In numerous digestive reconstruction techniques after proximal gastrectomy for tumor of the gastroesophageal junction,widely used methods are esophagogastrostomy,esophagogastric tube reconstruction and jejunalinterposition reconstruction.More studies have been focused on jejunalinterposition reconstruction in recent years,from which a variety of modified reconstructions derive.In clinical practice,a flexible choice is needed according to the actual situation of patients.

Objective To compare the outcomes of total hip replacement and minimally invasive dynamic hip screw in treating osteoporotic femoral intertrochanterie fractures.Methods Retrospectively analyze the clinical data of 56 patients with osteoporotic femoral intertrochanteric fractures who came to our hospital from July,2008-June,2012.Twenty eight cases who accepted minimally invasive dynamic hip screw were divided into the control group while 28 cases who accepted total hip replacement were divided into the experimental group.The blood loss and postoperative drainage,operative time,situation of implant loosening,the occurrence of postoperative complications and the clinical curative effect were compared between two groups.Results The differences in operative time,blood loss,and postoperative drainage flow,limited weight-bearing after operation was statistically significant between two group[(96.37 ± 20.42)min,(529.85±73.82) ml,(7.46±1.23) dvs (66.84±18.63)min,(152.79±37.35) ml,(14.32±2.62)d,t=5.653,24.117,12.542,P＜0.05].The differences in FRS score and Harris score between twogroups was not statistically significant [(27.75±3.59),(89.84±4.17) vs (26.41±3.16),(88.68±3.92),P＞ 0.05].The incidence in internal fixation loosening varied significantly with different degree of osteoporosis in the control group (66.7％vs18.8％,x2 =4.745,P ＜ 0.05) but not in the experimental group (11.1％ vs 10.0％,P＞0.05).Complication rate of the experimental group was significantly lower than the control group (3.6％vs 28.6％,x2 =4.766,P ＜ 0.05).Conclusions For the elder patients with osteoporotic femoral intertrochanteric fractures,the selection of surgical approach should be based on the patient's individual circumstances and the degree of osteoporosis.In the same time,attention should be paid to anti-osteoporosis therapy after operation.

Objective:To explore the feasibility and therapeutic efficacy of using the Henry approach to expose and place a metaphyseal bone plate laterally to fixate a proximal radial shaft fracture.Methods:A retrospective analysis was done of the 5 proximal radial shaft fractures (defined as the fracture involving the extent between the radial tuberosity to the insertion of the pronator teres) which had been treated from April 2018 to June 2019 at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital through the Henry approach to place a metaphyseal plate laterally to the radius for fixation. There were 2 males and 3 females, aged from 16 to 59 years (average, 41.4 years), with 3 cases on the left side and 2 cases on the right side. The imaging data, fracture healing time, forearm pronation-supination, and visual analogue scale (VAS) of the patients were regularly followed up; the therapeutic efficacy was evaluated at the last follow-up using Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH), Anderson and Grace-Eversmann evaluations.Results:The 5 patients were followed up for 7 to 16 months (average, 10.6 months). Their fracture healing time averaged 4.6 months, elbow flexion 146°, extension -2°, pronation 77°, and supination 88°. In postoperative VAS, 4 cases scored a 0 point and one case 1 point. At the last follow-up, their Quick-DASH scores averaged 4.1 points; by the Anderson evaluation, 5 cases were excellent; by the Grace-Eversmann evaluation, 4 cases were excellent and one case was good. No postoperative complication was observed.Conclusion:It is an effective treatment of proximal radial shaft fracture to use the Henry approach to expose and place a 3.5mm metaphyseal plate laterally to the radius for fixation.

AIM: To identify the non-steroid transcription factors upregulating the expression of L-plastin in hormone-independent prostate cancer, and partly elucidate the mechanism of hormone-refractory prostate cancer. METHODS: TF SEARCH software was used to analysis the possible binding sites of transcription factors in the 3’ end of L-plastin promoter that had been identified as important part of regulation response elements. Gel shift assay and supershift assay were used to confirm the transcription factors binding the speculated response elements. PCR site-mutagenesis technique was performed to delete the binding site of transcription factor and luciferase activity assay was carried out after deletion of the binding site. RESULTS: SP-1 respond element GGTGGGGCGGGGA located at -54- -41 of L-plastin promoter was identified with the TF SEARCH software. Gel shift assay and supershift assay confirmed that SP-1 was the transcription factor binding to GGTGGGGCGGGGA. Mutant deleted the SP-1 binding-site had low-luciferase activity than that of the naive. CONCLUSION: SP-1 plays an important role in the up-regulation of L-plastin expression in hormone-independent prostate cancer.

The non-stationary interference with the analysis parameters of short-term heart rate variability (HRV) has been studied. The results show that although all considered parameters fluctuate with the lapse of time, only HFnorm and sample entropy (SE) correlate significantly with non-stationary interference. Therefore, the low frequency fluctuations of HRV contain not only the non-stationary interference, but also the intrinsic cardiac dynamic characteristics. Specially, the results of the base-scale entropy (BE) analysis of three groups of people, and of three kinds of noises are contrasted. It is shown that, at the expense of outstanding anti-nonstationarity, BE fails to depict the long range correlation of HRV.
Algorithms ; Autonomic Nervous System ; physiology ; Electrocardiography ; methods ; Entropy ; Heart Rate ; physiology ; Humans ; Signal Processing, Computer-Assisted

AIM: To construct eukaryotic expression vector of small interfering RNA(siRNA) specific to bcl-2 and investigate the effect of recombinant plasmid on suppressing bladder cancer cell growth.METHODS: siRNA of bcl-2 gene was designed according to the principle of RNAi-based medicine, and was converted into cDNA coding expression of small hairpin RNAs(shRNA) of siRNA. The cDNA was synthesized and inserted into plasmid pGenesil-1. The recombinant eukaryotic expression vectors of pGenesil-1545 and pGenesil-1555 were controlled by the U6 promoter of RNA polymerase Ⅲ, identified by the restriction map and the sequence analysis, and transfected into T24 cells. After T24 cells were transfected for 72 h, expression of bcl-2 mRNA was assayed by RT-PCR; and MTT was used to observe the proliferation of T24 cells.RESULTS: The recombinant plasmids of pGenesil-1545 and pGenesil-1555 were identified by the restriction map and the sequence analysis. The sequences completely coincided with the designs. The expression of the bcl-2 mRNA in T24 cells transfected with recombinant plasmid decreased nearly 80%, and the growth of T24 cells was suppressed significantly.CONCLUSION: The siRNA eukaryotic expression vector against bcl-2 gene is successfully constructed. It effectively downregulates the expression of bcl-2 in T24 cells and suppresses the cell growth.

Objective To verify the efficiency of a new laparoscopic urethrovesical anastomosis training model by comparing it with the chicken skin model. Methods Chicken posterior trunks and porcine colons were used to construct the training model. The posterior trunk of a chicken was used to simulate a human pelvis, and a 3-mm cloacal stump was used to simulate a human urethral stump. A 15-cm segment of porcine colon with a 1-cm orifice was used to simulate a human bladder or neobladder. An imitation urethrovesical anastomosis was performed with laparoscopic instruments in a laparoscopic training box. Forty trainees with no laparoscopic experience were randomized into 2 groups.The trainees in group A (n=20) practiced using this new model for 8 h, while those in group B (n=20) practiced using the chicken skin model for 8 h. The trainees' skills were assessed using the porcine model before and after training. Results Compared with the chicken skin model, this new training model more accurately resembled the structure and characteristic of human pelvis, urethral stump, and bladder (neobladder). After the training sessions, both groups improved in anastomosis time [GroupA: (64±11)min vs. (123±20)min, P＜0.05; Group B: (77±12)min vs. (121±17)min, P＜0.05] and quality (Group A: 8.8± 1.0 vs. 3.8 ± 1.2, P＜0. 05 ; Group B: 7.7 ± 0.9 vs.3. 7± 1.1, P＜0. 05). Compared with trainees in group B, trainees in group A required less time and achieved a higher quality score (P＜0.05). Conclusions This new training model can help urologic surgeons to reduce learning curve of this technique and improve their suturing skills. It is an effective,convenient training model for laparoscopic urethrovesical anastomosis.

Objective To investigate the changes of regulatory T cells (Treg) in patients with hepatocellular carcinoma (HCC) after ultrasound- guided percutaneous cool- tip radiofrequency ablation (RFA), and to discuss its influence on the prognosis. Methods A total of 30 patients with HCC were enrolled in this study. The percentage of Treg in peripheral blood was estimated with flow cytometry before RFA and one, 4, 7 and 12 months after RFA. During the follow-up period, the therapeutic effects were evaluated by contrast enhanced sonography or contrast enhanced CT scanning. By using the methods of receiver operating characteristic (ROC) curve and Kaplan-Meier survival function, the correlation of Treg dynamic changes with the progression-free survival time was analyzed. Results One month after RTA, the tumor response (TR) rate in the 30 patients was 93.3% (28/30), the tumor progression (TP) rate was 6.67%(2/30). The percentage of Treg before RFA was (9.42 ± 1.16)%, which decreased to (6.55 ± 0.97)% one month after RFA, the difference was statistically significant (t = 15.325, P <0.001). Twelve months after RFA, TR rate became 33.3%(10/30), and TP rate became 66.7%(20/30). The preoperative percentage of Treg of TR group was (8.75 ± 0.72)%, which was significantly lower than that of TP group (9.76 ± 1.20)%, the difference was statistically significant (t=-2.448, P=0.021). ROC curves indicated that the optimal cut-off value of Treg nadir was 4.82%, the sensitivity was 90.0% and the specificity was 60.0%. The optimal cut-off time to reach Treg nadir was 5.5 months, the sensitivity was 70.0% and the specificity was 85.0%. Kaplan-Meier curve analysis showed that after RFA the progression-free survival rate (PFS) of patients with Treg nadir ≤ 4.82% was significantly higher than that of patients with Treg nadir>4.82%. PFS of patients with reaching Treg nadir≥5.5 months was significantly higher than that of patients with reaching Treg nadir<5.5 months. Log-rank test results were字2=5.207, P=0.023; 字2=22.079, P < 0.001, respectively. Conclusion Percutaneous cool-tip radiofrequency ablation can decrease the percentage of Treg cells. Besides, Treg nadir and the time reaching Treg nadir can reflect the prognosis of HCC patients after RFA to a certain extent.

Objective To compare superiorities of liver malignant tumors underwent regular and irregular hepatectomies through approaching perioperative factors.Methods 1019 consecutive hepatectomies of liver malignant tumor from 1986 to 2009 at Air Force General Hospital and General Hospital of Chinese PLA were investigated retrospectively according to their medical documentation.Results Multivariate analysis showed that liver malignant tumors on which regular hepatectomy and irregular hepatectomy were performed,there was no significant difference in the blood loss,complications,mortality related to operation,hospital stay,and so on.But the operating time of regular hepatectomy was obvious more than that of irregular hepatectomy (P＜ 0.001,OR=1.004).Conclusions Although for liver malignant tumor,regular hepatectomy seems to be superior to irregular hepatectomy based on oncological theory,in clinical practice,there were no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.

Objective To obtain shRNA sequences that can stably block the expression of Nuclear Factor kappa- B (p65) in the prostate cancer cell line LNCaP and construct the lentivirus vector.And validate the gene function of p65 in the cell line. Methods According to p65 genetic information, we design siRNA1, siRNA2, siRNA3 those three siRNA sequences targeting the ods area of p65 gene and then form the corresponding four pairs of complementary single strand DNA of shRNA, including the sense strand and the antisense strand. The synthetic shRNA sequence was inserted into the empty pSIH1-H1-copGFP shRNA Vector, and after transfecting the prostate cancer cells , the inhibitory effect of p65 mRNA by different sequences was detected through real-time PCR, and the inhibitory effect of p65 protein expression was detected by Western-blotting. Thus we can obtain highly effective shRNA sequences in the inhibition of p65 in prostate cancer cells. MTT, flow cytometry, transwell were chosen to test the cell growth, migration and invasive power in vitro to compare the difference of the experimental group, control group and negative group. Results The third shRNA sequence had the best inhibitory effect and the inhibitory effect of p65 mRNA in prostate cancer cell line was 59 % and the protein was 81%. It's position locates in p65 (NM_021975 ) 1096-1113 and it's stemloop sequence is 5'-GATCCGCCCTATCCCTTTACGTCATTCAAGAGATGACGTAAAGGGATAGGGCTTTTTG-3'. After transfecting, the prostate cancer cell line had the low expression of p65 stably. Through MTT, we got the growth curve, which showed that the growth ability of experimental group was significantly decreased compared with the control group and the Logarithmic growth didn't appear in the first 96 hours. Flow cytometry test displayed that the percentage of G0-G1-phase cells in experimental group was 61.49%, and the control group was 44.89%, idle group was 41.52%, which was increasing oberviously. The S-phase cells in the experimental group was 28.58%, compared with the 47.36% and 46. 10% diminished. The results of transwell showed that the experimental group had 16. 5000±6. 62076 cells and the other two groups had 45. 6333 13. 54159 and 36. 8333±5. 68412 cells, which showed the invasive power of experimental group was significantly declined(P＜0.05).Conclusions It's successful to obtain shRNA sequences that can stably block the expression of p65 in the prostate cancer cell line LNCaP and construct the lentivirus vector. p65 can positively regulates the biological behavior of prostate cancer LNCaP cell line in the cell growth, migration and invasive power.