Objective To explore the expression of P16, TGF-β1 and CD44v6 in gastric carcinoma and the relationship between their expression and clinicopathological features. Methods The expressions of P16, TGF-β1 and CD44v6 in 78 cases of gastric carcinoma, 20 cases gastric epithelial dysplasia and 25 cases normal gastric tissues were detected by immunohistochemistiy (SP method). Results The expressions of P16 in gastric carcinoma (46. 2% ) and gastric epithelial dysplasia (60. 0% ) were markedly lower than that in normal gastric tissues (92. 0% ). The expressions of CD44v6 in gastric carcinoma (51.3%) and gastric epithelial dysplasia (45.0% ) were markedly higher than that in normal gastric tissues (4.0% ). The expression of TGF-β1 in gastric carcinoma (65.4% ) was much higher than the counterparts in normal gastric group (12. 0% ) and gastric epithelial dysplasia group (35.0% ). P16 was positively correlated with the differentiation degree of gastric carcinoma, the depth of invasion, lymphatic metastasis and TNM stage ( P < 0. 05 ), and it had no significant correlation with tumor size,vessel tumor thrombus and the progression of the disease. CD44v6 was positively related with the invasive depth of gastric carcinoma, lymphatic metastasis, progression and TNM stage ( P <0.05) and had no significant correlation with differentiation degree of tissue, tumor size and vessel tumor thrombus ( P >0.05). TGF-β1l was positively correlated with the differentiation degree of gastric carcinoma, the depth of invasion, lymphatic metastasis and TNM stage ( P < 0.05 ) and had no significant correlation with tumor size, vessel tumor thrombusand the progression of the disease. There was a significant positive correlation between the expressions of CD44v6 and TGF-β1 of on gastric carcinoma ( r = 0. 532, P < 0.05 ). And a negative correlation was found between CD44v6 and P16 ( r = - 0. 615, P < 0. 05 ). Conclusions P16 ,TGF-β1 and CD44v6 may play a role in the tumorigenesis and progression of gastric carcinoma in some degree. Combined detection of P16, TGF-β1 and CD44v6 may be helpful to judge the degree of malignancy and potential lymph node metastasis and evaluate the prognosis.

Objective To explore the expression and clinical significance of two oncogenes,CerbB-2 and p53,on cervical squamous carcinoma.Methods The immunohistochemical S-P process was performed on 45 cases of cervical squamous carcinoma.The expressions of CerbB-2 and p53 on 15 cases of CIN(cervical intraepithelial neoplasia)and on 10 cases of normal cervical tissues were chosen and the relationship between the expressions and the related clinicopathological factors were analyzed.Results The positive expression rate of CerbB-2 on normal cervical tissues, CIN and cervical squamous carcinoma was 0,26.7% and 66.7%, respectively; that of p53 was 0,13.3% and 68.9% ,respectively.From the normal cervical epithelium to the CIN and to the cervical squamous carcinoma,the positive rate of CerbB-2 and p53 was increased significantly(P<0.05);the positive rate of CerbB-2 was associated with the pathological grade and the metastasis of lymph node(P <0.05) and that showed no statistic significance with the clinical stage ,the diameter of tumour,the infiltration of vessel and infiltrative depth(P > 0.05) ;the positive rate of p53 is only associated with the pathological grade(P <0.05) ;the difference between the CerbB-2 and p53 expressions on cervical squamous carcinoma were not statistically significant(P> 0.05).Conclusion The expressions of CerbB-2 and p53 have some practical values on the occurrence, the development and the clinical prognostic evaluation for the cervical squamons carcinoma.

ObjectiveTo evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.MethodsThe clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).ResultsAll the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score(KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.ConclusionsThe intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up.

Objective To investigate the effect of free toe transplantation in finger reconstruction.Methods Free toe transplantations were performed in 164 patients (185 fingers) suffering from finger defection.There were 134 males and 30 females,aged at 12-83 years [mean (44.8 ± 11.2)years].Finger deletion severity was classified as grade Ⅰ in one case,grade Ⅱ in 18,grade Ⅲ in 23,grade Ⅳ in 49,grade Ⅴ in 54,and grade Ⅵ in 19.According to Gilbert standards,dorsal metatarsal arteries were classified as type Ⅰ in 68 cases,type Ⅱ in 84,and type Ⅲ in 12.Survival ratio of the transplanted fingers and hand function rehabilitation were observed.Results The transplanted toe survived in 160 cases (173 fingers).They composed of all the cases of grade Ⅰ-Ⅴ finger deletion and 15 cases of grade Ⅵ finger deletion; all the cases of type Ⅰ dorsal metatarsal arteries,83 cases of type Ⅱ dorsal metatarsal arteries and nine case of type Ⅲ dorsal metatarsal arteries.Transplantation failed in four cases (12 fingers) of grade Ⅵ finger defection including one case of Gilbert Ⅱ dorsal metatarsal arteries and three cases of Gilbert Ⅱ dorsal metatarsal arteries.Postoperative results were excellent in 110 cases and good in 50.Conclusions Toe transplantation is helpful to restore the finger shape and function and the outcome is satisfactory.Anatomic deformation of dorsal metatarsal arteries is the main cause for the failure of finger reconstruction.

Objective To investigate periprosthetic femoral shaft remodeling with tapered femoral stems after total hip arthroplasty (THA) for elderly patients and evaluate the mid-term clinical outcomes.Methods The study involved 30 elderly (70-90 years) patients (34 hips) treated with femoral shaft remodeling with tapered stems after THA from January 2003 to January 2005. The postoperative X-ray images were collected and perioperative periprosthetic bone mineral density was analyzed by dual-energy X-ray absorptiometry (DEXA). The Harris score was applied in follow-up observation, and Kaplan-Meier method was used to evaluate the working life of the femoral prosthesis. Results Four patients were died of lung cancer. The remaining 26 patients ( 30 hips) were followed up for 5-7 years ( mean, six years). The postoperative X-ray measurements showed that total hip prosthesis subsidences were less than 1.5 mm within one year in 12 hips, with no prosthesis loosening observed. Bone proliferations were seen in Gruen zones 2, 3, 4, 5, 6, 11 and 12, and bone resorptions were seen in zones l and 7. DEXA showed that bone mineral density was increased in Gruen zones 2,3,4 and 5, but decreased mainly in Gruen zones 1,6 and 7. The increase of bone mineral density in zones 2 and 5 was faster compared to other sites six months after the operation ( P ＜ 0.05 ) and the change of bone mineral density was prone to be stable in two years ( P ＞ 0.05 ). Within one year after initial implantation, periprosthetic bone mineral density was significantly decreased ( P ＜ 0.05 ). Two years after the operation, rare changes of periprosthetic bone mineral density were found ( P ＞ 0.05 ), with only regional redistribution of bone mass from the proximal to the distal femur. The Harris score of hip joint function was increased from preoperative 38.56 ± 8.21 to 86.32 ± 6. 01 at the final follow-up. The 6-year survival rate of the prosthesis was 100%. Conclusion Femoral shaft remodeling with tapered stems after total hip arthroplasty for the elderly patients shows good periprosthetic bone remodeling and satisfactory mid-term clinical results.

BACKGROUND:Joint replacement surgery becomes difficult because of the abnormal changes in hip joint, especial y on the acetabular side. Therefore, the treatment on acetabulum is very important during total hip arthroplasty in patients with hip dysplasia. OBJECTIVE:To investigate the clinical therapeutic effects of total hip arthroplasty with onlay bone graft for treatment of CroweIII and IV adult hip dysplasia. METHODS:A total of in 14 patients with adult hip dysplasia were retrospectively analyzed. According to Crowe method, there were 11 cases of type III and 3 cases of type IV. Al patients underwent total hip arthroplasty. Autologous femur neck was used to make an onlay bone graft around the acetabulum during replacement. Radiographs were analyzed after replacement and during fol ow-up. Clinical efficacy was assessed using Harris standard. RESULTS AND CONCLUSION:Al patients were fol owed up for 1-9 years, averagely 4.5 years. Bone graft was partial y absorbed within 1 year after replacement in 4 patients, and began to grow 2 years later. Radiographs showed that al bone graft was fused to host bone. The average coverage rate of bone grafts on acetabulum was 36%. None hip was needed to be rebuilt up to now. Harris score of hip joint function increased from 35 points (26-52 points) before surgery to 91 points during final fol ow-up. Total hip arthroplasty with onlay bone graft is an effective method in treatment of CroweIII and IV adult hip dysplasia.

Objective To investigate the effect of PPARγ in acute coronary syndrome (ACS) patients with type 2 diabetes (T2DM) for the severity of coronary atherosclerosis and plaque stability. Methods We selected 102 patients with ACS, including 52 patients with type 2 diabetes mellitus (ACS+T2DM group) and 50 patients with simply ACS (ACS group). Meanwhile, we selected 30 patients without coronary heart disease and T2DM as the control group. All basic clinic data, CAG and the Gensini score were compared among all groups. To all patients, blood was drew when they were enrolled to detect the level of PPARγ and MMP-9. Results Gensini points in the ACS+T2DM group was much higher than that of the ACS group (P < 0.05). The levels of PPARγ of the ACS group and the ACS+T2DM group, when compared with the control group, were decreased significantly, but the level of MMP-9 were increased (all P < 0.05). The level of PPARγ in the ACS+T2DM group was much lower than the ACS group, and the level of MMP-9 was much higher (P<0.05). Gensini scores (r=-0.416, P<0.05), the level of MMP-9(r= - 0.503, P < 0.05) were correlated negatively with the level of PPARγ. Conclusions Complicating with T2DM can aggravate coronary artery disease and plaque instability degree in ACS patients, and PPARγpossibly make an protective effect.

Objective To observe the clinical efficacy of auricular point sticking with magnetic bead in treating insomnia in hepatocirrhosis patients. Method Ninety patients with hepatocirrhosis complicated with insomnia were randomized into a treatment group and a control group, 45 in each group. The treatment group was intervened by auricular point sticking with magnetic bead, while the control group was by auricular point sticking with medical adhesive tape. After successive 2-week treatments, the Insomnia Severity Index (ISI) and the Evaluation Criteria of Therapeutic Efficacy for Mental Disorders were observed for evaluating the treatment result. Result The ISI was significantly improved in the treatment group after intervention (P<0.05), and the improvement was significantly different from that in the control group (P<0.05). The total effective rate was 86.7% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.01). Conclusion Auricular point sticking with magnetic bead is easy-to-operate and can produce a satisfactory efficacy in treating insomnia of hepatocirrhosis patients.

Objective To investigate the effect of smoking and smoking cessation on the phosphorylation of IKK-β in type 2 diabetic rats. Methods Forty-two six-week-old Wistar rats were randomly divided into 4 groups: normal control(NC, n =7), diabetes control (DC, n =7), diabetes with smoking (DS, n = 14) and diabetes with smoking cessation(SC, n = 14). Rats in DS and SC groups were further assigned randomly into 8w and 12w subgroups. DS group was given passive smoking twice a day for 8 or 12 weeks, while SC group ceased passive smoking for 4 weeks after 8 or 12 weeks of smoking . Western blot method was used to detect the level of IKK-13 phosphorylation in skeletal muscle. Results Compared with the NC group,the phosphorylation of IKK-β protein in DC group was increased (0. 16±0. 05 vs 0. 30±0. 08, P < 0. 01). There was an increasing trend with the phosphorylation level of IKK-β in the DS (8w) subgroup, but there was no statistical difference between the DC group and SC(8w) subgroup (0. 40±0. 09 vs 0. 30±0. 08,0. 36±0. 10, P >0. 05). The phosphorylation level of IKK-β in DS(12w) group increased obviously, being significantly higher than that in the DC group and SC (12w) subgroup(0. 74 ± 0. 11 vs 0.30±0.08,0.35±0.07,P < 0.01). Conclusion With the prolongation of smoking duration, the phosphorylation of IKK-β in type 2 diabetic rats increased. After smoking cessation, the phosphorylation of IKK-β decreased. The phosphorylation of IKK-β may be involved in the mechanism by which smoking causes type 2 diabetes.

ObjectiveTo explore the expression of Glut1, HIF-1α and Ki-67 in hepatocellular carcinoma (HCC) and their relationship between their expression and clinicopathological features.MethodsImmunohistochemical study (EnVision method) for Glut1, HIF-1a and Ki-67 were performed on tissue microarray which consisted of 171 cases of HCC, 55 cases of adjacent non-neoplastic liver tissues, and 22cases of normal liver tissues.ResultsThe expression rate of Glut1 ,HIF-1α and ki-67 in 171 cases of HCC was 15.2％, 19.9％ and 66.1％, respectively, which was much higher than that in the adjacent non-neoplastic liver tissues (1.8％ ,1.8％and 5.5％) and normal liver tissues(all negative).The expressions of Glut1 and HIF-1α were positively correlated with the differentiation degree of HCC and TNM stage(P ＜0.01, P ＜0.05).The expression of ki-67 was positively correlated with the differentiation degree of HCC.There was a significant positive correlation between the expressions of Glut1 and HIF-1α in HCC (r1 =0.553, P ＜0.05), the expressions of Glut1 and HIF-1α were positively correlated with ki-67(r2 =0.560,r3 =0.613, P ＜0.05).ConclusionsGlut1, HIF-1α and ki-67 may play a role in the tumorigenesis and progression of HCC in some degree.Combined detection of Glut1, HIF-1α and Ki-67 may be helpful to judge the degree of malignancy and potential metastasis and evaluate the prognosis.