Objective To investigate the expression of DNA methyltransferase 1 (DNMT1)mRNA in tissue of human transitional cell carcinoma of bladder(TCCB)and its clinical significance.Methods DNMT1 mRNA expression in 35 tumor tissues and 10 normal bladder tissues was measured by real-time PCR.Results Higher expression of DNMT1 transcripts was detected in tumor(3.25±0.74)than in normal tissues(1.53±0.44,P＜0.001).The expression level of DNMT1 mRNA in stage Tis-T1,T2-T4 was 3.14±0.67,3.31±0.84;in grade Ⅰ,Ⅱ,Ⅲ was 3.13±0.59,3.25±0.64,3.43±0.55;in patients older tham 40 years and younger than 40 years was 3.34±0.50.3.01±0.27;in male and female group was 3.31±0.42,3.01±0.20;in primary and recurrence group was 3.21±0.63,3.45±0.33.mRNA levels did not correlate with grade.stage and recurrence (P＞0.05).Higher levels of expression were associated with advanced age(P＜0.05).Male group had significant higher levels of expression than female group(P＜0.05).Conclusions Over-expres-sion of DNMT1 may play an important role in TCCB.DNMT1 can be an important therapeutic target in TCCB.

Objective To investigate effects of compound LJZ on antitumor activity and immune function in mice bearing implanted tumor in vivo.Methods The antitumor effects on the sarcoma 180(S180) and hepatoma 22(H22) bearing in mice were evaluated by weight of tumor.The effects of compound LJZ on specific immunity function were observed by delayed-type hypersensitivity(DTH) response induced by 2,4-dinitro-1-fluorobenzene(DNFB)and the effects of compound LJZ on non-specific immunity function were studied by macrophage phagocytosing neutral red.Results Compound LJZ inhibited significantly the growth of S180 and H22 bearing in mice,and showed dose-dependent relationship.Compound LJZ could enhance the phagocytic capacity of macrophage in bearing S180 mice.But it had no effect on DTH.Conclusion Compound LJZ has significant antitumor effects in vivo,and the effects on phagocytic capacity of macrophage maybe one of its antitumor mechanisms.

Objective To establish a scientific and practical principle , grading standard and reasonable statistical method for evaluating the protective effect of health food to gastric mucosal injury , based on general pathology and histopathological diagnosis .Methods A methodological study was conducted on rat model of acute gastric mucosa injury induced by alcoholic through comprehensive analysis and comparing shortcomings of the current standard evaluation method, and methods of semi-quantitative analysis and corresponding information statistic processing were based on characteristics of the lesion and principles of pathology .Results Gross pathological evaluation of gastric mucosa lesion was based on the area occupied and proportion in the whole gastric mucosa .Histopathological diagnosis was based on the mucous layer depth of lesion as main determination point and other lesions as reference factors .Grades of lesion were divided into no abnormality (0), mild lesions (1 point), moderate lesions (2 points), and severe lesions (3 points). Ridit statistical method was used for pathological analysis of semi-quantitative results .Conclusion A scientific and feasible evaluation method for the protective effect of health food to gastric mucosal injury was provided from the aspects of gross pathology , histopathological evaluation method , data processing method and result determination .

AIM:To establish and characterize the patient-derived esophageal squamous-cell carcinoma xeno-graft (PDECX) in mice.METHODS:The samples of human esophageal cancer were grafted into severe combined immu-nodeficient ( SCID) mice.The xenografts were transferred to SCID mice when the first passage of xenografts grew up .The growth of tumors in the first, second and third passages was observed .HE staining was performed.The expression of CK5/6, p63 and p40 in the patient samples , and the first and third passages of the xenografts were detected by immunohisto-chemical analysis.The expression of mTOR, p-mTOR, p70S6K, p-p70S6K, Akt1, p-Akt (Ser473), Erk1/2 and p-Erk1/2 were determined by Western blot .RESULTS:The PDECX was successfully established .The positive expression of CK5/6, p63 and p40 in the xenografts was consistent with that in the patients ’ samples.The levels of phosphorylated and total proteins of proliferation-related signaling pathways were different in the xenografts from different patients .CONCLU-SION:The PDECX model adequately reflects the tumal heterogeneity that is observed in the patients .

Objective To investigate the clinical results and summarize the advantages and surgical indications in the treatment of femoral head fractures (Pipkin type Ⅰ and Ⅱ) via medial hip approach.Methods From October 2014 to August 2015,sixteen patients of femoral head fracture (Pipkin type Ⅰ and Ⅱ) surgically treated via medial hip approach were retrospectively analyzed in our Hospital.There were 13 males and 3 females with an average age of 44.8 years (range,22-62 years old).According to Pipkin classification,12 femoral head fractures were classified as type Ⅰ and 4 type Ⅱ.Thirteen patients were injured by traffic accidents,two patients by falling down from height and one patient was injured by collapses of a heavy objective.All femoral head fractures were combined with posterior hip dislocation.The skeletal traction was performed in each patient after successful close reduction of the hip joint under general anesthesia.Computed Tomography scans of hip joints were performed routinely.All femoral head fractures were fixed with absorbable screws via medial hip approach.The mean time from injury to operation was 5.3 days (range,2-14 days).Results The average duration of the operations was 75 min (range,60-110 min).The average length of incisions was 7.1 cm (range,6-9 cm).The average blood loss was 160 ml (range,80-300 ml).All the patients were followed up for an average period of 26.3 months (range,24 to 30 months).Eight femoral head fractures with Pipkin Ⅰ and three with Pipkin Ⅱ were union and the healing time was 3-12 months,with an average time of 8.8 months.Three femoral head fractures with Pipkin Ⅰ were incomplete union at the latest follow-up of 24 months after surgery.One femoral head fracture with Pipkin Ⅰ and one with Pipkin Ⅱ didn't get union at the latest follow-up of 24 months after surgery.According to Thompson and Epstein function evaluation,the clinical outcomes were rated as excellent in 12 cases,good in 1,fair in 3.The excellent and good rate was 81.3％ (13/16).According to Merled'Aubigne-Postel evaluation criterion,there were 13 cases excellent,1 good and 2 fair.The excellent and good rate was 87.5％ (14/16).There were no intraoperative complications in all patients such as neurovascular injury injuries.No incision infection,fat liquefaction and other incision related complications occurred postoperatively.Avascular necrosis of the affected femoral head occurred in one case whose symptom didn't aggravate after appropriate conservation.Fractures were nonunion in 2 cases but the patients' functions were satisfactory in daily living.Traumatic arthritis of the affected hip occurred in 2 cases.The patients felt uncomfortable with long walking but could get better after taking NSAIDs.The fracture fragment absorption occurred in 3 cases but these patients had a good function and needed no further treatment.Conclusion Good exposure could be achieved for reduction and fixation in the treatment of femoral head fractures (Pipkin Ⅰ、Ⅱ) via hip medial approach.The operation is a minimally invasive procedure and the treatment outcome is satisfactory,but the indication should be strictly controlled.

Objective: To explore the treatment outcome of triangular osteosynthesis (TOS) for the treatment of unilateral Isler type II lumbosacral junction injuries (LSJIs). Methods: Data of sixteen patients with unilateral Isler type II LSJIs surgically who were treated in our Hospital from March 2015 to February 2017 were retrospectively analyzed. There were 13 males and 3 females with an average age of 35.5 years (range, 24-61 years). Seven patients were multiple injuries including head, thoracic, musculoskeletal and nerve injuries. According to Isler classification of LSJIs, there were 5 cases of type IIa, 9 of type IIb and 2 of type IIc. All the LSJIs combined with ipsilateral sacral fractures. The sacral fractures were classified by Denis classification with 1 case of zone I, 13 cases of zone II and 2 cases of zone III. According to Tile classification of pelvic fractures, there were 3 cases of type B2, 11 of type C1 and 2 of type C3. There were 3 cases combined with sacral nerve injury among which there were 2 cases of grade II and 1 case of grade III according to Gibbons classification of neurologic deficits. All cases were surgically treated with triangular osteosynthesis. There were 14 cases combined with iliosacral screws fixation in S₁ and 2 cases combined with posterior locking plates. Results: All patients were followed up for 20.6 months (range, 16-30 months). CT scan was conducted 12 to 24 months after surgery which showed all the sacral fractures were union, and 2 cases achieved bony fusion in L₅S₁ facets while the other 14 didn’t. According to Majeed’s pelvic injury evaluation, clinical outcomes were rated with excellent in 12 cases, good in 2 cases, fair in 2 cases. The excellent and good rate was 87.5% (14/16) . According to Mears-Velyvis evaluation criterion, there were 14 cases with anatomical reduction and 2 cases with satisfactory reduction. Among the 3 cases with sacral nerve injury, 2 cases were improved from Gibbons grade II to grade I and the other 1 case was improved from Gibbons grade III to grade II, still feeling numbness on the lateral foot. There were no intraoperative complications in all patients such as neurovascular injuries. No incision infection, fat liquefaction and other incision related complications occurred postoperatively. Irritation and pain in iliac spine about prominent implant occurred in 1 case and lumboscaral stiffness in 1 case, in which the symptom relieved and disappeared after implants removal. Conclusion Triangular osteosynthesis can provide enough stabilization for Isler type II LSJIs and achieve satisfactory outcomes.

Objective:To evaluate the clinical outcomes of traumatic spinopelvic dissociation treated with robot-assisted bilateral triangular fixation.Methods:From March 2016 to March 2020, 30 patients with traumatic spinopelvic dissociation were retrospectively analyzed. According to operation and fixation methods, the patients were divided into robot-assisted minimally invasive bilateral triangular fixation group (Robot triangular group) and traditional open reduction lumbopelvic fixation group (Lumbopelvic group). There were 16 patients in the Robot triangular group, 4 males and 12 females, average age 35.7±13.3 years (range, 16-58 years). There were 10 cases of U-shaped, 4 cases of H-shaped, 2 cases of Y-shaped sacral fractures according to shape classification of sacral fractures. According to ROY-Camille classification, there were 4 cases of type I, 9 cases of type II, 3 cases of type III. There were 13 cases with sacral nerve injuries, including 10 cases of Gibbons grade II, 3 cases of grade III. There were 14 patients in the Lumbopelvic group, 4 males and 10 females, average age 37.4±15.1 years (range, 18-66 years), there were 10 cases of U-shaped, 3 cases of H-shaped, 1 case of Y-shaped sacral fractures according to shape classification of sacral fractures. According to ROY-Camille classification, there were 1 case of type I, 10 cases of type II, 3 cases of type III. There were 10 cases with sacral nerve injuries, 7 cases of Gibbons grade II, 3 cases of grade III. The patients' age, operation time, intraoperative blood loss, and Majeed score of the two groups were compared by independent sample t-test; gender, sacral fracture classification, ROY-Camille classification, fracture reduction quality, postoperative wound infection, and sacral nerve recovery were compared by Chi-square test. Results:All patients were followed up for 23.6 months (range, 12-54 months). In the Robot triangular group, the operation time was 95.3±27.5 min (range, 70-180 min), and intraoperative blood loss was 98.7±47.5 ml (range, 50-250 ml). According to Mears and Velyvis imaging evaluation criteria, anatomical reduction was achieved in 6 cases, satisfactory reduction was achieved in 9 cases and unsatisfactory reduction in 1 case. The Majeed score was 85.5±7.7 points. 8 cases of Gibbons grade II sacral nerve injury were recovered to grade I after surgery, 1 case of grade III recovered to grade I, and 1 case recovered to grade II. In the Iliolumbar fixation group, the operation time was 148.6±59.1 min (range, 90-240 min), and intraoperative blood loss was 582.1±244.6 ml (range, 300-1 200 ml). According to Mears and Velyvis imaging evaluation criteria, anatomical reduction was achieved in 7 cases, satisfactory reduction was achieved in 6 case and unsatisfactory in 1 case. The Majeed score was 77.6±7.7 points. 5 of 7 cases of Gibbons grade II sacral nerve injury were recovered to grade I after surgery, and 2 of 3 cases of grade III recovered to grade I. Compared with the Iliolumbar fixation group, the Robot triangular group has shorter operation time ( t=3.23, P<0.05), less bleeding ( t=7.76, P<0.05), and higher postoperative Majeed score ( t=2.83, P<0.05). There are statistical differences in the above indicators significance. Conclusion:For traumatic spinopelvic dissociation, especially fractures involving the lumbosacral junction, those who do not require sacral nerve decompression, Robot-assisted bilateral triangular fixation shows satisfactory clinical outcomes, which is minimally invasive, with fewer postoperative complications.

Objective:To investigate the clinical efficacy of MIPO combined with non-contact bridging periprosthesis fracture plate (NCB.PP) in the treatment of re-fracture around the nail after intramedullary fixation of intertrochanteric fracture.Methods:From October 2015 to January 2020, 12 patients with re-fracture around the nail after intramedullary fixation of intertrochanteric fracture were treated in our hospital. There were 7 males and 5 females with an average age of 74.88±12.1 years (range, 65-83 years old); 8 patients on the left side and 4 patients on the right side received short nail of proximal femoral nail (PFN), 6-36 months after operation, they fell down and caused closed fracture around the nail body. According to Vancouver classification system, all the patients were Vancouver type B; preoperative bone mineral density examination showed that 1 case had normal bone mass, 10 cases had osteoporosis, and 1 case had low bone mass. All patients were treated with minimally invasive plate osteosynthesis (MIPO) technique for reduction and fixation, and fixed with proximal femur NCB.PP. The visual analogue scale (VAS) and Harris hip score at 1 day, 3 months and the last follow-up were compared.Results:The average operation time was 68.7±4.33 min (range, 65-75 min); the average intraoperative blood loss was 291.67±114.48 ml (range, 150-400 ml); the average postoperative drainage volume was 79.17±17.17 ml (range, 50-100 ml). After fracture reduction, all patients were able to obtain 2-5 bicortical screws fixation, with an average of 3.25±0.96. Among them, 3 cases were fixed with additional binding straps; 3 cases underwent autologous iliac bone grafting during the operation. All cases were followed up for 9-60 months, with an average of 16 months. At the last follow-up, 10 patients had fracture healing, the healing time was 7.75±2.83 months (range, 4-13 months), and the fracture healing rate was 83.3% (10/12). Among the other two patients, one was an 83 years old patient with severe osteoporosis, who was bedridden after operation and remained unhealed after 12 months of follow-up; a 68 years old patient had bone restoration at the broken end of the fracture 6 months after operation. The second operation was performed. Iliac combined with allogeneic bone graft was taken from the broken end. At the end of 13 months after operation, the fracture was partially healed. The VAS at one week, three months and the last follow-up were 8.00 (8.00, 9.00), 2.50 (2.00, 3.00) and 0.00 (0.00, 0.75), respectively. There were significant differences in VAS scores between 1 week after operation and 3 months after operation, 1 week after operation and the last follow-up, and 3 months after operation and the last follow-up ( Z=-3.129, -3.097, -3.134, all P < 0.05). The Harris scores at 3 months after operation and at the last follow-up were 72.50±2.91 and 86.67±5.30 respectively. After statistical analysis, the difference was statistically significant ( t=8.857, P< 0.001). At the last follow-up, except for 1 case of fracture nonunion and 1 case of reoperation, the Harris score of hip joint of the other 10 patients was excellent in 6 cases and good in 4 cases, and the excellent and good rate was 83.3% (10/12). One case of superficial wound infection was healed by intravenous drip of sensitive antibiotics. One patient had incision fat liquefaction and was given local dressing change to heal the incision. Conclusion:MIPO combined proximal femoral NCB.PP in the treatment of re-fracture around the nail after intramedullary fixation of intertrochanteric fracture has the advantage of less surgical damage, less blood loss, higher healing rate, and it can obtain satisfactory short and medium-term clinical efficacy.

Objective:To explore the prognostic utility of LifePort perfusion parameters plus perfusate biomarkers for predicting delayed graft function(DGF)and recovery time during deceased donor kidney transplantation(KT).Methods:From January 1, 2019 to August 31, 2019, retrospective analysis was performed for clinical data of 113 KT recipients. Based upon whether or not DGF occurred within 3 months, they were divided into two groups of DGF group(20 cases)and non-DGF (93 cases). Two groups were compared using LifePort perfusion parameters, biomarker concentrations, incidence of DGF and kidney recovery time. Statistical analysis was performed.Results:The incidence of DGF was 17.7%(20/113); Multivariate Logistic regression results indicated that terminal resistance(OR 1.879, 95% CI 1.145~3.56)and glutathione S-transferase(GST)(OR 1.62, 95% CI 1.23~2.46)were independent risk factors for DGF; Cox hazard model revealed that terminal resistance was a risk factor for recovery time of renal function(HR=0.823, 95% CI 0.735~0.981). The model combining terminal resistance and GST(AUC=0.888, 95% CI 0.842~0.933)significantly improved the predictive efficacy for DGF as compared with using terminal resistance(AUC=0.756, 95% CI 0.693~0.818)or GST alone(AUC=0.729, 95% CI 0.591~0.806).Conclusions:Combining LifePort perfusion parameters and fluid biomarkers can improve the predictive utility of DGF.

Objective:To evaluate the application value of preconceptional laparoscopic cervical cerclage(LCC)in improving the pregnancy outcomes with cervical incompetence(CIC).Methods:Clinical data of 112 pa-tients with CIC who underwent preconceptional LCC in The First Affiliated Hospital of Zhengzhou University from July 1,2014 to May 31,2023 were retrospectively reviewed.The surgical indications of preconceptional LCC in-cluded:failed transvaginal cervical cerclage(TCC)(42 patients),history of cervical surgery+failed TCC(7 pa-tients),unsuitability for TCC(10 patients)and strong request from patients(53 patients).The surgical situation and pregnancy outcome of preconceptional LCC were analyzed,and the gestational age of delivery before and af-ter preconceptional LCC surgery and different surgical indications were compared in postoperative delivery pa-tients who underwent preconceptional LCC.Results:The median operation time of 112 patients was 65.5 min,the median intraoperative blood loss was 10.0 ml,and there were no intraoperative complications.The postopera-tive hospital stay was 2.9±0.6 d.108 cases were followed up after surgery,with 77 cases of pregnancy and de-livery after LCC.A total of 205 deliveries were made before surgery,and 81 deliveries were made after surgery.Successful postoperative deliveries(delivery after 28 weeks)were 78(96.3% ),with an average gestational age 37.4±1.7 weeks.The preterm birth rate was 16.7%,term birth rate was 83.3% .The delivery rate at≥28 weeks after preconceptional LCC was significantly higher than the previous delivery rate of pre pregnancy LCC(96.3% vs.10.7%,P<0.05),and the gestational age was significantly prolonged(36.4±5.5 weeks vs.19.8±7.5 weeks,P<0.05).The postoperative delivery gestational week of preconceptional LCC with different surgical indi-cations was significantly later than the previous delivery gestational week of pre pregnancy LCC(P<0.05),ex-cept for the indication of unsuitability for TCC(P>0.05).Conclusions:Preconceptional LCC surgery is highly safe and can effectively prolong the gestational age and improve pregnancy outcomes in patients with CIC.It can be an effective treatment method for patients with a history of TCC failure.