Objective To investigate the different biological characteristics of high-and low-expression of ATP-binding cassette transporter(ABCG2)in human multi-drug resistant nasopharyngeal carcinoma CNE2/DDP cell line(abbreviated as ABCG2High cell and ABCG2Low cell),and to analyze drug-resistant characteristics of the two cell lines.Methods ABCG2High and ABCG2Low cells were isolated by flow cytometry,while their cloning efficiency,cell cycle distribution,and the expression of ABCG2 before and after the 5th passage were examined as well.mRNA expressions of drug-resistant genes,such as ABCG2,Bcl-2,MDR1,MRP and MGMT,were detected by reversed transcriptive polymerase chain reaction(RT-PCR).MTT assay was utilized to detect the light absorbance(A)from day 1 to 14 to determine growth kinetics.Moreover,the drug sensitivity of the two cell lines to fluorouracil,cisplatin,vincristine,carboplatin,epirubicin,daunorubicin,paclitaxel and mitomycin were detected by MTT assay.Results The cloning efficiency of ABCG2High and ABCG2Low cells was 25.24%?1.18% and 16.28%?1.11%,respectively,on day 7.ABCG2High cells in S phase accounted for 41.5%,while the ABCG2Low cells in the G1/M0 phase went up to as high as 63.9%.The expression of ABCG2 in original ABCG2HighCNE2/DDP cells was 98%,while in ABCG2Low CNE2/DDP cells was 2%.However,at the 5th passage,the expression of ABCG2 decreased to 75% in the former cells and increased to 20% in the latter ones.The expression of ABCG2 mRNA in ABCG2High cells was obviously higher than that in ABCG2Low cells,while there was no difference in expression of other drug resistance genes between two cell lines.The growth velocity of ABCG2High cells exceeded that of ABCG2Low cells in early stage,but it slowed down 7 days later.MTT assay showed that IC50 of ABCG2High cells to 8 kinds of anti-tumor drugs were twofold higher than that of ABCG2Low cells,with statistically significant difference between them(P

BACKGROUND:Kienb?ck disease lacks of suitable animal models, which are similar to the pathological process of avascular necrosis of human lunate bone.
OBJECTIVE:To establish a new animal model of Kienb?ck disease using medical TH adhesive embolism and to explore the rationality of model establishment.
METHODS:A total of 30 healthy adult New Zealand rabbits, male or female, were selected. Using self-control method, the rabbits were randomly assigned to experimental sides and control sides. By dril ing in the center of the lunate bone, 0.2 mL of medical TH glue was injected three times. An equal volume of physiological saline was injected into the center of the lunate bone on the control side. X-ray examination, general observation, Micro-CT measurement of bone, and tissue pathology detection were conducted at 4, 8 and 12 weeks.
RESULTS AND CONCLUSION:Gross specimen, X-ray and histological results showed that ischemic necrosis of the lunate bone on the experimental side was visible at 8 weeks after model induction. The ischemic necrosis of the lunate bone became more typical at 12 weeks. Among the Micro-CT microscopic parameters of trabecular bone, trabecular bone density parameters bone volume fraction and the number of trabecular bone were significantly lower on the experimental side than those on the control side (P<0.05). Spatial parameters of trabecular bone significantly increased. Trabecular separation and structure model index on the experimental side were significantly greater than those on the control side. Results suggested that ischemic necrosis of the lunate bone appeared on the experimental side at 8 weeks after injection of medical TH glue. Rabbit models of ischemic necrosis of the lunate bone can be established at 12 weeks. Thus, alterations, which were similar to ischemic necrosis of human lunate bone, appeared, such as blood transportation damage in the lunate bone, trabecular bone fracture, and empty lacuna, when surrounding tissues were not obviously injured.

BACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics.
OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator cuff repair, and evaluate the difference of therapeutic efficacy between two methods.
METHODS:A computer-based search was performed in the Medline (from January 2003 to February 2014), EMBASE (from January 2003 to February 2014) and Cochrane library (February 2014). According to the inclusion and exclusion criteria, al the randomized control ed studies addressing the outcome of single-row repair and double-row repair techniques were included in this meta-analysis. The methodological quality of each study was judged and a meta-analysis was conducted using Revman5.0. The preoperative and postoperative differences between the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, the re-rupture rate and the muscle strength were compared. The forest chart was used to compare the data between two groups, and the funnel plot was finished to detect the publication bias.
RESULTS AND CONCLUSION:A total of 10 randomized control ed trials (Levels I, II) were included. Meta-analysis showed that, there was no statistical y significant difference in the Constant, ASES and UCLA scores in the double-row group and the single-row group before and after treatment. In the postoperative fol ow-up, double-row group had a lower re-rupture rate and a higher abductor muscle strength than single-row group. When the rotator cuff tear was less than 3 cm, double-row group had no significant difference with the single-row suture group. While in the over 3-cm tear group, double-row group showed better results than the single-row suture group on the Constant scpre, ASES score and UCLA score. Double-row suture has a low re-rupture rate than single-row suture in rotator cuff injury, and could achieve better abduction muscle strength. There is no significant difference in the functional score between double-row suture and single-row suture in the rotator cuff tear of less than 3 cm, while in the over 3-cm tear, double-row suture could achieve better functional score.

Objective To explore the method and effect of transinfection of rabbit early knee osteoarthritis models via chitosan microsphere with gene of recombined human IL-1Ra gene and TGF-β1 gene. Methods Chitosan microspheres with plasmids of IL-1Ra gene and TGF-β1 gene, and rabbit early knee osteoarthritis models were prepared. Rabbits in different groups had intra-articular injections of chitosan microsphere containing IL-1Ra gene and / or TGF-β1 gene, and chitosan solution as control group before being executed regularly and randomly. The joint specimens were evaluated by HE staining, lycopene red O staining and immunohistochemical analysis and Mankin's score. ELISA was used for detection of IL-IRa and TGF-β1 concentration of articular cavity fluid in each group. Results The control group was consistent with the pathological changes of early OA. In co-transinfection group, judging from the appearance and staining of cartilage,the OA damage of the specimens was less serious than other groups'. Its Mankin's score was significantly lower than single-gene transinfection group (P ＜ 0.05), and the latters Mankin's score were significantly lower than control group (P ＜ 0.05). Conclusion Intra-articular injection of chitosan microspheres containing both IL-1Ra gene and TGF-β1 gene could inhibit the degeneration of cartilage and promote cartilage repair.

Objective To study the anatomic data of the first metatarsal dorsal artery and to provide anatomical basis for clinical tissue transplantation based on the first metatarsal dorsal artery.Methods The 16 adult cadaver specimens with 32 feet were dissected and meas-ured by vernier caliper.Then the anatomic data of the first metatarsal dorsal artery were analyzed.Results Through the examinations of 32 feet sample,the first metatarsal dorsal artery were classified into 5 types.Type Ⅰ:the first metatarsal dorsal artery runs at the surface of the first dorsal interosseous muscle (13 sides,40.6%).Type Ⅱ:the first metatarsal dorsal artery runs in the interior of the first dorsal interosse-ous muscle (11sides,34.4%).Type Ⅲ:the first metatarsal dorsal artery runs underneath the first dorsal interosseous muscle (6 sides, 18.8%).Type Ⅳ:the first metatarsal dorsal artery is slender (1 side,3.1%).TypeⅤ:the first metatarsal dorsal artery is absent (1 side, 3.1%).Distance relationship was measured between the first metatarsal bone and the first metatarsal dorsal artery:the vertical distance be-tween the origin of the posterior branch of the first metatarsal dorsal artery and base of the first metatarsal bone was (2.4 ±0.3)mm,the ver-tical distance between the origin of the posterior branch of the first metatarsal dorsal artery and head of the first metatarsal bone was (10.1 ±1.0)mm;the vertical distance between the origin of the anterior branch of the first metatarsal dorsal artery and the first metatarso-phalangeal joint was (7.6 ±2.7)mm.Conclusion The first metatarsal dorsal artery has clinical reference significance for the hands and feet’s trauma and skin flap transplantation such as thumb reconstruction.

Objective To evaluate effect of case-based action-oriented learning mode based on cases in advanced vocational nursing education of Surgical Nursing. Methods A total of 103 nursing students from two classes enrolled in 2013 were selected and divided into experimental group ( 51 ) and control group ( 53 ) . Students in experimental group were taught in action-oriented learning mode based on cases, while those in control group received traditional teaching. Students′ performance in theory and practice combination and self-learning ability were compared between two groups. Results Students in experimental group significantly performed better in operating skills, problem analysis, communication skills and team skills (P<0.05) than those in control group. Overall score of self-learning ability and score in the dimension of self-management, cooperative learning, information literacy in experimental group were significantly higher than that in control group (P<0.05). Conclusions Application of case-based action-oriented learning mode based on cases in advanced vocational nursing education of Surgical Nursing could effectively improve students′ comprehensive abilities including self-management, information-gathering and team cooperation.

Objective To explore the expression profiles and their clinical significance of serum exosomal microRNA (miRNA ) in the different phases of natural history in chronic hepatitis B (CHB ) patients .Methods A total of 92 treatment-naive CHB patients in Shanghai Public Health Clinical Center between January 2014 and January 2017 were retrospectively studied .The cases in immune tolerant (IT) phase ,immune reactive (IR) phase ,inactive carrier (IC) phase and HBeAg-negative CHB (ENH) phase were 24 ,24 ,24 ,and 20 ,respectively .Exosomes were isolated by ExoQuick solution from 250μL serum . The expressions of the surface protein markers LAMP2 and TSG101 in serum exosomes were determined by Western blotting . The expressions of miRNA-122 , miRNA-125a , miRNA-29c , miRNA-200c in exosomes were detected by real-time fluorescent quantitative PCR .The Kruskal-Wallis H test and Mann-Whitney U test were used to determine intergroup differences . The correlation coeffcients ( r) were calculated using Spearman′s correlation .Receiver operating characteristic (ROC) and the area under the curve (AUC ) were used to calculate the diagnostic values . Results Western blotting showed that exosome-specific markers LAMP2 and TSG101 were positive .The levels of serum exosomal miRNA-122 , miRNA-125a ,miRNA-29c and miRNA-220c were significantly different in CHB patients in different phases (H=41 .06 ,29 .31 ,49 .14 and 31 .73 ,respectively ,all P<0 .05) .Based on the results of liver function test and liver biopsy , serum exosomal miRNA-122 , miRNA-29c and miRNA-200c in inflammation group were down-regulated (U = 804 ,317 and 574 ,respectively ,all P< 0 .05) ,while miRNA-125a was up-regulated (U=279 ,P<0 .01) compared with non-inflammation group .The level of exosomal miRNA-200c was negatively correlated with ALT (r= -0 .3932 ,P<0 .01) ,while the level of miRNA-125a was positively correlated with ALT (r=0 .5981 , P<0 .01) .AUC of the above exosomal miRNA were 0 .6193 ,0 .8396 ,0 .8243 and 0 .6883 ,respectively .The highest AUC was miRNA-125a with the sensitivity of 84 .62％ and the specificity of 74 .47％ .AUC of ALT discrimination for liver inflammation was 0 .7953 ,with the sensitivity of 81 .08％ and the specificity of 70 .97％ .Conclusions The serum exosomal miRNA levels are significantly different among the different phases of natural history in CHB patients .Inflammation-associated exosomal miRNA is expected to be the non-invasive diagnostic biomarkers of liver inflammation and is of great benefit for determining the best time for clinical medication of CHB patients .

Objective To evaluate the efficacy and adverse reactions of platinum-based combined chemotherapeutical regimens in treating relapsed or refractory non-Hodgkin lymphoma(NHL).Methods The clinical data of 68 patients with relapsed or refractory NHL treated with platinum-based combined chemotherapeutical regimens in the Affiliated Tumor Hospital of Guangxi Medical University from January 2008 to December 2014 were retrospectively analyzed.The curative effect of related regimens,adverse reactions and related influence factors were analyzed.Results Sixty-eight cases received 283 cycles of chemotherapy.In all cases,11 cases(16.18 ％) achieved the complete response(CR),31 cases(45.59 ％) achieved the partial response(PR),the overall response rate(ORR) was 61.76％;the median progression-free survival(PFS) was 6.51 months(95％CI:4.97-8.04 months).ORR and PFS in the cases of stage Ⅱ-Ⅲ,IPI score 0-2 and receiving only one chemotherapeutical regimen were superior to those in the cases of corresponding subgroup(P＜0.05);ORR and PFS had no statistical difference between the B cells lymphoma and Tcells lymphoma(P＞0.05).The medion PFS in the combined R group was 11.16 months,which was longer than 5.84 months in the non-combined R group(P =0.004).The major adverse events (stage Ⅱ-Ⅲ) included leukopenia (41.18 ％),thrombocytopenia (27.94％),hemoglobin decrease(11.76％),vomiting(8.82％) and diarrhea(1.47％).Conclusion The platinum-based combined chemotherapeutical regimens are effective with good safety in the treatment of relapsed or refractory NHL.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.

Objective To explore the mechanism underlying the protective effect of α2-macroglobulin (A2M) against glucocorticoid-induced femoral head necrosis. Methods In a human umbilical vein endothelial cell (HUVEC) model with injuries induced by gradient concentrations of dexamethasone (DEX;10-8-10-5 mol/L), the protective effects of A2M at 0.05 and 0.1 mg/mL were assessed by examining the changes in cell viability, migration, and capacity of angiogenesis using CCK-8 assay, Transwell and scratch healing assays and angiogenesis assay. The expressions of CD31 and VEGF-A proteins in the treated cells were detected using Western blotting. In BALB/c mouse models of avascular necrosis of the femoral head induced by intramuscular injections of methylprednisolone, the effects of intervention with A2M on femoral trabecular structure, histopathological characteristics, and CD31 expression were examined with Micro-CT, HE staining and immunohistochemical staining. Results In cultured HUVECs, DEX treatment significantly reduced cell viability, migration and angiogenic ability in a concentration- and time-dependent manner (P<0.05), and these changes were obviously reversed by treatment with A2M in positive correlation with A2M concentration (P<0.05). DEX significantly reduced the expression of CD31 and VEGF-A proteins in HUVECs, while treatment with A2M restored CD31 and VEGF-A expressions in the cells (P<0.05). The mouse models of femoral head necrosis showed obvious trabecular damages in the femoral head, where a large number of empty lacunae and hypertrophic fat cells could be seen and CD31 expression was significantly decreased (P<0.05). A2M treatment of the mouse models significantly improved trabecular damages, maintained normal bone tissue structures, and increased CD31 expression in the femoral head (P<0.05). Conclusion A2M promotes proliferation, migration, and angiogenesis of DEX-treated HUVECs and alleviates methylprednisolone-induced femoral head necrosis by improving microcirculation damages and maintaining microcirculation stability in the femoral head.