BACKGROUND:5-Fluorouracil is a common chemotherapy drug for gastric cancer, but it is more likely to develop drug resistance in clinical treatment. Studies have shown that tumor stem cels are lowly sensitive to chemotherapeutic drugs, which may be an important cause of chemotherapy resistance. OBJECTIVE:To analyze the sensitivity of gastric cancer stem cels to 5-fluorouracil in vitro, and to understand the mechanism of drug resistance associated with gastric cancer. METHODS:Based on the sorting strategy, human gastric cancer cel clones were isolated from AGS cel lines. CD44 and thymidylate synthetase expression in different clones was detected using immunocytochemistry analysis. Clone formation assay was used to evaluate self-renewal capacity of different clones. Cel counting kit-8 was used to determine the clonal growth inhibition rate of AGS under treatment with different concentrations of 5-fluorouracil. RESULTS AND CONCLUSION:The AGS cels that were inoculated with low density and cultured could differentiate into 32 forms, including the ful clone (16%, 5/32), the second clone (66%, 21/32) and the accessory clone (19%, 6/32). Among them, the ful clones highly expressed CD44 and thymidylate synthetase, and could generate a great amount of passage 2 clones after inoculation; the second clones showed a weak expression of CD44 and thymidylate synthetase, and could generate a smal number of passage 2 clones after inoculation; the accessory clones showed a weak or no expression of CD44 and thymidylate synthetase, and there was no passage 2 clone after inoculation. Under the effect of different concentrations of 5-fluorouracil, the growth inhibition rates of the secondary clones and AGS cels were both higher than that of the ful clones (bothP < 0.05). These findings indicate that gastric cancer stem cels have a relatively lower sensitivity to 5-fluorouracilin vitro, which is speculated to be an important mechanism of drug resistance.

[Objective]To compare the clinical results,advantages and disadvantages of the mono-segment lateral lumbar disc herniated patients with the treatment of micro-endoscopic discectomy(MED) and fenestration discectomy(FD).[Methods]Sixty-nine cases operated with mono-segment discectomy were analyzed from July 2003 to July 2005,among them,32 cases operated with microendoscopic discectomy and 37 cases operated with fenestration discectomy.The operating time,blood loss,time stay-in-bed,duration of hospitalization after operation were compared.[Results]The rate of excellent and good outcomes was 93.7% in MED group,and 91.9% in FD group.No significant difference was found between them,and the same with the postoperative sciatica relief significant differences ould be observed in the operation time,blood loss,duration of hospitalization after operation and postoperative visual analog scales.[Conclusion]The symptoms of the lumbar disc herniation can be reliefed effectively by both methods,but micro-endoscopic discectomy has more advantages of less trauma,less blood loss,earlier rehabilitation,less postoperative low back pain.

Objective To analyze the reasons and therapeutic effects for revision of spinal fractures.Method Ninteen patients with revised internal fixation on spinal fractures were reviewed in average of 3.5 years follow-up. Neurological function, pain and daily life quality of patients with revision surgery were evaluated by questionnaire.ResultIncomplete spinal canal decompression as well as improper application of instrumentation were the main reasons of failed internal fixation for spinal fractures.All patients with incomplete spinal cord injury had improvement on neurological function to some extent after re-operation, and 17 of 19 patients (89%) indicated improved daily life quality. However, revision surgery failed to have motor recovery in patients with complete spinal cord injury.ConclusionCorrect surgical technique and selection of internal fixation are very important in the treatment of spinal cord injury.

Objective To explore the effects of upper limb robot-assisted therapy on motor recovery in acute stroke patients. Methods From August, 2013 to September, 2014, 46 acute stroke patients at their first-ever stroke were enrolled and randomized into experimental group and control group with 23 cases in each group. Both groups received routine therapy. Additional robot-assisted therapy was provided to the experimental group, and additional repetitive movement training was provided to the control group, 30 minutes a day, 5 days a week for 12 weeks. Fugl-Meyer Assessment-Upper Limb (FM-UL), modified Ashworth Scale (MAS) and modified Barthel index (MBI) were used to assess the motor function of the upper limbs and hands, the muscular tension of elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FM-UA, MAS and MBI improved in both groups (t>3.856, Z>1.889, P<0.05), and the scores of FM-UA and MAS were better in the experiment group than in the control group (t=-2.386, Z=-2.625, P<0.05), however, there was no significant difference in the score of MBI between two groups (t=-1.326, P=0.098). Conclusion Upper limb robot-assisted therapy can facilitate the recovery of the motor function of upper limbs in acute stroke patient.

Objective To compare the clinical effects of vacuum sealing drainage and traditional method on subcutaneous effusion after spinal operation .Methods From June 2009 to June 2011 ,52 cases were randomly divided into 2 groups:group A(treat with vacuum sealing drainage) and group B(treat with traditional method ) .Comparing the cure rate ,wound healing time ,infection rete and satisfaction rate between two groups .Results All cured cases were followed up for 3 months ,all wounds achieved primary healing postoperatively ,and without recurrence .The cure rate was 92 .31% (24/26)in group A ,there was statistically significant difference compared with group B[69 .23% (18/26)](χ2 =4 .457 ,P<0 .05) .The wound healing time was(12 .13 ± 1 .39) d in group A ,and(17 .72 ± 1 .78) d in group B ,which showed statistically significant difference between two groups (t=11 .455 ,P<0 .05) . The satisfaction rate was 84 .62% (22/26)in group A ,and 61 .54% (15/26)in group B ,which showed statistically significant differ-ence between two groups(χ2 =4 .457 ,P<0 .05) .Conclusion The clinical effects of vacuum sealing drainage on subcutaneous effu-sion after spinal operation was obviously superior to traditional method ,and vacuum sealing drainage has advantages such as less pain ,more satisfaction in patients and less workload in medical staff .

0.05).A total of 121 patients were involved in present study.Ninety days after treatment the BI scores of group Ⅰ,Ⅱ and Ⅲ were 63.7?12.7,62.3?13.5 and 42.6?13.1,respectively,and the significant differences existed between group I and group Ⅲ(P0.05).Compared with the baseline data,the fibrinogen of group Ⅰ and Ⅱ decreased at day 3,5 and 7(P

Objective:To find a feasible method to stimulate tumor-draining lymph node(TDLN) cells in clinic.Methods:CTL activity of TDLN cells induced by different stimulus (IL-2 group, IL-2+autologous tumor antigen group, IL-2+GM-CSF+IL-4+autologous tumor antigen group) was measured by the method of maximal LDH enzyme release. The mechanisms were explored by observation in morphology and detection of the CD83 positive rate of TDLN cells.Results:The level of growth of TDLN cells induced by (IL-2+GM-CSF+IL-4+autologous tumor antigen) was significantly higher than TDLN cells induced by IL-2 and (IL-2+autologous tumor antigen)(P

Objective To provide an anatomical basis for treatment of coronoid process fractures through an anteromedial elbow approach and evaluate its clinical effects.Methods Forty cadaveric specimens of adult upper limb were dissected to evaluate the anatomical relationships between the median nerve branches and the nearby muscles in the field of the anteromedial elbow approach.On the basis of the anatomical study,10 patients with coronoid fracture were treated from June 2014 to June 2015.They were 7 males and 3 females,from 17 to 63 years of age (average,43 years).By the O'Driscoll classification,there were 2 cases of type Ⅰ1,3 ones of type Ⅰ2,one of type Ⅱ1,3 ones of type Ⅱ2 and one of type Ⅲ2.The anteromedial elbow approach through the intramuscular space between the pronator teres and the flexor carpi radialis was used to reduce and fixate the fractures of unlar coronoid process and to explore and repair the medial collateral ligaments in all the patients.The ranges of extension,flexion and rotation of the elbow joint were measured at the last follow-ups;the function of the elbow was evaluated according to Mayo elbow performance scores (MEPS).Results The main branch of the median nerve ran between the lateral and the medial epicondyles of the humerus,27.34 mm away to the medial epicondyle of the humerus.The mean distance between the first pronator teres nerve branch and the coronoid process was 13.19 mm.The mean distance between the flexor carpi radialis nerve branch and the coronoid process was 47.02 mm.The mean distance from the medial epicondyle to the flexor carpi radialis nerve branch was 64.40 mm.All the patientswere followed up for an average of 12 months (from 6 to 18 months).Fractures united after an average of 1.8 months (from 1.5 to 2.0 months).Deformity,instability,pain or limited motion of the elbow joint was not observed during the follow-ups.At the last follow-ups,the mean flexion-extension arc of the elbow was 133.0° (from 120° to 140°),the mean rotation was 144.5° (from 130° to 160°),and the mean MEPS was 98 points (from 95 to 100 points).Conclusions The anteromedial approach through the intramuscular space between the pronator teres and the flexor carpi radiafis is a reliable and safe access for coronoid process fractures,because it leads to less injury to the median nerve than the anterior approach,and exposes the coronoid more favorably than the medial approach to facilitate reduction and fixation of the fracture fragments.

OBJECTIVETo investigate clinical effects of arthroscopy in the treatment of medial meniscal cyst.

METHODSFrom June 2011 to January 2013, 7 patients with medial meniscal cyst were treated with arthroscopy. There were 3 males and 4 females,ranging in age from 27 to 63 years old,with a mean age of (43.93±2.10) years old. The cysts have been discovered for 3 to 30 months,with a mean time of (10.6±1.3) months. All the patients complained of knee pain,especially in the medial joint gap. The Pisani sign, Caklin sign and medial McMurray sign were all positive. Preoperative MRI examination confirmed the diagnosis. Lysholm score changes and clinical efficacy were observed through a six-month follow-up.

RESULTSThe postoperative Lysholm scores were all significantly higher than the preoperative scores. According to Sarimo standard, 6 patients got an excellent result, and 1 good.

CONCLUSIONArthroscopic treatment of medial meniscal cyst has replaced the traditional method, which could retain the normal meniscus as much as possible and repair the meniscus injury simultaneously, as well as get a good curative effect and a good recovery of knee function. This method is worthy of clinical application.

Adult ; Arthroscopy ; methods ; Cysts ; physiopathology ; surgery ; Female ; Humans ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged

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