Objective To construct pcDNA3.1 RASSF1 eukaryotic vector and observe the influence of RASSF1 on the apoptosis of hepatocarcinoma cell line HepG2. Methods RASSF1 gene was amplifled from human RASSF1 cDNA by polymerase chain reaction (PCR) and cloned into pcDNA3.1. The recombinant plasmid pcDNA3. 1 RASSF1 was transfected into hepatocarcinoma HepG2 cell line. The expression of RASSF1 was examined by Western blot. The influence of RASSF1 on the cell apoptosis was measured by Annexin V/PI assay. Results DNA enzyme digestion and sequencing results showed that recombinant plasmid pcDNA3. 1-RASSF1 was successfully constructed. RASSF1 protein was overexpressed in HepG2 cell line transfected with pcDNA3. 1-RASSF1 plasmid. The apoptosis rate of blank, pcDNA3. 1 and pcDNA3. 1-RASSF1 group was (5.8 ±0.42)%, (7.48 ±0.68)% and (35. 1 ±3. 15)%, respectively.Conclusion The pcDNA3. 1- RASSF1 eukaryotic vector was successfully constructed, RASSF1 protein overexpression could induce apoptosis in HepG2 cell line.

Objective To investigate the change of gene rstn expression in brain tissues following traumatic brain injury (TBI). Methods A total 90 SD rats were involved in the study and divided into normal control group (5 rats), sham operation group (10 rats), mild, moderate and severe trauma groups (25 rats per group). Rat model was made with sap pressure clash method and RT-PCR assay was employed to detect expression change of gene rstn at 3, 6, 24, 72 h and 1, 2, 4 weeks after TBI. The change of peripheral blood glucose concentration was measured in moderate trauma group to observe its relationship with gene rstn expression in brain tissue. Results Postoperative expression of gene rstn was increased in severe trauma group at 24 hours, in moderate trauma group at 72 hours and in mild trauma group at four weeks (P＜0.05). The expression of gene rstn was increased in hippocampus, thalamus and cortex of all trauma groups at four weeks postoperatively, when the hippocampus showed the highest expression while the thalamus showed the least (P＜ 0.05). Moreover, the expression of gene rstn showed high level in injury side but low level in contralateral side in different districts (P ＜ 0.05). The expression of gene rstn was increased the most obviously in severe trauma group (P ＜0.05). Peripheral blood glucose concentration showed a linearity positive correlation with gene rstn expression in brain tissue (R=5.32,P＜0.05). Conclusions Expression of gene rstn shows obvious increase after TBI, and the time course correlates with the injury severity. The gene rstn expresses the most in the ipsilateral hippocampus. There shows a certain correlation between gene rstn expression and peripheral blood glucose concentration in brain tissues after TBI.

Objective To explore the feasibility and evaluate its efficacy of transnasal marsupialization of maxillary cyst under nasal endoscope. Methods 15 cases of maxillary cyst were treated by endoscopic marsupialization in nasal. According to the situation of maxillary cysts, the fenestration of bottom nasal was opened in 6 cases, the fenestration of inferior nasal meatus was opened in 7 cases and inferior nasaI meatus was opened through the prelacrimal duct recess in 2 cases under the nasal endoscope. With partial removal of the cyst wall, the cyst and maxillary sinus was fused into a cavity if necessary. This ensured nasal drainage through the cyst cavity and nasal cavity or maxillary sinus. Results The operations of the 15 patients were success without complications. All patients were followed up for 6 to 24 months after operation. Operation cavity to complete epithelization in 2 to 3 months, the cyst cavity drained well with no recurrence. Conclusion Endoscopic marsupialization in nasal is a feasible alternative for management maxillary cyst. It makes the procedure simple, less traumatic, quick recovery, definite curative effect and low recurrence rate.

Objective To investigate the perioperative risk of deep vein thrombosis (DVT) in patients with hepatic cirrhosis that underwent total hip arthroplasty (THA), and to evaluate the safety and feasibility of individualized anti-coagulation treatment.Methods There were 25 patients complicating hepatic cirrhosis that underwent THA (from Jan.to Dec.2014), including 17 males and 8 females, aged 57.9t9.2 years.The primary causes of THA were avascular necrosis of the femoral head (eighteen cases) and osteoarthritis of the hip (seven cases).Low molecular weight heparin (LMWH) was applied for anti-coagulation treatment.Parameters of hepatic function and coagulation function of THA cases (randomized thirty cases, from Jan.2008 to Dec.2008) without hepatic cirrhosis were used as reference for monitoring.For the cases of massive blood loss or upper gastrointestinal hemorrhage, a LMWH administration pause and an administration of fresh frozen plasma and clotting factors were performed in order to maintain a hemorrage/coagulation balance.The clinical outcome of the hip joint was evaluated and complications were treated.A subsequent follow-up was also carried out after perioperative period.Results All cases received successful surgeries and followed up.The follow-up duration was 34± 15.7 months.The preoperative Harris hip score was 32.4± 10.2 points, while the most recent follow-up score was 82.9±6.1 points, which was statistically significant.Dislocation, periprosthetic fracture and periprosthetic infection were absent.All cases received individualized anti-coagulation treatments during peripoerative period.A hemorrage/coagulation balance was achieved.The dynamic parameter curves did not present excessive deviation from reference.One case encountered intermuscular hematoma of the lower limbs 48 hours postoperatively, which was solved by a LMWH pause and administration of fresh frozen plasma and clotting factors.One case suffered upper gastrointestinal hemorrhage five days postoperatively, which was controlled by a LMWH pause and the administration of somatostatin and proton pump inhibitor.Jaundic got worse in one case three days postoperatively but got relieved after treatment.Overt blood loss was 686t141.8 ml.Perioperative death, hepatic failure, hepatic encephalopath, hepatorenal syndrome were absent.No DVT was observed.Conclusion There are risks of DVT in patients of hepatic cirrhosis.Individualized anti-coagulation treatment is needed during perioperative period of THA.

BACKGROUND:It is the key point to choose the right size of the prosthesis, and grasp the direction and thickness for osteotomy during total knee arthroplasty. In order to achieve the goal, accurate preoperative planning is very important.
OBJECTIVE:To compare the accuracy of preoperative templating in total knee arthroplasty using conventional two-dimensional (2D) and computed tomography (CT)-based three-dimensional (3D) procedures (templating on 3D image&surgical rehearsing on rapid prototype technology-models), and to confirm the necessity of 3D evaluation for preoperative planning.
METHODS:A total of 25 patients undergoing primary total knee arthroplasty were randomly selected, including 10 males and 15 females, at the age of 58 and 79 years old. 2D and 3D images were col ected from al patients. Preoperative templating was performed for each total knee arthroplasty using both conventional 2D radiographs and a CT-based 3D image model. Accuracies with regard to the predicted and actual implant sizes were determined for each procedure.
RESULTS AND CONCLUSION:The 3D procedure was found to be more accurate in predicting implant size of 80%femoral and 72%tibial components than those of the 2D procedure (4%femoral and 12%tibial components). Significant differences in the consistent rate of femoral and tibial prosthesis models were detected significantly (P<0.05). Kappa coefficient statistics demonstrated that goodness of fit of prosthesis model was good in 3D preoperative templating. Results confirmed that the superiority of 3D preoperative templating over 2D conventional evaluation is in predicting implant size, and provides more comprehensive information on skeletal anatomy.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.