OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

OBJECTIVETo investigate the effect of heat exposure during the second week of pregnancy on placental development and intrauterine growth of fetal rats.

METHODS24 pregnant rats were either exposed or not to a temperature of 35∓1 degrees celsius; during the second week of pregnancy. The body weight gain of the pregnant rats was measured regularly, and in late pregnancy, the pregnant rats were dissected and the number, weight, length, tail length, appearance of the offspring rats, number of live and still births, and the placental weight were recorded. The expressions of HSP70, Bax and Bcl-2 in the placenta were determined.

RESULTSCompared with the control group, the pregnant rats in heat exposure group had significantly lower body weight at the end of pregnancy and gestational weight gain, and the body weight, body length and tail length of the offspring rats were also significantly lower or smaller (P<0.05). The placental weight was comparable between the two groups. The placental expressions of HSP70,Bax,and Bcl-2 were significantly higher in the heat exposure group than in the control group (P<0.05).

CONCLUSIONHeat exposure during the second trimester of pregnancy has adverse effects on placental development and intrauterine growth of the fetal rats by inducing heat shock response of placental tissue and apoptosis of the placental cells.

OBJECTIVETo in vitro study the inhibition effect and possible mechanism of As2S3 nanoparticles (As2S3 nano) on human MDS cell line MUTZ-1 and to compare with that of traditional As2S3.

METHODMUTZ-1 cells were treated with As2S3 nano and traditional regular-sized particles (TRSP) at different concentrations. The cell growth inhibition rate was determined by MTT assay, cell apoptosis by morphology and flow cytometry (FCM), cell cycle by FCM and the activity of caspase-3 by chemiluminescence assay.

RESULTSTreatment of As2S3 nano and TRSP at concentrations of 2, 4, 8 and 16 micromol/L for 48 h could lead to a significant dose-dependent decrease of MUTZ-1 cells and induce apoptosis. The percentages of inhibition were 48.9%, 75.9%, 89.4% and 96.5% in As2S3 nano vs 14.5%, 25.4%, 34.7% and 51.5% in TRSP and apoptosis rates were (12.9 +/- 1.9)%, (19.2 +/- 2.2)%, (30.1 +/- 2.5)% and (45.9 +/- 2.3)% in As2S3 nano vs (5.3 +/- 1.8%)%, (11.1 +/- 2.6)%, (19.3 +/- 2.3)% and (25.5 +/- 2.5)% in TRSP respectively. There was statistically significant difference in these two groups (P < 0.01). The proportion of cell in G2/M phase and the activity of caspase-3 of MUTZ-1 cells treated with A2S32 nano were significantly higher than those treated with control group and As2S3 TRSP groups (P < 0.01).

CONCLUSIONSAs2S3 nanoparticles and TRSP can inhibit the proliferation of MUTZ-1 cells and induce apoptosis, which maybe through activating caspase-3 pathways and increasing the proportion of G2/M phase. As2S3 nanoparticles can produce a much better antitumor effect than As2S3 TRSP do.

Apoptosis ; drug effects ; Arsenicals ; administration & dosage ; pharmacology ; Caspase 3 ; metabolism ; Cell Cycle ; drug effects ; Cell Line ; Cell Proliferation ; drug effects ; Humans ; Myelodysplastic Syndromes ; metabolism ; pathology ; Nanoparticles

OBJECTIVETo study the relation of the sex, age, location and chemotherapy with recurrence of the tumor.

METHODSFrom January 2000 to August 2010, 47 patients with giant cell tumor of tendon sheath in upper extremity were retrospectively analyzed. Statistical analysis of sex, age at presentation, lesion location, chemical inactivation, surgical complications, tumor recurrence and pathological findings were explored. There were 28 females and 19 males, ranging in age from 17 to 78 years, with an average of 38.15 years. All the patients underwent surgical excision. Fourteen patients received intraoperative chemically inactive treatment. All the patients had routine follow-up to observe the wound healing, pathological findings,tumor recurrence, and received necessary imaging examinations.

RESULTSAll the patients were followed up, and the duration ranged from 22 to 129 months, with a mean time of 53.89 months. Four patients who received intraoperative alcohol inactivation appeared wound complications such as wound swelling, discharge of necrotic tissue, delayed wound healing. Fifteen patients had active growth of tumor tissue, 1 patient had low-grade malignant giant cell tumor of tendon sheath. The recurrence rate was significantly higher in the group which preoperative X-ray was found to have bone destruction (P = 0.003); patients receiving chemically inactivation had lower risk of recurrence after surgery than patients not receiving chemically inactivation (P = 0.042).

CONCLUSIONThe recurrence rate of giant cell tumor of tendon sheath in upper limb was closely related to tumor growth site, bone destruction and chemical inactivation. Local excision of giant cell tumor of tendon sheath was the effective treatment. How to identify the patients at high risk of recurrence, how to reduce the recurrence rate and the functional restoration after wide resection are the priorities and difficulties of future researches.

Adult ; Female ; Giant Cell Tumors ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; epidemiology ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Soft Tissue Neoplasms ; pathology ; surgery ; Tendons ; pathology ; Upper Extremity

OBJECTIVETo investigate Bcl-2/Bax gene expression in different types of carotid plaque, and examine the relationship between gene expression and atherosclerotic plaque instability and the main cause of brain ischemic events.

METHODSTotally 42 human carotid plaque specimens obtained during carotid endarterectomy were divided into stable group (n=19) and unstable group (n=23) based on histopathological studies (HE staining). Eight aortic arteries and their branches from hepatic transplantation donors were taken as control group. Bcl-2/Bax was detected by immunohistochemistry (IHC) staining (n=42) and in situ hybridization (ISH) (n=25, stable 13/unstable 12).

RESULTSBcl-2 gene expression, which was expressed in smooth muscle cells (SMC), endothelial cells (EC), macrophages (MP) and foam cells, was detected in 20 and 9 cases in unstable plaque while 11 and 4 cases in stable plaque by IHC and ISH, respectively (P < 0.05). Bax, which was expressed in SMC and MP, was detected in 18 and 11 cases in unstable plaque, while 8 and 5 cases in stable plaque by IHC and ISH, respectively (P < 0.05).

CONCLUSIONThe expression rate of Bcl-2/Bax in unstable plaques was higher than in stable plaques. Bcl-2 was one of the elements that maintain plaque stability whereas Bax was one element that facilitates plaque instability. Therefore, Bcl-2/Bax expression in different stage of atherosclerosis may be one of the molecule regulation mechanisms in carotid atherosclerosis.

Apoptosis ; genetics ; Carotid Arteries ; metabolism ; pathology ; Carotid Artery Diseases ; metabolism ; Carotid Stenosis ; metabolism ; pathology ; Endothelium, Vascular ; metabolism ; Humans ; Macrophages ; metabolism ; Muscle, Smooth, Vascular ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Up-Regulation ; bcl-2-Associated X Protein

The protective effect of aspirin during exposure to heat stress in broiler chickens was investigated. We assayed pathological damage, expression and distribution of Hsp90 protein and hsp90 mRNA expression in chicken heart tissues after oral administration of aspirin following exposure to high temperature for varying times. Heat stress induced increases in plasma aspartate aminotransferase, creatine kinase and lactate dehydrogenase activities while causing severe heart damage, which was characterized by granular and vacuolar degeneration, nuclear shrinkage and even myocardium fragmentation in cardiac muscle fibers. After aspirin administration, myocardial cells showed fewer pathological lesions than broilers treated with heat alone. A high positive Hsp90 signal was always detected in the nuclei of myocardial cells from broilers treated with aspirin, while in myocardial cells treated with heat alone, Hsp90 in the nuclei decreased, as did that in the cytoplasm. Aspirin induced rapid and significant synthesis of Hsp90 before and at the initial phase of heat stress, and significant expression of hsp90 mRNA was stimulated throughout the experiment when compared with cells exposed to heat stress alone. Thus, specific pre-induction of Hsp90 in cardiovascular tissue was useful for resisting heat stress damage because it produced stable damage-related enzymes and fewer pathologic changes.
Animals ; Anti-Inflammatory Agents, Non-Steroidal/pharmacology ; Aspirin/*pharmacology ; Cell Nucleus/genetics ; Chickens ; Gene Expression Regulation/*drug effects ; HSP90 Heat-Shock Proteins/*genetics ; Hot Temperature ; Myocytes, Cardiac/*drug effects/enzymology/pathology ; Stress, Physiological/*drug effects

OBJECTIVETo investigate the expression of long non-coding RNA NANCI in lung tissues of neonatal mice with hyperoxia-induced lung injury and its regulatory effect on NKX2.1.

METHODSA total of 48 neonatal C57BL/6J mice were randomly divided into an air group and a hyperoxia group, with 24 mice in each group. Each group was further divided into 7-day, 14-day, and 21-day subgroups, with 8 mice in each subgroup. The mice in the air group were fed in the indoor environment (FiO=21%) and those in the hyperoxia group were fed in a high-oxygen box (oxygen concentration: >95%). The mice were sacrificed at each time point and lung tissue samples were collected. Hematoxylin and eosin staining was used to observe pathological changes in lung tissues. RT-qPCR and Western blot were used to measure the mRNA and protein expression of NANCI and NKX2.1.

RESULTSThe air group had the highest mRNA expression of NANCI and NKX2.1 at 7 days and the same level of mRNA expression at 14 and 21 days. Compared with the air group, the hyperoxia group had significant reductions in the degree of alveolarization and radial alveolar count (RAC) in lung tissues (P<0.05), and in the hyperoxia group, RAC gradually decreased over the time of hyperoxia exposure (P<0.05). The hyperoxia group had significantly lower mRNA and protein expression of NANCI and NKX2.1 than the air group at all time points (P<0.05). In both groups, the relative mRNA and protein expression of NANCI and NKX2.1 gradually decreased over the time of hyperoxia exposure (P<0.05). The expression of NKX2 was positively correlated with that of NANCI (r=0.585, P=0.003), and the expression of NKX2 and NANCI was positively correlated with RAC in the hyperoxia group (r=0.655 and 0.541 respectively, P<0.05).

CONCLUSIONSNANCI may be involved in the development of immature lung tissues. Lung injury is gradually aggravated over the time of hyperoxia exposure. The levels of NANCI and NKX2.1 are associated with the severity of lung injury, suggesting that the NANCI/NKX2.1 target gene signaling pathway might be involved in the development of hyperoxia-induced lung injury in neonatal mice.

Animals ; Animals, Newborn ; Female ; Hyperoxia ; complications ; Lung ; metabolism ; Lung Injury ; etiology ; Male ; Mice ; Mice, Inbred C57BL ; Nuclear Proteins ; physiology ; RNA, Long Noncoding ; physiology ; Signal Transduction ; physiology ; Thyroid Nuclear Factor 1 ; Transcription Factors ; physiology

OBJECTIVETo assess bone health in epileptic children who have been treated with carbamazepine (CBZ) or valproate (VPA) by using quantitative ultrasound (QUS) and determining the biochemical indices of bone metabolism, and to provide a proposal to improve quality of life of epileptic children.

METHODSNinety-two epileptic children who had been treated with CBZ or VPA for more than two years were evaluated for bone mineral density (BMD) at the mid-shaft tibia and the distal third of the radius. Biochemical indices of bone metabolism including urine deoxypyridinoline (DPD) and serum osteocalcin (OC), and daily calcium intake were also evaluated. Thirty-five age-matched healthy children were used as controls. Reduced BMD was defined as speed of sound (SOS) Z scores of the mid-shaft tibia and (or) the distal third of the radius less than -0.7.

RESULTSBMD was reduced in epileptic children significantly when compared to the controls (P < 0.05). In addition, a negative correlation was found between the duration of anti-epileptic drugs (AEDs) use and BMD (r(s) = -0.21 - -0.31, P < 0.05), the lowest BMD was observed in those who had been treated for the longest time. The serum values of OC in epileptic children were significantly reduced relative to the controls (P < 0.01), children who took VPA had the lowest value of OC. However, the urine values of DPD showed no significant difference between epileptic and healthy children (P > 0.05); children who took CBZ had the highest value of DPD. Thirty-two epileptic children (35%) and five (14%) sex- and age-matched healthy children had reduced BMD, significant difference was found between them (P < 0.05). Moreover, epileptic children with reduced BMD seemed to have higher body mass index (BMI) (P < 0.05), take less daily calcium intake (P < 0.01), and had longer duration of AEDs (P < 0.01). The two risk factors of having reduced BMD in epileptic children were those who had been treated with AEDs for more than five years and higher BMI, while the protective factor was daily calcium intake.

CONCLUSIONSLong-term use of CBZ or VPA is associated with bone metabolism abnormalities, which include reduced BMD and decreased bone turnover (mainly decreased bone formation). Long-term anti-epileptic therapy is an important factor for impaired bone health in epileptic children, and that low calcium intake and high BMI could be two aggravating factors. QUS is a useful method to evaluate BMD of epileptic children who are on long-term anti-epileptic therapy, and to recognize the status of bone health, in helping to promote bone health and improve quality of life in epileptic children by the use of calcium and vitamin D supplementation.

Amino Acids ; urine ; Anticonvulsants ; adverse effects ; therapeutic use ; Bone Density ; drug effects ; Bone and Bones ; diagnostic imaging ; drug effects ; metabolism ; Calcium, Dietary ; analysis ; Carbamazepine ; adverse effects ; therapeutic use ; Child ; Epilepsy ; drug therapy ; Female ; Humans ; Male ; Osteocalcin ; blood ; Radius ; diagnostic imaging ; Tibia ; diagnostic imaging ; Ultrasonography ; Valproic Acid ; adverse effects ; therapeutic use

The expression of BAX in carotid atherosclerosis and its regulation is far from defined. Objectives To investigate BAX expression in stable/fibrous and instable/vulnerable carotid plaque and its clinical significance. Methods Twenty-five cases of carotid plaque specimens obtained from endarterectomy were divided into two groups, stable/fibrous 14 cases, vulnerable/instable 11 cases; aortic artery and its branches from hepatic transplantation donors 6 case as control. The expression of proapoptotic BAX was detected by immunohistochemistry (IHC), in situ hybridization(ISH) and in situ TdT dUTP nick end labeling (TUNEL). Results Five cases of BAX ( + ) were detected by ICH and ISH, 4 case of TUNEL ( + ) were detected by TUNEL in stable/fibrous carotid plaque , while 10 cases were BAX ( + )by IHC(P < 0.05) , 11 cases by ISH and 9 cases by TUNEL were detected in instable/vulnerable carotid plaque ( P < 0.01 ), respectively. The intensity of BAX ( + ) cells by IHC and ISH was (8.63 +/- 2.62) and (10.32 +/- 3.12) in fibrous plaques, whereas (122 +/- 21.64) and (152 +/- 23.35) in vulnerable plaques, respectively. No expression of BAX was found in controlled group. Conclusion The higher expression of Bax in vulnerable carotid plaque may be one mechanism in molecular pathogenesis of carotid atherosclerosis which affect plaque stability and be the cause of higher incidence of stroke than fibrous carotid plaques, the regulation of BAX expression in different stage of atherosclerosis may provide targets in gene therapy for carotid atherosclerosis.

OBJECTIVETo study the anatomy of peroneal tendofascial flap combined with adipofascial flap for the repair of heel tissue defects.

METHODSThe lower extremities of five cadavers (10 sides) were perfused with red latex, the blood supply of peroneal tendofascial flap and vicinity adipofascial flap were observed. The diameter, course, branches and location of the blood vessels were measured. Eight fresh cadavers (16 sides) were perfused with lead oxide-gelatine mixture. The covering fascia tissues of the lower extremities was obtained and photographed by X-ray. The vascular anastomosis and association of nutrient vessel of peroneal tendofascial flap and vicinity adipofascial flap were observed. Two adult lower extremities specimens (4 sides) were used to construct vessel diagrams for observation of the course, distribution and anastomosis of the vessels. Eight cases were treated successfully with theses flaps.

RESULTSThe blood supply of the combined fascial flap is multi-originated. For the area within 4 cm below and above the lateral malleolus cusp, the blood supply includes 2-5 branches from heel lateral artery with an average diameter of (0.5 +/- 0.2) mm, 1-2 branches from posterior lateral malleolus artery with an average diameter of (0.6 +/- 0.2) mm and 2-3 branches from the descending part of perforating branches of peroneal artery with an average diameter of (0.5 +/- 0.2) mm. The blood supply of area 4 cm above lateral malleolus cusp is 1-3 branches from intermuscular septum perforating branches of peroneal artery with an average diameter of (1.0 +/- 0.2) mm. These above branches are anastomosed each other and also send off many smaller branches to form vascular net around tendon. The fascial flaps and free skin grafts in eight patients were completely survived. All patients were followed up for 3-24 months, the donor and recipient sites were healed very well. The functional and cosmetic results were satisfactory.

CONCLUSIONSPeroneal tendofascial flap combined with adipofascial flap, with proximal pedicle or reverse distal pedicle, can be used to repair the defect at the lower leg and refractory small- and medium-sized defects at the heel.

Adipose Tissue ; anatomy & histology ; transplantation ; Adult ; Aged ; Fascia ; anatomy & histology ; transplantation ; Female ; Fibula ; Heel ; injuries ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; anatomy & histology ; transplantation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps