ObjectiveTo study effects of oxymatrine on proliferation and apoptosis of gastric cancer cell line BGC-823 and explore role of endoplasmic reticulum stress in apoptosis of gastric cancer cells induced by oxymatrine and elucidate its mechanism.MethodsThe gastric cancer BGC-823 cells at the logarithmic phase were divided into a control group, oxymatrine alone group (oxymatrine at 10, 30, 60 and 90 μmol/L concentrations), and combination group (oxymatrine at various concentrations combined with 2 μmol/L endoplasmic reticulum stress inhibitor salubrinal). The MTT assay was used to observe the inhibitory effect of the oxymatrine on the growth of BGC-823 cells. The flow cytometry was used to analyze the apoptosis and cell cycle. The Western blot and RT-PCR methods were used to detect the expressions of GRP78/Bip and the caspase-12 protein and gene, respectively.Results① Compared with the control group, the oxymatrine could significantly inhibit the growth of gastric cancer BGC-823 cells in a concentration-time dependent manner (P<0.05) and its IC50 (48 h) value was (59.5±0.5) μmol/L. The inhibitory effect of the combination group of 30, 60, and 90 μmol/L oxymatrine was significantly weakened as compared with the the corresponding oxymatrine alone group (P<0.05). ② The oxymatrine could significantly induce the apoptosis and arrest the G2/M phase in the gastric cancer BGC-823 cells in a concentration-dependent manner (P<0.05). The combination group of 60 μmol/L oxymatrine could significantly decreased the apoptosis rate and the number of cells in the G2/M phase in the gastric cancer BGC-823 cells after treating 48 h (P<0.05). ③ The protein and gene levels of GRP78/Bip and caspase-12 showed significant increases with the increase of oxymatrine concentrations in the oxymatrine alone group (except the protein and gene levels of caspase-12 at 10 μmol/L oxymatrine) as compared with the control group (P<0.05), which in the combination group of 60 μmol/L and 90 μmol/L oxymatrines were significantly decreased as compared with the corresponding oxymatrine alone group (P<0.05).ConclusionOxymatrine can inhibit growth of human gastric cancer cell line BGC-823, which maybe related to caspase-12-dependent induction of apoptosis and up-regulation of GRP78/Bip expression, which needs further experimental verification.
ObjectiveTo investigate the effectiveness of total elbow arthroplasty (TEA) with preservation of triceps brachii insertion approach.MethodsBetween January 2012 and September 2017, 17 patients with elbow disease were treated with TEA with preservation of triceps brachii insertion approach. There were 3 males and 14 females, with an average age of 65.2 years (range, 48-85 years). The injuries located on left elbow in 5 cases and on right elbow in 12 cases. There were 11 cases of distal humerus fracture (AO type C1 in 2 cases and type C3 in 9 cases); the interval between fracture and operation was 3-10 days (mean, 4.1 days). There were 3 cases of osteoarthritis and 3 cases of rheumatoid arthritis, with the disease duration of 2-26 years (mean, 8.7 years). The postoperative elbow function and pain was assessed by Mayo elbow performance score (MEPS) and visual analogue scale (VAS) score, respectively. The prosthesis position, heterotopic ossification, and periprosthetic fracture were observed by X-ray films.ResultsAll incisions healed by first intention. Sixteen patients were followed up 18-69 months (mean, 40.6 months). Intraoperative ulnar nerve injury occurred in 2 cases, and healed after symptomatic treatment. At last follow-up, the MEPS score was 55-100 (mean, 90.3). The results were excellent in 11 cases, good in 2 cases, fair in 2 cases, and poor in 1 case, with an excellent and good rate of 81.3%. The VAS score was 0-2 (mean, 0.4). X-ray reexamination showed that no polyethylene wear, prosthesis loosening and fracture, abnormal prosthesis position, periprosthetic fracture occurred during the follow-up period, and the prosthesis survival rate was 100%. Heterotopic ossification occurred in 2 and 3 months after operation in 2 cases, respectively.ConclusionThe triceps on approach for TEA are satisfactory for distal humerus fracture, osteoarthritis, and rheumatoid arthritis.
Objective To analyze the effectiveness of tuberosity suture combined with autogenous bone grafting in reverse total shoulder arthroplasty for elderly patients with proximal humerus fracture. Methods A clinical data of 28 patients with fresh proximal humerus fractures, who met the selection criteria and admitted between June 2014 and April 2022, was retrospectively analyzed. There were 7 males and 21 females. Age ranged from 65 to 81 years, with an average of 73.8 years. The causes of injury were 21 cases of fall, 6 cases of traffic accident, and 1 case of falling from height. The time from injury to operation ranged from 5 to 20 days with an average of 9.2 days. There were 8 cases of Neer three-part fracture and 20 cases of four-part fracture. The reverse total shoulder arthroplasty was performed, and the greater and lesser tuberosities were sutered and reconstructed with autogenous bone grafting. After operation, the Constant score, American Society for Shoulder Surgery (ASES) score, and visual analogue scale (VAS) score were used to evaluate shoulder function and pain; and the active range of motion of the shoulder joint was recorded, including flexion, external rotation, and internal rotation. X-ray films were taken to observe the position of prosthesis. According to the evaluation criteria proposed by Boileau, the healing of greater tuberosity was evaluated, and the effectiveness was compared between the patients with healed and non-healed (displacement and absorption) greater tuberosity. ResultsAll incisions healed by first intention after operation. All patients were followed up 24-106 months, with an average of 60.9 months. At last follow-up, the VAS score of shoulder joint ranged from 0 to 6 (mean, 1.1). The Constant score ranged from 45 to 100 (mean, 80.1). The ASES score ranged from 57 to 100 (mean, 84.7). The active range of motions of shoulder joint were 60°-160° (mean, 118°) in flexion, 0°-50° (mean, 30°) in external rotation, and corresponding to reaching the S5-T8 vertebral body level in internal rotation. During follow-up, no shoulder joint re-dislocation or severe shoulder instability occurred, and no revision surgery was performed. X-ray film reexamination showed that there was no loosening of the prosthesis. According to the evaluation criteria proposed by Boileau, the greater tuberosity fused in 22 cases (78.6%), displaced in 3 cases (10.7%), and absorbed in 3 cases (10.7%). The shoulder joint function and pain related evaluation indicators in the healed group were significantly better than those in the non-healed group (P<0.05). ConclusionTuberosity suture combined with autogenous bone grafting is a relatively simple procedure that provides a reliable fixation for the anatomic recovery of greater and lesser tuberosities and is beneficial for the recovery of shoulder function in elderly patients with proximal humeral fractures.