Silent information regulator 1 (SIRT1) is a kind of histone deacetylase which dependents on nicotinamide adenine dinucleotide.It is involved in the occurrence and development of tumors.Data show that SIRT1 is highly expressed in many tumors,such as gastric cancer,breast cancer,prostate cancer and so on.On the other hand,the expression of SIRT1 is lower in many other types of tumors,including glioblastomas,bladder cancer,ovarian cancer and so on.Therefore,the role of SIRT1 in tumor formation process is still uncertain and controversial.

BACKGROUND: The treatment strategy for femoral neck fractures has not been confirmed, and choosing internal fixation or arthroplasty remains controversial. After internal fixation, the occurrence of bone nonunion and osteonecrosis of femoral head makes its long-term treatment outcomes far from satisfactory. Can we improve the functional recovery through high-quality reduction, accurate fixation and active postoperative exercise? If so, it may be favorable for the elderly with femoral neck fractures, especially for those combined with other serious diseases.OBJECTIVE: To compare the quality of life in the elderly with femoral neck fractures after internal fixation and hemiarthroplasty.METHODS: 148 patients with femoral neck fractures aged more than 60 years old in the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2013 were analyzed retrospectively. The operation time,intraoperative blood loss, hospitalization time, mortality rate, reoperation rate and postoperative quality of life were compared between internal fixation and hemiarthroplasty in the patients with undisplaced femoral neck fractures (Garden type I or II) displaced femoral neck fractures (Garden type III or IV), respectively.RESULTS AND CONCLUSION: (1) Among 148 patients, 137 cases completed follow-up, and the follow-up rate was 92.6%. (2) The operation time, intraoperative blood loss and hospitalization time in the internal fixation group were significantly superior to those in the hemiarthroplasty group in patients with displaced or undisplaced femoral neck fractures (P < 0.05). (3) There was no significant difference in the mortality rate between two groups, and the reoperation rate in the internal fixation groups was slightly higher than that in the hemiarthroplasty group. (4) The Harris and SF-36 scores in both groups were increased with time, and the difference between two groups was decreased with time, which became equal at 2.5 years postoperatively (P > 0.05). Besides, the time of the patients with undisplaced femoral neck fractures in the internal fixation group achieving the same quality of life with the hemiarthroplasty group was earlier than that of displaced ones. (5) These results suggest that internal fixation holds short operation time, simple operation skills and less trauma in the treatment of femoral neck fractures, and with the development of technology, it can achieve the early functional recovery. Thereafter, it is an effective method for senile femoral neck fractures.

BACKGROUND:Open reduction and internal fixation has been confirmed to treat posterior Pilon fracture,but choosing which fixation scheme is still under discussion.OBJECTIVE:To explore the biomechanical properties of posterior Pilon fracture after repaired by two different fixation methods,thus providing reference for selecting an appropriate fixation scheme.METHODS:Twenty right artificial femurs were randomized into two groups A and B,and the models of posterior Pilon fracture were established based on its characters and classification.The group A received with 5 holes distal tibial posterior locking plate fixation,and the group B underwent two 3.5 mm of cortical screws from back to front bicortical fixation,followed by placed in the InstronElectroPulsE3000 universal electronic static and dynamic materials testing systems,vertical speed loaded until internal fixation failure,the loading was recorded when different steps appeared.RESULTS AND CONCLUSION:(1) After loading,none of groups presented with screw bent or broken.(2) The axial load when appeared with 0.5,1.0,1.5,and 2.0 mm steps in the group A was higher than that in the group B,and the axial load significantly increased with fracture fragment displacement increasing (P ＜ 0.05).(3) The biomechanical test shows that the distal tibial posterior locking plate fixation is better than screws in the treatment of posterior Pilon fracture.

Objective To evaluate the effects of three-dimensional conformal radiotherapy(3D-CRT) on the patients with esophageal carcinoma.Methods From October 2001 to October 2004,68 patients with esophageal carcinoma,the diagnosis of whom was finally confirmed by pathological examination,received coplanarity or noncoplanarity multifield 3D-CRT with Varian 1800C liner accelerator,using three-dimensional conformal radiotherapy planning system.Conventional fractionated dose was 2Gy per fraction,5 fractions per week,with a total dose of 60-70Gy in 6-7 weeks.Clinical target volume(CTV) and planning target volume(PTV) were enlarged outwards on the basis of gross tumor volume(GTV) which included primary tumors and regional lymph nodes.Results One-year and 3-year local tumor control rates were 80.9% and 47.1%,respectively,as the result of 3D-CRT.One-year and 3-year survival rates were 76.4% and 44.1% respectively.Grade 2 acute esophagitis occurred in 20 cases and grade 3 in 2 cases,grade 1 radiation pneumonia was found in 8 cases and grade 1 esophageal stenosis in 4 cases.Conclusions With tolerable reactions and after effects,the technique of 3D-CRT could effectively elevate the local tumor control rate and survival rate for the patients with esophageal carcinoma.

Objective To retrospectively analyze the clinical and pathological characteristics of breast cancer in women ≤ 40 years of age.Methods One hundred and thirty one young (≤ 40 years) female patients with breast cancer pathologically confirmed in the General Hospital of PLA from January 1 st 2008 to December 31st 2012 (young group) were collected,and 262 elderly (41-69 years) female patients with breast cancer in the same period (old group) were collected as control using the random number table method.The clinicopathological characteristics involved TNM staging,histological grade,the expression levels of estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (Her-2) and clinical stage of the two groups were contrastively analyzed.Results Compared with elderly patients,young female patients with breast cancer had lower positive rate of ER or PR (64.9％ vs.76.7％;x2 =6.171,P =0.013),higher positive rate of Her-2 (26.7％ vs.15.3％;x2 =7.415,P =0.006) and higher histological grade (grade Ⅱ 38.2％ vs.35.1％;grade Ⅲ 55.7％ vs.49.6％;x2 =6.835,P=0.033).There were no significant differences in T stage (x2 =1.764,P =0.623),N stage (x2 =0.129,P =0.988),clinical stage (x2 =4.916,P =0.178),molecular subtype (x2 =7.475,P =0.058) and different surgical procedures (x2 =0.913,P =0.339) between the two groups.Conclusion Young (≤ 40 years) female patients with breast cancer have specific clinical and pathological characteristics including higher histological grade,higher positive rate of Her-2,lower positive rate of ER or PR and higher degree of malignancy,who should be diagnosed and treated as soon as possible.

Objective To study the influence of postoperative chemotherapeutic regimens on menstruation in pre-menopausal patients with breast cancer. Methods 120 pre-menopausal patients with breast cancer from Jan 2010 to Dec 2012 were followed-up. The occurrence rate and recovery rate of chemotherapy-induced amenorrhea (CIA) were analyzed. The relationship between different chemotherapeutic regimens and CIA of various age groups was analyzed. Results 120 women were followed-up, 94 (78.3 %) patients developed CIA. The frequency of CIA in younger patients (≤ 35 years) was significantly lower than that in patients older than 35 years (P < 0.05). 50 (53.2 %) patients returned to normal menses. The recovery situation of CIA was significantly different among various age groups (P < 0.05). The difference of the occurrence rate of CIA was not statistically significant between the patients who received anthracycline-based chemotherapy and docetaxel-based chemotherapy (P > 0.05). Conclusions Age is an important influence factor of the CIA. Chemotherapy has less influence on the menstruation of younger patients (≤35 years) and most amenorrhea is reversible. The effects of sequential addition of taxanes in chemotherapy and anthracyclines alone on menstruation have no significant difference.

Objective To investigate the stimulating effect of exogenous hydrogen sulfide (H2S) on angiogenesis in glioblastoma (GBM). Methods Twenty adult Sprague-Dawley (SD) rats were randomly divided into two groups, glioma group (C6 glioma cell intracerebral implantation, n=10) and glioma-H2S group (C6 glioma cell intracerebral implantation and sodium hydrosulfide (NaHS) intraperitoneal injection, n=10). The tumor-bearing rat model was established by intracerebral injection of rat C6 glioma cells. After one week, normal saline was injected in glioma group and NaHS was injected in glio-ma-H2S group. Food and water were freely available during all phases of the experiment. After three weeks, rats were decapi-tated and brains were removed. HE staining was performed to show tumor structure and intratumoral angiogenesis. The immu-nohistochemical analysis was used to detect the expressions of CD34 and MMP-2, respectively. The microvessel density (MVD) in GBM was also measured. Results HE staining showed that the implanted tumors were predominantly spheroid with clear border and no capsule could be detected. The neovascular proliferations were observed in tumors. There were high-er expressions of CD34 and MMP-2 in glioma-H2S group. The value of MVD was significantly higher in glioma-H2S group than that of glioma group (P＜0.01). Conclusion Exogenous H2S serves as a stimulator of angiogenesis in the development of rat GBM, which may be related with the increased MMP-2 expression promoted by H2S.

Objective To evaluate the therapeutic effects and pathologic changes of VX2 liver tumor in rabbits treated with CT-guided percutaneous ethanol injection (PEI) with different concentration. Methods Thirty-two New Zealand rabbits with VX2 liver tumor were randomly divided into 4 groups (each n=8), i.e. anhydrous ethanol, 75% ethanol, 50% ethanol and control group (administrated physiological saline). Tumor size, imaging and pothologic changes were observed 7 d, 14 d, 21 d and 60 d after PEI. Results The volume was (4.68±5.05) cm~3 in anhydrous ethanol group, (6.33±6.59) cm~3 in 75% ethanol group, (17.54±5.06) cm~3 in 50% ethanol group and (16.87±5.27) cm~3 in control group 21 d after PEI. Tumor size in control group was larger than that in 75% ethanol group (t=6.32, P＜0.05) and anhydrous ethanol group (t=6.74, P＜0.05), in 50% ethanol group was larger than that in 75% ethanol group (t=4.99, P＜0.05) and anhydrous ethanol group (t=12.77, P＜0.05). No difference of tumor size was found between 50% ethanol group and control group, nor between 75% ethanol group and anhydrous ethanol group. ALT and AST both increased in all groups 1 d after PEI and returned to normal 7 d later except anhydrous ethanol group. ALT and AST in anhydrous ethanol group were higher than those in other groups (t=4.10, 4.49, 3.06, 5.79, 5.91, 4.11, all P＜0.05), and no difference of ALT and AST was detected between other groups. Area of coagulation necrosis enlarged with the increase of ethanol concentration. Conclusion Anhydrous ethanol and 75% ethanol both have obvious inhibition function to the rabbit VX2 tumor, while 75% ethanol has little damage to the liver function and is suitable for PEI.

BACKGROUND:Total hip arthroplasty is an optimal choice for patients with late hip dysplasia. Crowe type IV developmental dysplasia of the hip increases the difficulty of the operation, and the surgery is controversial.
OBJECTIVE:To evaluate the clinical effects of total hip arthroplasty on Crowe type IV developmental dysplasia of the hip and the method of reconstruction of acetabulum and the treatment of proximal femur.
METHODS:A total of 12 patients (14 hips) with Crowe type IV developmental dysplasia of the hip underwent total hip arthroplasty. Preoperative Harris hip score was averagely (35.0±6.8) points. Al hips were treated with smal acetabular components combined with medial protrusion technique in acetabular reconstruction, as wel as subtrochanteric shortening osteotomy in femur. Joint function of hips was evaluated according to the Harris hip score.
RESULTS AND CONCLUSION:Al patients were fol owed up with an average of 4.6 years (ranged 1 to 7 years). Two cases (two hips) suffered from infraction of greater trochanter of femur during replacement, and it was fixed with wire. There was complete sciatic nerve injury in one case, which partial y restored after conservative treatment for 1 month. No infection, prosthesis loosening, or deep venous thrombosis with obvious clinical manifestations was visible. Bone union was observed at the site undergoing osteotomy at the side of femur. After replacement, final fol ow-up showed that Harris hip score was averagely (84.0±7.0) points. The mean amount of postoperative leg lengthening was 5 cm (range 4-6 cm). Shortened limbs were corrected satisfactorily. These results suggested that total hip arthroplasty using smal acetabular component, medial protrusion, and femoral subtrochanteric shortening osteotomy technique for the Crowe type IV developmental dysplasia of the hip can effectively restore hip function and leg length. The long-term curative effects require further investigations.

Object To find out which of the 27 ginsenosides isolated from Panax ginseng C A Mey that may inhibit the proliferation of human osteosarcoma cell line U 2OS Methods Effects of each individual ginsenoside on the proliferation of U 2OS cell were studied by determining the viability of cancer cells during culture with or without the presence of the test compound DNA assay was determined by flow cytometry Results Ginsonosides Ro, Rh 1, Rh 2, F 1 and L 8 at concentrations of 5 ?mol/L could obviously suppress the proliferation of U 2OS cells while ginsenosides Rg 1, F 3, Rf, PPT and PT significantly inhibited the cancer cells Flow cytometry revealed that ginsenosides Ro, Rg 1, Rf, F 1, Rh 2 ,PPT and PT induced cell cycle arrest at G 0/G 1 phase with obvious decrease of cell count at S and G 2+M phase Moreover, ginsenosides Rf 1, Rg 1, F 1 and PPT induced significantly high rates of cell death as compared with the control Conclusion These data suggested that ginsenosides inhibited U 2OS proliferation via cell cycle arrest or induction of cell death