AIM:To investigate the function of macrophage differentiation antigen-1 (Mac-1) in receptor acti-vator of nuclear factor-κB ligand ( RANKL )-induced osteoclast differentiation and the mechanisms .METHODS: The spleen cells were isolated from 4-week-old C57BL/6J mice, and cultured with RANKL, macrophage colony-stimulating fac-tor and CD11b and CD18 antibodies for 1 week.The actin bundles were stained with rhodamine-labeled phalloidin, and nu-clei were stained with DAPI.CD11b and CD18 antibodies, lentivirus with interfering vector plasmid of target gene Itgam (encoding CD11b) and empty virus (control virus) were used to treat osteoclasts for 1 week, and then immunofluorescence staining was performed.CD11b antibody, lentivirus and control virus were used to treat osteoclasts for 1 week, and total protein was taken for Western blot .RESULTS:Lower multinuclear positive rates in the groups treated with CD 11b anti-body were observed than that in the groups treated with CD 18 antibody and control group .Lower immunofluorescence inten-sity of Syk, CD11b and NFATc1 was found in CD11b antibody group than that in control group .Lower Syk, CD11b and NFATc1 immunofluorescence intensity was also observed in lentivirus group than that in control virus group .The results of Western blot analysis showed that the protein levels of CD 11b, Syk, NFATc1, c-Fos and p-ERK/ERK in CD11b antibody group were decreased as compared control group .Compared with control virus group , the protein levels of CD11b, Syk, NFATc1, c-Fos and p-ERK/ERK in lentivirus group were also decreased .CONCLUSION:CD11b subunit of Mac-1 pro-motes osteoclast differentiation by up-regulating c-Fos, ERK activity and NFATc1.

[Objective]To evaluate the unreamed femoral nail with spiral blade (UFN-SB) in the treatment of nonpathologic subtrochanteric femoral fractures.[Method]Twenty-seven patients who suffer subtrochanteric femoral fracture.Those fractures were classified with Seinsheimer’s way.Two cases of typeⅠ,9 cases of typeⅡ(5 of typeⅡ_A,3 of typeⅡ_B,1 of typeⅡ_C),12 cases of typeⅢ(7 of typeⅢ_A,5 of typeⅢ_B),3 cases of typeⅣ,1 case of typeⅤ.[Result]All cases were fellowed-up for 9~42 months,average 15 months.The authordidn't find any severe complications.All these patients could exercise early and bearing weight early.The authordidn't observe broken or loosen or quitted of this kind of internal fixation.[Conclusion]The UFN-SB is a better way for the treatment of subtrochanteric fractures of the femur.It can provide a satisfied restoration,a dependable fixation.It does good use to the concrescence of bone.It prevents short,rotation and varus angulation of femoral.The author get very good curative effect,less trauma,good sciatic function by using this kind of way to heal subtrochanteric femoral fracture.Especially in old people who suffer osteoporosis,this kind of interlocking way decreases the quantity lose of the bone,increases the contact area between bone and internal fixation,provides better angulation stability and rotation stability.

Objective To discuss the possibility of mucin-1 gene(MUC1 mRNA)in mediastinal lymphnodes(MLNs)and peripheral blood as a symbol of occult metastasis in patients with non-small cell lung cancer(NSCLC).Methods By reverse transcriptase-polymerase chain reaction(RT-PCR),MUC1 mRNA in peripheral blood and in 67 MLNs from 30 patients with benign pulmonary diseases(negative control group)and in 30 MLNs which had metastasis determined by routine pathologic examination(positive control group)was detected;MUC1 mRNA in peripheral blood in 158 patients with NSCLC and in 296 MLNs proven to be tumor-free by routine histopathologic examination from 97 NSCLC patients was detected(experimental group).Results MUC1 mRNA was not identified in peripheral blood in 30 patients with benign pulmonary diseases,but 49 specimens from 158 NSCLC patients were positive(positive rate 31.0%),there was significant difference between these two groups(P0.05),but the positive rate of MUC1 mRNA in stage Ⅲ and Ⅳ NSCLC was significantly higher than that in stage Ⅰ and Ⅱ(P

Abscess ; surgery ; Adult ; Ear, External ; surgery ; Humans

Objective To assess the effect of polygonum peffoliatum L on the expression of Hypoxia inducible factor-1 (HIF-1α) and vascular endothelia growth factor (VEGF) in hepatic fibrosis rats induced by Dimethylnitrosamine (DMN) . Methods Seventy-two SD rats were randomly divided into six groups, after the model of HF rat induced by DMN and intervened by different concentrations of Polygonum perfoliatum L. Conventional flaking of liver and HE were used to observed histopathological change. Immunohistochemstry was used to detect HIF-1αand VEGF in hepatic tissues of hepatic fibrosis rats. Results The expression of HIF-1α and VEGF in hepatic fibrosis rats of the high dose of Polygonum perfoliatum L from (-) to (3 +) were one , nine, one, zero and one, eight, two, zero, respectively. The expression of HIF-1α and VEGF in hepatic fibrosis rats of the middle dose of Polygonum perfoliatum L from (-) to (3 +)were one , seven, two, zero and one, six, three, zero, respectively. Compared with the model group, the high and middle dose of Polygonum perfoliatum L can reduce the expression of HIF-1 oand VEGF in hepatic fibrosis rats (P ＜ 0. 01). Conclusions Polygonum peffoliatum L has a good curative effect of anti hepatic fibrosis. Its therapeutic mechanism mainly maybe due to adjust the metabolism of extracellular matrix by decreasing HIF-1 αand VEGF expression.

Objective To explore the diagnostic value of contrast-enhanced spiral CT after low tension and drinking water in papillary carcinoma of ampulla. Methods CT manifestations of papillary carcinoma of ampulla comfirmed pathologically in 20 cases were analysed retrospectively emphasized in artery phase on contrast CT which was performed after injecting 654-2 20 mg and drinking 300~500 ml water.Results Of all the cases , only 2 cases showed tumor filling defect in the descending part of duedenum nearby pancreas on routine CT, but all the cases showed more or less tumor filling defect on contrast-enhanced spiral CT . The diameters of the tumor were between 0.8 to 2.6 cm,2 cases with head of pancreas affected,the diameters of the tumor were between 2.4 to 2.6 cm.There were 2 cases with lymph node metastasis nearby duedenum.All the cases showed expansion of gallbladder ,intrahepatic duct and choledochus expanding in the liver. Conclusion Contrast-enhanced spiral CT after low tension and drinking water is superior to routine CT in determining the size and morphosis of tumor.

Objective To investigate the neuroprotective effect of panaxynol on primary cultured cortical neuron against oxidative stress. Methods Viability of panaxynol acted on neuron oxidative stress was monitored by MTT assay and FCM method. Scavenging effects of panaxynol on free radicals were observed in vitro. Effects of panaxynol on SOD activity and GSH-Px, and MDA content in primary neuron injured by H_2O_2 were also determined. Results Panaxynol (2—16 ?mol/L) could dose-dependently protect neuron from oxidative stress induced by H_2O_2; 8 ?mol/L of panaxynol could decrease necrosis and apoptosis rate of neuron significantly (P

Objective The stentless full root aortic bioprosthesis has superior hemodynamics.Clinical data of Bio-Bentall procedure using stentless full root bioprosthesis of our center was retrospectively analyzed in this perspective for validation.Methods From November 2001 to March 2009,317 adult patients ( 196 male and 121 female) underwent modified Bio-Bentall procedure using the Medtronic Freestyle xenograft as a full root replacement.Two hundred and three patients received an isolated root replacement or a root and ascending aortic replacement (ARR).In 114 patients a variety of concomitant procedures including coronary artery bypass grafting ( n =32 ),mitral valve repair ( n =11 ) and aortic arch replacement ( n =36 ) were performed.(ARR + ).Results Mean patient age was (70.3 ± 10.2) years (range 17 -94 years),97 patients were 75 and older at time of procedure.Mean operative time for the ARR was ( 190 ± 57 ) min with a clamp time of 88 - 27 min.Mean operative time for ARR + group was (282 ±93) min with an average clamp time of (110 ±32) min.Overall operative mortality was 7.9％ (25/317),for ARR it was 5.4％ (11/203 ).Mean ICU stay was (4.9 ± 8.1 ) days,mean hospital stay being (9.8 ± 8.1 ) days.Necessity for bailout bypass surgery among patients with ARR was low at 1.5％ (3/203) comparable to stented xenograft implantations.Echocardiography demonstrated excellent clinical results with low transvalvular gradients especially when a single suture inflow anastomosis technique was used.Conclusion Full root stentless valve implantation preserving porcine root integrity is a valuable option in aortic valve/ascending aorta surgery.Though technically a more challenging operation,it does not lead to increased perioperative morbidity and mortality and can be beneficial mainly for elderly patients with small aortic roots with or without aortic root pathology.

ObjectiveTo investigate the effect and medical cost of different revascularization strategies for acute myocardial infarction (AMI) patients with multi-vessel disease (MVD).Methods A prospective randomized controlled trial (RCT) was conducted. From January 2009 to June 2012, patients with AMI and MVD undergoing primary percutaneous coronary intervention (PCI) were enrolled. They were randomly assigned to group A [staged PCI for non-infarction related artery (non-IRA) within 7-10 days after AMI] and group B (subsequent PCI for non-IRA recommended only for those with evidence of ischemia). All of patients were given optimized medical therapy according to clinical guideline, and they were followed up for 24 months at regular intervals. Major adverse cardiovascular events(MACE) including recurrence of myocardial infarction and death due to cardiac ailments were recorded. Meanwhile, re-hospitalization from cardiac causes, recurrence of angina, heart failure, and re-PCI, number of stents, total hospital stay days, and total medical expenditure were recorded.Results A total of 428 patients accomplished the 24-month follow up. All the patients underwgennt PCI for non-IRA in group A (215 patients), while 62 patients in group B (213 patients) undergone PCI for myocardial ischemia, and 51 patients received non-IRA treatment. There was no significant difference in MACE incidence between group A and group B [8.4% (18/215) vs. 10.8% (23/213),χ2= 0.727,P = 0.394]. The difference of death rate due to cardiac causes (5.1% vs. 6.6%), recurrence of myocardial infarction (4.2% vs. 6.6%), and heart failure (4.2% vs. 7.0%) were not significantly different between groups A and B (allP> 0.05). The rate of recurrence of angina (14.4 % vs. 32.9%), re-hospitalization from cardiac causes (14.4% vs. 33.8%), and re-treatment of implanting stents (12.6% vs. 29.1%) were significantly lower in group A than group B (allP< 0.01), and the rate of revascularization was significantly higher in group A than group B (10.7% vs. 5.2%,P< 0.05). The total number of stents (610 vs. 366), mean number of stents per patient (2.83±0.91 vs. 1.72±0.91,t = 12.725,P = 0.000), and total cost per patient (kRMB: 63.7±12.6 vs. 51.5±12.3,t = 10.107,P = 0.000) in group A were significantly higher than those in group B. Total hospital stay days in group A was significantly less than group B (days: 8.21±2.45 vs. 9.89±3.23, t = 6.071,P = 0.000). Because non-IRA-vascular reconstruction rate was low in group B, the rate of usingβ-blocker and anti-anginal agents during the 24-month follow up in group B was significantly higher than group A [59.2% (126/213) vs. 47.0% (101/215),χ2= 6.371,P = 0.012; 56.3% (112/213) vs. 17.6% (36/215),χ2 = 64.704,P = 0.000]. Conclusions In patients with AMI and MVD undergone emergency PCI, staged PCI within 7-10 days for non-IRA cannot decrease the incidence of myocardial infarction and death due to cardiac causes, recurrence of angina and rehospitalization for cardiac causes was diminished, and it may increase the number of stents and medical cost significantly.

Objective To explore a new method of functional reconstruction of hand digits and joints with free transfer of foot tissues so as to increase the success rate of the operation.Methods After micro-anatomic study of the plantar and dorsal metatarsal arteries,retrograde and free grafts of foot tissues pedicled with plantar metatarsal arteries were designed and applied in transplantation to treat 76 cases of hand digital or joint defects.The surgeries included 58 cases of transfer of the second toe,four cases of transfer of composite tissues of the second toe, eight cases of transfer of proximal interphalangeal joint,and six cases of nail flap transfer.Results The mi- cro-anatomic study found that the first plantar metatarsal artery was anatomically constant and the diameter of its branch to the second toe was larger than that of the first dorsal metatarsal artery.Flaps survived in 75 of the 76 patients(98.7%),with fine appearance and significantly improved function.One patient who had received free transfer of the second toe to reconstruct the thumb function had to undergo a second repair with infraclavicula skin tube because of refractory arteriospasm of anastomosed vessels.Conclusion Transfer with free retrograde grafts of foot tissues pedicled with plantar metatarsal artery to reconstruct hand functions can effectively improve the success rate of the operation,because it is free of the shortcomings of great anatomic variation of blood vessels and time-consuming and complex procedures in conventional transfer.