ObjectiveTo investigate the changes of serum growth hormone (GH)/insulin-like growth factor- Ⅰ ( IGF- Ⅰ ) in patients with traumatic long bone fractures and the related clinical significance.MethodsTwenty-one patients with traumatic long bone fractures from the same trauma care center treated between November 2009 and April 2010 were enrolled in the study..There were 14 males and 7 females,at age range of 22-60 years (mean 45.0 years).Seventeen patients (81％) were with closed trauma and four ( 19％ ) with open trauma.Enzyme Linked Immunoadsorbent Assay (ELISA) was used to determine the levels of serum GH and IGF- Ⅰ within 14 days after fractures and the relationship between changes of GH-IGF- Ⅰ axis and injury severity score (ISS) was further analyzed.Eight patients with normal GH/IGF- Ⅰ were set as control group.ResultsThe GH level in the peripheral blood was significantly higher at day 1 after fractures ( P ＜ 0.05 ),and rapidly declined and stabilized at day 5 compared with the control group.The GH level in the patients with ISS≥ 18 points was sigmficantly higher than that in those with ISS＜18 points at day 1 after fractures (P＜0.05).The IGF- Ⅰ level in the peripheral blood in the patients with 1SS≥ 18 points was significantly higher than that in those with ISS ＜ 18 points at days 5-10 after fractures ( P ＜ 0.05 ).ConclusionThe hypothalamus GH-IGF- Ⅰ axis plays an important role in early metabolism and fracture healing during the acute phase of traumatic long bone fractures.

Objective To treat complex fractures of the proximal tibia with the hybrid external fixation and internal fixation and to evaluate their efficiency. Methods During January 2000 to January 2005, 69 patients with complex proximal tibia fractures received operation in our hospital, which included Schatzker types Ⅳ(17 cases), Ⅴ(14 cases) and Ⅵ(9 cases) and AO A3 type 27 cases, and 2 amputation. The average age was 39 years(range from 18 to 74 years). Among them, 19 open fractures and 21 closed fractures were operated with hybrid external skeleton fixation(HESF) combined limited internal fixation, the others were treated by open reduction and internal fixation (ORIF). Results All the patients were followed from 6 months to 5 years(mean, 25 months), in the HESF group the average time of operation was 2.66 h, the bleeding in operation was 170.50 ml, while ORIF group was 3.33 h and 285.19 ml, the amount healing time of HESF group was 16.40 weeks, while the ORIF groups was 12.37 weeks; there were no deep infectious and skin necrosis patients in the HESF group. According to the HSS score system, there were excellent 31, good 5, fair 3 and bad 1 case, the rate of excellent and good was 90%. In the ORIF group, there were 1 deep infectious and 2 skin necrosis patients, 6 cases were malunion, 2 cases were nonunion. There were excellent 5, good 12, fair 7, bad 3 cases, the rate of excellent and good was 63%; and there were significantly difference between the two groups(u=219, P

Pedicle screw fixation is biomechanically most reliable for reconstruction of the cervical spine, which can ef?fectively restore cervical sagittal profiles, provide rigid fixation and higher fusion rate. Because of the large individual differ?ences in cervical pedicle, vertebral artery and nerve root, preoperative evaluation should be individualized. Cervical pedicle screw techniques include freehand technique and the computer-assisted navigation technology developed recently. Although complications associated with cervical pedicle screw fixation cannot be completely obviated, they can be minimized by com?bination of sufficient preoperative imaging studies of the pedicles and meticulous surgical techniques of screw placement. Cervical pedicle screw fixation techniques have been used in the treatment of various cervical disorders, with fewer complica?tions and good clinical efficacy, and a wide range of clinical applications.

Objective To establish a three-dimensional finite element model of thoracolumbar fractures treated by mono-segmental instrumentation in the fractured part for testing effect of such fixation mode on adjacent segments.Methods CT scanning data of T10-L2 were used to build a normal model at T10-L2 region,a fracture model at T12 segment as well as a mono-segment fixation or short-segment fixation model.Stress of discs and vertebral body adjacent to the fixed vertebrae were tested in axial compression,anteflexion,extention,lateroflexion,and axial rotation.Results The fracture model presented significant increase concerning stress of nucleus pulposus and annular fibrosus at T10-T11 segments and annular fibrosus at L1-L2 segments in anteflexion,extention,and lateroflexion when compared with the normal model.General raise range of the stress reached around 75％,but was dropped to 23％ after short-segment fixation and to 18％ after mono-segmental fixation.And again,stress of nucleus pulposus at L1-L2 segments was increased by 46％ or so,which was declined to 12％ after short-segment fixation and to 8％ after mono-segmental fixation.Stress at lower endplate of T10 and at upper endplate of L2 in the fracture model group were increased by 24％ and 43％ respectively when compared to the normal model,but both presented a notable drop after internal fixation.The latter was decreased to a level slightly higher than that of model group,namely 8％ more after short-segmental fixation and 4％ more after mono-segmental fixation; the former was decreased to a level even lower than that of control group,namely 2％ less after short-segmental fixation and 8％ less after mono-segmental fixation.Conclusion Mono-segmental fixation reduces adjacent disc stress in contrast to conventional short-segmental fixation and hence is an effective alternative treatment of monosegmental thoracolumbar fractures.

Objective To analyze the evolution of acetabular morphology changes of different Crowe types among adults with developmental dysplasia of the hip through standard hip 3D CT reconstruction.Methods From June 2010 to January 2013,there were 62 patients with 68 hips (8 hips of 6 male cases,56 female cases of 60 hips) diagnosed as acetabular dysplasia in our hospital,with an average age of 53.7±5.8 years old (range,47-59 years).According to Crowe classification,there were 14 cases (17 hips) of Crowe type Ⅰ,17 cases (17 hips) of Crowe type Ⅱ,15 cases (17 hips) of Crowe type Ⅲ,and 16 cases (17 hips) of Crowe type Ⅳ.Through standard hip 3D CT reconstruction,Harris nest in the pelvic side 3D image was marked,and the coronal and horizontal position of acetabular rotation center was determined by using the cross axis; secondly,in the anteroposterior 3D image (by gray level adjustment to the shape of X ray perspective effect) through Ranwant triangulation,sagittal position of the center of rotation of the hip joint was determined; finally,the acetabular rotation center in the acetabular horizontal reconstruction plane.The bone stock of anterior and posterior columns of acetabular was observed and acetabular anteversion,front cover angle,rear cover angle and medial wall thickness were measured.Results 1) With Crowe type increased,acetabular anteversion angle gradually increased as well,and there was a positive correlation between them with statistically significant (P＜0.05) except in Crowe Ⅰ and Ⅱ group.2) With Crowe type increased,anterior acetabular coverage angle was significantly decreased; the mean anterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 50°.3) With Crowe type increased,posterior acetabular coverage angle was decreased significantly as well the mean posterior acetabular coverage angle of Crowe Ⅲ and Ⅳ groups was less than 90°.4) With Crowe type increased,acetabular medial wall thickness was increased significantly.Conclusion Adult acetabular morphology changes between different Crowe types in patients with developmental dysplasia of the hip.For acetabular reconstruction of Crowe Ⅰ and Ⅱ,we could make full use of the acetabular bone stock of anterior and posterior column; for acetabular reconstruction of Crowe Ⅲ and Ⅳ,we could moderately shift the acetabular center superiorly and (or) medially.

BACKGROUND: Establishment of individual femoral model can describe the stereochemical structure of femoral accurately,which is conductive to measuring femoral anatomic forms. This model possesses unified standard, and removing the potential confounding factors, thus, it is more suitable for biomechanical test.OBJECTIVE: To explore a method for establishing an accurate individual femoral model.METHODS: A male, healthy, volunteer was selected from General Hospital of Tianjin Medical University, and the cross section of femur was successive scanned by 16 slice CT. In accordance with Dicom 3.0 standard, the CT image was reconstructed using Mimics software to establish the space model, and UG software was used to type on the workpiece, and cimatron software was used to sort, then set the coordinate system of computer numerical control machining, clamp and correct the workpiece to produce mold toolpath, so the mold was established. The femur model made by mould was compared with the femur by the method of point cloud.RESULTS AND CONCLUSION: An individual femur model was produced. The comparison results of point cloud showed that error was in allowing range. This is an advisable method to make a femoral model, which can achieve predetermined requirement.

BACKGROUND:At present,there are many established femoral finite element studies,but previous studies focused on femoral biomechanics of the outside are few.OBJECTIVE:To establish three-dimensional finite element model of structure of the proximal femur,and to analyze its biomechanics in normal standing position to provide reasonable evidence for clinical application.DESIGN,TIME AND SETTING:A three-dimensional finite element model analysis was performed in General Hospital of Tianjin Medical University from December 2008 to April 2009.PARTICIPANTS:One male volunteer aged 30 years was enrolled at General Hospital of Tianjin Medical University.Femur lesion or injury was excluded by means of X-ray.METHODS:The primitive femur CT data were adopted according to Dicom 3.0 standard in Mimics so as to obtain the primitive three-dimensional femur model which was established via threshold defining,region enlarging and morphological performing.The primitive model was remeshed and combined with ANSYS software to create a final finite-element model.The model obtained by using the Mimics was loaded with 200 N vertical loading to check out the difference of the stress distribution.MAIN OUTCOME MEASURES:Using 200 N as the external load in the vertical direction,the Vonmises stress distribution of the femur was detected.RESULTS:The applications of Mimics and Ansys software could create a finite element model of proximal femur.It was found that the correspondent relationship between stress and structure in proximal femur was verified.CONCLUSION:Mimics can build more three-dimensional finite element models in line with the proximal femoral mechanical structure and mechanical properties.The mechanical properties of the femur are more credible,and the results of the analysis support the clinical application of the guidance.

RNA-seq can help us quickly obtain the whole transcriptome sequences of species under different conditions. Many Unigenes that are assembled by raw reads always do not contain complete open reading frame (ORF). In addition, it also has some redundancy in transcriptome library. Some Unigenes in the library, although belong to one transcript, cannot be assembled without overlapping. We found five incomplete Unigenes annotated ammonium transporter (AMT) from Salicornia europaea transcriptome, in which two Unigenes (Uni4 and Uni5) had identical expression patterns across four transcriptomes. The two Unigenes may come from one transcript. Analyzing the Unigene position of transcript by NCBI blastx, we found that Uni4 and Uni5 respectively located in 5' end and 3' end compared with the reference transcript, and an unknown gap of 120 bp may exist in a hypothetic transcript to which Uni4 and Uni5 both belong. To verify the hypothesis, single forward primer and single reverse primers were respectively designed on Uni4 and Uni5, and a fragment with about 800 bp was generated by PCR. Then it was sequenced and aligned with Uni4 and Uni5. Finally, we assembled a sequence with 1 667 bp, which contains a complete ORF (1 482 bp, coding 494 amino acids). It belongs to amt1 subfamily and was named Seamt1 via the phylogenetic analysis. It was pointed by bioinformatics tools that SeAMT1 protein conformed to the AMT characteristics of other species. This work clustered expression pattern to explore the Unigenes of one transcript, and the feasibility of this method was validated through the other two groups of Unigenes. The handy method will benefit extension and assembling of Unigene in transcriptome, it also helps achieve the complete ORF and gene function.
Ammonium Compounds ; Chenopodiaceae ; genetics ; Computational Biology ; Gene Expression Profiling ; Genes, Plant ; Membrane Transport Proteins ; genetics ; Molecular Sequence Annotation ; Open Reading Frames ; Phylogeny ; Plant Proteins ; genetics ; Transcriptome

Objective To investigate the relationship between the MR findings of lumbar elements and chronic low back pain(CLBP).Methods The patients underwent lumbar MRI examinations and sent for a questionnaires of low back pain (LBP).Among them,139 patients whose questionnaires illustrated with CLBP were enrolled.The enrolled patients included 68 patients with nerve roots compression and 71 patients without.Meanwhile,198 hospital staffs underwent lumbar MRI examinations and were sentfor a LBP questionnaire.Among them,62 patients without LBP and nerve roots compression were enrolled.Categorical regression was used to analyze the relationship between MR findings and CLBP.The MR findings iucluded nerve roots compression,average disk degeneration scores(ADD),high-intensity zones (HIZ),Schmorlnodes,Modic Ⅰ change,average facet joints degeneration scores(AZZ),facet joint effusion,high T2 signal in interspinous ligament and subcutaneousparaspinal muscles edema.The regression model was used to analyze the MR imaging and CLBP.Results The regression model was statistically significant (F=9.478,P＜0.01).All predictors yielded an adjusted value was 0.446.Among all predictors,nerve roots compression,ADD,AZZ,subcutaneous or paraspinal muscles edema were statistically associated with the VAS degree (P＜0.05).The sum of the importance of the four predictors above was 0.983.The quantification of predicted VAS degree increased as ADD level increased.The quantification of predicted VAS degree increased to the top at the 2 AZZ level and then decreased.Nerve roots compression and Subcutaneous or paraspinal muscles edema yielded higher quantification of predicted VAS degree level.Conclusion ADD,AZZ,subcutaneousparaspinal muscles edema were probably associated with CLBP degree after adjusting for nerve roots compression.

Venous thromboembolism (VTE) is a kind of venous disorder that the abnormal condensation of blood within the vein,leading to complete or incomplete vein obstruction.VTE is mainly a combination of deep vein thrombosis (DVT)and pulmonary embolism (PE) and is an important complication after major orthopedic surgery (total hip arthroplasty,total knee arthroplasty,hip fracture surgery).Foreign literature reported that incidence rate of VTE after arthroplasty was as high as 42％-57％.Conventional notion was that DVT and PE were two different but interrelated types of VTE,while the latest research reported that the formation of DVT and PE after arthroplasty may be two events individually.Prevention of VTE after major orthopedic surgery includes general,pharmacological and mechanical methods.The efficacy of physical combined with pharmacological methods was better than drug prevention alone in preventing distal DVT.Dabigatran,apixaban,rivaroxaban and other new oral anticoagulants were better than low molecular weight heparin and other traditional medicines in effectiveness and safety.The effects of low molecular weight heparin are remarkable,while it cannot take orally.A recent study found that staged VTE prophylaxis,namely patients received low molecular weight heparin injection in hospital,and received aspirin,rivaroxaban or dabigatran orally after discharge is safe and effective in prevention of VTE.