Animals ; Corticosterone ; pharmacology ; Hippocampus ; drug effects ; physiology ; In Vitro Techniques ; Long-Term Potentiation ; drug effects ; physiology ; Male ; Rats ; Rats, Wistar

Objective To assess the diagnostic value of various preoperative imaging examinations for the point of the lateral femoral circumflex artery perforators through the deep fascia,in order to provide reasonable evidence for the design of location and protocol of anterolateral thigh perforator flap.Mehtods From September,2013 to December,2013,23 patients (including 1 patient with bilateral anterolateral thigh perforator flap) preparing anterolateral flap surgery were randomly divided into 4 groups(every group was 6 side).The patients in different groups were using different imaging techniques respectively,such as handheld doppler (HHD),Color doppler sonography (CDS),MDCT angiography (MDCTA),CDS and MDCTA united image location technology.The flap sizes varied from 8 cm × 5 cm to 28 cm × 12 cm.Moreover the coincidence rate between preoperative and intraoperative location of the perforator vessel was evaluated.Results Ali flaps were survived after the operation.The donor site were primarily closed while partial skin grafting was performed in 8 cases.The appearance and functional resuhs were satisfactory with following up for 3 to 9 months.The rates of coincidence between the preoperative and intraoperative location of perforating branches were HHD 61.53％,CDS 87.50％,MDCTA 85.71％,CDS and MDCTA united image location technology 93.33％ respectively.The HHD group showed significant decrease compared with the other groups (x2 =7.92,P ＜ 0.01; x2 =6.15,P ＜ 0.05; x2 =12.54,P ＜ 0.01,respectively).The CDS group had no statistically difference with the MDCTA group (P ＞ 0.05).The united CDS and MDCTA group showed significant increase compared with the other groups (x2 =4.22,P ＜ 0.05; x2 =3.94,P ＜ 0.05).Conclusion CDS and MDCTA united image location technology are more accurate for perforator preoperative location in auterolateral thigh flap,and should be widely used.

Objective To evaluate the dosage regimen of sulfasalzine combined with recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR) in the induction and maintenance of remission in active ankylosing spondylitis.Methods This study enrolled 100 ankylosing spondylitis patients with disease duration for less than five years who were treated with sulfasalzine and rhTNFR combination therapy.Patients were randomly assigned to three groups six weeks later:patients in the G1 group received sulfasalzine combined with rhTNFR at a 25 mg dosage twice each week.Patients shifted to monotherapy with sulfasalzine six weeks later:patients in G2 group received sulfasalzine combined with rhTNFR at 25 mg dosage per week.Patients were switched to monotherapy of sulfasalzine twelve weeks later:patients in G3 group received sulfasalzine combined with rhTNFR at 25 mg dosage once every ten days.Patients were changed to monotherapy of sulfasalzine seventeen weeks later.The whole treatment lasted for 24 weeks.All participants were followed up at week 0,6,12,18,24 respectively and were evaluated by BASDAI 50.The primary end-point of this study was the percentage of patients achieved BASDAI 50 remission.Data were analyzed with SPSS version 17.0.Independent t-test and x2 test were adopted to analyze data.Results 90％ of patients treated with combination therapy reached BASDAI50 at the 6th week.All patients in the G1 group achieved BASDAI 50 remission at 12th week,but the percentage dropped to 68.7％ at 18th week,which gradually decreased to 37.5％ at the 24th week.In G2 group,93.9％ patients reached BASDAI50,which declined to 81.8％ at the 18th week.The whole number accounted for 60％ at the end point of 24th week.In G3 group,85.7％ patients achieved BASDAI50 at the 12th week,accounted for 74.3％ at 18th week,and declined to 68.6％ at the 24th week.G3 group of patients presented a significantly higher rate than other groups(P＜0.05).Conclusion Sulfasalzine and rhTNFR combination therapy can gain remission in active AS patients after treated for six weeks.Doctors may extend TNF antagonist treatment in order to achieve long-term remission.

Objective To compare the mRNA level of macrophage inflammatory protein-3α(MIP-3α) in 3 different mucosal epithelial cell lines. Methods RNA standards were prepared by in vitro transcription. One-step real-time RT-PCR was established and optimized using TaqMan EZ RT-PCR Core Reagents with TaqMan probes and primers specific to human MIP-3α mRNA sequence. The specificity of one-step real-time RT-PCR method was confirmed by sequencing the PCR products. The sensitivity and reproducibility of the method was examined by repeating the test 8 times with the same sample. Results The one-step real-time RT-PCR with a wide detection range is sensitive, reproducible. It was found that MIP-3α mRNA level in Caco-2 and T-84 cells was much higher than that in the HeLa cells. Conclusion High level of MIP-3α mRNA could be found in mucosal epithelial cells and difference in transcription level of MIP-3α may exist in epithelial cells from different mucosa.

ObjectiveTo investigate the expression and significance of CD28- cells, CD4+ and CD8+T lymphocytes in the peripheral blood and synovial fluid in patients with rheumatoid arthritis ( RA ). Methods The expression of CD28, CD4+, CD8+ T lymphocytes and inducible co-stimulator(ICOS) in the peripheral blood and synovial fluid in 45 patients with RA were detected by three-color flow cytometry. Independent sample's t test was used for statistical analysis between the two groups. ResultsSynovial fluid CD4+CD28+ICOS+, CD4+CD28- ICOS+ , CD8 + CD28 + , CD8 + CD28 + 1COS+ T lymphocytes were significantly increased than the peripheral blood in RA patients[(36±19)％ vs (15±8)％, t=-4.234, P＜0.01; (2.1±2.2)％ vs (0.6±1.4)％, t=-3.143, P＜0.01; (62±15)％ vs (47±18)％, t=-2.885, P＜0.01; (9±9)％ vs (3±3)％,t=-2.131, P＜0.05], Synovial fluid CD8+CD28-T lymphoc-ytes were significantly reduced than the peripheral blood[(38±15)％ vs (54±18)％, t=2.975, P＜0.01], Synovial fluid CD8+ CD28-ICOS+, CD4+CD28+and CD4+ CD28- T lymphocytes had no significant difference than the peripheral blood (P＞0.05). Compared with peripheral blood in the same patients with RA, CD4+CD28+ ICOS+, CD8+ CD28+ T lymphocyteswere significantly increased[(38±18)％ vs (16±10)％, t=-4.065, P＜0.01 ; (61±16)％ vs (41±21)％, t=-4.065,P＜0.01], CD8+CD28-T was significantly reduced[(39±16)％ vs (59±21)％, t=2.949, P＜0.01]. The level of CD4+ CD28-, CD8+ CD28-, CD28-ICOS+ T lymphocytes in the active and remission patients with RA was not significantly different (P＞0.05). ConclusionSynovial fluid CD28T lymphocyte subsets disturbance and the abnormal expression of ICOS in patients with RA may play important roles in the mechanism of joint damage.

Objective To establish chronic cerebral infarction animal model in nonhuman primate. Methods 10 adult male rhesus monkeyswere embolized the middle cerebral artery (MCA) in contra-lateral of handedness, and divided into M1 segment embolism group (n=3), upper trunk embolism group (n=5), and lower trunk embolism group (n=2). Acute neurological deficit was evaluated with standard neurologicalscale, and the motor function in chronic stage was assessed with a task of retrieving food pill in wells. Results Animals in M1 segmentembolism group all died 38~62 h after surgery. Upper trunk embolism group survived, and MRI showed front parietal cortex infarctioncontra-lateral paralyzed side. All of them paralyzed one side in acute stage, and 4 of them persisted dysfunction in chronic stage, that couldnot finish the task of retrieving food pill in wells; only one completed the task. The lower trunk embolism group paralyzed one side in acutestage, but recovered quickly and completely, that finished the task within 7 d. Conclusion Embolism of MCA upper trunk can cause infarctionof precise and proper size with one side limb dysfunction in the acute stage and long-term dysfunction in most animals, which is feasiblefor treatment and neural plasticity research in recovery.

BACKGROUNDAlthough video-assisted radical operation for lung cancer has been widely accepted for treatment of nonsmall cell lung cancer (NSCLC), the debate over video-assisted thoracic surgery (VATS) segmentectomy still remains. This study analyzed the clinical outcomes using VATS segmentectomy for stage I NSCLC patients to explore the safety and efficacy of VATS segmentectomy for Ia NSCLC.

METHODSRetrospective review was conducted of patients who underwent VATS segmentectomy for clinical stage I NSCLC at Shanghai Chest Hospital between November 2009 and May 2012. VATS segmentectomy was performed on 36 patients. Analyses of the patient group were performed on patient demographics and clinical characteristics, intraoperative parameters, complications, and postoperative survival.

RESULTSThirty-five of thirty-six patients underwent VATS segmentectomy with only one conversion to open thoracic surgery. There was one peri-operative mortality from the segmentectomy group and all other patients are alive with a median follow up of 327 days. The mean volume of chest tube drainage after operation for segmentectomy was 1021.4 ml. Among other parameters, the mean blood loss was 162.5 ml (50.0 - 1600.0 ml), the mean operation time 124.8 minutes (75.0 - 271.0 minutes), chest tube duration 4.1 days (2 - 8 days), and the mean length of hospital stay 6.2 days (4 - 11 days). There was one (2.8%) locoregional recurrence after segmentectomy. Two patients successfully underwent bilateral segmentectomies and are still disease free.

CONCLUSIONFor patients with stage I NSCLC, VATS segmentectomy offers a safe and equally effective option and can be applied to complicated operations such as bilateral segmentectomy.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; mortality ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

Objective To explore the investigate of X-chromosome-linked inhibitor of apoptosis pro- tein(XIAP)and its effect on chemotherapeutic sensitivity in bladder carcinoma.Methods Using immu- nohistochemistry methods,the expression of XIAP was evaluated in 47 bladder carcinomas and 6 normal bladder tissues.The XIAP gene was transfected into bladder cancer cell line T24 by liposome and the positive clone was screened by G418.Cellular XIAP mRNA level was detected by RT-PCR.The apoptosis of T24 cells was induced by low-dose of mitocycin C(0.005 mg/ml and 0.05 mg/ml,respectively).The in vitro cellular growth activities were assayed by MTT color imetry;and the apoptosis rate was assayed by TUNEL methods. Results The expression rate of XIAP was 78.7%(37/47)in bladder carcinoma samples,with no corre- lation with carcinoma stages and grades(P＞0.05).XIAP mRNA level in transfected T24 ceils was signifi- cantly increased by 3.8 times.Treated with 0.005 mg/ml and 0.05 mg/ml of mitomycin C,the growth rates of XIAP transfected T24 cells were increased [(11.60?0.25)% and(16.51?0.87)% ,respectively,P＜0.05];and the apoptosis rates were decreased [(10.1?0.2)% and( 11.9?0.2)% ,respectively,P＜0.05]compared with those in control cells.Conclusions XIAP is highly expressed in humun bladder car- cinoma samples.Overexpression of XIAP in T24 cells results in decrease in bladder carcinoma cell apoptosis induced by MMC,which may decrease the chemotherapeutic sensitivity of T24 cells.

Objective To compare the effect of palliative mitral valve surgeries and medication therapies for secondary non-ischemic mitral regurgitation. Methods The clinical data of patients with non-ischemic functional mitral regurgitation treated in our hospital between 2009 and 2019 were retrospectively analyzed. Patients with a left ventricular ejection fraction (LVEF)＜40% underwent a dobutamine stress test, and a positive result was determined when the LVEF improved by more than 15% compared to the baseline value. Positive patients were divided into a surgery group and a medication group. The surgery group underwent surgical mitral valve repair or replacement, while the medication group received simple medication treatment. Follow-up on survival and cardiac function status through outpatient or telephone visits every six months after surgery, and patients underwent cardiac ultrasound examination one year after surgery. The main research endpoint was a composite endpoint of all-cause death, heart failure readmission, and heart transplantation, and the differences in cardiac function and cardiac ultrasound parameters between the two groups were compared. Results Ultimately 41 patients were collected, including 28 males and 13 females with an average age of 55.5±11.1 years. Twenty-five patients were in the surgery group and sixteen patients in the medication group. The median follow-up time was 16 months, ranging 1-96 months. The occurrence of all-cause death in the surgery group was lower than that in the medication group (HR=0.124, 95%CI 0.024-0.641, P=0.034). The difference between the two groups was not statistically significant in the composite endpoint (HR=0.499, 95%CI 0.523-1.631, P=0.229). The New York Heart Association (NYHA) grade of the surgery group was better (NYHA Ⅰ-Ⅱ accounted for 68.0% in the surgury group and 18.8% in the medication group, P<0.01) as well as the grade of mitral valve regurgitation (87.5% of the patients in the medication group had moderate or above regurgitation at follow-up, while all the patients in the surgery group had moderate below regurgitation, P<0.01). There was no statistical difference in preoperative and follow-up changes in echocardiograph parameters between the two groups (P＞0.05). Conclusion For non-ischemic functional mitral regurgitation, if the cardiac systolic function is well reserved, mitral valve surgery can improve survival and quality of life compare to simple medication therapy.

OBJECTIVETo identify the expression of DOG-1 in gastrointestinal stromal tumors (GIST) and to explore its potential association with clinicopathological features of GIST.

METHODSTwo tissue microarrays (TMA) were used for the study. Each TMA contained 80 tissue samples of GIST from 80 different patients, with each tumor represented by one core, and paraffin-embedded sections of 40 samples from normal gastrointestinal tissue were used as control. Immunohistochemistry staining (SABC method) was performed on TMA and paraffin-embedded sections to detected the expression of c-Kit (CD117) and DOG-1.

RESULTSImmunohistochemistry showed that in 80 GIST patients, 76 cases (95.0%) were DOG-1 positive and 67 cases (83.8%) were CD117 positive. The positive rate of DOG-1 was higher than that of CD117 (P<0.05). In 13 GIST samples of negative CD117, the positive rate of DOG-1 was 100%. Expressions of both DOG-1 and CD117 were negative in all the 40 samples of normal gastrointestinal tissue. The positive expression of DOG-1 and CD117 was not significantly different in spindle cell type (96.0% vs. 96.0%, P>0.05) and in mixed cell type (91.7% vs. 75.0%, P>0.05). While in the epithelioid cell type, the DOG-1 expression was higher than CD117 expression (94.1% vs. 52.9%, P<0.05). The positive expression of DOG-1 and CD117 was not associated with age, gender, location and risk stratification of the tumors (all P>0.05).

CONCLUSIONSDOG-1 expression is up-regulated in gastrointestinal stromal tumors, especially in epithelioid cell GIST, and may be used as a new marker in the diagnosis of GIST.

Adult ; Aged ; Anoctamin-1 ; Biomarkers, Tumor ; metabolism ; Chloride Channels ; metabolism ; Female ; Gastrointestinal Neoplasms ; metabolism ; Gastrointestinal Stromal Tumors ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Young Adult