[Objective]To discuss the perioperative management of thoracolumbar fractures fixed with latero-anterior screw-plate system.[Method]The entry point and direction of screw on 30 thoracic and lumbar vertebra specimens were marked based on the principle and demand of implantation of latero-anterior screw-plate system and were determined exactly by anatomic landmarks in order to make reference for operation.Sixty patients with thoracolumbar fractures were treated with anterior decompression,bone grafting and internal fixation from January 2000 to June 2007.Reference data such as the length of vertebral body screw and plate and the height of bracing gotten from the patients'X-ray and CT findings before operation were compared with practical data measured during operation.The entry point and the direction of screw were determined exactly by anatomic landmarks of thoraco lumbar vertebrae and were checked by X-ray during operation.[Result]The judgement of the entry point and the direction of screw was easy and accurate during operation and the reference data were in coincidence with practical data.The effects of operation were satisfactory.[Conclusion]The perioperative management is both scientific and practical.The surgical complications can be reduced in this way.

[Objective]To explore the mechanism of hip joint capsule contracture induced by intragluteal injection. [Method]Thirty young Chinese rabbits were divided into four groups of A(n=6),B(n=6),C(n=6) and D(n=12) at random.Rabbits in groups A,B and C were treated with deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol(group A),2% benzyl alcohol(group B)and penicillin dissolved in physiologic saline(group C).Rabbits in group D were treated with immobilization of unilateral hip joint and deep intramuscular injection of physiologic saline on the homolateral buttock.Each rabbit was injected twice a day for 20 days.Specimens were obtained at 30,60 and 90 days after first injection and the evaluation of the functions of hind limbs was obtained at the same time.The thickness of hip joint capsules were measured with micrometer and sections of joint capsules were stained by Sirius red and were observed with microscope and polarization microscope.[Result]Capsules of hip joint in group A and B became thicker and contractural,and the change of joint capsules was reflected in the change of motion of hind limbs.Sections in groups A and B showed shrinked capsules with thick collagens in disordered arrangement;while there were no gluteus contracture and contracture of joint capsule in the other groups.[Conclusion]Deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol or 2% benzyl alcohol into young rabbits can cause contracture of hip joints.The contracture of joint capsule is largely induced by tissue trauma and repair of joint capsules.The limited locomotion of hip joint induced by the contracture of gluteal muscle does not play an important role in the contracture of joint capsule.

National advanced training course of traditional Chinese orthopedic and traumatology in anatomy experiment is a short-term courses designed for grassroots doctors.Special training content and methods are designed for the multi-level cadets in the short-term courses.How to use teaching staff advantage to optimize course setting and improve the teaching effects will be discussed in this article.

Aberrant activation of the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(PKB,Akt)-mammalian target of rapamycin(mTOR) pathway is commonly observed in human cancer and is critical for cell survival, proliferation and differentiation.A variety of small molecule inhibitors targeting PI3K-Akt-mTOR pathway are under clinical studies.This review will summarize the recent studies in terms of the PI3K-Akt-mTOR signaling pathway and cancer,research progress of the antitumor activity possessed by PI3K-Akt-mTOR inhibitors,as well as the recent research in the related field conducted by our group.

BACKGROUND:The dynamic changes of hypoxia inducible factor-1 alpha (HIF-α) and inducible nitric oxide synthase (iNOS) genes in the pulmonary artery wall during the process of hypoxic pulmonary hypertension (HPH) development need to be investigated.OBJECTIVE: This study was to observe the gene expressions of HIF-α and iNOS in the pulmonary artery wall at the different hypoxic time points, and to investigate their effects in HPH development.DESIGN: Controlled observation animal experiment.SETTING: Department of Respiration, Second Hospital Affiliated to Nanhua University.MATERIALS: Forty healthy male Wistar rats of clean grade, aged 6-8 weeks, with body mass of (220±10) g were involved in this study. They were randomized into control group (n =8) and hypoxia group (n =32). Four time points, i.e.3, 7, 14, and 21 days after hypoxia were set for the animals in the hypoxia group, 8 rats at each time point.METHODS: This study was carried out in the Institute of Oncology, Nanhua University between August 2004 and December 2005. Rats in the hypoixa group were treated according to the method reported by Li et al. Hypoxia treatment was omitted for the rats in the control group. At each time point, the rats were anesthetized, and then a micro-catheter was inserted into the right jugular vein and connected to a multichannel physiologic recorder, which was used for detecting the mean pulmonary arterial pressure (mPAP). The heart of each euthanized rat was taken out, and its right ventricle (RV), and left ventricle and septum (LV+S) were weighted. Right ventrical hypertrophy index (RVHI) reflected right ventricle hypertrophy degree. Right upper lung tissue of rat was harvested for haematoxylin & eosin (HE) staining and elastic fiber staining. Pathological image analysis software was used to determine pulmonary arterial wall area/total vascular area, lumina area/total vascular area, smooth muscle cell density in the media of pulmonary arteriole, and media thickness of pulmonary arteriole, which were used as remodeling indexes of pulmonary arteriole. HIF-1α and iNOS in the pulmonary arteriole were performed in situ hybridization and immunohistochemical detection. The mean absorbance of pulmonary arteriole wall was used as the relative content of mRNA expression and protein level.MAIN OUTCOME MEASURES: ①Changes in mPAP, RV hypertrophy degree and remodeling indexes of pulmonary arteriole of rats. ② Expressions of HIF-α and iNOS as well as their correlations with mPAP and remodeling indexes of pulmonary arteriole.RESULTS: All the 40 Wistar rats were involved in the final analysis. ①At hypoxia 7 days, mPAP was significantly higher than that of control group (P ＜ 0.05). mPAP reached to the high level at hypoxia 14 days, and then maintained at this level. ② At hypoxia 14 days, RVHI was higher than that of control group (P ＜ 0.05). ③ At hypoxia 7 days, pulmonary arteriole wall was thickened, and lumina became narrowed. There were significant differences in pulmonary arterial wall area/total vascular area, lumina area/total vascular area between hypoxia group and control group (P ＜ 0.05). At hypoxia 14 days, smooth muscle cell density in the intima-media of pulmonary arteriole, and intima-media thickness of pulmonary arteriole were significantly increased (P ＜ 0.05). At hypoxia 21 days, lumina was further narrowed, and obvious smooth muscle hyperplasy was found. HIF-1α and iNOS mRNA expression presented weak-positive in the control group; The relative content of HIF-1α mRNA did not significantly alter at hypoxia 3 and 7 days, but was obviously increased at hypoxia 14 days ,and after this, it maintained at high level. iNOS mRNA was markedly higher than that in the control group at hypoxia 3 days, reached its peak at hypoxia 7 days, was close to the level in the control group at hypoxia 14 days, and enhanced again at hypoxia 21 days, but it was still lower than that at hypoxia 3 days. ⑤HIF-α was mainly found in the intima and media, while iNOS was found in the whole layer of vessels. iNOS was weakly expressed in the intima and media of pulmonary vessels in the control group. No obvious difference in iNOS existed at hypoxia 3 days as compared with control group. iNOS was obviously expressed in media and intima at hypoxia 7 days. Vascular media was thickened at hypoxia 14 days, and the expression of iNOS was enhanced. iNOS was not found in the vascular adventitia in the control group, but was found in the vascular adventitia in the hypoxia group. ⑥mPAP was positively correlated with pulmonary vascular remodeling (r =0.976, P ＜ 0.01 ), and HIF-1α mRNA was positively correlated with iNOS protein(r =0.927, P ＜ 0.05).CONCLUSION: Both HIF-1α and iNOS exert effects in the process of HPH development of rats, and HIF-1α and iNOS gene expression may be mutually regulated.

Objective To analyze the relationship between the radiation doses to mediastinal lymph nodes regions and the regional failure patterns when involved field radiation therapy (IFRT) was used for limited-stage small cell lung cancer (SCLC).Methods The mediastinal lymph node regions (group 1 to 10) of the iimited-stage SCLC patients received definitive radiotherapy were contoured in treatment planning system.The intentional or incidental radiation doses to each lymph node regions were recorded.In-field recurrence,marginal recurrence and out-of-field recurrence were respectively defined as the volume of failed lymph nodes located within the 80％ iso-dose lines,in the 80％-20％ iso-dose lines and beyond the 20％ iso-dose lines of prescribed doses.Results A total of 1 216 lymph node regions in 76 patients were contoured.The median follow-up time was 17.4 months.At diagnosis,lymph node regions with metastatic rates ＞50％ were 4R (68.7％),4L (57.9％),10R (57.9％),2R (56.6％) and 7 (51.3％).The positive lymph node regions were all subjected to prescribed doses.The lymph node regions that received incidental radiation doses of more than 3 000 cGy were:3P,4L,7,6,4R,5,2L.The median lymph node failure-free time was 9.8 months.In this study,only 1 patient developed out-of-field mediastinal lymph nodes failure.The rest of out-of-field recurrences and marginal recurrences were developed in the supraclavicular regions or contralateral hila.Conclusions When IFRT is used to treat mediastinal lymph node regions for patients with SCLC,negative mediastinal regions can be subjected to considerable incidental radiation doses.Out-of-field recurrences of the mediastinal lymph node regions are rare.This is contributed by the incidental radiation dose to these regions.

Objective To evaluate the detection rate and the efficiency of the modified crushing-cercariae escaping method.Methods The detection rates of the modified crushing-cercariae escaping method and the crushing methods were compared by using a double-blind control experiment with the latter as a gold standard.meanwhile the number of the cercariae was quantified.The efficiency of the two methods aforementioned and the cereariae escaping method were compared in field.Results The detection rate of the modified crushing-cercariae escaping method was 100%.the average number of cercariae in each infected snail was (4 778±1 157);and the number in certain volume of water sample was positively correlated with the number of infected snails.The efficiency of the modified menthed Was 18.2 times and 17.3 times as high as those of the crushing method and cereariae escaping method,respectively.Conclusions The modified crushing-cercariae escaping method Can detect the infected snails quicky and Can quantify the number of infected snails and cercariae,and is suitable for the detection of infected snails in large number.

Objective The study was designed to observe influence of simvastatin on lung tissue angiogenesis and the gene expression of vascular endothelial growth factor(VEGF) and platelet factor 4(PF4) of rats with bleomycin (BLM)-induced pulmonary fibrosis. Methods Ninety-six healthy male SD rats were divided into four groups by random number table, including normal control group (A), bleomycin group (B), prednisone acetate treatment group (C) and simvastatin treatment group (D). Lung tissue of rats in each group was detected as specimens. HYP was detected by digestion method. Angiogenesis, VEGF and PF4 protein expression were determined by immunohistochemical method (SP). Expression of VEGF and PF4 mRNA were respectively detected by RT-PCR assay. Results (1)HYP content of group C, D was lower than the group B, which was statistical significance (P <0.01). (2)MVD and the expression of VEGF in group B, C and D was higher than that in group A. PF4 expression of group B, C and D were lower than that of group A (P < 0.01). MVD and the expression of VEGF of group D were lower than those of group B, the expression of PF4 of group D was higher than that in group B (P < 0.05). Conclusion Mechanism of simvastatin on pulmonary fibrosis may be related to regulate the expression of VEGF and PF4 in lung tissue, inhibit pathological angiogenesis.

According to the National Scheme of Shistosomiasis Surveillance,the endemic situation in 8 national surveillance sites in Jingzhou City were monitored and analyzed.The results showed that the average human infection rate in 8 sites was 0.93%,and the rates in residents above 40 years old were high.People with positive results in fecal examination were all farmers,with an infection rate of 1.16%.The average infection rate of cattle was 6.26%.The total snail area was 1 511.50 hm~2,among which an area of 0.98 hm~2 was newly discovered and the area with infected snails was 1.17 hm~2.It concludes that the endemie situation in surveillance sites decreases year by year.However,the infection rate of earle still remains high and the snail status is still severe,which suggests that the control should be strengthened further.

A survey on schistosomiasis conducted in sampled 453 out of 1971 villages in Jingzhou City in the year of 2006. Miracidia hatching test demonstrated that the prevalence in human population was 3.9% (12 006/310 232), with sporadic cases of acute schistosomiasis, and the prevalence in cattle was 10.2%(270/2 651). The mean density of living snails was 0.67/0.11 m2(1 988/1 054 597) with a density of infected snails of 0.001 9/0.11 m2(1 988/713 486). In comparison to those of 2004, prevalence in humans decreased by 40.0%, prevalence in cattle increased by 22.3%; the snail-ridden area increased by 4.0%, but the mean density of living snails increased by 68.5% and the infected snail density increased by 18.8% with a decrease of 36.4% in snail infection rate. Consequently, there is an urgent need in controlling schistosome infection in cattle.