Breast cancer ranks among the most prevalent malignancies in women. Specific aspects of both breast cancer cells and the bone microenvironment contribute to the development of bone metastases. Breast cancers express chemokine receptors, integrins, cadherins, and bone-resorbing and bone-forming factors that contribute to the successful and preferential spread of tumor from breast to bone. Bone is rich in growth factors and cell types that make it a favorable environment for breast cancer cell growth. Once breast cancer cells enter the bone, breast cancer cells can secrete factors that act on bone cells and other cells within the bone, causing them to secrete factors that act on adjacent cancer cells. The steps in the metastatic cascade and the vicious cycle within bone offer unique targets for adjuvant treatments to treat and cure bone metastasis.

Objective To report the surgical technique and preliminary clinical results of bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis. Methods Sixteen eases of lumbar stenosis were treated in our institute. For the surgical treatment, only one side paraspinous muscle was dissected. The upper and lower margins of the adjacent laminae were drilled, and the underlying ligament flavum was exposed. By changing the direction of the microscopy, the base of the spinous process and the internal side of the contralateral laminae were also drilled off till the lateral recess. Finally, decompression of the spinal canal was achieved by removing the ligament llavum. Results Follow-up ranged from 6 to 47 months. Intermittent claudication was totally relieved in 14 out of 16 cases, and markedly relieved in 2 cases. Back pain was relieved totally in 6 cases, marked improved in 8 cases, not change in 2 cases. Pain was significantly relieved in all 5 cases with sciatica, among them, diseetomy had to be performed in 3 cases. During follow-up, there was no symptom recurrence, and dynamic X ray did not show lumbar in-stability. Conclusion Bilateral decompression under microscope via unilateral approach for the treatment of lumbar stenosis is minimally invasive surgery, the effect of the operation is good. The technique has little in-fluence on spinal stability.

Objective To use the syphilis helicoid gelatin aggregation experiment (TPPA ) method to compare the results of syphilis serological detection reagents between the ELISA method and the colloidal gold method for evaluating the clinical applica ‐bility of each detection reagent .Methods 6 291 serum samples were selected from the hospitalized patients before surgery or before blood transfusion ,and performed the preliminary screening detection by the ELISA method (reagent A and B) and the colloidal gold method ,the positive or weakly positive specimens in preliminary screening were performed the confirmation test by the TPPA method .Results In 6 291 serum specimens ,the positive cases of the reagent A ,reagent B and colloidal gold method were 66 ,64 and 56 cases respectively ,the positive detection rate of colloidal gold method had no obvious difference between the reagent A and rea ‐gent B (P> 0 .05) .The positive samples were confirmed to be 66 cases by TPPA ,including 61 cases of reagent A and reagent B positive ,and the colloidal gold method had 56 cases .5 cases of reagent A positive and 3 cases of reagent B positive were confirmed to be 3 and 2 cases by TPPA respectively ,the sensitivity of the colloidal gold method had significant difference between the reagent A and reagent B(P< 0 .05) .Conclusion ELISA method has high sensitivity and is easy to realize the automated enzyme‐linked im‐munoassay ,which is suitable for the screening of the patient sample before surgery or before blood transfusion .The colloidal gold method has low sensitivity ,but high specificity ,is simple and convenient which is suitable for large‐scale healthy physical examina‐tion and preliminary screening test before emergency surgery .In order to avoid medical disputes ,the positive samples by the ELISA method and colloidal gold method should be confirmed by the TPPA method .

Objective To investigate the effect of cytarabine (Ara-C) on proliferation and apoptosis of human erythroleukemia K562 cell linethrough autophagy pathway and its possible mechanism.Methods The cellular proliferation inhibiting rate after different concentrations of Ara-C acting for 24,48 h was detected by CCK-8;the cell cycle and apoptosis were detected by flow cy tometry(FCM);the chromatin morphological changes in nucleus were observed by Hoechst staining;the cell acidic autophagy vesicles were detected by acridine orange staining;the expression changes of p38 and p-p38 proteins were detected by Western blot.The expressions of autophagy apoptosis related gene and protein were examined by RT-PCR and immunofluorescence.Results The CCK-8 results found that different concentrations of Ara-C could inhibit the proliferation of K562 cells with dose-and time-dependent manners.FCM detecting indicated that Ara-C could increase apoptosis and could arrest the cell cycle at S phase;Hoechest staining showed that K562cells had typical apoptotic morphological changes after Ara-C treating;the Acridine orange staining revealed that Ara-C caused the inclease of the green fluorescene in cells of the Ara-C group,and the cells appeared a great number of acidic autophagy vesicles;RT-PCR results showed that Ara-C up-regulated the expression of autophagy key genes Beclin-1,LC3A and LC3B;Western blot results showed that Ara-C increased the expression of phosphorylated p-p38.Immunofluorescence results showed the expression of LC3B was significantly enhanced.Conclusion Ara-C canactivate p-p38 mediated K562 cells to generate autophagy,then inhibit the cell proliferation and promotes apoptosis.

Objective To observe the effect of repetitive transcranial magnetic stimulation (rTMS) and functional magnetic stimulation over spinal cord (SC-MS) on motor function recovery after spinal cord hemisection in rats. Methods T10 spinal cord hemisection model was made. The stimulation (5×10 s bursts of 5 Hz at 35% maximal stimulator output, each burst separated by a 2 m interval) was delivered daily, 5 d per week for 2 weeks. The treatment began at 4 d after surgery for rTMS group and SC-MS group. Motor function recovery was assessed with Basso, Beattie & Bresnahan locomotor rating scale (BBB) and the Horizontal Ladder test. The tibialis anterior was surgically removed at 38 d after spinal cord injury for calcitonin gene-related peptide (CGRP) iummunohistochemical staining. Results The scores of BBB and Horizontal Ladder test were significantly more at 17 d after spinal cord hemisection in rTMS group than before treatment and in spinal cord injury group (P<0.05). In SC-MS group, the scores of BBB and Horizontal Ladder Test were significantly more 10 d after SCI than before treatment and in SCI group (P<0.05). The score of Horizontal Ladder test of SC-MS group was more 10 d after SCI than that in the rTMS gourp (P<0.05). The expression of CGRP on motor endplates of the tibialis anterior in rTMS group and SC-MS group were more than those of SCI group (P<0.01). Conclusion rTMS and SC-MS in acute stage can improve the motor function recovery and muscle plasticity after spinal cord hemisection in rats. The magnetic stimulation can facilitate the recovery of motor function after spinal cord hemisection in rats.

Adolescent ; Adult ; Aged ; Endoscopy ; Epistaxis ; pathology ; therapy ; Female ; Humans ; Light Coagulation ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Young Adult

Background and purpose: p21-activated kinase 5 (PAK5) is a recently identified member of PAKs that regulate many intracellular processes such as cytoskeleton remodeling, cell proliferation, cell differentiation, gene transcription and cell apoptosis. Recently, studies found that PAK5 was overexpressed in some cancer such as gastric and colon cancer. However, the expression status and biological function of PAK5 in osteosarcoma are not clearly known. The objective of this study was to investigate the expression of PAK5 in osteosarcoma tissue and their relationships with the prognosis of osteosarcoma. Methods: The expression of PAK5 was detected by using immunohistochemical method in 92 specimens of human osteosarcoma tissues and 33 cases of osteoclastoma tissue, respectively. Results: The positive rate of PAK5 was 71.7% (66/92) in all the 92 cases of osteosarcoma. PAK5 expressions were not related to clinical variables such as gender, age, tumor location, tumor size, histological type and local recurrence, but signiifcantly related to Enneking grade, tumor cell necrosis rate and lung metastasis, and the high expression of PAK5 may reduce the efifciency of chemotherapy. Survival analysis indicated that high expression of PAK5 correlated with poor prognosis of patients with osteosarcoma. Univariate survival analysis showed that the signiifcant prognostic factors were tumor size, Enneking grade, local recurrence, lung metastasis and expression levels of PAK5. COX multivariate regression identified that the PAK5 expression levels (P=0.001) and lung metastasis (P=0.015) were independent prognostic factors of patients with osteosarcoma. Conclusion:The positive expressions of PAK5 closely correlate with Enneking grade, tumor cell necrosis rate and lung metastasis. Detection of PAK5 may be used as a molecular marker for prognosis of osteosarcoma. The high expression of PAK5 may reduce the efifciency of chemotherapy.

Objective To explore the effect of prevention and treatment of external application of Algoplaque for controlling phlebitis caused by peripheral indewelling needle in vein for patients. Methods This research was divided into two parts,prevention and treatment. As for prevention research,patients were randomly divided into the experimental and the control groups,each group included 30 patients. In the experimental group,we applied directly external application of Algoplaque at the upper of needle puncture site of the vein and nearby the eye. In the control group,we applied the film directly to fix the indwelling needle. As for the treatment research, it was carried out in patients with occurred phlebitis, who were randomly divided into two groups,the experimental group included 30 cases of patients and the control group included 28 cases of patients. Observation time was one to five days. Results The incidence of phlebitis in the experimental group of prevention research was 23%, in the control group it was 90%. The incidence of phlebitis in the experimental group was significantly lower than that of the control group. The effective rate in the experimental group of treatment research was 96.7% and it was 67.9% in the control group. The difference was very significant. Conclusions External application of Algoplaque can effectively control phlebitis caused by peripheral indewelling needle in vein.

Objective To evaluate the application of microvascular coupler device (MVCD) in the free-tissue flap transfer for head-and-neck defects reconstruction.Methods Its a retrospective study of the clinical data of 743 patients who received 763 free-tissue flap transfer for head and neck defects reconstruction in Hunan Cancer Hospital from January,2014 to January,2016.For microvascular anastomoses,413 were done manually (the manual group) and 350 done with MVCD (the MVCD group),of which the latter included end-to-end venous anastomosis in 159,endto-side venous anastomosis in 190 and end-to-end arterial anastomosis in 1.The time for anastomosis,rate of blood leakage from the anastomosis and venous thrombosis,and the survival rate of flaps were compared between the manual group and the MVCD group.The impacts of types of anastomosis of end-to-end vs end-to-side (both with MVCD),on the formation of venous thrombosis and survival of flaps were also recorded.The analysis was performed under t-test and chi-square test using SPSS software 19.0 with P ＜ 0.05 for differences with a statistical significance.Results Time for anastomosis was significantly shorter in the MVCD group (4.43±0.51min) than in the manual group (14.75± 2.43min,P＜0.05).The rates of anastomosis leakage were 0 in the MVCD group and 9.7％ in the manual group(P＜0.01),flap necrosis were 0.57％ and 1.69％ (P=0.15),the rate of venous thrombosis were 1.15％ and 3.63％(P=0.02),respectively.There was no significant difference in the time for anastomosis,the rate of venous thrombosis and the survival rate of flaps with end-to-end anastomosis and end-to-side anastomosis with MVCD.Conclusion The application of microvascular coupler device is valuable in the reconstruction of head-and-neck defects with free-tissue flaps because it can significantly shorten the time for anastomosis,decrease the ocurrence of anastomosis leakage and venous thrombosis,reduce the risk of flap failure.