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Objective:To investigate the correlation of human epidermal growth receptor 2 (HER2) with clinicopathological characteristics and its postoperative prognostic value in patients with gastric cancer.Methods:The clinicopathological data of 543 patients with gastric cancer who underwent open radical gastrectomy were retrospectively analyzed in the Gastrointestinal Surgery Department of Jiangyin People′s Hospital Affiliated to Southeast University from June 2011 to December 2016, including 404 males and 139 females, aged from 26 to 84 years old. According to the results of HER2 immunohistochemical staining, gastric cancer patients were divided into HER2 0+ group ( n=427), HER2 1+ group ( n=56), HER2 2+ group ( n=29) and HER2 3+ group ( n=31), and the differences in clinicopathological indicators of the four groups were compared. Furthermore, HER2 0+ and 1+ gastric cancer patients were classified as HER2-negative group( n=26), and HER2 3+ as HER2-positive group( n=26). Propensity score matching method was used to balance the basic data variables related to prognosis of the two groups, and Kaplan-Meier method was used for survival analysis. Cox risk regression model was used to analyze the risk factors associated with postoperative survival in patients with HER2-positive gastric cancer. Results:The overexpression rate of HER2 in gastric cancer patients was 5.7% (31/543). The expression level of HER2 was significantly correlated with gender ( χ2=8.30, P=0.040), tumor longitudinal location ( χ2=22.86, P=0.029) and histological differentiation ( χ2=13.27, P=0.004). There was no significant correlation between median survival time and HER2 expression level( χ2=5.44, P=0.142). After propensity score matching, the median survival time of gastric cancer in the HER2-positive group was 23 months. Univariate and multivariate analysis showed that ABO blood group ( HR: 1.619, 95% CI: 1.081-2.423, P=0.019) was an independent risk factor for prognosis of HER2-positive gastric cancer. Conclusion:The expression of HER2 is higher in men, cardia fundus and high and medium differentiated gastric adenocarcinoma, but there is no significant correlation between the expression level of HER2 and the median survival time of gastric cancer. ABO blood group may be an independent risk factor for the survival of HER2-positive gastric cancer.
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Objective:To explore the expression of long non-coding RNA-myeloid differentiation factor 88 (lnc-MyD88) and its relationship with the prognosis of patients with epithelial ovarian cancer (EOC).Methods:A total of 70 EOC patients who underwent initial cytoreductive surgery and platinum-based drugs combined with paclitaxel for 6 to 8 courses were selected at Sichuan Cancer Hospital from January 2016 to January 2019. The fresh cancer tissue specimens were collected. In addition, 28 fresh normal ovarian tissues from patients who underwent surgery for benign gynecological diseases during the same period were collected as control group. Reverse transcription (RT) and real-time quantitative polymerase chain reaction (qPCR) were used to detect the expression of lnc-MyD88 and myeloid differentiation factor 88 (MyD88) mRNA in EOC tissues and normal ovarian tissues. The correlation between the expression of lnc-MyD88 and MyD88 mRNA in EOC was analyzed by Pearson′s correlation coefficient. The relationship between lnc-MyD88 expression and clinicopathological characteristics of patients with EOC was analyzed. Kaplan-Meier method was used to calculate the survival rate of patients. The log-rank test was used for univariate survival analysis, and Cox proportional hazard model was used for multivariate survival analysis.Results:(1) RT-qPCR showed that the relative expression level of lnc-MyD88 and MyD88 mRNA in EOC were 0.009 (0.000-0.049) and 0.001 (0.000-0.006), respectively, which were significantly higher than those of normal ovarian tissues (all P<0.01); Pearson′s correlation coefficient showed that the expression of lnc-MyD88 and MyD88 mRNA in EOC was positively correlated ( r2=0.610, P<0.01). (2) The high expression rate of lnc-MyD88 in EOC patients with lymph node metastasis, distant metastasis and chemotherapy resistance (71%, 64% and 70%, respectively) were significantly higher than the patients in control group (41%, 40% and 35%, respectively; all P<0.05). There were no statistically significant in the high expression rate of lnc-MyD88 in EOC patients with different ages, pathological types, pathological grades, surgical pathological stages, postoperative residual lesion size, and ascites cancer cells (all P>0.05). (3) Univariate analysis showed that surgical pathological staging, lymph node metastasis, distant metastasis, postoperative residual tumor size, and high expression of lnc-MyD88 and MyD88 mRNA significantly affected the progression-free survival (PFS) and overall survival (OS) of EOC patients (all P<0.05), ascites cancer cells were the risk factors that significantly affected PFS in EOC patients ( P=0.040); multivariate analysis showed that surgical pathological staging and high expression of lnc-MyD88 and MyD88 mRNA were independent factors affecting PFS and OS in EOC patients (all P<0.05), the size of residual lesions after surgery was an independent factor affecting PFS in EOC patients ( P=0.001). Conclusions:The level of lnc-MyD88 expression in ovarian cancer tissues was significantly increased. Lnc-MyD88, as a molecular marker for the poor prognosis of EOC, is related to the expression of MyD88 in EOC, and may be involved in its expression regulation, thereby affecting the survival and prognosis of EOC patients.
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Objective:To evaluate the effectiveness of anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft.Methods:A retrospective analysis was made of the clinical data of 12 patients who had undergone anterior minimally invasive osteosynthesis using a locking compression plate for spiral fractures of the mid-distal humeral shaft between December 2016 and January 2018. They were 8 males and 4 females, aged from 18 to 38 years (mean, 21.8 years). According to the AO/OTA classification, 5 cases were defined as type 12-A1.2, 2 as type 12-A1.3, 2 as type 12-B1.2, 2 as type 12-B1.3 and one as type 12-C1.1. The operation time, intraoperative blood loss, early postoperative complications and union time were recorded; the functional recovery of the elbow joint was evaluated by the Mayo elbow performance score (MEPS) and that of the shoulder by the University of California at Los Angeles (UCLA) shoulder rating scale at the final follow-up.Results:The mean operation time was 63 minutes (range, from 43 to 130 minutes), and the mean intraoperative blood loss 139 mL (range, from 60 to 280 mL). All incisions healed by the first intention without any neurologic complications or wound infection. All the 12 patients were followed up for 10 to 21 months (mean, 13.7 months). Bony union was obtained in all cases after 11 to 20 weeks (mean, 15.8 weeks). No loosening or breakage of internal fixation occurred. At the final follow-up, the MEPS ranged from 90 to 100 (mean, 99) and the UCLA shoulder scores from 31 to 35 (mean, 34.5).Conclusion:Anterior minimally invasive osteosynthesis using a locking compression plate is safe and feasible for spiral fractures of the mid-distal humeral shaft, leading to minimal invasion, a low risk for iatrogenic nerve injury and satisfactory effectiveness.
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Objective To evaluate the radiosensitization effect and micro CT imaging of multifunctional gold nanoparticles in lung adenocarcinoma A549 tumor-bearing mouse models.Methods The tumor-bearing mice were injected with gold nanoparticles and irradiated with different energy levels of 160 kV and 6 MV X-ray.The tumor volume changes were measured.Intra-tumoral injection of gold nanoparticles was administered and micro CT scan was performed at different time points to observe the imaging and retention time of gold nanoparticles in the tumor tissues.Results The tumor volume did not significantly differ between the control and gold nanoparticles groups (P=0.941).The tumor volume in the 6 MV X-ray combined with gold nanoparticles group was slightly reduced compared with that in the 6 MV X-ray group with no statistical significance (P=0.730).The tumor volume in the 160 kV X-ray combined with gold nanoparticles group was significantly smaller than that in the 160 kV X-ray group (P=0.026).Micro CT scan demonstrated that gold nanoparticles could be deposited in the tumors for 30 d and yielded excellent imaging effect.No gold nanoparticles-induced toxicity was observed.Conclusions Multifunctional gold nanoparticles exert significant radiosensitization effect in the lung adenocarcinoma A549 transplanted tumors irradiated with 160 kV X-ray.Stable CT imaging of the gold nanoparticles-injected tumors can be used as a potential method for mapping and delineating the target area in tumor-guided radiotherapy.
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Objective To study the radiosensitization effect of thio-glucose capped gold nanoparticles (Glu-GNPs) on human lung adenocarcinoma A549 cells in vitro.Methods Human lung adenocarcinoma cell line A549 in logarithmic phase was divided into four groups:control group,drug group (Glu-GNPs),irradiation group (irradiation of 6 MV group and irradiation of 160 kV group),Glu-GNPs combined irradiation group (6 MV + Glu-GNPs group,160 kV + Glu-GNPs group).Transmission electron microscopy (TEM) was used to observe the distribution of Glu-GNPs in cells.Toxicity of Glu-GNPs on A549 cells and the inhibitory effect of Glu-GNPs combined with irradiation on cell proliferation were determined using crystal violet assay.Clonogenic assay were performed to evaluate radiosensitization of Glu-GNPs on A549 cells.Immunofluorescence assay of γ-H2AX,a biomarker of DNA damage that underlies cellular response to irradiation was used to evaluate radiation-induced DNA double-strand break (DSB).Results TEM images showed that Glu-GNPs were mainly distributed in the cytoplasm of A549 cells,including endosomes and mitochondria.Glu-GNPs had little cytotoxicity toward A549 cells with a concentration lower than 100 nmol/L.Different concentrations (0-100 nmol/L)of Glu-GNPs combined with different energy of X-rays had significant inhibitory effects on A549 cells.Under 160 kV and 6 MV X-ray conditions,the Glu-GNPs treatment further decreased the survival fraction of irradiation group (P ＜ 0.05),and the sensitizing enhancement ratio (SER) was 1.41 and 1.15,respectively.Moreover,Glu-GNPs significantly increased radiation-induced γ-H2AX foci in A549 cells,and the number of γ-H2AX foci with 160 kV X-ray radiation was higher than that with 6 MV X-ray radiation (t =12.392,14.893,18.947,P ＜ 0.05).Conclusions Uptake of Glu-GNPs by A549 cells could enhance radiation effects,especially for kilovolt X-ray radiation.
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As injury to distal tibiofibular syndesmosis is commonly associated with ankle fractures,it calls for timely and correct diagnosis and treatment because it might result in chronic pain and ankle instability.Its severe cases can lead to traumatic arthritis.Stable injury to distal tibiofibular syndesmosis can be treated conservatively,but internal fixation is mostly recommended for severe cases of the injury.Internal fixation with metal screws usually requires a secondary surgery for removal of the implants but application of bioabsorbable screws overcomes this trouble and avoids a secondary surgery and its related complications.This article reviews the advantages of bio-absorbable screws,choice of bioabsorbable materials and screws,therapeutic outcomes and adverse reactions in the treatment of distal tibiofibular syndesmotic injury.
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Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.
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Objective: To explore influence of bisoprolol on neuroendocrine factor levels in patients with chronic heart failure (CHF), and its therapeutic effects.Methods: A total of 116 CHF patients, who were treated in our department from Jan 2014 to Nov 2015, were selected.According to random number table, they were randomly and equally divided into routine treatment group and bisoprolol group.Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDd), 6min walking distance (6MWD), serum levels of brain natriuretic peptide (BNP), endothelin (ET) and atrial natriuretic peptide (ANP) before and three months after treatment, and therapeutic effect were compared between two groups.Results: There were no significant difference in above indexes between two groups before treatment, P>0.05 all.Compared with routine treatment group after three-month treatment, there were significant rise in LVEF [(28.13±4.16)% vs.(36.02±5.14)%] and 6MWD [(245.74±44.62)m vs.(315.23±53.12)m], significant reductions in LVEDd [(62.73±10.14)mm vs.(52.82±9.47)mm], serum levels of BNP [(424.51±62.26) ng/ml vs.(324.35±50.46) ng/ml], ET [(80.14±13.25) ng/ml vs.(57.91±10.32) ng/ml] and ANP [(233.24±42.35)ng/ml vs.(164.83±31.26) ng/ml] in bisoprolol group, P<0.05 all.Compared with routine treatment group, there was significant rise in total effective rate (72.4% vs.86.2%) in bisoprolol group, P=0.04.Conclusion: Bisoprolol can significantly reduce BNP, ET and ANP levels, then delay ventricular remodeling and improve cardiac function in patients with chronic heart failure.The therapeutic effect is significant, which is worth extending.
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Objective To investigate the possibility of chloroquine radiosensitization of esophageal cancer cell line TE-1 and its further mechanism.Methods Effect of chloroquine on cell viability of TE-1 cells was determined by MTT method.Expression of LC3,Beclin-1 and formation of acidic vesicular organelles (AVOs) were determined by Western blot,and fluorescence staining with Lyso-Tracker Red DND-99,respectively.Clonogenic survival of TE-1 cells was examined by clonogenic forming assay.Results Chloroquine showed dose-dependent inhibition of TE-1 cell growth,and its values of IC50 and IC10 were (72.33 ± 5.28) and (15.42 ± 3.33) μmol/L,respectively.The expression of Beclin-1 and LC3-Ⅱ/Ⅰ markedly increased in irradiated TE-1 cells.The addition of chloroquine with IC10concentration significantly reduced the fluorescence and intensity of AVOs accumulation in the cytoplasm of TE-1 cells.Clonogenic survival fraction decreased obviously,in TE-1 cells with addition of chloroquine after radiation and the value of SERD0 was 1.439.Conclusions Chloroquine could radiosensitize esophageal cancer cells by blocking autophagy-lysosomal pathway and be used as a potential radiosensitizing strategy.
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Epithelial-mesenchymal transition (EMT) is a major mechanism in tumor metastasis.As the key regulatory factor,Twist gene plays an important role in EMT,and it can be induced by radiotherapy,chemotherapy and a variety of cytokines.Researches show that tumor cells can get stem cell-like properties via EMT,which can lead to chemo-radiotherapy resistance,tumor angiogenesis and distant metastasis.EMT has a great influence on the prognosis of tumor,and it is expected to become an important target for tumor treatment.
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Objective To evaluate effect of combined corpeetomy for multilevel cervical spondylotic myelopathy (CSM) and ossified posterior longitudinal ligament (OPLL).Methods Fifteen patients with CSM or OPLL,including 9 males and 6 females,were treated with combined corpectomy which is characterized by C4 and C6 corpectomy,excision of osteophyma,protruded disc and/or ossified posterior longitudinal ligament on basis of preservation of C5 vertebral body,structural bone grafting in C3-5 and C5-7,and anterior cervical plate fixation at C3,C5,and C7.The clinical results were evaluated with Japanese Orthopaedic Association (JOA) score.X-rays and CT scans were taken to evaluate vertebral fusion,and MRI was used to access spinal canal decompression and condition of spinal cord.Results All patients were followed up for 9 to 42 months (average,26.7 months).Bony fusion was achieved in all 15 patients.The JOA score improved from preoperative 13.44±2.81 to postoperative 16.16±2.19 (P=0.0354).The cervical lordosis improved from preoperative 1.16°±11.74° to immediately postoperative 14.36°±7.85° (P=0.00217),and 12.92°+6.17° at the final follow-up (P=0.00292).The complications included temporary hoarseness in 2 cases,dysphagia in 1 case.Conclusion The combined corpectomy for treating CSM and OPLL can obtain reliable and satisfactory results.In operation,the preservation of C5 vertebral body can provide an additional screw anchoring force and strengthen stahility.
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OBJECTIVE@#To determine the characteristics, classification, and treatment of thoracic fracture accompanied with sternum fracture.@*METHODS@#Data of 32 patients with thoracic fractures accompanied with sternum fracture were reviewed. Patients information such as age, gender, cause of injury, site of sternum fracture, level and type of thoracic vertebral fracture, spinal cord injury and associated injuries was included in the analysis. Of the 32 patients, 13 had compressed fractures, 13 had fracture-dislocations, 5 had burst fracture and 1 had burst-dislocation. Six patients had a complete lesion of the spinal cord, 13 sustained a neurologically incomplete injury, and the other 13 were neurologically intact. Ten patients were treated nonoperatively and the other 22 surgically.@*RESULTS@#All patients were followed up for 10-103 months. Road traffic accidents and falling dominated among the causes. All patients were accompanied with other injuries. None of the 6 patients with a complete paralitic lesion regained any significant function. Of the 13 neurologically intact patients, 5 had local pain although 12 of them remained normal function. One patient showed tardive paralysis. Three of the 13 patients with incomplete paraplegia returned to normal, 5 regained some function and 5 did not recover.@*CONCLUSION@#Thoracic fractures accompanied with sternum fracture are marked by violent force, severe fracture of the spine, severe injuries of the spinal cord, and high incidence of other injuries. The new classification method is more suitable to thoracic fractures accompanied with sternum fracture,and confirms the existence and clinical relevance of the 4th column of the thoracic spine and its role in providing spinal stability in patients with thoracic fracture.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Fracture Fixation, Internal , Methods , Fractures, Bone , Classification , General Surgery , Fractures, Compression , General Surgery , Joint Dislocations , General Surgery , Multiple Trauma , Classification , Spinal Fractures , Classification , General Surgery , Sternum , Wounds and Injuries , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General SurgeryABSTRACT
Objective To compare the accuracy of blood volume perfusion imaging (perfusion CT)with contrast enhanced 64-slice spiral computed tomography (CECT) in the evaluation of gross tumor volume (GTV) and clinical target volume (CTV) using rabbits with VX2 brain tumor. Methods Perfusion CT and CECT were performed in 20 rabbits with VX2 brain tumor. The GTV and CTV calculated with the maximal and minimal diameter of each tumor in the blood volume (BV) maps and CECT were measured and compared to those in pathological specimens. Results The mean value of the maximal and minimal diameter of GTV was (8.19 ± 2. 29) mm and (4.83 ± 1.31) mm in pathological specimens, (11.98 ±3.29) mmand (7.03±1.82) mm in BV maps, while (6.36±3.85) mm and (3.17±1.93) mm in CECT images, which were significantly different (pathological specimen vs. BV map, t = 7. 17,P =0. 000;pathological specimen vs. CECT, t = 8.37, P = 0. 000, respectively). The mean value of the maximal and minimal diameter of CTV in pathologic specimens was (12.87 ± 3.74) mm and (7.71 ± 2. 15) mm, which was significantly different from that of GTV and CTV in CECT (t = - 3. 18, P = 0. 005 and t = - 4. 24, P =0. 000;t= -11.59,P=0.000 and t= -9.39,P=0.000), while similar with that of GTV in BV maps (t = - 1.95,P = 0. 067; t = - 2. 06, P = 0. 054). For CECT, the margin from GTV to CTV was 81.83% ±40.33% for the maximal diameter and 276.73% ± 131.46% for the minimal. While for BV maps, the margin was 7.93% ± 17. 84% and 12.52% ± 27. 83%, which was significant different from that for CECT images (t=7.36,P=0. 000 and t= -8.78,P=0.000). Conclusions Compared with CECT, the BV map from 64-slice spiral CT peffusion imaging might have higher accuracy in target volume delineation for brain tumor.
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Objective To find the safe vertical displacement for minimal infusion rate change of syringe pumps as the theoretical guidance for moving pumps. Methods The infusion volume within 1 minute after none and vertically moving 15, 25, 35, 50 cm of the pumps (microinfusion pump WZ-50C、WZ-50C2、BRAUN perfusor compact) at 10 ml/min were weighted and compared by the electronic balance. Results Significant differences of the infusion rate were detected. The difference of average infusion volume within 1 minute after vertically moving 15, 25, 35, 50 cm and non-movement were 0.004 (minimal),0.017, 0.033, 0.046ml. The lowest infusion curve of 15cm displacement stretches slightly above the horizontal plane until the inflexion in the section graph, leading to steeper in accordance with the increasing vertical displacement of the pumps,which implied the following drastic increase in infusion rate. Conclusions The minimal infusion change is obtained at 15cm, thus becomes the safe displacement height and the inflexion point of further soaring changes.
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Objective To study the influence of survivin mutant-T34A ( survivinT34A) and survivin deletant-N-terminal 8 amino acids residues ( survivinN-8AA ) on the cell cycle distribution and chemosensitivity in human ovarian cancer HO-8910 cells for explorating the roles of modified survivin-mediated apoptosis induced by chemotherapeutic agents and possible signaling pathways involved. Methods pcDNA3.1 plasmid contained wild-type, survivinT34A and survivinN-8AA genes were transfected into HO-8910 cells,respectively, the control groups were HO-8910 cells transfected with pcDNA3. 1 plasmids. The expression of mRNA was examined by reverse transcription(RT) PCR and identified by DNA sequencing; the cell cycles were determined by flow cytometer analysis ( FCM ); the growth inhibitions rate of cisplatin ( DDP),paclitaxel (PTX) and LY294002 on the transfected cells were determined using methyl thiazolyl tetrazolium (MTT) assay. Results (1) The RT-PCR procedures and genome sequences showed that the survivin mRNA were expressed stable in the transfected HO-8910 cells. (2) There was lower percent of G0/G1 phase cells in SN-HO-8910 cells than that in PC-HO-8910 cells (44. 72% vs. 49.64%, P ＜0. 05) ;while higher percentage of G2/M phase and S phase cells( 1.06% and 54. 22% vs. 0. 56% and 49. 80%, P ＜ 0. 05 ).There was lower the G2/M phase and S phase cells in M-HO-8910 cells 0. 16% and 36. 33%, than that in PC-HO-8910 cells( P ＜ 0. 05 ); while higher percentage of G0/G1 phase cells(63. 51% ,P ＜ 0. 05 ). G0/G1 ,G2/M and S phase cells in Sur-HO-8910 cells were 54. 46%, 0. 62% and 44. 92%, and there were not significantly difference ( P ＞ 0. 05 ), compared to those in PC-HO-8910 cells. ( 3 ) The inhibitory concentration ( IC50 ) of DDP and PTX were higher in Sur-HO-8910 cells than those in control cells [(20. 4 ±6. 1)vs. (14.4 ±3.9)μmol/L,(36.7 ±4.0) vs. (28.6 ±3.6) μmol/L;all P＜0.05]. The IC50 of DDP and LY294002 in SN-HO-8910 cells were lower than those in control cells[(7. 6 ± 1.0) vs. ( 14. 4 ± 3.9)μmol/L, ( 13.2 ± 4. 0) vs. (41.0 ± 7. 9 ) μmol/L; all P ＜ 0. 01]. The IC50 of PTX [( 37. 9 ± 4. 8 ) μmol/L]in SN-HO-8910 cells were higher than that in control cells(P ＜0. 05). The IC50 of DDP in M-HO-8910 cells [(9.9 ± 1.2) μmol/L] were lower than that in control cells(P ＜0. 05) ,and the IC50 of LY294002 in M-HO-8910 cells [(66. 9 ± 4. 8) μ mol/L] higher than that in control cells ( P ＜ 0. 01 ). Conclusions The changes of cells cycle distribution caused by survivinT34A or survivinN-8AA enhanced the G2/M cell cycle-dependent chemosensitivity of PTX. Compared to survivinT34A, survivinN-8AA preferentially to mediate the cytotoxicity of DDP and LY294002, suggesting that it may be related to the cell cycle-dependence of survivin function and to blockage of the formation of its active dimer.
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BACKGROUND:It is controversial to treat sacroiliac joint fracture.Some scholars advocated expectant treatment,and some others advocated surgery therapy.Pelvic stability was responsible for the scheme selection.Sacroiliac joint fracture-dislocation destroys pelvic stability,which easily induces instability and bone nonunion,resulting in sacroiliac joint pain,unequal size of lower limbs,sitting pain and dysfunction.Thus,prognosis of mental implant is significantly better than expectant treatment in treatment of unstable pelvic fracture.OBJECTIVE:To summarize the treatment of unstable pelvic fractures and their clinical application using various internal and external fixation of metal implants.METHODS:The computer-based research was done in Pubmed database (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang database (http://www.wanfangdata.com.cn) for articles published from January 1991 to December 2009 with the key words of "Pelvic fractures,instability,surgical treatment" by the first author.A total of 115 articles were retrieved,and those concerning characteristics and clinical application of implants in the treatment of unstable pelvic fracture.Articles addressing old and repetitive contents were excluded.Literatures of the same fields published in recent years or in authorized journals were selected.Finally,30 articles were included.RESULTS AND CONCLUSION:Sacroiliac joint fracture-dislocation is a severe,high-energy trauma,has been paid great attention in the therapy,particularly in unstable sacroiliac joint fracture-dislocation.A stable type of fracture and dislocation of the sacroiliac joint received a conservative treatment of unstable sacroiliac joint fracture-dislocation appropriate line of external fixation,internal fixation for reconstruction of pelvic stability and internal fixation treatment varied,but the therapeutic effect of internal fixation needs to be improved.What are bio-mechanical characteristics of various internal fixation methods,and how the timing of weight-bearing activities following various internal fixations require further basic and clinical studies.An unstable sacroiliac joint fracture-dislocation fixation has many ways,including the anterior and posterior fixed-fixed.Minim ally invasive therapy such as posterior CT guided sacroiliac joint lag screw is the developmental trend.
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BACKGROUND: Using low-intensity pulsed ultrasound (LIPU) to promote the repair of articular cartilage injury is very common,and we also have more options to choose the cytoskeleton, but the application conditions of LIPU and the appropriate cytoskeleton have not reached any consensus yet.OBJECTIVE: To investigate the feasibility of establishing tissue-engineered cartilage by cell-free allograft demineralized bone matrix (CFDBM) co-cultured with rabbit cartilage cells and bone marrow mesenchymal stem cells (BMSCs) in vitro, and to investigate the effect of LIPU on the cells in CFDBM.DESIGN, TIME AND SETTING: Multiple sample observation was performed at the Institute of Biomedical Engineering, Second Military Medical University of Chinese PLAfrom May to August 2009.MATERIALS: The CFDBM was prepared as modified Urist's method; the cartilage cells were obtained using mechanical disintegration and enzyme digestion; the BMSCs were separated using whole bone marrow rinsing method, purified, and amplified layer by layer.METHODS: As CFDBM With a composite of different cellular components, and whether applying LIPU stimulation, the samples were divided into four groups: chondrocyte group, BMSCs group, compound group (CFDBM was compounded with chondrocytes,BMSCs, and chondrocytes/BMSCs, respectively, without LIPU stimulation), and LIPU group (CFDBM was compounded with chondrocytes/BMSCs, and then the samples were stimulated with LIPU on the second day, 1.0 MHz frequency, 10 mW/cm~2 transient spatial intension, 20 min/d).MAIN OUTCOME MEASURES: ① the 2~(nd)-generation of cartilage cells and BMSCs were examined by immunohistochemical method; ② The CFDBM prepared as modified Urist's method was examined as HE staining; ③ The samples of four groups were examined by collagen II immunohistochemical staining on the 21~(st) day.RESULTS: ① The collagen II immunohistochemical staining of the second generation of the articular cartilage cells showed that the morphostructure was polygon, star or round, and pseudopodia extended, and the cells were rich in cytoplasm; the cytoplasm was brownish yellow, and the cell nuclear was round. ② The result of immunohistochemical staining of BMSCs showed that,CD34 was negative, CD44 and CD105 were positive. ③ In the center of CFDBM prepared as modified Urist's method, there was no obvious cell-like structure and the gap size was uniform. ④ On the 21~(st) day after combining CFDBM with cells, collagen II immunohistochemical staining demonstrated that BMSCs group was negative, chondrocyte group was weak positive, compoundgroup was positive, and the LIPU group was strongly positive.CONCLUSION: ① Biological property of the 1~(st)-3~(rd)-passage chondrocytes and BMSCs was similar to primary-cultured cells. ②Both chondrocytes and BMSCs had a highly proliferative ability in CFDBM. ③ 10 mW/cm~2 LIPU could not affect activity of BMSCs but could promote differentiation Into articular cartilage cells, and it also could not promote celt proliferation.
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AIM: To observe the curative effect of titanium wiring in treatment of the fractures of Neer Ⅱ type distal clavicle and dislocation of Tossy Ⅲ type acromioclavicular joint. METHODS: From March 2004 to December 2006, 37 cases with Neer Ⅱ type distal clavicle fractures or Tossy Ⅲ type acromioclavicular joint dislocation were treated with titanium wiring in Changzheng Hospital, Second Military Medical University of Chinese PLA. Titanium wiring (produced by Sofamor-Danek Company in USA) had good histocompatibility, intensity of tension and flexibility. The broken coracoclavicular ligament was repaired directly by titanium wiring in all cases. The outcomes were evaluated according to Herscovici's criteria. RESULTS: All the cases were followed up for 6 to 24 months. All the dislocated acromioclavicular joints returned to normal 2 weeks after operation. Excellent and good rate of shoulder function was 100% according to Herscovici standard. X-ray imaging showed all clavicle fractures united, acromioclavicular joint had no redislocation or titanium wiring breaking. The incisions of all cases had no obvious swelling and exudation. CONCLUSION: When Neer Ⅱ type distal clavicular fracture and Tossy Ⅲ type acromioclavicular joint dislocation are treated with titanium wiring, the acromioclavicular joint can exercise earlier and recover quickly.
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[Objective]To investigate the clinical effects of the treatment of thoracolurnbar fracture with pedicle screw system under endoscopy assisted X-tube system.[Method]Twenty-one cases of pure thracolumbar fracture without neural impairment were treated with pedicle screw system under endoscopy assisted X-tube system.With the image intensifier,the pedicle based in the affected segments were localized and exposed through 4 small incisions(3cm).Transpedicular fixation and reduction by endoscopy assisted X-tube system were performed through the 4 small incisions.[Result]Twenty-one cases were followed up for 12-18 months(averaged,14 months).Radiography showed good reduction fixation of the vertebral bodies,good correction of the kyphosis deformities and good restoration of lumbar motion.[Conclusion]The treatment of thoracolumbar fracture with pedicle screw system under endoscopy assisted X-tube system is indicated for thoracolumbar fracture without neural impairment.This technique has advantages of minimal invasion and early functional recovery.
ABSTRACT
BACKGROUND: Allergic airway inflammation (AAI) is the pathological basis of pathogenesis of asthma. Manghua decoction, from Zhang Zhongjing's "On cold damage", is the basic recipe for treating asthma, its addminus recipe is widely used in clinic now.OBJECTIVE: To investigate the effect of mahuang decoction on allergic airway inflammation in asthmatic mouse.DESIGN: Randomized controlled observation SETTING: Staff Room of Internal Medicine, Department of Clinical Medicine, Guangdong University of Pharmacy.MATERIALS: The experiment was performed in the Animal Laboratory of Guangdong College of Pharmacy and Laboratory of Pathology, Guangdong University of Pharmacy from March 2003 to February 2004. Totally 36 mice were recruited.METHODS: Mice were randomly divided into normal control group, asthma group and treatment group, with 12 in each one. The mice in the control group were given intraperitoneal injection of 0.2 mL of normal saline on day 1,7,14 and 21 separately. From 28th day, the mice were given intragastric administration of normal saline of 0.5 mL for 60 minutes followed by water spray(only normal saline ) for 30 minutes , for consecutive 7 days.The mice in the asthma group were given intraperitoneal injection of normal saline of 0.2 mL containing egg albumin (10 μg) and aluminium hydroxide (20 mg) on day 1, 7, 14 and 21 separately. From 28th day, the mice were given intragastric administration of normal saline of 0.5 mL for 60 minutes followed by water spray (normal saline containing egg albumin of 50 g/L) for 30 minutes, for consecutive 7 days. Sensitization and stimulati on of the mice in the treatment group were the same as that in the asthma group. Intragastric administration of mahuang decoction of 0.5 mL was performed 60 minutes before spray. The procedure was conducted for consecutive 7 days. The pathologic change and the lung tissues expression of interleukin-4 (IL-4) and interferon-γ (IFN-γ) of the mice in each group were analyzed with hamatoxylin-eosin staining and immunohistochemical staining.MAIN OUTCOME MEASURES: Comparison of airway infiltration cells and lung tissue IFN-γand IL-4 of the mice in each group RESULTS: Totally 36 mice entered the stage of result analysis with no loss in the midway. ① Inflammation of the mice relieved obviously in the treatment group than in the asthma group, and the number of the inflammatory cells in or around bronchi of the mice was significantly less in the treatment group than in the asthma group . ② The number of IL-4 and IFN-γ was significantly increased in the asthma group than in the normal control group, among which , the number of IL-4 was more significant, and the ratio of IFN-γ / IL-4 was decreased. However, the number of IL-4 on the treatment group was significantly decreased, and that of IFN-γ was remarkably increased , and the ratio of IFN-γ / IL-4 was significantly increased as compared with that in the asthma group.CONCLUSION: Asthmatic mice might exist the disequilibrium of Th1/Th2 subgroup. Mahuang decoction can improve the inflammation of bronchus,regulate the ratio of Th1/Th2, which might be one of the mechanism for treatment of asthma.