外移型肱骨远端全骺分离骨折（附4例报告）

肱骨远端全骺分离骨折的移位,文献载明均向内侧移位,尚无外移报告。本院自1978～1989年8月收治肱骨远端全骺分离骨折13例中4例为外移型。现就外移型损伤的移位机理、诊断与鉴别诊断及治疗方法讨论如下。 病历摘要 例1,女,13岁。左前臂内收、拇指朝内、半屈肘位跌扑致伤左肘8天,经当地医院多次手法整复不满意转入本院。左肘关节肿痛、伸屈障碍,呈肘关节脱位、外翻畸形。肘内侧可扪及尖锐骨突,第4、5指麻木。

Kinetics of phytohemaglutinin-induced IFN-γ and TNF-a expression in peripheral blood mononuclear cells from patients with chronic hepatitis B after liver transplantation

AIM： To study the association between host immunity and hepatitis B virus （HBV） recurrence after liver transplantation. METHODS： Peripheral blood mononuclear cells （PBMC） were isolated from 40 patients with hepatitis B and underwent orthotopic liver transplantation （OLT） before and 2, 4, 8 wk after surgery. After being cultured in vitro for 72 h, the levels of INF-γ and TNF-α in culture supematants were detected with ELISA. At the same time, the quantities of HBV DNA in serum and PBMCs were measured by real time PCR. RESULTS： The levels of INF-γ and TNF-α in PBMC culture supernatants decreased before and 2, 4 wk after surgery in turns （INF-γ 155.52±72.32 ng/L vs 14.76±9.88 ng/L vs 13.22±10.35 ng/L, F= 6.946, P= 0.027〈0.05; TNF-α 80.839±46.75 ng/L vs18.59±17.29 ng/L vs9.758±7.96 ng/L, F= 22.61, P = 0.0001〈0.05）. The levels of INF-γ and TNF-α were higher in groups with phytohemagglutinin （PHA） than in those without PHA before surgery. However, the difference disappeared following OLT. Furthermore, INF-γ and TNF-α could not be detected in most patients at wk 4 and none at wk 8 after OLT. The HBV detection rate and virus load in PBMC before and 2, 4 wk after surgery were fluctuated （HBV detected rate： 51.4%, 13.3%, 50% respectively; HBV DNA： 3.55±0.674 log（10） copies/mL vs 3.00±0.329 log（10） copies/mL vs 4.608±1.344 log（10） copies/mL, F= 7.582, P= 0.002〈0.05）. HBV DNA in serum was 4.48±1.463 log（10） copies/mL before surgery and 〈 10^3 copies/mL after OLT except for one with 5.72×10^6 copies/mL 4 wk after OLT who was diagnosed as HBV recurrence. The levels of INF-γ and TNF-α were lower in patients with a high HBV load than in those with a low HBV load （HBV DNA detected/undetected in PBMCs： IFN-γ 138.08±72.44 ng/L vs 164.24±72.07 ng/L, t = 1.065, P= 0.297〉0.05, TNF-α 80.75±47.30 ng/L vs 74.10±49.70 ng/L, t= 0.407, P= 0.686〉 0.05; HBV DNA positive/negative： IFN-γ 136.77±70.04 ng/L vs 175.27±71.50 ng/L, t= 1.702, P= 0.097〉0.05; TNF-α 75.37±43.02 ng/L vs 81.53±52.46 ng/L, t = 0.402, P = 0.690〉0.05）. CONCLUSION： The yielding of INF-γ and TNF-α from PBMCs is inhibited significantly by immunosuppressive agents following OLT with HBV load increased, indicating that the impaired immunity of host is associated with HBV recurrence after OLT.

The Anti—tumor Effects of an Anti—CD71 Chimeric Antibody in Vitro and Its Distribution in a Tumor Xenograft Model

Objective To investigate the anti-tumor effects in vitro and in vivo distribution of the human/murine chimeric antibody (D2C). Methods The CD71 positive target cells (K562, GEM and SMMC7721) and the effector cells, freshly isolated human PBMC, with the ratio of target cells to effector cells 1:50, were incubated in various dilutions of D2C antibody ( Ab) . Antibody dependent cytotoxicity (AD-CC) was tested by using an LDH-release assay. Instead of effector cells, complement was added to the target cells (GEM, SMMC-7721) with various dilutions of D2C Ab. A method of counting death cells was used in complement dependent cytotoxicity (CDC) assay. Tumor localization and distribution of the chimeric antibody (D2C) were observed by labeling the chimeric Ab with radioiodine(131I) and injecting it into nude mice (Balb/c nu/nu) transplanted with human hepatocellular carcinoma cells (SMMC-7721).Results A significant ADCC was observed with the increased concentration of the D2C Ab. Cytolysis of CD71-positive target cells by the D2C Ab was found in the presence of fresh rabbit complement. Labeled D2C administered by intraperitoneal as well as tumor regional injection, was visualized by SPECT. The distribution of D2C Ab in murine organs and tissues showed that non-specific binding was lower following tumor regional administration than when the antibody was administered by an intraperitoneal injection. The human/murine chimeric antibody (D2C) has in vitro anti-tumor effects and can exert its effects in specific tumor localization. Its distribution and local effects in vivo can be detected by radioimmunoimaging.Conclusion CD71 human/murine chimeric antibody showed marked killing of tumor cells in vitro, and specific recognition and high affinity binding to tumor tissue in vivo

改良型胫前肌腱外移术治疗小儿脑瘫马蹄内翻足疗效分析

目的探讨分析小儿脑瘫马蹄内翻足治疗方式选择改良型胫前肌腱外移术的临床疗效。方法该次研究时间为2016年9月—2018年11月,研究对象是该院50例脑瘫马蹄内翻足患儿,分组方式为随机原则,对照组手术方式为传统手术,观察组手术方式为改良型胫前肌腱外移术,分析两组临床疗效。结果观察组患儿治疗后优良率为96.7%,而对照组优良率为77.4%,相比差异有统计学意义(P<0.05);观察组患儿足部功能评分为(46.5±1.3)分,出现感染的患儿1例,出现脓肿的患儿2例,发生率为10.0%,患儿足部功能评分为(30.5±1.8)分,出现感染的患儿4例,出现脓肿的患儿5例,发生率为29.0%,相比差异有统计学意义(P<0.05)。结论脑瘫马蹄内翻足选择改良型胫前肌腱外移术治疗可提高患儿的治疗效果,有助于患儿足部功能的恢复,对患儿预后情况进行有效的改善,可在临床上推广应用。

Second-line panitumumab as a triweekly dose for patients with wild-type KRAS exon 2 metastatic colorectal cancer:a single-institution experience

Objective: Panitumumab administered as monotherapy in colorectal cancer(CRC) has shown response and disease stabilization rates of approximately 30%. The current study aimed to evaluate the progression-free survival(PFS) and overall survival(OS) of patients with metastatic colorectal cancer(mCRC) treated with panitumumab every 3 weeks as a second line treatment.Methods: This study is a retrospective analysis of 18 patients, aged more than 18 years, with wild-type KRAS exon 2 mCRC treated with panitumumab as a second-line single agent after progression on first-line chemotherapy.Results: The median number of courses received was 10(range, 4-29), and the median duration of treatment was 30 weeks(range,12-96 weeks). After a median follow-up period of 13 months, the median PFS was 6 months(range, 4.3-7.7 months) and the median OS was 11 months(range, 7.4-14.5 months). The median PFS was 4 months for patients with < grade 2 skin toxicity and 6months(range, 4.5-7.5 months) for patients with ≥ grade 2 skin rash(P=0.05). The median OS was 9 months(range, 6.4-11.5months) and 14 months(range, 11.6-16.3 months) for the two groups of patients(P=0.002).Conclusions: Panitumumab given every 3 weeks is effective and well tolerated in patients with advanced CRC that progressed after standard chemotherapy.

Coherent Point Drift Registration Combined with Image Feature and its Application

A key step of constructing active appearance model is requiring a set of appropriate training shapes with well-defined correspondences.In this paper,we introduce a novel point correspondence method(FB-CPD),which can improve the accuracy of coherent point drift(CPD) by using the information of image feature.The objective function of the proposed method is defined by both of geometric spatial information and image feature information,and the origin Gaussian mixture model in CPD is modified according to the image feature of points.FB-CPD is tested on the 3D prostate and liver point sets through the simulation experiments.The registration error can be reduced efficiently by FB-CPD.Moreover,the active appearance model constructed by FB-CPD can obtain fine segmentation in 3D CT prostate image.Compared with the original CPD,the overlap ratio of voxels was improved from 88.7% to 90.2% by FB-CPD.

Effects of electro-acupuncture on embryo implanted potential of patients with infertility of different syndromes

Objective To explore the impacts of electro-acupuncture on embryo implanted potential and its molecular mechanism in patients with infertility of different syndromes. Methods Among infertile patients treated with in vitro fertilization and embryo transplantation （IVF-ET） combined with electro-acupuncture, 82 cases of kidney deficiency syndrome （group A）, 74 cases of liver qi stagnation syndrome （group B） and 54 cases of phlegm dampness syndrome （group C） were selected. Patients in three groups all received a long program of ovarian hyperstimulation. Additionally, electro-acupuncture was applied before controlled ovarian hyperstimulation （COH） and in the process of ovarian hyperstimulation. Contents of human leukocyte antigen G （HLA-G） in the serum were determined in three groups respectively on the 2nd day of menstruation （M2） and the day of human Chorionic Gonadotropin （hCG） injection. Content of HLA-G in the culture solution of three groups was examined separately on the day of embryo transplantation. The fertilization rate, implantation rate and clinical pregnancy rate were observed for patients in three groups. Results Contents of HLA-G in the serum on the day of hCG injection and in the culture solution on the day of embryo transplantation in group A and B were significantly higher than those in group C （all P0.05）. However, there was no significant difference with contents of HLA-G in serum on M2 day among three groups. The high quality embryo rate in either group A （73.6%, 352/478） or group B （70.6%, 379/537） was significantly higher than that in group C （54.2%, 208/384） with significantly statistical difference （all P0.01）. But there were no significant differences in clinical pregnancy rate, fertilization rate and cleavage rate among three groups. Conclusion Electro-acupuncture combined could increase contents of HLA-G in the body and the level of HLA-G secreted from embryos of patients in the process of IVF-ET. Eventually, the pregnancy outcome and the pregnancy rate are improved. It showed better clinical effects of electro-acupuncture for patients with kidney deficiency and liver qi stagnation syndromes than those of phlegm dampness syndome.