Objective To evaluate the advantage of using computer navigation system in the resection of rib tumors.Methods We carried out rib tumor resection in 5 patients using computer navigation system.Preoperative CT of each patient was performed.The preoperation CT-based planning was made for every patient with the navigation system software including confirming the tumor surgical margin and designing resection margin.A C-arm scan was carried out intraoperatively.With image fusion of both data,tumor resection were performed under navigation image guidance.Results The mean time of image fusion was 58 minutes.Four tumor resection specimens showed safe and clear margins.Histological examination of all tumor specimens showed tumor-free margins.One patient who was suspected lung cancer with bone metastases was performed a biopsy under navigation image guidance and obtained a pathology diagnose successfully.Conclusion The computer navigation system helps surgeons determine the surgical margin,implement precision tumor resection and reduce surgical damage.

Treatment with the combination of Chinese herbs and cytotoxic chemotherapies showed a higher survival rate in clinical trials. In this report, the results demonstrated that the tanshinone II A, a key component of Salvia miltiorrhiza bunge, when it is combined with the cytotoxic drug cisplatin showed synergistic antitumor effects on human prostate cancer PC3 cells and LNCaP cells in vitro. Antiproliferative effects were detected with MTT assay. Cell cycle distribution and apoptosis were detected by flow cytometer. Protein expression was detected by Western blotting. The intracellular concentration of cisplatin was detected by high performance liquid chromatography. The results demonstrated that tanshinone II A significantly enhanced the antiproliferative effects of cisplatin on human prostate cancer PC3 cells and LNCaP cells with the increase of the intracellular concentration of cisplatin. These effects were correlated with cell cycle arrested at S phase and cell apoptosis. The apoptosis might be achieved through death receptor pathway and mitochondrial pathway. Furthermore, the Bcl-2 family members were also involved in this apoptotic process. Collectively, these results indicated that the combination of tanshinone II A and cisplatin had a better treatment effect in vitro not only on androgen-dependent LNCaP cells but also on androgen-independent PC3 cells.
Androgens ; metabolism ; Antineoplastic Agents ; pharmacology ; Antineoplastic Agents, Phytogenic ; isolation & purification ; pharmacology ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Diterpenes, Abietane ; isolation & purification ; pharmacology ; Drug Synergism ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Humans ; Male ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Prostatic Neoplasms ; metabolism ; pathology ; Salvia miltiorrhiza ; chemistry

This study is to investigate the antitumor activity of ophiopogonin B (OP-B). MTT assay, flow cytometric analysis, acridine orange staining, Lyso-Tracker Red staining and HeLa-GFP-LC3 transfect cells assay were used to detect the proliferation activity, apoptosis and autophagy of HeLa cells. The results showed that OP-B exerted potent antiproliferative activity on HeLa cells, the cell growth inhibition effect of OP-B was not due to apoptosis and OP-B could induce autophagy of HeLa cells. OP-B also induced the protein expression up-regulation of Beclin-1 and promoted LC3 I transformation LC3 II, which were representative proteins of autophagy. Furthermore, 3-MA, an inhibitor of autophagy, not only inhibited OP-B-mediated autophagy but also almost completely reversed the antiproliferative effect of OP-B, suggesting that the growth inhibition effect of OP-B was autophagy dependent. Western blotting demonstrated that OP-B inhibited the phosphorylation of Akt and its' downstream vital protein, such as mTOR and p70S6K. In addition, OP-B also induced the protein expression up-regulation of PTEN, which is a negative regulation protein for Akt/mTOR signaling pathway. However, OP-B did not affect the protein expression of total Akt. Collectively, the antitumor effects of OP-B were autophagy-dependent via repression Akt/mTOR signaling pathway. Therefore, OP-B is a prospective inhibitor of Akt/mTOR and may be used as an alternative compound to treat cervical carcinoma.
Adenine ; analogs & derivatives ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; Beclin-1 ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; HeLa Cells ; Humans ; Membrane Proteins ; metabolism ; Microtubule-Associated Proteins ; metabolism ; Ophiopogon ; chemistry ; PTEN Phosphohydrolase ; metabolism ; Phosphorylation ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-akt ; metabolism ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; Saponins ; pharmacology ; Signal Transduction ; drug effects ; Spirostans ; pharmacology ; TOR Serine-Threonine Kinases ; metabolism ; Up-Regulation

Objective To investigate the efficacy and safety of using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroptasty for the treatment of long or multi-seg-ment urethral strictures. Methods Seven patients with long and 4 cases with multi segment urethral strictures(range 10 to 15 cm,mean 12)underwent substitution urethroplasty using combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap urethroplasty.The patients'age ranged 24 to 56,mean 32 and the course of disease was from 6 to 96 months.Of the 11 patients 7 underwent com-bined lingual mucosa and buccal mucosa grafts urethroptasty,4 patients underwent combined lingual mucosa graft and foreskin flap Urethroplasty. Results The patients were followed up 5-1 2(mean 10)months postoperatively. Meatal stenosis developed 3 months postoperatively in 1 patient who un-derwent combined lingual mucosa and foreskin flap urethroplasty.The patient could void well after re-operation.The other patients could void well and the peak flow rate ranged from 2 1 to 3 6 ml/s(mean 26.8 ml/s). Conclusions Combined lingual mucosa and buccal mucosa onlay grafts or foreskin flap substitution urethroplasty may have the advantage of easier harvest,less trauma.It could be a good U- rethral substitution technique for the treatment of long or multi-segment urethral stricture.

BACKGROUND:With the increasing incidence of distal tibial fractures, locking plate fixation has become the preferred internal fixation method. OBJECTIVE:To analyze the biomechanical performance of distal tibial fractures, and to study the difference between medial and lateral locking plate methods for internal fixation of distal tibial fractures. METHODS:Articles concerning the biomechanics of the internal fixation of distal tibial fractures were col ected by literature search. The articles that met the criteria were analyzed in depth. In this paper, a biomechanical comparison between locking plate fixation and intramedul ary nail fixation was done as wel as the stress distribution and mechanism of the ankle joint. Meanwhile, 60 patients with distal tibial fractures who had received medial or lateral locking plate fixation at the Department of Orthopedics, Chongming Branch, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China from January 2009 to January 2012 were enrol ed for efficiency comparison. RESULTS AND CONCLUSION: For patients with distal tibial fractures, it is easy to cause posterior mal eolus fractures, Y-shaped fractures and anterior tibial compression, respectively, in the plantar flexion position, neutral position, and dorsiflexion position. Locking plate is better than the intramedul ary nail in the torsional force, and the intact fibula contributes to the improvement of fixed effects of these two internal fixation methods. When the fibula cannot be effectively fixed, the locking plate fixation has a better stability than the intramedul ary nail. Moreover, there is no difference in the fracture healing after fixation with medial and lateral locking plates. However, a lower incidence of complications and better function recovery of the ankle joint can be realized after lateral locking plate fixation.

Objective To compare the clinical therapeutic effect of radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy (RECTL) with traditional radical resection of esophageal carcinoma(TREC).Methods 80 patients receiving RECTL and 80 patients receiving TREC were chosen in our hospital.The general conditions during operation,pathologic data,postoperative complications and recurrence or metastasis rates were compared between two groups.Results Compared with TREC group,RECTL group had longer operation time 、less bleeding、less postoperative chest drainage liquid amount and less postoperative morphine administration (P ＜ 0.05 or P ＜ 0.01).The postoperative hospital stays were not statistically different between the two groups(P ＞0.05).The length of resected esophagus specimen and tumor near end cutting edge length in RECTL group are longer than that in TREC group,but with the former no statistically different(P ＞0.05) and the latter statistically different(P ＜ 0.05).There were no statistical differences about the number of dissected lymph nodes and the incidence of complications and local recurrence by cut plant between the two groups(P ＞ 0.05).The incidence of postoperative reflux gastritis was 7.1％ in RECTL group and 45 ％ in TREC group,with significantly statistical difference(P ＜0.01).The two groups had similar recurrence or metastasis rate(P ＞ 0.05).Conclusion Radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy,with small wound and early recovery,has the same effect as traditional operational resection of esophageal carcinoma.

Objective To evaluate the long-term efficacy of using penile skin flaps for urethroplasty in the treatment of anterior urethral strictures.Methods Between Jan 2006 and Dec 2012,138 patients with anterior urethral stricture were treated by using penile skin flaps for urethroplasty.The mean age was 38 years (range,7-82 year).The etiology of stricture included trauma in 78 cases,iatrogenicity in 41 cases,infection in 17 cases,unknown reason in 2 cases.The penile urethral stricture was found in 110 cases and the bulbourethral stricture was found in 28 cases.The mean length of anterior urethral stricture was 6.5 cm (range 3-14 cm).Among them,the length of urethral stricture was more than 10 cm in 48 patients.Basing on location,length of stricture and condition of penile skin,different penile skin flaps were chosen,including vertical pedicle skin flap,pedicle circular flap,L-flap,Q-flap.Three different techniques were used for urethroplasty,such as lateral patch flap urethroplasty (group1,n=80),dorsal and ventral inlaid flap urethroplasty (group 2,n =42) and tubularized flap urethroplasty (group 3,n =16).Results 4 patients were lost during follow-up.The mean duration of follow-up in the remaining 134 patients was 39 months (range,8-84 months).Complications developed in 29 of 134 patients (21.6％),including strictures recurrence in 17 (group 1,n =12,group 2,n=2 and group 3,n =3),urethrocutaneous fistulas in 7 (group 1,n =5,group 2,n=1 and group 3,n =1) and urethral diverticulum in 5 (group1,n =4,and group 3,n =1).105 cases voided well and the urinary peak flows ranged from 13-49 ml/s (mean 25 ml/s),The overall success rate was 78.4％ (105/134).Conclusions Penile skin is thinner,rich in blood supply and easy to be manipulated,which is one of the excellent materials for the urethral reconstruction.Q-flap or L-flap urethroplasty is an effective technique for the treatment of long-segment urethral strictrues (≥ 10 cm).

Traditionally, a novice ear doctor acquires the skillfully operative ability through dissecting cadaveric temporal bone in ear surgical training lab. For conceivable reasons donated bodies are always short in supply, virtual reality-based simulator provides a new model for surgical training. It has been proven that the simulator is a useful tool for surgical training. And it can be used in the rehearsal of operation procedures, real-time operation guidance, and remote surgery. Our design is different from the existing virtual surgical system. It has a parallel, distributed multi-workstation with the vivid three-dimensional model of temporal bone, and it can be used not only to learn the ear surgical skills in the virtual environment, but also preoperative plan and surgical consultation.
Ear Diseases ; surgery ; Microsurgery ; methods ; Otolaryngology ; education ; User-Computer Interface

To develop a new small molecular probe for discovering an antitumor lead compound from the replacement of carboxylic group of two molecular antibacterial fluoroquinolones with a heterocyclic ring, a series of the C3/C3 bis-fluoroquinolones tethered with an 1, 3, 4-oxadiazole ring were synthesized as their respective HCl salts, and their structures were characterized by elemental analysis and spectral data. The in vitro antitumor activity against L1210, CHO and HL60 cell lines was also evaluated via the respective IC50 values by methylthiazole trazolium (MTT) assay.
Animals ; Antineoplastic Agents ; chemical synthesis ; chemistry ; pharmacology ; CHO Cells ; drug effects ; Cell Line, Tumor ; Cricetinae ; Cricetulus ; Drug Design ; Fluoroquinolones ; chemical synthesis ; chemistry ; pharmacology ; HL-60 Cells ; drug effects ; Humans ; Inhibitory Concentration 50 ; Leukemia L1210 ; pathology ; Molecular Structure ; Oxadiazoles ; chemical synthesis ; chemistry ; pharmacology ; Structure-Activity Relationship

ObjectiveTo evaluate the efficacy of using oral mucosal grafts (buccal mucosa and lingual mucosa) for urethroplasty in the treatment of anterior urethral strictures. Methods Between Jan 2001 and Dec 2010,255 patients with urethral strictures (length ranging from 3 cm to 18 cm,mean 6 cm)underwent one-stage onlay oral mucosal grafts urethroplasty.Two different techniques were used for urethral reconstruction.The first technique involved tubularized dorsal lingual mucosa graft (LMG) augmentation of urethral plate ; the second technique used dorsal patch graft urethroplasty.Of the 255 patients,49 patients with long-segment urethral strictures ( ≥ 8 cm) underwent dual buccal mucosal graft ( BMG),dual LMG,combined LMG and BMG or long-strip LMG urethroplasty. ResultsThe patients were followed up for 8 -120 months postoperatively ( mean 37 months).Of the 255 cases,230 cases voided well and the urinary peak flows ranged from 16 to 51 ml/s (mean 26 ml/s).The overall success rate was 90.2％.Seventeen cases developed a recurrence of urethral stricture.Among these patients,15 underwent BMG urethroplasty again and 2 underwent direct vision internal urethrotomy,after which the patients voided well.Eight cases presented with urethrocutaneous fistula,these patients underwent a second operation,after which,the urethrocutaneous fistulas were cured. Conclusions The buccal mucosa and lingual mucosa are excellent sources of graft materials for the repair of anterior urethral strictures.Combined two oral mucosal grafts substitution urethroplasty is an effective technique for the treatment of long-segment urethral strictures.