Objective To investigate causes and effects of medial meniscus extrusion in patients with knee osteoarthritis.Methods A total of 120 patients diagnosed as knee osteoarthritis between January 2011 and March 2012 were enrolled in this study,including 60 patients with medial meniscal extrusion confirmed by MRI (extrusion group) and other 60 patients without medial meniscal extrusion (control group).The extrusion distance of medial meniscus and tibiofemoral angle were measured on MRI.The correlation between tibiofemoral angle and extrusion distance were analyzed.The incidences of genu varum,medial meniscus injury and cartilage lesion of medial tibiofemoral joint were compared between two groups.The effect of medial meniscal extrusion on meniscus injury and effect of genu varum on meniscal extrusion were analyzed.Results In extrusion group,the extrusion distances of medial menisci ranged from 3.76 to 11.6 mm (average,8.3±1.79 mm); all patients had genu varum,and the tibiofemoral angle ranged from 174°to 181°(average,179.0°±2.2°); the incidence of medial meniscus injury was 50.0％ (30/60) in the anterior horn,93.3％ (56/60) in the body,and 93.3％ (56/60) in the posterior horn; the incidence of medial meniscus tear in the root of the posterior horn was 23.3％ (14/60); the incidences of cartilage degeneration in medial tibial plateau and medial femoral condyle both were 100％ (60/60); a significant negative correlation was observed between dimension of tibiofemoral angle and extrusion distance of medial meniscus.In control group,the extrusion distances of medial menisci ranged from 0 to 2.61 mm (average,0.57±0.80 mm); four patients had genu varum,and the tibiofemoral angle in all patients was 180°; the incidence of medial meniscus injury was 0 in the anterior horn,16.7％ (10/60) in the body,and 70.0％ (42/60) in the posterior horn; no medial meniscus tear was found in the root of the posterior horn; the incidence of cartilage degeneration was 26.7％(16/60) in medial tibial plateau and 30.0％ (18/60) in medial femoral condyle.The odd ratio of meniscus injury and the number of genu varum (extrusion group/control group) was 6.0 and 15.0,respectively.Compared with the control group,the incidences and severities of medial meniscus injury and cartilage lesion of medial tibiofemoral joint were higher in extrusion group.Conclusion Genu varum may be one cause of medial meniscal extrusion.Medial meniscal extrusion increases incidence of medial meniscus injury and has a significant influence on generation and development of osteoarthritis in medial tibiofemoral joint.

Objective To explore the relationship and clinical significance between the serum levels of oxidized low density lipoprotein (Ox-LDL) and soluble P-selectin (SP-S),and carotid atherosclerosis (CA) in metabolic syndrome (MS) patients.Methods In 103 cases of MS patients and 44 healthy subjects (control group),in MS patients with 3 MS diagnostic criteria for the low risk group (51 cases),with ≥ 4 MS diagnostic criteria for high risk group (52 cases).Carotid artery intima-media thickness (IMT) and plaque was measured by color Doppler ultrasound,serum Ox-LDL,SP-S was determined by enzyme linked immunosorbent assay,and pearson regression analysis of linear correlation and classification of two non condition Logistic was performed.Results The serum levels of Ox-LDL,SP-S,carotid artery IMT in low risk group and high risk group were higher than those in control group [(36.42 ±7.17) μg/L and (54.44± 8.10) μg/Lvs.(30.08±7.15) μg/L,(71.46± 12.52) μ g/Land (89.33±20.28) μg/Lvs.(49.95 ± 12.49) μ g/L,(0.86 ± 0.11) mm and (1.00 ± 0.10) mm vs.(0.69 ± 0.11) mm],the difference was statistically significant (P ＜ 0.01).The incidence of plaque in high-risk group and low-risk group was significantly higher than that in control group [55.8％ (29/52) and 45.1％ (23/51) vs.15.9％ (7/44)],the difference was statistically significant (P ＜ 0.01).Linear correlation analysis results of Pearson display,Ox-LDL was positively correlated with SP-S (P ＜0.01).Conclusion Serum Ox-LDL and SP-S are independent risk factor for carotid atherosclerosis in MS patients,they can evaluate progression of carotid atherosclerosis in patients with MS.

Objective To examine the expression of heparin binding-epidermal growth factor-like growth factor (HB-EGF) in paclitaxel-resistant ovarian cancer and elucidate the relationship between HB-EGF and the resistance of ovarian cancer to paclitaxel. Methods The human ovarian carcinoma cell line A2780 and the paclitaxel-resistant human ovarian carcinoma cell line A2780/Taxol were cultured in vitro. Western blot was used to dectect the expression of HB-EGF protein in A2780 and A2780/Taxol groups. The A2780 cells were treated with cross-reacting material 197 (CRM197 and A2780 + CRM197 group) or dimethyl sulphoxide (DMSO;A2780 group), while the A2780/Taxol cells were treated with CRM197 (A2780/Taxol+CRM197 group) or DMSO (A2780/Taxol group). The effects of CRM197 on growth and proliferation was tested by methyl thiazolyl tetrazolium( MTT) and the results were showed as absorbance (A).The effects of CRM197 on cell cycles was tested by flow cytometry, while the effects of CRM197 on apoptosis was examined by caspase-3 activity assay and the results were showed as p-nitroaniline(pNa). In animal experiment, four groups of cells were inoculated to BALB/c nude mouse subcutaneously to observe tumor formation ability following CRM197 treatment. Immunohistochemistry was used to determine the expression of HB-EGF protein in A2780 and A2780/Taxol group. Results The expression level of HB-EGF protein in A2780/Taxol group (2.11±0.41) was significantly higher than that of A2780 group (0.75±0.20;P<0.01). The inhibition effect of CRM197 on the cell growth of A2780+CRM197 and A2780/Taxol+CRM197 group was accompanied by the acceleration of CRM197 concentration(P<0.01). When CRM197≥1 μg/ml, the inhibition effect of CRM197 on the cell growth of A2780/Taxol+CRM197 group was significantly higher than that in A2780/Taxol group(P<0.05). In cell cycle experiment, CRM197 induced the cell-cycle arrest at the G0/G1 phase in A2780+CRM197 cells[(67 ± 4)%] compared with A2780 cells[(54 ± 6)%;P<0.01], while CRM197 significantly induced the cell-cycle arrest at the G0/G1 phase in A2780/Taxol+CRM197 cells [(72± 4)%] compared with A2780/Taxol cells [(24±8)%;P<0.01]. CRM197 treatment in A2780+CRM197 group [(40 ± 6)μmol/L] led to the acceleration of the caspase-3 activity when compared to A2780 group [(6 ± 6)μmol/L;P<0.01], while CRM197 treatment in A2780/Taxol+CRM197 group [(66 ± 12)μmol/L] led to significant acceleration of the caspase-3 activity when compared to A2780 group [(9 ± 6)μmol/L;P<0.01]. In experiments in vivo, the expression scores of HB-EGF protein in A2780/Taxol tumors(10.8 ± 3.3) were higher than that in A2780 tumors (5.0±2.2;P<0.01). The tumor size and tumor weight of the A2780/Taxol+CRM197 group were both higher than those of the A2780+CRM197 group [(546 ± 85) mm3 vs (1 355 ± 119) mm3,(0.56 ± 0.09) g vs (1.31 ± 0.27) g; all P<0.01]. The CRM197 inhibition rate of the A2780+CRM197 and A2780/Taxol + CRM197 group were 43% and 68% respectively, showed that CRM197 significantly suppressed the growth of A2780/Taxol xenografts in vivo(P<0.01). Conclusions HB-EGF is over-expressed in paclitaxel-resistant ovarian cancer and may be contributes to drug resistance. Inhibition of HB-EGF expression potently enhances apoptosis and inhibit the growth of paclitaxel-resistant ovarian cancer, shedding light on the HB-EGF-targeted therapy options for chemoresistant ovarian cancer patients.

Objective To investigate the effect and mechanism of CRM197, the heparin binding-epidermal growth factor-like growth factor (HB-EGF) inhibitor, on the reverse of the resistance ofovarian cancer to paclitaxel. Methods (1)The effect of CRM197 on the 50% inhibitory concentrations (IC50) of human ovarian carcinoma cell line A2780 and paclitaxel-resistant ovarian carcinoma cell line A2780/Taxol was tested by methyl thiazolyl tetrazolium (MTT) assay. Western blot was used to detect the effect of CRM197 on the expression of HB-EGF,epidermal growth factor receptor (EGFR) and plasma membrane glycoprotein (P-gp) protein in A2780 and A2780/Taxol cells. Real-time PCR was used to examine the MDR1 mRNA expression in these cells. (2) A2780/Taxol cells were divided into 4 groups, including the cells transfected with empty vector and saline treatment (empty vector group), MDR1 small interference RNA (siRNA)vector and saline treatment (MDR1 siRNA group),empty vector and CRM197 treatment (empty vector+CRM197 group) and MDR1 siRNA vector and CRM197 treatment (MDR1 siRNA+CRM197 group), respectively. Flow cytometry was used to detecte the effect of intracellular rhodomine 123 (Rh123) accumulation, and caspase-3 activity assay was used to test the effect of apoptosis in four groups of A2780/Taxol cells. (3) In experiments in vivo, A2780/Taxol cells were inoculated to nude mouse subcutaneously to determine the EGFR and P-gp protein expression following CRM197 treatment by immunohistochemistry. Results (1)In vitro,MTT examination showed that the IC50 of A2780/Taxol cells to paclitaxel in A2780/Taxol+CRM197 group [(6.4±0.3)μmol/L] was significantly lower than the IC50 in A2780/Taxol group [(34.1± 0.5)μmol/L,P<0.01], and the reveral fold of CRM197 was 5.3. The expression level of HB-EGF protein in A2780/Taxol+CRM197 group (1.44 ± 0.29) was significantly lower than HB-EGF protein in A2780/Taxol group (2.72 ± 0.32),respectively (P<0.05). The expression level of EGFR protein (0.71 ± 0.25) and P-gp protein (0.82±0.19) in A2780/Taxol+CRM197 group was significantly lower than EGFR protein (1.87±0.31) and P-gp protein (1.84 ± 0.27) of A2780/Taxol group (P<0.05). Compared with A2780/Taxol group(1.78 ± 0.27), MDR1 mRNA was significantly down-regulated in A2780/Taxol+CRM197 group (0.79 ± 0.13,P<0.05). (2) The fluorescence intensity of Rh123 of the A2780/Taxol cells in empty vector group, MDR1 siRNA group,empty vector+CRM197 group, MDR1 siRNA+CRM197 group was 33.4±1.6, 56.3±3.3, 43.5± 3.1,100.4 ± 7.4, and the pNA of the A2780/Taxol cells was(11.4 ± 1.2),(52.8 ± 0.9),(71.2 ± 3.6),(82.7 ± 3.8)μmol/L. The expression levels in MDR1 siRNA+CRM197 group were both higher than the expression levels in empty vector+CRM197 group, and the expression levels in empty vector+CRM197 group, MDR1 siRNA group were both higher than the expression levels in empty vector group (P<0.05). (3) In vivo, the expression scores of EGFR protein in A2780/Taxol+CRM197 tumors (4.4 ± 1.4) were lower than that in A2780/Taxol tumors (10.2 ± 3.1,P<0.05). The expression scores of P-gp protein in A2780/Taxol+CRM197 tumors (3.8 ± 1.1) were lower than that in A2780/Taxol tumors (8.8 ± 2.7,P<0.05). Conclusion CRM197 reverses the resistance of ovarian cancer to paclitaxel by increasing caspase-3 activity to advance apoptosis via EGFR/MDR1/P-gp pathway.

The clinical data of 24 bladder cancer patients reoperated shortly after laparoscopic radical cystectomy were retrospectively analyzed.The reoperative reasons included intestinal injury,wound bleeding,intestinal anastomosis fistula,deep vein thrombosis,ileus and single-J tube slipping.All of them were cured after reoperation.The postoperative complications were infected incisional wound (n =2),urinary leakage (n =1) and pulmonary infection (n =1).All were cured by symptomatic treatments.The keys of reducing the rate of reoperation shortly after laparoscopic radical cystectomy included selecting indications strictly,standardizing operative procedures and adopting special measures.

Objective To study the effect of background music on spatial long-term learning and memory in rats.Methods Morris' water maze was used to examine the mean latencies and strategies of the rats to the target while playing rock music(RM) and light music(LM).The long-term memory was tested on day 7 after the training sessions.Results During Morris' water maze training,no significant difference was found in the mean latencies and the strategies to the target between RM and LM groups as well as LM and the normal control(NC) groups.But the mean latency in RM group was significantly longer than that in the NC group.The average percentage of straight strategy in RM group was significantly smaller than that in the NC group.The examination of memories,when tested on day 7 after the end of training,indicated that the mean latencies and the strategies to the target as well as the time taken to cross the target in the three groups were not significantly different.Conclusion Background rock music can influence the spatial learning ability,but not the spatial long-term memory.On the other hand,there is no effect in the spatial long-term learning and memory when light background music is played.

Objective:To evaluate whether urological patients at nutritional risk are at higher risk for complications after radical cystectomy than those not at nutritional risk .Methods:We performed a retro-spective observational study in the consecutive patients undergoing radical cystectomy between 2010 and 2013 .A total of 147 patients were enrolled in this study .The nutritional risk score was assessed preoper-atively by a specialized study nurse .The patients with NRS ( nutritional risk screening ,NRS2002) scores≥3 were considered to have nutritional deficiency .Postoperative complications were defined using the standardized Clavien-Dindo classification .Univariate and multivariate analyses were performed to identify the predictors of complications.Results:The patients aged ≥70 years(50.57%) were more prone to nutritional risk than those aged <70 years (31.67%, P=0.023).Of the 63 patients at nutritional risk, 39 (61.90%) presented with at least 1 complication compared with 29 of the 84 controls (34.52%, P=0 .001 ) .The patients at nutritional risk were at threefold risk for complications on binary Logistic analysis (OR=3.128,95%CI 1.538-6.361,P=0.002).The length of hospital stay of the patients at higher nutritional risk was longer than that of those without nutritional risk [(12.9 ±5.7) d vs.(10.4 ± 4.3) d, P=0.003].Conclusion:The patients aged ≥70 years are at higher nutritional risk than that of those aged <70 years .Patients at nutritional risk are more prone to complications after radical cystectomy .

Post-tumbhng stress reaction is associated with postoperative recovery and quality of life in dderly patients.It is essential to realize the characteristics of elderly patients,and to make full evaluation and foreseeing nursing during the perioperative stage.Therefore,major points of foreseeing nursing of elderly patients were reviewed,including the offer of familiar and safe circumstance,a good communication,the sufficient knowledge of illness state,the periodic investigation and the education of minder.

Aneuploidy ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Male ; Spermatozoa ; ultrastructure

Objective To explore the correlation of total IgE and childhood atopic dermatitis (AD) in maternal serum and newborn cord blood, as well as its clinical significance of allergen testing. Methods Thirty-five cases diagnosed as AD (AD group) were selected, and other 35 children who were not diagnosed as AD (control group) were randomly selected from a birth cohort established in 2009—2011. The total IgE levels were detected by ELISA in maternal serum and newborn cord blood. The serum specific IgE antibody level was detected by quantitative immunoblotting method. Results The serum total IgE level was significantly higher in mother and newborn cord blood in AD group than that in control group (χ2=16.568 and 14.933, P<0.01). Compared to control group, there was a significantly higher positive rate of mother serum allergen includ?ing dust mites, house dust, ragweed pollen, song kind of pollen, poplar, surname and elm pollen, mould, shrimp, marine fish, in AD group (P<0.05). There was a significantly higher positive rate of artemisia pollen and fungi IgE in newborn cord blood in AD group (P<0.05). Conclusion The increased total IgE in maternal serum may play a predictive effect on infants suf?fering from AD. There is no obvious consistency in allergic state between mothers and infants.