Safety of allogeneic γδT cell immunotherapy for advanced hepatocellular carcinoma and its effect on patients' immune function / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨使用同种异体Vγ9Vδ2 T细胞回输治疗晚期肝细胞癌（HCC）患者的安全性及治疗后患者免疫功能的变化。方法：选择2021年10月至2022年10月珠海市人民医院收治的4例晚期HCC患者，从健康供体获取外周血单个核细胞（PBMC）后经刺激扩增培养获得Vγ9Vδ2 T细胞，经质控放行后予以回输治疗，回输细胞剂量为5×108个/次，每两周一次，回输次数9次以上，治疗后检测患者αβT细胞、B细胞、NK细胞、γδT细胞各亚群比例，转氨酶、肌酐、肌酸激酶等肝、肾、心功能生化标志物，以及血常规三系（白细胞系统、红细胞系统和血小板系统）细胞数量的变化。结果：4例患者在回输治疗后均显示出对异体Vγ9Vδ2 T细胞良好的耐受性；转氨酶、肌酐、肌酸激酶等肝、肾、心功能生化标志物以及血常规三系细胞数量在回输前后均无明显变化；患者的Tfh1、Tc1、CD127+TEM、HLADR+CD8+ T细胞、CD27- B细胞比例有升高趋势，提示特异性免疫功能的增强。结论：同种异体Vγ9Vδ2 T细胞治疗晚期HCC有较好的安全性并可在一定程度上改善患者的免疫功能。

Mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021 / 预防医学

Objective@#To investigate the mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021, so as to provide insights into improving diabetes prevention and control strategies.@*Methods@#Data on morbidity and mortality of diabetes in Hangzhou City from 2013 to 2021 were collected through the Chronic Disease and Death Cause Monitoring System of Hangzhou Center for Disease Control and Prevention, and the crude and age-standardized mortality (standardized by the population of the Seventh National Population Census in China in 2020) were calculated. Data on the prevalence of diabetes were collected from the China Chronic Disease and Risk Factors Surveillance (CCDRFS), and the burden of disease was evaluated by calculating years of life lost (YLL), years lived with disability (YLD) and disability-adjusted years (DALY) with reference to the methodology of the Global Burden of Disease Study (GBD). The trends in mortality and disease burden of diabetes were evaluated with the average annual percent change (AAPC). @*Results@#There were 8 686 deaths of diabetes in Hangzhou City from 2013 to 2021, with the average annual crude mortality of 13.17/105 and age-standardized mortality of 10.89/105. The crude mortality of diabetes showed a tendency towards a rise (AAPC=2.62%, P<0.05), while the trend in age-standardized mortality was not significant (P>0.05). The crude and age-standardized mortality of diabetes were higher in women than in men (14.11/105 vs. 12.21/105, 12.16/105 vs. 9.71/105; both P<0.05); however, the crude mortality in men increased more rapidly (men: AAPC=4.46%, P<0.05; women: AAPC=1.09%, P>0.05). The YLL, YLD and DALY of diabetes were 155.42, 1 246.73 and 1 402.15 thousand person-years, and the rates of YLL, YLD and DALY were 2.36, 18.90 and 21.25 person-years per thousand, respectively. The rates of YLL, YLD and DALY appeared a tendency towards a rise (AAPC=1.57%, 6.03% and 7.11%, all P<0.05). Higher rates of DALY and more remarkable increase were seen in men than in women (P<0.05; AAPC=8.37%, 5.54%, both P<0.05). @*Conclusions@# The mortality of diabetes in Hangzhou City from 2013 to 2021 is high, and the burden of disease, especially disability, is growing rapidly, with the burden of disease being more serious in men.

A holistic approach for postoperative pain management in children receiving dental treatment under general anesthesia: a randomized clinical trial / 口腔疾病防治

Objective @# To investigate the efficacy of a holistic approach for postoperative pain management in children receiving dental treatment under general anesthesia in day-surgery operating room. @*Methods@#A total of 120 children, aged 3-7 years, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with ≥ 10 treated teeth, receiving comprehensive dental treatment under general anesthesia from January 2020 to August 2020 were enrolled in this trial and randomly allocated into the holistic approach group (group H, n=60) and including preemptive analgesia, instructions to parents for pain management and web-based assessment system (assessment pain by scanning the quick response code 4, 6, and 24 hours postoperatively) and the control group (group C, n=60) only scanning the quick response code. Pain, face, legs, activity, cry and consolability (FLACC) scale was used to assess the level of pain 2 h postoperatively and the parents postoperative pain measure (PPPM) was used to assess the level of pain 4, 6, and 24 h postoperatively in two groups.@* Results@# The FLACC scores of group H 2 h postoperatively were significantly lower than group C (P <0.05). The incidences of significant pain (PPPM scores ≥ 6) 4, 6 and 24 h postoperatively in group H were lower than group C (P <0.05). Altogether, 91.7% of parents in group H and 71.6% in group C assessed the level of pain of children over time. The compliance rate of parents in group H was significantly higher than group C (P <0.05).@*Conclusion @# The holistic approach had a positive effect on reducing postoperative pain for children receiving dental treatment under general anesthesia in the day-surgery operating room.

Effect of fatigue load on internal mechanical properties of the intervertebral disc / Efecto de la carga de fatiga en las propiedades mecánicas internas del disco intervertebral

SUMMARY: Lumbar disc herniation is considered to be the main pathological factor for the common clinical disease of low back pain. Biomechanical factor is an important cause of lumbar disc herniation, so it is urgent to analyze the stress/strain behavior of intervertebral disc under different loading condition. Slow repetitive loading is considered to be an important factor of spine and disc injuries, and the effect of fatigue load on internal displacement in the intervertebral disc was investigated by applying the optimized digital image correlation technique in this study. The first finding was that fatigue load had a significant effect on the displacement distribution in the intervertebral disc under compression. Superficial AF exhibited the largest axial displacements before fatigue load, while it exhibited the smallest axial displacements after fatigue load. Inner AF exhibited slightly smaller radial displacements than outer AF before fatigue load, while it exhibited significantly greater radial displacements than outer AF displacements after fatigue load. The second finding was that fatigue load had a certain effect on the internal displacement distribution in the flexed intervertebral disc under compression. Middle AF exhibited the smallest axial displacements before fatigue load, while deep AF exhibited the smallest axial displacements after fatigue load. The radial displacement distribution did not change before and after fatigue load, as the radial displacement in outer AF was the smallest, while the radial displacement in inner AF was the largest. The third finding was that with the increase in fatigue time and amplitude, the Young's modulus of the intervertebral disc increased significantly. This study can provide the basis for clinical intervertebral disc disease prevention and treatment? and is important for mechanical function evaluation of artificial intervertebral disc as well.

RESUMEN: La hernia de disco lumbar se considera el principal factor patológico para la enfermedad clínica común del dolor lumbar. El factor biomecánico es una causa importante de hernia de disco lumbar, por lo que es urgente analizar el comportamiento de esfuerzo / tensión del disco intervertebral bajo diferentes condiciones de carga. La carga repetitiva lenta se considera un factor importante de lesiones de columna y disco, y en este estudio el efecto de la carga de fatiga sobre el desplazamiento interno en el disco intervertebral se investigó mediante la aplicación de la técnica de correlación de imagen digital optimizada. El primer hallazgo fue que la carga de fatiga tuvo un efecto significativo en la distribución del desplazamiento en el disco intervertebral bajo compresión. El AF superficial exhibió los desplazamientos axiales más grandes antes de la carga de fatiga, mientras que exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. El AF interno exhibió desplazamientos radiales ligeramente más pequeños que el AF externo antes de la carga de fatiga, mientras que exhibió desplazamientos radiales significativamente mayores que los desplazamientos AF externos después de la carga de fatiga. El segundo hallazgo fue que la carga de fatiga tenía un cierto efecto sobre la distribución del desplazamiento interno en el disco intervertebral flexionado bajo compresión. El AF medio exhibió los desplazamientos axiales más pequeños antes de la carga de fatiga, mientras que el AF profundo exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. La distribución del desplazamiento radial no cambió antes ni después de la carga de fatiga, ya que el desplazamiento radial en la FA externa fue el más pequeño, mientras que el desplazamiento radial en la FA interna fue el más grande. El tercer hallazgo fue que con el aumento del tiempo de fatiga y la amplitud, el módulo de Young del disco intervertebral aumentó significativamente. Este estudio puede proporcionar la base para la prevención y el tratamiento clínico de la enfermedad del disco intervertebral, y también es importante para la evaluación de la función mecánica del disco intervertebral artificial.

Intrathyroid injection of dexamethasone inhibits Th2 cells in Graves disease

ABSTRACT Objective Intrathyroid injection of dexamethasone (IID) was used for decrease the relapse rate of hyperthyroidism in the treatment of Graves' disease (GD), but the mechanism is still unclear. We aimed to explore the effect of IID on T help (Th)1/Th2 cells and their chemokine in patients with GD. Subjects and methods A total of 42 patients with GD who were euthyroidism by methimazole were randomly divided into IID group (n = 20) and control group (n = 22). Thyroid function and associated antibody, Th1/Th2 cells proportion, serum CXCL10 and CCL2 levels, and CXCR3/CCR2 mRNA expression in peripheral blood mononuclear cells before and after 3-month IID treatment were tested by chemiluminescence assay, Flow cytometry, ELISA, and real-time PCR, respectively. Thyroid follicular cells were stimulated by IFN-γ and TNF-α and treated with dexamethasone in vitro. CXCL10 and CCL2 levels in supernatant were determined. Results After 3-month therapy, the proportion of Th2 cells and serum CCL2 levels, as well as TPOAb, TRAb levels and thyroid volume decreased in IID group (p < 0.05). However, the proportion of Th1 and CXCL10 levels had no change in IID group and control (p > 0.05). The CXCR3/CCR2 ratio had no change in both groups (p > 0.05). Conclusion IID therapy could inhibit peripheral Th2 cells via decreasing CCL2 level in peripheral blood, and this result partly explain the effects of IID therapy on prevention of relapse of GD. Arch Endocrinol Metab. 2020;64(3):243-50

Trend of fall mortality among the elderly in Hangzhou from 2006 to 2018 / 预防医学

Objective@#To analyze the status and trend of fall mortality among the elderly from 2006 to 2018 in Hangzhou, and to provide basis for fall prevention and control. @*Methods@#Through the medical certificate of death in hospitals at the county level and above and community health service centers, the monitoring data of the deaths from fall among the elderly aged 60 years and above in Hangzhou from 2006 to 2018 were collected. The crude motality rate, standardized mortality rate of fall and the annual percentage change ( APC ) were calculated to examine the status and trend of fall mortality in different gender, age and areas. @*Results@#The crude mortality rate of fall among the elderly in Hangzhou was 85.60/100 000 and the standardized mortality rate was 71.42/100 000 from 2006 to 2018. The crude and standardized mortality rate from 2006 to 2018 showed increasing trends and the APCs were 3.46% and 2.33%, respectively ( P<0.05) . The crude mortality rate was 93.01/100 000 in females, which was higher than 77.82/100 000 in males ( P<0.05 ) , the APCs were 3.25% and 3.77%, respectively. The crude mortality rate of rural areas was 129.03/100 000, which was significantly higher than 60.73/100 000 of urban areas ( P<0.05 ) . The mortality rate of urban and rural areas showed increasing trends, the APCs were 5.02% and 2.43%, respectively. The crude mortality rate of fall among the elderly in Hangzhou increased gradually with age ( P<0.05 ) . @*Conclusion@#The fall mortality among the elderly in Hangzhou increased from 2006 to 2018. More efforts are needed to reduce fall mortality in females and rural population.

Incidence trend of gestational diabetes mellitus in Hangzhou from 2009 to 2018 / 预防医学

Objective @#To learn the incidence trend of gestational diabetes mellitus (GDM) among women of childbearing age in Hangzhou from 2009 to 2018, providing evidence for GDM prevention and control.@*Methods@#The information of GDM cases aged 15 to 49 years in Hangzhou from 2009 to 2018 was extracted from Zhejiang non-communicable diseases surveillance system. The crude and age-standardized (by national standard population in 2000) incidence rate of GDM were calculated, the annual change percentage (APC) and the average APC (AAPC) of GDM incidence rate were calculated to understand the trend of incidence in different age groups and areas. @*Results@#A total of 45 519 cases of GDM were reported in Hangzhou from 2009 to 2018. The crude and age-standardized incidence rates were 248.04/100 000 and 158.52/100 000, respectively, both showed upward trends with 59.7% and 56.4% in AAPC (both P<0.05). The APCs of crude and age-standardized incidence rates of GDM were 139.76% and 134.60% from 2009 to 2012, 30.35% and 27.65% from 2012 to 2018, which all had increasing trends (all P<0.05). There were upward trends in GDM incidence in each age groups of 15-24, 25-29, 30-34, 35-39 and 40-49 years old (all P<0.05). The AAPC of GDM incidence in 40-49 year-old women was 65.3% and ranked the first among all the age groups. The age-standardized incidence rate of GDM increased more in rural areas (AAPC=66.0%) than in urban areas (AAPC=53.4%). @*Conclusion@# A rising trend in GDM incidence among women aged 15-49 years in Hangzhou has been found in recent ten years, especially in women aged 40-49 years and lived in rural areas.

Expert consensus on marsupialization of cystic lesions of the jaw / 口腔疾病防治

@#Marsupialization is effective in the treatment of cystic lesions of the jaw. It is a simple operation that can result in minimal trauma, the reduction of postoperative recurrence, and maximum preservation of the surrounding tissue structure and function. However, there is a certain failure rate in clinical treatment due to the improper grasp of indications and nonstandard operation. The highest failure rate reported in the literature is 32.6%. To further standardize the clinical application of marsupialization and improve the success rate of treatment, we put forward an expert consensus of marsupialization in the treatment of jaw cystic lesions by reviewing the domestic and foreign literature and summarizing the experience in marsupialization from some famous domestic experts. In this consensus, we propose three elements of marsupialization: the establishment of the opening, the maintenance of cyst plugs and regular washing. The scope of application of marsupialization includes jaw cysts and cystic ameloblastomas. It is necessary to standardize the position of the opening, the size of the opening and the manufacture of the cyst plug, and a panoramic film or cone beam computed tomography(CBCT) should be used to observe the changes in the cystic cavity before and after operation. A second-stage operation should be performed when the lesion is significantly reduced by more than 50% or at least 5 mm from important structures; furthermore, the teeth of focus should be treated according to the relationship between the lesion and tooth and the type of tooth.

A practical new strategy to prevent bile duct injury during laparoscopic cholecystectomy. A single-center experience with 5539 cases

Abstract Purpose Bile duct injury (BDI) is a catastrophic complication of cholecystectomy, and misidentification of the cystic anatomy is considered to be the main cause. Although several techniques have been developed to prevent BDI, such as the "critical view of safety", the infundibular technique, the rates remain higher during laparoscopic cholecystectomy (LC) than during open surgery. We, here, propose a practical new strategy for ductal identification, that can help to prevent laparoscopic bile duct injury. Methods A retrospective study of 5539 patients who underwent LC from March 2007 to February 2019 at a single institution was conducted. The gallbladder infundibulum was classified by its position located on an imaginary clock with the gallbladder neck as the center point of the dial, 3-o'clock position as cranial, 6-o'clock as dorsal, 9-o'clock as caudal, and 12-o'clock as ventral, as well as the axial position. Patient demographics, pathologic variables and infundibulum classification were evaluated. Detailed analysis of ductal identification based on gallbladder infundibulum position was performed in this study. All infundibulum positions were recorded by intraoperative laparoscopic video or photographic images. Results All the patients successfully underwent LC during the study period. No conversion or serious complications such as biliary injury occurred. Gallbladders with infundibulum of 3-o'clock position, 6-o'clock position, 9-o'clock position, 12-o'clock position, axial position were 12.3%, 23.4%, 28.0%, 4.2%, and 32.1%, respectively. The 3-o'clock and 12-o'clock position were pitfalls that might cause biliary injury. Conclusion The gallbladder infundibulum as a navigator is useful for ductal identification to reduce BDI and improve the safety of LC.

Biological evaluation of 2,3-dioxoindolin-N-phenylacetamide derivatives as potent CDC25B and PTP1B phosphatase inhibitors

A series of 2,3-dioxoindolin-N-phenylacetamide derivatives was evaluated for inhibitory activity against CDC25B and PTP1B enzymes. Most of the derivatives showed inhibitory activity against CDC25B (IC50 = 3.2-23.2 µg/mL) and PTP1B (IC50 = 2.9-21.4 µg/mL). Compound 2h showed the most inhibitory activity in vitro with IC50 values of 3.2 and 2.9 µg/mL against CDC25B and PTP1B, respectively, compared with the reference drugs Na3VO4 (IC50 = 2.7 µg/mL) and oleanolic acid (IC50 = 2.3 µg/mL). The results of selectivity experiments showed that the 2,3-dioxoindolin-N-phenylacetamide derivatives were selective inhibitors against CDC25B and PTP1B. Enzyme kinetic experiments demonstrated that compound 2h was a specific inhibitor with the typical characteristics of a mixed inhibitor. In cytotoxic activity assays compound 2h had potent activity against A549, HeLa, and HCT116 cell lines. In addition, compound 2h showed potent tumor inhibitory activity in a colo205 xenograft model in vivo.

Synthesis and antibacterial activity of a series novel 5,7-diisoprenyloxyflavone derivatives

In the present study, a series of novel 5,7-diisoprenyloxyflavone derivatives were designed, synthesized, and evaluated for their antibacterial activity. Most of these compounds displayed significant antibacterial effects against Gram-positive bacteria, especially against strains of multidrug-resistant clinical isolates. Compounds 4c, 4g, 4i, 4j, 4k, 4l, 4n, 4q and 4t showed high levels of antimicrobial activity against Staphylococcus aureus RN4220 with minimum inhibitory concentrations of 4.0-20 µM. Compound 4k showed the most potent activity among these compounds against all multidrug-resistant clinical isolates tested. Unfortunately, none of the compounds were active against Gram-negative bacteria at the doses of 24-164 µM.

The characteristics of blood glucose fluctuations in patients with fulminant type 1 diabetes mellitus in the stable stage

ABSTRACT Objective: The aim was to characterize blood glucose fluctuations in patients with fulminant type 1 diabetes (FT1DM) at the stable stage using continuous blood glucose monitoring systems (CGMSs). Subjects and methods: Ten patients with FT1DM and 20 patients with classic type 1 diabetes mellitus (T1DM) (the control group) were monitored using CGMSs for 72 hours. Results: The CGMS data showed that the mean blood glucose (MBG), the standard deviation of the blood glucose (SDBG), the mean amplitude glycemic excursions (MAGE), the blood glucose areas and the percentages of blood glucose levels below 13.9 mmol/L were similar between the two groups. However, the percentage of blood glucose levels below 3.9 mmol/L was significantly higher in the FT1DM group compared to the T1DM group (p < 0.05). The minimum (Min) blood glucose level in the FT1DM group was significantly lower than that of the T1DM group (p < 0.05). Patients with FT1DM had severe dysfunction of the islet beta cells and alpha cells compared to patients with T1DM, as indicated by lower C-peptide values and higher glucagon/C-peptide values. Conclusion: In conclusion, patients with FT1DM at the stable stage were more prone to hypoglycemic episodes as recorded by CGMSs, and they had a greater association with severe dysfunction of both the beta and alpha islet cells compared to patients with T1DM.

Anatomical Risk Factors of Anterior Cruciate Ligament Injury / 中华医学杂志(英文版)

Background@#Nowadays, the anterior cruciate ligament (ACL) injury has been one of the most common diseases of the knee joint. The relationships between the ACL injury and the anatomical structures are still controversial. This study aimed to identify the anatomical risk factors of ACL injury by magnetic resonance imaging (MRI) of the knee.@*Methods@#This was a retrospective study of 125 patients undergoing primary ACL reconstruction between July 2013 and May 2017. Another 125 patients without any organic knee joint injury were served as controls. The shape of intercondylar notch, the intercondylar notch width index, the intercondylar notch height index, the α angle, the β angle, and the medial and lateral tibial plateau slope were measured with MRI and compared. The data were compared by binary logistic regression to find the risk factors.@*Results@#The two groups differed in the proportion of male patients (70.4% vs. 52.0%, χ = 8.911, P = 0.003), but gender was excluded as a risk factor for ACL injury with regression analysis (odds ratio = 1.476, 95% confidence interval [CI]: 0.689-3.160, P = 0.317). The injured group was found to have a smaller notch width index (95% CI = 7.960E-23-2.154E-9, P 7.5°), and larger β angle (>38.5°) might be the factors associated with ACL injury.@*Trial Registration@#ChiCTR-RRC-17014116; http://www.chictr.org.cn/showproj.aspx?proj=24119.

Association Study of a Proliferation-inducing Ligand, Spermatogenesis Associated 8, Platelet-derived Growth Factor Receptor-alpha, and POLB Polymorphisms with Systemic Lupus Erythematosus in Chinese Han Population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with complex genetic inheritance. This study was conducted to examine whether the association of a proliferation-inducing ligand (APRIL), spermatogenesis associated 8 (SPATA8), platelet-derived growth factor receptor-alpha (PDGFRA), and DNA polymerase beta (POLB) with SLE can be replicated in a Chinese Han population.</p><p><b>METHODS</b>Chinese SLE patients (n = 1247) and ethnically and geographically matched healthy controls (n = 1440) were genotyped for the APRIL, SPATA8, PDGFRA, and POLB single-nucleotide polymorphisms (SNPs), rs3803800, rs8023715, rs1364989, and rs12678588 using the Sequenom MassARRAY System.</p><p><b>RESULTS</b>The Chinese Han SLE patients and controls had statistically similar frequencies of alleles and genotypes of four gene polymorphisms. Moreover, no association signal was detected on different genetic models (additive, dominant, and recessive, all, P> 0.05) or in SLE subgroups stratified by various clinical manifestations (all, P> 0.05).</p><p><b>CONCLUSIONS</b>Different genetic backgrounds from different ancestries and various populations may result in different genetic risk factors for SLE. We did not detect any significant association with SNPs of APRIL, SPATA8, PDGFRA, and POLB.</p>

Removal of algae from raw water by ultrasonic irradiation and flocculation: A pilot scale experiment.

Using Chl a removal rate as index, a 28 kHz/900w ultrasonic cleaning machine was applied to testify algal removal by ultrasonic irradiation from raw water of a pool, where Microcystis aeruginosa colonies is absolutely dominated with temperature being over 20oC, and the irradiation lasted for 5 min. PAC was used as flocculant at the dose of 60 mgl-1, jar tests were done to investigate the Chl a removal by flocculation. The results showed that ultrasound raised the water temperature instantly but did not lead to a regular pH change pattern in all the treated samples. Ultrasound could remove more than 90% of Chl a from raw water with temperature over 31oC, but less than 20% of Chl a or even increased Chl a concentration in some samples with temperature lower than 31 oC. Compared with the algal removal effects by direct raw water flocculation with PAC, ultrasound did not enhance markedly the flocculation effects on algae removal, which was not in agreement with the findings reported. The reason might be due to morphology and characteristics of natural algae differed greatly from that of algae cultured in laboratory.

Fate of dissolved organic nitrogen during biological nutrient removal wastewater treatment processes.

Due to its potential to form toxic nitrogenous disinfection byproducts (N-DBPs), dissolved organic nitrogen (DON) is considered as one of the most important parameters in wastewater treatment plants (WWTP). This study describes a comprehensive investigation of variations in DON levels in orbal oxidation ditches. The results showed that DON increased gradually from 0.71 to 1.14 mg l-1 along anaerobic zone, anoxic zone, aerobic zone 1 and aerobic 2. Molecular weight fractionation of DON in one anaerobic zone and one aerobic zone (aerobic zone 2) was performed. We found that the proportion of small molecular weight (<6 kDa) decreased and large molecular weight (>20 kDa) showed opposite trend. This variation may have been caused due to the release of different types of soluble microbial products (SMPs) during biological processes. These SMPs contained both tryptophan protein-like and aromatic protein-like substances, which were confirmed by three-dimensional excitation-emission matrix (EEM) analysis.

Comparison of radiographic and pathologic sizes of renal tumors

Purpose The determination of the size of a renal tumor is important for staging, prognosis and selection of the appropriate surgical treatment. We investigated the difference of radiographic and pathologic size of renal tumors in a contemporary cohort of patients who underwent nephron sparing surgery and evaluated its clinical implications. Materials and Methods The records of 169 patients who received nephron sparing surgery for renal lesions suspicious for malignancy between January 2006 and December 2010 were reviewed retrospectively. Radiographic tumor size, defined as the largest diameter of tumor measured by CT images, and pathologic size, the largest diameter of tumor measured in the surgical specimen, were compared and analyzed. Results Among all subjects, mean radiographic and pathologic tumor size were 3.25 ± 1.78 cm and 3.03 ± 1.91 cm, respectively (P < 0.001), with a discrepancy of just 0.22 cm. When the patients were categorized according to radiographic tumor size in the 1 cm range, the mean radiographic tumor size was significantly greater than pathologic tumor size in the following groups: 2 to 3 cm (P < 0.001), 3 to 4 cm (P < 0.001), and 4 to 5 cm (P = 0.028). When radiographic and pathologic tumor sizes were compared according to the pathologic tumor subtype, a significant difference was observed only among those with clear cell renal carcinoma (P < 0.001). Conclusions Renal tumor size was overestimated by radiography as compared with pathology. The difference was just 0.22 cm with little clinical significance, suggesting that CT provides an accurate method to estimate renal tumor size preoperatively. .

Surgical management of traumatic injury of upper cervical spine / 中国骨伤

<p><b>OBJECTIVE</b>To analyze retrospectively the clinical outcome of surgical management for upper cervical spine injury caused by trauma.</p><p><b>METHODS</b>From January 2005 to March 2007, 16 patients with injury of upper cervical spine were treated by different management. There were 11 males and 5 females with an average age of 44 years ranging from 24 to 75. Of all, 5 cases were the odontoid fracture, 3 were atlas fracture, 5 were Hangman's fracture, 3 were atlanto-axial dislocation. MR imaging of cervical spine showed cervical cord compression and changes of T2 high signal in 5 cases. According to the injury mechanism, the imageological appearance, fracture classification, the methods of treatment were selected.</p><p><b>RESULTS</b>Seven patients received non-operative treatment and nine patients underwent operation. Sixteen patients were followed up for 7 to 34 months (means 10.5 months). All fractures were healing or bone graft fusion and no internal fixation was lossing. There were no injuries of vertebral artery, nerve root or spinal cord.</p><p><b>CONCLUSION</b>CT and MRI are required in the course of diagnosis for the traumatic injury of upper cervical spine. The optimal modus operandi should be choose to retain upper cervical spine, meanwhile, can reserve the cervical movement.</p>

Evaluation of intraoral distraction osteogenesis by scanning electron microscopy and mineral content / 实用口腔医学杂志

Objective:To study the ultrastructural characters and mineral content of the newly formed bone induced by distraction osteogenesis(DO) in the canine mandibular defects.Methods:4 beagle canines were used to establish 2.0 cm segmental mandibular defect surgically. Intraoral bifocal distraction osteogenesis was used to repaire the defects. After a 10-day latency, the transport disc was advanced at a rate of 0.5 mm? 2/day until the bone fragment was docked at the planned position. Specimen retrieval at 35 weeks after completion of distraction, scanning electron microscopy(SEM) analysis was then performed. The mineral content was measured by electron dispersive spectroscopy.Results:35 weeks after application of DO the mandibular defects were completely filled with regenerated bone. The regenerated bone was compact, sturdy and mature. The new bone was closed to the transport disk. The Ca/P content ratio was 1.80 in the regenerated bone and 2.02 in the transport disk.Conclusion: DO may induce new bone formation and may be used to repaire mandibular defects.

Intraoral distraction osteogenesis for the repair of mandibular defect——An biomechanical study / 实用口腔医学杂志

Objective:To explore the roentgenographic and biomechanical characters of distraction osteogenesis(DO) in the treatment of mandibular defect.Methods:4 beagle dogs were used to establish 2.0 cm mandibular defect model,after 6 months, a 1.5 cm transport disc was surgically created adjacent to the defect area in an intraoral way, and intraoral device was placed on the transport disc and the base bone segments.A reconstructive plate was applied to stabilize the bone segments. After a 10 day latency period, the transport disc was advanced at a rate of 0.5 mm ? 2/day until the bone fragments were docked at the planned position.35 weeks after completion of distraction the animals were sacrificed,specimen retrieval,roentgenography and the stress testing were performed.Results:The regenerated segments were comparable with the corresponding segments of native mandible,and exact location of junction between the regerated and preexisting bone could not be determined easily. Roentgenographic revealed that the defects were reconstructed with outer cortical layer and trabecular medullary cavity of the bone.The regenerated segments remained less radiodense than the native mandible.Stress test demonstrated that the average ultimate strength of regenerated segmens was (69.4?19.2) MPa,that of the corresponding normal mandible was (86.9?31.9) MPa,and that of junction between transport disc and base bone was(46.9?8.4) MPa. Conclusion:Intraoral distraction osteogenesis may be feasible in the treatment of mandibular defect.