Tibial transverse bone transport assisted by nose ring drainage for treatment of foot and ankle chronic osteomyelitis / 中华创伤骨科杂志

Objective:To investigate the clinical effects of tibial transverse bone transport assisted by nose ring drainage (NRD) in the treatment of foot and ankle chronic osteomyelitis.Methods:A retrospective study was conducted to analyze the data of 32 patients with foot and ankle chronic osteomyelitis who had been treated at Department of Orthopedics, Beijing Rehabilitation Hospital from March 2013 to February 2022. The patients were assigned into a study group and a control group. In the control group, there were 12 males and 3 females, aged (39.5±8.8) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 2 cases, at the midfoot in 4 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 5 cases of type Ⅰ and 10 cases of type Ⅱ. The control group was treated with Ilizarov transverse tibial bone transport in combination with thorough debridement and anti-infection therapy. In the study group, there were 12 males and 5 females, aged (42.3±13.4) years. The osteomyelitis was located at the distal tibia in 4 cases, at the talus in 1 case, at the calcaneus in 3 cases, at the midfoot in 5 cases and at the forefoot in 4 cases. According to the Crerny-Mader classification, there were 7 cases of type Ⅰ and 10 cases of type Ⅱ. The study group was treated with NRD drainage in addition to the procedures in the control group. The curative effects were evaluated by comparing the cure, recurrence, amputation (toe amputation), antibiotic use time, wound healing time, relevant inflammatory indicators [WBC, neutrophil percentage (NEU), erythrocyte sedimentation rate (ESR), procalcitonin, interleukin-6 (IL-6), C-reactive protein (CRP)], and postoperative functional recovery between the 2 groups.Results:The 2 groups were comparable because there was no statistically significant difference in the general data between them ( P>0.05). The follow-up period was (36.0±9.8) months. There was no significant difference between the 2 groups in the cure or amputation (toe amputation) ( P>0.05), but the recurrence rate in the study group was significantly lower than that in the control group ( P<0.05). The antibiotic use time [(20.7±3.6) d] and wound healing time [(88.3±17.1) d] in the study group were significantly shorter than those [(37.9±6.5) d and (102.2±22.6) d] in the control group ( P<0.05). The ESR, IL-6 and CRP at 1 week after operation in the study group were significantly lower than those in the control group ( P<0.05), but there was no significant difference between the 2 groups in the WBC, NEU or PCT at 1 week after operation ( P>0.05). There was no significant difference either in the inflammatory indicators between the 2 groups at 1 month after operation ( P>0.05). In all patients, the inflammatory indicators like WBC, NEU, ESR, PCT, IL-6 and CRP at 1 week and 1 month after operation were significantly better than those before operation, and the Maryland foot functional score at 12 months after operation was significantly higher than the preoperative one ( P<0.05). There was no significant difference between the 2 groups in the Maryland foot functional score at 12 months after operation ( P>0.05). Conclusion:In the treatment of foot and ankle chronic osteomyelitis, compared with the Ilizarov transverse tibial bone transport, our tibial transverse bone transport assisted by NRD can achieve satisfactory therapeutic effects, shorten antibiotic use time and treatment cycle, and reduce recurrence rate.

Research progress on role of Hippo pathway in bone repair / 中华骨科杂志

The initiation and operation of the tissue repair program between the broken ends after fracture is very important for fracture healing, which goes through three intertwined and gradual evolution stages: hematoma inflammatory organization stage, primitive callus formation stage and callus remodeling stage. It is completed by a variety of tissues, cells and cytokines in the bone marrow cavity. In the study of the mechanism of fracture healing, it is found that there are many signal pathways and molecules regulating bone repair, including bone formation, bone remodeling and neovascularization. At the cellular level, it regulates osteoblasts, chondrocytes, osteoclasts and endothelial cells. Hippo signaling pathway is a signal pathway that maintains the size of organs and the balance between cell proliferation and apoptosis, and also plays an important role in maintaining bone homeostasis and bone metabolism. In the process of regulating bone development and repair, it regulates the physiological activities of cells in microenvironment through protein kinase cascade reaction and transcriptional coactivator. The upstream and downstream effectors of Hippo signal pathway directly or indirectly regulate the proliferation, differentiation and apoptosis of bone metabolic cells, and the interaction with Wnt signal pathway, Notch signal pathway and other important pathways related to bone repair show that Hippo signal pathway plays an important role in the regulation of fracture healing and may become a new target to promote fracture healing. This article reviews the regulatory mechanism of Hippo signaling pathway and its regulatory role in the process of fracture healing, and looks forward to the research prospect of promoting bone healing by using it as a target.

Analysis of clinicopathology and risk of lymph nodes metastasis in 315 patients with early gastric cancer according to World Health Organization criteria / 中华消化杂志

Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0％ (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7％ (37/315),which was lower than 24.8％(2 752/11 104) in Japan and 19.9％(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P＜0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 ％,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 ％) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P＜0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P＜0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.

Isolation and Adherent Culture of Neural Stem Cells from Mouse Embryo / 华中科技大学学报(医学版)

Objective To develop a modified method of adherent culturing NSCs to replace the traditional suspension culturing method.Methods Neural stem cells(NSCs)were isolated from brain of fetal mouse at 15.5-day fetal age.In culture bottle which had been pre-coated with poly-L-ornithine hydrochloride/fibronectin(PO/FN),the cells were adherently cultured and passaged.The cell morphology was observed under inverted microscope.NSCs and their differentiated cells were identified by immunofluorescence.Results NSCs obtained in this study were successfully adherently cultured and expressed specific markers.Conclusion NSCs are successfully adherently cultured in this study.As compared with the traditional suspension culturing method,adherent culturing is simpler and has lower wastage of passage.It is easy to observe cell morphology and differentiation by this method.It is also helpful to culturing and storage of NSCs.

Expression and Its Clinical Significance of Forkhead Box J2 in Non-small Cell Lung Cancer Tissues and Paracancerous Tissues / 现代检验医学杂志

Objective To evaluate the expressions and its clinical significance of Foxj2 in non-small cell lung cancer (NSCLC) patients.Methods Fifty cancer tissues from patients who underwentsurgery were collected.Western blot and immunohisto-chemical methods were used to detect the expressions of Foxj2.Results Results of western blot showed that Foxj2 expres-sion in lung cancer tissue was significantly lower than adjacent tissues.The difference between the two groups was statisti-cally significant(P<0.05).Immunohistoehemical results showed that the number of Foxj2-positive cells in adjacent tissues was significantly higher than that in cancer tissues,and the expression of Foxj2 in non-lymphatic node metastasis group was higher than that in lymphatic node metastasis.The difference between the two groups was statistically significant (P<0.01).Conclusion The expressions and location of Foxj2 was related to the lymphatic node metastasis of lung cancer.This phenomenon indicates that Foxj2 may play an important role in the development of lung cancer.

Expression and clinical significance of Kif2a in breast carcinoma by the application of tissue microarray / 实用医学杂志

Objective To study the expression and clinical significance of Kif2a in breast carcinoma by the application of tissue microarray. Methods Tissue microarray and immunohistochemistry method (S-P) were used to examine the expression of Kif2a in 102 cases of breast carcinoma tissue and adjacent tissue. The prognosis of 62 cases followed up were studied by both univariate and multivariate analysis. Results The expression of Kif2a has significant difference between breast carcinoma tissue and adjacent tissue. Kif2a expression were associated with lymph nodal involvement and HER2 expression (P < 0.05). In the 62 cases with followed-up data, univariante analysis revealed that the expression of Kif2a, lymph nodal involvement and HER2 expression were correlated with the survival rate. Cox stepwise proportional hazards analysis showed that they were independently prognostic factors. Conclusions Kif2a expression in breast carcinoma were associated with lymph nodal involvement and HER2 expression (P<0.05). It is meaningful to examine Kif2a expression for prognosis of the breast carcinoma.

Bone marrow biopsy pathology in combination with bone marrow smear and peripheral blood smear in diagnosis of stubborn hematonosis / 中国综合临床

Objective To investigate the diagnostic significance of synchronous observation on bone marrow biopsy,bone marrow smear and peripheral blood smear in stubborn hematonosis.Methods Thirty-seven patients with difficult and complicated hematologic diseases were detected by peripheral blood smear,bone marrow smear and bone marrow biopsy.Those slides and smears were observed.Results The 37 cases with blood disease was diagnosed of aplastic anemia in 3 cases,5 cases of myelodysplastic syndrome,6 cases of primary myelofibrosis,13 cases of secondary myelofibrosis,7 cases of lymphoma with bone marrow infiltration and 3 cases of metastatic carcinoma of bone marrow.In the diagnosis of aplastic anemia,myelodysplastic syndrome,primary and secondary myelofibrosis,lymphoma and metastatic carcinoma of bone marrow diagnosis,bone marrow biopsy is superior to smear.Conclusion Bone marrow biopsy,bone marrow smear and peripheral blood smear synchronous observation can effectively increase the diagnostic rate,decrease misdiagnosis rate,and correctly identify the stage of the disease.

Expression and clinicopathological significance of ADAM17 mRNA in esophageal squamous cell carcinoma / 肿瘤研究与临床

ObjectiveTo investigate the clinicopathologic significance of a disintegrin and metalloproteinase 17(ADAM 17) mRNA in esophageal squamous cell carcinoma (ESCC),and to evaluate its relation to clinicopathological features. MethodsThe expression of ADAM17 mRNA in 50 ESCC and 50 normal esophageal tissues were detected by RT-PCR. ResultsThe mRNA expression of ADAM17 in 50 ESCC and 50 normal esophageal tissues were 0.937±0.241 and 0.225±0.077,respectively.The expression of ADAM17 mRNA in the ESCC was much higher than in normal esophageal tissues (t=-19.899,P＜0.01).The expression of ADAM 17 mRNA was positively correlated with lymph node metastasis(t=-4.703,P＜0.01 ) and TNM staging (t=-2.652,P＜0.05).There were no correlation between the expression of ADAM17 mRNA and sex,age and histological grade (t=0.299,-0.907,-3.163,all P＞0.05).ConclusionADAM17 mRNA was higherly express in ESCC than in normal esophageal tissues and may play an important role in the development,invasion and metastasis of ESCC.It may be used as a prognostic factor.

Relationship between the co-expression of CD105 and cyclin D1 and lymph node metastasis and prognosis of esophageal squamous cell carcinoma / 中华消化外科杂志

Objective To investigate the relationship between the co-expression of CD105 and cyclin D1 and lymph node metastasis and prognosis of esophageal squamous cell carcinoma ( ESCC ). Methods Eighty cases of ESCC tissue were collected at The First People's Hospital of Nantong. The expression of CD105 and cyclin D1 of ESCC was detected by immunohistochemistry. The relationship between the co-expression of CD105 and cyclin D1 and lymph node metastasis and prognosis of ESCC was analysed. Eighty normal esophageal tissues were selected as controls. All data were analysed by t test, chi-square test, and Pearson correlation analysis. Survival was analysed by the Kaplan-Meier survival curve. Microvessel density (MVD) was used to indicate the expression of CD105 in the form of -x±s. Results The expression of CD105 in ESCC tissues was higher (36±8) than that in normal esophageal tissues ( 11±3) (t =25. 129, P＜0.05). The positive rate of cyclin D1 expression in ESCC tissues was 61% (49/80), which was significantly higher than 23% (18/80) in normal esophageal tissues ( x2 =4.972, P＜0.05). The MVD value of 44 patients was ≤36 (LCD105), and nine of them had lymph node metastasis. The MVD value of the remaining 36 patient was ＞ 36 ( HCD105 ), and 26 of them had lymph node metastasis. Twenty-eight patients with positive expression of cyclin D1 had lymph node metastasis, while seven patients with negative expression of cyclin D1 had lymph node metastasis. The results of Pearson correlation analysis revealed that a high expression of CD105 and a positive cyclin D1 expression were correlated with lymph node metastasis (x2 =21.562, 9.217, P＜0.05). The survival times of 28 patients with positive cyclin D1 and HCD105,21 patients with positive cyclin D1 and LCD105, eight patients with negative cyclin D1 and HCD105, and 23 patients with negative cyclin D1 and LCD105 were (31±6) months, (47±7) months, (51±9) months and (61±5) months, respectively, with a significant difference among the four groups (F = 11.76, P ＜ 0. 05 ).Conclusion Co-expression of CD105 and cyclin D1 may be used as a prognostic factor of ESCC.

Expression of survivin,caspase-3 in gastric carcinoma by using tissue microarray and its significance / 中国癌症杂志

Background and purpose:Unbalance of apoptosis regulation plays an important role in tumor initiation and progression.Survivin and caspase-3 all take part in the regulation of cell cycle and apoptosis.We investigated the role of survivin and caspase-3 in apoptosis of gastric carcinoma,as well as its relationship with the clinicopathologic features and the prognosis of gastric carcinoma by using tissue microarray.Methods:The gastric cancer tissue microarrays were composed of tissues from 100 cases of carcinoma of the stomach without a history of chemo-radiation therapy and 30 gastric tissues of control subject.The diameter of each specimen on tissue microarrays was 2.0 mm.Expressions of survivin,caspase-3 were investigated immunohistochemically on these tissue microarrays.Tumor cell apoptosis index was also examined by TUNEL method.Of the 100 cases,47 cases were followed-up from 14 months to 13 years,in which the prognosis was analyzed.Results:Two paraffin-embedded gastric carcinoma tissue microarrays were successfully constructed,including 114 and 116 tissue spots,respectively.Immunohistochemical analysis showed that survivin expression was positive in 78 cases(78%) in this series.In contrast,no expression of survivin in control tissues was detected(P