Expression and clinical significance of B cell ectopic gene 2 in pancreatic cancer tissue / 中华胰腺病杂志

Objective:To investigate the expression of the B cell ectopic gene 2 (BTG2) in the pancreatic cancer tissue and analyze its relationship with the clinicopathological features and prognosis.Methods:46 pairs of pancreatic cancer tissues and corresponding adjacent tissues kept in paraffin in the pathology department, and 9 fresh pancreatic cancer tissues and corresponding adjacent tissues resected by surgery in Department of Pancreatic Surgery of Sinopharm Dongfeng General Hospital from June 2015 to December 2020 were collected. BTG2 gene expression in 46 pairs of pancreatic cancer tissues and corresponding adjacent tissues were detected by immunohistochemical staining, and high and low BTG2 expression groups were divided. BTG2 gene expression in 9 fresh pancreatic cancer tissues and corresponding adjacent tissues were detected by RT-PCR. The correlation between BTG2 protein expression level and clinicopathological features was analyzed. Furthermore, the survival curve and death risk curve were drawn using the Kaplan-Meier method, and the Cox regression hazards model was applied for the univariate and multivariate analysis of the factors affecting the prognosis of pancreatic cancer.Results:29 of 46 (63.04%) pancreatic cancer tissues had high BTG2 expression, and 38(82.61%) of corresponding adjacent tissues had high BTG2 expression; and BTG2 high expression rate of adjacent tissues was significantly higher than that of cancer tissues. Three out of 9 pancreatic cancer tissues were highly differentiated, and six cases had medium-and low differentiation. The BTG2 expression of highly differentiated pancreatic carcinoma was significantly higher than that of moderately and poorly differentiated carcinoma tissues [(0.66±0.07 vs 0.24±0.18); the expression level of adjacent tissues was significantly higher than that of cancer tissues (1.00±0.00 vs 0.38±0.30), and all differences were statistically significant (all P values <0.001). Low BTG2 expression in pancreatic cancer was associated with low tumor differentiation and vascular invasion (all P values <0.05), but was not correlated with tumor location, volume, lymph node metastasis, CA19-9 level and postoperative liver metastasis. The median survival of high BTG2 expression group was significantly longer than that of low BTG2 expression group (525 d vs 266 d, P<0.001). Among patients with survival time ≥300 d, the survival time was significantly higher in the high BTG2 expression group than in the BTG2 low expression group (616±135d vs 426±113 d), and the difference was statistically significant ( P<0.001). Among patients with survival time <300 d, there was no significant difference between BTG2 high and low expression group. The results of the univariate analysis showed that tumor differentiation degree, vascular invasion, BTG2 expression, CA19-9 levels, and postoperative liver metastasis were all associated with the prognosis of pancreatic cancer. The results of the multivariate analysis showed that BTG2 expression level ( HR=2.572, 95% CI1.140-5.802, P=0.023), vascular invasion ( HR=0.023, 95% CI0.072-0.572, P=0.003) and postoperative liver metastasis ( HR=0.240, 95% CI0.102-0.564, P<0.001) were independent risk factors affecting the prognosis of patients with pancreatic cancer. Conclusions:BTG2 expression in pancreatic cancer tissues was significantly lower than that in adjacent tissues, and its low expression was associated with strong aggressiveness, low differentiation degree and poor prognosis of pancreatic cancer. The effect of BTG2 on the prognosis in pancreatic cancer patients was mainly in the long term.

Effect of posterior short-segment fixation plus percutaneous kyphoplasty via the outer upper edge of the base of the fractured vertebral pedicle in the treatment of osteoporotic thoracolumbar burst fracture / 中华创伤杂志

Objective:To investigate the safety and efficacy of short-segment fixation covering the fractured vertebrae via posterior intermuscular approach plus percutaneous kyphoplasty (PKP) through the outer upper edge of the base of the fractured vertebral pedicle in the treatment of osteoporotic thoracolumbar burst fracture.Methods:A retrospective case series study was used to analyze the clinical data of 56 patients with osteoporotic thoracolumbar burst fracture admitted to Ningbo No.6 Hospital from January 2018 to February 2021, including 24 males and 32 females; aged 56-72 years [(63.5±4.6)years]. All patients underwent short-segment fixation covering the fractured vertebrae via posterior intermuscular approach combined with PKP through the outer upper edge of the base of the fractured vertebral pedicle. The operation time, intraoperative blood loss, hospitalization day and surgery-related complications were recorded. The visual analogue score (VAS) of back pain, ratios of the anterior, middle and posterior height of the fractured vertebrae and kyphotic Cobb angle were compared before operation, at postoperative 2 days and at the final follow-up.Results:All patients were followed up for 12-28 months [(14.5±2.2)months]. The operation time was 55-85 minutes [(62.0±12.1)minutes], intraoperative blood loss was 80-150 ml [(94.0±18.5)ml], and hospitalization day was 5-9 days [(7.4±1.1)days]. Based on CT examination at postoperative 2 days, there were 2 patients with paravertebral cement leakage, 2 with intervertebral space leakage and 1 with intracanal leakage, but none reported associated clinical symptoms. No implant failure or fractures of adjacent segments was detected during the follow-up period. The VAS was significantly decreased from preoperative (7.5±1.2)points to (3.2±0.8)points at postoperative 2 days ( P<0.01), and the score was further lowered to (2.2±0.8)points at the final follow-up when compared with that at postoperative 2 days ( P<0.01). The ratios of the anterior, middle and posterior height of the fractured vertebrae and kyphotic Cobb angle were significantly improved at postoperative 2 days [(89.5±13.2)%, (85.8±7.9)%, (89.5±9.0)% and (5.6±3.2)°] when compared with those before operation [(48.9±11.8)%, (61.9±11.9)%, (79.9±9.8)% and (26.3±5.6)°] (all P<0.01). Slight losses were observed in the ratios of the anterior, middle and posterior height of the fractured vertebrae and kyphotic Cobb angle at the final follow-up [(87.0±12.7)%, (82.1±7.8)%, (88.6±10.0)% and (5.4±3.2)°], but not significantly different from those at postoperative 2 days (all P>0.05). Conclusion:Short-segment fixation covering the fractured vertebrae via posterior intermuscular approach plus PKP through the outer upper edge of the base of the fractured vertebral pedicle can safely and effectively treat osteoporotic thoracolumbar burst fracture, for it can significantly improve back pain, restore the height of the fractured vertebrae and correct the kyphotic deformity.

Effect of miR-200c Regulation of Peptidyl-Prolyl Cis/Trans Isomerase on the Biological Behavior of Hep-2 Cells / 中国医科大学学报

Objective To explore the influence of miR-200 c on the biological behavior of laryngeal carcinoma Hep-2 cells and determine whether miR-200 c exerts its biological function through peptidyl-prolyl cis/trans isomerase (PIN1) in laryngeal carcinoma. Methods A qRT-PCR assay for the expression of miR-200 c was performed in laryngeal carcinoma tissues. Hep-2 cells were transfected with miR-200 c related small RNAs. Transwell assay detected the migration ability of the cells. Immunofluorescence assay was used to detect the abnormal amplification of the centrosome. A dual luciferase reporter gene system was used to detect the binding ability between miR-200 c and PIN1. Western blotting detected the protein expression level of PIN1. Results The expression of miR-200 c in laryngeal carcinoma was significantly increased. miR-200 c inhibited the migration of Hep-2 cells and could weaken the abnormal amplification of centrosome.PIN1 was confirmed as one of the target genes of miR-200 c. miR-200 c inhibited the expression of PIN1 at the translation level and could inhibit Hep-2 cell migration and abnormal centrosome amplification by regulating PIN1. Conclusion miR-200 c can inhibit the migration ability of laryngeal carcinoma cells and abnormal centrosome amplification by regulating PIN1.

The levels of serum MCP-1 and IL-6 in patients with acute pancreatitis and its clinical significance / 国际检验医学杂志

Objective To explore the dynamic changes of serum monocyte chemoattractant protein-1 (MCP-1) and interleukin-6 (IL-6) in patients with acute pancreatitis (AP) and its clinical significance.Methods A total of 103patients with AP admitted to our hospital from June 2016to December 2017were selected, which were divided into mild AP (MAP group, n=62) and severe AP (SAP group, n=41) according to the condition of disease.The levels of serum MCP-1and IL-6at 1st, 3rd, 7th day after admission were determined by the radioimmunoassay.At the same time, a total of 40healthy volunteers as control group were randomly selected.The predictive value of serum MCP-1and IL-6on for AP was analyzed.Results The serum MCP-1, IL-6level and APACHEⅡscore of MAP group and SAP group at 1st day were higher than those of control group (P<0.05) .The serum MCP-1, IL-6level and APACHEⅡscore of MAP group and SAP group at 3rd, 7th day were higher than those at 1st, and which at 7th were lower than those at 3rd (P<0.05) .The serum MCP-1, IL-6level and APACHEⅡscore of SAP group at 1st, 3rd, 7th were higher than those of MAP group (P<0.05) .Among patients with AP, serum MCP-1and IL-6were positively associated with APACHEⅡscore (P<0.05) .The best cutoff value of serum MCP-1for AP was 31.6pg/mL, and the area under ROC curve was 0.852, and the sensitivity and specificity was 0.87and 0.82respectively, and the accuracy was 0.85.The best cutoff value of serum IL-6for AP was 35.9ng/L, and the area under ROC curve was 0.876, and the sensitivity and specificity were 0.91and 0.85respectively, and the accuracy was 0.87.Conclusion The serum MCP-1and IL-6of patients with AP abnormal changes, which were closely related to the severity and prognosis.Early detection of MCP-1and IL-6can help to judge condition and evaluate prognosis.

Phenotypic and genetic analysis of a boy with 3p26.3-pter deletion and 7q31.33-qter duplication / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To delineate the nature and origin of chromosomal copy number variants (CNVs) in a boy with mental retardation and multiple congenital malformation.</p><p><b>METHODS</b>The karyotypes of the patient and his parents were analyzed with routine G-banded chromosomal analysis. Genome DNA was analyzed by next generation sequencing (NGS).</p><p><b>RESULTS</b>The patient was found to harbor a structural aberration involving chromosome 3p. The karyotype of his father was 46,XY,t(3;7)(p26;q31), while his mother was found to be normal. NGS analysis of the patient revealed a 2.16 Mb microdeletion at 3p26.3-pter and a duplication at 7q31.33-qter.</p><p><b>CONCLUSION</b>The structural aberration of 3p carried by the patient has derived from his father whom carried a balanced translocation of t(3;7), and his karyotype was finally determined as 46,XY,der(3) t(3;7)(p26.3;q31.33)pat. The abnormal phenotype of the patient can probably be attributed to the presence of 3p26.3-pter microdeletion and 7q31.33-qter duplication.</p>

Postural reduction combined with posterior screw-rod system and percutaneous kyphoplasty in treatment of osteoporotic thoracolumbar burst fractures / 中华创伤杂志

Objective To evaluate the clinical effect of postural reduction combined with miniincision screw-rod system and percutaneous kyphoplasty (PKP) in treating osteoporotic thoracolumbar burst fractures.Methods A retrospective case series study was performed for data of 35 patients with osteoporotic thoracolumbar burst fractures without neurological deficits undergone mini-incision screw-rod system fixation and PKP between January 2012 and January 2014.There were 14 males and 21 females,with a mean age of 63.2 years (range,50-72 years).Operation time,intraoperative blood loss,complications,visual analogue score (VAS),height of fractured vertebrae and kyphosis Cobb angle were recorded.Results Operation time was (49.6 ± 6.8) min,and intraoperative blood loss was (45.6 ±7.8)ml.All patients were followed up for 9-18 months (mean,13.5 months).No intraoperative or postoperative serious complications occurred,including intracanal cement leakage,breakage or loosening of the screws.VAS of back pain was decreased from (8.4 ± 1.1)points preoperatively to (3.5 ± 0.6)points postoperatively (P ＜ 0.05).Height of the fractured vertebrae was improved from (49.62％ ± 5.68)％ preoperatively to (86.64 ± 6.63) ％ postoperatively (P ＜ 0.05).Kyphosis Cobb angle was improved from (28.12 ± 1.06) °preoperatively to (5.15 ± 1.08) °postoperatively (P ＜0.05).At the final follow-up,VAS was further decrease and vertebral height and Cobb’ s showed a slight loss of correction.Conclusion Postural reduction combined with mini-incision screw-rod system and PKP can relieve back pain,restore the height of injured vertebrae,correct kyphotic deformity and reduce operation time and blood loss,indicating a minimally invasive,safe and effective procedure for treatment of osteoporotic thoracolumbar burst fractures.

Apoptosis of rat superficial renal medulla cells after femoral fracture and the protective role of panax notoginseng saponins / 西安交通大学学报(医学版)

Objective To study the effects of panax notoginseng saponins (PNS)on rat superficial renal medulla cells after femoral fracture and to discuss the protective role of PNS in renal injury after fracture. Methods We divided 102 Wistar rats randomly into simple fracture group (n =36),fracture and medication group (n =36)and normal control group (n =30).In the former two groups 6 rats were respectively executed at 1,6,12, 24,36,48 h after fracture modeling,while 5 rats in normal control group were executed at the corresponding time points.Regular HE staining was used to observe pathological changes and TUNEL was used for apoptotic cells.And immunohistochemistry and in situ hybridization were used to detect the expressions of Bcl-2 and Bax in superficial renal medulla tissues.Results In simple fracture group,mild granular degeneration could be seen in renal tubular epithelial cells of superficial renal medulla and the interstitial small vessels were slightly expanded and congested. Compared with simple fracture group,the lesions were slighter in fracture and medication group.In simple fracture group,Bcl-2 and Bcl-2 mRNA expressions were significantly higher than those in normal control group at 1 -36 h (P <0.01).Bax expression was higher than that in normal control group at 12-36 h (P <0.01),and Bax mRNA expression was higher than that in normal control group after 6 h after fracture (P < 0.01 ).In fracture and medication group,Bcl-2 expression was obviously higher than that in simple fracture group at 1 h (P <0.01),and Bcl-2 mRNA expression was higher than that in simple fracture group at 1 -48 h (P <0.01).Bax and Bax mRNA expressions were both lower than those in simple fracture group at 1 - 48 h (P < 0.01 ).Conclusion Fracture trauma has significant influences on protein expression and mRNA transcription of Bcl-2 and Bax in superficial renal medulla.PNS can upregulate anti-apoptosis gene Bcl-2 and downregulate pro-apoptosis gene Bax,thus playing the role of inhibiting tissue cell apoptosis.

Radiological and anatomical study of posterior occipital condyle screw trajectory / 中华创伤杂志

Objective To investigate the optimal trajectory of posterior occipital condyle screw fixation via radiological and anatomical study.Methods Twelve adult craniocervical junction complete specimens were selected.The length,width and height of occipital condyle and the inclination angle of the longest axis were measured by CT scanning and reconstruction.Subsequently,occipital condyle screws were inserted with reference to CT measurements.After screw fixation,accuracy and safety of the placement of occipital condyle screw were verified by gross observation and CT scanning.Results Preoperative measurements of height and width of the occipital condyles indicated the placement of 4.0 mm bicortical screws was secure.Left vertebral artery horizontal sections of 2 specimens were slightly pressed without damage.CT scanning identified no damage to the inner or outer wall of the occipital condyle and the hypoglossal canal.Trajectory parameters between the right and left sides were slightly different,but no significant difference was observed (P ＞ 0.05).Average screw channel length and inclination angle were (20.8 ±2.6)mm and (37.1 ± 4.7)°respectively.Angle between screw and skull base tangent was observed as (8.5 ± 1.7) °.Distance between screw axis and hypoglossal canal was observed as (3.1 ± 1.1) mm.And the distance averaged (4.6 ± 1.4) mm between occipital condyle screw entry point and skull base and (6.1 ± 1.5) mm between entry point and inside edge of the occipital condyle.Conclusion Occipital condyle can be used as a new alternative fixed point in occipitocervical fusion.

Research on effect of clopidogrel on platelet VASP phosphorylation level after PCI operation / 国际检验医学杂志

Objective To use the flow cytometry to detect the platelet vasodilator-stimulated phosphoprotein(VASP)phospho-rylation level and to evaluate the clopidogrel curative effect after PCI.Methods 17 cases in the control group without any drug in-tervention and 26 cases of acute coronary syndrome(ACS)after PCI operation with clopidogrel were selected.Platelet VASP phos-phorylation levels at being selecting and on 7 d after anti-platelet therapy were detected by the flow cytometry and the platelet reac-tivity index (PRI)was calculated.Results The PRI after anti-platelet therapy in the ACS group was decreased significantly,the difference between before treatment and after treatment had statistical significance (P <0.05 ).Conclusion The platelet VASP phosphorylation level detected by the flow cytometry can specifically evaluate the effect of clopidogrel.

Effect of panax notoginseng saponins on renal cortical tubule cell Bax in early stage after renal trauma in rats / 中华创伤杂志

Objective To measure the effect of panax notoginseng saponins (PNS) on renal cortical tubule cell apoptosis and apoptosis-related genes in early stage after renal trauma and to investigate the protective mechanism of PNS for renal trauma.Methods Seventy-eight Wistar rats were divided into trauma group (n =36),trauma + treatment group (treatment group,n =36),normal control group (control group,n =6) according to the random number table.In treatment group,rats received intraperitoneal administration of PNS (70 mg/kg).Instead,substitute of an equal dose of isotonic saline was used for the rats in trauma and normal control groups.Trauma and treatment groups were subdivided at 1,6,12,24,36 and 48 hours posttrauma,with 6 rats per group.The kidney specimens were extracted at each time point to detect Bax expression in the cortex with immunohistochemistry and in situ hybridization histochemistry.Moreover,the positive expression of Bax was compared among groups and its variation regularity with time were detected.Results In trauma group,mRNA transcription of pro-apoptosis gene Bax increased at 12 hours in the superficial cortex,but increased at 1 hour in deep cortex; protein expression of pro-apoptosis factor Bax showed no apparent reduction within 36 hours in the superficial cortex,but evident decrease within 12 hours in the deep cortex.In treatment group,mRNA transcription of pro-apoptosis gene Bax decreased immediately after treatment in the renal cortex and lasted until 48 h; protein expression of pro-apoptosis factor Bax showed unidirectional reduction until 48 h in the renal cortex.Conclusion PNS inhibits cell apoptosis by down-regulating the mRNA and protein expression of Bax.

Comparison of three approaches to establishing Balb/c mouse models of hind-limb ischemia / 南方医科大学学报

<p><b>OBJECTIVE</b>To compared 3 approaches to establishing Balb/c mouse models of hind-limb ischemia suitable for studies of regenerative medicine.</p><p><b>METHODS</b>Thirty eight-week-old male Balb/c mice were randomly divided into 3 groups for establishing models of hind-limb ischemia by both ligating and transecting the femoral artery proximal to the origin of the deep femoral artery branch, ligating the femoral artery proximal to the origin of the deep femoral artery branch, or ligating the femoral artery distal to the femoral artery trunk. The mice were continuously observed for 5 days after the operation, and hind-limb blood perfusion was monitored by laser Doppler imaging on the second postoperative day.</p><p><b>RESULTS</b>All the 3 surgical approaches caused blood flow block in the hind-limbs of the mice. In mice with ligation and transaction of the femoral artery proximal to the origin of the deep femoral artery branch, dry gangrene occurred in the whole hind-limb. Dry gangrene also occurred in the legs and paws of mice with ligation of the femoral artery proximal to the origin of the deep femoral artery branch. In mice with femoral artery ligation distal to the origin of the deep femoral artery branch, the sole of the foot was dry with scaling skin and necrosis of several digits; microscopically examination revealed a large quantity of necrotic muscles accompanied by muscle regeneration.</p><p><b>CONCLUSION</b>Ligating the femoral artery distal to the origin of the deep femoral artery branch can be optimal for establishing Balb/c mouse models of hind-limb ischemia.</p>

Protective effect of panax notoginseng saponins against femoral fracture-induced apoptosis in the superficial cells of rat renal cortex / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the protective effect of panax notoginseng saponins (PNS) against apoptosis of the superficial cells of rat renal cortex following femoral fracture in rats.</p><p><b>METHODS</b>Ninety Wistar rats were randomized into 3 groups, namely the fracture group (n=36), fracture with PNS treatment group (n=36), and normal control group (n=18). At 1, 6, 12, 24, 36, and 48 h after femoral fracture, 6 rats from first two groups and 3 from the control group were sacrificed to observe renal pathologies with HE-staining. Immunohistochemistry and in situ hybridization were used to detect Bcl-2 and Bax expression, and TUNEL staining was employed to detect the distribution of apoptotic cells.</p><p><b>RESULTS</b>In the fracture group, the renal cortex showed telangiectasia and granular degeneration of proximal tubule, which were lessened in the PNS treatment group. Compared with the control group, the fracture group showed significantly increased Bcl-2 and Bcl-2 mRNA expressions in the renal cortex at 1-12 h (P<0.01) and increased Bax protein expression at 12-36 h (P<0.01) with increased Bax mRNA expression at 24-48 h (P<0.01). In PNS treatment group, Bcl-2 protein expression at 1 h and Bcl-2 mRNA expression at 12-48 h were significantly higher (P<0.01), but Bax protein and mRNA expressions at 24-48 h were significantly lower (P<0.01) than those in the fracture group.</p><p><b>CONCLUSION</b>Femoral fracture obviously affects Bcl-2 and Bax protein and mRNA expressions in the superficial cells of the renal cortex, PNS can suppress the cell apoptosis by down-regulating Bax expression and up-regulating Bcl-2 expression.</p>

Unstable atlas fractures treated by anterior plate fixation through transoral approach / 中华骨科杂志

Objective To explore the clinical outcomes of anterior plate fixation through transoral approach in the treatment of unstable atlas fractures.Methods From March 2004 to May 2010,20 patients with unstable atlas fractures were treated by anterior plate fixation through transoral approach,including 12 males and 8 females,aged from 23 to 68 years (average,47.7±13.9 years).Of the 20 cases of unstable atlas fractures,4 cases were classified as anterior 1/2 Jefferson fracture,8 cases as 1/2 ring Jefferson fracture,and 8 cases as anterior 3/4 ring Jefferson fracture.The preoperative average VAS scores were 6.0±1.3 points,ranged from 4 to 8 points.Clinical and imaging examinations were performed during follow-up period to evaluate the outcomes.Results All patients were followed up for 12 to 81 months,with an average of 48.5±20.0 months.There were no screw loosing and breakage,no plate displacement,and no spinal cord and vertebral artery injury during operation.A total of 20 plates were placed and all 40 screws were inserted into atlas lateral mass.Computed tomography scans demonstrated 2 screws were placed too close to the vertebral artery canal,but without clinical consequences.The postoperative VAS scores were from 0 to 3 points with an average of 1.3±1.0 points.Static and dynamic films 6 months after surgery demonstrated that fusion was achieved in all cases.Atlantoaxial rotational function was restored satisfactorily.No plate-related complication was observed in all patients in the whole follow-up period.Conclusion Anterior plate fixation through transoral approach is an effective method for management of unstable atlas fractures,which has advantages such as solid bony fusion and low incidence of complication.

Effects of exogenous adrenomedullin on expressions of IL-4 and IFN-γ in the early period of mechanical renal trauma of the rats / 中华创伤杂志

Objective To observe the effects of exogenous adrenomedullin(ADM)on expressions of IL-4 and IFN-γ following mechanical renal trauma in the rats. Methods A total of 104 healthy adult plain grade Wistar rats were,randomly divided into four groups,ie,normal control group(eight rats),simple trauma group(32 rats),prevention group(32 rats,injected with ADM before trauma)and treatment group(32 rats,injected with ADM after trauma).The experimental model of rat with mechanical renal trauma was prepared by striking the ridge of the left rib area with free dropping forrous hammer in all groups except for the control group.Ten minutes before and after mechanical renal trauma,ADM ly.All rats were sacrificed by draining out all the blood in their hearts at 1,6,12 and 24 hours after mechanical renal trauma.Then,the renal tissues were removed and fixed with 10% formalin for observing the positive expressions of IL-4 and IFN-γ by means of SABC staining. Results Compared with the simple trauma group,the positive expression of IL-4 in the prevention group Wag observed at 1 hour,gradually increased at 6 and 12 hours and reached the peak at 24 hours after mechanical renal trauma,with statistical difference(P<0.05).The positive expression of IL-4 in the treatment group WaS increased at one hour and reached the peak at 6 hours after mechanical renal trauma,with statistical difference(P<0.05).Compared with the simple trauma group,the IFN-γ expression in the prevention group was,increased at 6 and 24 hours but decreased at 12 hour,while that in the treatment group was decreased significantly at 1,12 and 24 hours.Compared with the normal control group,the IFN-γ expression in the treatment group was significantly decreased at 1 and 12 hours.The IFN-γ expression in the treatment group was lower than that in the prevention group at every time points,with statistical difference(P<0.05). Conclusions Preventive and therapeutic administration of exogenous ADM can enhance the expression of IL-4.IL-4 and IFN-γ play an antagonistic role in repair ofthe renal injury.The primary role of exogenous ADM is the dynamic regulation of IFN-γ expression.

Clinical study of combined C2 laminar screw fixation technique for cervical vertebral injury / 中华创伤杂志

Objective To explore the feasibility and application value of combined C2 laminar screw fixation technique in treatment of cervical vertebral injury. Methods Dense axial CT scanning was done on C2 laminar of 32 specimens of cervical vertebra to measure the length and height of the axis, the thickness of upper, middle and lower parts of the axis as well as the angle between the axial ray and the sagittal plane. There were eight patients with cervical vertebral injury including two with type Ⅱ odon-told process fractures combined with backward dislocation of atlanto-axial joint, one with forward disloca-tion of atlanto-axial joint, one with nonunion of odontoid process fractures, two with type Ⅲ odontoid process fractures combined with atlanto-axial joint instability and transverse ligament rupture, one with type Ⅱ Hangman fracture combined with instability of C2～3 and one with forward dislocation of atlanto-axial joint combined with transverse ligament rupture. With accomplishment of traction reduction, combined fixation with axis laminar screws and posterior autogenous lilac graft fusion were done based on injury se-verity of the patients. Results The length and height of axis laminar was (26.2±1.2) mm and (12.8±1.6) mm, respectively. The thickness of upper, middle and lower parts of the C2 laminar was (3.0±1.4) mm, (6.0±1.6) mm and (5.6±1.2) mm, respectively. The mean angle between the axial ray and sagittal plane was 43.5°. All patients were followed up for 6-14 months ( mean 6 months), which showed that all patients obtained favourable bone union and all screws remained at sound position, without deflexion of the screws or any perioperative or postoperative complications. No screw loosening or breakage occurred. Conclusions C2 laminar screw fixation technique can prevent the risk of vertebral artery injury during screw insertion. In the meantime, such technique is simple to operate and free from limitation of the vertebral artery in the cervical foramen. Whole course of visualization during C2 laminar screw insertion may facilitate it as a supplementary method for conventional posterior C2 screw fixation.

Treatment strategies for lower cervical distractive flexion injuries / 中华创伤杂志

Objective To discuss the strategies for treatment of lower cervical distractive flexion injuries. Methods Sixty-eight patients including 43 males and 25 females at age range of 18-72 years (average 43 years) suffered from lower cervical distractive flexion injuries were operated from January 2002 to June 2007. According to Allen's classification, there were 7 patients at grade Ⅰ, 19 at grade Ⅱ,29 at grade Ⅲ and 13 at grade Ⅳ. Temporary skull traction was used for each subject before surgery. Only posterior approach was performed in 26 patients who were fixated by pedicle screw system,lateral mass screw system or transarticular screw system. Combined anterior and posterior approach was applied for the other 42 patients at one stage. The curative effect was followed up for all patients after the procedures. Results All patients were followed up for 6-65 months ( average 34 months), which showed posterior incision infection in 2 patients who were cured after debridement or change dressing. Two patients with aggravated neural symptome were cured following treatment with methylprednisolone. Neural function was improved at least for one level in all patients except for 18 patients (Frankel A). Of 11 patients at grade B, there were 4 patients improved to grade C and 5 to grade D. Of 10 patients at grade C, there were 6 patients recovered to grade D and 4 to grade E. All 15 patients at grade D reached grade E. It was not found loosening, breakage or defuxion. The graft bone was fused within 3-4 months, with no any complications related to surgical fixation. Conclusions The strategies for lower cervical distractive flexion injuries should be taken according to Allen' s classification. Single posterior procedure is suitable for grade Ⅰ and Ⅱ injuries. While combined posterior and anterior procedure can be used for grade Ⅲ and Ⅳ injuries.

Artificial cervical disc replacement for the treatment of cervical spondylotic radiculopathy and myelopathy / 中国组织工程研究

BACKGROUND: Anterior cervical decompression and bone graft fusion is always the standard operation type for the treatment of cervical spondylotic radiculopathy and myelopathy. However, secondary degeneration and new symptoms caused by the stress increase of adjacent segments following anterior cervical spinal fusion have been paid more and more attention. Artificial cervical disc replacement provides a new choice for the treatment of cervical syndrome.OBJECTIVE: To observe the therapeutic effect of BRYAN& artificial cervical disc displacement for the treatment of cervical spondylotic radiculopathy and myelopathy.DESIGN: Self-control experiment.SETTING: Department of Orthopaedics, Sixth Hospital of Ningbo.PARTICIPANTS: Seventeen patients with cervical spondylotic radiculopathy and/or myelopathy admitted to the Department of Orthopaedics, Sixth Hospital of Ningbo were involved between December 2003 and February 2005 were involved in the study. Informed consents were obtained, and all participates were approved by Medical Ethics Committee.There were 9 patients with cervical spondylotic myelopathy, and 8 patients with cervical spondylotic radiculopathy.BRYAN& artificial cervical disc system is an artificial cervical intervertebral disc with composite structure. It is constructed by two titanium alloy end plates and polymer core, which can bear loading and took polyisocyanate as matrix.METHODS: BRYAN& artificial cervical disc system was used in the treatment. All the patients underwent single-segment displacement. Two patients underwent the displacement at C3-4, five at C4-5, 8 at C5-6 and 2 at C6-7. At postoperative 1, 3and 6 months, X-ray lateral position, anteflexion position, posterior extension position, the left and right side dynamic position plains were taken to investigate prosthetic stability. Neurologic function was evaluated according to Japanese Orthopaedic Association (JOA) scoring system.MAIN OUTCOME MEASURES: ① Investigating whether or not prosthesis displaced by means of dynamic position plains.② Investigating the recovery of neurologic function by JOA scoring system.RESULTS: ①JOA average scores were elevated to 15 from preoperative 8.5. Nervous system symptoms had improved to different extents, and the mean improvement rate was 75%. At postoperative 1,3 and 6 months, all the patients were followed up and their X-ray plains of cervical lateral position and flexion-extension position showed good stability,indicating that motor function was not lost obviously. No heterotopic ossification was found around the prothesis. ②Wound infection was not found in any patient. At postoperative 3 months, less than 2 mm slight displacement appeared in the prothesis in one patient, and there were no obvious symptoms. Prothesis abrasion, subsidence, bone bridge formation and other rejections were not found in the other prothesis. Prothesis had good biocompatibility, and could be examined by routine CT and MRI.CONCLUSION: Artificial cervical disc replacement can obviously improve the symptoms of patients, and has good therapeutic effects in the treatment of cervical syndrome.

C_(2,3) pedicle screw fixation for management of unstable Hangman fractures / 中华骨科杂志

Objective To introduce the method of C2,3 pedicle screw fixation for management of unstable Hangman fractures and evaluate the clinical effects.Methods From October 2001 to October 2005,26 cases with unstable Hangman fractures were treated using Axis and Vertex pedicle screw system.According to the classification system designed by Levine depending on the radiological manifestations of Hangman fractures,there were unstable fractures in 26 cases,who were subdivided into type Ⅱ in 11 cases,type ⅡA in 10 cases and type Ⅲ in 5 cases.There were 18 males and 8 females,aging from 21 to 56 years with an average of 38.5 years.According to Frankel scale,graded as spinal injury D in 6 cases and E in 20 cases.Points of entry for C2 screw insertion were located at the entrance at the posterior aspect of lateral mass.The drill bit was parallel to both of the medial and superior border of C2 pars interarticularis(usually 15?-25? cephalad to the transverse plane and 20?-25? medial to the sagittal plane).The screw hole in the posterior cortex was overdrilled.3.5-4.0 mm screws(26-30 mm,determined by depth gauge)were drived in after the cortex being tapped.The points of screw penetration for the C3 pedicles was slightly lateral to the center of the articular mass and close to the inferior margin of the inferior articular process of the cranially adjacent vertebra.The insertion angle of the pedicle screw was 35?-45? medial to the midline in the transverse plane.3.5-4.0 mm screws,determined by depth gauge were drived in after the cortex being tapped.The whole procedure was done under monitoring of "C"-arm fluoroscopy for safety and accuracy.Results All patients were followed up from 6 to 54 months,with the average of 29 months.There were no screw loosing and breakage,and no spinal cord and vertebral artery injury after surgery.3 screws were placed too close to the vertebral artery canal in C2 and 7 screws in C3,but without clinical consequences.There were 16 cases in excellent,7 good,3 fair according to Mayo(McGrory)scores.Conclusion C2,3 pedicle screw fixation is a effected method for management of unstable Hangman fractures,which proved its value as a method achieving solid bony fusion combined with low rate of complications.

Ethical Analysis on the Doctor-patient Relationship during Gynaecology Clinic Operation / 中国医学伦理学

The service object of gynaecology clinic operation is female,which involves reproductive organs,personal secrets,marriage,family and parenting.Not only the patients, but also their families,children and social relationship have close relationship with this operation.Tberefore,it is apt to cause contraditions between doctors and patients and difficult to solve.Medical staff should be strict with oneself,strengthen the study of medical ethics while learning to improve professional technique constantly.

Relationship between single nucleotide polymorphisms of hPOT1 genes and helicobacter pylori infection in gastric carcinoma / 西安交通大学学报(医学版)

Objective To explore the relationship between the single nucleotide polymorphisms(SNPs) of IVS13-98G/T of human protection of telomeres 1(hPOT1) genes and H.pylori infection.Methods A total of 150 cases of gastric carcinoma and 156 cancer-free controls were genotyped by polymerase chain reaction(PCR) and PCR-restriction fragment length polymorphism(PCR-RFLP) method.H.pylori was identified with PCR and Warthin-Starry methods.Results The frequencies of GG,GT,and TT genotypes of hPOT1IVS13-98 G/T were 22.00%,41.67% and 36.67% in patients and 24.36%,51.92%,and 23.72% in controls,respectively.The OR for any GT and GG genotype was 0.432(95% CI: 0.242-0.772,P=0.005) and 0.540(95% CI: 0.274-1.064,P=0.075) when compared with TT genotype,respectively.There were no differences in genotype distribution and allele frequency of IVS13-98 G/T polymorphism(?2=3.0257,P= 0.0820).hPOT1IVS13-98 G/T polymorphism was not correlated with H.pylori infection in gastric cancer.Conclusion Our results indicated that IVS13-98 G/T SNP of hPOT1 gene might be associated with reduced risk for gastric carcinoma,but not with H.pylori infection.