Objective To investigate the clinical effect of ilium grafting combined with Duhuojishengtang on the delay fracture healing and explore the effect on hemorheology. Methods Eighty patients with delayed fracture healing were randomly divided into two groups. Forty patients in control group were treated by ilium grafting and 40 patients in observation group were treated by ilium grafting combined with Duhuojishengtang. The clinical effect was observed after treatment and indexes of hemorheology were recorded after different treatment time. Results The cure rate of observation group was 62.5%, which was significantly higher than that of control group 35.0%, the effective rate of observation group was 92.5%, which was significantly higher than that of control group 72.5% (P<0.01) . There were no significant differences between two groups in indexes of hemorheology after ilium grafting (P>0.05) . After the first, second, third course, the indexes of hemorheology of observation group were better than those of control group, with statistically significant differences (P<0.05) . Conclusions Ilium grafting com-bined with duhuojishengtang can improve the indexes of hemorheology, improve the cure and effective rate and also has high security. It has high clinical value and worth of popularization and application.

Objective To investigate the factors affecting the efficacy,safety and prognosis of R0 resection in hepatocellular carcinoma(HCC)patients with portal hypertension(PH).Methods Clinical data of 600 patients with cirrhosis related HCC undergoing hepatectomy at the Dept.of Hepatobiliary Surgery were studied retrospectively.According to whether the patients with portal hypertension or not,they were divided into PH group and non PH group.Postoperative complications and mortality were compared between the two groups.Kaplan-Meier was used to analyze influencing factors of patients with R0 postoperative survival.Cox regression risk model was used to analyze the risk factors.Results The operative mortality of PH group and non PH group was 3.6%(3/84)and 0.5%(1/216),respectively.The difference was statistically significant(P<0.05).The incidence of postoperative complications in PH group was 22.6%,significantly higher than 9.7% in non PH group(P<0.05),especially the incidence rate of the liver related complications(ascites>800 ml/d,hepatic insufficiency and liver failure).Alcoholism,with PH,AFP ≥20 ng/ml,tumor size>5cm and non-solitary type HCC(all P<0.05) were important factors for overall survival.Cox regression analysis showed that tumor size>5cm and non-solitary type HCC were independent predictors for survival.Conclusion PH combined with HCC patients after R0 resection can significantly increase the incidence of complications related to liver disease and mortality,tumor size >5cm and non-isolated HCC are the risk factors for long-term survival of patients.

Electronic portal imaging device(EPID) is now been used widely.EPID was initially used for the purpose of checking set-up error.There are two ways to verify set-up errors-on-line and off-line.With advanced knowledge about the dosimetry characteristics of EPID,the use of EPID for dosimetry verification was adapted from the research study to the clinic.EPID plays an important role in quality assurance of radiotherapy accessories including multileaf collimator(MLC)that has been most studied in the past couple of years.This article briefly reviews the clinical use of EPID.

AIM: To study the enhancing effect of penetration enhancer on percutaneous absorption of antifungal agents. METHODS: Percutaneous penetration experiment was performed on device in vitro, and the deposit effects were observed with vivoperception. RESULTS: Combination of 1-menthol (1%) and azone (1%) showed the best effect on percutaneous absorption of cidopicox olamine, and 1-menthol (1%) had the best effect on percutaneous absorption of salysic acid. The compound penetration enhancer, consisting of 1-menthol (1%), azone (1%), propylene glycol ( 2.5%) and oleic acid ( 2.5%), had prominent action on absorption of cidopirox olamine through rabbit skins, and shorten the lag times obviously. CONCLUSION: L-menthol and azone can significantly enhance the percutaneous absorption of both salysic acid and cidopicox olamine. Combination of 1-menthol and azone can further increase the absorption.c

Comprehensive treatment dominated by surgery is the mainstay in the treatment of hepatic cancer,and hepatectomy is still the most effective treatment method.Bile duct reconstruction after hepatectomy is still the difficult point for the treatment of hepatic cancer complicated by bile duct invasion.A 45-year-old patient with hepatic cancer and gallstone was admitted to the Affiliated Hospital of Guiyang Medical College,magnetic resonance cholangiopancreatography and enhanced computed tomography indicated that intrahepatic duct was dilated and tumor had invaded both left and right hepatic ducts.Cholecystectomy,mesohepatectomy,duct to duct anastomosis of left hepatic duct and common hepatic duct,duct to duct anastomosis of right hepatic duct and cystic duct were performed during the operation.The patient was cured 2 weeks after surgery.

Background and purpose:Radiotherapy (RT) is one of the most important therapeutic tools for esophageal cancer. Because tumors are heterogeneous, including for18F-FDG uptake and, most likely, for radioresistance, selective boosting of high FDG uptake zones within the tumor has been suggested. Therefore, it is critical to know whether the location of these high FDG uptake patterns within the tumor remains stable during RT.Methods:Twenty-two patients with esophageal squamous cell carcinoma treated with concurrent chemo-radiation underwent repeated18F-FDG PET-CT scans before RT and after 20 fractions of RT. On all scans, the high and low FDG uptake regions were auto-delineated using several standard uptake value (SUV) thresholds, varying from 40% to 70% of SUVmax on the pretreatment scan [gross tumor volume (GTV)40%pre, GTV50%pre, GTV60%pre, GTV70%pre] and from 70% to 90% of SUVmax on the dur-treatment scan (GTV70%dur, GTV80%dur, GTV90%dur) and ifxed thresholds of 2.5 and 5 (GTV2.5pre, GTV5pre). The volumes and overlap fractions (OF) of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT.Results:The high uptake regions within the tumor during RT largely corresponded (OF>70%) with the 50% SUVmax high FDG uptake area (GTV50%pre) of the pretreatment scan. The hotspot within the residual area (GTV90%dur) was completely within the GTV and pre-radiotherapy high uptake regions (OF=100%). Although the location of the high FDG uptake patterns within the tumor during RT remained stable, the delineated volumes varied markedly.Conclusion:The location of the high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.

BACKGROUND:Percutaneous vertebroplasty for vertebral fractures can effectively relieve acute pain and has the advantages of smal trauma, good curative effect and less complications, but for patients with osteoporotic compression fractures, there were varying degrees of osteoporosis after surgery, which have a longer course of disease and cannot be easy to cure. So the effectiveness of percutaneous vertebroplasty cannot be ful y evaluated based on the pain relief. OBJECTIVE:To study the curative effect of percutaneous vertebroplasty for patients with fresh osteoporotic thoracolumbar vertebral compression fractures. METHODS:We selected 24 patients undergoing percutaneous vertebroplasty and 24 patients receiving conservative treatment at the same time who had fresh osteoporotic compression fractures as research objects;and compared pain degree, vertebral body height and the kyphosis Cobb angle, function activity of the lower lumbar before and after treatment, the quality of life and clinical incidence of complications within 6 months after treatment in the two groups. RESULTS AND CONCLUSION:The degree of pain, the vertebral body height, kyphosis Cobb angle, function activity of the lower lumbar were al improved in the two groups after treatment (P<0.05), and these indexes in the percutaneous vertebroplasty group were better than those in the conservative treatment group (P<0.05). The quality of life and incidence of complications within 6 months after treatment were improved better in the percutaneous vertebroplasty group than the conservative treatment group (both P<0.05). These results suggest that the percutaneous vertebroplasty for fresh osteoporotic thoracolumbar vertebral compression fractures can effectively reduce the pain of patients, improve vertebral deformity and activities of the lower lumbar, and has obvious role in promoting the postoperative quality of life of patients.

AIM: To construct a recombinant plasmid vector containing human pancreatic duodenal homeobox1(Pdx1) and neurogenic differentiation 1(NeuroD1) genes,and to detect its effective expression in eukaryocytes and the ability to induce differentiation of hepatocytes.METHODS: Using human embryo pancreas mRNA as template,Pdx1 and NeuroD1 genes were amplified by RT-PCR and cloned into the two different multiple cloning sites(MCSA and MCSB) of plasmid pIRES.The recombinant plasmid pI/Pdx1/NeuroD1 was transfected into L02 cells.The expression of Pdx1 and NeuroD1 in transfected cells was detected by immunocytochemistry,IFA,RT-PCR and Western blotting,respectively.RESULTS: The length and sequence of cloned segments were correct.Pdx1 and NeuroD1 were expressed in eukaryocytes.Furthermore,the hepatic cells were induced to express glucose transporter 2(GLUT2) and eukaryocyte transcription factor Nkx6.1,which were functionally correlated to ? cells.CONCLUSION: pI/Pdx1/NeuroD1 plasmid is successfully constructed and expressed in human eukaryocytes,with which the cells express the eukaryocyte transcription factor and GLUT2,indicating the transfected cells functionally correlates to ? cells.The results suggest that Pdx1 and NeuroD1 genes can induce the differentiation the cells from hepatic cells to pancreatic endocrine secretion cells.

AIM:To differentiate bone marrow mesenchymal stem cells(BMSCs) into functional insulin-producing cells to produce sufficient pancreatic islet cells for transplantation.METHODS:Recombinant adenovirus vectors carrying PDX1 and NKX6.1 genes were constructed and the bone marrow mesenchymal stem cells were infected by the recombinant adenovirus combined with several cytokines for differentiation.The expressions of PDX1,NKX6.1 and insulin and C-peptide in the differentiated bone marrow mesenchymal stem cells were detected by RT-PCR and Western blotting.After the differentiated bone marrow mesenchymal stem cells were transplanted into subrenal capsule of diabetic mice,cell morphology of the grafts as well as their secretion of insulin and C-peptide were detected.Besides,regulating capacities of grafts on the blood glucose level of the diabetic mice were also detected.RESULTS:BMSCs induced by recombinant adenovirus(pAdxsi-CMV-PDX1/CMV-NKX6.1) and several cytokines showed positive dithizone staining and the expressions of ?-cell related molecule such as insulin and glucose transporter 2 were detected by RT-PCR,which showed a sustaining and stable expression.The similar results were showed by Western blotting,immunohistochemical staining and indirect immunofluorescence.The insulin secretions in the cells stimulated with glucose at concentrations of 5.5 and 25 mmol/L in the experimental group were(1 240.4?109.3) mU/L and(3 539.8?245.1) mU/L,respectively,and were significantly higher than those in control group.Moreover,transplantation of the cells to STZ mice in treatment group made serum glucose recover to normal level.CONCLUSION:PDX1 and NKX6.1 gene-modified bone marrow mesenchymal stem cells differentiate into insulin-producing cells in vitro.When these cells transplanted into STZ induced diabetic mice,their serum glucose could return to the normal level and they could live well.Thus this is a promising method for diabetes treatment.