[Retracted] P21 activated kinase 2 promotes pancreatic cancer growth and metastasis.

[This retracts the article DOI: 10.3892/ol.2019.10040.].

[Clinical efficacy and radiation exposure analysis of vertebroplasty and curved vertebroplasty in the treatment of osteoporotic vertebral compression fracture].

OBJECTIVE: Taking the classic bilateral puncture vertebroplasty as a reference, to evaluate the clinical efficacy of vertebroplasty of the curved-angle puncture device, analyze the radiation exposure of patients and surgeons during the operation and summarize the protective measures. METHODS: The clinical data of 49 patients with osteoporotic vertebral compression fractures admitted from March 2018 to September 2019 were retrospectively analyzed. According to the different surgical puncture methods, 49 patients were divided into vertebroplasty group (using classic bilateral puncture) and curved vertebroplasty group (using curved angle puncture). Among them, there were 26 cases in vertebroplasty group, including 7 males and 19 females, aged (73.25±6.36) years, 2 cases in thoracic segment, 21 cases in thoracolumbar segment, and 3 cases in lumbar segment. In curved vertebroplasty group, there were 23 cases, including 6 males and 17 females, aged (73.09±6.52) years, 3 cases in thoracic segment, 19 cases in thoracolumbar segment, and 1 case in lumbar segment. The operation time and the amount of injected bone cement in the two groups were recorded. Visual analogue scale (VAS) and modified Oswestry Disability Index (ODI) were respectively used to assess the pain degree and lumbar function, the postoperative bone cement leakage or other complications were observed. The radiation doses of the two groups of patients and surgeons were compared. RESULTS: All 49 patients were followed up for 10-22 (14.55±3.83) months. Eleven cases in vertebroplasty group and 9 cases in curved vertebroplasty group occurred bone cement leakage after surgery, and there was no statistically significant difference between two groups. VAS scores of vertebroplasty group were 6.23±0.68 before operation and 1.69±0.47 at 1 day after operation, respectively, modified ODI were (72.59±3.25)% and (33.59±2.85)%. The preoperative and postoperative VAS scores of curved vertebroplasty group were 6.46±0.56 and 1.57±0.49, respectively, modified ODI were (73.21±3.18)% and (33.17±2.37)%. The postoperative pain degree and lumbar function of the two groups were significantly improved, but the difference between the groups was not statistically significant. The operation time of curved vertebroplasty group and vertebroplasty group were (17.27±9.58) min and(23.19±8.56) min, and the amount of injected bone cement were (4.91±1.49) ml and (6.58±1.42) ml. Obviously, curved vertebroplasty group has more advantages in operation time and the amount of injected bone cement. In curved vertebroplasty group, the radiation dose of the operator was (0.53±0.05) mSv and the patient was (10.64±1.65) mSv;in vertebroplasty group, the operator was (0.59±0.08) mSv andthe patient was (13.52±1.81) mSv. The radiation dose of patients in curved vertebroplasty group was significantly lower than that of the vertebroplasty group, but there was no statistically significant difference in the operator between two groups. CONCLUSION: Both puncture methods can achieve satisfactory clinical results, but curved angle puncture can optimize the distribution of bone cement and reduce the radiation dose of patients.

Impact of Prior Digestive System Disease on In-Hospital Gastrointestinal Bleeding in Patients with Acute Myocardial Infarction.

OBJECTIVE: Patients presenting with acute myocardial infarction (AMI) with prior digestive system disease are more likely to suffer from gastrointestinal (GI) bleeding than those without these diseases. However, few articles reported how the different conditions of the digestive tract produced different risks of GI bleeding. METHODS: A single-center study on 7464 patients admitted for AMI from December 2010 to June 2019 in the Beijing Chaoyang Heart Center was retrospectively examined. Patients with major GI bleeding (n = 165) were compared with patients without (n = 7299). Univariate and multivariate logistic regression models were constructed to test the association between GI bleeding and prior diseases of the digestive tract, including gastroesophageal reflux disease, chronic gastritis, peptic ulcer, hepatic function damage, diseases of the colon and rectum, and gastroenterological tract tumors. RESULTS: Of the 7464 patients (mean age, 63.4; women, 25.6%; STEMI, 58.6%), 165 (2.2%) experienced major GI bleeding, and 1816 (24.3%) had a history of digestive system disease. The risk of GI bleeding was significantly associated with peptic ulcer (OR = 4.19, 95% CI: 1.86-9.45) and gastroenterological tumor (OR = 2.74, 95% CI: 1.07-7.04), indicated by multivariate logistic regression analysis. CONCLUSION: Preexisting peptic ulcers and gastroenterological tract tumors rather than other digestive system diseases were indicators of gastrointestinal bleeding in patients with AMI who undergo standard antithrombotic treatment during hospitalization.

Erratum: P21 activated kinase 2 promotes pancreatic cancer growth and metastasis.

[This corrects the article DOI: 10.3892/ol.2019.10040.].

UPLC-MS metabolomics method provides valuable insights into the effect and underlying mechanisms of Rhizoma Drynariae protecting osteoporosis.

Osteoporosis (OP) is a metabolic bone disease in which that volume of bone tissue per unit volume decrease, which is a common disease disturbing the elderly or postmenopausal women. Rhizoma Drynariae (RD) is a kind of herb widely used in thousands of years of clinical practice in China to tonify kidney and prevent osteoporosis, with reliable curative effect. However, the mechanism of its anti-osteoporosis action is still unclear. This study is dedicated to exploration the therapeutic effect of RD on retinoic acid solution-induced OP model rats based on high-throughput metabolomics technology platform, and reveal its influence on metabolomics level, so as to find effective potential biomarkers and therapeutic targets for diagnosing OP. OP model was established by intragastric administration of retinoic acid solution for 21 days, and then the treatment group was treated by intragastric administration of RD solution for 60 days. Blood samples of all groups were collected and analyzed based on UPLC-MS metabolomics and combined with EZinfo 3.0 data analysis, 32 potential biomarkers were identified, including 22 in ESI+ and 10 in ESI-, these biomarkers are related to 9 metabolic pathways. After treatment with RD solution, 21 biomarkers were obviously regulated, these mainly affected linoleic acid metabolic, glycerophospholipid metabolism and arachidonic acid metabolism pathway. The results show that RD can reduce the risk of OP disease, which may be related to the metabolic pathway mentioned above, and provides the foundation for the administer prophylaxis and treatment of OP with natural products.

Effects of antidiabetic drugs on left ventricular function/dysfunction: a systematic review and network meta-analysis.

BACKGROUND: Although a variety of antidiabetic drugs have significant protective action on the cardiovascular system, it is still unclear which antidiabetic drugs can improve ventricular remodeling and fundamentally delay the process of heart failure. The purpose of this network meta-analysis is to compare the efficacy of sodium glucose cotransporter type 2 (SGLT-2) inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) agonists, metformin (MET), sulfonylurea (SU) and thiazolidinediones (TZDs) in improving left ventricular (LV) remodeling in patients with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD). METHODS: We searched articles published before October 18, 2019, regardless of language or data, in 4 electronic databases: PubMed, EMBASE, Cochrane Library and Web of Science. We included randomized controlled trials in this network meta-analysis, as well as a small number of cohort studies. The differences in the mean changes in left ventricular echocardiographic parameters between the treatment group and control group were evaluated. RESULTS: The difference in the mean change in LV ejection fraction (LVEF) between GLP-1 agonists and placebo in treatment effect was greater than zero (MD = 2.04% [0.64%, 3.43%]); similar results were observed for the difference in the mean change in LV end-diastolic diameter (LVEDD) between SGLT-2 inhibitors and placebo (MD = - 3.3 mm [5.31, - 5.29]), the difference in the mean change in LV end-systolic volume (LVESV) between GLP-1 agonists and placebo (MD = - 4.39 ml [- 8.09, - 0.7]); the difference in the mean change in E/e' between GLP-1 agonists and placebo (MD = - 1.05[- 1.78, - 0.32]); and the difference in the mean change in E/e' between SGLT-2 inhibitors and placebo (MD = - 1.91[- 3.39, - 0.43]). CONCLUSIONS: GLP-1 agonists are more significantly associated with improved LVEF, LVESV and E/e', SGLT-2 inhibitors are more significantly associated with improved LVEDD and E/e', and DPP-4 inhibitors are more strongly associated with a negative impact on LV end-diastolic volume (LVEDV) than are placebos. SGLT-2 inhibitors are superior to other drugs in pairwise comparisons.

Sodium tanshinone IIA sulfonate protects against Aß-induced cell toxicity through regulating Aß process.

Sodium tanshinone IIA sulfonate (STS) has been reported to prevent Alzheimer's disease (AD). However, the mechanism is still unknown. In this study, two in vitro models, Aß-treated SH-SY5Y cells and SH-SY5Y human neuroblastoma cells transfected with APPsw (SH-SY5Y-APPsw cells), were employed to investigate the neuroprotective of STS. The results revealed that pretreatment with STS (1, 10 and 100 µmol/L) for 24 hours could protect against Aß (10 µmol/L)-induced cell toxicity in a dose-dependent manner in the SH-SY5Y cells. Sodium tanshinone IIA sulfonate decreased the concentrations of reactive oxygen species, malondialdehyde, NO and iNOS, while increased the activities of superoxide dismutase and glutathione peroxidase in the SH-SY5Y cells. Sodium tanshinone IIA sulfonate decreased the levels of inflammatory factors (IL-1ß, IL-6 and TNF-α) in the SH-SY5Y cells. In addition, Western blot results revealed that the expressions of neprilysin and insulin-degrading enzyme were up-regulated in the SH-SY5Y cells after STS treatment. Furthermore, ELISA and Western blot results showed that STS could decrease the levels of Aß. ELISA and qPCR results indicated that STS could increase α-secretase (ADAM10) activity and decrease ß-secretase (BACE1) activity. In conclusion, STS could protect against Aß-induced cell damage by modulating Aß degration and generation. Sodium tanshinone IIA sulfonate could be a promising candidate for AD treatment.

Overexpression of EIF5A2 is associated with poor survival and aggressive tumor biology in gallbladder cancer.

Gallbladder cancer (GBC) is a malignant tumor of the biliary tract. The main problem affecting the treatment of gallbladder cancer is late diagnosis and poor prognosis. EIF5A2 is one of two isoforms of the EIF5A family and is reported to be a new oncogenic protein in many human cancers. In this study, our results showed for the first time that EIF5A2 was overexpressed in GBC samples compared with non-tumor tissue. Overexpression of EIF5A2 was associated with lymph node metastasis, tumor differentiation, UICC (Union for International Cancer Control) staging, histological type, metastasis, and tumor size. Overexpression of EIF5A2 in gallbladder carcinoma tissues is also associated with poor prognosis in patients. The interference of EIF5A2 significantly inhibited the proliferation, cell cycle, migration and colony formation of GBC-SD cells in vitro. Our results suggest that EIF5A2 is a target oncogene and may be an important prognostic biomarker in the pathogenesis of gallbladder cancer.

A Review on Daphnane-Type Diterpenoids and Their Bioactive Studies.

Natural daphnane diterpenoids, mainly distributed in plants of the Thymelaeaceae and Euphorbiaceae families, usually include a 5/7/6-tricyclic ring system with poly-hydroxyl groups located at C-3, C-4, C-5, C-9, C-13, C-14, or C-20, while some special types have a characteristic orthoester motif triaxially connectedat C-9, C-13, and C-14. The daphnane-type diterpenoids can be classified into five types: 6-epoxy daphnane diterpenoids, resiniferonoids, genkwanines, 1-alkyldaphnanes and rediocides, based on the oxygen-containing functions at rings B and C, as well as the substitution pattern of ring A. Up to now, nearly 200 daphnane-type diterpenoids have been isolated and elucidated from the Thymelaeaceae and Euphorbiaceae families. In-vitro and in-vivo experiments of these compounds have shown that they possess a wide range of biological activities, including anti-HIV, anti-cancer, anti-leukemic, neurotrophic, pesticidal and cytotoxic effects. A comprehensive account of the structural diversity is given in this review, along with the cytotoxic activities of daphnane-type diterpenoids, up to April 2019.

P21 activated kinase 2 promotes pancreatic cancer growth and metastasis.

Pancreatic cancer has an overall 5-year survival rate of only 9%, due to its rapid metastasis and poor prognosis. To combat this disease, novel therapeutic targets and biomarkers are required. In this study, immunohistochemistry was used to detect the expression of P21 activated kinase 2 (PAK2) protein in the tissues of cancer and the paired adjacent normal tissues. The association between PAK2 and the clinicopathologic features of patients with pancreatic cancer was subsequently analyzed. The results indicated that PAK2 was overexpressed in the cancer tissues, which indicated high pTNM stage, poor tumor grade, lymph node metastasis and vascular invasion. In addition, the results demonstrated evidence of a close association between PAK2 expression and poor prognosis of patients with pancreatic cancer. The results also suggested that PAK2 may promote pancreatic cancer cell proliferation and migration in vitro through clone formation, MTT, wound healing and Transwell assays. The present study further identified that PAK2 could stimulate pancreatic cancer growth and metastasis in mice. Decreased expression of proliferation marker protein Ki-67 and proliferating cell nuclear antigen in response to PAK2 knockdown further verified the role of PAK2 in promoting cell proliferation by western blot analysis. In addition, the expression levels of matrix metallopeptidase (MMP) 2 and MMP9 were decreased in PANC1 and BxPC3 cell lines transfected with PAK2-short hairpin RNA as indicated in western blot analysis, suggesting a function of PAK2 in promoting cell invasion. Collectively, these findings revealed a critical role for PAK2 in the development of pancreatic cancer and may have important implications for the management of this disease.

Effect of dexmedetomidine on blood coagulation in patients undergoing radical gastrectomy under general anesthesia: A prospective, randomized controlled clinical trial.

BACKGROUND: Dexmedetomidine can inhibit the perioperative stress response, which plays an important role in postoperative hypercoagulability. This study aimed to investigate whether dexmedetomidine could attenuate the activation of postoperative coagulation. METHODS: Patients undergoing open radical gastrectomy under total intravenous anesthesia were randomly allocated to the control group (group Con) and the dexmedetomidine group (group Dex). Dexmedetomidine was intravenously infused at 0.5 µg/kg over 10 minutes before anesthesia induction and then infused at a rate of 0.5 µg/kg/h until peritoneal closure in group Dex, whereas saline was administered in group Con. Blood samples were collected for thrombelastograph (TEG) analysis [reaction time (R time), clot formation time (K time), and clot formation rate (α angle)] and laboratory coagulation testing before dexmedetomidine administration and at the end of surgery. RESULTS: Coagulation was activated after radical gastrectomy, as indicated by TEG analysis and the increased concentrations of plasma fibrin (fibrinogen) degradation product (FDP) and thrombin-antithrombin complex (TAT). The R and K times were significantly prolonged and α angle was significantly decreased in group Dex compared with that in group Con at the end of surgery (P < .05). The concentrations of plasma TAT and FDP in group Dex were significantly lower than those in group Con at the end of surgery (P < .05 or .01). CONCLUSION: Adjunctive dexmedetomidine with general anesthesia attenuates the activation of coagulation following radical gastrectomy.

Stimulation of osteogenic differentiation in bone marrow stromal cells via Wnt/ß-catenin pathway by Qili Jiegu-containing serum.

A capsule of Qili Jiegu, a traditional Chinese medicine with numerous biological activities, may exert a protective eff ;ect against postmenopausal bone loss. However, it remains unclear whether Qili Jiegu-containing serum regulates the osteogenic diff ;erentiation of bone marrow stromal cells (BMSCs) in vitro. In this study, BMSCs were treated with medium and Qili Jiegu-containing serum over a 14-day period. We found that Qili Jiegu-containing serum promoted the BMSC proliferation and alkaline phosphatase (ALP) activities, as well as stimulated the expression of osteogenic markers and Wnt/ß-catenin pathway-related genes, i.e., runt-related transcription factor 2 (Runx2), osteocalcin (OCN), ß-catenin and Wnt4a, in BMSCs. Finally, we found that Qili Jiegu-containing serum activated the Wnt/ß-catenin pathway. An addition of Dickkopf-related protein-1 (an inhibitor of the Wnt/ß-catenin signaling pathway) to the Qili Jiegu-containing serum could decrease the stimulatory osteogenic effect of Qili Jiegu-containing serum on BMSCs. Therefore, Qili Jiegu-containing serum could promote the osteogenic diff ;erentiation of BMSCs, and the potential mechanism may involve regulation of Wnt/ß-catenin signaling.

Clinical analysis of acute myocardial infarction caused by coronary embolism.

BACKGROUND: This study aims to investigate the clinical and angiographic features in patients with acute myocardial infarction (AMI) induced by coronary artery embolism. METHODS: Clinical data of five patients with AMI induced by coronary artery embolism were analyzed retrospectively. RESULTS: One patient had left atrial myxoma, one patient had non-valvular atrial fibrillation, and three patients had rheumatic heart disease. Furthermore, one patient had mitral mechanical valve prostheses, two patients had atrial fibrillation. Coronary angiography showed the absence of significant atherosclerostic lesions in the coronary arteries except infarct related artery in five patients. Angiography suggested the presence of IRA occlusion caused by embolism. CONCLUSIONS: The status for AMI due to coronary artery embolism usually expresses embolic material originating from the left heart chambers. Rheumatic heart disease and atrial fibrillation are the common reasons for coronary artery embolism. Coronary artery occlusion is the common performance in the results of primary coronary artery angiography. Sometimes it expresses visible signs of embolism.

Overexpression of the transcription factor NF-YC9 confers abscisic acid hypersensitivity in Arabidopsis.

Nuclear factor Y (NF-Y) family proteins are involved in many developmental processes and responses to environmental cues in plants, but whether and how they regulate phytohormone abscisic acid (ABA) signaling need further studies. In the present study, we showed that over-expression of the NF-YC9 gene confers ABA hypersensitivity in both the early seedling growth and stomatal response, while down-regulation of NF-YC9 does not affect ABA response in these processes. We also showed that over-expression of the NF-YC9 gene confers salt and osmotic hypersensitivity in early seedling growth, which is likely to be directly associated with the ABA hypersensitivity. Further, we observed that NF-YC9 physically interacts with the ABA-responsive bZIP transcription factor ABA-INSENSITIVE5 (ABI5), and facilitates the function of ABI5 to bind and activate the promoter of a target gene EM6. Additionally, NF-YC9 up-regulates expression of the ABI5 gene in response to ABA. These findings show that NF-YC9 may be involved in ABA signaling as a positive regulator and likely functions redundantly together with other NF-YC members, and support the model that the NF-YC9 mediates ABA signaling via targeting to and aiding the ABA-responsive transcription factors such as ABI5.

Overexpression of an Arabidopsis cysteine-rich receptor-like protein kinase, CRK5, enhances abscisic acid sensitivity and confers drought tolerance.

Receptor-like kinases (RLKs) have been reported to regulate many developmental and defense process, but only a few members have been functionally characterized. In the present study, our observations suggest that one of the RLKs, a membrane-localized cysteine-rich receptor-like protein kinase, CRK5, is involved in abscisic acid (ABA) signaling in Arabidopsis thaliana Overexpression of CRK5 increases ABA sensitivity in ABA-induced early seedling growth arrest and promotion of stomatal closure and inhibition of stomatal opening. Interestingly, and importantly, overexpression of CRK5 enhances plant drought tolerance without affecting plant growth at the mature stages and plant productivity. Transgenic lines overexpressing a mutated form of CRK5, CRK5 (K372E) with the change of the 372nd conserved amino acid residue from lysine to glutamic acid in its kinase domain, result in wild-type ABA and drought responses, supporting the role of CRK5 in ABA signaling. The loss-of-function mutation of the CRK5 gene does not affect the ABA response, while overexpression of two homologs of CRK5, CRK4 and CRK19, confers ABA responses, suggesting that these CRK members function redundantly. We further showed that WRKY18, WRKY40 and WRKY60 transcription factors repress the expression of CRK5, and that CRK5 likely functions upstream of ABI2 in ABA signaling. These findings help in understanding the complex ABA signaling network.

Characterization of a Novel Dengue Serotype 4 Virus-Specific Neutralizing Epitope on the Envelope Protein Domain III.

The dengue virus (DENV) envelope protein domain III (ED3) has been suggested to contain receptor recognition sites and the critical neutralizing epitopes. Up to date, relatively little work has been done on fine mapping of neutralizing epitopes on ED3 for DENV4. In this study, a novel mouse type-specific neutralizing antibody 1G6 against DENV4 was obtained with both prophylactic and therapeutic effects. The epitope was mapped to residues 387-390 of DENV4 envelope protein. Furthermore, site-directed mutagenesis assay identified two critical residues (T388 and H390). The epitope is variable among different DENV serotypes but is highly conserved among four DENV4 genotypes. Affinity measurement showed that naturally occurring variations in ED3 outside the epitope region did not alter the binding of mAb 1G6. These findings expand our understanding of the interactions between neutralizing antibodies and the DENV4 and may be valuable for rational design of DENV vaccines and antiviral drugs.

[The impact of community-based organizations in HIV testing mobilization among men who have sex with men].

OBJECTIVE: To analyze the impact of efforts of community-based organizations (CBO) in HIV testing mobilization and case finding among men who have sex with men(MSM). METHODS: Results of HIV testing mobilization among MSM through CBOs in 15 program areas were collected and compared with corresponding HIV case reporting data to demonstrate the contribution of CBO-based HIV testing in HIV case finding among MSM from July 2008 to December 2011. Meanwhile,the proportion of screened HIV positives who received testing results notification,confirmatory test, following up and CD4 cell tests were analyzed and compared with those identified in medical institutions. RESULTS: A total of 196 075 HIV tests were performed for MSM, as a result of mobilization efforts of CBOs. Cumulatively 7704 new HIV cases were identified, accounting for 51.7% (7704/14 914) of all newly diagnosed HIV cases infected via homosexual sex in the program areas.Among the newly diagnosed MSM HIV infections in the program areas,the proportion of infections detected through the mobilization of CBOs increased from 35.4% (609/1722) in 2008 to 63.7% (2371/3722) in 2010, and 58.3% (3024/5189) in 2011. Compared with those identified through medical institutions, newly diagnosed MSM infections detected though CBOs testing mobilization have higher rates of receiving screening testing results notification (97.3% (4441/4563) vs 92.8% (13 140/14 153)) , (84.6% (2559/3024) vs 79.8% (5589/7002)) and CD4 cell tests (66.1% (1999/3024) vs 52.9% (3705/7002)), and a lower rate of receiving confirmatory test (78.6% (3588/4563) vs 85.6% (12 115/14 153)). CONCLUSION: CBOs can take their advantages in mobilizing MSM to receive HIV test, and MSM HIV cases detected through CBOs have become the main source of MSM HIV case finding in program areas.

Overexpression of kallikrein gene 10 is a biomarker for predicting poor prognosis in gastric cancer.

AIM: To analyze the expression of kallikrein gene 10 (KLK10) in gastric cancer and to determine whether KLK10 has independent prognostic value in gastric cancer. METHODS: We studied KLK10 expression in 80 histologically confirmed gastric cancer samples using real-time quantitative reverse transcription-PCR and hK10 expression using immunohistochemistry. Correlations with clinicopathological variables (lymph node metastasis, depth of invasion and histology) and with outcomes (disease-free survival and overall survival) during a median follow-up period of 31 mo were assessed. Gastric cancer tissues were then classified as KLK10 positive or negative. RESULTS: KLK10 was found to be highly expressed in 57/80 (70%) of gastric cancer samples, while its expression was very low in normal gastric tissues. Positive relationships between KLK10 expression and lymph node metastasis (P = 0.048), depth of invasion (P = 0.034) and histology (P = 0.015) were observed. Univariate survival analysis revealed that gastric cancer patients with positive KLK10 expression had an increased risk for relapse/metastasis and death (P = 0.005 and 0.002, respectively). Cox multivariate analysis indicated that KLK10 was an independent prognostic indicator of disease-free survival and overall survival in patients with gastric cancer. CONCLUSION: KLK10 expression is an independent biomarker of unfavorable prognosis in patients with gastric cancer.

[Percutaneous pelvic fracture stabilization using CT-based 3D navigation software combined with targeting mechanical arm: a cadaver model trial].

OBJECTIVES: To investigate a new targeting mechanical arm for CT-based navigated percutaneous fixation of pelvic fractures, and to evaluate the safety and efficiency of the procedures. METHODS: Using CT-based 3D navigation software combined with targeting mechanical arm, percutaneous insertion of pelvic models (3 dry human cadaver pelvic skeletons and 5 plastic Sybone pelvic models) were performed, 8 pelvic models allowed percutaneous cannulated screw insertion of both S-I joint (2 S-I screws placement for each side, total 32 screws in this experiment) and both superior ramus (1 ramus medullary screw placement for each side, total 16 screws in this experiment). Percutaneous insertion of pelvic models (4 dry human cadaver pelvic skeletons and 4 plastic Sybone pelvic models, 1 S-I screws and 1 ramus medullary scre placement for each side, 32 screws in this experiment) were performed using fluoro-navigation system (Stryker, USA). Time necessary for every screw insertion were recorded. Accuracy of screw placement was assessed using C-arm imaging and direct eyes inspecting. The time and accuracy of the two methods were compared. RESULTS: The time required for the CT-based 3D navigation procedure (3.6 ± 1.2) min was significantly less than using the targeting mechanical arm compared to drilling freehand with navigation (9.1 ± 0.8) min (t = 2.50, P < 0.01). There was no significant difference in accuracy between the two methods. CONCLUSION: CT-based 3D navigation software combined with targeting mechanical arm should be potential to apply percutaneous sacroiliac screwing for pelvic fractures with more accurate and more reliable.