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Objective:To investigate the clinical efficacy of pancreaticoduodenectomy with TRIANGLE operation in the treatment of pancreatic head cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 51 patients with pancreatic head cancer who were admitted to the Sichuan Provincial People′s Hospital, Affiliated Hospital of School of Medicine of University of Electronic Science and Technology of China from January 2017 to July 2018 were collected. There were 33 males and 18 females, aged from 42 to 74 years, with a median age of 56 years. Of the 51 patients, 24 cases undergoing standard pancreaticoduodenectomy, in which No.12, 13 and 17 lymph nodes were dissected, combined with transcatheter arterial infusion chemo-therapy (TAI) were allocated into the standard group, and 27 cases undergoing pancreaticoduo-denectomy with TRIANGLE operation, in which No.7, 8, 9, 12, 13, 16, 17 lymph nodes were dissected, combined with TAI were allocated into the TRIANGLE group, respectively. Observation indicators: (1) intraoperative conditions of the two groups; (2) postoperative conditions of the two groups; (3) follow-up and survival. Follow-up was conducted using outpatient examination and telephone interview once three months to detect tumor recurrence and metastasis and survival of patients up to July 2021 or the death of patient. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the chi-square test or the Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Kaplan‐Meier method was used to calculate the survival rate and median survival time and draw survival curve. Log‐Rank test was used for survival analysis. Results:(1) Comparison of intraoperative conditions between the two groups. The operation time, volume of intraoperative blood loss, cases with intraoperative blood transfusion were (501±61)minutes, (563±278)mL, 4 in the standard group, versus (556±46)minutes, (489±234)mL, 6 in the TRIANGLE group, respectively. There was a significant difference in the operation time between the two groups ( t=3.62, P<0.05) but there was no significant difference in the volume of intraoperative blood loss or cases with intraoperative blood transfusion between the two groups ( t=1.03, χ2=0.25, P>0.05). (2) Comparison of postoperative conditions between the two groups. Of the 51 patients, 30 had 50 times of postoperative complications, including 18 times of grade Ⅰ complications of Clavien-Dindo classification, 29 times of grade Ⅱ complications of Clavien-Dindo classification, 2 times of grade Ⅲa complications of Clavien-Dindo classification, 1 time of grade Ⅲb complications of Clavien-Dindo classification, respectively. Cases with postoperative complications, cases with delayed gastric emptying, cases without or with pancreatic fistula as class A or class B, cases with biliary fistula, cases with bleeding, cases with diarrhea were 15, 4, 13, 7, 4, 4, 2, 2 in the standard group, versus 15, 6, 14, 10, 3, 4, 1, 3 in the TRIANGLE group, respectively. There was no significant difference in cases with postoperative complications, cases with delayed gastric emptying, cases with pancreatic fistula between the two groups ( χ2=0.16, 0.02, Z=-0.04, P>0.05) and there was no significant difference in cases with biliary fistula, cases with bleeding, cases with diarrhea between the two groups ( P>0.05). Cases with complications as Clavien-Dindo grade Ⅰ, grade Ⅱ, grade Ⅲ were 10, 11, 2 in the standard group, versus 8, 18, 1 in the TRIANGLE group, showing no significant difference between the two groups ( Z=-0.67, P>0.05). The duration of postoperative hospital stay was (23±8)days in both of the standard group and the TRIANGLE group, showing no significant difference between the two groups ( t=0.31, P>0.05). (3) Follow-up and survival. All the 51 patients were followed-up for 6 to 54 months, with a median follow-up time of 17 months. The postoperative 1-year overall survival rate was 75.0% and 81.5% in the standard group and the TRIANGLE group, respectively. The postoperative 3-year overall survival rate was 12.5% and 22.2% in the standard group and the TRIANGLE group, respectively. The median postoperative survival time was 15.00 months (95% confidence interval as 12.63 to 17.37 months) and 21.00 months (95% confidence interval as 15.91 to 19.62 months) in the standard group and the TRIANGLE group, respectively. There was a significant difference in survival of patients between the two groups ( χ2=4.30, P<0.05). Cases with tumor recurrence during post-operative 1 year and 3 year were 9 and 20 in the standard group, versus 6 and 15 in the TRIANGLE group, respectively. There was no significant difference in cases with tumor recurrence during postoperative 1 year between the two groups ( P>0.05) and there was a significant difference in cases with tumor recurrence during postoperative 3 year between the two groups ( P<0.05). Conclusion:Compared with standard pancreaticoduodenectomy, pancreaticoduodenectomy with TRIANGLE operation can prolong the median survival time of patients with pancreatic head cancer without increasing surgical related complications.
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BACKGROUND: Curcumin pre-conditioning can alleviate liver Injury induced by limb Ischemia/reperfusion (l/R), but whether curcumin post-conditioning has protective effect against liver cold l/R Injury and its mechanism are still poorly studied. OBJECTIVE: To Investigate the effects of curcumin post-conditioning on hepatocyte apoptosis in rats with liver cold l/R Injury in rats. METHODS: Eighty adult male Sprague-Dawley rats were randomly divided Into four groups (n-20 per group) by using a random number table: Sham group, l/R group, curcumin post-conditioning group (l/R+Cur group), and dexamethasone group (l/R+Dex group). The liver blood flow was completely blocked. Then the splenic vein and the adrenal vein were used as the inflow and outflow tracts to inject 0 °C compound Ringer lactate solution followed by cold perfusion for 30 minutes. After stopping cold perfusion, the proximal splenic vein and the right adrenal vein were ligated to remove the spleen, and then the blood flow In the liver restored. The cold l/R model was successfully established. After 30 minutes of cold ischemia, 60 mg/kg curcumin was injected Into the rat tail vein In the l/R+Cur group, 0.5 mg/kg dexamethasone was injected Into the rat tail vein In the l/R+Dex group, and the same amount of saline was Injected in the other groups. Blood sample was taken from the carotid artery at 6 hours after reperfusion. Serum levels of aspartate aminotransferase and alanine transferase were detected. Then the rats were sacrificed to detect malondlaldehyde level In liver tissue, observe liver pathological changes by hematoxylin-eosin staining, measure hepatocyte apoptosis Index by Hoechst 33258 staining, detect expression of Bcl-2 and Bax protein by western blot, expression of caspase-9 mRNA by RT-PCR, and levels of tumor necrosis factor-a and interleukin-1 ß by ELISA. RESULTS AND CONCLUSION: Compared with the sham group, aspartate aminotransferase, alanine transferase, malondialdehyde levels and apoptosis Index in the l/R group increased significantly (P 0.05). In a word, curcumin-post conditioning can alleviate liver injury induced by cold l/R in rats. Its mechanism may be related to down-regulation of Bcl-2/Вах ratio, inhibition of caspase-9 mRNA expression, and reduction of the release of tumor necrosis factor-a and interleukin-1 ß, therefore playing an antl-apoptotic role in liver protection.
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BACKGROUND: To date, it has been confirmed that etomidate pre-treatment can reduce the damage of remote organs caused by limb ischemia-reperfusion, but whether etomidate post-treatment has protective effect on remote organs and its mechanism has been rarely reported. OBJECTIVE: To investigate the influence of etomidate post-treatment on limb ischemia-reperfusion lung injury. METHODS: A rat model of limb ischemia-reperfusion lung injury was prepared by clamping the bilateral femoral arteries for 2 hours and reperfusion for 3 hours. After 2 hours of limb ischemia, I/R group experienced the process of limb ischemia-reperfusion; I/R+ETO group, I/R+Dex 0.2 group, I/R+Dex 0.5 group and I/R+Dex 1.0 group, besides the model of limb ischemia-reperfusion, were injected with etomidate 1.0 mg/kg and dexamethasone 0.2, 0.5 and 1.0 mg/kg respectively through tail vein. At 3 hours of reperfusion, blood samples were extracted from the carotid artery, blood gas analysis was performed and the partial pressure of blood oxygen (PaO2) was recorded. The pathological changes were detected by immunohistochemistry. Apoptotic index was detected by Hoechst 33258 staining and wet/dry weight ratio was detected. Fas protein and Fasl mRNA of lung tissue were detected by western blot and RT-PCR respectively. Tumor necrosis factor-α and interleukin-1β levels were detected by ELISA. RESULTS AND CONCLUSION: Compared with the I/R group, PaO2 increased (P 0.05). To conclude, etomidate post-treatment can reduce lung injury caused by limb ischemia-reperfusion in rats, and its mechanism may be related to the down-regulation of Fas/FasL. In the statistical point of view, etomidate 1.0 mg/kg has the potency intensity of reducing lung injury, almost equivalent to dexamethasone 0.5 mg/kg.
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Objective:To evaluate the clinical efficacy of different treatment methods for chronic pancreatitis based on M-ANNHEIM system.Methods:The retrospective cross-sectional study was conducted. The clinicopathological data of 177 patients with chronic pancreatitis from two medical centers between July 2008 and July 2018 were collected, including 95 in the Sichuan Provincial People′s Hospital and 82 in the West China Hospital of Sichuan University. There were 100 males and 77 females, aged (49±5)years, with a range from 29 to 72 years. The M-ANNHEIM system was used to decide clinical stages of chronic pancreatitis. Patients in different clinical stages received drug, endoscopic or surgical treatment. Observation indicators: (1) general data and follow-up of patients; (2) treatment of patients in asymptomatic stage; (3) treatment of patients in stage Ⅰ; (4)treatment of patients in stage Ⅱ; (5) treatment of patients in stage Ⅲ; (6) treatment of patients in stage Ⅳ; (7) aggravation and new-onset of diabetes; (8) complications. Follow-up using outpatient examination, telephone, mail, and Sojump was performed to collect data for M-ANNHEIM system up to December 2018. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the AVONA. Repeated measurement data were analyzed using repeated ANOVA. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Results:(1) General data and follow-up of patients: there were 11, 72, 55, 31, and 8 patients with chronic pancreatitis classified as asymptomatic stage, stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅳ of M-ANNHEIM system before treatment. Of the 177 patients, 49, 49, and 79 patients underwent drug, endoscopic and surgical treatment, respectively. All the 177 patients were followed up for (2.4±0.5)years. (2) Treatment of patients in asymptomatic stage: 11 patients in asymptomatic stage underwent drug treatment. The M-ANNHEIM score was 1.91±0.21 before treatment, and 1.27±0.14, 1.73±0.19, 2.09±0.16 at 1 month, 12 months, 24 months after treatment, respectively. (3) Treatment of patients in stage Ⅰ: of the 72 patients in stage Ⅰ, 13 underwent drug treatment, 26 underwent endoscopic treatment, and 33 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 8.11±1.05 before treatment, and 6.31±0.31, 7.69±0.24, 10.00±0.23 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing endoscopic treatment was 8.42±0.93 before treatment, and 5.13±0.25, 6.89±0.20, 8.27±0.24 at 1 month, 12 months, 24 months after treatment, respectively. The M-ANNHEIM score of patients undergoing surgical treatment was 8.13±0.77 before treatment, and 4.79±0.15, 5.42±0.22, 7.76±0.20 at 1 month, 12 months, 24 months after treatment, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.23, P>0.05). For patients in M-ANNHEIM stage Ⅰ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=2.94, 4.98, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.26, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=2.43, 5.99, 4.80, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=4.61, 6.29, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.63, P>0.05). (4) Treatment of patients in stage Ⅱ: of the 55 patients in stage Ⅱ, 8 underwent drug treatment, 15 underwent endoscopic treatment, and 32 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 12.61±1.16 before treatment, and 11.63±0.26, 12.57±0.30, 14.50±0.27 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 12.42±1.43, 8.47±0.24, 11.07±0.21, 11.93±0.30, respectively. The above indicators of patients undergoing surgical treatment was 12.53±1.22, 8.78±0.15, 9.94±0.21, 11.00±0.24, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.38, P>0.05). For patients in M-ANNHEIM stage Ⅱ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=8.37, 8.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=1.13, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=4.13, 8.48, 3.33, P<0.05). At 24 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=5.61, 6.83, 2.26, P<0.05). (5) Treatment of patients in stage Ⅲ: of the 31 patients in stage Ⅲ, 9 underwent drug treatment, 8 underwent endoscopic treatment, and 14 underwent surgical treatment. The M-ANNHEIM score of patients undergoing drug treatment was 17.25±0.89 before treatment, and 17.11±0.35, 18.44±0.41, 17.33±0.44 at 1 month, 12 months, 24 months after treatment, respectively. The above indicators of patients undergoing endoscopic treatment was 17.38±1.06, 15.00±0.53, 16.50±0.33, 16.88±0.44, respectively. The above indicators of patients undergoing surgical treatment was 17.63±1.06, 14.64±0.34, 16.00±0.35, 16.57±0.33, respectively. There was no significant difference in M-ANNHEIM score before treatment between patients receiving different treatments ( F=1.19, P>0.05). For patients in M-ANNHEIM stage Ⅲ, at 1 month after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.37, 4.82, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.59, P>0.05). At 12 months after treatment, there was a significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment ( F=3.63, 4.48, P<0.05); there was no significant difference in M-ANNHEIM score between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.95, P>0.05). At 24 months after treatment, there was no significant difference in M-ANNHEIM score between patients receiving drug treatment and patients receiving endoscopic treatment, between patients receiving drug treatment and patients receiving surgical treatment, between patients receiving endoscopic treatment and patients receiving surgical treatment ( F=0.73, 1.41, 0.55, P>0.05). (6) Treatment of patients in stage Ⅳ: 8 patients in stage Ⅳ underwent drug treatment. The M-ANNHEIM score of patients was 17.94±0.59 before treatment, and 18.01±0.34, 17.54±0.19, 17.34±0.26, 17.88±0.43 at 1 month, 6 months, 12 months, 24 months after treatment, respectively. (7) Aggravation and new-onset of diabetes: of 49 patients undergoing endoscopic treatment, 17 had diabetes before treatment, 5 had aggravated diabetes and 11 had new-onset of diabetes after treatment. Of 79 patients undergoing surgical treatment, 31 had diabetes before treatment, 21 had aggravated diabetes and 7 had new-onset of diabetes after treatment. There were significant differences in the aggravation and new-onset of diabetes between the two groups ( χ2=2.07, 2.04, P<0.05). (8) Complications: 49 patients undergoing drug treatment had no treatment related complications. Of 49 patients undergoing endoscopic treatment, 4 patients with stent related complications were cured after replacing stent under endoscopy, 6 patients had acute pancreatitis, 2 had gastrointestinal bleeding including 1 patient was cured after endoscopic hemostasis, other patients with complications were improved after symptomatic and supportive treatment. Of 79 patients undergoing surgical treatment, 17 had pancreatic leakage (including 11 of biochemical leakage, 5 of grade B pancreatic leakage, and 1 of grade C pancreatic leakage), 3 had postoperative gastroparesis, 3 had intraabdominal infection, 1 had deep venous thrombosis, 2 had hemorrhage of which 1 combined with grade C pancreatic leakage was improved after open hemostasis and 1 was improved after interventional treatment, other patients with complications were improved after symptomatic and supportive treatment. Conclusions:For chronic pancreatitis, individualized treatment should be formulated according to the different stages. M-ANNHEIM score system can be used the evaluate clinical efficacies of drug treatment, endoscopic treatment, and surgical treatment.
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Objective To evaluate the effects of interferon therapy after curative surgical intervention on improving prognosis of patients with hepatitis C-related hepatocellular carcinoma (HCC).Methods We searched randomized clinical trials from 1990 to 2015 on interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC from the Cochrane Library,the Cochrane Database of Systematic Reviews,MEDLINE and Embase.A Meta-analysis was carried out using Revman 5.Results There were 7 studies included in this research.The results showed that interferon therapy after curative surgical intervention in patients with hepatitis C-related HCC reduced the recurrence rate of HCC at 3 years (RR =0.84,95％ CI 0.73 ～0.97,P ＜0.05).The therapy could not improve the 3-year survival rate in these patients (RR =1.04,95％ CI 0.90 ～ 1.21,P ＞ 0.05).Stratified subgroup analyses showed interferon therapy after liver resection reduced the recurrence rate (RR =0.62,95 ％ CI 0.39 ～ 1.00,P =0.05).For patients with tumors less than 3 cm,interferon therapy reduced the recurrence rate (RR =0.82,95％ CI 0.69 ～ 0.98,P ＜ 0.05).Conclusion Interferon therapy after curative surgical intervention improved prognosis in patients with hepatitis C-related HCC.
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Forty-eight male Wistar rats,weighing 280 to 320 g,were selected and prepared by fasting but free drinking for 12 hours before the experiment.They were randomly divided into four groups by random number table (12 rats in each group):control group,ischemic group,reperfusion group and propofol group.Control group:normal saline infusion[10 ml /(kg?h)]for 1 h in caudal vein without any other treatment.Ischemic group:on the basis of control group,supply with 20 mmHg(1 mmHg =0.133 kPa)pneumoperitoneum pressure for 1 h. Reperfusion group:on the basis of ischemic group,keep pneumoperitoneum pressure open for 30 min.Propo-fol group:infusion propofol in caudal vein [10 ml /(kg?h),saline 10-fold dilution],given 20 mmHg pneu-moperitoneum pressure for 1 h,then kept this pressure open for 30 min.The expression changes of blood urea nitrogen(BUN),creatinine(Cr),superoxide dismutase(SOD),malondialdehyde(MDA)and nuclear factor E2-related factor 2(Nrf2)were detected individually.Results The levels of BUN,Cr and MDA gradually increased,while the level of SOD decreased in control group,ischemic group and reperfusion group (P ﹤0.05,respectively).Compared with ischemic group and reperfusion group,the levels of BUN,Cr and MDA decreased significantly,and the level of SOD increased markedly in propofol group(P ﹤0.05,respectively). The expression of Nrf2 protein and mRNA gradually increased in the control group,ischemia group,reperfu-sion group and propofol group (P ﹤0.05).Conclusion Carbon dioxide pneumoperitoneum can cause renal IRI in rats.Propofol has a protective effect of IRI by regulating the expression of Nrf2 protein.
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<p><b>OBJECTIVE</b>To investigate whether transplantation of autologous peripheral blood CD34+ stem cells is a viable approach for treating patients with advanced cirrhosis,which is currently hindered by a shortage in liver donors.</p><p><b>METHODS</b>A total of 100 patients with advanced cirrhosis and who had failed to respond to conservative therapy were recruited for transplantation of autologous peripheral blood CD34+ stem cells.The success of transplantation was investigated 6-and 12-months later by measuring markers of liver biosynthesis function (coagulation,albumin level,indocyanine green clearance,Child-Pugh score) and assessing pathological changes (Knodell score) and morphologic changes in the liver tissue.Complications were also recorded during follow-up.</p><p><b>RESULTS</b>The 1-year cumulative survival rate was 100%. Fifty-two patients with massive ascites showed gradual reduction and disappearance of the ascites.Four patients experienced upper gastrointestinal bleeding and three patients developed with hepatic encephalopathy (I-II degree) at 3 months post-transplantation.All patients showed significantly improved liver biosynthesis function,liver elasticity and Knodell score after transplantation (P less than 0.05).</p><p><b>CONCLUSION</b>Autologous peripheral blood CD34+ stem cell transplantation is a safe and effective treatment for advanced cirrhosis,and has high cost-benefit since it improves liver function,liver histology,and quality of life.</p>
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Humans , Ascites , Liver Cirrhosis , Therapeutics , Quality of Life , Stem Cell Transplantation , Transplantation, Autologous , Treatment OutcomeABSTRACT
BACKGROUND: It has been proved that vascular endothelial growth factor 165(VEGF165) and bone morphogenetic protein 2(BMP2) can accelerate the vascularization synergistically.OBJECTIVE:To construct the vectors, pDsVEGF165Red1-N1 and pIRES2-BMP2-enhanced green fluorescent protein(EGFP) followed by co-transfected into HEK 293-T cells,and study their expression and location of VEGF165and BMP2 in the cells.DESIGN: A randomized and controlled experiment.SETTING: National Key Laboratory,Institute of Surgery Research,Daping Hospital,Third Military Medical University.MATERIALS: The experiment was conducted at National Key Laboratory,Institute of Surgery Research,Daping Hospital,Third Military Medical University from September 2002 to March 2004. pcDNA3.1\BMP2 ( gift of Dr.Bostrom, UCLA School of Mediine, Los Angeles,USA).pDsRed1-N1(gift of Pro. Roger Y.Tisen,University of California,San Diego,USA). pUC18/VEGF165,293-T cells(preserved by our Laboratory).METHODS: According to the nucleotide sequence of hVEGF165, the primers were designed.The hVEGF165 gene without stop codon was amplified by polymerase chain reaction (PCR).The fragment digested was cloned into the expression vector pDsRed1-N1.Meantime,the pIRES2-BMP2-EGFP expression vector was constructed.The two plasmids were co-transfected into HEK 293-T cells.The co-expression and distribution of the VEGF165and BMP2 were observed with confocal laser microscopy (CLSM) and detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blotting.MAIN OUTCOME MEASURES: Identification of the recombinant plasmids and the expressing mRNA and protein in 293-T cells.RESULTS: The recombinant plasmids were verified correct construction by restriction enzyme analysis, PCR and sequencing. The two genes which were co-transfected could express in HEK 293-T cells.The co-expression of the report genes,RFP and EGFP, were found over the cytoplasm and in the nuclei by CLSM.CONCLUSION: Two report gene expression vectors contain VEGF165 and BMP2 have been constructed successfully, which can be co-expressed in HEK 293-T cells. Thus, they can provide important and convenient tool to study intracellular interaction of VEGF165 and BMP2.
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[Objective]To analyze the causes of anterior knee pain after intramedullary(IM) nailing treatment of tibial shaft fractures.[Method]A total of 256 patients with tibial shaft fractures were treated with intramedullary nailing from 2000 to 2007 in our hospital.There were 183 males and 73 females with a mean age of 45 years.All patients were followed up at least once after fracture healing.[Result]Among 256 patients,166 experienced anterior knee pain,accounting for 65%.Ninety-six(58%) treated with transtendinous nailing complained of and 70(42%) treated with paratendinous nailing complained of anterior knee pain.It was worsened after activity but relieved only in 33(20%) by resting or taking analgesic drugs.The anterior knee pain disappeared one year after the IM nailing was taken out.[Conclusion]Anterior knee pain can not be reduced by different approaches of operation for tibial shaft fractures.However,the removal of intramedullary nailing and the muscle exercises around the knee joint can reduce the occurrence of anterior knee pain.
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Objective:To construct the pIRES2-enchanced green flurescent protein expression vector carrying BMP_2 gene in order to provide an ideal reporter gene for the expression and identify the location of portein in vitro and vivo.Methods:The BMP_2 cDNA sequence was excised,and subcloned on pUC18 vector.And then the BMP_2 sequence on the pUC18 plasmid was excised again and ligated into Sal Ⅰ site of pIRES2-EGFP treated by phosphorylase in sense and antisense direction.The correct recombinant plasmid was transfected into 293-T cells,the expression of BMP_2 was determined by FCM,LCM and RT-PCR.Results:The recombinant expression vector was verified correctly by enzyme digestion,sequence analysis.This vector was expressed in cells.Conclusion:A pIRES2 green fluorescent protein reporter gene vector containing BMP_2 has been constructed successfully,thus providing an important and convenient tool to study intracellular localization of BMP_2.