Objective To investigate the effect of mRNA expression of gelatinase A on the invasion and metastasis of human gastric carcinoma (HGC). MethodsThirtysix cases of HGC were examined by in situ hybridization technique. ResultsPositive expression rates of gelatinase A in the normal gastric tissue, peritumor tissue and HGC were 8.3%,35.7% and 83.3% respectively （P＜0.01）. The positive rates of gelatinase A in the group with serosal invasion and lymph node metastasis were 93.1% and 90.6%, much higher than those in the group with negative ones (42.9% and 25.0%).By in situ hybridization, gelatinase A mRNA was showed to be expressed in the extracellular matrix of tumor tissues,which surrounded the invasive margin of cancer tissues. The positive cells at these sites were mainly tumorinfiltrating macrophages. Conclusion There is good correlation between gelatinase A mRNA expression and the invasion, metastasis of HGC. So it can be used as a useful marker for invasion and metastasis of HGC.
To investigate the relationship between metallothionein (MT) and prognosis in breast cancer MT expression was determined with immunohistochemical method (SABC). Results: There was a statistically significant association between expression of MT in breast benign and malignant disease (Ｐ＜0.005). The positive rate was 73.8%(62/84) and 15.0%(3/20) in breast cancer and mastofibroma respectively. The positivity of MT was ber in advanced clinical stages than in early clinical stages. There was no association between MT expression and lymph node metastasis. The mortality of the cancer cases with lymph node metastasis having positive MT expression was higher than those with negative MT expression. Conclusion: MT can be taken as a prognostic index of breast cancer.
Objective To highlight the characteristics of giant cell interstitial pneumonia ( GIP) . Methods The clinical, radiological, and pathological data of two patients with GIP pathologically proven by open lung and TBLB biopsy were presented respectively, and relevant literatures were reviewed. Results Patients with GIP usually had a history of exposure to metal dust. Clinical presentations included cough and dyspnea on exertion, and pulmonary function testing showed a restrictive abnormality. On chest radiography and high-resolution CT scans, it presented as bilateral areas of ground-glass attenuation, areas of consolidation, diffuse small nodules, extensive reticular opacities, and traction bronchiectasis. The main pathological findings included a desquamative interstitial pneumonia ( DIP) -like reaction with intra alveolar macrophages and numerous large multinucleated histiocytes that ingested inflammatory cells were admixed with macrophages. The finding of GIP was almost pathognomonic for hard metal pneumoconiosis. Conclusions GIP is a very rare chronic interstitial pneumonia, and has no characteristic clinical manifestations. Radiographic findings are similar to other idiopathic interstitial pneumonias. Careful collection of the occupational history can help to minimize misdiagnosis.
Objective To investigate the protective effects of metallothionein （MT） for immature myocardium and myocardial interstitium.Methods Twenty-four rabbits （aged 14-21 days） were divided into 4 groups with random number table, 6 each group. Distilled water was injected intraperitoneally in control group and 3.6% ZnSO4 （1.5 ml/kg） was injected intraperitoneally in group 1, group 2 and group 3. Control group, group 1, group 2 and group 3 isolated working rabbit heart model were used in 24h, 12h, 24h and 48h after intraperitoneally respectively. The MT content, recovery of hemodynamics, biochemistry and myocardial ultrastructure were tested. Results The MT content, hemodynamics recovery, adenosine triphosphate （ATP） content, superoxide dismutase activity, Ca2＋-ATPase activity, synthesizing ATP activity of mitochondria, hydroxyproline in group 2 and group 3 were higher than those in control group and group 1 （P 〈 0. 01）. The myocardial watery content, creatine kinase and dehydrogenase leakage, malondialdehyde content, endothelin, mitochondrial Ca2＋ content in group 2 and group 3 were lower than those in control group and group 1（P〈0.01）. The myocardial ultrastructure injuries were less in group 2 and group 3 than that in control group and group l. Conclusion This study demonstrates that myocardial MT prolonged expression can be induced by ZnSO4 and the ischemia-reperfusion injury of immature myocardium and myocardial interstitium could be reduced by MT.
Objective To investigate the feasibility and effectiveness of absorbable screws for the treatment of tibiofibular syndesmotic disruptions by comparing with metallic screws. Methods Between July 2007 and May 2012, 69 patients with tibiofibular syndesmotic disruptions associated with ankle fractures were treated; absorbable screw fixation was used in 38 cases (group A) and metallic screw fixation was used in 31 cases (group B). There was no significant difference in gender, age, injury causes, the type of fracture, the side of fracture, and disease duration between 2 groups (P gt; 0.05). The fracture healing time, weight bearing time, and complications were recorded and compared between 2 groups. According to Baird-Jackson scoring system, the function of the ankle was assessed after 6 months. Results Infection of incision occurred in 3 cases (7.9%) of group A and 2 cases (6.5%) of group B, and skin necrosis of incision in 1 case (2.6%) of group A and 5 cases (16.1%) of group B, showing no significant difference in the incidences of infection and necrosis of incisions between 2 groups (P gt; 0.05); primary healing of incision was obtained in the other patients. The 69 cases were followed up 12-26 months (mean, 18.6 months). The weight bearing time was (2.97 ± 0.59) months in group A and was (3.16 ± 0.74 ) months in group B, showing no significant difference (t=1.175, P=0.244). X-ray films showed that fractures and tibiofibular syndesmotic disruptions healed in 2 groups; the healing time was (5.71 ± 1.01) months in group A and was (5.81 ± 1.08) months in group B, showing no significant difference (t=0.381, P=0.705). No fixation failure, breakage, or loosening occurred in 2 groups. According to Baird-Jackson scoring system, the results were excellent in 29 cases, good in 5 cases, and fair in 4 cases with an excellent and good rate of 89.5% in group A at 6 months after operation; the results were excellent in 20 cases, good in 7 cases, and fair in 4 cases with an excellent and good rate of 87.1% in group B; no significant difference was found in the excellent and good rate between 2 groups (Z= — 0.991, P=0.321). Conclusion Treatment of tibiofibular syndesmotic disruptions with absorbable screws can get good effectiveness and replace metallic screws because of avoiding additional operation for removing the screw.
Objective Metal wear products cause the aseptic loosening of joint prosthesis. To investigate the effect of metal ions Co2+ and Cr3+ on the osteoblast apoptosis, cell cycle distribution, and secretion of alkal ine phosphatase (ALP), and to search a method to prevent and treat aseptic loosening. Methods The mouse calvarial osteoblasts (MC3T3-E1) were cultured in vitro to 3-5 generations (5 × 105 cells/ mL) and divided into 2 groups: the experimental group and the controlgroup. The osteoblasts were cultured in α-MEM medium containing 10%FBS (the control group), and the mixed solution ofCoCl2 and CrCl3 was added after the osteoblasts cultured in α-MEM medium containing 10%FBS attached completely (the experimental group). At 12, 24, and 48 hours after culture, the osteoblast apoptosis and the cell cycle distribution were assessed by flow cytometry; and ELISA method was appl ied to detect ALP content in serum supernatant. Results At 12, 24, and 48 hours after culture, the apoptosis rates in the experimental group (13.90% ± 0.52%, 14.80% ± 0.41%, and 13.40% ± 0.26%) were significantly higher than those in the control group (8.56% ± 0.31%, 8.19% ± 0.24%, and 2.15% ± 0.11%), (P lt; 0.05); G2M (dividing phase) distribution ratio significantly decreased and G0G1 (dormancy stage) distribution ratio significantly increased when compared with those in the control group (P lt; 0.05); and the absorbency (A) values of ALP were 0.955 ± 0.052, 0.624 ± 0.041, and 0.498 ± 0.026 in the exprimental group, and were 1.664 ± 0.041, 1.986 ± 0.024, and 2.192 ± 0.041 in the control group, showing significant differences between 2 groups (P lt; 0.05). Conclusion Metal ions Co2+ and Cr3+ have a marked effect on osteoblasts cell cycle distribution, which can make most of the cells to be in dormancy stage (G0G1), up-regulate the apoptosis rate and inhibit the releasion of ALP from osteoblasts.
Objective Lots of metal ions accumulation and over-expression of receptor activator of NF-κB l igand (RANKL) around the prosthesis could be found in revision of total hip arthroplasty. To investigate the relationship between metal ions and aseptic loosening by observing the effects of Co2+ and Cr3+ ions on the expression of RANKL and osteoprotegerin(OPG) from osteoblast. Methods Osteoblasts were cultured in vitro at the density of 1 × 105 cells/mL, and were divided into 2 groups according to different culture solutions. In control group, osteoblasts were cultured with normal medium without CoCl2 and CrCl3. In experimental group, osteoblasts were cultured with the medium including CoCl2 (10 mg/ L) and CrCl3 (150 mg/L) solutions. The RT-PCR and ELISA methods were appl ied to detect the mRNA expression of RANKL and OPG and protein level at 24 and 48 hours after co-cultured, respectively. Results RT-PCR revealed that the mRNA expression of RANKL and OPG could be found in two groups at 24 and 48 hours after co-cultured, the expression was higher in the experimental group than in control group, especially the expression of RANKL, showing significant difference (P lt; 0.05). At 24 and 48 hours after co- cultured, the ratios of RANKL mRNA to OPG mRNA in the experimental group were 0.860 and 1.232, respectively, which were significantly higher than those in the control group (0.695 and 0.688,P lt; 0.05). ELISA revealed that the protein level of RANKL and OPG in experimental group were significantly higher than those in the control group (P lt; 0.05). Conclusion Co2+ and Cr3+ can stimulate the mRNA expressions of RANKL, OPG and secretion of those protein from osteoblasts, especially increase of the RANKL, which promotes the formation and activation of osteoblasts and the generation of aseptic loosening.
Objective To evaluate the short-term cl inical outcomes of metal-on-metal total hi p resurfacing arthroplasty in treating osteonecrosis of the femoral head (ONFH) in young and middle-aged patients and to compare with patients of hip osteoarthritis at the same period. Methods From July 2006 to October 2008, 33 patients (45 hips) with ONFH (ONFH group) and 39 patients (45 hips) with osteoarthritis (osteoarthritis group) were treated with metal-on-metal total hipresurfacing arthroplasty. In ONFH group, there were 18 males (27 hips) and 15 females (18 hips) with an average age of 42.7 years (range 19-58 years), including 22 left hips and 23 right hips. The causes were trauma (4 cases), glucocorticoid (25 cases), drugs (2 cases), alcohol (1 case), and psoriasis (1 case). According to Steinberg classification, there were 10 hips at stage III, 18 hips at stage IV a, 13 hips at stage IV b, and 4 hips at stage IV c. The Harris score was 52.0 ± 4.6. The disease course was 1-12 years. In osteoarthritis group, there were 26 males (30 hips) and 13 females (15 hips) with an average age of 47.1 years (range 42-65 years), including 17 left hips and 28 right hips. The causes were degenerative arthritis (23 cases), trauma (11 cases), and ankylosing spondyl itis (5 cases). The Harris score was 57.0 ± 3.8. The disease course was 3-17 years. There were no significant differences in general data between two groups (P gt; 0.05). Results All incisions achieved heal ing by first intention without compl ications of infection and thrombosis of deep vein of lower extremities. The patients were followed up for 26 months in ONFH group and 28 months in osteoarthritis group. Femoral neck fracture occurred in 1 case of osteoarthritis group after 4 months, who received total hip arthroplasty; no compl ication of prosthesis loosening, dislocation, incision infection, osteonecrosis, and bone absorption occurred in other patients. At last follow-up, the Harris scores were 93.0 ± 5.5 in ONFH group and 94.0 ± 2.4 in osteoarthritis group, showing no significant difference between two groups (P gt; 0.05); but there were significant differences between pre- and post-operation (P lt; 0.01). Conclusion The cl inical short-term outcomes ofmetal-on-metal total hip resurfacing arthroplasty to treat ONFH are satisfactory. It can achieve similar outcomes to that ofosteoarthritis group. More cases and long-term follow-up are needed to investigate long-term cl inical outcomes.
Objective To observe the human mononuclear cell releasing TNF-α and the activation of Caspase-3 during apoptosis after stimulated by Co2+ and Cr3+, to discuss the mechanism of artificial joint wear production metal ion on aseptic loosening. Methods CoCl2 powder and CrCl3 powder were dissolved by asepsis inject water, preparing solution for10 mg/L and 500 mg/L, respectively. Mononuclear cells were acquired from peripheral blood, 4 × 106/culture dish. According to the difference of culture solution, the cells were divided into 3 groups. Group A: mononuclear cell was culture with normal sal ine as control; group B: mononuclear cell was cultured with CoCl2 solution; group C: mononuclear cell was cultured with CrCl3 solution. The production of TNF-α was assessed by ELISA, the activation of Caspase-3 was measured by colorimetric assay and the apoptotic cell was detected by TUNEL assays at 12, 24 and 48 hours after co-cultured respectively. Results The concentration of TNF-α and the expression of Caspase-3 in groups B and C were higher than those in group A (P lt; 0.05), and reached the peak level at 24, 48 hours, respetively. The TUNEL positive cells were detected in the all groups, nucleus was pyknotic and darker-staining, cell body was crinkle and cell membrane was integrity. There were significant differences in the apoptosis rate between groups B, C and group A (P lt; 0.05). And the activation of Caspase-3 increased and had the positive correlation with the apoptosis rate (r=0.765). Conclusion Co2+ and Cr3+ ions can stimulate human mononuclear cell to release TNF-α and induce human mononuclear cell apoptosis, which result in periprosethetic osteolysis and related to activation of Caspase-3.
【Abstract】 Objective To review the recent progress of hi p resurfacing arthroplasty. Methods Literatureconcerning hip resurfacing arthroplasty and current achievements was extensively and comprehensively reviewed. Results The new metal-on-metal hip resurfacing arthroplasty made much progress especially in materials and technology, and the results were satisfactory for short-term follow-up. This was increasingly widely used especially in treating young patients. But there were still some problems such as elevation of metal ions which had already aroused publ ic attention. Conclusion The new metal-onmetal hip resurfacing arthroplasty is an efficient method in the treatment of adult hip joint disease and has an encouraging future, but long-term follow-up is still needed.