Objective To observe the biomechanics of the anterior and posterior interosseous talo-calcaneal ligaments (ITCLs) . Methods Load-displacement characteristics of the subtalar joint were studied in 12 cadaver specimens whose ankle joints were mutilated. The ankle articular surfaces of the talus and the post-calcaneus were exposed. Bone blocks were then embedded in polymethylmethacrylate. The an-terior ITCLs were abscised in 6 of them, and the posterior ITCLs in the other 6. A multi-functional biome-chanical machine was used to perform the biomechanical tests on the specimens. Results When the anterior ITCLs were cut, the tali moved to the anterior-lateral side. When the posterior ITCLs were cut, the tali mostly moved to the anterior-interior side. Conclusions The anterior and posterior ITCLs have dif-ferent roles in maintaining stability of the subtalar joint. Since the posterior ITCLs seem more important than the anterior ones, they should have priority in ITCL reconstruction.

Objective To explore the clinical value of microsurgery in the treatment of lateral ventricle tumors. Methods Microsurgery was conducted in 14 cases of lateral ventricle trmors in this department from May 1996 to August 2002. According to the location of tumors, we selected the approach close to the focus, protected the surrounding nerve tissue and the deep venous system, and resected the tumor in fractions. Results Among the 14 cases, 13 (92.9%) received total resection and 1 (7.1%) subtotal resection. A total of 11 cases of complications occurred postoperatively, including 3 cases of intracranial infection, 2 cases of hemiparalysis, 1 case of hydrocephalus, 3 cases of frontal lobe mental symptoms, 1 case of intraventricular hematoma and 1 case of nominal aphasia. Except for 1 case of hemiparalysis who were not able to resume the ability to take care of his own basic needs, the remaining 10 cases obtained full recovery. Follow-up in 9 cases for 6～60 months (mean, 29 months) showed 2 cases of recurrence of astrocytoma. Conclusions Microsurgery offers good visualization, minimal invasion and a high total resection rate for tumor.

Digital angiography system is mainly composed of Digital Subtraction Angiography(DSA)equipment and mostly used in angiography and interventional radiology.With the improvement of image quality,modern DSA equipment has a higher radiation output capacity,which increases the potential radiation damage to the operators and patients.Dose optimization studies the relationship between image quality and radiation dose for reasonable reduction of radiation dose and good image quality.

Objective To observe the effect of acute hypervolemic hemodilution(AHH) combined with nicardipine controlled hypotension on hemodynamics changes in revision operation of total hip replacement.Methods Forty patients were divided into two groups according to the sequence of the surgery(odd number came into group A,even number came into group B,20 in each group).In group A,AHH was carried out with nicardipine controlled hypotension;group B was control group.AHH was carried out in both groups before anesthesia induction.6%voluven was transfused in group A at 15 mL?kg-1 and 30 mL?min-1 and nicardipine was transfused at 0.3-0.5 mL?kg-1?h-1 with MAP altering between 60 and 65 mmHg;Same quantity of physiological saline was transfused in group B.HR,MAP,CVP,Hb,Hct and Plt were recorded and observed at preoperation,1 h after AHH and 24 h after the operation.Results In group A after AHH with nicardipine controlled hypotension,MAP was obviously lower than pre-operation(P

Objective To investigate the killing effect and molecular mechanism of different doses of ~(125)I seed interstitial brachytherapy for human hepatoma HepG2 cells in nude mice transplanted tumor.Methods Twenty nude mice bearing human hepatoma HepG2 cells were randomly divided into 4 groups (each n=5) and given ~(125)I seed interstitial brachytherapy at different doses including 18.5 MBq ~(125)I,29.6 MBq ~(125)I,37.0 MBq ~(125)I and 0 (the control group) ,respectively.~(125)I seeds were percutaneously implanted into tumors,each mouse with 1 ~(125)I seed implanted.Twenty-eight days later,nude mice were sacrificed and routine pathological examination was performed,.The expression of Bcl-2 and Bax was detected with immunohistochemical methods.Results Pathological examination showed serious coagulation necrosis of tumor cells surrounded by extensive fibrosis in all treatment groups,whereas rich tumor cells with proliferative growth were observqed in the control group.Immunohistochemical analysis showed that the expression of Bax in all treatment group were higher than that in the control group.the expression of which was up-regulated with increasing doses of ~(125)I seed.The expression of Bcl-2 and the ratio of Bcl-2/Bax in all treatment groups were lower than those in the control group.the expression of which was down-regulated with increasing doses of ~(125)I seed.The expression of Bcl-2.Bax and the ratio of Bcl-2/Bax among treatment groups and control group had statistical difference (P＜9.05) ,so as the difference among treatment groups (P＜0.05) .Conclusion ~(125)I seed interstitial brachytherapy induces apoptosis in human hepatoma HepG2 cells by reducing the ratio of Bcl-2/Bax and thereby inhibits the growth of tumor in nude mice,and the extent positively correlates with dosage in a certain range.

Objective Production of autotoxin protein in sf9 insect cells with biological activity. Methods Autotaxin cDNA was cloned into pFastBacTMHTA from melanoma cell by extraction of total RNA using TRIzol method and RT-PCR. Bacmid-ATX is isolated from transformed competent bacterial DH10 which carries Bac genomic sequences and transfected into sf9 using lipofectamine 2000. Recombinant ATX virus was amplified in sf9 and further used for infection and expression of ATX protein. Two step purification product using HistrapTMHP and Hiload 16/600 Suerdex 200pg was determined for lysophospholipase D (lysoPLD) activity. Results Correct insertion of PCR fragment is confirmed by BamH I/Xho I digestion and sequencing. ATX virus can infect sf9 and induced enzymatic activity. Column purification and SDS-PAGE resulted 95% in purity and 6mg/liter in yield with significant lysoPLD activity. Conclusion ATX Baculovirus was successfully constructed that can infect sf9 cells and express active lysoPLD. Production of active ATX can be used for crystalography studies and screening for small pharmaceutical inhibitors.

Objective To investigate the anti carcinoma role of integrin targeted photodynamic therapy (PDT) on pancreatic carcinoma cells in vitro.Methods Pancreatic carcinoma cells SW1990 were divided into four groups:cells without quantum dots (QDs) and light-treated as blank control group,pure light-treated group,photosensitizer group and PDT group.The targeting of QDs-arginine,glycine,aspartic acid (RGD) and integrin probe was confirmed by laser confocal microscopy.And as a photosensitizer for photodynamic therapy,after treated for 48 hours the morphology changes of pancreatic carcinoma cells of each group were observed.After 48 hours,the cell proliferation,apoptosis and cell cycle changes were detected by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry (FCM).The expressions of myeloid cell leukemia-1 (Mcl-1),protein kinase B(Akt) and tumor necrosis factor-related apoptosis inducing ligand (TRAIL) were detected by reverse transcriptase polymerase chain reaction(RT-PCR).The amount of reactive oxygen species (ROS) of each group were evaluated by fluorescence probe.One-way ANOVA was performed for comparison between groups to analyze the treatment effects of PDT group.Results The QDs RGD probe could effectively targeting pancreatic carcinoma cells.The MTT results indicated that the relative inhibition rate of pancreatic carcinoma cells proliferation of PDT group was statistically higher than that of the other groups at 24,48,72 h (F=73.00,85.10,126.58; all P＜0.01).The FCM results revealed that the cell apoptosis rate of PDT group (17.860％ ±1.230％) was higher than that of the other groups (F=130.617,P＜0.01) and cell cycle G0/G1 phase (69.14％±2.63％) and S phase (24.41％ ± 2.67 ％) retardance was also significant (all P＜0.05).The expression of proliferation and apoptosis related gene Mcl-1 and Akt at mRNA level was lower than that of the other groups however the expression of apoptosis-inducing ligand TRAIL at mRNA level was higher than that of the other groups (F=567.456,446.817,145.238; all P＜0.05).The ROS level of PDT group was higher than that of the other groups (F=3262.559,P＜0.01).Conclusion PDT with a QDs-RGD probe could significantly inhibit pancreatic carcinoma cell proliferation and promote cell apoptosis.

Aim Paclitaxel(PTX)has shown an effect against human cancer. However, serious drawbacks hamper PTX clinical use.Overcoming paclitaxel limi-tations is one of the best approaches to enhance water solubility.Methods In this study,water-soluble pa-clitaxel prodrug was prepared,folic acid-polyethylene glycol-glutamic-paclitaxel (FA-PEG-Glu-PTX ) com-posed of folic acid (FA,target),amino acids (Glu, linker),and polyethylene glycol(PEG)in order to im-prove the solubilization and stability. The chemical structure and physicochemical property of prodrug were measured by LC-MS,solubility,drug release rate to e-valuate the antitumor activity and cytotoxicity of FA-PEG-Glu-PTX.MTT assays were conducted on MDA-MB-231,MCF-7,A549 and HELF cell lines.FA-PEG-Glu-PTX prodrugs were labeled with 5 amino flu-orescence visible fluorescent dye (5 AF ) for fluores-cence microscopy.Results The successful conjugation of FA-PEG-Glu-PTX was confirmed by LC-MS,and had better water solubility,release rate curve.In vitro studies indicated that foliate receptor(FR-α)mediated uptake of PTX-conjugated multi-small molecules carri-ers induced highly targeting ability,and antitumor ac-tivity,as well as reduced side toxicity effects of PTX. Conclusion FA-PEG-Glu-PTX has a good antitumor activity.

Objective To evaluate the value of D-dimer in assessing severity and predicting longterm prognosis in patients with community acquired pneumonia (CAP).Methods From June 2009 to December 2010,a total of 189 patients with CAP were enrolled.After admission,D-dimer,procalcitonin (PCT) and C-reactive protein (CRP) were measured,and Pneumonia Severity Index (PSI) was calculated.They were assigned into two groups according to their D-dimer levels:high D-dimer levels group (D-dimer levels≥500 μg/L) and normal D-dimer levels group (D-dimer levels ＜ 500 μg/L).The followup time was one year.A Kaplan-Meier survive curve was constructed to assess the 1-year mortality,and multivariate logistic regression analysis were used to assess the value of D-dimer for predicting long-term prognosis.Results D-dimer levels increased with increasing PSI class [class Ⅰ-Ⅲ:378.37 μg/L (216.74,649.50) μg/L; class Ⅳ:673.41 μg/L (544.77,866.85) μg/L; class Ⅴ:831.58 μg/L (591.78,1066.39) μg/L,x2 =56.58,P ＜ 0.01].The Kaplan-Meier survival curve showed that 1-year mortality rate of high D-dimer levels group was higher than normal D-dimer levels group (log-rank test,x2 =52.51,P ＜ 0.01).The multivariate logistic regression analysis showed an independent relationship between higher D-dimer levels and long-term mortality (OR =2.05,95％ CI:1.48-2.61,P ＜ 0.01).Conclusion D-dimer is an independent predictor of severity and long-term prognosis in patients with CAP.