BACKGROUND: Currently,the research of posterior cruciate ligament (PCL) construction mainly focuses on the surgical technique or graft selection. However,studies on vascular regeneration after construction are few,especially those on allograft construction. OBJECTIVE: To observe the effect of vascular endothelial growth factor (VEGF) on vascular regeneration of reconstructed PCL with femur-anterior cruciate ligament (ACL)-tibia allograft in rabbits. DESIGN,TIME AND SETTING: The factorial design experiment was performed at the Orthopedics Laboratory of the Third Affiliated Hospital of Weifang Medical College from March 2006 to September 2007. MATERIALS: Sixty-eight adult female Japanese white rabbits,weighing (3.3?0.1) kg,were adopted. Twenty-three of them were used to excide the femur-ACL-tibia complexes to establish the animal model of PCL reconstruction with allograft. METHODS: Forty-five rabbits were randomly divided into 3 groups,15 rabbits in each group. In the control group,no additional treatments were applied. In the phosphate-buffered saline (PBS) group,0.2 mL of PBS was injected into the knee joint. In the VEGF group,30 ?g VEGF mixed with 0.2 mL PBS was injected into the knee joint. MAIN OUTCOME MEASURES: The immunological rejection of allograft was observed after reconstruction. Five rabbits were randomly selected in each group at 3,6,12 weeks,respectively,for immunohistochemistry staining; and the microvessel density of the medio-one-third ligament part of allograft was evaluated with the Chalkley scoring method. RESULTS: Forty-five rabbits were involved in the result analysis. There were no hydrops articuli or aneretic cartilage when every rabbit’s knee joint was opened. The gross morphology of the grafts was similar to normal posterior cruciate ligament. Immunological rejection,such as degeneration,necrosis,dilapsus or defluxion was not appeared. Plenty of good vascular tissue in the arthrosis could be seen in the VEGF group,but could not be found in the control group or in the PBS group. The microvessel density score of the allograft in the VEGF group was higher than that in the control group and PBS group (P

Objective To investigate the effect of extracorporeal shock waves (ESWs) combined with expanding bone marrow autografts in treating nonunion of femoral shaft fractures with interlocking intramedullary nails.Methods Thirty patients with femoral shaft fractures which had not united were divided into an ESW group,an expanding bone marrow group,and a combined treatment group using a table of random numbers.Each group had 10 cases.In the ESW group,no expanding bone marrow was employed in fixing the intramedullary nails and ESW therapy was begun at day 14 after the operation.In the expanding bone marrow group,bone marrow was grafted around the broken ends of fractured bones.In the combined treatment group patients underwent both treatments.The conditions of the callus and the fracture lines in the 3 groups were separately evaluated using X-rays at the 4th,8th,12th and 16th week after the operation.Results At week 4,the average callus and fracture line scores in the combined treatment and expanding bone marrow groups were significantly better than those in the ESW group.At the 8th week after the operation,the average callus and fracture line scores in the combined treatment group were significantly higher than in the ESW group and expanding bone marrow groups.Later,the callus and fracture scores in all 3 groups continued to rise significantly.At the 12th and 16th week the scores in the combined treatment group were significantly better than those in the ESW group and the expanding bone marrow group,while the scores in the ESW group were significantly better than those in the expanding bone marrow group.The cure rates in the ESW,bone marrow and combined treatment groups were 60％,50％ and 100％ respectively at week 16.Conclusions The combined treatment was significantly more effective than either treatment alone.There was no significant difference in effectiveness between the ESW and expanding bone marrow treatments.ESW combined with expanding bone marrow autograft is an effective way to promote bone knitting in the treatment of nonunion of femoral shaft fractures with interlocking intramedullary nails.

ObjectiveTo investigate the clinical significance of determination of 20S proteasomal activities changes in circulating white blood cells (WBC) in patients with advanced gastric carcinoma.MethodsThe 20S proteasomal activities in circulating WBC separated from 80 patients with advanced gastric carcinoma were determined by 20S proteasome assay kit; the concentrations of interleukin-6(IL-6) in plasma were determined by radioimmunoassay method.The result was compared with that of 11 healthy volunteers.ResultsThe proteasomal activities in circulating WBC[(38.26 ±9.23),(101.85 ±27.63)pmol AMC/ ( s *mg pro) ] and concentrations of IL-6 [ (23.89 ± 6.76),(72.52 ± 20.71 ) ng/L ] of healthy volunteers and the patients with advanced gastric carcinoma had statistical significance (P ＜ 0.01 ).The proteasomal activities and the concentration of IL-6 were correlated with age,pathological type,weight changes,Karnofsky score and disease severe degree(P ＜ 0.01 );while they had no relationship with sex(P ＞ 0.05).Cox's proportional hazard regression model demonstrated that pathological type,Karnofsky score and proteasomal activities were the independent risk factors affecting the survival of patients with advanced gastric carcinoma (P ＜0.01 or ＜0.05).20S proteasomal activities and the concentration of IL-6 had positive correlation (r =0.691,P =0.000).ConclusionsThe proteasomal activites in circulating WBC and the concentration of IL-6 in plasma increase and are correlated with age,pathological type,weight changes,Karnofsky score and disease severe degree.Proteasomal activities in circulating WBC can be used as the prognostic reference factor of advanced gastric carcinoma.20S proteasomal activities and the concentration of IL-6 have positive correlation.

Objective To study whether transient overexpression of tumor suppressor gene PTEN could lead to growth suppression and up-regulate the sensitivity to doxorubicin of human breast cancer MCF-7 cells. Methods The eukaryotic expression plasmid pEGFP-C 1-PTEN containing whole cDNA of PTEN was constructed and transfected into MCF-7 cells by Lipofectamine 2000 in vitro. Growth inhibition of the cells was observed by phase contrast microscope and flow cytometry. The clonogenic cell survival ability was studied by clony forming assay. MCF-7 cells′ chemosensitivity to adriamycin was studied with MTT assay. Results PTEN overexpression led to morphological changes characteristic of apoptosis of MCF-7 cells. PTEN overexpression also resulted in a significant increase in G 0/G 1 cell population (14.79%) and apoptosis (10.60%) detected by flow cytometry. The clonogenic survival rate of cells transfected with PTEN was significantly decreased after doxorubicin treatment compared with control. The transfected cells were more sensitive to doxorubicin compared with the control cells ( ? 2=8.59 , P

70%). TCD monitored the microembolic signals (MES) and cerebral blood flow of middle cerebral artery (MCA) using M-Mode before, after and during CAS. TCD and color ultrasound duplex were examined and new vascular events recorded during the following-up. Results Except a large numbers of MES arising from the recent contrast injection, the most MES were detected during the phase of predilation (MES number=116) and stent placement (MES number=135, 91, 113, 90, 106, 125). The MES count during the phase of postdilation was relatively reduced (MES number=8, 14, 37, 16). The most MES were characterized by high intensity and over-loading in TCD spectrum. MCA blood flow velocity varied predominantly in phases of predilation (Vsys/Vmean=46/31 to 76/54) and postdilation (Vsys/Vmean=40/26 to 74/49, 0/0 to 114/69, 35/24 to 116/71, 50/36 to 137/86). MES recorded in 2 patients prior to CAS disappeared in post-procedure. MCA blood flow velocity was enhanced or MCA pulsative index increased after CAS. No complications occurred. Tissue debris was collected in one filter device. During 3 to 19 months following-up, only one patient had a new vascular event of cerebral infarction located in the contralateral side of the CAS. Conclusions TCD monitoring might evaluate the microemboli and cerebral blood flow before, after and during CAS with filter devices. Filter devices might reduce embolization by preventing the bigger particulate microembolism into the distal part of the cerebral vessel without influencing cerebral blood flow. The gaseous and the smaller particulate microembolism unfiltrated should not result in clinical symptoms in most cases.

Objective To evaluate the method and effect of double-bundle posterior cruciate ligament (PCL) reconstruction using bone-semitendinosus and gracilis tendons under arthroscope.Methods The data of 16 patients was reviewed,who had underwent arthroscopic PCL reconstruction using the bone-semitendinosus and gracilis tendons from March 2004 to March 2007.A special technique using trephine was allowed for the cylindrical bone plugs attached to the semitendinosus and gracilis tendons.The femoral double-tunnel and the tibial tunnel were prepared,and the adequate press-fit fixations of tendon grafts were ensured within them.Results All patients were followed up.Before operation,the mean Lysholm score was 57 points (43-65 points).While 12 months later after operation,the mean Lysholm score was 86 points (68-92 points).The excellent and good results were obtained in 87.5%.Conclusions Arthroscopic PCL reconstruction using bone-semitendinosns and gracilis tendons can effectively improve the stability of the knee joint.The key to achieve a good treatment is that precise positions of femoral and tibial tunnels in operation and systematic rehabilitation trainings after operation were performed.

Objective To study the relationship between the risk of malignant tumor and occupational radiation factor among medical diagnostic X-ray workers in Jiangsu province.Methods The retrospective and prospective cohort studies were adopted to investigate the incidence of cancer.Eligible medical diagnostic X-ray workers from the department of radiology in hospitals were selected and assigned into exposure group,while other medical workers from the departments of Internal Medicine,Ear-NoseThroat (ENT) or Pediatrics who attended work at the same period in the same hospital but not engaged in radiation work were regarded as control group during 1950-2011 in Jiangsu province.We calculated the total person-year and analyzed the relative risk (RR) of malignant tumor using Poisson regression model.Results 7 703 participants (3 961 in exposed group and 3 742 in unexposed group) were recruited and followed up,with a total of 315 309 person years and the lost follow-up rate was 6.92％ (533/7 703).During the follow up period,a total of 819 tumor cases were identified (771 were malignant tumors).We found the significant relationship between the risk of malignant tumor and occupational radiation factor,and the RR of solid cancer and total malignant tumor were 1.31 (95％ CI:1.11-1.55) and 1.33 (95％ CI:1.13-1.57),respectively.In addition,the risk of lung cancer in medical diagnostic X-ray workers was significantly higher than that in control group (RR =1.45,95％ CI:1.00-2.09).Conclusions The incidence risk of lung cancer,solid caner and total malignant tumors in medical diagnostic X-ray workers was significantly higher than that in the control group,which might be associated with occupational exposure to ionizing radiation.

Objective To continue following up the cohort members in Jiangsu province who were the largest subgroup in Chinese medical X-ray workers cohort subgroups on radiation carcinogenesis and analysis the cancer risk of medical X-ray workers which might be induced by chronic low-dose ionizing radiation between 1997 and 2011.Methods A retrospective cohort study was utilized to accumulate data.Epicure was applied to compute cumulative person years (with module of Datab) and relative risk (including 95％ CI) of malignant tumor on exposed group(with module of AMFIT) while the factors such as sex and attained-age were adjusted in the cohort members.Results The 7 708 follow-up members included 3 668 medical X-ray workers.The cumulative person-year in the cohort members was 94 651.2 (1997-2011) and its lost rate was 5.79％.During the follow-up period,441 cases had became cancer patients.The relative risk of all cancers was 1.44 (95％ CI:1.18-1.75),so was the solid cancers.Significant elevated risks of cancer were found on lung (RR =1.95,95％ CI:1.30-2.92),esophagus (RR =3.04,95％ CI:1.20-7.70),lymphoma(RR =2.24,95％ CI:0.67-7.48),leukemia(RR =1.57,95 ％ CI:0.33-7.39),throat (RR =2.47) and thyroid (RR =2.80,95 ％ CI:0.24-32.26) among medical X-ray workers.However,The RR of malignant tumors might not be associated with occupational exposure to ionizing radiation if we considered the lost factors (RR =1.2,95％ CI:0.94-1.46)Conclusions The RR of malignant tumors such as the cancer on lung,esophagus,thyroid among the medical X-ray workers in Jiangsu province were enhanced which might be associated with occupational exposure to ionizing radiation.

Objective To ascertain the frequency distribution of CT examinations in children.Method A wide range of information was collected through the radiology information system (RIS),including ID,sex,birth date,examination time,the examined part of body and other relevant ones related to children who underwent CT examinations between Jan 1,2012 and Dec 31,2012.The SAS software was used for data processing and statistical analysis.Results A total of 1 542 children underwent 1 670 examinations,of which 67％ were male.Head CT examination was the most frequent,accounting for 71.9％ of all CT examinations,and followed by the abdomen/pelvis examinations.The number of examinations of children undergoing the repetitive examination accounted for 6.4％; 51.7％ of the examinations was for trauma.The positive rate of CT examination was 51％,dependent upon the age and examined body parts to some extent.The younger patients had lower positive rate,and the positive rate of head CT examination was lower than those in other parts.Conclusions To reduce the possible cancer risk to be induced by the ionizing radiation from CT,justification of CT examination should be considered for children.

Objective To study the epidemiological status of reproductive health related behaviors of out of school adolescents in Kunming and Shenzhen City,and to explore the social-psychological influencing factors of the behaviors.Methods A cross-sectional study was conducted in 410 out of school adolescents aged 15-24 years who were recruited with accidental sampling.All the subjects were required to complete a self-administrated questionnaire.Single factor Chi-square analysis and multi-factor Logistic method were used for data analysis.Results The correct respondent rate of the questions on reproductive health knowledge among the adolescents was low.The sexual intercourse rate was 42.9％ (176/410).Nearly 44.9％ (79/176) of the adolescents who had sexual experience did not use condom in the latest sexual intercourse,and those who had no less than one sexual partner accounted for 48.9％ (86/176).The prevalence of genital discomfort and sexual transmitted disease was 48.8％ (200/410) and 2.9％ (12/ 410),respectively.Chi-square test showed that marriage,living statue,behaviors of holding hands,kiss,caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort(x2 values were 4.667,10.862,10.032,15.619,17.423,28.239,17.817 and 21.369,respectively ; all P ＜ 0.05).In binary Logistic analysis,living in a dormitory or with other people,behaviors of caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort (odds ratio (OR) was 0.449 (95％ CI:0.216-0.933),0.377 (95％ CI:0.147-0.967),4.364 (95％ CI:1.594-11.949),0.312 (95％ CI:0.111-0.877) and2.646 (95％ CI:1.417-4.941),respectively ; all P ＜ 0.05).Conclusions The status of reproductive health was poor among out of school girls in kunming and Shenzhen,and living status,behaviors of caress the body,sexual intercourse and having no less than one sexual partner could influence the prevalence of genital discomfort.Comprehensive measures should be taken to strengthen the reproductive health management in this population.