Robot-assisted total knee arthroplasty research on safety and effectiveness / 中华骨科杂志

Objective:To investigate the safety and effectiveness of robot-assisted total knee arthroplasty (TKA).Methods:From August 2021 to March 2022, the data of 69 patients who received robot-assisted TKA for inflammatory disease of knee in 6 hospitals were collected, including 24 males and 45 females, aged 52±6 years (range, 46-72 years), including 53 cases of knee osteoarthritis,10 cases of rheumatoid arthritis, and 6 cases of traumatic arthritis. Imaging data examination of patients was completed according to the multicenter specification. Preoperatively, the patient's CT data were extracted before surgery and a personalized prosthesis positioning plan was designed by the robotic system to determine the prosthesis size, lower limb force lines, and femoral and tibial osteotomy volumes; intraoperatively, the osteotomy template was robotically controlled to complete the osteotomy according to the prosthesis positioning plan, and the intraoperative osteotomy volumes were measured to verify the accuracy of the robot-assisted TKA osteotomy with the preoperative planning. Postoperatively, the lateral angle of the distal femur, the medial angle of the proximal tibia and the hip-knee-ankle angle were measured in the coronal plane according to radiographs; the postoperative outcome was evaluated 3 months after operation, using the American Knee Society score (KSS), including the KSS knee score and functional score.Results:The operative time was 97.3±2.3 min (range, 80-110 min) and the amount of bleeding was 320.0±6.2 ml (range, 300-350 ml) in 69 patients. Three months after operation, the mean range of motion of knee joint was increased from 82.2°±1.1° before surgery to 119.7°±0.8° after surgery ( t=27.65, P<0.001), and the line of force of lower limb was improved from 160.9°±0.5° before surgery to 178.0°±0.2° after surgery ( t=32.03, P<0.001). KSS-knee score increased from 54.8±0.7 points before operation to 85.0±0.5 points after operation, and KSS-functional score increased from 56.5±0.7 points before operation to 85.9±0.4 points after operation, the difference was statistically significant ( t=35.45, 36.58, P<0.001). The proportion of patients with intraoperative femoral and tibial osteotomies within 2 mm osteotomy error compared with preoperative planning was 97% for the lateral tibial plateau, 100% for the medial tibial plateau, 100% for the lateral distal femur, 99% for the medial distal femur, 93% for the lateral posterior femoral condyle, and 100% for the medial posterior femoral condyle; The proportion of patients with postoperative anteroposterior X-ray measurement angle error within 3° was: 100.0% for the distal lateral femoral angle, 100.0% for the proximal medial tibial angle, and 100% for the hip-knee-ankle angle. No complications occurred in all patients except for one case in which fat liquefaction occurred in the postoperative wound. Conclusion:Robot-assisted TKA is a safe and effective surgical method for the treatment of inflammatory disease of knee with accurate prosthesis installation and good postoperative recovery of lower limb alignment.

The recent advances in developing gene editing and expression tools and the synthesis of natural products in Yarrowia lipolytica / 生物工程学报

Yarrowia lipolytica, as an important oleaginous yeast, has been widely used in metabolic engineering. Y. lipolytica is considered as an ideal host for the production of natural products such as terpenes, polyketides and flavonoids, due to its ability to utilize a variety of hydrophobic substrates, high stress tolerance to acid and salt, high flux of tricarboxylic acid cycle and the ability in providing abundant the common precursor acetyl-CoA. Recently, more and more tools for genetic editing, gene expression and regulation has been developed in Y. lipolytica, which facilitate the metabolic engineering of Y. lipolytica for bio-manufacturing. In this review, we summarized the recent progresses in developing gene expression and natural product synthesis in Y. lipolytica, and also discussed the challenges and possible solutions in heterologous synthesis of natural products in this yeast.

Ketogenic Diet in Infants with Early-Onset Epileptic Encephalopathy and SCN2A Mutation

Research has shown mutations in the voltage-gated sodium channel gene SCN2A to be associated with developmental delays and infantile seizures in patients with early-onset epileptic encephalopathies (EOEEs). Here, we report the case of an infant with a de novo SCN2A mutation with EOEE who had medically refractory seizures that improved with a ketogenic diet (KD) implemented at an age less than 2 months. On the day of his birth, the infant presented with a pattern of convulsions with dozens of episodes per day. An initial video electroencephalogram revealed poor reactivity of background activity, with multiple partial episodes starting from the right temporal region, and abnormal electrical activity in the right hemisphere. The seizures previously were not controlled with successive therapy with phenobarbital, topiramate, and levetiracetam. Genetic testing revealed the presence of a mutation in the SCN2A gene (c.4425C>G, p.Asn1475Lys). The infant’s seizures decreased significantly with a combination of KD and medication. The present case exemplifies the potential for personalized genomics in identifying the etiology of an illness. Furthermore, the KD appears to feasible in infants younger than 2 months and might elicit good responses to EOEE associated with SCN2A mutation.

Relationship between childhood sexual abuse and sexual behavior among female nursing students / 中国学校卫生

Objective@#To explore the relationship between childhood sexual abuse (CSA) experience and sexual behavior among female nursing students and to provide a scientific reference for intervening sexual behavior for female nursing students.@*Methods@#A cross-sectional study was conducted among 2 549 female students majoring nursing from four medical schools (one is a medical college and the other is medical junior college) by self-administered questionnaire. A questionnaire survey regarding demographic information, childhood sexual abuse, sexual behavior was conducted and multi-factor Logistic regression method was used to analyze the effect of childhood sexual abuse in different stages made on their sexual behavior.@*Results@#Among 2 549 female nursing students, 143(5.6%) reported having had sexual intercourse, 141 reported having had sexual intercourse with the opposite sex, 6 reported having had sexual intercourse with the same sex, and 4 reported having sexual intercourse with both sexes. The report rate of sexual behavior of nursing students in undergraduate colleges (6.8%) was lower than that of junior college (3.9%), the second-grade nursing students reported the highest rate of sexual behavior (7.8%), the lowest in first grade (4.0%). Nursing students in good relationship with parents reported lowest rate of sexual behavior(P<0.05). Compared to those who had not experienced CSA, students who had experienced contacting or no-contacting CSA reported a higher percentage engaged in sexual intercourse(P<0.05). CSA in all types and different stages in childhood associated with higher risk of sexual intercourse among nursing students(P<0.05).@*Conclusion@#Childhood sexual abuse shows significant impacts on sexual behaviors during young adulthood, which warrants further attention to promote physical and mental health of college students.

Analysis and treatment of complications in peripheral totally implantable venous access port / 中国实用外科杂志

OBJECTIVE: To explore the clinical application of the peripheral totally implantable venous access port(TIVAP) in breast cancer chemotherapy patients,and to understand the clinical applicability and safety of peripheral TIVAP.METHODS: The clinical data of 201 cases using peripheral TIVAP of multi-course chemotherapy in the First Affiliated Hospital of Chongqing Medical University from March 2017 to June 2018 were analyzed retrospectively.The difference of composition ratio of various complications,and difference between the conventional pressure bandaging method and the modified pressure bandaging method for incision hemorrhage,the conventional implantation method and the improved implantation method for catheter ectopic and the difference of the catheter ectopic after left/right peripheral vein TIVAP placement were compared.RESULTS: There were 50 cases(24.9%) of postoperative complications,15 cases(7.5%) of incision hemorrhage,4 cases(2.0%)of catheter-related thrombosis,3 cases(1.5%) of base exposure,4 cases(2.0%) of sack infection,15 cases(7.5%)of primary catheter ectopic,7 cases(3.5%) with no blood withdrawal,2 cases(1.0%) with catheter-related upper limb movement limitation.Using the goodness of fit test(equal ratio) to compare the composition ratio of various complications,χ~2=30.520,P<0.001,the proportion of complications was not obeyed,and the proportion of incision hemorrhage and catheter ectopic was the highest.The conventional pressure bandaging method(78 cases) and the modified pressure bandaging method(123 cases) showed incision bleeding,and the difference was statistically significant [11 cases(14.1%) vs.4 cases(3.3%),χ~2=6.642,P=0.010];the conventional implantation method(90 cases) and the modified implantation method(121 cases) were compared with catheter ectopic,and the difference was statistically significant [9 cases(10.0%) vs.3 cases(2.4%) χ~2=4.131,P=0.042];there was no statistically significant difference in catheter ectopic position after left(106 cases)/right(95 cases) peripheral TIVAP implantation [8 cases(7.5%) vs.7 cases(7.3%),χ~2=0.020,P=0.962].CONCLUSION: The complication of peripheral TIVAP can be effectively controlled through safe management,close observation and active treatment.TIVAP is still a safe and effective intravenous infusion channel for long-term clinical use if there is no contraindication.

Analysis of SCN4A gene variation in a Chinese pedigree affected with skeletal muscle sodium channelopathies / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features of a Chinese pedigree affected with skeletal muscle sodium channelopathies due to variation of SCN4A gene.@*METHODS@#Potential variation of the 24 exons of the SCN4A gene was screened using PCR and Sanger sequencing.@*RESULTS@#Four family members were affected with the disease in an autosomal dominant inheritance pattern. Three patients had normekalemic periodic paralysis, while 1 showed paramyotonia congenita. Genetic analysis detected a missense variation c.2078T>C (p.Ile693Thr) in exon 13 of the SCN4A gene in the proband and other 3 affected relatives.@*CONCLUSION@#Normokalemic periodic paralysis and paramyotonia congenita can occur in different family members with skeletal muscle sodium channelopathies due to c.2078T>C(p.Ile693Thr) variation of SCN4A gene.

Effect of laparoscopic salpingotomy with suturing on prognosis of patients / 中国综合临床

Objective To investigate the effect of laparoscopic salpingotomy with suturing on prognosis of patients.Methods One hundred and thirty two cases patients of laparoscopic salpingotomy and embryo extraction in our hospital from October 2015 to Febrary 2017 were were divided into observation group (68 cases) with suturing and control group (64 cases) without suturing according to the operation procedure.The patency of fallopian tube was observed at 3 months after operation and the intrauterine gestation rate and recurrent ectopic pregnancy rate were observed 1 years after operation in two groups.Results The fallopian tube patency in the observation group and the control group was 58 cases (85.3％) and 39 cases (60.9％) respectively at 3 months after operation.7 cases (10.3％) and 12 cases(18.8％) of the fallopian tube were not smooth in the observation group and the control group respectively at 3 months after operation.The fallopian tube obstruction in the observation group and the control group was 3 cases (4.4％) and 13 cases (20.3％) respectively at 3 months after operation.The patency rate of fallopian tube in the observation group was higher than that in the control group (Z =6.215,P ＜ 0.05).The intrauterine gestation rate (69.1％ (47/68)) in the observation group was significantly higher than that in the control group (37.5％(24/64)) 1 years after operation and the difference between the two groups was statistically significant (x2 =5.41,P ＜0.05).The rate of recurrent ectopic pregnancy in the observation group (10.3％(7/68)) was significantly lower than that in the control group (26.6％(17/64)) and the difference between the two groups was statistically significant (x2 =4.826,P ＜ 0.05).Conclusion The laparoscopic salpingotomy with suturing can improve the patency rate of the fallopian tube and the rate of intrauterine gestation and reduce the rate of recurrent ectopic pregnancy in the patients after the operation.

Effectiveness of the specific removal of exogenous endotoxin by an affinity adsorption material / 中国比较医学杂志

Objective To investigate the effectiveness of the affinity adsorption material developed by our team for the specific removal of exogenous endotoxin in the blood circulation. Methods Fifteen beagle dogs were intravenously injected with endotoxin to establish a dog model of endotoxemia, and then they were randomly divided into the treatment group(n=10)and the control group(n=5). The treatment group received an extracorporeal perfusion to remove the endotoxin using the self-made disposable hemoperfusion device,while the control group using routine perfusion device. The levels of endotoxin, tumor necrosis factor α(TNF-α), interleukin 1β(IL-1β), interleukin 6(IL-6)and interleukin 8 (IL-8)in the blood of the dogs were measured at the beginning and 120 min after hemoperfusion for 120 minutes. The vital signs of the dogs were monitored during the hemoperfusion. Results After successful establishment of the endotoxemia model,the level of endotoxin at the beginning of hemoperfusion in the treatment group and control group was 118.63 ± 27.98 EU/mL and 117.16 ± 22.95 EU/mL,respectively. After hemoperfusion for 120 min,it was 0.039 ± 0.01 EU/mL and 131.98 ± 7.01 EU/mL, showing a significant difference(P﹤0.05). The clearance rate of hemoperfusion in the treatment group was 94.07%. At the beginning of hemoperfusion, the levels of TNF-α, IL-1β, IL-6 and IL-8 in the treatment group were 1.53 ± 0.27 ng/mL,12.82 ± 1.66 ng/mL,54.77 ± 3.98 ng/mL and 0.25 ± 0.32 ng/mL, and the levels in the control group were 1.53 ± 0.06 ng/mL,13.05 ± 0.18 ng/mL,54.58 ± 0.19 ng/mL and 0.28 ± 0.06 ng/mL, respectively. After hemoperfusion for 120 min, the levels of TNF-α, IL-1β, IL-6 and IL-8 in the treatment group were 0.13 ± 0.06 ng/mL, 0.70 ± 0.36 ng/mL, 1.62 ± 0.80 ng/mL and 0.01 ± 0.00 ng/mL, respectively, and as for the control group,the levels were 2.26 ± 0.15 ng/mL,15.12 ± 0.18 ng/mL,62.54 ± 0.93 ng/mL and 0.73 ± 0.93 ng/mL. There were significant differences between the beginning and after perfusion for 120 min in those two groups(P< 0.05). Conclusions This affinity adsorption material can effectively remove endotoxin and the inflammatory mediators in the blood of experimental dogs,with a clearance rate of 94.07%.

Expressions of FEZ1 and HIF-1αprotein in oral squamous cell carcinoma and its prognosis / 天津医药

Objective To investigate the expressions of tumor suppressor gene FEZ1 and hypoxia inducible factor (HIF)-1α in oral squamous cell carcinoma (OSCC), and their correlation with clinicopathological features and prognosis. Methods A total of 146 specimens of OSCC and 80 normal oral mucosa were used to detect the expressions of FEZ1 and HIF-1αby immunohistochemistry. Thirty specimens of fresh OSCC tissues, 30 samples of the paracancerous tissues and 30 normal mucosa tissues were also included in the study. The relationship between the expressions of FEZ1 and HIF-1α, the clinicopathological features and the prognosis of the patients were analyzed. Western blot assay was used to detect the expres?sions of FEZ1 and HIF-1αin 30 fresh OSCC tissues, 30 samples of the paracancerous tissues and 30 normal mucosa tissues. Results In OSCC tissues, the positive rate of FEZ1 protein (30.14%) was significantly lower than that in normal oral muco?sa (81.25%), and the positive rate of HIF-1αprotein (71.23%) was significantly higher than that in normal mucosa (12.50%,χ2=54.076 and 71.317, P<0.01). There was a correlation between the expression of FEZ1 and clinical stage, tumor size and differentiation. The expression of HIF-1αwas correlated with gender, lymph node metastasis, tumor size and differentiation. There was no significant difference in 5-year survival rate between positive and negative FEZ1 expression groups. The 5-year survival rate was significantly lower in HIF-1α positive expression group than that of HIF-1α negative expression group (P<0.05). The expression level of FEZ1 was decreased by the sequences in normal oral mucosa, paracancerous tissue and OSCC (P<0.01), but the expression level of HIF-1αwas increased in turn (P<0.01). Conclusion FEZ1 and HIF-1αmay be involved in the occurrence and progress of OSCC. The expressions of FEZ1 and HIF-1αcan be used as a reference for the biological behavior of OSCC.

Practice and reflection on medical cell biology teaching for international students in English / 中华医学教育探索杂志

Medical cell biology is a very important course for medical international students. It is a new challenge for medical colleges to carry out the international students curricula in English. In order to successfully accomplish the teaching of cell biology course ,the teachers in Teaching and Research Section of Medical Cell Biology and Genetics in Guangzhou Medical University made the following preparation before class:choosing or compiling English teaching material,writing English teaching plan,making English PPT and trial teaching before lass. Meanwhile,they improved the teaching links in theoretical teaching and experimental teaching and emphasized on students' feed-back,which provided references for teaching of medical cell biology course.

Earlier assessing death toll after disastrous earthquake / 中华急诊医学杂志

Objective To explore a method for earlier evaluating death toll based on a function relationship ( an increasing hour-increasing death index ( K value) followed with time (T) changing after catastrophic earthquake. Methods Information data of 10 typical occurrences of catastrophic earthquake obtained from China International Search and Rescue Team (CISAR) were analyzed. Total deaths were estimated according to the simulation function made by hour-increasing death index (K value) followed with time (T) changing. Expected value of the simulation function was assessed by statistical software SPSS version 17.0 to establish the model of simulation function.Results The length of time (T) to reach K maximum (Kmmax) was ( 12.94 ± 8.18) h and then the K value was gradually decreased. Kmax was symmetrically scattered within 2 T time.Estimated death toll (W) within 2 T was obtained from calculating the integration summation of the function to get a formula as W =∫∞ kf(t) dt.This Estimated death toll(W) numbers was correlated approximately with the death toll (M) from authoritative report (P ＜ 0.01 ).According to the regression analysis of model simulation curve,the predictive function of death toll within 2 T was M =W1.23 ×0.194.A determinant coefficient of this power function R2 was 0.88. Conclusions Earlier estimating death toll within about 12 h should be carried out by using the data of real-time information report system.

Cloning and expression of lipase gene to enantioselective resolution of (S)-ketoprofen / 生物工程学报

We screened a strain NK13 for a certain extent asymmetric hydrolysis the rac-ketoprofen Chloroethyl ester to (S)-Ketoprofen. As identified, NK13 was Bacillus megaterium. Digested NK13 genomic DNA with Sau3AI partially and recovered the fragment from 2 kb to 6 kb, cleaved the plasmid of pUC18 with BamH I, ligated the 2-6 kb fragment of NK13 genomic DNA into pUC18 plasmid, and then transformed an Escherichia coli strain DH5alpha. We created the gene library of NK13 and obtained a positive clone, pUC-NK1 in the library from the tributyrin flat. The result of sequencing showed that there was a whole open read frame (ORF) of 633 bp lipase gene in the plasmid of pUC-NK1. To compare with the genes of GenBank, this lipase gene was reported firstly (GenBank Accession No. EU381317). The lipase gene was amplified by PCR, using pUC-NK1 plasmid as template, and subcloned into the high expression vector pET21b(+) under the control of T7 promoter. The recombinant plasmid, pET-NKest1, was then transformed into an Escherichia coli strain BL21 (DE3) for the production of recombinant lipase protein. After 3 hours of induction by isopropyl-beta-D-thiogalactoside (IPTG), lipase was expressed. SDS-PAGE analysis showed that the relative molecular mass of the lipase protein was about 20 kDa. The result of high performance liquid chromatography (HPLC) showed that the conversion rate of the recombinant strain was fifty times than the wild strain NK13's. The (S)-Ketoprofen enantiomeric excess of the recombinant strain was 75.28%, which indicated that the lipase could hydrolyze (S)-Ketoprofen Chloroethyl ester firstly. If we research the conditions of the hydrolysis rac-ketoprofen Chloroethyl ester of this lipase further, maybe it could offer a foundation to product (S)-Ketoprofen industrially.

Effects of the fixed metallic dental materials on MRI images / 实用口腔医学杂志

In this paper,to evaluate the existence and extent of MRI artifacts caused by frequently used metallic dental materials and to compare the influence of different MRI sequences on artifacts. The artifact of Au-Pt-Pd alloy crown were the smallest and Au-Ag-Pd alloy crown, pure Titanium crown were smaller. But the artifact of Ni-Gr alloy crown were the largest.With the same scan sequences, the different metal materials can make different effects on MRI images with the different scan sequences, the MRI artifact is not obvious caused by the same metal materials. Artifacts produced by oral metallic materials related closely to the type of the materials.The high quality MRI can be gained by choosing proper metallic materials.

Association of the DJ-1 gene polymorphism with sporadic Parkinson's disease in Sichuan province of China / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the frequencies of three polymorphisms in DJ-1 (g.168-185del; SNP405, refSNP ID:rs3766606 and 293 G/A) and their association with sporadic Parkinson's disease.</p><p><b>METHODS</b>An association study was performed to determine the genotype of each subject using polymerase chain reaction, restriction fragment length polymorphism and sequence analysis in 192 patients with sporadic Parkinson's disease and 198 healthy controls.</p><p><b>RESULTS</b>In the g.168-185del locus, the Ins/Ins genotype was common and the frequency of Del allele was very low (0.38%). The SNP of 293G/A was not detected in both groups. In the SNP405 G/T site, the GT genotype frequency was significantly higher in patients with age of onset before 40 years than in controls (18.75% vs 5.54%, P=0.004, OR=6.30 95%CI:1.96-20.18).</p><p><b>CONCLUSION</b>The results suggest that the frequencies of the g.168-185del and 293G/A polymorphisms might be different between Chinese and European. The SNP405 GT genotype might be a risk factor for sporadic Parkinson's disease with early age of onset in Sichuan Han population.</p>

Association of the polymorphisms in NURR1 gene with Parkinson's disease / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association between the polymorphisms of [c.-2922(C)2-3 and IVS6+ 18insG] in the NURR1 gene and Parkinson's disease (PD) in a Han population from Sichuan province.</p><p><b>METHODS</b>PCR, allele-specific PCR (AS-PCR) and restriction fragment length polymorphism (RFLP) were used to determine the genotype of each subject.</p><p><b>RESULTS</b>The two polymorphic sites in 241 PD patients and 236 controls with matched age, gender and ethnicity were analyzed. In the IVS6+ 18insG site, the difference of genotype frequencies of 3G/3G, 3G/2G and 2G/2G was not statistically significant. However, the 3G/2G genotype frequency was significantly higher in the PD with age of onset being < 50 years than that in controls (chi (2)= 6.537, P= 0.011; OR= 1.913, 95%CI: 1.159-3.158). No significant differences were found in allele and genotype frequencies of the c.-2922(C)2-3 site in the promoter region between the PD and controls (P= 0.766).</p><p><b>CONCLUSION</b>This study suggested that the IVS6+ 18insG polymorphism may be associated with genetic susceptibility of PD with age of onset being < 50 years and the c.-2922(C)2-3 site in the promoter region may not be a risk factor for PD in authors' patient group.</p>

Treatment of intercondylar humeral comminuted fractures / 中国矫形外科杂志

[Objective]To evaluate surgical treatment and curative effect of intercondylar humeral comminuted fractures.[Method]Twenty-one cases of intercondylar humeral comminuted fractures were collected from February 2001 to December 2005. The fractures were classified to 5 cases of C1,9 cases of C2 and 7 cases of C3 according to the AO classification.Seventeen fractures were internal fixed by open-reduction, and 4 fractures were treated by total elbow replacement. After olecranon osteotomy, capitate eminence and trochlea humerus were reducted and fixed with bone screw,while shaft of humerus and the distal end of humerus were fixed with AO double plate or Y-shaped plate in internal fixed group. Early physiotherapy were started as soon as possible. The elbow replacement group were replaced by semi-restriction elbow prosthesis and fixed with cemente following physiotherapy after 4 to 7 days.[Result]forteen of 17 cases were postoperatively followed-up in internal fixed group from 12 to 44 months, and all cases had been visited for 14 to 36 months in elbow replacement group. According to modified Cassebaum scoring system, 71.4% were good in internal fixed group and 100% in elbow replacement group.[Conclusion]It has good curative effect in intercondylar humeral comminuted fractures with olecranon osteotomy, the AO double plate or Y-shaped plate internal fixation and early physiotherapy. With severe injury of the distal end of humerus, obviously osteoporosis and older than 50 years, the total elbow arthroplasty and replacement are preferred.

Diagnosis and surgical treatment of sacral fracture accompanied by neurological damage / 中国矫形外科杂志

[Objective]To study the diagnosis and treatment of sacral fracture accompanied by neurological damage.[Method]Twelve patients with sacral fracture accompanied by nerve injuries were treated and analyzed during 1999 to 2004,including 9 males and 3 females. Final diagnosis was given according to the evaluation of physical examination,X-ray,CT and MRI examinations. Dennis classification found 2 cases of I type,6 cases of Ⅱ type and 4 cases of Ⅲ types.The surgical approach of these patients were selected according to the Dennis classification,Type Ⅰ and type Ⅱ were treated with conservative methods,and operations were taken if little symptom was no or a little improved. Posterior approach enlargement for sacral nerve canal,exploration and endoneurolysis on sacral nerve were performed on type Ⅲ as early as possible.Old fracture of type Ⅱ and type Ⅲ with neurologic signs had to be operated early.Conservative and operative treatments were taken 7 and 5 respectively.[Result]After six months to three years following up,two cases of Denis type Ⅰ,six cases of Denis type Ⅱ and one in four Denis type Ⅲ cases were recovered completely.Two cases of Denis Ⅲ were improved significantly while one case was improved a little.[Conclusion]The anatomical position of sacrum is not conspicuous and the symptom caused by neurological damage is too tiny to detect.Carefully physical examination combined with image analysis is necessary to elevate the rate of final diagnosis.Different surgical treatments were used to different type of sacral fracture. Posterior approach enlargement for sacral nerve canal and exploration and endoneurolysis on sacral nerve may be an ideal choice to treat sacral fracture accompanied by neurological damage.Nerves injuries is an critical operation indication for delayed sacral fracture.

The effect of calmodulin antagonist berbaminederivative-EBB on hepatoma in vitro and in vivo / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the anti-hepatoma effect of Calmodulin antagonist 0 - 4-ethoxyl-butyl-Berbamine (EBB), one of the berbamine derivatives.</p><p><b>METHODS</b>Monotetrazolium (MTT) method was used to analyze the effect of EBB on the proliferation and growth inhibition effect. Of a hepatoma cell line in vitro. A mouse hepatoma model was induced by injection of hepatoma cells (H22) in the abdominal cavity. The effect of EBB on survival at different concentrations as well as in combination with 5-FU were investigated in vivo. Flow cytometry analysis, dot blot hybridization, western blot, immunochemistry, enzyme-linked lectin assay (ELISA), trifluoperazine (TFP) and electron microscopic observation were used to study the effect of EBB on cell cycle process, P53 mRNA and protein levels, calmodulin content and ultrastractural changes of hepatoma cells.</p><p><b>RESULTS</b>EBB exerts a very strong inhibitory effect on human hepatoma cell line 7402 and mouse hepatoma cell line H22 in vitro. The IC(50) value of EBB for the two cell lines are 3.312 microg/ml and 1.167 microg/ml, respectively. The sensitivity of H22 cells to 5-FU can be markedly enhanced: The IC(50) dosage of 5-Fu can be decreased from 0.75 microg/ml down to 0.15 microg/ml, when jointly administered with nontoxic dosages of EBB (IC(10)). In vivo, EBB can prolong the lifespan of mice with ascites H22 to more than three months. 64% of mice survived, while all animals in the control group died by the 18th day. When EBB (5 mg x kg(-1) x d(-1)) is jointly used with 5-FU (25 mg x ml(-1) x d(-1)), 73% of mice with ascites H22 survived, much higher than 27% in the 5-FU treated group. EBB can enhance the anti-hepatoma ability of 5-Fu treatment. EBB mechanism against hepatoma: P53 expression in the EBB treated group is substantially higher than that in the control group. EBB increased the translation of P53. As a calmodulin antagonist, EBB decreases amount of the CaM in hepatoma cells and blocked the hepatoma cell proliferation cycle at the G(2)M phase. Before the G(0)/G(1) phase, a diploid peak and apoptic cells in the treated groups were observed.</p><p><b>CONCLUSIONS</b>The CaM antagonist, EBB, has a strong anti-hepatoma effect and enhances the effect of 5-FU, induces hepatoma cell to apoptosis, promotes the P53 protein expression and decreases the amount of CaM in the cytoplasm. All these results demonstrate that EBB is a new and potentially useful drug against hepatoma and should be researched further.</p>