OBJECTIVE: To investigate the protection of hepatocyte growth factor (HGF) on CML cell line K562 from apoptosis induced by etoposide (VP-16) and its molecular mechanism. METHODS: Quantitative and qualitative analyses on cell morphological change of apoptosis were performed through acridine orange (AO) staining and HE staining, and fluorescent flow cytometry.The test analyzes membrane on the surface of the PS evagination and integrity of cell membrane surface and mitochondrial membrane potential changes were performed through Annexin V-FITC/PI double dyeing and JC-1 cell dyeing tests, and apoptotic factors such as Bcl-2, Bax, Caspase-3 and Caspase-9 were measured by SYBR Green (Takara) qRT-PCR. RESULTS: The HE and AO staining revealed that apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.05), HGF can inhibit the apoptosis of cells induced by VP-16; FCM (Annexin V-FITC/ PI and JC-1) tests showed that cells apoptotic rates in HGF+VP-16 groups were significantly lower than those in VP-16 groups (P<0.05, P<0.001), indicating that HGF has the anti-apoptosis function. Apoptosis related gene mRNA expression tests found that the Bcl-2 mRNA expression in HGF+VP group was obviously higher than that in the VP-16 group (P<0.001), while Bax mRNA, Caspase-3 mRNA, and Caspase-9 mRNA expressions were significantly lower than those in the VP-16 group (P<0.05, P<0.001, P<0.001), suggesting that HGF possesses antiapoptotic effect through inhibiting apoptosis gene expression and promoting the antiapoptotic gene expression simultaneously. CONCLUSION: HGF can significantly protect K562 cells from apoptosis induced by VP-16 through the HGF/c-Met way to regulate PI3K/AKT pathway.

OBJECTIVE: To explore the method and accuracy of measuring the femoral neck anteversion in children with developmental dislocation of the hip by using 3D printing technology, so as to find out the method of measuring the femoral neck anteversion accurately and guide the formulation of the operation plan. METHODS: From June 2016 to September 2018, 17 patients with unilateral developmental dislocation of the hip were enrolled in the study, including 2 males and 15 females, aged 2 to 13 (5.47±0.81) years old, 11 on the left and 6 on the right. The methods of CT, 3D printing and intraoperative anteversion of femoral neck were used to measure the anteversion of femoral neck respectively. The intraoperative measurement was used as the standard reference value forstatistical analysis, and the accuracy of the first two methods was compared. RESULTS: The average value of CT was (36.00±1.66)°, the average value of model method was(43.91±1.62)°, and the average value of intraoperative method was(44.21±1.62)°. There were significant differences in CT measurement, model measurement and intraoperative measurement(<0.05). There was no significant difference between model method and intraoperative method (>0.05). CONCLUSION Compared with the traditional CT method, the 3D printing model method is simpler, more accurate and more repeatable, and can simulate the operation before operation. It is an ideal method to measure the femoral neck anteversion.
Adolescent ; Arthroplasty, Replacement, Hip ; Child ; Child, Preschool ; Female ; Femur ; Femur Neck ; Humans ; Male ; Printing, Three-Dimensional ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the surgical treatment and outcome of capitellum and trochlea fractures in adult through Kaplan approach associated with anteromedial approach. METHODS: From September 2012 to September 2016, 15 patients with capitellum and trochlea fractures were treated by Kaplan approach associated with anteromedial approach. Of the 15 cases, there were 6 males and 9 females, aged from 21 to 69 years old, with a mean of (42.0±10.5) years old. Eight patients had fractures on the left and 7 patients on the right. All the fractures were classified into type IIA(5 cases), type IIIA(4 cases) and type IIIB (6 cases) according to Dubberley classification. The results were evaluated by Mayo elbow function score for analysis. RESULTS: All the patients were followed up, the mean follow-up duration was(13.0±4.7) months(ranged 8 to 26 months). The mean Mayo elbow function score was 85.6±5.3(ranged 76 to 94). Postoperative follow-up had 4 cases excellent, 7 cases good, and 4 cases fair. Average arc of motion in elbow was(129.2±12.1)° in flexion and(6.6±1.9)° in extension. CONCLUSIONS The surgical treatment of capitellum and trochlea fractures in adult through Kaplan approach associated with anteromedial approach can better expose the fractures to achieve the satisfactory exposure and finish the surgical procedure, and the short-term outcome is satisfactory.
Adult ; Aged ; Elbow ; Elbow Joint ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Humeral Fractures ; Male ; Middle Aged ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

OBJECTIVE: To summarize the surgical treatment of different proximal clavicle fractures, and discuss the classification of proximal clavicle fractures. METHODS: Total of 24 patients with displaced proximal clavicle fractures were treated from January 2017 to December 2020 including 16 males and 8 females, aged 28 to 66 years old. Among them, 20 cases were fresh fractures and 4 cases were old fractures. According to the Edinburgh classification, 14 cases were type 1B1 fractures and 10 cases were type 1B2 fractures. The different internal fixation methods were selected for internal fixation treatment according to different fracture types.The operation time, blood loss, preoperative and postoperative displacement difference, fracture healing time and Rockwood scoring system were recorded. RESULTS: All patients were followed up for 12 to 24 months. There were no patients with infection or loss of reduction after the operation. Three patients had internal fixation failure after operation, and the internal fixation device was removed. Results The operation time was 30 to 65 min, and the blood loss was 15 to 40 ml. No important nerves, blood vessels, or organs were damaged. The imaging healing time was 3 to 6 months. According to the Rockwood functional score, the total score was (13.50±1.86), pain (2.57±0.50), range of motion (2.78±0.41), muscle strength (2.93±0.28), restricted daily activity (2.85±0.35), subjective results (2.63±0.61);the results were excellent in 20 cases, good in 3 cases, fair in 1 case. CONCLUSION Proximal clavicular fracture is a type of fracture with low incidence. According to different fracture types, different internal fixation methods and treatment methods can be selected, and satisfactory surgical results can be achieved.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Clavicle/surgery* ; Treatment Outcome ; Bone Plates ; Fractures, Bone/surgery* ; Fracture Fixation, Internal/methods* ; Retrospective Studies

OBJECTIVE: To investigate the clinical efficacy of unicompartmental knee arthroplasty (UKA) in the treatment of knee osteoarthritis in patients over 75 years old. METHODS: The clinical efficacy of primary fixed platform UKA in patients with osteoarthritis, was retrospectively analyzed from October 2014 to November 2020. Age, body mass index (BMI), range of motion (ROM), preoperative joint function score, the quality of life score and other preoperative indicators were measured by propensity score matching (PSM). The patients were divided into elderly group (≥75 years old) and control group (<75 years old). Oxford knee score(OKS), Western Ontario McMaster Universities osteoarthritis index(WOMAC), Short Form-12 including physical component summary (PCS), mental component summary(MCS), minimal clinically important difference(MCID ) and clinical complications were evaluated preoperatively and postoperatively. RESULTS: A total of 514 patients were analyzed, 428 patients fulfilled the inclusion criteria. A propensity-score matching study was conducted to eliminate confounding factors. After 1∶2 propensity match, there were 84 patients in elderly group (≥75 years), age ranged from 75 to 88 years old, with an average of (78.79±3.08) years old, and 168 patients in control group (<75 years), age ranged from 47 to 74 years old, with an average of (64.10±5.96)years old. The follow-up duration of two groups ranged from 12 to 84 months with an average of (29.35±16.52) months in elderly group, and 12 to 85 months with an average of (31.83±17.34) months in control group. There was only significant difference in age between the elderly and control groups preoperatively (P<0.01). Postoperatively, the elderly group showed significantly higher WOMAC (P<0.01) and lower SF-12 PCS scores (P<0.01) as compared to the control group. There was no significant difference between the elderly group and the control group in knee range of motion, OKS and the proportion of each scoring system reaching the minimum clinical difference value (P>0.05). In the aspect of preperative complications, the elderly group exhibited more surgical site complications and postoperative delirium compared to control group(P<0.05). The differences in other indicators including deep vein thrombosis, acute urinary retention, cardiovascular events, cerebrovascular events and radiolucent lines around prothesis were not statistically significant(P>0.05). CONCLUSION UKA in the treatment of elderly patients over 75 years old with knee osteoarthritis was safe and feasible, and could obtain satisfactory short-term efficacy.
Humans ; Aged ; Aged, 80 and over ; Middle Aged ; Osteoarthritis, Knee/surgery* ; Knee Prosthesis ; Retrospective Studies ; Propensity Score ; Quality of Life ; Knee Joint/surgery* ; Arthroplasty, Replacement, Knee/methods* ; Treatment Outcome

Objective: To compare the effects of two anesthetic schemes on pediatric laparoscopic surgery, and the influence on stress response and hemodynamics. Methods: From November 2016 to November 2017, 100 children underwent laparoscopic surgery in the Affiliated Hospital of Medical College of Ningbo University were selected and divided into two groups by odd even number of beds, with 50 cases in each group.The control group was treated with general anesthesia.The observation group received total intravenous anesthesia with remifentanil and propofol.The anesthesia effect, stress response and hemodynamic indexes were compared between the two groups. Results: The postoperative waking time[(31.48 ±4.19)min], the time of disappearance of mascara reflex[(2.32±1.62)min], the recovery time of spontaneous respiration [(1.96±1.45)min], the incidence of adverse reactions[4.00%(2/50)], Ramsay score[(3.69±0.43)points], VAS score[(1.96±1.42)points], immediate Ramsay score[(2.11±0.82)points] and immediate VAS score[(2.31±0.43)points] in the observation group were better than those in the control group (t=15.623, 1.436, 5.436, χ²=5.432, t=1.187, 1.528, 2.136, 2.431, all P<0.05). At different time points, the MAP, HR and stress response(cortisol, blood glucose, PaO₂, MAP) in the observation group were better than those in the control group(all P<0.05). Conclusion General anesthesia has higher risk in children undergoing laparoscopic surgery and can prolong the time of conscious consciousness.Remifentanil combined with propofol, total intravenous anesthesia can stabilize hemodynamics, improve the safety of anesthesia and alleviate stress reaction in children undergoing laparoscopic surgery.

BACKGROUND: Invasive mucinous adenocarcinoma (IMA) was a rare and specific type of lung adenocarcinoma, which was often characterized by fewer lymphatic metastases. Therefore, it was difficult to evaluate the prognosis of these tumors based on the existing tumor-node-metastasis (TNM) staging. So, this study aimed to develop Nomograms to predict outcomes of patients with pathologic N0 in resected IMA. METHODS: According to the inclusion criteria and exclusion criteria, IMA patients with pathologic N0 in The Affiliated Lihuili Hospital of Ningbo University (training cohort, n=78) and Ningbo No.2 Hospital (validation cohort, n=66) were reviewed between July 2012 and May 2017. The prognostic value of the clinicopathological features in the training cohort was analyzed and prognostic prediction models were established, and the performances of models were evaluated. Finally, the validation cohort data was put in for external validation. RESULTS: Univariate analysis showed that pneumonic type, larger tumor size, mixed mucinous/non-mucinous component, and higher overall stage were significant influence factors of 5-year progression-free survival (PFS) and overall survival (OS). Multivariate analysis further indicated that type of imaging, tumor size, mucinous component were the independent prognostic factors for poor 5-year PFS and OS. Moreover, the 5-year PFS and OS rates were 62.82% and 75.64%, respectively. In subgroups, the survival analysis also showed that the pneumonic type and mixed mucinous/non-mucinous patients had significantly poorer 5-year PFS and OS compared with solitary type and pure mucinous patients, respectively. The C-index of Nomograms with 5-year PFS and OS were 0.815 (95%CI: 0.741-0.889) and 0.767 (95%CI: 0.669-0.865). The calibration curve and decision curve analysis (DCA) of both models showed good predictive performances in both cohorts. CONCLUSIONS The Nomograms based on clinicopathological characteristics in a certain extent, can be used as an effective prognostic tool for patients with pathologic N0 after IMA resection.
Humans ; Prognosis ; Lung Neoplasms/pathology* ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma of Lung/pathology* ; Neoplasm Staging ; Lung/pathology* ; Retrospective Studies

OBJECTIVETo investigate the feasibility of a drill template for the placement of reverse intramedullary lag screws on the outside of the pubis based on digital design and 3D printing technology.

METHODSThe preoperative CT images of a 23-year-old male patient with pelvic fracture were collected retrospectively. According to the Young and Burgess classification, the type of pelvic fracture was LC IIwith the 3D printing technology. The data was reconstructed by 3D imaging reconstruction software to produce 1:1 three dimensional model. The screw channel and the individual drill template was designed by the softwares of Mimics 10.01 and Geomagic 12, the accuracy of a drill template was observed by X-rays and CT scans after the placement of 2.0 mm K-wires in the three dimensional template fixed on the model.

RESULTSThree dimensional pelvic model and digital, individual drill template could meet the requirement of the placement of reverse interamodullary lay screw for the treatment of superior ramus of pubis fracture. K-wire was placed and the accuracy of screw placement was confirmed using the X-ray and CT scanning. Template and the corresponding anatomical landmark fitted well.

CONCLUSIONSWith the assistance of the individual design and 3D printing technology, the accurate placement of superior ramus of pubis fracture screws can be realized. This technology is helpful to reduce the operation time and X-ray exposure of the patients and doctors.

Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology* ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology* ; SARS-CoV-2

Objective: To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall. Methods: The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed. Results: The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder. Conclusions Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway.