Objective To analyse the application effect of intramedullary interlocking nail in the treatment of femoral and tibial fracture,to discuss the key of the mini-invasive operation.Methods 110 cases of femoral and tibial fracture treated by intramedullary nail from May,1997 to Oct,2001 were reviewed,78 cases were treated by mini-invasive open-reduction and internal fixation,32 cases were treated by intermal fixation without open-reduction.Results All cases were followed-up ,15 cases were delayed at the healing time,but all cases were healed in six months.Conclusion The application of intramedullary nail in the treatment of femoral and tibial frature by mini-invasion has advantages of less trauma,strong fixation,high healing rate,early motion can be obtanied ,but the key of the operation must be grasped.

BACKGROUND:Recent studies have found that bone marrow mesenchymal stem cells play an important role in the development of multiple myeloma, especial y for angiogenesis, but whether the pro-angiogenesis ability of bone marrow mesenchymal stem cells in multiple myeloma in active and remissive state is different is yet unclear. OBJECTIVE:To investigate the difference in the pro-angiogenesis ability of bone marrow mesenchymal stem cells in multiple myeloma in active and remissive state. METHODS:Bone marrow samples were extracted from 13 patients with multiple myeloma before treatment and after four therapeutic cycles to isolate bone marrow mesenchymal stem cells. ELISA assay was used to detect levels of vascular endothelial growth factor, hepatocyte growth factor and basic fibroblast growth factor in the supernatant of bone marrow mesenchymal stem cells. The proliferative ability and movement of human umbilical vein endothelial cells cultured in the supernatant of bone marrow mesenchymal stem cells were detected by MTT assay and Transwel assay, respectively. The pro-angiogenesis ability of bone marrow mesenchymal stem cells was measured by Matrigel in vitro. RESULTS AND CONCLUSION:The levels of vascular endothelial growth factor, hepatocyte growth factor and basic fibroblast growth factor in the cellsupernatant were significantly higher in active myeloma than those in remissive myeloma (P<0.05). The supernatant of bone marrow mesenchymal stem cells of active myeloma more significantly promoted the proliferation, migration and blood vessel formation of human umbilical vein endothelial cells than that of remissive myeloma in a dose-dependent manner (P<0.05). These findings indicate that bone marrow mesenchymal stem cells from active myeloma have stronger pro-angiogenesis ability than those from remissive myeloma.

Objective To investigate the changes of PTX3,NT -ProBNP level and the correlation between them and the prognosis of the patients with AMI combined T2DM.Methods 143 patients with primary AMI were enrolled,of which 63 patients with type 2 diabetes (observation group)and 80 patients with no diabetes (control group).Plasma PTX3 values were measured with ELISA method and NT -ProBNP was detected by the electrochemi luminescence method.All patients were observed for the occurrence of MACE during hospitalization and 12 months after discharge.The correlation between PTX3,NT -ProBNP concentration and occurrence of MACE in observation group were analyzed.Results The PTX3,NT -ProBNP concentration[(8.95 ±5.06)ng/mL,(1 609 ±1 049)pg/mL]in the observation group were significantly higher than those in the control group[(7.03 ±3.70)ng/mL,(1 198 ± 809)pg/mL](P =0.010,P =0.009);The number(n =26)of patients with occurrence of MACE in the observation group was significantly higher than 15 cases in the control group(P =0.003).In the observation group,the PTX3, NT -ProBNP concentration[(10.98 ±5.45)ng/mL,(2 007 ±1 097)ng/mL]in patients with MACE were signifi-cantly higher than those in patients without MACE[(7.53 ±4.28)ng/mL,(1330 ±930)ng/mL](P =0.007,P =0.010),and in MACE group,the PTX3,NT -ProBNP concentration[(13.88 ±6.84)ng/mL,(2 596 ±1 333)ng/mL] in patients with death weresignificantly higher than those in patients without death[(9.18 ±3.52)ng/mL,(1 639 ± 751)ng/mL](P =0.029,P =0.023).Conclusion More strong chronic inflammatory reaction and serious myocar-dial injury might occur in the patients with AMI combined and T2DM,and those patients would have poorer prognosis. The combined detection of PTX3,NT -ProBNP has an important significance in evaluating of the degree of myocardial damage and the prognosis of the patients with AMI combined T2DM.

Background and purpose: Natural killer/T-cell lymphoma (NKTCL) is a scarce subtype of malignant lymphoma, and it has heterogeneous clinical manifestation and treatment effect. Currently, no precise risk stratification is used to guide prognosis. This study aimed to evaluate the prognostic impact of pre-treatment peripheral blood absolute monocyte count (AMC) and platelet-lymphocyte ratio (PLR) in patients with primary nasal NKTCL, and provide more precise information for better risk stratification to select appropriate treatment and improve survival. Methods: Clinical data of 132 patients newly diagnosed with primary nasal NKTCL was collected in the Tianjin Medical University Cancer Institute and Hospital from Jan. 2008 to Dec. 2013. The relationship between AMC and PLR in pre-treatment peripheral blood and 5-year overall survival (OS) and progression-free survival (PFS) of patients was analyzed retrospectively. Independent prognostic factors of patients were determined by univariate analysis and Cox regression analysis. Results: Pre-treatment peripheral blood AMC and PLR play important roles in the prognosis stratification of patients with primary nasal NKTCL. The prognosis in patients of AMC<0.5×109/L were higher than those of AMC≥0.5×109/L, The prognosis in patients of PLR<150 were higher than those of PLR≥150 (P<0.05). Based on the four independent risk factors of staging, ECOG scoring, AMC and PLR, we tried to establish a new prognostic model, dividing all patients into three different risk groups and found that the 5-year OS and PFS of three groups had significant statistical differences. Conclusion: Peripheral blood AMC and PLR were significantly correlated with the prognosis of patients with primary nasal NKTCL. The new prognostic patterns based on the four independent risk factors, such as staging, ECOG scoring, AMC and PLR may be more convenient and more economical than IPI (International Prognostic Index, IPI) and KPI (Korean Prognostic Index, KPI).

OBJECTIVE: To evaluate the clinical outcome of surgical management for post-traumatic thoracolumbar kyphotic deformity with single-stage posterior transpedicularlimited osteotomies. METHODS: From March 2007 to May 2010, 17 patients with post-traumatic thoracolumbar kyphotic deformity treated with posterior limited transpedicular osteotomy were admitted. The preoperative Cobb angle was 41°-62°(52.5° ±6.4°). Sagittal balance was evaluated by the standing lateral films measuring the C7 plumb line distance (C7 PLD) from the posterior superior corner of S1. The C7 PLD was 18-58 (41.2 ±12.4) mm in the sagittal plane. The preoperative oswestry disability index (ODI) was 42-50 (45.7 ±2.7), and the average preoperative visual analogue scale (VAS) was 8-10 (8.8 ±0.7). The American Spinal Injury Association (ASIA) impairment scale was used to assess the neurological deficits, and grade C in 1 patient, grade D in 7 and grade E in 9 patients. The operation time, blood loss, complications, post-operative Cobb angle, ODI and VAS score at the follow-up were collected and analyzed. RESULTS: The average duration of postoperative follow-up was 24-53 (34.5 ±7.1) months. The operation time was 180-400 (287.1 ±65.9) min, with an blood loss of 350-1 300 (838.2 ±276.4) mL. The postoperative kyphotic angle was 3°-12° (6.1° ±3.0°), and it was 7.5° ±2.6° at the final follow-up evaluation. The postoperative C7PLD was (3.6 ±3.9) mm and it was (3.4 ±2.3) mm at the final follow-up evaluation. Postoperatively, the ASIA impairment scale was grade D in 4 and grade E in 13 patients. At the final follow-up ODI and VAS were reduced to an average of 5.2 ±2.4 and 2.4 ±1.0, respectively. Cerebrospinal fluid leakage was found in 2 patients, deep wound infection in 1, and intercostal neuralgia in 2. All the complications were relieved after conservative medical therapy. One patient received additional surgery at postoperative 12 weeks due to breakage of posterior implants. Another screw pullout case was treated with reinsertion of larger screws at postoperative 4 months. Solid fusion was confirmed by plain film and CT scan in all patients within 1 year after the surgery. CONCLUSION Single-staged posterior transpedicular limited osteotomies is safe and effective to correct post-traumatic thoracolumbar kyphotic deformity.
Bone Screws ; Humans ; Kyphosis ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Osteotomy ; Postoperative Period ; Posture ; Spinal Injuries ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

The present study aimed to explore the neuroprotective effect and possible mechanisms of rhGLP-1 (7–36) against transient ischemia/reperfusion injuries induced by middle cerebral artery occlusion (MCAO) in type 2 diabetic rats. First, diabetic rats were established by a combination of a high-fat diet and low-dose streptozotocin (STZ) (30 mg/kg, intraperitoneally). Second, they were subjected to MCAO for 2 h, then treated with rhGLP-1 (7–36) (10, 20, 40 µg/kg i.p.) at the same time of reperfusion. In the following 3 days, they were injected with rhGLP-1 (7–36) at the same dose and route for three times each day. After 72 h, hypoglycemic effects were assessed by blood glucose changes, and neuroprotective effects were evaluated by neurological deficits, infarct volume and histomorphology. Mechanisms were investigated by detecting the distribution and expression of the nuclear factor erythroid-derived factor 2 related factor 2 (Nrf2) in ischemic brain tissue, the levels of phospho-PI3 kinase (PI3K)/PI3K ratio and heme-oxygenase-1 (HO-l), as well as the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA). Our results showed that rhGLP-1 (7–36) significantly reduced blood glucose and infarction volume, alleviated neurological deficits, enhanced the density of surviving neurons and vascular proliferation. The nuclear positive cells ratio and expression of Nrf2, the levels of P-PI3K/PI3K ratio and HO-l increased, the activities of SOD increased and the contents of MDA decreased. The current results indicated the protective effect of rhGLP-1 (7–36) in diabetic rats following MCAO/R that may be concerned with reducing blood glucose, up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.
Animals ; Blood Glucose ; Brain ; Diet, High-Fat ; Hypoglycemic Agents ; Infarction ; Infarction, Middle Cerebral Artery ; Malondialdehyde ; Neurons ; Neuroprotective Agents ; Phosphotransferases ; Rats* ; Reperfusion ; Reperfusion Injury* ; Streptozocin ; Superoxide Dismutase

BACKGROUNDEvidence shows that ezrin plays an important role in the development of some human malignancies. But the mechanism by which ezrin may affect tumor cell invasion and metastasis remains unclear.

METHODSIn this study, the expression of ezrin was verified in osteosarcoma (OS) cells and tissues by comparison with normal bone cells and tissues using Western blotting. OS-MG63 were transfected with pcDNA3.1-ezrin or pGenesil-1/shRNA-ezrin and the stably transfected cells were selected with G418 to yield the ezrin cell line. The OS-MG63 tumor cells were delivered by tail vein to female BALB/c to develop pulmonary metastasis model in vivo. Ezrin was identified as a direct target of miR-183 via a luciferase reporter carrying the 3'-untranslated region of ezrin. Migration assays and invasion assays were done with the transwells. Signaling pathway was studied by Western blotting and/or inhibitor.

RESULTSEctopic overexpression of ezrin in OS cell line MG63 promoted tumor cell invasion and migration. Consistent with this, knockdown of ezrin inhibited tumor cell invasion and migration. Similar results were obtained in the experimental metastasis model in vivo. We identified ezrin as a direct target of miR-183. What is more, ectopic expression of ezrin could induce the expression of N-cadherin and enhance the activity of extracellular signal-regulated kinase (ERK) signaling.

CONCLUSIONCollectively, these results suggest that ezrin as a direct target of miR-183 promotes the aggressiveness of OS via increased N-cadherin and activating ERK signaling.

Animals ; Bone Neoplasms ; metabolism ; pathology ; Cadherins ; genetics ; metabolism ; Cell Line, Tumor ; Cell Movement ; drug effects ; genetics ; Cytoskeletal Proteins ; genetics ; metabolism ; Female ; Humans ; In Vitro Techniques ; Mice ; Neoplasm Invasiveness ; genetics ; Osteosarcoma ; metabolism ; pathology

OBJECTIVE: To investigate the role of miR-181a in promoting the proliferation and metastasis of osteosarcoma cells by targeting RASSF1A.
 METHODS: The level of miR-181a in 30 human osteosarcoma tissues and corresponding bone tissues was detected by real-time PCR, and the correlation between the level of miR-181a and clinicopathological characteristics of osteosarcoma was analyzed. Osteosarcoma cells MG-63 were transfected with chemically-synthesized miR-181a mimics and inhibitors, and the proliferation, migration and invasion of MG-63 cells were detected by MTT and Transwell assay. The specific binding ability of miR-181a to RASSF1A 3'-UTR was theoretically predicted and detected by the dual luciferase reporter gene assay.
 RESULTS: The level of miR-181a in osteosarcoma tissues was statistically higher than that in the corresponding bone tissues (P<0.001). However, the level of miR-181a was not correlated with gender, age, tumor size and stage (P>0.05). MTT and Transwell assays showed that the growth rate, migration and invasion ability of MG-63 cells with up-regulation of miR-181a was significantly increased compared with negative control (P<0.05), while the growth rate, migration and invasion ability of MG-63 with down-regulated miR-181a was significantly decreased compared with negative control (P<0.05). Luciferase reporter gene assay showed that miR-181a targeted the 3'-UTR of RASSF1A and regulated the expression of RASSF1A.
 CONCLUSION MiR-181a promotes the proliferation and metastasis of osteosarcoma cells through specifically binding to RASSF1A 3'-UTR and subsequent down-regulation of RASSF1A.
Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Humans ; MicroRNAs ; Neoplasm Metastasis ; Osteosarcoma ; Real-Time Polymerase Chain Reaction ; Transfection ; Tumor Suppressor Proteins ; Up-Regulation