Acupuncture Therapy ; instrumentation ; Humans ; Needles ; Suggestion

Objective To investigate the risk factors leading to complications in patients undergoing laparoscopic cholecystectomy (LC). Methods Clinical data of 11?974 patients undergoing LC from Mar. 1991 to June 2003 were collected and analyzed retrospectively. Fifteen clinical factors were recruited for the study in relation to surgical complications. Data were analyzed by ?2 test and Logistic regression. Results The overall operative complication rate was 1.896%. The procedure was shifted to open surgery in 2.389% of all cases, Logistic regression analysis revealed that Calot triangle adhesion, stage, expertise of the team, gallbladder wall thickness, gallbladder and vicinity adhesion were important risk factors for complications. Conclusion LC complications can be prevented by good training, strictly following protocol, and timely shifting to open surgery.

Objective: To evaluate the effect of synthesized small interfering RNA targeting to HIF-lα on the adhesion and invasion of human tongue squamous cell carcinoma cell line (Tca8113). Methods; A double strand small interference RNA (siRNA) targeting HIF-1α (siRNAH1Fla) was transfected into cultured Tca8113 cells by lipofectamine2000. The expression of HIF-1α was investigated on mRNA level by real time-PCR and protein level by Western blot. The adhesion and invasion of Tca8113 cells to extracellular matrix (ECM) was also analyzed. Results: Exposure to hypoxia induced a prolonged elevation of HIF-lα protein and siRNAHIF.la reduced HIF-la synthesis as measured on mRNA level and protein level compared with the controls. No matter under normoxic or hy-poxic conditions, the adhesion potency of siRNAHIF-1α treated Tca8113 cells was markedly inhibited compared with controls(P<0.05 or P <0.01). So did the invasion potency (P<0.01). The adhesion and invasion potency of siRNAHIF.,a treated Tca8113 cells were inhibited more greatly under hypoxic condition than under normoxic condition ((36.4±2.7)% vs(26±2.35);(44.2±2.2)% vs (35±1.75), P<0.01)). Conclusion; siRNAH1F.lo can knockdown the expression of HIF-la and inhibit the cell adhesion and invasion to ECM in Tca8113 cells. HIF-la may play an established role in the regulation of Tca8113 cells invasion and metastasis. Interfering with HIF-1α pathways by siRNA strategy may provide a therapeutic target for human tongue squamous cell carcinomas.

OBJECTIVETo analyze effects of fracture of processus styloideus ulnae on prognosis in the treatment of distal radial fracture of type C according to AO classification.

METHODSThis was a retrospective case-control study, and the information was got ten through case evaluation and follow-up, including sex, age, patient satisfaction, Gartland & Werley score and radiographic score. There were 76 patient treated with open reduction and plate fixation in People's Hospital Affiliated to Peking University from July 2006 to July 2011. All the patients were divided into two groups: no combination with fracture of processus styloideus ulnae (group A, 56 cases), combination with fracture of processus styloideus ulnae (group B, 20 cases). The patients in group A and B were treated with open reduction and internal fixation; however the fracture of processus styloideus ulnae was not fixed. The indexes such as clinical data, bone grafting, joint movement, Gartland & Werley score and radiographic score were compared between two groups.

RESULTSThe ulnaris pain of patients in group B was more obvious than that in group A. The local VAS, palmar and dorsal flexion degree of wrist joint, motion VAS, patients satisfaction score, radial and ulnar deviation degree, pronation and supination of forearm degree, Gartland & Werley score and radiographic score were separately 0.1 ± 0.1, (51.1 ± 1.9)°, (60.2 ± 1.9)°, 0.6 ± 0.1 (23.1 ± 0.9)°, (28.7 ± 1.3)° (81.5 ± 2.6)°, (68.2 ± 2.7)° 1.9 ± 0.3, 89.6 ± 12.3 in group A; and separately 0.3 ± 0.3, (51.4 ± 2.3)°, (66.6 ± 1.7)°, 0.5 ± 0.2, (24.5 ± 2.0)°, (26.9 ± 1.8)°, (80.3 ± 2.5)°, (70.3 ± 3.7)°, 1.2 ± 0.4, 92.5 ± 7.5 in group B; there were no statistical differences in above indexes between two groups.

CONCLUSIONWhether the distal radial fracture with a concomitant unrepaired ulnar styloid fracture or not exerts no influence on mainly outcomes including function, radiography and motion of the wrist.

Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Radius Fractures ; surgery ; Retrospective Studies ; Ulna Fractures ; surgery

Objective To summarize the technique and managements of complications in endovascular embolization on intracranial aneurysm with Guglielmi detachable coils(GDC),and to evaluate the effect of the treatment.Methods One hundred and thirty six cases with Aneurizym were treated using GDC to embolize the aneurismal sac via femoral artery approach.Results One hundred and thirty six aneurysms were cured.Of them 132 cases recovered clinically,4 patients died.The mortality was 2.9%. The sac of 123 aneurysms were embolizied at 100%,8 cases with 95% embolization,5 with 90% embolization.3 aneurysms reptured during the embolization,cerebral vasospasm happened in 7 eases. microcoil escaped in 2 case.Three recurring cases were cured after second GDC embolization.The technique-related complications occured in 13 cases.No re-bleeding occurred during the 6 to 54-month follow-up.Conclusion Endovascular embolization of intracranial aneurysm with coils is a safe and effective treatment for intracranial aneurysm.Advances in Techniques and treating the complications correctly would decrease the complications and improve future outcomes.

OBJECTIVETo improve the safety and accuracy of trans-pedicle internal fixation for cervical vertebra by the parameter data measuring by CT reconstruction.

METHODSThirty volunteers were enrolled and be subjected to high-speed spiral CT for getting the data of C3-C7. The data included pedicle point-midline distance, pedicle sponge width, pedicle angle. The cervical vertebra pedicle morphology were reconstructed.

RESULTSReconstructed CT image data displayed that pedicle sponge width become larger and larger from C3 to C7; the pedicle depth didn't change significantly even from C3 to C7; pedicle angle become small from C3 to C7 and the range is from 33.76 degrees to 47.20 degrees; pedicle point-midline distance were almost similar even from C3 to C7. There were not statistical differences between the right side and the left side, but there were statistical differences between man and woman.

CONCLUSIONReconstructed CT image can provide useful data for clinical cervical vertebra trans-pedicle internal fixation.

Adult ; Bone Screws ; Cervical Vertebrae ; anatomy & histology ; diagnostic imaging ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Image Processing, Computer-Assisted ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

Objective To explore the methods of early etiological diagnosis and principles of endovascular embolization in Hunt-Hess Ⅳ—Ⅴ grade subarachnoid hemorrhage(SAH),and to evaluate the therapeutic efficacy.Methods Thirty-one patients underwent imaging examinations such as CT and DSA to make the early diagnosis of SAH.Meanwhile,Guglielmi detachable microcoil(GDC)was used to applying aneurysmal intracapsular embolization in the ruptured aneurysms,and efficient symptomatic treatment was adopted early postoperatively.The results were tested by ?~2 test.Results All 31 cases were diagnosed early and operated successfully.Among them,the aneurysm lumen was 100% occluded in 26 cases,95% occluded in 3 cases;90% occluded in 2 cases.There were 5 cases complicating with cerebral vasospasm.One case recurrent was cured with secondary complementary GDC embolization.Nine cases(29.0%)had permanent sequelae associated with SAH.According to the Glasgow prognosis score, the therapeutic efficacy was as following:6 patients were in grade Ⅰ,9 in grade Ⅱ,4 in grade m,2 in grade Ⅳ,and 10 in grade Ⅴ;10 patients died,and the morality rate was 32.3%.None of them exhibited re-bleeding with follow-up period of 3 to 68 months postoperatively.Morality rates were significantly different between the group with aneurysmal diameter of 11—25 mm and the group of 5—10 mm(?~2=6.60,P

OBJECTIVETo explore the possibilities of bone marrow stromal cells (MSCs) to adopt Schwann cell phenotype in vitro and in vivo in SD rats.

METHODSMSCs were obtained from tibia and femur bone marrow and cultured in culture flasks. Beta-mercaptoethanol followed by retinoic acid, forskolin, basic-FGF, PDGF and heregulin were added to induce differentiation of MSCs'. Schwann cell markers, p75, S-100 and GFAP were used to discriminate induced properties of MSCs' by immunofluorescent staining. PKH-67-labelled MSCs were transplanted into the mechanically injured rat sciatic nerve, and laser confocal microscopy was performed to localize the PKH67 labelled MSCs in the injured sciatic nerve two weeks after the operation. Fluorescence PKH67 attenuation rule was evaluated by flow cytometry in vitro.

RESULTSMSCs changed morphologically into cells resembling primary cultured Schwann cells after their induction in vitro. In vivo, a large number of MSCs were cumulated within the layer of epineurium around the injured nerve and expressed Schwann cell markers, p75, S-100, and GFAP.

CONCLUSIONMSCs are able to support nerve fiber regeneration and re-myelination by taking on Schwann cell function, and can be potentially used as possible substitutable cells for artificial nerve conduits to promote nerve regeneration.

Animals ; Biomarkers ; analysis ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cells, Cultured ; Flow Cytometry ; Fluorescent Antibody Technique, Indirect ; Fluorescent Dyes ; Glial Fibrillary Acidic Protein ; analysis ; Morphogenesis ; Organic Chemicals ; analysis ; Phenotype ; Rats ; Receptor, Nerve Growth Factor ; analysis ; S100 Proteins ; analysis ; Schwann Cells ; cytology ; metabolism ; Sciatic Nerve ; cytology ; injuries ; Stromal Cells ; cytology ; metabolism ; transplantation

OBJECTIVETo discuss the efficacy of total elbow replacement in the treatment of complex distal humeral fractures.

METHODSFrom May 2005 to October 2008 12 patients were retrospectively studied who were diagnosed complex fractures of the distal humerus and treated by total elbow replacement (Coonrad-Marrey). The mean age was 60 years old, the mean follow-up time was 12 months. According to AO classification, there was 3 C2 and 9 C3. The study included: pain evaluation, range of motion, elbow stability, muscle strength, complications, Mayo elbow score, DASH score, radiological assessment of ectopic bone formation and loosening.

RESULTSTwo cases with mild pain. The mean flexion is 98.3 degrees, extension limit is 17.9 degrees, mean pronation is 82.9 degrees and supination is 70.8 degrees. All joints were stable postoperatively. All patients were satisfied with the outcome. There was 1 case of superficial soft tissue nonhealing and 2 cases of ulnar nerve symptoms. No ectopic bone formation or loosening was found. Mayo elbow score was 3 cases of excellent and 9 cases of good. The mean DASH score was 41.3.

CONCLUSIONTotal elbow replacement can be used in such conditions as severe osteoporosis, severe comminution that internal plates can not get stable fixation, severe cartilage damage (because of fracture or inflammatory arthritis) that indicate traumatic or inflammatory arthritis.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Elbow ; Female ; Follow-Up Studies ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

BACKGROUNDCalcitonin gene-related peptide (CGRP), a sensory neuropeptide, affects osteoblast proliferation and bone formation. However, the mechanisms are not fully understood. Monocyte chemoattractant protein-1 (MCP-1) is a chemokine that stimulates the migration of monocytes and plays important roles in regulating bone remolding during fracture repair. In this study, we investigated the effects of CGRP on proliferation and MCP-1 expression in cultured rat osteoblasts.

METHODSPrimary rat osteoblasts were isolated from fetal rats calvariae. Cells were exposed to gradient concentrations (10(-9) to 10(-7) mol/L) of CGRP. Protein and mRNA levels of MCP-1 were quantified by Western blotting and semiquantitative reverse transcription-polymerase chain reaction, respectively. The protein level of MCP-1 was investigated and compared in cell culture media by enzyme linked immunosorbent assay (ELISA). Phospho-extracellular signal-regulated kinase (ERK) expression was detected by Western blotting. Cell proliferative activity was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and BrdU assay. The effects of MAPK/ERK kinase (MEK)-inhibitor U0126 on CGRP-induced MCP-1 expression in primary rat osteoblasts were examined.

RESULTSCGRP effectively enhanced primary rat osteoblast proliferation and led to significant increases in the expression of MCP-1 mRNA and protein in time- and dose-dependent manners. CGRP activated the ERK pathway. Pretreatment of cultured rat osteoblasts with MEK inhibitor U0126 resulted in dose-dependent inhibitions of CGRP-induced MCP-1 mRNA and protein levels. Thus, CGRP promoted cell proliferation and stimulated MCP-1 expression in cultured rat osteoblasts.

CONCLUSIONThese studies document novel links between CGRP and MCP-1 and illuminate the effects of CGRP in regulating bone remodeling.

Animals ; Blotting, Western ; Butadienes ; pharmacology ; Calcitonin Gene-Related Peptide ; pharmacology ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Chemokine CCL2 ; genetics ; metabolism ; Enzyme Inhibitors ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; Extracellular Signal-Regulated MAP Kinases ; antagonists & inhibitors ; metabolism ; Nitriles ; pharmacology ; Osteoblasts ; drug effects ; metabolism ; Rats