Objective To investigate the regulatory effect of somatostatin analogue (SMS201995,SMS) on proliferation and apoptosis in human cholangiocarcinoma cell line in vitro. MethodsProliferation curve, flow cytometry, agarose gel electrophoresis, Annexin VFITC and flow cytometric immunofluorescent technique were performed to identify the inhibitory effect on cell proliferation and the induction of apoptosis of human cholangiocarcinoma cells (SKChA1). ResultsSMS significantly reduced the SKChA1 cell growth by serum in long experiments and transiently accumulated it in G0/G1 phase. Dotplot analysis of cells duallabeled with Annexin VFITC and PI confirmed the induction of apoptosis by SMS in SKChA1 cells.AnnexinVFITC labeling was markedly enhanced following treatment with SMS for 24 h. DNA of treated SKChA1 cells appeared a ladder pattern characteristic of apoptosis. Besides, timedependent increase in bax and decrease in bcl2 occured during SMS treatment. Conclusion SMS could inhibit the proliferation activity and induce apoptosis of cholangiocarcinoma cell line SKChA1. The mechanisms of apoptosis might be correlated with the expression of apoptosisregulatory gene bax and bcl2.
Objective To review the recent advances in treatment of aseptic femoral shaft nonunion. Methods The clinical studies about the treatments of aseptic femoral shaft nonunion in recent years were widely reviewed and analyzed. Results There are several surgical methods for aseptic femoral shaft nonunion. Due to uncertain clinical outcome, dynamization of nail should be carefully selected. The exchange nailing is suitable for the hypertrophic nonunion of the isthmal femoral shaft fracture. The exchange lateral plating is suitable for nonunion with obvious malformation. However, wave plate or dual plate should be chosen when the bone nonuinon is combined with the medial defect. The augmentation plating improves the success rate of nailing for femoral shaft nonunion, but it should be carefully selected for patients with obvious deformity or bone defect. Ilizarov technique is suitable for various bone nonunion, especially with complicated or large segmental bone defects. Induced membrane technique is also an important method for the treatment of bone nonunion with large bone defects. The clinical efficacy of the blocking screw remains to be supported by further evidence. Biological stimulants are mainly used for atrophic nonunion, and the clinical efficacy of them alone are still controversial. Conclusion Due to lack of comparative studies between different surgical methods, the orthopedist should choose the appropriate treatment according to the individual situations of the patient and the types of bone nonunion.
Objective To evaluate feasibility and clinical application value of laparoscopic spleen-preserving distal pancreatectomy (LSPDP). Method The clinical data of 17 patients underwent LSPDP from January 2015 to June 2017 in this hospital were retrospectively analyzed. Results The LSPDP was successfully completed in the 17 cases, with Kimura procedure and Warshaw procedure were performed in the 12 cases and 5 cases, respectively. The operative time was (218±60) min, the intraoperative blood loss was (136±114) mL, the time to get out of bed after surgery was (1.4±0.6) d, the postoperative fasting time was (2.0±0.8) d, and the postoperative hospital stay was (13.4±5.7) d. The rate of the postoperative pancreatic fistula was 17.6% (3/17). The spleen infarction occurred in the 2 cases following the Warshaw procedure. The pathologic examination showed that there were 2 patients with the serous cystadenoma, 7 patients with the mucinous cystadenoma, 3 patients with the solid pseudo-papillary tumor, 3 patients with the intraductal papillary mucinous cystadenoma neoplasm, and 2 patients with the insulinoma. All the patients were followed-up for 5 to 26 months (average 13 months), and the perigastric varice occurred in 1 patient, no recurrence or spleen infarction occurred during the following-up. Conclusion LSPDP is a safe, feasible and effective method with less injury and rapid recovery.
ObjectiveTo review the history, current situation, and progress of augmentation plate (AP) for femoral shaft nonunion after intramedullary nail fixation.MethodsThe results of the clinical studies about the AP in treatment of femoral shaft nonunion after intramedullary nail fixation in recent years were widely reviewed and analyzed.ResultsThe AP has been successfully applied to femoral shaft nonunion after intramedullary nail fixation since 1997. According to breakage of the previous nailing, AP is divided into two categories: AP with retaining the previous intramedullary nail and AP with exchanging intramedullary nail. AP is not only suitable for simple nonunion, but also for complex nonunion with severe deformity. Compared with exchanging intramedullary nail, lateral plate, and dual plate, AP has less surgical trauma, shorter healing time, higher healing rate, and faster returning to society. However, there are still some problems with the revision method, including difficulty in bicortical screw fixation, lack of anatomic plate suitable for femoral shaft nonunion, and lack of postoperative function and quality of life assessment.ConclusionCompared with other revision methods, AP could achieve higher fracture healing rate and better clinical prognosis for patients with femoral shaft nonunion. However, whether patients benefit from AP in terms of function and quality of life remain uncertain. Furthermore, high-quality randomized controlled clinical studies are needed to further confirm that AP are superior to the other revision fixations.
ObjectiveTo investigate the effectiveness of three-dimensional (3D) navigation template in the adult cubitus varus osteotomy.MethodsBetween April 2013 and September 2015, 17 patients with cubitus varus were admitted. There were 6 males and 11 females, aged from 19 to 38 years, with an average age of 26.9 years. There were 10 cases of left elbow joints and 7 cases of right elbow joints. The disease duration was 9-30 years (mean, 18 years). Based on the preoperative X-ray film, the humerus-elbow-wrist (HEW) angle was (−13.2 ±3.3)°, the anteversion angle was (−10.5±2.3)°. The preoperative range of motion (ROM) of flexion was (127.3±7.3)° and ROM of extension was (−10.0±2.5)°. Based on the CT 3D reconstruction, the osteotomy navigation template was designed and printed by 3D printing technique. The cubitus varus osteotomy was assisted by 3D navigation template. The postoperative HEW angle, anteversion angle, and ROMs of the elbow joints of both sides were measured. The elbow function was evaluated based on the Oppenheim elbow function score at 1 year after operation.ResultsAll cubitus varus osteotomies succeeded with the assist of 3D navigation template. All incisions healed by first intention. All patients were followed up 12-15 months (mean, 13 months). X-ray films showed that all osteotomies healed after 9-12 weeks (mean, 11 weeks). At 1 year after operation, the HEW angle was (9.7±1.9)°, the anteversion angle was (20.7±4.3)°, the ROM was (2.6±3.5)° in extension and (139.2±4.8)° in flexion of affected side. The HEW angle, anteversion angle, and ROMs significantly increased compared with preoperative values (P<0.05). And there was no significant difference between affected and normal elbow joints (P>0.05). The elbow functions were excellent in 13 cases and good in 4 cases based on the Oppenheim elbow function score at 1 year after operation. There was no complication such as the nerve injury or osteomyositis of elbow joint during follow-up. ConclusionThe 3D navigation template can provide a personalized and precise osteotomy treatment for adult cubitus varus deformity and obtain a satisfactory effectiveness.
ObjectiveTo review the literature about the clinical application and research progress on medial support augmentation of plate osteosynthesis for proximal humeral fractures, and to provide reference for clinical treatment.MethodsThe literature concerning medial support augmentation of plate osteosynthesis for proximal humeral fractures in recent years was extensively reviewed, as well as the biomechanical benefit and clinical advantage were analyzed thoroughly.ResultsMedial support augmentation of plate osteosynthesis for proximal humeral fractures is very important, especially in osteoporotic and/or comminuted fractures. Many medial support augmentation methods have been proposed which can be divided into extramedullary support and intramedullary support. It can also be divided into autogenous bone support and allogenic bone support according to the material and source, divided into medial column support, calcar support, and humeral head support according to the support site, and divided into fibular shaft support, femoral head support, anatomic fibula support according to the shape of the augmented fixation. At present, clinical and biomechanical researches show that medial support augmentation is an effective treatment for proximal humeral fractures.ConclusionAs an important treatment strategy for the treatment of proximal humeral fractures, the medial support augmentation of plate osteosynthesis gets the focus from the biomechanical studies and clinical treatment. However, there are still widespread controversies among orthopedic surgeons regarding the support mode, site, implant shape, and material of medial column support for augmentation of proximal humeral fractures. More high-quality clinical trials and biomechanical researches as well as multi-disciplinary integration, are needed to provide better strategy treatment for the treatment of proximal humeral fractures.