Objective:To explore caspase-6's effect on the apoptosis of osteosarcoma cell line SOSP 607. Methods: The expression level of caspase-6 in the osteosarcoma cell line SOSP-9067 was examined by RT-PCR method. The adeno-virus adv5 vector with caspase-6 gene was constructed and transferred into the osteosarcoma cell line SOSP-9607 by lipo-fection. The cell survival rate after transfection was assayed by MTT method. The cell morphological changes were observed by microscope and electron microscope, the apoptosis of transferred cells were examined by gel electrophoresis. Results:No expression of caspase-6 was examined in the osteosarcoma cell line SOSP-9607. A high expression of caspase-6 was identified by RT-PCR after the transfection. The cell growth curve declined after transferring caspase-6. Electrophoresis of DNA displayed the apoptosis ladder. Conclusion: Transferring caspase-6 into the osteosarcoma line SOSP-9607 may inhibit the growth of the osteosarcoma cell line SOSP-9607 and this effect might be achieved by inducing apoptosis.

Objective:To evaluate the clinical outcomes of patients with single spinal metastasis of thoracic, lumbar or sacral vertebra treated with microwave ablation in situ.Methods:For 28 patients with single spinal metastasis of thoracic, lumbar or sacral vertebra, detailed and personal surgical plans were carried out. Instead of en bloc resection, hyperthermia ablation in situ was performed followed by strengthening procedures under the guidance of G-arm fluoroscopy machine. Intraoperatively, spinal cord and nerve root were properly protected. The bone defects were reconstructed by bone cement after the diseased lesions were revomed. All patients were followed up for almost 1 year postoperatively. During follow-up, X-ray and MRI images were obtained, and the level of pain and neurologic outcomes were also examined.Results:All 28 patients successfully received microwave ablation in situ. The average ablation time was approximately 8 minutes and the average amount of bone cement implanted was approximately 10.5 ml. The pain scores of digital pain classification before and 3 months after operation were 7.86±1.58 and 3.07±1.89( P<0.05). The postoperative neurological function of 22 patients was improved than that before operation. No significant changes were observed in 5 patients. The neurological function of the affected limb was relieved, whereas the symptoms of the healthy limb were slightly worse in the remaining case. Conclusions:Microwave ablation in situ is a feasible and effective surgical method for single spinal metastasis of thoracic, lumbar or sacral vertebra. It might possess many advantages, such as clear surgical field, smaller incisions, less bleeding, and safe margins during the operations. Further more, it could significantly relieve pain, restrict tumor growth, and improve the quality of life of patients. It is an innovative and distinctive therapeutic alternative for single spinal metastasis, which deserves widespread application.

AIM: To study apoptosis and bcl-2 mRNA gene expression of cardiomyocytes in donor hearts of immature rabbits underwent prolonged protection by 11, 12-epoxyeicosatrienoic acid (11, 12-EET), and further probe into the possible mechanisms. METHODS: 24 isolated immature rabbit hearts were performed to the model in a Langendorff perfusion apparatus and randomly assigned to normal control group,ST control group and EET group. The isolated rabbit hearts in ST control group and EET group were stored for 24 hours with 4 ℃ hypothermia, and underwent 30 minutes of reperfusion (37 ℃). TUNEL and in situ hybridization (ISH) methods were applied in the present study and apoptotic cells and bcl-2 mRNA gene expression were observed. RESULTS: The numbers of apoptotic cardiomyocytes in ST group and EET group were higher than that in normal control group, and the numbers of apoptotic cardiomyocytes were significantly decreased in EET group and bcl-2 mRNA positive expression were higher than that in ST control group, respectively. CONCLUSIONS: There were apoptosis during the prolonged protection of donor heart in our study, and we proved that: ①11,12-EET could decrease cardiomyocyte apoptosis significantly. ②Up-regulation of the bcl-2 mRNA expression in cardiomyocytes may be one of the mechanism responsible for inhibition of cardiomyocyte apoptosis by 11, 12-EET.

ObjectiveTo investigate methods of early postoperative rehabilitation and its effects on patients with bicondylar tibial plateau fracture treated by modified dual plating.Methods66 patients with bicondylar tibial plateau fracture from Tianjin Hospital were divided into 2 groups according to the starting time for postoperative rehabilitation: early rehabilitation group (n=30), convalescents rehabilitation group (n=36). The two groups had the same treatment since the fourth week postoperative. Tibial plateau angle (TPA) and posterior slope angle (PA) of tibial plateau were measured to evaluate the stability of proximal tibial and knee alignment. The Hospital for Special Surgery (HSS) score system and knee joint range of motion (ROM) were used as the parameters for knee function.ResultsThe mean value of TPA and PA had no significant changes, compared to the final follow-up and postoperative X-ray films(P>0.05); the differences between the two groups were statistically significant in the mean HSS score and mean value of knee flexion and extention ROM(P<0.01 or 0.05). There was significantly positive correlation between starting time and the total number of treatment was significant(P<0.01), while negative correlation with flexion ROM of knee joint and the HSS score(P<0.01).ConclusionThe correlation between rehabilitation intervention timing and functional recovery for patients with bicondylar tibial plateau fracture treated by modified dual plating is significant, early individual and systematic rehabilitation therapy can effectively improve the prognosis features of patients.

Objective To study the diagnostic value and clinical efficacy of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for mediastinal and abdominal lymphadenopathy. Methods Thirty patients who underwent EUS-FNA for mediastinal or abdominal lymphadenopathy between May 2009 and December 2015 were reviewed. The clinical efficacy of EUS-FNA was evaluated by pathological results and the follow-up. The EUS-FNA effect on clinical decision was also analyzed. Results Lesions were located in the mediastinum in 10 cases and in the abdomen in 20 cases. The total diagnostic accuracy, sensitivity, specificity, positive predictive value ( PPV) and negative predictive value ( NPV) of EUS-FNA were 96. 7%, 94. 7%, 100. 0%, 100. 0% and 91. 7%, respectively. Of all the 30 cases, 20 lymph glands were of unknown origin. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of EUS-FNA in these lesions were 95. 0%, 88. 9%, 100. 0%, 100. 0% and 91. 7%, respectively. The combination of cytological and histological examination had higher accuracy ( 96. 7% VS 73. 3%, P=0. 026) and sensitivity ( 94. 7%VS 57. 8%, P= 0. 019 ) than cytological examination only. Immunohistochemistry stains were performed in 12 neoplastic cases, and 11 ( 91. 7%) were confirmed. The diagnosis by EUS-FNA had positive impact on clinical decisions in 27 patients ( 90. 0%) . Conclusion EUS-FNA is an effective approach for mediastinal and abdominal lymphadenopathy, and the result has a positive impact on clinical decisions. The combination of cytological and histological examination and application of ancillary techniques, such as immunohistochemistry stains, can improve the diagnostic efficacy of EUS-FNA.

Objective:To evaluate the efficacy and safety of lenvatinib combined with camrelizumab as the second-line treatment for advanced intrahepatic cholangiocarcinoma (ICC).Methods:The clinical data of patients with advanced ICC undergoing the second-line treatment of lenvatinib combined with camrelizumab in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from June 2021 to June 2022 were screened and analyzed. A total of 12 patients were enrolled, including seven males and five females, aged (67.5±8.6) years. Response evaluation criteria in solid tumor 1.1 was used to evaluate the efficacy of treatment. The safety assessment adopts the Adverse Event Evaluation Standard 5.0. Kaplan-Meier method was conducted to plot survival curves.Results:Among the 12 patients (after 1-7 cycles of immune and targeted therapy), three achieved partial response, four achieved stable disease, and five were defined as progression disease. Adverse events of different degrees occurred in seven cases, among which three patients had adverse events of grade ≥ 3: one with hypertension, which was managed after antihypertensive and symptomatic treatment; one with elevated serum total bilirubin, which was improved after reducing the dose of lenvatinib; one with liver dysfunction, which was considered as immune-related liver toxicity and alleviated after discontinuing camrelizumab. The 1-month, 3-month, and 6-month survival rates and progression-free survival rates of the patients were 100.0%, 91.7%, 66.7%, and 83.3%, 41.7%, and 25.0%, respectively. The median overall survival of patients was 14.7 months (95% CI: 9.2-21.2) and the median time to progression was 8.0 months (95% CI: 4.1-11.9). Conclusion:Combination of lenvatinib and camrelizumab could bring survival benefits with controllable adverse events as the second-line treatment of patients with advanced ICC.

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy