Background and purpose:Despite the high remission rate in patients with multiple myeloma (MM) after the standard regimen, but often relapsed and resistant. It has been shown that modulation of cAMP can induce cell cycle arrest and apoptosis in a variety of tumor cells, which has become an interesting approach to cancer therapy. This study aimed to investigate possible effects of cyclic adenosine monophosphate (cAMP) analogue 8-(4-chlorophenylthio) adenosine 3’, 5’-cyclic monophosphate (8-CPT-cAMP) on multiple myeloma cells, provide direction to develop new drugs for the treatment of MM. Methods:The myeloma cell line U266 cells were treated with 8-CPT-cAMP of different concentrations. The proliferation of U266 cells was evaluated through cell counting kit (CCK-8) assay, lfow cytometry was used to analyze the changes of cell were distribution, apoptosis rate as well as mitochondrial transmem-brane potential (ΔΨm) in U266 cells before and after the treatment. Meanwhile, real-time quantitative polymerase chain reaction (RT-PCR) and Western blot assay were used to detect expression levels of apoptosis regulators including caspase-8, caspase-9, Bcl-2 and Bax genes in U266 cells before and after the treatment. Results:The U266 cells were treated 5 days with 8-CPT-cAMP of different concentration, it was shown that 8-CPT-cAMP could signiifcantly inhibit cell growth of U266 cells in a concentration and time dependent manner, the IC50 of 8-CPT-cAMP was reduced obvious prolonged reaction time, and reached to 58.52μmol/L in the iffth day. The cell cycle of U266 cells was stopped in G0/G1 stage as the progress of concentration. It was showed statistical signiifcant difference associated with the cellular proliferation inhibition rate and apoptosis rate in different concentration and control (P<0.05). Meanwhile, 8-CPT-cAMP could induce mitochondrial transmembrane potential collapse in U266 cells. Compared with control groups, the levels of Bcl-2 mRNA transcripts and protein in U266 cells were reduced in 8-CPT-cAMP treated groups (P<0.05), while the levels of caspase-9, Bax mRNA transcription and the expression of Bax protein were increased in treatment groups, but the caspase-8 mRNA had no statistical signiifcant difference with controls. Conclusion:8-CPT-cAMP can inhibit the proliferation and promote apoptosis of myeloma cells, which might be mediated by caspase via mitochondrial pathway.

Objective To evaluate the accuracy of a new generation bioimpedance cardiac output monitor as compared with thermodilution and end expiratory CO 2 techniques Methods Sixteen patients (14 males, 2 females) aged (58?12) years undergoing elective coronary artery bypass (CAB) surgery were studied Cardiac output was measured after CAB surgery in ICU using a new generation bioimpedance cardiac output monitor(Rheo Bioimpedance Hemodynamic monitor) and conventional thermodilution technique in 16 patients and end expiratory CO 2 technique in 10 patients Cardiac output was also measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers consisting of equal numbers of male and female The volunteers of each sex were further divided into 5 equal groups of 20 each: (1)20 29 years, (2)30 39 years, (3)40 49 years, (4)50 59 years and (5)60 70 years Results Cardiac outputs measured by bioimpedance and thermodilution techniques were well correlated (r=0 83) and there was also a good correlation between cardiac outputs measured by bioimpedance and end expiratory CO 2 techniques(r=0 88) Cardiac out measured with Rheo Bioimpedance Hemodynamic monitor in 200 healthy volunteers showed that there was a significant difference in cardiac output between 60 70 years age group and the other age groups in both male and female Conclusions Cardiac output and other hemodynamic parameters measured with the new generation bioimpedance hemodynamic monitor are accurate and can be used for preoperative cardiovascular function evaluation and postoperative monitoring of dynamic changes in circulatory function

OBJECTIVETo explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation (ORIF) compared with those that underwent titanium plate removal postoperatively.

METHODSFifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients' frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image.

RESULTSAll patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients (P>0.05).

CONCLUSIONThe titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.

Bone Plates ; Dental Implants ; Dental Occlusion ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Mandible ; Mandibular Fractures ; Prostheses and Implants ; Time Factors ; Titanium

BACKGROUND:The design and communication of cosmetic operation is more refined than that of traumatic operation. Thus, more accurate data should be acquired and more precise three-dimensional models should be reconstructed.
OBJECTIVE:To investigate the prospect of 3D laser scanner and matched graphics-processing software which acquire and analyze facial morphological data in the modern cosmetic surgery.
METHODS: We obtained the point clouds of the facial surface in two cases of facial soft tissue defects or dissatisfied facial appearance using a hand-held laser scanner to reconstruct a visualized facial model, which was used for measurement of facial profile, simulation of cosmetic operation and evaluation of the therapeutic effects.
RESULTS AND CONCLUSION:We simulated and designed upon the NURBS model before the operation primarily. Then the three-dimensional comparison was done between the simulate model and the postoperative model. Deviation analysis showed that the ratio of variation degree of the two models within 1 mm was more than 80%. It enables the rapid three-dimensional reconstruction of the facial surface by the combination of reverse engineering and laser scanning, thus providing accurate three-dimensional data for cosmetic design and quantitative evaluation of therapeutic effects in cosmetic surgery.

Objective To investigate the effect of augmenter of 1iver regeneration(ALR)on hepatocytes transplanted intraperitoneally in acute hepatic failure(AHF)rats.Methods AHF SD rats were induced by D-gal.The rats were divided into 5 groups randomly:blank control group(only receiving normal saline),transplantation control group(transplanting 2 X 107 hepatocytes from SD rats),ciclosporin A group(CsA group,receiving hepatocytes and CsA 6 days after transplantation),ALRgroup(receiving hepatocytes plus ALR 6 days after transplantation),ALR control group(only receiving ALR 6 days after transplantation).All drugs and cells were intraperitoneally injected.There was a observation period of 14 days after transplantation.The survival rate of receptors and transplanted hepatocytes was observed.The expression levels of CD4,CD8 and CD68 in abdominal cells,the levels of IL-1β and TNF-a in serum and douche of peritoneal cavity were detected.Results The 2-week SuFvival rate in blank control group,transplantation control group,CsA group,ALR group and ALR control group was 0,46.7%,20%,66.7%and 14.3%respectively.Survival rate in AI.R group was higher than in blank control group(P=0.001).Serum levels of d1-2 TNF-a in ALR group was all lower than in blank and transplantation control groups(P＜(0.01).Serum levels of d1-2 IL-18 in ALR group were lower than in transplantation control group.Ascitic levels of d1-2 TNF-a and IL-1β in transplantation control group were higher than in other groups(P＜0.05,P＜0.01).The serum levels of TNF-a and IL-1β in all survival groups were similar tO normal levels on the 14th day after transplantation.The positive expression rate of d1-2 CD68 in grafts of ALR group was(0.5±0.3)%.The positive expression rate of CD68 in grafts of ALR group was obviously lower than in transplantation control group and CsA groups(P＜0.01).The expression of d1-2 CD68,CD4 and CD8 in ALR group was respectively(1.3±1.2)%,(0.1±0.3)%and(0.2±0.1)%,all obviously lower than in transplantation control group(P＜0.01,P＜0.01,P＜0.05).Assembled conglobate hepatocyte noduses were observed in abdominal cavity in rats receiving hepatocytes transplantation during first to third day after transplantation.The number of survival grafts in ALR group was more than that in transplantation control group and CsA group,and infihrated inflammatory cells were less.On the 14th day posttransplantation.small amounts of normal hepatocytes in grafts were observed only in ALR group.Conclusion After HcT plus ALR intraperitoneally,the survival rate of AHF rats was increased.ALR improved survivorship of transplanted hepatocytes in short term.

Objective To discuss the microstructure and properties of vascular puncture with a blunt needle Pix'L filling injection.Methods Scanning electron microscopy (SEM) and photoelectron spectroscopy were employed for the analysis of the different morphology and elements,and a rat model was established to study thrusts of different microcannulas and hypodermic needle when stabing vessels.Ultimately we analyzed the correlation between the morphology and puncture force of different microcannulas.Results The SEM images of microcannulas from different manufacturers were different,and revealed the different technics of different manufacturers.Puncture forces of different microcannulas corresponded to the cross-section and smooth degree of the tips.Conclusions The SEM morphology and puncture force of microcannulas from different manufacturers are different,which indicate the different characters and usability.Plastic surgeons should select to use them more judiciously.

Background and purpose:Although bortezomib has become one of the major therapeutic agents against newly diagnosed or relapsed multiple myeloma (MM), there are some patients who become resistant to bor-tezomib and then relapse, emerging as a major obstacle to long-term survival of MM patients. It has been found that elevation of intracellular cyclic adenosine monophosphate (cAMP) levels could induce cell cycle arrest and apoptosis in MM cells,which has become an interesting approach to MM therapy. This study aimed to investigate possible effects of forskolin combined with bortezomib on bortezomib-resistant myeloma cells and further explore its mechanisms. Methods:The bortezomib-resistant MM cell lines H929-R and primary cells from patients who do not respond to bortezomib were used asin vitro models. The inlfuences of bortezomib and/or forskolin on MM cells were evaluated through cellular morphology, changes of cell distribution and apoptotic rate. Meanwhile, lfow cytometry analysis was used to detect mitochondrial transmembrane potential (ΔΨm) and the expression levels of apoptosis regulators in these cells before and after the treatment were detected by Western blot.Results:Bortezomib (20 nmol/L) synergized with forskolin (50nmol/L) to induce apoptosis of H929-R cells and bortezomib-resistant primary cells. In addition, borte-zomib synergized with forskolin to induce collapse of mitochondrial transmembrane and facilitate the degradation of anti-apoptosis proteins including Bcl-2 and Mcl-1.Conclusion:Bortezomib could synergize with forskolin to induce apoptosis in bortezomib-resistant MM cells.

Objective To detect the ascites CD64 index of patients with decompensated cirrhosis ,and explore the value in the di-agnosis of spontaneous bacterial peritonitis (SBP) .Methods Decompensated cirrhosis with ascites patients were divided into non-SBP group ,SBP suspected group and SBP diagnosed group .Two control groups were composed of patients with ascites culture pos-itive and non-SPB group .SBP suspected group were further grouped according to abdominal pain and the percentage of peripheral blood neutrophils .The CD64 index was detected by flow cytometry .Compared the difference of ascites CD64 index after treatment , and analyzed diagnosis performance of procalcitonin in human peripheral blood and ascites white blood cell count of SBP .Results The level of the ascites CD64 index was significantly higher in SBP diagnosed group (179 .39 ± 65 .56)and SBP suspected group (115 .49 ± 58 .42)than that of non-SBP group(26 .88 ± 26 .05)(P<0 .01) .The differences of the ascites CD64 index between SBP suspected associated with abdominal pain group and SBP suspected associated with painless group was not statistically significant (P>0 .05) .The level of the ascites CD64 index in SBP suspected with percentage of peripheral blood neutrophils elevated group was increased significantly than non-elevated group(P<0 .05) .CD64 index level in effective treatment group was significantly lower than the ineffective treatment group(P<0 .01) .The area of the ascites CD64 index under the curve was greater than procalcitonin in human peripheral blood and ascites WBC count ,and had a higher sensitivity and specificity .Conclusion The detection process of the ascites CD64 index is fast and with less influential factors ,which provides a new choice for the clinical diagnosis of SBP .

Objective To investigate the effect of parent artery occlusion with liquid embolic agents (Onyx)for the treatment of distal intracranial aneurysms. Methods The clinical data of 27 patients with 29 ruptured distal intracranial aneurysms were analyzed retrospectively.Seventeen aneurysms located in the posterior inferior cerebellar artery,3 in the anterior inferior cerebellar artery,2 in the superior cerebellar artery,2 in the posterior cerebral artery,1 in the anterior cerebral artery,and 4 in the middle cerebral artery.Twenty-eight aneurysms were treated with Onyx to occlude proximal parent arteries and aneurysms, and 1 distal middle cerebral artery aneurysm was occluded spontaneously. Results All the aneurysms treated were occluded completely.One patient died of intraoperative hemorrhage.The remaining patients were followed up for 8 to 67 months.The final Glasgow outcome scale (GOS)scores were 5 in 23 patients and 4 in 3 patients. 17 patients were followed up with digital subtraction angiography (DSA)and 5 were followed up with computed tomography angiography (CTA)after procedure.There was no recurrence of the aneurysm. Four patients were followed up clinically.No new neurological disturbance or rebleeding was found in all the survived patients. Conclusion Medium-long term follow-up results have shown that the clinical efficacy of proximal parent artery occlusion with Onyx for the treatment of distal intracranial aneurysms is satisfactory,and the recurrence rate is low.

Objective To investigate the effectiveness and safety of endovascular embolization for the treatment of middle cerebral artery aneurysms. Methods From March 2007 to May 2015,the clinical data of 170 patients with 173 middle cerebral artery aneurysms treated with endovascular embolization at the Department of Neurosurgery,Nanjing Jinling Hospital were analyzed retrospectively,including 120 (69.4%)ruptured aneurysms and 53 (30. 6%)unruptured aneurysms. The incidence of complications and prognosis were compared between the 2 groups. Results (1)A total of 170 patients who could perform endovascular embolization after preoperative evaluation successfully completed the interventional procedure. None of the patients died. (2)18 patients (10. 6%)had intraoperative and postoperative complications,including 4 (7. 5%,4/53)in the unruptured aneurysm group and 14 (11. 7%,14/120)in the ruptured aneurysm group. There was no significant difference in the incidence of complications between the two groups. (3)101 patients were followed up for 3-48 months. No new nervous system symptoms and reruptured aneurysm were observed. One patient had recurrence in the unruptured aneurysm group and 4 had recurrence in the ruptured aneurysm group. Conclusion Endovascular treatment of middle cerebral artery aneurysms is a safe,effective,and feasible technique.