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Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.
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Objective To analyze the clinical characteristics of children with knee joint diseases and discuss the curative effect of arthroscopy.Methods Eighty-nine children with knee joint diseases in Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical University from October 2012 to October 2015 were selected,and they were given knee arthroscopic surgery according to the disease types and characteristics,such as meniscal suture,suture plus angioplasty and synovectomy etc.All the symptoms,signs and the joint functions were recorded preoperatively and postoperatively.At the end of follow-up,surgical results were analyzed according to Lysholm score and International Knee Documentation Committee Knee evaluation form (IKDC) classification standard.Results The patients with discoid meniscus tear were the most,accounting for 55.55％ (55/99 knees).All patients were followed up for 6-30 months(the average time was 21 months) to find that all symptoms were relieved or disappeared within 1 year after operation.The outcome was evaluated according to the Tegner knee function:76 knees (76.76％) were markedly effective,16 knees (16.16％) were effective,6 knees (6.06％) were invalid and 1 knee (1.01％) was poor,and the excellent rate was 92.92％.The curative effect was evaluated according to Lysholm knee function score and IKDC score at the last follow-up.The Lysholm score in preoperation [(52.46 ± 4.79) scores] improved to (96.52 ± 3.97) scores in postoperation,and the difference was significant (t =-36.24,P ＜ 0.05);the IKDC score in preoperation [(46.52 ± 10.25) scores] improved to (90.67-± 5.89) scores in postoperation,and the difference was significant (t =-50.69,P ＜ 0.05).There was no joint infection,blood vessel or nerve damage and so on.Conclusions Meniscus tear is common in children with knee joint diseases,and most common is discoid lateral meniscus tear,and arthroscopy can have satisfactory outcome,with no obvious complications.Therefore,arthroscopic surgery is an ideal method for surgical treatment of children with knee joint disease.
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Objective To investigate the expressions of E-cadherin (E-cad)in arterial chemoembolization interventional therapied bladder carcinoma.Methods The expressions of E-cad in bladder tumor tissues of30 non-muscle-invasive bladder carcinoma treated with preoperative interventional chemotherapy and 20 invasive bladder carcinoma treated with surgical were measured by streptavi-din-peroxidase immunohisto chemical method.The changes of E-cad expression in bladder carcinoma before and after interventional treatment were analyzed.Results The averaged normal expressions rate of E-cad in non-muscle-invasive and muscle invasive bladder carcinoma was 70.0% (21/30),25.0% (5/20)respectively.The averaged normal expressions rate of E-cad after interventional treatment was improved to 90% (27/30),the differences were statistically significant (P <0.05 ).Conclusion The expressions of E-cad in bladder carcinoma had significant relations with pathological grade and clinical stage.The abnormal expressions of E-cad in the mucosal surface, may be associated with inflammation.Interventional treatment can significantly improve the expressions of E-cad of tumor tissue and delay the progress of bladder cancer.
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Objective To investigate the influence of preoperative arterial chemoembolization on the expression of Survivin,and study the clinical significance in bladder cancer.Methods The tissue before and after chemoembolization of 50 patients with bladder cancer were selected,the Survivin expression was examined by immunohistochemical method.The Survivin expression was compared between before and after chemoembolization in bladder cancer tissue,and the relation of its expression to the pathological grade and clinical stage was evaluated clinically.Results The positive rate of Survivin expression before chemoembolization raised with the rising of the pathological grade and clinical stage,there was statistical difference (P ＜ 0.05).The positive rate of Survivin expression before and after chemoembolization was 72％ (36/50) and 22％ (11/50),there was statistical difference (P ＜0.01).The positive rate of Survivin expression in high grade pathological grade and T2-T4 clinical stage after chemoembolization was significantly lower than that before chemoembolization,there was statistical difference (P ＜0.01).The survival rate 3 years after chemoembolization in Survivin negative expression patients was higher than that in Survivin positive expression patients [94.87％(37/39) vs.7/11],but there was no statistical difference (P ＞ 0.05).The Survivin positive expression in recurrence patients was significantly higher than that in non-recurrence patients [5/8 vs.5.56％ (2/36)],there was statistical difference (P ＜ 0.01).Conclusions Preoperative arterial chemoembolization can reduce the expression of Survivin,adjust malignancy of bladder cancer,could downgrade and downstage the tumor,reduce recurrence rate.The expression of Survivin can serve as predictive factor for prognosis of bladder cancer.
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Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.
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Objective To study the influence of transeatheter bladder arterial chemoembolization on neovascularization and vascular endothelial growth factor (VEGF) expression in bladder cancer treatment. Methods Thirty bladder cancer patients (Tis =1, Ta =2, T1 =6, T2 =11, T3 =9, T4 = 1; G1 = 9, G2=13, G3 = 8) were treated with transcatheter arterial chemotherapy with Mitomycin (20 mg) or Hydroxycamptothecin (10 nag) adding cisplatin (60 rag) and embolization with gelatine sponge particle gelform 1 week before surgery. Before and after the chemoembolization, the expression of VEGF and microvessel density (MVD) count in cancer tissue were examined by SP immunohistochemical staining. Tumor samples after chemoembolization were taken and sent for pathological examination. The over all survival rates were recorded and analyzed as well. Results Before and after the chemoembolization, positive rates of VEGF expression in bladder cancer tissue were 73. 3% and 43.3%, respectively and MVD were 69.8±3.4 and 56. 4±3.3, respectively. There were significant differences between the parameters before and after the treatment (P<0.05). After the intervention, tumor diameter decreased from 2.2±0.9 cm to 1.6±0. 9 cm (P<0.05) and tumor tissues were in severe necrosis and degeneration. During the follow-up of 24. 6 months (ranging from 12 to 36 months),there were 5 recurrent cases (G1 T1 =1, G2 T1=1, G2T3=1, G3T3 = 1, G3 T4 =1, primary transitional cell carcinoma= 4, admixture carcinoma= 1). In the recurrent group, VEGF expression were positive in 5 cases (100% strong positive) and 4 cases (80%, 3 positive, 1 strong positive) (P>0. 05) before and after the chemoembolization. However, it had significant difference in strong positive expression (P<0.05); MVD were 87.4±3.0 and 72.4±4.1 (P<0.05) before and after the treatment. The MVD in no recurrent group was 53.2±3. 5 after chemoembolization, and it had statistical significance comparing with the recurrent group (P<0. 05). Conclusions The chemoembolization can decrease the expression of tumor VEGF and MVD. Thus, it can adjust bladder cancer malignancy, downgrade and downstage the tumors and decrease the risk of postoperative metastasis. For the long-term, this treatment will improve the survival rate and reduce recurrence rate.
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Objective To investigate the influence of preoperative arterial chemoembolization on expression of Ki-67,and clinical significance in bladder cancer. Methods Before and after chemoembolizafion of therapy,the expression of Ki-67 in 30 patients of bladder cancer tissue were examined by immunohistochemical staining.The rehtion of its expression to the pathological grade and clinical stage was evaluated clinically.Results Positive rate of Ki-67 expression in the bladder cancer tissue was 70.00% and 26.67% respectively.There was significant difference between the before and after therapy (P＜0.01). Follow-up for mean 24.6 months recurrence rate in 30 cases was 16.67%.The expression of Ki-67 correhted to the pathological grade, clinical stage and patient recurrence rates of bladder cancer.Conclusions Preoperative arterial chemeembelization can reduce the expression of Ki-67,adjust malignancy of bladder cancer,could downgrade and downstage the tumors,and cut down the postoperative metastasis,improve survival rate and reduce recurrence rate.Both of the Ki-67 labeling index are predictive factor for recurrence of superficial bladder cancer.
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Objective To evaluate imaging diagnostic value of synovial osteochondromatosis.Methods Imaging features of synovial osteochondromatosis proved by surgery,arthroscopy and pathology in 39 cases were retrospectively analyzed.Results The lesions involving thejoints included knee in 11 cases,hip in 10,ankle in 7,shoulder in 8 and elbow in 3,and multiple joints involved in 5 cases.The loose bodies inside the joints or parajoints with different number,size,shape and calcification were seen on radiography.CT(25 cases) was superior to X-ray in showing these loose bodies and also could showed the thickened synovial membranes intra-articular effusion.MRI(30 cases)not only could showed the non-calcification cartilage nodules,but also the changes of soft tissue around the joints,the thickened synovial membranes and articular effusion,and could make the staging of this disease.Conclusion Imaging examination is of significant value in diagnosing synovial osteochnodromatosis and for clinical procedures.