Objective To observe the pathophysiological change of right heart remodeling model of beagle dogs caused by tricuspid regurgitation. Methods Six beagle dogs were separated to TR group and sham operation group randomly and equally. The anterior and posterior leaflets of tricuspid valve of beagle dogs from TR group were cut off under direct vision on the beating heart. The echocardiography data were measured pre-operation and post-operation 3, 6, 12 months respectively and autopsy results were acquired after the sacrifice of two animals who had been raised for 18 months. Results The operation was successful and survival 100%. The weight of TR group increased, and the echocardiography showed right atrium and ventricle enlargement and right heart dysfunction. The autopsy of TR group found myocardial fibrosis , liver cirrhosis and ascites. All of the results indicated the occurrence of right heart remodeling and right heart failure. There is no significant difference in sham operation group before or after operation. Conclusion The myocardial fibrosis is one of the pathological basis of right heart remodeling.

BACKGROUND: Acetabular cup orientation using a standard radiograph of the pelvis is quite common method to assess artificial hip replacement nowadays. Non-standardization of pelvic orientation affected accuracy of measurement results, and it is difficult to compare. OBJECTIVE: To make sure how pelvis tilting affect the anteveration of the cup and to elevate clinical accuracy and compare study comparability. METHODS: Designed a simulated acetabular cup with serial concentric circles which pass through the same polars and represent anteveration of 0°, 10°, 20°, 30°, 40°, Loaded the simulated acetabular cup at an inclination of 35°, 40°, 45°, 50°, 55° to6 cadaver pelves, Made the pelves tilt around the frontal axis and sagittal axis with 5° each time in a scope of+30°. Takestandard radiograph of the pelvis accordingly. Radiograph was photographed end frontal angle of dip was measured. RESULTS AND CONCLUSION: Pelvic tilt of about 1° causes measuring errors of anteveration 0. 61 °-0. 73°. The anteveration decreased at both acetabular cups when pelvic posterior tilt and at the acetabular cup that near the X-ray source as pelvic lateral tilt. The anteveration rose at both acetabular cups when pelvic anterior tilt and at the acetabular cup that away from the X-ray source as pelvic lateral tilt. During clinical evaluation, pelvic orientation effects on measurement results should be considered.

OBJECTIVETo study the clinicopathologic features, immunophenotype and gene rearrangement of primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL).

METHODSSeven cases of PCLBCL were enrolled into the study. Clinicopathologic analysis, immunohistochemical staining and gene rearrangement for IgH and Igκ were undertaken in the study.

RESULTSAll the seven cases were male, and the median age was 72 years. Patients usually presented with multiple purple tumors, nodules, papules and infiltrative plaques. Two patients had a history of leg injury before onset, and one had mosquito bites. Histologically, the tumor involved the dermis and subcutis with dense and diffuse infiltrative pattern composing of centroblasts and/or immunoblasts. Immunohistochemical staining showed that seven cases (7/7) expressed CD20, six (6/6) expressed bcl-2, four (4/4) expressed MUM-1, four (4/5) expressed CD79a, four (4/5) expressed PAX-5 and four (4/6) expressed bcl-6, respectively. All cases did not express CD3ε, CD45RO, CD10 and CD30. IgH gene rearranged bands were detected in three (3/6) cases and Igκ was detected in one (1/5) case. Six of the seven cases died and the remaining patient, who was 44-year-old, was alive after 22 months of follow-up.

CONCLUSIONSPCLBCL is rare, predominantly affects elderly male patients. PCLBCL has poor prognosis and high mortality, but younger patients seem to have better prognosis. Some cases had a history of trauma or mosquito bites. The relationship between the history and the onset of PCLBCL needs further evaluation.

Aged ; Aged, 80 and over ; Animals ; Antigens, CD ; analysis ; Culicidae ; Gene Rearrangement ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Immunoglobulin kappa-Chains ; genetics ; Immunophenotyping ; Insect Bites and Stings ; complications ; Leg ; Leg Injuries ; complications ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Proto-Oncogene Proteins c-bcl-6 ; metabolism ; Skin Neoplasms ; genetics ; pathology

OBJECTIVETo identify factors that predictive of quality of life after microsurgical removal of petroclival meningiomas.

METHODSA consecutive series of 71 cases of petroclival meningiomas received microsurgical removal between July 1991 and April 2010 were analyzed retrospectively. Quality of life was measured using Karnofsky performance scale (KPS). Complete pre-operative, post-operative and follow-up data were obtained from all 71 patients including 18 male and 53 female patients with the mean age of (47 ± 11) years (aging from 15 to 68 years). The duration between onset of symptoms and diagnosis ranged from 1 week to 180 months with the mean duration of (32 ± 30) months. And the tumor size was 15-72 mm with the average of (44 ± 11) mm. Main presentations included headache, unsteady gait, hemiparesis, dysphagia, hoarseness, facial numbness or pain, Bell's palsy, hearing impairment etc. The preoperative KPS was 40-100 with the average of 69 ± 11. The retrosigmoid (-transtentorial) approach was performed in most cases (91.5%). Intergroup χ² test and logistic regression analysis were conducted for prognostic factor characterization.

RESULTSThe gross total resection (all were Simpson gradeII) reached in 48 cases (67.6%) and 1 case died postoperatively. The main new neurological dysfunctions were cranial nerve paralysis and hemiplegia with the postoperative KPS of 20-100 with the average of 73 ± 16.Sixty-four cases were followed for 4-132 months with the average of (61 ± 48) months. Seven patients died during follow-up, tumor recurrence and progression were identified in 6 and 8 cases, respectively. The KPS at the last visit ranged from 50 to 100 with the average of 83 ± 13. The extent of tumor resection (OR = 0.280, 95% CI: 0.081-0.967, P = 0.044), preoperative brainstem edema (OR = 0.100, 95% CI: 0.027-0.372, P = 0.001), relationships between tumor and neurovascular structures (OR = 0.288, 95% CI: 0.084-0.985, P = 0.047) and depth of invasion into cavernous sinus (OR = 0.254, 95% CI: 0.061-1.057, P = 0.048) had significant correlations with the prognostic quality of life.

CONCLUSIONSWith regard of the choice of surgical approaches, the extent of tumor resection, the protection of neurovascular structures surrounding the tumor and the management of perioperative period, the therapeutic strategies for each patient should be customized to achieve better prognosis.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Meningeal Neoplasms ; diagnosis ; surgery ; Microsurgery ; Middle Aged ; Prognosis ; Quality of Life ; Retrospective Studies ; Treatment Outcome ; Young Adult

Aiming at the background and significance of biomechanical researches on lumbar interbody fusion, the research progress of interbody cage and interbody fusion was reviewed and its prospect was forecasted. The related work was summarized, including research method of lumbar biomechanics, biomechanics of interbody cage, and biomechanics of lumbar interbody fusion. The main research directions on biomechanical study of lumbar interbody fusion were: modeling refinement of finite element method， geometrical optimization of traditional fusion device, clinical application of new porous fusion device, and diversification of the supplemented fixation method. Finally, the prospect of biomechanics of lumbar interbody fusion was discussed. The review and prospect on biomechanics of lumbar interbody fusion will provide references for clinical treatment of lumbar spine diseases.

The research progress of finite element method (FEM) applied in biomechanics of lumbar fusion and artificial lumbar disc replacement was reviewed and its prospect was forecasted. The main research directions of FEM are optimal selection of operation plans before the surgery, performance evaluation of implanted devices and prediction of postoperative outcomes. Based on the recent research progress, the application prospects of FEM in simulation of personalized surgery, evaluation of elastic implants and postoperative prediction of novel operation method were discussed. By reviewing and prospecting the application of FEM in biomechanical research of lumbar fusion and artificial lumbar disc replacement, the purpose of this paper is to provide theoretical references and practical guidance for the treatment of lumbar diseases in clinic.

Recombinant HLA-Ⅰ molecules/antigenic peptide complexes (pHLA complexes) are applied in the research of human T cell-specific immune responses. The preparation of pHLA complex is based on genetic engineering and protein in vitro dilution and folding-refolding technology. In an in vitro refolding system, recombinant HLA-Ⅰ molecules correctly fold and bind with antigenic peptides to form complexes. In this study, ultrafiltration-high performance liquid chromatography (ultrafiltration-HPLC) was used for quantitative determination of the antigenic peptides in recombinant pHLA complexes, especially for those in a small amount of prepared products. By adding the recombinant HLA-Ⅰ molecules and antigenic peptides into the refolding buffer, the heavy chain (HC) and light chain (β2m) of recombinant HLA-Ⅰ molecules were refolded and bond with the VYF antigenic peptide containing anchor residues to form a pHLA complex. The unbound free antigenic peptide VYF was removed by ultrafiltration to retain the complex. Finally, the pHLA complex was treated by acid to destroy its interaction, thus releasing the antigenic peptide. The results showed that the prepared recombinant pHLA complex was recognized by HLA-Ⅰ molecule specific antibody W6/32, which indicated that the recombinant HLA-Ⅰ class molecule had correct folding and was identified as pHLA complex. The antigen peptide VYF contained in the pHLA complex was also detected by ultrafiltration-HPLC, so it is feasible to apply ultrafiltration-HPLC for determination of pHLA complex. Compared with Western blotting, the concentration of antigenic peptides detected by ultrafiltration-HPLC was 0-9 μg/mL. The binding conditions can be optimized according to the amount of antigenic peptides bound in the complex in order to improve the folding efficiency of HLA-Ⅰ molecules and promote the binding of HLA-Ⅰ molecules to antigenic peptides. The production rate of pHLA complexes in the refolding system can also be calculated according to the content of antigenic peptides bound by pHLA complexes. Therefore, ultrafiltration-HPLC in this study can be used for the quality control of the preparation process of pHLA complexes, and may facilitate the research of T cell-specific immunity, artificial antigen-presenting cells, and development of specific tetramer probe applications.
Amino Acid Sequence ; Antigens ; Chromatography, High Pressure Liquid ; Humans ; Peptides/chemistry* ; Ultrafiltration

Objective To study the biomechanical properties of porous titanium cages used for different lumbar interbody fusion surgeries. Methods The three-dimensional (3D) finite element model of the lumbar spine was constructed, and mechanical parameters of porous materials were obtained by mechanical test. The biomechanical properties of porous titanium cages in anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), direct lateral interbody fusion (DLIF) were compared. Results After lumbar interbody surgery, the predicted range of motion (ROM) and the maximum stress in cage of DLIF model and ALIF model were substantially lower than those of PLIF model and TLIF model. The maximum stress in endplate of DLIF model, ALIF model and TLIF model were obviously lower than that of PLIF model. Conclusions DLIF with the porous cage showed advantages in biomechanical properties, which was simple to operate and suitable for minimally invasive surgery in clinical practice. DLIF performed the superior comprehensive properties.

【Objective】 To investigate the quality changes of suspended red blood cells (SRBCs) prepared from the blood of Tibetan high Hb population, and explore the availability and safety of blood collected from Tibetan high Hb population. 【Methods】 The voluntary blood donors were grouped according to the Hb concentration at the initial screening: female blood donors from Tibet Autonomous Region (>3 500 m) with Hb≥190 g/L and male blood donors with Hb≥210 g/L were classified as plateau high hemoglobin group. A total of 13 male blood donors from Tibet Autonomous Region were recruited. And the female blood donors (n=13) with Hb(115~165) g/L and male blood donors (n=12) with Hb(120~185) g/L from Chengdu were classified as control group. Whole blood of 200 mL specification was centrifuged to remove the plasma, and MAP additive solution was added to prepare SRBCs, then SRBCs were divided into four aliquots (50 mL/bag and stored at 4℃. Parameters as blood routine, free Hb and hemolysis rate were measured aseptically at day 1, 14, 21, 35 of storage. And 10 mL SRBCs was used to extract membrane proteins for tyrosine phosphorylation detection of band 3 protein. 【Results】 The RBCs counts(×10¹²/L), hematocrit(%) and hemoglobin(g/L) of Tibetan high Hb group and control group were 6.76±0.95 vs 4.65±0.52, 63.3±6.8 vs 43.1±4.4 and 214.4±19.8 vs 143.2±16.9 (P<0.01). The erythrocyte deformability test on the day 1, 14, 21, 35 of storage showed that the deformability of SRBCs prepared from Tibetan high Hb group was significantly lower than that of the control group under shear stress of 3, 5.33, 9.49, 16.87, and 30 Pa, while the hemolysis rate of SRBCs prepared from the Tibetan high Hb group and the control group on the day 1, 14, 21, 35 were 0.050 2±0.040 2 vs 0.022 2±0.011 1, 0.055 4±0.043 vs 0.032 1±0.028 7, 0.061 2±0.025 9 vs 0.034 3±0.031 7 and 0.069 6±0.032 0 vs 0.044 0±0.033 3 (P<0.05). Western blotting showed that the cytoplasmic N-terminal Y21 of band 3 protein of SRBCs prepared from Tibetan high Hb group was highly phosphorylated. 【Conclusion】 The deformability of SRBCs prepared from the Tibetan high Hb group was significantly lower while the hemolysis rate of SRBCs was higher than that of the control group. The hemolysis rate of the SRBCs at the end of storage prepared from the Tibetan high Hb group meets the requirements of the national standard GB18469-2012(<0.8%). The increase of hemolysis rate of SRBCs prepared from the Tibetan high Hb group was closely related to the phosphorylation of band 3 protein.