Objective To investigate indications,technique,prognosis and complications of anterior flap hemipelvectomy (hemipelvectomy using a quadriceps femoris muscle flap with superficial femoral artery)in the treatment of pelvic tumors.Methods From April 2009 to October 2010,10 patients with pelvic tumors underwent anterior flap hemipelvectomy in our department.There were 9 males and 1 female,aged from 30 to 62 years (average,46 years).There were 7 cases of chondrosarcoma,1 case of epithelioid sarcoma,1 case of pleomorphic liposarcoma and 1 case of spindle cell sarcoma.Results Nine patients were followed up for 12 to 30 months (average,21.5 months).Superficial skin necrosis occurred in 1 patient,while there was no wound infection.Local recurrence (33.3％) occurred in 3 patients,including 2 cases of chondrosarcoma and 1 case of epithelioid sarcoma.Three patients died at last,including 2 patients with local recurrence and 1 with pulmonary metastasis from liposarcoma.Two patients survived with pulmonary metastasis,and remaining 3 patients survived without recurrence and metastasis.Conclusion Anterior flap hemipelvectomy is indicated for:(1) patients with extensive soft tissue sarcoma in the buttock,and the tumor or reaction zone involve the subcutaneous tissue; (2) patients with recurrent pelvic tumors,and the conventional posterior flap can't be used due to contamination by the original incision; (3) patients whose posterior flap has poor blood supply due to radiotherapy or other factors.The prerequisite of the surgery is that the blood stream between external iliac artery and femoral artery is unobstructed; moreover the blood vessels are not in the tumor reaction zone.Compared with conventional posterior flap,the anterior flap hemipelvectomy is an easier procedure,which not only can easily cover surgical defect and obtain better surgical margin,but also has less complications.

Objective To investigate the effect of capsaicin and cisplatin on the proliferation and immunogenic cell death of human osteosarcoma cells.Methods MTT assay was used to examine the growth inhibiting effects of capsacin and cisplation on MG-63 cells;Mitochondrial membrane potential (MMP) was used to investigate the apoptosis;flow cytometry was used to detect the expression of calreticulin (CRT) on the cell membrane,fluorescein enzymatic method was used to detect the release of ATP,ELISA was used to detect the secretion of high mobility group B1 (HMGB1).Results Capsaicin and cisplatin can inhibit MG-63 cells proliferation in the dose-dependent manner and induce MG-63 apoptosis(P＜0.01).Only capsaicin can induce translocation of CRT from endoplasmic reticulum to the cell surface and release of extracellular ATP and HMGB1 (P＜0.01).Conclusions Capsaicin can induce human osteosarcoma cells apoptosis and immunogenic cell death.

Objective To explore the possible mechanism of Jianyi Recipe for improving the function of islet cells from the aspects of synthesis,secretion and inactivation of glucagon-like peptide-1 (GLP-1).Methods The diabetic rat model was established by feeding with high-lipid food combined with injection of streptozotocin (STZ).The rats were randomly divided into model group,Jianyi Recipe group,and normal group.The treatment for the rats lasted for 4 weeks.The blood glucose level was detected by the rapid blood glucose meter.The plasma levels of GLP-1 and insulin were detected by Luminex liquid phase protein chip technology.Pancreatic duodenal homeobox-1 (PDX-1) mRNA expression level was detected by quantitative real-time fluorescence polymerase chain reaction (PCR).The level of GLP-1 in ileum L cells was detected by immunohistochemistry,and dipeptidyl peptidase Ⅳ (DPP-Ⅳ)level was detected by enzyme-linked immunosorbent assay.Results Jianyi Recipe could decrease the levels of fasting blood glucose and postprandial glucose (P ＜ 0.05),promote the secretion of insulin (P ＜ 0.05),and increase PDX-1 mRNA expression level in the pancreas of the diabetic rats.Compared with the model group,plasma GLP-1 level,and ileal GLP-1 positive expression area and integrated optical density were increased (P ＜ 0.05) in Jianyi Recipe group,while the differences of serum DPP-Ⅳ levels were insignificant between the two groups (P＞ 0.05).Conclusion Jianyi Recipe maybe regulate the synthesis and secretion of GLP-1 to promote PDX-1 gene expression and insulin secretion,so as to reduce blood glucose in diabetic rats.

OBJECTIVETo summary the characteristics of cervicothoracic junction (C7T1) fracture-dislocation,and explore the surgical treatment of combined anterior-posterior procedure.

METHODSFrom January 2005 to March 2010,8 cases of cervicothoracic junction (C7T1) fracture-dislocation were treated by stage I operation through anterior and posterior approacheg, supplemented by non-structural bone graft. All patients were male with a mean age of 45.0 years old ranging from 32 to 68 years. Six cases were diagnosed clearly by CT scan but with normal cervical spine X-ray film at admission. According to AO classification, 4 cases were of type B, 4 cases of type C, with unilateral locked articular process in 2 cases, bilateral in 2 cases. Preoperative MRI showed intervertebral disc injury in 6 cases.

RESULTSThe average operation time was 246.3 min ranging from 150 to 320 min. The blood loss was with an average of 307.5 ml (150 to 600 ml). One patient got hoarseness but recovered without special treatment 6 months later; No other complications happened. One patient of preoperative Frankel grade A died, the remaining patients were followed up from 12 to 63 months (38.6 months in average). These fracture-dislocations were completely reduction after operation, healed with bony union 12 months later, and no pseudoarthrosis. The function of the spinal cord improved obviously at the final follow-up, 1 patient of preoperative grade A had died,and the spinal cord function of the other one had no significant changes,the 2 cases of grade B recovered to C and D respectively, 1case recovered from grade C to D, and 3 case recovered from D to E.

CONCLUSIONCervicothoracic junction (C7T1) fracture-dislocation is a rare clinical spine trauma, and missed easily. The CT is a necessary complement to these patients highly suspected C7T1 fracture-dislocation but with negative cervical spine X-ray film. The patients diagnosed clearly could receive stage I operation of anterior and posterior approaches, supplemented with non-structural bone graft.

Adult ; Aged ; Cervical Vertebrae ; injuries ; surgery ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Spinal Fractures ; diagnostic imaging ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Tomography, X-Ray Computed

Objective To analyse the distribution characteristics of major allergens initiating allergic diseases in children from rural Shanghai. Methods Eight hundred children with allergic diseases from rural Shanghai (rural ease group), 450 children with allergic diseases from urban Shanghai (urban ease group) and 100 healthy children from rural Shanghai (rural normal control group) underwent skin prick tests (SPT), and children of rural case group were subdivided into infant group, preschool age group and school age group according to age. The positive rates of allergens and SPT were compared among groups. Results The positive rate of SPT of rural case group was significantly higher than that of rural normal control group (73.38% vs 26.00%, P<0.05), and was significantly lower than that of urban ease group (73.38% vs 80.22%, P<0.05). Dermatophagoidesfarinae and Dermatophagoides pteronyssinus were the major allergens in rural ease group, with the positive rates of 57.88% and 59.13%, respectively. Except weed and rubber, there were significant differences in positive rates of the other allergens between rural ease group and the other two groups(P<0.05). There were significant differences in positive rates of SPT among different age groups of rural children with allergic diseases (P<0.05). Conclusion Dermatophagoides farinae and Dermatophagoides pteronyssinus are the major allergens in children with allergic diseases from rural Shanghai, whose positive rates of SPT are lower than those of children with allergic diseases from urban Shanghai. The positive rate of SPT is related to age to some extent.

This study was aimed to evaluate effect of Qinghua Granules (QHG) on glycometabolism, pancreatic islet function and oxidative stress in type-2 diabetics with heat syndrome. A total of 60 cases of type-2 diabetics with heat syndrome (according to the Syndrome Element Syndrome Differentiation) were enrolled in the clinic of the Department of Endocrinology and Metabolism, Shuguang Hospital Affiliated to Shanghai University of Tradi-tional Chinese Medicine. The average age of enrolled cases was (57.9 ± 6.9) years. Enrolled cases were randomly divided into the treatment group and the control group. The original hypoglycemic plan was continued to use. In the treatment group, QHG was administrated. And in the control group, placebo was given. The administration dosage in both groups was one package per day. The treatment course was 12 weeks. The fasting and postpran-dial (120 min after standard meal) blood samples before and after medication were collected. The main evalua-tion indexes were fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and hemoglobin A1c (HbA1c). The secondary evaluation indexes were homeostasis model assessment (HOMA2-%B, HOMA2-%S, HOMA2%-IR), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), maleic dialdehyde (MDA), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL). The anal-ysis of variance was used in the comparison of efficacy between two groups . The results showed that HbA1c in the treatment group was obviously reduced, and HOMA2-%B was obviously increased. There was no significant changes in the control group ( P = 0 . 044 , P = 0 . 016 ) . In the treatment group , SOD increased obviously , MDA reduced obviously. There was no significant change in the control group. There was difference b etween two groups (P = 0.011, P = 0.049). There was no change on blood lipids or other evaluation indexes. It was conclud-ed that QHG is effective in the improvement of glycometabolism, islet β-cell functions and oxidative stress in type-2 diabetics with heat syndrome .

OBJECTIVETo explore the interaction of folate deficiency and aberration of DNA methyltransferase 1 (DNMT1) in the progression of cervix carcinogenesis.

METHODSAll clinical samples were collected from 80 patients with cervix squamous cell carcinoma (SCC), 105 patients with cervical intraepithelial neoplasm (CINI, n = 52; CINII/III, n = 53) and 53 patients with cervix inflammation (CI). The participants were diagnosed by histology at Shanxi Province Tumor Hospital and Second Hospital of Shanxi Medical University during the period of September 2009 to May 2010. Meanwhile, cervical cancer cell lines Caski and C33A were treated with different concentration of folate. Radioimmunoassay (RIA), Western blotting and real-time PCR were used to detect the levels of serum folate, the expression of DNMT1 protein and mRNA, respectively. The data were analyzed by Student t test, ANOVA, chi-square test and Spearman correlation using SPSS statistical package. The correlation strength between factors and cervical canceration was calculated by OR and 95%CI value. Interaction effect was evaluated by the application of additive effect model.

RESULTSThe levels of serum folate (median inter-quartile range) were (2.66 ± 1.82), (2.83 ± 2.23), (3.17 ± 1.91) and (3.21 ± 1.74) ng/ml, the levels of DNMT1 protein (x(-) ± s) were 2.28 ± 0.55, 1.84 ± 0.37, 1.33 ± 0.38 and 0.92 ± 0.29, the Ct-ratio (Ct value of DNMT1/Ct value of β-actin) of DNMT1 mRNA (x(-) ± s) were 1.26 ± 0.13, 1.27 ± 0.12, 1.27 ± 0.12 and 1.33 ± 0.11 in the group of SCC, CINII/III, CINIand CI, respectively. The results showed that the serum folate levels were descended, and the expression levels of DNMT1 protein (χ(2)(tend) = 50.80, P < 0.05) and mRNA (χ(2)(tend) = 17.63, P < 0.05) were increased steadily with the severity of the cervix lesions. Moreover, our results revealed that there was an additive interaction between folate deficiency and high-expression of DNMT1 protein related to the risk of CIN and SCC. And it showed that the relative excess risk of interaction (RERI), attributable proportion of interaction (API) and synergy index(S) was 0.27, 0.14 and 1.40 in CINI group, 0.47, 0.19, 1.46 in CINII/III group, 1.60, 0.31, 1.61 in SCC group, respectively. It was found that folate was able to reduce the proliferation of Caski and C33A cells (r values were 0.954 and 0.969, all P values < 0.05), with 11.4% and 13.6% of growth inhibition at the concentration of 10 µg/ml, 64.8% and 49.4% at 1000 µg/ml in Caski and C33A cells, respectively. The result showed there was an inverse correlation between the levels of folate and DNMT1 protein (r values were -0.859 and -0.914, all P values < 0.05), with 1.96 and 1.92 of expression levels at the concentration of 10 µg/ml, and 1.60 and 1.38 at 1000 µg/ml in Caski and C33A cells, respectively. At folate concentration of 1000 µg/ml, the expression of DNMT1 protein or mRNA was higher in Caski cell than in C33A cell (t values were -4.22 and 3.50, all P values < 0.05).

CONCLUSIONOur finding indicated that the low levels of serum folate and high-expression of DNMT1 protein or mRNA seemed to be associated with high risk of cervical cancer and cervix precancerous lesion. Sufficient folate is able to effectively inhibit the growth of cervical cancer cells in vitro, and would counteract transcriptional and posttranscriptional aberration of DNMT1. It suggested that there might be a synergistic action between folate deficiency and aberration of DNMT1 in the progression of cervix carcinogenesis.

Adult ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cell Transformation, Neoplastic ; metabolism ; pathology ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; metabolism ; Female ; Folic Acid ; blood ; Folic Acid Deficiency ; metabolism ; Humans ; Middle Aged ; RNA, Messenger ; genetics ; Uterine Cervical Neoplasms ; metabolism ; pathology

AIM: To study the relationship between Chlamydia pneumoniae (Cpn) and spontaneous brain bleeding. METHODS: The IgG and IgM antibody titers to Cpn in peripheral blood from 9 patients of spontaneous brain bleeding were detected by microimmunofluorescence antibody technique (MIF). The Cpn DNA of arteries in brain bleeding region from these cases was detected by polymerase chain reaction (PCR). The Cpn major outer membrane protein (MOMP) expression of arteries in brain bleeding region from these cases were tested by Western blot. RESULTS: All the geometric average titer to IgG antibody (190 3?3 2) and the positive rate of IgG antibody (85 2%) and IgM antibody (30 8%) were significantly higher in spontaneous brain bleeding patients than those (48 1?2 0, 48 1% and 4 8%) in control ( P

This study aimed at analyzing the medication regularity based on differentiation in traditional Chinese medicine (TCM) for losing weight using text mining technique.All the references over losing weight were retrieved in CNKI,Wangfang Database,VIP Database and Pubmed.The drugs from the references were classified in accordance with drug property,drug flavor,channel tropism and drug efficacy.Frequency and constituent ratio of a single drug in TCM prescriptions for losing weight were put into analysis using chi square test and factor analysis to find out the medication regularity.It was found that the properties of TCM drugs in the prescriptions contained both cold and warm,while the flavors of the drugs involved pungent,sweet and light.The channel tropism of the drugs mainly belonged to spleen meridian,liver meridian,stomach meridian and lung meridian.They were mostly tonic,relieving,blood-activating,qi regulating,inhibiting-damp and antipyretic drugs.Through factor analysis we found that the common formula compatibilities were concluded as:cassia seed,lotus leaf,hawthorn,salvia miltiorrhiza,polygonum cuspidatum and radix polygonum multiflorum;capillary artemisia,epimedium herb,stephania tetrandra and ligusticum wallichii;dried tangerine peel,pinellia ternata and poria cocos;plantain seed,pericarpium arecae and selfheal;paeonia lactiflora,angelica sinensis,scutellaria baicalensis and ligusticum wallichii;poria cocos,cassia twig,atractylodes and glycyrrhiza;immature bitter orange and bark of magnolia;radix bupleuri,lycium chinensis and jujube;Chinese yam and coix seed;and astragalus,pueraria lobata and polygonatum.In conclusion,formula compatibility mainly combined syndrome differentiation with disease differentiation for the treatment of obesity in clinic,using the drugs belonging to liver meridian,spleen meridian,stomach meridian and lung meridian with the flavors of sweet,bitterness or pungent and the nature of both warm and cold.

OBJECTIVETo provide algorithmic morphological data that enables safe elevation of the flow-through perforator flap, chimeric perforator flap in the thigh.

METHODS15 fresh cadavers were injected with a modified lead oxide-gelatin mixture for three-dimensional reconstruction using a spiral computed tomography scanner and specialized volume-rendering software (MIMICS). All of specimens were then dissected by layers. Angiography and photography were used to document the precise course, size, location, and type of individual perforators in the thigh region. The surface areas of cutaneous territories and perforator zones were measured and calculate with Photoshop and Scion Image.

RESULTSThe main artery supplying the thigh is femoral artery. There are (41 +/- 4.0) perforators whose outer diameters > or = 0.5 mm. These perforators have a superficial pedicle length of (4.2 +/- 1.7) cm. The average outer diameter is (0.8 +/- 0.1) mm. Each perforator supplies an average area of (44 +/- 6.4) cm2. There are lots of truly anastomoses among perforaors to form a subcutaneous network in the thigh.

CONCLUSIONSThe volume rendering technique is very useful for showing the subcutaneous network and preoperative flap design. The thigh appears to have the greatest potential for harvesting new or modified perforator flaps, especially, flow-through perforator flap or chimeric perforator flap.

Cadaver ; Femoral Artery ; physiology ; Humans ; Perforator Flap ; blood supply ; Regional Blood Flow ; physiology ; Thigh ; blood supply ; Tomography, Spiral Computed ; Tomography, X-Ray Computed