Objective To determine the factors contributing to the development of deep vein thrombosis (DVT) in the lower extremity in patients after hip or knee arthroplasty and hip fracture internal fixation.Methods One hundred and forty-seven consecutive patients receiving hip or knee arthroplasty and hip fracture internal fixation from 2004 to 2005 were included in this study. Their age ranged from 33 to 92 years. Duplex color ultrasonic inspection was performed on veins of the bilateral lower extremities before operation and 2 weeks after operation for detection of DVT. The patients were divided into a DVT group and a DVT-free group based on the development of DVT after operation. Detailed perioperative clinical information about the patients, surgery and anesthesia was collected.Results Lower extremity DVT was found in 42.2% of the patients after operation, while the incidence of proximal DVT was 2.7%. Compared with the DVT-free group, the usage rate and dosage of ephedrine increased significantly, the duration of anesthesia was significantly longer, and the white blood cell count (WBC) on the 1st postoperative day and the highest WBC count were significantly higher in the DVT group(P＜0.05). Logistic regression analysis indicated that the above factors were closely related to DVT.Conclusion Duration of anesthesia ＞ 3 h, ephedrine administration and a marked increase in WBC count after operation are the risk factors for DVT in the lower extremities in patients after hip or knee arthroplasty and hip fracture internal fixation.

0.05).There were no significant differences in thrombus-associated indexes except a slight change of plasminogen activator antigen.CONCLUSIONS:The incidence of DVT after tumor removal of urinary system is mainly associated with malignant tumor itself, operation wound, postoperative immobilization and the risk factors of thrombus,the administration of reptilase does not increase the incidence of DVT,but might promote the fibrinolytic activity of patients.

BACKGROUND: Previous results of our study show that oyster extract has some protective effects on apoptosis of the neuroepithelium in neural tube defects induced by hyperthermia in vivo.It remains unclear whether the extraet also protects in vitro cultured neural stem cells.OBJECTIVE: To investigate the protective effect of oyster extract on apoptosis of cerebral neural stem cells induced by hyperthermia.METHODS: The cerebral neural stem cells of embryonic mice of 13 days were cultured in vitro.Nestin expression was detected by immunofluorescence method to identify neural stem cells.The neural stem cells of passage 3 were divided randomly into 4groups: hyperthermia control group and oyster treated Ⅰ,Ⅱ,Ⅲ groups(mass concentration 2.5,5,10 g/L oyster extract solution).In addition,culture solution control group(no cells),and culture solution+oyster extract control group(no cells)were designed.All oyster extract groups and control groups were treated by hyperthermia over 39 ℃.The survival rate and the vitality of neural stem cells were detected by trypan blue staining and MTT assay.Western-blotting was employed to explore the expression of p53 in cerebral neural stem cells of each group.RESULTS AND CONCLUSION: The survival rate and the value of MTT assay in oyster treated groups Ⅱ and Ⅲ were significantly greater than hyperthermia control group(P < 0.05),but the expression of p53 in oyster treated groups Ⅱ and Ⅲ were weaker than hyperthermia control group.Oyster extract plays an important protective role in the apoptosis of neural stem cells induced by hyperthermia.

Animals ; Cochlea ; growth & development ; metabolism ; Female ; Guinea Pigs ; Male ; Nerve Growth Factor ; metabolism

Objective To compare the clinical efficacy of intralesional betamethasone versus triamcinolone acetonide acetate in the treatment of active alopecia areata. Methods A total of 160 patients with active alopecia areata were divided into two groups, test group (n = 100) treated with intralesional betamethasone, and control group (n = 60) treated with intralesional triamcinolone acetonide. Both injections were given once every 3 weeks for 12 consecutive weeks. Results After 12-week treatment, the cure rate, response rate, and total response rate were 60.0%, 32.0% and 92.0% in the test group, respectively, compared to 41.7%, 31.67% and 73.3% in the control group, respectively. A significant increase was observed in the cure rate and response rate in the test group compared with the control group (χ2 = 10.25, 5.06, P < 0.01 and 0.05). During the treatment course, 8 (8%) patients in the test group and 9 (15%) patients in the control group developed localized atrophy of the scalp; 8 (8%) patients in the test group and 3 (5%) patients in the control group developed localized folliculitis; no significant difference was observed between the two groups in the occurrence of adverse reactions (P> 0.05). Conclusion Intralesional use of compound betamethasone injection has a notable therapeutic effect on alopecia areata.

Objective:To get specific monoclonal antibodies ( mAbs) against PD-L1 which can block PD-1/PD-L1 binding, and explore the feasibility of its application on the treatment of chronic HBV infection preliminarily by in vitro and in vivo model. Methods:E. coli expression and series chromatography purification system were employed to get human and mouse PD-1/PD-L1 that had binding activity in vitro. By immunizing BALB/c mouse with purified recombination proteins of PD-L1,mAb hybridoma cell lines against PD-L1 were obtained. The reactivity with human/mice PD-L1 of individual antibody and the interaction blocking activity of the mAbs to PD-1/PD-L1 in vitro were examined by indirect chemiluminescence immune assay. Results: 8 cell lines against PD-L1 were obtained and 2 Anti-PDL1 mAbs (Ab5 &Ab6) performed strong immune activity to human/mice PD-L1 and blocking activity to PD-1/PD-L1. In the PBMC stimulation experiment of chronic HBV patient,Ab5 and Ab6 could promote theγ-IFN levels. With HBV in-fecting mice model,intravenous injections of these mAbs induced dramatically decrease of HBV DNA copies about 20 times, HBsAg levels in serum reduced to 30% of the baseline level. Conclusion:We obtained 2 PD-L1 mAbs with the reactivity to human/mice PD-L1 and blocking activity to PD-1/PD-L1. The 2 mAbs can promote T cell function in PBMC stimulation culture of chronic HBV patient, have significant antiviral effect in HBV transgenic mice and can be candidates for immunotherapy applications.

AlM: To observe the effect of dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope and discuss the operation technique. METHODS: A retrospective clinical analysis was performed on the clinical data followed up for 6 ~12mo from 140 patients (169 eyes) with dacryocystorhinostomy for the treatment of chronic dacryocystitis using nasal endoscope. The effect of the treatment was evaluated and the operation technique for the treatment of chronic dacryocystitis using nasal endoscope was discussed.RESULTS: ln all of cases 155 eyes ( 91. 7%) were recovery, 3 eyes ( 1. 8%) were improved, and 11 eyes (6. 5%) were failure. The total efficiency was 93. 5%, there was no significant difference compared with traditional dacryocystorhinostomy group (χ2=3. 743, P>0. 05). CONCLUSlON: Dacryocystorhinostomy using nasal endoscope for treatment of chronic dacryocystitis has a good curative effect. Techniques including lacrimal sac location and size, colostomy position and size, treatment of colostomy mucosal flap and nasal disease, postoperative follow - up and physical condition of patients are likely to affect the operation curative effect.

Background Chemical crosslinking agent can be used to strengthen the intensity of sclera tissue,but the intensity of the sclera may be influenced by different crosslinking methods.Objective The aim of this study was to compare the effectiveness of collagen crosslinking on porcine sclera between whole-eye crosslinking method and scleral strip crosslinking method.Methods Whole-eye crosslinking or sclera strip crosslinking was performed on 70 fresh porcine eyeballs in five groups using 1％ genipin,1％ glutaraldehyde or PBS respectively for 40 minutes.After crosslinking,10 sclera strips with l0 mm×4 mm from the temporal lateral were prepared in every group for the stress-strain measurement using a Instron5848 microtester,and the other 4 scleral strips in each group were extracted for the thermal shrinkage temperature test.Results Biomechanical property test reveled that the elastic modulus value of sclera strips reduced by 70.0％-82.8％ in the whole-eye crosslinking method group compared with scleral stip crosslinking method group after treated with 1％ genipin ((8.98 ± 1.81) MPa vs.(10.85 ± 1.83) MPa,t =3.375,P =0.003)) and 1％ glutaraldehyde((12.78 ±2.91) MPa vs.(18.25 ±5.16) MPa,t =4.007,P =0.001)) ;The tensile stress of whole-eye crosslinking method group was 54.9％-90.1％ of scleral stips method group,showing significant decline after corsslinked of whole-eye in 5％,10％,15％ and 20％ strain conditions (all P ＜ 0.05).Thermomechanics test showed that the thermal shrinkage temperature was lower in the whole-eye crosslinking group compared with scleral stip crosslinking group after treated with both 1％ genipin ((68.8 ±0.9)℃ vs.(74.8± 1.3)℃,t=11.129,P=0.000)) and 1％ glutaraldehyde((73.3±0.9)℃ vs.(79.3±1.3)℃,t=11.112,P=0.000)).Conclusions Different crosslinking methods have an influence on the efficacy of collagen crosslinking on porcine sclera.Sclera strip crosslinking offers a better crosslinking intensity for selera.

Objective To investigate the mobility of the lung tumors in order to guide the margin that CTV is to be expanded to PTV during stereotaetic radiotherapy for lung tumors.Methods Eighty-three lung tumom ineluded,in which 7 invaded the chest wall.1-2 gold marker(s)was/were implanted into or nearby the tumor.The motion of lung tumors in x(right-left),y(superior-inferior)and:(anterior-posterior)directions were measured via X-ray simulator system.One week later,1.25 mm thick of 16-slice spiral CT lung scan were taken.Apex,middle,and bottom of the lung were classified according to anatomic boderlines.Results No significant difference was detected among movements of apex,middle and bottom of the lung lesions in x axis direction((1.6±0.8),(2.6±1.1),(2.8±1.7)mm,respectively(F=1.76,P=0.179))and,y axis direction((2.0±1.3),(4.3±2.8),(4.0±2.0)mm,respectively(F=2.06,P=0.135))in 76 lesions of 63 patients.Significant differences were detected in:axis((2.7±0.8),(7.3±3.6),(12.0±5.3)mm(F=16.33,P=0.000)).The mobilities of the 7 lesions of 7 patients invading the chest wall were very small in all directions(0.9±0.7,0.7±0.7.and 2.0±0.6 mm,respectively).Motion amplitude did not correlate with the sex,age,height,weight and FEV1/FVC(r=-0.001-0.136.all P>0.05).Conclusions Motion amplitude of lung tumor due to breathing is associated with tumor loeation and status of chest wall invoivement.Identification of the mobile rules and the influencing factors is important for the internal margin set-up in lung tumor radiotherapy.

Objective To analyze the clinicopathological factors on the prognosis and investigate the necessity of adjuvant chemotherapy for patients with stage Ⅱ colorectal cancer.Methods The clinical data of 255 patients with stage Ⅱ colorectal cancer who were admitted to the First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2005 were collected.The survival curve was drawn by Kaplan-Meier method,and the survival rate of the patients were analyzed by Log-rank test.Factors influencing the survival were analyzed by Cox regression model.Results All patients were followed up till April 23,2010,and the mean time of follow-up was (63 ± 22)months.The median survival time was 63 months.The 5-year and tumor-free survival rates were 85.3％ and 83.7％,respectively.The 5-year overall and tumor-free survival rates of patients without preoperative bowel obstruction or perforation were 86.9％ and 85.6％,which were sigaificantly higher than 72.7％and 68.4％ of patients with preoperative bowel obstruction or perforation(x2 =4.546,4.573,P ＜ 0.05 ).The 5-year overall and tumor-free survival rates of patients with negative resection margin were 85.5％ and 83.9％,which were significantly higher than 75.0％ and 75.0％ of patients with positive resection margin(x2 =7.020,6.009,P ＜ 0.05 ).The result of multivariate analysis revealed that preoperative bowel obstruction or perforation were the independent risk factors for patients with stage Ⅱ colorectal cancer(Wald =4.477,relative risk =2.371,95 ％ confidence interval:1.066-5.275,P ＜ 0.05 ).The 5-year overall and tumor-free survival rates were 87.3％ and 86.0％ for patients who received adjuvant chemotherapy,and were 82.2％ and 80.3％ for patients who did not receive adjuvant chemotherapy (P ＞ 0.05 ).Conclusions Preoperative bowel obstruction or perforation are independent risk factors for the survival of patients with stage Ⅱ colorectal cancer.Adjuvant chemotherapy could not improve the prognosis of patients with stage Ⅱ colorectal cancer.