[Correlation between serum level of miRNA-106a expression with clinicopathological characteristics and prognosis of patients with renal cell carcinoma].

OBJECTIVE: To analyze the expression of microRNA-106a(miR-106a) in renal cell carcinoma (RCC) and its correlation with clinicopathological characteristics and prognosis of patients. METHODS: Serum samples of 64 patients with newly diagnosed RCC were collected as the study group, and serum samples of 40 healthy individuals were used as the control group. Real-time fluorescence quantitative PCR was used to determine the expression level of miR-106a in each group. The correlation between miR-106a expression and clinicopathological characteristics of the patients was studied with single factor analysis and multiple Logistic regression model. Kaplan-Meier survival curve was used to analyze its correlation with the prognosis of patients. RESULTS: Before surgery, compared with the control group (1.17± 0.58), RCC patients with high- (9.15± 0.96) and low-expression(3.45± 0.37) had increased expression of miR-106a. Postoperatively, the expression level of miR-106a in both groups of patients decreased to 1.53± 0.18 and 1.75± 0.21, respectively. The area under the curve (AUC) of the diagnostic value of serum miR-106a for RCC was 0.782 (95% CI: 0.661-0.902). With an optimal cutoff value of 0.531, the sensitivity was 78.10% and the specificity was 75.00%. Serum miR-106a level of RCC patients with TNM stage T3 or T4, clinical stage II or III, lymph node metastasis, and recurrence were significantly increased. The high expression of serum miR-106a in RCC patients has an independent relationship with the tumor TNM stage and lymph node metastasis. Of the 64 follow-up patients, 4 were lost and 30 had died. Among them, the median survival time of patients in the miR-106a high expression group was 30 months, which was significantly shorter than that of the low expression group (52 months). CONCLUSION: The serum level of miR-106a is elevated in RCC patients, and may be used as a molecular marker for the diagnosis of RCC. High serum expression of miR-106a is an independent predictor for tumor TNM stage and lymph node metastasis, as well as an independent predictor for poor prognosis of RCC patients.

[Design and application of adjustable triangle external fixator for the treatment of calcaneal fractures].

OBJECTIVE: To design a kind of adjustable triangle external fixator, and to use it for treating calcaneal fractures. METHODS: The external fixator was installed into extremity near the both sides of three Kirschner wires crossing the calcaneal tubercle, the lower end of the tibia and the first cuneiform. The support rod length was adjusted to ensure the Kirschner wires affecting the calcaneal tubercle, so the Böhler angle and anteroposterior diameter of the calcaneus were recovered. From April in 2003 to April in 2008, the external fixators were used to treat 34 patients with calcaneal fractures, including 30 males and 4 females, ranging in age from 19 to 54 years, with an average of 36.7 years. The Böhler angles were -5 degree to 15 degree, with an average of 13.5 degrees. According to Sander's classification, 2 patients were type II, 20 patients were type III, and 12 patients were type IV. RESULTS: Thirty-four patients were followed up, and the duration ranged from 3 months to 4 years, averaged 25 months. The Böhler angle recovered to 30 degree to 40 degrees, with a mean of 32.5 degrees. The Maryland mean score improved from preoperative (24.76+/-15.05) to postoperative (83.26+/-16.81). Based on Maryland criteria, 8 patients got an excellent result, 21 good, 3 fair and 2 bad. CONCLUSION: The adjustable triangle external fixator for treating calcaneal fractures has the following advantages : simple approach, good recovery, little reinjury and complications, effectiveness to recovery Böhler angle and anteroposterior diameter of calcaneal, which is an ideal method to treat calcaneal fractures.