Purpose:To investigate the related factors affecting the prognosis of patients with cervical carcinoma treated with radiotherapy. To analyze the relationship between the survival rate and some factors such as the tumor size,treatment days and local control.Methods:From April 1993 to April 2001,83 cervical carcinoma patients with stage Ⅰ,Ⅱ,Ⅲ were treated with cobalt teletherapy and 192 Ir high-dose-rate brachytherapy as primary treatment. The method of external irradiation: first deliver DT25-26Gy/13 fraction,then increase the dose to DT48-50Gy with middle lead block in the field. The internal radiation method: the dose ir A point is DT 35 Gy/7 fraction. Kaplan- Meier method was used to calculate the survival rate and Log-rank test for the difference significance.Results:①local control: the 1-,2-,3-,5-year survival rates in complete response and partial response patients and progressive patients were respectively 95.87%,77.12%,73.09% 73.09%and 34.29%,0%,0%,0%,there is significant difference between them . ②treatment days :the 1-,2-,3-,5-year survival rates in the patients with treatment days exceeding 56 days and not exceeding 56 days were respectively 93.88%,82.86% 80.19%,80.19% and 78.95%,30.55%,22.91%,22.91%,there is significant difference between them . ③the maximum tumor diameter : the 1-,2-,3-,5- year survival rates in patients with the maximum tumor diameter exceeding 4 centimeters and not exceeding 4 centimeters were respectively 95.12%,82.86%,79.67%,79.67% and 81.93%,58.20%,53.35%,53.35%,there is significant difference between them.Conclusions:①The patients with local residual tumor and bigger tumor volume had relatively poorer prognosis;②The treatment days should be shortened to 8 weeks if possible;③ The comprehensive treatment and shortened treatment days may improve the therapeutic effect for the patients with tumor size ≥4cm,local residual and progressive tumor.

Objective: To study the chemical constituents of the methylene chloride of Rubus chingii Hu.. Methods: Chromatography on silica gel column, Sephadex LH-20 column, and recrystallization technique were used to isolate and purify the compounds. Spectroscopy methods including EI-MS, ES-MS, 1H-NMR, 13CNMR, HMQC, and HMBC were used to elucidate the structures of compounds. Results: Ten compounds were obtained and 9 compounds were identified as: hexacosanol (I), β-sitosterol (II), 4-hydro-3-methlbenzal acid (III), 4-hydrobenzal dehyde (IV), oleanolic acid (V), stigmast-5-en-3-ol, oleate (VI), H-2-indenone, 2, 4, 5, 6, 7, 7a-hexahydro-3-(1-methylethyl)-7a-methyl (VIII), 4-hydroxy-3-methoxybenzoic acide (IX), and liballinol (X). Conclusion: Compounds I, III, IV, VI, VIII, and X have been obtained from Rubus chingii for the first time.

Objective To examine the efficacy of applying clinical pathway (CP) teaching model in orthopedics clinical teaching.Methods Totally 64 medical undergraduates were randomized into 2 groups.The traditional teaching method and CP model were separately preformed on them.Their scores of theoretical,manipulation and case analysis exams at the end of internship were compared.Meanwhile the questionnaire of satisfaction degree also was conducted.Results Scores of exams and satisfaction degree were better in CP group than in classical group (P ＜ 0.05).Conclusions The novel CP model can promote the standardization and systematization of clinical teaching in orthopedics.It is conducive to evaluating teaching effect and performing teaching reform.Meanwhile,it is in accordance with the problem-based learning and can improve clinical teaching effect and satisfaction degree.

Objective To compare the efficacy of Lichtenstein and transabdominal preperitoneal patch repair(TAPP) in the treatment of primary inguinal hernia in adults. Methods The clinical data of 223 patients who received Lichtenste and 121 patients who underwent TAPP in our hospital between January 2002 and January 2006,were analyzed retrospectively.The efficacy and complications of the two methods were compared.Results The rate of intraoperative injury of the inner organs in the TAPP group was significantly higher than that in the Lichtenstein group [5.8%(7/121) vs 0.4%(1/223),?2=7.626,P=0.006],while no significant difference was detected in the rate of abdominal organ injury between the two groups [0.8%(1/121) vs 3.1%(7/223),?2=0.969,P=0.325].The rate of postoperative complications in the TAPP group was significantly lower than that in the Lichtenstein group [14.0%(17/121) vs 36.3%(81/223),?2=18.881,P=0.000].In the TAPP group,during a follow-up of(14?7) months,one case of recurrence was found(0.8%).Whereas in the Lichtenstein group,the patients were followed up for(16?8) months,two of them had recurrence(0.9%).No significant difference existed in the recurrence rate between the two groups(?2=0.000,P=1.000).Conclusions Both the Lichtenstein and TAPP have benefits and drawbacks.Individulized therapy is recommended for the patients with inguinal hernia.It is important for surgeons to know the indications of the operations.

BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding.
OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty.
METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis.
RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were<2 mm. The stress shielding phenomenon occurred in al patients, including first-degree in 31 hips, second-degree in 19 hips, third-degree in 2 hips, and fourth-degree in no case. Experimental findings indicate that, Ribbed stem with a rational design can achieve satisfactory clinical outcomes with good initial stability, rapid bone growth and low stress shielding.

BACKGROUND: To search for an alloxenogeneic bone with good load bearing function and osteoblastic activity for treating bone defects is an important study issue. We have made a comparative study on its biome chanical characteristics and found that there was no significant difference in maximum load stress, maximum pressure as compared with fresh bone of the same size. Clinicians are concerned about the osteoblastic activity and whether the osteoblastic activity can be reserved after human allogenous a cellular bone (HAB) loaded with bone marrow stromal cells (BMSCs). OBJECTIVE: To investigate the experimental effect of HAB loaded with induced BMSCs, and observe the cellular adherence and growth as well as detect its osteoblastic activity. DESIGN: Single sample experiment. SETTING: Second Affiliated Hospital of Harbin Medical University. MATERIALS: This experiment was conducted at the Experimental Center of the Second Affiliated Hospital of Harbin Medical University between January 2003 and August 2004. HAB was obtained from fresh corpse iliac bones (donated voluntarily). METHODS: Connective tissues and cell compounds of the iliac bones were removed by processing with hydroperoxide andether solution and sterilized for preparing HAB. BMSCs from living femoral shaft bone marrow were cultured immediately in ordinary and mineralized medium containing DMEM, fetal bovine serum, dexomethasone, β-glycerophophate and ascor bic acid. Proliferation and differentiation of bone stromal cells were deter mined by detecting the level of alkaline phosphatase (ALP) and osteocalcin (OCN) in the culture medium. Induced bone stromal cells solution was condensed and implanted within HAB scaffold. Cellular osteoblastic activ ity was determined through morphological observation under the light mi croscope and electron microscope as well as biochemical index detection. MAIN OUTCOME MEASURES: ① Detection results of ALP and OCN of BMSCs/HAB composite. ② Histological observation results of BMSCs/ HAB composite. RESULTS: ① Iliac bone block cells were cleaned with good reservation of bone matrix. ② The level of ALP and OCN of MSCs was higher after in ducing for 8 days than that in control group [MSCs after induction: (181.54±40.01) nkat/L, (7.2±1.3) μg/L. There was no method to detect the level in control group, P ＜ 0.05]. ③ BMSCs were adhered and grew well in HAB scaffold. CONCLUSION: HAB loaded with induced BMSCs has an excellent os teogenic function in vitro and shows an effective potential as a good bone tissue engineering material.

10.3969/j.issn.2095-4344.2013.25.003

BACKGROUND:Naringin can increase bonemorphogeneticprotein 2 gene expression and promote the proliferation and differentiation of multipotential stem cel line. In vitro cel experiment indicates that naringin can suppress osteoclast formation and anti-osteoporosis activity.
OBJECTIVE:To prepare a mouse calvarial bone culture model containing naringin and to observe the effect of naringin with different concentrations on the formation and function of osteoclasts.
METHODS:Calvarial bone was dissected out aseptical y from the 4-day-old Sprague Dawley mice, and cultured in the culture medium containing 0, 1, 10 and 100 mg/L naringin. The effects of naringin on the number of tartrate-resistant acid phosphatase-positive osteoclast marker enzyme in calvarial bone and the concentration of calcium in the culture medium were detected after cultured for 1, 3, 7 and 10 days.
RESULTS AND CONCLUSION:After cultured for 1 day, the number of tartrate-resistant acid phosphatase-positive cel s in calvarial bones and the calcium concentration in the culture medium had no difference between the groups. After cultured for 3 and 7 days, the number of tartrate-resistant acid phosphatase-positive cel s was decreased and the calcium concentration was increased with the increasing concentration of naringin. At 10 days after culturing, this trend was most obvious. It showed that naringin could affect the number and function of tartrate-resistant acid phosphatase-positive cel s in calvarial bones, and this effect showed a significant time-and dose-depend manner. The results show that naringin can not only promote the proliferation of osteroclasts, but also reduce the differentiation of osteoclasts or accelerate the apoptosis.

Objective To investigate the prognosis correlation factors of sudden hearing loss.Methods A retrospective analysis was performed in 137 cases (149 ears) of sudden hearing loss.The relationships between the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,tinnitus,diabetes mellitus,high blood pressure and therapeutic effect were observed.Results The total effective rates in ＜ 45 years,45-59 years and ＞ 59 years patients were 86.36％(38/44),77.78％ (56/72) and 57.58％ (19/33) respectively.There were statistical differences in the total effective rate between ＜ 45 years,45-59 years patients and ＞ 59 years patients (x2 =8.128,P =0.004; x2 =4.525,P =0.033).The total effective rates in patients who were treated ≤7 d,8-14 d and ≥ 15 d were 83.52％ (76/91),76.67％(23/30) and 50.00％(14/28) respectively.There were statistical differences in the total effective rate between patients who treated ≤7 d,8-14 d and patients who were treated ≥ 15 d (x2 =13.050,P =0.000; x2 =4.459,P =0.035).The total effective rates in low-mid frequency type,all frequency type,total deafness type and mid-high frequency type were 89.66％ (52/58),84.44％ (38/45),7/12,47.06％ (16/34) respectively.There were statistical differences in the total effective rate between low-mid frequency,all frequency type and total deafness type,mid-high frequency type (P ＜ 0.05).The total effective rates in hearing loss mild degree,middle degree,severe degree,extremely severe degree and total deafness were 87.23％ (41/47),86.11％ (31/36),61.90％ (13/21),7/15 respectively.There were statistical differences in the total effective rate between mild degree,middle degree and severe degree,extremely severe degree and total deafness (P ＜ 0.05).The hearing loss prognosis with the dizziness,diabetes mellitus,high blood pressure was worse.Conclusions It is considered that the age,prehospital delay time,type of hearing loss,degree of hearing loss,and whether with dizziness,high blood pressure,diabetes mellitus are related to the total effective rate.The prognosis of hearing loss can be estimated according to these correlation factors.