Surgical treatment for perihilar cholangiocarcinoma:a single-center experience / 中华外科杂志

Objective: To investigate surgical strategies and the corresponding benefits for patients with perihilar cholangiocarcinoma(pCCA). Methods: A total of 81 patients with pCCA who underwent radical excision in the Department of Biliary and Pancreatic Surgery of Sun Yat-Sen Memorial Hospital between January 2014 and December 2021 were retrospectively collected.The cohort consisted of 50 male and 31 female patients,with an age of (62.5±11.5)years(range:26 to 83 years).Seventy-five cases were diagnosed with jaundice,60 of whom received preoperative biliary drainage,while 20 patients received portal vein embolization.Their serum bilirubin level within one week before the operation(M(IQR)) was 44.3 (41.9) μmol/L(range:8.0 to 344.2 μmol/L).Preoperative imaging examinations were performed to evaluate the Bismuth-Corlette type of pCCA,showing 3,6,21,27,and 24 cases of Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb,and Ⅳ,respectively.The primary outcome was overall survival (OS),and the secondary outcomes were relapse-free survival (RFS),90-day postoperative morbidity and 90-day postoperative mortality.OS and RFS were estimated using the Kaplan-Meier method and compared by the Log-rank test.Significant prognostic factors were determined using univariate and multivariable Cox proportional hazard regression analyses. Results: In the cohort of 81 pCCA patients,67 cases(82.7%) underwent major hepatectomy while 3 cases received major hepatectomy combined with pancreaticoduodenectomy.Thirty-four patients underwent hepatectomy combined with vascular resection and reconstruction(18 cases of portal vein resection and reconstruction alone;9 cases of hepatic artery resection and reconstruction alone;7 cases of combination of portal vein and hepatic artery resection and reconstruction).Margin negative(R0 excision) were achieved in 53.1%(43/81) of these patients.The operation duration was (627±136)minutes(range:565 to 940 minutes),and the intraoperative blood loss was 400(455)ml(range:200 to 2 800 ml).The 90-day postoperative mortality was 3.7%(3/81).Grade 3-4 postoperative morbidity was 23.4% (19/81) according to the Clavien-Dindo classification of surgical complications.Up to the last follow-up at September 2022,the follow-up time was 34.0(24.2)months (range:0.4 to 103.6 months).Three patients who died within 90 days after surgery were excluded from the survival analysis.The median OS was 36.10 months (95%CI:18.23 to 42.97 months) and the 1-,3-and 5-year OS rates were 85.3%,46.8% and 27.3%,respectively.The median OS of 41 patients with negative margins was 47.83 months(95%CI:36.90 to 58.80 months) and that of 37 patients with positive margins was 20.47 months(95%CI:10.52 to 30.58 months).The median RFS of 70 patients with R0 and R1 resection was 24.50 months(95%CI:12.15 to 31.85 months)and the 1-,3-and 5-year RFS rates were 65.2%,45.7% and 29.9%,respectively.The median RFS of 41 patients with R0 resection was 38.57 months(95%CI:21.50 to 55.63 months) and that of 29 patients with R1 resection was 10.83 months(95%CI:2.82 to 19.86 months). Conclusions: The primary therapy for pCCA is radical surgical resection.A precise preoperative evaluation and sufficient preparation can reduce postoperative morbidity.Surgical treatment can achieve a better survival outcome by increasing the radical resection rate.

Protective effect and mechanism of AKAP1 on myocardial injury induced by highland hypobaric hypoxia / 中华劳动卫生职业病杂志

Objective: To investigate the protective effect and its possible mechanism of A-kinase anchored protein 1 (AKAP1) on the myocardial injury induced by highland hypobaric hypoxia. Methods: From January 2021 to May 2022, male C57BL/6 SPF grade mice were divided into wild type control (WT) group and highland hypobaric hypoxia (HH) group with 6 mice in each group. HH group simulated 6000 m altitude with low pressure oxygen chamber for 4 weeks to build the model. Primary myocardial cells of SD rats were divided into normoxia control group and hypoxia experimental group (n=3). Cell models were constructed in a three-gas hypoxia incubator with 1% oxygen concentration for 24 h. AKAP1 protein and mRNA expression in myocardial tissue and cells were detected by western blotting, immunohistochemistry and quantitative real-time polymerase chain reaction (qPCR). After myocardial point injection of the AKAP1 or the control adenovirus, the mice were divided into 3 groups (n=6) : WT group, highland hypobaric hypoxia overexpression control group (HH+Ad-Ctrl group) and highland hypobaric hypoxia overexpression experimental group (HH+Ad-AKAP1 group). The cardiac function of mice was detected by noninvasive M-type ultrasonic cardiomotive, myocardial fibrosis was detected by Masson and Sirius Red staining, and cardiomyocyte hypertrophy was detected by wheat germ agglutinin. After the expression of AKAP1 in primary cardiomyocytes was downregulated by siRNA and upregulated by adenovirus, the cells were divided into three groups (n=3) : normoxia control group, hypoxia interference control group (hypoxia+siCtrl group), hypoxia AKAP1 knockdown group (hypoxia+siAKAP1 group) ; normoxia control group, hypoxia overexpression control group (hypoxia+Ad-Ctrl group), hypoxia AKAP1 overexpression group (hypoxia+Ad-AKAP1 group). Apoptosis was detected by flow cytometry, AKAP1, apoptosis-related protein and mRNA expression levels were detected by western blotting and qPCR, mitochondrial membrane potential was detected by JC-1 staining, and mitochondrial reactive oxygen specie (ROS) level was detected by MitoSOX. Results: The expression of AKAP1 in cardiac muscle of HH group was lower than that in the WT group, and the expression of AKAP1 in hypoxia experimental group was lower than that in normoxia control group (P<0.01). Compared with WT group, the left ventricular ejection fraction and fraction shortening of left ventricle in HH+Ad-Ctrl group were decreased (P<0.01), myocardial fibrosis and hypertrophy were aggravated (P<0.01), and the expression of B-cell lymphoma-2 (BCL-2) was decreased, the expressions of BCL-2-associated X protein (BAX), Caspase 3 and Caspase 9 were increased (P<0.01). After AKAP1 overexpression, compared with HH+Ad-Ctrl group, the left ventricular ejection fraction and left ventricular fraction shortening were increased in HH+Ad-AKAP1 group (P<0.01), myocardial fibrosis and hypertrophy were reduced (P<0.01), and the expression of BCL-2 was increased, the expressions of BAX, Caspase 3 and Caspase 9 were decreased (P<0.01). Compared with normoxia control group, the expression of BCL-2 in hypoxia+siCtrl group was decreased, the expressions of BAX, Caspase 3, Caspase 9 were increased, the apoptosis level was increased (P<0.01), the mitochondrial membrane potential was decreased and the production of ROS was increased (P<0.01). After AKAP1 knockdown, compared with hypoxia+siCtrl group, the expression of BCL-2 in hypoxia+siAKAP1 group was decreased, the expressions of BAX, Caspase 3, Caspase 9 were increased, the apoptosis level was increased (P<0.01), mitochondrial membrane potential was decreased, and the production of ROS was increased (P<0.01). After AKAP1 overexpression, compared with hypoxia+Ad-Ctrl group, the expression of BCL-2 in hypoxia+Ad-AKAP1 group was increased, the expressions of BAX, Caspase 3 and Caspase 9 were decreased (P<0.05), the apoptosis level was decreased (P<0.01), and the mitochondrial membrane potential was enhanced, and the production of ROS was decreased (P<0.01) . Conclusion: The downregulation of AKAP1 in cardiomyocytes under highland hypobaric hypoxia may lead to the decrease of mitochondrial membrane potential and the increase of ROS generation, leading to the apoptosis of cardiomyocytes, and thus aggravating the myocardial injury at highland hypobaric hypoxia.

α-Mangostin regulates the proliferation and apoptosis of osteoarthritis chondrocytes / 中成药

AIM To analyze the effects of α-mangostin on the proliferation and apoptosis of osteoarthritis (OA) chondrocytes.METHODS Human OA chondrocytes were isolated and then treated with 5,10 or 20 μmol/L α-mangostin.24,48 or 72 h after the treatment,the cell proliferation was measured by MTT assay,and the cell apoptosis was detected by flow cytometry.The expression check on MMP-1,MMP-3,MMP-13,PPARγ,PPARδ,PGC-lα and TNF-α was accomplished by Western blot.The contents of collagen-Ⅱ,PG,IL-1β and IL-6 were tested by ELISA.RESULTS α-Mangostin significantly induced cell proliferation and suppressed cell apoptosis,and it significantly increased the production of collagen-Ⅱ and PG,decreased the expressions of MMP-1,MMP-3 and MMP-13,induced the expressions of PPARγ,PPARδ and PGC-1α,and decreased the expression of TNF-α.Furthermore,α-mangostin significantly inhibited the production of IL-1β and IL-6.CONCLUSION α-Mangostin attenuates the destruction and degradation of cartilago articularis by inducing OA chondrocytes proliferation,inhibiting cell apoptosis and inflammation,and increasing expressions of PPARγand PPARδ.

Treatment of proximal humerus fractures combined with shoulder dislocation using bone setting manipulation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the treatment skill and clinical effect of bone setting manipulation in treating proximal humeral fracture with shoulder dislocation.</p><p><b>METHODS</b>From January 2015 to December 2015, 118 cases of proximal humeral fractures with shoulder joint dislocation were treated by bone setting reduction and fixation with adhesive tape or Kirschner wire after reduction, including 56 males and 62 females with an average age of 61 years old ranging from 48 to 88 years old. The time from injury to treatment was 1 to 31 days with an average of 3 days. All fractures were closed, according to Neer standard classification, there were 27 cases of type II, 55 cases of type III and 36 cases of type IV. There were 85 cases of shoulder subglenoid dislocation, 33 cases of subcoracoid dislocation. All the patients were accompanied by obvious shoulder joint deformity, dysfunction and other symptoms. All cases were diagnosed by X-ray examination, and the bone setting manipulation was performed under the brachial plexus anesthesia. According to the type of fracture and fixation method, the patients were encouraged to exercise the limb rehabilitation, and the curative effect was determined by Constant-Murley shoulder score system.</p><p><b>RESULTS</b>All cases were followed up for 6 to 12 months with an average of 9 months. There were 1 case of humeral head necrosis, 2 cases of traumatic frozen shoulder. The score of shoulder joint function Constant-Murley was 84.5±4.5; among them, 78 cases were excellent, 28 cases were good, 9 cases were fair, 3 cases were poor, the excellent and the good rate was 89.8%. X-ray showed bony union of all cases.</p><p><b>CONCLUSIONS</b>The treatment of proximal humeral fracture with dislocation of shoulder joint by bone setting manipulation is a skillful method, with simple operation, small trauma and satisfactory curative effect.</p>

Sarpogrelate hydrochloride in the treatment of chronic arterial ischemia of the lower extremities / 中华普通外科杂志

Objective To evaluate the clinical efficacy of oral Sarpogrelate hydrochloride in the treatment of chronic arterial ischemia of the lower extremities.Methods In this study 892 patients,who suffered from arteriosclerosis (ASO) or thromboangiitis obliterans ( TAO ) or diabetic foot ( DF ),with symptoms of intermittent claudication, sensation of cold, pain, ulcer, and without a history of vasotransplantation or bypass grafting or interventional therapy, were treated by taking Sarpogrelate hydrochloride tablets 100 mg tid for consecutive 8 weeks.The improvement rate of concomitant symptoms and the total effective rate of ASO, TAO, DF were evaluated.Drug adverse reaction were recorded.Results The improvement rate of intermittent claudication,sensation of cold,pain and ulcer were 96.9％,97.1％,89.0％ and 86.9％ respectively.The total effective rate for ASO,TAO,DF was 83.5％.A total of 81 cases (9.1％) reported mild side effects,including 7 patients with mild rash after 2- 5 days' medication,21 patients with mild nausea and 53 patients with stomach discomfort after 1 - 2 days' medication.Symptoms were managed conservatively without discontinuing taking sarpogrelate hydrochloride.Conclusions Sarpogrelate hydrochloride oral is a safe and effective therapy for chronic arterial ischemia diseases of the lower extremities.

Study on lower He-sea points / 中国针灸

The development of the theory of lower He-sea points is analyzed, and the indication law of acupoints as well as its significance on understanding of meridians are discussed in this article. It is concluded that the application experiences of Zusanli (ST 36) has great significance to the recognition of major points for diseases of fu organs. However, it is held that the relationship between the major indications of Xiajuxu (ST 39) and the relation between Weiyang (BL 39) and Sanjiao are not the complete embodiment of application experiences. There is a precedence relationship between the formation consequence of the five-shu points and the lower He-sea points, which concerning the formation of the concept that He-sea points can treat diseases of their corresponding fu organs and the incomplete theory of the lower He-sea points. The formation of the theory of lower He-sea points also indicates the change of recognition of the relation between yang meridians and internal organs. Therefore, it is held that the relation between meridians and internal organs as well as the indication law of acupoints can be studied on the base of the above theory.

Effect of aluminum on Ca²+ concentration and expression of phospholipase C and NMDA receptor α genes in hippocampus of weaning rats as well as their neural behavior through subchronic exposure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To estimate the effect of aluminum on hippocampal intracellular Ca²+ concentration and expression of phospholipase C (PLC) and NMDA receptor α (NMDARα) genes in hippocampus as well as the neural behaviors in weaning rats through subchronic exposure in order to explore the mechanism which aluminum impaired the ability of learning and memory of central nervous system development.</p><p><b>METHODS</b>Weaning Wistar rats were randomly divided into four groups based on their body weight. Aluminium chloride was administered by water at the doses of 0.2%, 0.4% and 0.6% (m/v) for 90 days. Platform experiment was used to detect the activity of learning and memory. Fura-2/AM calcium ions fluorescence indicator was used to measure Ca²+ concentration in hippocampal neurons. Western blot method was used to detect the expressions of PLC and NMDARα genes.</p><p><b>RESULTS</b>The incubation of rats in platform experiment [(232.20 ± 57.45), (35.00 ± 9.37), (16.10 ± 5.57) s] shortened while increase of mistake times (1.10 ± 0.74, 2.20 ± 0.92, 3.40 ± 1.51) was significantly associated with the dose of aluminum (P < 0.01). The Ca(2+) concentration decreased significantly in the rats of aluminum exposed groups (P < 0.01). The expression of PLC and NMDARα in aluminum exposed groups (0.30 ± 0.06, 0.18 ± 0.04, 0.16 ± 0.03; 0.38 ± 0.03, 0.32 ± 0.02, 0.25 ± 0.02) decreased significantly compared with that in the control group (0.47 ± 0.07, 0.48 ± 0.04) (P < 0.01) and there was a dose-effect relationship in the NMDARα expression.</p><p><b>CONCLUSION</b>Subchronic exposure of aluminium could impair the ability of learning and memory in rats during development, inhibit the expression of NMDARα and PLC and reduce Ca²+ concentration, suggesting that the disorder of Ca²+ signaling system might be one of mechanisms of aluminium damaging the ability of learning and memory.</p>

Concept and terminology study on Xiahe points (lower confluent point) / 中国针灸

The six points on the foot yang channels with the main indications of disorders of six fu organs are named as he points in ancient time, while as Xiahe points in modern times. Both of the names share the Chinese character of He, which confounded with He (sea) point of the five shu points. The related ancient literatures, modern compiled textbooks and dictionaries are studied, and the original meaning and paraphrase of the name are analyzed so as to make clear the concept of the so-called Xiahe points and standardized its name. And it is held that the terminology of Xiahe points is inappropriate with the definition unclear and the concept indistinct. In the Internal classic, Xiahe points is also named as he points following the He (sea) points of the five shu points, and there was no proper name for the points at that time. The meaning of "he" in Xiahe points are different from the meaning of "He" in He (sea) points. And the article proposes that Xiahe points should be replaced as Liu fu Xiashu (lower shu points of six fu organs) or redefined with other names.

Four seasons acupuncture and Five Shu Points / 中国针灸

The method of four seasons acupuncture was initially recorded in the Internal Classic. It has the important meaning for understanding the contents of acupoints, especially the Five Shu Points. Its original meaning is that the place of acupuncture is difference on each season in order to cooperate with the both qi from the depth of acupuncture and four seasons. Through the interpretation from different aspects, the depth of qi is mainly considered as layer location and further considered as acupoints, and then gradually formed the principle of using the Five Shu Points. Following this way, we could correctly understand the contents of the Five Shu Points.

On two modes of channel theories / 中国针灸

In the present paper the authors explore the differences in both theoretical and clinical significance between centripetal mode and cyclical mode which are the two modes of channel theories presented successively, from the following factors: (1) The centripetal mode focus on the regularity in the distant effects of acupoints on four limbs and embodies the primary meaning of hand-foot meridians, the cyclical mode explains qi-blood circulation mode and reflects the TCM knowledge of the principle of the coordination from structure and function of the whole body; (2) Most formation of channels and acupoints is based on the centripetal mode in stead of the cyclical mode; (3) The key reasons resulted in the major academic mistake in current research on channel knowledge are unknown or confusion of the different channel mode, under illusion about the cyclical mode is the subject or representative of channel theory and explaining or research on channels and acupoints within the framework of the cyclical mode of channels theory.

Association between RsaI and AluI polymorphism in the estrogen receptor beta gene and primary hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether there is a association between estrogen receptor beta (ERb) gene polymorphism and primary hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>100 primary HCC patients and 100 controls from southwestern China were recruited in this study. The polymorphism of RsaI and AluI in ERb gene was analyzed by PCR- restriction fragment length polymorphism (RFLP).</p><p><b>RESULTS</b>R allelic frequency was 35.0% and 51.0% in HCC patients and in control group, respectively, odds ratio (OR) was 0.517 [95% confidence intervals (CI) = 0.346-0.773], P less than 0.01. A allelic frequency was 20.5% and 11.0% in HCC patients and in control group, respectively, OR was 2.086 (95% CI = 1.191-3.654), P less than 0.01. Gene frequency of RsaI and AluI in the two groups was distributed with polymorphism.</p><p><b>CONCLUSION</b>ERb gene polymorphism is associated with primary liver cancer. R allele may be the guard factor, and A allele may be its risk factor.</p>

Randomized and controlled clinical study of modified prescriptions of Simiao Pill in the treatment of acute gouty arthritis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the compatibility of a modified prescription of Simiao Pill in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial.</p><p><b>METHODS</b>A randomized and controlled clinical trial was designed based on clinical epidemiological principles. A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group (Group I) included 27 patients taking gout prescription I; the second group (Group II) included 27 patients taking gout prescription II; the third group (Group III) included 28 patients taking gout prescription III; and the fourth group (control group) included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured.</p><p><b>RESULTS</b>The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%, significantly superior to that of the control group (68%, P<0.05). In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences (P<0.05). Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group III (P<0.05). There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen.</p><p><b>CONCLUSION</b>The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The patients had good compliance with less adverse reactions noted. The modified prescription has a favorable prospect for future development and is worthy of further blind trials with larger samples.</p>

Effect of vitamin E and fructose 1,6-diphosphate on lipid peroxidation in erythrocytes during artificial total knee replacement / 中国组织工程研究

BACKGROUND:Recent studies have demonstrated that surgical trauma leads to lipid peroxidation in erythrocytes.However,injured erythrocytes play an important role in thrombosis following replacement.OBJECTIVE:To evaluate the influence of artificial total knee replacement on the lipid peroxdation in erythrocytes,and the prophylactic treatment of vitamin E and fructose 1,6 diphosphate(FDP)on it.DESIGN,TIME AND SETTING:Contrast clinical study,which was carried out in the Department of Otthopaedics,Affiliated Hospital of Nantong University from January 2003 to June 2006.PARTICIPANTS:Sixty patients with knee osteoarthritis who underwent artificial total knee replacement by anesthesia of epidural block were divided into four groups,including control group,vitamin E group,FDP group and vitamin E+FDP group,with 15 cases in each group.METHODS:Vitamin E was orally taken in the vitamin E group three days before replacement,three times a day,100 mg for each.The administration was performed until the surgical morning.Thirty minutes after the operation,FDP(10 g)was intravenously dripped in the FDP group.Additionally.vitamin E was also orally taken in the vitamin E+FDP group three days before replacement,three times a day,100 mg for each;on the surgical morning,FDP(10 g)was intravenously dripped on the first 30minutes.Blood samples were taken for biochemical determination before and after the operation at 1,3,5,and 7 days.MAIN OUTCOME M[EASURES:Corltents of malonaldehyde(MDA)and cuprum/zincum/superoxide dismutase (Cu-Zn-SOD)in the erythrocytes.RESULTS:MDA level in the vitamin E group and FDP group was significantly higher than that in the vitamin E+FDP group before and 5 and 7 days after replacement(P<0.05);while,Cu-Zn-SOD level was significantly lower(P<0.05).Otherwise,there were no significant differences in vitamin E+FDP group before and after replacement(P>0.05).CONCLUSION:The artificial total knee replacement can enhance lipid peroxidation and decrease antioxygen capability.However,the combination of vitamin E and FDP can prevent and relieve lipid peroxidation and antioxygen capability after replacement.

Influence of human C-type natriuretic peptide on vascular endothelial cell proliferation / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of human C-type natriuretic peptide (hCNP) on proliferation of vascular endothelial cells (HUVECs).</p><p><b>METHODS</b>Reconstructed pcDNA3.1 (+)/hCNP was transfected into HUVECs with polyethylenimine and its plasmid expression was examined with RT-PCR, immunohistochemistry and Western blot. MTT method was used to determine the effect of expressed protein on proliferation of HUVECs. pcDNA3.1 (+)/hCNP transfection was used for control.</p><p><b>RESULTS</b>The proliferation of HUVEC 48 h after pcDNA3.1 (+)/hCNP transfection was (0.301 +/- 0.096), which was obviously higher than that with pcDNA3.1 (+) transfection (0.164 +/- 0.012). Reconstructed pcDNA3.1 (+)/hCNP might be expressed in HUVECs effectively and its protein expression was capable of promoting HUVECs proliferation markedly.</p><p><b>CONCLUSION</b>The successive expression of reconstructed pcDNA3.1 (+)/hCNP and the promoting activity of its expressed protein on HUVECs lay the foundation potential therapeutic value of C-type natriuretic peptide.</p>

Determination of microvessel density of abdominal flap / 上海第二医科大学学报

Objective To determine the difference of microvessel density(MVD) in each layer and region of abdominal flap. MethodsFlaps were obtained from 60 patients with abdominal operations,10 in each of the regions from I to VI.The vascular endothelial cells were marked with CD34 by immunohistochemistry,and the MVD in each region and layer of the abdominal flaps was determined.Results The vascular net of abdominal flap was divided into five layers: papillary layer of corium,papillary underlayer of corium,papillary deep layer of corium,superficial fascia and deep fascia.The mean MVD of the five layers were 17.80?1.68,9.12?1.84,27.91?2.44,37.18?6.55 and 46.91?7.02,respectively,with significant differences among them(P0.05).Conclusion Anatomic factors may be responsible for the survival of large abdominal flaps.Either of the direct and retrograde motion is feasible in the transplantation.

Regulation of anticoagulation effect of human umbilical vein endothelial cells by thrombomodulin gene transfection / 中华血液学杂志

<p><b>OBJECTIVE</b>To transfect pcDNA3.1/hTM plasmids containing human thrombomodulin (hTM) gene into human umbilical vein endothelial cells (HUVECs), and investigate the expression of hTM and anticoagulating function of transfected HUVECs.</p><p><b>METHODS</b>HUVECs were transfected with pcDNA3.1/hTM by lipofectin. Expression of hTM mRNA was determined by semi-quantitative RT-PCR, hTM antigen on HUVECs membrane by immunohistochemistry, and activated protein C (PC) in HUVECs by chronometry. By using a semiautomatic coagulator, the effect of the reacting liquid from transfected HUVECs mixed with PC from normal peripheral blood was assayed.</p><p><b>RESULTS</b>About 10% HUVECs were transfected by pcDNA3.1/hTM with high-level hTM mRNA and protein expression. Activated PC produced by pcDNA3.1/hTM group, pcDNA3.1(+)/neo group and untransfected group was (2.80 +/- 0.43) microg/ml, (0.75 +/- 0.08) microg/ml and (0.85 +/- 0.11) microg/ml, respectively. APTT was (51.68 +/- 2.73) s, (38.38 +/- 2.44) s, (39.65 +/- 2.39) s, (33.93 +/- 1.73) s and (34.60 +/- 1.86) s and PT was (21.89 +/- 1.66) s, (20.56 +/- 1.74) s, (20.42 +/- 2.04) s, (19.57 +/- 1.36) s and (20.16 +/- 1.35) s in pcDNA3.1/hTM group, pcDNA3.1(+)/neo group, untransfected group, inactivating PC group and control, respectively.</p><p><b>CONCLUSIONS</b>The pcDNA3.1/hTM plasmid could be transfected into endothelial cells and expressed biologically functioning hTM protein on HUVECs membrane. Activated PC could inhibit intrinsic coagulation pathway obviously with slight effect on extrinsic pathway.</p>

The application of three dimensional analysis system in measuring rotation angles of thumb carpometacarpal joints / 中华外科杂志

<p><b>OBJECTIVE</b>To measure the axial rotation angles of the carpometacarpal joints during the digital opposition of thumb-index finger, thumb-medial finger, thumb-ring finger, thumb-little finger and the thumb's maximal opposition, then the application of these parameters were studied.</p><p><b>METHODS</b>Twenty neutrality-occupation volunteers (female 10, male 10) with no history of hand injuries or related diseases were involved in the study. First, all the markers' 3-D coordinates were obstained using the 3D motion analysis system (EVaRT4.1) during the digital opposition movements of thumb. Then, the axial rotation angles were calculated.</p><p><b>RESULTS</b>The average rotation angles of carpometacarpal joints during all kinds of digital oppositions were 29.1 degrees +/- 9.4 degrees (male), 24.8 degrees +/- 10.2 degrees (female), while the maximal rotation angles are: 35.3 degrees (male), 28.8 degrees (female).</p><p><b>CONCLUSIONS</b>The combination of video-based 3-D analysis system and mathematics make it possible to measure the axial rotation angles of thumb in vivo, as a result, the rotation angles of thumb carpometacarpal joints are measured precisely for the first time. These results can provide a few parameters for treatment and rehabilitation of carpometacarpal arthrositis.</p>

Effects of co-expression plasmid of human tPA and VEGF165 on the proliferation of vascular cells and fibrinolysis activity / 中南大学学报(医学版)

OBJECTIVE@#To observe the expression of the co-expression plasmid of tissue-plasminogen activator (tPA) and vascular endothelia growth factor165 (VEGF165) in vascular smooth muscle cells (VSMC) and to study the effect of expressing products on the proliferation of VEC and VSMC and fibrinolysis activity.@*METHODS@#The co-expression plasmid of tPA and VEGF165 (pBudCE4.1/tPA-VEGF165) was transfected into VSMC with the lipofection. The expression of tPA and VEGF165 at mRNA level was detected by RT-PCR and the protein level expression was detected by enzyme linked immunosorbent assay (ELISA). The fibrinolysis activity of culture medium of VSMC transfected tPA and VEGF165 genes was detected by fibrin plate technique. The VEC and VSMC were cultured with culture medium of VSMC transfected tPA and VEGF165 genes. And the proliferation of VEC and VSMC was evaluated with monoterazolium (MTT) and flow cytometry (FCM).@*RESULTS@#The expression of tPA and VEGF165 at mRNA and protein levels in the transfected VSMC was demonstrated by RT-PCR and ELISA, respectively. The VSMC culture medium of transfected genes possessed evidently fibrinolysis activity. The expression products of tPA and VEGF165 in the VSMC had an evident effect on the VEC proliferation. But it had not an effect on the VSMC proliferation.@*CONCLUSION@#The eukaryotic co-expression plasmid of tPA and VEGF165 can be expressed in transfected VSMCs. The expression products have an obvious biological activity. The present study lay the foundation for future making use of tPA and VEGF165 to prevent and treat vascular stenosis in transplanted heart.

Effects of platelet derived growth factor antisense oligodeoxynucleotides and tissue-type plasminogen activator gene transfection on inhibition of intimal proliferation / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To observe the effects of co-transfection of platelet derived growth factor antisense oligodeoxynucleotides (PDGF-AODN) and tissue-type plasminogen activator (tPA) gene on inhibition of intimal proliferation of auto-transplantion artery.</p><p><b>METHODS</b>One hundred male New Zealand rabbits were randomly divided into four groups (25 in each): Group A (control group), Group B (PDGF-AODN transfection group), Group C (tPA gene transfection group) and Group D (PDGF-AODN and tPA co-transfection group). The left and right external iliac arteries were transplanted reciprocally. The transplanted arteries were respectively soaked in PDGF-AODN, pBudCE4.1/tPA and PDGF-AODN plus pBudCE4.1/tPA solution about 15 minute before transplantation. The rabbits were sacrificed at 3d, 1w, 2w, 4w and 8w after operation. The specimens were harvested for pathologic examination, electron microscopy, chromogenic substrate test, 3H-TdR incorporation test and immunohistochemical staining.</p><p><b>RESULT</b>The scan electron microscopy showed that there were a few thrombocytes on vas-wall of Group C and D without thrombus, whereas there were abundant thrombocytes and thrombus forming on vas-wall of Group A and B. The intimal area, stenosis ratio of transplanted artery, 3H-TdR incorporation,the number of PDGF positive cell in Group D were significantly less than those in Group A (P<0.01),Group B and Group C (both P<0.05). The activity of tPA gene products in transplanted vas-wall of Group D was significantly higher than that of Group A (P<0.01).</p><p><b>CONCLUSION</b>Local co-transfection of PDGF-AODN and tPA gene can effectively inhibit the proliferation of vascular smooth muscle cells, hyperplasia of intima and restenosis of transplanted artery.</p>

The study on platelet-derived growth factor and proliferating cell nuclear antigen antisense oligodeoxynucleotides together inhibiting the stenosis of transplanted vascular / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of platelet-derived growth factor (PDGF) and proliferating cell nuclear antigen (PCNA) antisense oligodeoxynucleotides (AODN) together on inhibiting the proliferation of the stenosis of transplanted vascular.</p><p><b>METHODS</b>The left and right external iliac arteries (length 1.0 cm) of rabbits were transplanted reciprocally. The transplanted vascular were respectively soaked in liposomes, PDGF-AODN, PCNA-AODN and PDGF-AODN adding PCNA-AODN solution about 20 minute, the vascular anastomotic were sutured by 8/0 suture of soaked in AODN solution. Four weeks later, the specimens were harvested for microscopy. The pathological morphology of transplanted vascular were observed under microscope (HE). The intimal thickness and area, stenosis ratio(%) of transplanted vascular were calculate and analysed statistically among group by computer system. The number of positive cells of PDGF's mRNA in transplanted vascular wall were counted with in situ hybridization histo-cytochemistry and the number of positive cells of PCNA's protein in transplanted vascular wall were counted by S-P immunochemistry.</p><p><b>RESULTS</b>The intimal thickness and area, stenosis ratio of transplanted vascular, the number of PDGF and PCNA positive cell in PDGF-AODN adding PCNA-AODN group were significantly lower than those in other group (P < 0.01), and that were lower evidently than PDGF-AODN group and PCNA-AODN group.</p><p><b>CONCLUSION</b>PDGF and PCNA antisense oligodeoxynucleotides together could significantly inhibit the proliferation of vascular smooth muscle cell and stenosis of transplanted vascular.</p>