AIM:The limitation of materials' strength results in the external fixation of patients with patellar fracture following absorbable screw fixation.This study was aimed to guide the patients do progressive rehabilitation and observe the recovery of knee joint function.METHODS:Totally 35 patients with patellar fractures were enrolled from the Sixth People's Hospital in Shanghai Jiao Tong University between June 2004 and June 2006,including 27 cases of transverse fractures and 8 cases of comminuted fractures.They were all treated with BIOFIX self-reinforced poly-lactide absorbable screws,which were produced by Finland BIONX Company.Postoperatively isometric contraction training of quadriceps femoris was followed,and then progressive knee joint range of motion was carried out.The curative effect was evaluated by the recovery of knee joint function and radiograph.Normal knee joint function was taken as excellent effect,while nearly normal knee joint function and slightly poor squatting were taken as good effect.RESULTS:All the patients completed the treatment and rehabilitation,followed up for no less than 12 months,with a mean of 22 months.The average healing time was 6 weeks,excellent result cases were seen in 29 patients and good in 6.There was two cases occurred postoperative complications(wound swelling).CONCLUSION:Self-reinforced poly-lactide absorbable screws for treatment of patellar fractures and appropriate postoperative rehabilitation is believed to prevent the second operations.

AIM:To observe the effect of levcromakalim(Lev) on endthelin-1(ET-1) induced proliferation and the expression of protein kinase C(PKC) in cultured rat vascular smooth muscle cells(VSMCs).METHODS: VSMCs were isolated from rat aorta and were cultured with different concentrations of Lev in vitro after stimulated to proliferation by ET-1(10~(-8)(mol?L~(-1))).Vitality of VSMCs was detected by MTT;DNA replication was evaluated by 3H-TdR method.Flow cytometry was used to analyze cell cycle and apoptosis.The expression of PKC? protein and mRNA were determined by Western blot and reverse transcription-polymerase chain reaction(RT-PCR).RESULTS:Vitality of VSMCs and 3H-TdR intermingle rate were decreased(P

Objective To explore the morphology,cell phenotype and cell function in dendritic cells (DCs) derived from bone marrow after treatment with Sirolimus or Sirolimus combined with sTNFRI-IgGFc gene segment transfection.Method DCs were divided into 5 groups (imDCs,mDCs,Rapa-DCs,sTNFRI-DCs and Rapa-sTNFRI-DCs) according to different interventions.The expresson of MHC-Ⅱ,CD80 and CD86 was detected by flow cytometry.T cell proliferation of the mixed lymphocyte reaction was evaluated by MTT method.The levels of IL-12,IFN-γ and sTNFRI-IgGFc were determined by ELISA.Result On the day 10,the flow cytometry showed that the expression levels of MHC-Ⅱ,CD80 and CD86 on the cell surface in Sirolimus group were significantly higher than the other groups (P＜0.05).The expression level of CD86 in Rapa-sTNFRI group was significantly lower than in imDC group (P＜0.05).MTT results demonstrated that T cell proliferation ability in Sirolimus group,sTNFRI group and Rapa-sTNFRI group were reduced as compared with mDC group (P＜0.05).The ELISA results revealed that the levels of IL-12 and INF-γ in rnDC group were significantly higher than other groups (P＜0.05).The levels of IL-12 and INF-γ in Rapa-sTNFRI group were significantly lower than other groups (P＜0.05).Conclusion Sirolimus combined with modified sTNFRI-IgGFc gene could synergistically inhibit maturation of DCs more effectively than Sirolimus or modified sTNFRI-IgGFc gene used alone.

Objective To investigate the overall survival prediction of the Bolondi substaging model for patients in intermediate-stage of Barcelona clinic liver cancer (BCLC) after hepatectomy.Methods The retrospective cohort study was adopted.The clinical data of 343 patients with intermediate-stage hepatocellular carcinoma (HCC) who were admitted to the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University between February 2008 and January 2010 were collected.All the patients received the detailed medical history collection,physical examination,laboratory and imaging examinations after admission,and then hepatectomy was performed according to the results of above examinations.Research methods:(1) patients were allocated into the B1,B2 and B3/4 groups based on the Bolondi's substaging model,and the prognostic analyses among groups were conducted.(2) The related factors affecting the prognosis of patients in the B1 and B2 groups were analyzed.(3) The patients in the B1 and B2 groups were allocated into the 4 groups [patients of B1 group with negative microvascular invasion (MVI) were divided in the M1 group,patients of B1 group with positive MVI in the M2 group,patients of B2 group with negative MVI in the M3 group and patients of B2 group with positive MVI in the M4 group] according to the situations of MVI,and stratified analysis was conducted.Observation indicators:basic clinical and pathological features and survival of patients in the B1,B2 and B3/4 groups were observed.Risk factors analysis affecting the prognosis of patients and stratified analysis of MVI in the B1 and B2 groups were conducted.All the patients were followed up by outpatient examination and telephone interview up to February 2014,and the abdominal ultrasound,liver function and serum alpha-fetoprotein (AFP) tests was performed once every 3 months within 2 years postoperatively and once every 6 months after 2 years postoperatively.The continuous variables and categorical variables were respectively represented as M(Qn) and percentage.The comparisons of continuous variables and categorical variables among groups were analyzed by ANOVA or Kruskal-Wallis test and chi-square test or Fisher exact probability,respectively,and one-way ordinal categorical variables were analyzed by the Kruskal-Wallis test.The survival curve was drawn using the KaplanMeier method.The univariate analysis and multivariate analysis were done using the Log-rank test and COX regression model.Results (1) The basic clinical pathological features:of 343 patients with HCC,143,183 and 17 patients (12 in the B3 substaging and 5 in the B4 substaging) were respectively allocated into the B1,B2 and B3/4 groups.There were statistically significant differences in the age,peritoneal effusion,total bilirubin (TBil),albumin (Alb),alanine transaminase (ALT),prothrombin time (PT),platelet (PLT),alpha-fetoprotein (AFP),extent of liver resection,surgical margin ivasion,tumor diameter,number of tumor,Edmondson-Steiner grade,Up-to-7 score,Up-to-7 standard and Child-pugh score among the 3 groups (F =3.377,NA,11.245,32.616,6.884,11.564,33.100,12.902,NA,NA,239.089,10.357,x2=8.906,F =251.508,x2 =343.000,106.790,P ＜ 0.05).(2) Survival of patients:all the patients were followed up for 2.8-70.8 months with a median time of 38.7 months.The 1-,3-,5-year survival rates and median survival time in the B1,B2 and B3/4 groups were 85.8％,72.8％,52.9％ and 63.2％,47.5％,16.8％ and 45.5％,30.4％,8.4％ and 55.1 months,35.1 months,12.2 months,respectively,showing a statistically significant difference (x2 =22.800,P ＜ 0.05).(3) Risk factors analysis:the results of univariate analysis showed that the peritoneal effusion,Alb,Hb,AFP,esophagogastric varices,surgical margin invasion,tumor diameter,MVI and Edmondson-Steiner grade were related risk factors affecting the prognosis of patients with HCC after hepatectomy [HR =2.04,2.46,2.50,1.78,1.55,3.54,1.71,1.76,1.69,95％ confidence interval (CI):1.13-3.69,1.20-5.02,1.51-4.15,1.29-2.45,1.06-2.25,1.65-7.61,1.23-2.38,1.23-2.51,1.08-2.64,P＜0.05].The results of multivariate analysis showed that the Alb ＜ 35 g/L,Alb ＜ low limit of normal,tumor invading to surgical margin,tumor diameter ＞ 5 cm and positive MVI were independent risk factors affecting the overall survival of patients with HCC after hepatectomy (HR =2.82,2.16,2.93,1.48,1.53,95％ CI:1.37-5.80,1.27-3.69,1.33-6.44,1.05-2.09,1.06-2.22,P＜0.05).(4) There were 61,82,57 and 126 patients in the M1,M2,M3 and M4 groups,and M2 and M3 groups were merged into the M2/3 group because of being similar survival situations of patients.The 1-,3-,5-year survival rates and median survival time in the M1,M2/3,and M4 groups were 90.0％,83.2％,67.7％ and 68.8％,59.9％,41.6％ and 52.7％,42.1％,23.6％ and 69.0 months,49.2 months,24.9 months,respectively,with a statistically significant difference among the 3 groups(x2=20.200,P ＜ 0.05).Conclusions The Bolondi substaging model produces an optimal survival prediction for patients in intermediate stage of BCLC after hepatectomy.The patients in the B1 and B2 substaging have better long-term survival outcomes after hepatectomy.

Purpose To observe the histopathologic changes of acquired immure deficiency syndrome (AIDS) in a Chinese Rhesus monkeys model and the pathogenesis that initiated the changes.Methods Chinese Rhesus monkeys were sacrificed after being inoculated SIVmac239 by Ⅳ(n=2)for four months.Autopsy was carried out by pathologic routine method.The lymph nodes, heart, liver, spleen, lung, kidney, digestive tract and other tissues were selected, the tissues fixed with 10% neutral formalin, and the pathologic sections were prepared by HE staining and immunohistochemical staining and special staining after paraffin imbedding.Results The main histopathological changes appeared in the immune system in different organs. The lymph nodes began to display the complex changes in a short period of time infected by the virus, including proliferation of lymphoid follicles, atrophy, or both; some lymphoid follicles of lymph nodes had few lymphocytes, with fibrous hyperplasia and immune complex (IC) deposition, displaying a burning down phenomenon.Splenomegaly and blood vessel and its endothelial cell proliferation in splenic corpuscles were noted with the immune complex deposition. Other parts of the mucosa-associated lymphoid tissue had different degrees of hyperplasia, or atrophy.Conclusion Histopathologic changes in Chinese Rhesus monkeys infected by SIVmac239 strain are very similar to human AIDS, which suggests that the model is a useful tool for the prevention and treatment study of AIDS.

OBJECTIVEThis study investigated the role and mechanism of calcineurin (CaN)-nuclear factor of activated T cells (NFAT) pathway in the myoblast apoptosis induced by cyclic tensile strain.

METHODSMyoblasts were cultured using an in vitro-mechanical stimulation model and imposed with tension for different hours with a multi-channel cell stress loading system. Cyclosporine (CsA) was used as CaN inhibitor to clarify the role of CaN in the apoptosis induced by cyclic stress. Hochest 33258 staining and flow cytometry detection were performed to detect the apoptotic cells. Real-time polymerase chain reaction was conducted to detect the mRNA expression of CaN and NFAT. Protein levels of NFAT3 were evaluated by Western blot.

RESULTSThe apoptosis rate increased with the extension of loading time. The mRNA expression of the CaN subunits, CnA and CnB, and the protein levels of NFAT3 also increased. When the myoblasts were incubated with CsA, the apoptosis rate decreased, the mRNA expression of CnA and NFAT3 significantly decreased, and the NFAT3 protein expression levels became significantly lower than those of the groups without CsA.

CONCLUSIONContinuous cyclic tensile stress can induce myoblast apoptosis. The CaN-NFAT signaling pathway may be involved in the cyclic stretch-induced apoptosis of myoblasts.

Apoptosis ; Calcineurin ; genetics ; Cyclosporine ; Flow Cytometry ; Myoblasts ; physiology ; NFATC Transcription Factors ; metabolism ; Real-Time Polymerase Chain Reaction ; Signal Transduction ; T-Lymphocytes

OBJECTIVEResearch was done on the possible roles of beta-catenin, p53 and proliferating cell nuclear antigen (PCNA) in the carcinogenesis of colorectal adenoma (CRA).

METHODSbeta-catenin and p53 and PCNA expressions were studied with immunohistochemical stain in 77 specimens of CRA together with mild epithelial dysplasia (CRA-MD), CRA with moderate/severe epithelial dysplasia (CRA-D/SD) and CRA with cancerous changes (CRA-C).

RESULTSThe percentage of abnormal expression of beta-catenin increased during the transition from CRA-MD to CRA-D/SD to CRA-C (P < 0.01). The nuclear expressions of beta-catenin in CRA-D/SD and CRA-C were all significantly higher than that in CRA-MD. Expression of p53 and PCNA were increased from CRA-MD to CRA-D/SD to CRA-C, with the positive rates in these three groups of 10.3%, 43.8%, 75.0% for p53 and 17.2%, 62.5%, 87.5% for PCNA, respectively. 69.7% of cases with positive nuclear beta-catenin expression showed strong PCNA positivity which was much higher than the 36.4% of cases without nuclear beta-catenin expression (P < 0.05). The percentage of strong PCNA expression in the p53 positive cases was significant higher than that in cases with negative p53 expression (72.4% vs 37.5%, P < 0.05). Nuclear beta-catenin and p53 co-expression rates in CRA-C reached 50%.

CONCLUSIONbeta-catenin, p53 and PCNA may play important roles in the carcinogenesis of colorectal adenoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; biosynthesis ; Colorectal Neoplasms ; diagnosis ; metabolism ; Cytoskeletal Proteins ; biosynthesis ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Trans-Activators ; biosynthesis ; Tumor Suppressor Protein p53 ; biosynthesis ; beta Catenin

Abstract The prevalence of overweight and obesity among children in China has entered a new phase of pandemic, with substantial regional differences. There are diverse and complex determinants for overweight and obesity in school age children, it is necessary to take targeted measures towards children of different ages and regions, comprehensively consider the effects of physiological, social, household and behavioral factors and simultaneously strengthen connections between schools, medical institutions and families, so as to actively respond to the severe situation of childhood obesity epidemic.

Bispecific antibodies can target two different targets simultaneously with a wide application prospect and rapid development in tumor treatment. The main function is to recruit effector cells selectively in order to kill tumor cells or bind tumor-associated growth factor receptor to inhibit cell proliferation. This paper reviews the current situation of bispecific antibodies in design, mechanism of action and the research progress in the clinical cancer treatment.

Based on the characteristics of forensic pathology, this paper explains the concept, connotation and advantages of holistic medicine and integrated medicine in the teaching of forensic pathology. Then, through the introduction of the specific teaching process design and effect analysis of the death cause analysis practical cases, it clarifies the necessity and effectiveness of integrated medicine and holistic medicine in the teaching of forensic pathology, and provides new ideas for the reform of the overall teaching of forensic pathology.