OBJECTIVETo detect the character of surgical treatment of massive soft tissue sarcoma in the shoulder girdle and analyze the impact factor to the result.

METHODSSeven patients with massive soft tissue sarcoma in the shoulder girdle were treated in our department between 2005 and 2009. There were 4 males and 3 females. All the patients were referred to our hospital after local recurrence post-operatively. The mean age was 43.8 years old (range 14 - 75). The maximum diameter of the tumor varied from 10 to 16 centimeters. All the patients were performed surgery, wide margin in 4 cases and marginal margin in 3 cases. Five were performed tumor resection and reconstruction with latissimus dorsi muscle flap transfer and skin graft. One was reconstructed with advanced skin flap and skin graft. The other one was treated with skin graft. The diagnosis included 3 malignant fibrous histiocytomas, 1 low grade myxoid fibrosarcoma, 1 Primitive neuroectodermal tumor, 1 rhabdomyosarcoma, 1 dermatofibrosarcomas protuberans. The MSTS score system was used to evaluate the shoulder function.

RESULTSSeven patients were followed up with long time. The mean follow up was 29 months (range 10 to 46 months). Two patients suffered local recurrence and one died of pulmonary metastasis 6 months after the second surgery for local recurrence. One patient suffered pulmonary metastasis. The last four patients were disease-free at the end of follow-up. The function of shoulder girdle was satisfactory. The mean MSTS score was 28.

CONCLUSIONSSoft tissue sarcomas in the shoulder girdle are easy to be misdiagnosed and mistreated. Wide surgical margin was the key impact factor to the local recurrence of soft tissue sarcoma in the shoulder girdle. The surgical margin and invasion of the tumor are the key factor to the prognosis. The soft tissue defect after surgery is often reconstructed by muscle flap transfer or skin flap transfer. The latissimus dorsi muscle flap transfer is often used.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sarcoma ; diagnosis ; surgery ; Shoulder ; pathology ; Soft Tissue Neoplasms ; diagnosis ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo analyse the causes and the management of massive hemorrhage in hepatectomy.

METHODSWith over 1 000 ml of bleeding, 4 368 patients with hepatectomy between 1955 and 2000 were analysed retrospectively.

RESULTSAmong 4 368 patients receiving hepatectomy, 286 (6.5%) had massive hemorrhage because of damage to the major hepatic veins, portal hypertension, hepatic insufficiency, and the extensive adhesion around the tumor. Massive hemorrhage was managed by repair and transfixation of the damaged vessels; transfixation or devascularization of variceal bleeding; complete vessels ligation of the hepatic section with mattress suture; resection of the ruptured tumor after temporary occlusion of the porta hepatis; fibrinogen infusion; hot saline compression of the surface of the wound and/or daub biological glue; argon beam coagulation and packs placement.

CONCLUSIONSLight performance and nonforce dragging of liver can reduce massive hemorrhage caused by major vessel injury or tumor rupture. Normothetic occlusion of porta hepatis can reduce blood loss effectively when liver resection. In situ hepatectomy must be adopted if there is extensive adhesion around the tumor. Packs placement is still an effective measure to stop bleeding caused by defective coagulation and extensive blood oozing of wound surface.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical ; Child ; Child, Preschool ; Female ; Hemostasis, Surgical ; Hepatectomy ; adverse effects ; Humans ; Male ; Middle Aged

OBJECTIVETo analyze the transcription activation and possible regulation mechanism of human X-box binding protein 1(XBP1)gene 5'upstream DNA sequence in different cell lines.

METHODSSix kinds of XBP1 promoter deletion mutants were cloned into pGEM-Teasy vector, which included XBP1 gene 5' upstream -1039 to 66 bp,-859 to 66 bp,-623 to 66 bp,-351 to 66 bp,-227 to 66 bp,-227 to -45 bp respectively. Every deletion mutant sequence was cut from Teasy-XBP1p by KpnI and Xho I, and subcloned into pCAT3-Basic to produce a set of constructs termed as p1-XBP1p, p2-XBP1p, p3-XBP1p, p4-XBP1p, p5-XBP1p, p6-XBP1p, respectively. The transcription activity of each construct was detected after transiently transfecting K562, HepG2,NIH-3T3 and L0(2)cell with FuGENE 6 transfection reagent. Cells transfected by pCAT3-Basic or pCAT3-Promoter were used as negative and positive controls. The activity of chloramphenicol acetyltransferase(CAT), which reflects the transcription activation of the XBP1 gene promoter, was detected by ELISA after 48 hours of transfection.

RESULTSThe reporter vectors of six kinds of XBP1 promoter deletion mutants were successfully constructed, as confirmed by restriction enzyme digestion and sequencing. The activities of p4-XBP1p and p5-XBP1p were higher than the other deletion mutants in K562 and HepG2. And the activity of p5-XBP1p was the highest in HepG2. There was no activity detected from any transfected NIH-3T3.

CONCLUSIONThe XBP1 gene promoter can transactivate its downstream gene to transcription. The core sequence of XBP1 promoter was implied between -227 bp and 66 bp. This sequence was connected with the transcriptional activity of XBP1 promoter closely. Its transcription activity varies with different cell lines. XBP1 promoter might drive gene expression with cell-type specificity.

3T3 Cells ; 5' Flanking Region ; genetics ; Animals ; Base Sequence ; Cell Line ; Chloramphenicol O-Acetyltransferase ; metabolism ; DNA ; analysis ; DNA-Binding Proteins ; genetics ; Gene Deletion ; Gene Expression Regulation ; physiology ; Genes, Reporter ; Humans ; K562 Cells ; Mice ; Molecular Sequence Data ; Nuclear Proteins ; genetics ; Promoter Regions, Genetic ; genetics ; Regulatory Factor X Transcription Factors ; Transcription Factors ; Transcription, Genetic ; physiology ; Transcriptional Activation ; Transfection ; Tumor Cells, Cultured ; X-Box Binding Protein 1

OBJECTIVETo evaluate the role of human leukocyte antigen G (HLA-G) in the better effect of allogenetic bone marrow transplantation than that of peripheral blood stem cell transplantation.

METHODSFlow cytometry was used to detect the expression of membrane-bound HLA-G (mHLA-G) on donor peripheral blood (PBC) or bone marrow (BM) mononuclear cells. The levels of soluble HLA-G (sHLA-G) in the plasma and bone marrow fluid were determined using enzyme-linked immunosorbent assay (ELISA) before and after granulocyte colony-stimulating factor (G-CSF) mobilization.

RESULTSThe mean levels of mHLA-G after G-CSF mobilization in the PBC and BM were significantly higher than that before G-CSF mobilization (P=0.001 and 0.000), but the plasma levels of sHLA-G showed no significant changes after the mobilization (P=0.279). The mean levels of sHLA-G in the BM fluid significantly increased (P=0.002) to a level higher than that in the PBC after G-CSF mobilization (P=0.004).

CONCLUSIONHLA-G plays an important role in immune tolerance after hematopoietic stem cell transplantation with G-CSF mobilization.

Adult ; Bone Marrow Transplantation ; immunology ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; HLA Antigens ; immunology ; metabolism ; HLA-G Antigens ; Hematopoietic Stem Cell Mobilization ; methods ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Antigens Class I ; immunology ; metabolism ; Humans ; Immune Tolerance ; Male ; Middle Aged

Adult ; China ; epidemiology ; Female ; Humans ; Low Back Pain ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology

OBJECTIVETo observe therapeutic effect of acupuncture combined with inductance coupling for treatment of delayed union and nonunion.

METHODSSixty cases with delayed union and nonunion after operation were randomly divided into 2 groups. The observation group (n=30) received acupuncture with Shenshu (BL 23), Mingmen (GV 4), Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Xuanzhong (GB 39) and Taichong (LR 3) selected as main points, in combination with inductance coupling treatment and the routine treatment. The patients (n=30) in the control group received routine treatment. Bony callus growth was observed by X-ray 30 and 120 days after treatment respectively.

RESULTSTwenty-three cases 30 days after treatment and 29 cases 120 days after treatment were found the bone callus growth in the observation group , and 11 cases and 17 cases in the control group, with significant difference between the two groups (P<0.05), the observation group being better than the control group, with no bad event and side effect.

CONCLUSIONAcupuncture combined with inductance coupling is a good method for promoting fracture healing.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Female ; Fracture Healing ; Fractures, Ununited ; therapy ; Humans ; Magnetics ; Male ; Middle Aged

The recombined adenovirus DNA was transfected into 293 cells for packing and amplification of replication-deficient Ad-CMV-E6/E7, Ad-K14 -E6/E7 virus was purified by CsCl density gradient centrifugation , recombined adenovirus Ad-CMV-E6/E7, Ad-K14 -E6/E7 were used as experimental group, while pAd-CMV and pAdtrack-K14 were used as control group. Four of them were injected through one main vein of nude mice tail respectively. These mice were then treated with 0.05 mg 17beta-estradiol over 12 weeks. Mice were anaesthesiaed with 2.5% Avertint and the vagina, mammary gland, ovaries and uterus were dissected and fixed in 3.75% paraformaldehyde overnight at 4 degrees C. Paraffin-embedded sections, HE staining and identification of P53 and Bcl-2 protein via immunohistochemistry were performed. The expression of E6/E7 was verified by RT-PCR in different tissue of nude mice. HE staining showed evident hyperplasy in cervix-uterus transformation zone of experimental group 2. The expression of mutant P53 and Bcl-2 were higher than control group via immunohistochemical S-P method in uterus stroma-cell. Western blotting also showed that E6 protein was expressed. The expression of E6/E7 was higher than control group by human cytokeratin promoter 14 and hyperlasy changes were detected in epithelial tissue of cervix-uterus transformation zone.
Adenoviridae ; genetics ; Animals ; Blotting, Western ; Cell Line ; Female ; Genital Diseases, Female ; pathology ; virology ; Genitalia, Female ; pathology ; virology ; Humans ; Immunohistochemistry ; Mammary Glands, Animal ; metabolism ; pathology ; Mice ; Mice, Nude ; Oncogene Proteins, Viral ; genetics ; metabolism ; Ovary ; metabolism ; pathology ; Papillomaviridae ; metabolism ; physiology ; Papillomavirus E7 Proteins ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Repressor Proteins ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Protein p53 ; metabolism ; Uterus ; metabolism ; pathology ; Vagina ; metabolism ; pathology

OBJECTIVETo report our primary experience with immediate breast reconstruction using laparoscopically harvested omental flap after breast-conserving surgery. The safety, feasibility, and clinical effect are also evaluated.

METHODSFrom Jun. 2010 to Jan. 2011, 5 cases who underwent immediate breast reconstruction using laparoscopically harvested omental flap after breast-conserving surgery were retrospectively analyzed. The operative duration, postoperative days in hospital, complication and therapeutic effect were reviewed.

RESULTSAll the patients were treated successfully without laparotomy. The average operative duration was 310 min, including 60 min for harvesting the omental flap. The median postoperative days in hospital was 8 days (ranged, 5-9 days). One case complained of slight pulled feeling in upper abdomen. No other complication happened. The cosmetic result of reconstructed breasts was satisfactory.

CONCLUSIONSThe immediate breast reconstruction using laparoscopically harvested omental flap is safe and feasible with less morbidity in donor sites and good cosmetic effect. It is one of the ideal methods for immediate breast reconstruction.

Adult ; Breast Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; Mammaplasty ; methods ; Mastectomy, Segmental ; Middle Aged ; Omentum ; transplantation ; Postoperative Period ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo study proteins correlated with the mechanical properties of engineered cartilage by screening significantly changed proteins during cartilage formation by comparative proteomic analysis.

METHODSHuman chondrocyte, cultured and expanded, were seeded onto a polyglycolic acid/polylactic acid (PGA/PLA) scaffolds. After 4 weeks of culture in vitro, the constructs were divided into three groups. There were 6 specimens in each group. For the regular in vitro culture group (A), the constructs were kept in culture at the original condition for an additional 6 weeks. For in vivo groups, the constructs were implanted subcutaneously into nude mice for either 6 weeks (B) or 12 weeks (C). All specimens were harvested for gross observation, average wet weight and volume measurement, histology, immunohistochemistry and biomechanics to evaluate the results. Meanwhile, comparative proteomic analysis was performed for each group, and those proteins involved in extracellular matrix with at least 2 folds up-regulation were chosen for further exploration. The correlations between Young's modulus and the relative content of the selected proteins were analyzed by Pearson correlation coefficient.

RESULTSAll these samples in the three groups eventually formed hyaline-like cartilage structure. Specimens in C and B groups were similar with adult articular cartilage in appearance, and had multiple mature lacuna in histology. However, those specimens in A group had loose texture with irregular hypertrophy lacuna. Specimens implanted for 12 weeks in vivo had better wet weight (372.5 +/- 35.4) mg and Young's modulus (8.68 +/- 2.65) MPa than those cultured in vivo for 6 weeks (346 +/- 34.5) mg, (3.25 +/- 1.24) MPa (P < 0.01). In group A, they were (184.4 +/- 12.28) mg and (0.7 +/- 0.23) MPa. This study had detected 44 proteins in ECM by comparative proteomic analysis, then chosing the greatest ratio of 6 up-regulation proteins compared between C and A groups. The correlation results indicated the content of Decorin, Chondroadherin and Fibromodulin were linear correlation with the mechanical properties of engineered cartilage (P < 0.05).

CONCLUSIONSComparative proteomic analysis could provide large scale information of associated proteins, making it profit for advanced research on the relationship between extracellular matrix and mechanical properties of engineered cartilage by combination with tissue reconstruction techniques.

Animals ; Cartilage ; cytology ; metabolism ; physiology ; Cells, Cultured ; Chondrocytes ; cytology ; metabolism ; Fetus ; cytology ; Humans ; Mice, Nude ; Proteome ; metabolism ; Proteomics ; Tissue Engineering ; methods ; Tissue Scaffolds

OBJECTIVETo investigate the distribution of mast cells (MC) in colon tissue of Hirschsprung disease (HD) and explore the role of mast cells in the pathogenesis of HD.

METHODSForty-one cases of HD (male 23, female 18), age from 2 months to 15 years, and eight age-matched normal cases were enrolled in this study. The distribution of MC in all layers of colon was examined by immunohistochemistry with mouse antihuman mast cell tryptase monoclonal antibody.

RESULTSThe count of MC in all layers of colon aganglionic segments of HD was significantly higher as compared with colon ganglionic segments of HD and normal controls (21.47+/-3.59 vs 3.18+/-0.87, 2.75+/-0.51). The average optical density values(A) of MC in aganglionic and ganglionic segments significantly decreased as compared to normal control (0.38+/-0.10,0.31+/-0.11 vs 0.51+/-0.08).

CONCLUSIONMast cells may play an important role in the pathogenesis of HD.

Adolescent ; Child ; Child, Preschool ; Female ; Hirschsprung Disease ; metabolism ; pathology ; Humans ; Infant ; Intestinal Mucosa ; pathology ; Male ; Mast Cells ; cytology ; metabolism ; pathology ; Tryptases ; metabolism