Objective To investigate the effect of parathyroid hormone(PTH)on the proliferation and invasion of chondrosarcoma cells,and the relationship between PTH and the regulation of primary cilia expression.Methods After stimulation of the chondrosarcoma cell line SW1353 with different concentrations of PTH,induction of the expression of cilia with hypoxia and destruction of cilia structure with chloral hydrate,the cell viability was detected by CCK8 assay,the proliferation and invasion of SW1353 by Western blotting and Transwell method,the primary cilia expression by immunofluorescence assay and the GLI1,PTCH1 and IFT88 expression levels by real-time PCR.Results PTH could promote the proliferation of chondrosarcoma cells in a concentration-dependent manner and this effect was correlated with the structural integrity of the primary cilia.PTH could up-regulate the invasive ability of SW1353 cells and increase the expression levels of MMP9,which was suppressed when the primary cilia structure was damaged.Additionally,it was found that PTH could down-regulate the number of primary cilia,which was related to the structural integrity of the primary cilia.It could also regulate the expression levels of GLI1 and PTCH1,the target genes in Hedgehog pathway,and the expression levels of IFT88,the gene associated with the cilia function.Conclusion PTH can promote the proliferation and invasion of chondrosarcoma cells,down-regulate the expression of primary cilia and the downstream target genes.PTH may regulate the malignant biological features of chondrosarcoma by regulating the primary cilia expression.

Objective To explore the feasible approach for establishment of a liver cancer model induced by N-nitrosodiethylamine(DENA)with Sprague-Dawley rat,and to provide ideal animal model for imaging diagnosis and interventional therapy.Methods One-hundred and forty male SD rats were administrated with 0.95 g/L DENA for 10 weeks,and MRI was performed for inspecting pathological changes of rat livers on the following week.When the liver tumor was proved then the rat will be the candidate for sequential procedures,otherwise the animal continued under observation until next MRI examination after 4 weeks.DSA was done in 64 rats'for detecting blood supply of liver tumors.Animals were sacrificed with an overdose of chloral hydrate,The representative tumor tissues were fixed in 10% formalin and 2.5% glutaraldehyde for light and electron microscopy analysis respectively.Alpha fetoprotein(AFP) and hepatocyte were assaied by immunohistochemistry technique in order to identify intrinsic trait of the harvested tumors.Results The earliest induced tumor was detected on 11th week and the latest was on 20th week by MRI,and the median period was 13.9 weeks.Tumor size ranged from 2 mm to 40 mm in diameter. The rate of single and multi-induced tumor was 9.7%(7/72)and 90.3%(65/72),respectively.87.7% (57/65)" of the induced multiple tumors was with hepatocirrhosis and 18.1% of these tumors combined with extrahepatic neoplasm or metastasis.Plenty blood supply was proved by DSA in most of those tumors. Tumors not only derived from hepatocyte but also manifested positive expression of AFP.Histological types of these tumors include hepatocellular carcinoma(HCC)(92.0%,66/72),intrahepatic cholangiocarcinoma (ICC)(4.0%,3/72),and combined HCC and ICC(4.0%,3/72),respectively.Electro-microscope analysis indicated that cytoplasm and organelle of induced tumors were abnormal distinctly compared with those of non-carcinomatous cells.Conclusion DENA can induce ideal rat liver cancer as a feasible animal model,MRI is the best approach for scrutinizing pathological changes of rat livers during induced period.

Abstract: Suxamethonium chloride is a depolarizing muscle relaxant used in general anesthesia. In overdose, it causes adverse reactions such as bradycardia, arrhythmia, cardiac arrest, and death. The article reviews the progress on testing methods of suxamethonium chloride such as infrared spectroscopy, chemical color reaction, chemical titration, enzyme electrode, chromatography and mass spectrometry.
Anesthesia, General ; Arrhythmias, Cardiac/chemically induced* ; Biosensing Techniques ; Bradycardia/chemically induced* ; Chromatography ; Drug Overdose ; Heart Arrest/chemically induced* ; Humans ; Mass Spectrometry ; Neuromuscular Depolarizing Agents/analysis* ; Spectrophotometry, Infrared ; Succinylcholine/analysis*

Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

Objective To summarize our surgical experience in repair and functional reconstruction for compound defects of proximal phalanx and dorsal skin at multiple digits,Methods Six patients with multiple digital defects were treated in our department between June 1996 and March 2005.At the first stage,free iliac bone grafts were used to repair defects of proximal phalanges and temporary syndactyly between adjacent affected fingers was created through digital palmar skin sutures.The defects were covered with free flap transfer finally.Dorsalis pedis flaps were used in four patients,a lateral arm flap in one and a lateral thoracic flap in one respectively.At the second stage,a partial debulking procedure and division of syndaetyty followed three to six months later.Additional procedures were performed in three eases to reconstruct the digital extensor function through tendon transfer.The follow-ups ranged from six months to nine years.Results The flaps survived uneventfully in the six patients postoperatively.The dorsal aspects of reconstructed fingers demonstrated an aesthetically pleasing effect after the flap debulking procedures and division of syndactyly.Follow-up X-Ray examinations showed good lilac bone union and nearly normal structure of digital bone.The distal interphalangeal extension restored to normal in the three cases after extensor reconstruction.Conclusions Iliac bone graft to repair phalangeal defects and free flap transplantation to cover skin defects can be a good treatment for compound defects of proximal phalanx and dorsal skin at multiple digits.Secondary plastic procedure may greatly improve the appearance of a reconstructed digit,and extensor re- construction the function of distal interphalangeal extension too.

Objective To evaluate the association between recurrent miscarriages and insulin resistance.Methods The case-control studies on the association between recurrent spontaneous abortion and insulin resistance from June 1996 to April 2012 were collected from Medline,Elsevier,Chinese Journal Fulltext Database,Chinese Biological Medicine Database,data base of Wanfang,Springer link and EMBASE.RevMan 5.1 software was used for Meta analysis.Results According to the included criteria,7 clinical trials were finally selected.Total 467 cases with recurrent pregnancy loss were enrolled in study group,while 413 women with no history of abnormal pregnancies were enrolled in control group.No significant difference was found in average age and body mass index between the two groups (P ＞ 0.05).Meta analysis results showed that the level of fasting glucose was no statistical difference between study group and control group (WMD =2.27,95％ CI:-1.11 to 5.65,P ＞0.05); fasting insulin level was higher 2.05 mU/L in study group than that of in control group,the difference was statistically significant (WMD =2.05,95％ CI:1.03 to 3.08,P ＜ 0.01).Case number of study group on Homa-insulin resistance ＞ 4.5 was more than that of control group (OR =3.36,95％ CI:1.72 to 6.57,P ＜ 0.01).Case number of study group on glucose/insulin ratio ＜ 4.5 was more than that of the control group,statistical difference was found (OR =3.37,95％ CI:1.90 to 5.99,P ＜ 0.01).Conclusion Insulin resistance is associated with the susceptibility to recurrent miscarriages,and it may contribute to the occurrence of recurrent miscarriages.

Adult ; Air Pollutants ; adverse effects ; Humans ; Male ; Military Medicine ; Monitoring, Physiologic ; Noise, Occupational ; adverse effects

To investigate the relationship between serum glutamic acid decarboxylase antibody (GAD-Ab)titer and the first-phase insulin release (1PH)in newly-diagnosed type 2 diabetic patients. 1053 newly-diagnosed type 2 diabetic patients were divided into 3 groups, including 71 individuals with GAD-Ab≥1 U/ml (positive group), 171 individuals with GAD-Ab ranging from 0 to 1 U/ml (negative-1 group), and 811 individuals with GAD-Ab=0 (negative-2 group). IPH was evaluated by arginine stimulation test. In the patients of negative-2, negative-1, and positive groups, the respective values of 1 PH were subsequently decreased significantly (P< 0. 01) , and the detection rates of the decreased insulin secretion were 74. 85%, 87. 13%, and 100%, respectively. Stepwise regression analysis indicated that disease duration, GAD-Ab titer, HbA_1C, and body mass index were the major independent contributing factors. The titer of GAD-Ab has an important impact on 1PH defect in type 2 diabetic patient. Detection of GAD-Ab not only provides an evidence for clinical type, but would also be helpful in determining the islet β-cell function.

Objective To review the clinical characteristics and treatment of type 1 diabetes mellitus (T1DM) in children. Methods The clinical data of 103 children with T1DM admitted to our hospital from Februry 2002 to August 2010 were retrospectively analyzed. Thirty one cases with diabetic ketoacidosis (KDA) were treated with continuous insulin pump (group A) or basal-bolus insulin therapy (group B). The differences in blood glucose control time, the rate of hypoglycemic episodes, glucose fluctuation, fasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPBG), insulin dosage, the time of urine acetone bodies disappear and length of stay were compared in two groups. Results The age of 103 children with T1DM was from 38 d to 15. 33 y with an average of (8 ±3) y; most of them was 7 - 10 y (47, 45.6% ). Seventy eight children were first diagnosed accounting for 75.7%; boys accounted for 55.3% of total. Fifty one cases (49.5%) were diagnosed in winter and spring and 67 (65.2%) had infections, most of them were respiratory tract and gastrointestinal infections. Sixty two cases (60. 2% )presented as diabetic ketoacidosis at the first onset, including 4 cases (3.9%) with cerebral edema. Some patients were complicated by Hashimoto's thyroiditis, hyperthyroidism, SLE and other autoimmune diseases.Among 31 cases with ketoacidosis the FBG and PBG were decreased significantly after treatment, there were no significant differences between two groups (P ＞ 0. 05 ). Compared to group B the correction time of DKA and urine acetone bodies was shorter, and reached the targeted glucose levels more quickly, the frequency of blood fluctuation and the hypoglycemia was significantly lower, the length of stay was shorter, and the daily dose of insulin was lower in group A; the differences between two groups were statistically significant ( P ＜0. 05 or P ＜0. 01 ). Conclusions The clinical symptoms at first onset of T1 DM in children are not typical,and likely to be combined with DKA; infection may be one of the inducing factors for DKA. Continuous subcutaneous insulin infusion with pump can control the blood glucose more effectively and equably, and are convenient for use by children; so it is a better treatment option for type 1 diabetes mellitus in children.

Objective To evaluate the radical effect and prognosis of laparoscopic resection for colorectal cancer in China.Methods Articles of non.randomized comparative studies(NRCs)of laparoscopic resection and open Burgery for colorectal cancer which were published before October 2007 were retrieved,and correlated indexeswere extraeted for meta.analysis.Results The mean quality score of the 14 articles selected was 18.92±1.27.The basic characteristics of patients in laparoscopic resection group were similar to those in open surgery group.Compared with open surgery group,the incised length of the intestine in the laparoscopic resection group was shorter by 0.66 cm.and the distance between distal margin of resection and tumor was farther by 0.26 cm.The 2-year survival rate of patients in laparoscopic group Was 1.67 times higher than that of open surgery group.There was no significant difference upon follow-up rate,tumor diameter,number of resected lymph nodes,local recurrence rate and distal metastasis rate between the 2 groups.Conclusions The results of meta-analysis show that laparoscopic resection has the sanle radical effect as open surgery for colorectal cancer.but the 2-year survival rate of patients treated by laparoscopic resection is comparatively higher.