Thoracic outlet syndrome(TOS) are constellation of symptoms caused by compression of the neurovascular bundle including the brachial plexus, the subclavian artery and the subclavian vein at the thoracic outlet region. It includes neurogenic TOS, venus TOS, arterial TOS, and neurogenic TOS is the most common type. TOS has varied manifestations and lack of confirmatory testing, therefore, the diagnosis should be conbination with thorough history, physical examination and associated supplementary examinations. Conservative and surgical treatment can be choosed for TOS and the outcomes are generally good. Conservative management is the initial treatment strategy for neurogenic TOS. In cases of symptomatic vascular TOS and neurovascular TOS, which has been failed by conservative treatment, surgery should be considered more promptly.
Brachial Plexus ; Conservative Treatment ; Humans ; Physical Examination ; Thoracic Outlet Syndrome ; diagnosis ; therapy

OBJECTIVETo retrospectively study curative effects of three repair methods for rotator cuff tears under arthroscopy, and to explore relationships between different repair methods and cuff lesions.

METHODSFrom January 2009 to Jaunary 2014, a total of 353 patients with rotator cuff tears treated with surgical repair under arthroscopy were included in this study. All the patients were divided into three groups according to time of visitiny hospital and it was divided into three periods. The patients on the first period were treated with single row rivet fixation(115 cases), including 51 males and 64 females, with an average age of (57.46±9.08) years old. The patients on the second period were treated with double row rivet fixation(163 cases), including 76 males and 87 females, with an average age of (56.93±9.92) years old. The patients in the third period were treated with suture bridge fixation(75 cases), including 32 males and 43 females, with an average age of (55.90±9.15) years old. There were 29 patients with huge rotator cuff injuries, who were treated with single-row suture. The shoulders were protected by a brace for 6 weeks after operations were permit ted to perform passive movement within 6 weeks, and then perform active shoulder exercise 6 to 10 weeks after operation. Constant-Murley score, UCLA score and VAS score were recorded preoperatively and postoperatively.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 62 months, with a mean of 30 months. There was no infection or nerve injury. UCLA score was improved from preoperative 10.71±2.45 to postoperative 32.07±3.16; Constant-Murley score was improved from preoperative 43.33±11.55 to postoperative 78.15±12.64; VAS score was improved from preoperative 5.81±1.27 to postoperative 0.52±0.71. There were no statistical differences among three groups in UCLA score, Constant-Murley score and VAS score. Total 337 cases were satisfied with treatment results and 16 cases were not satisfied with the results. Among the 16 cases, 3 cases had huge rotator cuff surgery, and 13 cases had no joint stiffness before operation. The main complaints that resulted in dissatisfaction were weakness of the postoperative muscles and failure to restore the labour capacity(11 cases).

CONCLUSIONSRotator cuff repair under arthroscopy has a reliable clinical effect for the patients with rotator cuff tears. Stable and reliable clinical results can be obtained regardless different repair methods or different rotator cuff tears. The following factors such as no stiffness before operation, too early active exercise and preoperative rotator cuff atrophy may be the risk factors for postoperative dissatisfaction of patients.

AIM:To study the effect and the molecular mechanism of CDX 2 over-expression on the prolifera-tion, growth and cell cycle of human gastric cancer cell line SGC-7901.METHODS:The SGC-7901 cells in LV-CDX2-GFP group were transfected with the recombinant lentivirus vector LV-CDX2-GFP, the cells in LV-GFP group were trans-fected with the negative control lentiviral vector for the negative control , and the cells in blank control group were without any treatment.The cell proliferation was detected by CCK-8 assay.The cell cycle distribution was analyzed by flow cytome-try.The expression of CDX2, Bax, Bcl-2, cyclin D1 and survivin was determined by semi-quantitative RT-PCR and Wes-tern blotting .RESULTS:Compared with LV-GFP group and blank control group , the proliferation activity of the SGC-7901 cells was significantly lower (P<0.05), the G0/G1 phase proportion increased (P<0.05), the mRNA and protein levels of Bcl-2, cyclin D1 and survivin were reduced (P<0.05), and the mRNA and protein levels of Bax were up-regula-ted (P<0.05) in LV-CDX2-GFP group.No statistically significant difference of the above indexes was observed (P>0.05) between LV-GFP group and blank control group .CONCLUSION:Over-expression of CDX2 mediated by lentivirus inhibits the proliferation and growth of human gastric cancer SGC-7901 cells and arrestes the cell cycle at G 0/G1 phase, which may be related to down-regulation of Bcl-2, cyclin D1 and survivin and up-regulation of Bax .

Objective This report was to discuss the efficacy and complications of non-surgical therapy for patients with early lower extremity deep vein thrombosis.Methods A total of 412 patients were treated with thrombolysis or anticoagulation in our department during January 2000 and December 2006.Their clinical data were retrospectively analyzed.Results All patients were followed up for 12 to 83 months (mean,41 months).After treatment,42 patients(10.2%)were completely recovered,331 patients (80.3%)experienced large improvement,32 patients(7.8%)had mild improvement and 7 patients (1.7%)were failed,resulting in total effective rate of 98.3%.In comparison with long clinical course group(>7 days),the recovery rate and improvement rate of short clinical course group(≤7 days)was significantly increased(11.0% vs 5.4%,χ2=4.17,P<0.05;8.7%vs 1.8%,χ2=4.96,P<0.05).Complications included bleeding(2.2%),pulmonary embolism(1.9%),cerebral accident(0.7%),post-thrombotic syndrome(84.0%)and recurrence(6.1%).Bleeding rate in patients≥60 years was significantly higher(4.3%vs 0.8%,χ2=6.82,P<0.01).Incidence of post-thrombotic syndrome was significantly increased in long clinical course group(98.2% vs 81.7%,χ2=3.67,P<0.05).Condusions Non-surgical therapy,including thrombolysis and anticoagulation,might be safe and effective for patients with early lower extremity deep vein thrombosis.Early identification and management would be helpful to improve outcomes and reduce post-thrombotic syndrome.

Objective To investigate the value of multislice spiral CT(MSCT,)in interventional therapy of the hepatocellular carcinoma(HCC)emphasising on transcatheter hepanc arterial chemoembolization(TACE).Methods MSCT were performed in 60 cases of HCC before interventional procedure,CT findings of hepatic artery phase,portal venous phase and hepatic venous phase were observed respectively,among which CTA were done in 15 cases,and the anatomy of celiacartery and its branches were observed in 45 cases.The schemes of interventional therapy were worked out according to the findings of MSCT.Results MSCT showed 250 lesions,10 cases of tumor thrombosis in portal vein and 19 cases of hepatic arterioportal shunt.There was no significant difference between MSCT and digital subtraction angiography(DSA)in positive rate of in showing number of tumor or tumor thrombosis in portal vein(P＞0.05),but the 3D construction of celiac artery branches in CTA was better than that in DSA,while angles between celiac artery and abdominal aorta in MSCT were more convenient than that in DSA.MSCT showed 5 eases of hepatic artery original abnormality,according to that in DSA.Conclusion MSCT is of importance for guidance of interventional therapy of hepatocellular carcinoma.

OBJECTIVETo study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODSFrom July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTSAll the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONAnatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

Adult ; Ankle Joint ; anatomy & histology ; pathology ; surgery ; Female ; Humans ; Joint Instability ; pathology ; surgery ; Lateral Ligament, Ankle ; anatomy & histology ; pathology ; surgery ; Male ; Middle Aged ; Models, Biological ; Reconstructive Surgical Procedures ; methods ; Young Adult

OBJECTIVETo study the clinical effects of Müller method for reconstruction of posterolateral corner (PLS) of knee joint.

METHODSFrom June 2005 to June 2007, 13 patients with PLS injured were treated with Müller method. Four patients complicated with injuries in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), 7 patients complicated with injuries in PCL, 4 patient also had injuries in ACL, 1 patient complicated with ACL injury, and 1 patient complicated with avulsions fractures of the tibial ACL insertion. Among the patients, 5 patients had chronic injuries with a duration of 2 to 7 months. After the cruciate ligament was reconstructed, the popliteus tendon was reconstructed with iliotibial band and lateral collateral ligament (LCL) reconstructed with biceps femoris tendon. All the ligaments were fixed with interface screws. The patients were encouraged to do strength and motion exercise on bed immediately after operation and permit toe-touch weight-bearing till two months after operation. The brace was used till six months after operation.

RESULTSThe average follow-up period was 13 months (ranged from 6 to 27 months). There was no restriction of range of motion. External rotation range were good compared to the normal side. One year after operation, one-grade varus instability at 30 degrees flexion was found only in 2 patients. The postoperative Lysholm scores were from 77 to 94 (average 86).

CONCLUSIONThe method is easier to perform, easier to get the materiar for reconstruction and promised satisfactory clinical results.

Adult ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods

Objective: To investigate the differential expression profiles of circular RNA (circRNA) in human epidermal growth factor receptor 2 (HER-2) positive breast cancer cells and normal mammary epithelial cells, and to develop novel diagnostic and therapeutic markers for HER-2 positive breast cancer. Methods: Total RNA were extracted from HER-2 positive breast cancer cell SK-BR-3 and normal mammary epithelial cell MCF10A. RNA quality was detected using NanoDrop ND-1000. Rnase R was applied to remove linear RNA and enrich circRNAs. After amplification and reverse transcription into fluorescent complementary RNA (cRNA) using random primer, the labeled cRNAs were hybridized onto the Arraystar Human circRNA Arrays. The raw data were extracted and the acquired array images were subjected to quantile normalization followed by heat map and volcano plot analysis. The expression of circRNAs with large fold change was verified by real-time quantitative polymerase chain reaction (RT-qPCR). Finally, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed in the differentially expressed circRNAs and circRNA-microRNA (miRNA) network was constructed. Results: The total RNA extracted from SK-BR-3 and MCF10A had high integrity and quality. The expression profiles of circRNA in SK-BR-3 and MCF10A cells were significantly different shown by fluorescent expression signals. Compared with MCF10A cells, there were 6 584 up-regulated circRNAs and 6254 down-regulated circRNAs in SK-BR-3 cells. There were 348 circRNAs with |log₂FC|≥2, of which 153 were up-regulated and 195 were down-regulated. Moreover, 8 circRNAs with |log₂FC|>5. Among them, 5 were up-regulated in SK-BR-3 cells, including hsa_circRNA_074595 (|log₂FC|=7.84), hsa_circRNA_074598 (|log₂FC|=6.50), hsa_circRNA_085362 (|log₂FC|=5.86), hsa_circRNA_101379 (|log₂FC|=5.71) and hsa_circRNA_406683 (|log₂FC|=5.34); as well as 3 were down-regulated, including hsa_circRNA_021714 (|log₂FC|=5.46), hsa_circRNA_100777 (|log₂FC|=5.40), and hsa_circRNA_100796 (|log₂FC|=5.03). The expression levels of hsa_circRNA_074595, hsa_circRNA_074598 and hsa_circRNA_100777 were further validated by RT-qPCR in consistent with the results of microarray. GO analysis showed that differentially expressed circRNAs were significantly enriched in the biological process of heart development (P<0.001), cellular component in the cell adhesion-related components (P<0.001), molecular function in protein serine/threonine kinase activity (P<0.001). KEGG analysis revealed that differentially expressed circRNAs were significantly enriched in the PI3K-Akt signaling pathway. Conclusions The expression profile of circRNA in HER-2 positive breast cancer cells is significantly different from that in normal mammary epithelial cells. The differentially expressed circRNAs may be served as potential diagnostic or therapeutic targets for HER-2 positive breast cancer.

Objective To investigate the differential expression profiles of circular RNA (circRNA) in human epidermal growth factor receptor 2 ( HER?2) positive breast cancer cells and normal mammary epithelial cells, and to develop novel diagnostic and therapeutic markers for HER?2 positive breast cancer. Methods Total RNA were extracted from HER?2 positive breast cancer cell SK?BR?3 and normal mammary epithelial cell MCF10A. RNA quality was detected using NanoDrop ND?1000. Rnase R was applied to remove linear RNA and enrich circRNAs. After amplification and reverse transcription into fluorescent complementary RNA (cRNA) using random primer, the labeled cRNAs were hybridized onto the Arraystar Human circRNA Arrays. The raw data were extracted and the acquired array images were subjected to quantile normalization followed by heat map and volcano plot analysis. The expression of circRNAs with large fold change was verified by real?time quantitative polymerase chain reaction ( RT?qPCR). Finally, Gene Ontology ( GO) and Kyoto Encyclopedia of Genes and Genomes ( KEGG) enrichment analyses were performed in the differentially expressed circRNAs and circRNA?microRNA ( miRNA ) network was constructed. Results The total RNA extracted from SK?BR?3 and MCF10A had high integrity and quality. The expression profiles of circRNA in SK?BR?3 and MCF10A cells were significantly different shown by fluorescent expression signals. Compared with MCF10A cells, there were 6 584 up?regulated circRNAs and 6254 down?regulated circRNAs in SK?BR?3 cells. There were 348 circRNAs with |log2FC|≥2, of which 153 were up?regulated and 195 were down?regulated.Moreover, 8 circRNAs with |log2FC|＞5.Among them, 5 were up?regulated in SK?BR?3 cells, including hsa＿circRNA＿074595 (|log2FC|＝7.84), hsa＿circRNA＿074598 (| log2FC | ＝ 6.50 ), hsa＿circRNA＿085362 (| log2FC | ＝ 5.86 ), hsa＿circRNA＿101379 (|log2FC|＝5.71) and hsa＿circRNA＿406683 (|log2FC| ＝5.34); as well as 3 were down?regulated, including hsa＿circRNA＿021714 (|log2FC|＝5.46), hsa＿circRNA＿100777 (|log2FC|＝5.40), and hsa＿circRNA＿100796 (|log2FC|＝5.03). The expression levels of hsa＿circRNA＿074595, hsa＿circRNA＿074598 and hsa＿circRNA＿100777 were further validated by RT?qPCR in consistent with the results of microarray. GO analysis showed that differentially expressed circRNAs were significantly enriched in the biological process of heart development (P＜0.001), cellular component in the cell adhesion?related components ( P＜0.001), molecular function in protein serine／threonine kinase activity (P＜0.001). KEGG analysis revealed that differentially expressed circRNAs were significantly enriched in the PI3K?Akt signaling pathway. Conclusions The expression profile of circRNA in HER?2 positive breast cancer cells is significantly different from that in normal mammary epithelial cells. The differentially expressed circRNAs may be served as potential diagnostic or therapeutic targets for HER?2 positive breast cancer.

Objective To investigate the differential expression profiles of circular RNA (circRNA) in human epidermal growth factor receptor 2 ( HER?2) positive breast cancer cells and normal mammary epithelial cells, and to develop novel diagnostic and therapeutic markers for HER?2 positive breast cancer. Methods Total RNA were extracted from HER?2 positive breast cancer cell SK?BR?3 and normal mammary epithelial cell MCF10A. RNA quality was detected using NanoDrop ND?1000. Rnase R was applied to remove linear RNA and enrich circRNAs. After amplification and reverse transcription into fluorescent complementary RNA (cRNA) using random primer, the labeled cRNAs were hybridized onto the Arraystar Human circRNA Arrays. The raw data were extracted and the acquired array images were subjected to quantile normalization followed by heat map and volcano plot analysis. The expression of circRNAs with large fold change was verified by real?time quantitative polymerase chain reaction ( RT?qPCR). Finally, Gene Ontology ( GO) and Kyoto Encyclopedia of Genes and Genomes ( KEGG) enrichment analyses were performed in the differentially expressed circRNAs and circRNA?microRNA ( miRNA ) network was constructed. Results The total RNA extracted from SK?BR?3 and MCF10A had high integrity and quality. The expression profiles of circRNA in SK?BR?3 and MCF10A cells were significantly different shown by fluorescent expression signals. Compared with MCF10A cells, there were 6 584 up?regulated circRNAs and 6254 down?regulated circRNAs in SK?BR?3 cells. There were 348 circRNAs with |log2FC|≥2, of which 153 were up?regulated and 195 were down?regulated.Moreover, 8 circRNAs with |log2FC|＞5.Among them, 5 were up?regulated in SK?BR?3 cells, including hsa＿circRNA＿074595 (|log2FC|＝7.84), hsa＿circRNA＿074598 (| log2FC | ＝ 6.50 ), hsa＿circRNA＿085362 (| log2FC | ＝ 5.86 ), hsa＿circRNA＿101379 (|log2FC|＝5.71) and hsa＿circRNA＿406683 (|log2FC| ＝5.34); as well as 3 were down?regulated, including hsa＿circRNA＿021714 (|log2FC|＝5.46), hsa＿circRNA＿100777 (|log2FC|＝5.40), and hsa＿circRNA＿100796 (|log2FC|＝5.03). The expression levels of hsa＿circRNA＿074595, hsa＿circRNA＿074598 and hsa＿circRNA＿100777 were further validated by RT?qPCR in consistent with the results of microarray. GO analysis showed that differentially expressed circRNAs were significantly enriched in the biological process of heart development (P＜0.001), cellular component in the cell adhesion?related components ( P＜0.001), molecular function in protein serine／threonine kinase activity (P＜0.001). KEGG analysis revealed that differentially expressed circRNAs were significantly enriched in the PI3K?Akt signaling pathway. Conclusions The expression profile of circRNA in HER?2 positive breast cancer cells is significantly different from that in normal mammary epithelial cells. The differentially expressed circRNAs may be served as potential diagnostic or therapeutic targets for HER?2 positive breast cancer.