ABSTRACT
Objective:To explore the association between body mass index (BMI) and the incidence of thyroid nodules, the clinical characteristics and efficacy evaluation of differentiated thyroid cancer (DTC), respectively.Methods:Clinical data of 1 375 healthy people (1 031 males, 344 females, age: (43.5±10.6) years) who underwent routine physical examination (PE) and 1 450 patients (490 males, 960 females, age: (44.3±12.4) years) with medium-high risk DTC in Tianjin Medical University General Hospital from April 2016 to July 2020 were analyzed retrospectively. PE and DTC patients were classified into underweight group (BMI<18.5 kg/m 2), normal weight group (18.5≤BMI<24.0 kg/m 2), overweight group (24.0≤BMI<28.0 kg/m 2) and obesity group (BMI≥28.0 kg/m 2) respectively. χ2 test was employed to analyze the relation between BMI and thyroid nodules (with/without), BMI and clinical characteristics and efficacy evaluation of DTC, respectively. Logistic regression analysis was used to analyze the independent risk factors for the occurrence of thyroid nodules and the aggressiveness of DTC. Results:Among PE, there were 779 cases with nodules, and 596 cases without nodules. Comparing with those without nodules, more overweight and obese were found in PE cases with nodules (42.1%(328/779) vs 37.2%(222/596), 24.5%(191/779) vs 20.5%(122/596); χ2=13.42, P=0.004). Higher risk of developing thyroid nodules was related with older age and lower thyroid stimulating hormone (TSH) level (odds ratio ( OR): 1.044, 0.919, 95% CI: 1.029-1.060, 0.845-0.999; P<0.001, P=0.046). People with high-risk nodules were more likely to be obese than those with intermediate and lower risk nodules (5/15 vs 24.3% (186/764); χ2=21.11, P<0.001). Among 1 450 DTC patients, comparing with patients with normal weight, patients in the overweight and obesity groups were more likely to have central regional lymph node metastasis ( OR: 1.418, 1.427, 95% CI: 1.075-1.870, 1.044-1.952; P values: 0.013, 0.026), and patients in obese group were with greater risk of lesions being bilateral ( OR=0.696, 95% CI: 0.519-0.934; P=0.016). BMI was not related with the efficacy evaluation of DTC ( χ2=9.13, P=0.425). Conclusions:The incidence of thyroid nodules in people with high BMI is higher. DTC patients with high BMI may have more aggressive incidence. But BMI has no correlation with the efficacy evaluation of DTC patients after treatment.
ABSTRACT
Objective:To study whether male was the risk factor for prognosis of patients with differentiated thyroid cancer (DTC) after 131I treatment based on propensity score matching (PSM) method. Methods:From April 2016 to January 2021, 1 677 patients (age: 11-84 (43.9±12.5) years) with DTC who underwent total thyroidectomy and received 131I treatment in Tianjin Medical University General Hospital were retrospectively enrolled and patients were divided into male group ( n=546) and female group ( n=1 131). The evaluation results of patients were divided into excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR) and structural incomplete response (SIR). Among them, ER and IDR were divided into good prognosis group, and BIR and SIR were divided into poor prognosis group. The PSM method was adopted to process all data to reduce the influence of data bias and confounding variables. χ2 test was used for data analysis. Multivariate logistic regression was used to analyze the risk factors affecting prognosis, and ROC curve was used to analyze the relationship between stimulated thyroglobulin (sTg) level and poor prognosis. Results:Before PSM, the proportion of male patients with poor prognosis was significantly higher than that of female patients (21.2%(116/546) vs 14.0%(158/1 131); χ2=17.53, P=0.001). After PSM, there was no difference in the proportion of poor prognosis between male and female groups (19.9%(107/537) vs 15.6%(84/537); χ2=5.43, P=0.143). Multivariate logistic regression analysis showed that male (odds radio ( OR)=1.439 (95% CI: 1.016-2.038), P=0.040), high T stage(T3+ T4 stage)( OR=1.816 (95% CI: 1.273-2.590), P=0.001), N1b stage ( OR=1.766 (95% CI: 1.233-2.530), P=0.002), M1 stage ( OR=9.833 (95% CI: 3.190-30.309), P<0.001) and sTg level ( OR=1.035 (95% CI: 1.029-1.042), P<0.001) were risk factors for poor prognosis before PSM, while high T stage (T3+ T4 stage)( OR=1.870 (95% CI: 1.212-2.886), P=0.005), M1 stage ( OR=8.993 (95% CI: 2.434-33.225), P=0.001), sTg level ( OR=1.040 (95% CI: 1.030-1.049), P<0.001) were still risk factors, and N1b stage ( OR=1.459 (95% CI: 0.938-2.270), P=0.094), male ( OR=1.383 (95% CI: 0.912-2.096), P=0.127) were no longer risk factors for poor prognosis after PSM. ROC curve analysis showed that the cut-off value of sTg was 10.25 μg/L, with the sensitivity of 81.0%(222/274) and the specificity of 84.2%(1 181/1 403). Conclusions:After reduction of selection bias by PSM, male is no longer a risk factor for prognosis after 131I treatment of DTC. In addition, high T stage(T3+ T4 stage), M1 stage and sTg≥10.25 μg/L were risk factors for poor prognosis.
ABSTRACT
Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.
ABSTRACT
Objective:To analyze the short-term effect of targeted drugs on quality of life in patients with radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC).Methods:From February 2020 to April 2022, 19 RAIR-DTC patients (10 males, 9 females; age (54.5±14.5) years) who received targeted drugs therapy (sorafenib, lenvatinib or anlotinib) in Tianjin Medical University General Hospital were prospectively enrolled. The thyroglobulin (Tg) levels prior and 1, 3, 6 months post the targeted treatment, and the adverse events were measured and recorded. Response evaluation criteria in solid tumors (RECIST) 1.1 version was used to evaluate the treatment response. The quality of life based on five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) was monitored prior and 3 months post the targeted treatment, and the prevalence rates of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression were analyzed, and the scores of health assessment were assessed. Paired t test, Kruskal-Wallis rank sum test and χ2 test were used to analyze data. Results:The prevalence rates of mobility (8/19), self-care (6/19), usual activities (10/19), pain/discomfort (10/19), and anxiety/depression (12/19) in 3 months post treatment were higher than those prior treatment (1/19, 1/19, 1/19, 2/19, 2/19; χ2 values: 4.38-11.31, all P<0.05). The score of health assessment prior treatment was (84.37±6.25), which was higher than that at 3 months post treatment (71.63±9.14; t=5.02, P=0.001). After targeted treatment, 10 patients were with skin toxicity, 8 patients were with hypertension, 8 patients were with weight loss, 7 patients were with diarrhea, 6 patients were with fatigue, 5 patients were with hepatic dysfunction, 2 patients were with proteinuria, 2 patients were with muscle pain and 1 patient was with oral ulcer. Of 19 patients, 17 insisted on continuing treatment, and the other two stopped treatment. The Tg levels at 1, 3 and 6 months post treatment were 56.26(44.60, 210.50), 53.36(41.25, 203.07) and 54.35(34.71, 223.52) mg/L, respectively, which were lower than the level prior treatment with no significant difference (110.16(49.63, 294.50) mg/L; H=2.42, P=0.490). After 3 months of targeted treatment, the progression-free survival (PFS) rate was 16/17, including 7 patients with partial response (PR), 9 patients with stable disease (SD), and 1 patient with progression of disease (PD). After 6 months of targeted treatment, the PFS rate was 10/17, including 5 patients with PR, 5 patients with SD, and 7 patients with PD. Conclusion:After 3-6 months of targeted treatment, the tumor markers of most patients are decreased with metastases improved, but the adverse events of targeted drugs have a great impact on quality of life in patients with RAIR-DTC.
ABSTRACT
Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.
ABSTRACT
Objective:To analyze the trends and influencing factors of residual radioactivity in patients with differentiated thyroid carcinoma (DTC) after 131I therapy. Methods:A total of 132 DTC patients (34 males, 98 females; age (42.8±12.8) years) who received 131I therapy from November 2018 to February 2019 in Tianjin Medical University General Hospital were prospectively analyzed. Patients were divided into first treatment (FT) group ( n=88) and repeat treatment (RT; with 131I treatment≥2 times) group ( n=44). In FT group, there were 30 patients received 131I for remnant ablation, 33 patients for adjuvant therapy and 25 patients for therapy. In RT group, there were 18 patients received 131I for remnant ablation and 26 patients for therapy. 131I dosage: 3.70 GBq for remnant ablation therapy, 3.70-5.55 GBq for adjuvant therapy, 5.55-7.40 GBq for therapy. The residual body radioactivity of patients was monitored at 24, 48 and 72 h after the administration of 131I by dynamic radiation whole-body scanner and compared among groups. All clinical data were reviewed to explore the factors associated with the residual radioactivity. Independent-sample t test, χ2 test and logistic regression analysis were used to analyze the data. Results:At 24 h after 131I therapy, the residual radioactivity of patients in FT group were significantly lower than those in RT group ((880.60±396.64) vs (1 022.31±503.94) MBq; t=-2.765, P=0.035). In FT group, the residual radioactivity of patients with 131I adjuvant therapy+ therapy at 24 and 48 h after 131I administration were higher than those with 131I ablation (24 h: (987.16±447.33) vs (766.27±277.87) MBq, 48 h: (233.47±146.52) vs (183.52±90.65) MBq; t values: -2.711 and -2.021, both P<0.05). In RT group, the residual radioactivity of patients with 131I therapy at 24, 48 and 72 h after 131I administration were (1 246.90±531.69), (244.57±131.35) and (90.65±67.37) MBq respectively, which were higher than those with 131I ablation ((715.50±300.07), (149.85±68.82) and (58.46±31.45) MBq; t values: from -3.822 to -2.682, all P<0.05). There were 17.4%(23/132; 10 patients in FT group, 13 patients in RT group) patients with residual radioactivity >400 MBq at 48 h after 131I treatment, and 100% (132/132) patients with residual radioactivity <400 MBq at 72 h after 131I treatment. T staging, N staging, stimulated thyroglobulin level, and 131I dosage were significant factors affecting the residual radioactivity of patients ( t values: from -2.562 to 4.211, χ2 values: 3.988-8.332, all P<0.05), and T staging and 131I dosage were independent factors ( Walds values: 4.253-14.035, all P<0.05). Conclusions:The residual radioactivity of patients at 24 h after 131I treatments is higher than 400 MBq and hospital isolation time should be appropriately controlled. At 72 h after 131I treatment, the residual radioactivity of patients meets the national standard of discharging hospital. The residual radioactivity of patients with more advanced T staging and 131I dosage (>5.55 GBq) may not reach the standard at 48 h after 131I therapy, and the isolation time should be extended to 72 h.
ABSTRACT
Objective To explore the clinical effectiveness and reliability of combined acetabular quadrilateral surface plates for the treatment of both column fractures.Methods From June 2016 to August 2017,data of 15 cases with acetabular both column fractures who were treated in our department were retrospectively analyzed.Among them 9 cases were male and 6 were female.The mean age was 42.8 years (range,26-68 years).All cases were both column fractures according to the LetournelJudet's classification,including 4 cases combined with posterior wall fracture.Before operation,the pelvic CT thin layer scanning data of patients were collected in DICOM format,and then the data were imported to print the simulated model by 3D printing technology in order to understand the characteristics of fracture directly.The contralateral half pelvis was mirror printed in order to simulate the placement of combined quadrilateral surface plates and preshape all plates.During operation,infrapectineal main plate,pubo-ischiatic plate and ilio-ischiatic plate were placed consequently to fix the anterior column,"middle column" and posterior column respectively.The pubo-ischiatic and ilio-ischiatic plates were combined with the main plate.All cases were operated by supra-ilioinguinal approach.Results The average incision length was 11 cm (range,9-13 cm).The average operative time was 150 min (range,100-240 min).The average blood loss was 850 ml (range,600-1500 ml).Once reduction was obtained,plates could be placed easily and adhere to bone surface well.The quality of postoperative fracture reduction was evaluated according to Matta standard,of which there were 9 cases excellent,4 cases good,and 2 cases poor,with an excellent rate of 86.7％ (13/15).All patients were followed up for an average time of 10 months (range,6-12 months).At the latest follow-up,the average modified Merle d'Aubigne and Postel score was 16.4 (range,12-18),and there were 8 cases excellent,4 cases good,2 cases fair and 1 case poor,with an excellent rate of 80.0％ (12/15).Conclusion For the treatment of acetabular both column fractures,the combined quadrilateral surface plates could resist the medial displacement of quadrilateral area,and on the other hand the total floating posterior column and ischium could be fixed firmly.At the same time,this plate system is a multi-dimensional framework fixation,which is more effective and safer with lower complications rate,resulting in a satisfactory clinical outcomes.
ABSTRACT
Objective To investigate the clinical outcomes in the treatment of complex acetabular fractures through a single supra-ilioinguinal approach after the application of preoperative 3D printing and rapid prototyping simulating the operative procedure.Methods From January 2013 to January 2016,24 cases of complex pelvic and acetabular fractures in our hospital were retrospectively analyzed.Among them 18 cases were male and 6 were female.The average age was 39.2+±13.8 years (range,24-68 years).According to Letoumel-Judet's classification,there were 6 cases of transverse,4 cases of T shaped,4 cases of combined anterior column and posterior hemi-transverse (ACPHT) and 10 cases of 2-column fractures.The time from injured to operation averaged 9 days (range,4-18 days).Before operation,pelvic AP view,three-dimensional CT as well as CTA of iliac blood vessels was taken routinely in all cases.The CT and CTA scan data were then imported into Mimics software for 3D reconstruction.Surgical simulation and optimal placement of internal fixations were performed on computer.After that,the individual simulated model of the pelvis was printed by the use of 3D printing and rapid prototyping technique.The order of reduction,selection and optimal position of the implants were determined.The plates were bent before operation and the length and direction of the screws were recorded.A uniform supra-ilioinguinal approach was used in all cases.Results The length of incision averaged 9 cm (range,8-13 cm).The operative time average 130 min (range,90-220 min).The blood loss averaged 600 ml (range,300-1 500 ml).Once a satisfactory reduction was obtained,single placement of the plates was achieved.In accordance with the preoperative plan,the plates were perfectly fitted to the bone surface.The 24 patients were followed for an average time of 18.3 months (range,15-30 months).The fractures healed in all cases.The average healing time was 4.2 months (range,3-6 months).According to Matta criteria,there were 16 cases of excellent,6 cases of good,2 cases of poor and the excellent rate was 91.7％ (22/24).The average modified Merle d'Aubigne score was 16.5 (range,13-18).The functional outcome was excellent in 13 cases,good in 6 cases and poor in 5 cases.The excellent rate of hip functions was 79.2％ (19/24).There were 2 cases of femoral lateral cutaneous nerve injury (recovered one month later) and another 1 case of fat liquefaction of the incision happened three days postoperatively (the wound healed completely after several dressing changes).No inguinal hernia or abdominal wall hemias was found.No other postoperative complications was found.Conclusion The application of 3D printing and rapid prototyping technique allows preoperatively simulating reduction in vitro,determining the optimal position of the implants,bending the plates and measuring the length of the screws in advance,which could largely reduce the operative time,intraoperative blood loss and occurrence of postoperative complications.Adopting supra-ilioinguinal approach for the treatment of complex acetabular fractures with a small incision and less trauma,a full exposure could be obtained,so the reduction and fixation of the anterior,posterior and middle column (also named pubo-ischiatic column) could be completed in a direct visualization,resulting in a satisfactory clinical outcomes.
ABSTRACT
Objective To investigate the effect of autologous platelet rich plasma along with bone transportation in tibia defect.Methods This was a randomized single-blind placebo controlled clinical trial.From Jan 2013 to Mar 2015,28 patients (28 cases) suffering from tibia defect because of trauma or osteomyelitis were randomly assigned to PRP group (PRP along with bone transportation,n=15) or bone transportation group (bone transportation only,n=13) through random number table and sealed envelop method.PRP group:male to female 12∶3,average age:40.9 years old,average bone defect:7.1 cm,6 caused by trauma,9 by osteomyelitis;while bone transportation group:male to female 10∶3,average age:37.7 years old,average bone defect:6.5 cm,3 caused by trauma and 10 by osteomyelitis.Bony results and tibia function were evaluated according to the Association of the Study and Application of the Method of Ilizarov (ASAMI) protocol.The external fixation index,complications and VAS pain score were also evaluated.Results The mean follow-up time was 21.8 m in PRP group and 23.2 m in bone transportation group and there were no loss to follow-up.There were no differences between two groups on postoperative VAS pain score:1st d postoperative (3.33±2.58 vs 4.46±2.73);7th d postoperative (2.67±2.09 vs 3.00±2.20);and 2 weeks postoperative (1.46± 1.77 vs 2.62±2.72).There was significant difference between two groups on external fixation index (37.9±7.7 d/cm vs 46.9± 13.7 d/cm).According to the ASAMI protocol,all patients achieve bone union,except 2 cases in control group which need revision surgery;excellent and good rate of bone defect union was 93％ in PRP group while 77％ in control group;while no difference was found on complication and lower extremity function.Conclusion Application of PRP along with bone transportation in the treatment of tibia defect resuits in shorter healing duration and external fixation duration.But no short-term postoperative analgesic effect,lower extremity function,and complication rates were found.
ABSTRACT
Objective To investigate the biological effects of internal radiation and therapeutic effectiveness of 131I-labeled anti-epidermal growth factor receptor (EGFR) in colorectal cancer of model mice.Methods Nano-liposome characterized for EGFR-targeting was constructed.The efficacy of cellular binding and uptake of the liposome was evaluated by the analysis of confocal microscopy observation and the iodide uptake assay.After intra-tumor injections of 74 MBq (740 MBq/ml) 131 I-antiEGFR-BSA-PCL,131 I-BSA-PCL,131 I or an equivalent volume of normal saline.The biological effects of internal irradiation and therapeutic efficacy of the liposomes on colorectal cancer modeled in a male BALB/c mouse were evaluated by means of tumor size,body weight,histopathology,and SPECT imaging.Results The confocal fluorescence images showed that the antiEGFR-BSA-PCL was successfully internalized into LS180 cells.The 131I uptake efficacy of 131I-antiEGFR-BSA-PCL was significantly higher than that of 131I-BSA-PCL in LS180 cells (t =2.77-5.40,P ＜ 0.01).Tumor size measurement showed that tumor growth was inhibited by the treatment with 131 I-EGFR-BSA-PCL and 131I-BSA-PCL,but had no significant differences between these two groups (P ＞0.05).It was found that the 131I-antiEGFR-BSA-PCL was markedly taken up by the tumor and reac hed its uptake value of (21.61 ± 1.0 1) and (20.58 ± 0.65)％ ID/g at 72 h following drug injection,which was higher than the uptake value of 131 I (t =9.36,8.69,P ＜ 0.01).SPECT imaging assay showed that,after being injected into mouse tumor,the 131 I-EGFR-BSA-PCL and 131I-BSA-PCL were uniformly distributed inside the tumor.Conclusions 131 I-antiEGFR-BSA-PCL obviously suppresses the development of colorectal cancer in mice.
ABSTRACT
Objective To construct 131 I labeled anti?EGFR immunoliposome nanoparticle ( 131 I?Cetuaximab ( C225)?BSA?PCL) , and investigate its inhibitory effect on EGFR?overexpressing cancer cells in vitro. Methods Anti?EGFR liposome nanoparticle C225?BSA?PCL and non?targeted liposomes BSA?PCL were constructed. The products were observed with transmission electron microscopy and dynamic light scat?tering. The EGFR?targeted binding and cellular uptake in EGFR?overexpressing cancer cells were observed with flow cytometry and confocal microscopy. Anti?EGFR and non?targeted liposomes were labeled with 131 I using the chloramine?T method. The targeted cell killing effects of 131 I labeled liposomes were analyzed using MTT assay. The time?dependent cellular uptake analysis was used to evaluate the slow?release effects of the 131 I labeled liposomes. The independent?samples t test was used for data analysis. Results The EG?FR?targeted liposome C225?BSA?PCL and non?targeted liposome BSA?PCL were successfully constructed, and the effective diameters were approximately 130-180 nm. Flow cytometry and confocal microscopy re?vealed significant uptake of C225?BSA?PCL in EGFR?overexpressing tumor cells. BSA?PCL could also bind to cells with minimal and weak tumor retention. The EGFR?targeted radioactive liposome 131I?C225?BSA?PCL showed greater targeted cell killing effect than non?targeted liposome 131I?BSA?PCL,the IC50 values of 131I?C225?BSA?PCL and 131 I?BSA?PCL were 0. 03-1. 32 and 0. 25-12. 19, respectively. The uptakes of 131 I?C225?BSA?PCL was higher than that of 131 I?BSA?PCL ( t=3.03-16.86, all P<0.05) and reached the maxi?mal level at 4 h after incubation. Conclusions The EGFR?targeted liposome C225?BSA?PCL demonstrated superior cellular binding and uptake on EGFR?overexpressing cancer cells compared with BSA?PCL. The EGFR?targeted radioactive liposome 131 I?C225?BSA?PCL had favorable intracellular retention and excellent targeted cell killing effect, and could effectively suppress the growth of EGFR?overexpressing cancer cells.
ABSTRACT
Objective To investigate the effect of the percutaneous autologous bone marrow stem cell transplantation for the treatment of nonunion of tibial fracture. Methods From 2007 to 2011,the data of 11 patients with tibial nonunion who received autologous bone marrow stem cell transplantation was analyzed retrospectively. Taking bone marrow,examine,isolation,cultivation and expansion marrow mesenchymal stem cells( MSCs) ,and then marrow needle was inserted into the site of the nonunion under the X-ray,the MSCs were injected into the site of nonunion. Compression bandage was applied after operation. X-rays following-up were reviewed. Results All 11 patients were followed up from 4~27 months,with average of 13 months,X-ray showed:fracture healed well,no adverse events happen. Conclusion Satisfactory out-come can be obtained by percutaneous autologous bone marrow stem cell transplantation in treatment of tibial nonunion. Clinical application value is high,especially to patients who had suffered from severe skin and soft tissue injury with keloids healed.