10.3969/j.issn.2095-4344.2013.26.016

Purpose　To study the correlation of integrinα4β1 and its two ligands (vascular cell adhesion molecule-1 and fibronectin)with mast cell（MC）recruitment around the rat hepatocarcinoma. Methods　Eighteen male Wistar rats with liver tumor were divided into three different groups in terms of mast cell numbers in the surroundings of liver tumor. Eight normal Wistar rats were used as control. Integrin VLA-4 expression in rat peritoneal mast cells was analyzed by indirect immunofluorescence and flow cytometry. Immunohistochemistry was also used to investigate whether endothelial cell VCAM-1 and fibronection were expressed positively. Results　There were markedly different in mast cell numbers around rat liver tumor. Mast cells express high levels of integrin α4β1 on their surfaces. And the more mast cells around liver tumor, the higher levels of integrin VLA-4. We also found that endothelial cells expressed VCAM-1 and there are a number of fibronectin deposition around rat hepatocarcinoma. Conclusions　Integrin α4β1/VCAM-1 and fibronectin play an important role in mast cell recruitment mechanism around liver tumor. The expression levels of integrin α4β1 are paralleled by mast cell accumulation in the surroundings of hepotocarcinoma.

BACKGROUND:The bony crista has been found in the distal humeral medullary cavity,but its specific morphological characteristics and clinical significance are not clear.OBJECTIVE:To study the morphology of bony crista inside the distal intramedullary of the human humerus and its potential clinical relevance.DESIGN,TIME AND SETTING:CT scanning and measurement as well as visualized observation to the specimen for the dry adult humeri was performed at CT Room and Department of Orthopaedics,First Affiliated Hospital,Nanchang University from June to December 2007.MATERIALS:A total of 80 dry adult humeri (left:49;right:31) were purchased from the Department of Anatomy,Medical College of Nanchang University,excluding the fractured and lesion humerus.METHODS:The low 1/3 of eighty human humeri were scanned by 16 layer spiral CT.The morphological features of the intramedullary bony prominence above the olecranon fossa was described in terms of coronal plane,sagittal plane and transverse section after three-dimensional reconstruction.The low 1/3 of twenty humeri were then split vertically in the middle line in coronal plane,to view the intramedullary bony crista directly.MAIN OUTCOME MEASURES:The bony crista mainly located on the medial or lateral side,the range of the bas'dar part of the bony crista,alinement characteristic of the bony crista.RESULTS:The extent of intramedullary bony crista ranged from 1.9 to 3.2 cm (mean 2.6 cm) above the olecranon fossa,the density similar to cortical bone,with an basement posterior,and medial part and lateral side intero-inferiody incline.59 out of the 80 humeri,medial side dorminated;on the rest humeri the lateral side dorminated.2 or 3 parallel lines on the dorminate side,irregular alignment on the other side.CONCLUSION:The study described the morphology of the distal intramedullary bony crista of the humerus,which has never been reported so far.In addition,its clinical relevance in terms of the internal fixation of fracture on the distal humerus and elbow arthroplasty was also demonstrated.

Aim To investigate the protective effect of riboflavin on ischemia brain damage and the mecha-nism.Methods The in vivo experiments were pro-cessed in male SD rats .Rats were randomly arranged into control group , model group and riboflavin group . The rats in riboflavin group were intraperitoneally in-jected riboflavin at the dose of 1 mg? kg -1 for seven consecutive days .Then the rats in model and riboflavin groups were carried out middle cerebral artery occlu-sion( MCAO) operation.After 24 h, all rats were sacri-ficed and the brain tissue was dissected to observe the infarct area, the edema and the ultrastructure damage . The brain tissue was dyed by triphenyl tetrazolium chloride .The brain edema was observed by the weight of ischemia-side semi-brain.The ultrastructure was ob-served by electron microscope .The in vitro experiments were processed in primary culture neurons by exposed to oxygen and glycose deprivation ( OGD) .The viability of neurons was assayed by MTT method .The enzyme activity of superoxide dismutase ( SOD) , catalase ( CAT)and glutathione peroxidase ( GSH-Px ) was assayed to explore the mechanism .Results Riboflavin signifi-cantly decreased the infarct area ( P<0.01 ) , inhibited the brain edema ( P <0.01 ) and inhibited the ultra-structure damage in rats after MCAO;riboflavin protec-ted the viability ( P <0.01 ) and the ultrastructure of neurons exposed to OGD .The enzyme activity of an-tioxidant SOD1 ( P <0.01 ) , CAT ( P <0.01 ) and GSH-Px ( P <0.01 ) was protected by riboflavin in MCAO model .No difference was found in the activity of SOD2 . Conclusion Riboflavin inhibits ischemia brain damage , and the protection of the activity of an-tioxidants is involved in the mechanism .

Objective To explore a new modified stable genioplasty with modified MortiseTenon joints technique and to analyze the surgicaI results in clinic as well as to discuss the advantages in theory.Methods Eleven patients were performed by the genioplasty with Mortise-Tenon joints technique intraoral approach from June 2012 to March 2014,who were suffered from retrusion of chin with different degree accompanying with long chin.The two segments of the chin by osteotomy were made into the Mortise-Tenon joints and fixed by titanium plates.The results were evaluated by clinical appearances and image analyses.Results All 11 patients were satisfied with the procedure and the contour of the chin.The surgical effects were stable without any complications.The advancement in average Mortise-Tenon joints technique was 7.38 mm.Conclusions Much better in stablility and less relapse are achieved by using modified Mortise-Tenon joints technique;furthermore,the genioglossal muscle and geniohyoid muscle are reserved as much as possible,and therefore the normal function of them could be maintained.This method is a good alternative technique for chin retrusion coexisted withlong chin.

Objective To investigate the expression of neural-nitric oxide synthase (nNOS) in renal clear cell carcinoma and its clinical significance.Methods The expression of nNOS mRNA in 533 samples of TCGA database was analyzed with Student t test,and statistical analysis was performed to assess the relationship between nNOS expression and clinical prognosis with Kapla-Meier test.Western blot analysis of nNOS protein expression in 10 cases of clear cell renal cell carcinoma(ccRCC) from department of urology of Wuhan union hospital with student t test.Results The mRNA levels of nNOS in 72 cases of ccRCC in tumor tissues and adjacent tissues and were 2.99 ± 0.28 and-1.57 ± 0.17,it is significantly lower than those in adjacent tissues (P ＜ 0.01).The mRNA levels of nNOS in 533 cases of ccRCC,in tumor tissues and adjacent tissues and were 2.99 ± 0.28 and-1.76 ± 0.05,it is significantly lower than those in adjacent tissues (P ＜ 0.01).A total of 533 sample studies showed a low correlation between nNOS expression and clinical T stage,T1-1.59 ±0.08,T2-1.96 ±0.13,T3-1.90 ±0.09,T4-2.38 ±0.28 (P =0.0029) and -1.63 ±0.06 and-2.16 ± 0.13 between non-metastasis and no-metastasis (P =0.0009),and-1.57 ± 0.08 and-2.03 ± 0.11 between non-recurrence and recurrence (P =0.008).Survival analysis showed that the overall survival time were (40.3 ± 5.6) months and (48.3 ± 5.7) months in lower and higher nNOS expression,and disease free survival time were (37.1 ± 2.1) months and (40.3 ± 5.6) months in lower and higher nNOS expression,both with shorter time in low expression of nNOS (P ＜ 0.01).nNOS proteins were 1.02 ± 0.16 and 0.61 ± 0.1 1 in tumor tissues and adjacent tissues with significantly lower expression(P＜0.05).Conclusions The mRNA and protein of nNOS are lower in ccRCC with a poor prognosis of ccRCC.

Objective To summarize the clinical experience and efficacy of surgical treatment for Stanford type A aortic dissection leading to acute lower limb ischemia.Methods From January 2014 to January 2018,12 patients with severe lower limb ischemia caused by acute type A aortic dissection were treated with Suns surgery.Among them,11 patients were treated with restoration of lower limb blood supply preferentially,including 10 cases of femoral artery bypass and 1 case of abdominal aorta-iliac artery stent graft implantation.Another case was treated with ascending aorta-femoral artery bypass after Sung surgery.Results 3 cases died of ischemia and necrosis of the lower extremities.Two of them died of multiple organ failure due to amputation and one died of low cardiac output due to refractory acidosis.Acute renal failure performed bedside CRRT in 5 patients and ECMO in 1 patient.The remaining 9 patients were discharged from the hospital and the symptoms of lower limb ischemia disappeared.After an average follow-up of 23 months,the re-examination of the aorta CTA showed that the bypass artery was unobstructed and the distal femoral artery was well developed.One patient infecting vascular prosthesis was cured by taking out the unit.Conclusion For acute lower limb ischemia caused by type A aortic dissection,blood flow of lower extremities should be restored as soon as possible to reduce mortality and complications.Femoral artery bypass and abdominal aorta-iliac arterial repair are simple and effective in reconstructing lower limb blood supply.

Objective: Study the response of GMDTC to cadmium ions and metal ions in vivo to determine whether GMDTC are specifically complexed with cadmium ions to provide a reference for the safety and dfficacy of GMDTC. Methods: Complexometric titration, HPLC and HPLC-MS were applied to research the complexation reaction of GMDTC and various metal ions. The molecular ion peak of GMDTC, GMDTC-Cd complex and GMDTC-Pb complex also detected by LC-MS. Additionally, the initial structure was determined by DFT simulation method. Results: Results of complexometric titration and HPLC detection showed that GMDTC characteristic absorption peak area was proportional to the concentration of itself and there was no color change and peak time change when the GMDTC mixed with Ca²⁺, Fe²⁺, Mg²⁺, Zn²⁺. However, the color changed to black transition when the GMDTC mixed with Cu²⁺ and the color changed from yellow precipitate to light yellow transparent transition when GMDTC mix with Hg²⁺. Moreover, the peak area as well as the retention time has changed a lot which indicated that a chemical reaction has already happened. When the GMDTC mixed with Cd²⁺ and Pb²⁺, the color has changed from pale yellow to colorless transparent and the peak area of GMDTC has increased a lot. Finally, the GMDTC-Cd complex ratio both of which are 2:1 were calculated based on the results of LC-MS instrument and atomic calculations. Conclusion The specific cadmium chelating agent GMDTC can not react with the Ca²⁺, Fe²⁺, Mg²⁺, Zn²⁺, but it can react chemically with Cu²⁺ and Hg²⁺, even specific complex with Pb²⁺ and Cd²⁺.

Objective:To investigate the effectiveness and feasibility of 3D printing-assisted extracorporeal fenestration techniques in thoracic aortic endoluminal repair.Methods:Retrospectively analyzed the clinical data of patients who underwent endovenous repair of the thoracic aorta with the application of 3D printing technology-assisted extracorporeal windowing in the Department of Cardiovascular Surgery, Wuhan University Hospital from January 2019 to May 2021, and analyzed the surgical results as well as the occurrence of perioperative complications.Results:A total of 10 patients with a mean age of(53.3±15.7) years were included, including 4 cases of complex B aortic coarctation, 5 cases of thoracic aortic aneurysm and 1 case of abdominal aortic aneurysm. All patients in this group underwent endoluminal repair of the thoracic aorta with 3D printing assisted extracorporeal fenestration, including 1 case of PCI performed at the same time. There were no postoperative complications and no perioperative deaths.Conclusion:3D printing technology assisted extracorporeal fenestration and endoluminal aortic repair can accurately position aortic stents for fenestration, optimise endoluminal treatment options and improve patient prognosis.

From the perspectives of the pathogenesis, diagnosis and treatment of cardiac graft vasculopathy(CGV), this review summarized the current understanding and cognition of its pathology, monitoring, diagnosis and treatment to provide rationales for better survivals of CGV.