Humans ; Multiple Myeloma ; Neoplastic Stem Cells

Objective To explore the possible risk factors associated with postoperative lower respiratory infections in the elderly patients with lung carcinoma,and to formulate the appropriate preventive strategies according to the results of the study.Methods From January 2014 to April 2015,182 elderly patients with lung carcinoma who were undergoing surgical treatment in Renji Hospital of Shanghai Jiaotong University were collected.All patients were divided into infection group (n =29) and control group (n =153) according to whether occuring postoperative lower respiratory infections or not.The possible risk factors associated with postoperative lower respiratory infections were analyzed by single factor analysis and multivariable Logistic regression model.Results Single factor analysis showed that the postoperative lower respiratory infections of elderly patients with lung carcinoma were associated with age (t =-3.03,P ＜ 0.05),smoking (x2 =5.69,P =0.02),albumin (t =2.40,P =0.02),forced expiratory volume (FEV) 1.0％ (t =5.85,P ＜ 0.05),lung carcinoma stage (x2 =7.06,P =0.01),small cell lung cancer (x2 =5.09,P =0.02),complication with chronic obstructive pulmonary disease (COPD) (x2 =16.28,P ＜0.01) and complication with coronary heart disease (x2 =10.13,P ＜ 0.01).Multivariable Logistic regression analysis showed that age (OR =1.34,95％CI:1.13-1.59,x2 =11.17,P＜0.01),smoking (OR=12.68,95％ CI:2.06-78.04,x2 =7.50,P=0.01),FEV1.0％ (OR =0.90,95％ CI:0.83-0.97,x2 =7.76,P =0.01),squamous-cell carcinoma (OR =6.88,95％ CI:1.41-33.56,x2 =5.70,P =0.02),complication with COPD (OR =12.44,95％ CI:1.41-109.90,x2 =5.15,P =0.02) and complication with coronary heart disease (OR =10.61,95％ CI:2.25-90.50,x2 =7.18,P =0.01) were independent risk factors for postoperative lower respiratory infections in the elderly patients with lung carcinoma.Conclusion Age,smoking,squamous-cell carcinoma,low value of FEV1.0％,complication with COPD or coronary heart disease can increase the risk of postoperative lower respiratory infections in the elderly patients with lung carcinoma.Comprehensive and effective preventive strategies should be performed to reduce the risk of postoperative respiratory infections.

Objective To study the long-term results of Carbon -Titanium combined femoral head.Methods From April,1980to April,2000,72patients undergone hemi-arthroplasty of hip joint with more than five years followed up were reviewed.Among them,58cases were still alive,and 57of them were ex-amined with X-ray films.Results The follow-up was between 5years and18.7years,with an average of 10years and 8months.X-ray films of 50p atients showed that the acetabular c onfiguration was normal,with the ratio of 87.7%(50/57).In 7cases,the X-ray films demonstr ated different wear in the acetabula r profile,with the ratio of 12.3%.Two patients suffered from acetabular ossification,both of them were classified as less than Brooker II degree,and had a satisfactory function of the hip.The prosthetic stem sinkage happened in 2cases(5.3%).There was no complication of infection and hip central dislocation.Evaluation by Harris method,the average scores was 96,th e satisfactory rate of the clinical r esults was 96%.Conclusion Carbon -Titanium combined femoral head replacement is an alternative fo r patients with femoral neck fractur e in need of arthorplasty.

Objective The experiment was designed to evaluate whether the tendon healing inside the bone tunnel improved when the periosteal graft was wrapped around the tendon. Methods Sixty normal and healthy New Zealand white rabbits were used in the experiment. These rabbits were randomly divided into three groups. Each group included 20 rabbits. Group Ⅰ, periosteal graft was wrapped around the tendon with the cambium layer facing toward the bone; Group Ⅱ, periosteal graft was wrapped around the tendon with the fibrous layer facing toward the bone; Group Ⅲ, as control group, no periosteal graft was used with the tendon. In control group, the rabbit flexor hallucis longous tendon with calcaneus was designed as tendon-bone model. At 1, 2, 3, 4, 6 weeks after the operation, the specimens in three groups were got respectively and the structural integrity of the tendon bone interface were observed using optical microscope. The histological changes and the biomechanical parameters at varies interval were recorded. Results Three weeks after operation, there was significant osteochondral ossification of the periosteal cambium layer in the group of the cambium layer facing toward the bone, but no new bone appeared in the other two groups. Four weeks after operation, the newborn trabecular in the group of the cambium layer facing toward the bone was more than the other two groups. Six weeks after operation, the amount of the newborn trabecular and the tight interdigitation between the tendon graft and the newly formed bone in the group of the cambium layer facing toward the bone were superior to the group of the fibrous layer toward the bone and the control group. Biomechanical testing, according to a one-factor ANOVA and Student-Newman-Keuls multiple range test, there was significant difference in statistics between the group of the cambium layer facing toward the bone and the other two groups (P0.05). Conclusion Periosteal graft was wrapped around the tendon with the cambium layer facing toward the bone, may shorten the time of osteochondral ossification of the periostum and improve the tendon healing in the bone tunnel.

AIM:To investigate the immune depressive effect on the reactive T cells and to explore the immunologic injury mechanism of beta cells of islet in type 1 diabetes mellitus(DM-1).METHODS:pAd5/PD-L1-GPI adenovirus vector with target gene was constructed and transfected into NIT cells which are known as a mouse insuloma cell line.The highly expressed membrane protein of PD-L1-GPI was confirmed by Western blotting.The peripheral blood non-adherence lymph leukocytes and target cells were cultured to detect lymph leukocyte proliferation and the T cell function.The level of IL-2,TNF-? and IFN-? were detected in the cell culture fluid.RESULTS:Compared with the control group,the NIT cells modified with PD-L1-GPI inhibited the sensitized lymph leukocyte proliferation effectively and down-regulated the level of some cytokine secretions such as IL-2,IFN-? and TNF-?(P

Objective To investigate the effects of interleukin-17 (IL-17) on the cell proliferation, apoptosis and migration of human laryngeal carcinoma Hep-2 cells.Methods IL-17 was transiently transfected into Hep-2 cells, and at the same time empty vector group (pEGFP-N1) and normal control group were set up.The efficiency of transfection was evaluated by fluorescence microscope, and the mRNA and protein expressions of IL-17 were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.The proliferation of cells was detected by methyl thiazolyl tetrazolium (MTT) method, and the apoptosis was detected by flow cytometry.The migration ability was detected by wound-healing assay and Transwell assay.ResultsHep-2 cells transfected with empty vector pEGFP-N1 and IL-17 showed green fluorescence under the fluorescence microscope.Hep-2 cells expressed IL-17 at both mRNA and protein levels after transfection with IL-17.Compared with the normal control group, the proliferation of IL-17 transfected Hep-2 cells was significantly inhibited after 48 h transfection (0.34±0.03 vs.0.46±0.04, P=0.006).The apoptotic rate of IL-17 transfected cells was higher than that of normal control group (26.80%±0.80% vs.2.90%±0.31%, P=0.000).According to the wound-healing assay, compared with the normal control group, the scratch width of IL-17 transfected cells was significantly greater (1.59±0.01 vs.1.36±0.01, P=0.000).Transwell migration experiment showed that the migration of IL-17 transfected cells was significantly lower than that of the normal control group (26.33±2.08 vs.49.33±1.53, P=0.000).Conclusion IL-17 can inhibit the proliferation of human laryngeal carcinoma Hep-2 cells, reduce their migration ability and enhance their apoptosis ability.Therefore, IL-17 may inhibit the occurrence and development of laryngeal carcinoma through a variety of mechanisms.

PUMA (p53 up-regulated modulator of apoptosis) is a recently discovered Bcl-2 family member which could be rapidly induced by p53 and has strong pro-apoptotic effects.PUMA has attracted much attention in the research of life science.PUMA expression results in potent growth suppression of some cancer cells through induction of apoptosis.PUMA can also significantly sensitize some cancer cells to chemotherapeutic agents and irradiation through induction of apoptosis.PUMA is potentially useful in gene therapy of tumor.But recently,researchers have also found that PUMA participates in the process of carcinogenesis and possessed important biological functions.

Objective To evaluate the clinical features and guanosine triphosphate cyclohydrolase 1 (GCH-1) gene mutation in a family with dopa-responsive dystonia (DRD).Methods The clinical features of this family were collected and their peripheral blood samples were screened for mutation in GCH-1 gene using PCR and DNA direct sequencing.Results The clinical features among each patient in this family were different.But all affected family members had quite a good response to levodopa treatment without significant adverse reactions.DNA test showed an AT deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene in 5 affected members and 1 asymptomatic immediate family member.Conclusions Clinical heterogeneity is an important characteristic of DRD and clinical symptoms vary intra-families.Same gene type may cause different phenotype and not all carriers are patients.The deletion mutation at point of 631-632 in the 6th exon of GCH-1 gene should be considered as a pathogenic mutation for DRD.

Objective To present our experience in two-stage procedure immediate breast reconstruction,which aimed to retain local tissue condition for breast reconstruction,overcome the limitation of radiotherapy on implant reconstruction,and simplify the procedure as well as improve cosmetic result.Methods The proceduces of our method were divided into two stages:in the first stage,the round-shaped expander was implanted in the subpectoral major space during the procedure of mastectomy; at the same time as expander implanted,the first saline injection was performed; with 4 to 8 weeks of inflation,the tissue expander offered adequate tissue for breast reconstruction; in the second stage,silicon gel implant,latissimus dorsi muscle flap,extended latissimus dorsi muscle flap and deep inferior epigastic perforatior flap were used for breast reconstruction after the tissue expander was exchanged.Results Thirty-four patients had undergone the two-staged breast reconstruction using tissue expansion.The average time of therapy was 5.5 months.There were no postoperative complications such as implant exposure,additional scar,and flap necrosis.The follow-up time was 6 to 18 months and the result showed excellent contour of the breast at a satisfactory rate of 97.1％.Conclusions Two-staged technique using tissue expansion in breast reconstruction is easily done and the complications are rare.The technique possesses advantages such as avoiding affection of radiotherapy on silicongel implant and elasticity of skin,retaining maximal local tissue for breast reconstruction.There is no necessary for correction of skin defect and additional scarring,thus the patch-like appearance of breast is avoided.The patients need not to experience depression post mastectomy.Two-staged procedure immediate breast reconstruction is a safe and reliable technique that is especially applicable to the patients who need radiotherapy.

AIM　To develop a sensitive and specific LC/MS/MS method for determination of amlodipine in human plasma. METHODS　Amlodipine and internal standard 4′-hydroxypropafenone were extracted from plasma using liquid-liquid extraction, then separated on a Zorbax C8 column. The mobile phase consisted of acetonitrile-water-formic acid (75∶35∶1), at a flow-rate of 0.4 mL*min-1. A Finnigan TSQ tandem mass spectrometer equipped with electrospray ionization source was used as detector and was operated in the positive ion mode. Selected reaction monitoring (SRM) using the precursor → product ion combinations of m/z 409 → 238 and m/z 358 → 116 was used to quantify amlodipine and internal standard, respectively. RESULTS　The linear calibration curves were obtained in the concentration range of 0.4-16.0 ng*mL-1. The limit of quantification was 0.4 ng*mL-1. Each plasma sample was chromatographed within 3.7 min. The method was successfully used in several pharmacokinetic studies for amlodipine. More than 1 500 plasma samples were assayed within two weeks. CONCLUSION　The method is proved to be suitable for clinical investigation of amlodipine pharmacokinetics, which offers advantages of specificity, speed, and greater sensitivity over the previously reported methods.