OBJECTIVETo study the effect of continuous passive motion (CPM) on basic fibroblast growth factor (b-FGF) expression during tendon-bone repair in rabbits and explore the role of stress in the postoperative repair after acute rotator cuff injury.

METHODSSixteen rabbits randomized into CPM group (n=8) and non-CPM group (n=8) were subjected to surgically induced acute rupture of the supraspinatus tendon and subsequent surgical repair, with another two rabbits serving as the control. Two weeks after the operation, the rabbits in CPM group underwent CPM training, and those in non-CPM group were normally fed only. At 2, 4, 6, and 8 weeks after the operation, 2 rabbits from each group were sacrificed and the tissue samples were obtained for detecting the changes in b-FGF expression.

RESULTSTwo weeks after the operation, b-FGF expression was detected in both groups, and the CPM group showed slightly higher and more diffusive expression. At 4 weeks, b-FGF expression was significantly higher and distributed over a greater area in CPM group and in the non-CPM group. A large number of fibroblasts positive for b-FGF expression were identified in CPM group, aligning in parallel with the tendon membrane. At 6 weeks, b-FGF in the CPM group showed no obvious changes but that in the non-CPM group became lightened. At 8 weeks, b-FGF expression was reduced in both groups, which was more obvious in the non-CPM group.

CONCLUSIONCPM can promote b-FGF expression to enhance type III collagen synthesis at the tendon-bone interface in early stage of tendon-bone repair following acute rupture of supraspinatus tendon in rabbits, thereby contributing to tendon-bone recovery after rotator cuff injury.

Animals ; Bone Remodeling ; drug effects ; physiology ; Fibroblast Growth Factor 2 ; metabolism ; Male ; Postoperative Period ; Rabbits ; Random Allocation ; Range of Motion, Articular ; Rupture ; surgery ; Tendon Injuries ; rehabilitation ; surgery ; Tendons ; metabolism ; Wound Healing ; physiology

OBJECTIVETo investigate the changes in transforming growth factor beta 1 (TGF-beta1)/Smads signaling pathway in rats with chemical hepatocarcinogenesis.

METHODSFresh diethylnitrosamine (DENA) solution was administered in SD rats to induce hepatocellular carcinoma (HCC). The protein expressions of TGF-beta1, phosphorylated Smad2, Smad4 and Smad7 were detected in these rats with immunohistochemistry, and the mRNA expression of Smad4 was evaluated with RT-PCR.

RESULTSCirrhotic nodules occurred in the rats 8 weeks after DENA treatment, and HCC nodules were found 16 weeks after the treatment. In the normal liver tissue, very low levels of TGF-beta1 and Smad4 expressions, low Smad7 expression and high phosphorylated Smad2 expression were detected. The development of liver cirrhosis was accompanied by increased expressions of TGF-beta1, Smad4 and Smad7 but at 8 weeks after DENA treatment, the expression of phosphorylated Smad2 was significantly decreased, followed then by gradual increment till nearly the normal level. Twenty-two weeks after DENA treatment, Smad4 expression in liver tissue decreased markedly as compared with the levels at 8 and 16 weeks. The expressions of Smad4 and phosphorylated Smad2 in the HCC tissue was significantly lower than those in normal liver tissue.

CONCLUSIONHepatocarcinogenesis involves very complex mechanisms, can can be related partially to the decreased Smad4 and phosphorylated Smad2 expression and TGFbeta1 and Smad7 overexpression in advanced stage of liver cirrhosis.

Animals ; Diethylnitrosamine ; Liver Neoplasms, Experimental ; chemically induced ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Smad2 Protein ; metabolism ; Smad4 Protein ; metabolism ; Smad7 Protein ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism

Objective:To explore the clinical effect of bench treadmill training on functional recovery for patients with severely burnt on lower limbs. Methods:From October, 2016 to December, 2017, 30 patients with severe lower limb burn were divided into control group (n = 15) and observation group (n = 15). The control group accepted routine comprehensive rehabilitation, while the observation group accepted the bench treadmill training in addition. They were assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Numerical Rating scale (NRS) of pain, Berg Balance Scale (BBS) and 6-minute walking test (6MWT) before and after six weeks of treatement. Results:The scores of SAS, SDS and NRS decreased in both groups (t > 3.636, P < 0.01), and they were less in the observation group than in the control group (t > 2.319, P < 0.05). The score of BBS and distance of 6MWT increased in the observation group compared with those in the control group (t > 2.541, P < 0.05). Conclusion:Early training with bench treadmill may promote the functional recovery for patients with severe lower limbs burns.

Animals ; Cholesterol ; metabolism ; Cryopreservation ; Cytochromes c ; metabolism ; Hepatocytes ; cytology ; metabolism ; Ischemic Preconditioning ; Male ; Mitochondria, Liver ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transplantation Conditioning ; methods

OBJECTIVETo explore the anatomic features of mesoesophagus in combined thoracoscopic and laparoscopic esophagectomy with three-fields lymphadenectomy.

METHODSClinical data of 67 patients undergoing thoracoscopic and laparoscopic esophagectomy with three-fields lymphadenectomy from July 2011 to September 2012 were analyzed retrospectively. All the patients underwent three-fields lymphadenectomy. Proper surgical planes were selected according to anatomy of mesoesophagus. Thoracoscopic surgical space was bounded on azygotic vein and divided into upper and low esophageal triangle. Pancreas was the key anatomical mark for laparoscopic gastric dissection, and peripancreatic space was the natural laparoscopic surgical plane. Prevertebral fascia was bottom surface of neck dissection and carotid sheath was the boundary of two sides.

RESULTSThe median operative time was 251.6 min (range, 220 to 320 min). The median operative blood loss was 105.6 ml (range, 40 to 320 ml). The median number of lymph nodes dissected was 29.1 (range, 13 to 46, totally 1949). There was no perioperative death. Sixty-six patients were followed up with a mean follow-up time of 8.2 months (range, 2 to 14 months). Postoperative complications included reflux esophagitis in 10 and anastomotic stenosis in 3 cases.

CONCLUSIONIt is safe and more radical for minimally invasive esophagectomy that overall concept of minimally invasive anatomy of mesoesophagus is applied to identify the anatomic plane and landmark during operation.

Aged ; Esophageal Neoplasms ; pathology ; surgery ; Esophagectomy ; Esophagus ; anatomy & histology ; pathology ; Female ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo analyze the factors affecting prognosis of patients with nasal carcinoma.

METHODS163 patients treated from 1985 to 1998 were analyzed. The survival analysis was performed by Kaplan-Meier estimate and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model.

RESULTSThe overall 5-year survival rate was 58.2%. The 5-year survival rate was 55.8% in squamous-cell carcinoma, 44.0% in adenocarcinoma, 59.7% in undifferentiated carcinoma, 76.3% in adenoid cystic carcinoma, 71.4% in mucoepidermoid carcinoma, 25.0% in rhabdomyosarcoma, 26.7% in malignant melanoma, 50.0% in neuroblastoma (P > 0.05). Patients with cervical metastasis gave a 5-year survival of 53.5% while those without gave 58.9% (P > 0.05). Patients with involvement of sphenoidal sinus or maxillary sinus gave the worse survival. The 5-year survival rate was 73.8% in patients whose cancer completely disappeared after treatment. It was 41.6% in patients whose cancer incompletely disappeared, and 34.3% in patients whose cancer remained refractory (P < 0.01). The 5-year survival was 78.3% in stage I disease, 56.4% in stage II disease, 54.2% in stage III and 35.9% in stage IV (P < 0.05). The 5-year survival rate of patients who were treated with radiotherapy only was 56.9%. That of patients who were treated with surgery only was 56.6%. That with chemotherapy only was 25.0% whereas that of patients treated with combination treatment was 61.8% (P > 0.05). So far, 85 patients have died up to writing this report, 57.6% (49 patients) of recurrence or uncontrolled.

CONCLUSIONClinical stage, immediate therapeutic response and involvement of sphenoidal or maxillary sinus; but not the pathologic type, the presence of cervical metastasis nor the method of treatment, are the factors affecting the prognosis of patients with nasal carcinoma. Recurrence and uncontrolled disease are the cause of death.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Nasal Cavity ; Nose Neoplasms ; mortality ; therapy ; Prognosis ; Survival Rate

OBJECTIVETo evaluate the value of mediastinoscopy in diagnosing unknown mediastinal disease and staging of lung cancers.

METHODSFrom October 2000 to August 2001, 41 patients were examined by cervical mediastinoscopy with or without anterior mediastinotomy for diagnostic and staging purposes. Of these 41 patients, 12 were for diagnosis of unknown mediastinal disease, 3 for diagnosis and staging of pulmonary nodule or mass clinically suspected to be malignancy and 26 for the staging of lung cancer.

RESULTSTen of 12 patients with unknown mediastinal disease were diagnosed pathologically as thymoma in 1, metastatic lesion from lung cancer in 1, metastatic thyroid carcinoma in 1, lymph node hyperplasia in 1, teratoma in 1, sarcoidosis in 1, inflammatory pseudotumor in 1 and tuberculosis in 3, giving a diagnostic rate of 83.3%. Of three patients with suspected malignancy, one was diagnosed as tuberculosis by cervical mediastinoscopy and the other two as lymphoma and pulmonary inflammatory pseudotumor by thoracoscopy and thoracotomy. The sensitivity and specificity of mediastinoscopy for the staging of mediastinal nodes in 26 lung cancers were 87.5% and 100%. Only one wound infection but no other major complication was found.

CONCLUSIONMediastinoscopy is a safe procedure which can accurately provide information on diagnosis and staging.

Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; diagnosis ; Male ; Mediastinal Neoplasms ; diagnosis ; Mediastinoscopy ; Middle Aged ; Neoplasm Staging

BACKGROUNDBilirubin is the end product of heme catabolism and has strong antioxidant properties. Serum bilirubin levels are reported to be reduced in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO). The pathophysiology of optic neuritis (ON) resembles that of MS; however, the role of endogenous bilirubin in ON is unclear. The aim of this study is to measure serum bilirubin levels in patients with ON, and to investigate the correlation between ON and serum antioxidant status of bilirubin.

METHODSSerum levels of bilirubin were measured in 42 patients with ON, 50 patients with multiple sclerosis (MS), 48 patients with neuromyelitis optica (NMO) and 48 healthy control subjects.

RESULTSSerum total bilirubin (Tbil), direct bilirubin (Dbil) and indirect bilirubin (Ibil) levels in patients with ON were significantly lower than those in the healthy controls. However, no statistical significance was found between levels in the ON and MS, ON and NMO, and MS and NMO groups. In patients with ON, serum Tbil, Dbil, and Ibil levels were lower in those with recurrence or those with ON for a longer duration (≥ 1 year). Moreover, Tbil, Dbil, and Ibil concentrations were lower in patients with papillitis than in those with retrobulbar type ON, but the differences were not statistically significant.

CONCLUSIONSLow antioxidant status may exist in patients with ON. But serum levels of Tbil, Dbil, and Ibil did not correlate with clinical presentations, such as recurrence, duration of disease and subtypes of ON. Low antioxidant status already existed in MS or NMO patients before systemic symptoms appeared.

Adolescent ; Adult ; Aged ; Antioxidants ; metabolism ; Bilirubin ; blood ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Multiple Sclerosis ; blood ; Neuromyelitis Optica ; blood ; Optic Neuritis ; blood ; Young Adult

OBJECTIVESTo analyze associated factors and the prognosis of patients with residual cancer after esophagectomy for squamous cell carcinoma of the esophagus, and to assess outcomes after salvage treatment.

METHODSClinical and pathological data of 1074 patients with squamous cell carcinoma of the esophagus who underwent esophagectomy in the Cancer Center of Sun Yat-sen University from 1997 to 2003 were analyzed retrospectively. The relationship between the associated factors (differentiation, location, length of the lesion, surgical route, anastomosis site, T stage, N stage) and the incidence of residual cancer was analyzed, using the chi-squared test and Logistic regression analysis methods. The value and the modality of the salvage treatment were investigated.

RESULTSForty-four patients had residual cancer (4.3%). Cancers in the upper esophagus were associated with the highest incidence of residual cancer on esophageal stump (6.5%), while the lower esophagus had the highest incidence of residual cancer on gastric stump (0.78%). The Incidence correlated with T and N stage. Logistic regression analysis showed that T and N stage were the risk factors of residual cancer. Three-year survival rate was 22.7% in patients with residual cancer. The mean survival time was 25.2+/-3.3 months. Three-year survival rates of patients with and without salvage treatment were 53.2% and 7.8%, respectively (P=0.027). Three-year survival rate of patients with salvage radiotherapy was 56.0%.

CONCLUSIONSAdvanced T and N stage are the risk factors of residual cancer after esophagectomy in the patients with squamous cell carcinoma of the esophagus. Salvage treatment can improve the survival of the patients.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Esophageal Neoplasms ; diagnosis ; pathology ; surgery ; Esophagectomy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm, Residual ; epidemiology ; Prognosis ; Retrospective Studies

OBJECTIVETo detect HBV antigen specific cytotoxic T lymphocyte (CTL) changes in patients during acute flare-ups and to study their association with flare-ups and aggravations into grave hepatitis by quantitative analysis of HLA-A2* restricted HBcAg-specific CTL cells.

METHODSThe frequency of HBcAg-specific CTL cells in the peripheral blood mononuclear cells (PBMC) from 29 patients with persistent infection with HBV were quantified by flow cytometry using one HLA-A2*HBV peptide pentamers complex (Pro5TM MHC Pentamers).

RESULTSThere was a statistical difference of HBcAg specific CTLs between the patients with acute exacerbations (1.4%+/-0.8%) and the patients with immune tolerance (0.6%+/-0.4%) (t = 2.180, P = 0.01-0.05); There was no significant difference between the grave hepatitis group (1.3%+/-1.0%) and the chronic hepatitis group (1.4%+/-0.8%) regarding frequencies of antigen specific CTL (t = 0.215, P = 0.833-0.05). The level of antigen specific CTLs in PBMC in the 6 cases of chronic hepatitis B with acute exacerbations maintained a relatively high level (more than 0.7%) within the 12 week follow-up period.

CONCLUSIONHBcAg-specific CTLs may play an important role in hepatic flare-ups in patients with chronic HBV infection, but there was no direct relationship between antigen- specific CTLs and grave hepatitis.

Adult ; Female ; HLA-A2 Antigen ; immunology ; Hepatitis B Core Antigens ; immunology ; Hepatitis B virus ; immunology ; Hepatitis B, Chronic ; immunology ; virology ; Humans ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; immunology ; Viral Load ; Young Adult