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Objective:To explore the establishment and application of ovarian cancer organoids.Methods:Fresh ovarian tumor tissues, obtaining from patients underwent surgery in the First Affiliated Hospital of Nanjing Medical University between October 2021 and March 2022, were collected, enzymatic degraded, digested, and embedded into matrigel to establish organoids. A total of 32 ovarian cancer samples were collected. Hematoxylin eosin (HE) staining and immunofluorescence (IF) procedure were used to verify the morphological structure of organoids and their expression of molecular markers. 3D cyto-live or dead assay was used to detecte the live or dead cells in organoids. Carboplatin with a concentration ranging from 5 to 80 μmol/L (5, 10, 20, 40, 80 μmol/L) was added to organoids to calculate the 50% inhibitory concentration (IC 50) in different organoids. Results:(1) Organoids from a total of 32 patients were established, of which 18 cases could be passaged stably in the long term in vitro, while 14 could be passaged in the short time. The average amplification time of long-term passage in vitro was over 3 months, and the longest reached 9 months. (2) In HE staining, significant nuclei atypia and local micropapillary structures were observed in organoids. IF staining revealed that ovarian cancer organoids expressed molecular markers similar to primary tumor tissues, such as Pan cytokeratin (Pan-CK), p53, paired box gene 8 (PAX8), and Wilms tumor gene 1 (WT1). (3) In 3D cyto-live or dead assay, a large number of apoptotic cells were observed inside and around the organoids after added carboplatin. The sensitivity to carboplatin varied in 18 organoids could amplify in the long term, with an average IC 50 of (29.5±15.8) μmol/L. Moreover, IC 50 values of 4 organoids derived from patients received neoadjuvant chemotherapy were much higher than the 14 organoids which did not received neoadjuvant chemotherapy [(48.7±11.3) μmol/L vs (24.0±12.1) μmol/L; t=3.429, P=0.022]. Conclusions:Organoids recapitulate ovarian cancers in vitro and could be stably passaged. Organoids derived from patients received neoadjuvant chemotherapy have higher resistance to carboplatin.
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Objective:To compare the short-term therapeutic effects of Gamma 3 U-Blade system and Gamma 3 nails in the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture.Methods:The data of 70 elderly patients with osteoporotic unstable intertrochanteric fracture were retrospectively analyzed who had been admitted to the Department of Orthopedics, Wuhan Fourth Hospital from June 2018 to December 2020. They were divided into 2 groups according to their treatments. In the U-Blade group of 35 cases subjected to fixation with Gamma 3 U-Blade system, there were 14 males and 21 females with an age of (77.7 ± 4.8) years; in the Gamma 3 nail group of 35 cases subjected to fixation with Gamma 3 nails, there were 14 males and 21 females with an age of (79.3 ± 5.2) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, apex distance, fracture union time, postoperative complications, timed up and go (TUG) at postoperative 2 weeks, 3 months and 6 months, and hip function at postoperative 9 months.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). There was no significant difference either in operation time, intraoperative blood loss or apex distance between the 2 groups ( P>0.05). The fracture union time [(12.0 ± 0.2) weeks] and Harris hip score at postoperative 9 months [90 (90, 91)] in the U-Blade group were insignificantly different from those in the Gamma 3 nail group [(12.0 ± 0.3) weeks and 91 (89, 91)] ( P>0.05). The rate of implant-related complications in the U-Blade group [0% (0/35)] was significantly lower than that in the Gamma 3 nail group [17.1% (6/35)] and the TUGs at postoperative 2 weeks and 3 months [(80.2 ± 3.6) s and 45 (43, 49) s] in the former were significantly shorter than those in the latter [(89.3 ± 4.2) s and 56 (54, 59) s] ( P<0.05). Conclusion:In the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture, compared with traditional Gamma 3 nails, Gamma 3 U-Blade system can reduce implant-related complications and facilitate early recovery of walking ability.
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Objective:To investigate the clinical efficacy of 3D printed osteotomy guide plate combined with "Jail" screw technique in the treatment of tibial plateau fractures involving external posterior condylar collapse.Methods:From January 2016 to January 2021, 41 patients (22 males and 19 females) with tibial plateau fractures involving external posterior condylar collapse were treated with 3D printed osteotomy guide plate combined with "Jail" screw technique and followed up. The age was 47.4±11.5 years (range, 22-69 years). According to Schatzker fracture type, 18 cases were type IV, 14 cases were type V and 9 cases were type VI. All fractures were closed, and 12 of them were complicated with lateral meniscus injury, but none of them were complicated with nerve and vascular injury. The time from injury to operation was 7.2±3.4 d (range, 4-17 d). All patients underwent 3D CT scanning and digital modeling before operation. According to the modeling results, a 1∶1 solid size fracture model was made by 3D printing, and the osteotomy guide plate and the "Jail" screw preset guide plate were designed. During the operation, the tibial lateral condyle osteotomy was performed with customized osteotomy guide plate. After reduction, the fixation of the fracture was performed with the preset guide plate using "Jail" screw. Postoperative fracture reduction was evaluated according to Rasmussen score, and knee function was evaluated by Hospital for Special Surgery (HSS) score.Results:All the 41 patients were followed up for 15.2±5.8 months (range, 6-26 months). Immediate postoperative radiographs showed good fracture reduction, and the average healing time was 14.1±1.2 weeks (range, 12-17 weeks). One year after operation, the Rasmussen score of knee joint was 17.4±1.6 points (range, 13-19 points), of which 31 cases were excellent, 8 cases were good, and 2 cases were fair, with an excellent/good rate of 95% (39/41). HSS scores was 87.3±5.6 points (range, 68-95 points), including 30 excellent cases, 10 good cases and 1 fair case, with an excellent/good rate of 98% (40/41). The range of motion of knee joint was 126.8°±3.8°. At the last follow-up, no serious complications such as common peroneal nerve injury, popliteal vascular injury, postoperative infection, or internal fixation failure occurred.Conclusion:3D printed osteotomy guide plate combined with "Jail" nail placement technique is an effective method for tibial plateau fractures involving external posterior condylar collapse, and the postoperative treatment results are satisfactory. The use of customized osteotomy guide plate is more accurate and less damaging. The use of "Jail" screw preset guide plate can ensure more accurate screw placement.
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Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （ P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （ P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （ P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （ P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.
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Objective To investigate the diagnostic value of 99mTc-DTPA nuclide renal dynamic imaging in early renal damage in elderly essential hypertension(EH). Methods Among the elderly patients with essential hypertension who were enrolled in our hospital. 86 patients were enrolled as the study subjects. They were divided into two groups according to the results of 24-hour urinary microalbuminuria(MA):MA negative(A) group and MA posistive(B) group.Meanwhile,20 elderly healthy persons were selected as the control group. 99mTc-DTPA re-nal dynamic imaging was performed in all subjects to detect couple glomerular filtration rate(GFR),the peak time(TP),half emptying time(T1/2) and ration of 20 min and peak phase kidney radioactivity count(T20/P%).At the same time,MA,serum cystatin C(Cys-C),surem creatinine(SCr) and blood urea nitrogen(BUN) were de-tected and compared with three groups. Rusults(1)The positive rate of early renal damage with 99mTc-DTPA nu-clide renal dynamic imaging method was significantly higher than those of two later methods(P < 0.01).(2)The levels of GFR,TP,T1/2,and T20/P% in group A were significantly higher than those in the control group and those in group B significantly higher than those in group A(P<0.05).(3)The levels of MA and Cys-C in group A was sig-nificantly higher than that of the control group,and those in group B significantly higher than that of group A(P<0.05).In comparisons of SCr and BUN among the three groups,the results had no significant difference. Conclu-sion 99mTc-DTPA nuclide renal dynamic imaging can early detect the renal damage in elderly EH patients,and it has better clinical value.
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Objective To explore the mid-term efficacy of porous titanium trabecular metal ( TTM ) components manufactured by 3D printing for primary total hip arthroplasty ( THA ). Methods Enrolled for this prospective clinical trial were 19 patients ( 20 hips ) who were to receive primary THA from May 2012 to June 2013 at Department of Orthopaedics and Traumatology, Puai Hospital. Of them, 9 patients ( 10 hips) used 3D printing porous TTM for acetabular prosthesis in primary THA while the other 10 patients ( 10 hips ) used Pinnacle acetabular prosthesis. At 5 years after operation, clinical and radiographic evaluations were conducted to assess acetabular component stability, osseointegration in the acetabulum-bone interface, and osteolysis incidence. Harris scores were used to assess the hip functions. Results The follow-up duration for all the patients averaged 5 years. By the Harris scores, 8 cases were excellent and 2 good in the TTM group while 9 excellent and one good in the Pinnacle group. The Harris scores were significantly improved from preoperative 48.2+5.5 to 92.8+3.1 at 5 years after operation in the TTM group and significantly from 46.5 ± 8.7 to 94.6 ± 2.9 in the Pinnacle group ( P ＜0.05 ). There were no significant differences regarding the preoperative Harris scores and those 5 years after operation between the 2 groups ( P ＞ 0.05 ) . Radio-graphic evaluation showed stable acetabular components, fine osseointegration, and no implant loosening or osteolysis. Two hips in the TTM group had a postoperative radiolucent line which disappeared 6 months later. The 5-year survival rate of the acetabular components was 100% for both groups, taking prosthetic loosening or revision as the end point. Conclusion The 3D printing TTM has shown excellent mid-term efficacy but its long-term efficacy needs further follow-up study.
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Objective To report the operative procedures and clinical outcomes of open reduction and internal fixation for the treatment of tibial plateau fractures involving anteromedial margin caused by hyperextension varus injury.Methods From December 2013 to December 2015,11 patients with tibial plateau fracture involving anteromedial margin caused by hyperextension varus injury were treated at our department.They were 6 males and 5 females with a mean age of 42.3 years (range,from 19 to 65 years).Simple medial column fracture happened in 2,fractures of medial and lateral columns in 4,fractures of medial and posterior columns in 3,and 3-column fractures in 2 cases.The cortical bone fractures of anteromedial margin were fixated by open reduction and internal fixation using self-clipped joint line plating.Bone grafting was conducted if necessary.Results The 9 patients were followed up for an average of 17.6 months (range,from 12 to 30 months).All the fractures healed.The average time for radiographic bony union and full weight bearing was 11.4 weeks (range,from 9 to 14 weeks) and 16.1 weeks (range,from 14 to 19 weeks),respectively.On average,the Rasmussen's radiological grading scored 16.9 (range,from 14 to 18)immediately after operation;the Hospital for Special Surgery scores of all the patients at 12 months postoperatively averaged 89.1 (range,from 75 to 94),yielding an excellent to good rate of 92.3％.The average range of motion of the affected knee was from 2.3° to 125.1°.There were significant differences in both tibial plateau angle and posterior slope angle on radiography between preoperation and postoperation (P ＜ 0.05).There were no significant differences in either tibial plateau angle or posterior slope angle on radiography between immediate postoperation and 12 months postoperation (P ＞ 0.05).Partial incision necrosis occurred postoperatively in one case which was uneventfully healed after wound management.One case complicated with preoperative common peroneal nerve injury reported dorsal sense of numbness which was healed after administration of neurotrophic drugs.No screw loosening,plate breakage or fixation failure was found during follow-ups.Conclusions It is difficult to treat the tibial plateau fractures involving anterumedial margin caused by hyperextension varus injury.Internal fixation with joint line plating is an appropriate treatment for this fracture pattern,leading to satisfactory clinical outcomes.
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Objective To report our clinical outcomes of treating tibial defects combined with soft tissue defects using Ilizarov technique.Methods From May 2010 to February 2015,52 patients with combined bone and soft tissue defects of the tibia were treated at our department.They were 41 males and 11 females,aged from 19 to 65 years (average,37.7 years).By Gustilo classification,49 cases were type ⅢB and 3 type ⅢC.The areas of soft tissue defect ranged from 7 cm ×3 cm to 28 cm × 15 cm,and the tibial defects ranged from 5 cm to 15 cm in length (average,12.6 cm).The schemes of Ilizarov technique depended on the location and size of the tibial defects.Open wound dressing combined with bone transport was adopted in 21 cases,limb shortening followed by bone lengthening with compression at the fracture ends in 12 cases,and tissue flap transplantation combined with bone transport or lengthening in 19 cases.Results The follow-up time of the 52 patients ranged from 13 to 61 months (average,27.1 months).The distance of bone transport or lengthening ranged from 5.0 cm to 13.6 cm (average,10.8 cm);the bone transport speed averaged 0.81 mm/day.The tibiae united in all the 52 patients;the time for external fixation ranged from 13 to 21 months (average,15.3 months);the external fixation index was 2.3 months/cm.According to the Paley functional criteria,23 cases were excellent,19 good,9 fair,and one poor,yielding an excellent to good rate of 80.7％.Conclusion According to the location and size of the bone and soft tissue defects of the tibia,the 3 schemes of Ilizarov technique can be rationally chosen to obtain fine clinical outcomes.
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Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.
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<p><b>OBJECTIVE</b>To study the effect of autologous drained blood reinfusion on hidden blood loss and limb swelling following rivaroxaban anticoagulation for primary total hip arthroplasty.</p><p><b>METHODS</b>From May, 2011 to October, 2012, 98 patients undergoing primary unilateral total hip arthroplasty received rivaroxaban therapy for prevention of deep venous thrombosis (DVT). Forty-five of the patients used a drained blood reinfusion device (group A) and 53 patients did not (group B). Hidden blood loss and the maximal changes of postoperative circumferential length of the mid-thigh were measured and compared between the two groups.</p><p><b>RESULTS</b>The mean total blood loss, the hidden blood loss, and the maximal changes of postoperative thigh circumference were 1591.1∓337.3 ml, 1591.1∓337.3 ml, and 5.1∓2.8 cm in group A, as compared to 1374.5∓317.3 ml, 467∓96.8 ml, 3.9∓1.4 cm in group B, respectively. The two groups showed a significant difference in the maximal changes of postoperative mid-thigh circumference (P<0.01) but not in hidden blood loss (P>0.05).</p><p><b>CONCLUSION</b>Reinfusion of autologous drained blood does not affect hidden blood loss but can increase limb swelling following primary total hip arthroplasty with rivaroxaban anticoagulation.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticoagulants , Therapeutic Uses , Arthroplasty, Replacement, Hip , Blood Loss, Surgical , Blood Transfusion, Autologous , Methods , Edema , Morpholines , Therapeutic Uses , Rivaroxaban , Thiophenes , Therapeutic Uses , Venous ThrombosisABSTRACT
Objective To investigate the clinical effect of transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defects at foot and ankle and functional reconstruction.Methods From January,2008 to January,2013,25 pediatric patients with soft tissue defects at foot and ankle were transplantation of the free anterolateral thigh flap and iliotibial band.Of the 25 cases,there were 12 cases at heel,8 cases at dorsum of foot,3 cases at medial malleolus and 2 cases at external malleolus.All the cases were accompanied with different degree of fracture or dislocation,and with soft tissue defect such as achilles tendon,extensor tendon of dorsal,collateral ligament of ankle.The length of soft tissue defect which were reconstructed with iliotibial band were 3 cm to 16 cm.The causes of injury:19 cases were crushed by motorcycle or bicycle,4 cases were crushed machines,2 cases were injuryed in traffic accidents.The areas of free anterolateral thigh flaps were 8 cm × 5 cm to 18 cm × 12 cm.All the patients begined to early rehabilitative exercise under the protection of orthosis after 2 weeks of the operation.Results All cases were followed up from 6 to 24 months,averaged of 14 months.All the flaps survived,and only 2 cases with necrosis of small area in distal,and which were healed by dressing.The healing time were 12 to 24 days,and the average of 15.1 days; The surgery function were assessed according to Thermann's scale,and the results was 14 cases for excellent,9 cases was good,the general was 2 cases,and the excellent and good rate was 92％.Conclusion The transplantation of the free anterolateral thigh flap and iliotibial band for the repair of soft tissue defect at foot and ankle and functional reconstruction is a safe and effective strategy,and it has the advantages such as covering the wound at foot and ankle approvingly,reconstruction of power device once,the flap and iliotibial band were in the same wound,the trauma of doner site is small invasive,early recovery functional exercise,shorten the treatment cycle,and relieve the suffering of children.
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Objective To investigate the clinical features of gynecological malignant tumor related multiple primary malignant neoplasms (MPMN).Methods Apply retrospective and comprehensive analysis to the clinical data of 30 patients with gynecological malignant tumor related MPMN.Results Synchronous MPMN were found in 9 patients.Their average age was 50.2 years old and their median age was 49 years old.The neoplasms were located at ovary,uterus,cervix,breast and intestine.Metachronous MPMN were found in 21 patients.Their average age was 57.7 and their median age was 57 years old.The median interval between the first and the second primary malignant neoplasm was 4.0 years.The neoplasms were located at breast,ovary,uterus,gastrointestinal tract,uterine cervix,lung etc.In 30 cases,26 of them were treated by surgical operation and further adjunctive treatment of chemotherapy and (or) radiotherapy was conducted as per the neoplasm staging and its pathological results.The rest 4 patients (first primary malignant neoplasms were excised from 3 of them and another one was not treated by surgical operation) received adjunctive treatment of chemotherapy and (or) radiotherapy.Followed ups,which varied from 6 to 60 months,were made to 29 patients and 20 out of the 29 were alive.5-year survival rate of patients with gynecological malignant tumor related MPMN was 47.8％,2-year survival rate was 73.9％,and 1-year survival rate was 88.6％.Conclusion Pay more attention to the patients with gynecological malignant tumor related MPMN,examine the high-risk patients with malignant tumor comprehensively,identify whether it is recurrence,metastasis or new growth of malignant neoplasm,and further ensure early diagnosis and proper treatment,avoiding misdiagnosis and missed diagnosis.
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Objective To compare the efficacy and safety of a new low-dose oral contraceptive pill (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 μg with placebo in reducing symptoms of premenstrual dysphoric disorder (PMDD). Methods This multicenter, double-blind, randomized clinical trial consisted of 2 run-in and 3 treatment cycles (84 days) with daily symptom charting; 187 women with symptoms of PMDD were randomized to either placebo group (n=94) or YAZ group (n=93), and assessed with daily record of severity of problems scale (DRSP) and clinical global impressions scale (CGI) before, during and after the treatments. Hormones were administered for 24 days, followed by 4 days of inactive pills. Results Compared with baseline level of DRSP, both groups got improvement after treatment; the YAZ group (median-28.7, range:-82.5 to 2.3) had greater improvement than that in the placebo group (median-23.7, range:-86.0 to 11.8), while there was not significant difference (P>0.05). The main adverse effects of YAZ included intermenstrual bleeding [13% (12/93) versus 3% (3/94)], menorrhagia [9% (8/93) versus 1%(1/94)], nausea [5%(5/93) versus 4%(4/94)] and skin rash [4%(4/93) versus 2%(2/94)]. Conclusions YAZ could improve symptoms of PMDD better than placebo, while without statistic significance in this study. The most common adverse effects are intermenstrual bleeding, menorrhagia, nausea and rash.
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Objective To explore the early-term efficacy of porous titanium trabecular metal acetabular (TTM) compo-nents produced by E-beam technology in total hip arthroplasty(THA). Methods From May 2012 to JUN 2013, nineteen primary THA patients (20 hips) were devided into observation group of porous TTM acetabular prosthesis produced by E-beam technology and control group of Pinnacle acetabular prosthesis. TTM group had nine patients (10 hips), including 7 males and 2 females, with the mean age of 61.0 years. Pinnacle group had ten patients (10 hips), including 6 males and 4 females, with the mean age of 58.6 years. The patients were followed up at the 6,12,24 weeks after operation. X-rays were taken at the follow-ups. Acetabular compo-nent stability and osseointegration were assessed through radiograph. Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Osteoarthritis index were recorded before and after operation to evaluate clinical effects of surgery. Results In TTM group, the Harris score improved from 48.2 ± 5.5 preoperatively to 89.5 ± 4.0 postoperatively, SF-36 scores from 329.1 ± 86.7 to 763.8 ± 15.1, and WOMAC index from 18.8 ± 11.0 to 1.3 ± 0.9. No cases suffered aseptic loosening and migration. After 24 weeks, There was no significant difference regarding Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Os-teoarthritis index between two groups. In TTM group, two hips had a radiolucent line postoperatively, which occurred in 2 and 3 zone. The lines were disappeared 24 weeks later. Conclusion In THA, the initial stability of TTM produced by E-beam tech-nology was fine, which can facilitate bone ingrowth in early stage. However, the long-term follow-up effect still needs to be con-firmed.
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GRP78,as endoplasmic reticulum resident chaperone,is highly induced by a variety of tumor microenvironmental stresses,such as hypoxia and glucose deprivation.GRP78 is implicated in tumor cell proliferation,apoptosis,invasion,metastasis and angiogenesis.Recent evidence indicates that GRP78 levels is correlated with pathological grade,stage and prognosis for the majority of solid tumors.In addition,GRP78 plays an important role in drug tolerance and knockdown of GRP78 has been shown to sensitize malignant cells.GRP78 could not only be a good biomarker to predict cancer progression and chemo-responsiveness,but also an appealing target for the development of a more selective chemotherapy.
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Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.
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Objective To investigate the effects of miR-135a on HOXA10 expression,proliferation and apoptosis of SKOV3 cells.Methods (1) Through computer-aided algorithms,the predicted target gene of miR-135a (HOXA10)were determined.(2) miR-135a mimics,miR-135a inhibitor and negative control were transfected into SKOV3 cells,respectively.Reverse transcription (RT)-PCR,western blot analysis were used to examine the expression levels of HOXA10 at different times (24,48 and 72 hours).(3) A luciferase reporter assay was used to confirm the direct regulation between miR-135a and HOXA10.(4) SKOV3 cells proliferation at different times (24,48 and 72 hours) was detected by methyl thiazolyl tetrazolium(MTT) assay [quantified by absorbance(A)].Western blot was used to examine the expression of apoptosis-associated protein bcl-2,bax and caspase-3 in SKOV3 cells after 48 hours transfection.Results (1) HOXA10 was predicted to be the target gene of miR-135a by computer-aided algorithms.(2) RT-PCR shown that HOXA10 mRNA levels were decreased over time (24,48 and 72 hours) after miR-135a mimics transfectionin SKOV3 cells (0.94 ±0.04 vs 0.78 ±0.03 vs 0.70 ±0.03,P ＜0.05).While,the expression of HOXA10 mRNA was increased over time after miR-135a inhibitor transfection (1.14 ± 0.05 vs 1.16 ±0.03 vs 2.60 ±0.08,P ＜0.05).After transfected with miR-135a mimics or miR-135a inhibitor over 48 and 72 hours,the HOXA10 expression levels in SKOV3 cells were significantly lower or higher than each control group,respectively (all P ＜ 0.01).Western blot analysis of HOXA10 expression in SKOV3 cells confirmed the results of RT-PCR detected.(3) After cotransfection of miR-135a plasmid and pMIR-REPORT luciferase plasmid containing HOXA10,luciferase reporter assays showed that the luciferase activity reduced by 67.8％ (P ＜0.01).(4) MTT showed that SKOV3 cells growth after miR-135a mimics transfection for 48 and 72 hours were significantly lower than those in control group (0.38 ± 0.03 vs 0.52 ± 0.05,0.67 ±0.05 vs 0.75 ± 0.06 ; respectively,all P ＜ 0.05).While,SKOV3 cells transfected with miR-135a inhibitor for 72 hours grew significantly faster than that in control group (0.95 ± 0.05 vs 0.75 ± 0.06,P ＜ 0.01).After miR-135a mimics transfection,the level of bcl-2 protein was significantly lower than that in control group (0.28 ±0.06 vs 0.76 ±0.09,P ＜0.01).The activity of caspase-3 was significantly higher than that in control group (115.0 ± 2.4 vs 95.4 ± 2.1,P ＜ 0.01).While,there was no statistical difference of bax expression (P =0.142).However,after miR-135a inhibitor transfection,the expression level of bcl-2 protein was significantly higher than that in control group (0.92 ± 0.03 vs 0.76 ± 0.09,P =0.037) and the activity of caspase-3 was significantly lower than that in control group (59.5 ± 4.1 vs 95.4 ± 2.1,P ＜ 0.01).There was also no statistical difference of bax expression (P =0.066).Conclusion miR-135a may play an important role in cell proliferation and apoptosis of ovarian cancer cells by regulating HOXA10 and its downstream pathways.
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Objective To study the effect of a novel injectable scaffold material chitosan- beta-TCP combining bone marrow mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) on repairing bone defect of goat. Methods The model of the studies was 12ram diameter circular hole tibia bone defect of goat. 30 Chinese goats were raudomly divided into 5 groups: blank group: nothing was embeded in bone defect; simple material group: the material embeded in bone defect was chitosan-beta-TCP; PRP group: the material was chitesan-beta-TCP combining PRP; MSCs group: the material was chitosan-beta-TCP combining MSCs; PRP/MSCs group:the material was chitosan-beta-TCP combining MSCs and PRP. At 4,8 weeks after operation, the samples were observed, histological and image analysis were used to evaluate the effect of bone regeneration. Results At 8 weeks, the surface of bone defect zone of PRP/MSCs group were coverd by continuous new bones, like normal bone. Histological slice showed the esteoid at boundary of normal bone of MSCs/PRP group obviously increased compare to other groups at the 4th or 8th week after operation respectively. The new bone tissues of bone defect were punctiform or lamellar new bone tissues, in which the proportion of big lamellar new bone tissue obviously increased. Image analysis showed that the areas of balnk group, simple material group, PRP group, MSCs group, PRP/MSCs group were 8.79±3.63,14.49± 3.72,24.18 ± 5.38,24.42 ± 5.10,31.10 ± 3.49 at 4 weeks and 15.41 ± 4.21,25.36 ± 5.37,30.71 ± 4.39, 33.97 ± 4.45,48.60 ± 5.97 at 8 weeks respectively. The effect of bone regeneration of PRP/MSCs group was better than other groups (P < 0.05). Conclusion The injectable tissue-engineering bone constructed with chitosan-beta-TCP, MSCs and PRP possesses good ability on repairing bone defect.
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BACKGROUND: Many experiments indicate that the angiogenesis of tissue engineered bone graft plays a key role in the osteogenesis.OBJECTIVE: An experimental pattern was set up designed to prepare a kind of vascularized engineered-bone graft for repairing rhesus tibia defects and analyze the relation of angiogenesis and osteogenesis in vivo by rontgenographic and morphological approaches.DESIGN: Random controlled animal experiment.SETTING: Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University.MATERIALS: The composite graft was constructed by seeding the induced bone marrow stem cells (BMSCs) on to a beta-tricalcium phosphate(3-TCP) scaffold in vitro, a circular cylinder (20 mm × 8 mm diameter) with a slit (width 2 mm and length 3 mm ) open to both ends and slot. Porosity 60% and pore diameter 100-150 μm. Twenty-nine healthy rhesuses aged 4-5 years and weighted 3.5-5 kg were adopted without gender limitation.METHODS: The experiment was conducted in the Department of Orthopaedics and Traumatology, Nanfan Hospital, Southern Medical University from October 2003 to July 2005. ①Bone-periosteum defect of 20 mm was made in the middle part of right tibia of the 27 rhesuses, and randomly divided into 3 groups equally. ②The defect gaps in fascia-blood vessel group (A) were plugged with in vitro engineered composites constructed by bone marrow stem cells and 3-TCP scaffold, which were totally hugged by a sheet of pedicled deep fascia and additionally a corresponding portion of saphenous artery and veins. The gaps in fascia group (B) and control group(C), however, were inserted with fascia-coated tissue engineered bone and tissue engineered bone only, respectively. Furthermore, two rhesuses without filling materials on the defect were picked up as blanks fixed by steel pins. ③The angiogenesis and osteogenesis for each treatment was assessed by radioactive imaging, roentgenographic analyses, blocking density and vaso-area image analysis at time intervals of 4, 8 and 12 weeks postoperative.MAIN OUTCOME MEASURE: The score of radioactive imaging,roentgenographic, morphological and vaso-area image analyses RESULTS: Totally 29 rhesuses were involved in the result analysis.① General observation of samples: In group A, all the surfaces of the implanted material and the central part were wholly wrapped up or replaced by bonelike tissues which were hard and could not be broken. And 2/3 materials had been absorbed; In group B and C, partial materials of the medial surface and the front were not coated or replaced by bonelike tissues, which could be broken with force, and 1/3 material had been absorbed.②Histological observation of scaffolds: With time passing, the scaffold materials were absorbed to different degrees in group A, B and C, among which, group A was most significant; Under the microscope, the implanted materials at 12 weeks were completely coated with the bonelike tissues, while the blood vessels structures in the materials were mostly alveoli alike and multi-braches. In group B, most of the materials at 12 weeks were wrapped up by the new bone, and few blood vessels could be seen in the center of the materials. In group C, the implanted materials at 12 weeks were slightly absorbed. The new bone and the vascular structures were both increased a little, but still very few.③Analyses of vaso-area: The vaso-areas of both central and peripheral parts in group A were significantly bigger than those of group B and C (P ＜ 0.05). Furthermore, it tended to increase with the time.④X-rays observation: At 12 weeks, group A's images presented obviously decreased density which was lower than that of the normal bone in individual areas and the continual bony callus manifested. Whereas group B and C's images showed slightly decreased density and the continual bony callus appeared on the sections. ⑤The roentgenographic scores of bone defects: The results indicates that the scores of group A was better than those of group B and C at 4, 8 and 12 weeks, respectively (P ＜ 0.05).CONCLUSION: ①This study shows that a feasible and effective angiogenesis approach of tissue engineered bone can accelerate osteogenesis in vivo. ②The absorption level is positively related to local angiogenesis.
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Objective To incestigate the fetures of cranial CT and MRI in the patients with hypertensive encephalopathy. Methods The CT and MRI findings of ten cases of hypertensive encephalopathy with the charge of CT,MRI appearance of FLAIR (fluid attenvated inversion-recovery), DWI(difussion weighted imaging),ADC(apparent diffusion coefficient) were analyzed retrospectively. Results Of ten patients,3 cases had abnormal finding in the cranial CT;10 cases had abnormal finding in the cranial MRI,the lesions were demonstrated as slightly hypointensity on T1WI and slightly hyperintensity on T2WI and remarkably hyperintensity on FLAIR,and iso or slightly hyperintensity on DWI,and remarkably hyperintensity on ADC.The lilateral parietal occipital lobes and cerebellar hemisphere and Brain Stem were the more common sites. Conclusions The only characteristric finding of hypertensive encephalopathy in MRI and CT imaging studies is vasogenic edema,especially in the subcortical white matter of the parietal and occipital lobes bilaterally,and cereballar hemisphere et al;especially FLAIR,DWI and ADC of MRI can be helpful for diagnosis and diffenential diagnosis,prognosis and curative effect of hypertensive encephalopathy.