Objectives To study the effect of preoperative platelet transfusion for splenectomy and devascularization in the prevention of intraoperative and postoperative bleeding.Methods The 230 patients with cirrhosis and portal hypertension who received splenectomy and periesophagogastric davascularization were divided into strata A,B and C according to the platelet counts.Stratum A patients had a platelet count of less than 30× 10/L,B between 30× 10/L and 50× 109/L,and C more than 50 × 109/L.The patients in each stratum were then randomly divided into a preoperative transfusion group (T group) and a non-transfusion group (NT group).The amounts of intraoperative bleeding,postoperative drainage in 48 hours after operation,rates of postoperative bleeding,and general medical conditions were compared.Results A comparison in stratum A showed lower amounts of intraoperative bleeding and 48 hour postoperative drainage,and a lower rate of bleeding in the T group (P＜0.05).There were no significant differences between the T and the NT groups in strata B and C (P＞0.05).Conclusions For patients with a platelet count lower than 30 × 109/L,preoperative platelet transfusion significantly reduced bleeding suggesting that preoperative platelet transfusion for splenectomy and periesophagogastric devascularization should be a routine.For those patients whose platelet count was above 30 × 109/L,platelet transfusion is not recommended.

Objective:To investigate the relationship between cervical lesion development and histone acetylation that regulates RAR-β2 expression. Methods:Immunohistochemistry and Western blot analysis were performed to detect AcH3, RAR-β2, and involu-crin expression in normal cervical tissues as well as in tissues with cervical intraepithelial neoplasia (CIN)Ⅱ-Ⅲand squamous cell cer-vical carcinoma. The relationship among histone acetylation level, RAR-β2 expression, and cervical lesion severity were analyzed. Re-sults:AcH3, RAR-β2, and involucrin expression were reduced or absent with the progression of cervical lesions;significant differences were noted between the groups (P<0.05). Histone acetylation level and RAR-β2 expression were positively correlated (r=0.797, P<0.05). AcH3 and RAR-β2 expression, which were both associated with the cervical lesions, were negatively correlated [r=-0.547(AcH3), r=-0.585(RAR-β2), P<0.05]. Conclusion:Histone acetylation modification is associated with the regulation of RAR-β2 expression. This pro-cess is also likely to participate in the carcinogenesis of cervical carcinoma.

OBJECTIVETo analyze the neglected hidden blood loss before and after operations in the elderly patients with intertrochanteric fractures and strengthen the treatment and clinical nursing in the perioperative period in order to ensure clinical effects.

METHODSThe clinical data of 99 patients with intertrochanteric fracture treated with intramedullary nailing from January 2010 to January 2014 were retrospectively analyzed (47 males and 52 females). Forty-seven cases got blood transfusion supporting and 52 cases were not (blood transfusion group and no-blood transfusion group respectively). According to the Gross equation, the average hemoglobin (Hb) and hematocrit (HCT) were used to analyze blood loss in perioperative period and assess the patients' hidden blood loss situation.

RESULTSThere were 22 males and 30 females in blood transfusion group. The average operative time was (62.13±4.01) min; intraoperative visible blood loss and postoperative drainage were 215 ml, totally; preoperative Hb was (103.22±9.01) g/L and postoperative was (81.13±6.20) g/L; preoperative HCT was (96.93±3.38) I/L and postoperative was (308.00±11.81) I/L. There were 25 males and 22 females in no-blood transfusion group. The average operative time was (60.12±3.27) min; intraoperative visible blood loss and postoperative drainage were 196 ml, totally; the average blood transfusion were 621 ml; preoperative Hb was (92.15±5.46) g/L and preoperative was (95.20±8.93) g/L; preoperative HCT was (96.52±3.63) I/L and preoperative was (392.70±14.03) I/L. According to the Gross equation, the blood loss of no-blood transfusion group and blood transfusion group in peroperative period were (937.29±63.04) ml and (706.43±35.02) ml, respectively. The hidden blood loss was dominant. At 1, 3 months after operation, Harris score of blood transfusion group was better than that of no-blood transfusion group, and 12 months after operation, there was no significant difference between two groups.

CONCLUSIONThe hidden blood loss of intramedullary nailing for intertrochanteric fracture should be emphasized in perioperative period, it can avoid the perioperative complications caused by anemia and affect the prognosis of patients.

Aged ; Blood Loss, Surgical ; Blood Transfusion ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Perioperative Period ; Retrospective Studies

OBJECTIVETo evaluate the technique and therapeutic effect of sternoclavicular hook plate fixation in treating sternoclavicular joint (SCJ) dislocation.

METHODSFrom January 2010 to March 2014,6 patients with SCJ dislocation were treated with sternoclavicular hook plate fixation in our hospital. Among the 6 patients, 5 patients were male and 1 patient was female, and the average age was 34 years, ranging from 26 to 48 years. The course of the disease ranged from 3 to 20 days. All the SCJ dislocations were caused by external injury and accompanied with the symptoms of swelling pain and obvious shoulder joint activity restricted in affected side. All SCJ dislocations were anterior dislocation by the diagnosis of X-ray and CT scan. The postoperative curative effect was evaluated according to Rockwood score.

RESULTSAll the patients' operative incision were healed well and in good appearance. X-ray showed that the dislocated SCJ was well reduced and the plate was on right position. All the 6 patients were followed up for 4 to 18 months, with an average of 12 months. The results were evaluated according to Rockwood score, 4 got excellent results, 1 good and 1 fair. No fixation loosening, redislocation or side injury such as vessel, nerve or pleura injury were found.

CONCLUSIONWith sternoclavicular hook plate fixation, SCJ dislocation could be reduced while keeping its amphiarthrodial function and the completeness of the cartilage surface. Sternoclavicular hook plate fixation has advantages of safety and stabilization in fixation, and patients can begin function exercises earlier.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Sternoclavicular Joint ; injuries ; surgery

Objective To explore the feasibility of echo planar imaging with short time inversion recovery(STIR-EPI)diffusion weighted imaging with background signal(DWIBS)suppression in breast cancer.Methods The diffusion weighted imaging(DWI)with background suppression(b=800 mm2/s)was performed in 26 patients with breast cancer.Apparent diffusion coefficient(ADC)of all lesions,vere measured and compared.3D maximum intensity projection(3D-MIP)and reverse black and white technique were used to show the lesions.DWI and DWIBS were performed and compared for the detection of breast cancer. Randomized blocks analysis of variance was used for the ADC values in different breast tissues.the ADC values in breast cancer and benign lesion were compared using t test.The paired chi square tes:was used for the detection rate of breast cancer in two different imaging methods.Results Most of the breast cancers were hyperintense on DWI(b:800 mm2/s).,rhe ADC value of caneer tissue was(0.93±0.25)×10-3mm2/s,tumor necrosis was(2.06±0.17)×10-3 mm2/s,normal breast tissue was (1.92±0.23)×10-3 mm2/s and metastatic lymph node was(1.10±0.14)× 10-3mm2/s and the differenees were statistically significant between two structures(P＜0.01).The signal of the tissue8 around the breast cancer was decreased on DWIBS with 3 D-MIP and reverse black and white technique and similar to positron emission tomography(PET).DWIBS sequence detected more breast cancers(92.3/)and metastatic lymph nodes(88.4/)than DWI sequence did(57.6/and 42.3/,respectively,X2:8.307,P＜0.05;X2=12.235,P＜0.05).The ADC values in breast cancer(1.09±0.17)×10-3mm2/s and benign lesion (2.15±0.53)×10-3 mm2/s had significant statistical differences(t=8.626,P＜0.05).conclusion Diffusion weighted MRI with background suppression can detect more lesions than DWI and can be potentially applied for the detection of the breast cancer eombining the ADC value.

OBJECTIVETo investigate apoptosis-inducing effect and its mechanisms of HY-1, a carbazole alkaloid, on human erythroleukemia K562 cells.

METHODSCell proliferation was detected by sulforhodamine B (SRB) assay after treated with HY-1 at indicated doses. Cell cycle analysis was performed by flow cytometry, mitochondria membrane voltage change was assessed by rhodamine 123 staining, annexin V-PI apoptosis detecting kit and DNA agarose gel electrophoresis were used to identify apoptosis-inducing effect of HY-1. The alterations of apoptosis-relating proteins were detected by Western blot.

RESULTSThe IC(50) of HY-1 in K562 cells was (29.05 +/- 0.90) micromol/L by SRB assay. HY-1 had significant apoptotic inducing effect on K562 cells in a dose- and time-dependent manner as verified by appearance of Sub-G(1) peak on histogram of flow cytometry analysis, reduction of mitochondria membrane voltage, appearance of double positive cell group in Annexin V-PI apoptosis detecting test, and remarkable DNA ladder. The expression of cytosolic cytochrome c was apparently increased. Pro-caspase-9, pro-caspase-3 and PARP were all cleaved to active segments. There was no change in the expression of caspase-8.

CONCLUSIONHY-1 exerts its anticancer activity through triggering apoptosis of K562 cells by mitochondria-activating pathways.

Alkaloids ; isolation & purification ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Carbazoles ; isolation & purification ; pharmacology ; Humans ; K562 Cells ; Mitochondria ; metabolism ; Rutaceae ; chemistry

BACKGROUND:Intervertebral disc degeneration is one of the ancient and common clinical diseases. Its complex pathogenesis affected by various factors, such as environment and genes, is stil in debate. Because of the technical limitations, there is stil no deep understanding on the molecular mechanism of intervertebral disc degeneration. However, its molecular mechanism in recent years has made considerable development. OBJECTIVE: To summarize and discuss the molecular mechanism of intervertebral disc degeneration, thereby providing the basis for the effective treatment. METHODS: CNKI and Medline databases were retrieved by the first author using computer to search relevant articles published from 2005 to 2015. The key words were “intervertebral disc degeneration, molecular mechanism, environmental factors, genes, matrix, degradation enzyme,inflammatory factor, biological environment, treatment” in Chinese and English, respectively. Mechanisms of intervertebral disc degeneration, involving genes, cel senescence and apoptosis, degradation enzyme and substrate, inflammatory cytokines, were summarized to explore the pathogenesis and possible effective treatment of intervertebral disc degeneration. RESULTS AND CONCLUSION:Totaly 153 articles were initialy retrieved and finaly 52 articles were included in result analysis according to inclusive and exclusive criteria. Unique structure and biochemical properties of the intervertebral disc are easy to cause intervertebral disc degeneration. Traditionaly, environmental factors, such as occupation and smoking, are considered as the main factors inducing intervertebral disc degeneration; however, more and more studies have shown that genes have the most important influence on intervertebral disc degeneration. Declined extracelular matrix, increased degradation enzymes, and overexpression of inflammatory factors can al destroy the entire structure of intervertebral disc, and accelerate the process of intervertebral disc degeneration. Effective treatment for intervertebral disc degeneration can be formulated depending on the deep understanding on its molecular mechanisms. Although there is a further understanding on the molecular medium of intervertebral disc degeneration, the complex biochemical environment within the intervertebral disc is stil a great chalenge to the treatment of intervertebral disc degeneration.

BACKGROUND: Cervical intervertebral foramen stenosis induced by cervical spondylosis of nerve root type usual y requires surgical treatment. The ways mainly include anterior cervical discectomy and fusion and cervical posterior intervertebral foramen decompression. Which is the best way is stil inconclusive. With innovation, anterior cervical discectomy and fusion for cervical spondylosis of nerve root type has become the mainstream in the current treatment. OBJECTIVE: To study the relationship between curative effects and intervertebral foramen-associated parameter changes in patients with cervical spondylosis of nerve root type after anterior cervical discectomy and fusion. METHODS: From March 2011 to April 2013, 132 patients with cervical spondylosis of nerve root type were treated with anterior cervical discectomy and fusion in the Changzheng Hospital Affiliated to the Second Military Medical University. Neck pain and arm pain visual analogue score, neck disability index score and imaging changes were evaluated before and after treatment. RESULTS AND CONCLUSION: 132 patients were fol owed up for 25(4-28) months. Significant differences in neck pain visual analogue scale, anterior intervertebral disc height, posterior intervertebral disc height, intervertebral foramen height, anterior and posterior diameters of the intervertebral foramen, the area of the intervertebral foramen, and the Cobb angle of the fused segment were detected in al patients before and after treatment (P < 0.05). Posterior intervertebral disc height was positively correlated with intervertebral foramen area (r=0.427, P=0.000). The increased Cobb angle of the fused segment was negatively associated with the size of intervertebral foramen (r=-0.273, P=0.003). Intervertebral foramen area was negatively associated with arm pain visual analogue score (r=-0.502, P=0.000). These results indicated that anterior cervical discectomy and fusion with an interbody fusion cage can obviously enlarge intervertebral foramen in patients with cervical spondylosis of nerve root type, and obtain good curative effect. The size of the intervertebral foramen is negatively related to the axial pain. The reconstruction of the intervertebral disc height is necessary to expand the intervertebral foramen. However, the increase of the curvature fusion segments is not helping to expand the intervertebral foramen.

To produce specific monoclonal antibody (McAb) against human thrombomodulin (hTM), the full-length hTM cDNA-expressing plasmid pThr402 was transfected into CHO cells by Lipofectamine 2000 reagent. The hTM-expressing CHO cells, which was confirmed by flow cytometry and Western blot, were obtained by G418 selection. Then the McAb against hTM was prepared with classic hybridoma technique. A cell line of CHO-TM5 with high level of hTM was used to immunize female Balb/c mice 3 times at an interval of 4 weeks. On the third day after the third immunization, mice were sacrificed and spleen cells were harvested to prepare hybridoma cells with SP2/0 cells at the ratio of 10 to 1. Hybridoma cells were then cultured at 96-well plates for screening. Cellular enzyme-linked immunoabsorbent assay (CELISA) was applied twice. The first CELISA was done with polythene ELISA plate with a monolayer of CHO-TM5 cells. The positive clones from the first screen were then selected by reacting with similar screening ELISA plate but with CHO cell monolayer instead. Only clones that were positive for the first screening and negative for the second screening were kept, and called as CHO-TM5(+)CHO(-) hybridoma cells. Balb/c mice were intraperitoneally injected with the selected hybridoma cells. Ascites were collected and monoclonal antibodies were purified using FPLC, and its Ig class, subclass, and titer were then determined respectively. The specificity of the yielded McAb was identified with CELISA, flow cytometry, ABC immunohistochemistry and immunoblotting. One line of hybridoma cells with high expression of specific McAb against hTM, NH-1, was obtained. The Ig subclass of the McAb was IgG1 and the titer of ascitic McAb was 1x10(-6). Flow cytometry, CELISA and Western blot assays demonstrated that McAb NH-1 could specifically recognize hTM expressed in CHO-TM5 cells and human umbilical vascular endothelial cells. Meanwhile, the tissue specificity of antigen recognized by McAb NH-1 was identified by immunohistochemical ABC staining. NH-1 can specifically recognize the natural hTM expressed mainly in vascular endothelial cells, which will potentially be useful for investigation of the functions and clinic values of hTM.
Animals ; Antibodies, Monoclonal ; biosynthesis ; immunology ; Antibody Specificity ; CHO Cells ; Cricetulus ; Female ; Humans ; Hybridomas ; secretion ; Mice ; Mice, Inbred BALB C ; Thrombomodulin ; immunology ; Transfection

AIMTo study the pharmacokinetics of genistein in Beagle dogs.

METHODSGenistein, suspended in 0.5% CMC-Na solution, was orally administered to Beagle dogs at the dose of 5.34 mg.kg-1. At various time intervals, 1.5 mL of blood was drawn from the vein of dogs in their front legs. At the same time, urine and feces were collected. After the collection, the feces were homogenized with physiological saline (to 1 g feces, 10 mL physiological saline were added). The genistein in plasma, urine and homogenized feces was extracted twice by vortexing with 2.0 mL mixture of methyl tert-butyl ether and pentane (8:2). The organic phase was transferred into tubes and evaporated in ventilation cabinet. The residue was dissolved in 50 microL of methanol and 20 microL of the solution was drawn and detected by high-performance liquid chromatography. The pharmacokinetic parameter was calculated by 3P97 software.

RESULTSThe plasma concentration-time curve was fitted to a one-open-compartment model. The peak time was 0.29 h, and the elimination half-life was 0.52 h. After genistein was administered, 10.79% of genistein were excreted from urine and 21.55% from feces within 24 h. It was also found that 13.00% genistein were excreted from urine and 52.46% from feces within 60 h.

CONCLUSIONIt showed that the speed of absorption and elimination of genistein was high in Beagle dog, and genistein was mainly excreted in the form of parent compound in urine and feces.

Animals ; Anticarcinogenic Agents ; blood ; pharmacokinetics ; urine ; Area Under Curve ; Chromatography, High Pressure Liquid ; Dogs ; Feces ; chemistry ; Genistein ; blood ; pharmacokinetics ; urine