【Abstract】 Objective To research the significance on expression of vascular endothelial growth factor-C (VEGF-C) in human breast carcinoma, benign diseases and normal mammary gland by self-constructed tissue chips and research its relationship to regional lymph node metastasis. Methods The tissue chips containing specimens of breast carcinoma, breast benign disease and normal mammary gland were designed and constructed. The expression of VEGF-C in the specimens was detected by the tissue chips and immunohistochemical method, and researched the relationship of the expression of VEGF-C in breast cancer with regional lymph node metastasis. Results The positive rates of VEGF-C in the centre and borderline of carcinoma and distant mammary gland （the distance from the tumor’s bouncary ＞3 cm） were 69.4%（68 /98）, 69.1%（67 /97） and 52.9%（36 /68）, respectively， but not in benign disease and normal mammary gland specimens. The positive rates of VEGF-C in the centre and borderline of carcinoma in lymph node metastasis group 〔75.0%（51/68）， 76.1%(51/67)〕 were significantly higher than that of no metastasis group 〔25.0%（17/68），23.9%(16/67)〕, P＜0.05. The positive rates of VEGF-C in the centre and borderline of carcinoma and distant mammary gland were no correlation with size, type and clinical stage of tumor. Conclusion The tissue chips is high efficiency and well quality control in multiple factor investigation. There are overexpression of VEGF-C in primary breast cancer, and that may play an important role in lymph node metastasis.
【摘要】 目的 探讨口服百草枯中毒患者口腔护理的方法及早期护理的临床意义。 方法 2009年1月-2010年3月，采用半随机方法将62例白草枯中毒患者按中毒时间的长短分A组（中毒时间lt;3 d，n=32）、B组（中毒时间gt;3 d，n=3），比较两组患者口腔溃疡的治愈率、并发症发生状况，分析早期口腔护理的必要性。 结果 A组患者百草枯所致的口腔黏膜损害明显减轻，并发症发生率降低，为改善预后提供了条件，显示了早期加强口腔护理的成效。 结论 重视百草枯早期口腔护理，能够减轻口腔糜烂溃疡痛苦，减少并发症，提高患者生活质量。【Abstract】 Objective To investigate the clinical significance of early oral care for paraquat-poisoned patients. Methods A quasi-randomized controlled trial was used. A total of 62 paraquat-poisoned patients (from January 2009 to March 2010) were divided into experimental group and control group in order to compare the healing rate of oral ulcer, complications and the necessity of early oral care between the two groups. Results The oral mucosa lesions in experimental group obviously alleviated and the complications decreased. The effective early oral care provided the very favorable conditions for better prognosis. Conclusion The early oral care for paraquat-poisoned patients could relieve the pain of oral ulcer, reduce the complications and improve patient′s life quality.
ObjectiveTo explore a simple and rapid pathological slices method to observe the porous structure and the composition distribution of composite materials. MethodsTaking polyurethane/small intestinal submucosa (PU/SIS) composite as an example, PU/SIS was OCT-embedded and sliced into sections by frozen section technology, after which general observation of the section integrity was carried out. After dyed with water-soluble eosin in alcoholic solution, the staining effect and the porous structure of the composite were observed under light field microscope. Sections were sealed with five different sealing methods. Group A: sealing piece using glycerogelatin method; group B: anhydrous alcohol dehydration→transparency using TO transparent reagent→sealing piece using neutral quick drying glue; group C: color separation using deionized water→air-drying→sealing piece using neutral quick drying glue; group D: air-drying→transparency using TO transparent reagent→sealing piece using neutral quick drying glue; group E: air-drying→sealing piece using neutral quick drying glue. Then, the morphology and the components distribution of the composite were observed under light field microscope, and the simple and feasible method was selected as optimum method. ResultsFrom general observation, the frozen section of the PU/SIS composite, which was 6 μm in thickness, was complete and continuous. Although the outline of the material and the porous structure in the sections could be observed clearly under light field microscope, the two components still could not be identified by using eosin staining method. After sealing piece, the material components in groups A, B, and C still could not be identified or be dissolved and deformed; the morphology of the material in groups D and E were preserved and the two components in the composite were clearly visible. ConclusionThe morphology and the components distribution of PU/SIS frozen sections can be characterized after soluble eosin staining and neutral quick drying glue sealing.
ObjectiveTo evaluate long-term radiographic and clinical effectiveness of total cervical disc replacement (TDR) with Prodisc-C prosthesis at a minimum of 10 years follow-up.MethodsThe clinical data of 118 patients with cervical disc degeneration disease (CDDD) treated with TDR by using Prodisc-C prosthesis between December 2005 and April 2008 were retrospectively analyzed. There were 66 males and 52 females, with the age of 25-62 years (mean, 46.8 years). There were 38 cases of cervical spondylotic radiculopathy, 28 cases of cervical spondylotic myelopathy, and 52 cases of mixed cervical spondylotic myelopathy. The operative segments were C3-7, including 90 cases of single segment, 20 cases of continuous double segments, and 8 cases of continuous three segments. A total of 154 Prodisc-C prostheses were used during the operation. The clinical effectiveness was evaluated by pain visual analogue scale (VAS) score, neck disability index (NDI), Japanese Orthopaedic Association (JOA) score, and Odom grade before and after operation. Imaging evaluation indicators included range of motion (ROM), sagittal lordosis angle, intervertebral disc height (IDH), and prosthesis displacement, subsidence, loosening, locking, and heterotopic ossification (HO), adjacent segment degeneration (ASD), and other complications. Patients were grouped according to whether HO or ASD occurred or not, the ROM of surgical segment was compared.ResultsAll patients were followed up 121-150 months (mean, 135.8 months). No revision operation was performed during the follow-up period. The VAS, NDI, JOA scores and Odom grades were significantly improved at 1 week after operation and last follow-up when compared with preoperative ones (P<0.05); VAS and NDI scores were further improved at last follow-up than those at 1 week after operation (P<0.05); there was no significant difference in JOA scores and improvement rates between at 1 week after operation and at last follow-up (P>0.05). The ROM of the whole cervical spine and the operative segment decreased at 1 week and 10 years after operation when compared with preoperative ones (P<0.05), but there was no significant difference in the other time points (P>0.05); there was no significant difference in the ROM between the upper adjacent segment (UAS) and the lower adjacent segment (LAS) at each time point after operation (P>0.05). There was no significant difference in sagittal lordosis angle of cervical spine before and after operation (P>0.05); the sagittal lordosis angle of operative segment increased significantly at 1 week, 6 months, 1 year, and 2 years after operation (P<0.05). The IDH of operative segment was significantly improved at each time point after operation (P<0.05), but there was no significant difference in IDH between UAS and LAS at each time point after operation (P>0.05). No prosthesis displacement, subsidence, or loosening occurred at each time point after operation. There was no significant difference of the prosthetic displacement and subsidence distance between all time points after 6 months after operation (P>0.05). At last follow-up, the incidence of prosthetic locking/fusion was 10.4%, showing no significant difference when compared with 6 months (1.9%) (P<0.05). The incidence of upper ASD and lower ASD was 1.3% and 2.6% respectively at 1 week after operation. The incidence of upper ASD and lower ASD increased gradually with time prolonging, and there were significant differences between different time points (P<0.05). The ROM of operative segment in ASD group was lower than that in non-ASD group at each time point after operation, but there was no significant difference (P>0.05). HO appeared in 58.4% of the segments at 6 months after operation, and the incidence of HO increased significantly with time, which was significantly different from that at 6 months after operation (P<0.05). The ROM of operative segments in HO group was significantly lower than that in non-HO group at 6 months, 2 years, 5 years, and 10 years after operation (P<0.05).ConclusionTDR has little effect on adjacent segments, although there are some imaging complications, it has no significant effect on the improvement of overall clinical effectiveness. Prodisc-C prosthesis can provide long-term, safe, and definite clinical effectiveness in the treatment of CDDD.
Objective To research clinic characteristics, therapies and 2-year progress of female patients with Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS). Methods This study was part of the internationalized Organization to Assess Strategies for Ischemic Syndromes (OASIS) registry. There was no intervention in the therapy. Patients admitted to hospital with NSTE-ACS (including unstable angina and non-Q wave myocardial infarction) were enrolled. The patients’ clinical characteristics, treatment procedure, major events in hospital and two-year progress were recorded by filling in Case Report Forms. Single-variate analyses were made between patients of difference genders. Results A total of 2 294 patients with NSTE-ACS were enrolled in China. The female patients were 37.7% (n=864), whose mean age was 65.1±6.7 years. Unstable angina dominant (90.7%) was noted on admission. The percentage of patients with abnormal ECG was 92.6%. The prior hypertension and diabetes were 64.1% and 23.4%, respectively, in female patients which were evidently higher than those of males (P≤0.001). The prior coronary heart disease, old myocardial infarction, smoking, and percutaneous coronary intervention (PCI) were 39.4%, 16.8%, 11.7%, and 2.3% respectively, in females, which were evidently lower than in males (P≤0.001). The prior history of coronary artery bypass graft (CABG) surgery was 0.5% in females, which was evidently lower than in males (P≤0.05). During hospitalization, the therapeutic rates of anti-platelets and β-adrenergic blockers were 92.8% and 64.8%, respectively, in female patients, which were observably lower than in males (P≤0.05). The therapeutic rates of nitrates, angiotensin-converting enzyme inhibitor (ACEI), calcium antagonists, lipid lowering agents were 96.9%, 60.0%, 59.1%, and 47.1%, respectively, in females, which were not significantly different from those of males. The medication rate in females fell off gradually after discharge, which was more evident than in males. In two-year follow up, the therapeutic rates of anti-platelets, β-adrenergic blockers, ACEI, and lipid lowering agents were 68.4%, 39.5%, 27.4%, and 19.4%, respectively, in female patients, which were markedly lower than those in males (P≤0.05). During hospitalization, the therapeutic rates of PCI and CABG were 10.5% and 2.7%, respectively. In two year follow-up, their therapeutic rates were 13.4% and 4.8%, respectively. The rate of females performing revascularization procedures was evidently lower than that of males (P≤0.001), either during hospitalization or in two-year follow up. In two years of follow up, mortality and incidence rates of new myocardial infarction, stroke, heart failure, hospitalization because of refractory angina were 7.4%, 4.7%, 6.8%, 15.4%, and 31.3%, respectively, in female patients. There were no significant differences between females and males (Pgt;0.05). Conclusion Compared with male patients, female patients with NSTE-ACS are less likely to adopt and / or attach importance to treatment. As to the reason why there are no significant differences in major events of NSTE-ACS between females and males under the current circumstance that females’ treatment is inferior to males’, gender of females is an important protective factor.
ObjectiveTo explore the effects of exogenous estrogen receptor β1 (ERβ1) gene on the expression of human telomerase reverse transcriptase (hTERT) as well as the changes of proliferation ability in MDA-MB-231 cell line by transfecting recombinant eukaryotic expressing vector containing ERβ1 cDNA into human breast cancer MDA-MB-231 cell. MethodsRecombinant eukaryotic expressing vector containing ERβ1 cDNA was transfected into human breast cancer MDA-MB-231 cell by using cationic liposome as transfecting agent (acted as pcDNA3.1ERβ1 transfection group), empty vector group and non-transfection group acted as controls. The expression levels in both the mRNA and protein of both the ERβ1 and hTERT were tested by real-time PCR and Western blot, respectively. The change of proliferation ability in MDA-MB-231 cell was displayed by cell growth curve, and the change of cell apoptosis was detected by flow cytometry. ResultsThe expression level of ERβ1 mRNA in the pcDNA3.1-ERβ1 transfection group (0.449±0.077) significantly increased as compared with the nontransfection group (0.153±0.035) or the empty vector group (0.160±0.020), P=0.001 or P=0.000. The expression level of ERβ1 protein in the pcDNA3.1-ERβ1 transfection group (0.847±0.065) significantly increased as compared with the non-transfection group (0.356±0.050) or the empty vector group (0.390±0.030), P=0.001 or P=0.000. The expression level of hTERT mRNA in the pcDNA3.1-ERβ1 transfection group (0.127±0.020) significantly decreased as compared with the non-transfection group (0.283±0.025) or the empty vector group (0.283±0.049), P=0.001 or P=0.002. The expression level of hTERT protein in the pcDNA3.1-ERβ1 transfection group (0.147±0.023) significantly decreased as compared with the non-transfection group (0.783±0.025) or the empty vector group (0.802±0.019), P=0.001 or P=0.002. The rate of cell apoptosis in the pcDNA3.1-ERβ1 transfection group 〔(6.15±0.94)%〕 was higher than that in the non-transfection group 〔(1.41±0.42)%〕， P=0.001. Cell proliferation curve showed that proliferation ability significantly decreased in the pcDNA3.1-ERβ1 transfected groups as compared with the non-transfection group (Plt;0.05). ConclusionERβ1 could inhibit cell growth of human breast cancer MDA-MB-231 cell by down-regulating the expression of hTERT.
ObjectiveTo optimize the culture method of human primary pancreatic ductal adenocarcinoma (PDAC) cells and cancer associated fibroblasts (CAFs) and investigate the effect of CAFs on the growth of primary PDAC cells in vitro and tumor formation in patient-derived xenograft (PDX) model.MethodsThe PDAC specimens were collected and primarily cultured. In order to observe the effect of CAFs on the growth of primary PDAC cells in vitro, the CAFs were co-cultured with primary PDAC cells consistently and the alone cultured primary PDAC cells served as the control. Then, these cells were injected into the shoulder blades of NOG mice in order to develop the PDX model.ResultsWhen the primary PDAC cells separated from the CAFs, the proliferation capacity of the primary PDAC decreased rapidly in the passage culture in vitro, and the most cells were terminated within 5 generations. By contrast, when the CAFs co-cultured with the primary PDAC cells, the proliferation capacity of primary PDAC cells were preserved, which could be stably transferred to at least 10 generations. The tumors of NOG mice were detected during 2–3 weeks after injecting the mixed cells (primary PDAC plus CAFs), while had no tumor formation after injecting CAFs alone. The rate of tumor was 92.9% (13 cases) in the primary PDAC plus CAFs group, which was higher than that of the CAFs alone group (64.3%, 9 cases), but there was no statistical difference because of the small sample size. The volume of tumor in the primary PDAC plus CAFs group at 2, 4, 6, and 8 weeks after the tumor cells injection was significantly larger than that in the CAFs alone group at the corresponding time point, the differences were statistically significant (P<0.01).ConclusionsThe CAFs could promote the growth of primary PDAC cells in vitro. This new method of co-culture CAFs with primary PDAC could improve the success rate of primary PDAC cells culture and improve the success rate of PDX model in NOG mice.
A great number of studies have demonstrated functional abnormalities in children with attention-deficit/hyperactivity disorder (ADHD), although conflicting results have also been reported. And few studies analyzed homotopic functional connectivity between hemispheres. In this study, resting-state functional magnetic resonance imaging (MRI) data were recorded from 45 medication-naïve ADHD children and 26 healthy controls. The regional homogeneity (ReHo), degree centrality (DC) and voxel-mirrored homotopic connectivity (VMHC) values were compared between the two groups to depict the intrinsic brain activities. We found that ADHD children exhibited significantly lower ReHo and DC values in the right middle frontal gyrus and the two values correlated with each other; moreover, lower VMHC values were found in the bilateral occipital lobes of ADHD children, which was negatively related with anxiety scores of Conners' Parent Rating Scale (CPRS-R) and positively related with completed categories of Wisconsin Card Sorting Test (WCST). Our results might suggest that less spontaneous neuronal activities of the right middle frontal gyrus and the bilateral occipital lobes in ADHD children.
Objective To evaluate the effectiveness of mifepristone concomitant with misoprostol for medical abortion. Methods We searched the related original studies worldwide, and controlled prospective studies and systematic reviews based on randomized controlled trials （RCTs）. Nine electronic databases were searched. Ten journals and reference lists of eligible studies were handsearched. Two reviewers independently screened the studies for eligibility, evaluated the quality, and extracted the data from eligible studies, with confirmation by cross checking. Any disputes were decided by a third person. Meta-analysis was conducted using statistical software RevMan 4.2. After heterogeneity test was done （α=0.05 ） , data without heterogeneity were pooled using a fixed effect model, and those with heterogeneity could be solved by sensitivity＂ analysis, subgroup analysis or random effect model. Results We found eight original trials （n = 3 348 ） that compared medical abortion with surgical abortion, nine trials （n =6 116） that investigating the effect of gestational ages on medical abortion, five trials （n = 1 934） on the use of mifepristone and two trials （n =2381 ） on intervals of administration of mifepristone and misoprostol were located. Quality of foreign studies was better than that of Chinese studies. Therate of complete abortion was higher in surgical abortion group than that in medical abortion group with odds ratio （OR） 0. 18 and 95% confidence interval （CI） 0. 11 to 0.27. The rate of incomplete abortion and abortion failure was higher in medical abortion group with OR 3.32, and 95% CI 1.79 to 6.17, OR 7.36, 95% CI 4. 17 to 12.98, respectively. The rate of complete abortion in the group with gestational age over 49 days was lower than that with gestational age under 49 days with OR 0.51 and 95% CI 0.43 to 0.61. The rate of incomplete abortion and abortion failure was higher in the group with gestational age over 49 days with OR 1.66, 95% CI 1.32 to 2.09 and OR 3.37, 95% CI 2.30 to 4. 94.There were no significant differences observed in the rates of complete abortion, incomplete abortion, abortion failed, time of expelling pregnant sac and time of menses recovery between the single and multi-dosage of mifepristone. Except for the rate of complete abortion, which was higher in 〈48h group, there was a comparable effectiveness for different intervals of mifepristone and ntisoprostol. Conclusions This review showes that it is important to improve the quality of Chinese original studies. Although the effectiveness is better in the surgical abortion group, the rate of complete abortion of medical abortion achieved is 91.6% （1 648/1 800）. This is acceptable for clinicians and women who do not want to be pregnance. The rate of complete abortion is lower in the gestation over 49 days, which had a statistically difference, but little clinical significance. It is necessary to consider increasing the gestational age of medical abortion, especially for those women who have contradictions of surgical abortion or are afraid of operation. Effectiveness of single dosage of mifeprostone is similar to that ofmulti-dosage, but single dosage might be more convenient. This review suggests that shortening the interval ofmifepristone and misoprostol administration should be considered and the best and shortest interval time need to be identified with better evidence.