Background and purpose:Huachansu has been widely used to treat cancer in China.But maximum tolerated dose(MTD) of huachansu is still not well defined.The purpose of this study was to conduct a Phase Ⅰ study to determine the MTD of huachansu in the treatment of patients with hepatocellular carcinoma,non-small cell lung or pancreatic cancer.Toxic profile and efficacy of huachansu were also assessed qualitatively.Methods:Huachansu was intravenously administered to patients with stage Ⅲ/Ⅳ hepatocellular carcinoma,non-small cell lung cancer,or pancreatic cancer.Each cycle consisted of daily huachansu for 14 days with an interval of 7 days between two cycles.2 or more cycles were delivered to the patients if no severe adverse event occurred.The planned dose escalation schedule for huachansu was as follows,10,20,40,60,90 and 120 ml/(m2?d).Results:Fifteen patients(3 at each level) have been recruited to the study(11 with hepatocellular carcinoma,2 with pancreatic cancer,and 2 with lung cancer).There were no dose limiting toxicities found after dose level 5.Among all these patients,the efficacy in 14 patients could be valued,in which,6 were SD(42.9%),8 were PD(57.1%).At dose level 1,there was one patient with hepatocellular carcinoma achieving a 20% reduction in tumor mass that lasted 11 months,6 of 15(42.9%) patients with stable disease and 8 of 15(57.1%) with progress disease after the treatment.Conclusions:To date,dose limiting toxicity has not been seen with doses up to eight times higher than that typically used before.Of interest, several patients had prolonged stable disease or minor tumor shrinkage.

OBJECTIVETo investigate the roles of mouse erythroid differentiation and denucleation factor (MEDDF), a novel factor cloned in our laboratory recently, in erythroid terminal differentiation.

METHODSMouse erythroleukemia (MEL) cells were transfected with eukaryotic expression plasmid pcDNA-MEDDF. Then we investigated the changes on characteristics of cell growth by analyzing cells growth rate, mitotic index and colony-forming rate in semi-solid medium. The expressions of c-myc and beta-globin genes were analysed by semi-quantitative RT-PCR.

RESULTSMEL cells transfected with pcDNA-MEDDF showed significant lower growth rate, mitotic index, and colony-forming rate in semi-solid medium (P<0.01). The percentage of benzidine-positive cells was 32.8% after transfection. The expression of beta-globin in cells transfected with pcDNA-MEDDF was 3.43 times higher than that of control (MEL transfected with blank vector, pcDNA3.1), and the expression of c-myc decreased by 66.3%.

CONCLUSIONSMEDDF can induce differentiation of MEL cell and suppress its malignancy.

Activins ; genetics ; pharmacology ; Animals ; Cell Differentiation ; drug effects ; Cell Division ; drug effects ; Friend murine leukemia virus ; Globins ; biosynthesis ; genetics ; Inhibin-beta Subunits ; genetics ; pharmacology ; Leukemia, Erythroblastic, Acute ; metabolism ; pathology ; Mice ; Proto-Oncogene Proteins c-myc ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; Transfection ; Tumor Cells, Cultured

BACKGROUND:Anterior cruciate ligament avulsion fracture at tibial insertion is a special type of intra-articular fracture,which is mostly seen in sports injuries.At present,there are relatively few anatomical studies on this disease,but a large number of studies focus on the injury of the anterior cruciate ligament.It is generally believed that the increase in the posterior slope of the tibial plateau,the decrease of the depth of the medial tibial plateau,and the decrease in the width index of the femoral intercondylar notch are the risk factors for the injury of the anterior cruciate ligament.It is unclear whether avulsion fractures of the anterior cruciate ligament at the tibial insertion point are also related to it. OBJECTIVE:To investigate the correlation between the avulsion fracture of the anterior cruciate ligament at the tibial insertion and the posterior tibial slope,the medial tibial depth,the notch width index of the femoral intercondylar fossa,and the coronal slope angle of the tibial plateau. METHODS:A retrospective analysis was made on 101 patients who were admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University due to anterior knee pain from January 2019 to December 2022.Totally 51 patients with tibial insertion avulsion fracture of anterior cruciate ligament who received arthroscopy treatment were taken as the observation group,and 50 patients with anterior knee pain but no knee joint injury confirmed by physical examination and imaging examination were taken as the control group in the same period.The posterior tibial slope,anatomical parameters such as the medial tibial depth,and the notch width index of the femoral intercondylar fossa,were statistically analyzed for the anatomical risk factors leading to the tibial insertion avulsion fracture of the anterior cruciate ligament. RESULTS AND CONCLUSION:(1)There was no significant difference between the two groups in the comparison of the lateral posterior tibial slope,the posterior slope ratio of the lateral/medial tibial plateau,the notch width index of the femoral intercondylar fossa,and the coronary slope angle of the tibial plateau(P>0.05).The medial posterior tibial slope in the observation group was significantly higher than that in the control group(P<0.05).The medial tibial depth in the observation group was significantly lower than that in the control group(P<0.05).(2)Multifactor logistic regression analysis showed that the medial posterior tibial slope and the medial tibial depth were independent risk factors for tibial insertion avulsion fracture of anterior cruciate ligament(P<0.05).(3)The receiver operating characteristic curve shows that the medial posterior tibial slope and the medial tibial depth had certain predictive values for the tibial insertion avulsion fracture of the anterior cruciate ligament.(4)It is indicated that the increased medial posterior tibial slope and the shallower medial tibial depth are the anatomical risk factors for the avulsion fracture of the tibial insertion of the anterior cruciate ligament.

BACKGROUND:Many studies have shown that total hip arthroplasty will improve low back pain in patients with hip-spine syndrome.However,there are few studies on the relationship between postoperative low back pain improvement and changes in spinal-pelvic sagittal parameters.This study aims to reveal their connections between the two. OBJECTIVE:To explore the relationship between the improvement of low back pain and changes in the spinal-pelvic sagittal parameters in patients with hip-spine syndrome after total hip arthroplasty. METHODS:A retrospective analysis was performed on the clinical and imaging data of 93 end-stage hip disease patients who underwent primary total hip arthroplasty and combined with low back pain and were admitted to Affiliated Hospital of Xuzhou Medical University from January 2019 to January 2022.Spinal-pelvic sagittal parameters were measured on lateral lumbar X-rays before surgery and 1 year at the last follow-up:pelvic incidence,pelvic tilt,sacral slope,lumbar lordosis,pelvic incidence-lumbar lordosis(difference between pelvic incident angle and lumbar lordosis angle).Visual analog scale score,Oswestry disability index,and hip Harris score were recorded before and 1 year after arthroplasty.The patients were divided into two groups according to whether the change in visual analog scale scores 1 year after surgery reached the minimal clinically important difference for low back pain treatment,including 45 cases in the low back pain unimproved group and 48 cases in the low back pain improved group.The preoperative general data of patients,differences in spinal-pelvic sagittal parameters,Oswestry Disability Index and hip Harris score before and after surgery were compared between the two groups. RESULTS AND CONCLUSION:(1)There was no significant difference in age,gender,surgical side,body mass index,and etiology between the two groups(P>0.05),and they were comparable.(2)There was no significant difference in visual analog scale scores before surgery(P>0.05).The visual analog scale scores of the low back pain improved group were lower than those of the low back pain unimproved group 1 year after surgery(P<0.01).(3)At 1 year after surgery,the lumbar lordosis of the low back pain unimproved group was significantly smaller than that before surgery,while the lumbar lordosis of the low back pain improved group was significantly smaller than that before surgery(P<0.01).At the same time,the pelvic incidence-lumbar lordosis mismatch in the low back pain unimproved group was greater than before surgery,while the pelvic incidence-lumbar lordosis mismatch in the low back pain improved group was smaller than before surgery,with significant differences between the two groups(P<0.01).There was no significant difference in the changes of other spinal-pelvic sagittal parameters between the two groups(P>0.05).(4)Preoperative lumbar Oswestry disability index and hip Harris score were not significantly different between the two groups(P>0.05).At 1 year after surgery,Oswestry disability index of the low back pain improved group was lower than that of the low back pain unimproved group and the hip Harris score was higher than that of the low back pain unimproved group(P<0.05).(5)The results showed that the improvement of low back pain was related to changes in spinal-pelvic sagittal parameters in patients with hip-spine syndrome after total hip arthroplasty,showing reduced lumbar lordosis and pelvic incidence-lumbar lordosis mismatch.Moreover,patients with improved low back pain after surgery had better functional scores,indicating that total hip arthroplasty improved spinal alignment and spinal-pelvic sagittal balance.For patients with hip-spine syndrome,a total hip arthroplasty performed before the onset of lumbar disease can have a favorable effect on the lumbar spine.