bjective To study the change of mucins of expression in lithic cholecystitis and cholecystic adenomatiod polyps. MethodsMUC1 and MUC3 were detected in the mucosa of human normal gallbladders (20 cases, control group), of calcareous cholecystitis (38 cases, calcareous group) and of adenomatoid polyps (18 cases, polyp group) with immunohistochemical stains and Western blotting methods. ResultsThe positive rate and optical density values of MUC1 were increased significantly in calcareous and polyp group vs control group (P＜0.01), otherwise, MUC3 was decreased markedly (P＜0.01). Conclusion The expressions of MUC1, MUC3 were not synchronization in different lesions of cholecyst.
ObjectiveTo study the expression of p27 in hepatocellular carcinoma (HCC) and its clinical significance.MethodsFortyfive specimens of HCC and 30 specimens of adjacent noncancerous lesions obtained from 45 patients who underwent surgery were examined for p27 expression by immunohistochemistry SABC method. The diameter of tumor ranged from 1 cm to 19 cm (d ≤5 cm, 9 samples; 5 cmlt;d≤10 cm, 19 samples; d＞10 cm, 17 samples). These tumors were graded according to the criteria described by EdmondsonSteiner: highdifferentiated HCC group (Grade Ⅰ＋Ⅱ), 26 samples; lowdifferentiated HCC group (Grade Ⅲ＋Ⅳ), 19 samples. According to the clinicopathological features: 19 samples were poorly encapsulated, 15 samples had portal invasion, 11 samples had extrahepatic metastasis, 12 samples had intrahepatic metastasis; all of the above were classified as the invasive and metastatic group, while the others were classified as the noninvasive and nonmetastatic group. ResultsThe average labeling index (LI) of p27 in HCC was significantly higher than that of adjacent noncancerous lesions (45.87±14.21 vs 33.77±12.92, Plt;0.001). The LI of p27 in lowdifferentiated HCC group (stage Ⅲ＋Ⅳ) was significantly lower than that of highdifferentiated group (stage Ⅰ＋Ⅱ), 34.46±12.29 vs 52.80±11.36 (Plt;0.001). The LI of p27 had significant difference between the large ones (d＞10 cm, 37.59±13.12) and the small ones (d≤5 cm, 53.28±15.17 or 5 cmlt;d≤10 cm, 49.50±10.96) (Plt;0.05). The LI of p27 in the invasive and metastatic group was significantly lower than that in the noninvasive and nonmetastatic group (41.42±12.86 vs 51.44±14.10, Plt;0.05).ConclusionThe expression of p27 is more frequently detected in HCC than in adjacent noncancerous lesions. It indicates that p27 might be a compensatory factor during HCC carcinogenesis. The LI of p27 significantly decreases in poor differentiation group, invasive and metastatic group. It indicates that p27 might be related with the differentiation, invasion and metastasis of HCC.
【Abstract】ObjectiveTo investigate the effect of CDAⅡ on the cell cycle progression of breast cancer cells.MethodsThe effects of CDAⅡ on growth curve, cell cycle progression and morphology of breast cancer cell lines MCF7 and MDAMB231 were observed when CDAⅡ and MCF7 or CDAⅡ and MDAMB231 were blended to cultivate in vitro, in comparison with the classical cell differentiation inducer ATRA. ResultsCDAⅡ decreased the growth speed and inhibit proliferation ability in breast cancer cell lines MCF7 and MDAMB231.It caused G0/G1 phase block of cell cycle and reduced the rate of S phase of breast cancer cells. ConclusionCDAⅡ has remarkable effect of anticellproliferation and can induce cell cycle block of G0/G1 on breast cancer cells. This results provide experimental bases for the treatment of breast cancer with CDAⅡ.
ObjectiveTo investigate the prognostic value of platelet volume indices ［mean platelet volume (MPV) and platelet distribution width (PDW)］ in early period for patients with sepsis .MethodsThis retrospective study was conducted in a general ICU at a University Hospital from January 2015 to January 2017. Patients with sepsis were divided into a survival group and a death group according to 28-day prognosis. The demographic and clinical data were recorded and analyzed, including platelet indices, Charlson comorbidity index, Glasgow Coma Scale (GCS) score and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score. Multivariable COX proportional hazard ratio model was used to evaluate the 28-day mortality risk, and receiver operating characteristic (ROC) curve were used to evaluate the value of platelet volume indices.ResultsA total of 209 patients were enrolled in this study. Mean arterial pressure, pH, platelet count, serum creatinine, bilirubin, troponin I, prothrombin time, GCS score and platelet volume indices showed significant differences between the survival group (n=137) and the death group (n=72) (all P<0.05). Multivariable COX regression analysis revealed that the PDW was independently associated with 28-day mortality in sepsis (HR=1.068, 95%CI 1.002-1.139, P=0.043). The area under the ROC curve of PDW was 0.762 (95%CI 0.694 - 0.831), with a sensitivity of 86% and a specificity of 63% at a cut-off value of 18.65%.ConclusionPDW can be used as a powerful prognostic indicator in patients with sepsis following 28-day.
Objective To study the composition, distribution, and influencing factors of acute hand injuries in daily l ife in the Beijing area by analyzing the cl inical data from patients with acute hand injuries. Methods Between April 1st 2005 to September 30th 2005, 2 575 patients with acute hand injuries in daily l ife from Beijing area were investigated by questionnaire.The epidemiological factors were analyzed, including gender, age, injury time, injury cause, accident place, injury mechanism, and location. Results The 2 575 patients injuried in daily l ife accounted for 49.2% of all. Most of them were young males, and the male to female ratio was 3.3 ∶ 1. Most of the patients were 21-30 years old. The most common accident place was resting place (43.3%), and next was outdoors (28.8%) and leisure place (20.0%). Accidental injury was the major injury cause, accounted for 51.0%, followed by injury after drinking (16.1%) and violence (15.5%). The major injury mechanism was cutting (52.23%), followed by coll ision (16.04%) and fall ing (15.18%). A total of 2 405 patients were right hander, and handedness affected the distribution of injured hands significantly. Open injuries accouonted for 70.7% of the patients, and the tissues in deep layer were involved in the injury in 54.4% of all. Conclusion Hand injury in daily l ife is a common problem, which has its own epidemiological features. More appropriate measures should be taken to decrease the incidence.
Objective To explore the anatomical features of some major dorsal wrist interosseous l igaments, and to measure their biomechanical properties to screen a suitable donor site for the repair of scapholunate dorsal l igament. Methods Sixteen wrist joints from 8 frozen fresh male adult cadavers were selected, whose age was 20-38 years and whose height was 165-178 cm. There were no injuries to their wrists. The follow l igaments were observed and measured for the interosseous l igaments: volar and dorsal scapholunate l igaments (SL-v, SL-d), lunotriquetral dorsal l igament (LT), trapezoidcapitate dorsal l igament (TC), capitohamate l igament (CH) and the 2nd-4th carpometacarpal l igaments (CMC-2-4). The bone-l igament-bone samples of the above l igaments were prepared for further biomechanical measurements. Ligament extension testing was performed for each bone-l igament-bone sample on a material testing system. The broken load and length were measured and statistically analyzed. Results The SL and the LT were both “C” shape, attaching to the volar, proximal and dorsal joint surface. The TC and CH l igaments were mainly transverse fibers, which connected with each other at the dorsal side of capitate. The CMC-2-4 l igaments were obl iquitous fibers. Within these wrist interosseous l igaments, the SL-v and CMC-4 were relatively long. The l igament length differences were significant between SL-v and TC and between CMC-4 and TC (P lt; 0.05). TC and CMC-2 were fairly thick. But there was no significant difference among the l igaments (P gt; 0.05). SL-d had the highest broken load of (73.6 ± 9.6) N. The broken load differences were all significant between SL-d and other l igaments (P lt; 0.05). SL-v had largest broken length of (5.24 ± 1.65) mm. The broken length differences were all significant between SL-v and other l igaments (P lt; 0.05). Conclusion The anatomical structures and biomechanical features of the wrist interosseous l igaments were closely related with their physiological functions. CMC-2 and CH are both suitable to be used for the repair of scapholunate dorsal l igament.
Objective To discuss influence of spinal surgery on quality of life (QOL) of patients with late-period spinal metastatic tumor and to explore if spinal surgery could influence on survival time of patients or not. Methods From July 2007 to March 2009, we identified patients who were eligible for the observational study hospitalized in Changzheng Hospital, the Second Military Medical University in Shanghai, China. All eligible patients were divided into two groups depending on whether they would receive spinal surgery or not. Then, all eligible patients completed five QOL assessments using the Functional Assessment of Cancer Therapy-General (FACT-G) Questionnaire when they were diagnosed as late-period spinal metastatic tumor, after 1-month treatment, after 3-month treatment, after 6-month treatment, and after 9-month treatment. Survival time of each patient was also recorded. Results We identified 312 patients who were eligible for the study (surgery group, 147 cases; and non-surgery group, 165 cases). There was no significant difference in survival time between the two groups (χ2=3.167, P=0.075). Within 9 months, the surgery group had significantly higher physical well-being scores, emotional well-being scores, functional well-being scores and total QOL scores than the non-surgery group. Conclusion The results of this study suggest that spinal surgery can significantly improve the QOL of patients with late-period spinal metastatic tumor, but cannot prolong the survival time.
ObjectiveTo explore the method and effectiveness of multidirectionally three-dimensional steel wire ring sleeve fixation in the treatment of inferior patellar pole avulsion fractures.MethodsBetweern January 2015 and January 2019, 22 patients with inferior patellar pole avulsion fractures were admitted and treated. There were 12 males and 10 females. The age ranged from 20 to 69 years, with an average age of 39.4 years. The causes of injury included 9 cases of traffic accident and 13 cases of falling. All of them were unilateral closed injury of knee joint, including 7 cases of skin contusion around patella. Preoperative range of motion of the affected knee was (20.82±7.16)° (range, 10°-35°). The time from injury to operation ranged from 3 to 12 days, with an average of 5.9 days. During the operation, the inferior patellar avulsion fracture was reduced with forceps; the patella was circumferentially ligated through the distal bone surface of the fracture with 0.8 mm diameter steel wire; then 3 longitudinal bone tunnels were made in the upper patella, respectively. The 0.8 mm diameter steel wire passed through the bone tunnel, and the longitudinal ring was attached to the ring to fix the upper and inferior patellar fracture. Tighten the transverse and longitudinal rings with No.2 tendon suture line, then longitudinally ringed and sutured to strengthen the patella. The knee range of motion, fracture healing time, and complications were recorded. The functional recovery of the knee joint was evaluated by Böstman score.ResultsAll incisions healed by first intention, and no incision related complications occurred. All the 22 patients were followed up 13 months to 5 years with an average of 26.7 months. The fracture healing time was 9-12 weeks (mean, 10.9 weeks). At last follow-up, the knee range of motion was (129.77±2.35)° (range, 126°-135°), showing significant difference when compared with preoperative one (t=−67.022, P=0.000). The Böstman score ranged from 31 to 36, with an average of 34.3. No reduction loss, fracture of steel wire, failure of internal fixation, and other complications occurred during follow-up.ConclusionMultidirectionally three-dimensional steel wire ring sleeve fixation in the treatment of inferior patellar pole avulsion fractures has the advantages of reliable fixation, early functional recovery, and fewer complications, so the effectiveness is satisfactory.
Objective To investigate the effectiveness of arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of posterior cruciate ligament (PCL). Methods A retrospective analysis was conducted on the clinical data of 52 patients (52 knees) with tibial insertion avulsion fractures of PCL, who were treated by arthroscopic suspension fixation with Endobutton between June 2017 and October 2022. There were 29 males and 23 females, with an average age of 40.6 years (range, 19-66 years). There were 24 cases of traffic accident injuries, 17 cases of sports injuries, and 11 cases of fall injuries. The time from injury to operation ranged from 6 to 19 days (mean, 13.3 days). According to the Meyers-McKeever classification, there were 30 cases of type Ⅱ and 22 cases of type Ⅲ fractures. All patients exhibited positive posterior drawer test results. Preoperative knee joint function was assessed with Lysholm score (21.3±6.7), International Knee Documentation Committee (IKDC) score (20.7±5.8), and visual analogue scale (VAS) score (5.3±0.7); and knee joint range of motion was (41.73±3.17)°. Based on preoperative CT three-dimensional reconstruction measurements, the longitudinal diameter of the avulsed bone fragment ranged from 13 to 25 mm (mean, 18.1 mm). Operation time and occurrence of complications were recorded, and postoperative imaging was used to assess fracture healing. Knee joint function and pain severity were evaluated using knee joint range of motion, Lysholm score, IKDC score, and VAS score. Results The operation time ranged from 46 to 81 minutes (mean, 56.2 minutes). All patients were followed up 12-28 months (mean, 20.1 months). The iatrogenic fractures of bone fragments occurred during operation in 4 cases; and knee effusion occurred in 2 cases and anterior knee pain in 1 case after operation. All incisions healed by first intention. Imaging evaluations at 3 months after operation showed the fracture healing and no internal fixation failure. All patients demonstrated good knee function and had returned to normal activities at 12 months after operation. At last follow-up, the knee joint range of motion was (133.44±4.17)°, Lysholm score 93.6±3.1, IKDC score 93.4±2.5, and VAS score 1.0±0.6, with significant differences compared to preoperative scores (P<0.05). Conclusion Arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of PCL is simple to operate, and the knee joint function recovers well.
ObjectiveTo investigate the incidence of perioperative deep venous thrombosis (DVT) of lower extremities and its risk factors in elderly patients with femoral neck fracture. Methods The clinical data of 4 109 elderly patients with femoral neck fracture admitted between August 2012 and November 2020 and met the selection criteria were retrospectively analyzed. Among them, there were 1 137 males and 2 972 females; their ages ranged from 65 to 101 years, with an average of 77.0 years. The time from fracture to admission ranged from 1 to 360 hours, with an average of 35.2 hours. There were 1 858 cases of hemiarthroplasty, 1 617 cases of total hip arthroplasty, and 634 cases of internal fixation surgery. The preoperative age-adjusted Charlson comorbidity index (aCCI) was 4 (3, 5). Perioperative DVT occurred in 857 cases (20.9%). Univariate analysis was performed on age, gender, body mass index, fracture side, time from fracture to admission, operation type, anesthesia type, blood transfusion, blood pressure after admission, and preoperative aCCI in patients with and without perioperative DVT, and logistic regression analysis was used to screen the risk factors of perioperative DVT in elderly patients with femoral neck fracture. ResultsUnivariate analysis showed that there were significant differences in age, gender, time from fracture to admission, operation type, and preoperative aCCI between the two groups (P<0.05). Further logistic regression analysis showed that age>75 years, female patients, time from fracture to admission>24 hours, and preoperative aCCI>5 were risk factors for perioperative DVT (P<0.05). Conclusion Elderly patients with femoral neck fracture have a higher incidence of perioperative DVT. The advanced aged and female patients, patients with longer fracture time and more comorbidities need to pay special attention to the prevention of perioperative DVT to minimize the occurrence of DVT during femoral neck fractures.