Objective To observe how ox-LDL impacts the mRNA expressions of MMP-9 and LOX-1 of human umbilical endothelial cells (HUEVC) and how LOX-1 acts as in inflamation course.Methods HUVEC were incubated in vitro.mRNA Expressions of MMP-9 and LOX-1 were determined by reverse transcription polymerase chain reaction (RT-PCR).Results Compared to the control group(0.252±0.032;0.279 ±0.041 ),ox-LDL significantly increased the mRNA expressions of MMP-9 and LOX-1 (25 ng/group 0.486 ± 0.012,0.586 ± 0.02;50 ng/L group 0.668 ± 0.011,0.739 ± 0.014; 100 ng/group 0.817 ±0.030,0.872 ±0.003,P ＜0.01 ).Those expressions were increased by ox-LDL( 1.020 ±0.039)in a concentration-and time-dependent manner.MMP-9 mRNA(0.872 ±0.046) was reduced when LOX-1 was inhibited by polyinosinic acid ( P ＜ 0.01 ).Conclusions The mRNA expressions of MMP-9 and LOX-1 were induced by ox-LDL in HUVEC.Inhibition of LOX-1 may decrease the expression of MMP-9.Those data demonstrate that LOX-1 is involved in the process of ox-LDL-induced MMP-9 expression.

Objective To describe the clinical features and imaging characteristics of nodular splenic sarcoidosis. Methods We describe a patient with splenic sarcoidosis and review the related medical literature, the etiology, symptomatology, pathology, diagnosis, differential diagnosis, management and prognosis of splenic sarcoidosis. Results The etiology of this rare disease remains unknown. Symptoms are scanty and usually mild; computed tomography usually reveals splenomegaly or the presence of multiple nodules, confusing with metastatic tumor in spleen. On histopathologic examination, sarcoid produces noncaseating granulomas. Sarcoid is typically treated only when symptomatic. Oral corticosteroids is the most important method of treatment in patients with progressive loss of organ functions. Prognosis has closed relationship with early clinical manifestation. Conclusion Splenic sarcoidosis is rare and often misdiagnosis as other diseases.

Strontium added into porous hydroxyaptite ceramics has the functions of improving its osseointegration, decreasing its dissolution rate and improving the bone density. Strontium-containing hydroxyaptite (Sr-HA) ceramics has been used as bone replacement and scaffold to treat the osteoporosis and bone default in clinic, but the mechanism of interfacial tissue response caused by the trace element Sr in Sr-HA ceramics still remains to be further studied. Four types of Sr-HA ceramic samples with different contents of Sr were prepared by microwave plasma sintering for testing the response of the soft tissue implanted in dog muscles in our laboratory. The contents of Sr element in the samples are 0 mol%, 1 mol%, 5 mol%, and 7 mol%, respectively. The samples were implanted in the muscle of the dogs for 4 weeks, 8 weeks and 12 weeks, respectively. The histological observations at the end of each period showed that the irritant ranking increased with the content of Sr in Sr-HA ceramics at the end of 12 weeks, and there were rich bone tissue in Sr-HA ceramic samples with 5 mol% Sr element. The overdose of element Sr is harmful to soft tissues. When the content of Sr in Sr-HA ceramic was below 5 mol%, the soft tissue response was very slight and the new bones were induced to grow well.
Animals ; Bone Substitutes ; chemical synthesis ; Ceramics ; chemical synthesis ; chemistry ; Dogs ; Durapatite ; chemical synthesis ; chemistry ; Female ; Male ; Muscle, Skeletal ; surgery ; Osseointegration ; physiology ; Porosity ; Prostheses and Implants ; Strontium ; chemistry ; Tissue Engineering

Three-dimensional finite element models of the large defect of proximal femur were reconstructed with allograft prosthesis composite in clinical bone-healing phase; current model was under the given conditions of 138mm-intramedullary stem-length of host bone and 135mm defect-length of proximal femur. The femur was constructed with efilm software from CT data, then three-dimensional concrete models were created by using Proe-Wildfire software; the three-dimensional finite element models of allograft prosthesis composite were made in ANSYS11 software. Loads were simulated using the peaking values during stance walking. The stress on femur-cement-callus-prostheses and the influence of stress on the clinical bone-healing phase were analysed. The highest stress value of femur is on the medial side of the tip of the prostheses. The highest stress value of cement mantle is on the medical side of the cement mantle at the tip of the stem. The highest stress value of the prostheses is on the medial side near the upper 4cm of the stem tip. The highest stress value on the callus is at the medial side of the callus layer. The highest stress value on every part is under the corresponding fatigue strength. Clinical bone-healing phase model is well enough for stance walking.
Biomechanical Phenomena ; Female ; Femoral Neoplasms ; diagnostic imaging ; surgery ; Finite Element Analysis ; Hip Prosthesis ; Humans ; Imaging, Three-Dimensional ; Male ; Osteosarcoma ; diagnostic imaging ; surgery ; Tomography, Spiral Computed ; Weight-Bearing ; physiology ; Wound Healing

Benign anastomotic stricture is one of the most common complications after esophagectomy,which can result in the dysphagia and weight loss of patients.It can severely impair the patient's quality of life with the progress of the stricture.What is more,refractory benign stricture is a major challenge for physicians and needs repeated treatments,which aggravates the patient's pain and increases extra costs.Benign anastomotic stricture is associated closely with various risk factors,which can be prevented by adopting some measures.Dilation remains the first-line treatment to manage benign anastomotic stricture and it may be effective to combine with drug therapy.Endoscopic incisional therapy is a promising method as a new treatment therapy.The use of various stents fails to improve overall long-term dysphagia-free rate.In addition,stent has a possible risk of migration and hyperplastic tissue growth,which should be used by weighing the pros and cons.

The esophageal cancer is a commmon maligant tumor.The main treatment for esophageal cancer is surgery.Robotic surgery,a new rising surgery,offers an option for esophageal cancer,besides the traditional open surgery and minimally invasive esophagectomy.The robotic surgical system with the advantages like magnifying 3-dimensional view,accuracy and stability,has been increasingly applied in the field of esophageal cancer recent years.Robotic surgery for esophageal cancer has a wide range of indication,and its trauma is small.Long-term and short-term outcone is good.So robotic surgery for esophageal concer is a safe and feasible surgical approach.

Objective To investigate the clinical features,essentials of diagnosis,selection of endovascular treatment and prognosis of aorto-esophageal fistula(AEF).To improve the understanding of the disease.Methods 3 patients with AEF from October 2010 to July 2016 in Changhai Hospital,including clinical symptoms and signs,endovascular treatment process and follow-up results,and review the relevant literature.Results Two of the 3 patients are men,and another is a woman.Aged 64-70 years.The causes of AEF are chest trauma,thoracic aorta pseudoaneurysms and foreign body ingestion,respectively.All the 3 patients had chest pain,hematemesis,and fever.Two of them showed sentinel hemorrhage and another showed a sudden massive hematemesis.Upper gastrointestinal endoscopy or computed tomographic angiography (CTA) confirmed the diagnosis in all patients.They all underwent thoracic endovascular aortic repair(TEVAR).The effect was good in acute phase.It didn't have any significant short-term complications.Re-bleeding time was 35 days to 85 days.Two patients died of recurrent severe hemorrhage post operation,and one of them had received TEVAR again but not it was ineffective.Another died of multiple organ failure after open surgery.Conclusion Since it showed the short-term effect but not the long-term effect,TEVAR can only be applied as a temporary remedy to the patients in poor conditions and be substituted by the open surgery when the patients were in better conditions.

Background::Early detection of esophageal squamous cell carcinoma (ESCC) can considerably improve the prognosis of patients. Aberrant cell-free DNA (cfDNA) methylation signatures are a promising tool for detecting ESCC. However, available markers based on cell-free DNA methylation are still inadequate. This study aimed to identify ESCC-specific cfDNA methylation markers and evaluate the diagnostic performance in the early detection of ESCC.Methods::We performed whole-genome bisulfite sequencing (WGBS) for 24 ESCC tissues and their normal adjacent tissues. Based on the WGBS data, we identified 21,469,837 eligible CpG sites (CpGs). By integrating several methylation datasets, we identified several promising ESCC-specific cell-free DNA methylation markers. Finally, we developed a dual-marker panel based on methylated KCNA3 and OTOP2, and then, we evaluated its performance in our training and validation cohorts. Results::The ESCC diagnostic model constructed based on KCNA3 and OTOP2 had an AUC of 0.91 [95% CI: 0.85–0.95], and an optimal sensitivity and specificity of 84.91% and 94.32%, respectively, in the training cohort. In the independent validation cohort, the AUC was 0.88 [95% CI: 0.83–0.92], along with an optimal sensitivity of 81.5% and specificity of 92.9%. The model sensitivity for stage I–II ESCC was 78.4%, which was slightly lower than the sensitivity of the model (85.7%) for stage III–IV ESCC. Conclusion::The dual-target panel based on cfDNA showed excellent performance for detecting ESCC and might be an alternative strategy for screening ESCC.

Background and objectiveIt is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.MethodsThe Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were fol-lowed and their survival status were analyzed.Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93%vs 88%; 83%vs 81%,P=0.034) respectively. The survival rate was signiifcantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003). Among patients with advanced stage thymoma (stage III, IVa, IVb), the constitu-ent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were signiifcantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classiifcation, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were signiifcant factors, and multivariate analysis showed WHO Classiifcation, Masaoka stage, and resectability were strong independent prognostic indicators.ConclusionAlthough MG is not an independent prognostic factor, the sur-vival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.

Background and objectiveTo compare the predictive effect of the Masaoka-Koga staging system and the International Association for the Study of Lung Cancer (IASLC)/the International Thymic Malignancies Interest Group (ITMIG) proposal for the new TNM staging on prognosis of thymic malignancies using the Chinese Alliance for Research in Thymomas (ChART) retrospective database.MethodsFrom 1992 to 2012, 2,370 patients in ChART database were ret-rospectively reviewed. Of these, 1,198 patients with complete information on TNM stage, Masaoka-Koga stage, and survival were used for analysis. Cumulative incidence of recurrence (CIR) was assessed in R0 patients. Overall survival (OS) was evalu-ated both in an R0 resected cohort, as well as in all patients (any R status). CIR and OS were ifrst analyzed according to the Masaoka-Koga staging system. Then, they were compared using the new TNM staging proposal.Results Based on Masaoka-Koga staging system, signiifcant difference was detected in CIR among all stages. However, No survival difference was revealed between stage I and II, or between stage II and III. Stage IV carried the highest risk of recurrence and worst survival. According to the new TNM staging proposal, CIR in T1a was signiifcantly lower comparing to all other T categories (P<0.05) and there is a signiifcant difference in OS between T1a and T1b (P=0.004). T4 had the worst OS comparing to all other T categories. CIR and OS were signiifcantly worse in N(+) than in N0 patients. Signiifcant difference in CIR and OS was detected between M0 and M1b, but not between M0 and M1a. OS was almost always statistically different when comparison was made between stages I-IIIa and stages IIIb-IVb. However, no statistical difference could be detected among stages IIIb to IVb.Conclusion Compared with Masaoka-Koga staging, the IASLC/ITMIG TNM staging proposal not only describes the extent of tumor invasion but also provides information on lymphatic involvement and tumor dissemination. Further study using prospectively recorded information on the proposed TNM categories would be helpful to better grouping thymic tumors for predicting prognosis and guiding clinical management.