Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation / 中国骨伤

OBJECTIVE@#To explore the application value and clinical effect of three-dimensional printing combined with composite plate internal fixation in the treatment of old acetabular posterior wall fracture.@*METHODS@#From May 2010 to October 2016, Mimics 19.0 software was used to plan preoperatively according to a 1:1 print pelvic 3D model. At the same time, 23 patients with old acetabular posterior wall fractures were treated with combined plate internal fixation, including 15 males and 8 females, aged 20 to 63 (43.0±5.1) years old, and the time from injury to operation was 23 to 101(47.0±10.5) days. According to Letournel-Judet classification, 11 cases were posterior wall fracture, 7 cases were transverse with posterior wall fracture, and 5 cases were posterior column with posterior wall fracture. All patients were treated with single Kocher-Langenbeck approach combined plate internal fixation, and the evaluation indexes were recorded during operation, after operation and during follow-up.@*RESULTS@#The operation time of 23 patients was (113.5±11.5) min, bleeding was (550.0±104.7) ml and fluoroscopy was (12.7±0.8) s. Matta radiographic reduction criteria were used: excellent in 14 cases, good in 7 cases and poor in 2 cases; 23 patients were followed up for 10 to 24 (16.0±5.6) months. The hip function was evaluated according to the modified Merle d'Aubingne and Postal scoring system at the last follow-up: excellent in 11 cases, good in 8 cases, fair in 3 cases and poor in 1 case. There were 3 cases of traumatic arthritis, 1 case of femoral head necrosis, 2 cases of heterotopic ossification and 5 cases of sciatic nerve irritation.@*CONCLUSIONS@#3D printing technique is an effective and fast method for the treatment of old acetabular posterior wall fractures. In addition, the printing model can provide three-dimensional morphological structure for the operator, combined with preoperative simulation, facilitate intraoperative reduction, and effectively improve the efficiency of surgery.

Expression of Gli1 in Adult Acute Lymphoblastic Leukemia and Its Clinical Significance / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the expression and clinical significance of Hedgehog signaling transcription factor Gli1 in acute lymphoblastic leukemia (ALL) patients.</p><p><b>METHODS</b>The clinical specimens were obtained from 32 newly diagnosed and 6 relapsed ALL patients. Normal bone marrow cells from 15 healthy donors were used as controls. Real-time qPCR and Western blot were applied to detect Gli1 mRNA and protein expression in bone marrow mononuclear cells (BMMNC) of these samples respectively. The relation of Gli1 mRNA levels with clinical parameter was also evaluated.</p><p><b>RESULTS</b>The expression level of Gli1 mRNA in de novo and relapsed ALL patients was significantly higher than that in the normal controls (P < 0.05). There was no stalistically significant difference of the Gli1 mRNA expression between de novo and relapsed ALL cases (P > 0.05). In 24 de novo ALL patients with complete remission (CR) after induction chemotherapy, the levels of Gli1 mRNA were significantly reduced as compared with levels before treatment (P < 0.05). However, in 4 ALL patients without remission, no obvious difference of Gli1 mRNA levels were observed as compared with levels of Gli1 before treatment (P > 0.05). A positive correlation between the Gli1 mRNA expression level and white blood cell count (WBC) was found in the BMMNC of ALL patients (R = 0.725, P < 0.05). Similarly, Gli1 protein expression was significantly higher in the de novo and relapsed ALL cases compared with normal controls. The Gli1 protein level was down-regulated when the ALL patients was in CR.</p><p><b>CONCLUSION</b>The expression of Gli1 mRNA and protein has been found to be high in de novo and relapsed ALL patients, and the change of Gli1 expression maybe relate to therapeutic efficacy and prognosis of ALL patients.</p>

Mechanism of Notch1 Pathway in SUP-B15 Cell Apoptosis Induced by JQ1 / 中国实验血液学杂志

<p><b>OBJECTIVE</b>The study was aimed to investigate the possible mechanism of Notch1 pathway in apoptosis of Ph(+) human ALL Cells(SUP-B15 cells) induced by bromodomain inhibitors JQ1.</p><p><b>METHODS</b>The SUP-B15 cells were treated with different concentrations of JQ1 for different times. The cell proliferation was analyzed with cytotoxicity test(MTT method). Cell cycle was detected by fluorescence microscopy and flow cytometry. The mRNA expression of MIS2, Notch1, Hes1, BCR-ABL in Notch1 pathway was detected by real-time quantitative PCR.</p><p><b>RESULTS</b>JQ1 0-4 µmol/L could significantly inhibit the viability of SUP-B15 cells treated in does-and time-dependent manner. After SUP-B15 cells were treated with 1,2,4 µmol/L JQ1 for 48 h, the JQ1 could induce S cycle arrest in does-dependent manner which was statistical different from the control at the same time (P<0.05). MIS2, Notch1, Hes1, BCR-ABL mRNA expression was down-regulated by JQ1 which was statistical different from the control (P<0.05).</p><p><b>CONCLUSION</b>The JQ1 can effectively inhibit the growth and proliferation of SUP-B15 cells and the Notch1 pathway may be one of the important apoptosis mechanisms in Ph(+) ALL cells induced by JQ1.</p>

Effects of optic disc topography and retinal nerve fiber layer thickness measurement by spectral-domain OCT on diagnosis of glaucoma / 中华实验眼科杂志

BackgroundGlaucoma is an optic neuropathy caused by structural damage of the optic nerve,and its early diagnosis is critical for arresting the irreversible damage of visual function. Optical coherence tomography (OCT) allows an early diagnosis of glaucoma by the measurements of the optic disc and retinal nerve fiber parameters. Objective This study was carried out to evaluate the effects of optic disc tomography and the measurement of the retinal nerve fiber layer (RNFL)thickness by spectral-domain OCT on the diagnosis of glaucomatous eye. MethodsIt was a noninterventional, cross-sectionalstudy. The optic disctopographic parameters and total and regional RNFL thickness were measured by RTVue OCT in 62 normal eyes and 67 glaucomatous eyes. The area under the receiver operating characteristic curve( ROC ) was used to assess the ability to differentiate glaucoma eyes from normal eyes of each testing parameter. This trial complied with the Helsinki Declaration and was approved by the Clinical Trial Ethic Committee of Beijing TongrenHospital. All of the participants signed the written informed consent before any medical examination. Results In the comparison of demography ,the ages of patients, the mean deficiency( MD ) and pattern standard difference( PSD ) of perimetry were obviously larger in the glaucoma group, primary open angle glaucoma ( POAG ) group and primary closure-angle glaucoma(PACG) group than those of normal controls( P＜0. 01 ). No significant differences were found in the disc area between a total glaucoma group, POAG group or PACG group and normal group ( P =0. 101,0. 741 and 0. 652, respectively) ;however, the average RNFL thickness between normal eyes and glaucomatous eyes were significantly different( 109. 758 μm versus 79. 539 μm, P＜0. 01 ). Among the eight regions around the optic disc, the thickest RNFL located at the inferotemporal( 150. 109 μm) and superotemporal( 146. 105 μm) regions in normal eyes,and at the superotemporal( 104. 354 μm) and inferotemporal( 102. 436 μm) regions in glaucomatous eyes. Both in normal and glaucomatous eyes,the thinnest RNFL located at the nasal(NU+NL) and temporal(TU + TL) regions. For optic disc topographic parameters,the highest ROC were observed in rim volume( ROC--0. 850,0. 841 and 0. 862 in total glaucoma,POAG and PACG, respectively) and vertical cup/disc ratio( ROC =0. 840,0. 849 and 0. 830 in total glaucoma,POAG and PACG,respectively), and the sensitivities for specificity cutoff set at 80％ were 73.1％ and 76. 1％ in total glaucoma,73.0％ and 81.1％ in POAG and 73.3％ and 70.0％ in PACG, respectively. For RNFL thickness ,the highest ROC was observed in average RNFL( ROC =0. 925,0. 910 and 0. 942 in total glaucoma, POAG and PACG,respectively) ,and the sensitivities for specificity cutoff set at 80％ were 89. 6％ ,89.2％ and 90. 0％ in total glaucoma,POAG and PACG, respectively. Among the eight regions around the optic disc, RNFL thickness of region IT achieved the highest ROC, RNFL thickness of region TU and TL had the lowest ROC. Conclusions RTVue OCT appears to be of fair discriminating ability in distinguishing normal from glaucomatous eyes. RTVue OCT shows promise for the diagnosis of glaucoma.

Effects of HepII domain peptides V of fibronectin on corneal permeability, endothelial cells, intraocular pressure and morphology of trabecular meshwork in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Trabecular meshwork (TM) cell volume may be an important determinant of aqueous humor outflow in the eye. This study aimed to evaluate the role of HepII domain peptides V on corneal permeability, corneal endothelial cells, intraocular pressure (IOP) and morphology of trabecular meshwork in rats.</p><p><b>METHODS</b>The IOP of rat eyes was measured before and 3, 5, 7 and 8 hours after topical delivery of HepII domain peptides V through intracameral injections. The peptide's concentration in aqueous humor was assessed by high performance liquid chromatography (HPLC). The shape and density of endothelial cells were observed by laser confocal microscopy 8 hours, 3 and 14 days after intracameral injections of HepII domain peptides V. The morphological changes in TM of rat eyes were assessed by transmission electron microscopy (TEM).</p><p><b>RESULTS</b>Intracameral injection of HepII domain peptides V significantly (P < 0.001) decreased IOP by (5.71 ± 2.10) mmHg in rats at 5 hours after injection. There were no obvious changes of the shape and the density of corneal endothelial cells. In addition, morphological changes in the TM of rats were observed including the expansion of intercellular spaces in the juxtacanalicular meshwork, removal of extracellular material, cellular relaxation, and cytoskeleton reorganization.</p><p><b>CONCLUSIONS</b>HepII domain peptides V could not penetrate cornea and was safe to corneal endothelial cells. HepII domain peptides V could significantly decrease IOP in rat probably by disorganizing actin cytoskeleton and cell-junction in the TM.</p>

Measurement of anterior chamber volume with rotating scheimpflug camera and anterior segment optical coherence tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Measurement of anterior segment parameters plays an important role in diagnosis and treatment of glaucoma. The objective of this study was to evaluate the repeatability and reproducibility of anterior chamber volume (ACV) measurements with rotating scheimpflug camera (RSC) and to examine agreement with anterior segment optical coherence tomography (AS-OCT).</p><p><b>METHODS</b>Thirty nine healthy normal subjects were recruited from the Eye Center of Tongren Hospital. ACV was measured using RSC and AS-OCT in a randomly selected eye for each subject. For RSC measurements, both automatic and manual ACV measurements and 2 independent operators' ACV measurements were obtained. All subjects were invited for 3 visits within a week to evaluate repeatability and reproducibility of ACV measurement by RSC. Agreement was evaluated between RSC and AS-OCT.</p><p><b>RESULTS</b>Good repeatability and reproducibility were found for both automatic and manual ACV measurements obtained by RSC. For intrasession repeatability, coefficient of variation (CVw) and intraclass correlation coefficient (ICC) values for automatic were 3.52% and 0.98; the values for manual were 3.44% and 0.97, respectively. For intersession reproducibility, the respective CVw and ICC values were 3.96% and 0.96. Good agreement was also found in 2 operators for both automatic and manual ACV measurements; nevertheless, poor agreement was found between RSC and AS-OCT (95% confidence interval (CI) for agreement of automatic RSC measurement versus AS-OCT were -96.3 to 72.8 microl and 95% CI for agreement of manual RSC measurement versus AS-OCT were between -41.7 to 10.1 microl).</p><p><b>CONCLUSIONS</b>Both RSC automatic and manual ACV measurements showed good repeatability and reproducibility, and showed comparable agreement between 2 independent operators, but poor agreement was found between RSC and AS-OCT.</p>

Reproducibility of RTVue retinal nerve fiber layer thickness and optic nerve head measurements in normal and glaucoma eyes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>RTVue spectral-domain optical coherence tomography (OCT) is a new, ultra high-speed and high-resolution instrument, potentially to measure the presence of glaucoma or its progression accurately. The objective of this study was to evaluate its reproducibility of retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) measurements in normal and glaucoma eyes.</p><p><b>METHODS</b>This study was an observational clinical study. One eye was selected randomly from each of 89 normal individuals and 63 glaucoma patients in a range of severity. RNFL thickness and ONH were measured 3 times on the same day to determine intrasession variability. The same instrument was used by the same operator for all scans. Intrasession within-subject standard deviation (Sw), precision (1.96 x Sw), coefficient of variation (CVw, 100 x Sw/overall mean), and intraclass coefficient (ICC) were calculated to evaluate reproducibility.</p><p><b>RESULTS</b>RTVue OCT demonstrated double hump patterns in the RNFL profiles. High reproducibility was observed in all ONH parameters. For normal eyes, the value of ICC ranged between 0.98 and 1.00. For eyes with different extent of glaucoma, it ranged between 0.94 and 1.00. High reproducibility was also observed in RNFL thickness measurements. The values of ICC for averaged RNFL thickness ranged between 0.95 and 1.00 in all cases. For regional parameters, it ranged from 0.94 to 0.98 for normal eyes, 0.94 to 1.00 for mild glaucoma eyes, 0.87 to 1.00 for moderate glaucoma eyes, and 0.77 to 0.97 for severe glaucoma eyes. The nasal regions of severe glaucoma appeared to be most variable, as nasal lower region and inferior nasal region had the ICC values of 0.77 and 0.87.</p><p><b>CONCLUSION</b>Reproducibility of RTVue RNFL and ONH measurements was excellent in normal and glaucoma groups.</p>

Effect of different chemotherapy regimens for concurrent chemoradiotherapy on locally advanced non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the effects of different chemotherapy regimens for concurrent chemoradiation on locally advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>The data from 106 patients diagnosed as locally advanced NSCLC (IIIa: 29, IIIb: 77), who received various chemotherapy regimens for concurrent chemoradiotherapy, were retrospectively analyzed. Paclitaxel-based chemotherapy regimen was administered in 55 patients, topotecan regimen in 21 patients, PE (cisplatin and etopside) regimen in 26 patients, and other regimens in the remaining 4 patients. The effect of different chemotherapy regimens on overall survival and toxicity was analyzed.</p><p><b>RESULTS</b>The median survival time was 18.6 months, and the overall 1- and 3-year survival rates were 72.2% and 27.5%, respectively. The median survival time of 102 patients treated with paclitaxel-containing, topotecan-containing or PE regimens was 16.3, 27.3 and 29.1 months, respectively. The overall survival times of topotecan and PE groups were superior to that of paclitaxol-based group, but not significantly different (P = 0.32). Both univariate and multivariate analysis showed that paclitaxol-based chemotherapy regimen was significantly associated with a poorer survival (P < 0.05). N stage was another significant prognostic factor determined by COX multivariate regression model. Compared with the other regimens (10.6%), paclitaxel-based regimen (27.3%) had more acute radiation pneumonitis (grade >or= 2, P = 0.03), but no significant differences were observed in blood toxicity and esophagitis.</p><p><b>CONCLUSION</b>There is a correlation between different chemotherapy regimens for concurrent chemoradiotherapy and the overall survival and acute radiation pneumonitis in patients with locally advanced NSCLC.</p>