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Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017. A young child who suffered destructive injury of left forearm, wrist and palm with severed 3rd-5th fingers. Tendon and neurovascular repairs of forearm, wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery. In the Phase II surgery, the abdomina flap division was carried out. The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF) were carried out in Phase III surgery. In Phase IV surgery, fingers functional reconstruction and foot flap thinning were performed. Four years after surgery, the thumb oppositions to middle, ring and little fingers could be completed, with slightly limitations. The appearance and texture of transferred foot flap were good, and the child could walk and run almost normally.
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Objective:To investigate the changes of skeletal muscle-derived microparticles (SKMPs) and their scaving proteins lactadherin in peripheral blood of patients with perihip fractures and their effects on blood coagulation. It provides a theoretical basis for clinical evaluation of hypercoagulability in patients with perioperative hip fractures.Methods:A total of 44 patients (72.87±13.9 years old) with perihip fractures from October 2020 to January 2021 were included in the fracture group, and 40 healthy people were included in the group without fracture. Activated clotting time (ACT) in fracture group and control group was measured by coagulation and platelet function analyzer. The level of SKMPs in peripheral venous blood was determined by flow cytometry. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of MPs scaving proteins lactadherin in peripheral blood of fracture group and control group.Results:A total of 44 patients with perihip fractures were included. There were 33 (75%) femoral neck fractures and 11 (25%) intertrochanteric fractures. SKMPs concentration in peripheral blood of perihip fracture group 175.73/μl; postoperative fracture group 124.28/μl; Normal control group 90.69/μl. ACT was (377.5±76.2) s in the perihip fracture group, (498.1±97.1) s in the post-fracture group, and (505.7±44.0) s in the control group. Correlation analysis showed that there was a linear relationship between SKMPs count and ACT value in fracture patients ( r=-0.52, P<0.001). There was no significant correlation between SKMPs concentration and ACT value in peripheral venous blood of the post-fracture group ( P>0.05); Lactadherin protein concentration in perihip fracture group: 2 779.61 pg/ml; Fracture postoperative group 1 985.38 pg/ml; Normal control group 1 651.19 pg/ml. There is a positive correlation between Lactadherin concentration and SKMPs concentration with a correlation coefficient of 0.70. Conclusion:SKMPs plays a role in the hypercoagulability of patients with perihip fractures. Decompensation of lactadherin protein may be one of the causes of perioperative hypercoagulation in patients with hip fractures.
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Objective:To investigate the effect of the liquid resuscitation therapy strategy using intra-abdominal pressure (IAP) and oxygenation index (PaO 2/FiO 2) as the end point in patients with severe acute pancreatitis (SAP). Methods:A retrospective study was performed, including 84 patients with SAP in emergency intensive care unit of Qingzhou Hospital Affiliated to Shandong First Medical University from January 2018 to August 2021. According to the status of fluid balance at admission, all patients were divided into the positive fluid balance group (43 cases) and the negative fluid balance group (41 cases). The clinical data including gender, age, etiology, underlying disease, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) of all patients were collected. Fluid balance, PaO 2/FiO 2, IAP, compliance rate, new mechanical ventilation rate and overall hospital stay of 1 week after admission were recorded and compared between the two groups. Results:After 72 hours of treatment, the cumulative fluid balance was (5 219.5±1 038.4) mL in the positive fluid balance group; IAP was higher than that before treatment [mmHg (1 mmHg≈0.133 kPa): 11.9±2.0 vs. 11.7±2.1], but no significant difference was found ( P > 0.05); PaO 2/FiO 2 was significantly higher than that before treatment (mmHg: 299.8±51.4 vs. 220.5±50.4, P < 0.05). After 72 hours of treatment, the cumulative fluid balance in negative fluid balance group was (-3 542.4±1 310.6) mL; IAP was significantly lower than before treatment (mmHg: 11.4±1.8 vs. 15.2±1.9, P < 0.05); PaO 2/FiO 2 was significantly higher than that before treatment (mmHg: 309.9±50.9 vs. 215.4±49.7, P < 0.05). In the fluid resuscitation goals, after 72 hours of treatment, the compliance rate in the negative fluid balance group was significantly higher than that in the positive fluid balance group [82.93% (34/41) vs. 62.79% (27/43), P < 0.05]; 1 week after admission, the new mechanical ventilation rate in the negative fluid balance group was significantly lower than that in the positive fluid balance group [21.95% (9/41) vs. 41.86% (18/43), P < 0.05]; however, there was no significant difference in overall hospital stay between the two groups (days: 41.2±10.9 vs. 39.1±11.5, P > 0.05). After treatment, 70 patients survived and 14 patients died (including 9 cases in the positive fluid balance group and 5 cases in the negative fluid balance group). Conclusions:Using IAP and PaO 2/FiO 2 to guide liquid therapy could result in effective fluid resuscitation in SAP. The treatment strategy effectively improved prognosis of patients with SAP.
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Objective:To explore the effect of the new model of "5G cloud plus medicine" network and linkage in improving the therapeutic effect for patients with severe trauma.Methods:A retrospective cohort study was conducted to analyze the clinical data of 410 patients with severe trauma admitted to Qingzhou People′s Hospital affiliated to Shandong First Medical University from November 2016 to November 2020. There were 258 males and 152 females, aged 16-80 years [(45.7±16.1)years]. The injury severity score (ISS) ranged from 17 to 55 points [(28.1±7.6)points]. A total of 210 patients with severe trauma were rescued by using the new model of "5G cloud plus medicine" network and linkage from November 1, 2018 to November 30, 2020 (observation group), and another 200 patients with severe trauma were rescued by the traditional treatment mode from November 1, 2016 to October 31, 2018 were selected as the control group. Time to start rescue (time from admission to the start of rescue), CT examination time (time from consultation to completion of CT scan), time to receive blood transfusion (time from blood transfusion request to execution), residence time in emergency room, ISS at postoperative 28 days, proportion of patients with blood transfusion, success rate of rescue and mortality rate were compared between the two groups.Results:Time to start rescue [(2.4±1.1)minutes], CT examination time [(29.1±10.3)minutes], time to receive blood transfusion [(28.1±10.2)minutes] and residence time in emergency room [(3.0±1.1)hours] in observation group were significantly shorter than those in control group [(5.5±1.2)minutes, (42.8±10.1)minutes, (48.5±13.1)minutes, (5.0±1.4)hours] (all P<0.05 or 0.01). ISS was (18.7±2.8)points in observation group, significantly lower than (22.1±3.4)points in control group ( P<0.05). Proportion of patients with blood transfusion was 49.5% (104/210) in observation group, similar with 42.5% (85/200) in control group ( P>0.05). Success rate of rescue was 99.0% (208/210) in observation group, significantly higher than 93.0% (186/200) in control group ( P<0.05). The mortality rate was 4.3% (9/200) in observation group, significantly lower than 8.5% (17/200) in control group ( P<0.05). Conclusion:For patients with severe trauma, the new model of "5G cloud plus medicine" network and linkage can effectively shorten the time to start rescue, CT examination time, time to receive blood transfusion and residence time in emergency room, improve the success rate of rescue and reduce the mortality rate, which is worthy of further promotion.
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The clinical pathological data of a patient large cell undifferentiated bladder carcinoma was retrospectively analyzed and understand.The clinical and imaging findings of large cell undifferentiated bladder carcinoma was nonspecific.Diagnosis depended on the pathological and immuno-histochemical staining.The tumor is aggressive with high risk of recurrence.It is mainly treated with radical resection.
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Objective:To study the correlation between hypercoagulant status of patients with hip fracture and the level of microparticles (MPs) in their peripheral blood, and to explore the feasibility of removing MPs to correct hypercoagulant status in patients with hip fracture.Methods:Sixty-five patients from December 2018 to September 2019 with hip fracture were included. There were 24 males and 41 females with the average age of 75.6±9.8 years old (range 58-95 years). Among them, 27patients (43.1%) were femoral neck fracture and38 patients (56.9%) were intertrochanteric fracture.All patients were diagnosed with X-ray and CT. Meanwhile, about 20 healthy people in the physical examination center included as controls in our study. There were 8 males and 12 females with the average age of 72.3±6.5 years old (range 56-81years). 2 ml of anticoagulant whole blood was taken on an empty body in the morning, and purified microparticlesby whole-blood density gradient centrifugation in whole blood were identified by electron microscope and nanoparticle tracking analyzer. After cell free plasma (CFP) was obtained by whole-blood density gradient centrifugation, the number of whole annexin V (AV) positived MPs and these MPs which from platelet (PMPs) was determined by flow cytometry. The activated clotting time (ACT) was determined by coagulation and platelet function analyzer to evaluate the degree of hypercoagulability. Then, Logistic analysis was performed on risk factors associated with hypercoagulability to determine whether the level of MPs was an independent risk factor for hypercoagulability, and the correlation between ACT value and MPs level was analyzed. Finally, the four coagulation items of each sample CFP before and after MPs removal were determined by automatic coagulation analyzer.Results:Under electron microscopy, MPs presented vesicular appearance,with a complete double-layer membrane structure, the size was in the range of 100-1 000 nm, and the morphology was not uniform. there were irregular vesicular and circular vesicular general shapes. The average size of MPs in peripheral blood of patients with hip fractures was 239.7±4.0 nm. The mean size of MPs distribution in the control group was 247.7±3.3 nm, and there was no statistically significant difference in MPs diameter between the two groups. The average level of circulating AV +MPs in patients with hip fracture was 564±171/μl, and the average level of PMPs was 326±104/μl. In the control group, the average level of AV +MPs was 252±82/μl, the average level of PMPs was 192±41/μl, the difference between AV +MPs and PMPs was statistically significant ( P<0.05). The average ACT level of patients with hip fracture was 324±94 s, while the average ACT level of the normal population was 535±76 s, and the difference between the two was statistically significant ( P<0.05). Single factor logistic regression analysis showed that the levels of APTT, PMPs and AV +MPs may be risk factors for hypercoagulability, and multivariate logistic regression analysis showed that AV +MPs is an independent risk factor for hypercoagulability.It has a highly negative correlation with ACT ( r=-0.822, P<0.05). The results of four coagulation items determined by CFP were PT 10.8±0.46 s, APTT 30.6±1.56 s, Fib 3.08±0.36 g/L, INR 0.98±0.04 and TT 19.3±0.62 s. After the removal of MPs, the coagulation function was PT 10.8±0.52 s, APTT 32.4±3.0 s, Fib 2.90±0.33 g/L, INR 0.99±0.05 s, and TT 19.9±0.63 s. There was no statistically significant difference before and after coagulation function. Conclusion:There is a hypercoagulable state in patients with hip fracture, moreover, the level of AV +MPs is an independent risk factor for hypercoagulability, which is highly correlated with ACT, and MPs has no significant effect on the classic four factors of coagulation.
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Objective:To establish a hypergravity loading model with a high-acceleration centrifugal loading device and to investigate the effects of different hypergravity loading and icariin on osteoblast adhesion and cytoskeleton.Methods:MC3T3-E1 cells were seeded in the dishes of cell culture at a density of 2×10 5/cm 2. And the experiment was divided into 6 groups: control group (without icariin and loading); simple administration group (only icariin); 10 G loading group (only loading); 10 G administration group (with icariin and loading); 40 G loading group (only loading); 40 G administration group (with icariin and loading). The experimental loading group was loaded with MC3T3-E1 cells using a high-acceleration centrifugal loader. And continuous loading for 3 d, 30 min per d. The control group and the simple administration group were exposed to normal gravity, and the remaining conditions were not different from the experimental group. Icariin was used at a concentration of 10 -7 mol/L in all administration groups, and the experiments were carried out according to the method of preventive administration. At the same time, the related molecular biological techniques such as alizarin red staining, alkaline phosphatase (ALP) activity measurement, CCK-8 cell proliferation experiment, cytoskeleton phalloidin staining, qPCR and Western Blot were used to detect the effects of icariin on osteoblasts adhesion protein integrin α5 and integrin β1 and cytoskeleton protein F-actin under hypergravity extreme mechanical environment. Results:All models were successfully prepared. The alizarin red staining: The icariin could significantly promote the formation of osteoblastic calcified nodules. And the 10 G loading could also promote the mineralization of osteoblasts and increase the number of mineralized nodules, while the mineralization and the number of mineralized nodules of osteoblasts are significantly reduced in 40 G loading. ALP activity test: The OD values of simple administration group, 10 G loading group and 40 G loading group were 0.246, 0.331 and 0.163, respectively. Compared with 0.207 in the control group, the differences were statistically significant ( P<0.05). The 10 G administration group and the 40 G administration group were 0.373 and 0.180, and the differences were statistically significant ( P<0.05). The results of CCK-8 proliferation experiments: The OD value of simple administration group were 0.650, which was statistically significant compared with 0.551 of control group ( P=0.031). The 10 G loading group and 40 G loading group were 1.193 and 0.245, and their differences with the control group were both statistically significant ( P<0.05). The OD value of 10G administration group and the 40 G administration group were 1.300 and 0.310, which were significantly different from the respective loading groups ( P<0.05). Phalloidin staining: 10 G loading significantly increased the number of cells, but the changes in cells morphology and skeleton were not obvious. 40 G loading significantly inhibited the increase of the number of cells, meanwhile, made the pseudopods of cells more shorter and even disappeared. 40 G loading made the seriously damage of the cytoskeleton and even cause the cells to death. Icariin had no effect on the cells morphology, but it did has a certain repair effect after the cells loading. The results of qPCR and Western Blot experiments all confirmed that the expressions of integrin α5, integrin β1 and F-actin were up-regulated after icariin treatment. 10 G loading could promote the expression of integrin α5, integrin β1 and F-actin, and 40 G loading significantly inhibited the expression of the mRNA and proteins. Conclusion:Both 10 G condition and icariin can promote the development, cell adhesion and the cytoskeleton's stability of osteoblasts, while 40 G has a significant inhibitory effect.
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Objective@#To investigate the prognostic value of pretreatment albumin to globulin ratio(AGR)in prostate cancer(Pca)patients treated with maximal androgen blockade(MAB).@*Methods@#Clinical and pathological data of 210 Pca patients who underwent MAB as first-line therapy between January 2013 and June 2018 were retrospectively analyzed.The ages of patients in our cohort ranged from 61 to 90 years, with a mean of(77.0±6.5)years.According to the cut-off point for AGR calculated by the receiver-operating curve analysis, patients were categorized into two groups: the high-AGR group and the low-AGR group.Clinical and pathological features were compared between the groups.Independent factors affecting prognosis were analyzed by using univariate and multivariate analysis.@*Results@#The median follow-up duration was 44.0 months.Of the 210 patients, 99 cases had castration resistance, 100 patients(47.6%)had disease progression and 67 patients(31.8%)died.The cut-off point for AGR calculated by the receiver-operating curve analysis was 1.56.There were 103 cases in the low-AGR group(AGR<1.56)and 107 cases in the high-AGR group(AGR≥1.56). Univariate analysis revealed that the progression-free survival(PFS), cancer-specific survival(CSS)and overall survival(OS)were lower in the low-AGR group than in the high-AGR group[1.773(1.298~2.442), 1.948(1.220~3.213), 1.965(1.217~2.996), all P<0.05]. Multivariate Cox regression analysis showed that Gleason score, regional lymph nodes and bone metastases and AGR were independent prognostic factors for PFS(P=0.007, 0.040 and 0.022, P=0.031), CSS(P=0.003, 0.035 and 0.041, P=0.009)and OS(P=0.003, 0.026 and 0.023, P=0.002).@*Conclusions@#Pretreatment AGR<1.56 is an independent predictor for poor prognosis in Pca patients treated with MAB.
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The interface of ligaments, tendons, and bones are susceptible to damage, often fail to heal themselves, and even cannot achieve a good prognosis after surgery. Interface tissue engineering is a comprehensive strategy to functionally connect soft and hard tissues to regenerate original anatomical functions and structures, thereby improving clinical efficacy. In this paper, the interface tissue engineering and composite tissue regeneration in soft tissue healing were systematically reviewed. The recent advances in interface engineering were summarized, based on the treatment of structural damage from two common soft tissue-bone connections (ligamentous bone connections, tendon bone connections), from the development of single tissue to composite tissue structures. The latest interface tissue engineering innovation structure design and potential clinical applications in recent years were reviewed. For future research, in-depth research on the mechanisms of interface development, regeneration, and internal environment balance, structure-function relationships, and biological processes that drive interface development, regeneration, and internal environment balance are still necessary. The innovative studies on interface tissue engineering have promoted the significance of the integration of tissue engineering and clinical, and the construction of complex tissues, so that it has broader significance for the future regeneration of total joints.
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Objective To investigate the prognostic value of pretreatment albumin to globulin ratio(AGR) in prostate cancer(Pca)patients treated with maximal androgen blockade(MAB).Methods Clinical and pathological data of 210 Pca patients who underwent MAB as first-line therapy between January 2013 and June 2018 were retrospectively analyzed.The ages of patients in our cohort ranged from 61 to 90 years,with a mean of(77.0-±-6.5)years.According to the cut-off point for AGR calculated by the receiver-operating curve analysis,patients were categorized into two groups:the high-AGR group and the low-AGR group.Clinical and pathological features were compared between the groups.Independent factors affecting prognosis were analyzed by using univariate and multivariate analysis.Results The median follow-up duration was 44.0 months.Of the 210 patients,99 cases had castration resistance,100 patients (47.6％) had disease progression and 67 patients (31.8％)died.The cut-off point for AGR calculated by the receiver-operating curve analysis was 1.56.There were 103 cases in the low-AGR group(AGR＜ 1.56)and 107 cases in the high-AGR group(AGR≥1.56).Univariate analysis revealed that the progression-free survival(PFS),cancer-specific survival (CSS)and overall survival(OS)were lower in the low-AGR group than in the high-AGR group[1.773(1.298～ 2.442),1.948 (1.220 ～ 3.213),1.965 (1.217 ～ 2.996),all P ＜ 0.05].Multivariate Cox regression analysis showed that Gleason score,regional lymph nodes and bone metastases and AGR were independent prognostic factors for PFS (P =0.007,0.040 and 0.022,P =0.031),CSS (P=0.003,0.035 and 0.041,P =0.009)and OS(P=0.003,0.026 and 0.023,P=0.002).Conclusions Pretreatment AGR＜1.56 is an independent predictor for poor prognosis in Pca patients treated with MAB.
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The interface of ligaments, tendons, and bones are susceptible to damage, often fail to heal themselves, and even cannot achieve a good prognosis after surgery. Interface tissue engineering is a comprehensive strategy to functionally connect soft and hard tissues to regenerate original anatomical functions and structures, thereby improving clinical efficacy. In this paper, the interface tissue engineering and composite tissue regeneration in soft tissue healing were systematically reviewed. The recent advances in interface engineering were summarized, based on the treatment of structural damage from two common soft tissue-bone connections (ligamentous bone connections, tendon bone connections), from the development of single tissue to composite tissue structures. The latest interface tissue engineering innovation structure design and potential clinical applications in recent years were reviewed. For future research, in-depth research on the mechanisms of interface development, regeneration, and internal environment balance, structure-function relationships, and biological processes that drive interface development, regeneration, and internal environment balance are still necessary. The innovative studies on interface tissue engineering have promoted the significance of the integration of tissue engineering and clinical, and the construction of complex tissues, so that it has broader significance for the future regeneration of total joints.
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Current status and problems of experimental teaching for medical postgraduate were an-alyzed. Based on experimental teaching in Center of Experimental Teaching for Postgraduates in Medicine at Xi'an Jiaotong University , application of flipped classroom to experimental teaching for postgraduates were discussed in details. Application of flipped classroom to experimental teaching of Cellular and Molec-ular Biology for postgraduates in medicine was introduced. After advantages and disadvantages of flipped classroom were analyzed, countermeasures were proposed. Combining flipped classroom with traditional teaching method is considered to be helpful to the utilization of flipped classroo, and the enhancement of in-novative thinking of postgraduates.
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Objective To investigate the role and mechanism of nico-tinamide adenine dinucleotide phosphate oxidase 4 (NAPHD oxidase 4,Nox4)-mediated reactive oxygen species (ROS) generation on high-dose dexamethasone (DEX) induced apoptosis in osteoblasts.Methods According to culture conditions,3rd passage of murine osteoblastic MC3T3-E 1 cells were divided into control group,Dexamethasone group,Dexamethasone+NAC (N-acetyl-L-cysteine) group,NAC group,Dexamethasone+DPI (Diphenyleneiodonium) group and DPI group.24 hours after culture,the morphology of osteoblasts was observed by inverted phase contrast microscope.Cell viability was determined by MTT assay.The generation of ROS in osteoblasts was measured using a fluorescent probe DCFH-DA.The apoptosis of each group was observed through Hoechst staining.The mRNA level and protein expression of Nox4 were detected by real-time quantitative PCR and Western Blot.In addition,after silence of Nox4 with small interfering RNA (siRNA),the ROS generation was further detected by a fluorescent probe DCFH-DA.Results After treatment with 1000 nmol DEX for 24 hours,compared to control group,the results of inverted phase contrast microscope and MTT showed that osteoblasts in DEX group exhibited more obvious signs of shrinkage and deformation with decreased cell viability.After intervene with NAC and DPI,morphology of osteoblasts was good with increased viability of osteoblasts.Compared to control group (5.86％± 0.28％),the production of ROS in DEX group (45.14％±1.49％) was significantly increased (P=0.000).The apoptotic rates in DEX group (29.60％± 1.52％) was significantly increased compared with control group (4.12％±0.67％) (P=0.000).Compared to DEX group,the production of ROS generation in DEX+NAC group (28.06％±1.61％) and DEX+DPI group (23.70％±1.28％) was significantly decreased (P=0.000).It presented that NAC or DPI significantly decreased the formation of ROS.Compared to DEX group,the apoptotic rate in DEX+NAC group (8.94％± 1.47％) and DEX+DPI group (12.96％±2.03％) was significantly decreased (P=0.000).It presented that NAC or DPI significantly decreased osteoblast apoptosis.In addition,the Nox4 mRNA level in DEX group was 2.67-fold compared with control group (t=-10.301,P=0.009).The difference had statistically significance.The protein expression of Nox4 in DEX group was 2.37-fold compared with control group (t=-15.542,P=0.004).The difference has statistically significance.After silence of Nox4 by siRNA,the generation of ROS in DEX+Nox4 siRNA group (14.53％± 1.00％) was decreased by 16.92％ compared with DEX group 31.45％±0.72％ (P=0.000).The difference had statistically significance.Conclusion Nox4-mediated ROS generation plays an important role in osteoblasts apoptosis induced by high-dose dexamethasone.It provided us the new target in the management of Nox4 to provide possible therapy for steroid-induced avascular necrosis of the femoral head (SANFH).
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Objective:To establish the fingerprint of the volatile oil in Xiangjuganmao granules and study the attribution of original herbs. Methods:The fingerprint of the volatile oil was established by GC-MS,and the characteristic peaks were used to study the attribution of original herbs by comparing with those of single herb and negative herb. Results:Totally 22 characteristic peaks were shown in the fingerprint of Xiangjuganmao granules. The similarities of 18 batches of Xiangjuganmao granules were within the range of 0.892-0.998. Among the 22 peaks,19 ones were defined the attribution of original herbs, and 22 chemical components were identified. Conclusion:The method is with good precision,reproducibility and stability,which can be used to control the quality of Xiangjuganmao granules.
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Objective To provide reference for drug use in infant patients with Rhodococcus equi(R.equi) infection. Methods By participating in drug therapy for an infant patient with Rhodococcus equi infection,clinical pharmacist assisted physicians to develop treatment plan and provide reasonable pharmaceutical care. Results Therapeutic selection was improved through pharmaceutical care process. Conclusion Participation of clinical pharmacist can fully play their advantages in the field of drug efficacy,and improve the level of clinical treatment.
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New characteristics and changes of laboratory security were summarized,and then current status and problems of awareness of laboratory security of medical postgraduate under the new situation were analyzed in detail.Based on laboratory security education in Center of Experimental Teaching for Postgraduates in Medicine at Xi'an Jiaotong University,strategies to enhance their awareness and capacity of laboratory security were proposed.Compilation of textbooks on laboratory security,development of curriculum content,training of laboratory security practice,and establishment of evaluation system and laboratory access regulation,will be helpful to maximize safety of postgraduates and to guarantee security of laboratory.
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Objective Molecular targeted drugs have anti-angiogenesis and anti-tumor effects.The study was to investigate the role of sunitinib on treating metastatic renal cell carcinoma ( mRCC) and its long-term efficacy and adverse reactions. Methods From November 2007 to March 2013, 281 mRCC patients were divided into two groups according to their own willingness.102 patients in the experimental group received sunitinib 50 mg per day.Pain score, metastatic focuses before and after targeted therapies were compared.179 patients in control group was treated by immunotherapy.Kaplan-Meier survival analysis was used to draw the survival curves and Cox regression model was applied in multivariate analysis. Results There was no difference between the two groups on baseline (P>0.05).In the experimental group, 78 cases were clear cell carcinoma, with remission rate 29.4%, stablity rate 53.8%and total effective rate 83.2%after treatment;15 cases were papillary renal cell carcinoma, with remission rate 33.3%, stablity ratio 46.7%and total effective rate 80.0% after treatment;9 cases were collecting duct carcinoma, with the remission rate 22.2%, the stablity ratio 55.6% and the total effective rate 77.8% after treatment.The bone scan after 1 cycle of treatment showed 2 cases progressed(10.5%), 5 cases relieved(26.3%) and 12 cases sta-blized(63.2%), the total effective rate of bone metastasis amounting to 89.5%, the effective rate of lung metastasis 81.7%, the effective rate of liver metastasis 60.0%and the effective rate of lymph node metastasis 72.8%.The median overall survival in the experimental group was 28.9 months, 20.7 months in control group(P<0.05).Cox regression analysis showed age, tumor classification, liver, lung, bone and lymph node metastasis were prognostic factors influencing mRCC.The common averse events were white blood cells, thrombocytopenia, neutropenia and hypoalbuminemia. Conclusion Sunitinib for the treatment of mRCC can diminish the metastatic focuses , ease the pain , improve the quality of life, delay the progression of the disease, and prolong the overall survival.
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A total of 210 female patients with overactive bladder (OAB) were divided into M receptor blockage (M,n =71),pelvic floor muscle stimulation physiotherapy (S,n =70) and combination (C,n =69) groups.After one course of treatment,the OAB symptom scores were compared to pretreatment values (P ＜ 0.05).After a second course,the overall response rate was 69％ in group S.Pelvic floor muscle stimulation physiotherapy provided excellent sustained outcomes.
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Objective To assess whether highly cross-linked polyethylene liners are superior to conventional polyethylene liners in total hip arthroplasty (THA).Methods Randomized controlled trials (RCTs) of highly cross-linked and conventional polyethylene liners in THA were retrieved from MEDLINE,PubMed,EMBASE,Cochrane Central,CBMdisc,CBM,and VIP.Until April 2012,reference lists of the included articles and related reviews were manually searched as supplements.Meta analysis was performed with RevMan 5.1.Mean difference (MD) was used to assess the linear wear rate in highly cross-linked group versus conventional group.Odds ratio (OR) was used to estimate the osteolysis and revision incidence in the two groups.Results Meta analysis indicated that the two-dimensional linear wear rate [MD =-0.08,95％ CI (-0.1,0.06),P ＜ 0.05],three-dimensional linear wear rate [MD=-0.15,95％CI (-0.22,0.08),P＜0.05],volumetric wear rate [MD=-53.03,95％ CI (-84.39,-21.67,P＜0.05],total linear wear [MD=-0.19,95％CI (-0.23,-0.15),P＜0.05],and osteolysis incidence [OR =0.23,95％ C1 (0.13,0.39),P ＜ 0.05] were significantly reduced in highly cross-linked group than in conventional group.There were no statistical differences between the two groups concerning the creep value of the polyethylene liners and revision incidence.Conclusions Highly cross-linked polyethylene liners for primary THA present a low incidence of wear and osteolysis.As the number and quality of the included studies are limited,a long-term follow-up of more large-sample and high-quality RCTs are needed to evidence the outcome.
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ObjectiveTo investigate the proliferation of rat's osteoblasts promoted by mechanical strain via the protein kinases C ξ(PKCξ) protein path-way.MethodsOsteoblasts were retrieved from SD rats' skulls in the sterilized environment.BioDynamic testing instrument was used to exert 2％ and 0％ mechanical strain on rats' osteoblasts for 180 min on the each group(2％ mechanical strain was experimental group and 0％ mechanical strain was control group); and the same method was applied on the rats' osteoblasts which pretreated with the classical PKC ξ inhibitor with 2％ mechanical strain (inhibitor group).The cell cycles of rats' osteoblasts were measured by flow cytometry; and Western blotting and immunofluorescence were used to detect expression of protein PKC ξ and phosphorylationed PKC ξ in the rats' osteoblasts.ResultsThe mechanical strain obviously increased the ratio of S period in the cell cycles.Compared to the control group and inhibitor group,a significant increase of the expression of protein PKC ξ and phosphorylationed PKC ξ in the osteoblasts was detected in the mechanical strain experimental group.ConclusionPKCξ can respond to the stimulus of the mechanical strain,which promotes the proliferation of osteoblasts through PKCξ pathway.And it plays an important role in the process of signal conduction.