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OBJECTIVE@#To study the clinical manifestations and treatment of intervertebral space infection after percutaneous lumbar radiofrequency ablation of nucleus pulposus.@*METHODS@#A retrospective analysis was performed of 496 patients who underwent percutaneous lumbar disc decompression using low-temperature plasma radiofrequency ablation nucleus pulposus from June 2009 to June 2019. Six patients had lumbar infection, and the infection rate was 1.21%. All patients were male, ranging in age from 20 to 61 years old. Three patients underwent single segment radiofrequency ablation, two patients underwent dual segments ablation;and one patient underwent three segment ablation, totaling 10 intervertebral discs. One patient was complicated with type 2 diabetes before operation. The interval between infection occurrence ranged from 21 to 65 days.@*RESULTS@#All 6 patients were followed up, and the duration ranged from 18 to 40 months, with an average of 24 months. Among them, 2 patients presented with symptoms of low back pain accompanied by fever, and imaging examination showed intervertebral space infection accompanied by abscess. In addition, 4 patients experienced low back pain but no fever, and MRI showed abnormal signals of the infected intervertebral endplate or vertebral body. One patient showed staphylococcus aureus in blood culture, while the remaining 5 patients showed negative bacterial culture. All the patients were treated with antibiotics after diagnosis. Four patients were treated with conservative management to control infection;1 patient was treated with debridement of posterior lumbar infection focus, and 1 patient was treated with debridement of posterior lumbar infection focus combined with interbody fusion and internal fixation.@*CONCLUSION@#The occurrence of intervertebral space infection during lumbar radiofrequency ablation nucleoplasty should be given sufficient attention. Strict aseptic technique, avoiding repeated multi segment puncture, realizing early detection and treatment, and selecting appropriate treatment methods according to the severity of infection is the guarantee of achieving curative effect.
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Humanos , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Feminino , Dor Lombar , Núcleo Pulposo , Diabetes Mellitus Tipo 2 , Estudos Retrospectivos , Punção EspinalRESUMO
BACKGROUND: Mechanical thrombectomy (MT) is an effective treatment for large-vessel occlusion in acute ischemic stroke, however, only some revascularized patients have a good prognosis. For stroke patients undergoing MT, predicting the risk of unfavorable outcomes and adjusting the treatment strategies accordingly can greatly improve prognosis. Therefore, we aimed to develop and validate a nomogram that can predict 3-month unfavorable outcomes for individual stroke patient treated with MT. METHODS: We analyzed 258 patients with acute ischemic stroke who underwent MT from January 2018 to February 2021. The primary outcome was a 3-month unfavorable outcome, assessed using the modified Rankin Scale (mRS), 3-6. A nomogram was generated based on a multivariable logistic model. We used the area under the receiver-operating characteristic curve to evaluate the discriminative performance and used the calibration curve and Spiegelhalter's Z-test to assess the calibration performance of the risk prediction model. RESULTS: In our visual nomogram, gender (odds ratio [OR], 3.40; 95%CI, 1.54-7.54), collateral circulation (OR, 0.46; 95%CI, 0.28-0.76), postoperative mTICI (OR, 0.06; 95%CI, 0.01-0.50), stroke-associated pneumonia (OR, 5.76; 95%CI, 2.79-11.87), preoperative Na (OR, 0.82; 95%CI, 0.72-0.92) and creatinine (OR, 1.02; 95%CI, 1.01-1.03) remained independent predictors of 3-month unfavorable outcomes in stroke patients treated with MT. The area under the nomogram curve was 0.8791 with good calibration performance (P = 0.873 for the Spiegelhalter's Z-test). CONCLUSIONS: A novel nomogram consisting of gender, collateral circulation, postoperative mTICI, stroke-associated pneumonia, preoperative Na and creatinine can predict the 3-month unfavorable outcomes in stroke patients treated with MT.
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AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Nomogramas , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/cirurgia , Trombectomia/efeitos adversos , Resultado do TratamentoRESUMO
BACKGROUND: Left atrial enlargement is associated with increased risk for stroke. However, few studies that evaluated the correlation between left atrial size and ischemic stroke severity. In this study, we aim to evaluate the association between left atrial size and stroke severity, especially with cardioembolic and cryptogenic stroke in the Chinese population. METHODS: A total of 1271 patients with acute ischemic stroke were included in this study. Echocardiographic left atrial diameter was measured and indexed to height. Stroke severity was assessed at admission with the National Institutes of Health Stroke Scale (NIHSS). Moderate-to-severe neurologic deficit was defined as NIHSS greater than or equal to 5. Patients were divided into mild, moderate, or severe abnormal left atrial size by tertile distribution. Binary logistic regression analysis was used to identify independent predictors of severe stroke after adjustment. RESULTS: Among all enrolled patients, 328 (25.8%) were classified into moderate-to severe stroke severity (NIHSS ≥ 5). In the multivariable model, compared with the lowest tertile of left atrial size, the odds ratio for moderate-to-severe neurologic deficit was 0.902 (95% CI, 0.644-1.264, P = .550) when left atrial size was the highest tertile. Of all patients, 190 patients were further categorized as cardioembolic and cryptogenic subtypes, and 70 (36.8%) were classified into moderate-to-severe stroke severity. After adjusting for confounders, compared with the lowest tertile, the top tertile of left atrial size was significantly associated with moderate-to-severe stroke (3.156, 95% CI, 1.143-8.711, P = .027). CONCLUSION: Left atrial enlargement was associated with more severe initial neurologic deficits of embolic subtypes (cardioembolic and cryptogenic stroke) in patients with acute ischemic stroke.
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Função do Átrio Esquerdo , Remodelamento Atrial , Átrios do Coração/fisiopatologia , Cardiopatias/complicações , Embolia Intracraniana/etiologia , Acidente Vascular Cerebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etiologia , Isquemia Encefálica/fisiopatologia , China , Avaliação da Deficiência , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Cardiopatias/fisiopatologia , Humanos , Embolia Intracraniana/diagnóstico , Embolia Intracraniana/fisiopatologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologiaRESUMO
INTRODUCTION: Antiplatelet therapy combining aspirin and clopidogrel is considered to be a key intervention for acute ischaemic minor stroke (AIMS) and transient ischaemic attack (TIA). However, the interindividual variability in response to clopidogrel resulting from the polymorphisms in clopidogrel metabolism-related genes has greatly limited its efficacy. To date, there are no reports on individualised antiplatelet therapy for AIMS and TIA based on the genetic testing and clinical features. Therefore, we conduct this randomised controlled trial to validate the hypothesis that the individualised antiplatelet therapy selected on the basis of a combination of genetic information and clinical features would lead to better clinical outcomes compared with the standard care based only on clinical features in patients with AIMS or TIA. METHODS AND ANALYSIS: This trial will recruit 2382 patients with AIMS or TIA who meet eligibility criteria. Patients are randomly assigned in a 1:1 ratio to pharmacogenetic group and standard group. Both groups receive a loading dose of 300 mg aspirin and 300 mg clopidogrel on day 1, followed by 100 mg aspirin per day on days 2-365. The P2Y12 receptor antagonist is selected by the clinician according to the genetic information and clinical features for pharmacogenetic group and clinical features for the standard group on days 2-21. The primary efficacy endpoint is a new stroke event (ischaemic or haemorrhagic) that happens within 1 year. The secondary efficacy endpoint is analysed as the individual or composite outcomes of the new clinical vascular event (ischaemic stroke, haemorrhagic stroke, myocardial infarction or vascular death). Baseline characteristics and outcomes after treatment will be evaluated. ETHICS AND DISSEMINATION: This protocol has been approved by the ethics committee of Yangpu Hospital, Tongji University School of Medicine (No. LL-2018-KY-012). We will submit the results of this trial for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ChiCTR1800019911; Pre-results.
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Aspirina/uso terapêutico , Clopidogrel/uso terapêutico , Ataque Isquêmico Transitório/tratamento farmacológico , Inibidores da Agregação Plaquetária/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Ticagrelor/uso terapêutico , Citocromo P-450 CYP2C19/genética , Quimioterapia Combinada , Hemorragia/induzido quimicamente , Humanos , Testes Farmacogenômicos , Prevenção SecundáriaRESUMO
BACKGROUND: Tissue plasminogen activator (t-PA) is an effective therapy for acute ischemic stroke, but some patients still have poor clinical outcome. In this study, we investigated clinical characteristics of stroke patients and determined predictors for poor clinical outcome in response to t-PA treatment. METHODS: Clinical data from 247 patients were retrospectively reviewed. Clinical parameters that were associated with survival of patients were analyzed. Areas under receiver operating characteristic curves (ROC) were used to determine the feasibility of using various combinations of the clinical parameters to predict poor clinical response. The clinical outcome was defined according to the changes in Modified Rankin Scale. RESULTS: Overall, 145 patients had improved/complete recovery, 73 had no change, and 29 had worsening conditions or died during the in-clinic period. A univariate analysis showed that baseline characteristics including age, CRP, blood glucose level, systolic blood pressure, and admission NIHSS were significantly different (p < 0.05) among patients with different clinical outcome. A further multivariate analysis was then performed. Variables associated with poor clinical outcome (worsening/death) (p < 0.1) were included in the logistic regression model. Four parameters were retained in the model: Age, CRP, Blood glucose level, and Systolic blood pressure (ACBS). To allow a convenient usage of the ACBS classifier, the parameters were put into a scoring system, and the score at 7.7 was chosen as a cut-off. The ROC curve of this ACBS classifier has an area under the curve (AUC) of 0.7788, higher than other individual parameters. The ACBS classifier provided enhanced sensitivity of 69.2% and specificity of 74.3%. CONCLUSION: The ACBS classifier provided a satisfactory power in estimating the patients' clinical outcome. After further validating, the classifier may provide important information to clinicians for making clinical decisions.
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Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Acidente Vascular Cerebral/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Terapia Trombolítica , Resultado do TratamentoRESUMO
To obtain insight into the function of miRNAs in the synthesis and storage of important nutrients during the development of Camellia oleifera fruit, Illumina sequencing of flower and fruit small-RNA was conducted. The results revealed that 797 miRNAs were significantly differentially expressed between flower and fruit samples of Camellia oleifera. Through integrated GO and KEGG function annotations, it was determined that the miRNA target genes were mainly involved in metabolic pathways, plant hormone signal transduction, fruit development, mitosis and regulation of biosynthetic processes. Carbohydrate accumulation genes were differentially regulated by miR156, miR390 and miR395 in the fruit growth and development process. MiR477 is the key miRNA functioning in regulation of genes and involved in fatty acid synthesis. Additionally, miR156 also has the function of regulating glycolysis and nutrient transformation genes.
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Camellia/química , Frutas/metabolismo , MicroRNAs/metabolismo , RNA de Plantas/genética , Flores/genética , Flores/metabolismo , Frutas/genética , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas/genética , Regulação da Expressão Gênica de Plantas/fisiologia , Sequenciamento de Nucleotídeos em Larga Escala , MicroRNAs/genética , Microscopia Eletrônica de VarreduraRESUMO
OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of pitavastatin comparison of atorvastatin in the treatment of primary hypedipemia in Chinese adults,and to provide evidence-based reference for clinic.METHODS:Retrieved from The Cochrane Library,PubMed,Chinese Journal Full-text Database,Wanfang database,and manually search Google Scholar,Baidu academic search engine,randomized controlled trials (RCTs) about pitavastatin (trial group) vs.atorvastatin (control group) in the treatment of primary hyperlipemia in Chinese adults were collected.After literature screening,data extraction,quality evaluation of included studies with modified Jadad scale,Meta-analysis of the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C),response rate and the incidence of ADR was conducted by using Rev Man 5.3 statistical software.RESULTS:A total of 5 RCTs were included,involving 456 patients.Results of Meta-analysis showed that the decrease of TC level [MD=0.09,95%CI(0.01,0.16),P=0.03] in trial group was more better than control group,while the increase of HDL-C level [MD=0.08,95% CI (0.01,0.14),P=0.03] and the decrease of the TG level [MD=-0.13,95% CI (-0.20,-0.06),P=0.000 4] in trial group were worse than control group,with statistical significance.There was no statistical difference in the decrease of LDL-C[MD=-0.01,95% CI (-0.13,0.10),P=0.84],response rate [OR=0.75,95%CI (0.15,3.66),P=0.72] or the incidence of ADR [OR=0.68,95 % CI (0.44,1.05),P=0.08] between 2 groups.CONCLUSIONS:Pitavastatin has better therapeutic efficacy in decreasing TC,but its therapeutic efficacy in decreasing LDL-C is similar to that of atorvastatin;its therapeutic efficacy in decreasing TG and increasing HDL-C is worse than that of atorvastatin.The safety of them is equivalent.
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<p><b>Background</b>Many clinical studies over the past decade have indicated positive outcomes for patients treated with Dynesys dynamic stabilization for lumbar degenerative disease. However, long-term outcomes of Dynesys for lumbar spinal stenosis are rarely reported. The aim of this study was to analyze the long-term clinical and radiologic outcomes for patients with lumbar spinal stenosis treated with Dynesys stabilization.</p><p><b>Methods</b>Thirty-eight patients with lumbar spinal stenosis were treated with Dynesys stabilization from July 2008 to March 2010. The minimal duration of follow-up was 72 months. The patients were divided into stenosis and spondylolisthesis groups according to degenerative spondylolisthesis. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and visual analog scale (VAS). Radiographic evaluations included range of motion (ROM) and the disc heights of stabilized segments and the upper adjacent segments. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD).</p><p><b>Results</b>There were 23 patients in stenosis group and 15 patients in spondylolisthesis group. The ODI scores were significantly improved at the final follow-up evaluation, as compared to the baseline values (16.1 ± 5.7 vs. 57. 2 ± 14.2, t = 61.41, P < 0.01). The VAS scores for back and leg pain were significantly improved from 4.82 ± 0.89 and 4.04 ± 0.82 preoperatively to 0.93 ± 0.61 and 0.54 ± 0.51 postoperatively (t = 6.59, P < 0.01, and t = 5.91, P < 0.01, respectively). There were no differences between the two groups with respect to VAS and ODI scores. The ROM of stabilized segments decreased significantly from 7.8° ± 2.4° to 4.5° ± 1.5° (t = 7.18, P < 0.05), while the upper adjacent segments increased significantly from 8.3° ± 2.4° to 10.4° ± 2.4° (t = 2.87, P = 0.01). The change in disc height of stabilized segments was not significant (11.9 ± 2.1 preoperatively vs. 12.5 ± 1.5 postoperatively, t = 1.43, P = 0.15), whereas the decrease in disc height of the upper adjacent segments was significant (12.5 ± 2.0 preoperatively vs. 11.0 ± 1.7 postoperatively, t = 2.94, P = 0.01). The occurrence of radiographic and symptomatic ASD was 16% (6/38) and 3% (1/38), respectively.</p><p><b>Conclusions</b>Decompression and Dynesys stabilization for lumbar stenosis with or without spondylolisthesis showed good long-term clinical and radiographic results. Lumbar stenosis with or without Grade I spondylolisthesis, particularly in patients <60 years of age with mild-to-moderate lumbar disc degeneration, would be one of the main indications for the Dynesys system.</p>
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Objective To observe the clinical efficacy of Tong Du Tiao Shen needling (unblocking the Governor Vessel and regulating the mind) in treating post-stroke deglutition disorders. Method Sixty patients with post-stroke deglutition disorders were randomized into a treatment group and a control group by the random number table, 30 cases each. In addition to the conventional neurological treatment, the control group was given ordinary acupuncture, and the treatment group was given Tong Du Tiao Shen needling, 3 times a week, 10 sessions as a treatment course. The Water Swallowing Test (WST) and Videofluoroscopic Swallowing Study (VFSS) were observed in the two groups before and after 1 course of treatment. Result The total effective rate was 93.3% in the treatment group, significantly superior to 66.7% in the control group (P<0.05). The VFSS showed that the intra-group differences were statistically significant in comparing oral transit, pharyngeal retention and pharyngeal transit of semi-fluid food in both treatment and control groups by the paired t-test (P<0.05), and the between-group differences after the treatment were also statistically significant (P<0.05). Conclusion Tong Du Tiao Shen needling can produce a more significant efficacy in improving the swallowing function in post-stroke dysphasia compared to ordinary acupuncture.
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<p><b>OBJECTIVE</b>To compare of clinical effects of different surgical methods in the treatment of elderly femoral neck fractures.</p><p><b>METHODS</b>From January 2013 to June 2016, 144 elderly patients with femoral neck were treated and divided into artificial hip replacement group and cannulated screw fixation group according to the surgical methods. In the total hip arthroplasty group, there were 89 cases, 28 males and 61 females, with an average age of(84.10±3.10) years old;Hollow nail fixation group 55 cases, 20 males and 35 females, with an average age of (86.80±2.88) years. Preoperative patients data, postoperative complications, mortality and postoperative Harris hip score were compared between the two groups.</p><p><b>RESULTS</b>A total of 144 cases were followed up for 12 to 36 months with an average of 18 months. There was no significant difference between two groups in gender, fracture side, preoperative complications, osteoporosis, ASA score, injury to surgery interval, the number of patients admitted to ICU and perioperative death. However, the patients in hollow screw fixation group was older than the joint replacement group(=5.311,<0.05);The degree of preoperative fracture displacement in the joint replacement group was higher than that in the hollow nail fixation group(χ²=6.894,=0.009<0.05);Hollow nail fixation group in operation time, hospital stay, intraoperative blood loss, perioperative blood transfusion was significantly better than the number of joint replacement group(<0.05);The Harris score of the joint replacement group was higher than that of the hollow screw fixation group(<0.05).</p><p><b>CONCLUSIONS</b>For elderly femoral neck patients, if there is a significant shift in the fracture (Garden III, IV), the preferred treatment is hip replacement. Postoperative complications are relatively small, satisfactory joint function recovery. If the fracture displacement is not obvious (Garden type I, II) or patients with more medical diseases, poor physical condition, poor surgical tolerance, postoperative life expectancy is not high, the first choice is closed reduction and cannulated screw fixation.</p>
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<p><b>OBJECTIVE</b>To investigate the changes and clinical significance of biomarker fecal bile acids (BA) in children with Henoch-Schönlein purpura (HSP).</p><p><b>METHODS</b>Nineteen children with HSP and twenty-seven healthy children were enrolled in this study. The stool samples were obtained at the acute and remission phases. Fecal BA levels were measured by high performance liquid chromatography mass spectrometry (HPLC-MS).</p><p><b>RESULTS</b>The fecal cholic acid level in the HSP remission group was significantly higher than in the HSP acute group and the healthy control group (P<0.016). The fecal chenodeoxycholic acid level in the HSP remission group was significantly higher than in the healthy control group (P<0.016). The levels of fecal secondary colonic bile acids, deoxycholic acid and lithocholic acid, in the HSP acute and remission groups were significantly lower than in the healthy control group(P<0.05, P<0.016 respectively). No significant differences were found in the levels of fecal urosodeoxycholic acid among the three groups (P>0.05).</p><p><b>CONCLUSIONS</b>Fecal secondary colonic bile acids, deoxycholic acid and lithocholic acid, are in decrease in children with HSP at the acute stage, which may be involved in the pathogenesis and treatment outcomes of HSP.</p>
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Criança , Feminino , Humanos , Masculino , Ácidos e Sais Biliares , Biomarcadores , Fezes , Química , Vasculite por IgA , Diagnóstico , TerapêuticaRESUMO
The expression changes of Rars gene in ischemia-injured neurons were investigated by detecting its translational product arginyl-tRNA synthetase (ArgRS), and the inhibitory effects of ischemic preconditioning (IPC) on Rars gene were explored. Both IPC model and prolonged ischemia (PI) model were established by using the classic oxygen glucose deprivation (OGD) method. The primary cultured neurons were assigned into the following groups: the experimental group (IPC+PI group), undergoing PI after a short period of IPC; the conditional control group (PI control group), subjected to PI without IPC; blank control group, the normally cultured neurons. The Rars transcriptional activities and ArgRS expression levels were measured at different time points after re-oxygenation (3 h/6 h/12 h/24 h). Data were collected and statistically analyzed. Compared to the blank control group, the Rars activities and ArgRS levels were significantly increased in PI control group, peaking at the time point of 6 h after re-oxygenation. Rars activities and ArgRS levels were significantly lower in the experimental group than in the PI control group at different time points after re-oxygenation. PI insult can induce an escalating activity of Rars and lead to ArgRS over-expression in primary cultured neurons. IPC can inhibit the increased Rars activity and down-regulate ArgRS expression of ischemia-insulted neurons. This mechanism may confer ischemic tolerance on neurons.
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Animais , Humanos , Ratos , Arginina-tRNA Ligase , Genética , Metabolismo , Isquemia Encefálica , Genética , Metabolismo , Patologia , Regulação da Expressão Gênica , Genética , Glucose , Metabolismo , Precondicionamento Isquêmico , Métodos , Neurônios , Metabolismo , Patologia , Oxigênio , Metabolismo , Cultura Primária de CélulasRESUMO
In the title compound, {[NiWO(4)(C(16)H(36)N(4))]·4H(2)O}(n), the Ni(II) ion lies on an inversion center and is octahedrally coordinated by four N atoms of the tetradentate macrocyclic 5,5,7,12,12,14-hexa-methyl-1,4,8,11-tetra-aza-cyclo-tetra-decane (L) ligand in the equatorial plane and two O atoms of [WO(4)](2-) anions in axial positions. Each [WO(4)](2-) anion bridges two adjacent [NiL](2+) cations, forming a chain along [001]. The chains are further connected via N-Hâ¯O, O-Hâ¯O and C-Hâ¯O hydrogen-bonding inter-actions, generating a three-dimensional structure.
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S1P (sphingosine 1-phosphate) is one of the metabolite products of membrane sphingomyelin, and it plays an important role in formation, transformation and progression of many malignant tumors as well as the regulation of cell proliferation, apoptosis and angiogenesis. Furthermore, S1P plays different roles in regulation of biological behaviors of malignant tumors depending on the types of the cells and S1PR (sphingosine 1-phosphate receptor). For ovarian cancer and colon cancer, S1P improves the growth of tumors cells by S1PR1/S1PR3, but for malignant melanoma, it inhibits the cell growth by S1PR2. There is a difference in the downstream pathways mediated by difficult receptors. This review summarizes the advances in research on the roles of S1P in regulating biological behaviors of tumor cells and different signal pathways of S1P mediated by various receptors. Copyright © 2012 by TUMOR.
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<p><b>OBJECTIVE</b>To evaluate the treatment and effect of a technique using single femoral posterior longitudinal strip osteotomy in revision total hip arthroplasties.</p><p><b>METHODS</b>Between September 2005 and December 2009, 35 hips of 35 patients underwent a revision total hip arthroplasties (THA) in conjunction with extraction of femoral components. Among them, 23 cases were with uncemented, and 12 cases were with cemented femoral components. Those cases being followed up were chosen by two standards described as follows: one was the examination of preoperative radiographs, which showed that there was difficult in the extraction of the femoral components; Another followed was the trying with routine procedure to remove the stem. If these were unsuccessful, a single longitudinal strip osteotomy was performed, whose length was about 11 - 14 cm, and width was about 1 cm. Then the femoral component was disimpact. The osteotomy was fixed with wires or cables. If there was cortical deficiency or insufficient cancellous bone, grafting was performed. A cementless composite revision prosthesis of the Lima-Lto with a tapered modular distal fixation stem was used. All the patients were evaluated with preoperative and postoperative Harris score, the length of limb and radiographs.</p><p><b>RESULTS</b>All cases were followed up with 5 to 55 months, average 15 months. Compared with preoperative, the average Harris score increased from 30 (range, 19 - 40 points) to 85 points (range, 80 - 92 points). All pains of hip joint were alleviated from the mean 12 points (range, 10 - 20 points) before the operation to 40 points (range, 30 - 44 points) after the operation. All the femoral osteotomy and bone grafting were healing ultimately. And on average, the healing began in 20 weeks (range, 10 - 32 weeks). All the cases remain the same length of lower limbs. There was no hip joint dislocation, loosening or infection.</p><p><b>CONCLUSIONS</b>The femoral posterior longitudinal strip osteotomy facilitates the exposure and extraction of the femoral stem, the clear up of medullary cavity and then the femoral reconstruction in revision total hip arthroplasties. It has satisfactory short-term radiographic evaluation and clinical effect as a simple, effective and reliable technique.</p>
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artroplastia de Quadril , Remoção de Dispositivo , Fêmur , Cirurgia Geral , Seguimentos , Prótese de Quadril , Osteotomia , Métodos , Reoperação , Estudos Retrospectivos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To investigate the role of EPHA2 in regulating apoptosis, proliferation and vasculogenic mimicry of osteosarcoma cells, by gene silencing through RNA interference.</p><p><b>METHODS</b>EPHA2-siRNA plasmids were achieved by gene cloning. The plasmids were transfected into human osteosarcoma cells (MG63). The expression level of EPHA2 protein was measured by Western blotting. The proliferation, apoptosis and vasculogenic mimicry features of osteosarcoma MG63cells were assessed by light microscopy, MTIP assay, flow cytometry, annexin V-FITC/PI and HE staining, respectively.</p><p><b>RESULTS</b>The EPHA2-siRNA plasmid was confirmed by DNA sequencing. After treatment with Sequence-specific siRNA targeted EPHA2, the protein level of the transfected group decreased significantly. As compared to non-siRNA transfected cells, the transfected group showed lower proliferation, higher and earlier apoptosis and less osteosarcoma-generated vasculogenic mimicry.</p><p><b>CONCLUSION</b>EPHA2 gene may be involoved in apoptosis and proliferation of osteosarcoma cells, and may be necessary for vasculogenic mimicry. Down-regulation of EPHA2 expression by sequence-specific siRNA may be considered as a new option in the treatment of EPHA2 over-expressing cancer including osteosarcoma in future.</p>
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Humanos , Apoptose , Neoplasias Ósseas , Metabolismo , Patologia , Linhagem Celular Tumoral , Proliferação de Células , Neovascularização Patológica , Patologia , Osteossarcoma , Metabolismo , Patologia , Plasmídeos , Interferência de RNA , RNA Interferente Pequeno , Genética , Receptor EphA2 , Genética , Metabolismo , TransfecçãoRESUMO
<p><b>OBJECTIVE</b>To investigate the optimal margin in nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) 4 cm or less in diameter.</p><p><b>METHODS</b>Eighty-two kidneys with RCC 4 cm or less in diameter resected by radical nephrectomy were prospectively studied. The kidney samples were sectioned at 3 mm interval and examined for multicentricity. On each layer of tissue sectioned, parenchyma margin of 15 mm beyond pseudocapsule was continuously sectioned and examined for completeness of pseudocapsule and extra-pseudocapsule cancer lesion. The farthest distance between extra-pseudocapsule lesion and primary tumor was measured. PCNA expression was detected in 41 patients by using standard SP immunohistochemistry technique.</p><p><b>RESULTS</b>The diameter of 82 primary tumors was 3.4 +/- 0.8 cm (range 1.5 - 4.0 cm). Of these, 31.7% (26/82) were found without intact pseudocapsule and 17.1% (14/82) with positive cancer lesions beyond pseudocapsule. The average distance between extra-pseudocapsule cancer lesion and primary tumor was 0.5 +/- 1.3 mm (range 0 - 5.0 mm), with a confidential interval (CI) of 95% (0.11, 0.94). Statistically, the one side percentile P(95) was 4.9 mm, P(97.5) was 5.0 mm and P(100) was 5.0 mm. The mean PCNA index in the 41 patients with RCC was (29.5 +/- 17.6)%, which was (49.6 +/- 21.5)% in the group with extra-pseudocapsule cancer lesions and (24.6 +/- 12.7)% in the group without (t = 3.162, P = 0.013). The ratio of strong expression was 5/8 in the group with extra-pseudocapsule cancer lesions, and 18.2% (6/33) in the group without the lesions (chi(2) = 6.442, P = 0.011). Logistic regression analysis showed that completeness of pseudocapsule and PCNA index were significant predictors of extra-pseudocapsule cancer lesions (P = 0.019).</p><p><b>CONCLUSIONS</b>These data suggest that when NSS is performed in RCC 4 cm or less in diameter, a margin of more than 5 mm of adjacent parenchyma should be excised with the tumor. Enucleation alone was associated with a significant risk of incomplete excision, and therefore liable for local recurrence. Tumors with incomplete pseudocapsule and(or) high PCNA indices are more likely to have extra-pseudocapsule cancer lesions, so intensive follow-up is necessary after NSS.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Renais , Metabolismo , Patologia , Cirurgia Geral , Neoplasias Renais , Metabolismo , Patologia , Cirurgia Geral , Nefrectomia , Métodos , Antígeno Nuclear de Célula em Proliferação , Metabolismo , Estudos RetrospectivosRESUMO
A novel amperometric immunosensor setup is described which uses horseradish peroxidase (HRP) as a label in conjunction with a current-based Brucella sensor. The Bacteria modified immunosensor was constructed by using a biocomposite formed by dispersing graphite powder into a mixture of Brucella melitensis and silicate polymer gel. The enzyme-labeled antibody can readily diffuse toward the encapsulated antigen (Brucella melitensis), which retains its binding properties, and the association reaction is easily detected at the surface exposed to the solution. The use of an oaminophenol (o-AP) substrate and amperometric detection at -150 mV (vs. SCE) results in a relatively low detection limit of 3.5 ng/ml and a linear detection range of 3.5 ng/ml to 200 ng/ml. Based on an optimized parameter, the prepared sensor was used to detect the Brucella melitensis antibody in serum samples by using a competitive binding assay. The results demonstrate the feasibility of employing the proposed immunosensor for the detection for Brucella melitensis antibody in a clinical analysis.
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Anticorpos Antibacterianos/análise , Técnicas Biossensoriais/métodos , Brucella melitensis/imunologia , Eletroquímica/métodos , Imunoensaio/métodos , Animais , Antígenos de Bactérias/sangue , Antígenos de Bactérias/imunologia , Sítios de Ligação de Anticorpos , Ligação Competitiva , Técnicas Biossensoriais/instrumentação , Brucella melitensis/isolamento & purificação , Brucelose/sangue , Brucelose/diagnóstico , Eletroquímica/instrumentação , Ensaio de Imunoadsorção Enzimática/métodos , Cabras , Peroxidase do Rábano Silvestre , Imunoensaio/instrumentação , Técnicas Imunoenzimáticas/métodosRESUMO
In this paper, the synthesis of a novel ionophore, chloro[5,10,15,20-tetrakis[2-(2,3,4,6-tetraacetyl-beta-D-glucopyranosyl)-1-O-phenyl]porphinato]manganese (MnT(o-glu)PPCl), and its application as a neutral carrier for a PVC membrane electrode are described. The MnT(o-glu)PPCl-based PVC membrane electrode shows a potentiometric responses to SCN- over a concentration range of 3.4 x 10(-7) - 1.0 x 10(-1) mol L(-1) with a Nernstian slope and a response time of 20 s. The electrode exhibits an anti-Hofmeister selectivity toward SCN- with respect to common coexisting anions. As active materials, MnT(o-glu)PPCl shows better selectivity toward SCN- than chloro(tetraphenylporphinato)manganese (MnTPPCl). The effect of the electrode membrane compositions has been studied and the experimental conditions were optimized. The electrode was applied to the determination of SCN- in body fluids with satisfactory results.
Assuntos
Eletrodos , Metaloporfirinas/química , Cloreto de Polivinila/química , Técnicas Biossensoriais/métodos , Sequência de Carboidratos , Glicosilação , Humanos , Concentração de Íons de Hidrogênio , Membranas Artificiais , Estrutura Molecular , Plastificantes/química , Sensibilidade e Especificidade , Tiocianatos/química , Tiocianatos/urinaRESUMO
By replacing the hydrogen of the 4-amino group of a 4-amino-1,8-naphthalimide derivative with an N-acryloxyethyl group, the fluorophore has been covalently immobilized on an optical sensor surface by UV photopolymerization. The optical sensor obtained can be used for the determination of picric acid. The linear range and detection limit of the sensor are 9.80x10(-7)-1.96x10(-4) mol L(-1) and 7.1x10(-7) mol L(-1), respectively. Leaching of the fluorophore from the membrane is effectively prevented by covalent immobilization, resulting in a sensor with a relatively long lifetime. The response time of the sensor is short, and the reproducibility and reversibility are good. The sensor has been used for the indirect determination of the chloroquine content of pharmaceutical tablets.