[Objective]To evaluate the clinical value in treatment of subtrochanteric fracture of the femur by dynamic condylar screw(DCS).[Method]This study retrospectively reviewed 29 patients who suffered from subtrochanteric fracture of the femur.There were 18 males,11 females,with an average age of 52.2 years.Seven cases were caused by traffic accident,8 cases caused by falling from hight,14 cases caused by pedestrian injury.According to Seinsheimer classification,there were 5 cases of typeⅡ(2 of typeⅡB,3 of typeⅡC),12 cases of typeⅢ(7 of type ⅢA,5 of type ⅢB),5 cases of type Ⅳ,7 cases of type Ⅴ.All patients accepted the treatment with traction reduction and dynamic condylar screw fixation and were fellowed up for 9～24 months(average 16 months).Outcoms were assessed by Sanders traumatic hip rating scale and postoperative complications were analyzed.[Result]All patients obtained bone union in average 3.5 months(3～5 months),Only one case who had obtained bone union suffered subtrochanteric refracture 16 months after operation because of plate breakage.All patients were encouraged to early exercise and walk by nonweight-bearing.There was no postoperative infection,deep venous thrombosis,internal fixation loosening,limb shortening and varus deformity.According to sanders traumatic hip rating scale,18 cases were excellent,10 cases were good,1case was fair.The excellent and good rate was 96.5%.[Conclusion]In treatment of subtrochanteric fracture of the femur,DCS not only maintain satisfying reduction with reliable fixation,but also prevent femoral shortening,rotation and varus deformity,thus get good curative effect,fast recovery,satisfying function and so on.So it is one of the best choices to heal subtrochanteric fracture.

Objective To analyze the correlation between renal blood flow (BF)of CT perfusion and effective renal plasma flow (ERPF)of radionuclide labeled microspheres.Methods CT perfusion was applied to 26 cases of renal cell carcinoma (RCC)in order to obtain the average unit BF of the target layer of the uninjured lateral kidney.For the renal image of the uninjured lateral kidney in the nephrographic phase (NP),we used the value of maximal renal cross-sectional area times the value of renal maximal height as the standardized volume.The product of this standardized volume and average unit BF could be used as an approximation of total re-nal blood flow,which was a standardized renal BF value.Meanwhile,we took radionuclide labeled microspheres into practice to ob-tain an ERPF value of the corresponding uninjured lateral kidney.The correlation between standard renal BF and ERPF was obtained by using Pearson chi-square test.Results The standard renal BF values of the uninjured lateral kidney for the group of 26 cases of RCC ranged from 620.59 to 820.76 mL·min-1 ·g-1 ·cm3 (mean=718.87 ±58.40 mL·min-1 ·g-1 ·cm3 ),and the values of ERPF tested by radionuclide labeled microspheres ranged from 244 to 41 1 mL/min (mean= 320.54 ± 55.71 mL/min).The two groups were positively correlated (r=0.754,P <0.01).Conclusion CT perfusion imaging of the kidney,to some extent,has the potential to replace renal functional examination of radionuclide labeled microspheres.

Advanced gastric cancer has a low survival rate while traditional Chinese medicine (TCM) therapy has effects in inhibiting tumor growth, lengthening survival time and improving the quality of life.

BACKGROUND: The biomechanical studies about calcium sulfate cement vertebroplasty are only limited to the single fracture vertebra, not performed in spinal compression fracture unit with posterior transpedicular screw fixation. Furthermore, performing experimental study in the whole function spine unit (FSU) conforms to actual clinical situation. OBJECTIVE: To assess the biomechanical properties of calcium sulfate vertebroplasty combined with posterior transpedicular screw fixation in treatment of thoracolumbar compression fractures. DESIGN, TIME AND SETTING: A controlled experiment was performed at the Biomechanical Laboratory of Shanghai University in March 2009. MATERIALS: Fifteen fresh thoracolumbar spines were harvested from male calves and made into T_(11)-L_1 FSU, then divided into 3 groups randomly: normal control group, posterior transpedicular screw fixation group and transpedicular screw fixation plus vertebroplasty group. METHODS: T_(12) flexion-compression fracture models were made in all specimens of posterior transpedicular screw fixation group and transpedicular screw fixation plus vertebroplasty group, undergoing reduction and posterior transpedicular screw fixation, and calcium sulfate vertebroplasty combined with posterior transpedicular screw fixation respectively. MAIN OUTCOME MEASURES: All specimens were placed on the WE-10A universal testing machine for mechanical test. Load-straining, load-displacing, rigidity, strength and torsion of the FSU were performed in axial compression, flexion, extension and lateral bending states. The experimental outcomes were collected and compared by statistic analysis. RESULTS: The load-strain and loed-displacement showed a linear relationship. Straining values in vertebral body and intervertebral disc of calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 14% and 12% less than that of posterior transpedicular screw fixation group, 21% and 13% less than that of normal control group. The thoracolumbar displacement in calcium sulfate vertebroplasty Plus posterior transpedicular screw fixation group decreased 25% and 37% as compared with other 2 groups respectively. Compared with normal control and posterior transpedicular screw fixation group, the thoracolumbar stiffness in calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group increased 53% and 44% respectively. The strength in vertebral body and intervertebral disc of calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 14% and 24% higher than that of posterior transpedicular screw fixation group, 13% and 20% higher than that of normal control group. The maximal twisting strength of FSU in calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 18% and 30% higher than that of other 2 groups, the twisting stiffness were 30% and 40% higher than that of other 2 groups. The data above were significant differences statistically (P < 0.05). CONCLUSION: Posterior transpedicular screw fixation combined with calcium sulfate vertebroplasty show superior biomechanical properties for treatment of thoracolumbar compression fractures, which exhibits not only strong strength and stiffness, but also stable FSU, thus could decrease the stress loading of the internal fixation, the incidences of screw breakage and avoid the altitude loss of vertebral body.

Objective To investigate the value of contrast enhanced ultrasonography in evaluating cystic renal mass. Methods According to the imaging diagnosing standard, 29 cystic renal mass lesions were studied with contrast enhanced ultrasonography(CEUS), unenhanced ultrasonography (US), contrast enhanced CT(CECT) and then correlated their results with final histopathological results. The data were tested by receiver operating characteristic(ROC) curve. Results The area under ROC curve of CEUS and US was 0. 721, 0. 997, respectively. There was significant difference between the 2 groups (P=0. 003). The area under ROC curve of CEUS and CECT was 0. 997, 0. 997,respectively. There was no significant difference between the 2 groups (P= 1. 000). Conclusions CEUS is better than US and similar to CECT in evaluating cystic renal mass. CEUS with the Bosniak classification is useful for evaluating cystic renal mass.

OBJECTIVE: To investigate the mechanism of Chinese herbal recipe Weichang'an (WCA) in inducing cell apoptosis of human gastric cancer grafted onto nude mice. METHODS: The high performance liquid chromatography was used for monitoring the stability of WCA. A human gastric cancer cell line SGC-7901 grafted in nude mouse was used as the animal model. The mice were divided into untreated group and two experimental groups. Animals in the two experimental groups received either WCA over a 34-day period or 5-fluorouracil (5-FU) over a 6-day period starting at the 8th day after grafting. Animals in the untreated group received normal saline on an identical schedule. Animals were killed 41 days after being grafted. To assess the effect of the treatment on tumor, the tumor weight was determined by the electron balance immediately after the animals were killed. SP immunohistochemical method was used to detect the expression of proliferating cell nuclear antigen (PCNA) in grafts. Apoptotic indices (AI) of the tumor cells were examined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate fluorescence nick end labeling (TUNEL) method. SP method was also used to detect the expressions of cleaved caspase-3, caspase-8 and caspase-9. SYBR green dye I real-time quantitative polymerase chain reaction (real-time quantitative [corrected] PCR) was used to assess the related gene alterations in mRNA level. The expressions of phospho-Stat3 (Tyr705) and bcl-2 proteins were detected by using SP method. RESULTS: Compared with the untreated group, tumor growth was significantly inhibited by treatment of WCA or 5-FU (P<0.01, respectively). The tumor inhibition rate in the WCA-treated group was 48.70% and that in the 5-FU-treated group was 60.10%. The average labeling index (LI) for PCNA in the WCA-treated group and 5-FU-treated group was significantly decreased as compared with that in the untreated group, respectively. The AI of human gastric cancer grafted in the nude mice detected by using TUNEL method was significantly increased to (9.72+/-4.51)% in the WCA-treated group, while it was (2.45+/-1.37)% in the untreated group. 5-FU-treated group was also found a significantly increased AI compared with the untreated group. The expressions of cleaved caspase-3 and caspase-9 in the WCA-treated group and 5-FU-treated group were significantly increased as compared with those in the untreated group. But caspase-8 showed no significant alteration either in the WCA-treated group or in the 5-FU-treated group. The expression levels of Stat3 (2(-)delta delta C(T))=0.16) and bcl-2 (2(-)delta delta C(T))=0.10) detected by using real-time quantitative [corrected] PCR were lower in the WCA-treated group than those in the untreated group. The expressions of phospho-Stat3 (Tyr705) and bcl-2 in the WCA-treated group were significantly decreased as compared with those in the untreated group. CONCLUSIONS: Chinese herbal recipe WCA can inhibit gastric cancer cell SGC-7901 growth in vivo, induce gastric cancer cell apoptosis and suppress the cell proliferation. WCA induces apoptosis through the caspase-9 and caspase-3 pathway in vivo. Its mechanism might be involved in the down-regulation of Stat3 and bcl-2 genes.

OBJECTIVE: To evaluate the growth-inhibiting and anti-metastasis effects of Weichang'an Decoction (WCAD) on orthotopic transplant nude mouse model of human gastric cancer. METHODS: Forty-one nude mice were implanted with SGC-7901 cells at orthotopic site, whereas 25 were implanted with SGC-7901 cells subcutaneously. Then the nude mice in each transplantation model were divided into the same three groups which were WCAD-treated group with WCAD 0.5 ml/d taken orally, 5-FU-treated group with 5-FU 50 mg/kg intraperitoneally injected weekly and untreated control group with physiological saline 0.5 ml/d taken orally. The growth-inhibiting rates of transplant tumors were detected and the metastatic lesions were examined in the orthotopic transplant mouse model while PCNA-positive rate and apoptotic index (AI) were observed in the subcutaneous transplant mouse model. RESULTS: The growth-inhibiting rates in the WCAD-treated and 5-FU-treated groups of orthotopic transplant mouse model were 40.82% and 37.92% respectively whereas those of subcutaneous transplant mouse model were 48.70% and 60.10%. The incidence rates of metastasis in perigastric lymph notes, lymph nodes in the porta hepatis, liver, diaphragm and peritoneum in the WCAD-treated and 5-FU-treated groups were lower than those in the untreated control group, and the total metastasis rates in the WCAD-treated, 5-FU-treated and the untreated control groups were 30.77%, 28.57% and 71.43% respectively with significant differences (P<0.05). The total PCNA-positive rates in the WCAD-treated and 5-FU-treated groups were obviously lower than that in the untreated control group (P<0.05 or P<0.01) while the AI was higher than that in the untreated control group (P<0.01). The growth-inhibiting rate, total PCNA-positive rate and total metastasis rate in the WCAD-treated group had no significant differences as compared with those in the 5-FU-treated group, but the AI in the WCAD-treated group was significantly higher than that in the 5-FU-treated group (P<0.05). CONCLUSION: WCAD has the inhibiting effects on tumor growth and metastasis of gastric cancer which is orthotopic implanted onto nude mice. This effect may be obtained by proliferation suppression and apoptosis induction in cancer.

BACKGROUND:Tumor has been considered as a specific nonhealing trauma. Bone marrow mesenchymal stem cel s participate in tumor mesenchymal reconstitution by tumor tissue homing and differentiation into mesenchyme, resulting in changing tumor microenvironment and affecting tumor growth and transfer. OBJECTIVE:To explore the mechanisms of participation of bone marrow mesenchymal stem cel s in tumor tissue repair in an A549 lung cancer-bearing mouse model. METHODS:Bone marrow mesenchymal stem cel s were isolated in vitro, cultured, and identified using flow cytometry, and then used to establish a mouse model of A549 lung cancer-bearing. In the experimental group, human bone marrow mesenchymal stem cel s were injected into tissue surrounding the tumor. In the control group, an equal volume of PBS was injected. Animal survival condition and tumor size were compared. At 4 weeks, the specimens were harvested. Hematoxylin-eosin staining was used to compare tumor tissue. Masson staining was utilized to compare col agen fiber content. Reverse transcription-PCR was employed to detect the expression ofα-smooth muscle actin. Immunohistochemistry was used to examine the expression of fibroblast specific protein and fibroblast activation protein to reflect the degree of interstitial fibers in tumor tissue in both groups. The expression levels of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C were compared between the two groups using immunohistochemistry. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cel s promoted tumor growth in tumor-bearing mice. The growth rate of tumor tissue in experimental group was faster than the control group (P<0.05). Compared with the control group,α-smooth muscle actin mRNA expression was significantly higher in the experimental group. Immunohistochemistry was used to detect the expression of tumor angiogenesis factors markers (fibroblast specific protein and fibroblast activation protein) in tumor tissue of experimental group. The expression levels of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C were significantly greater in the experimental group than in the control group (P<0.05). Results indicated that bone marrow mesenchymal stem cel s differentiated into fibroblasts in tumor microenvironment, participated in the formation and construction of tumor stroma as wel as promoted the growth and repair of tumor via the secretion of vascular endothelial growth factor, hepatocyte growth factor, interleukin-6 and tenescin-C.

The incidence of colorectal cancer is high among the elderly. Traditional Chinese medicine (TCM) has been widely used in the treatment for colorectal cancer of old people. However, controlled trials with large sample size evaluating the effect of TCM are rare.

Objective:To investigate whether astragaloside IV (AS-IV) exerts neuroprotective effects via zinc ion (Zn 2+) modulation of mitochondria-associated endoplasmic reticulum membranes (MAMs) and to elucidate the possible mechanisms. Methods:PC12 cells (rat adrenal pheochromocytoma cells) were routinely cultured; they were divided into 7 groups: control group (routinely cultured), 2-DG group (treated with 2-DG at 50 μmol/L for 30 min), astragaloside IV+2-DG group (treated with 50 μmol/L astragaloside IV for 20 min, and then treated with 50 μmol/L 2-DG for 30 min), astragaloside IV group (treated with 50 μmol/L astragaloside IV for 20 min), N,N,N',N'-tetrakis(2-pyridylmethyl)ethylenediamine (a zinc chelator, TPEN)+astragaloside IV+2-DG group (treated with 10 μmol/L TPEN for 10 min, 50 μmol/L astragaloside IV for 20 min, and then 50 μmol/L 2-DG for 30 min); TPEN group (treated with 10 μmol/L TPEN for 10 min), TPEN+2-DG group (treated with 10 μmol/L TPEN for 10 min and then treated with 50 μmol/L 2-DG for 30 min). The expressions of glucose-regulated protein (GRP)78, GRP94, cysteine-containing aspartate proteolytic enzyme caspases-8, B cell receptor associated protein 31 (BAP31) and mitochondrial fission protein 1 (Fis1) were detected by Western blotting. Annexin V-FITC/PI kit was used to detect the apoptosis level. Immunofluorescence was used to detect the Fis1 protein expression, and mitochondrial fluorescence probe TMRE was used to detect the opening of mitochondrial permeability transition pore (mPTP).Results:(1) Compared with the control group, the 2-DG group had significantly increased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05); compared with the 2-DG group, the astragaloside IV+2-DG group had significantly decreased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05); compared with the astragaloside IV+2-DG group, the TPEN+astragaloside IV+2-DG group had significantly increased expressions of GRP78, GRP94, Caspase-8, Bap31 and Fis1, and green fluorescent intensity of Annexin V-FITC ( P<0.05). (2) Compared with the control group, the 2-DG group had significantly enhanced Fis1 protein fluorescent intensity ( P<0.05); the astragaloside IV+2-DG group had significantly decreased Fis1 protein fluorescent intensity compared with 2-DG group ( P<0.05); Compared with astragaloside IV+2-DG group, TPEN+astragaloside IV+2-DG group had significantly enhanced Fis1 protein fluorescence intensity ( P<0.05); compared with the control group, the TPEN+2-DG group had significantly enhanced Fis1 protein fluorescent intensity ( P<0.05). (3) TMRE fluorescence intensity in 2-DG group was significantly decreased compared with control group ( P<0.05); TMRE fluorescence intensity in astragaloside IV+2-DG group was significantly enhanced compared with 2-DG group ( P<0.05); TMRE fluorescence intensity in TPEN+astragaloside IV+2-DG group was significantly decreased compared with astragaloside IV+2-DG group (P<0.05); TMRE fluorescence intensity in TPEN+2-DG group was significantly decreased compared with the control group ( P<0.05). Conclusion:Astragaloside IV can exert neuroprotective effects through Zn 2+ inhibiting endoplasmic reticulum stress-induced apoptosis and preventing mPTP opening in PC12 cells, whose mechanism may be related to Fis1 and Bap31 expressions.