Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

AIM:Cyclin is a decisive factor of regulating cell cycle,and RNA interference as an effective and specific gene silencing technique,can induce cell express the phenotype of specific gene deficiency. This study is to apply cyclinD1 specific small interfering RNA(siRNA) on inhibiting cyclinD1 gene expression and investigate the effect of cyclinD1 specific siRNA on the cell cycle and multiplication in keloid fibroblasts. METHODS:The experiment was conducted at the Institute of Genetic Engineering(Grade BSL-2) in Southern Medical University from July 2006 to May 2007.①siRNA was designed with siRNA target finder of ambion Company,and synthesized chemically in Shanghai GeneChem,Co.,Ltd. Then double-strand siRNA was obtained following degenerative renaturation. Keloid fibroblasts were sampled from the patients in the Department of Plastic Surgery,Southern Medical University(informed consents were obtained from the patients or their relatives).②The keloid fibroblasts were divided into experimental group and control group. The cyclinD1 specific siRNA was transfected into the keloid fibroblast of the experimental group by the liposome-mediated gene transfection method. The untreated cells were set as controls.③At hours 24,48 and 72 of transfection,light microscope was used to observe cell morphologic change and flow cytometry was used to examine cell cycle. The viable cells were counted by MTT colorimetry and a cell growth curve was drawn. RESULTS:①Abnormal change of cell morphology that became into spherical shape or oval-shape from normal long fusiform after transfection may be the apoptosis or necrosis cells.②The G1 stage of cell cycle extended and the S stage decurtated. At 24,48 and 72 hours after transfection,the radio of G1 stage cell was 60.13%,66.22% and 67.53%,which were all significantly higher than that in the control group(54.53%);the radio of S stage cell(18.25%,17.11% and 11.15%) was also significantly lower than that in the control group(22.31%),indicating that the proportion of the cells blocked in G1 stage and those in S stage decreased in the keloid fibroblast.③siRNA-cyclinD1 inhibited the growth of keloid fibroblasts obviously by using MTT assay,and the cell growth curves indicated that the proliferation of cell transfected with cyclinD1 specific siRNA was inhibited significantly when compared with controls. CONCLUSION:CyclinD1 specific siRNA effectively inhibits the expression of cyclinD1 in keloid fibroblasts thus arresting the cell cycle at G1 stage and enhancing cell apoptosis.

Objective To investigate the effect of transplantation of human umbilical cord blood CD34+cells on spinal cord injury. Methods CD34+cells were separated from fresh human umbilical cord blood by magnetic cell sorting. Ninety-six female Wistar rats were injured at T10 by IMPACTOR MODEL-Ⅱ, and then randomly assigned to three groups:Cyclo?sporin A (CsA)+Dexamethasone (Dex) treated group (Ⅰ, n=32), local transplantation of cells+CsA+Dex treated group (Ⅱ) at the first day after operation (DAO 1, n=32), local transplantation of cells+CsA+Dex treated group (Ⅲ) at DAO 6 (n=32). BBB locomotor scoring system was used to assess the recovery of the lower limbs. The survival and neural differentiation of transplanted cells at the injury site were observed by double immunofluorescence. The tissue vitality at the injury site was ob?served by 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) staining, and the blood vessel density was observed by infusing mixture of Chinese ink and glutin followed by HE staining. Results BBB score at DAO 8-56 was significantly higher inⅡgroup than that of other two groups (P<0.05). TTC staining showed that the proportion of decreased vitality area was signifi?cantly smaller inⅡgroup than that of other two groups (P<0.01). The result of gelatin ink perfusion showed that the blood vessel density at the injury site was significantly bigger inⅡgroup than that of other two groups (P<0.01). There were more survival transplanted cells inⅡgroup than those of III group (per visual field, 7.51 ± 1.00 vs 5.51 ± 0.89,t=6.051, P<0.01). All the transplanted cells didn’t differentiate into neural cells. Conclusion Human umbilical cord blood CD34+cells can promote the recovery of the lower limbs after spinal cord injury by repairing blood vessels to increase tissue vitality at the in?jury site in rats.

ObjectiveTo summarize experiences of diagnose and disposal of acute abdomen of patients with spinal cord injury (SCI) in order to raise the successful rate.MethodsThe data of 10 acute abdomen patients with SCI were analyzed retrospectively.ResultsAmong 10 cases, 9 cases were cured, 1 case died.ConclusionDiagnosing and managing acute abdomen of patients with SCI in time can get satisfied outcome.

Objective To study the expression and significance of P53 and nm23 in colorectal adenocarcinoma.Methods The expression of P53 and nm23 was examined by immunohistochemical technique in 83 cases of colorectal adenocarcinoma.Results In colorectal adenocarcinoma,the positive intensities of P53 and nm23 was associated with tumour depth,histological grade,lymph node metastasis diseases and distant metastasis disease(P0.05).Conclusion P53 and nm23 may play an important role in the development and metastasis of colorectal adenocarcinoma.It is an useful marker for predictinng the prognosis of colorectal adenocarcinoma.

Objective To investigate the effect of atorvastatin on vascular endothelial cell function and vasoactive substances in essential hypertensive patients without hyperlipemia. Methods Sixty-five essential hypertensive(EH) patients without hyperlipemia were enrolled and randomly divided into atorvastatin group and conventional treatment group(oral taken atorvastatin or placebo once every night in addition of routine antihypertensive drugs).Twenty five healthy subjects were also recruited as control.All cases were followed up for eight weeks.Serum cholesterol,nitric oxide(NO),emdothelin-1(ET-1),vonWillebrand-factor(vWF) levels were determined in each case.Flow-medizted dilation(FMD) was determined by high-resolution ultrasonography before and after eight weeks atorvastatin medication.Results (1)Before treatment,the FMD and NO levels of EH group were significantly lower than those of control group(P＜0.01),while the ET-1 and vWF levels of EH group were significantly higher than those of control group(P＜0.01);(2)In EH patients,the FMD and NO levels significantly increased after treatment and increased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01);(3)In EH patients,the ET-1 and vWF levels significantly decreased after treatment and decreased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01).Conclusion In patients of EH without hyperlipemia,atorvastatin can decrease plasma levels of ET-1,vWF,while increase plasma NO concentration and improve vascular endothelial function.

Objective To explore the essentiality of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) examination before breast-conserving surgery (BCS) in breast cancer patients with young women.Methods The data of DCE-MRI and mammography X-ray in 30 breast cancer patients with young women (＜ 40 years old) who received surgery with pathology-proven were retrospectively analyzed.The detection rate of breast lesion,number,size,extent of invasive and lymph node metastasis of preoperative were observed.The DCE-MRI was assessed accuracy of BCS in accordance with indications for BCS and histopathology results.Results The breast cancer detection rate of DCE-MRI was significantly higher than mammography X-ray [100.00％(30/30) vs.73.33％(22/30),P =0.002].The maximum tumor diameter of DCE-MRI was (3.55 ± 1.50) cm,mammography X-ray was (3.38 ± 1.70) cm,postoperative pathology was (3.51 ± 1.20) cm,and DCE-MRI was closer to postoperative pathology than mammography X-ray.The discovery of additional lesions of DCE-MRI was more than mammography X-ray (P ＜ 0.05).The surrounding tissue invasion of DCE-MRI was detected in 22 cases,mammography X-ray was in 9 cases,postoperative pathology was in 19 cases,there was no significant difference between DCE-MRI and postoperative pathology (P =0.598),there was significant difference between mammography X-ray and postoperative pathology (P =0.010).The number of axillary fossa lymph node metastasis of DCE-MRI was in 127,mammography X-ray was in 48,compared with postoperative pathology (91),there was significant difference (P =0.026,0.034).The detection of microcalcification of mammography X-ray was better than DCE-MRI (7 cases vs.0 case,P =0.001).The number of BCS of postoperative pathology was in 12 cases,DCE-MRI was in 11 cases,mammography X-ray was in 8 cases,DCE-MRI was higher than mammography X-ray,but there was no significant difference (P=0.132).Conclusion DCE-MRI provides comprehensive and accurate information for breast cancer patients with young women for BCS,and it is feasible to assess them using DCE-MRI preoperative for BCS.

Objective To analyze the clinical features and factors affecting prognosis for intracerebral hemorrhage (ICH) during pregnancy and postpartum.Methods A study of ICH was performed on 61 women in Beijing Tiantan Hospital,Capital Medical University between January 1997 and December 2014,and all cases were diagnosed with cerebral hemorrhage or subarachnoid hemorrhage during pregnancy or six weeks after delivery with CT or MRI after exclusion of ICH due to craniocerebral trauma.The subjects were divided into surgery (n=26) and conservative treatment (n=35) groups according to different ways of treatment;pregnancy associated problems (n=11) and cerebrovascular diseases groups according to the aetiology of ICH;low (n=13) and high score group (n=48) according their Glasgow score at the first visit;and short clinical onset to diagnosis time (O-D time) group (≤ 24 h,n=33) and long O-D time (＞24 h) group (n=28).We compared the maternal clinical features and prognosis between different groups with t,Mann-Whitney U or Chi-square tests.A stratified logistic regression was used to assess the effect of factors affecting the prognosis.Results The average gestational age at the onset of ICH of the 61 cases was (28.8±8.3) weeks (6-40 weeks),the Glasgow score was (11.3±4.8),the median O-D time was 24.0 h,the modified Rankin scale (mRS) was 2.7,and 14 maternal deaths were reported (23.0％).Among the 61 women,three were terminated in early trimester,12 terminated in second trimester,and the rest 46 delivered in late term among which two fetal deaths,44 live births,and four neonatal deaths.Thus the perinatal infant death rate was 13.0％ (6/46).The difference of maternal clinical features and prognosis between the surgery and conservative treatment group was not significant (all P＞0.05).However,comparison between the cerebrovascular disease and pregnancy associated diseases group showed the latter had a lower Glasgow score and Apgar score [12.2(3.0) vs 7.5(12.0),(8.9±1.9) vs (7.2±2.6)],the higher mRS [2.4(2.0) vs 3.9(5.0)] and gestational age [(27.7±8.4) vs (34.9±4.1)],maternal mortality rate [14.0％ (7/50) vs 7/11] and perinatal death rate [5.4％ (2/37) vs 4/11] (t or x2=-3.09,-2.34,1.93,1.17,2.12 and 1.78,all P＜0.05).For women with low Glasgow score,the median O-D time was shorter than that of higer Glasgow score group (8.0 vs 48.0 h),the mRs and maternal mortality rate were higher 4.9(2.5) vs 3.1(2.0);9/13 vs 10.4％(5/48),t,U or x2=426.00,5.77 and 19.14,all P＜0.05].The short O-D time group showed lower Glasgow score and average Apgar score of the newborns than the long O-D time group [9.8(11.3) vs 13.2(2.0),(7.9±2.7) vs (9.2±0.9);t,U or x2=-2.91 and-2.23,both P＜0.05].The Glasgow scores was negatively associated with the mRs (OR=-0.26,95％CI:-0.16 to-0.05).In particular,O-D time (OR=0.03,95％CI:0.00-0.66) and pre-eclampsia (OR=0.33,95％CI:0.12-0.26) were both positively related to maternal mRs.However,the Glasgow scores,surgical treatment,O-D time and concomitant pre-eclampsia were irrelevant to the death ofperinatal infants (all P＞0.05).Conclusions The prognosis is poor in women with ICH during pregnancy or postnatal period whose Glasgow score was low or O-D time was long,or the ICH occurred due to pre-eclampsia.Antenatal care should be strengthened and early identification and diagnosis might improve the prognosis.

ObjectiveTo explore the diagnosis and treatment of acute mesenteric ischemia.MethodsClinical data of 12 cases with acute mesenteric ischemia diagnosed by both operation and pathology were analyzed retrospectively.ResultsThe cases were mainly aged patients accompanied by cardiovascular disease and easily developed to strangulative intestinal obstruction. The mortality rate of this disease was very high.ConclusionThe early diagnosis with suitable techniques and prompt treatment are the keys to the management of this disease.

OBJECTIVETo explore clinical characteristics and treatment of posterior Pilon fracture.

METHODSFrom January 2011 to January 2013,18 patients with posterior Pilon fracures were treated. Among them, 13 were male and 5 were female, aged from 22 to 63 years old, with an average age of 46. All the patients were closed fractures. Open reduction and internal fixation were performed after swelling subsided, lateral malleolous and posterior Pilon fracture were exposured through lateral approach on healthy side, plates were used to fixed,screws or small plates were used to fix the posterior prominence of medial malleolus after changed to supine position. AOFAS scoring were applied to evaulate clinical effects.

RESULTSAll patients were followed up with an average of 22(ranged, 12 to 48)months. All patients obtained satisfactory reset except one patient. All factures were recovered well with an average healing of 11 weeks. According to AOFAS score at the final following up, 7 cases were excellent,2 cases were moderate, and the total score was 86.8±9.2.

CONCLUSIONPosterior Pilon fracture is not rare in clinical, its mechanism of injury, traumatic anatomy, surgical procedure and prognosis are different from that of classical ankle fracture and Pilon fracture.

Adult ; Ankle Injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult