Humans ; Stomach Neoplasms ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVETo investigate methods and short-term effects on tantalum metal block for reconstruction of Paprosky type III severe acetabulum bone defect.

METHODSTwelve patients (12 hips) with Paprosky type III severe acetabulum bone defect,treated with tantalum metal block in revision of total hip arthroplasty, were retrospectively analyzed from March 2009 to December 2012. Among the patients, there were 5 males and 7 females aged from 45 to 78 years old with an average of 64 years old; the courses of disease ranged from 3 to 32 months with an average of 16 months. According to classification of Paprosky, all patients were Paprosky type III acetabulum bone defect. All patients were used tantalum metal block in revision of total hip arthroplasty, and large diameter biological acetabulum cups were used in combination. Operative time,blood loss and postoperative complications were recorded and compared, Harris score were used to evaluate clinical effects.

RESULTSEleven patients ( 11 hips) were followed up from 9 to 36 months with an average of 25 months, 1 case was lost to follow-up for dying in car accident. The incisions were healed at stage I . Operative time ranged from 2 to 6 h with an average of 3 h; blood loss was 300 to 1 600 ml with an average of 900 ml. No deep venous thrombosis, periprosthetic femoral fracture and infection, sciatic nerve injury occurred after operation. Harris score were improved from (46.25 ± 8.99) before operation to (83.75 ± 6.76) after operation. There was significant difference in Harris score before and after operation (t = 3.14, P = 0.00 < 0.05), and 7 cases got excellent results, 2 good and 2 moderate. CONCLUCSION: Tantalum metal block is suitable for revision of Paprosky III acetabulum bone defect, could repair different kinds of acetabulum cup defect, could fill up inclusive defect of inner wall combined with particulate bone graft, induce bone growth pressured between metal block and metal cup, provide a new further choose for the treatment of Paprosky type III severe acetabulum bone defect.

Acetabulum ; surgery ; Aged ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Tantalum

Objective:To evaluate the acute oral toxicity , skin irritation and skin allergy of Thuja essential oil ( TEO) , and pro-vide experimental basis for the clinical use of TEO .Methods:The acute oral toxicity was measured by Horn ’ s assay .Totally 40 KM mice were divided into four groups and intragastrically administered with TEO at different dose of 21.50, 10.00, 4.64 and 2.15 g · kg-1 .After the 14-day observation, the death number and toxic manifestations were recorded and observed , and LD50 was calculated by checking the Horn's form of LD50 .The skin irritation test was performed on healthy adult white rabbits .Totally 9 rabbits were divid-ed into 3 groups randomly , and TEO at the concentration of 100%, 50%and 25%was painted on the skin of the rabbits .Edible vege-table oil was used as the negative control .The erythema and edema of the treated skin were evaluated and scored .Delayed skin hyper-sensitivity reaction was used to investigate the allergy of TEO .Totally 30 white guinea pigs were randomly divided into 3 groups:TEO group, the negative control (edible vegetable oil) and the positive group (1%2, 4-dinitrochlorobenzene).After the intracutaneous in-duction stage and local induction stage , TEO was used to activate the hypersensitive reaction .The skin response was observed and scored after the 24-hour and 48-hour activation.Results:The mice in 21.50 g · kg-1 TEO treatment group were all dead , while only a part of the mice in 10.00 and 4.64 g · kg-1 TEO treatment groups were dead , and no mice died in 2.15 g · kg-1 TEO treatment group.According to the Horn's form of LD50 , LD50 of TEO was 9.26 g · kg -1 for male mice and 7.94 g · kg -1 for female mice.The results of skin irritation test indicated the strong irritation effects of TEO .However , the irritation of TEO was reduced after the dilution , and 25%TEO showed no irritation to the skin of rabbits .The results of delayed skin hypersensitivity reaction showed obvious erythema and edema induced by 2, 4-dinitrochlorobenzene , while no obvious erythema and edema were found in TEO treated guinea pigs , indi-cating non-allergic effect of TEO .Conclusion:TEO has strong skin irritation in rabbits , while no obvious oral toxicity in mice and skin allergy in guinea pigs .

Objective: To evaluate the genetic toxicity of Thuja essential oil by salmonella reversion test (AMES test) and mammal micronucleus test.Methods: TA97, TA98, TA100 and TA102 were used in AMES test to evaluate the mutagenesis of Thuja essential oil.Mouse bone marrow micronucleus test was conducted to assess the chromosome toxicity of the drug.Results: Both in S9 present and absent situations, the numbers of reverse mutation of Thuja essential oil at different doses for the four strains were all less than 1-fold of that of solvent control, and the difference had no statistical significance (P>0.05), suggesting negative mutation.The micronucleus test indicated that Thuja essential oil had no influence on the rate of mouse bone marrow micronucleus (P>0.05).Conclusion: Thuja essential oil shows no obvious genetic toxicity.

Objective To investigate the protein expression of cyclooxygenase(COX)-2 and matrix metalloproteinase(MMP)-2 and their correlation in human gastric carcinoma.Methods The protein expression of COX-2 and MMP-2 was determined by immunohistochemistry in tumor tissues and adjacent cancerous tissues (3 cm and 6 cm away from tumor margin) of 30 patients with gastric cancer,and in gastric mucosa of 10 healthy individuals.Results Expression of COX-2 was found in cancer cells of 26 out of 30 cases (86.67%),which was significantly higher than that in normal control (0 of 10,P

OBJECTIVETo explore the effect of peimine on excision repair cross-complementation 1 (ERCC1) mRNA and lung resistant protein (LRP) expressions in A549/cisplatin (DDP) multidrug resistance (MDR) cell line.

METHODSLung cancer A549/DDP cells were cultured in vitro.Cells at logarithmic growth phase were divided into 4 groups, i.e., the blank control group, the DDP group, the ligustrazine group (DDP+ligustrazine), the peimine group (DDP + peimine). After 48-h drug action, ERCC1 mRNA expression was detected by RT-PCR and LRP expression detected by cell immunofluorescence.

RESULTSThere was no statistical difference in expression levels of ERCC1 mRNA and LRP between the DDP group and the blank control group (P > 0.05). Compared with the DDP group, expression levels of ERCC1 mRNA and LRP obviously decreased in the ligustrazine group and the peimine group (P < 0.05). They were obviously lower in the peimine group than in the ligustrazine group (P < 0.05).

CONCLUSIONSPeimine could reverse MDR of A549/DDP cell line. Its mechanism might be associated with down-regulating ERCC1 mRNA and LRP expression levels.

Cell Line, Tumor ; Cevanes ; pharmacology ; Cisplatin ; DNA-Binding Proteins ; genetics ; Down-Regulation ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; drug effects ; Endonucleases ; genetics ; Humans ; Low Density Lipoprotein Receptor-Related Protein-1 ; genetics ; Lung Neoplasms ; RNA, Messenger ; metabolism

Objective:To explore the necessity of combined transverse upper gracilis flap and adductor magnus perforator flap in breast reconstruction.Methods:From December 2016 to February 2019, 16 female breast cancer patients, aged 27-59 years, with an average of 40.3 years, were treated in the Department of Oncoplastic Surgery, Hunan Cancer Hospital. The tumors were unilateral in 9 cases on the left side and 7 cases on the right side, with a diameter of 1.5-4.5 (2.9±0.3) cm, and all of them were stage I. Pathological diagnosis included 9 cases of invasive ductal carcinoma and 7 cases of invasive lobular carcinoma. After the modified radical mastectomy, the medial thigh perforator flap was used to reconstruct the breast. Patients were randomly divided into group A and group B. In group A, the gracilis myocutaneous flap combined with the adductor magnus perforator flap was elevated. In group B, the adductor magnus perforator flap with large size reaching the front edge of gracilis muscle was directly harvested. After all the flaps were harvested with only one major adductor perforator as vascular pedicle, ICG fluorescence imaging technology was used to verify the blood supply of the flaps.Results:Eight cases of gracilis myocutaneous flap combined with adductor magnus perforator flap and 8 cases of adductor magnus perforator flap were transplanted, The length, width and thickness of the flaps were (27.5±0.4) cm, (7.1±0.5) cm and (3.8±0.4) cm, (7.4±0.3) cm and (10.8±0.5) cm respectively. The average weight of the flap was 255 g (195 g-315 g). The mean ischemia time was 75 min (55-90 min). In 16 cases, the proximal and distal ends of internal mammary vessels were used as the recipient vessels. Only anastomosing the adductor magnus perforator vessels could ensure the reliable blood supply of the flap. All flaps survived successfully in one stage. The appearance of reconstructed breast was good and there was no obvious flap contracture and deformation. 16 cases were followed up for an average of 12.5 months, and the patients＇ self perception and appearance were satisfactory. Only hidden linear scar was left on the donor site of the medial thigh flap, and the function of hip joint and leg was not affected.Conclusions:Large size of medial thigh perforator flap pedicled with the perforator of adductor magnus can be safely and reliably cut with no needing additional harvest of gracilis muscle vascular pedicle.

Objective To evaluate the outcome of incomplete revasculariszation by percutaneous coronary intervention (PCI) in elderly patients with coronary artery disease.Methods Data of 48 patients (age≥75 years old) underwent incomplete coronary revascularization during the period from 2008 to 2011 were collected.Their data before PCI and the 6 months follow-up results were comparatively analyzed.Results Six months after incomplete coronary revascularization,the LVEF was higher than that before revascularization ((48.10 ± 7.19)％ vs (39.82 ± 8.23)％) and BNP declined significantly ((575.17 ± 67.27) ng/L vs (793.57 ± 87.53)ng/L).T peak-T end (Tp-Te) √RR and Tp-Te/QT also declined significantly (Tp-Te √RR:(96.38 ± 10.79)ms vs (147.81 ± 17.32)ms;Tp-Te/QT:(0.25 ±0.05) vs (0.30 ±0.07)) (P ＜0.05).Six months after PCI,LVEDV and LVESV were higher than those before surgery,but there was no significant difference(P ＞ 0.05).Conclusion Incomplete coronary revascularization can improve heart function and stability of cardiac electrophysiology in elderly patients with coronary artery disease,but it can not prevent the development of left ventricular remodeling.

BACKGROUND:Tranexamic acid is a synthetic anti-fibrinolytic drug, and can effectively control blood loss after total knee arthroplasty through vein. OBJECTIVE:To evaluate the effectiveness and safety of tranexamic acid in reducing blood loss after primary unilateral total knee arthroplasty. METHODS:From 2014 to 2015, 100 patients from the Department of Lower Limb, Sichuan Orthopaedic Hospital underwent primary unilateral total knee arthroplasty, and randomly divided into test group which used tranexamic acid and control group which used tranexamic acid, with 50 cases in each group. 1 g tranexamic acid was infused into the vein at 10 minutes before total knee arthroplasty in the test group, but tranexamic acid was not given in the control group. RESULTS AND CONCLUSION:The amount of total blood loss, postoperative wound drainage in 24 hours, and the amount of blood transfusion were significantly less in the test group than in the control group (P < 0.05). No significant differences in intraoperative blood loss and the number of patients receiving blood transfusion were found between the test and control groups. No significant difference in preoperative hemoglobin levels was detected before surgery, but hemoglobin levels were decreased after surgery between the two groups. Postoperative hemoglobin levels were apparently higher in the test group than in the control group after surgery. At 24 hours after surgery, no significant difference in coagulation was detectable between the two groups. At 6 days, double lower limb vein color Doppler ultrasound examination did not reveal deep vein thrombosis in both groups. These findings verify that treatment with tranexamic acid in the vein before primary unilateral total knee arthroplasty can evidently diminish the amount of perioperative blood loss and blood transfusion, reduce the risk and cost of blood transfusion, which is good for rehabilitation and does not increase the risk of deep vein thrombosis.

Objective To evaluate the diagnostic and therapeutic methods for hilar bile duct carcinoma. Methods The clinical data of 36 patients with hilar bile duct carcinoma from Jan 1998 to Jul 2003 were retrospectively analyzed. Results The misdiagnosis rate(39%) was high. All patients underwent a surgery. The median survival time of 16 patients treated by radical resection was 30 months. The 1,3,5-year survival rate was 93%,50% and 25% respectively. While the median survival time of the rest 20 patients treated by a variety of non-radical operation was 16 months with 1,3,5-year survival rate of 47%,8% and 0 respectively(t=2.585).Conclusions Early diagnosis and radical resection improves long-term survival of patients with hilar bile duct carcinoma.