Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Female ; Humans ; Liposomes ; metabolism ; Oligonucleotides, Antisense ; pharmacology ; Proto-Oncogene Proteins c-myc ; metabolism

OBJECTIVETo investigate the effects of the quinoline derivative PQ1 combined with cisplatin on the proliferation and gap junction communication of prostate cancer PC3 cells.

METHODSWe cultured in vitro prostate cancer PC3 cells and divided them into DMSO blank control, cisplatin control, and cisplatin (10 mg/ml) plus PQ1 (1, 2, 5, 10, and 15 μmol/L) groups. We measured the proliferation of the prostate cancer PC3 cells, determined the expressions of the connexin 43 (Cx43) mRNA and protein by RT-PCR and Western blot, and compared the indexes among different groups.

RESULTSCisplatin combined with PQl at 1 - 10 μmol/L significantly inhibited the proliferation of the PC3 cells and the inhibition rate rose in a concentration- and time-dependent manner, from (48.72 ± 0.98)% vs (50.33 ± 0.62)% at 0 μmol/L to (77.38 ± 1.12)% vs (83.50 ± 1.05)% at 15 μmol/L at 24 and 48 hours (P < 0.05). Compared with the cisplatin control, cisplatin combined with PQ1 at 1, 2, 5, 10, and 15 μmol/L increased the expression of Cx43 mRNA from 0.379 ± 0.113 to 0.669 ± 0.031, 0.831 ± 0. 127, 0.769 ± 0.100, 0.532 ± 0.086, and 0.475 ± 0.134, respectively (P < 0.05), and cisplatin combined with PQ1 at 1, 2, 5, and 10 μmol/L elevated that of Cx43 protein from 0.138 ± 0.146 to 0.263 ± 0.111, 0.306 ± 0.152, 0.415 ± 0.280, and 0.643 ± 0.310, respectively (P < 0.05).

CONCLUSIONThe quinoline derivative PQ1 can promote the gap junction communication of prostate cancer PC3 cells and enhance the killing effect of cisplatin on PC3 cells by upregulating the expressions of Cx43 mRNA and protein.

Aminoquinolines ; pharmacology ; Antineoplastic Combined Chemotherapy Protocols ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Connexin 43 ; genetics ; metabolism ; Dose-Response Relationship, Drug ; Gap Junctions ; drug effects ; physiology ; Humans ; Male ; Prostatic Neoplasms ; metabolism ; pathology ; physiopathology ; RNA, Messenger ; metabolism ; Time Factors

OBJECTIVETo investigate the factors upgrading the International Society of Urological Pathology (ISUP) Gleason score using the specimens from preoperative prostatic biopsy and radical prostatectomy.

METHODSA total of 164 patients diagnosed with prostate cancer by biopsy underwent radical prostatectomy. We retrospectively analyzed their age, prostate volume, preoperative PSA level, PSA density (PSAD) , the time interval between biopsy and surgery, the number of positive punctures, positive surgical margin, seminal vesicle invasion, lymphatic invasion, and Gleason scores from biopsy and prostatectomy. We also determined the predictors of Gleason score upgrading by logistic regression analysis.

RESULTSOf the 164 cases analyzed, 95 (57.93% ) showed a consistency between the Gleason score of preoperative prostatic biopsy and that after radical prostatectomy, 55 (33.54% ) increased and 14 (8.52%) decreased after prostatectomy as compared with preoperative biopsy. The prostate volume (P < 0.01) and biopsy score (P < 0.05) were independent predictors of Gleason score upgrading. The risk of Gleason score upgrading was 27 times higher in the patients with the prostate volume ≤ 25 ml and 9 times higher in the 25-40 ml group than in the > 60 ml group (P < 0.05).

CONCLUSIONLow Gleason score of biopsy (≤ 6) and small prostate volume (≤ 40 ml) may be the predictors of Gleason score upgrading after radical prostatectomy.

Biopsy ; Humans ; Male ; Neoplasm Grading ; Organ Size ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; classification ; surgery ; Retrospective Studies ; Risk Factors

OBJECTIVETo compare the influence of propofol and isoflurane on pro-inflammatory and anti-inflammatory cytokine response to perioperative period of tongue cancer surgery.

METHODSTwenty-four adult patients undergone the operation of tongue cancer were assigned to two groups randomly, propofol group (Group P) and isoflurane group (Group I). In group P, anesthesia was induced with fentanyl 2-3 microg/kg, propofol 2 mg/kg, atracurium 0.6 mg/kg and maintained with propofol 5-8 mg x kg(-1) x h(-1) and inhalation of 50% nirous oxide (N2O:O2=50%:50%). In group I, anesthesia was induced with 3%-4% isoflurane, fentanyl 2-3 microg/kg, diazepam 0.06-0.1 mg/kg, atracurium 0.6 mg/kg and maintained with inhalation of 50% N2O and isoflurane (ended-tidal isoflurane was maintained at 0.6%), in two groups atracurium was given intermittently. Blood samples were taken from peripheral vein before anesthesia (TO), at the end of operation (T1), 24 h (T2) and 48 h (T3) after operation for determination of serum IL-6 and IL-10 concentrations. The mean arterial pressure (MAP) and body temperature in two groups were recorded.

RESULTSIL-6 and IL-10 levels increased significantly in two groups at T1, T2 and T3 compared with T0 (P < 0.01). The increasing trend of IL-6 and IL-10 levels were similar in both groups, whereas the level of IL-6 at T1 in propofol group was lower than that of isoflurane group significantly (P < 0.01), however the level of IL-10 was much higher in propofol group than that of isoflurane group at T1 and T2 (P < 0.05).

CONCLUSIONThe influence of total intravenous anesthesia of propofol on post-operation inflammatory response is much gentler than isoflurane.

Adult ; Anesthesia, Intravenous ; Cytokines ; Female ; Humans ; Interleukin-10 ; Interleukin-6 ; Isoflurane ; Male ; Middle Aged ; Neoplasms ; Perioperative Period ; Postoperative Period ; Propofol

BACKGROUNDPulmonary embolism, a potentially fatal event, occurs more frequently in cancer patients than in the general population. To offer an accurate diagnosis and effective treatment to such patients in China, we analyzed the incidence rate and clinical features of pulmonary embolism in patients with solid tumor hospitalized in the Peking Union Medical College (PUMC) Hospital.

METHODSA retrospective analysis was made of the hospitalized patients with solid malignancies complicated with pulmonary embolism who had been admitted into the PUMC Hospital from January 2002 to December 2008.

RESULTSThe incidence of pulmonary embolism in hospitalized patients with solid malignancies was 0.27% (120/43 967). The median age at diagnosis was 57.5 years. The male to female ratio was 1.0:1.4 (49:71). Patients with non-small-cell lung cancer (NSCLC) constituted the largest proportion of the 120 patients (37.5%), followed by patients with breast (9.2%), ovarian (8.3%), pancreatic (6.7%), and liver cancer (6.7%). Eighty patients (66.7%) had stage IV cancer. Bone was the most common site of distant metastasis (46.3%). D-dimer level was elevated in 90.9% of the 66 tested patients. The incidence of bleeding due to anti-coagulation therapy was 3.6%. Thirty-six (30.0%) of the 120 patients had concurrent deep venous thrombosis in the lower extremities. Seventeen patients developed acute pulmonary embolism within 2 weeks after surgery, 3 of whom died suddenly. Four patients presented with deep venous thrombosis and 1 with pulmonary embolism prior to the identification of malignancy.

CONCLUSIONSPatients with cancer of the lung, ovarian, breast, pancreas, and liver are more likely to be complicated with pulmonary embolism than those with other types of solid tumors. Patients with distant metastasis are at a higher risk of pulmonary embolism. Pulmonary embolism without concurrent deep venous thrombosis is more frequently observed than concurrence of both disorders in the clinical setting.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; therapeutic use ; Child ; Child, Preschool ; Female ; Heparin ; therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasms ; classification ; complications ; diagnosis ; drug therapy ; Pulmonary Embolism ; diagnosis ; drug therapy ; etiology ; Young Adult

OBJECTIVETo compare the suppressive effects of tramadol and low-dose ketamine on postoperative hyperalgesia after remifentanil-based anaesthesia.

METHODSA total number of sixty ASA I - II adult patients who undergone the operation of cranio-cervical region were assigned to three groups randomly, controlled group (Group C), tramadol group (Group T) and low-dose ketamine group (Group K). Before the end of surgery, Group T was given tramadol 0.3 mg/kg, Group K was given ketamine 0.5 mg/kg and Group C wasn't given any medicine. When the visual analogue scale (VAS) score of the group C was over five, tramadol 0.3 mg/kg was given to the patients. The four-level verbal rating scale after trachea extubation, VAS score, the time of requiring analgesia again by patients and adverse drug reactions such as nausea, vomit, diplopia and hallucination were recorded for 24 hours after surgery.

RESULTSAfter operation, the VAS score of Group C was much higher than that of Group K in the first 4 hours and Group T was higher than Group K during 2, 3 and 4 hours (P < 0.05). The time of requiring analgesia by patients in Group C and Group T was earlier than Group K. The adverse drug reaction showed no significant difference in three groups.

CONCLUSIONLow-dose ketamine had significant suppressive effect on patients with postoperative hyperalgesia and acute opioid tolerance after remifentanil-based anaesthesia.

Adult ; Analgesics, Opioid ; Anesthesia ; Humans ; Hyperalgesia ; Ketamine ; Male ; Middle Aged ; Pain, Postoperative ; Piperidines ; Postoperative Period ; Tramadol

OBJECTIVETo determine the incidence of post-operative delirium after oral and maxillofacial surgery under general anesthesia in elderly patients, and to examine its association with plasma concentrations of beta amyloid protein 1-40 (Abeta1-40).

METHODSFifty patients underwent elective oral and maxillofacial surgery were divided into two groups: Group C (n=20) aged from 20 to 60 years old, and Group T (n=30) aged from 62 to 78 years old. The two group received the same general anesthesia. Delirium rating scale-revised-98 (DRS-R-98) was used as an instrument to diagnose and access the postoperative delirium of the two groups. The scores of DRS-R-98 were recorded before operation (T0) and at 24 h (T1), 48 h (T2), 72 h(T3) and 96 h(T4) after the operation. Serial measurements of serum concentrations of Abeta1-40 were also performed at the same time.

RESULTSThe incidence of post-operative delirium after oral and maxillofacial surgery in Group T was 20.0%. The concentrations of plasma Abeta1-40 in group T were much higher than group C at TO, T1, T2 and T3 significantly (P < 0.01). The concentrations of plasma Abeta1-40 at T1 and T2 were higher than those at TO in the same group (P < 0.05). The scores of DRS-R-98 in Group T at T3 and T4 were much higher than those at T1 and Group C significantly (P < 0.01).

CONCLUSIONThe constant increase of plasma Abeta1-40 may be one of the important factors related to post-operative delirium in elderly patients underwent oral and maxillofacial surgery.

Aged ; Amyloid beta-Peptides ; Delirium ; Female ; Humans ; Male ; Peptide Fragments ; Surgery, Oral

OBJECTIVETo discuss the reasons for the operation performed on 13 patients with upper cervical disease and to explore the management and prevention of upper cervical disease.

METHODSThirteen patients with upper cervical disease were retrospectively reviewed. The reason for of reoperations on these patients were analyzed. The measures to reduce upper cervical operational complication and bad prognosis were discussed to avoid reoperations.

RESULTSThe reasons for reoperations included 9 cases with unstable or re-dislocated atlantoaxial joint, 10 cases with residual spinal cord compression, 1 case with malposition of odontoid screw, 1 case with adjacent cervical spine regression, 1 case with occipital-cervical fusion failure, 1 case with spinal cord injury during operation, 1 case with bone-plant slipped into canales spinalis, and 1 case with demand to take out internal fixation for aggravated symptom.

CONCLUSIONSThe common reasons for upper cervical reoperations were due to instability or redislocation of atlantoaxial joint and residual of spinal cord compression. Some measures such as reducing operate miss, using firm internal fixation and decompressing were advisable to decrease the incidence of reoperations.

Adolescent ; Adult ; Atlanto-Axial Joint ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; Female ; Humans ; Joint Instability ; etiology ; prevention & control ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; surgery ; Reoperation ; statistics & numerical data ; Spinal Cord Compression ; etiology ; prevention & control ; surgery ; Spinal Fusion ; Young Adult

BACKGROUNDCavity reconstruction after benign bone tumor removal is varied and controversial. Allograft is widely used but is associated with complications. New bone substitutes, such as calcium sulfate artificial bone, have been introduced for bone tumor operation. However, the bone healing response of artificial bone has not been compared with allograft bone. We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.

METHODSWe retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction. The two groups were well matched. The mean follow-up time of the study group was 19.9 (12-55) months. We investigated bone healing response, complications, and factors affecting bone healing.

RESULTSAt the last follow-up, 84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P = 0.013). The initial healing rate showed no significant difference between the two groups (100% vs. 96%, P = 0.153). The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months, respectively (P < 0.01). Complications in the study group were minor and resolved. Implant volume was a significant factor affecting bone healing.

CONCLUSIONThe calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage, especially in smaller cavities.

Adolescent ; Adult ; Aged ; Allografts ; Bone Neoplasms ; surgery ; Calcium Sulfate ; chemistry ; Child ; Curettage ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Young Adult

Animals ; Apoptosis ; drug effects ; Cell Line, Tumor ; DNA Damage ; Doxorubicin ; pharmacology ; Fas Ligand Protein ; Gene Expression Regulation ; drug effects ; Humans ; Liver Neoplasms, Experimental ; drug therapy ; metabolism ; pathology ; ultrastructure ; Membrane Glycoproteins ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Necrosis ; Sulfinic Acids ; pharmacology ; Tumor Necrosis Factors ; genetics ; Up-Regulation ; bcl-2-Associated X Protein ; genetics