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@#The lymphatic system is the main way of tumor metastasis and diffusion. Esophageal cancer is one of the typical cancers that are prone to metastasis through the lymphatic system. At present, an increasing number of studies show that the interaction between tumor cells and lymphatic endothelial cells is the first step in tumor lymphatic metastasis, but the underlying molecular mechanism is unclear. This article reviews the role and changes of tumor-related lymphatic vessels and lymphatic endothelial cells in the process of tumor lymphatic metastasis, which lays a foundation for further study of the specific molecular mechanism of esophageal cancer lymphatic metastasis and provides a new treatment direction for esophageal cancer patients.
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Objective:To investigate the incidence rate, surgical rate and spontaneous cure of indirect inguinal hernia in children of Xinjiang region.Methods:Children, aged from 4?14 years, coming from 24 kindergartens, 18 primary schools and 9 junior middle schools of 3 countries and 5 cities in Xinjiang Uygur Autonomous Region were recruited to participate as respondents. The survey time for baseline data collection was from May 2013 to June 2014 and the retrospective cross-sectional survey was conducted. Parents of children were investigated by questionnaire, and children were examined on site. Observation indicators: (1) results of questionnaire survey; (2) illness and treatment of children involved in the study; (3) follow-up. Follow-up was conducted using telephone interview. Children who had been diagnosed and not been treated surgically at the time of questionnaire survey were followed up to detect disease progression and treatment in the past 5 years. If the symptoms of a child had disappeared during follow-up, parents of the child should accompany the child to hospital for physical examination and B-ultrasound examination to confirm the diagnosis, and then follow-up was conducted by telephone interview. The follow-up was up to January 2020. Count data were described as absolute numbers and percentages, and compari-son between groups was conducted using the chi-square test. Odds ratio and 95% confidence interval were calculated. Results:(1) Results of questionnaire survey. A total of 19 132 question-naires were distributed, and 19 132 complete questionnaires were recovered. Of the 19 132 children who completed the questionnaire survey, there were 9 670 males and 9 462 females. (2) Illness and treatment of children involved in the study. ① Incidence of indirect inguinal hernia in children with different sexes. Of the 19 132 children, 498 cases were diagnosed as indirect inguinal hernia, including 368 boys and 130 girls, with the prevalence as 3.806%(368/9 670) and 1.374%(130/9 462), respectively. There was a significant difference in the prevalence of indirect inguinal hernia between boys and girls ( χ2=111.54, P<0.05). The proportion of boys and girls in children with indirect inguinal hernia was 73.896%(368/498) and 26.104%(130/498), respectively, with the ratio of 2.8:1. The prevalence of boys was higher than girls ( odds ratio=2.84, 95% confidence interval as 2.32?3.48).② Age of children at first onset. Of the 498 children with indirect inguinal hernia, 59 cases were aged 1?4 years at first onset including 54 boys and 5 girls, 264 cases were aged 5?8 years including 196 boys and 68 girls, 148 cases were aged 9?12 years including 104 boys and 44 girls, 27 cases were aged 13?14 years including 14 boys and 13 girls. There was a significant difference in the age of children at first onset between boys and girls ( χ2=17.33, P<0.05). ③ Pathogenic factors in children with indirect inguinal hernia. Of the 498 children with indirect inguinal hernia, 457 cases had complete family history and crying history, and 41 cases were missing. Family history: of the 457 children with indirect inguinal hernia who had complete family history, there were 175 cases with the family history of indirect inguinal hernia and 282 cases without the family history. Of the 478 healthy children surveyed in the same period, there were 25 cases with the family history and 453 cases without the family history. There was a significant difference in the family history between the 457 children with indirect inguinal hernia and the 478 healthy children ( χ2=515.89, P<0.05). Crying history: of the 457 children with indirect inguinal hernia who had complete crying history, there were 194 cases with obvious crying history and 263 cases without obvious crying history. Of the 496 healthy children surveyed in the same period, there were 99 cases with obvious crying history and 397 cases without obvious crying history. There was a significant difference in the crying history between the 457 children with indirect inguinal hernia and the 496 healthy children ( χ2=56.51, P<0.05). ④ Surgical treatment. Of the 498 children with indirect inguinal hernia, 233 cases underwent surgical treatment including 217 boys and 16 girls, 265 cases were followed up without surgical treatment including 151 boys and 114 girls. The surgical rate for indirect inguinal hernia in boys and girls was 58.967%(217/368) and 12.308%(16/130), respectively, showing a significant difference between them ( χ2=84.01, P<0.05). The operation ratio of boys and girls was 13.6:1, and the surgical rate of boys was higher than girls ( odds ratio=10.24, 95% confidence interval as 5.83?17.98). (3) Follow-up. All the 265 children without surgical treatment for indirect inguinal hernia were followed up for 5 years. During the follow-up, there were 142 of 151 boys with surgical treatment and 9 boys without surgical treatments, showing negative in spontaneous cure. There were 27 of 114 girls with surgical treatment and 87 girls without surgical treatment, showing 55 cases positive in spontaneous cure and 32 cases still with indirect inguinal hernia. There was a significant difference in spontaneous cure between the 151 boys and the 114 girls ( χ2=143.79, P<0.05). Conclusion:In Xinjiang region, the incidence rate and surgical rate of indirect inguinal hernia are lower in girls compared with boys, and the spontaneous cure rate is higher in girls compared with boys.
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@#Chalcones are polyphenolic flavonoid substances with various pharmacological effects and low toxicity.In this study, 15 novel trifluoromethyl chalcone derivatives (3a-3o) were designed and synthesized using the chalcone nucleus of natural licorice chalcone as the lead compound skeleton in order to find the candidate drugs with high efficiency and low toxicity against cervical cancer.The structures of the target compounds were confirmed by 1H NMR, 13C NMR and HRMS. The inhibitory activities of compounds 3a-3o, licorice chalcone, cisplatin and Nutlin3a on SiHa, HeLa and C-33A human cervical cancer cells and H8 and HaCaT normal cells were determined by MTT assay, and the structure-activity relationship was analyzed.Transwell and flow cytometry methods were used to assess the target compounds'' ability to inhibit cell migration and invasion, promote apoptosis, and arrest the cell cycle.Molecular docking technology was used to further study the binding characteristics of the target compound with MDM2 protein.The results showed that the compounds had different degrees of inhibitory activity against the three types of cervical cancer cells.Compound 3n showed the strongest activity against HeLa cells (IC50 = 11.69 μmol/L), which was superior to the lead compound, and had lower toxicity against the two normal cells.Compound 3n was found to significantly inhibit the migration and invasion of HeLa cells, induce apoptosis and arrest the cell cycle at G2/M phase.The results of molecular docking showed that the effective binding of compound 3n to MDM2 protein may be one of its anti-tumor mechanisms.This study provides an experimental basis for the screening of new anti-cervical cancer candidate drug from chalcone derivatives.
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Objective:To investigate the chronic restraint stress induced expressions of acid sensitive receptors and its role in the esophageal inflammation and oxidative stress.Methods:Twenty male specific pathogen free (SPF) Kunming mice were randomly divided into two groups: stress group and control group (each group, n=10). Stress mice were restrained in self-made restraint device for 2 hours per day and lasted for total 14 days. The histopathological changes of esophageal mucosa were observed by hematoxylin eosin (HE) staining under light microscope. The expression of nicotinamide adenine dinucleotide phosphate (Nox-4) was detected by immunohistochemistry, real time fluorescent quantitative polymerase chain reaction (qRT-PCR) and enzyme linked immunosorbent assay (ELISA). The mRNA expressions of acid sensitive receptors were detected by qRT-PCR. Results:HE staining showed that stress mice had obvious infiltrations of neutrophils and eosinophils, and also showed inflammatory change in esophgus, while no significant abnormality was found in the esophagus of control mice. The inflammotory scores in stress group were significantly higher than that in control group ( P<0.001). Immunohistochemistry showed that Nox-4 was mainly expressed in the lamina propria, mucosa and submucosa of esophagus. The mRNA expression levels of Nox-4 in stress group was (2.67±0.62) times higher than control group, with statistically significant difference ( P<0.001). In addition, the plasma concentration of Nox-4 in stress group was significantly higher than that of control group [(0.42±0.01)ng/ml vs (2.13±0.35)ng/ml, P<0.001]. The transcription levels of acid sensitive receptors in stressed mice, such as transient receptor potential vanilloid-1 (TRPV-1), TRPV-4, acid-sensing ion channel-1 (ASIC-1), ASIC-2 and ASIC-3 were significantly higher than those in the control group, with statistically significant difference ( P<0.001). Pearson correlation analysis showed that there was a positive correlation between Nox-4 mRNA expression and TRPV-1, TRPV-4, ASIC-1, ASIC-2, ASIC-3 mRNA expression in stress group ( r=0.97, 0.94, 0.98, 0.95 and 0.99, P<0.01). Conclusions:Stress may increases the expression of acid sensitive receptors and result in an esophageal inflammation and oxidative stress, which may contribute to the formation of esophageal hypersensitivity.
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Objective:To study the correlation between OPRM1 A118G gene polymorphism (rs1799971) and the dosage of opioid analgesics in patients after lumbar decompression.Methods:From July 2017 to September 2018, 147 patients undergoing selective posterior lumbar decompression under general anesthesia in the People's Hospital of Xinjiang Uygur Autonomous Region were treated with sufentanil intravenous controlled analgesia(PCIA). The gene polymorphism was detected by PCR.The VAS, Ramasy sedation score, total dosage of sufentanil and adverse reactions of sufentanil in 48 h after operation were observed.Results:The genotype frequencies of AA, GA and GG were 30.6%, 55.5% and 13.9%, respectively, the difference was statistically significant(χ 2=6.324, P=0.423), and G and A allele frequencies were 41.7%, 58.3%, respectively, the difference was statistically significant(χ 2=5.559, P=0.184). There were no statistically significant differences in SpO 2, Ramasay sedation score and VAS score among the groups after operation(all P>0.05). The total dosage of sufentanil in OPRM1 mutant GG[(151.0±23.4)μg] and GA[(132.0±19.1)μg] was higher than that in AA[(123.0±16.2)μg] within 48 h of PCIA, the differences were statistically significant( t=5.206, 2.817, all P<0.05). Conclusion:The OPRM1 A118G gene polymorphism(rs1799971) is correlated with the dosage of opioid analgesics after lumbar decompression.
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Objective@#To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation.@*Methods@#A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014. Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases. The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery.@*Results@#All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recovered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the musculocutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3. In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively.@*Conclusion@#Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes.
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To investigate the role of the bionic multi-channel nerve conduit by reducing mis-match of regenerated nerve fibers in the rabbit sciatic nerve defect. Methods The experiment was conducted from July, 2017 to February, 2019. A total of 55 New Zealand white rabbits were randomly divided into two groups (First group, n=30 and Second group, n=25).There were 5 subgroups (n=6) in the first group, which were autograft and cus-tom-anatomic nerve conduits (CANC) with different channel (1-CANC, 2-CANC, 3-CANC, 4-CANC) that implanted to repair the rabbit sciatic nerve defect (10 mm). The electrophysiological, triceps muscle wet weight recovery rate, histological study and ankle index analysis were used to evaluate the treatment of each group at 12 and 24 weeks postoperatively. There were 5 subgroups (n=5) in the second group. The simultaneous retrograde tracing method was applied to compare with the number of mismatched nerve fibers at 24 weeks postoperatively. All data were recorded and analyzed by One-way ANOVA method, the Turkey’s method was used to compare the differences between each subgroup. The difference was considered to be statistically significant if P＜0.05. Results The autograft group showed the best recovery in the electrophysiology, histology study and ankle index at 12 and 24 weeks postoperatively (P＜0.05).Histology results showed that the same number of myelinated nerve fibers in all CANC group (P＞0.05), but di-ameters of nerve fiber and myelin thickness were higher in 2-CANC and 3-CANC [(10.67±0.56) μm,(10.65±0.53) μm, respectively] compared with 1-CANC and 4-CANC groups [(8.43±0.63) μm, (9.03±0.55) μm, respectively].The differ-ences were similar in electrophysiological, wet weight recovery rate of triceps muscle, histological study and ankle index analysis.Simultaneous retrograde tracing showed that the autograft group had highest total number of labeled profiles, but no significant difference of the total number of labeled profile was showed among the CANC groups. However, the 1-CANC group[(7.1±2.4) %] showed highest percentage of the FB-NY-neurons than other CANC groups[(2.7±1.9)% in 2-CANC, (2.5±2.3) % in 3-CANC, and (2.2±1.2)% in 4-CANC](P＜0.05). Conclusion The autograft group showed the best results among all groups.Compared with the 1-CANC group, the 2-CANC and 3-CANC group obtained more mature regenerated nerve fibers and with a fewer mismatch rate.Moreover, that did not affect the number of regenerated fibers.
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Objective To investigate stress induced Nox-4 expression and to explore its role in adipose inflammation. Methods Twenty male Kunming mice were randomly divided into two groups ( n=10 each) , chronic restraint stress group and control group. Stress mice were restrained in self-made restraint device for 2 hours per day for 14 days. HE staining, immunohistochemistry, RT-PCR, and ELISA were used to analyze the expression of Nox-4, CD11b, antioxidant protein ( Mn SOD, GSH-Px, Catalase), adipocytokines ( adiponectin, MCP-1, IL-6, TNF-a). Results White adipose tissue (WAT) of stress mice inguinal fat pad significantly shrank compared to control group. HE staining showed that there were a large number of mononuclear cells, neutrophils, eosinophils, and cell infiltration reactions and inflammatory changes in WAT of stress mice. The stress significantly increased CD11b-positive cells and the expression of mF4/80, CD68. The concentration of serum FFA in stress group increased significantly, nearly twice of the control group ( P<0.01) . Nox-4 positive staining cells in stress WAT were deeper and more abundant. The level of Nox-4 in stress WAT was significantly higher than that of control group(P<0.01). The levels of antioxidant proteins such as Mn-SOD, GSH-Px, and catalase in stress WAT were significantly lower than those of control group (P<0.01). The expression levels of adiponectin in stress WAT were significantly reduced as compared to control group ( P<0.01) . The levels of MCP-1, IL-6 and TNF-α in stress WAT were significantly higher than those in control group (P<0.01). Conclusion Stress may lead to imbalance of adipose oxidation/antioxidant system and abnormal expression of adipocytokines, which may result in adipose inflammation.
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Objective To investigate the expression of malondialdehyde ( MDA) in esophageal mu-cosa of different types of gastroesophageal reflux disease ( GERD) patients and its role in the esophageal in-flammation. Methods According to the inclusion and exclusion criteria, 42 patients hospitalized in the the Xinjiang Uygur Autonomous Region People's Hospital from December 2017 to October 2018 were selected as the research group. 8 healthy subjects completed physical examination were set up as healthy control group. GERD completed GERDQ score, 24 h pH monitoring, and taken 3 cm on the dentate line of the esophagus as a specimen. The study group was divided into non-erosive reflux disease (NERD) group (17 cases) and Ero-sive reflux disease [erosive esophagitis (RE)] group (25 cases). Then hematoxylin-eosin (HE) staining, immunohistochemistry, real-time polymerase chain reaction ( qPCR ) , enzyme-linked immunosorbent assay (ELISA) methods were used to detect inflammation, oxidative stress (MDA), antioxidant enzyme [manga-nese superoxide dismutase (Mn SOD), glutathione (GSH), catalase (CAT)], and proinflammatory cyto-kines [monocyte chemotactic protein-1 (MCP-1), interlukin-8 (IL-8), tumor necrosis factorα(TNF-α)]. Results There was no significant difference in body mass index ( BMI ) between the three groups ( P >0. 05). 24 h pH monitoring of esophagus showed that the indexes of weak acid reflux (4<pH<7), acid re-flux ( pH<4 ) , esophageal near end acid reflux (％) and DeMeester score in RE group were significantly higher than those in NERD group, with statistical significance between the groups (P<0. 05). There was no significant difference in esophageal pressure between high resolution groups (P>0. 05). In RE group , the infiltration of immune cells (neutrophils, eosinophils), nipple lengthening, edema and other inflammatory changes were found in the esophageal mucosa, and the inflammation score reached the peak, which was signif-icantly higher than that in NERD group, with statistical significant difference (P<0. 001). The positive ex-pression of MDA in the two groups ( NERD, RE) was higher than that in the control group, and the MDA ex-pression in the RE group was almost covered with the full layer esophagus. The serum MDA concentration in the NERD and RE groups was significantly higher than that in the control group (P<0. 001). Compared with the NERD group, the serum MDA in the RE group reached the peak (P<0. 01). The relative expression of mRNA ( Mn SOD, GSH and CAT) in NERD group and RE group was significantly decreased, and there was a significant difference between the three groups (P<0. 001). Compared with the NERD group, the mRNA expression level of Mn SOD and CAT in RE group was significantly decreased (P<0. 01). The relative ex-pression of mRNA (MCP-1, IL-8, TNF- α) increased significantly in the two groups (NERD, RE), and there was a statistically significant difference between the three groups ( P <0. 001 ) . Compared with the NERD group, the expression of its inflammatory factors in the RE group significantly increased (P<0. 01). Conclusions The expression level of MDA in different types of GERD is significantly higher, which may be closely related to esophageal inflammation induced by acid reflux.
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Objective To investigate the expression of NADPH oxidase Nox-4 induced by stress in gastric mucosa and its role in inflammation.Methods Twenty male SPF Kunming mice were randomly divided into chronic restraint stress group(stress group) and control group.Stress mice were restrained in selfmade restraint device for 2 hours each day.The rest of the time,the mice in the two groups had free access to food and water normally,experiment lasted 14 days.The histopathological changes of gastric mucosa were assessed by HE staining under light microscope.The expression of Nox-4 in gastric mucosa of mice was carried out by immunohistochemical method.The relative expression levels of Nox-4,antioxidant protein (Mn-SOD,GSH,Catalase) and inflammatory factors(IL-8,IL-1β,TNF-α) in gastric mucosa were detected by real-time quantitative RT-PCR and ELISA.Results Basal cell proliferation,neutrophil,eosinophil and plasma cell infiltration and inflammatory changes were observed in the lamina propria and glandular epithelium of stress mice,while no obvious abnormalities were found in control mice.The expression of Nox-4 in stress group was deeper and more abundant than that in control group,mainly expressed in lamina propria and glandular epithelium.The mRNA expression levels of Nox-4 in gastric mucosa of stress group was(2.42±0.51) times higher than that of control group,and blood concentration of stress group was(2.23±0.67) times higher than that of control group(t=-46.32,P＜0.001).The RT-PCR of antioxidant proteins in gastric mucosa showed that the transcription levels of Mn SOD,GSH and Catalase in stress group were significantly lower than that of control group (Mn-SOD:0.59± 0.10,GSH:0.58± 0.11,Catalase:0.57± 0.09),and there were significant differences between the two groups(t=13.57,11.67,15.01,P＜0.01).RT-PCR results showed that the transcription levels of IL-8,IL-1β,TNF-α in stress group were significantly higher than those in control group (IL-8:1.47±0.34,IL-1β:1.48 ± 0.42,TNF-α:1.51 ± 0.37),and there were significant differences in two groups(t=-18.45,-19.14,-20.85,P＜0.01).ELISA results showed that the serum levels of inflammatory factors in stress group were significantly higher than those in control group(2.25±0.37,3.59±0.45,3.41±0.34),and the differences were statistically significant(t=-47.11,-79.36,-96.32,P＜0.01).Pearson correlation analysis showed that there was a positive correlation between serum concentration of Nox-4 and inflammatory factors(IL-8,IL-1β,TNF-αt) in stress group(r=0.97,0.99,0.98,P＜0.01).Spearman rank correlation analysis showed that the grade of gastric mucosal inflammation was positively correted with serum levels of Nox-4 and inflammatory factors (IL-8,IL-1β,TNF-α) (r =0.96,0.92,0.91,0.94,all P＜ 0.01)Conclusion Stress may lead to gastric mucosal lesion by overexpression of proinflammatory factors through destroying the balance of oxidation/antioxidant system in gastric mucosa.
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Objective To evaluate the long-term functional recovery after contralateral 7th cervical nerve(C7) transfer with brachial plexus root avulsion and the effect on the contralateral limbs after operation. Methods A total of 83 patients with injory of brachial plexus avulsion were underwent contralateral C7 transfer from September, 2004 to December, 2014.Among them, contralateral C7 were transferred to the median nerve in 33 cases, to radial nerve in 14 cases, to musculocutaneous nerve in 22 cases, and simultaneous transfer to median and musculocutaneous nerve in 14 cases.The followed-up contents included recovery of muscular strength and sensory innervated by the recipient nerve, bilateral limbs synergistic activity and the effect on the contralateral limbs after the surgery. Results All 83 cases were successfully followed-up for 3.2-6.2 years (average, 4.5 years), and found no significant effect on function of the contralateral limbs. In the group of C7 transferred to the median nerve group, 10 cases had muscle strength recov鄄ered≥M3, and 26 cases had sensory recovered≥S3; In the group of C7 transferred to the radial nerve, 6 cases had muscle strength recovered≥M3, and 9 cases had sensory recovered ≥S3; In the group of C7 transferred to the muscu鄄locutaneous nerve, 12 cases had muscle strength recovered≥M3, and 17 cases had sensory recovered≥S3.In the group of C7 simultaneous transferred to the median and musculocutaneous nerve, 6 cases had muscle strength of wrist and digital flexion recovered≥M3, 5 cases had elbow flexion recovered≥M3, 9 and 10 cases had sensory of innervated area and lateral forearm region recovered≥S3, respectively. Conclusion Contralateral C7 transfer is an ideal procedure for the treatment of total brachial plexus root avulsion with definitive clinical outcomes.
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Aim To investigate the role of berberine in mouse primary hepatocytes steatosis and whether aden-osine monophosphate-activated protein kinase(AMPK) is essential in this process in order to explore the mech-anism of non-alcoholic fatty liver disease treatment. Methods Different concentrations of oleic acid(OA) were used in mouse primary hepatocytes to determine the appropriate dose inducing steatosis. Subsequently, hepatocytes were treated with berberine and OA at the same time for 24 h serving metformin as positive con-trol. Lactic dehydrogenase (LDH) release test was performed to investigate cell viability. Lipid level was determined by oil red staining and triglyceride assay. Western blot measured the phosphorylation level of AMPK and Acetyl CoA carboxylase. An AMPK inhibi-tor compound C(CC) pre-treated hepatocytes for 1 h followed by berberine 24 h-treatment. The relationship between free fatty acid(FFA) uptake and mitochondri-al inhibition was evaluated by measuring FFA in the supernatant of OA,berberine and rotenone (mitochon-drial complex I inhibitor) group. Results Berberine could significantly reduce primary hepatocytes steatosis induced by oleic acid and stimulate AMPK and ACC phosphorylation at a non-toxic dose. In addition, CC obviously inhibited AMPK activity,but failed to dimin-ish the lipid dysregulation improvement of berberine. Berberine and rotenone intervention reduced OA up-take by 31.2% and 23.6%,respectively. Conclusion Berberine ameliorates hepatocytes lipid accumulation by suppressing fatty acid uptake,which is probably re-sulted from inhibition of mitochondrial respiratory chain complex I,independently of AMPK activation.
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Objective To analyze and summarize the experience of surgical treatment of carotid body tumor and prevention of relevant complications.Methods The clinical data of 45 cases of carotid body tumor diagnosed and treated by Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region from August 1996 to June 2016 were retrospectively analyzed.All the patients were followed up for 18 months and were followed up in Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region inpatient or outpatient review form,the main observation during follow-up of patients with postoperative complications and recovery.Carotid compression test (Matas test) will be performed 2 weeks preoperation.There were 20 males (4 carotid body lesions located on both sides,16 carotid body lesions on the unilateral side) and 25 females (1 carotid body lesion located on both sides of the neck,neck arteriomatous lesions in unilateral patients were 24 cases),duration of 0.5 to 6.0 years,the average duration of 3 years,analysis of postoperative complications.Results All the operations were successful.There were no perioperative deaths.Among the 45 patients undergoing surgical treatment,one or more surgical procedures were used.Thirty patients were followed up and the remaining 15 patients were lost to follow-up.During an average follow-up of 18 months,complications included 1 stroke,8 hypoglossal nerve injury,13 vagal injury ard 9 homer syndrome.No recurrence of patients was followed up within 6 months,the basic symptoms of nerve injury,1 case of vagus nerve and the tumor was followed up for 6 months,there was still difficulty swallowing and hoarseness.Five cases of bilateral lesions,including 3 cases underwent bilateral staging surgery,the operation was successful.One case of unilateral excision after vagal injury,it did not contralateral surgery;one case of one-sided surgery after the lost,the contralateral did not receive surgery.Conclusions Hoarseness after operation is not caused by recurrent laryngeal nerve injury,and it was recommended that bilateran lesions with smaller one should removed firstly.Matas test could not be regarded as criterion of intraoperative ligation during the operation.
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Objective To study the clinical efficacy of two-stage bone transport combined with induced membrane technique in the treatment of post-traumatic tibial osteomyelitis.Methods A retrospective study was conducted of the 14 patients with post-traumatic tibial osteomyelitis who had been treated by two-stage bone transport combined with induced membrane technique from February 2009 to August 2015.They were 12 males and 2 females,aged from 26 to 59 years (average,40.4 years).By the Cierny & Mader classification,they all belonged to type Ⅳ.Their disease course ranged from 6 to 30 months,averaging 15.3 months.The number of their previous operations ranged from 2 to 6 times,averaging 3.3 times.In the first stage of operation,tibial extended external fixation was installed according to preoperative design,followed by early debridement and extensive removal of osteomyelitis lesion.The length of bone defect after resection of osteomyelitis lesion was from 4 to 18 cm (average,8.5 cm).10％ vancomycin-contained polymethyl methacrylate (PMMA) bone cement was molded and placed in the bone defects.In the second stage of operation,the PMMA-induced membrane was opened to remove the PMMA bone cement,the bone marrow was drilled through and the induced membrane was then sutured up.Tibial osteotomy was conducted at an appropriate part.The average interval between the first and second stages was from 4 to 7 weeks (average,4.8 weeks).The clinical efficacy was evaluated according to the Paley criteria at final follow-ups.Complications were recorded.Results All the patients were followed up for 15 to 50 months (17.5 months).No relapse of osteomyelitis occurred.The total treatment time ranged from 11 to 19 months,with an average of 14.7 months.The total time for external fixation was from 10 to 18 months,averaging 13.2 months.The external fixator indexes ranged from 31 to 75 day/cm,with an average of 48.5 day/cm.According to Paley criteria at final follow-ups,the clinical efficacy was excellent in 11 and good in 3 cases.Pin tract infection occurred in 9 patients,mal-alignment after removal of external fixation in 6,and malunion or nonunion at the docking site in 5.Conclusions Two-stage bone transport combined with induced membrane technique can cure thoroughly post-traumatic tibial osteomyelitis.Its operation procedures are simple but effective.
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Objective To explore the possibility of reduce the treatment cycle of post-traumatic osteomyelitis patients treat with bone transportations. Methods In February, 2017, a patient was diagnosis as left tibial os-teomyelitis with soft tissue defects and treated. Before start trifocal bone transportation with Orthofix external fixator, we did preoperative practice with computer and model. Except this case we also had some article review in this report. Results This case not only finished 12.5 cm bone transportation in 45 days but also treated soft tissue defect before bone transportations. In this method we save almost 2/3 time to compare with monofocal bone transportations, and frame time were also faster than previous method. But because of some mishaps when we follow-up, the gap was occurred in docking side after 140 days follow-up that may need bone transplants. After 140 days of operation, the gap was disap-peared. Conclusion A new type bone transportations in this study and it may reduce treatment time of osteomyelitis.
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Objective To evaluate the safety and efficacy of super mini-percutaneous nephrolithotomy (SMP) by ultrasound-guided renal access in pediatric with renal calculus.Methods From May to August 2015, 20 pediatric patients with upper tract stones underwent the SMP by ultrasound guidance.The patients aged 11-144 months , median age 31.5 months, The stone size ranged 0.8-2.5 cm, mean(1.48 ±0.59) cm.Among the 20 children, single pelvis stones were in 8, multiple stones in 10 and upper ureter stones in 2.All patients had no previous surgery treatment.The SMP system consists of a F6.0 -7.5 nephroscope and a modified F12-14 access sheath with suction-evacuation function.Nephrostomy tract dilation was performed up to F12-14 and lithotripsy procedure was performed by using pneumatic lithotripter.Nephrostomy tube or double J stent was placed only if clinically indicated.Results The stone size was 0.8-2.5 cm ,mean (1.48 ± 0.59)cm.Among the 20 children, there were 8 patients with single pelvis stone, 10 with multiple stones and 2 with upper ureter stones.All the patients were completed successfully without surgery conversion.Mean operative time ranged 6-40 minutes ,mean(17.6 ± 11.6) minutes.The stone free rate was 100％ after the evaluation in the postoperative day.The hemoglobin drop was 2-16 g/L,mean (7.6-± 4.1) g/L.No major complications occurred, neither patient required transfusion.The tubeless PCNL without double J stents and nephrostomy tubes placed were achieved in all patients.Only 14 patients had a ureter catheter placement for one day.The average hospital stay ranged 1-4 days, mean (2.4 ± 0.8) days.Conclusions SMP could be a safe and effective treatment for kidney stone up to 2.0 cm in pediatric cases with advantages of short recovery time, high stone free rate and no catheter placement.SMP could be the ideal procedure for children with upper urinary tract calculus.
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Objective To investigate the clinical efficacy of laparoscopic diaphragmatic hernia repair.Methods The clinical data of 15 patients who underwent laparoscopic repair for acquired diaphragmatic hernia at the People's Hospital of Xinjiang Uyghur Autonomous Region from August 2011 to June 2015 were retrospectively analyzed.Two-side composite patch at the hernia ring-center was fixed on the diaphragm using laparoscopic hernial screw nail for defect repair.The follow-up was performed by telephone interview and outpatient examination till August 2015, which included postoperative recurrence of hernia and complications.Measurment data with normal distribution were presented as mean value (range).Results Fifteen patients received successful laparoscopic repair for tension-free diaphragmatic hernia.The operation time, volume of intraoperative blood loss and average duration of hospital stay were 134.5 minutes (range, 120.0-150.0 minutes), 25.6 mL (range, 10.0-50.0 mL) and 5 days (range, 10-12 days), respectively.No postoperative complications of respiratory and digestive system in 15 patients were detected, and there were the remissions of preoperative respiratory symptoms (cough, cough sputum, wheezing and suffocating) and digestive symptoms (nausea, vomiting and acataposis) of some patients.All the 15 patients were followed up for 2-48 months without severe postoperative complications and recurrence.Conclusion Laparoscopic diaphragmatic hernia repair is safe and feasible.
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Objective To access the effectiveness of modified early warning score (MEWS) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) in predicting the degree of injury and outcome for emergently admitted polytrauma patients.Methods In this single-center prospective study,266 polytrauma patients hospitalized from June 2012 to January 2013 were enrolled.MEWS and APACHE Ⅱ score were collected and compared for the rate of ICU admission,high dependency unit admission,outpatient therapy,death,and discharge within 30 days.Diagnostic and predictive performance of MEWS and APACHE Ⅱ were assessed by the receiver operating characteristic curve (ROC).Results A higher values in MEWS and APACHE Ⅱ were linked to much severe injury,increased likelihood of admission to the ICU or high dependency unit and high mortality.Patients with MEWS value ≥5 had increased risk of death as compared with those with MEWS value ＜ 5 (x2 =90.749,P ＜0.01).MEWS =5,for injury severity evaluation,showed a sensitivity of 85.7％ and specificity of 84.8％.MEWS value≥5 predicted ICU admission with a sensitivity of 80.0％ and specificity of 91.1％ and high dependency unit admission with a sensitivity of 67.9％ and specificity of 79.9％.APACHE Ⅱ score ≥ 21 was associated with increased rate of death,with significant difference from that among patients with APACHE Ⅱ score ＜ 21 (x2 =73.518,P ＜ 0.01).APACHE Ⅱ score =21,for injury severity evaluation,showed a sensitivity of 90.5％ and specificity of 79.5％.APACHE Ⅱ score ≥ 21 predicted ICU admission with a sensitivity of 95.0％ and specificity of 73.6％ and high dependency unit admission with a sensitivity of 88.2％ and specificity of 72.8％.In prediction of prognosis,ICU admission and high dependency unit admission,area under the ROC curve with 95％ CI for NEWS was 0.889 (0.830-0.948),0.937 (0.900-0.975) and 0.946 (0.916-0.977) respectively and for APACHE Ⅱ was 0.939 (0.898-0.979),0.761 (0.677-0.845) and 0.832 (0.782-0.883) respectively.MEWS and APACHE Ⅱ score in death group were (6.4 ± 2.7) points and (29.9 ± 6.4) points,but lowered to (3.0 ± 1.5) points and (16.8 ± 5.7) points respectively in survival group (P ＜ 0.01).Conclusions Both APACHE Ⅱ and MEWS have the ability to discriminate the severity of polytrauma patients and identify the potential of seriously ill patients.MEWS is more suitable for early identification of critically ill trauma patient due to its easy and quick operation as well as low cost,while APACHE Ⅱ is more suitable for evaluation of emergency observing patients and ICU patients.
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OBJECTIVE@#To observe reinforcing effect of calcium sulfate cement (CSC) bovine bone morphogenetic protein (bBMP) on vertebral in the rabbit model of osteoporosis.@*METHODS@#A total of 48 New Zealand white rabbits were randomly divided into group I (blank control group), group II (CSC injection group), group III (CSC/bBMP injection group) and control group. White rabbit osteoporosis model was established rapidly by using castration method+methylprednisolone candidate. After modeling, groups II, III were given corresponding vertebral body injection material, and 4 animals were sacrificed respectively at 24 h, 6 weeks, 12 weeks after vertebral plasty. Tissue pathological status, vertebral mineral density and vertebral body bone mechanical strength were observed.@*RESULTS@#Vertebral body structure form was normal in the groups II and III. Trabecular bone coarsens, connection and repair were observed in micro fracture and bone defects, bone trabecular connectivity was superior to group I significantly; vertebral body compression strength in the group I was on the decline, vertebral compression strength in the groups II and III was on the rise, the largest vertebra. Postoperative BMC and BMD in groups II and III were increased, and significantly higher than group I after 6 weeks (P<0.05), BMC and BMD in group III after 12 weeks were higher than the other three groups.@*CONCLUSION@#Compound bBMP CSC has good bone induction. It can improve the three-dimensional construction effect for osteoporosis vertebral trabecula, and can significantly improve the vertebral strength, as a vertebral packing material with good application prospect.
Subject(s)
Animals , Cattle , Female , Rabbits , Biomechanical Phenomena , Bone Cements , Chemistry , Pharmacology , Bone Density , Bone Morphogenetic Proteins , Chemistry , Pharmacology , Calcium Sulfate , Chemistry , Pharmacology , Osteoporosis , Shear Strength , Spine , PhysiologyABSTRACT
OBJECTIVE@#Aim of the study is to report the unique clinicopathologic feature, treatment outcome and prognostic factors of head and neck hemangiopericytoma (HNHPC).@*METHOD@#A retrospective data collection of reported HNHPC cases, in which therapy, follow-up and outcome data were available, was performed from the electronic database of PubMed, Embase, Google scholar, China National Knowledge Infrastructure, Wan Fang and Wei Pu until on December 31, 2013.@*RESULT@#A total of 213 HNHPC cases were identified from 122 peer-reviewed articles. The recurrence rate was 24.4% (51/209). The positive surgical margin (OR= 3. 977, P5. 0 cm in diameter (OR= 2. 860, P5. 0 cm in diameter and non-surgical treatment was correlated with death (HR= 5. 461, P<0. 01 and HR= 8. 563, P<0. 01, respectively).@*CONCLUSION@#The surgical resection was the mainstream treatment and it was superior to multiple treatments. The tumor size, surgical margins, pathological differentiation and non-surgical treatment were independent prognostic factors.