Objective To observe the effect of You Gui Yin and MSCs interventional therapy on the early stage of avascular necrosis of the femoral head (ANFH) and its role of improving revascularization and reossification. Methods Twenty-four adult Beagle dogs weighing (10.0 ± 0.5) kg were divided into 4 groups (n=6): group A (model group), group B (You Gui Yin group), group C (MSCs intervention group), group D(You Gui Yin and MSCs intervention group). The model of ANFH at early stage was establ ished by l iquid-nitrogen cryopreservation method, and MSCs were isolated, cultured and labeled by BrdU. Three weeks after model ing, groups C and D received 1 mL MSCs with artery perfusion [(0.5-1.0) × 106/mL)], groups B and D received intragastric administration of 100 mL You Gui Yin per day, groups A and C received intragastric administration of 100 mL distilled water. Gross observation on femoral head was conducted 4 and 8 weeks after continuous treatment. Meanwhile, DSA and MRI were adopted to observe the quantity and the diameter of femoralhead blood vessel, histology and immunohistochemistry staining were performed to observe the expression of VEGF and BrdU, and the expression of VEGF mRNA was detected by real-time fluorescence quantitative RT-PCR. Results At 4 and 8 weeks after treatment, the figuration of the femoral head in group A was flat and mushroom-shaped, while it was relatively normal in groups B, C and D. DSA observation: the number and the diameter of blood vessel in groups C and D were increased, and the obstructed blood vessel was open. At 4 and 8 weeks after treatment, significant differences between group C and group D were evident in the number and the diameter of blood vessel (P lt; 0.05); compared with before treatment, the diameter of blood vessel in two groups were significantly improved (P lt; 0.05) and the number of blood vessel in group D was significantly increased (P lt; 0.05). MRI observation: compared with group A, groups B, C and D were obviously improved, especially group D, T1W showed lower signal, T2W and STIR showed no abnormal changes of signal. Histopathology and immunohistochemistry staining: compared with group A, the structure of groups B, C and D were obviously improved, the positive expression of VEGF in group D was significantly higher than that of other groups (P lt; 0.05), the positive rate of BrdU, the number of positive osteoblast and the number of positive blood vessel in group D was obviously higher than that of group C (P lt; 0.05). Real-time fluorescence quantitative RT-PCR detection: the expression of VEGF mRNA in group D was significantly higher than that of other groups (P lt; 0.05), the expression of VEGF in groups B, C and D was higher than that of group A (P lt; 0.05). Conclusion The combination of You Gui Yin and MSCs interventional treatment has significant therapeutic effects on the early-stage ANFH, can improve the blood supply of the necrotic femoral head, promote repair and prevent collapse.
ObjectiveTo establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). MethodsLower third and abdominal part of EAC patients were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. ResultsIn total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. ConclusionThis nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.