Objective To analyze the causes for failed treatments of proximal femoral fractures and to evaluate the curative results of total hip replacement(THR)to salvage the failures.Methods A retrospective study was conducted for 23 consecutive cases of THR to salvage failed treatments of proximal femoral fractures from February 2002 to April 2005.There were 17 cases of femoral neck fracture,five cases of intertrochanteric frac- ture,and one case of femoral head fracture.Results Inadequate reduction after inadequate fixation,incorrect materials or technical errors in internal fixation were the most significant reasons for the failure of early treatment. Twenty-one of the 23 patients were available for fullow-up that ranged from 8 to 46 months(mean,32 months). No such complications as wound infection,hip dislocation,prosthesis breakage or deep venous thrombosis were found.Their mean Harris score increased from 48.3 preoperatively to 87.6 postoperatively.Condusions Re- duction,internal fixation,and fixation technique are very important to treatments of proximal femoral fractures. High energy trauma in young patients and osteoporosis in old patients make treatment of proximal femoral fractures even more difficult.THR is a satisfactory and safe way to salvage a failed treatment of proximal femoral fracture.

Objective To investigate effects of different doses of recombinant human bone morphogenetic protein-2 (rhBMP-2) on vascular endothelial growth factor (VEGF) expression in fetal mouse osteoblasts.Methods Calvaria osteoblasts of fetal mice of 19 days were cultured.The effects of rhBMP-2 at different doses and different action times on VEGF expression patterns in fetal mouse osteoblasts were observed with reverse transcrip- tion-polymerase chain reaction (RT-PCR) and Western blot staining.Results In the present study,RT-PCR detected a steady expression of VEGF mRNA in the control fetal mouse osteoblasts.The levels of VEGF mRNA increased in an apparent biphasic manner with a maximum stimulation (about 2-fold above the control,P＜0.05 ) in both VEGF mRNA species observed at 300 ng/mL of rbBMP-2.After 48 h of rhBMP-2 treatment,the VEGF mRNA levels approached those in the control.The VEGF mRNA levels appeared to be biphasic in rhBMP-2-treated cultures,showing peak induction at 3 and 24 h and remaining elevated at 48 b.Compared with the individual control value at each time point,an apparent maximum increase (about 2.5-fold above the control,P＜0.05) occurred at 6 h.The second peak induction,about 2-fold above that in the control,occurred at about 36 h.Conclusions The expression of VEGF mRNA is steady in the control fetal mouse osteoblasts.RhBMP-2 can promote the expression of VEGF in dose-dependent and time-dependent manners.

Objective: The study aims at preparing the didodecyldimethylammonium bromide (DMAB)-modified PLGA nanoparticles (NPs) loading tetrandrine (Tet) (DMAB-Tet-PLGA-NPs) and investigating the preparation process, physicochemical characterization, in vitro cytotoxicity, and particle cellular uptake. Methods: DMAB-Tet-PLGA-NPs were prepared by the emulsion solvent diffusion method and the preparation process was optimized with the uniform design experiment. The drug loading, entrapment efficiency (EE), and in vitro drug release were studied to evaluate the drug-loading property. The in vitro cytotoxicity against human lung cancer cell A549 was measured by the standard MTT assay. The particles cellular uptake in A549 was evaluated by qualitative and quantitative methods. Results: DMAB-Tet-PLGA-NPs in the mean size of (205.40±2.66) nm with spherical shape and showed positive surface charge. Drug loading and EE were (2.130±0.035)% and (50.780±3.253)%, respectively. DMAB-Tet-PLGA-NPs could retard drug release in pH 7.4 release media and the cumulative release was up to 64.56% over 48 h. And DMAB-Tet-PLGA-NPs showed the significant dose-and time-dependent cytotoxicity of Tet in vitro and well cellular uptake by A549. Conclusion: DMAB-Tet-PLGA-NPs shows the good EE, uniform particle size, and could retard drug release in vitro. And DMAB-Tet-PLGA-NPs shows the significant cytotoxicity in vitro and well cellular uptake by A549.

Objective： The aim of this study was to evaluate the expression of E-cadherin,α -catenin,β -catenin,and γ -catenin in gastric carcinoma and dysplasia and to determine the relationship with tumorigenesis and biological behavior of gastric cancer. Methods： The expression of E-cadherin, α -catenin, β -catenin, and γ -catenin in 43 patients with gastric carcinoma and gastric biopsy specimens from 22 patients with dysplasia and 10 healthy controls were determined using immunohistochemistry. Results： Membranous staining was observed in control biopsy specimens for all components of the complex. Abnormal expressive rates of E-cadherin,α -catenin,β -catenin in gastric carcinomas (53.5％ ,55.8％ ,51.2％ ,respectively) were significantly higher than that in gastric mucosal dysplasials （ 22.7％ ,22.7％ , 18.2％ , respectively P<0.05） ,and the rates in advanced gastric carcinomas were also significantly higher than that in early gastric carcinoma（ P< 0.01, P< 0.05, P< 0.01,respectively） . Tumors with a decrease in E cadherin occurred significantly more frequently in undifferentiated gastric carcinoma (P< 0.05). There were higher abnormal expressive rates of E-cadherin and β  catenin in the patients with tumor infiltrating out of serosa and with lymph nodes metastasis （ P<0.01 or P< 0.05） . Up to 50.0％ of gastric dysplasials and 76.7％ of tumors stained abnormally for one or more components of the cadherin catenin complex (P< 0.05), and the lymph nodes metastasis rates for one or more components of the E cadherin complex was significantly higher than that for no one components of the E cadherin complex (P< 0.01). Conclusion： The decreased expression of E cadherin and part of the catenins correlate with tumor stage, poor differentiation, infiltrative tumor growth, and lymph nodes metastasis, which suggests that E cadherin complex play a critical role in the course of chang from gastric mucosal dysplasials to gastric carcinoma. Thus, study of all the components of E cadherin catenin complex may be more valuable than single component of the complex for the detection of patients with gastric carcinoma.

Objective To introduce a method of functional reconstruction for total lower lip defects.Methods Six patients with lower lip cancer were treated by surgery from November 2007 to February 2009.The full thickness defects with a size from eighty percent to total lower lip were reconstructed with two triangular mental neurovascular island flaps of chin.The musculocutaneous and mucous flaps with neurovascular pedicles were advanced in a V-Y manner to close the defect and reconstruct the orbicularis oris muscle.Results All flaps survived and no recurrence and complication were observed and showed excellent cosmetic and functional results over 6 months of follow-up.The reconstructed lower lips provided a wide-enough mouth opening,and the sensation of oral mucosa and the muscle function of oral sphincter were preserved.Conclusions The technique of mental neurovascular V-Y advancement island flap can get satisfactory results in both functional and the aesthetic perspects.

Objective:To explore the reasons of secondary fracture after percutaneous vertebroplasty (PVP) for osteo-porotic vertebral compression fractures (OVCFs) and discuss the measure of prevention and cure. Methods:From January 2011 to January 2013,the clinical data of 180 patients with primary OVCFs treated by PVP were retrospectively analyzed. There were 75 males and 105 females,aged from 68 to 95 years old with an average of (79.50±5.45) years. The involved ver-tebrae were identified according to the clinical symptoms and imaging data. PVP were performed in 362 vertebrae and the pa-tients were followed up with an average of 12 months. Subsequent vertebral fractures were found through the pain ’s reappearance and MRI or bone scan. The patients were divided into secondary fracture group and no secondary fracture group according to the subsequent fractures or no. Secondary fracture group was divided into two groups according to gender ,and the patients with sec-ondary fracture were also categorized into the original surgical vertebral fractures ,adjacent vertebral fracture and remote verte-bral fractures. The age,gender,the cement volume,the cement leakage,secondary fracture site,the incidence and type of sec-ondary fracture were observed and compared among different groups. Results:Among the 362 vertebrae of PVP,there were 109 vertebrae in male and 253 vertebrae in female. And 27 vertebrae (10 in male and 17 in female) of 22 cases (9 males and 13 fe-males) occurred secondary fracture. The second PVP were performed in 13 cases (16 vertebrae) and the third PVP in 2 cases (4 vertebrae);7 cases (7 vertebrae) were treated with conservative therapy. There was no statistically significant difference on age , gender,cement volume and leakage between secondary fracture group and no secondary fracture group (P>0.05). There was no statistically significant difference on the incidence and type of secondary fracture between male and female (P>0.05). No signifi-cant difference was found on the adjacent and remote vertebral fractures (P>0.05). Most of secondary fracture occurred in 6 months,and whether the single and double side injection,cement leakage had no obvious relation. Conclusion:There is no significant difference in the subsequent fracture after PVP for the OVCFs different gender and fractured site ,and also no signif-icant difference in the adjacent and remote vertebral fractures. The report didn't support the biomechanical viewpoint that verte-bral body stiffness increasing after PVP would lead to adjacent vertebral stress increasing and result easily in adjacent vertebral fracture. Secondary fracture occurs always in 6 months after operation ,which is the natural course of osteoporosis.

OBJECTIVETo investigate the changes of drug sensitivity of spindle poison-induced polyploid tumor cells to chemotherapeutic agents and its possible mechanism.

METHODSNocodazole in a dose of 100 ng/ml was used to induce polyploidization in a breast cancer cell line MDA-MB-231 cells. The polyploid cells (T-MDA-MB-231) were sorted by flow cytometry. The morphological changes and proliferation of T-MDA-MB-231 cells were compared with that of MDA-MB-231 cells. The cell growth inhibition was assessed by MTT assay. The cells were treated with paclitaxel, docetaxel, vincristine, epirubicin, 5-Fu, VP16 and oxaliplatin, respectively. Those cells were labeled with annexin V-FITC/PI and analyzed by flow cytometry. Bcl-2 was knocked down in T-MDA-MB-231 cells using SiRNA and their growth inhibition was evaluated by MTT assay to evaluate the reversing effect of Bcl-2-silencing on drug resistance.

RESULTSThe polyploid T-MDA-MB-231 cells grew in vitro continuously and maintained constant DNA content. They had a larger cell size, and grew more slowly than MDA-MB-231 cells. The IC(50(s)) of T-MDA-MB-231 cells were significantly higher than that of the MDA-MB-231 cells: paclitaxel: (6.37 ± 0.07) vs. (2.05 ± 0.83) µmol/L; docetaxel: (32.98 ± 1.48) vs. (11.95 ± 0.98) µmol/L; vincristine: (35.28 ± 1.66) vs. (14.58 ± 0.94) µmol/L; oxaliplatin: (19.07 ± 0.45) vs. (9.75 ± 1.05) µmol/L; 5-Fu: (85.49 ± 3.21) vs. (31.35 ± 1.51) µmol/L; and epirubicin: (0.53 ± 0.06) vs. (0.15 ± 0.01) µmol/L, (all P < 0.05). The IC(50(s)) of VP16 in T-MDA-MB-231 cells was (2.85 ± 0.50)µmol/L, significantly lower than the (12.20 ± 1.55) µmol/L in MDA-MB-231 cells (P < 0.05), and that of T-MDA-MB-231 cells after Bcl-2-knocked down by siRNA was (19.59 ± 0.48) µmol/L, significantly higher than the (12.20 ± 1.55) µmol/L in the MDA-MB-231 cells (P < 0.05). The IC(50(s)) of docetaxel of T-MDA-MB-231 cells after Bcl-2-knocked down by siRNA was (21.52 ± 0.68) µmol/L, significantly decreased and lower than that before Bcl-2 silencing (32.98 ± 1.48) µmol/L.

CONCLUSIONSOur results indicate that polyploid tumor cells induced by spindle poison Nocodazole are more resistant to most of chemotherapeutic drugs. Downregulation of Bcl-2 increases the sensitivity of polyploid cells to docetaxel. The high expression of Bcl-2 may be one of the drug resistance mechanisms of polyploid tumor cells. The polyploid tumor cells are relatively sensitive to VP16, suggesting that VP16 might be an effective candidate drug for treatment of chemoresistant polyploid tumors.

Antineoplastic Agents ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; genetics ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Down-Regulation ; Drug Resistance, Neoplasm ; Epirubicin ; pharmacology ; Etoposide ; pharmacology ; Female ; Fluorouracil ; pharmacology ; Gene Knockdown Techniques ; Humans ; Inhibitory Concentration 50 ; Nocodazole ; pharmacology ; Organoplatinum Compounds ; pharmacology ; Paclitaxel ; pharmacology ; Polyploidy ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Taxoids ; pharmacology ; Vincristine ; pharmacology

Objective To observe the clinical efficacy and safety of cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets in the treatment of elderly patients with Parkinson's disease complicated with mild cognitive impairment(PD-MCI).Methods Elderly patients with PD-MCI were randomly divided into control group and treatment group.Two groups were treated with levodopa and benserazide hydrochloride tablet for anti-Parkinson's disease therapy,and on this basis,the control group was given intravenous drip of reduced glutathione 1.2 g(qd),and the treatment group was given intravenous drip of cattle encephalon glycoside and ignotin injection 10 mL(qd)on the basis of the control group.Both groups of patients were treated continuously for 4 weeks.The clinical efficacy,serum regulated upon activation,normal T cell expressed and secreted(RANTES),α-synuclein(α-syn),brain-derived neurotrophic factor precursor protein(pro-BDNF),catalase(CAT),total superoxide dismutase(T-SOD),cognitive function and quality of life were compared between both groups,and the adverse drug reactions were observed.Results In treatment group,48 cases were enrolled but 3 cases were lost,thus 45 cases were finally included in the analysis.In control group,48 cases were enrolled but 6 cases were lost,thus 42 cases were included in the analysis.After treatment,the total effective rates in treatment and control groups were 93.33％(42 cases/45 cases)and 76.19％(32 cases/42 cases)respectively(P＜0.05).After treatment,RANTES levels in treatment group and control group were(25.57±4.62)and(30.29±4.92)pg·mL-1;α-syn levels were(3.08±0.76)and(3.74±1.09)μg·L-1;pro-BDNF levels were(144.65±17.54)and(182.26±15.75)ng·mL-1;CAT levels were(168.54±10.64)and(160.48±9.74)kU·L-1;T-SOD levels were(123.75±20.54)and(110.18±22.66)kU·L-1;Montreal Cognitive Assessment Scale scores were(25.08±2.75)and(23.14±2.64)points;and 39-item Parkinson's Disease Quality of Life Questionnaire scores were(45.84±8.42)and(50.34±7.62)points,respectively.The differences of above indexes were statistically significant between two groups(all P＜0.05).The adverse drug reactions in treatment group were arrhythmia,dizziness,chills and gastrointestinal discomfort.The adverse drug reactions in control group were transient thrombocytopenia and arrhythmia.The total incidences of adverse drug reactions in treatment group and control group were 8.89％and 4.76％wthout significant difference(P＞0.05).Conclusion Cattle encephalon glycoside and ignotin injection combined with reduced glutathione injection and levodopa and benserazide hydrochloride tablets has exact clinical efficacy in the treatment of elderly patients with PD-MCI,and it can significantly enhance the neuroprotective and antioxidant effects and improve the cognitive function and quality of life of patients,and it does not increase the incidence rate of adverse drug reactions.

Objective To evaluate the accuracy of Hadeco ES-1000spm hand-held doppler during the anterolateral thigh(ALT)flap harvest.Methods Twenty-five patients(26 sides)with ALT flaps for head and neck reconstruction between May 2005 and May 2010 received preoperative Doppler examination for the location of the cutaneous perforators of ALT flaps.The Doppler signals and body mass index(BMI)were recorded preoperatively according to ABC system.The locations of Doppler signals and of the actual cutaueous perforators at surgery were plotted and compared.The diameter of perforators was measured.Results One to three cutaneous perforators of the ALT flap were consistently found at specific locations.They were named perforators A,B,C from proximal to distal.Perforators A,B and C were present in 15(58%),24(92%)and 20(77%)cases and the diameter(>0.5 mm)of A,B and C were 11/15,22(92%)and 8(40%)respectively.The Doppler signal was within 0.5 cm of the actual perforator location in 85% flaps.The accuracy of Doppler decreased with increase of BMI.Conclusions Preoperative assessment by hand-held Doppler is useful in predicting the perforator vessels'locations and diameter although it's accuracy is limited.

OBJECTIVETo establish the theories and methods to determine solubility parameters of multiple components for the traditional Chinese material medica (TCMM) with HPLC.

METHODThe mathematical expresses to determin the solubility parameters were established according to chromatographic and Hildebrand-Scatchard theories, The HPLC experiments were carried out at 40 degrees C on an Alltech Apollo C18 column (4.6 mm x 250 mm, 5 microm) eluted with acetone and water in gradient mode. The flow rate was 1.0 mL min(-1), and the detection wavelength was 254 nm. The injection volume was 1 0 microL.

RESULTThe mathematical expresses between the retention time and the solubility parameters were established and used to determin caffeine solubility parameter as 28.31 J(1/2) cm(-3/2) in accordance with 28.84 J(1/2) cm(-3/2) reported by literature, and those of aloe-emodin, rhein, emodin, physcione as 39.70 J(1/2) cm(-3/2), 39.08 J(1/2) cm(-3/2), 38.37 J(1/2) cm(-3/2), 36.42 J(1/2) cm(-3/2) respectively.

CONCLUSIONThe retention time of HPLC can be used to determine the solubility parameters of multiple componets. The established method is useful for the compatibility rule study of traditional Chinese medicine.

Anthraquinones ; chemistry ; Caffeine ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Emodin ; analogs & derivatives ; chemistry ; Materia Medica ; chemistry ; Models, Chemical ; Regression Analysis ; Solubility ; Temperature