Objective To study the feasibility and clinical results of C2, 3 pedicle-lateral mass plate fixation in the treatment of unstable Hangman's fractures. Methods From March 1999 to July 2005, 25 cases of unstable Hangman's fracture were treated surgically using the C2, 3 pedicle-lateral mass plate. All the cases were followed up for the healing of bone and function of the cervical vertebrate. Results The average follow-up period was 38 months. Twenty-three cases had a perfect reduction. Three cases had kyphosis deformity. There were no other complications related to the operation. AH the cases had a perfect early fusion of the C2 pedicle isthmus and long-term stability of C2, 3 intervertebral space. The clinic results were good. Conclusion Since the C2, 3 pedicle-lateral mass fixation can provide immediate reduction and satisfactory biomechanical stability, it is a good device for unstable Hangman s fractures.

Objective To evaluate the clinical value of using three-dimensional reconstruction and incising software in facial fracture. Methods Twenty-nine patients of facial fracture were examined with spiral CT first and then the images were taken with three-dimensional reconstruction and incising software on work-station. 2D images, 3D images and incising images were evaluated. Results BZ 3D images were superior to 2D images in demonstrating the space relationship of facial fractures, such as the fracture location, range, fragments displacement. However 2D images were better in illustrating deep structure; The 3D images could illustrate deep structure as well as 2D images when combined with incising software. Conclusion 3D images can provide information of space relationship in assessing facial fracture. The range can be extended combining with the incising software, and do better for illustrating deep struction.

Objective To study the expression of reversion-inducing-cysteine-rich protein with Kazal motifs (RECK) in human pancreatic carcinoma tissues and pancreatic carcinoma cell lines; the effects of recombinant lentiviruses carrying RECK gene(LV-RECK) therapy on human pancreatic carcinoma xenograft in nude mice; and to find out the relationship between the expression of RECK and the prognosis of pancreatic carcinoma.Methods Immunohistochemical method was used to detect the expression of RECK in the resected specimens of pancreatic carcinoma and their corresponding normal pancreatic tissues in 42 patients.Western blotting was used to examine the expression of RECK in human pancreatic carcinoma cell lines (PANC-1,MIAPaCa-2,AsPC-1).Statistical analyses were performed to determine the relationship between RECK expression and the clinicopathological characteristics and prognosis in pancreatic carcinoma.Subcutaneous xenograft tumor models of human pancreatic carcinoma were established in nude mice.These nude mice were then divided into the experimental group,the negative control group and the blank control group randomly.The three groups of nude mice were intratumorally injected with LV-RECK,LV-EGFP and normal saline (NS) respectively.The antitumor effect was studied.Immunohistochemical method was used to detect the expression of RECK and microvessel density (MVD).Terminal deoxynucleotidyl transferase mediated dUTP-DIG nick end labeling (TUNEL) was used to detect the apoptosis of tumor cells.Survival analysis was performed.Results All three pancreatic carcinoma cell lines did not express RECK.The overall positive rate of RECK expression was 45.2 ％ (19/42) in pancreatic carcinoma,and 88.1 ％ (37/42) in normal pancreatic tissue.The expression level of RECK was significantly lower in the tumor tissues than in the normal tissues (P＜0.01).The expression of RECK was significantly associated with TNM stage,lymph node metastasis and local infiltration of pancreatic carcinoma (P＜0.05).Kaplan-Meier survival analysis revealed that the survival time was significantly longer in the RECK positive patient group than in the RECK negative patient group.Univariate Cox regression analysis revealed that RECK expression,TNM stage,lymph node metastasis and local infiltration were significantly related with prognosis for pancreatic carcinoma (P＜0.05).Multivariate Cox regression analysis revealed that only RECK expression remained as an independent significant factor in predicting the prognosis of pancreatic carcinoma (P ＜ 0.001).When compared with the negative control and the blank control groups,the volume of subcutaneous xenograft tumor in the experimental group was significantly decreased (P＜0.05).RECK protein in the experimental group was re-expressed.MVD of the experimental group was significantly less than those of the control groups (P＜0.05).Apoptotic index (AI)of the experimental group was significantly higher than those of the control groups (P＜0.05).The survival time of nude mice in the experimental group was significantly longer than those in the control groups (P＜0.05).Conclusions RECK expression was closely related to invasion,metastasis and prognosis of pancreatic carcinoma and it was an independent prognostic marker.RECK gene over-expression inhibited neovascularization of pancreatic carcinoma,induced apoptosis of tumor cells,inhibited the growth of tumor xenograft and improved the prognosis of tumor-bearing mice.These results suggest a possible new treatment for pancreatic carcinoma.

Objective To evaluate the guiding effect of CT software to reduce the postoperative syndrome and surgery risk in patients with sinus disease performed the functional endoscopic sinus surgery (FESS). Methods Fifty patients of accessory sinus disease were scanned by spinal CT, and then three dimensions reconstruction made in workstation. Under center of ethmoid sinus ,the five groups of anatomy data measured were obtained , used to guide surgery and contrasted with result of no used to guide surgery in 68 patients in FESS. The data were performed the statistical management and compared with results of FESS. Results Under guided by five groups of anatomy data measured ,the postoperative syndrome was reduced by 16.0 percent; the curative effect went up by 15.0 percent; the pay for hospital was reduced 31.0 percent and the recurrence rate was reduced 8.6 percent. Conclusion Used the technic in FESS, the surgery risk, the recurrence rate and pay for hospital are reduced, but the curative effect go up. The technic is much adapt to be used in village and towns hospital where there aren′t navigation equipment.

BACKGROUND: Most reported biomechanical studies on sacroiliac joint injury and fixation use cadavers or artificial bone models to simulate the sacroiliac joint injury.OBJECTIVE: To analyze the vertical stability of anterior plate fixation for sacroiliac joint dislocation using three-dimensional finite element method. METHODS: The anterior plate fixation model of unilateral sacroiliac joint dislocation was constructed on the basis of the three-dimensional finite element model of a complete pelvis. An axial load of 500 N was applied on the model; the cloud pictures of stress, strain and displacement were obtained after calculation and compared with that of the complete pelvis under the same conditions.RESULTS AND CONCLUSION: Stress concentration occurred at the internal fixation system; the maximum stress was found at the screws near the injured sacroiliac joint, far greater than the maximum stress of the complete pelvis under the same condition. The maximum strain was found in the healthy sacroiliac joint; the fixed sacroiliac joint had no strain. The maximum displacement was found in the injured sacroiliac joint; it was about twice longer than the complete pelvis. These findings indicate that the vertical stability of pelvis is poor using anterior plate internal fixation treatment for sacroiliac joint dislocation; and stress concentration occurs at the screws and plates.

BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL reconstruction using B-TP-B autograft, B-TP-B allograft and semitendinosus tendon graft (P > 0.05); 10° flexion limitation was found in 3 cases of B-TP-B autograft, 5° flexion limitation in 1 case of B-TP-B allograft and flexion limitation in 2 case of semitendinosus tendon graft. There was no significant difference in the ratio of knee joint flexion limitation among three groups. No synarthrophysis, wound infection, implant disrupture, screw loose, patellar fracture or vascular nerve injury was observed in three groups of patients; There were 12 cases presenting anterior knee pain in the B-TP-B autograft group and 5 cases presenting posterior knee pain in the semitendinosus tendon graft group. The difference of peal-knee pain incidence was statistically significant among three groups (P=0), the highest in B-TP-B autograft group, then semitendinosus tendon graft group and the lowest in B-TP-B allograft group. The time of post-operative fever in B-TP-B autograft group was earlier than that in the B-TP-B allograft and semitendinosus tendon graft groups (P=0). There was no significant difference between allogreft group and semitendinosus tendon autograft group (P=0.844). The rejections appeared in 4 cases of B-TP-B allograft with the manifestations of the sustained jam-like liquid outflow from tibial tunnel. After dressing, hormones or indomethacln, the rejection was healed. CONCLUSION: The arthroscopic B-TP-B autograft, B-TP-B autograft and semitendinosus tendon autograft have the same clinical curative effect in PCL reconstruction.

Objective To discuss a convenient and pragmatic method of fitting and optimizing standard curve for determining concentration of serum hepatitis B virus large surface protein(HBV-LP).MethodsEnzyme-linked immunosorbent assay(ELISA)was used to measure the absorbance of standard preparation of HBV-LP.Concentration and absorbance of standard preparation of HBV-LP was carried out curve fitting with 4-parameter formula model and linear model and log-linear model and quadratic polynomial model and cubic polynomial model and S model by program solution of Excel,respectively.The most standard curve for determining concentration of serum HBV-LP was determined with coefficient of determination of regression model.ResultsThe scatterplot of standard preparation of HBV-LP submited nonlinear tendency.There were all significance to regression equation of 4-parameter formula model and linear model and log-linear model and quadratic polynomial model and cubic polynomial model and S model(P

Objective To study the clinical value of operation in advanced endometrial carcinoma.Methods A retrospective study was carried out in 78 patients with advanced endometrial carcinoma received operation in our hospital from Jan.1,1997 to Dec.31,2007.The basic operation procedures were included total hysterectomy,adnexectomy,omentectomy,appendectomy and resection of metastatic lesions located in abdomino-pelvic cavity.The criteria of satisfied operation Was considered that the sizes of residual leision was smaller than or equal to 2 cm,which Was used to evaluate the effect of operation.The prognostic factors were also analyzed.Results Among the 78 cases,the rate of ideal cytoreductive surgery was 83%(65/78),included 23 cases of no residual leisions,42 cases of residual leisions size smaller than or equal to 2 cm,while 13 cases of residual leisions size larger than 2 cm.The Survival rate of 1-year,3-year and 5-year were 91%(61/67),55%(28/51)and 28%(10/36),respectively.The results by single factor analysis shown that the survival rate were correlated with prognostic factors included extent of disease,ascites,size of residual lesions,circles of chemotherapy.Conclusion It is important value for advanced endometrial carcinoma to ideal cytoredutive surgery followed by combined chemotherapy,while radiotherapy no further therapeutic effects.

BACKGROUND: Lateral collateral ligaments play an important role in maintaining knee stability.Motion reduction of knee joint can be realized and the changes laws of medial and lateral collateral ligaments' length after anterior cruciate ligament(ACL)injury during weight-bearing flexion can be obtained via 2D/3D image registration technique.OBJECTIVE: To study in vivo stability of length changes of the medial and lateral collateral ligaments of ACL injury knee during weight-bearing flexion.METHODS: Eight volunteers with unilateral ACL rupture and contralateral normal knees,was captured CT images and 2orthogonal images of the knee at 0,15°,30°,60°,and 90° of weight-bearing flexion.These orthogonal images were used to recreate the in vivo knee positions at each of the targeted flexion angles by the method of 2D/3D image registration.Through the bone insertion of medial and lateral collateral ligaments,the elongation changes of medial and lateral collateral ligaments were obtained.RESULTS AND CONCLUSION: At 0°,15° and 30°,the length of medial collateral ligament of ACL injury knees was longer than normal knees,but the lateral collateral ligaments length of ACL injury knee was shorter than that of normal knees.All the differences have statistical significances(P < 0.05).The findings demonstrated that,at 0°,15° and 30°,the medial collateral ligament length of ACL injury knees was longer than normal knees,but lateral collateral ligaments length of ACL injury knees was shorter than normal knees.

BACKGROUND: The rudiment of tissue engineering is to obtain tissue from patients. The cells are expanded into a population through cellular culture, and seeded into scaffolds, which can accommodate and guide the growth and proliferation of new cells in the three-dimensional scaffolds. At last, the constructed tissue is transplanted in vivo to repair or replace damaged or diseased tissues. Afterward neovascularization of the graft, the scaffolds are absorbed gradually. Finally, the new tissue replaces completely the damaged or diseased tissuesOBJECTIVE: To evaluate the feasibility of designing and fabricating customized anatomical-shaped bone tissue-engineering scaffolds with reverse engineering and rapid prototyping (RP) techniques. To avoid the disadvantage of the conventional fabricated methods of the scaffolds.DESIGN: The method of fabricating customized anatomical-shaped bone tissue engineering scaffolds.SETTING: Computer-aided design (CAD) of the scaffold was conducted in CAD training center, Guangdong Machinery Research Institute. Rapid prototyping fabrication of the scaffold was conducted in Guangdong Longchuangyu Limited Cooperation. The scaffold was fabricated by sterophotocureable technology and was made of photosensitized resin.METHODS: This experiment was carried out at the Center of Department of Traumatic Orthopedics, General Hospital of Guangzhou Military Area Command of Chinese PLA from October 2004 and January 2005. According to reverse engineering, layered image information of skeleton of the patients was scanned with CT/MRI. Anatomical models of region of interesting were created by means of CT or MRI three-dimensional reconstruction and surface reconstruction. The internal construction of the scaffolds was designed with CAD software in the outline of the anatomical models to develop computer-aided model. The prototypes of the scaffolds were fabricated by RP process.MAIN OUTCOME MEASURES: ①CT/MRI scanning, three-dimensional reconstruction, anatomical modeling; ② computer-aided design of customized bone tissue engineering scaffolds; ③rapid prototyping fabrication of customized bone tissue engineering scaffold.RESULTS: ①Anatomical models of bone joint were established through CT/MRI three-dimensional reconstruction. ② The internal structure of the scaffold was designed to establish the entity model of bone tissue engineering scaffold successfully with computer-aided design software. ③ CAD model of bone tissue engineering scaffold guided prototypes to develop the customized anatomical-shaped bone tissue engineering scaffolds. The internal structure of bone tissue engineering scaffold was fine and had high degree of porosity-and pore interconnectivity.CONCLUSION: Customized anatomical-shaped bone tissue engineering scaffolds can be fabricated with reverse engineering and RP technology. Among all RP processes, stereophotocureable technology (SLA) is the best one with good precision, smooth surface and good shaping.