Cysts ; complications ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; complications

Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Stomach Neoplasms ; epidemiology ; surgery

Objective To evaluate effect of two-stage exchange total hip arthroplasty (THA) using an antibiotic-loaded cement spacer in the treatment of hip infection secondary to hip surgery.Methods From January 2005 to January 2010,6 consecutive patients with infected hip secondary to hip surgery,including 2 males and 4 females,aged from 43 to 68 years (average,59.7±9.2 years) were treated with two-stage exchange THA.There were 3 cases of femoral neck fracture treated with compression screws fixation,1 case of femoral head necrosis treated with bone graft,and 2 cases of early stage femoral head necrosis treated with core decompression and local interventional therapy respectively.Debridement and insertion of antibioticloaded cement spacer was performed in the first stage.After eradication of infection,it was converted to THA in the second stage.All patients were followed up regularly.Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested.Harris score was used to evaluate the function of the hips.Results All patients were followed up for an average of 46 months (range,24 to 81 mouths).Five of 6 patients were successfully converted to THA after an average of 14 weeks.One patient accepted the second debridement and reinsertion of a spacer owing to the abnormal values of ESR and CRP; this case was converted to THA successfully 12 weeks after the second debridement.Harris hip score improved from preoperative 35.6±3.3 to 57.8±5.4 between the two stages and 92.3±5.7 at final follow-up.One patient suffered deep vein thrombosis in the infected extremity and pulmonary embolism.There was no reinfection after THA.Conclusion Twostage exchange THA using an antibiotic-loaded cement spacer can obtain satisfactory results for the treatment of hip infection secondary to the hip surgery.

Overexpression of human ether-脿-go-go (eag) related gene (hERG) has been found in a broad range of human leukemia cell lines and primary human leukemia. The block of hERG protein might be a potential therapeutic strategy for leukemia. Gambogic acid (GA) has recently exhibited marked anti-tumor potency on solid tumors of various derivations. Here, we investigated the anti-leukemia effects of GA and its relation to the regulation of hERG in K562 leukemia cells in vitro. K562 cells were treated with various concentrations of GA (0.125-8.0 micromol/L) for 0-72 h. MTT assay was used to evaluate the inhibition effect of GA on the growth of K562 cells. Cell apoptosis was measured through both Annexin-V FITC/PI double-labeled cytometry and transmission electron microscopy. Cell cycle regulation was studied by a propidium iodide method. RT-PCR and Western blot were applied to detect the expression level of hERG in K562 cells. GA presented striking growth inhibition and apoptosis induction potency on K562 cells in vitro in a time- and dose-dependent manner. The IC(50) value of GA for 24 h was 2.637+/-0.208 micromol/L. Moreover, GA induced K562 cells arrested in G(0)/G(1) phase, accordingly, cells in S phase decreased gradually, and no obvious changes were found in G(2)/M phase cells. Under the transmission electron microscopy, apoptotic bodies containing nuclear fragments were found in GA-treated K562 cells. After treatment with GA of 2.0 micromol/L for 24 h, the percentage of apoptotic cells was increased from 4.09% to 18.47% (P<0.01). Overexpression of hERG channel was found in K562 cells, while GA could down-regulate it at both protein and mRNA levels (P<0.01). It was concluded that GA exhibited its anti-leukemia effects partially through down-regulating the expression level of hERG channel in K562 cells, suggesting that GA may be a potential agent against leukemia with a mechanism of blocking hERG channel.

The inhibitory effect of wortmannin on leukemic cells and the possible mechanisms were examined. K562 cells were treated with wortmannin of various concentrations (3.125-100 nmol/L) for 0-72 h. MTT assay was used to evaluate the inhibitory effect of wortmannin on the growth of K562 cells. Cell apoptosis was detected by both Annexin-V FITC/PI double-labeled cytometry and transmission electron microscopy (TEM). The expression of p-Akt, T-p-Akt, NF-kappaBp65 and IKK-kappaB was determined by Western blotting and reverse transcription-polymerase chain reaction (RT-PCR). Our results showed that wortmannin obviously inhibited growth and induced apoptosis of K562 cells in vitro in a time- and dose-dependent manner. The IC(50) value of wortmannin for 24 h was 25+/-0.14 nmol/L. Moreover, wortmannin induced K562 cells apoptosis in a dose-dependent manner. TEM revealed typical morphological changes of apoptosis in wortmannin-treated K562 cells, such as chromatin condensation, karyopyknosis, karyorhexis and apoptotic bodies. Additionally, several important intracellular protein kinases such as p-Akt, NF-kappaBp65 and IKK-kappaB experienced degradation of various degrees in a dose-dependent manner both at protein level and transcription level when cultured with wortmannin, but the expression of total Akt showed no change. It is concluded that wortmannin can inhibit the proliferation and induce apoptosis of K562 leukemia cells possibly by down-regulating the survival signaling pathways (PI3K/Akt and NF-kappaB channels).

Objective To evaluate the clinical value of midfrontal keyhole approach for the treatment of severe intra-ventricular hematoma. Methods The clinical data of 21 cases of severe intraventricular hemorrhage through midfrontal key-hole approach were analyzed retrospectively. Results Both inside and outside intraventricular hematoma were satisfied cleared. The GCS score and intraventricular hemorrhage Graeb score were improved. There were complications after opera-tion including 1 patient with diffuse brain swelling, 3 patients with cerebral vasospasm, 1 patient with intracranial infection, and seven patients with pulmonary infection. Follow-up schedules included 1-6 months. According to ADL score, 5 patients recovered well, 9 patients were moderately disabled, 3 were severely disabled, 1 was in a vegetative state and 3 died. Conclu-sion The intraventricular hematoma can be removed through midfrontal keyhole approach. The obstructive hydrocephalus can be relieved, the secondary brain damage was reduced and the prognosis was improved in patients.

Objective To study the clinical application value of humidified high flow nasal cannula(HHFNC) on bronchitis in children.Methods Total 85 cases of bronchitis that needed oxygen therapy in our department from Oct 2015 to Feb 2016 were randomly divided into three groups,HHFNC group,NCPAP group and nasal cannula oxygen group(control group).According to the blood gas results,FiO2 was adjusted to maintain PaO2 in 50~70mmHg(1mmHg=0.133kPa),TcSO2 90% to 95%.The main symptoms and signs(wheezing,shortness of breath,three depression sign,wheezing rale) disappeared time,length of oxygen inhalation and stay,the change of PaO2,PaCO2,respiratory rate were compared among the three groups.Results Compared with control group,the clinical symptoms and signs disappeared time and length of oxygen inhalation and stay were significantly shorter in HHFNC group(P<0.05).The recovery of blood gas and respiratory rate in HHFNC group were better than those in control group(P<0.05).No statistically significant differences existed between HHFNC group and NCPAP group(P>0.05).Conclusion HHFNC can significantly improve the clinical symptoms,signs and blood gas results in children with bronchitis,reduce the length of oxygen inhalation and stay.HHFNC is an effective and well-tolerated treatment for bronchitis in children.

Objective To investigate the method and efficacy in treating acetabular bone defects by the use of titanium wire mesh and impact bone allograft in revision total hip arthroplasty.Methods Twenty-two patients (22 hips) with acetabular bone defects in revision total hip arthroplasty were treated with wire mesh and impact bone allograft from January 2008 to December 2013.There were 7 males and 15 females in the present study.The average age of the patients at the surgery was 64.8 (37-78) years.According to Paprosky classification,there were 9 cases of type ⅡA,4 cases of ⅡB,7 cases of ⅡC and 2 cases of ⅢB.Twenty cases with aseptic loosen and 2 with periprosthetic infection were underwent revision surgery.Deep frozen cancellous bone allograft was sterilized and morselized to particles with the size of 7 to 10 mm.After removal of loosed acetabular component,the bone grafts were impacted into the acetabular defects area to restore the bone quantity.Titanium wire mesh with appropriate diameter was chosen to fix on impacted bone graft and fixed acetabulum with screws.Polyethylene cup was cemented in the mesh wire with proper position.Harris hip score system was used to evaluate the hip joint function.The AP pelvis X-ray was taken at 1 week,3 months,12 months and annually thereafter postoperatively to evaluate the rotation center,fusion of the bone graft and loosening of cup.Results All patients were followed up with the average period 5.1 years (3-7 years).The average Harris hip score before revision was 43.75±13.45,while the score was 85.33±7.84 at last follow-up (t=7.930,P=0.000).The average height of hip rotation center of surgical side was 3.49±0.77 cm before surgery,while its height at last follow-up was 2.22±0.22 cm (t=4.390,P=0.005).The distance between hip rotation center and the base of acetabulum was 3.54±0.45 cm before surgery,while its value was 3.52± 0.76 cm at last follow-up.All the bone grafts came to infusion with the average time 12 months (9-15 months).There was no case with cup migration more than 4 mm or rotation greater than 5° at last follow-up.One patient had the symptom of sciatic nerve injury.No case was with infection or dislocation.Conclusion In the treatment of acetabular bone defects,wire mesh and impact bone allograft with cemented cup in revision total hip arthroplasty can reconstruct hip rotation center and the acetabular bone quantity effectively.Satisfied early-midterm curative effects could be acquired by using this method.

Objective To investigate the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFA) on systemic inflammatory response and intestinal mucosa barrier in rats with traumatic brain injury and hemorrhagic shock (TBIS).Methods A total of 36 male Wistar rats were equally randomized into 3 groups:sham operation group,TBIS model group,and ω-3 PUFA pretreatment group.The serum levels of tumor necrosis factor-α (TNF-α),8-iso-prostaglandin F2 a (8-iso-PGF2 a),interleukin (IL)-1 β,and IL-10 were measured by enzyme linked immunosorbent assay (ELISA).HE staining was performed for morphological assessment of the intestinal tissue and evaluation of the intestinal mucosa damage index (IMDI).The marked bacilli of the mesenteric lymph nodes,lung,liver,spleen,and kidney tissue were counted under a fluorescent microscope.Results Compared with those in the sham group [ (38.15 ± 6.37) ng/ml,(84.91 ± 17.22) pg/ml,(2.52 ± 0.83 ) μg/L,(2.86 ± 0.82) μg/L,0.36 ±0.14,and 8.33％ ],the serum levels of TNF-α [ (328.11 ±20.09) and (244.37 ±21.82) ng/rrl],8-iso-PGF2a [ (263.47±55.19) and (176.35±41.63) pg/ml],IL-1β [ (27.06±2.61) and (18.91 ±1.78) μg/L],IL-10 [ (7.63 ± 1.29) and (9.52 ± 4.66) μg/L],the IMDI (4.18 ±0.39 and 3.31 ±0.40),and the positive rates of bacterial translocation (56.67％ and 35.00％ ) were significantly higher in both the TBIS model group and ω-3 PUFA group ( all P ＜ 0.01 ).Compared with TBIS model group,the levels of TNF-α,8-iso-PGF2 a,and IL-1 β,the IMDI,and the positive rate of bacterial translocation were significantly lower ( all P ＜ 0.05 ) and the levels of IL-10 were significantly higher in the ω-3 PUFA group (P ＜0.01 ).Conclusion The supplementation of ω-3 PUFA can remarkably inhibit the systemic inflammatory response and protect the integrity of intestinal mucosa in rat with TBIS.

Objective To determine the incidence of avascular necrosis after closed reduction and cannulated compression screws fixation of intra-capsular femoral neck fracture and to investigate the multiple factors correlated to avascular femoral head necrosis.Methods All the patients of intra-capsular femoral neck fracture who accepted closed reduction and cannulated compression screws fixation between 2001 and 2010 in Jiangsu Province were reviewed in multi-centers retrospectively.The multiple factors were analyzed including age,gender,affected side,mechanism of injury,fracture classification,procedure delay,quality of reduction,time of full-weight-bearing,configuration of the screws and removal of the screws.Multiple correlation factors were analyzed with SPSS 13.0 statistic system.Results Complete case records were documented in 1849 cases who were followed up for an average 6.5±2.7 years (range,2-10 years).Avascular necrosis occurred in 246 cases (13.3％).The average time of diagnosis of avascular necrosis was 17±4.6months (range,8-72 months) after injury.The average Harris score of the hips which didn't develop to avascular necrosis was 93.8±8.9 (range,78～100) at the last follow up.Multiple correlation factors analysis indicated that displacement degrees of fracture and the quality of reduction were significantly correlated to the incidence of avascular necrosis (OR=2.078,3.423).Conclusion Closed reduction and cannulated compression screws fixation after the intra-capsular femoral neck fracture can get satisfactory results.Displacement degrees of fracture and the quality of reduction are significantly correlated to the incidence of avascular femoral head necrosis.