Finite element analysis of PMMA bone cement reinforced screw plate fixation for osteoporotic proximal humeral fracture / 中国骨伤

OBJECTIVE@#With the help of finite element analysis, to explore the effect of proximal humeral bone cement enhanced screw plate fixation on the stability of internal fixation of osteoporotic proximal humeral fracture.@*METHODS@#The digital model of unstable proximal humeral fracture with metaphyseal bone defect was made, and the finite element models of proximal humeral fracture bone cement enhanced screw plate fixation and common screw plate fixation were established respectively. The stress of cancellous bone around the screw, the overall stiffness, the maximum stress of the plate and the maximum stress of the screw were analyzed.@*RESULTS@#The maximum stresses of cancellous bone around 6 screws at the head of proximal humeral with bone cement enhanced screw plate fixation were 1.07 MPa for No.1 nail, 0.43 MPa for No.2 nail, 1.16 MPa for No.3 nail, 0.34 MPa for No.4 nail, 1.99 MPa for No.5 nail and 1.57 MPa for No.6 nail. These with common screw plate fixation were:2.68 MPa for No.1 nail, 0.67 MPa for No.2 nail, 4.37 MPa for No.3 nail, 0.75 MPa for No.4 nail, 3.30 MPa for No.5 nail and 2.47 MPa for No.6 nail. Overall stiffness of the two models is 448 N/mm for bone cement structure and 434 N/mm for common structure. The maximum stress of plate appears in the joint hole:701MPa for bone cement structure and 42 0MPa for common structure. The maximum stress of screws appeared at the tail end of No.4 nail:284 MPa for bone cement structure and 240.8 MPa for common structure.@*CONCLUSION@#Through finite element analysis, it is proved that the proximal humerus bone cement enhanced screw plate fixation of osteoporotic proximal humeral fracture can effectively reduce the stress of cancellous bone around the screw and enhance the initial stability after fracture operation, thus preventing from penetrating out and humeral head collapsing.

Surgical treatment methods and classification of proximal clavicle fracture / 中国骨伤

OBJECTIVE@#To summarize the surgical treatment of different proximal clavicle fractures, and discuss the classification of proximal clavicle fractures.@*METHODS@#Total of 24 patients with displaced proximal clavicle fractures were treated from January 2017 to December 2020 including 16 males and 8 females, aged 28 to 66 years old. Among them, 20 cases were fresh fractures and 4 cases were old fractures. According to the Edinburgh classification, 14 cases were type 1B1 fractures and 10 cases were type 1B2 fractures. The different internal fixation methods were selected for internal fixation treatment according to different fracture types.The operation time, blood loss, preoperative and postoperative displacement difference, fracture healing time and Rockwood scoring system were recorded.@*RESULTS@#All patients were followed up for 12 to 24 months. There were no patients with infection or loss of reduction after the operation. Three patients had internal fixation failure after operation, and the internal fixation device was removed. Results The operation time was 30 to 65 min, and the blood loss was 15 to 40 ml. No important nerves, blood vessels, or organs were damaged. The imaging healing time was 3 to 6 months. According to the Rockwood functional score, the total score was (13.50±1.86), pain (2.57±0.50), range of motion (2.78±0.41), muscle strength (2.93±0.28), restricted daily activity (2.85±0.35), subjective results (2.63±0.61);the results were excellent in 20 cases, good in 3 cases, fair in 1 case.@*CONCLUSION@#Proximal clavicular fracture is a type of fracture with low incidence. According to different fracture types, different internal fixation methods and treatment methods can be selected, and satisfactory surgical results can be achieved.

Effect of Method of Relieving Depression and Resolving Phlegm on Expression of IRS-1 and IRS-2 in Liver Tissues of Rats with Polycystic Ovary Syndrome / 中国实验方剂学杂志

Objective::To observe the effect of Erchentang, Chaihu Shugansan, Erchentang+ Chaihu Shugansan and metformin on insulin receptor substrate-1(IRS-1)and insulin receptor substrate-2(IRS-2)mRNA and protein expression in liver tissues of model rats with polycystic ovary syndrome(PCOS), and to explore the biological mechanism of relieving depression and resolving phlegm to improve insulin resistance of polycystic ovary syndrome. Method::A model of polycystic ovary syndrome was replicated in rats by subcutaneous injection of dehydroepiandrosterone(DHEA) under the neck and back.The control group was the normal group, The model rats were divided into model group, Erchentang group(9.135 g·kg-1), Chaihu Shugansan group(6.615 g·kg-1), Erchentang+ Chaihu Shugansan group (Hefang group, 9.135 g·kg-1+ 6.615 g·kg-1), and metformin group(0.158 mg·kg-1). The corresponding drugs were given by intragastric administration once a day for 4 weeks. The ovarian and liver tissues of rats were isolated, and serum testosterone(T)and estradiol(E2)hormone levels in each group were detected by enzyme-linked immunosorbent assay(ELISA), the histopathological changes of ovary in each group were detected by hematoxylin-eosin (HE) staining, IRS-1 and IRS-2 mRNA and protein expression levels in rat liver tissues were detected by quantitative real-time fluorescence PCR(Real-time PCR)and Western blot. Result::Compared with normal group, the serum T and E2 level of model group were significantly decreased (P<0.01), the histology of ovary showed a large number of saccate dilated follicles, thin granular cell layer and rare corpus luteum, IRS-1, IRS-2 mRNA and protein levels in liver tissues decreased significantly (P<0.01). Compared with model group, the serum T and E2 level of each group significantly decreased (P<0.01), histopathology of ovarian tissue showed that the number of saccular dilated follicles decreased, and the granulosa cell layer thickened, showing follicles of all levels, IRS-1, IRS-2 mRNA and protein expression were significantly increased in Erchentang group(P<0.05, P<0.01), IRS-1 mRNA and protein expression were significantly increased in Chaihu Shugansan group(P<0.01), IRS-2 mRNA and protein expression were on the rise, IRS-1 mRNA and protein expression and IRS-2 mRNA expression were significantly increased in the Hefang group (P<0.05), while IRS-2 mRNA was on the rise, IRS-1 protein and IRS-2 mRNA and protein expression were significantly increased in metformin group (P<0.01), while IRS-1 mRNA showed an upward trend. Conclusion::Erchentang improved the insulin resistance of PCOS model rats more significantly than Chaihu Shugansan, and its mechanism may be related to IRS-1, IRS-2 mRNA and protein expression levels of key signaling molecules regulating insulin signal transduction pathway.

Research on Medication Rules of Depression Syndrome Based on Ancient Medical Records / 中国实验方剂学杂志

Objective::To analyze and excavate the medication rules of ancient physicians in the treatment of depression syndrome, so as to provide reference for clinical treatment of depression syndrome. Method::The ancient medical records of depression syndrome sorted out in Yian Leiju were retrieved and collated, the data of traditional Chinese medicine (TCM) prescriptions in medical records were extracted, the obtained data of TCMs in prescriptions were standardized, and the data mining function of the ancient and modern medical records cloud platform V1.5 was adopted to carry out frequency statistics, cluster analysis, association analysis and complex network analysis of TCM data, the common drugs used by ancient physicians for treatment of depression syndrome, properties and classifications of commonly used medicines, pairs of commonly used medicines and core prescriptions were obtained. Result::After screening, a total of 364 medical cases, 461 visits and 439 prescription data of TCM were included, involving 67 ancient books. A total of 607 Chinese medicines were involved, and the total frequency of medication was 4 127.High frequency medicines included Poria (186 times), Citri Reticulatae Pericarpium (115 times), Glycyrrhizae Radix et Rhizoma (113 times), Ginseng Radix et Rhizoma (101 times), Angelicae Sinensis Radix (98 times), Atractylodis Macrocephalae Rhizoma (94 times), etc. The main properties and flavors of commonly used Chinese medicines were warm, flat, bitter and acrid, which were mainly attributed to the four meridians of spleen, lung, heart and liver. Commonly used couplet medicines were Atractylodis Macrocephalae Rhizoma-Poria, Poria-Glycyrrhizae Radix et Rhizoma, Poria-Angelicae Sinensis Radix, Atractylodis Macrocephalae Rhizoma-Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma-Poria, etc. The core prescription was based on the addition and subtraction of Danzhi Xiaoyaosan. Conclusion::In the treatment of depression syndrome, ancient physicians adopt the principles of invigorating the spleen, nourishing Qi and blood, soothing the liver and regulating Qi, nourishing the heart and tranquilizing the mind, giving consideration to both Qi and blood, and harmonizing the liver, spleen and heart.

Preliminary development of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach due to three dimentional soft tissue print technique / 中国骨伤

OBJECTIVE@#To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology.@*METHODS@#The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded.@*RESULTS@#The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively.@*CONCLUSION@#By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.

Surgical treatment of capitellum and trochlea fractures in adult through Kaplan approach associated with anteromedial approach / 中国骨伤

OBJECTIVE@#To investigate the surgical treatment and outcome of capitellum and trochlea fractures in adult through Kaplan approach associated with anteromedial approach.@*METHODS@#From September 2012 to September 2016, 15 patients with capitellum and trochlea fractures were treated by Kaplan approach associated with anteromedial approach. Of the 15 cases, there were 6 males and 9 females, aged from 21 to 69 years old, with a mean of (42.0±10.5) years old. Eight patients had fractures on the left and 7 patients on the right. All the fractures were classified into type IIA(5 cases), type IIIA(4 cases) and type IIIB (6 cases) according to Dubberley classification. The results were evaluated by Mayo elbow function score for analysis.@*RESULTS@#All the patients were followed up, the mean follow-up duration was(13.0±4.7) months(ranged 8 to 26 months). The mean Mayo elbow function score was 85.6±5.3(ranged 76 to 94). Postoperative follow-up had 4 cases excellent, 7 cases good, and 4 cases fair. Average arc of motion in elbow was(129.2±12.1)° in flexion and(6.6±1.9)° in extension.@*CONCLUSIONS@#The surgical treatment of capitellum and trochlea fractures in adult through Kaplan approach associated with anteromedial approach can better expose the fractures to achieve the satisfactory exposure and finish the surgical procedure, and the short-term outcome is satisfactory.

FXR expression is associated with the prognosis and pathological staging of patients with pancreatic cancer / 基础医学与临床

Objective To explore the correlation among farnesoid X receptor (FXR), clinical stage and survival time of patients with pancreatic cancer. Methods The total protein and mRNA were extracted from cultured 8 pan-creatic cancer cell lines,and the expression level of FXR in pancreatic cancer cells was detected by Western bolt and real-time PCR. We collected 5 cases of normal pancreatic tissue and 50 cases of pancreatic cancer tissues,and used immunohistochemistry method to detect FRX expression in normal pancreatic tissue and pancreatic cancer. Ac-cording to the different expression level of FXR,these 50 patients were divided into low expression group and high expression group, the correlation of clinical data and FRX expression level was analyzed. Furthermore, Kaplan-Meier and log-rank analysis of prognostic factors was assessed in a multivariable analysis using a Cox proportional hazards model. Results FXR was differently expressed in 8 pancreatic cancer cell lines and pancreatic cancer tis-sues. FXR was closely related to the pathological G stage of pancreatic cancer(P＜0.05). FXR and pathological G stage were significantly correlated with the patients' survival time. The survival time of the patients with high FXR expression was significantly longer than that of patients with low FXR expression (P＜0.05). Conclusions The expression of FXR is closely related to the pathological G stage in patients with pancreatic cancer. Both FXR expression and pathological G stage are independent prognostic factors in patients with pancreatic cancer.

Preliminary development of drill template-assisted placement of reverse intramedullary lag screw for superior ramus of pubis using three dimentional print technique / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the feasibility of a drill template for the placement of reverse intramedullary lag screws on the outside of the pubis based on digital design and 3D printing technology.</p><p><b>METHODS</b>The preoperative CT images of a 23-year-old male patient with pelvic fracture were collected retrospectively. According to the Young and Burgess classification, the type of pelvic fracture was LC IIwith the 3D printing technology. The data was reconstructed by 3D imaging reconstruction software to produce 1:1 three dimensional model. The screw channel and the individual drill template was designed by the softwares of Mimics 10.01 and Geomagic 12, the accuracy of a drill template was observed by X-rays and CT scans after the placement of 2.0 mm K-wires in the three dimensional template fixed on the model.</p><p><b>RESULTS</b>Three dimensional pelvic model and digital, individual drill template could meet the requirement of the placement of reverse interamodullary lay screw for the treatment of superior ramus of pubis fracture. K-wire was placed and the accuracy of screw placement was confirmed using the X-ray and CT scanning. Template and the corresponding anatomical landmark fitted well.</p><p><b>CONCLUSIONS</b>With the assistance of the individual design and 3D printing technology, the accurate placement of superior ramus of pubis fracture screws can be realized. This technology is helpful to reduce the operation time and X-ray exposure of the patients and doctors.</p>

linical application of personalized 3D printing-guided template of intramedullary lag screw insertion on lateral superior ramous of pubic / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy and advantages of personalized 3D printing-guided template of lateral superior ramous of pubic intramedullary lag screw.</p><p><b>METHODS</b>From July 2015 to December 2016, 20 patients with the superior and inferior ramous of pubis fracture were treated with lag screws placement. All the patients were divided into test group(with guided template) and control group(with general operation). There were 7 males and 3 females with an average age of (46.20±3.03) years old in test group and 6 males and 4 males with (48.50±2.25) years old in control group. There were 6 cases and 5 cases of superior and inferior branches fractures of pubic on the left side and 4 cases and 5 cases on the right side in two groups respectively. The operation time, perspective times and bleeding loss were compared between two groups.</p><p><b>RESULTS</b>The test group and the control group had no statistically significant relative to gender, age, fracture classification. The average time of surgery, average intraoperative fluoroscopy times, mean blood loss in test group were (31.0±5.3) min, (3.5±2.1) times, (75.6±10.5) ml respectively, and in control group were(55.0±6.8) min, (27.6±3.2) times, (85.5±12.5) ml respectively. There were significant Statistical differences between two groups(<0.05) in average operation time and average fluoroscopy times, however, mean blood loss had no significant differences between two groups(>0.05).</p><p><b>CONCLUSIONS</b>The personalized guide template based on 3D printing technology could realize precise placement of the lateral intramedullary lag screw fixation in the superior branch of pubic, also could save the operation time and reduce the times of radiation exposure of patients and surgeons.</p>

Clinical characteristics of hereditary and sporadic medullary thyroid carcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the clinical characteristics and outcomes of the hereditary medullary thyroid carcinoma (HMTC) and the sporadic medullary thyroid carcinoma (SMTC).</p><p><b>METHODS</b>The clinical data of 78 patients with medullary thyroid carcinoma who underwent surgery in our hospital between July 1980 and May 2011 were retrospectively analyzed.</p><p><b>RESULTS</b>Of these 78 patients, there were 23 HMTC cases and 55 SMTC cases. The HMTC group was significantly younger age of onset [(36.4±13.5) years vs. (46.6±11.2) years, P<0.01] and a lower pre/post-operative serum calcitonin levels [(850.4±110.20) ng/L vs. (1450.4±118.3) ng/L, P<0.01 and (410.8±133.2) ng/L vs. (1585.4±129.5) ng/L, P<0.01] than the SMTC group. In addition, the mean tumor diameter was also significantly smaller in the HMTC group (14.3 mm vs. 21.0 mm in SMTC group, P<0.05). Tumor multifocality was seen in a significantly higher proportion of HMTC cases compared with the SMTC cases (56.6% vs. 29.1%, P<0.05). The overall 10-year survival was 100% in HMTC group and 80.2% in SMTC group (P<0.05).</p><p><b>CONCLUSION</b>HMTC has a better prognosis than SMTC.</p>

Validation of candidate immunogenic membrane antigens of human pancreatic cancer screened by proteomics / 中华外科杂志

<p><b>OBJECTIVE</b>To validate those obtained immunogenic membrane antigens candidate of human pancreatic cancer in the performed research.</p><p><b>METHODS</b>In the pre-studies, serum IgG purified from clinically collected sera of pancreatic cancer patients underwent immunoblot with human pancreatic cancer cell line SW1990 membrane protein, totally obtained 9 positive protein spots. Number 5 and 6 positive dots of immunoblot were identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry and peptide mass fingerprinting matching. The candidate membrane antigens were further validated in cell lines by RT-PCR and real-time PCR. RNA of human normal pancreatic tissue and pancreatic cancer tissue was extracted respectively, different gene expression level of prohibitin 2 was studied by real-time PCR.</p><p><b>RESULTS</b>Number 5 and 6 positive dots were identified as prohibitin 2 and prohibitin. RT-PCR and real-time PCR all showed that gene of prohibitin 2 and prohibitin were expressed in the human pancreatic cancer cell line SW1990, AsPc and P3 respectively, especially in P3 cell with highest expression (t = 7.442, P < 0.01). In addition, gene expression level of prohibitin 2 was significant higher in human pancreatic cancer than that of normal pancreatic tissue (t = 0.893, P < 0.01).</p><p><b>CONCLUSIONS</b>Prohibitin 2 and prohibitin are both differently expressed in the pancreatic cancer cell line SW1990, AsPc and P3. Prohibitin 2 is obvious highly expressed in human pancreatic cancer tissue. Prohibitin 2 and prohibitin might be the candidate immunogenic membrane antigens of human pancreatic cancer.</p>

A new experimental model to study healing process of metaphyseal fracture / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There are few researches for the healing of metaphyseal fractures; moreover, the animal models to study the metaphyseal fractures are usually made by the oscillating saw osteotomy without reliable fixation, which is not in accordance with our current clinical practice. In this study, we established a new model to observe the healing process of metaphyseal fractures.</p><p><b>METHODS</b>Eighteen New Zealand rabbits were used in the study. The fracture model was created by splitting the medial tibial plateau in rabbits, then reset, and fixed with compression screws. At 1, 2, 3, 4, 6, and 8 weeks postoperatively, the tibial specimens were collected; firstly, a general observation and an X-ray examination of the specimens was done, and then they were embedded in methylmethacrylate and cut into sections with hard tissue slicer. The sections were stained with Giemsa reagent and examined under light microscopy.</p><p><b>RESULTS</b>There was no fracture displacement in the tibial specimens of all time points, except for one showing a collapse. No external callus formation could be observed by X-ray and general examination. After 1 week of the operation, the fracture gap was filled by mesenchymal tissue; 2 weeks postoperatively, a large number of woven bones were formed; from the third week onwards, the woven bone began to turn into lamellar bone, and new trabecular structure began to form. In all of the slices, no obvious chondrocytes formed in fracture areas; thus, there was no endochondral ossification.</p><p><b>CONCLUSIONS</b>This model was an ideal fracture animal model and suitable for the study of metaphyseal fracture healing. The X-ray and histological images demonstrated that metaphyseal fracture healing was a process of direct bone healing through intramembranous bone formation under the conditions of minor trauma, good reduction, and firm fixation.</p>

Clinical characters of gastrointestinal lesions in intestinal Behcet's disease / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the clinical features, diagnosis methods, therapeutic principles of intestinal Behcet's disease.</p><p><b>METHODS</b>king Union Medical College Hospital from August 1998 to April 2010 were retrospectively analyzed.</p><p><b>RESULTS</b>The clinical courses of patients with intestinal Behcet's disease were from 26 days to 33 years, and the average duration was 6.32 +/- 1.01 years. The appearance of extra-gastrointestinal symptoms was significantly earlier than that of gastrointestinal symptoms (7.35 +/- 1.39 years vs. 3.24 +/- 0.82 years, P<0.05). The predominant gastrointestinal manifestations were right lower quadrant pain (95.56%) and hematochezia or melena (40.00%). Misdiagnosis occurred in 17 cases. In patients without systemic medicine therapy before surgery, the incidence of postoperative infection of incision site and abdominal cavity was significantly higher than that in those undergoing systemic medicine therapy (80.00% vs. 0%, P<0.05).</p><p><b>CONCLUSIONS</b>Because of the diversity of gastrointestinal manifestations, intestinal Behcet's disease is easily misdiagnosed. The systemic medical therapy before surgery could decrease the incidence of infection of incision and abdominal cavity.</p>

Candidate immunogenic membrane antigens of human pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To verify the obtained immunogenic membrane antigens candidate of pancreatic cancer in the performed research.</p><p><b>METHODS</b>Pancreatic cancer cell line SW1990 membrane protein underwent immunoblot with serum IgG purified from clinically collected sera of 66 pancreatic cancer patients. Number 3 and number 8 positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and peptide mass fingerprinting matching. The candidate membrane antigens were further validated in cell lines by RT-PCR, real-time PCR and Western blot, and their different expression level of gene and protein in pancreatic cancer cell lines were contrastly studied.</p><p><b>RESULTS</b>Number 3 and number 8 positive dots were identified as: voltage-dependent anion channel (VDAC3) and catechol-o-methyltransferase (COMT). RT-PCR, real-time PCR and Western blot showed that gene and protein of VDAC3 and COMT were expressed in the pancreatic cancer cell line SW1990, AsPc and P3 respectively.</p><p><b>CONCLUSION</b>VDAC3 and COMT might be the candidate immunogenic membrane antigens of human pancreatic cancer, and their gene and protein are differently expressed in the pancreatic cancer cell line SW1990, AsPc and P3.</p>

Multifocal papillary thyroid carcinoma: clinical analysis of 168 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features and treatment of multifocal papillary thyroid carcinoma (PTC).</p><p><b>METHODS</b>A retrospective survey was carried out in 648 patients with PTC who underwent surgery from January 1997 to December 2006. One hundred and sixty-eight cases of the patients presented with multiple tumor masses (> or = 2). The risk factors, including sex of the patients, age at diagnosis, family history of thyroid tumor, multiplicity and bilaterality of tumor, extra-thyroidal extension, lymph node involvement and other were analyzed between solitary PTC and multifocal PTC group.</p><p><b>RESULTS</b>The mean age of the patients was 42 years (range, 14 - 78 years), included 49 male and 119 female. Tumor foci were found in both thyroid lobes in 117 cases (69.6%). Patients with multifocal PTC were characterized by a higher ratio of male (P = 0.004), family history of thyroid tumor (P = 0.031), neck lymph node metastasis (P = 0.008) and extra-thyroidal extension (P = 0.001). However, solitary PTC tended to be with a higher rate of benign goiters in pathologic examination. In multifocal PTC group, male, neck lymphadenectasis, > or = 3 tumor masses or bilaterality of tumor tended to presented with larger tumor, more neck lymph node metastasis and extra-thyroidal extension; And a less malignant tumor in the cases detected with benign goiters in histological examination. By the end of 2007, 164 cases (97.6%) completed follow-up with a mean period of 46.1 months (range, 2 - 127 months), 5 died in the meantime. One patient has been followed-up for 16 months for suspect of lung metastases by chest X-ray. Recurrence occurred in 8 patients and were re-resected, 2 in remnant thyroid and 6 in neck lymph nodes. The overall 1-, 2-, 5-, and 10-year survival rate was 98.2%, 97.4%, 96.5% and 96.5%, respectively. American Joint Committee on Cancer (AJCC) stage was associated with prognosis significantly (chi(2) = 168.832, P = 0.000).</p><p><b>CONCLUSIONS</b>Multifocus is one of the clinical features of PTC and is more malignant than solitary PTC. Total thyroidectomy with central compartment neck dissection could be standard treatment. Lateral nodal dissection is not necessary except for the cases with lymph node metastasis. AJCC stage is still the best prognostic factor.</p>

Research of immunogenic membrane antigens of pancreatic cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To screen and obtain the validate immunogenic membrane antigens in pancreatic cancer.</p><p><b>METHODS</b>Pancreatic cancer cell line SW1990 membrane protein was extracted and separated by two-dimensional gel electrophoresis (2-DE). One of the three parallel 2-DE gels underwent Coomassie blue staining while the other two underwent immunoblot. Serum IgG was purified from clinically collected sera of 66 pancreatic cancer patients and 24 chronic pancreatitis patients and used as the primary antibody of the immunoblot. Positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and PMF matching. The candidate membrane antigens were further validated respectively in cell lines and tissues by RT-PCR, real-time PCR, Western blot, and their different expression level of gene and protein between pancreatic cancer cell line and normal pancreatic tissue were compared studied.</p><p><b>RESULTS</b>The immunoblot of SW1990 membrane protein with serum IgG from cancer patients showed nine positive dots which were not the same as those from immunoblot with serum IgG from chronic pancreatitis patients. One talent dot was identified with MALDI and PMF as VDAC2. RT-PCR and real-time PCR showed that the gene of VDAC2 was expressed in the pancreatic cancer cell line. Western blot showed that the expression of protein level of VDAC2 in the pancreatic cancer cell line was obviously higher than in normal pancreatic tissue.</p><p><b>CONCLUSIONS</b>VDAC2 might be the candidate immunogenic membrane antigens of pancreatic cancer, and its gene is all expressed in the pancreatic cancer cell line SW1990, AsPc and P3. The protein level of VDAC2 is significantly overexpressed in pancreatic cancer cell line than in normal pancreatic tissue.</p>

Clinical study of the improvement gastrostomy in pancreaticoduodenectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical significance of improvement gastrostomy in pancreaticoduodenectomy.</p><p><b>METHODS</b>Clinical data of 82 patients who underwent pancreaticoduodenectomy and jejunostomy from November 2004 to December 2006 were collected, among which 36 patients received improvement gastrostomy (treatment group), 24 patients accepted traditionary gastrostomy (control group 1) and 22 patients without any gastrostomy (control group 2). Operative time, postoperative duration of gastrointestinal decompression tube, postoperative gastroparesis, pancreatic fistula, biliary fistula, and abdominal cavity infection were compared.</p><p><b>RESULTS</b>The incidence of postoperative gastroparesis in the treatment group and control group 2 were can significantly lower than that in the control group 1 (P < 0.05). The postoperative duration of gastrointestinal decompression tube of the treatment group was significant shorter than that of control group 2 (P < 0.01). There were no significant difference in other items.</p><p><b>CONCLUSIONS</b>The improvement gastrostomy in pancreaticoduodenectomy is simple and secure. It can significantly shorten the postoperative duration of gastrointestinal decompression tube and also obviously reduce the incidence of postoperative gastroparesis compared with traditionary gastrostomy.</p>

Immuno-proteomic screening of human pancreatic cancer associated membrane antigens for early diagnosis / 中华外科杂志

<p><b>OBJECTIVE</b>To screen and identify the immunogenic membrane antigens in human pancreatic cancer for early diagnosis.</p><p><b>METHODS</b>Membrane protein was extracted from pancreatic cancer cell lines and separated by using 2-DE. One of the two parallel 2-DE gels went for staining while the other underwent immunoblot. Serum IgG, which was purified from clinically collected sera of pancreatic cancer patients, was used as the primary antibodies for the immunoblot. Positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and PMF matching, and then evaluated by bio-informatics methods. The candidate membrane antigens were further validated respectively in cell lines and tissues by RT-PCR and immunohistochemistry.</p><p><b>RESULTS</b>The immunoblot of mixed membrane protein with serum IgG from cancer patients showed eight positive dots. These dots were identified with MALDI and PMF as: VDAC-1, VDAC-2, CHCHD3, SLP-2 and TOM40. RT-PCR showed that these membrane antigens were expressed in several pancreatic cancer cell lines. Immunohistochemistry showed prominent SLP-2 over expression in cancer tissue.</p><p><b>CONCLUSIONS</b>VDAC-1, VDAC-2, CHCHD3, SLP-2, and TOM40 are the new candidate immunogenic membrane antigens of pancreatic cancer. These membrane antigens can be subsequently tested in high dangerous population for early diagnosis of pancreatic cancer.</p>

Risk factors for postoperative gastroparesis syndrome after pancreaticoduodenectomy with binary logistic regression / 中华外科杂志

<p><b>OBJECTIVE</b>To study the risk factors of postoperative gastroparesis syndrome after pancreaticoduodenectomy.</p><p><b>METHOD</b>Clinical data of 166 patients who underwent pancreaticoduodenectomy from January 2002 to April 2006 were analyzed with binary logistic regression in order to explore the risk factors of postoperative gastroparesis syndrome after pancreaticoduodenectomy.</p><p><b>RESULTS</b>There were 60 patients occurred postoperative gastroparesis syndrome after pancreaticoduodenectomy. Among 15 factors, 6 factors were proved to be the risk factors of postoperative gastroparesis syndrome after pancreaticoduodenectomy by unitary anylasis; 7 factors were proved related factors of postoperative gastroparesis syndrome after pancreaticoduodenectomy by analyzed with binary logistic regression.</p><p><b>CONCLUSIONS</b>The risk factors are preoperative gastro-intestinal obstruction syndrome, extensive lymphadenectomy, postoperative abdominal cavity infection, starting time of postoperative enteral nutrition, postoperative blood glucose level; The protective factors are preoperative percutaneous transhepatic cholangial drainage (PTCD) and postoperative blood terminal protein (TP) level.</p>

Edge detection and modeling in frontal facial contour image for plastic surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To find a new method for edge detection and modeling in frontal facial contour image.</p><p><b>METHODS</b>Searching circle-based edge detection algorithm was developed on the basis of Sobel edge detector. Apriori knowledge of the facial contour and searching limitations as the minimum curvature radius, concave-convex property, and maximum edge disconnected distance were used to detect the edge of frontal facial contour. The frontal facial contour model was established with least squares curve fitting methods, and the relationship between the model rank and model precision was analyzed.</p><p><b>RESULTS</b>The edge detected by the new method was consistent with the actual edge of the facial contour and the irrelevant edge was well eliminated. Variation of the 2,4,10 time models from the actual image were compared, which identified the 10 time model as the best one.</p><p><b>CONCLUSION</b>The effectiveness and practicability of this new method for edge detection and modeling has been tested, which provides a theoretic basis for designing facial contouring image system.</p>