Effects of colpotomic approaches on prognosis and recurrence sites of stage Ⅰa2-Ⅱa2 cervical cancer after laparoscopic radical hysterectomy / 中华妇产科杂志

Objective:To investigate the factors affecting the prognosis of stage Ⅰa2-Ⅱa2 cervical cancer after laparoscopic radical hysterectomy (LRH), and to compare the prognosis and recurrence sites of patients with different colpotomy paths.Methods:The clinical data of 965 patients with stage Ⅰa2-Ⅱa2 cervical cancer who underwent LRH in the First Affiliated Hospital of Army Medical University from January 2015 to December 2018 were collected. The median age was 47.0 years of all patients with a median follow-up of 62 months (48-74 months). Cox regression was used to perform the univariate and multivariate analysis of the clinicopathological factors associated with the prognosis that included disease-free survival (DFS) and overall survival (OS). Patients were categorized into LRH through vaginal colpotomy (VC group, n=475) and LRH through intracorporeal colpotomy (IC group, n=490) according to the colpotomic approaches. The prognosis and recurrence sites of patients in each group were compared. Results:(1) During the follow-up period, 137 cases recurred (14.2%, 137/965) and 98 cases died (10.2%, 98/965). The 5-year DFS and OS were 85.8% and 89.9%, respectively. In univariate analysis, positive vaginal margin (PVM) was significantly affected the 5-year OS of patients with cervical cancer ( P=0.023), while clinical stage, maximum diameter of tumor, degree of pathological differentiation, lymph node metastasis (LNM), depth of cervical stromal invasion, parametrium involvement, and uterine corpus invasion (UCI) were significantly associated with 5-year DFS and OS in patients with cervical cancer (all P<0.05). In multivariate analysis, clinical stage ( HR=1.882, 95% CI: 1.305-2.716), LNM ( HR=2.178, 95% CI: 1.483-3.200) and UCI ( HR=3.650, 95% CI: 1.906-6.988) were independent risk factors of 5-year DFS (all P<0.001). Clinical stage ( HR=2.500, 95% CI: 1.580-3.956), LNM ( HR=2.053, 95% CI: 1.309-3.218), UCI ( HR=3.984, 95%C I: 1.917-8.280), PVM ( HR=3.235, 95% CI: 1.021-10.244) were independent risk factors of 5-year OS (all P<0.05). (2) Different colpotomy paths did not significantly affect the 5-year DFS and OS of patients with stage Ⅰa2-Ⅱa2 cervical cancer. The 5-year DFS in VC group and IC group were 85.9% and 85.6% ( P=0.794), and the 5-year OS were 90.8% and 89.3% ( P=0.966), respectively. Recurrence patterns consisted of intraperitoneal recurrence, pelvic recurrence, vaginal stump recurrence, and lymph node and distant metastasis. The intraperitoneal recurrence rate of VC group was significantly lower than that of IC group [0.6%(3/468) vs 2.3% (11/485), P=0.037], while the rates of pelvic recurrence, vaginal stump recurrence, lymph node and distant metastasis and overall recurrence were not significantly different between two groups (all P>0.05). Subgroup analysis of patients with different clinical stages, LNM and UCI showed that statistical differences of the intraperitoneal recurrence rates between two groups were only in patients without LNM (0.5% vs 2.3%, P=0.030) or without UCI (0.7% vs 2.3%, P=0.037). Conclusions:Clinical stage, LNM, PVM and UCI are independent risk factors for the prognosis of patients with stage Ⅰa2-Ⅱa2 cervical cancer. For patients without LNM or UCI, LRH through VC could reduce the intraperitoneal recurrence rate, while it is not enough to improve 5-year DFS and OS of patients. Low proportion of intraperitoneal recurrence, intra-operative tumor cells spillage to vagina stump and pelvic cavity might be the explanation.

Analysis of early treatment of 12 cases with congenital knee dislocation / 中华实用儿科临床杂志

Objective:To investigate the curative effect of the Pavlik harness and polyester material casting bandage for the early treatment of congenital knee dislocation (CDK).Methods:The clinical data of 12 patients (13 knees) with CDK treated in Provincial Hospital Affiliated to Shandong First Medical University from December 2011 and January 2019 were studied retrospectively.There were 3 males and 9 females.The median age at the initial visit was 3 days ( 1-29 days). Eleven patients had unilateral CDK, and 1 patient had bilateral CDK.There were 5 cases(5 knees) with dislocation and 7 cases(8 knees) with subluxation.Associated musculoskeletal anomalies were observed in 7 patients, which included developmental dysplasia of the hip (DDH) in 6 patients, bilateral DDH and right clubfoot in 1 patient.The Pavlik harness was applied to keep the knee in position for 1.5-2.0 months if passive flexion achieved 90°or more.If passive flexion was below 90°, the polyester material casting bandage was employed to increase knee flexion, and the bandage was changed once a week.After passive flexion reached 90°, the patient was treated with the Pavlik harness for 1.5-2.0 months.Cases with DDH who worn the Pavlik harness were evaluated by ultrasonography in the follow-up period, and cases with clubfoot were treated with Ponseti polyester material casting bandages.Results:Three children (4 knees) were directly fixed with Pavlik harness for 1.5-2.0 months, 9 children (9 knees) were fixed with Pavlik harness for 1.5-2.0 months after 1-8 times (average 2.9 times) of plaster fixation. No plaster and Pavlik harness complications were found during the treatment.Twelve patients were followed up for 29.8 months on average (12.0 to 65.0 months). Ten patients (11 knees) were rated excellent, and 2 patients (2 knees) were rated good.Conclusions:The Pavlik harness and polyester material casting bandage for early treatment of CDK is simple, effective and safe.Associated musculoskeletal anomalies can also be corrected in the treatment process.The knee joint dislocation should be treated at first.

Establishment and application of a nomogram model for prognostic risk prediction in patients with epithelial ovarian cancer / 中华妇产科杂志

Objective:To explore the prognostic factors of epithelial ovarian carcinoma (EOC), construct a nomogram model, and evaluate the prognosis of EOC patients.Methods:A retrospective analysis was performed on clinicopathological data of 208 cases of EOC patients who received initial treatment in the First Affiliated Hospital of Army Medical University from August 11, 2016 to July 11, 2018, including age, preoperative ascites, preoperative neoadjuvant chemotherapy, surgical method, pathological type, pathological differentiation degree, surgical pathology stage, preoperative and post-chemotherapy serum cancer antigen 125 (CA 125) level, human epididymal protein 4 (HE4) level, platelet count and platelet/lymphocyte number ratio (PLR). The univariate and multivariate Cox risk ratio models were used to analyze the related factors affecting progression free survival (PFS) in EOC patients, and the prediction nomogram of PFS in EOC patients was established to evaluate its efficacy in predicting PFS. Results:Univariate analysis showed that preoperative neoadjuvant chemotherapy, pathological type, pathological differentiation degree, surgical pathology stage, serum CA 125 and HE4 level before operation and after chemotherapy, platelet count and PLR before operation and after chemotherapy were significantly correlated with PFS in EOC patients (all P<0.05). Multivariate analysis showed that surgical pathology stage, preoperative PLR, serum CA 125 and HE4 level after chemotherapy were independent prognostic factors affecting PFS of EOC patients (all P<0.01). The index coefficient of the prediction model for the prognosis of EOC patients established by this method was 0.749 (95% CI: 0.699-0.798), which had good prediction ability, and could help clinicians to more accurately evaluate the prognosis of EOC patients. Conclusion:The nomogram model constructed based on surgical pathology stage, preoperative PLR, serum CA 125 and HE4 level after chemotherapy could effectively predict the PFS of EOC patients after initial treatment, could help clinicians to screen high-risk patients, provide individualized treatment, and improve the prognosis of EOC patients.

A prospective multicenter cohort study comparing vNOTES and laparoscopic sentinel lymph node mapping for endometrial cancer / 부인종양

Objective@#To determine the feasibility and safety of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in hysterectomy and sentinel lymph node (SLN) mapping for endometrial cancer by comparing its SLN detection rate and perioperative outcomes with those of laparoscopic staging. @*Methods@#In this multicenter prospective cohort study, 68 patients with early endometrial cancer between 2020 and 2021 in 2 tertiary referral centers in China were grouped to vNOTES (n=33) or laparoscopy (n=35). All the patients underwent hysterectomy with SLN mapping. @*Results@#The total successful SLN detection was 97.0% in the vNOTES group and 91.4% in the laparoscopy group (p=0.32), whereas the bilateral success rates were 81.8% and 80.0%, respectively (p=0.84). There was no difference in SLN detection observed between the 2 groups regarding the side-specific mapping efficacy quotient (89.4% vs 85.7%; p=0.05). The number of harvested SLNs, the location of SLNs, operative time, estimated blood loss, intraoperative and postoperative complications and hospital cost in the 2 groups were similar (p>0.05), but there were differences in the 2 groups; the one was postoperative exhaust time that was 18 vs. 21 hours (p=0.01), the other was median postoperative hospital stay which was 4 vs. 5 days (p=0.05). @*Conclusion@#This study suggests that lymph node mapping can be completed through the vNOTES procedure. It can ensure effective surgical staging and show the advantages of a fast recovery and good cosmetic effect.

The value of MRI anterior cartilaginous acetabulum-head-index to evaluate hip function after treatment of developmental dysplasia of the hip / 中华放射学杂志

Objective:To evaluate the feasibility of high resolution MRI for the measurement of anterior cartilaginous acetabulum-head-index (A-CAHI) and the value of A-CAHI for predicting hip clinical function after treatment in developmental dysplasia of the hip (DDH).Methods:The imaging data of 92 hips from 61 children with treated DDH were retrospectively reviewed in Shandong Medical Imaging Research Institute from January 2019 to January 2020. All children underwent conservative treatments or surgical interventions 3 years ago. Hip function after treatment was evaluated clinically based on the modified MacKay criteria. The hips were divided into satisfactory clinical function group (McKay rating excellent or good, n=46) and unsatisfactory group (McKay rating fair or poor, n=46). All patients were imaged with conventional MRI, high resolution fat suppressed proton density weighted image (FS-PDWI) of the unilateral hip joint in oblique sagittal view, and anteroposterior hip radiographs. A-CAHI and lateral cartilaginous acetabulum-head-index (L-CAHI) were measured respectively on high-resolution oblique sagittal PDWI and conventional coronal T 1WI. Acetabulum head index (AHI) was also measured on anteroposterior hip radiograph. Mann-Whitney U test or independent-samples t test was used to compare the difference of A-CAHI, L-CAHI and AHI between satisfactory and unsatisfactory clinical function groups. The diagnostic value using A-CAHI, L-CAHI, AHI, or A-CAHI combined with L-CAHI for unsatisfactory clinical function were investigated by the ROC curve. The area under the curve (AUC) and the Z statistic were used to compare diagnostic performance. Results:The values of A-CAHI, L-CAHI and AHI were significantly higher in satisfactory clinical function group compared with the unsatisfactory group ( Z=-7.746, -7.735, t=-7.199, all P<0.001).A-CAHI combined with L-CAHI had the significant highest diagnostic accuracy compared with A-CAHI, L-CAHI and AHI (AUC were 0.994, 0.969, 0.968, 0.861, respectively), with significant differences ( Z=1.975, 2.006, 3.553, P=0.048, 0.051,<0.001). The sensitivity and specificity of A-CAHI combined with L-CAHI for the diagnosis of prognosis were 95.7% and 97.8%, respectively. Conclusions:A-CAHI measured by high resolution MRI was found to have the highest diagnostic accuracy for prediction of hip clinical function in the treated DDH, and combined with L-CAHI can improve the diagnostic accuracy significantly.

Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers / 中华妇产科杂志

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.

Ultrasonic evaluation of the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip / 中华超声影像学杂志

Objective To investigate the effect of cartilage acetabular ,glenoid labrum and acetabular tissue on closed reduction of developmental dysplasia of hip ( DDH ) by analyzing the outcomes of the ultrasound measurement on DDH before and after Pavik Harness treatment . Methods Graf method was used in ultrasound measurement before the treatment . Position of cartilaginous acetabulum and glenoid labrum and displacement direction of femoral head in 31 patients with hip dislocations ( type D ,type Ⅲ ,typeⅣ ,36 hips) were recorded . T he follow‐up testing with ultrasound measurement on the inside of the hip were performed after 1 －2 weeks of Pavik Harness treatment . M ediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue were measured . Reduction effects were evaluated . Results T he success rate of reduction of dislocation hips with cartilaginous acetabulum on the head orientation was obviously higher than that on the foot orientation( P ＜0 .000 1) . T he success rate of reduction of dislocation hips with glenoid labrum on the head orientation was obviously higher than that on the foot orientation ( P ＝ 0 .001 6 ) . T here was a statistically significant difference in the success rate of different types of hip dislocation ( type D , type Ⅲ , type Ⅳ ) ( P＝ 0 .002 7 ) . T here were statistically significant differences in mediolateral dimension ,anteroposterior dimension and the area of maximum section of acetabular tissue between the reduction group and the group without dislocation ,the irreducible group and the group without dislocation ,the irreducible group and the reduction group ( P ＜ 0 .01) . Conclusions Ultrasonography is of great significance in the diagnosis and treatment of children with DDH . T he position of hip cartilaginous acetabulum and glenoid labrum ,types of hip dislocation and the volume of acetabular tissue have important effects on the success of the closed reduction .

Relationships between baseline R2*of BOLD-MRI and Semi-quantitative parameters of DCE-MRI in cervical cancer / 局解手术学杂志

Objective To investigate the relationships between baseline R2? of blood oxygenation level-dependent magnetic resonance imaging(BOLD-MRI) and Semi-quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in cervical cancer,to lay a foundation for the further development of assessing tumor hypoxia techniques. Methods Twenty-four patients with cervical cancer were subjected to DCE-MRI and BOLD-MRI before treatment,Semi-quantitative parameters(SI-I、MER、Tmax、IAUC) of DCE-MRI and the baseline R2?of BOLD-MRI produced by special post-processing softwares,the relationships between baseline R2?of BOLD-MRI and Semi-quantitative parameters of DCE-MRI were analyzed. Results Significant positive correlations were observed between baseline R2?and Tmax(r=0.423,P=0.014),there were no correlation between baseline R2? and SI-I、MER or IAUC(P>0.05). Conclusion Semi-quantitative parameters of DCE-MRI and baseline R2? of BOLD-MRI respectively reflected the oxygenation of tumor in different principle. The combined use of the above parameters is expected to improve the performance for defining tumor hypoxia.

Relation between antibody titer in pregnant women with maternal-fetal ABO blood incompatibility and hemolytic disease of fetuses and newborns / 中华围产医学杂志

Objective To investigate the relationship between IgG antibody titer in pregnant women with maternal-fetal ABO blood incompatibility and hemolytic disease of fetuses and newborns.Methods From January 31 2009 to January 31 2010,1269 singleton pregnant women who were suspected to have maternal fetal ABO blood incompatibility in Department of Obstetrics and Gynecology,Southwest Hospital,Third Military University were collected.Anti-A or anti-B IgG titers of them were detected at 28-30 gestational age,and umbilical cord blood were taken when delivery and hemolytic disease of the newborn serological test were done to diagnose hemolytic disease of the newborn (HDN).The relationship between the titers and incidence of fetal or neonatal hemolytic disease was retrospectively analyzed by Kendall tau rank correlation.Results No IgG of anti-A or anti-B in serum were found in 58.4％ (741/1269) pregnant women,while the antibody titer of 5.1％ (65/1269) pregnant women were more than or equal to 1 ∶ 128.When they were tested again at 36 gestational week,the titer of 17 cases increased twice but lower than 1 ∶ 512.No signs of intrauterine hemolysis,such as edema,ascites and pleural effusion,were found.Three hundred and eighty neonates (29.9％,380/1269) were diagnosed as HDN.Among which,12 cases (3.2％,12/380) showed mild anemia and (or) jaundice within 24 hours after delivery.There was positive correlation between incidence of neonatal hemolysis and antibody titer(Tb=-0.293,P＜0.01).The incidence of HDN increased from 85.4％ (35/41) in women with antibody titer of 1 ∶ 128 to 5/5 inwomen with antibody titer at 1 ∶ 512 (x2=108.906,P＜0.01).Among 380 HDN neonates,322 cases were transferred to neonatal intensive care unit for phototherapy based comprehensive therapy,and two underwent exchange transfusion.All patients were cured.Conclusions The intrauterine hemolysis incidence of patients with suspected maternal-fetal ABO blood incompatibility is very low,and no special care is required during pregnancy.Anti-A or anti-B tests during pregnancy is helpful in early diagnosis and management of HDN.

Screening of bone-related microRNAs in serum of patients with osteogenesis imperfect / 生物工程学报

We screened differential expression bone-related microRNAs (miRNAs) in serum of patients with osteogenesis imperfect (OI). First, we selected the reference gene (s) fit for quantitative detection of serum miRNAs by using geNorm and several other programmes. Then real-time fluorescent quntitative PCR was used to detect the expression level of bone-related miRNAs gained by means of miRanda, Targetscan and Pictar softwares caculation and reading literature. Then, the results were analyzed with the matched t test. All 6 candidate reference genes had a stable expression level in serum of healthy controls and patients with different characters, and the optimal number of reference genes is 4 (miR-16, let-7a, snRNAU6, miR-92a) after Pairwise Variations analysis (V4/5 = 0.133 < 0.15). For validating the universality of expression stability, we detected the relative expression value of miR-16, let-7a, snRNAU6 and miR-92a in another 8 healthy controls and 16 patients with OI and the result revealed that the expression of 4 genes remained stable (M < 1.5). After measuring serum levels of more than 100 bone-related miRNAs in patients with real-time qPCR, 11 miRNAs showed differential expression, and bioinformatic analysis suggested these altered expressional mioRNAs had possibilities to participate in the process of OI. So the experiment indicated that there existed many differential expression bone-related miRNAs in serum of patients with OI, and these miRNAs had potentials to be promising biomarkers for serologic tests and diagnosis of OI.

Evaluation of closed reduction with cast fixation on developmental dislocation of the hip by ultrasound / 中华超声影像学杂志

Objective To discuss the feasibility of ultrasound in evaluating the effect of closed reduction with cast fixation on developmental dislocation of the hip.Methods Seventy-three cases with unilateral DDH treated by closed reduction with cast fixation under frog position were detected by ultrasound on the medial cross-section of the hips.The position relation between femoral head and acetabulum of the hips were demonstrated,the relevant parameters (the vertical distance between the femoral head and the central line through pubic symphysis) were measured and compared with the contralateral side to understand the situation of the femoral head.Results The contour of the femoral head and the ossification center can be visually displayed,the relative position relation of the femoral head and acetabulum can be demonstrated on the medial cross-section of the hip under frog position by ultrasound to judge the status of closed reduction.The measurement of the ultrasonic parameters can provide quantitative indicator for the status of reduction.Conclusions Ultrasound can be viewed as the first imaging tool to evaluate the effect of closed reduction with cast fixation on developmental dislocation of the hip for it is simple,intuitive and no radiation injury.

Ultrasonography on developmental dislocation of the hip in infants of different months and the correlation analysis of each parameter index / 中华超声影像学杂志

Objective To discuss the changes of correlative ultrasonic parameter index of normal hips and abnormal hips with developmental dislocation of the hip (DDH) in infants of different months in order to provide objective information for the diagnosis. Methods Three-hundred and seventy-eight normal hips and 244 hips with DDH among 622 hips of 311 infants were detected by ultrasonography(US). The morphology and structure information of hips were observed, and the values of ultrasonic parameter index,including angle α,angle 3, acetabular index( AI), femoral head percentage of cover(FHC) of normal hips and abnormal hips were measured. The values of each parameter index were collected by being divided into different groups (3 months a group) ,then the correlation was analyzed. Results Morphology and structure,position relation between femoral head and acetabulum of the hips were demonstrated by US. Normal or abnormal hips,the degrees of abnormal hips and the types of hips could be judged according to the findingsof US. Analysis of values of parameter index of normal hips:①There was significantly statistical significance in the values of ultrasonic parameter index, such as angle α, angle β, AI, FHC of normal hip between the groups of different age (P＜0.01). ②There was correlation between the age and the values of each parameter index, among which angle α, FHC had positive correlations with age ( r = 0. 537, 0. 554,respectively ) while angle β and Al negative correlations ( r = -0. 465, -0.424, respectively ). ③There was correlation between the values of different parameter index. Both angle β and AI had negative correlation with angle α,among which the latter correlation was closely ( r = - 0. 794). No statistical significance was found between the ultrasonic values of each group under different ages of different type abnormal hips( P ＞0.05) ,but closely negative correlations still existed between angle α and AI. ConclusionsUS can be viewed as an early definite and a screening method of diagnosing DDH.For older infants (above 6 months) it will be more accurate to analyze the ultrasonic parameter index together with the age of infants.

Effects of muscular traumatic fluid on biological properties of muscle-derived stem cells in rats / 中华创伤杂志

Objective To study the effects of muscular trumatic fluid on the biological properties of muscle-derived stem cells (MDSCs) in rats.Methods MDSCs were isolated and purified by the preplate technique,muscle injury was made for the extraction of muscular traumatic fluid.Bradford colorimetric was used to detect the protein content in the muscular traumatic fluid,and the fluid with the highest protein was used to co-culture with MDSCs.Methyl thiazolyl tetrazolium (MTT) assay and wound model of monolayer of cells were used to observe the effects of wound fluids on the proliferation and mobility of MDSCs.The expressions of α-SMA and Vimentin were tested by immunohistochemistry and Western blot technique.Results MTT assay showed that wound fluid with concentration of 10% could most significantly increase the proliferation of MDSCs.The increased expressions of α-SMA and Vimentin were found in MDSCs after cultrue with muscular traumatic fluid in vitro,and the time-dependent relation exists.Conclusions Wound environment can directly participate in the muscle regeneration by inducing the proliferation,mobility of MDSCs;on the other hand,MDSCs can differentiate into fibrotic cells under stimulation of muscular traumatic fluid.

Application of Ponseti method in patients older than 6 months with con-genital talipes equinovarus / 北京大学学报(医学版)

Objective:To evaluate the effectiveness of Ponseti method in the treatment of congenital talipes equinovarus (CTE) in children older than 6 months. Methods: Ponseti method was used to treat 157 cases (227 feet) of CTE in children older than 6 months. All cases were classified by age and by the degree of deformity severity. The age group classification was: (1) Ⅰ Group (6 months to 12 months),113 feet in 81 cases; (2) ⅡGroup (1 to 3 years old), 78 feet in 52 cases; (3) Ⅲ Group (>3 years old), 36 feet in 24 cases. The degree of deformity of CTE was evaluated with Pirani scoring system. The cases were classified into three groups according to the deformity degree : (1) Mild Group (scoring 1-2. 5) , 85 feet in 56 cases; (2) Moderate Group (scoring 3-4. 5) , 104 feet in 71 cases; (3) Severe Group (scoring 5-6) , 38 feet in 30 cases. A Pirani score of 0-0. 5 is regarded as an excellent result. For each group, we evaluated the number of casts used, the percentage of excellent result according to the Pirani score, and the percentage of percutaneous achillotenotomy. The result was compared among different groups. Results: The overall percentage of excellent result among all cases was 96.92%. A-mong the age groups, the percentage of excellence was not statistically different between Ⅰ Group and Ⅱ Group (P>0. 05). The percentage of excellence was lower in the Ⅲ group than the other groups (P> 0. 01). Among the groups classified by deformity degree, the percentage of excellence was the lowest in severe group (P<0. 05), and the difference between the mild group and moderate group was not statistically different (P>0. 05). The number of casts used among different groups were different (P<0. 01). Among different groups, the percentages of percutaneous achillotenotomy were significantly different (P<0. 01). 209 feet in 148 caseswere followed up for average time duration of 3 years and 11 months. Re-lapse was observed in 40 feet in 29 cases. The percentages of relapse were not statistically different among different groups (P>0. 05). Conclusion: Using Ponseti method to treat CTE for children older than 6 months can achieve excellent results in this study.

Comparison between the effects of Ponseti method in treating infants older and younger than six-month with congenital clubfoot / 中国矫形外科杂志

[Objective]To compare the differences in using Ponseti method treating congenital clubfoot (CCF) patients older than six-month and younger than six-month of congenital clubfoot(CCF). [Method]Five hundreds and forty-four feet in 378 cases of CCF were treated with Ponseti method. According to the age differences, they were divided into older infancy group (﹥6 month, 227 feet in 157 cases and younger infancy group(≤6 month,317 feet in 221 cases). The deformation degree of CCF was evaluated by the Pirani scoring system. A scoring of 0-0.5 was regarded as being excellent. For each group, we evaluated the percentage of excellence result according to the Pirani score, the number of casts used, and the percentage of percutaneous achillotenotomy. The result was compared between the two groups. [Result]The excellence rate showed no significant differences between the two groups (P﹥0.05). Both the number of casts used and the percentage of percutaneous achillotenotomy in the younger infancy group were more than that in the older infancy group. There was obvious difference between the two groups (P

Application of Ponseti method in patients older than 6 months with congenital talipes equinovarus / 北京大学学报(医学版)

0.01). Among the groups classified by deformity degree,the percentage of excellence was the lowest in severe group (P0.05). The number of casts used among different groups were different (P0.05). Conclusion:Using Ponseti method to treat CTE for children older than 6 months can achieve excellent results in this study.

Construction and identification of lentiviral vector encoding shRNA against Smad3 / 第三军医大学学报

Objective To construct a lentiviral vector expressing small-hairpin RNA(shRNA) targeting Smad3 gene.Methods The targeting sequence of Smad3 gene which can be effectively silenced in RNA inference was confirmed in our previous study.The cDNA containing both sense and antisense Oligo DNA fragments of the targeting sequence was designed,synthesized and cloned into the pGCSIL-GFP vector.The obtained lentiviral vector containing Smad3 shRNA was confirmed by PCR and sequencing.293T cells were cotransfected with lentiviral vector GC-shSmad3,pHelper 1.0 and pHelper 2.0.The titer of virus was tested according to the expression level of GFP.Results PCR and DNA sequencing demonstrated that the constructed lentivirus vector GC-shSmad3 produced Smad3 shRNA.The titer of concentrated virus was 3?108 TU/ml.Conclusion The lentivirus RNAi vector targeting Smad3 is constructed successfully.

MMP-1 and TIMP-1 expression in pubocervical fascia from patients with stress urinary incontinence / 第三军医大学学报

Objective To investigate collagen metabolism in stress urinary incontinence(SUI) so as to determine the alteration that contributes to SUI.Methods Biopsy specimens of vaginal wall tissue from 24 women with stress urinary incontinence were collected,with matched specimens from 24 female patients without SUI.Immunohistochenical technique were applied to detect the expression of MMP-1 and TIMP-1.Results SUI group demonstrated a significant increase in MMP-1 expression and a decrease in TIMP-1 expression,with significant difference with control group.Conclusion Patients with SUI were in the predominant status of collagen breakdown,which may contribute to the pathogenesis of SUI.

Cell-cell contact induces mesenchymal stem cells differentiation to smooth muscle cells / 第三军医大学学报

Objective To establish a co-culture system between mesenchymal stem cells (MSCs) and smooth muscle cells (SMCs) in vitro, and study the influence of SMCs on the differentiation of bone marrow MSCs (BMSCs) into SMCs in the co-culture system. Methods Density gradient centrifugation was used to separate and culture BMSCs, and collagenase digestion was employed to separate and culture bladder smooth muscle cells(BSMCs). Then the 2 types of cells were identified respectively. Then the cells were divided into 4 groups, BMSCs culture group (positive control), BSMCs cells culture group (negative control), BMSCs and BSMCs co-culture groups with contact or non-contact. The expression of ?-smooth muscle actin (?-SMA) and calponin were detected by immunofluorescence staining. Western blot analysis was employed to determine protein expression of calponin. Results In contact co-culture group, the positive rate of CD90 abd CD44 were 99.78% and 60.27% respectively in BMSCs, while only 0.21% for CD45. Western blotting showed that BMSCs expressed little calponin, but those contacting with BSMCs had an increasingly stronger expression of calponin with the elapse of contact culture time, while there was no significant change in its expression in BMSCs with contact. Immunofluorescence staining indicated that part of BMSCs were calponin positive at the 8th day after culture, but no positive cell was observed in non-contact culture group and BMSCs culture group. Conclusion The contact between BSMCs and BMSCs can promote the differentiation of BMSCs into SMCs.