Endostatin, a 20 kD (184 aa) C-teminal fragment of collagenⅩⅧ,is the most potent inhibitor of tumor angiogenesis described so for. Endostatin was initially isolated from a murine hemangioendothelioma cell line (EOMA). Purified recombinant murine endostatin generated in E.coli bacteria injected as unfolded suspension, inhibited the growth of a varity of metastatic and primary tumors in mice. However, its widespread application has been hampered by difficulties in the large-scale production of the antiangiogenic proteins. The limitation may be resolved by in vivo delivery and expression of the antitangiogenic gene. This review summarized the advances in endostain research in recent years including structure, the mechanism of generating ,function and therapy.

Objective: To study the effectiveness of anti-tumorgenecity of human IL-10 antisense and viral IL-10 antisense on nasopharyn-geal carcinoma(NPC) cells.Methods:Human IL-10 cDNA and viral IL-10 gene had been amplifed and cloned. A two-valent eukaryotic expression vector for antisense nucleic acids of human IL-10 cDNA and viral IL-10 gene had been constructed and designated as pcDNA3/AS hIL-10 + AS vIL-10.The recombinant vector was transfected into a NPC-clerived cell strain-SUNE cells. After that, the transfected and nontransfected SUNE cells were inoculated i.d. in the right flank of SCID mice and hu-PBL-SCID mice to evaluate their tumorgenecity changes.Results:The results of ELISA analysis showed that the concentration of hIL-10 and vIL-10 was 242 ?3 pg'ml-1 in supernatant of the nontransfected SUNE cells, and onry 22 ? pg ?ml-1 of hIL-10 and vIL-10 contained in supernatant of the transfected SUNE cells. After inoculation to SCID mice, the transfected and nontransfected SUNE cell showed the same growth manner. But inoculating to hu-PBL-SCID mice, the transfected SUNE cells grew slowerly than the nontransfected SUNE cell. With statistical analysis, the size and mean weight of the tumors from the hu-PBL-SCID mice inoculated with transfected SUNE cells were significantly lower in contrast to that from the hu-PBL-SCID mice inoculated with nontransfected SUNE cells( P

SUMMARY Peripheral T cell lymphomas-unspecified(PTCL-U) is an uncommon malignant tumor, accounting for 5%-7% of non-Hodgkin’s lymphoma. Clinical feature of a case of PTCL-U was investigated and the optimal treatment protocol was proposed. The clinical presentation of this case was progressing limbs weakness with sudden paralysis. Multiple superficial lymph nodes swelling and decreased sensation in all modalities below T10 level were found in physical examination. Bilateral leg paralysis (Grade 0/5) with high muscle tension, overactive knee reflex, bilateral Babinski sign (+) were present. Magnetic resonance imaging(MRI) showed the mass, which was around spinal cord located in T6-T8 vertebra canal, with intense enhancement after the administration of gadolinium diethylenetriamine penta-acetic acid. Abnormal signal in multiple centrums and accessories could also be found in MRI scan. Initial diagnosis was lymphoma, multiple systems involved. Laminectomy and epidural tumor resection were performed immediately. The dural sac was narrowed obviously by surrounding tumor. The result of pathological examination was PTCL-U. After operation, the level of pain sensation was descent, and touch sensation recovered. The patient received chemotherapy and his muscle strength was partly recovered in 4 months. Early diagnosis of peripheral T cell lymphomas-unspecified was difficult and easily misdiagnosed with poor prognosis. A review of literature showed central nervous system lesions occurred in advanced stage. However, the report of representation of intraspinal mass as initial symptom like the case was rare. For acute paraplegia, laminectomy and tumor resection should be performed as soon as possible. Regular radiotherapy and chemotherapy should be considered after operation. However, the value of local chemotherapy need to be further investigated.

ObjectiveTo observe the curative effect of Gustilo typeⅢ fracture with soft tissue defect of leg in children.MethodsOf the 15 patients,the area of the soft tissue defect varied from 5 cm × 6 cm to 8 cm × 12 cm.With regard to the location of soft tissue defect,two were situated at the upper third of the leg,eight were middle part of the leg,four were lower portion of the leg and dorsum of foot,one was lower portion of the leg and heel.The fracture was fixed by external fixation device and raw surface was closed by negative pressure drainage in the first stage.The raw surface was eventually covered by the transposition of regional flap or cross leg flap in the second stage.Among them,three patients underwent transposition of saphenous neuro-veno-fasciocutaneous flap, three patients underwent sural neuro-veno-fasciocutaneous flap transposition,one case of medial head of gastrocnemius muscle flap and 7 cases of cross leg flap were performed,while only 1 patient underwent free lateral anterior thigh flap transposition.ResultsOne patient who underwent transposition of saphenous neuro-veno-fasciocutaneous flap present with necrosis of the distal end of the flap 5 days after operation,which was then cured by cross leg saphenous neuro-veno-fasciocutaneous flap.Dark crust in distal end of flap occurred in 1 patient who underwent sural neuro-veno-fasciocutaneous flap,which was cured by changing dressings.Bone fracture of 14 patients were all healed.One patient who was classified as Gustilo Ⅲ c underwent cross leg flap, but bone defect was produced 18 months later.Through 3 months to 2 years follow-up,the texture,colour and shape of flap is good. ConclusionWith regard to Gustilo type Ⅲ fracture combined with soft tissue defect of leg in children,external fixation coupled with flap transposition can cure effectively.

Seen from the development of the treatment for hepatocellular carcinoma (HCC),although great progress has been made on the optimization of the treatment,the patients' overall survival (OS) has not been greatly improved compared with other tumors of digestive system such as colorectal cancer.That is mainly because of the early microvascular invasion (MIV) and portal vein tumor thrombus (PVTT) which are among the most important reasons for poor prognosis in HCC.Thus we overviewed the recent research findings on the treatment of HCC with PVTT,which might help the clinicians select the optimal therapeutic strategy.

Objective:To explore the changes of NK and NKT cells and the expression levels of their activated, inhibitory receptors in the peripheral blood of patients with newly diagnosed rheumatoid arthritis ( RA), and to reveal the potiential role of NK and NKT cells played in the pathogenesis of RA.Methods:32 patients with new onset RA and 15 healthy controls were recruited.Activated and inhibitory NK and NKT cells in peripheral blood were quantified by flow cytometry.The frequency of spontaneous and stimulated IFN-γ+NK and NKT cells and CD107aγ+NK cells were examined.Finally,the potential relationship between the frequency of NK and NKT cells subsets and clinical indexes were analyzed.Results:The frequencies of NK cells in peripheral blood in RA patients were sig-nificantly lower than those in the controls ( P=0.026 ).The frequencies of NKG2D+, NKP46+activated NK cells and NKG2C+, NKG2D+,NKP46+activated NKT cells in RA patients were significantly higher than those in the controls (P=0.011,P=0.010,and P<0.001,P=0.032,P=0.001,respectively),whereas the frequencies of KIR2DL3+,KIR3DL1+and NKG2A+inhibitory NK cells and KIR2DL3+,NKG2A+inhibitory NKT cells in RA patients were significantly lower (P=0.002,P=0.002,P=0.014,and P=0.027,P=0.002,respectively).Moreover, the frequencies of stimulated IFN-γ+NK cells and IFN-γ+NKT cells, spontaneous and stimulated CD107 aγ+NK cells in RA patients were significantly higher than that in the controls ( P=0.037, P=0.004 and P=0.001, P=0.001, respectively).Furthermore,the frequencies of NK cells,NKG2Aγ+and KIR2DL3γ+inhibitory NK cells were correlated significantly with the values of DAS28 in RA patients (r=0.357,P=0.045;r=0.399,P=0.024;r=0.468,P=0.021,respectively).Conclusion:Lower frequencies of NK cells, higher frequencies of activated NK cells and activated NKT cells, lower frequencies of inhibitory NK cells and inhibitory NKT cells, and higher NK cell activity may induce the autoimmune reaction involved in the pathogenesis of RA.

Objective: To investigate the status of regular HIV testing and post exposure prophylaxis (PEP) behaviors among men who have sex with men (MSM) in Lishui City, Zhejiang Province, so as to provide the reference for developing targeted intervention strategies. Methods: A total of 389 MSM were selected from Lishui City by convenient sampling method from April to August 2022, and demographic information, sexual behaviors, HIV testing and PEP behaviors were collected through questionnaire surveys. MSM were clustered using two step clustering analysis, and regular HIV testing and PEP behaviors among different groups of MSM were compared. Factors affecting regular HIV testing and PEP behaviors were evaluated using a multivariable logistic regression model. Results: The MSM surveyed had a median age of 31.00 (interquartile range, 16.00) years. There were 146 MSM undergoing regular HIV testing, accounting for 37.53%, and 47 MSM receiving PEP, accounting for 12.08%. MSM were divided into two groups. There were 28.05% of MSM with regular HIV testing in group 1, which was lower than the 44.44% in group 2; and 22.56% receiving PEP, which was higher than the 4.44% in group 2 (both P<0.05). Multivariable logistic regression analysis identified age (OR=1.030, 95%CI: 1.011-1.050), sexual roles (both receptive and insertive, OR=2.999, 95%CI: 1.732-5.194) and homosexual behaviors in the past 6 months (use condoms every time, OR=4.567, 95%CI: 2.593-8.044) as factors affecting regular HIV testing among MSM; age (OR=0.970, 95%CI: 0.942-0.999), sexual orientation (OR=0.292, 95%CI: 0.139-0.612) and homosexual behaviors in the past 6 months (not use condoms, OR=0.135, 95%CI: 0.040-0.460; use condoms every time, OR=0.076, 95%CI: 0.018-0.326) as factors affecting PEP behaviors among MSM. Conclusion MSM with different characteristics of sexual behaviors have different preferences for HIV regular testing and PEP, with homosexual behaviors in the past 6 months, sexual roles and sexual orientation being the main influencing factors.

Objective To explore the clinical safety and validity of Da Vinci surgical system in distal pancreatic tumor resection.Methods The clinical data of 14 patients with distal pancreatic tumor underwent robotic surgeries by using Da Vinci surgical system from January 2009 to June 2012 were retrospectively analyzed.Results The average operation time was 343.93 (170-575) min,average blood loss was 192.5 (10-700) ml,without blood trahsfusion.Pathologic examination showed:pancreatic ductal adenocarcinoma in 7 patients,pancreatic cystadenoma in 1 patient,mucous cystadenoma in 1 patient,cystadenocarcinoma in 1 patient,high levels of pancreatic ductal intraepithelial neoplasia in 1 patient,insulinoma in 1 patient,solid pseudo-papillary tumor in 2 patients.Two patients with pancreatic leaks after operation and then relieved after conservative medical therapy.Others were discharged from hospital without complications.The average hospital stay was 10.64 d.Conclusions Da Vinci surgical system is safe and effective in treatment for patients with distal pancreatic rumor with minimally invasive advantage.Because lack of surgical experience and small sample,a large sample with long term follow-up of high-quality clinical research is required and then update the system to evaluate the efficacy and safety.

Objective To compare three different internal fixations using dual plates in treatment of type C distal humerus fractures.Methods A total of 59 patients with type C distal humerus fractures fixed with dual plates between January 2004 and December 2008 were enrolled in the study,including 34 patients managed by perpendicular dual plate internal fixation (Group A),14 patients by dorsal dual plate internal fixation (Group B),and 11 patients by parallel dual plate internal fixation (Group C).Functional outcomes of injured elbow joints were assessed using Mayo elbow performance score (MEPS).Fisher' s exact probability,chi-square test and variance analysis were used to compare the perioperative variables among groups.Results The patients were followed up for average 28 months (range,12-55 months),which showed that all fractures were smoothly healed with satisfactory curative effects in each group.There were no significant differences with respect to functional outcomes among three groups.The patients with surgery difficulty in Group C were more than those in other two groups.Besides,an additional intercondylar screw was always required in Groups A and B,but rarely in Group C.Conclusions All internal fixations with three dual plates are effective in management of type C distal humeral fractures.The location of plates is determined by experiences of orthopedic surgeons and specific fracture type.