[摘 要] 目的：探讨β-1,6 N-乙酰氨基葡萄糖转移酶2（GCNT2）基因在胃癌（GC）组织中的表达及其在GC发生、发展和诊断及预后中的作用。方法：利用TIMER、GEPIA2、Oncomine和UALCAN等数据库数据，以及2018年1月至2019年12月滨州医学院附属医院手术切除的25例GC患者的癌和配对癌旁组织标本，分析GCNT2基因在GC组织中的表达及其在GC诊断和预后中的价值，利用LinkedOmics、GSEA和ssGSEA分析GCNT2所涉及的主要信号通路及其与免疫浸润之间的相关性。将pc-GCNT2及其阴性对照质粒转染进胃癌SGC-7901和BGC-823细胞，用克隆形成实验和Transwell实验检测GCNT2对GC细胞增殖和侵袭的影响，WB法检测细胞中GCNT2、STAT3和PD-L1蛋白的表达水平。结果：GCNT2 mRNA在GC组织中的表达水平显著低于癌旁组织（P<0.05或P<0.01），其表达水平与患者预后显著相关（P<0.05），其对GC诊断有较高的价值。GCNT2在GC组织中的甲基化状态显著高于癌旁组织，GCNT2基因参与的生物过程主要是参与细胞形态发生的成分、细胞间黏附、多细胞生物信号和突触传递等。单基因GSEA分析发现，GCNT2在GC中主要抑制IL-6/JAK/STAT3、IL-2/STAT5信号通路和炎症反应、α/γ干扰素响应与NF-κB表达等。GCNT2的表达与GC组织的免疫浸润具有显著相关性。过表达GCNT2可显著抑制GC细胞的增殖和侵袭能力（均P<0.01），降低细胞中STAT3和PD-L1的表达水平（均P<0.01）。结论：GCNT2基因在GC组织中低表达，与GC的诊断及预后显著相关，其主要通过抑制IL-6/JAK/STAT3和免疫相关致癌信号通路而在GC的发生、发展中发挥重要的作用。

OBJECTIVE: To study the effectiveness of TightRope elastic fixation combined with functional total repair of the inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury. METHODS: The clinical data of 34 patients with distal tibiofibular syndesmosis injury who met the selection criteria between January 2020 and January 2022 were retrospectively analyzed, and they were divided into improved group (TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament) and control group (distal tibiofibular screw fixation) according to the surgical methods, with 17 cases in each group. There was no significant difference in age, gender, body mass index, fracture type, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, and complications were recorded in the two groups. The American Orthopaedic Foot and Ankle Society (AOFAS) score, ankle metatarsal flexion and dorsal extension range of motion were used to evaluate the ankle function. The patient satisfaction survey was conducted at last follow-up. RESULTS: All 34 patients were followed up 8-20 months, with a median of 13 months. The operation time and intraoperative blood loss in the improved group were significantly longer than that in the control group (P<0.05). In the improved group, no infection or poor reduction occurred, and only 1 patient had TightRope knot reaction at 6 months after operation. In the control group, there were 2 cases of poor reduction, 1 case of lower tibiofibular screw rupture, and 1 case of subcutaneous infection (cured after anti-infection treatment). There was no significant difference in the incidence of complications between the two groups (P>0.05). At last follow-up, the AOFAS score and ankle metatarsal flexion and dorsal extension range of motion of the improved group were significantly better than those of the control group (P<0.05). The satisfaction rates of patients in the improved group and the control group were 94.1% and 82.4%, respectively, showing significant difference (P<0.05). CONCLUSION TightRope elastic fixation combined with functional total repair of inferior tibiofibular ligament in the treatment of distal tibiofibular syndesmosis injury has sufficient fixation strength, and can achieve better effectiveness and joint function compared with traditional screw fixation.
Humans ; Ankle Joint/surgery* ; Blood Loss, Surgical ; Ligaments/surgery* ; Plastic Surgery Procedures ; Retrospective Studies ; Ankle Injuries/surgery*

OBJECTIVE: To compare the effectiveness of supramalleolar osteotomy (SMOT) and ankle arthrodesis (AA) in the treatment of inverted ankle osteoarthritis (OA) in Takakura 3A stage with talus tilt. METHODS: The clinical data of 41 patients with inverted ankle OA in Takakura 3A stage with talus tilt admitted between January 2016 to January 2020 and met the selection criteria were retrospectively analyzed, and they were divided into SMOT group (21 cases) and AA group (20 cases) according to the surgical method. There was no significant difference in baseline data such as gender, age, affected side, cause of injury, and preoperative talar tilt angle (TT), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, short-form 36 health survey scale (SF-36) score, and sagittal range of motion (ROM) between the two groups ( P>0.05). The operation time, intraoperative blood loss, partial weight-bearing time, and complications were recorded in the two groups. AOFAS ankle-hindfoot score, VAS score, SF-36 score, and sagittal ROM were used to evaluate the effectiveness. Bone healing was observed and the time of bony healing was recorded. In the SMOT group, the tibial lateral surface angle (TLS), TT, and the tibial articular surface angle (TAS) were measured on ankle joint weight-bearing anteroposterior and lateral X-ray films and compared with those before operation. And Takakura staging assessment was also performed. RESULTS: The operation time and intraoperative blood loss in AA group were significantly less than those in SMOT group ( P<0.05). Patients in both groups were followed up 24-36 months, with an average of 28.9 months. Incision infection occurred in 2 patients in SMOT group and 1 patient in AA group, respectively, and no vascular or nerve injury occurred in both groups. The partial weight-bearing time of SMOT group was significantly less than that of AA group ( P<0.05), but there was no significant difference in bony healing time between the two groups ( P>0.05). At last follow-up, the difference of VAS score and SF-36 score before and after operation of AA group were less than those of SMOT group, and the difference of sagittal ROM before and after operation in SMOT group was less than that of AA group, with significant differences ( P<0.05). The difference of AOFAS ankle-hindfoot score before and after operation in AA group was slightly greater than that in SMOT group, but the difference was not significant ( P>0.05). The above scores in both groups significantly improved when compared with those before operation ( P<0.05). Sagittal ROM in AA group was significantly less than that before operation ( P<0.05), while there was no significant difference in SMOT group ( P>0.05). In the SMOT group, 17 patients (81.0%) showed improvement in imaging staging, 2 patients (9.5%) showed no improvement in staging, and 2 patients (9.5%) showed stage aggravation. TLS, TAS, and TT significantly improved when compared with those before operation ( P<0.05). At last follow-up, 2 patients in SMOT group received AA due to pain and stage aggravation, and 1 patient with bone nonunion underwent bone graft. Subtalar joint fusion was performed in 1 case of subtalar arthritis in AA group. CONCLUSION For inverted ankle OA in Takakura 3A stage with talus tilt, both SMOT and AA can significantly releave pain, improve foot function and quality of life, but AA has more definite effectiveness and better patient satisfaction.
Humans ; Ankle ; Talus/surgery* ; Retrospective Studies ; Blood Loss, Surgical ; Quality of Life ; Ankle Joint/surgery* ; Osteoarthritis/surgery* ; Osteotomy/methods* ; Arthrodesis ; Pain ; Treatment Outcome

Objective: To explore the preoperative whole perforator evaluation and intraoperative eccentric design of anterolateral thigh flap (ALTF) based on superficial fascial perforators by modified computed tomography angiography (CTA), and the clinical effects were observed. Methods: A prospective observational study was adopted. Twelve patients with oral and maxillofacial tumors and 10 patients with open injury of the upper limb with large soft tissue defects were hospitalized in the Department of Hand & Microsurgery and Department of Oral & Maxillofacial Surgery of Affiliated Hospital of Binzhou Medical University from January 2021 to July 2022, with 12 males and 10 females, aged from 33 to 75 years, an average age of 56.6 years. The wounds of the patients with oral and maxillofacial tumors were reconstructed by ALTF after the extensive tumor resection and radical cervical lymph node dissection in the same stage; the wounds of the patients with skin and soft tissue defect on the upper limb were covered by ALTF in stage Ⅱ after debridement in stage Ⅰ. After debridement, the area of wound was 3.5 cm×3.5 cm-25.0 cm×10.0 cm and the area of the required flap area was 4.0 cm×4.0 cm-23.0 cm×13.0 cm. Modified CTA scan was performed on the donor site of ALTF before the operation, with the parameters of modified CTA being set to mainly reduce the tube voltage and tube current, and increase the contrast dose and the dual phase scan. The acquired image data were sent to GE AW 4.7 workstation and adopted the volume reconstruction function for visual reconstruction and evaluation of the whole perforator. The information of perforator and source artery was marked on the body surface before operation according to the above evaluation. During the operation, an eccentric flap centered on the visible superficial fascia whole perforator was designed and cut according to the desired flap area and shape. The donor sites of the flap were repaired by direct sutures or full-thickness skin grafts. The total radiation dose was compared between the modified CTA scan and the traditional CTA scan. The distribution of outlet point of perforator of double thighs, the length and direction of superficial fascia perforators based modified CTA were recorded. The type, number, and origin of the target perforator, distribution of of outlet point of perforator, and the diameter, course, and branch of the source artery observed before the operation were compared with those observed during the operation. The healing of donor site wound and the survival of flaps in recipient site were observed after operation. The texture and appearance of flap, oral and upper limb functions, and the functions of femoral donor sites were followed up. Results: The total radiation dose of modified CTA scan was lower than that of the traditional CTA scan. A total of 48 perforators of double thighs were observed, among which, 31 (64.6%) perforators went outward and downward, 9 (18.8%) perforators went inward and downward, 6 (12.5%) perforators went outward and upward, and 2 (4.2%) perforators went inward and upward, and the average length of superficial fascia perforators was 19.94 mm. The preoperative observed type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery were basically consistent with the intraoperative exploration. The types of 15 septocutaneous (including musculoseptocutaneous) perforators and 10 musculocutaneous perforators observed before the operation was consistent with intraoperative exploration. The distance between the mark of the surface perforator point and the actual exit point of the perforator during operation was (0.38±0.11) mm. All flaps survived without vascular crisis. The donor site wounds of 5 cases of skin grafting and 17 cases of direct suturing wounds healed well. The postoperative follow-up was 2 months to 1 year, with an average of 8.2 months, the flaps were soft and slightly bloated; the function of diet and mouth closing was accessible in patients with oral and maxillofacial tumors, the speech function was mildly impaired in patients with tongue cancer, but they could complete basic oral communication; the wrist and elbow joints and forearm rotation function were not significantly limited in patients with upper limb soft tissue injuries; there was no obvious tightness in the donor sites, and the function of the hip and knee joints was not limited. Conclusions: The whole perforator and even the subcutaneous perforator of the donor site of ALTF can be evaluated by modified CTA, and the flap can be used in oral or maxillofacial reconstruction and repair of skin and soft tissue defects of upper limbs to achieve good results. By clarifying the type, number, and source of the perforator, the distribution of the outlet point of the perforator, diameter, course, and branches of the source artery before the operation, the eccentric design of the ALTF based on the superficial fascia perforator was realized. This study has strong guiding value.
Female ; Male ; Humans ; Middle Aged ; Adult ; Aged ; Thigh ; Computed Tomography Angiography ; Prospective Studies ; Subcutaneous Tissue ; Tomography, X-Ray Computed

PURPOSE: Few cells with stem cell characteristics possess capabilities of self-renewal and differentiation, which leads to high tumorigenesis and resistance to standard chemotherapeutic agents. These cells are mostly quiescent, and arrest occurs at the mitotic G0/G1 phase in mitosis. We explored the effects of basic fibroblast growth factor (bFGF) on the MCF-7 cell cycle with CD44+/CD24-. METHODS: Cancer-initiating cells were propagated as mammospheres. The CD44+/CD24- subpopulation was sorted by a fluorescence activating cell sorter-Vantage flow cytometer. A cell cycle analysis was performed with different bFGF concentrations. RESULTS: Differences in the CD44+/CD24- cell proliferation under different bFGF concentrations were observed (p=0.001). When the bFGF concentration was increased, the proportion of CD44+/CD24- at G0/G1 decreased (p=0.023). CONCLUSION: We conclude that bFGF may sustain CD44+/CD24- cell proliferation and could promote cell progression through the G0/G1-->G2/S phase transition.
Breast Neoplasms ; Cell Cycle ; Cell Proliferation ; Cell Transformation, Neoplastic ; Fibroblast Growth Factor 2 ; Fibroblast Growth Factors ; Fluorescence ; MCF-7 Cells ; Mitosis ; Phase Transition ; Stem Cells

Objective To explore the role and mechanism of stabilizing microtubules of endothelial cells and pericytes for ameliorating the dysfunction of microvasculature after spinal cord injury(SCI). Methods The endothelial cells and pericytes from rat brain microvascular tissue (microvessel) were separated and subjected to glucose oxygen deprivation (OGD). The cell viability was detected by CCK-8 and the expression of α-tubulin was detected by immunofluorescence and Western blotting. Rats (n = 36) were subjected to dorsal spinal cord transection at T

Pediatric neurogenic bladder (PNB) is defined as dysfunction of the detrusor and/or urethral sphincter due to myelodysplasia or spinal cord injury, manifesting as impaired urination or defecation, which seriously affects the patients’ quality of life. The main indication for sacral neuromodulation (SNM) is overactive bladder syndrome, which presents as refractory urinary frequency and urgency, urgency incontinence and non-obstructive urinary retention. Age more than 16 years are also recommended for this technique. Previous studies have revealed that SNM could significantly improve the outcome of refractory bladder bowel dysfunction. This paper reviews the advances of the application of SNM in the treatment of pediatric neurogenic bladder so as to provide reference for pediatricians.

OBJECTIVETo discuss the diagnosis and treatment of condylar resorption of unknown reason.

METHODSThe clinical data including the records of history, physical examination, radiography and laboratory of ten patients were studied. Ten patients consisted of 8 females and 2 males (mean age 24.1 years, range 19-31 years) had common clinical features including anterior open bite, posterior occlusal prematurities and Class II malocclusion. Images demonstrated a small and short condyle with abnormal shape, usually accompanied by the developmental insufficiency of the ramus and condyle. The condylar, even the ramus, showed the black marrow signal on MRI images. Four patients were treated by condylar reconstruction with costochondral graft after condylectomy under the supervision of endoscope. Two patients were treated by reduction and repair of disk. Four patients didn't accept any treatment.

RESULTSFour patients treated by condylar reconstruction with costochondral graft showed structures with the size and shape morphologically similar to normal joint and achieved a stable occlusion after follow-up of 6-18 months. Two patients treated by reduction and repair of disk didn't show significant change of open bite and remodeling of condyle after follow-up of 4-6 months.

CONCLUSIONThe diagnosis of condylar resorption of unknown reason can be achieved based on the physical examination and radiographical images. The condylar reconstruction with costochondral graft after condylectomy is feasible.

Adolescent ; Adult ; Dental Occlusion ; Female ; Humans ; Male ; Mandibular Condyle ; Retrospective Studies ; Treatment Outcome

Several studies have demonstrated the role of 4-1BBL in T cell activation. Furthermore, enhanced 4-1BB/4-1BBL interaction has been shown to amplify T-cell-mediated antitumor immunity in several mouse models. However, when applied in humans, it was difficult to generate sufficient T cells ex vivo and whole cell vaccines to transfer back into patients. To overcome this difficulty, we have focused on producing the human 4-1BBL extracellular domain/anti-CD20 Fab' fusion protein. In this report, PCR and overlap PCR were used to construct the human 4-1BBL extracellular domain/anti-CD20 Fab' expression vector. DNA sequence was analyzed by the Terminus of Dideoxy Nucleotide. The product was purified by affinity chromatography and analyzed by SDS-PAGE and HPLC; its antigen binding activity was examined by rosetting assay. The data of DNA sequence showed that the human 4-1BBL extracellular domain/anti-CD20 Fab' fusion protein was corrected. The fusion protein was recovered in high yield (up to 200 microg/mL) after E-taq purification. The fusion protein was capable of simultaneous binding to stimulated Jurkat cells and Raji cells as shown by cellular rosetting. In conclusion, the human 4-1BBL extracellular domain/anti-CD20 Fab' fusion protein was induced to express in E. coli 16C9. The results of some biological activity experiments indicated that the fusion protein could bind to stimulated Jurkat cells and Raji cells. Furthermore, 4-1BBL-negative tumors can be converted into 4-1BBL-positive tumors by the fusion protein without the need for 4-1BBL gene transfer to the malignant cells.
4-1BB Ligand ; biosynthesis ; genetics ; Antibodies, Bispecific ; immunology ; Antigens, CD20 ; immunology ; Humans ; Immunoglobulin Fab Fragments ; biosynthesis ; genetics ; Immunotherapy ; methods ; Lymphoma, Non-Hodgkin ; therapy ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; immunology

OBJECTIVETo investigate the influence of the prostaglandin E2 on the proliferation of the melanocytes in the full-thickness skin graft.

METHODSSixty-eight guinea-pigs were divided into experimental-1 group (skin graft), experimental-2 group (skin graft + diclofenac), and control groups. After the full-thickness skin graft, the dynamic changes of the prostaglandin E2 were measured and the proliferation of the melanocyte with its density was also evaluated by using histochemical and autoradiographic methods.

RESULTSIn the experimental-1 group, the content of PGE2 was increasing in seven days after the operation, continued to the one month, and then returned to the base level. The labelling indices of 3H-MC-TdR of the group was also increasing postoperatively between the second day and the fourteenth day, and reach a second peak after one month, then came to the normal level. The density of the melanocytes was decreasing rapidly 3 days after the surgery, then began to increase and exceeded over the normal level 21 days after the operation. However, in the experimental-2 group, the content of PGE2 decreased in two days after the surgery, and then showed the inclination similar to the experimental-1 group with the different points in narrower range. The number of melanocytes labelled by 3H-TdR began to increase at the first day after the surgery, which appeared earlier than the experimental-1 group and was similar in the changing tendency with a less extent. The density of MC showed the similar tendency to the experimental-1 group in a narrower changing range with both of increasing and decreasing. The density of the MC was much lower in 21 after the operation than the experimental-1 group and normal control group.

CONCLUSIONThe increased PGE2 in the earlier stage of the skin grafting could enhance the inflammatory reaction to the tissue, as well as the melanocytes. It may stimulate the proliferation of the MC with the result of increasing their density. The use of the diclofenac might reduce the inflammation and suppress the proliferation of melanocytes, and result in the skin with light color due to decreasing the number of MC in the epidermis of the graft.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Cell Count ; Cell Proliferation ; Diclofenac ; pharmacology ; Dinoprostone ; metabolism ; Epidermis ; Guinea Pigs ; Melanocytes ; cytology ; Skin ; Skin Transplantation ; Time Factors