Angiofibroma ; pathology ; Humans ; Soft Tissue Neoplasms ; pathology

Biopsy ; Endopeptidase K ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; pathology ; Glomerulonephritis, Membranous ; pathology ; Humans ; Kidney ; pathology ; Lupus Nephritis ; pathology ; Paraffin Embedding ; Staining and Labeling

Objective:To analyze the value of low dose enteral nutrition (EN) in treatment of septic shock combined with acute gastrointestinal injury Ⅲ (AGI Ⅲ).Methods:Clinical data of septic shock patients combined with AGI Ⅲ admitted at our hospital were analyzed.Patients were divided into two groups according to the nutrition therapy they received:treatment group (EN,n =41) and control group (no EN,n =46).The mortality and ICU hospital stays were collected.The intestinal barrier,inflammatory cytokines,and oxidative stress were evaluated before and after EN treatment.Results:For patients in the treatment group,the dosages of EN ranged from 200 to 410 kcal/d,with the median dose of 350 kcal/d.No significant differences were found on death rates between the two groups (24.4％vs 32.6％,P =0.398).Patients in the treatment group had shorter ICU hospital stays than those of the control group (11.8 ± 3.7 vs 16.2 ± 5.3,P ＜0.01).After one week EN treatment,patients in the treatment group had lower levels of CRP,IL-6,TNF-α,diamine oxidase,endotoxin and D-lactate than those of the control group (P ＜ 0.05).Conclusion:For septic shock patients combined with AGI Ⅲ,low dose EN can improve the intestinal barrier function and systemic inflammatory responses.

Objective To evaluate the technique and clinical results of the modular fluted tapered stems for treating periprosthetic femoral fractures in revision hip arthroplasty.Methods From August 2007 to February 2014,fourteen patients (14hips) with periprosthetic femoral fractures underwent revision hip arthroplasty with modular fluted tapered stem.A retrospective analysis was performed involving all patients who were followed-up more than 2 years.The subjects consisted of 4 males and 10 females with mean age of 73.4±6.6 years (range,62-82 years) at the time of revision.All patients were unilateral with 8 left hips and 6 right hips.The status of primary arthroplasty was bipolar hemiarthroplasty in 3 patients and total hip arthroplasty in 11 patients.Nine cases were with cemented stems,5 cases with uncemented stems.The interval from primary hip arthroplasty to revision surgery ranged from 40 to 163 months,with an average of 120.9±31.9 months.Eight cases with Vancouver type B3 periprosthetic femoral fracture were found preoperatively,6 cases with aseptic loosening and bone deficiency occurred periprosthetic femoral fracture during the operation.Based on the Paprosky classification system for femoral bone deficiency:type ⅢA in 8 hips,type ⅢB in 5 hips,type Ⅳ in 1 hip.Both the femoral and the acetabular components were revised in 9 patients.All femoral fractures were treated with cable fixation,and the cortical allograft struts were used to augment femoral bone stock in 7 patients.The patients were followed up at 6 weeks,3 months,6 months,9 months,12 months and annually thereafter.Harris Hip Score System and radiographic examination was used to evaluate the clinical results,including fracture union,implant stability,bone stock,hip joint function and postoperative complications.Results The mean duration of follow-up was 62.1 ±22.2 months (range,30-96 months).The mean times of fracture union were 6.2±2.5 months (range,3-12 months).The Harris Hip Score improved from 29.6± 10.3 preoperatively to 86.3±4.2 postoperatively (t=-21.6,P=0.00).Thirteen cases (93％,13/14) had the stem subsidence of 4.9±2.5 mm (range,0-9 mm).Thirteen cases (93％,13/14) were presented with femoral bony restoration.Two cases showed incorporation of the allograft in 7 patients.One patient developed deep venous thrombosis of lower limbs,and one suffered from subcutaneous hematomas after surgery.There was no infection,aseptic loosening,dislocation or periprosthetic fracture complications at the followup.Conclusion The short-medium term results of the modular fluted tapered prosthesis applied in periprosthetic femoral fractures are encouraging in revision hip arthroplasty.The present technology can provide reliable primary stability and can tolerate minimal subsidence postoperatively.

Objective To determine the steam distillation processing of Elsholtzia and to optimize different parts volatile oil of the anti-bacterial activity and anti-oxidation activityfrom Elsholtzia. Methods The volatile oil of different parts from Elsholtzia was extracted by steam distillation. The anti-oxidationactivity was texted by DPPH. The antibacterial activity was detected by disk diffusion test. Results Watering 14 times, soaking 6 hours, extracting 3 hours by steam distillation to extracte different parts of volatile oil. It is effective that volatile oil inhibit Escherichia coli, Staphylococcus aureus, Dysentery bacillus＇s blessing. The sequential of antibacterial activity was that Escherichia coli ＞ Dysentery bacillus＇s blessing ＞ Staphylococcus aureus ＞Pseudomonas aeruginosa. The anti-oxidation activity increased the concentration of volatile oil, and was konwn to be the best when the content of the volatile oil is 10%. The anti-oxidation activity of VC was stonger than volatile oil. Conclusions It is effective that volatile oil inhibit Escherichia coli, Staphylococcus aureus, Dysentery bacillus＇s blessing and the volatile oil from inflorescence have a stronger antibacterial activity than the volatile oil from leaf.

Objective To analyze the risk factors of periprosthetic acetabular fracture in total hip arthroplasty (THA) and to discuss the prevention and management.Methods A total of 1 023 patients (1 168 hips) undergoing THA were retrospectively analyzed between January 2012 and June 2015.There were 421 males (507 hips) and 602 females (661 hips),aged from 23 to 96 years with mean age of 64.2± 15.0 years.Primary total hip arthroplasty was conducted in 1 053 hips,while revision surgery was conducted in 115 hips.The reasons of periprosthetic acetabular fracture were summarized.Age,gender,BMI,primary disease,left or right sides,surgical approach,osteoporosis,prosthetic type,the coverage rate of acetabulum-bone,and the amount of surgical operation annually were compared between non-fracture and fracture.Risk factors associated with the fracture were analyzed using chi square test followed by a multivariate logistic regression.Furthermore,revision surgery was compared with primary THA using chi square test.Results The incidence of intraoperative periprosthetic acetabular fractures was 2.8％ (33/1 168).The incidence of fracture was higher in revision surgery than that in primary THA (6.1％ vs.2.5％).Multivariate logistic regression showed that primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the high-er coverage rate of acetabulum-bone,and the less amount of surgical operation annually were prone to appear periprosthetic acetabular fracture in primary THA.Among the 33 patients with acetabular fractures,13 cases (39.4％,13/33) were found intraoperatively and 20 cases (60.6％,20/33) postoperatively.Acetabular wall fractures were in 26 (78.8％,26/33),column fractures in 2 (6.1％,2/33),transverse fractures in 2 (6.1％,2/33) and quadrilateral surface fractures with prosthetic central dislocation in 3 (9.1％,3/33).Seven cases of 26 stable fractures and 6 cases of 7 unstable fractures were found intraoperatively.Acetabular wall fractures were fixed by additional augmentation screws or accepted no special treatment,and column fractures were fixed with plate.One quadrilateral surface fracture was accepted revision surgery using Jumbo cup,2 quadrilateral surface fractures and 2 transverse fractures with reconstruction cage.The patients were followed up for 42.3±13.7 months (range 29-60 months).The Harris hip score was 83.3±6.6 (range 72-94) at last follow-up.No complication,such as hip dislocation,osteolysis,and prosthetic loosening was reported.Conclusion Most of periprosthetic acetabular fiactures are wall fractures which could not endanger the periprosthetic stability.The detection rate of acetabular stable fracture is lower than that of unstable fracture in operation.Primary disease (developmental dysplasia of the hip and rheumatoid arthritis),osteoporosis,uncemented acetabular cup,the higher coverage rate of aeetabulum-bone,the less amount of surgical operation annually are the intraoperative risk factors which closely related to acetabular fractures of primary THA.The risk of intraoperative periprosthetic acetabular fractures in revision THA is higher than that in primary THA.

Objective To study CD10 expression in cancer-associated fibroblasts ( CAF ) and related effect on colorectal cancer initiation and progression .Methods A total of 226 surgical removed colorectal cancer specimens were collected with patient follow-up data.A panel of immunohistochemical markers(CD10, Ki-67, p53, cyclin D1 and β-catenin) were evaluated in carcinomas, adjacent adenomas and paired normal colorectal mucosa with correlation of clinicopathological parameters .Results CD10 expression was not detected in the normal colorectal mucosa by immunohistochemistry .The percentages of CD10 expression in CAF were 80.1%(181/226) in carcinoma tissue and 58.4%(132/226) in adjacent adenomas, respectively.SMA was positive and desmin was negative .The proliferation index of Ki-67 was 84.1%(190/226) in tumor tissue, 63.7%(144/226) in adenoma zone, and 7.1% (16/226) in the normal mucosa.The rate of p53 mutation was 50.4% (114/226) in tumor tissue, 53.1%(120/226) in adenoma and 8.8%( 20/226 ) in the normal mucosa. The expression rate of cyclin D1 was 83.6%(189/226) in tumor tissue, 48.7%(110/226)in adenoma zone, but negative in the normal mucosa.For normal tissue , the percentages of β-catenin expression was 53.1%( 120/226 ) , 95.6%( 216/226 ) and 10.6%(24/226) in the cell membrane, cytoplasm and nucleus, respectively.The β-catenin expression in cell membrane, cytoplasm and nucleus was 17.7% ( 40/226 ), 100.0% ( 226/226 ) and 49.1%(111/226), respectively, in the tumor cells.The expression of Ki-67, p53, cyclin D1 andβ-catenin in the tumor cells was positively associated with CD 10 in CAF (P<0.05).The CD10 expression was different in patients with different gender , age and differentiation degree ( P<0.05 ) , whereas the depth of invasion , lymph node metastasis and tumor emboli did not relate to it .Overall survival rates in CD10 negative group were higher than that in CD10 positive group.Conclusions CD10 is only expressed in CAF.Significant correlation is found between CAF with high CD 10 expression and neighboring tumor cells with p 53, Ki-67 and cyclin D1 expression and nuclear β-catenin expression.CD10-positive CAF and p53, β-catenin, cyclin D1 and Ki-67-labelled colorectal cancer cells together with nuclear β-catenin expression may provide helps for diagnosis of colorectal carcinoma from an angle of tumor interstitial microenvironment .CAF with CD10 expression may promote the initiation and progression of colon cancer cells by activating Wnt signaling pathway.

To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma.Tissue samples of low-grade adenoma (=50), high-grade adenoma (=50) and colorectal adenocarcinoma (=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups.There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all<0.05). The expression of Ki-67 and β-catenin in low-grade adenoma, high-grade adenoma, colorectal adenocarcinoma was on a rising trend (all<0.01). The expression of CyclinD1 in high-grade adenoma was higher than that in colorectal adenocarcinoma and low-grade adenoma (all>0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all<0.01). The expression of TAF CD10 was correlated with the expression of p53, Ki-67 and β-catenin-nucleus(=0.264、0.307、0.320, all<0.01),but not correlated with CyclinD1 and β-catenin-membrane (=0.012、-0.073, all>0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (<0.05).The expression of CD10 in recurrent colorectal adenocarcinoma was higher than that in recurrent adenoma (<0.05).The expression of TAF CD10 is increased gradually in the process of adenoma-cancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.
Adenocarcinoma ; chemistry ; genetics ; Adenoma ; chemistry ; genetics ; Biomarkers, Tumor ; analysis ; Cancer-Associated Fibroblasts ; chemistry ; Carcinogenesis ; chemistry ; Colorectal Neoplasms ; chemistry ; genetics ; Cyclin D1 ; analysis ; Disease Progression ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local ; chemistry ; Neprilysin ; analysis ; Predictive Value of Tests ; Tumor Suppressor Protein p53 ; analysis ; beta Catenin ; analysis