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Objective:To investigate the effect of autophagy inhibitor 3-methyladenine (3-MA) on uric acid (UA)-induced apoptosis of renal tubular epithelial cells.Methods:(1) Totally 24 SD rats were randomly divided into 4 groups: control group, treatment with 3-MA group, hyperuricemic nephropathy (HN) group, and HN+3-MA group, with 6 rats in each group. According to the body weight of the rats, adenine (100 mg/kg) and potassium oxonate (1 500 mg/kg) were mixed with distilled water to make a suspension, and the rats were given intragastrically once daily for consecutive 21 days to establish HN rat model. The control group and the 3-MA treatment group were fed an equivalent amount of distilled water. At the same time, the 3-MA treatment group and the HN+3-MA group were intraperitoneally injected with 3-MA (15 mg/kg), and the control group and HN group were intraperitoneally injected with an equal volume of saline once daily for 21 consecutive days. Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL) was used to observe renal cell apoptosis. Western blotting was used to detect the expression levels of cleaved caspase-3 and Bax, and immunofluorescence staining was used to detect the expression and localization of cleaved caspase-3 in renal tissue. (2) Human renal tubular epithelial cells (HK-2) were stimulated with UA (800 μmol/L), and cells were administrated with different concentrations of 3-MA or Beclin-1 small interfering RNA (siRNA). The apoptosis of renal tubular epithelial cells was detected by Western blotting and immunofluorescence staining.Results:Compared with the normal rats, the apoptosis of renal tubular epithelial cells in the HN group was significantly increased ( P<0.01), and the expression levels of cleaved caspase-3 and Bax were significantly up-regulated (both P<0.05). Compared with the HN group, the apoptosis of renal tubular epithelial cells in the HN+3-MA group was significantly decreased ( P<0.01). In addition, high level of uric acid could significantly increase the levels of apoptosis associated proteins in HK-2 cells (all P<0.05), and using different concentrations of 3-MA or transfecting with Beclin-1 siRNA could significantly reduce the expression of cleaved caspase-3 and Bax (all P<0.05). Conclusion:Autophagy plays an important role in uric acid-induced apoptosis of renal tubular epithelial cells. Inhibiting the excessive activation of autophagy may be a new strategy to prevent the progression of HN.
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Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.
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Objective To prepare generic irbesartan tablets and to evaluate its consistency of dissolution tests.Methods Using the original drugs (irbesartan) as reference drug,the single factor experiments were applied to investigating the type and amount of adhesive,tablet hardness,water content of tablets,and coating weight.ZRS-8G Dissolution Tester was used to conduct the dissolution tests which were carried on four different dissolution media.Then the similar factor (f2) was adopted to evaluate the similarity of dissolution between the original drug and generic drug.Results As the stabilizer,3％ HPMC-E5 was more stable than 5％ PVP K30.It had no difference of dissolution between original and generic drugs when the amount of adhesive,tablets hardness and water content were within the range of investigation.And the coating weight was 2％ to 3％.Moreover,the f2 values of original drug and generic drug were all greater than 50 in different dissolution media.Conclusion Thef2 results indicate a similarity in the dissolution behavior of reference drug and generic irbesartan tablets prepared by the single factor experiments.And the preparation process of generic irbesartan tablets is stable.
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Objective To explore the morphologic features of the biceps reflection pulley through the comparative study of the thin sec -tional anatomy based on the Chinese Visible Human ( CVH) and MRI sectional anatomy of the biceps reflection pulley ,and to provide ima-ging anatomic data for the diagnosis of lesions .Methods The thin slices of sagittal oblique plane and coronal oblique plane by visualization -al reconstruction based on 5 data set of the Chinese visible human ( CVH) were compared with the corresponding MR images from 20 shoulder joints of the normal volunteer individuals with routine MRI ,5 shoulders without abnormalities with MR arthrography .The detailed sectional a-natomy structure of the the biceps reflection pulley was marked from the CVH ,routine MRI and MR arthrography one by one with Photoshop CS2 software.Results The main three components of the biceps reflection pulley including the coracohumeral ligament (CHL),the superior glenohumeral ligament ( SGHL) ,and the long head of the biceps tendon ( LBT) were markedly displayed on the CVH and MRI .The CHL was markedly displayed on the sagittal oblique , using plain MRI .The SGHL was markedly displayed on the CVH , especially in the transverse plane.The LBT was markedly displayed on the CVH ,especially in the coronal oblique plane parallel to the LBT .The biceps reflection pulley was markedly displayed on the sagittal oblique plane with CVH and MR arthrography .The SGHL was perpendicular to the CHL , with T-shaped link anterior to the LBT on the sagittal oblique plane .Conclusion It is complementary for MRI and CVH displaying the components of the biceps reflection pulley .The sagittal oblique plane is the best position for displaying the components and adjacent structures of the bi -ceps reflection pulley ,which provide helpful position mark for the diagnosis of the lesions in the rotator interval .
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Objective To evaluate the diagnosis of frozen shoulder with the coracohumeral ligament on the coronal oblique plane with MRI.Methods There were 60 patients(120 shoulder joints)in control group,with 30 males and 30 females,the mean age was 50.5 years old.There were 72 shoulder joints in 72 patients of frozen shoulder group(50 femles and 22 males with a mean age of 53.5 years)with clini-cal evidence and MR imaging evidence of frozen shoulder.These were prospectively analyzed to identify the CHL visualization rate and meas-ure the maximum thickness of the CHL.Results The CHL visualization rate on the coronal oblique plane in the control group was 86.7%(104 /120),and the frozen shoulder group was 87.5%(63 /72),the difference was not significant(P >0.05).The CHL visualization rate on the axial view in the frozen shoulder group was 19.4%(14 /72)and the control group was 24.2%(29 /120),the difference was not signifi-cant(P >0.05).The CHL thickness on the coronal oblique plane (n =63)in the patients with frozen shoulder was (4.37 ±1.71)mm, which was significantly greater than (2.84 ±0.79)mm ofpatients in the control group(n =104),the difference was significant(P <0.001). The CHL thickness on the axial plane(n =14)in the patients with frozen shoulder was (3.93 ±1.49)mm,which was significantly greater than (2.29 ±0.65)mm of patients in the control group(n =29),the difference was significant(P <0.001).Conclusion A thickened CHL is highly suggestive of frozen shoulder,which is 4.37 mm on the coronal oblique plane.
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Objective To investigate the imaging characteristics and diagnostic value of tri-phase dynamic enhancement scan with CT for acute renal infarction. Methods The image features of CT plain scan and tri-phase dynamic enhancement scan of 10 patients (19 sides) with acute renal infarction were retrospectively analyzed, and the CTA expression of 6 patients were observed. Results Fourteen acute renal infarction lesions of 10 cases were diagnosed. The CT scan showed there were 4 cases with enlargement of kidney, and the other 6 cases were of no abnormality. The tri-phase enhancement CT scan showed there were 6 cases of unilateral renal infarction and 4 cases of bilateral renal infarction, which totally involving 14 sides. The acute renal infarction lesions lacked of high density region in the corticomedullary in cortical phase, and there were wedge-shaped hypodense area, even low density of full kidney in parenchymal phase and pyelographic phase. The a-cute renal infarction lesions were revealed better in parenchymal phase and pyelographic phase than in cortical phase. Six cases of CTA re-vealed the responsible vessels of renal infarction lesions and the other vascular diseases. Conclusion CT tri-phase dynamic enhancement scan has important value in the diagnosis of acute renal infarction, and CTA can identify the responsible vessels of renal infarction lesions.
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Objective To investigate the correlation between minimum apparent diffusion coefficient ( ADC) values and consistency of intracranial meningiomas of different parts and nature, providing radiographic evidence of selection for surgical approach. Methods The routine MRI, diffusion-weighted imaging imaging (DWI), ADC maps and ADC value of 23 patients (25 cases) who were confirmed as men-ingiomas through surgery and pathology were retrospectively analyzed and compared with the surgical findings and pathology results. Results ADC values in meningiomas with a hard consistency were significantly lower than those with a soft consistency. Meningiomas with low mini-mum ADC were considered to have a hard consistency. Conclusion The consistency of meningiomas is an important factor in developing the strategy of surgical resection and predicting the degree of removal. The minimum ADC value might have clinical use as a predictor of menin-gioma consistency.
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Objective To compare the efficacy of percutaneous radiofrequency ablation (PRFA) and repeat hepatectomy for solitary recurrent hepatocellular carcinoma (HCC) with the diameter≤3 cm. Methods The clinical data of 151 patients with recurrent HCC (diameter≤3 cm) who were admitted to the Cancer Center of Sun Yat-Sen University from January 1999 to December 2009 were retrospectively analyzed. Of all the patients, 79received PRFA (PRFA group) and 72 received repeat hepatectomy (repeat hepatectomy group). The survival rate, morbidity and recurrence of the tumor between the two groups were compared. All data were analyzed using t test, chi-square test or Log-rank test, and the survival of the patients were analyzed using the Kaplan-Meier method. Results The mobidities of the PRFA group and repeat hepatectomy group were 13% (10/79) and 36%(26/72), respectively, with a significant difference between the two groups (x2=11.411, P＜0.05). The cumulative 1-, 2-, 3-, 4-, 5-year survival rates were 89.7%, 75.2%, 67.1%, 61.5%, 56.6% in the PRFA group, and 86.0%, 67.6%, 53.6%, 44.1%, 40.2% in the repeat hepatectomy group, with no significant difference between the two groups (x2=1.610, P＞0.05). The cumulative 4-, 5-year survival rates of the PRFA group were significant higher than those in the repeat hepatectomy group (x2=4.682, 4. 196, P ＜ 0.05). The local tumor recurrence rate of the PRFA group was 5% (4/79), and the incisal margin recurrence rate was 3% (2/72) in the repeat hepatectomy group, with no significant difference between the two groups (x2=0.565, P＞0.05). Conclusion As a less invasive treatment method, PRFA is superior to repeat hepatectomy for solitary recurrent HCC with the diameter≤3 cm.
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Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.
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Objective To investigate method of in vitro measurement of adult Chinese scapula glenoid version angle with MSCT postprocessing technique. Methods Fifty dry scapula specimens and 50 wet anticorrosive shoulder specimens of adult Chinese were scanned with Siemens Somatom Sensation 16 scanner. The scapula glenoid version angle was measured with postprocessing technique of thick or thin multiplanner reformation (MPR), and the data were analyzed statistically. Results The scapula glenoid version angle of dry scapula specimens and wet anticorrosive shoulder specimens was (-0.40±4.10)°, (-3.00±4.49)° with thick MPR, and (-0.34±4.21)°, (-2.70±4.54)° measured with thin MPR, respectively. There was significant difference of the scapula glenoid version angles between the dry scapula specimens and wet anticorrosive shoulder specimens (P0.05). Conclusion Measuring the scapula glenoid version angle with thick MPR of MSCT is simple and fast. The scapula glenoid version angle is markedly variable between the dry scapula specimens and wet anticorrosive shoulder specimens. The retroversion angle of scapula glenoid is about 3°, which should be considered in the design of shoulder prosthesis.
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[Objective]To evaluate the effect of transepicondylar axis of different position on volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.[Method]Fifty-one dry humerus specimens were scanned with 16 slice spiral CT scanner,At top view the three-group humeral head retroversion angle decided by the transepicondylar axis of different position were measured by volume rendering technique,As to two-dimension CT method,the distal reference axis of the humeral head retroversion angle was defined by three sections of different levels,the total six-group data on humeral head retroversion angle were analyzed by Statistics.[Result]The humeral head retroversion angle ranged from 4? to 59.8?,the humeral head retroversion angle of six groups were(25.5?10.2)?,(25.0?10.8)?,(25.7?10.8)?,(27.3?10.3)?,(26.3?10.2)?,(25.8?10.4)? respectively.The Statistics showed that the results have no significant difference among them.The more distal the humerus was,the smaller humeral head retroversion angle defined by a line between the epicondyles on two-dimension CT method was.[Conclusion]The humeral head retroversion angle is markedly variable,the humeral head retroversion angle of shoulder joint prosthetic design should be individual.The transepicondylar axis of different position has no effect on volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.The top view at which lateral epicondyle of the humerus showing mini-triangulum and the anterior surface of the distal humerus articulation with the forearm being shaded is more simple,faster and precise for the volume rendering technique measuring the humeral head retroversion angle with multi slice spiral CT.
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Objective To observe the granule tissue remodeling under neoepithelium in minitype pigs' full thickness dermal wounds and discuss the relation between the remodeling and possible ulcers or scars. Methods After the establishment of eight full-thickness dermal wound models with the diameter of 4 cm on the back of six minitype pigs, the specimens were collected from wound edge and wound center immediately, 3, 6, 9, 12, 15, 20, 25, 30 and 45 days, respectively after injury for HE staining, immunohistochemical staining and Van Gieson staining and then observed under light microscope to count the cell number, fibroblasts and vascular endothelial cells as well as evaluate the quantity and arrangement of collagens. Results The mean wound healing time was (29.3?1.8) days. After 9-25 days, the granule tissues in the wound center contained more cells, fibroblasts, collagen and vascular endothelial cells than those under neoepithelium of wound edge (P 0.01). Meanwhile, the collagen quantity and arrangement style of granule tissues under neoepithelium during wounds healing (12-30 days) assembled those under neoepithelium 15 days after wound healing. Conclusion Granule tissue remodeling exists during the healing of full thickness dermal wound.
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<p><b>OBJECTIVE</b>To study the micrometastasis distribution in liver tissue surrounding hepatocellular carcinoma (HCC), and provide reference for appropriate surgical safety margin.</p><p><b>METHODS</b>Thirty-six patients with HCC but without clinical metastasis underwent hepatectomy. Their specimens showing ample surgical margin were made into giant sections. Tumor micrometastasis in liver tissue around the primary tumor were examined microscopically. In each specimen, the surrounding tissue was divided into proximal(p) and distal(d) areas. In either area, three lines of demarcation 0.5 cm, 1.0 cm, and 2.0 cm away from the margin of the primary tumor were designated as L(0.5), L(1.0) and L(2.0). Therefore, the surrounding tissue was divided into six zones - Z(p0.5), Z(p1.0), Z(p2.0) and Z(d0.5), Z(d1.0), Z(d2.0). The maximum micrometastasis spread distance (MMSD) and density (D(p0.5), D(p1.0), D(p2.0) and D(d0.5), D(d1.0), D(d2.0)) in each zone were analyzed after search for micrometastasis in the giant sections.</p><p><b>RESULTS</b>72.5% (111/153) micrometastases were found in form of microscopic tumor emboli. Their spread distance could be up to 6.1 cm. In 66.7% (24/36) specimens, micrometastases were found in the surrounding tissue. In 91.7% (22/24) of them, the distal MMSD was less than 3 cm. The proximal MMSD was less than 1.5 cm in 92.3% (12/13). The comparison of micrometastasis density in the different zones were D(d0.5) > D(d1.0) > D(d 2.0); D(p0.5) > D(p1.0) > D(p2.0); D(d1.0) > D(p1.0); D(d2.0) > D(p2.0) with significant differences.</p><p><b>CONCLUSION</b>(1) Micrometastases of HCC exist mainly in form of microscopic tumor emboli, (2) The longer the distance from the primary focus, the lower the micrometastasis incidence, (3) In zones more than 0.5 cm away from the primary focus, tumor micrometastasis incidence is significantly lower in the proximal zones than that in the distal zones and (4) For HCC patients without clinical metastasis, a surgical margin of 3 cm wide in the distal area and 1.5 cm wide in the proximal area may reduce the rate of postoperative recurrence.</p>
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Humans , Carcinoma, Hepatocellular , General Surgery , Hepatectomy , Methods , Liver Neoplasms , Pathology , General Surgery , Neoplasm Metastasis , Neoplasm Recurrence, LocalABSTRACT
Objective To evaluate the relationship between the tumor encapsulation,lymphocytic infiltration,fibroplasia and cirrhosis and transcatheter arterial chemoembolization(TACE)methods for hepatocellular carcinoma(HCC).Methods Histopathological changes were studied in 59 cases of HCCs treated with four kinds of TACE and 58 cases of HCCs treated with surgical resection alone.Results In TACE group the encapsulation,lymphocytic infiltration,fibroplasia was more severe and extensive than that in group of surgical resection alone(Ρ＜0.01）.The TACE method and treatment time had effect on encapsulation and fibroplasia of tumor,but treatment interval was no effect.The rate of cirrhosis among TACE method had no significantly difference（Ρ＞0.05）,had relation to TACE time（Ρ＜0.05）.Conclusion The changes in the encapsulation,lymphocytic infiltration,fibroplasia are more easily find by polytimes,multimaterial chemoembolization than that by one time single material chemoembolization and chemotherapy alone.The superselective cathetering can avoid the damage of normal liver.
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Objective To evaluate the relationship between the tumor encapsulation,lymphocytic infiltration,fibroplasia and cirrhosis and transcatheter arterial chemoembolization(TACE)methods for hepatocellular carcinoma(HCC).Methods Histopathological changes were studied in 59 cases of HCCs treated with four kinds of TACE and 58 cases of HCCs treated with surgical resection alone.Results In TACE group the encapsulation,lymphocytic infiltration,fibroplasia was more severe and extensive than that in group of surgical resection alone(?0.05),had relation to TACE time(?
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Objective To explore the clinical diagnosis and management of focal nodular hyperplasia (FNH) of the liver. Methods Forty-two FNH cases treated in the past 9 years were studied retrospectively. The clinical and pathologic data were reviewed. Results Preoperative liver function test and AFP were normal. The preoperative radiography in FNH was usually not specific, with less than 50% cases were suggestive of FNH of the liver. Surgical resection resulted in a permanent cure with no significant postoperative complications. More than one year follow-up found recurrence in one case. Conclusion Clinical, laboratory and radiological findings when combined could help in establishing tentative diagnosis of FNH. Surgery is recommended in cases with equivocal diagnosis or in fear of hepatocellular carcinoma.
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Objective To observe the effect of vacuum-assisted drainage (VAC) technique on the granulation tissue formation of infected soft tissue explosive injury in pig. Methods 16 wounds produced by explosion with electric detonators,which were fixed on the skin of the shoulders and hips of 4 small white pigs. The wounds were divided into 2 groups randomly: in group A the wounds were treated with conventional method,and in group B the wounds were treated with VAC set with a pressure of -15kPa. All wounds were infected on the third day after explosion. The depth of wounds was measured,and specimens were talcen from wound bed,immediately before treatment,and 1,3,6,9,14,19,and 24 days after treatment. The specimens were bistopathologieally studied with HE staining to assess the wound healing process of the two groups. Furthermore,immunohistochemistry for Factor Ⅷ related antigen and Ki67 was done to estimate the number of vascular endothelial cells and proliferating cells. Results From 1 to 19 days after the treatment,the depth of the wounds in group B were shallower than those of group A ( P
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Objective To evaluate the effect of transcatheter arterial chemoembolization using ethanol and iodized-oil emulsion(TACE-EIOE) on prognosis of patients with hepatocellular carcinoma(HCC). Methods Eighteen patients with histologically-proven HCC were underwent TACE-EIOE. The extent of apoptosis was analyzed by terminal deoxynucleotidy transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. Changes of these markers, tumor necrosis, encapsulation, volume, cumulative survival were analyzed. Results Complete tumor necrosis was 33.33%(6/18), severe tumor necrosis was 44.44%(8/18), moderate tumor necrosis was 5.56%(1/18), lesser tumor necrosis was 16.67%(3/18). Apoptosis rate was (22.79?3.34)%. Complete encapsulation was 88.89%(16/18). Evident volume-lessening was 66.67% (12/18), partial volume-lessening was 22.22%(4/18),and stable volume was 11.11%(2/18). Ki-67,PCNA, p53, Bcl-2, and Bax were (30.93?18.10)%, (41.16?11.83)%, (53.41?18.13)%, (6.32?2.10)%, and(58.73?17.32)%, respectively. The cumulative 1-, 2-,and 3-year survival rates were 83.33%,72.22%,and 66.67% for patients, respectively. Conclusions The preoperative TACE-EIOE is safe, it might benefit patients with HCC.
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Objective To evaluate the effect of preoperative transcatheter arterial chemoembolization on proliferation of hepatocellular carcinoma cells. Methods A total of 136 patients with hepatocellular(HCC) underwent liver resection and pathologic confirmation. One to five courses of TACE prior to liver resection were performed in 79 patients (TACE group); with one to four courses of chemotherapy alone were performed in 11 patients (Group A); one to five courses of chemotherapy combined with iodized oil were performed in 33 patients (Group B); one to three courses of chemotherapy combined with iodized oil and gelation sponge were performed in 23 patients (Group C); one to three courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge were performed in 12 patients (Group D). The other 57 patients only received liver resection (non-TACE group). The expressions of Ki-67 and proliferating cell nuclear antgen(PCNA) protein were detected by immunohistochemical method. Results The Ki-67 and PCNA protein expressions were significantly lower in Groups C and D than those in the non-TACE group (P
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Using the dimethylsulfoxide (DMSO)with final concentration of 4% as cryoproteclant, the human platelets were stored at - 30℃ and - 80℃ to provide cryopreserved platelets transfusion service. The results of in vivo and in vitro studies showed that DMSO could reversibly inhibit the platelet adhesion and its aggregation induced by the single aggregating agent. The platelet abhe-sion and aggregation could be recovered after washing and removing DMSO. The platelet aggregation caused by the combined aggregating agents wasn't influenced by DMSO. The adhesion, aggregation and resulting hypotonic shock reaction of cryopreserved platelets were used to be lower than those of fresh platelets, independent on the storage timed or 3 months). The quality of the platelets stored at - 80℃ was better than that at - 30℃. Being transfused with the platelets stored at - 80# could raise the platelet counts in patients, and effectively prevent and control the haemorrhage caused by thrombocytopenia.