ABSTRACT
Objective To OxplorO thO opOrating mOthods and clinical OffOcts of arthroscopic anatomical antO-rior cruciatO ligamOnt(ACL) rOconstruction with dirOct insOrtion tOchniquO vOrsus traditional mOthod.Methods From January 2017 to DOcOmbOr 2017,totally 52 patiOnts who accOptOd ACL rOconstruction and mOt thO inclusion and Oxclu-sion critOria in BOijing FriOndship Hospital of Capital MOdical UnivOrsity wOrO OnrollOd in this rOtrospOctivO study. ThOy wOrO dividOd into two groups by random sOquOncO softwarO and patiOnts′sOlOction rOsults. ThO obsOrvation group (27 casOs) rOcOivOd dirOct insOrtion tOchniquO,and thO control group(25 casOs) rOcOivOd traditional mOthod. At post-opOrativO 1 month, 3 months, 6 months, 1 yOar, thO clinical OffOct was OvaluatOd by imaging indOx, subjOctivO and objOctivO indicators.Results All 52 patiOnts wOrO availablO for follow up with an avOragO of 11.5 months. No postop-OrativO complications such as infOction, joint instability and soft lOgs, with a satisfiOd rOcovOry of rangO of motion, pain rOliOvOd significantly. ThO Lysholm scorO of thO obsOrvation group was (94.80 ± 4.18)points, which was signifi-cantly highOr than (91.02 ± 1.96)points of thO control group (t=2.674,P<0.05).Lachman tOst and KT-1000 wOrO improvOd significantly comparOd with thosO bOforO opOration ( all P <0.01), whilO thOrO was no statistically significant diffOrOncO bOtwOOn thO two groups(all P>0.05),but thO pivot-tOst of thO obsOrvation group was bOttOr than that of thO control group, thO diffOrOncO was statistically significant ( P < 0. 05 ). ThO ACL anglO of thO obsOrvation group was (51.52 ± 5.18)°, which was significantly lowOr than (55.86 ± 2.45)° of thO control group ( P<0.05). According to modifiOd Lysholm scorOs classification, in thO obsOrvation group, 24 casOs wOrO OxcOllOnt, 2 casOs wOrO good,1 casO was fair, and thO OxcOllOnt and good ratO was 96.3%. In control group,18 casOs wOrO OxcOllOnt,5 casOs wOrO good,2 casOs wOrO fair, and thO OxcOllOnt and good ratO was 92.0%. ThO diffOrOncO in thO OxcOllOnt and good ratO bOtwOOn thO two groups was statistically significant(P<0.05).Conclusion DirOct insOrtion anatomical rOconstruction is a safO and OffOctivO tOchniquO for rOconstruction of ACL. It can rOstorO thO stability of ACL and rotation of knOO joint.
ABSTRACT
Objective@#To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer.@*Methods@#We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ2 test were used to compare the short-term and long-term outcomes. The short-term outcomes included surgical related outcomes and operative complications, and the long-term outcomes included quality of life (pelvic floor functions and sexual functions), survival and recurrence. Pelvic floor function and sexual function were assessed with the International Consultation on Incontinence Quesonnaire Female Lower Urinary tract(ICIQ-FLUTS) and the Female Sexual Function Inventory (FSFI), respectively. Survival rates were estimated by Kaplan-Meier analysis. The survival curves were compared with Log-rank test. Cox regression analysis was used to evaluaterisk factors for prognosis.@*Results@#(1)The short-term outcomes : There were significant difference in operative time([(257±69) vs(238±56)min], estimated blood loss[(358±314) vs(707±431)ml], anus exhausting time[(2.5±0.9) vs (2.9±0.8)d], preserved days of catheter[(15±7) vs(18±9)d], and post-operative length of stay[(19±16) vs (30±21)d] between the laparoscopic surgery group and the opensurgery group(P<0.05). There was no significant difference in lymph nodes yielded[(21±9) vs (21±11)], left parametrial width[(2.5±0.8) vs (2.7±0.7)cm], right parametrial width [(2.6±0.3) vs (2.7±0.2)cm], vaginal cuff length[(2.4±0.7) vs (2.2±0.7)cm] between the laparoscopic surgery group and the opensurgery group(P>0.05). The intra-operative complications occurred in 8.1%(87/1 071)in the laparoscopic surgery group and in 10.7%(85/792)in the open surgery group(P>0.05). However, the complications of vascular injury in the laparoscopic surgery group[2.6%(28/1 071)]was lower than that in the open surgery group[7.7%(61/792), P<0.001]. The laparoscopic surgery exhibited lower post- operative complication rate [33.8%(362/1 071)vs 40.2%(318/792), P<0.05] and poorer wound healing rate [0.7%(7/1 071)vs 4.0%(32/792), P<0.05]. (2)The long-term outcomes(Hierarchical analysis): The overall incontinence in ICIQ-FLUTS questionnaire in nerve-sparing laparoscopic group [28.4%(67/236)] was lower than that in the open surgery group [35.9%(71/198), P=0.004] . However, There was no significant difference in degree of incontinence between the two groups(P>0.05). The overall sexual dysfunction in FSFI questionnaire after 12 months of postoperative in the nerve-sparing laparoscopic group [47.0%(111/236)]was lower than that in the open surgery group [58.6%(116/198), P=0.001], and the six different dimension scores in the laparoscopic surgery group were higher than that in the open surgery group (P<0.05). The recurrence rate was 3.5%(35/1 007)in the laparoscopicsurgery group and 4.7%(35/740)in the open surgery group(P>0.05). The 5-year OS was 94.0% for the laparoscopic surgery group and 90.2% for the open surgery group(P>0.05), and the 5-year DFS was 93.9% for the laparoscopic surgery group and 89.1% for the open surgery group(P>0.05). (3) Prognostic fators: In univariate analysis, tumor dimension, clinical stage, deep stromal invasion, LVSI, and retroperitoneal lymph node metastasis signficantly affected 5-year OS and 5-year DFS(P<0.05); In multivariate analyses, LVSI, deep stromal invasion and LN metastasis were independent prognostic factors(P<0.05).@*Conclusions@#Laparoscopy can reduceestimated blood loss, accelerate postoperative recovery and improve the quality of life after surgery compared to laparotomy, and it ensures the same oncological results as open surgery. Laparoscopic approach is a safe and effective treatment for early-stage cervical cancer.
ABSTRACT
Objective To observe changes of cell cycle after stable silencing of SNCG gene in human endometrial carcinoma HEC-1A cells.Methods Flow cytometry was used to observe the changes of SNCG stable silencing HEC-1A cell growth cycle.The percentage of G2/M phase of HCE-1A cells after acridine orange staining was observed by laser scanning confocal microscopy.Results Flow cytometry results showed that the group of SNCG stable silencing in G1 and G2/M phase of the cells increased,but the percentage of cells in the S phase were decreased,the difference were both statistically significant (P ＜ 0.05).The results of cells after confocal microscopy observation of acridine orange staining,the group of SNCG stable silencing were observed in G2/M phase high percentage were statistically significant (P ＜ 0.05).Conclusion Two experimental methods commonly validated that the cell cycle of SNCG stable silencing on HEC-1A cells was arrested in G2/M phase,suggesting that SNCG gene is closely related to the cell growth cycle of endometrial carcinoma.
ABSTRACT
Objective To observe the effect and its factors of open reduction and internal fixation of calcaneal fractures,and the influencing factors.Methods A retrospective analysis of 116 cases of calcaneal fracture were made.All patients were treated with open reduction and internal fixation,the effect was evaluated by Maryland foot score.The relation of the data before surgery (sex,age,cause of injury,associated injuries,injury and surgery,frac-tures sanders classification,opening and closing,diabetes,smoking history)and the effect,the surgical data (graft case,fixation,fractures,postoperative Bohler angle)and the effect were analyzed.The independent factors of the effect were analyzed by Logistic regression analysis.Results 116 patients with calcaneal fracture had been followed up for 6 -12 months,the excellent -good rate of Maryland foot score was 74.14%.Univariate analysis showed that different types of fractures,open and closed,with or without diabetes,with or without a history of smoking,different fixation methods,different fractures,patients with different postoperative Bohler angle foot function excellent rate differences were statistically significant (χ2 =17.194,4.077,6.766,9.116,5.136,6.919,4.458,all P <0.05).Logistic regres-sion analysis showed that the type of fracture,fixation,fractures,postoperative Bohler angle were independent risk factors for foot function excellent rate(OR =0.052,0.048,0.056,0.386,all P <0.05).Conclusion It has exact efficacy for open reduction and internal fixation with calcaneal fractures,the fracture type,fixation,fractures,postoper-ative Bohler angle are independent risk factors for affecting the calcaneal fractures patients.Perioperative treatment should take appropriate measures to avoid adverse factors affecting the efficacy of improved clinical efficacy.
ABSTRACT
Objective To study the occurrence of BRCA1 MSI in endometrial cancer and its relationship with clinic pathologic features; to explore the correlation between MSI and protein expression in BRCA1 gene. Methods Application of PCR-SSCP and DNA sequence analysis method was used to study D17S579 and D17S1349 in 49 sporadic endometrial cancer tissues, 20 cases with endometrial atypical hyperplasia and 28 cases with normal endometrial tissues. Results In the total samples of D17S579 and D17S1349, the three groups were significantly different: 34.69%(17/49) in the endometrial cancer group, 10%(2/20) in the endometrial atypical hyperplasia group and 7.14%(2/28) in the normal endometrium group (χ2= 11.208, P = 0.004). BRCA1 MSI positive rate related to the pathology grade and clinical stage, but no relationship was found in muscular infiltration depth, lymph node metastasis and histopathology types. In the endometrial cancer group, BRCA1 MSI positive rate and BRCA1 protein expression were in moderate correlated negatively (r = -0.779, P = 0.000). Conclusion BRCA1 MSI might play a role in the development of endometrial cancer, and low expression of BRCA1 protein. BRCA1 MSI might be associated with pathology grade and clinical stages in EC.
ABSTRACT
[Objective] To investigate the surgical method of transforminal lumbar interbody fusion(TLIF)technique in treatment of upper lumbar intervertebral disc herniation.[Methods]From January 2002 to December 2006,a retrospective analysis on TLIF surgery treatment of 45 patients with upper lumbar intervertebral disc herniation were carried out and they acquired 12~24 months(mean,15 months)follow up.There were 29 males,and 16 females aging from 30~55 years(mean,39.2 years).Eleven intervertebral spaces were T12-L1 hernination,25 intervertebral spaces were L1、2 hernination,and 18 intervertebral spaces were L2、3 hernination of the space.Nine were double disc herniation.All cases were treated with TLIF technique.A retrospective analysis on surgical therapeutic effect was made.[Results]Five patients developed complications after operation and recovered by symptomatic treatment.Patients moved around in 2~3 d after surgery.Oswestry score improved from(52.32 ?9.17)to(20.33 ?5.72)in an average 15-months follow-up.X-ray showed that all cases had bone graft fusion and no adjacent segment degeneration occurred.[Conclusion]TLIF technique is an effective method in treatment of upper lumbar intervertebral disc herniation.It can offer satisfactory clinical effects.
ABSTRACT
Objective:To evaluate the anti-tumor immune responses of nureplicable recombinant vaccinia virus-based vaccine expressing HPV16 L1 and L2E7 proteins.Methods:The anti-tumor effects of the vaccine were observed using mouse models of prophylactic,therapeutic and tumor excision.The cell-mediated immunity induced by the vaccine was assessed by enzyme-linked immunospot (ELISPOT) and cytotoxic T lymphocyte (CTL) assay.Results:The vaccine could protect 60% and 50% mice from the challenge of HPV16-positive tumor cells in prophylactic and therapeutic mouse model,respectively.It could protect from recurrence of the tumor in 70% mice of the excision model.The differences among the groups were significant.Strongly specific cell-mediated immunity was found using ELISPOT and CTL assay.Conclusion:The ideal anti-tumor immune responses can be induced by NTVJL1/L2E7 vaccine in mice and it can be considered to be one candidate vaccine of cervical cancer.