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Background@#The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. @*Methods@#A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50–77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. @*Results@#The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. @*Conclusion@#Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.
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Objective To study the effect and mechanism of autophagy in gastric cancer cells induced by β-sitosterol in vivo and in vitro,providing experimental evidence for antitumor study of β-sitosterol on gastric cancer.Methods Human gastric cancer SGC-7901 cells were cultured in vitro.The control group was treated with phosphate buffer (PBS) only,and the experimental group was treated with different concentrations of β-sitosterol.Tetrazolium salt colorimetry (MTT) was used to detect the inhibitory effect of β-sitosterol on gastric cancer cells.Flow cytometry was used to detect the apoptotic effect of β-sitosterol on gastric cancer cells.Green fluorescent protein labeling (GFP) was used to detect the induction of autophagy by β-sitosterol.Western blot was used to detect the expression of signal pathway proteins phosphorylated phosphoinositid 3-kinase (p-PI3K),phosphorylated protein kinase B (p-AKT) and phosphorylated mammalian target of rapamycin (p-mTOR).The nude mice model of gastric cancer was established by SGC-7901 cells.β-sitosterol was injected abdominally once every 3 days for 42 days.The weight and volume of transplanted tumors were observed.The expression of LC3-Ⅱ and LC3-Ⅰ in transplanted tumors was detected by immunohistochemistry.Results β-sitosterol could inhibite the viability and promote the apoptosis of SGC-7901 cells,inducing the autophagy of SGC-7901 cells when its concentration reached 20 μmol/L.The autophagy rate of experimental group was (19.32 ±2.51,32.25 ±3.18,57.45 ±4.02,78.93 ±4.21),which was significantly higher than that in the control group (7.28 ± 2.83,P ＜ 0.05).In the experimental group,the expression of p-PI3K,p-AKT and mTOR was down-regulated by β-sitosterol,which was significantly different from that in the control group (P ＜ 0.05).The inhibition rate of the experimental group was (69.8 ± 3.6) ％,and the weight and volume of the transplanted tumors were significantly reduced compared with those in the control group (P ＜ 0.05).β-sitosterol increased the expression of LC3-Ⅱ,decreased expression of LC3-Ⅰ,leading the rise of ratio of LC3-Ⅱ to LC3-Ⅰ in nude mouse tumor (t =7.28,P =0.008).Conclusions β-sitosterol can inhibite proliferation and promote apoptosis of SGC-7901 cells.The antitumor mechanism may related to the autophagy induced by beta-sitosterol through PI3K/AKT/mTOR pathway.
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Objective To investigate the effect of low nitrogen and low calorie parenteral nutrition combined with enteral nutrition support on inflammatory factors and immune function in patients with gastric cancer .Methods From May 2013 to May 2015,ninety patients with gastric cancer underwent surgical treatment in the Affiliated Hospital of Yanbian University were selected in the research ,and they were divided into control group and observation group according to different methods of nutritional support ,with 45 cases in each group.The control group received total parenteral nutrition support,the observation group was given low nitrogen and low calorie parenteral nutrition and enteral nutrition support, and supplemented by targeted nursing measures.The changes of levels of inflammatory factors and immune proteins in the two groups before operation and 7d after operation were compared.All patients were followed up for 6 months,and the quality of life and nursing satisfaction rate were compared between the two groups.Results At 7d after operation,the levels of immunoglobulin IgA ,IgM and IgG in the observation group were (2.62 ±0.43)g/L,(1.93 ±0.52)g/L,(14.58 ±3.32)g/L,respectively,which were significantly higher than those before operation [(2.01 ±0.30)g/L,(1.22 ±0.40) g/L,(12.42 ±5.64) g/L,t＝7.805,7.260,2.214,all P＜0.05] and those of the control group [(2.12 ±0.52) g/L,(1.53 ±0.41) g/L,(12.86 ±4.34) g/L,t＝4.971, 4.052,2.112,all P＜0.05].At 7d after operation,the levels of C reactive protein(CRP),tumor necrosis factor -α (TNF-α) in the observation group were (108.52 ±17.53)mg/L,(135.63 ±28.51)ng/L,respectively,which were lower than those before operation [(142.35 ±15.82) mg/L,(156.65 ±25.54) ng/L,t ＝9.611,3.684,all P＜ 0.05] and those of the control group[(135.68 ±14.54)mg/L,(145.52 ±27.53)ng/L,t＝8.000,3.824,all P＜0.05],the level of interleukin-2(IL-2) was higher than those before operation [(65.71 ±10.23)ng/L vs.(54.32 ± 7.83)ng/L,t ＝5.931,P ＜0.05] and that of control group [(57.62 ±5.86) ng/L,t ＝4.603,P ＜0.05].At 6 months after operation,the quality of life scores of the observation group were higher than those of the control group (t＝7.444,6.892,4.884,5.957,7.784,12.992,3.851,6.706,all P＜0.05).The nursing satisfaction rate of the observation group was 97.78%,which was higher than 82.22% of the control group ( χ2＝6.049,P ＜0.05). Conclusion Low nitrogen and low calorie parenteral nutrition combined with enteral nutrition support can effectively improve the immune function of patients with gastric cancer ,reduce the inflammatory response and ensure the quality of life of the prognosis,which is suitable for clinical application.
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Objective To investigate inhibitory effect and mechanism of extract from taraxacum mogonon (ETM) on human poorly differentiated gastric cancer MKN45 cells and their model nude mice tumors. Methods Human poorly differentiated gastric cancer MKN45 cells cultured in vitro were divided into the control group and the experimental group. The experimental group was treated with different concentrations of ETM, while the control group was treated with phosphate buffered saline (PBS). The tumor cell growth was examined by methyl thiazolyl tetrazolium(MTT).Cell apoptosis was detected by flow cytometry (FCM). The expression of Survivin mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR), and the protein expression of Survivin was detected by Western blot. The nude mouse model with poorly differentiated gastric cancer was established with MKN45 cells. Successful models of nude mice were divided into the experimental group and the control group according to random number table. ETM 0.4 ml (100 mg/ml) was injected into abdominal cavity of the nude mice in the experimental group, while only equal dose of 0.9 % NaCl solution was injected in the control group, every 3 days for once, 42 days in total. The weight and volume changes of transplantable tumors were observed. The protein expression of Survivin in transplantable tumors was examined by immunohistochemistry(IHC) method. Results ETM could inhibit the cell proliferation and promote apoptosis of MKN45 cells in a dose-dependent and time-dependent way when its concentration reached 0.2 μmol/L (P< 0.05). The expression of Survivin mRNA and Survivin protein was down regulated in a dose-dependent way in the experimental group. Survivin mRNA expression in the experimental group with 0.1,0.2,0.4,0.8, 1.6 μmol/L of ETM and in the control group was 0.18±0.04, 0.14± 0.03, 0.11±0.01, 0.08±0.04, 0.06±0.02 and 0.19±0.03 respectively (F = 132.35, P< 0.05); Survivin protein expression in the experimental group in 0.1, 0.2, 0.4, 0.8, 1.6 μmol/L of ETM, and in the control group was 0.86±0.03, 0.60±0.05, 0.43±0.01, 0.22±0.01, 0.14±0.03 and 0.92±0.06 respectively (F= 76.57, P< 0.05). The difference of experimental group was statistically significant when concentration of ETM reached 0.2 μmol/L or above compared with the control group (P< 0.05). Nude mouse experiment showed that the tumor inhibition rate was (60.3±3.2) % in the experimental group. The volume and weight of transplantable tumor in the experimental group was(326± 27)mm3and(0.31±0.13)g,which was obviously lower than that in the control group[(843±14) mm3and (0.78±0.25) g]. The difference was statistically significant (t= 3.94,P =0.043;t= 3.27,P = 0.037). IHC experiment results showed that positive cell count of Survivin protein in the experimental group was obviously less than that in the control group(28±11 vs.152±20;t =4.32,P =0.029). Conclusions ETM has an obvious inhibitory effect on human poorly differentiated gastric cancer MKN45 cell and its nude mouse tomor model. The mechanism may be related with down-regulation of Survivin expression caused by ETM.
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BACKGROUND: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. METHODS: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included ‘distal humerus fracture’ and ‘hemiarthroplasty’. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. RESULTS: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion (107.6° flexion-extension, 157.5° for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. CONCLUSIONS: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.
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Aged , Humans , Arm , Arthroplasty , Demography , Elbow , Follow-Up Studies , Hand , Hemiarthroplasty , Humeral Fractures , Humerus , Outcome Assessment, Health Care , Range of Motion, Articular , Shoulder , TeaABSTRACT
Objective To lessen the learning curve of percutaneous renal lithotripsy(PCNL),we introduced a novel ex-vivo learning and training model for PCNL under fluoroscopy and ultrasonography-guided access. Methods The model was set up nailing an adult porcine kidney with＞3 cm ureter (freshly removed from the slaughtering factory),with a full thickness flap of the thoracic wall or abdomen wall with two ribs,to a board.The porcine kidney was placed within the flap with the catheterized ureter outside.The kidney was enclosed by the flap so as to create a roodel for percutaneous renal surgery;with the ribs overlying the upper portion of the kidney.The model was fixed to the board by two nails.Artificial stone material was implanted in the renal pelvis.Fluoroscopy guidance access:Retrograde pyelography via injection of contrast medium into the ureteral catheter images the collecting system. After the long axis of the target calyx is identified,the C-arm is rotated 30 degrees toward the surgeon,placing the C-arm axis in the same posterior plane of the kidney.The needle is advanced in the plane of the fluoroscopic beam,and the appropriate needle placement is determined by obtaining a bull's-eye sign on the fluoroscope screen. Rotating the C-arm to a vertical position monitors the depth of the needle penetration. Ultrasonography guidance access:The renal pelvis can he filled with normal saline through a catheter to simulate hydronephrosis and the target calyx is identified under ultrasonography guidance.The tract dilation and stone disintegration were followed.After training,the kidney can be opened to examine the target calyx and the complication of dilation. Results Altogether,126 urologists attended a urologic endoscopic technique training course.Of the 126 trainees,104 (82.5%) successfully performed the whole percutaneous procedure.At the end of training,114 (90.5 %) of the 126 attendees rated the porcine kidney model for simulation of percutaneous renal surgery as very helpful or helpful.Conclusions This biological training model simulates realistically the clinical procedure of PCNL with respect to trainee experience in a low stress environment that provides an opportunity for repetitive performances in order to learn basic technical skills for the clinical procedure of PCNL in the future.
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Objective To assess the symptoms of patients due to indwelling double ureteral stent and their impact on quality of life. Methods Sixty patients were assessed by the specific questionnaire. Average time of indwelling stent was 21.4 d. All patients finished the special questionnaire when the stent was removed by cystoscope, including specific urinary symptoms, IPSS (international prostate symptom score), VAS (visual analogic scale) and QOL (quality of life). To assess the pain feeling, the patients were divided into 3 groups by varied methods of anesthesia, including local anesthesia, balance anesthesia and general anesthesia. Results Insertion or removal of ureteral stents with local anesthesia provoked pain in 11 of 12 (91%) patients and 8 of 10 (80%) patients in balance anesthesia group. But 38 patients of general anesthesia group did not feel any pain when inserting stents. In 54 of 60 (90%) patients, the indwelling catheter provoked one or several urinary symptoms: nocturia (70%), frequency (65%), urgency (60%), tenesmus (58%), dysuria (52%), hematuria (35 % ) and incontinence (30 %). 75 % of the patients experienced pain, in the flank and lower abdomen. 29 (48 %) patients were found to be unsatisfied with their quality of life due to the indwelling stent. Among them, 18 (62%) patients demonstrated that the provoked overactive bladder symptoms were the main influence factor of QOL, compared with 5(17 %) patients complaining pain feeling. Conclusions Urinary symptoms and pain associated with indwelling double J ureteral stents could interfere the daily activities and 50 % of patients were found reduced quality of life. Overactive bladder symptoms were the main influence of QOL during the time of indwelling stent.
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The PTD-NPY fusion gene derived from HIV-1 TAT protein transduction domain and rat neuropeptide Y was amplified by overlap extension PCR, digested and subcloned into yeast expression vector pPICZ alpha A to construct recombinant expression plasmid pPICZ alpha-PTD-NPY. The cloned PTD-NPY fusion gene was identified by PCR and restriction enzyme digestion and sequenced. The exact recombinant plasmid was linearized by Sac I and integrated by electrotransformation into the genome of Pichia pastoris GS115 cells. Then, these positive recombinant yeast cells were induced by 10 mL/L methanol to express soluble PTD-NPY fusion protein. After 120 h of methanol induction, the SDS-PAGE electrophoresis result indicated PTD-NPY fusion protein was efficiently secreted into the medium. Western blotting analysis proved that the expressed fusion protein had specific NPY binding activity. The successful expression of PTD-NPY fusion protein in Pichia pastoris provided basis for its further application study.