed left aortic arch with aberrant right subclavian artery in 1 case;One double aortic arch was misdiagnosed as right aortic arch with aberrant left subclavian artery in ultrasound. Conclusion Fetal cardiovascular MRI is an effective and supplementary examination to complement ultrasound in diagnosis of fetal aortic arch anomalies.

Objective: To explore the predictors in patients of paroxysmal atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). Methods: A total of 142 PAF patients received RFCA in our hospital from 2013-03 to 2016-03 were studied. The patients were divided into 2 groups: Recurrence group, n=46 and Non-recurrence group, n=96. Clinical data was compared between 2 groups and AF recurrent predictors were studied by single and multivariate Logistic regression analysis. Based on quartiles of uric acid (UA) level, the patients were categorized in another set of 4 groups: Q1 group, UA<259 &mu;mol/L, n=33, Q2 group, UA 259-320 &mu;mol/L, n=37, Q3 group, UA 321-380 &mu;mol/L, n=37 and Q4 group, UA>380 &mu;mol/L, n=35. The influence of UA on AF recurrence was measured by Kaplan-Meier test, the predictive value of UA combining metabolic syndrome (UA+MS) on AF recurrence was studied by ROC curve analysis. Results: The BMI, diabetes, MS, AF duration, CHADS2 score, creatinine, UA and BNP were different between Recurrence group and Non-recurrence group, all P<0.05. Logistic regression analysis indicated that AF duration (OR=1.02,95% CI 1.01-1.03, P=0.002), UA level (OR=1.01, 95% CI 1.00-1.01, P=0.046) and MS (OR=4.73, 95% CI 1.36-16.45, P=0.014) were the independent predictors for AF recurrence. UA quartile analysis indicated that gender, BMI, MS, creatinine, LVEF and the incidence of AF recurrence had signifcant discrepancy by different UA levels, all P<0.05. ROC curve showed that the predictive values for UA+MS in AF recurrence had the sensitivity at 80.4%, specificity at 74.1% (AUC 0.79±0.04, 95% CI 0.71-0.89, P=0.0001), for UA in AF recurrence had the sensitivity at 73.9%, specificity at 57.2% (AUC 0.66, 95% CI 0.56-0.76, P=0.02); UA+MS had the higher predictive value than UA alone, P<0.05. Conclusion: Both UA and MS were related to AF recurrence, high UA level combining MS had certain predictive value for AF recurrence in PAF patients after RFCA.

[Objective] To investigate the effect of long term occupational exposure on the immune function of workers of a power plant . [ Methods] An exposure group of 200 workers in a power plant and a control group of 80 normal people of health checkup were examined for their cellular immunity and humoral immunity by flow cytometry instrument testing technology of the United States BD company and im-mune turbidimetric method. [Results] The abnormality rate (16.5%) of immune globulin in exposure group were significantly higher than that (7.5%) in control group (P<0.01).The values of CD3, CD4, CD8 positive T-lymphocytes and the ratio CD 4/CD8 were significantly lower in exposure group than those in control group (P<0.05).The levels of IgG and IgA in exposure group were significantly lower than those in control group (P<0.05). [Conclusion] It is indicated that long term occupational exposure in power plant may lower the values of CD 3, CD4, CD8 positive T-lymphocytes and the ratio of CD4/CD8 and reduce the function of humoral immunity .

Objective] To study the effect of different placed time for vacutainer and specimen on the results of emergency electrolyte detection . [ Methods] With heparin lithium anticoagulation tube and common coagulation vacuum tube , electrolytes were detected at 30 minutes,one hour and two hours af-ter extracting blood . [ Results] At 30 minutes and one hour after extracting blood ,the levels of K +and Na+of the plasma group were significantly lower than those of the serum group (P<0.05).With the ex-tension of specimen placed time , the levels of K +and Na +of the plasma group were becoming higher than those previously ,and at two hours the difference had statistical significance ( P<0 .05 ) .There was not ob-vious difference found in the levels of K +, Na +and Cl -of the serum group at different placed times ( P>0.05).But the levels of CO2 of both the plasma group and the serum group were significantly lower than those previously with the extension of specimen placed time , and the difference had statistical significance (P<0.05). [Conclusion] It is indicated that the using of different vacutainers effects electrolyte de-tection.With the extension of specimen placed time , the levels of K +and Na +of the plasma group increase gradually , and the levels of CO 2 of the plasma group and the serum group both decrease gradually .

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Aim To investigate the role of berberine in mouse primary hepatocytes steatosis and whether aden-osine monophosphate-activated protein kinase(AMPK) is essential in this process in order to explore the mech-anism of non-alcoholic fatty liver disease treatment. Methods Different concentrations of oleic acid(OA) were used in mouse primary hepatocytes to determine the appropriate dose inducing steatosis. Subsequently, hepatocytes were treated with berberine and OA at the same time for 24 h serving metformin as positive con-trol. Lactic dehydrogenase (LDH) release test was performed to investigate cell viability. Lipid level was determined by oil red staining and triglyceride assay. Western blot measured the phosphorylation level of AMPK and Acetyl CoA carboxylase. An AMPK inhibi-tor compound C(CC) pre-treated hepatocytes for 1 h followed by berberine 24 h-treatment. The relationship between free fatty acid(FFA) uptake and mitochondri-al inhibition was evaluated by measuring FFA in the supernatant of OA,berberine and rotenone (mitochon-drial complex I inhibitor) group. Results Berberine could significantly reduce primary hepatocytes steatosis induced by oleic acid and stimulate AMPK and ACC phosphorylation at a non-toxic dose. In addition, CC obviously inhibited AMPK activity,but failed to dimin-ish the lipid dysregulation improvement of berberine. Berberine and rotenone intervention reduced OA up-take by 31.2% and 23.6%,respectively. Conclusion Berberine ameliorates hepatocytes lipid accumulation by suppressing fatty acid uptake,which is probably re-sulted from inhibition of mitochondrial respiratory chain complex I,independently of AMPK activation.

Adult ; Blood Coagulation ; Emergency Treatment ; Female ; Humans ; Intraoperative Period ; Liver Transplantation ; Male ; Middle Aged

OBJECTIVETo investigate the effect of the protocol recommended by NCCN-2007 on the diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC) in China.

METHODSNCCN protocol consists of identifying HNPCC characteristics according to the revised Bethesda Guidelines,genetic counseling with immunohistochemistry and finally genetic testing. Four hundred and nineteen patients diagnosed as colorectal cancer from January 2002 to February 2006 were selected. The hMLH1 and hMSH2 immunostaining were implemented for 90 patients who fulfilled the revised Bethesda Guidelines, in whom 8 patients fulfilling the Amsterdam II (Criteria were classified as group A and the other 82 patients as group B. The frozen tissues were collected from patients who showed loss of hMLH1 or hMSH2 protein expression, then RNA was extracted, and RT-PCR and cDNA sequencing were adopted to detect the germline mutations of hMLH1 and hMSH2.

RESULTSTumor tissues from 18 patients showed loss of hMLH1 or hMSH2 protein expression (5 patients in group A and 13 in group B). Finally, 21 patients(8 in group A and 13 in group B showed loss expression of MMR protein) were diagnosed as HNPCC, including 2 cases of hMLH1 and 1 case of hMSH2 mutations. These 3 cases with cDNA mutations did not fulfill the Amsterdam II( Criteria, and were finally diagnosed as HNPCC.

CONCLUSIONThe protocol recommended by NCCN-2007 offers a useful approach to identify HNPCC patients,and reduces the possibility of missed diagnosis of HNPCC.

Adult ; Aged ; Aged, 80 and over ; Base Pair Mismatch ; China ; Colorectal Neoplasms, Hereditary Nonpolyposis ; diagnosis ; genetics ; Female ; Gene Deletion ; Genetic Testing ; methods ; Guidelines as Topic ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo screen the clinicopathological factors of synchronous hepatic metastases from colorectal cancer for early diagnosis and therapy.

METHODSClinicopathological data of 367 cases with colorectal cancer from Jan. 2003 to Dec. 2006 in our department were collected to set up the database. All the patients were divided into two groups according to hepatic metastases or not. Clinicopathological factors were analyzed, such as age, sex, blood type, tumor family history, hepatitis and cirrhosis history, peritoneal or pelvic metastases, bowel obstruction, CEA, CA19-9, tumor localization and size, histological type, infiltration depth, lymph node metastases etc.

RESULTSOut of 367 colorectal cancer cases, there were 56 cases with synchronous hepatic metastases from colorectal cancer, accounting for 15.3%. The age, bowel obstruction, peritoneal or pelvic metastases, and tumor invasion depth were associated with the hepatic metastases. The primary tumor located in the right colon resulted in more right lobe hepatic metastases than those in the left lobe. The serum CEA level was associated with hepatic metastases. When serum CEA was more than 22.1 microg/L, the occurrence rate of hepatic metastases increased.

CONCLUSIONPeritoneal or pelvic metastases, bowel obstruction, age and serum CEA level are associated with synchronous hepatic metastases from colorectal cancer.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Liver Neoplasms ; pathology ; secondary ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Staging ; Young Adult