Comparison between computed tomography and magnetic resonance imaging in clinical diagnosis and treatment of tibial platform fractures.

BACKGROUND: Tibial plateau fracture is one of the common fracture types. It occurs mainly in teenagers and is usually caused by a fall. After the occurrence of fracture, knee swelling, pain, limited activity, etc. greatly affect the patient's exercise habits and lifestyle. X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were used in this examination. X-rays are relatively new and easy to operate. However, there are some errors in the observation of fracture collapse and fracture displacement. In recent years, CT and MRI have been actively used to diagnose various types of clinical fractures. They have more diagnostic power than X-ray film. However, some scholars believe that CT is also prone to errors in clinical application. The volume effect leads to missed diagnosis and misdiagnosis in some cases, while the multidirection scanning of MRI technology can effectively overcome the shortcomings of CT. To facilitate the selection of clinical examination regimens, this study further observed the diagnostic ability of these two regimens in the diagnosis of tibial plateau fractures. AIM: To explore the value of nuclear MRI and CT in the clinical diagnosis of tibial plateau fractures. METHODS: A total of 120 patients with tibial plateau fractures admitted from September 2017 to August 2019 were included. All patients were examined by nuclear MRI and CT scanning. The results were sent to senior physicians in our hospital to complete the diagnosis. RESULTS: Nuclear magnetic resonance showed the same effects as CT in four aspects: fracture displacement, bone defect, fracture site and fracture comminution. There was no significant difference in the score data (P > 0.05). Nuclear magnetic resonance and CT tended to be consistent in the B3, C2 and C3 fracture diagnosis coincidence rate, combined injury detection rate and fracture detection rate. The diagnostic coincidence rate of type B1, B2 and C1 fractures and the accuracy rate of overall fracture classification indicated that the MRI technique was significantly better than that of CT (P > 0.05). CONCLUSION: MRI and CT have good diagnostic typing in the diagnosis of tibial plateau fractures, but MRI is more accurate and may be preferred.

Role-play in Endodontic Teaching: a Case Study.

Objective: To investigate the role of the application of role-play in endodontic study in improving the communication skills of Chinese dental undergraduates prior to their direct interactions with patients at the Fourth Military Medical University's School of Stomatology, China. Methods: Students were recruited from the 5-year bachelor's programme (n = 36) and randomly divided into six groups, and from the 8-year DDS programme (n = 10) and randomly divided into two groups to participate in the role-play training. Cases selected randomly from the case pool were distributed to the groups. The teacher gave an outline of the roles in the simulation. Each member of each group randomly selected their own role for the role-play. Four types of surveys were distributed to students and faculty members at different points after the role-plays had taken place, to evaluate their attitude towards the use of role-plays in endodontic study. Frequency analysis and a one sample t test were used to describe and analyse students' acceptance of role-play as a teaching technique. The level of statistical significance was set at P < 0.05. Results: Students' performance and satisfaction as well as the supporting faculty responses were very favourable towards role-playing. In total, 93.5% of students responded favourably to the role-play, answering 'strongly agree' or 'agree' to the positive statements about their role-play performance. A total of 95.1% of students stated that they had benefited psychologically and technically from the role-play ('strongly agree' or 'agree') after their 1-year rotating internship. Conclusion: The application of role-play in endodontic study is an effective way of educating Chinese dental undergraduates and can be beneficial for their transition from students to dentists.

Orthopedic treatment for open fracture of lower extremities and soft tissue defects in young children and rapid rehabilitation after operation.

Objective: This study aims to explore the clinical features of open fracture of lower extremities with soft tissue injury in young children, and its surgical and postoperative rehabilitation methods.Methods: A total of 32 children with open fracture of lower extremities and soft tissue injury treated in our department from January 2010 to December 2016 were included into this study. An individualized treatment plan was established according to the characteristics of each patient's condition, and rapid rehabilitation procedures were carried out after the operation to promote the healing of the wound, and shape and function recovery.Results: In the present study, four children developed superficial infection after the operation, and healed after proper management. Furthermore, two children were found to have osteomyelitis during follow-up after discharge, and healed after they returned to the hospital for debridement. All patients were followed up until fracture healing, and the follow-up duration ranged within 6-15 months, with an average duration of 8.5 months. All patients achieved bony union, and none of the patients had bone exposure. In the curative effect assessment, 24 children were classified as excellent, six children were classified as good, one child was classified as moderate, and one child was classified as poor. The excellent and good rate was 93.75%.Conclusions: Open fracture of the lower extremities commonly occur in the middle and lower segment of the tibia and fibula in children, and is usually combined with soft tissue injury. The correct treatment of fractures, and skin and soft tissue injuries, as well as the rapid rehabilitation of children, are the keys to achieving a good clinical effect.

Prognostic value of ADAM17 in human gastric cancer.

A disintegrin and metalloproteinase-17 (ADAM17, also named as tumor necrosis factor-alpha-converting enzyme) is a member of the ADAM family. Of all ADAMs, the strongest evidence for a role in malignancy exists for ADAM17. Especially, it has been demonstrated that ADAM17 expression was significantly increased in human gastric cancer. The aim of this study was to investigate the association between ADAM17 expression and the clinicopathological features of patients with gastric cancer. The expression of ADAM17 was detected by real-time quantitative RT-PCR in gastric cancer and adjacent non-cancerous tissues. In addition, ADAM17 expression was analyzed by immunohistochemistry in 220 clinicopathologically characterized gastric cancer cases. The expression levels of ADAM17 mRNA and protein in gastric cancer tissues were both significantly higher than those in non-cancerous gastric mucosa. In addition, positive expression of ADAM17 correlated with the degree of tumor differentiation, depth of invasion, lymph node metastases, distant metastases, and TNM stage (all P<0.05). Furthermore, multivariate analysis suggested that lymph node metastases, distant metastases, TNM stage, and ADAM17 expression were independent prognostic indicators for gastric cancer. Our data suggest for the first time that the increased expression of ADAM17 in gastric cancer is associated significantly with aggressive progression and poor prognosis. ADAM17 may be an important molecular marker for predicting the carcinogenesis, progression, and prognosis of gastric cancer.

Surgical treatment of a giant neurofibroma.

Neurofibromatosis type 1, an autosomal dominant inherited disease, presents pathologic symptoms of multiple systems, including neurofibromatosis, skeletal dysplasia, café-au-lait spots in skins, and so on. A 45-year-old man with neurofibromatosis type 1 was reported in this article. The patient presented a giant neurofibroma in his head and neck, dysplasia of skull, facial bones and spinal columns, and multiple café-au-lait spots in systematic skins. Satisfactory curative effects were obtained in this case after tumor resection and prosthesis implantation.

[Establishment and characterization of a nude mice model of human diffuse large B-cell lymphoma].

OBJECTIVE: To establish a diffuse large B-cell lymphoma (DLBCL)-mice model using human DLBCL cell line LY8, to investigate its characteristics of growth and to provide a model for in vivo study of DLBCL pathogenesis and treatment. METHODS: LY8 cells were injected subcutaneously into the right flank of nude mice. Harvested tumor tissues were cut into small pieces of 1.5 mm × 1.5 mm × 1.5 mm and implanted subcutaneously into nude mice. Tumor growth was visualized and the histologic characteristics were documented. Expression of LCA, CD20, CD79α, Ki-67, CD3, CD45RO, bcl-6, MUM-1, CD10 and bcl-2 were examined by using immunohistochemistry. IgH clonal rearrangement and status of three microsatellite loci (D14S68, D18S69, D20S199) in the xenografted tumor samples and the parental cell line LY8 were detected using PCR amplification followed by PAGE. RESULTS: The subcutaneous xenograft DLBCL model was successfully established by using cell line LY8, and a stable growth was achieved up to the 9th generation. The tumor in each generation showed similar growth characteristics and the rate of subcutaneous tumor formation was 91.9% (114/124). The tumor growth was observed from the 2nd week after implantation, reaching 1.3 cm in major diameter at the 3rd week and 2.0 cm at the 4th week. The tumor had identical morphological characteristics with those of human DLBCL, and expressed LCA, CD20, CD79α, bcl-6, MUM-1, CD10 and bcl-2. The tumor of xenograft mice and cell line LY8 showed identical IgH rearrangement and microsatellite length. CONCLUSIONS: A human DLBCL bearing mouse model was successfully established. The mice model is similar to human counterpart with high stability and repeatability. Therefore, it provides an ideal animal model for in vivo studies of the biological characteristics and treatment of DLBCL.

[Study on PI3K inhibitor LY294002 for chemotherapeutic sensitization in diffuse large B cell lymphoma cell lines].

OBJECTIVE: To investigate the effects on chemotherapeutic sensitization of the PI3K inhibitor LY294002 in diffuse large B cell Lymphoma (DLBCL) cell lines ly1, ly8, ly10. METHODS: The three cell lines were treated with LY294002, or doxorubicin alone or combined or sequentially respectively. Western blotting was used to detect the level of phospho-AKT after the treatment. Flow cytometry combined with annexin V-FITC assay and Brdu incorporation assay were used to analyze the alterations of cell cycle, proliferation, and apoptosis, respectively. RESULTS: LY294002 decreased the level of phospha-AKT efficiently in the three DLBCL cell lines. The ratio of S phase cells was significantly decreased (P < 0.05). Sequential use of LY294002 and doxorubicin increased the ratio of apoptosis and there was significant difference between the sequential group and the other four groups (P < 0.05) at 24, 48, 72(ly1), 48, 72 (ly8) or 24 h (ly10). CONCLUSION: LY294002 can sensitize doxorubicin-induced apoptosis and may be a potential molecular therapeutic agent targeted at AKT signaling pathway in DLBCL.

[Effects of AKT protein kinase activation on biologic behavior of diffuse large B cell lymphoma cells].

OBJECTIVE: To observe the status of AKT and phospho-AKT (pAKT) in three diffuse large B cell lymphoma (DLBCL) cell lines, and to investigate the effects of AKT activation on biologic behavior of DLBCL cells. METHODS: Three DLBCL cell lines, ly1, ly8 and ly10 were maintained in 10% FBS or serum free culture medium. The expression of AKT and status of pAKT were detected by Western blotting. LY294002, an inhibitor of PI3K, was used to suppress the level of pAKT. Flow cytometry combined with PI staining, AnnexinV-FITC assay and Brdu incorporation assay were used to analyze the parameters of the cell cycle, apoptosis and proliferation respectively. RESULTS: There was constitutive activation of AKT in three DLBCL cell lines and the levels of pAKT were altered in the different environments. In 10% FBS culture medium, pAKT was higher than that in serum free culture medium in ly8 and ly10, however, pAKT in ly1 maintained in serum free culture medium was mildly higher than that in 10% FBS culture medium. When the cell lines ly1, ly8, ly10 were maintained in 10% FBS culture medium, the inhibitor LY294002 suppressed the level of pAKT efficiently in three DLBCL cell lines. The percentage of cells at S phase and the proliferation index were significantly decreased (P < 0.05) without an increase of apoptosis (P > 0.05). CONCLUSIONS: Activation of AKT may play an important role in the development of DLBCL. It is closely related to the control of cell cycle and proliferation, but is not associated with apoptosis. LY294002 can inhibit cell growth by decreasing the levels of pAKT in DLBCL cell lines.