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Purpose To investigate the expression of RSK4 (ribosomal S6 protein kinase 4),CD44 and MMP-9 protein in primary renal cell carcinoma (pRCC) and metastatic renal cell carcinoma (mRCC),and to explore the level of expression as well as the association with clinicopathologic features and clinical outcome.Methods The expression of RSK4,CD44 and MMP-9 in 52 pRCC and 48 mRCC samples was detected by immunohistochemistry and its relationship with clinicopathologic features as well as prognosis was analyzed by statistical methods.Results In the 48 mRCC samples,there were 36 (75％,36/48),33(68.75％,33/48) and 44 (91.7％,44/48) positive for RSK4,CD44 and MMP-9,respectively,while the positive rate in 52 pRCC samples were 23 (44.2％,23/52),18 (34.6％,18/52) and 36 (69.2％,36/52),respectively.Statistical analysis showed that the expression of RSK4,CD44 and MMP-9 in mRCC samples was higher than the pRCC samples (PRsK4 =0.002,PMMP-9 =0.002,PcD44 =0.001).Furthermore,the expression of RSK4,CD44 and MMP-9 in mRCC samples was not correlated with ages,genders,Fuhrman grading and the metastatic sites (P ＞ 0.05).Further analysis showed that there was positive correlation among the three proteins (P =0.008),particularly,the expression of RSK4 and CD44 (P =0.019),MMP-9 and CD44 (P =0.05) were positively correlated,while the expression of RSK4 and MMP-9 (P =1.00) had no significance of correlation.Conclusion The expression of RSK4,CD44 and MMP-9 in mRCC samples is significantly higher than pRCC samples,suggesting that the three may mediate the metastasis of renal cell carcinoma,and its specific mechanism of action remains to be further studied.
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<p><b>OBJECTIVE</b>To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation.</p><p><b>METHODS</b>From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups.</p><p><b>RESULTS</b>In treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects.</p><p><b>CONCLUSION</b>T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation,rapid recovery, less complications and good functional recovery, it has better clinical effects.</p>