BACKGROUND:Double inferior vena cava (DIVC), usually found at routine autopsies, is rare in the clinic. It has been described in numerous reports over the years since Adachi first depicted it in 1940. But all these reports were based on two-dimensional (2D) observation, and no three-dimensional and animated images reported. OBJECTIVE: To observe and establish the digital visible models of the structure of DIVC of the Virtual Chinese Human Male (VCH-M) Ⅲ.DESIGN: Repetitive measurement design by taking VCH-M Ⅲ as the subjects.SETTING : Department of Traumatic Orthopedics and Anatomy, Nanfang Hospital Affiliated to Southern Medical University.MATERIALS: The experiment was conducted in Southern Medical University from February 2006 to May 2006. The cross-sectional images of fresh tissues from VCH-M Ⅲ dataset were reviewed and 1 060 serially-sectioned slices of VCH-M Ⅲ, from the 2 600th slice to the 3 660th were taken as the source for the 3D models in our study.METHODS: Cross-sectional images of fresh tissues from the VCH-M Ⅲ dataset were reviewed and the structures of the DIVC were confirmed on a section-by-section basis. 3D computerized reconstructions of DIVC and its adjacent structures were generated from these data using Arnira 3.1 (TGS) imaging software.MAIN OUTCOME MEASURES: Cross-sectional images and 3D reconstruction of VCH-M Ⅲ.RESULTS: The cross-sectional images of the VGH-M Ⅲ could fairly display the main structure of DIVC. The digitized model of brachial plexus offers unique insights into the abnormity anatomy of DIVC.CONCLUSION: The VCH-M Ⅲ dataset can provide complete and accurate data of DIVC.

Purpose:To study the expression of uPA, uPAR ,PAI 1 in 3 nasopharyngeal carcinoma cell lines CEN 2Z,CEN 2Z H5,CEN 2Z H5 9,with different ability to metastasize through lymph.Methods:RT PCR was used to detect expression of uPA,uPAR,PAI 1 at levels of mRNA.Results:mRNA expression of uPA,uPAR was the highest in CNE 2Z H5 9,whereas the lowest in CNE 2Z;mRNA expression of PAI 1was detected in CNE 2Z and CNE 2Z H5, but revealed no differences,but not in CNE 2Z H5 9.Conclusions:uPA?uPAR may promote the metastasis and invasion of NPC,whereas PAI 1 maybe inhibit it

Objective To explore the impact of TIMP 3 regulated by miR-181b as a target gene on invasion and migration of hepatocellular carcinoma (HCC) in vitro.Methods The expressions of miR-181b were detected using SYBR Green real-time fluorescence quantitative polymerase chain reaction on liver cancer specimens and on HCC cell lines.The protein expression of TIMP 3 in HCC was detected using westen blot,and SKHep-1 as a cell line expressing high miR-181b was chosen through reporter gene experiment.TIMP-3 as a target gene regulated by miR-181b and its effect on invasion and migration treated by anti-miR-181 b were studied using transwell and cell scarification test,respectively.Results The expression of miR-181b in HCC was higher than cancer-adjacent tissues and normal liver tissues.The differences among them were significant.There was a correlation between the high expression of miR-181b and invasiveness and metastasis in HCC.The protein expression of TIMP-3 in HCC was significantly lower than normal liver tissues and cancer-adjacent tissues.Expression of miR-181b mRNA was detected in various HCC cell lines such as Hep3B,HepG2,Huh 7,SKHep-1,SNU182,SNU449 and hepatocyte,with the expression of miR-181b in SKHep-1 being the highest (P＜0.01).TIMP3-3UTR was low when the expression of miR-181b was high (P＜0.05).The invasion and migration abilities of SKHep-1 were significantly inhibited by anti-miR-181b (P＜0.05).Conclusion The data suggested that miR-181b promoted invasion and migration of SKHep-1 by down-regulating TIMP-3 in HCC.

Objective To provide a new method for sacral fracture fixation by means of 3D recon-struction and reverse engineering technique. Methods Pelvis images of 3D CT scan were obtained from patients with sacral fracture. The digital data were transferred into a computer workstation. 3D models of pelvis were reconstructed using Amira 3.1 software and saved in STL format. The 3D fracture models were imported into Imageware 10.0 software. Different situations of reduction (total reduction, half reduction and no-reduction) were simulated using Imageware 10.0 software. The extract locations and the best directions of inserting iliosacral lag screws were defined using Reverse Engineering according to the 3 situations to before navigation templates were designed according to the posterior anatomic features of the ilium and the insertion channels. Exact navi-gational templates were manufactured by rapid prototyping. Drill guides were sterilized and used intraoperatively to assist surgical navigation and placement of iliosacral lag screws. Results Accurate screw placement was confirmed with postoperative X-ray and CT scanning. The navigation templates were found to be helpful and highly accurate. Conclusion The navigation template may be a useful method for mini-invasive fixation of sacroiliac joint fracture.

Objective To explore the safe bone channels for transverse placement of sacroiliac screws via the second sacral vertebra in the fixation of longitudinal fracture of the sacrum by digital analysis and clinical observation.Methods Firstly,abdomen CT scanning was performed in 50 healthy adult volunteers.They were 30 males and 20 females,aged from 18 to 56 years (mean,34.6 years).After their CT images were transformed by software Materialise Mimics Innovation Suite 15.0,three-dimensional (3D) models of the pelvis were generated,stored in stereolithography format,and transferred into software Imageware 12.0.In the standard antero-posterior position,the sacrum was segmented and the points of 2D image coordinate geometric boundary were extracted to generate an optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra.Secondly,we admitted 10 patients with longitudinal fracture of the sacrum.They were 7 men and 3 women,aged from 20 to 51 years (average,38.3 years).By Tile classification,4 cases were type B2 and 6 type C1.All the fractures were Denis region Ⅱ ones.Pubic ramus fracture was complicated in 3 cases.After traction reduction of the tibial tubercle was conducted for patients with obvious displacement,the optimal channel was calculated on the basis of the CT data.On the lateral images of the sacrum acquired before operation by C-arm fluoroscopy,the optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra was located.After the skin was marked,2.5 mm Kirschner wire was drilled and the 6.0 mm hollow screws were fixated along the Kirschner wire.Postoperative CT scanning images and 3D reconstructed models were analyzed to validate the accuracy of screw placement.Results The projection of safety bone channel on the sagittal fluoroscopy of S2 vertebral body displayed an irregular water drop shape;the projection area in males (213.9 ± 52.4 mm2) was significantly larger than that in the females (171.6 ±49.6 mm2) (P ＜ 0.05).The average length of the channel in men (135.2 ± 12.9 mm) was significantly longer than that in women (121.1 ± 10.1 mm);the average diameter of the screw in men (10.2 ± 0.9 mm) was also significantly larger than that in women (9.1 ±0.8 mm) (P ＜ 0.05).The postoperative X-ray and CT scanning images showed satisfactory positions and lengths of the screws.The screw lengths averaged 98.2 mm;the operation time averaged 25.6 min.No nerve or vascular injury,loosening or breakage of the sacroiliac screws occurred in the patients.Follow-ups for 12 to 24 months revealed no other complications.Conclusion The safety channel for transverse placement of sacroiliac screws via the second sacral vertebra can be determined using the lateral 3D reconstruction images of the sacrum in preoperative planning,which facilitates the percutaneous transverse fixation of longitudinal fracture of the sacrum.

Objective With a computer-assisted program,retinal vascular calibers were measured quantitatively.In this study the relationship between retinal vascular calibers and components of the metabolic syndrome was examined.Methods A total of 450 hypertensive patients were collected.Medical history,physical examination,blood tests,and retinal photographs were taken.Retinal vascular calibers were measured quantitatively from digital retinal photographs.In the hypertensive population the associations of retinal vascular calibers with components of the metabolic syndrome were described,and the factors that influenced retinal vascular calibers were analyzed.Results In the enrolled population,mean age was (57.53 ± 10.01) years,mean systolic blood pressure (138 ± 17) mm Hg(1 mm Hg =0.133 kPa),diastolic blood pressure (84 ± 10) mm Hg.Mean central retinal arteriolar equivalent(CRAE) was(129.26 ± 12.68) μm,and mean central retinal venular equivalent (CRVE) (198.25 ± 18.37) μm.After adjusting for age,gender,etc,CRAE in group with poor blood pressure control was smaller than that in the group with good blood pressure control [(126.45 ± 15.74) μm vs (130.30 ± 11.30) μm,P =0.029].CRAE tended to be narrower with worsened blood pressure control (P =0.075).CRVE was smaller in patients with normal high density lipoprotein-cholesterol (HDL-C) than in those with abnormal level [(197.36 ±17.62) μm vs (203.07 ± 21.52) μm,P =0.040].The diastolic blood pressure was raised along with the decreasing CRAE(P=0.009).And the HDL-C level was reduced as CRVE was increasing(P=0.042).Old age (r =-0.090,P=0.013) and poor blood pressure control(r=-0.098,P=0.038) were independent risk factors for narrow CRAE,while lowered HDL-C (r =0.105,P =0.024) and smoking (r =0.141,P =0.010) were independent risk factors for wide CRVE.Conclusions Narrow CRAE was related to poor blood pressure control,while wide CRVE was related to lowed HDL-C.Aging and poor blood pressure control were independent risk factors for narrow CRAE,while lowed HDL-C and smoking were independent risk factors for wide CRVE in the hypertensive patients.

Objective To establish a breeding method ofMyodes rufocanus in the laboratory,collect their growth and reproduction data,and provide a basis for carrying out the experimental animalization.Methods Wild Myodes rufocanus caught in the Moranbong woodland were brought back to the laboratory.They were bred artificially in a large hard wall rodent negative pressure isolator.Their growth and reproduction data were recorded for evaluating the results of breeding.Results The Myodes rufocanus were successfully bred in the laboratory.The pregnancy rate was 54.55%.The average pregnancy length was 20.4 days(8 to 22 days).During one breeding period,they gave birth 2.9 times on average.The maximum number of births was 7 times,far more than the number tested under field conditions.The average litter size was 4.3±1.22.The highest litter number of a single nest was 8.The weaning rate of pups was 94.8%.The growth and development of pups were good.Conclusions The breeding method for Myodes rufocanus is established.The growth and reproduction data are tested too.The results of our study laid a foundation for the experimental animalization of Myodes rufocanus.

Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.

Objective Grey red-backed voles (Myodes rufocanus) are agile, fierce and hard to catch, thus, it is difficult to judge their gender by external appearance, especially for the juvenile voles. Therefore, it may cause difficulties to their allocation and later breeding in laboratories. The aim of this paper is to establish a rapid, simple and accurate method for gender identification of grey red-backed voles. Methods Fresh hair follicles were taken from 6 adult male voles, 3 adult females and 14 4-week-old juvenile voles, 5 male and 5 female 9-week-old Wistar rats, and 5 male and 3 female 6-week-old BALB/c mice. The genomic DNA was extracted using Chelex-100 resin and the zinc-finger Y/X gene (ZFY/ZFX) and the gene of sex-determining region of the Y (SRY) chromosome were amplified by PCR, and a double PCR amplification method was established. Results The ZFY/ZFX gene and SRY gene were simultaneously amplified from the male voles, while only the ZFY/ZFX gene was amplified from the females. The gender of all 23 voles, 10 Wistar rats and 8 BALB/c mice were correctly identified with this method, and the PCR results were consistent with the phenotypic and autopsy results. Conclusions Using fresh hair follicles as experimental materials for gender identification of grey redbacked voles can alleviate shock and damage to the animals. The established double PCR amplification method is accurate, simple, rapid, and deserves to be used for gender identification of grey red-backed voles.

Objective To provide a method to modify accurately the Reverdin osteotomy template for hallux valgus using 3D reconstruction and printing.Methods From June 2015 to June 2016,11 patients (16 feet) with hallux valgus at our departments underwent weight-bearing X-ray examination and continuous spiral CT scanning of the feet.The outer turning angle of hallux averaged 33.50° ± 6.80°,the first intermetatarsal angle 12.20°± 2.90° and the distal metatarsal articular angle 15.20°± 2.60°.Their imaging Dicom data were imported into Materialise Mimics Innovation Suite v16.0 software for generation of 3D models of the pelvis which were then stored in stereolithography format and imported into Imageware 12 software.After optimal templates were reversely rebuilt to have the best angles and range for Reverdin osteotomy in the 3D models,they were manufactured by a rapid prototyping machine.The osteotomy templates were used in surgery to guide the osteotomy of hallux valgus.Correction of hallux valgus,bone union at the osteotomy sites and weight-bearing walk were observed postoperatively.Results Accurate angles of osteotomy were confirmed by postoperative radiography in all the 16 feet.Follow-ups for 6 to 12 months showed in the 16 feet a mean outer turning angle of hallux of 7.31 °±0.33° (from 5° to 11 °) and a mean correction of 21.92°± 4.8° (from 13° to 24°).Bone union was fine at the osteotomy sites and no pain was reported during weight-bearing walk.Conclusion 3D reconstruction and printing can produce a patient-specific template for accurate Reverdin osteotomy for hallux valgus,leading to increased contact area and fine union of the osteotomy ends.