BACKGROUND: Recent studies have reported that more and more methods were used to prevent and cure tendon adhesion following tendon rupture by repairing tendinous sheath. Especially, amnion membrane is commonly used to effective prevent and cure adhesion and promote healing of biomembrane; however, the effect on tendon adhesion needs to be further studied. OBJECTIVE: To verify the efficacy of amnion membrane preserved in Honghua injection on preventing and curing tendon adhesion following transplanting into foot flexor tendon. METHODS: Bilateral foot flexor tendons of 32 healthy mature chickens were cut off. By anastomosis, amnion membrane preserved in Honghua injection was transplanted into left foot flexor tendon, considering as experimental group. Right foot flexor tendons were randomly divided into two groups: blank control group, anastomosis was performed alone; positive control group, amnion membrane not preserved in any injections was transplanted. At 4 weeks after fixation by plaster cast, sliding function of tendon was detected using biomechanics, and local samples were obtained for histopathological observation. RESULTS AND CONCLUSION: In the experimental group, broken end of left tendon was well healed; fiber tissues were formed surrounding tendon; tissue adhesion was not observed surrounding tendon. Proliferative quantity and adhesion of fiber tissues, as well as content of hydroxyproline in the experimental group were significantly less than in the blank control and positive control groups (P < 0.05, P < 0.01); total inflexion angle of articulationes digitorum pedis and slipping distance of flexor digitorum profundus tendon in the experimental group were significantly greater than in the blank control and positive control groups (P < 0.05, P < 0.01). The results indicated that amnion membrane preserved in Honghua injection might prevent tendon adhesion and effectively promote tendon healing.

Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

To understand the sero-epidemiological features of rickettesiosis of humans and domestic animals in Yunnan province, blood samples from 237 adults in different geographic area, including Xundian country,Yulong country and Simao country and 81 children aged from 4 to 6 years old were collected for serological testing. In addition, 90 blood samples from dogs, goats and ox in each investigated area were also collected. Antibodies against 8 rickettsiae, including R.typhi, R.heilongjiangii or R.sibirica, Orientia tsutsugamushi Karp or Kato, Ehrlichia chaffeensis, Anaplasma phagocytosis, Bartonella henselae, Coxiella burnetii and Hainan spotted fever group of rickettsia were examined by using immunofluorescence assays(IFA).It was found that the sero-epidemiologic rates of R.typhi, B.henselae and C.burnetii (16.46%、6.33% and 9.28%) of adults were higher than those of other rickerrsiae investigated. The positive rates of IgG antibody against R.typhi for children also shared the higher rate (12.35%). Similar sero-epidemiologic features were found for domestic animals. Among the 8 rickettsia tested in this study, the positive rate of IgG antibody against R.typhi appeared to be the highest(61.48%) without significant difference among these investigated sites. From this investigation, it is evident that the rickettsial infection of farm population and domestic animals are common in Yunnan province, and the active surveillance of rickettsiosis and differential diagnosis of unknown febrile patients in clinical practice should be enforced.

Aims HDAC2 gene was cloned into pEGFP-C2 vector to explore the efficiency of the plasmid trans-fection in renal fibroblasts COS-7 cells to identify the expression of both mRNA and protein levels and to ob-serve the distribution of the protein. Methods The HDAC2 cDNA was amlified by PCR and cut with the double enzyme Xho I and BamH I, then inserted into the eukaryotic expression vector pEGFP-C2 with T4 en-zyme. The recombinant vector was verified by PCR, restriction enzymes cut and sequencing identification. Then it was transfected into COS-7 cells and the ex-pression of pEGFP-C2-HDAC2 was monitored by fluo-
rescence microscope and PCR. Results Fragments of HDAC2 could be seen after dealt with double diges-tion, and GFP could also be detected in the transfected COS-7 cells. HDAC2 gene expression could be detec-ted by PCR and Western blot. The fusion expression of pEGFP-C2-HDAC2 could be detected by Western blot. Conclusion Eukaryotic expression vector of HDAC2 has been successfully constructed, the fusion expres-sion of HDAC2 and GFP protein can be detected in COS-7 cells.

Vagus nerve reflex is a rare complication of percutaneous renal decompression. It is often induced by excessively rapid decompression of severe hydronephrosis and traction of the main nerves innervating the kidney. The clinical manifestations are irritability, sweating, clammy skin, hiccups, slow heart rate. It is easy to misdiagnose. In this study, 4 patients with vagus nerve excitement after percutaneous renal decompression were treated. After monitoring the patient’s vital signs and giving treatment such as expanding blood volume and raising blood pressure, the symptoms gradually disappeared.

Objective To assess the contribution of transrectal realtime tissue elastography (TRTE) on the differential diagnosis of prostatic diseases. Methods A total of 88 prostatic disease patients with 95 lesions proved by pathology from May 2012 to January 2013 in the Afifliated Drum Tower Hospital of Medical College of Nanjing University were included. The elasticity grade and strain ratio were calculated by using TRTE. According to the gold standard of pathological results, the sensitivity, speciifcity, accuracy rate were calculated to evaluate the effectiveness of elasticity grade and strain ratio in distinguishing benign and malignant prostatic diseases;and the receiver operating characteristic (ROC) curves were made respectively. The accuracy of elasticity grade and strain ratio in diagnosing prostatic diseases was also compared using chi-square test. Results Forty-seven benign lesions were found in the 95 prostatic lesions and the other 48 lesions were malignant. The elasticity grades of the 95 prostatic lesions were as follows:GradeⅠ26, GradeⅡ19, GradeⅢ16, GradeⅣ21, and GradeⅤ13. Elasticity grade ≤Ⅱwas considered to be benign, while grade ≥Ⅲwas malignant. The sensitivity, speciifcity, accuracy rate of elasticity grade in diagnosis of prostatic malignant lesions was 79.17%(38/48), 74.47%(35/47) and 76.84%(73/95), respectively. According the ROC curve analysis, the cutoff point of strain ratio was 4.67, and Youden′s index was 0.622. The sensitivity, speciifcity, accuracy rate of strain ratio was 83.33%, 78.72%and 81.05%, respectively. The area under ROC curves of strain ratio was superior to that of elasticity grade. But the diagnosis accuracy of the two approaches was almost the same in statistics (χ2=0.51, P>0.05). Conclusions TRTE is valuable in the differential diagnosis of the prostatic benign and malignant lesions. Both strain ratio and elasticity grade are useful approaches, and have similar diagnostic accuracy.

The metastasis of renal cell carcinoma to the ureter is a rare phenomenon, and synchronal detection of metastasis to the contralateral ureter is a rarer phenomenon. A 62-year-old male patient with painless hematuria was examined and detected a renal cell carcinoma on the right kidney and bleeding from the left ureter. Ureteroscopy revealed a tumor in the left upper ureter, and biopsy suggested clear cell carcinoma. Laparoscopic radical nephrectomy was performed to resect the right renal cell carcinoma, and the pathology revealed a clear cell carcinoma, with Fuhrman nuclear grade 2 class. The ureteral tumor was resected 3 months later and the pathology revealed renal clear cell carcinoma. Sunitinib was used for 37 months, and there was no tumor recurrence or metastasis so far.

Objective To explore the analysis of the relationship of the serum levels of focal adhe-sion kinase(FAK)and fatty acid-binding protein 4(FABP4)with myocardial injury and cardiac function in elderly patients with acute myocardial infarction(AMI).Methods A total of 211 AMI patients admitted to our hospital from January 2020 to April 2023 were enrolled and assigned into the AMI group,while another 60 healthy volunteers who took routine physical examinations in our hospital during the same period served as the control group.The serum FAK and FABP4 lev-els were compared between the two groups.Multivariate logistic regression analysis was employed to identify influencing factors associated with AMI,and ROC curve was plotted to assess the pre-dictive efficacy of the serum FAK and FABP4 levels for AMI in the elderly population.Pearson correlation analysis was conducted to explore the relationship between serum FAK and FABP4 levels and myocardial injury as well as cardiac function.Results The AMI group exhibited signifi-cantly elevated serum FAK,FABP4,CK-MB,cTnⅠ and CK levels,and larger LVESD and LVEDD,but lower LVEF when compared with the control group(P＜0.05,P＜0.01).For the AMI patients,the serum FAK and FABP4 levels were positively correlated with CK-MB,cTnⅠ and CK levels,as well as LVESD and LVEDD,and negatively with LVEF(P＜0.05).Multivariate logistic regression analysis revealed that both serum levels of FAK(OR=2.872,95％CI:2.230-3.698,P=0.000)and FABP4(OR=2.667,95％CI:1.713-4.154,P=0.000)were influencing factors for AMI.ROC analysis indicated that the cut-off value of FAK level for diagnosing AMI was 25.60 pg/L,with an AUC value of 0.801(95％CI:0.750-0.852).Similarly,the cut-off value of FABP4 in the diagnosis was 23.22 pg/L,with an AUC value of 0.760(95％CI:0.707-0.812).Combined FAK and FABP4 levels yielded,with an AUC value of 0.899(95％CI:0.839-0.918).Conclusion Serum FAK and FABP4 levels are abnormally high in the elderly patients with AMI,which is closely related to myocardial injury and cardiac function.The two indicators alone or in combination can effectively predict the occurrence of AMI.

OBJECTIVETo evaluate the possibility and efficiency of nanoparticle as a new vector in specific gene transference.

METHODSNanoparticle-DNA complex was prepared with Poly-dl-lactic-co-glycolic acid (PLGA) bearing anti-sense monocyte chemotactic protein-1 (A-MCP-1), a specific expression gene, and the package efficiency, release progress in vitro, and the size of the complex were determined. The possibility of the new vector was evaluated with genomic DNA PCR by transferring gene into cultured smooth muscle cells (SMC), cationic lipids as a control. For study in vivo, jugular vein-to-artery bypass grafting procedures were performed on 20 New Zealand white rabbits, of which 6 grafts were transferred with nanoparticle-A-MCP-1 (200 microg), 6 with A-MCP-1 (200 microg) by cationic liposome, 4 with LNCX plasmid, and 4 as control. Fourteen days after the grafts were harvested, the expression of A-MCP-1 and its effect on MCP-1 in vein grafts were detected by dot blot, and the morphologic evaluation of grafts was performed.

RESULTSThe package efficiency of the nanoparticle-DNA complex was 0.9%, release progress in vitro lasted 2 weeks, and the size ranged from 150 to 300 nm. SMC genomic DNA PCR showed that A-MCP-1 gene could be successfully transfected into cells by nanoparticle. The study in vivo indicated that A-MCP-1 mRNA was expressed in both local gene delivery groups, nanoparticle and liposome, meanwhile, MCP-1 expression in vein grafts was significantly inhibited and neointimal hyperplasia was notably reduced.

CONCLUSIONNanoparticle can act as a vector to transfect specific gene.

Animals ; Chemokine CCL2 ; biosynthesis ; genetics ; DNA, Antisense ; biosynthesis ; genetics ; Drug Carriers ; Gene Expression ; Genetic Therapy ; Genetic Vectors ; Lactic Acid ; Nanotechnology ; Particle Size ; Polyglycolic Acid ; Polymers ; Rabbits ; Transfection

OBJECTIVETo initially explore the clinical effect of cool-tip radiofrequency ablation combined with enucleation for the giant hamartoma of kidney with narrow base and export-oriented way of growth.

METHODSThe clinical date of 15 patients including 6 male and 9 female with special hamartoma of kidney underwent cool-tip radiofrequency ablation assisted enucleation from July 2011 to October 2014 were reviewed.The median age was 49 years (ranging from 35 to 71 years). There were 6 cases with left renal tumor, 8 cases with right renal tumor and 1 case with solitary kidney tumor.All patients were confirmed by B ultrasound or CT scan, the mean diameter of hamartoma of kidney was 9.7 cm(8.5-12.7)cm, all tumors were located distant from the collecting system and presents with a special way of growth.The preoperative hemoglobin was (129±18)g/L, SCr was (92±41)μmol/L, glomerular filtration rate (GFR) was (32±12)ml·min(-1)·1.73 m(-2).

RESULTSCool-tip radiofrequency ablation assisted enucleation was technically successful in all patients.The mean operative duration was (115±31)minutes, and the average intraoperative bleeding was (72±21)ml with no blooding transfusion.The postoperative hospital stay was(7±2)days, and the postoperative hemoglobin was(129±18)g/L, SCr (92±41)μmol/L, GFR(30±15)ml·min(-1)·1.73 m(-2). No statistic change of hemoglobin and SCr or glomerular filtration rate after operations(all P>0.05). Postoperative pathology showed that all cases were hamartoma of kidney.During a mean follow-up period of 19.5 months, none of them had local tumor recurrence or chronic renal insufficiency.

CONCLUSIONSCool-tip radiofrequency ablation assisted enucleation is both safe and effective in the treatment of huge hamartoma of kidney with a narrow base and export-oriented way of growth. The short-term follow-up shows a satisfactory therapeutic effect.

Adult ; Aged ; Angiomyolipoma ; surgery ; Blood Transfusion ; Catheter Ablation ; methods ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Neoplasms ; surgery ; Length of Stay ; Lipoma ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Period ; Treatment Outcome