Objective To discuss the safety and advantages of prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus. Methods The clinical data of patients who were admitted into our hospital from March 2013 to Janaury 2015 and received transvaginal hysteromyomectomy were retrospectively analyzed. They were divided into group A ( prone-straddle position, 30 cases) and group B (traditional lithotomy position,24 cases). The exposure of operative field, convenience of operation, time of the placement, time of operation, patient satisfaction, as well as patients’ heart rate, blood pressure, and oxyhemoglobin saturation were observed and ana-lyzed. Results Compared with the lithotomy position, there were significant differences in the time of the placement and the time of opera-tion in the patients treated by prone-straddle position. The patients with prone-straddle position cooperated well, and there was no obvious discomfort. Their vital signs were stable during the operation. The operative field during prone-straddle position exposed better and it was more convenient which make the operation became easier for both the operators and nurses. Conclusion Prone-straddle position applied in transvaginal hysteromyomectomy of the posterior wall of the uterus is safe and practicable, and it is valuable for clinical application.

Objective To analyze the changes in the protein expression profile of peripheral blood mononuclear cells in systemic lupus erythematosus patients. Methods Peripheral blood was obtained from SLE patients and healthy controls, then mononuclear cells were isolated and the total protein was extracted by one-step method. Two-dimensional gel electrophoresis was performed and then stained with silver. Protein maps were analyzed and differentially expressed protein spots were detected using ImageMaster 2D Platinum 5.0 software. Results Match rates of (71±4)% and (72±4)% was obtained from gels from controls and pati-ents respectively. 791±17 spots were detected from control gels and 781±17 from patient gels. Eleven protein spots were up-regulated and 9 were down-regulated in SLE patients. Five proteins were identified by MS analysis, some of which had previously been shown to play a potential role in the pathogenesis of SLE. Conclusion There are significant changes in the protein expression of peripheral blood mononuclear cells in systemic lupus erythematosus patients. This study could be used as a preliminary work for better understanding of the pathogenesis and immune regulation pathways of SLE from an integrated lymphocyte protein profile perspective.

Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.

Objective To study the expression and clinical significance of MMP-2 and MMP-9 protein and their relationships in human gastric carcinoma. Methods MMP-2 and MMP-9 protein expression were examined by two-step immunohistochemistry in 96 cases of human gastric carcinoma and paracancerous normal tissue. Results The expression rate of MMP-2 and MMP-9 in gastric carcinoma tissue was 72.9 %(70/96)and 66.7 %(64/96) respectively, which was significantly higher than those in the normal tissue (30.2 % and 31.3 % respectively, P<0.001). The expression of MMP-2 and MMP-9 was significantly correlated with site, depth invaded,TNM stage and lymph node metastasis of gastric carcinoma (P <0.05), and not with age, sex, size, histological differentiation of gastric carcinoma(all P>0.05). Conclusion There are close relationships between the expressions of MMP-2, MMP-9 in gastric carcinoma and pathological characteristics in clinic metastasis and prognosis. They may be used as important indexes to judge the biological behavior and prognosis of gastric carcinoma.

Objective To investigate whether ligustrazine can reduce endotoxemia and inhibit the increase of lipopolysaccharide (LPS)-induced vascular permeability by suppressing Rho/ROCK signaling pathway in guinea pigs. Methods Eighteen of white male healthy guinea pigs were divided into three groups randomly and pretreated with intravenous injection of ligustrazine(3 or 6 mg/kg) or saline. 30 min later, LPS (100, 300, 1 000 μg/0.1 mL/site) and saline (0.1 mL/site) were administered intracutaneously at the dorsum of guinea pigs. Vascular permeability was determined by leakage area and absorbance of 610 nm (OD610) of Evans Blue dye after intracutaneous injection of LPS (100-1 000 μg/site). Results Dye leakage in the skin began to increase at 5 min, and revealed significant increase 2 h after LPS injection. Significant differences in the dye leakage area(F = 5.77, P < 0.05) and the OD610 (F = 7.736, P < 0.05) induced by 100, 300 and 1,000 ug/site of LPS administration were demonstrated between the control and ligustrazine groups (3 or 6 mg/kg). Conclusion Ligustrazine has protective effect on the hypermeability of endothelial cells induced by lipopolysaccharide, and inhibition of Rho/ROCK signaling pathway is a possible mechanism.

This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130+/-50 min and the time of two-level surgery was 165+/-53 min on average (from skin incision to skin suturing). Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68 degrees (3.6 degrees -6.1 degrees ) in flexion and extension position and 3.51 degrees (2.5 degrees -4.6 degrees ), 3.42 degrees (2.6 degrees -4.3 degrees ) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

In order to provide anatomical basis for transoral approach (TOA) in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults' fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2+/-3.5 mm and 39.3+/-3.7 mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1+/-5.2 mm and 50.2+/-4.6 mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0+/-2.9 mm and 24.0+/-3.5 mm respectively, and the distance of bilateral axis screw inserting points was 18.0+/-1.2 mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces: mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.
Atlanto-Axial Joint/*anatomy & histology ; Atlanto-Axial Joint/*surgery ; Bone Plates ; Bone Screws ; Cadaver ; Cervical Vertebrae/*anatomy & histology ; Cervical Vertebrae/surgery ; Equipment Design ; Internal Fixators ; Joint Prosthesis ; Models, Anatomic ; Odontoid Process/*surgery ; Prosthesis Design

Objective To investigate the application value and quality control of breast cancer cells PR,ER C-erbB-2,P53,Ki67 expressions in the patients with breast cancer.Methods The specimens were obtained by the fine needle aspiration cytological smear or intraoperative imprint cytology.The biological expressions of ER,PR,C-erbB-2,P53,Ki67 were detected by the immuno-cytochemical staining,the detection results with those detected by the immunohistochemical staining were performed the compara-tive analysis.Results The biological expressions of ER,PR,C-erbB-2,P53,Ki67 in 53 cases of breast cancer were 73.56%, 58.49%,56.60%,68.63%,81.13% respectively;ER,PR,C-erbB-2,P53,Ki67 had no statistical significant differences in positive cases and positive intensity between the immunocytochemical staining and the immunohistochemical staining (P >0.05).Conclusion The immunocytochemical staining can replace the immunohistochemical staining and has the important significance in the preop-erative diagnosis of breast cancer,therapeutical scheme selection and prognosis judgment.The whole process quality control is the key to do the breast cancer immunocytochemical staining well.

Objective To investigate the infection status of HIV/AIDS patients complicated with pneumocystis Carinii Poneumonia(PCP),and the role of CD4+ T lymphocyte in PCP.Methods PC was detected by Giemsa's staining and CD4+ T lymphocyte was counted by flow cytometry.Meanwhile,this text calculated and compared a series of indexes about PC infection,such as the total positive rate,the average annual positive rate,the average monthly positive rate,the positive rate between female and male,the positive rate between sputum and BALF specimens,and the relationship between the positive rate and CD4+ T lymphocyte count.Results The total positive rate about PC infection of the 1 806 eases of sputum specimens was 46.8％,and the incidence mainly from April to July during a year,and the positive rates were 46.3％ and 50.2％ for males and females respectively.The results showed that there were no significant differences when compared with the average annual positive rate ( P ＞ 0.05 ),but there were significant differences when compared with the average monthly positive rate ( P ＜ 0.05 ),the positive rate between female and male(P＞0.05),and among 3 formerly defined ranges of CD4+count(P ＜0.05).Conclusion Giemsa's staining showed the total positive rate was 46.8％ of the HIV/AIDS patients infected by PC with sputum specimens,which represented a seasonal fluctuation tendency.The positive rate of BALF was higher than that in sputum,and it increased with CD4+ count decreasing.Giemsa's staining was an efficient,simple and feasible way for PC detection and easy for generalization.Meanwhile,it is strongly relied on the operator's experience and skill.

Objective To investigate the effects of zoledronic acid on the expression of HIF-1α and VEGF in osteosarcoma LM8 cell line under hypoxic condition. Methods The hypoxic culture model was established. After LM8 cells were treated with zoledronic acid, semi-quantitative PCR was used to assess the expression of HIF-1α and VEGF mRNA. The expression of HIF-lct and VEGF protein was de-tected by immunohistochemical staining and ELISA respectively. Results Compared with cells in normoxic conditions, cells in the hypoxic environment and cells treated with zoledronic acid in the hypoxic condition did not show a significant change in the mRNA level of HIF-1α(P >0. 05). However, the protein expression of HIF-1α was markedly decreased in the cells treated with zoledronic acid in the hypoxic envi-ronment. In contrast, both mRNA and protein expression levels of VEGF were down-regulated in the zoledronic acid treatment hypoxic group (P <0.05). Conclusion Under hypoxic conditions in vitro, zoledronic acid inhibited the expression of HIF-1α protein, which decreased VEGF mRNA level and protein expression in osteosarcorna LM8 cell line.