Aim To determine whether there existed melatonin receptor (MR) in adult hepatoma tissue and to observe its property of binding.Methods Immuno-histochemistry was used to detect MR and identify its subcellular distribution. Specific binding and kinetic analyses of melatonin receptor were measured by radioligand binding assay.Results The results of immunohistochemistry showed that MT1 and MT2 existed in membrane, cytosol and nucleus of the hepatoma cells, but the expression of them principally localized in the membrane and cytosol. The specific binding assay properties of MR were presented as follows: the maximum binding capacity (B_(max)) was (0.29±0.07) pmol·g~(-1) protein. Equilibrium dissociation constant (K_d) was (48.7±6.5) pmol·L~(-1). The trait of MR, saturation and reversibility, was detected by ~(125)I-Mel specific binding kinetic analyses.Conclusions MR exists in adult hepatoma cells, furthermore, the subtypes of MR (MT1 and MT2) coexist in the membrane and cytosol, respectively,whose characters of the specific binding sites were low binding capacity,high affinity,saturation and reversibility.

Objective To explore the preventive effect of feedforward control on unexpected extubation in patients with cerebral apoplexy.Methods The clinical data of 42 cerebral apoplexy patients during May 2010 and May 2011 were retrospectively reviewed to find out the risk factors of unexpected extubation.The feedforward control was used to manage 49 cerebral apoplexy patients during June 2011 to June 2012 to control the risk factors.The incidence of unexpected extubation was compared between pre-and post-use of feedforward control. Results After application of feedforward control,the incidences of unexpected extubation of gastric tube,deep vein tubes and urinary tubes reduce were significantly decreased compared to pre-use of feedforward control(all P<0.01).Conclusion The feedforward control on patients with cerebral apoplexy is effective in reducing the incidence of unexpected extubation and ensuring the intubation safety.

Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.

OBJECTIVE: To study the assistant effect of Scutellaria barbata extract (ESB) in 5-fluorouracil (5-FU) chemotherapy. METHODS: A mouse model of transplanted hepatoma H22 was used in this study to evaluate the synergic and attenuating effects of ESB in chemotherapy. Tumor inhibition rate, life span of mice and the toxicity of chemotherapy were observed. The body weight, tumor weight, thymus index and spleen index in H22-bearing mice were also measured. The phagocytotic function of macrophages was studied by observing phagocytization of peritoneal macrophages. RESULTS: The increase of body weight in 5-FU plus ESB groups was higher than that in 5-FU group, and the side effects such as anorexia, abdominal distention and athrepsy were relieved. Compared with untreated group, prolonged lifetime in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group was improved. Life prolongation rates in 5-FU plus high-dose ESB group and 5-FU plus low-dose ESB group were 61.46% and 23.59% respectively. High-dose ESB, 5-FU, 5-FU plus low-dose ESB and 5-FU plus high-dose ESB could inhibit the tumor growth, and the tumor inhibition rates were 36.98%, 42.26%, 52.45% and 65.28%, respectively. Thymus index and spleen index were increased significantly in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. White blood cell (WBC) count was decreased obviously in 5-FU group, while the count of WBC was increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. The phagocytotic function of macrophages was also increased in 5-FU plus low-dose ESB group and 5-FU plus high-dose ESB group. CONCLUSION: ESB can enhance the effect of chemotherapy, relieve the side effects and improve immune function of mice in chemotherapy. These results suggest that ESB, as a biochemical modulator to enhance the therapeutic effects, is useful in cancer chemotherapy.

Objective To analyze the neurological complications in treatment of severe thoracolumbar spinal deformity with one stage posterior vertebral column resection (pVCR) and discuss the related risk factors. Methods There were 67 patients with severe thoracolumbar spinal deformity who underwent one-stage pVCR from February 2000 to September 2010.There were 29 males and 38 females at an average age of 31.4 years old(range,14-62 years).There were 21 patients at age less than 18 years old and 46 at age more than 18 years old.Patients were divided into four pathological types:severe scoliosis group(n=11,mean Cobb angle 90.4°),kyphoscoliosis group(n=25,mean scoliosis 94.5°,and mean kyphosis 65.5°),angular kyphosis group(n=28,mean kyphosis 74.3°)and global kyphosis group(n=3,mean kyphosis 91.1°).of all the patients,59 patients underwent primary surgery and eight underwent revision surgery.Surgical methods included posterior apex vertebral column resection,segemental pedicle screw fixation and correction as well as 360° bone fusion.Neurological complication was statistically analyzed. Results The average follow-up was 14 months (range,3-69 months),which showed severe neurologic complication in eight patients(11.9%)after surgery.Severe neurologic complication occurred in three patients (4.5%),among whom one patient presented delayed complete paraplegia 23 hours after surgery.Five patients had mild neurologic deficits(7.5%),the incidence of which was higher than 23.1%for thoracic osteotomy (P<0.05).Multilevel pVCR had high rate of neurological complications (P<0.05).The incidence rate was 33.3% for patients with preoperative neurologic compromise and 7.3%for patients mthom preoperative neuroiogic compromise (P<0.05).The incidence rate was increased in the revision surgery (P<0.05).Eight patients with neurological deficits had kyphotic angle of raore than 60°although there was no statistical difference (P>0.05). Conclusions pVCR is an effective surgical method for the correction of severe thoracolumbar spinal deformity.The neurological complications,however,should be paid attention to the surgeons.The risk factors for neurologic complications include improper manipulation,massive blood losing,preoperative neurologic compromise,osteotomy at thoracic rein,multi-level vertebrectomy,revision surgery and severe kyphosis.

Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

OBJECTIVE: To investigate the effects of serum containing Scutellaria Barbata extract (ESB) on apoptosis rate and mitochondrial transmembrane potential (MTP) of liver cancer cell line H22 from mice in vitro. METHODS: H22 cells were cultured in vitro and divided into 5 groups: blank control group, low-dose ESB group, medium-dose ESB group, high-dose ESB group and fluorouracil (5-Fu) group. Methyl thiazolyl tetrazolium assay was utilized to determine the proliferation rates of H22 cells. Cellular morphology was observed under a transmission electron microscope (EM). The rhodamine 123 was used as a fluorescence probe to label the H22 cells, and the fluorescence intensities were observed with a laser scanning confocal microscope. The fluorescence intensity of H22 cells indicated the MTP of H22 cells. RESULTS: The inhibition of serum containing ESB on the proliferation of H22 cells in vitro was observed in a time-dependent manner. The typical morphological changes of apoptosis were observed after incubation with ESB-containing serum in high dose for 48h. The apoptosis rates of blank control group, 5-Fu group, low-dose ESB group, medium-dose ESB group and high-dose ESB group were (0.51+/-0.32)%, (11.26+/-2.97)%, (1.07+/-0.46)%, (3.15+/-1.12)%, (7.83+/-2.25)% respectively. ESB could reduce the MTP of H22 cells from mice as compared with the untreated group. The MTPs of the blank control group, 5-Fu group, and low-, medium- and high-dose ESB groups were (245.45+/-67.37), (127.42+/-41.35), (213.68+/-65.52), (186.34+/-56.37) and (142.65+/-39.44) respectively, which were negatively correlated with the apoptosis rates. CONCLUSION: ESB-containing serum effectively induces apoptosis, which may be related to the decrease of MTP in H22 cells.

Objective To study the clinical efficacy of Bikini incision minimally invasive total hip arthroplasty on elder patients with femoral head necrosis and its effect on bleeding.Methods Seventy-six elder patients with femoral head necrosis in Sanmenxia Central Hospital from January 2015 to December 2016 were randomly divided into the study group(38 cases)and the control group(38 cases).The patients in the study group were treated with Bikini incision minimally invasive total hip arthroplasty by anterior approach,while the control group underwent total hip arthroplasty by anterolateral approach.Harris score and WOMAC score were used to evaluate the clinical function of hip joint.The operation time,length of incision,intraoperative blood loss, blood transfusion,hospitalization time,hemoglobin level at 72 h after surgery,the first ambulation time,the lower limb length discrepancy,postoperative complication were recorded and compared between two groups.Results The Harris scores at 1,2,4 months after operation in the two groups were significantly improved(P<0.05), while WOMAC scores of patients at 1,2,4 months after operation were significantly lower than those before treatment(P<0.05).However,there were no significant differences at different time between the groups(P>0.05).The hospitalization time and the first ambulation time in the study group were significantly shorter than those in the control group((6.1±2.8)d vs.(7.9±3.2)d,P=0.011;(5.3±1.5)d vs.(6.4±1.7)d,P=0.004).After 4 months of treatment,the lower limb length discrepancy in the study group was less than that of the control group((6.5 ± 2.3)mm vs.(10.4 ± 3.5)mm,P<0.01).In addition,there were no significant differences between two groups in the operation time,length of incision,complication occurrence,intraoperative blood loss and blood transfusion(P>0.05).Conclusion Treating femoral head necrosis with Bikini incision minimally invasive total hip arthroplasty can achieve favorable effectiveness,with no increase in intraoperative blood loss and rapid recovery of postoperative joint function,but further follow-up is needed.

OBJECTIVE: To analyze the reasons for the failure of thoracolumbar spine internal fixation after burst fracture, and to discuss the strategy for revision surgery. METHODS: From January 2005 to September 2010, 21 patients with thoracolumbar burst fracture received revision surgery after the failure of internal fixation. The etiology included loose of the fixation after anterior surgery in 4 patients, involving malunion with severe kyphosis in 1 patient, pedicle screw malposition in 3, fracture of adjacent segment vertebra in 2, broken of the fixation as non-union of the fracture vertebra in 10 comprising obvious kyphotic deformity in 5, and 2 had developing kyphosis for over distraction of the vertebra followed by pseudarthrosis after removing the internal fixation. After the first operation, symptoms remained in 6 patients, deteriorated in 7, light to moderate improved in 8. Surgical procedures such as anterior corpectomy and reconstruction, replacement of the internal fixation and canal decompression, vertebroplasty, and posterior pedicle subtraction osteotomy were directed based on individual situation. RESULTS: Patients were followed-up for 6-68 (27.0±13.2) months, and demonstrated solid fusion 6 to 12 months postoperatively. No failure of the internal fixation reccurred. No major complications or deterioration of neurologic status were noted. At the last follow-up, the improvement of Frankel grade was 0-2 (1.3±0.7). The mean visual analog scale (VAS) dropped down from 7.6 to 2.1, and the mean oswestry disability index (ODI) decreased from 48.7 to 10.3. Preoperative angle of 7 kyphotic deformity patients was 10 degree-75 degree (42.5 degree±15.3 degree), and was improved to -3 degree-10 degree (2.3 degree±3.7 degree). At the last follow-up, the loss of correction was 0 degree-1.3 degree (0.7 degree±0.3 degree), with the correction rate of 92.3%. CONCLUSION Solid reconstruction of the anterior and middle column of the spine is the imperative procedure to prevent failure of internal fixation in thoracolumbar burst fractures. Revision surgery with reasonable strategy is beneficial and rewarding with few complications.
Bone Screws ; Decompression, Surgical ; Fracture Fixation, Internal ; Humans ; Kyphosis ; Lumbar Vertebrae ; Prosthesis Failure ; Spinal Fractures ; Spine ; Thoracic Vertebrae ; Treatment Outcome ; Vertebroplasty

Objective To investigate the expression and significance of microtubule-associated protein 1 light chain 3 (LC3), an autophagy marker protein, in ameloblastomas. Methods Immunohistochemical methods were employed to evaluate the expression of LC3 in104 cases of ameloblastomas and 20 cases of normal oral mucosal tissues. The results were analyzed by a semiquantitative analysis method. Results The reactivity of LC3 in the epithelial cells of ameloblastomas was positive, and the positivity rate was significantly higher than that in normal oral mucosal tissues (P ＜ 0.05). There were no significant differences between the LC3 expression levels with respect to age, gender, or recurrence (P ＜ 0.05). The positivity rate in mandible ameloblastomas was significantly higher than that in maxilla and gingiva ameloblastomas (P ＜ 0.05). The reactivity for LC3 was significantly higher in solid ameloblastomas than that in the other three tissue types (P ＜ 0.05). Conclusion Autophagic activity in ameloblastomas was higher than that in normal oral mucosal tissues. This suggests that autophagy plays an important role during tumorigenesis, and contributes to the local invasion of ameloblastomas.