BACKGROUND:Double inferior vena cava (DIVC), usually found at routine autopsies, is rare in the clinic. It has been described in numerous reports over the years since Adachi first depicted it in 1940. But all these reports were based on two-dimensional (2D) observation, and no three-dimensional and animated images reported. OBJECTIVE: To observe and establish the digital visible models of the structure of DIVC of the Virtual Chinese Human Male (VCH-M) Ⅲ.DESIGN: Repetitive measurement design by taking VCH-M Ⅲ as the subjects.SETTING : Department of Traumatic Orthopedics and Anatomy, Nanfang Hospital Affiliated to Southern Medical University.MATERIALS: The experiment was conducted in Southern Medical University from February 2006 to May 2006. The cross-sectional images of fresh tissues from VCH-M Ⅲ dataset were reviewed and 1 060 serially-sectioned slices of VCH-M Ⅲ, from the 2 600th slice to the 3 660th were taken as the source for the 3D models in our study.METHODS: Cross-sectional images of fresh tissues from the VCH-M Ⅲ dataset were reviewed and the structures of the DIVC were confirmed on a section-by-section basis. 3D computerized reconstructions of DIVC and its adjacent structures were generated from these data using Arnira 3.1 (TGS) imaging software.MAIN OUTCOME MEASURES: Cross-sectional images and 3D reconstruction of VCH-M Ⅲ.RESULTS: The cross-sectional images of the VGH-M Ⅲ could fairly display the main structure of DIVC. The digitized model of brachial plexus offers unique insights into the abnormity anatomy of DIVC.CONCLUSION: The VCH-M Ⅲ dataset can provide complete and accurate data of DIVC.

Background The application of femtosecond laser in the corneal refractive surgery has made great progression recent years,but the morphology characteristic of corneal stroma surface after making-flap of femtosecond laser is closely concerned.Objective This study was to analyze the influence of photodisrnption of femtosecond laser on the corneal stroma surface and to investigate the effect of different laser pulse energy on the sudace ultrastructure of corneal stroma.Methods Corneal flaps were made with Visu Max femtosecond laser in 16 fresh porcine eyes with the pulse energy 125 nJ,155 nJ and 195 nJ respectively,and Moria-M2 microkeratome was used as control.Scanning electron microscopy (S-3400N Hitachi High-Technologies Corp) was used to observe and compare the ultrastructural characteristic of corneal stroma bed surface after making of corneal flap.Results The corneal strnma was evaporated and created a smooth surface when photodisrnption happened in the femtosecond laser group.Residual tissue bridges could been exhibited among the cavitation bubbles under the scanning electron microscope.Corneal strnma surface was smooth in the 125 nJ pulse energy group,but some tissue bridges still were visible.In the 155 nJ pulse energy group,much more smooth surface was seen without tissue bridges and mechanical damages on the corneal surface.However,the surface quality was worse and many tissue bridges and grooves existed in the 195 nJ pulse energy group.In addition,different sizes of slots caused by big cavitation bubbles were visible with the round and oval shape.The edges were regular and sharp with small damage zone after cutting with femtoseeond laser.However,many elevated fibril tissues could be seen on the corneal surface after making of flap with microkeratome.Many crimp and irregularity tissues were found on the surface.Blunt surface and indentations appeared in the cutting edge.Conclusions The mierostrueture of corneal stroma surface is more smoother after making of corneal flap with fentosecond laser in comparison with microkeratome.Pulse energy of 155 nJ is preferably during the making-flap with femtosecond laser.

OBJECTIVETo investigate the effect of midazolam on human ether-a-go-go (hERG) K+ channels exogenously expressed in human embryonic kidney cells (HEK-293) and the underlying molecular mechanisms.

METHODSWhole-cell patch clamp technique was used to record WT, Y652A and F656C hERG K+ current expressed in HEK-293 cells.

RESULTSMidazolam inhibited hERG K+ current in a concentration-dependent manner, the half-maximum block concentrations (IC50) values were (1.31 ± 0.32) µmol/L. The half-activation voltage (V1/2) were (2.32 ± 0.38) mV for the control and (-1.96 ± 0.83) mV for 1.0 µmol/L midazolam. The half-inactivation voltage (V1/2) was slightly shifted towards negative voltages from (-49.25 ± 0.69) mV in control to (-57.53 ± 0.53) mV after 1.0 µmol/L midazolam (P < 0.05). Mutations in drug-binding sites (Y652A or F656C) of the hERG channel significantly attenuated the hERG current blockade by midazolam.

CONCLUSIONMidazolam can block hERG K+ channel and cause the speed of inactivation faster. Mutations in the drug-binding sites (Y652 or F656) of the hERG channel were found to attenuate hERG current blockage by midazolam.

Dose-Response Relationship, Drug ; Ether-A-Go-Go Potassium Channels ; drug effects ; HEK293 Cells ; Humans ; Midazolam ; pharmacology ; Mutation ; Patch-Clamp Techniques ; Potassium Channel Blockers ; pharmacology

Objective To investigate rheumatic disease manifestations in patients with myelodysplastic syndromes and explore possible causes.Methods Nine myelodysplastic syndromes(MDS)inpatients with rheumatic disease manifestations were reviewed retrospectively.Results Nine patients with the diagnosis of MDS had active rheumatic disease manifestations with various degree of hypergammaglobulinemia and positive autoantibodies.Two patients had rheumatoid arthritis(RA)and RA+anti-phospholipid syndrome(APS),four systemic lupus erythematosus(SLE)and SLE+polymyositis(PM),one patients had adult onset Still's disease, one with acute arthritis and cutaneous vassulitis,one had lupus-like manifestations including polyserositis,al- buminuria,hypocomplementemia and positive Commb's test.Conclusion The rheumatic disease manifesta- tions in patients with myelodysplastic syndromes are characterized by various active rheumatic disease manifes- tation.Immunological abnormalities and ineffective hematopoiesis are persistent.Immunologic abnormalities in MDS such as impaired function of T and B cells,hypergammaglobulinemia,positive autoantibodies,may be the causes of various rheumatic manifestations.We suggest that there is a significant association between myeludys- plastic syndrome and rheumatic diseases.

Objective To investigate the association between arsenic(+3 oxidation state) methyltransferase (AS3MT) genetic polymorphism and susceptibility to endemic arsenism.Methods Polymerase chain reactionrestriction fragment length polymorphism-single strand conformation polymorphism(PCR-RFLP-SSCP) technology was performed to detect mutations of AS3MT gene intron 8 and exon 9 in genome DNA of the 79 cases and 110 controls.PCR products with abnormal band forms were further sequenced to find the types and sites of mutation.Chi-square test and multivariate Logistic analyses were conducted.Results The incidence of the 9149 base mutation(A→C) in AS3MT gene intron 8(AS3MT-9149) in case group(19.0％,15/79) was lower than that in control group (23.6％,26/110).The incidence of the codon 287 mutation(ATG→AT/CG) in AS3MT gene exon 9(AS3MT-287)in case group(10.1％,8/79) was lower than that in control group (11.8％,13/110).However,statistical analysis indicated no significant difference in both mutations between two groups[AS3MT-9149:odds ratio(OR) =0.59,95％ confidence interval(CI):0.26-1.31,P =0.195; AS3MT-287:OR =0.85,95％ CI:0.32-230,P =0.751].Conclusions There are no significant association between the genetic polymorphisms of AS3MT-9149,AS3MT-287 and the susceptibility to endemic arsenism.Similarly,due to small sample amount,we can not exclude the possibility that these gene polymorphisms are related to susceptibility to endemic arsenism.

Introduction:Transcatheter arterial chemoembolization (TACE) plus thermal ablation has been widely used recently in the treatment of hepatocellular carcinoma (HCC). In this study, we aimed to compare results of the combination of TACE and percutaneous thermal ablation with those of hepatectomy in patients with HCC. Methods:The clinical data of 137 HCC patients who sequentially received TACE and computed tomography (CT)-guided percutaneous thermal ablation as an initial curative treatment (combination group) and 148 matched HCC patients who received hepatectomy (surgery group) between 2004 and 2011 were collected and analyzed. After TACE, multiphase contrast-enhanced CT was performed to identify the total number of tumors as well as lipiodol deposition in the liver. Survival was calculated by using the Kaplan-Meier method and compared by using the log-rank test. The prognostic factors were assessed with multivariate Cox proportional hazards regression analysis. Results:Of all 285 patients, 225 (79.0%) had cancerous lesions≤5 cm in diameter. In preoperative contrast-enhanced CT or magnetic resonance imaging, the number of tumors was 1–4 for each patient. The 1-, 3-, and 5-year overal survival rates were 95, 74%, and 67%in the combination group and 88, 66, and 47%in the surgery group, respectively (P=0.004);the corresponding recurrence-free survival rates for the two groups were 92, 69, and 61%and 75, 58, and 44%, respectively (P=0.001). In the multivariate analysis, treatment al ocation was an independent prognostic factor for survival. Only 60 patients in the combination group had sufficient imaging data, and 135 new lesions with lipiodol deposition were diagnosed as malignancies in 22 of 60 patients, whereas 20 new lesions were found in 11 of 148 patients in the surgery group. Conclusion:The combination of TACE and CT-guided percutaneous thermal ablation for HCC improves survival of HCC patients compared with hepatectomy.

Objective To establish a network laboratory for blood cell analysis and better calibrate haematology analyzers in local lab.Methods According to GB/T 15481《General requirements for the competence testing and calibration laboratories》(idt ISO/IEC 17025),we established a network laboratory providing traceability for blood cell analysis.Complete blood count was traced to Calibration Laboratory in NCCL;The secondary standard haematology analyzer with the same model and calibrator with same lot number were used for verification for a long period.Fresh blood from healthy people was used to calibrate haematology analyzers.Results Gradually we have improved our laboratory quality management system, precision as well as accuracy,which was satisfactory.The unified blood sample was adopted to calibrate different equipments in our hospital and showed consistence when compared with calibration analyzer.The correlation coefficient of all tests is more than 0.99.The relative deviation of WBC,RBC,HCT,HGB and PLT are within?7%,?3.5%,?4%,?3% and?15%,respectively.Conclusions Secondary standard systems provides good comparable results with calibration laboratory.Its tracing mode and quality control scheme could ensure the traceability and accuracy of completed blood count.Furthermore,using elective fresh blood from healthy people,the comparable results from different analyzers were achievable.

Objective To investigate clinical features of lower motor neuron lesion (LMNL) caused by the single level lower thoracic disc protrusion (LTDP),and to observe clinical outcomes of surgical treatment.Methods Between January 1997 and December 2009,17 patients with LMNL caused by single level LTDP underwent en bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation in our hospital.MRI and CT scans were taken to confirm lesion levels:T10-11 in 4 patients of whom 3 had patellar clonus and ankle clonus,T11-12 in 5 patients of whom 4 had ankle clonus,and T12L1 in 8 patients who only had positive Babinski sign.The neurologic status was assessed using the Japanese Orthopaedic Association (JOA) scoring system.The muscle strength of the tibialis anterior was assessed using the Manual Muscle Test (MMT).Sagittal Cobb angle and cross-sectional area of the dural sac at the level of maximal compression in MRI were also observed.Results All patients were followed up for 22 to 76 months (average,48.6 months).The mean JOA score increased from preoperative 5.88±1.11 to 9.53±0.94 at final follow-up (t=16.143,P＜0.05).The muscle strength of the tibialis anterior recovered to more than grade 4 in all patients.Postoperative Cobb angle was unchanged compared with that before operation.MRI indicated that the cross-sectional area of the dural sac at the level of maximum compression increased from preoperative 35.8±7.3 mm2 to postoperative 132.9±6.5 mm2 (t=70.78,P＜0.05).Conclusion LMNL can be caused by LTDP.The eu bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation can provide a satisfactory decompression effect and marked recovery of neurological function.

Objective To provide a new method for sacral fracture fixation by means of 3D recon-struction and reverse engineering technique. Methods Pelvis images of 3D CT scan were obtained from patients with sacral fracture. The digital data were transferred into a computer workstation. 3D models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. The 3D fracture models were imported into Imageware 10.0 software. Different situations of reduction (total reduction, half reduction and no-reduction) were simulated using Imageware 10.0 software. The extract locations and the best directions of inserting iliosacral lag screws were defined using Reverse Engineering according to the 3 situations to before navigation templates were designed according to the posterior anatomic features of the ilium and the insertion channels. Exact navi-gational templates were manufactured by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist surgical navigation and placement of iliosacral lag screws. Results Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation templates were found to be helpful and highly accurate. Conclusion The navigation template may be a useful method for mini-invasive fixation of sacroiliac joint fracture.

OBJECTIVETo study the medium and long term effects of perfusion of bone marrow stromal stem cells through optional artery for the treatment of non-traumatic femoral head avascular necrosis.

METHODSFrom January 2000 to December 2004,62 cases(78 hips) with non-traumatic femoral head necrosis accepted optional artery marrow stromal stem cells infusion treatment and had complete follow-up data, including 43 hips of 35 males and 35 hips of 27 females with an average age of 36.3 years old (22 to 54). According to preoperative imaging data, 16 hips were ARCO I stage, 52 hips were II stage, 10 hips were III a stage. Harris score was 64.94 +/- 8.12 preoperatively. Postoperative Harris score at the last follow-up, imaging changes,DSA vascular changes were analysis.

RESULTSThe patients were followed up for 9 to 13 years (means 11 years). By the end of the follow-up, a total of 18 hips got artificial joint replacement, 10 hips of preoperative ARCO I, II period got artificial hip joint replacement, 8 hips of IIIa period got hip artificial joint replacement. Harris score was 71.21 +/- 0.19 at the end of the follow-up, it was obviously enhanced compared with preoperative. DSA showed blood vessels of supply the femoral head increased thickening.

CONCLUSIONPerfusion of bone marrow stromal stem cells through optional artery can effective treat non-traumatic femoral head necrosis of ARCO I, II period, it can make the femoral circumflex artery and its branches increased thickening.

Adult ; Angiography, Digital Subtraction ; Arthroplasty, Replacement, Hip ; Female ; Femur Head Necrosis ; therapy ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged