Objective To explore the methods of internal fixation for femoral neck fractures and evaluate the biomechanical characteristics of the interlocking expanding compressive screw (IECS)of Type HZS. Methods Based on the special biomechanical characteristics of the femoral neck fracture, the device of internal fixation was designed to consist of main screw, bifurcate screw, boost screw cap, washer, compressive screw cap, oblique interlocking screw and main screw cap. Its biomechanical performances were evaluated through comparison with those of the dynamic compressive screw (DCS), twin compressive screw (2CS) and three cannulated screws (3CS) respectively. Results The mechanical performances of the femoral neck fracture fixed with the interlocking expanding compressive screw were superior to those of the others in displacement ,axial and level stiffness, torsional strength and stiffness and terminal loading. Conclusion Interlocking expanding compressive screw can efficiently withstand the splitting, torsional, shearing, tensional and compressive forces in the fracture, and is simple, safe and easy to use. [

Objective To investigate the clinical manifestation of hMPV in infants and young chil-dren presented with acute respiratory tract infection and to identify the molecular character. Methods Na-sopharyngeal aspirates were taken from 310 hospitalized pediatric patients from February to May in 2006, March to April in 2008, and September 2008 to February 2009, and the N gene fragments of hMPV were de-tected by nested PCR amplification. Phylogenetic analysis of 17 strains hMPV N genes was performed. The clinical materials of patients were collected and analyzed. All hMPV-positive samples were examined by multi-PCR for other respiratory viruses. Results Of 310 pediatric patients, 20 (6.5%) were positive for hMPV. The median age of hMPV infected children was 15.0 months(from 16 days to 9 years old), 90% (18/20)of the cases were under 2 years, and 60% were male. Phylogenetic analysis of 17 N gene fragments showed that 11 hMPV strains were A2b subtype. 20 hMPV-positive children were subjected to pneumonia, accounting for 7.1% (20/282) among all pneumonia subjects in this study. The common clinical manifesta-tions of hMPV infected patients were cough, wheezing, shortness of breath and fever. 35% (7/20) needed intensive care, 15% (3/20) were given oxygen therapy. The median length of hospital stay was (11.9 ±4.8) d. No significant seasonal distribution of hMPV was displayed. Two patients were coinfected with ade-novirus and rhinovirus respectively. Conclusion hMPV was an important respiratory pathogen in young children subjected to pneumonia in Tianjin. Three subtypes(A2a/A2b, B1, B2) were prevalent in Tianjin, and A2b was the predominant subtype. No significant difference of clinical characters was observed between A and B type hMPV infected patients.

A reasonable and practicable quality standard was developed for mori liquid extract from different sources by TLC, HPLC and fingerprint technology. In TLC method, the compounds were separated on polyamide film using glacial acetic acid-water (1: 3) as mobile phase at a UV wavelength of 365 nm. All qualified samples had the spots of the same color as the control herb and substance. The RP-HPLC method was used to determine the content of mulberroside A with mobile phase of methanol-water (25: 75) at a wave-length of 326 nm. The mulberroside A was in good linear with a regression equation of Y = 46.965X (r = 0.999 6) in the range of 4.6 - 228 mg x L(-1). In 14 batches of samples, the mulberroside A in 4 batches of them was less than 0.5 g x L(-1), and was more than 2.0 g x L(-1) in the other batches. It was suggested that the content limit of mulberroside A should be no less than 1.5 g x L(-1). The HPLC fingerprints were evaluated by the similarities. It has found that the similarities of different mori liquid extracts were very low and the chemical diversity of mori cortex was the major factor of similarity. Moreover, the process impact was minimal. Thus the fingerprint was not included in this quality standard.
China ; Chromatography, High Pressure Liquid ; Disaccharides ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Morus ; chemistry ; Quality Control ; Stilbenes ; chemistry ; isolation & purification

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Adolescent ; Adult ; Anemia, Aplastic ; etiology ; therapy ; Benzene ; poisoning ; Bone Marrow Cells ; drug effects ; pathology ; Female ; Humans ; Male ; Occupational Diseases ; etiology ; therapy ; Occupational Exposure ; adverse effects

OBJECTIVETo study the clinicopathologic features, diagnosis and differential diagnosis of epithelioid hemangioma.

METHODSThe morphologic features of 7 cases of epithelioid hemangioma of skin, bone and venous vessels were studied.

RESULTSThere were altogether 4 male and 3 female patients (median age = 34 years; age range from 14 to 54 years). The 3 skin cases presented as single or multiple erythematous to bluish nodules or papules, with or without itchiness. The 2 bone cases appeared as osteolytic expansile lesions on radiologic examination. The remaining 2 cases involved medium-sized venous structures and presented as small isolated nodules in soft tissue. Histologically, the lesions were characterized by the presence of exuberant endothelial proliferations with various degree of inflammatory reaction. The neoplastic endothelial cells were plump, eosinophilic and polygonal, forming vascular channels. Occasional solid sheet-like arrangement was demonstrated. Intracytoplasmic vacuoles were commonly identified, indicating formation of primary lumen. The surrounding stroma contained various number of eosinophils and lymphoplasmacytic cells. Immunohistochemical study showed that the tumor cells were positive for endothelial markers (CD31 and CD34) and negative for epithelial marker (cytokeratin). Follow-up information was available in 6 cases. The duration of follow-up ranged from 5 to 36 months (median = 14 months). There was no evidence of recurrence or distant metastasis.

CONCLUSIONSEpithelioid hemangioma is a rare benign curable lesion which can be multifocal, involving skin, soft tissue and bone. It needs to be distinguished from Kimura's disease and epithelioid hemangioendothelioma.

Adolescent ; Adult ; Angiolymphoid Hyperplasia with Eosinophilia ; pathology ; Antigens, CD34 ; metabolism ; Bone Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid ; pathology ; Hemangioma ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; surgery

BACKGROUND AND OBJECTIVEAs chemotherapy is generally used in the clinical treatment of cancer, the problem of multidrug resistance (MDR) of tumors against the chemotherapeutic agents becomes more and more serious. It has been the major cause for the failure of the chemotherapy. We detected the expressions of beta-catenin and tumor drug resistance related proteins, MRP2, P-gp, and Bcl-2, in esophageal squamous cell carcinoma (ESCC) to explore their function and correlation in the occurrence and development of MDR in ESCC.

METHODSWe used the tissue microarray technique, immunohistochemistry, and image analysis methods to detect the expressions of MRP2, P-gp, beta-catenin, and Bcl-2 proteins and analyze their relationships with clinical data in a ESCC tissue microarray consisting of 582 specimens of ESCC, 294 specimens of normal mucosa, 92 specimens of basal cell hyperplasia, and 87 specimens of dysplasia adjacent to cancer tissue.

RESULTSThe integral optical density (IOD) of MRP2 and Bcl-2, which was 195.7 +/- 175.9 x 10(3)) and 90.5 +/- 112.5 x 10(3)), respectively, was significantly higher in ESCC than in normal mucosa, which was 104.8 +/- 86.1 x103) and 25.2 +/- 46.6 x 10(3)), respectively (P < 0.01). The IOD of P-gp and beta-catenin, which was 57.7 +/- 75.5 x 10(3)) and 32.0 +/- 47.0 x 10(3)) respectively, was significantly lower in ESCC than in normal mucosa, which was 114.8 +/- 106.6 x 10(3)) and 46.1 +/- 35.7 x 10(3)), respectively (P < 0.01). According to the following order, well differentiated moderately differentiated poorly differentiated, the IOD of MRP2 increased in ESCC (P < 0.01). The IOD of beta-catenin was higher in poorly differentiated ESCC than in well or moderately differentiated ESCC (P < 0.01). The IOD of Bcl-2 was lower in well differentiated ESCC than in poorly and moderately differentiated ESCC (P < 0.01). The IOD of beta-catenin and Bcl-2 was higher in the ESCC of specimens with infiltration depths that were in membrane mucosa than those in the muscular layer or serous coat (P < 0.01). The IOD of Bcl-2 was significantly higher in cases with lymph node metastasis than in cases without (P < 0.01). Positive correlations which were respectively between the expressions of P-gp and MRP2, the expressions of P-gp and Bcl-2 were found (r = 0.288 and r = 0.253, respectively, P < 0.01).

CONCLUSIONSMRP2, P-gp, and Bcl-2 may be taken as prognostic factors for MDR of ESCC. beta-catenin may play an important role in carcinogenesis and progression of ESCC.

ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Differentiation ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Multidrug Resistance-Associated Proteins ; metabolism ; Neoplasm Invasiveness ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Young Adult ; beta Catenin ; metabolism

Aim To observe the effect of laminarin L01 on the expression of eNOS and iNOS in aorta of rats with chronic inflammation induced by LPS. Methods Chronic inflammatory rat models were prepared by tail vein injection low dose LPS(0.4 mg·kg-1) once a week for four weeks. The rats were randomly divided into five groups. After the first injection of LPS, the DXM group was intraperitoneally injected with dexam-ethasone (10 mg·kg-1). L01 high,medium and low dose groups were intraperitoneally injected with L01 (50,30,10 mg·kg-1). The LPS group was injected intraperitoneally with equal volume of normal saline once a day. Another control group, only injection of normal saline, a total of four weeks. After the last administration,the number of whole white blood cells (WBC) was counted. ELISA was used to measure the hs-CRP in serum. The expressions of eNOS,iNOS and COX-2 mRNA were detected by RT-PCR. Results After four weeks of administration of L01, the number of WBC and the level of serum hs-CRP in chronic in-flammatory rats were significantly decreased. The ex-pression of eNOS was up-regulated, and iNOS and COX-2 expressions were down-regulated. Conclusions Laminarin L01 may regulate the expression and re-lease of endothelium-derived relaxing factor stimulated by LPS,and improve the endothelium-dependent dias-tolic function of aorta, thus protecting the damage of vascular endothelium.

OBJECTIVETwo genetic loci are associated with the myotonic dystrophy (DM) phenotype: DM1 DMPK on chromosome 19, and DM2 ZNF9 on chromosome 3. The aim of this study was to investigate the molecular genetics of a pedigree with DM.

METHODSIn twenty-six individuals from a family with DM, the CTG repeats in DMPK and CCTG repeats in ZNF9were evaluated genetically, using Long Expand trade mark Template polymerase chain reaction (PCR), Southern blotting and genomic scanning.

RESULTSThe numbers of CTG and CCTG repeat were all in normal range. There was no significant difference between the CTG repeat size in DMPK gene and that 4 years later from the same individual. The Lod score values with short tandem repeats STR markers chosen in 19q and 3q were all smaller than 1, which suggested that no STR marker was linked with this DM family.

CONCLUSIONThere might be some other mutant in this DM pedigree. Further study should be done to find the genetic basis of this pedigree.

Adolescent ; Adult ; Blotting, Southern ; Child ; Female ; Humans ; Male ; Microsatellite Repeats ; genetics ; Middle Aged ; Myotonic Dystrophy ; genetics ; Myotonin-Protein Kinase ; Pedigree ; Polymerase Chain Reaction ; Protein-Serine-Threonine Kinases ; genetics ; RNA-Binding Proteins ; genetics ; Trinucleotide Repeats ; genetics

OBJECTIVETo increase the sensitivity and specificity of conventional gene diagnosis of facioscapulohumeral muscular dystrophy 1A(FSHD1A) by analyzing the distribution of translocation between chromosomes 4q35 and 10q26 in suspected FSHD cases.

METHODSThe Bgl II- Bln I dosage test was performed to detect translocation between chromosomes 4q35 and 10q26 in 7 cases of presymptomatic FSHD patients showing positive result in gene diagnosis and 5 cases of sporadic FSHD patients showing negative result in gene diagnosis. DNA samples were digested with Bgl II and Bln I, followed by agrose gel electrophoresis. Probe p13E-11 was labeled with alpha-(32) P dCTP, followed by Southern hybridization. Then the ratio between the chromosomes 4 and 10 derived signal intensities was judged and hence was made known whether there was interchromosomal translocation between chromosomes 4 and 10.

RESULTSThe Bgl II-Bln I dosage test revealed a translocation from chromosome 4q35 to 10q26 in one presymptomatic FSHD patient, thus indicating the result of gene diagnosis for her might be false positive. There was one translocation from chromosome 10q26 to 4q35 detected in one sporadic FSHD patient, indicating the result of gene diagnosis for her might be false negative. There were no translocations between chromosomes 4 and 10 in the other 10 cases.

CONCLUSIONThe Bgl II-Bln I dosage test can detect the translocation between chromosomes 4q35 and 10q26. It can improve the accuracy of the conventional method for gene diagnosis of FSHD1A.

Adolescent ; Adult ; Bacterial Proteins ; pharmacology ; Child ; Child, Preschool ; Deoxyribonucleases, Type II Site-Specific ; pharmacology ; Female ; Humans ; Male ; Middle Aged ; Muscular Dystrophy, Facioscapulohumeral ; diagnosis ; genetics ; Nuclear Proteins ; Proteins ; genetics ; Translocation, Genetic