Clinical significance of beta-catenin and matrix metalloproteinase-13 in synovial tissue of osteoarthritis / 中国组织工程研究

BACKGROUND: Role of Wnt/β-catenin signaling pathway in the pathogenesis of osteoarthritis has been proved by numerous animal experiments and human specimen trials. Wnt/β-catenin signaling pathway and matrix metalloproteinase 13 (MMP-13) play important roles in pathological process of osteoarthritis, and they may be related with each other. OBJECTIVE: To detect the expression levels of β-catenin and MMP-13 in the synovial tissue of osteoarthritis, and to investigate the relationship between β-catenin and MMP-1 in the pathogenesis of osteoarthritis. METHODS: Synovial tissues were obtained from the 54 patients undergoing total knee arthroplasty or knee arthroscopic diagnosis and treatment surgery and 12 healthy patients suffering from amputation caused by trauma. The samples were divided into non-, mild-, medium-and severe-osteoarthritis groups based on advanced Mankin scores. The expression levels of β-catenin and MMP-13 in the synovial tissues were detected by immunohistochemistry, and correlation analysis was conducted. RESULTS AND CONCLUSION: Immunohistochemistry results showed that MMP-13 was negative in the non-osteoarthritis group, positive in 5 (50%) samples in the mild-osteoarthritis group, positive in 11 (65%) samples in the medium-osteoarthritis group and positive in 23 (85%) samples in the severe-osteoarthritis group. β-Catenin was positive in 1 (8%) sample in the non-osteoarthritis group, positive in 7 (70%) samples in the mild-osteoarthritis group, positive in 14 (82%) samples in the medium-osteoarthritis group and positive in 25 (93%) samples in the severe-osteoarthritis group. The expression levels of β-catenin and MMP-13 in the synovial tissues presented a positive correlation (r=0.806, P ＜ 0.001), and the levels increased with joint degeneration becoming severe. These results imply that there is a significant increase in the expression levels of β-catenin and MMP-13 in the synovial tissues of osteoarthritis compared with the non-osteoarthritis group, and β-catenin and MMP-13 exert effects in development of osteoarthritis. Beta-catenin and MMP-13 are closely associated with pathological changes such as cartilage degeneration and synovial inflammation, thus providing new theoretical direction and experimental basis for targeted gene therapy of osteoarthritis.

Application of simplified intensity modulated radiation therapy in gastric cancer after operation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the application and the dosimetry characteristic of the simplified intensity modulated radiation therapy (sIMRT) for gastric cancer after operation, and to compare the dose distribution with intensity modulated radiation therapy (IMRT) and three-dimension conformal radiation therapy (3D-CRT).</p><p><b>METHODS</b>Twelve patients with gastric cancer after operation were enrolled in this study. 3D-CRT plan, 5-field IMRT plans (20 degree, 80 degree, 180 degree, 280 degree, 340 degree) and 5-field sIMRT plans (20 degree, 80 degree, 180 degree, 280 degree, 340 degree) were performed for each patient. The conformal index (CI), heterogeneity index (HI) of the planning target volume (PTV) and the dose of normal organs were analyzed with the dose volume histogram (DVH). The total MU and treatment time were also compared.</p><p><b>RESULTS</b>The sIMRT and IMRT plans had comparable CI (sIMRT>IMRT>3D-CRT), and showed better dose conformity but worse homogeneity than 3D-CRT. The percentage of volume receiving 20 Gy, 25 Gy, 30 Gy and 40 Gy by liver were significantly lower in sIMRT than that in 3D-CRT, and comparable to IMRT. All the dose volumes to kidneys with sIMRT were still significantly lower as compared to 3D-CRT, and comparable to IMRT. The sIMRT plan was better than IMRT plan in total MU and treatment time.</p><p><b>CONCLUSIONS</b>sIMRT has comparable dose distribution in patients with gastric cancer to IMRT, but is significantly better than 3D-CRT. Treatment time of sIMRT is the shortest. So sIMRT technique can be applied more simply.</p>

A randomized controlled trial of intensity-modulated radiation therapy plus docetaxel and cisplatin versus simple intensity-modulated radiation therapy in II-III stage esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of intensity- modulated radiation therapy plus chemotherapy (IMRT-TP) with simple intensity-modulated radiation therapy (IMRT) in the treatment of locally advanced esophageal carcinoma.</p><p><b>METHODS</b>A total of 170 eligible patients with locally advanced esophageal carcinoma were recruited prospectively from September 2004 to April 2008 and randomly divided into IMRT-TP group and IMRT group. Two groups were treated with IMRT of 6MV-X. The radiation dose was 60 Gy in 30 fractions in IMRT-TP group and 66 Gy in 30 fractions in IMRT group. The regimen of chemotherapy consisted of docetaxel and cisplatin in IMRT-TP group for 2 cycles.</p><p><b>RESULTS</b>Of 170 patients, 160 completed the trial, including 75 patients of IMRT-TP group and 85 of IMRT group. As compared to IMRT group, total recurrence rate [69.3% (52/75) vs. 84.7% (72/85), P=0.020] and local recurrence rate [50.7% (38/75) vs. 67.1% (57/85), P=0.035] decreased in IMRT-TP group, the 5-year overall survival (29.3% vs. 15.3%, P=0.031) and 5-year recurrence free survival (24.0% vs. 10.6%, P=0.015) increased in IMRT-TP group. While severe side effect ratio increased obviously in IMRT-TP group [54.7% (41/75) vs. 4.7% (4/85), P=0.000].</p><p><b>CONCLUSION</b>As compare to simple IMRT, IMRT plus docetaxel and cisplatin can decrease the local recurrence rate, prolong the overall survival and regression-free survival, but bring more side effects.</p>

Application of fast-track surgery in the management of patients with esophageal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the influence of fast-track surgery in perioperative period on the clinical outcomes of patients with esophageal cancer.</p><p><b>METHODS</b>Clinical data of 117 patients with esophageal cancer between January 2011 and June 2011 were retrospectively analyzed. Sixty-three cases (study group) were treated with fast-track surgery and 54 cases(control group) were treated according to routine protocol in the perioperative period.</p><p><b>RESULTS</b>The operative time, time to drainage tube removal, and length of hospital stay were significantly shorter in the study group than those in the control group(all P<0.05). Compared with the control group, the medical cost was lower(P<0.05). The overall postoperative complication rate was 7.9% in the study group and 24.1% in the control group(P<0.05).</p><p><b>CONCLUSION</b>Fast-track surgery in the perioperative period for patients with esophageal cancer can promote bowel function recovery and decrease morbidity.</p>

Three dimensional conformal radiotherapy with late course accelerated hyper-fractionation for ad- vanced esophageal carcinoma / 肿瘤研究与临床

Objective To evaluate the results and toxic effects in three dimensional radiotherapy (3DCRT)with late course accelerated hyper-fractionation for advanced esophageal carcinoma.Methods From December 2001 to December 2003,115 patients were randomly divided into two groups:in 3DCRT group,55 patients were given late course accelerated hyper-fractionation radiotherapy to a total close of 66 Gy (2.0 Gy per fraction,5 times per week;to a dose of 36 Gy were changed into 1.5 Gy/f,2 f/d).In CF group,60 patients were given late course accelerated hyper-fractionation radiotherapy to a total dose of 66 Gy.Results The 1-, 2-,3-,4-year survival rates in 3DCRT group were 63.6 %, 50.9 %, 38.2 %, 30.9 % compared to 58.3 %, 38.3 %,33.3 %,23.3 % in CF group(X~2=4.44,P=0.031),and local control rates in 1-,2-,3-,and 4- years in 3DCRT group were 72.7 %,58.1%,47.2 % and 36.3 %,compared to 53.3 %,40 %,28.3 %,and 20 %(X~2=5.33,P=0.013)in CF group.However,in the 3DCRT group,the incidence of acute esophagitis was similar to CF group; hematogenous toxic and acute bronchitis were similar between the two groups. Late course lung injury in CF group was higher than that in 3DCRT group.Conclusion 3DCRT is able to improve the local control rate and survival rate,and unable to improve acute and late radiation toxie effects.

Treatment of thalassemia major with unrelated donor bone marrow transplantation / 中华儿科杂志

<p><b>OBJECTIVE</b>Allogeneic marrow transplantation is a curative therapy for thalassemia, but no more than 30% of patients have HLA-indentical sibling marrow donor. The selection of alternative donors of unrelative marrow and the study on the probability of treating thalassemia major with unrelated donor bone marrow transplantation are of importance.</p><p><b>METHODS</b>Nine children with thalassemia were included in the study, and their gene mutational type were homozygote of thalassemia and double heterozygote, respectively. All of them were finally diagnosed of thalassemia major, and treated with unrelated donor bone marrow transplantation. To high-resolution HLA typing, two patients were matched, five had one unmatched isoform and two had two unmatched isoforms. The erythrocyte blood type was not matched in six patients. The preparative regimen included busulfan (oral use, 16 mg/kg, divided for 4 days), cyclophosphamide (intravenous use, 200 mg/kg, divided for 4 days), antithymocyte immunoglobulin (intravenous use, 30 mg/kg, divided for 3 days), and fludarabine (intravenous use, 125 mg/m(2), divided for 3 days). Ciclosporin A and methotrexate were used for graft-versus-host disease (GVHD) prophylaxis.</p><p><b>RESULTS</b>All patients had allergen reactions. One had hypotension. Five patients experienced I degrees approximately III degrees acute GVHD in the skin, while one had II degrees acute GVHD in liver. One patient had III degrees GVHD of intestines and gradually developed chronic GVHD in the skin, lungs and brain. One patient died of pulmonary hemorrhage. The duration when peripheral blood neutrophil count exceeded 0.5 x 10(9)/L was 12 - 26 days. The recovery time of WBC was as long as 23 - 110 days. Thrombocytes exceeded 50 x 10(9) within 61 approximately 142 days. The time when hemoglobin reached 100 g/L varied from 23 to 116 days. The last blood transfusion was on 13 - 62 days. Eight patients were fully grafted, while one was not grafted. During the 6 - 24 months of follow-up, seven patients' genotype of thalassemia major became normal. The erythrocyte blood type of five patients also changed into the same as that of donor. The hemoglobin was kept over 110 g/L without blood transfusion.</p><p><b>CONCLUSION</b>The transplantation of unrelated donor bone marrow for thalassemia major was successful. Unrelated donor bone marrow transplantation could cure thalassemia major, which expanded the marrow donor source for the transplantation of thalassemia major.</p>

Studies on the effects of lead on the growth and differentiation of hippocampal neural cells as well as the expression of Oct-2 / 中华预防医学杂志

<p><b>OBJECTIVE</b>In order to explore the effects of lead on the growth and development of cultured hippocampal neural cells and on the expression of Oct-2, the II subtype POU domain protein.</p><p><b>METHODS</b>Experiment cell model was established using primary culture of hippocampal neural cells from SD rat embryos. Target cells were exposed to lead acetate in the different concentrations, i.e. 10(-1), 10(0), 10(1), 10(2), 10(3) micromol/L, while the control group was given the same quantity of the culture medium. The immunohistochemistry method was utilized to detect the expressions of Neurofilament (NF) and Glial Fibrillary Acidic Protein (GFAP), the markers for neuron and astrocyte, respectively, and the expression of Oct-2 as well.</p><p><b>RESULTS</b>The results showed that 10 micromol/L lead acetate treatment caused diminishing of neuronal cell body and the decreases of both axon lengths and inter-cellular connections. In addition, 1 micromol/L lead acetate significantly increased the number of GFAP-positive cells compared with the control group (P < 0.05). By image analysis system, 1 micromol/L lead acetate treatment was found to induce a statistically significant increase of the positive area rate concerning Oct-2 expression in hippocampal neurons and astrocytes, while both positive area rate and integral density of light of Oct-2 expression were found to increase markedly in the groups treated by 10 micromol/L lead acetate (P < 0.01).</p><p><b>CONCLUSIONS</b>Lead acetate treatment may contribute to the inhibitions of both growth and differentiation of hippocampus neurons, and to the stimulation of glial cell hyperplasia simultaneously. In addition, the CNS impairments caused by lead is partly correlated with the enhancement of Oct-2 expression.</p>