BACKGROUND:Estrogen receptor α gene polymorphisms is certainly associated with osteoporosis, but there is stil questionable for the study of risk genotypes. OBJECTIVE:To analyze the correlation between estrogen receptor gene polymorphism and bone mineral density in elderly women. METHODS: Totaly 120 healthy elderly women were enroled to extract the whole blood genomic DNA that was digested using Pvu II andXba I, the distribution and frequency of genotypes were analyzed. Meanwhile, dual-energy X-ray absorptiometry measurements of bone mineral density with the femoral neck, greater trochanter and Ward’s triangle and were done. RESULTS AND CONCLUSION:Xba I digested genotypes included the XX in 6 cases, Xx in 78 cases, xx in 36 cases;Pvu II digested genotypes included the PP in 32 cases, Pp in 50 cases, pp in 38 cases. The age, menopause age and body mass index showed no differences among the different genotypes of elderly women (P > 0.05). The bone mineral density values in the trochanter and Ward’s triangle atPvu II digested PP genotype were significantly greater than those at Pp and pp genotypes (P < 0.05); while no significant differences were found in the bone mineral density values at differentXba I digested genotypes in elderly women (P > 0.05). These findings suggest that estrogen receptor gene polymorphism has certain correlation with the bone mineral density in elderly women, P aleles has certain effect to maintain the bone mineral density of the trochanter and Ward’s triangle in elderly women.

Objective To investigate the clinical features,diagnosis and treatment of appendix tumor.Methods The clinical data of 58 cases with primary appendiceal tumor were analyzed retrospectively.Results In the 58 cases clinical presentation mimicked acute appendicitis in 22 cases,chronic appendicitis in 15 cases,appendiceal abscess in 12 cases,intra-abdominal mass in 7 cases,and gastrointestinal perforation in 2 cases.Primary appendiceal tumor was diagnosed intraoperatively by intraoperative frozen histopathological examination in 10 cases,and the diagnosis was made by postoperative histopathological examination in the other 48 cases.There was appendiceal carcinoid in 40 cases,adenocarcinoma in 6 cases,mucocele in 2 cases,mucous adenocystoadenoma in 5 cases,pseudomyxoma peritonei in 2 cases,malignant neurilemmoma in 1 case,and malignant lymphoma in 2 cases.Surgical procedures included appendectomy in 6 cases,ileocecal resection in 8 cases,and right hemicolectomy in 44 cases (including right hemicolectomy and intraperitoneal chemotherapy with 5-FU 1 000 mg for pseudomyxoma peritonei in 2 cases).Radical resection was achieved in 55 cases and palliative resection in 3 cases.The 2 cases with pseudomyxoma peritonei died of tumor recurrence at 36 months and 54 months after operation respectively.All the 5 cases of adenocystoadenoma and 2 cases of appendix cyst survived without an evidence of recurrence.7 of 49 cases of malignant appendiceal tumor suffered recurrence postoperatively,the recurrence rate was 14％,which included liver metastasis in 4 cases and intraperitoneal recurrence in 3 cases.The 1,3,5-year survival rates of malignant appendiceal tumors were 100％ (49/49),92％ (35/49) and 80％ (39/49),respectively,which were 100％,98％ and 92％ for carcinoid,and 100％,67％ and 33％ for adenocarcinoma,respectively.Conclusions The preoperative diagnosis of primary appendiceal tumor is very difficult,the intraoperative frozen histopathological examination is helpful for diagnosis,the prognosis of appendiceal carcinoid is fair after resection.

BACKGROUND:Many experiments have demonstrated that tissue engineering scaffolds prepared by polymer materials alone or biomaterials cannot meet the requirement of tissue engineering research.
OBJECTIVE:To evaluate biological characteristics and cel affinity of poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffold.
METHODS:Tissue engineering scaffolds were prepared by combination of poly(hydroxybutyrate-co-hydroxyoctanoate) and col agen at different proportions (2%, 4%, 6%, 8%and 10%) using solvent casting/particulate leaching method. Inner structure and apertures were observed by scanning electron microscope, and the porosity was determined by liquid displacement method. Rabbit chondrocytes were co-cultured with poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffold and poly(hydroxybutyrate-co-hydroxyoctanoate) scaffold. Growth curve of cel s was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and cel adhesion on the scaffolds was observed by scanning electron microscope.
RESULTS AND CONCLUSION:The pore size and porosity of the composite scaffold were about 200μm and (85±2)%, respectively. The cel affinity dynamical y increased with the increasing of proportion of col agen. Compared with the poly(hydroxybutyrate-co-hydroxyoctanoate) scaffold, the poly(hydroxybutyrate-co-hydroxyoctanoate)/col agen composite scaffolds are better to improve cel adhesion and proliferation, with favorable cel ular affinity.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and conventional-transbronchial needle aspiration (C-TBNA) in mediastinal and lung hilar lesions. Method 301 cases of lung hilar and mediastinal lesions were selected from 2010 to 2016. Among them, 183 cases underwent TBNA, and the other 118 cases received EBUS-TBNA technology. During the research, the associations of diagnostic positive rate and complications were analyzed in order to explore the advantage and the value of EBUS-TBNA. Results The positive rates of EBUS-TBNA in central groups (2R, 4L, 4R, 7) were higher than in the peripheral groups (10R, 10L, 11R, 11L) (P < 0.05). When studying the lymph node group 2R, 4R and 7R, the positive rate of EBUS-TBNA is much more significant than conventional TBNA (P < 0.05); When biopsying at the lymph node group R4 and group 7, one needle positive rate of EBUS-TBNA were much more superior than TBNA (P < 0.05), the three needles cumulative positive rate of EBUS-TBNA almost reach the total positive rate(P > 0.05), an approving effect of puncture can be acquired; The accuracy and sensitivity of EBUS-TBNA in the diagnosis of lung hilar and mediastinal lesions were much better than conventional TBNA (P < 0.05), especially the diagnostic positive rate of EBUS-TBNA in benign diseases was higher (P < 0.05); The complications rates in both two technologies were not significantly different (P > 0.05), there were no severe complications during the operations in all cases. Conclusion EBUS-TBNA is useful in diagnosis of mediastinal and hilar lesions of unknown reason, and significant in diagnosis of bronchial and extrabronchial diseases. It is an efficiency and safe operation while further application studies are needed.

Objective To observe the application and efficacy of dynamic condylar screw (DCS) in treating intertrochanteric fractures of the femur and discuss the fixation principle, feasibility, advanta-ges and related issues. Methods A retrospective analysis was done on 23 patients with intertrochanter-ic fractures of the femur treated with DCS from January 2000 to December 2006. Of all, there were 10 elderly patients with different levels of various kinds of internal diseases and 13 young patients injuried by high-energy such as traffic accidents. According to Boyd' s classfication, there was one patient with type Ⅰ fracture, five with type Ⅱ , nine with type Ⅲ and eight with type Ⅳ. After a detailed pre-operative physical examination and targeted treatment, DCS fixation was employed for intertrochanteric fractures of the femur. Results A follow-up for average 18 months showed no death. Early complications occurred in three patients including two with pulmonary infection and one with urinary tract infection, who got cured after proper treatment. There was one patient with long-term complication, post-traumatic arthritis. All 23 patients got bone healing, with excellenee rate of 96% according to Harris criteria. There were no complications like breakage of nails, nonunion, eoxa yarn deformity, shortening or external rotation of the lower limb. Conclusions DCS has advantages of simple operation, reliable fixation and coincidence with biomechanical characteristics and hence is one of ideal methods for treatment of intertrochanteric frac-ture of the femur, especially for subtrochanteric fracture, contrary chanteric fractur, fracture involving large pyriform troehanteric and comminuted fractures of sub-trochanteric lateral os integumentale.

Objectives To analyze the diagnosis and management of steroid-resistant nephrotic syndrome (SRNS) accompanied with irreversible leukoencephalopathy in children. Methods The clinical, laboratory and imaging data were retrospectively analyzed in a SRNS child accompanied with irreversible leukoencephalopathy. A literature review was performed. Results After clinical diagnosis of SRNS, glucocorticoid, immunosuppressant, and hemodialysis were administrated for 10 months. During the course of treatment, the seizures, visual problems, and hypertension were repeatedly occured. The cranial MRI showed bilateral occipital parietal lobe hyperintensity and right frontotemporal lobe hyperintensity on T2-weighted imaging and bilateral occipital parietal lobe hypointensity on T2-Flair imaging, which indicated that encephalomalacia was accompanied with gliosis. Conclusions A variety of reasons may induce leukoencephalopathy in children. The accompanied irreversible leu-koencephalopathy should be strongly considered in management of SRNS.

Objective To improve the operation method of rupture of Achilles tendon for decreasing complication. Methods Total 39cases with closed rupture of Achilles tendon were selected in this study. Short incision was made at achilles tendon wall, reveal and anneal the broken ends, using Kirschner wire and steel-wire to make rectangle frame ,intradermic fixation of fracture away from the broken ends, then sutured ends with rarities and smoothing,functional exercise after 6weeks ankle rest position fixation. Results According to the Arner Lindholm evaluation system,the treatment outcome were excellent in 34 cases ,and good in 5cases. No complication including re-rupture skin ,tendon necrosis and infection were found after operation. Conclusion Repaired closed rupture of Achilles tendon with short incision and rectangle frame, assisted with ankle rest position fixation after operation wasa worthy way for treating closed rupture of a chilles tendon.

Objective To analyze and explore the operative effect of coraccid process basilar part fractures combined injury of ligamental structure. Methods Use ilium-fascia lata complex tissue to reconstruct coronoid process of ulna and medial collateral ligament, recoverd anterior and wall horn anatomic structure of elbow joint. Total 9 cases of ulna coracoid process fractures concomitancy with elbow posterior dislocation . Among these one with olec-ranon fracture,five patients with head of radius fracture. Anterior trance joint approach was used,removal bone chips, restore defect with ilium-fascia lata complex tissue after cuting and trimming. Once reduction was achieved,fixed with screw. Repaird the collateral ligament and anterior joint capsule use the fascia lata, If there were combined fracture of the radius head or olecranon fracture,fixed through lateral approach,All injured extremities were treated with a posterior plaster splint with functional position for 3 weeks followed by elbow rehabilitation training. Results According to Moneys evaluation method,2 patients were classified as excellent ,5 as good,l as fair and 1 as poor. The excellent and good rate was 77. 8%. Two patients with gently ossifying myositis but no patients with wound infection,internal fixation loosening or break,elbow joint destabilizing orcorpus libemm. Conclusions Coracoid process basilar part fractures was simultaneous with the instability of osteal frame and soft tissue. To attain the favourable anatomical foundation for elbow joint functional recovery, it should rebuild the height and shape of coronoid process first and think highly of repair or rebuild medial collateral ligament and joint capsule. It reconstructed the coronoid process osteal frame and soft tissue instability at the same time to use ilium-fascia lata complex tissue. The operative procedure is simplify with reliability effect and fine functional rehabilitation.

Seventy eight children with Henoch-Schonlein syndrome (HSP) admitted in our hospital from October 2013 to April 2015 were enrolled in this study,and 30 healthy children were also enrolled as controls.The serum S-100 protein levels were measured with enzyme-linked immunosorbent assay (ELISA)in two groups;and electroencephalogram (EEG) examination was performed in HSP patients.The serum S-100 protein level of HSP group (0.206 ± 0.101) μg/L was significantly higher than that in the normal control group [(0.060 ±0.042) μg/L,P ＜ 0.001];and the serum S-100 protein levels in patients with kidney type (0.284 ±0.099) μg/L and mixed type [(0.284 ±0.043) μg/L,P ＜0.01] were higher than those in patients with skin type (0.151 ±0.098) μg/L,gastrointestinal type (0.138 ±0.036) μg/L and joint type [(0.117 ± 0.065) μg/L,P ＜ 0.001].Abnormal EEG findings were detected in 52 cases (66.7％),however,no clinical manifestations of nervous system were found in those patients.Serum S-100 protein levels were higher in patients with abnormal EEG than those with normal EEG [(0.223 ± 0.099) μg/L vs.(0.173 ± 0.096) μg/L,P ＜ 0.05].The results suggest that the serum S-100 protein is associated with HSP disease severity,and children with HSP may have subclinical neurological damage.

The self-renewal and multipotent potentials in neural stem cells (NSCs) maintain the normal physiological functions of central nervous system (CNS). The abnormal differentiation of NSCs would lead to CNS disorders. However, the mechanisms of how NSCs differentiate into astrocytes, oligodendrocytes (OLs) and neurons are still unclear, which is mainly due to the complexity of differentiation processes and the limitation of the cell separation method. In this study, we modeled the dynamics of neural cell interactions in a systemic approach by mining the high-throughput genomic and proteomic data, and identified 8615 genes that are involved in various biological processes and functions with significant changes during the differentiation processes. A total of 1559 genes are specifically expressed in neural cells, in which 242 genes are NSC specific, 215 are astrocyte specific, 551 are OL specific, and 563 are neuron specific. In addition, we proposed 57 transcriptional regulators specifically expressed in NSCs may play essential roles in the development courses. These findings provide more comprehensive analysis for better understanding the endogenous mechanisms of NSC fate determination.
Animals ; Astrocytes ; cytology ; metabolism ; Cell Differentiation ; genetics ; Gene Expression Profiling ; Gene Regulatory Networks ; Mice ; Neural Stem Cells ; cytology ; metabolism ; Oligodendroglia ; cytology ; metabolism ; Protein Interaction Mapping