24 days in mm, V1:the degree of expansion in ml) had linear correlation, E1=(0.86V1?0.60) mm. Conclusion The results of the study demonstrate that CT is an accurate and reliable imaging technique in the evaluation of the degree of expansion of the injured orbit and in the prediction of the possibility of the consequent enophthalmos and its degree. It is significantly helpful to the therapeutic planning for the quantity the retroglobal filling in the rectification of the enophthalmos.

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

BACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is one of the severe complications of total hip replacement (THR)during the perioperative period. The incidence rate was high. The effect of primary disease on the DVT after THR in the elderly remains poorly understood.OBJECTIVE: To explore the effect of primary disease on DVT after THR in the elderly.METHODS: 147 cases with unilateral THR aged 64-93 years, were included and divided into two groups. Fracture group contained 68 cases, which of them were all traumatic femoral neck fracture ones. Osteopathia group contained 79 cases, and they had no traumatic injury. We selected total hip prostheses according to their physiological age, preoperative socialization ability,substantia ossea and life expectancy. Biological prosthesis in 5 cases and mixed prosthesis in 12 cases were used, while the others used bone cement prosthesis. If the patient had pain and/or swelling on the injured limb, with or without Homans/Neuhofs sign, we did the pressurized ultrasonic Doppler to examine whether the patient had got DVT.RESULTS AND CONCLUSION: In the fracture group, 32 cases had swelling in the injured limbs, and 20 cases with pain, 15 cases with Homans/Neuhofs sign, and 29 DVT cases were confirmed by the pressurized ultrasonic Doppler. One femoral neck fracture case of THR had no DVT clinical signs and was dead 17 days later. The autopsy found that it was an mixed type combined of pulmonary embolism; Osteopathia group: 20 cases had swelling in the injured limbs, and 11 cases of pain, 9 cases of Homans/Neuhofs sign, 20 DVT cases were confirmed by the pressurized ultrasonic Doppler. The blood coagulation state was greater, and the incidence rate of DVT in the lower limbs was greater in the fracture group compared with osteopathia group (P ＜ 0.05). These indicated that femoral neck fracture is a high risk factor for DVT development in lower limb affer THR in the elderly.

Objective To examine the feasibility of using photothrombotic unilateral motor cortex lesion for establishing hindlimb spastic hemiplegia model in rats. Methods Twenty SD rats were randomized into 2 groups: rats in group A received erythrosine B injection followed by laser iiradiation, and those in group B received sham operation. Then the rate dependent depression (RDD) of H reflex was employed to measure the spasticity of the plantaris before and 3, 7, 14, 28 days postoperation. H-E staining was used to observed the lesions in the motor cortex. Cholera toxin B subunit was used to retrogradely labll motoneurons in the spinal cord. The number of vesicular glutamine transporter 1 (VGLUT1) boutons on motoneuron soma and dendrite was quantified by immunofluorescence staining and laser confocal microscope scanning. Results Hreflex RDD in the right plantaris muscle was significantly decreased in group A compared with that in group B at 3, 7,14, and 28 days postoperation (P<0. 01). However, the H reflex RDD was not significantly different between groups in the lett hindlimd at different time points after operation (P>0. 05). The number of VGLUT1 boutons on soma and dendrite in group A was significantly increased compared with that in group B (P<0. 01). H-E staining showed specific lesion in the motor cortex of the brain tissue in group A, but not in group B. Conclusion Unilateral photothrombotic motor cortex lesion is feasible to generate contralateral hindlimb spastic hemiplegia in rats.

Objective To detect EIA factor expression in human rectal cancer and normal tissue and to determine whether it is correlated with invasion and metastasis of human rectal cancer. Methods Real- time RT-PCR was used to detect E1AF expression in matched rectal cancers and normal tissues from g6 in- patients.Results Among the 86 rectal cancer samples tested,55 cases E1AF mRNA overexpression was ob- served. The mRNA expression of E1AF in the sample group was remarkably different from that in the control group.In carcinomas,E1AF mRNA expression correlated significantly with histological type,depth of inva- sion,lymph node and distant metastasis and advanced Duke stage.Conclusion E1AF is correlated signifi- cantly with invasion and metastasis of human rectal cancer and may be an important factor in the invasion and metastasis.

Objective To investigate the characteristics of infecting pathogens,their changes and antimicrobial susceptibilities on CAPD related peritonitis in our peritoneal dialysis(PD) center in the past 15 years.Methods Two hundred and six CAPD related peritonitis episodes in 145 patients from 2000 to 2005 were analyzed and compared with 109 episodes from 1991 to 2000.The causative pathogens,their antimicrobial susceptibilities and outcomes on CAPD related peritonitis from the two periods were retrospectively reviewed and compared.Results Culture negative rate decreased from 60.6% in 1990 s to 47.6% in the last five years (P=0.031 ).Among culture positive peritonitis episodes,the incidence of gram positive bacteria (GPB) peritonitis increased from 25.6% to 39.8% (P=0.059).This was mainly due to a significant increase in coagulase-neagative staphylococcus peritonitis,which significantly increased from 4.7% to 26.9% (P=0.01).Gram negative bacteria (GNB) peritonitis decreased slightly (44.2% vs 34.3%,P=0.322).The incidence of Klebsiella pneumoniae peritonitis significantly decreased (14.0% vs 3.7%,P=0.023),while Pseudomonas aeruginosa and Escherichis coli peritonitis rates slightly increased (4.7% vs 9.3%,P = 0.338;7% vs 18.7%,P=0.072).The decrease of fungal peritonitis rate was not significant (30.2% vs 17.6%,P= 0.123).The comparison of clinical outcomes showed an improvement of total recovery rate from 68.8% in 1990 s to 73.9% for 2000-2005 (P=0.09).The catheter removal rate decreased from 19.2% to 14.3% (P=0.238),and the mortality from 10.1% to 5.4% (P=0.118).In both periods,fungal peritonitis had the poorest results,which all the patients either withdrew from PD or died.Conclusions Compared with that in 1990 s,the culture positive rate for CAPD related peritonitis in 2000-2005 has been greatly improved.Coagulase-negative staphylococcus is the most common causative pathogen.The mortality and catheter removal rate have been markedly reduced in the last five years.Fungal peritonitis is the most important reason for patients' dropout.

OBJECTIVETo explore the therapeutic methods of fracture and dislocation of coccyx and evaluate its curative effects.

METHODSFrom May 2002 to March 2010,56 patients with fracture and dislocation of coccyx were divided into surgical treatment group and non-surgical treatment group. There were 7 males and 20 females in surgical treatment group with an average age of (48.1 +/- 0.6) years (ranged, 29 to 62 years), treated with open reduction and mini-plate internal fixation. There were 8 males and 21 females in non-surgical treatment group with an average age of (47.5 +/- 0.9) years (ranged, 19 to 54 years),treated with manipulative reduction. All patients were underwent X-ray examination and were finally diagnosed before treatment. Clinical symptoms and Visual Analogue Scales (VAS) of all patients were statistically analyzed before and after treatment.

RESULTSThere was no significant difference between two groups in gender, age, BMI index and VAS evaluation. All patients were followed up from 12 to 25 months with an average of 17.2 months. In surgical treatment group,there were 26 cases with I/a incision and 1 case with II/a incision; the excellent rate of clinical symptom was respectively 92.6% and 100% at leaving hospital and final follow-up; the improvement rate of VAS was 97.6% and was excellent result;internal fixtures were removed at the 1 to 2 years after treatment and no unwell symptoms occurred; VAS of all patients in the group was 0 point. In non-surgical treatment group,the excellent rate of clinical symptom was respectively 72.4% and 82.8% at leaving hospital and final follow-up; the improvement rate of VAS was 72.1% and was good result. There was significant difference in clinical results between two groups (P<0.05).

CONCLUSIONThe results indicated that fracture and dislocation of coccyx should be treated in time. For the treatment of patients with manipulative reduction failures, instability reduction by X-ray examination and serious rectal irritation, open reduction and mini-plate internal fixation can obtain satisfactory results.

Adult ; Bone Plates ; Coccyx ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Manipulation, Spinal ; Middle Aged ; Spinal Fractures ; surgery

OBJECTIVETo evaluate the effect of adenovirus-mediated double suicide gene (CD/TK) for selective killing of breast cancer cells.

METHODSVascular endothelial growth factor (VEGF)-expressing MCF-7 cells and normal human mammary epithelial cells that did not express VEGF were infected with the adenovirus containing VEGFP-CD/TK-GFP genes. CD/TK gene expression in the infected cells was detected by RT-PCR. After treatment of the infected cells with GCV and/or 5-FC, the cell growth status was evaluated using MTT assay, and the cell cycle changes were detected with flow cytometry. In nude mice bearing human breast cancer, the recombinant adenovirus vector was injected directly into the tumor followed by intraperitoneal injection of the prodrugs GCV and/or 5-FC, and the subsequent tumor growth was observed.

RESULTSThe recombinant adenovirus achieved similar infection rates in MCF-7 and human mammary epithelial cells, and the rates increased gradually with the multiplicity of infection (MOI) of the virus. RT-PCR demonstrated the presence of CD/TK gene product in infected MCF-7 cells, but not in the infected mammary epithelial cells. The infected MCF-7 cells, but not the mammary epithelial cells, were highly sensitive to the pro-drugs. The CD/TK fusion gene system showed significantly greater efficiency than either of the single suicide gene in killing the target cells (P<0.01). At the MOI of 100, treatment of the infected cells with the pro-drugs resulted in increased cell percentage in G(0)-G(1) phase and decreased percentage in S phase. In nude mice bearing MCF-7 cell-derived subcutaneous tumor, treatment with the double suicide gene system significantly inhibited the tumor growth, showing much stronger effect than either of the single suicide gene (P<0.01).

CONCLUSIONThe adenovirus-mediated CD/TK double suicide gene driven by VEGF promoter combined with GCV and 5-FC treatment can be an effective therapy against experimental breast cancer, and produces much greater efficacy than the single suicide gene CD/TK combined with GCV or 5-FC.

Adenoviridae ; genetics ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cytosine Deaminase ; genetics ; metabolism ; Female ; Flow Cytometry ; Flucytosine ; pharmacology ; Ganciclovir ; pharmacology ; Genes, Transgenic, Suicide ; genetics ; Genetic Therapy ; methods ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Recombinant Fusion Proteins ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Thymidine Kinase ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVETo evaluate the effect of adenovirus-mediated CD/TK double suicide gene system on tumor growth and cytokine levels in the tumor microenvironment in mice bearing transplanted colorectal cancer.

METHODSCT26 cells were implanted subcutaneously into 30 Balb/c mice, which were subsequently randomized into the control (n=15) and experimental group (n=15). After the tumor formation, CD/TK double suicide gene system was administered for tumor treatment, and the changes in the tumor volume, tumor inhibition rate, and levels of cytokines in the tumor microenvironment were investigated.

RESULTSCD/TK double suicide gene system resulted in a significant inhibition of the tumor growth and significantly increased levels of such cytokines as IL-2, IL-10, TNFalpha and IFNgamma in the tumor microenvironment.

CONCLUSIONCD/TK double suicide gene system produces significant tumor inhibition effect and causes obvious cytokine changes in the tumor microenvironment in mice bearing transplanted colorectal cancer.

Adenoviridae ; genetics ; metabolism ; Animals ; Cell Proliferation ; Colorectal Neoplasms ; metabolism ; pathology ; therapy ; Cytokines ; metabolism ; Cytosine Deaminase ; genetics ; metabolism ; Female ; Genes, Transgenic, Suicide ; genetics ; Genetic Therapy ; methods ; Green Fluorescent Proteins ; genetics ; metabolism ; Interleukin-2 ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Random Allocation ; Recombinant Fusion Proteins ; genetics ; metabolism ; Thymidine Kinase ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

BACKGROUNDCompared with smaller aneurysms, giant intracranial aneurysms (GICAs) have a poorer prognosis and require more meticulous surgical planning and techniques to exclude them from the circulation. GICAs continue to challenge the limits of neurosurgical techniques. A series of 170 patients with GICAs were reviewed for understanding the clinical characteristics, surgical treatment and outcomes of patients with GICAs.

METHODSCollected data of 170 consecutive patients with GICAs from January 1995 to July 2007 were analyzed. The clinical characteristics in this study included age, sex, intracranial aneurysms size, the first presentations, locations and Hunt & Hess grade. Surgical methods included direct clipping of the aneurysm neck, parent artery reconstruction, proximal artery ligation, trapping and wrapping. Surgical results were evaluated postoperatively by the Glasgow Outcome Scale (GOS).

RESULTSGICAs were more commonly diagnosed at age 30 to 50 years with a mean age of 39.3 years and without obvious gender preponderance in our study (88 male and 82 female patients). The size of the GICAs ranged from 2.5 cm to 8.0 cm (mean, 2.9 cm). Hemorrhage (41%), mass effect (34%) and headache (12%) were the first 3 most common presentations. Regarding the Hunt & Hess classification, at admission there were 100 cases in grade 0, 24 in grade 1, 21 in grade 2, 16 in grade 3, 8 in grade 4 and 1 in grade 5. There were 84 cases of GICAs treated by direct neck-clipping, 47 by parent artery reconstruction, 19 by proximal artery occlusion (with 4 combined with revascularization), 18 by trapping and 2 by wrapping. The follow-up study (ranging from 6 to 115 months, mean 32 months) showed good results in 108 cases, moderate disability in 26 and severe disability in 15 according to GOS. Six cases died.

CONCLUSIONSSurgical treatment is an effective treatment for GICAs. Surgical strategies should be made carefully and individually. Doppler ultrasonography, neuroendoscope and intraoperative angiography are useful to perfect surgical results.

Adult ; Aged ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Infant ; Intracranial Aneurysm ; pathology ; surgery ; Male ; Middle Aged ; Neurosurgical Procedures ; methods ; Treatment Outcome