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 effects of advanced oxidative protein products (AOPP) on the proliferation, apoptosis and matrix metalloproteinase-1 (MMP-1) synthesis of the human gingival fibroblast (HGF). To explore the possible mechanism of the periodontal destruction acceleration in diabetes through AOPP-mediated oxidative stress.

METHODSHGF were isolated by both tissue explant cultivation technique and enzyme digestion method. The culture media with 5, 50, 100 mg/L AOPP-HAS were added into each experimental group, but the culture media in the control group didn't contain AOPP-HAS. MTT colorimetric assay and ELISA were used to measure the changes of HGF proliferation and the levels of MMP-1 protein from HGF at different time periods, respectively. Seventy-two hours after co-culture with 50 mg/L AOPP-HSA, cell apoptosis was detected by flow cytometry with Annexin V/PI staining.

RESULTSCompared to the control group, the growth inhibition rate of HGF in 5, 50, 100 mg/L AOPP-HSA group was significantly different (P < 0.05). The peak value appeared at 48 hours of co-culture [(19.01 +/- 6.28)%, (30.48 +/- 5.75)%, (39.75 +/- 4.60)%, respectively]. There was a dose-dependent relationship between the growth inhibition rate and AOPP-HSA. No significant difference was detected on the apoptotic level between experimental group and the control (P > 0.05). The MMP-1 synthesis in 0.5, 5, 50, 100 mg/L AOPP-HAS group [(55.61 +/- 1.06), (65.78 +/- 4.04), (79.24 +/- 3.09), (89.76 +/- 28.88) mg/L, respectively] was significantly higher than that in the control [(34.90 +/- 3.15) mg/L] after 72 hours co-culture (P < 0.05). There was a dose-dependent relationship between MMP-1 and AOPP-HSA.

CONCLUSIONSAOPP may inhibit the proliferation of HGF and such effect was not achieved through apoptosis. AOPP may increase collagen degradation by promoting MMP-1 synthesis and thus may accelerate periodontal destruction process in diabetes.

Apoptosis ; drug effects ; Blood Proteins ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Gingiva ; cytology ; drug effects ; Humans ; Matrix Metalloproteinase 1 ; metabolism ; Oxidation-Reduction ; Oxidative Stress

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.

OBJECTIVEThis study was designed to evaluate whether sentinel node (SN) biopsy can accurately assess the cervical lymph node status of oral tongue carcinoma, as well to research the best method and indications of SN biopsy.

METHODSPreoperative lymphoscintigraphy with (99m)Tc-SC and intraoperative sentinel node mapping with methylene blue dye were administered on 20 cases of oral tongue carcinoma with cN(0) neck and 5 cases with cN(+) neck; routine pathological examination was used to assess the status of SNs. The results of routine pathological examination of cervical specimen were set as golden standard to assess the efficacy of SN biopsy in evaluating the cervical lymph node status.

RESULTS53 SNs were detected in 24 cases out of the total 25 cases (96%), averaging 2.2 SNs per case. SNs were detected in all 20 cases with cN(0) neck, in which 4 cases with occult cervical metastasis were detected by SN diopsy, without false negative case found in the procedure. In 5 cases with cN(+) neck, SNs were detected in 4 cases. In 4 cases whose SNs were detected, there were 5 cN(+) necks, out of which SNs were detected in 4 cN(+) necks but failed to predicted the cervical lymph node status in 2 necks. However, SNs were detected in 2 out of the other 3 cN(0) necks, both of which were diagnosed as SN(+)pN(+).

CONCLUSIONSNuclear lymphoscintigraphy and blue dye mapping can be used to trace the SNs in cases with oral tongue carcinoma, with satisfactory detective rate. SN biopsy can accurately evaluate the cervical lymph node status in cases of oral tongue carcinoma with cN(0) neck. Whether it can be used to evaluate the lymph node status of the cN(0) neck in case with a contralateral cN(+) neck is worthy of further research.

Humans ; Sentinel Lymph Node Biopsy ; Tongue Neoplasms ; pathology

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

BACKGROUNDHuman umbilical cord blood contains an abundance of immature stem/progenitor cells, which may participate in the repair of hearts that have been damaged by myocardial infarction (MI). This study aimed to evaluate the effects of human umbilical cord blood mononuclear cells (hUCBC) transplantation on cardiac function and left ventricular remodeling in rat model of MI.

METHODSForty-five male Wistar rats were randomized into three groups: MI or control group (n = 15), MI plus cell transplantation (n = 15), and sham group (n = 15). Acute myocardial infarction (AMI) was established by ligating the left anterior descending artery, thereafter, hUCBC were implanted into the marginal area of infarcted myocardium. In MI/control group, DMEM was injected instead of hUCBC following the same protocol. Left ventricular function assessment was carried out by echocardiography and invasive hemodynamic measurements one month post MI. All rats were sacrificed for histological and immunochemical examinations.

RESULTSThe transplanted hUCBC survived and engaged in the process of myocardial repair in the host heart. Echocardiography demonstrated that left ventricular function improved significantly in the rats that underwent cell transplantation. Hemodynamic studies found a significantly decreased left ventricular end-diastolic pressure (LVEDP) [(21.08 +/- 8.10) mmHg vs (30.82 +/- 9.59) mmHg, P < 0.05], increase in +dp/dt(max) [(4.29 +/- 1.27) mmHg/ms vs (3.24 +/- 0.75) mmHg/ms, P < 0.05), and increase in -dp/dt(max) [(3.71 +/- 0.79) mmHg/ms vs (3.00 +/- 0.49) mmHg/ms, P < 0.05] among MI group with hUCBC transplantation when compared with MI/control group. Masson's trichrome staining revealed that the collagen density in the left ventricle was significantly lower in rats of transplantation group than that in the MI control groups [(6.33 +/- 2.69)% vs (11.10 +/- 3.75)%, P < 0.01]. Based on immunostaining of alpha-actin, the numbers of microvessels were significantly (P < 0.01) increased at the boundary of infarction site. Similarly higher mRNA expression of vascular endothelial growth factor (VEGF) 164 and VEGF188 were found at 7- and 28-day post cell transplantation in MI group with hUCBC transplantation when compared with MI/control group.

CONCLUSIONSTransplanted hUCBC can survive in host myocardium without immunorejection, significantly improve left ventricular remodeling after AMI and promote a higher level of angiogenesis in the infarct zones. All these factors beneficially affect cardiac repair in the setting of MI. Therefore human umbilical cord blood may be potential source for cell-based therapy for AMI.

Actins ; analysis ; Animals ; Antigens, CD34 ; analysis ; Collagen ; metabolism ; Cord Blood Stem Cell Transplantation ; Electrocardiography ; Gene Expression ; Humans ; Immunohistochemistry ; Leukocytes, Mononuclear ; chemistry ; cytology ; transplantation ; Male ; Myocardial Infarction ; physiopathology ; surgery ; Myocardium ; chemistry ; metabolism ; pathology ; Neovascularization, Physiologic ; physiology ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Transplantation, Heterologous ; Vascular Endothelial Growth Factor A ; genetics ; Ventricular Function, Left ; physiology

OBJECTIVEA bias may be produced when only TNM stage is used to predict the prognosis of non-small cell lung cancer (NSCLC) after complete resection and multidisciplinary treatment. The reason is that histological type, differentiation, and postoperative treatment which may also affect the survival are excluded in the prognosis prediction. The aim of this study is to establish and evaluate a prognostic prediction model for NSCLC patients based on pathological parameters after completely resection and postoperative treatment.

METHODSAccording to the theory of Nottingham index model, a prognostic prediction model was established based on the pathological parameters and postoperative management of 899 NSCLC patients after complete resection and multidisplinary treatment in our hospital from Jan.1, 1997 to April, 2001, and its efficiency and feasibility were evaluated.

RESULTSUnivariate analysis and multivariate analysis showed that histological type (H), T stage (T), N stage (N), M stage (M), and postoperative mediastinal radiotherapy for positive lymph node (R) were independent factors affecting the survival of NSCLC after complete resection and multidisciplinary treatment. The prognostic prediction model based on these parameters is: S = 0.338H + 0.178T + 0.549N + 0.647M-0.361R. The high and low risks of prognostic index (PI) were 1.6695 and 1.1160, respectively. The 5-year survival rates of the patients in the low, middle and high risk groups stratified by this model were 70.1%, 54.5%, and 22.5%, respectively, with a significant difference among the groups (chi(2) = 132.091, P = 0.000).

CONCLUSIONA model based on the pathological parameters and postoperative management has been established, which may be helpful in predicting the prognosis for NSCLC after complete resection and multidisciplinary management.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; therapy ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; therapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Prognosis ; Proportional Hazards Models ; Radiotherapy, High-Energy ; Survival Rate ; Young Adult

OBJECTIVEThis study was designed to explore the optimal management option for cervical metastases in tongue squamous cell carcinoma (SCC) with clinically N0 neck in order to avoid excessive or inadequate treatment in clinical practice.

METHODSClinical data of 327 cases of tongue SCC with cN0 neck were retrospectively analyzed. Neck control rates affected by different pathoclinical parameters were compared. Prognosis analysis and death analysis were also performed.

RESULTSOverall 3-year survival was 69.7% (228/327), 3-year survival of neck recurrent group and non-recurrent group was 39.1% (25/64) and 77.2% (203/263), and 51.5% (51/99) of the death related to neck failure. Overall neck control rate was 80.4% (263/327); neck control rate of wait and watch group, level I neck dissection, level I + II neck dissection, supraomohyoid neck dissection, radical neck dissection, functional neck dissection, was 67.5% (27/40), 72.7% (24/33), 60.0% (15/25), 84.9% (45/55), 86.8% (131/151), 84.0% (21/25), respectively. Treatment modality and cervical lymph node involvement were independent factors for neck control.

CONCLUSIONSNeck control is a key for prognosis of tongue SCC with cN0 neck. Supraomohyoid neck dissection is the first choice in management of cervical metastases in tongue SCC with cN0 neck, during which the suspected involved lymph nodes should be sent for frozen section to determine whether comprehensive neck dissection required. Multimodal metastasis and/or capsular spread are the indications for postoperative irradiation.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; methods ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Tongue Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo summarize the experience of surgical resection of 103 hilar cholangiocarcinoma.

METHODSOne hundred and three consecutive cases of hilar cholangiocarcinoma who underwent surgical resection at our hospital over the past ten years were reviewed retrospectively. The clinical data and long-term outcome were analyzed.

RESULTSOut of 103 cases, 43 patients underwent radical resection (41.7%), and 60 patients underwent palliative resection. There were 34 patients developed postoperative complications and 8 patients died in hospital. For the radical resection group, the median survival time was 29.9 months and 1-year, 3-year, 5-year survival rate was 69.6%, 42.0%, 20.9%, respectively, which was significant greater than 34.1%, 10.2%, 0 of the palliative resection group (P < 0.05). Over the past five years, 42 cases underwent pre-operative drainage of bile and the rate of combined liver resection reached 53.8%. The tumor radical resection rate has increased to 45.7%, the median survival time have reached 24.7 months (P < 0.05).

CONCLUSIONSImprovement of pre-operative management, intraoperative pathology for resection margin, and combined liver resection may help in increasing the radical resection rate. Radical resection can improve postoperative survival, and produce a satisfactory outcome for patient with hepatic hilar cholangiocarcinoma.

Adult ; Aged ; Bile Duct Neoplasms ; mortality ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; mortality ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate