Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; therapy ; Treatment Outcome

Objective To investigate the effects of recombinant human growth hormone (rhGH) on tumor growth and tumor angiogenesis factor relevant to Janus kinase 2-signal transducer and activator of transcription 3 of human gastric carcinoma xenografts in nude mice with different expressions of growth hormone receptor (GHR).Methods Immunocytochemical method was used to pick out one GHR-positive and one GHR-negative cell line. The cells were subcutaneously injected into 26 nude mice separately, then the patterns of xenografts in nude mice with different expressions of GHR were established. The nude mice bearing two different kinds of human gastric caicinoma were equally randomized into control group, low-dose rhGH group, and high-dose rhGH group,and were treated with drugs for 14 days. Changes of tumor volumes and body weight of nude mice were record. The protein and mRN A expressions of tumor angiogenesis factor in tumor tissue were detected by RT-PCR and Western blot, respectively. Results GHR was highly expressed in SGC-7901 celk but negative in MKN-45 cells. For nude mice bearing GHR+ SGC-7901 xenografts, the tumor volumes were significantly larger in low-dose rhGH group [(1. 141 ±0. 234) cm3] and high-dose rhGH group [(2. 106 ±0. 260) cm3] than in control group [(0.612±0. 156) cm3] (P = 0. 034, P = 0. 001), and the high-dose rhGH group revealed greater effect (P =0. 043 ). Body weight was not significantly different among three groups. Compared with the control group, the mRNA expressions of tumor angiogenesis factor were significantly increased in low-does rhGH group, and the P values of GHR, Janus kinase 2, signal transducer and activator of transcription 3, vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), fibroblast growth factor, and matrix metalloproteinases-2 (MMP-2) was 0.001, 0.011, 0.042, 0.045, 0.040, 0.002, and 0.003, respectively; however, the high-does rhGH group did not show the greater effects. The protein expressions were significantly increased in low-does rhGH group, and the P value of phosphorylation-signal transducer and activator of transcription 3, signal transducer and activator of transcription 3, VEGF, HIF-1α, and MMP-2 was 0. 015, 0.003, 0.010, 0.008,and 0. 005, respectively; furthermore, the high-does group revealed the further greater effects, and the P value of VEGF, HIF-1α, and MMP-2 was 0.012, 0.025, and 0.046, respectively. On the contrary, for nude mice bearing GHR- MKN-45 xenografts, the body weights of low-dose rhGH group [(24.94 ±0. 517) g] and high-dose rhGH group [(26.97 ±0.686) g] were significantly higher than that of control group [(22.78 ±0.418) g] (P =0. 040, P = 0.012 ) , while tumor growth as well as the expressions of mRNA and protein of tumor angiogenesis factor in tumor tissue were not significantly different Conclusions rhGH can promote tumor growth and up-regulate the expression of tumor angiogenesis factor in the GHR-highly-expressed SGC-7901 xenograft tumor model; However,such effects do not exist in GHR-negatively-expressed MKN-45 xenograft tumor model. The existence of GHR may be a key target by which rhGH influences the tumor growth and the expressions of tumor angiogenesis factor, which is probably achieved through Janus kinase 2-signal transducer and activator of transcription 3 activation.

BACKGROUND:Unicompartmental knee arthroplasty for osteoarthritis can be accepted by more and more scholars, but some scholars believe that total knee arthroplasty is a better choice. OBJECTIVE:To compare knee scores between patients before and after unicompartmental knee arthroplasty and total knee arthroplasty. METHODS:A total of 53 patients with knee osteoarthritis, who underwent unicompartmental knee arthroplasty in the First Affiliated Hospital of Xinjiang Medical University from March 2013 to November 2014 and obtained fol ow-up, were enrol ed in this study. Simultaneously, 53 patients, who received total knee arthroplasty in the same period and obtained fol ow-up, were selected. Knee scores before surgery and in final fol ow-up were recorded in both groups, including KSS score, WOMAC score, OKS score and HSS score. The knee maximum flexion and patient satisfaction were recorded in final fol ow-up. RESULTS AND CONCLUSION:Patents with complications were excluded in both groups. Knee scores were significantly higher in final fol ow-up than in pre-operation (P<0.05). No significant difference in knee scores was detected in final fol ow-up between the two groups (P>0.05). Maximum range of motion in final fol ow-up was significantly larger in unicompartmental knee arthroplasty group than in total knee arthroplasty group (P<0.05). Patient satisfaction was similar between the two groups. Moreover, the association between WOMAC scores and OKS scores was high. These results suggest that unicompartmental knee arthroplasty could improve patient’s quality of life as total knee arthroplasty so long as physicians grasp strict indications;standard replacement operation and good functional exercise after replacement, but its long-term outcomes stil need further investigations.

[Objective]Through the clinical investigation of the conversative treatment of undisplaced femoral necks,to analyze the occurrence of secondary displacement and femoral head necrosis.[Method]The medical records of 216 patients with undisplaced femoral neck fractures who were primarily treated conservatively from January,2000 to January,2004 were analyzed.Among that,186 cases is in accordance with the selected standard,which were consisted of 82 men and 104 women.(the average age 67.5).One hundred and forty-one fractures were given to bed rest in rotation-proof shoes,and walking on the crutches was followed after four weeks.Forty-five patients began to get out of bed with double crutches on the third day.When displacement happened,the operation was carried out.Once X-rays showed the fracture line unclearly,it is considered as bone healing.The early stage of femoral head necrosis was defined by sclerotic region or cyst in the femoral head.[Result]Sixty-eight fractures(36.6%) united and secondary considered displacement occurred in 118 cases(63.4%); the average time was 16 days (2～68 d) after injury when the displacement is found.In all primary healing patients,femoral head necrosis rate was 25%.The discovery time of necrosis was between 4 and 18 months,the most was 36 cases in the interval of 6 to 12 months.As for patients of secondary displacement,92 for closed reduction and hollow screws fixation,and the head necrosis happened in 55 patients(59.8%).The discovery time was from 4 to 18 months,the most in 6 to 12 months was 36 cases.The operation of open reduction and internal fixation with hollow screws was in 26 cases,73% of necrosis rate for it.The time was range from 3 to 12 months,11 case was the most in the period of 3 to 6 months.[Conclusion]Undispalced femoral neck fractures treated conservatively bear higher risk of secondary displacement and femoral head necrosis.In addition with more mortality and general complications,we therefore recommend primary operative stabilization of undisplaced femoral neck fractures.

Objective To study the effect of thalidomide(Thd) used alone and in combination with cytoxan (CTX) on the growth and angiogenesis of human ovarian cancer transplanted subcutaneously in nude mice. Methods Human ovarian cancer model transplanted subcutaneously in nude mice was established, and divided into 3 groups: control group, Thd group, and Thd+CTX group.Tumor volume and weight,vascular endothelial growth factor(VEGF) mRNA, VEGF protein, microvascular density(MVD) were detected. The level of VEGF mRNA in tumor tissue was determined by relative quantative reverse transcription polymerase chain reaction. VEGF protein level in serum was determined by enzyme-linked immunosorbent assay (ELISA). MVD was calculated by immunohistochemistry. Results (1)Tumor volumes in Thd group and Thd+CTX group were smaller than those in control group(P

Background Optic neuritis is closely associated with multiple sclerosis (MS).Its pathogenesis is uncompletely clear,and less basic researches are carried out at home and abroad. Objective This study was to reveal the expression of myelin basic protein (MBP) in the optic nerve of rat with experimental allergic encephalomyelitis (EAE) and to provide a theoretical evidence for the research of the relationship of optic neuritis with MS. Methods Fifty clean Wistar rats were randomized into the control group and immune 8,12,18 and 25 days groups.Myelencephalon was collected from 5 guinea pigs to prepare the homogenate and mixed with the isovolumetric complete Freud' s adjuvant (CFA).The 0.5 ml mixed antigen emulsifier was subcutancously injected into the 4 maps together with Bordetella pertussis 0.2 ml under the cutancous of dorsalis pedis at 0 and 48 hours to induce the EAE.Behavior of the rats was evaluated to score the neurological function.The optical nerve sections were prepared 8,12,18 and 25 days after immunology for the histopathological examination,and immunochemistry and Western blot were used to detect the expression of MBP in optic nerve.The use of the animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission. Results The disorder of motor nerve was seen 12 days following the immune,and the clinical neural functional scores were significantly higher 12 day and peaked on 18 days myelination and then gradually reduced.The histopathological examination showed that the irregular alignment of neural fiber was found at 12 days,and changes of cellular structure,edema of neural shaft bunch were observed at 18 days.However,the abnormal cells were significantly less 25 days following the immune.Immunochemistry showed that the MBP was expressed mainly in the myelination of optic nerve fibers.The numbers of positive cells for MBP were (115.75±26.49)cells/5 fields at the 12th day,showing a significant lowing in comparison with (167.44±22.49)cells/5 fields of control group (t=4.537,P＜0.05 ).The positive cells were lest at the 18th day with the values ( 75.57 ± 34.54) cells/5 fields ( t =6.362,P＜0.01 ).At the 25th day,positive cells increased to ( 117.63 ± 13.78) cells/5 fields,which still was lower than those of the control group ( t =4.068,P＜0.05 ).Western blot assay illuminated that with the prolong of immune time,MBP/β-actin ratio in optic nerve was gradually reduced and followed the same pattern at the 12th day( t =4.639,P＜0.05 ).At 18 days after immune in comparison with the control group,the expression of MBP/β-actin ratio in optic nerve was the least (t=8.427,P＜0.01). Conclusions MBP can be degraded in rat optic nerve.This is a further evidence that optic neuritis is a severe demyelination disease.It is clearly related to MS.

ObjectiveTo investigate the effect of recombinant human growth hormone (rhGH) on JAK2-STAT3 signaling pathway and on the growth of human colon cancer cells at different growth hormone receptor (GHR) expression status.MethodsLOVO and HCT-8 cell lines were selected after the colon cancer cells were screened using flow cytometry according to the GHR expression status.The growth of human colon cancer cells after intervention with rhGH was detected by MTT assay.The proliferation index ( PI),cell cycle,and apoptosis were detected by flow cytometry.The expression of JAK2-STAT3 signaling pathway proteins was detected by Western blot.ResultsHCT-8 cell line showed positive GHR expression (59.6％),and LOVO cell showed negative GHR expression (3.5％).The growth rate of HCT-8 cells increased after rhGH treatment.Compared with the untreated HCT-8 cells,the rhGH-treated HCT-8 cells showed reduced apoptosis,elevated PI,and increased G2/Mphase cells ( P =0.0073).Western blot revealed that rhGH up-regulated the proteins of pJAK2,pSTAT3,VEGF,Cyclin D1,and Bcl-xL in HCT-8 cells.In contrast,no such changes were observed in LOVO cells treated with rhGH.ConclusionsrhGH may promote the growth of HCT-8,the cell line of high GHR expression,and up-regulate the expression of a number of key nodes in JAK2-STAT3 signaling pathway.However,rhGH may not affect LOVO,the cell line of low GHR expression.

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a breakthrough in the field of hepatobiliary surgery.The remnant liver regeneration was stimulated during the first stage of the operation,and the radical resection of the tumor could be successfully carried out during the second stage of the operation.ALPPS is a new approach for patients with tumor which is previously considered unresectable during one hospital stay.In April 2014,a patient with hepatocellular carcinoma (HCC) in the right liver and liver cirrhosis was admitted to the Southwest Hospital.Preoperative examination confirmed that the ratio of the remnant liver volume to the standard liver volume was 26.9％,which indicated that the patient was inappropriate to receive radical resection of HCC.Therefore,totally laparoscopic ALPPS was applied.In the first stage of the operation,the portal vein ligation associated with liver hanging tape placement and in situ splitting of liver were carried out after hanging the Glisson's pedicle under the laparoscope.Thirteen days after the first stage of the operation,the ratio of the remnant liver volume to the standard liver volume was 40.6％.The second stage of the operation was carried out 14 days after the first stage of the operation.The right hepatic pedicle and right hepatic vein were transected with a stapler.The tumor was removed after full mobilization of the right liver.The distance between the resection margin to the tumor was 1.5 cm.No complications were detected after the first stage of the operation,while the patient was complicated with pleural effusion after the second stage of the operation and was cured by pleural puncture and drainage.The patient was discharged at postoperative day 9 and followed up at postoperative month 1.The results of follow-up confirmed that the hepatic function was normal,and no mass occupying lesions and pleural effusion were detected.Totally laparoscopic ALPPS is safe and feasible with satisfactory short-term efficacy.

Objective To investigate the feasibility and clinical effect of one-stage total knee arthroplasty for old femoral condyle fractures combined with knee osteoarthritis.Methods From January 2003 to December 2010,11 patients with old femoral condyle fracture combined with knee osteoarthritis,including 4males and 7 females,aged from 38 to 77 years (average,58.3 years),underwent one-stage total knee arthroplasty.There were 8 cases of supracondylar fracture,and 3 cases of intercondylar fracture.Moreover,there were 2 cases of knee fibrous ankylosis with mild amyotrophy,3 cases of collateral ligaments injury of the knee,2 cases of fibrous union,and 2 cases of infective nonunion.Results All patients were followed up for 6 to 72 months (average,41.3 months).The HSS score improved from preoperative 6.65±7.01 (range,0-13)to 88.5±6.18 (range,81-95) at final follow-up.The range of motion of the knee improved from preoperative 32.7°±17.6° (range,0°-50°) to 101.3°±9.8° (range,85°- 115°) at final follow-up.One case underwent knee disarticulation 6 years after operation owing to infection.For other patients,there were no complications such as infection,deep vein thrombosis,knee instability,component loosening and inequality of lower limb.Conclusion One-stage total knee arthroplasty is a technically difficult but effective method for patients with old femoral condyle fracture and knee osteoarthritis.

OBJECTIVE:To explore the effect of subarachnoid block anesthesia in endoulogy minimally invasive surgery of el-derly patients. METHODS:198 elderly patients underwent endoulogy minimally invasive surgery were randomly divided into obser-vation group (100 cases) and control group (98 cases). Observation group received subarachnoid block anesthesia,and control group received epidural anesthesia. The anesthesia onset time,anesthesia dose,surgery time,complete block time,satisfaction de-gree of anesthesia effect,the occurrence of ADR were compared between 2 groups. RESULTS:Anesthesia onset time and complete block time of observation group were (1.5 ± 0.6) min and (7.9 ± 3.9)min,which were significantly shorter than those of control group (4.5 ± 1.2) and (17.5 ± 4.3) min,with statistical significance (P<0.05). The anesthesia dose of observation group was (20.2 ± 4.8)mg,which was significantly lower than that of control group [(103.4 ± 20.1)mg],with statistical significance (P<0.05);the satisfaction degree of anesthesia effect was 95.0% in observation group,which was significantly higher than that of con-trol group(69.4%),with statistical significance(P<0.05);there was no statistical significance in surgery time and the incidence of ADR between observation group and control group(P>0.05). CONCLUSIONS:Subarachnoid block anesthesia consumes small dose,acts rapidly and shows significant anesthesia effect,it is used for endoulogy minimally invasive surgery of elderly patients.