Humanized monoclonal antibodies(mAbs) are increasingly widely used in targeted therapy for cancer and some other major diseases.Complementarity-determining region(CDR) grafting makes quantities of humanized mAbs available.Herein,we provide an overview on the strategy and progress of CDR grafting.

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.

Objective To discuss microvessel density (MVD) and expression of vascular endothelial growth factor(VEGF), androgen receptor(AR) in the prostates of men who received re-operation after TURP. Methods Fifty cases were performed re-TURP (re-TURP group) and the remaining 50 cases served as controls. 150 specimens were collected. Sections were stained for CD34 and VEGF, AR by immuno-histo-chemistry(S-P). Statistical analysis of the results was performed using t-test or Pearson Chi-Square test Results The expression of VEGF, AR and MVD were significantly higher in the re-TURP group compared to controls(P<0. 05),but in re-TURP group, difference in VEGF and AR expression as well as MVD were not found to be significantly different between the first and the second TURP(P>0.05). Conclusion Over expression of VEGF and AR as well as high MVD in prostatic tissue might play an important role in the pathological process of BPH after TURP.

OBJECTIVETo evaluate the effect of local application of vascular endothelial growth factor (VEGF) via adenovirus-mediated gene transfer on survival of full thickness flaps selected randomly in rats.

METHODSThirty Sprague-Dawley rats weighing 480-520 g were used in this study. A dorsal flap (8 cm x 2 cm) in full thickness with the pedicle located at the level of the iliac crest was designed. Then the rats received 1,012 pfu replication-deficient recombinant adenovirus carrying VEGF (AdCMV-VEGF group, n=10), 1,012 pfu recombinant beta-galactosidase adenovirus (AdCMV-Gal group, n=10) and 1 ml saline (saline group, n=10), respectively, in the distal two thirds of the proposed flap by means of subdermal injection at 8 different locations. Three days after treatment, the flaps were elevated as originally designed and sutured back in situ. The survival rate of the flaps was evaluated on day 7 after operation.

RESULTSThe survival rate of the flaps in the AdCMV-VEGF group increased significantly as compared with those of the AdCMV-Gal group (P<0.01) and the saline group (P<0.01). Immunohistochemical staining showed that VEGF was expressed in the survival flaps injected with AdCMV-VEGF. Histological analysis showed that more granulation tissues and angiogenesis were observed in the AdCMV-VEGF group than those in the AdCMV-Gal and the saline groups.

CONCLUSIONSLocal application of adenovirus-mediated VEGF165 cDNA may efficiently improve the survival of ischemic skin flaps.

Adenoviridae ; genetics ; Animals ; Endothelial Growth Factors ; genetics ; Genetic Therapy ; Intercellular Signaling Peptides and Proteins ; genetics ; Lymphokines ; genetics ; Male ; Neovascularization, Physiologic ; Rats ; Rats, Sprague-Dawley ; Surgical Flaps ; Transfection ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

OBJECTIVETo investigate the hemodynamic changes of primary hepatocellular carcinoma (HCC) evolved from hepatic cirrhosis using CT perfusion imaging.

METHODSThirty-two patients with primary hepatocellular carcinoma evolved from virus-induced fibrosis or cirrhosis underwent dynamic CT scanning of the target slices for 60 min. The perfusion parameters of the hepatic parenchyma and HCC including the blood flow (BF), blood volume (BV), mean transit time (MTT), permeability-surface area product (PS), hepatic arterial fraction (HAF), IRF time of arrival (IRF TO) were obtained. Paired-sample t test was used to determine the differences in the perfusion parameters between the hepatic parenchyma and the primary HCC mass.

RESULTSCompared with hepatic BF (117.13-/+31.05 ml/100 mg/min), BV (14.73-/+3.91 ml/100 mg), PS (31.93-/+5.91 ml/100 mg/min), HAF (25.02-/+8.19%), MTT (12.79-/+3.31 s), IRF TO (3.14-/+1.09 s), the primary HCC mass showed significant increments in the BF (239.69-/+96.07 ml/100 mg/min), BV (20.26-/+6.73 ml/100 mg), PS (37.50-/+9.50 ml/100 mg/min), HAF (68.97-/+15.22%) with decreased MTT (7.17-/+1.38 s) and IRF TO (2.42-/+0.94 s). Significant differences were found in all the perfusion parameters between the hepatic parenchyma and HCC (P<0.05).

CONCLUSIONLiver perfusion parameters can represent the hemodynamic changes in the HCC derived from hepatic cirrhosis.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnostic imaging ; etiology ; physiopathology ; Female ; Hemodynamics ; Hepatitis ; complications ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Liver Cirrhosis ; complications ; Liver Neoplasms ; diagnostic imaging ; etiology ; physiopathology ; Male ; Middle Aged ; Perfusion ; methods ; Radiographic Image Enhancement ; instrumentation ; methods ; Tomography, X-Ray Computed

Aim: To put forward criteria for the pressure assessment in the operation of intercavemous embedding of bulboperineal urethra for the treatment of urinary incontinence after prostatic operation. Methods: A Fl4 urethral catheter is inserted during the operation and upon suturing the corpora cavemosa centrally, the catheter is slowly pushed in and pulled out in order that the operator feels a certain degree of close-fit resistance. The degree of tightness of the stitches,which regulate the compression pressure, is adjusted in accordance with this close-fit sensation. To further ascertain the adequacy of the force of compression, the bladder is filled with 300 ml physiological saline and observe the appropriateness (size and continuity) of the outflow stream when the lower abdomen is depressed with a pressure of 80-90 cm H2O. The operation was given to six patients suffered from urinary incontinence for 20 or more months after prostatic operation. Results: Five cases achieved complete recovery, while the therapeutic effect of the 6th one was not satisfactory. A second stage operation was carried out 3 months later with the addition of one more stitch both proximally and distally to reinforce the compression force. The condition was improved dramatically. The follow-up period averaged 3.5 years. Conclusion: The adequacy of the compression pressure exerted by the juxtaposed corpora cavernosa is the key point determining the outcome of the operation. The measures for assessing the compression pressure suggested by the authors are helpful in obtaining the good results of the present paper (6/6 success) as compared with 25/34success in the previous report.

OBJECTIVETo investigate the significance of early screening of pediatric developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT) using ultrasonography and establish a simultaneous screening model for pediatric DDH and CMT.

METHODSFrom January, 2013 to January, 2016, a total of 5060 pediatric patients with suspected DDH and CMT underwent ultrasonic examinations. The diagnostic results of the two diseases were classified into different clinical types, and Chi-square test was used to analyze the one-way relationship between different types of DDH and CMT; correspondence analysis was used for multivariate analysis of the variables. Chi-square test was used to analyze the difference between the detection rates in suspected CMT patients and the normal population.

RESULTSGrafIIa type DDH was associated with mass-type CMT in the children (χ=331.800, P<0.001). DDH of GrafIIb, GrafIIc, Graf III, and Graf IV types were related with non-tumor type of CMT. The children with a suspected diagnosis of CMT showed a significantly higher detection rate of DDH than the normal subjects (χ=321.889, P<0.001).

CONCLUSIONDDH is closely related with CMT. Early simultaneous screening of DDH and CMT can help to improve the early diagnosis rate of CMT in children.

OBJECTIVEConcerns of the effect of glucose on perinatal hypoxic-ischemic brain damage are increasing. It was previously considered that the glucose transporter (GLUT) genes and their productions played an important role in the regulation of cerebral energy metabolism. The present study aimed to explore the effect of different blood glucose levels on the expression of cerebral GLUT3 mRNA in neonatal rats with hypoxia-ischemia (HI), and to evaluate the neuroprotective effect of glucose against HI insults.

METHODSA total of 250 7-day-old neonatal SD rats were randomly divided into 10 groups (n=25 each): Normal control, Sham-operated, HI, Hypoglycemia, Hypoglycemia pre- and post-HI, Mild hyperglycemia pre- and post-HI, Severe hyperglycemia pre- and post-HI. Blood glucose levels of normal, hypoglycemia, mild hyperglycemia and severe hyperglycemia were defined as 5-7 mmol/L, 3-4 mmol/L, 10-15 mmol/L and 16-25 mmol/L, respectively. The expression of GLUT3 mRNA was detected with RT-PCT technique at 2, 24, 48 and 72 hrs and at 7 days after HI.

RESULTSThere was a correlation between increases in GLUT3 mRNA expression and postnatal age in the Normal control group. HI significantly enhanced the expression of GLUT3 mRNA from 2 hrs, peaking at 24 hrs after HI, and then significantly decreased at 72 hrs and 7 days after HI when compared with the Normal Control group (P < 0.01). GLUT3 mRNA expression in the Hypoglycemia pre-HI group was the lowest among all groups with HI at each time point after HI, and a statistically significant difference was found at 72 hrs after HI when compared with the HI group (P < 0.05). The expressional levels of GLUT3 mRNA in the Severe hyperglycemia pre-HI group were strikingly higher than those in any other groups with HI (P < 0.05 or 0.01). The GLUT3 mRNA expression patterns in the Mild and Severe hyperglycemia post-HI and the Hypoglycemia post-HI groups were similar to the Hypoglycemia pre-HI group.

CONCLUSIONSGLUT3 mRNA expression and the synthesis of GLUT3 can be down-regulated by hypoglycemia pre-HI, coupled with aggravation of cerebral pathology, but up-regulated by higher hyperglycemia pre-HI, coupled with improvement of cerebral pathology. This suggested that adequate glucose supplement before HI can improve the cerebral function against HI insults in neonatal rats.

Animals ; Animals, Newborn ; Blood Glucose ; analysis ; Cerebral Cortex ; metabolism ; Female ; Glucose Transporter Type 3 ; genetics ; Hippocampus ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; Male ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVEThe purpose of this study was to determine the effects of local delivery of vascular endothelial growth factor( VEGF) transferred with adenovirus-mediated gene on the survival of ischemic random skin flap in rats.

METHODSThe animals were divided into three groups randomly (n = 10) . A 2 cm x 8 cm dorsal skin flap was designed with the pedicle at the level of the iliac crest. In group A (AdCMV-VEGF), each animal received 10(12) PR replication-deficient recombinant adenovirus (AdCMV-VEGF) in the distal two-thirds of the proposed flap by means of the subdermal injection at ten different locations. In group B (AdCMV-GaI), each received 1012 PR AdCMV-Gal. In Group C (Saline), each received 1 ml saline. Three days after the treatment, the flap was elevated as planed way and re-sutured back to its donor site. All the animals were evaluated 7 days after the operation.

RESULTSThe mean percentage of surviving flap area was (85.91 +/- 2.54)% in group A, (59.56 +/- l.18)% in group B, and (61.48 +/- l.09)% in group C. There was a significant increase in the percentage of the survival area in the flaps of the group A, compared with the group B and group C (Group B vs. Group A, P < 0.01; Group C vs.Group A, P < 0.01, Group B vs. Group C, P >0.05). Hybridization in the situ, the immunohistochemical stain showed that the VEGF was expressed in the survival tissue of the flap treated with the AdCMV-VEGF, but it was not found in the control groups. Histological analysis demonstrated qualitatively greater amount of granulation tissue and angiogenesis was found in the group treated with the AdCMV-VEGF than the controls.

CONCLUSIONSThe results may indicate that Ad vector carrying VEGF cDNA could be useful in enhancing the survival of the skin flap due to the effect of the local delivery of the VEGF.

Adenoviridae ; genetics ; Animals ; DNA, Complementary ; Genetic Therapy ; Genetic Vectors ; Graft Survival ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; genetics ; Surgical Flaps ; Vascular Endothelial Growth Factor A ; genetics

BACKGROUNDA20, also known as tumor necrosis factor alpha induced protein 3 (TNFaip3), is a cytoplasmic zinc finger protein that inhibits nuclear factor kappa-B (NF-kappaB) activity and prevents tumor necrosis factor (TNF)-mediated programmed cell death. NF-kappaB is a transcription factor that regulates expression of genes involved in cell proliferation, cell survival and anti-apoptosis. Several studies have implicated that the NF-kappaB signal pathway is associated with angiogenesis and clinico-pathological process of adenoid cystic carcinoma (ACC) of the salivary glands.

METHODSThe ability of overexpression of A20 to influence the biological behavior and invasion of ACC cells was examined. The cells were stably transfected with full-length A20 cDNA. Stable gene transfer was verified by realtime-polymerase chain reaction (PCR) and Western blot analysis. The change of cell biological behavior was examined by methyl thiazolyl tetrazolium (MTT) and NF-kappaB luciferase reporter assay and the invasion of the cells was examined by a Matrigel invasion chamber.

RESULTSpEGPFN3-A20 gene was stably transferred into ACC-2 cells and overexpressed. When cells were treated with TNFalpha, the NF-kappaB activity of ACC-2-A20 cells could be down-regulated about 46.32% in contrast to ACC-2-GFP cells (P < 0.05). A20 potently inhibited growth of A20 transfectant ACC-2-A20 compared with control vector transfected groups and the ACC-2 empty control group (P < 0.05). The ACC-2-A20 cells showed significantly reduced ability to invade through Matrigei-coated filters compared to ACC-2-GFP and ACC-2 cells. The inhibition rate was up to 71.05% (P < 0.05).

CONCLUSIONSA20 gene transfer is associated with decreased tumor invasion, in part via the down-regulation of NF-kappaB expression, providing evidence for a potential application of A20 in designing a treatment modality for salivary gland cancers such as ACC.

Carcinoma, Adenoid Cystic ; pathology ; therapy ; Cell Line, Tumor ; DNA-Binding Proteins ; Genetic Therapy ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; NF-kappa B ; antagonists & inhibitors ; Neoplasm Invasiveness ; Nuclear Proteins ; genetics ; Salivary Gland Neoplasms ; pathology ; therapy ; Transfection ; Tumor Necrosis Factor alpha-Induced Protein 3