Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome.Intra-articular and extra-atticular tumor resection produced similar local recurrence rate in the present study,which suggested intra-articular resection may be an altemafive procedure.

Apoptosis ; Apoptosis Regulatory Proteins ; genetics ; Genetic Vectors ; Humans ; K562 Cells ; Transfection

Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.

Aim This study is designed to analyze the influence of L-arginine (L-Arg) on expression level of angiotensin Ⅱ receptors (ATR) and the mitogen-activated protein kinase (MAPK) in cultured cardiomyocytes, with the intention to clarify the mechanisms relative to L-Arg's inhibitory effects on formation of cardiac hypertrophy. Methods Five groups of cardiomyocytes were established: control group, Angiotensin Ⅱ (ATⅡ) group, ATⅡ + Saralasin group, ATⅡ + L-Arg group, ATⅡ + L-Arg+L-NAME (N-nitro-L-arginine methyl ester) group. After 48 hours in supplemented culture, synthetic velocity of protein, NO production, expression level of ATR and p38 MAPK in cardiomyocytes were detected through the [3H]-leucine incorporation method, colorimetry, RT-PCR and western blotting, respectively. Results L-Arg could decrease the expression level of ATR1 and phosphorylated p38 MAPK, enhance NO production and reduce the synthetic velocity of protein in cultured cardiomyocytes stimulated by ATⅡ. Both ATⅡ and L-Arg had no influence on the expression level of angiotensin receptor type 2(ATR 2). Correlation analysis revealed that the relationship of negative correlation was significant between NO production and each of following factors: ATR1 expression level and phosphorylated p38MAPK expression level; As indicated by multiple stepwise regression analysis, not ATR2 expression level, but ATR1 expression level acted as the regression predictor of expression level of phosphorylated p38MAPK. Conclusion By enhancing myocardial NO production, L-Arg-NO pathway inhibits the p38MAPK activation mediated by ATR1, leading to inhibition of the hypertrophic response of cardiomyocytes. ATR2 seems to be independent from the activation process of p38 MAPK.

Objective It has been shown that fluorinated inhalational anesthetics have various adverse effects on the lungs. The aim of this study was to investigate the effects of different concentrations of isoflurane (ISO) on the lungs in rats.Methods Ninety Wistar rats of both sexes weighing 140-200 g were randomly divided into two groups : (A) control group received only oxygen inhalation ( n = 30) and (B) isoflurane group (n = 60) which was farther divided into 2 subgroups (n = 30):0.6% and 1.4% isoflurane. In each subgroup isoflurane was inhaled for 2 h ( n = 10), 4h (n = 10) or 8 h ( n = 10) . The animals were placed in a glass container and isoflurane was delivered from ISO vaporizer into the container through the inlet. The end-tidal ISO concentration was checked at the outlet. The animals were sacrificed at the end of ISO inhalation. The lungs were immediately removed and blood was collected for determination of (1) lung water content, (2) protein content and neutrophil ratio in broncho-alveolar lavage fluid (BALF) , (3) serum and BALF surfactant protein-A (SP-A) content and (4) microscopic examination. Results There was no significant difference in all variables between control group and 0.6% ISO subgroup. Exposure to 1.4% ISO for 8 h caused an increase in neutrophil ratio and protein content in BALF, and serum SP-A content but a decrease in BALF SP-A content. There was no significant difference in lung water content between control group and 1.4% ISO (8 h) subgroup. Conclusion Isoflurane (1 MAC) inhalation over 8 h may impair the function of alveolar epithelium.

Objective To detect the level of serum melanoma-inbibiting activity (MIA) in patients with uveal melanomas, and investigate the value of MIA in diagnosing and inspecting uveal melanomas. Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of MIA in peripheral serum of 27 patients with uveal melanoma, 6 with melanocyte tumor, 7 with other ocular tumors and 16 healthy individuals, respectively. Results The concentration of MIA in patients with uveal melanoma was significantly higher than that in the healthy ones (16 individuals) and the patients with adenoma of non pigmented ciliary epithelium (4 patients), retinoblastoma (2 patients), and retinal angioma 91 patient). The concnetration of MIA in patients with uveal melanoma without scleral infiltration or remote metastasis was obviously lower than that in the patients with scleral infiltration or remote metastasis, but didn′t differ much from which in the patients with melanocyte tumor. In the patients with uveal melanoma without infiltration or remote metastasis, there was no significant difference of MIA level between patients with spindle cell and mixed and epithelioid cell. Conclusion The level of serum MIA may be an effective index in diagnosing uveal melanoma, which can monitor the metastasis of uveal melanoma.

One hundred and ninety-three patients undergoing transvaginal hysterectomy for cicatrix uterus (study group), 200 patients receiving transabdominal hysterectomy for cicatrix uterus (control group Ⅰ), and 200 patients having transvaginal hysterectomy for non-prolapsed uterus (control group Ⅱ) were retrospectively analyzed. In comparison with the control group Ⅰ, the study group showed a significantly reduced operation time and the average volume of blood loss (P < 0.01). Moreover, patients in the study group had shorter postoperative recovery time (P < 0.01) . The incidence of postoperative fever was decreased in the study group. There was no significant difference in complications of the vaginal wound between the three groups (P 0.05). This investigation demonstrates that transvaginal hysterectomy might be feasible and safe in removing cicatrix non-prolapsed uterus.

A new, convenient, and rapid method for kinetic measurement of human fibrinolysis was established. The alteration of absorbance (A) in the process of blood coagulation and lyses was automatically scanned and recorded using a UV2000 spectrophotometer connected to a computer. The parameters of human fibrinolysis kinetics were established. Urokinase at 20 U/mL was the optimal concentration used. There was significant difference in fibrinolysis kinetics and plasma plasminogen concentration between 22 normal subjects and 27 patients with acute myeloblastic leukemia (P<0.05 and <0.01 respectively). The coefficience of variation was (5.24+/-1.51)%. This method could also be used to measure the plasma fibrinogen concentration at the same time. It was concluded that this method was stable and was capable of providing dynamic, direct experimental data and multiparemeters for clinicians. It was also valuable in evaluating the anti-and pro-fibrinolytic capcity of patients' plasmas, allowing for monitoring of therapy, choice of drugs and adjustment of drug concentrations.

ted in a dose-dependent manner (P<0.01). Conclusion Quercetin can significantly inhibit the proliferation of HeLa cells, which may be induced apoptosis of cervical cancer cells via the Ca2+-dependent mitochondrial apoptosis pathway.

Objective Ascending aortic dissection(AAD),for which the pathogenesis remains unknown,is life-threatening.Matrix metalloproteinase-9(MMP-9)and the pathological changes of vascular smooth muscle cells(VSMCs)have been reported to have roles the pathogenesis.The study examined the expression of matrix metalloproteinase-9(MMP-9)and the pathological changes of,VSMCs in patients with AAD.Methods AAD samples were taken from 35 patients(disease group)in acute phase during aortic replacement operation for AAD and control samples were corresponding part of ascending aorta(control group,n=21)collected from the donor hearts for transplantation.Transmission electron microscepe,hematoxylin-eosin(H-E)staining.Mallory staining were used for observing the pathological changes of VSMCs and matrix in the affected aortic wall.The immunohistochemicai staining of MMP-9 was carried out in both groups and semi-quantified by staining intensity analysis.The affected patients were further grouped according to the diameter of dissected aorta as with a AAD of <55 mm or with a AAD of≥55 mm.The associations of clinical factors,such as smoking status,hypertensive disease and aneurysm diameter,with the expression of MMP-9 were analyzed.Results Increased synthetic function of VSMCs with decreased density,disrupted elastic fibers and fibrosis in the dissected aortic wall were observed in the disease group,but not in the control group.MMP-9 was scarcely expressed in the aortic wall of the patients in the control group,though it was notably expressed in the VSMCs of disease group.Both subgroups presented more MMP-9 than the control group(both P<0.001).In the disease group,sub-group with a AAD diameter of ≥55 mm presented more MMP-9 than that with a diameter of <55 mm(P<0.05).MMP-9 expression was positively correlated with a history of hypertension(P<0.01)or a great aneurysm diameter(P<0.05).MMP-9 expression was not associated with age,smoking status or other clinical factors.Conclusion Increased secretion of VSMCs and the expression of MMP-9 induced by elevated blood pressure may lead to the destruction of matrix proteins.The resulting fibrosis of the aortic wall would decrease the tensile strength of the wall.When the fibrotic aortic wall dilated further,the increased expression of MMP-9 would aggravate the damage to the wall.It can be speculated that acute AAD would occur as a result of partial tearing of the aortic intima.