Aged ; Carcinoma, Renal Cell ; pathology ; Carcinosarcoma ; pathology ; Chondroma ; pathology ; Chondrosarcoma ; complications ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; complications ; metabolism ; pathology ; secondary ; surgery ; Lung Neoplasms ; secondary ; Nephrectomy ; Pleural Effusion, Malignant ; etiology ; S100 Proteins ; metabolism ; Soft Tissue Neoplasms ; pathology ; Vimentin ; metabolism

Objective To investigate the effectiveness of femoral troehanter reconstruction and artificial femoral head replacement in treatment of unstable intertrochanterie fractures in the elderly pa- tients. Methods Femoral trochanter reconstruction and artificial femoral head replacement was done on 106 patients with unstable intertrochanterie fractures. There were 45 males and 61 females, at age range of 80-105 years (average 88 years). Most of patients slipt in the room and got fractured. According to the Evans classification, there were 31 patients with type ⅢA fractures, 45 with type ⅢB and 30 with type IV. We used 4 kinds of methods to reconstruct the fracturad imertrochanters : (1) shape of" ∞ " ten- sion band fixation after intertrochanterie fracture reduction;(2) wire loop fixation of the lesser troehanter around proximal femur;(3)defect within the femoral ealear was filled with bone cement and remodeled; (4) for patients with relative intact base of femoral neck, the intertrochanterie fracture was transformed in- to femoral neck fracture and the femoral ealear was fixed with femoral prosthesis stem. Results All the operations continued successfully, with duration of the operation for 45-70 minutes (average 55 minutes). No artificial femoral head dislocation occurred during hospitalization. Of all, 79 patients were followed up for 6-48 months (average 16 months). No Late loosening, dislocation or infections occurred, with total excellence rate of 87.3%. Conclusions For elderly patient with unstable intertrochanterie fractures, reconstruction of femoral intertrochant and artificial femoral head replacement can restore the proximal femoral anatomy, maintain stability of the hip joint and help early functional exeereise, as can reduce ease fatality rate and improve the quality of life.

Objective To evaluate clinical effectiveness of transcatheter closure of atrial septal defects ( ASD) with severe pulmonary arterial hyperyension ( sPAH) by fenestrated Amplatzer septal occluders ( ASO) . Methods From September 2002 to April 2013, 17 patients of ASD with sPAH received transcatheter ASD closure using fenestrated occluders. Aged from 18 - 72 years, the diameters of ASDs were 18 - 33 mm. The systolic pulmonary arterial hypertension measured by transthoracic echocardiogram were 80 - 112 (96. 9 ± 8. 9) mmHg. The follow-up study included electrocardiography, chest radiography and echocardiography. All the patients were followed up for 1. 5 - 12 ( mean 6. 4 ± 0. 7) years. Results Systolic pulmonary arterial pressure (sPAP) of 60 - 108 (88. 7 ± 11. 7) mmHg and mean pulmonary artery pressure ( mPAP) of 29. 3 - 60 (51. 0 ± 8. 1) mmHg were measured by cardiac catheterization before ASD closure. Qp/ Qs was 1. 50 - 2. 44 (1. 8 ± 0. 31) and the pulmonary vascular resistance was 3. 1 - 9. 7 (5. 6 ± 1. 5) wood units (wu) . Immediately after the implantation of fenestrated occluders, sPAP decreased to 56 - 99 (70 ± 11. 5) mmHg and mPAP to 27 - 51. 7 (41. 1 ± 7. 1) mmHg. On the 3 d, 3 m and 6 m follow-up exam, RVEDd decreased ( P ﹤ 0. 05), while LVEDd, LVEDV and LVEF increased significantly (P ﹤ 0. 05) . sPAP decreased significantly after transcatheter closure at 3 m and 6 m as compared to pre-closure levels (both P ﹤ 0. 05) . The mean sPAP in long term follow up was (60. 2 ± 13. 3) mmHg which had significant decrease compared to pre-closure level ( P ﹤ 0. 01), but no significant difference found when compared to 6 m follow up (P ﹥ 0. 05). Conclusions ASD closure with fenestrated ASO is a satisfactory approach for ASD with severe PAH.

Objective To investigate the occurrence and influencing factors of early allograft dysfunction (EAD) in patients receiving donation after cardiac death (DCD) liver Transplantation.Methods Forty-five patients received orthotopic liver transplantation in our center during January 2016 and May 2016 were included in this study.Based on the occurrence of EAD,patients were divided into EAD group and non-EAD group.Perioperative data of donors and recipients were collected to analyze the risk factors of EAD and the effect of EAD on the short-term prognosis of patients.Results In 45 patients,the incidence of EAD was 57.8％ (26 cases).During the follow-up period,the mortality of recipients in EAD group and non-EAD group was 15.4％ and 15.8％ respectively,which showed no significant difference.Donor age,preoperative ALT and AST levels,cold ischemia time (CIT) were significantly increased in EAD group than in non-EAD group (43.7 ±2.5 and36.2±2.5,P=0.0409;64.2 ±13.2 and 31.0 ± 5.9,P=0.0407;87.3±16.2 and48.2±6.2,P=0.047 3;629.5 ± 35.2 and 484.6 ± 30.5,P =0.004 0,respectively).Perioperative CRP level in EAD group was significantly higher than in non-EAD group (22.6 ± 5.9 and 4.7 ± 1.1,P =0.012 1).What's more,postoperative platelet level was significantly lower in EAD group than in nonEAD group (73.7 ± 8.0 and 111.7 ±16.0,P =0.0439).However,pre-and post-operative neutrophil-lymphocyte ratio (NLR) in recipients showed no significant difference between EAD group and non-EAD groups.Conclusion Older donor age,high levels of preoperative ALT and AST,prolonged cold ischemic time,as well as high level of preoperative CRP and decrease of postoperative platelet level in recipients are risk factors for the occurrence of EAD after liver transplantation.

Objective:To investigate the expression of NADPH Oxidase2 (NOX2) in gastric cancer tissues and its correlation with vascular endothelial growth factor(VEGF) level.Methods:The gastric cancer tissue and the adjacent tumor tissue were obtained from the patients who received radical operation for gastric cancer during July 2014 to July 2015 in Provincial Hospital Affiliated to Shandong University.The expression of NOX2 in the tumor tissue and the adjacent tissue were detected by the immunohistochemistry(IHC) and Western blot.The VEGF level were detected by IHC in gastric cancer tissues.The spearman rank correlation were used to detected the correlation between the NOX2 and VEGF.Results:The positive expression rate of NOX2 in gastric cancer tissue was 47.2％ (58/123),and the positive expression rate in the adjacent tissue was 8.13％ (10/123),mostly expression in the adjacent was weak positive.The outcome of Western blot show that the NOX2 was up-regulated in the tumor tissue compare to the adjacent tissue [39.0％(48/123)].The expression of NOX2 and the relationship of clinical-pathology showed the expression of NOX2 had no correlation with gender,age,differentiation of tumor (X2 value were 0.852,0.150,5.062,P＞0.05).The result of spearman rank correlation showed that the NOX2 was positively correlated with that of VEGF.Conclusion:NOX2 plays an important role in the genesis and development in the gastric cancer,the expression of NOX2 was closely correlated with the VEGF.

Objective Investigate the prognosis of patients undergoing liver transplantation (LT) for end-stage autoirnmune liver disease (ALD).Method The clinical data of 45 patients with endstage ALD undergoing LT from April 2001 to March 2015 in the first affiliated hospital of Zhejiang University were analyzed retrospectively.The postoperative cumulative survival rate of the recipients was calculated,and the causes of death were analyzed.The postoperative rejections,new onset viral hepatitis and ALD recurrence were also analyzed.Result In 45 ALD recipients,33 cases survived and the postoperative 5-year cumulative survival rate was 78.8％.Causes for 12 dead cases were mnultiple organ failure,liver graft failure,respiratory complications,hemorrhage and hepatic artery embolization.In 45 ALD recipients,6 cases suffered rejection after operation with the incidence bing 13.3％.One case suffered new onset hepatitis B infection 8 years after opcration.One recipient suffered primary disease (primary biliary cirrhosis) recurrence 2 years after operation,and 1 recipient with primary disease (primary sclerosing cholangitis) developed into overlap syndrome.They all survived for a long term after active treatments.Conclusion Most LT recipients with endstage ALD can obtain a long term survival.Attentions should be paid to the immunosuppressive regimens in early period after LT,prevention of infection,rejection and postoperative new onset viral hepatitis,and timely diagnosis of primary disease recurrence.

Objective To investigate the effects of different concentrations of crocin on receptor activator of nuclear factor kappa B ligand (RANKL)-induced osteoclastogenesis using the monocyte-macrophage cell line RAW264.7. Methods The monocyte-macrophage cell line RAW264.7 was cultured routinely.After treatment with 0,6.25,12.5,25, 50,100,200 and 400 μmol/L crocin,cell counting kit-8(CCK-8)assay was used to analyze the viability of RAW264.7 cells to screen out the appropriate experimental concentration. RAW264.7 cells were induced by RANKL (100 ng/L) to form osteoclasts. After treated with 0, 12.5, 50 and 100 μmol/L crocin respectively, the number of osteolasts was counted by tatrate resistant acid phosphatasec (TRAP) staining. Real-time PCR was used to detect the mRNA expression levels of calcitonin receptor(CTR),nuclear factor of active T cells 1(NFATC1),C-fos and TRAP.Results No significant effects of crocin (within 0-100 μmol/L) were found on the viability of RAW264.7 cells (P>0.05). However, When crocin concentration was over 100 μmol/L,the cell proliferation was decreased,and which showed a significant inhibitory effect on proliferation (P<0.05). Thus, 0-100 μmol/L crocin was selected as the experiment concentration. The amount of differentiated osteolasts and the expression levels of CTR,NFATC1,C-fos and TRAP mRNA were decreased significantly with the increased concentrations of crocin(P<0.05).Conclusion At a certain concentration(0-100 μmol/L),the higher levels of crocin could inhibit RANKL-induced osteoclastogenesis.

Acute basilar artery occlusion (ABAO) has a high rate of disability and mortality, and the key to its treatment is to start reperfusion therapy as early as possible. A number of retrospective studies have found that the good prognosis rate of endovascular treatment of ABAO is related to number of infarction locus, extent of ABAO, vascular occlusion and collateral circulation. Screening patients through imaging evaluation before endovascular treatment may further improve the rate of favorable outcome. This article reviews research progress on the correlation between imaging evaluation before endovascular treatment of ABAO and clinical prognoses.

Objective To explore the mechanism of percutaneous laser disc decompression (PLDD) for treating prolapse of intervertebral disc. Methods 15 rabbits were divided into 3 groups randomly: sham group, model group with PLDD treatment, model group without PLDD treatment. The nerve conduction velocity (NCV) of L6 nerve root and the activity of phospholipase A2 (PLA2) in the intervertebral disc of L5-6 were determined 2 weeks after the initial surgery. Results NCV in the group with PLDD was significantly faster than that in the group without PLDD (P<0.001); NCV in the group without PLDD was significantly lower than that in the sham group (P<0.001). The activity of PLA2 in the group with PLDD was significantly lower than that in the group without PLDD (P<0.001); The activity of PLA2 in the group without PLDD was significantly higher than that in the sham group (P<0.001). Conclusion The activity of PLA2 in the herniated discs is higher than that in normal discs, which result in NCV falls remarkably. The PLDD can reduces chemical factors such as PLA2.

Animals ; Cell Division ; drug effects ; Cells, Cultured ; Drug Delivery Systems ; Glycyrrhetinic Acid ; administration & dosage ; pharmacology ; Humans ; Liver ; cytology ; metabolism ; Liver Cirrhosis ; drug therapy ; Pilot Projects ; Rats ; Receptors, Cell Surface ; metabolism