BACKGROUND:Intertrochanteric fractures can be generaly treated by surgical treatment. Along with deep research on the biomechanics of the proximal femur, proximal femoral locking compression plate appears recently. The locking plate fixation is not strong, can reduce the local stress shielding, and maintain optimal system stability, but fracture fixation failure often occurs due to the inappropriate choice of nail plate. OBJECTIVE:To evaluate the value of digital orthopedics technology in preoperative planning in locking plate fixation for intertrochanteric fracture. METHODS: Forty intertrochanteric fracture patients receiving CT tomography femur upper segment were selected and divided into two groups. In the conventional group, after reading X-ray films and CT images, patients received locking plate fixation. In the computer planning group, before repair, fracture model was established using Mimics software to segment fracture fragments, simulate operation reset and 3-matic software was used to reconstruct locking plate and screws. Locking plate was assembled with Mimics to obtain the best plate position, best screw angle and screw length. Proximal femoral locking compression plate fixation was performed. Fluoroscopy times, operation time, blood loss and fracture healing time were compared in both groups. RESULTS AND CONCLUSION: Three-dimensional models of proximal femur were reconstructed, and a series of data were obtained. The optimal position of each plate was obtained from each patient. The screw length was predicted, so preoperative operation planning was realized. Al patients were folowed up for 6-20 months. Fluoroscopy times, operation time, and blood loss were significantly less in the computer planning group than in the conventional group (P < 0.05). No significant difference in fracture healing time was detected between the two groups (P > 0.05). These findings suggest that digital orthopedics technology used in intertrochanteric fracture can simulate the locking plate position, determine the screw placement angle and length of the screw in advance, and reduce fluoroscopy times, operation time, blood loss and screw position misalignment.

Objective To study the expression of PTEN,Fas and DCR3 in human gastric cancer and evaluate their effects on carcinogenesis,cell proliferation,invasion and metastasis of gastric carcinoma,as well as clinical significance.Methods The expression of PTEN,Fas and DCR3 were detected by immunohistochemical method (streptavidin-peroxidase) in the tissues of 75 primary gastric carcinomas and 15 gastric ulcers.Results The positive expression rate of DCR3 in gastric carcinoma tissues was significantly higher than that in normal tissues,and the expression of PTEN and Fas was obviously lower than that in normal tissues (P<0.01).The expression of DCR3 was negatively correlated with Fas and PTEN respectively (r=-0.720,P<0.001; r=-0.336,P<0.001).There was a positive correlation between PTEN and Fas.The expression of PTEN,Fas and DCR3 was closely correlated with lymph node metastasis,clinical stage,histological differentiation grade and tumor depth of gastric cancer,but not related to sex,age and tumor size (P>0.05).Conclusion PTEN,DCR3 and Fas have mutual restrictive relationships in the process of invasion and metastasis in gastric cancer.Detecting the expression of PTEN,Fas and DCR3 in gastric cancer is helpful to judge the malignant biological behavior of gastric cancer at a different angle,which may be considered as reliability index in clinic diagnosis,judging curative effect and monitoring the prognosis of gastric carcinoma.

Objective To investigate the significance of PI3K/AKT signal transduetion pathway in gastrointestinal stromal tumors(GIST).Methods The expression of PI3K、Akt、PTEN were detected with RT-PCR and Westem-blot of tumor specimens from 124 GIST cases and the corresponding normal gastric mucosa.Results In gastrointestinal stromal tumors,the tumor suppressor gene-PTEN was on low expression as with the inereased expression of PI3K and Akt.The positive expression rate of PTEN,PI3K and Akt was not statistically correlated with patients'demographics and tumor histological type,but they are significantly correlated with lymphatic metastasis and mucosal invasion.The expression of PI3 K and Akt are of significantly positive correlation(r=0.292,P=0.031).The expression of PI3K and PTEN are of significantly negetive correlation(r=-0.412,P=0.036).The expression of PTEN and Akt are of significantly negetive correlation(r=-0.386,P=0.024).Conclusion PI3 K/Akt and P,PTEN may have bean on reciprocally suppressive effect during the development of GIST.

Objective To observe the incidence of fragmented QRS complex (fQRS)and ST Segment depression fQRS (STD fQRS)during the first 48 hours after non-ST elevation myocardial infarction(NSTE MI)and discuss the value of predicting mortality in patients with NSTE MI .Methods Based on the ECGs ,the patients with NSTE MI were divided into two groups :fQRS and non fQRS group .And then fQRS group was divided into two sub-groups :STD fQRS and non-STD fQRS group .Their mortality was studied during long-term follow-up .Results (1)731 patients with NSTE ACS [the NSTE MI group(n=609) and the UA group(n=122)] were studied .The incidence of fQRS in the NSTE MI group was higher than that of the UA group .(2)All cause mortality in the fQRS group were higher than that in the non-fQRS group ,and all-cause mortality in the STD fQRS group were higher than that in the non-STD fQRS group ,all the above results were not only in the early stages of NSTE MI ,but also in the long term fol-low-up .(3) Multivariate Cox regression analysis revealed that STD fQRS was an independent significant predictor for all cause mortality ,but not of the fQRS .Conclusion The STD fQRS may be an independent predictor of mortality in patients with NSTE MI .

Objective To explore the effect of whole renal perfusion imaging removal of arterial phase data on perfusion parameters of renal clear cell carcinoma using Revolution CT.Methods Perfusion imaging with Revolution CT was retrospectively analyzed in 10 patients with pathologically proven clear cell renal cell carcinoma.The z-direction coverage model was used in perfusion imaging,and the images were analyzed with CT Perfusion 4D software.All images were analyzed twice.All 23 phases data was included in group A and only 16 phases except arterial data (9-15 phases) were selected in group B.The abdominal aorta on the level of right hilus was chosen to be the input artery,and the perfusion parameter maps were obtained,including blood flow (BF),blood volume (BV),mean transit time (MTT),permeability of surface (PS).Every perfusion parameters of lesions and contralateral normal cortex,lesions and normal cortex in both groups were compared.Results The BF and PS of lesions were lower than those of normal cortex in both groups (both P＜0.05).There was no statistical difference in BV and MTT between lesions and normal cortex in both groups (all P＞0.05).There was no statistical difference in all perfusion parameters of renal clear cell carcinoma between group A and group B (all P＞0.05).The difference of BF in normal cortex between the two groups was statistically significant (P 0.009),and the difference of the PS,BV,MTT had no statistically significant (all P＞0.05).Conclusion When the duration time of renal CTP is 600 s,there is no difference between including and excluding arterial phase in all perfusion parameters of renal clear cell carcinoma.

OBJECTIVETo study the molecular types of Staphylococcus aureus isolated from a severe food-poisoning and to trace the possible strains.

METHODSReal-time PCR was applied to detect nuc gene as a specific marker for S. aureus, mecA gene encoding methicillin resistance and 5 other genes encoding staphylococcal enterotoxins (sea, seb, see, sed, see). Isolates were also performed with 16S rRNA oligonucleotide sequence analyzing by DNAStar MegAlign 5.0 software and pulse-field gel electrophoresis (PFGE) by BioNumerics Version 4.0 software.

RESULTSThe nuc gene was detected from the 10 isolated strains, sea and seb genes were detected from 7 strains. There were 4 16 S rRNA types and 5 PFGE types found from all the strains.

CONCLUSIONSThree relative S. aureus strains were involved in the severe food-poisoning at least. Molecular subtyping might give a molecular epidemiological evidence and support the source tracing of an outbreak.

Bacterial Typing Techniques ; China ; Electrophoresis, Gel, Pulsed-Field ; Enterotoxins ; Humans ; Staphylococcal Food Poisoning ; epidemiology ; microbiology ; Staphylococcus aureus ; classification ; genetics ; isolation & purification

NDRG2, one of the new N-Myc downstream-regulated gene (NDRG) gene families, is believed to be involved in cell growth event. However, the exact function is still unknown. Identification of the tissue or cell types expressing this gene in vivo will provide clues in clarifying its physiological roles. Using RT-PCR and Western blot, we analyzed the expression level of NDRG2 mRNA and protein in human fetal tissues from different gestational ages. The anti-NDRG2 monoclonal antibody, which has been proved to react specifically with NDRG2 protein, was further used to analyze the cellular location of NDRG2 protein in various human fetal tissues by immunohistochemistry. We found that NDRG2 expression was developmentally dynamic, being generally lower in the early stages of development and markedly increasing during the later stages. NDRG2 mRNA and protein distribution were generally consistent in heart and lung. One of the differences was that NDRG2 protein appeared later than mRNA in kidney. Another unmatched expression was found in liver. NDRG2 mRNA appeared later than protein in liver. In human fetal tissues at sixteen and twenty-eight weeks of gestation, NDRG2 protein immunoreactions could be seen in epithelium of small intestine, epithelium of large intestine, superficial layer of epidermis, whisker follicles, epithelium of small bronchus, hepatocytes, cardiac myocytes, thymus corpuscles and epithelium of renal tubule, and the immunoreactions in those tissues from twenty-eight weeks of gestation was stronger than that from sixteen weeks of gestation. In the present study, we demonstrate the expression pattern and cellular location of NDRG2 protein in a large set of human fetal tissues. This is the first demonstration of NDRG2 protein expression in human fetal tissues. Taken together, the results suggest that NDRG2 protein found in a variety of tissues is not a tissue-specific protein, and may play important roles in histogenesis and organogenesis.
Fetus ; Gene Expression Regulation, Developmental ; Humans ; RNA, Messenger ; genetics ; metabolism ; Tissue Distribution ; Tumor Suppressor Proteins ; genetics ; metabolism

OBJECTIVETo identify the risk factors for cytomegalovirus (CMV) pneumonia after renal transplantation and investigate the early precaution measures.

METHODSA retrospective study was conducted in a group of 28 patients undergoing renal transplantation who were readmitted because of CMV pneumonia between Jan, 2005 and Dec, 2007. Chi-square test and multivariate logistic regression were used to identity the significant risk factors.

RESULTSSeven factors, namely recipient age, acute graft rejection, pre-transplantation dialysis, delayed graft function recovery, recipient peak PRA level, donor CMV positivity and the use of MMF were found to significantly correlate to post-transplant CMV pneumonia. Multivariate logistic regression further confirmed that donor CMV IgG positivity, acute graft rejection and pre-transplantation dialysis for over 6 months were independent factors to predict the occurrence of CMV pneumonia.

CONCLUSIONSAcute graft rejection control, appropriate donor selection and shortened dialysis before the transplantation can be crucial factors to reduce the incidence of CMV pneumonia after renal transplantation.

Age Factors ; Aged ; Cytomegalovirus Infections ; etiology ; prevention & control ; Female ; Graft Rejection ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Multivariate Analysis ; Pneumonia, Viral ; etiology ; prevention & control ; Postoperative Complications ; etiology ; prevention & control ; Renal Dialysis ; Retrospective Studies ; Risk Factors

BACKGROUND AND OBJECTIVETo ensure the accuracy of dose calculation for radiation treatment plans is an important part of quality assurance (QA) procedures for radiotherapy. This study evaluated the Monitor Units (MU) calculation accuracy of a third-party QA software and a 3-dimensional treatment planning system (3D TPS), to investigate the feasibility and reliability of independent verification for radiation treatment planning.

METHODSTest plans in a homogenous phantom were designed with 3-D TPS, according to the International Atomic Energy Agency (IAEA) Technical Report No. 430, including open, blocked, wedge, and multileaf collimator (MLC) fields. Test plans were delivered and measured in the phantom. The delivered doses were input to the QA software and the independent calculated MUs were compared with delivery. All test plans were verified with independent calculation and phantom measurements separately, and the differences of the two kinds of verification were then compared.

RESULTSThe deviation of the independent calculation to the measurements was (0.1 +/- 0.9)%, the biggest difference fell onto the plans that used block and wedge fields (2.0%). The mean MU difference between the TPS and the QA software was (0.6 +/- 1.0)%, ranging from -0.8% to 2.8%. The deviation in dose of the TPS calculation compared to the measurements was (-0.2 +/- 1.7)%, ranging from -3.9% to 2.9%.

CONCLUSIONSMU accuracy of the third-party QA software is clinically acceptable. Similar results were achieved with the independent calculations and the phantom measurements for all test plans. The tested independent calculation software can be used as an efficient tool for TPS plan verification.

Algorithms ; Phantoms, Imaging ; Quality Control ; Radiometry ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Software

OBJECTIVETo investigate the effect of trichostatin A (TSA) on proliferation and interleukin-2 (IL-2) expression of mouse T cells in mixed lymphocyte culture (MLC), and explore its effect on T cell-mediated immune response.

METHODSBALB/c and C57BL mouse MLC was treated with different concentrations of TSA for different durations, and the lymphocyte inhibition ratio was measured by MTT assay. With CTX as the control, one-way MLC system of BALB/c and C57BL mouse was treated with the same concentrations of TSA, and IL-2 expression in the T cells was observed by flow cytometry.

RESULTSTSA inhibited the proliferation of T cells in the MLC in a time- and dose-dependent fashion. It also reduced the IL-2 expression in one-way MLC dose-dependently, showing it significantly differed from the effect of CTX (P<0.01).

CONCLUSIONHistone deacetylase inhibitor TSA can inhibit the proliferation and reduce IL-2 expression of the T cells in MLC of mice, and therefore inhibit the T cell-mediated immune response.

Animals ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Enzyme Inhibitors ; pharmacology ; Female ; Flow Cytometry ; Histone Deacetylase Inhibitors ; Hydroxamic Acids ; pharmacology ; Interleukin-2 ; biosynthesis ; Lymphocyte Culture Test, Mixed ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; T-Lymphocytes ; cytology ; drug effects ; metabolism