BACKGROUND: Presently, it is a certain preventive effect of local emplacement of various isolated materials during operation and postoperatively drug-controlled inflammatory reaction on adhesion between epidural and nerve root after laminectomy.OBJECTIVE: To study the preventive effect of chitosan and titanium net on epidural cicatricle adhesion after laminectomy.DESIGN, TIME AND SETTING: Randomized controlled animal study, which was performed in Guiyang Medical College from June to December 2005.MATERIALS: Eighty adult rabbits, weighing (2.0±0.2) kg, were used to establish vertebral plate resection models. Chitosan was provided by Shanghai Qisheng Biological Agent Industry Company, and titanium net by Guizhou Kelun Pharmacology Company Limited.METHODS: Eighty adult rabbits were randomly divided into four groups, including control group (0.5 mL saline), titanium net group (titanium net in the size of 1.0 cm × 0.8 cm was covered on defect region of vertebral plate and fixed on processus spinosus of upper and lower cone, bilateral muscles and soft tissues), chitosan group (2 mL chitosan), and chitosan + titanium net group (combination of chitosan and titanium net). Six rabbits were sacrificed in the 2nd and 4th weeks postoperatively, and eight rabbits were chosen as the samples in the 8th week.MAIN OUTCOME MEASURES: Morphological changes of cicatricle.RESULTS: Cicatricle was clearer in the control group. Titanium net could relieve peripheral cicatricle of dura mater and effectively isolate peripheral cicatricial tissue and spinal dura meter. Chitosan could remarkably prevent from cicatricle adhesion and inhibit inflammatory reaction. The combination of chitosan and titanium net could effectively inhibit proliferation of cicatricle surrounding dura meter.CONCLUSION: Association of chitosan and titanium net can effectively inhibit cicatricle adhesion surrounding dura meter after laminectomy.

BACKGROUND: For its extensive sources and specific biological characteristics, heterogeneous deproteinized bone (DPB) as the tissue-engineered scaffold material gets a good application prospect in repair of large segmental bone defects.OBJECTIVE: To prepare scaffold material by compositing modified heterogeneous DPB with recombinant human bone morphogenetic protein 2 (rhBMP2) and evaluate the osteogenic ability in repairing large segmental long bone defects in large-sized animals.METHODS: Twenty-four goats were randomly and evenly divided into three groups: DPB, autologous bone, and DPB+rhBMP2. Bone defects (20% in length) were made in the middle and lower segments of the right tibia of each goat, and according to group design,different bone grafts were implanted and fixed using semi-ring slot external fixer. At 4-24 weeks after surgery, X-ray examination was performed once every other 4 weeks. At 24 weeks after surgery, newly formed bones were taken out for determining the repair effects of bone defects through duat-energy X-ray analysis, histological observation, and biomechanical analysis.RESULTS AND CONCLUSION: The prepared DPB exhibited a three-dimensional porous structure, with a porosity of (78.5±6.45)% and pore size of (472.5±7.02) μm. Time-dependent bone repair was found in each group. Results regarding anti-compression test, three-point anti-bend test, and anti-torsion test were greatest in the autologous bone group, followed by the DPB+rhBMP2 group, and lastly the DPB group. There were no significant differences in tibial bone density, bone mineral content,anti-compression pressure and ultimate pressure, anti-bending load and ultimate toad, anti-torsion torque and ultimate torque between autologous bone group, DPB+rhBMP2 group and normal bone control group. These findings indicate that modified heterogeneous DPB composited with rhBMP2 has osteogenic ability equivalent to autologous bone in repairing large segmental long bone defects in goat tibias. Therefore, it can be applied as tissue-engineered scaffold material.

The development and progression of colorectal cancer (CRC) is a process that accumulates the driver somatic mutations elicited by chronic inflammation. Epigenetic modifications and genetic mutations play key roles in the whole evolutionary process of chronic inflammation-induced CRC. Adenoma gradually progresses into adenocarcinoma via accumulating genetic mutations stimulated by cancer promoting stimulations. The next generation sequencing technology provides an effective way to identify the “driver” mutations and fusion genes in the carcinogenesis, providing molecular evidences for cancer evolution. The most significant genetic changes during malignant transformation from adenoma to adenocarcinoma are the significant increases in microsatellite instability and chromosome instability. The main purpose of investigating the evolutionary process of CRC, especially somatic mutations, is to identify the related signaling pathways, which are the key steps to explore early effective intervention strategies and targeted therapies for CRC.

Objective Degenerative lumbar scoliosis is frequent clinic spine malformation ,and it is complicated by lumbar inter-vertebral disc ,joint of lumbar vertebra cataplasia and lumbar spinal stenosis .The aim of this paper is to study surgical therapeutic regimen for analyzing clinic feature of degenerative lumbar scoliosis .Methods We comprehended symptom and analyzed imageology feature for lumbar spinal stenosis through reviewing 48 cases of operation from August 2003 to August 2010 ,and then approached its therapeutic principle and regimen .Results There were good therapeutic effect on the basis of comprehending degenerative lum-bar scoliosis and designing different treatment plan by different case feature .Conclusion Ii is need to know degenerative lumbar scoliosis again ,in order to work out individual therapeutic regimen based on clinic feather ,process segment ,state of spinal stenosis , angle of lumbar scoliosis ,degree of vertebra rotation and lumbar destabilizing .

The Wnt signaling pathway plays an important role in bone metabolism. Inducing the Wnt signaling pathway promotes bone formation while restraining it results in osteopenic states. Although the regulation of this signaling pathway may bring enormous therapeutic potential, it still requires cautious approach because of the risks of tumorigenesis. The role of the Wnt signaling pathway in bone metabolism and the molecular targets of therapeutic potential for osteoporosis are discussed in this review.

OBJECTIVETo investigate the way of diagnosis and therapy of parosteal osteosarcoma.

METHODSA retrospective review was conducted of 48 patients treated at our department between June 1964 and December 2001. The average age of patients in this study was 29.2 years (13 - 47 years). Thirty-two of the patients were female; sixteen were male. The single most common site is the posterior aspect of the distal femur (in 36 patients), followed by the femur shaft (in 6 patients), the proximal tibia (in 2 patients), etc. Nine patients had been operated on before referral to our department.

RESULTSThe average follow-up period from the first operation was 5.2 (0.25 - 24) years. In 36 of the 39 patients in whom a limb-salvage procedure was performed, a segment of the tumor-bearing bone was excised along with the tumor, whereas in 3 patients only the subadjacent cortex was excised with the tumor. In the limb-sparing group, the reconstruction was achieved by means of attenuated tumor bone or allograft in 23 cases, by endoprosthetic replacement in 9 cases, and by allograft replacement in 4 cases. The local resections were wide in 35 cases, and marginal in 13 cases. After marginal surgery, local recurrence occurred in 5/13 patients, whereas it occurred in 3/35 patients treated with wide resection. Pulmonary metastases developed in 6 patients, four patients died, and 2 patients are alive with disease. There were 4 cases of fractures of bone grafts. Four patients developed an infection. Long-term survival rate is 85.8%. For tumors that invaded the medullary canal there was no statistical association with local recurrence or metastasis. There is statistical significance between surgical margin and local recurrence.

CONCLUSIONSWide surgical excision alone is adequate treatment for patients with conventional parosteal osteosarcoma. A tumor-free margin remains the critical factor determining overall prognosis. When a marginal excision was knowingly done to preserve a major neurovascular bundle, the risk of recurrence was less than when it was done to shell-out a presumptively benign lesion. Repeated recurrence probably increases the risk of dedifferentiation and thereby worsens the prognosis. Recurrent lesions with multiple soft-tissue satellite nodules or involvement of the neurovascular structures may however require amputation to provide sufficient local control when a wide margin cannot be achieved. An individualized resection will be performed in the future probably under the help of the advanced technique of image to distinguish the reactive zone from the normal tissue precisely.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Osteosarcoma, Juxtacortical ; diagnostic imaging ; surgery ; Prognosis ; Radiography

Objective To investigate the potential role of angiotensinⅡ(AngⅡ)-angiotensinⅡreceptor 1 (ATRI) pathway on inflammatory activation in the lung of rats. Method Twenty four Sprague-Dawley rats were randomly divided into four groups: control group, Ang II group, AngⅡ+losartan group and losartan group. Lung wet/dry weight (W/D) was recorded to assess lung injury. The total lung homogenates were prepared to detect nuclear factor-kappa B (NF-?B) activation by electrophoretic mobility gel shift assary (EMSA), tumor necrosis factor (TNF)-?mRNA expression by reverse transcription polymerase chain reaction (RT-PCR), myeloperoxidase (MPO) and malondialdehyde (MDA) by colorimetry. Plasma yon Willebrand Factor (vWF) were assessed by enzyme-linked immunosorbent assay (ELISA). Meanwhile, pathological changes were examined under optical microscope. Results Histologically, alveolar edema, hemorrhage, and massive inflammatory cell infiltration were observed in AngⅡgroup, but not in control group and losartan group. Compared with AngⅡgroup, histological injury was lesser in AngⅡ+ losartan group. In AngⅡgroup, lung W/D, NF-?B activation, TNF-?mRNA expression, MPO, MDA and vWF were markedly higher than those in the other three groups. There were not significant differences of lung W/D, NF-?B activation, TNF-?mRNA expression, MPO, MDA and vWF in control group, AngⅡ+ losartan group and losartan group. Conclusions Systemic infusion of AngⅡcould up- regulate inflammatory mediator expression and induce lung injury in rats. AngⅡ, acting mainly through ATRI, induced inflammatory activation in the lung of rats.

Objective To study the feasibility of the measurement of the thickness of rabbit knee joint cartilage by comparing the optical coherence tomography (OCT)and the undecalcified frozen section method on respectively measure the thickness of New Zeal-and white rabbit’s knee cartilage.Methods 50 standardized cultivation,adult and male New Zealand white rabbits (100 knees) were selected in this study.The measurement point was at the knee weight-bearing area of the medial femoral condyle with a 2 milli-meter diameter trephine,and the cartilage thickness data at the same center point and ±0.5 mm from the center were obtained.OCT and freeze-sectioning method were adopted at each site,respectively.The difference between OCT and histological method was com-pared and Bland-Altman plot was constructed.Results The thickness results of the center,+0.5 mm,-0.5 mm points were (296.5± 1.6)μm,(302.6± 3.5)μm,(287.9±5.6)μm by OCT,(278.4±1.9)μm,(290.3±5.9)μm,(280.3±4.6)μm by freeze-sectio-ning method,respectively.In Bland-Altman diagram,mean difference and 95% confidence interval were 18.1 1 (1 6.65,1 9.56)μm, 12.4 (5.5,1 9.2)μm,7.4 (2.8,12.0)μm.Intra-class correlation coefficients(ICC)for resemblance between the 2 techniques were 0.93(95%CI:0.89-0.95,P <0.000 1),0.84(95%CI:0.77-0.89,P <0.000 1),0.91(95%CI:0.87 -0.94,P <0.000 1),respec-tively.Conclusion As compared with the measurement of undecalcified frozen section,OCT for the rabbits’knee joint cartilage thickness measurement is feasible with the advantages of noninvasiveness,good repeatability.OCT can provide data reference in ani-mal experiments of cartilage tissue engineering for articular cartilage defect repair.

Living with internationalization, it becomes increasingly important to develop the ability of acquiring knowledge from and publishing professional articles international medical journals.However, current English teaching in colleges is predominantly by cramming method and without clear aims.As a result, students make little learning progress.Production-oriented Approach, proposed by Professor Qiufang Wen, is an important theory to reform the modern English Teaching.Based on this theory, we designed and performed the course of Medical English Writing and Literature Reading for graduate students.For the aim of literature writing, we matched the teaching content with the pertinent language ability to achieve the goal.The process of teaching was initiated with output, followed by input, then tested by another output.As a result, students′ writing was improved effectively in correctness and in awareness of the rules.In addition, their ability to comprehend difficult and long sentences was also found to be improved.We believe Production-oriented Approach conforms to the requirements of English Teaching in college and can contribute to the teaching goal.

Objective To investigate the adjustment methods and evaluation for children after cochlear implantation. Methods 6 children after artificial cochlear implantation were debugged by subjective psychological physical test, objective methods such as electricity induced composite action potential (ECAP), electrically evoked stapedius reflex threshold (ESRT) and electrically evoked auditory brainstem response (EABR). Results All the children got satisfied data. Conclusion For the children after cochlear implantation, objective methods such as ECAP, ESRT, EABR combined with subjective psychological physical test all together are helpful to obtain accurate threshold.