Interleukin-6(IL-6)is associated with cancer staging, survival, apoptosis and the sensitivity to chemotherapeutic drugs, and it is overexpressed in the cancer tissue and serum of cancer patient.IL-6 Can regulate proliferation and differentiation of cancer cells through IL-6/STAT3 signaling pathway. Therefore, blocking IL-6/STAT3 signaling pathway has potential therapeutic implications for cancer.

Objective To investigate the feasibility of a single-stage operation in the treatment of traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone. Methods Forty-one cases using one single-stage operation in the treatment of traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone were cured, osteomyelitis recurred in 2 cases, and was cured after debridement and vancomycin-impreganted artificial bone plantation again. 1 case occurred nonunion and was cured by autogenous nonvascular iliac bone transplantation. Results All cases were followed from 4 months to 2 years, the average fracture cured time was 5.3 months(3-9 months), and the average wound cured time was 3.7 weeks. The soft tissue defect was cured in one stage, the osteomyelitis of all cases was cured at last. Conclusion It is feasible that one single-stage operation treated the traumatic osteomyelitis with flap and vancomycin-impreganted artificial bone.

Objective To investigate the clinical efficiency of perforator pedicled propeller flaps for soft-tissue coverage of the lower leg and foot defects.Methods From July 2007 to December 2011,twentyfive cases with soft-tissue defects of the lower leg and foot were cured by using the perforator propeller flaps.The origins of the perforator were 18 cases from peroneal artery,six cases from posterior tibial artery and 1 case from dorsal foot artery.The minimum of the flap scale was 4-9 cm,and the maximum was 10-33 cm.Results All cases were followed-up from 1 to 26 months.All the flap pedicles were smooth with a satisfied appearance.The donor sites were sutured directly in 9 cases and cured with skin-grafting in 16 cases.Three cases suffered from vein congestion,two cases were cured by incisions in the distal parts of the flaps,one flap had necrosis of the distal 1/3 part and was cured by skin-grafting.Conclusion The perforator pedicled propeller flap is a simple,safe and useful flap.It has more advantages than other pedicled flaps for softtissue coverage of the lower leg and foot defects.

OBJECTIVE: To optimize the formula and preparation technology of gel-matrix sustained release tablet of nicotinic acid(GSTNA).METHODS: The formula of GSTNA was optimized by orthogonal experiment with the amount of hydrophilic gel-matrix material HPMC(K15M,E15-LV) and that of adjuvant calcium hydrogen phosphate(CHP) as factors and with the in vitro release rates as index.Meanwhile,the verification test on the intra-and inter-batch release rates of the samples was performed.RESULTS: The optimum formula could be seen as follows: the ratios of HPMC(K15M,E15-LV) and CHP were 4%,40% and 25% respectively.The GSTNA prepared in this formula achieved a sustained drug release of up to 12 h,and both the intra-batch homogenicity and the inter-batch reproducibility were satisfactory.CONCLUSION: The GSTNA is reasonable in formula and simple in preparation technology.

Objective To investigate the effect of Mycobacterium vaccae vaccine combined with chemotherapy on immune function in treatment of children with pulmonary tuberculosis.Methods 89 cases with pulmonary tuberculosis from December 2010 to December 2013 treated in three hospitals in xinxiang city were randomly divided into control group and observation group.The control group was given regular chemotherapy,the observation group was given chemotherapy combined with Mycobacterium vaccae vaccine therapy.CD4 +,CD8 +,CD8 +/CD4 +and CD16 +CD56 +in peripheral blood were evaluated by FCM before and after treatment.Serum TNF- αand IL-10 levels were detected by the method of ELISA.Taking 3 sputum samples (night sputum,morning sputum and sputum at moment)of each patient to smear after treatment.Results Before treatment,there was no significant difference of each index between two groups.After treatment,CD4 +,CD4 +/CD8 +and CD16 +CD56 +in the observation group were significantly higher than that before treatment and the control group(P<0.05).The proportion of CD8 +in two groups was significantly lower than before treatment(P<0.05),the difference between groups was not statistically significant.Serum TNF- αand IL-10 levels decreased significantly in two groups than those before treatment and the control group(P<0.05).After treatment,the negative conversion rate in the control group was 90.9%(n=40),while 100%(n=45)in the observation group.The difference between two groups was statistically significant(P<0.05).Conclusion Mycobacterium vaccae vaccine combined with chemotherapy has a significant effect on children with pulmonary tuberculosis.It could significantly improve the immune function of children.

Objective To study the effects of siltuximab on the interleukin-6 (IL-6)/signal transducer and activator of transcription 3 (Stat3) signaling pathway in ovarian epithelial carcinoma.Methods (1) Expressions of IL-6 in ovarian cancer patient specimens were assessed by immunohistochemistry.(2) Expression of phosphorylation Stat3 (pStat3) protein in siltuximab and IL-6 treated SKOV3 cell lines was determined by western blot, and expression levels of Stat3-induced bcl-XL,MCL-1, survivin, in siltuximab treated SKOV3/TR and CAOV3/TR cells lines were also determined by western blot.(3) Real-time image analysis was used to study the nuclear translocation of pEGFP-Stat3 fusion protein in ovarian cancer cell line SKOV3-pEGFP-Stat3 treated with siltuximab and IL-6.(4)Paclitaxel sensitivity in siltuximab treated SKOV3/TR and CAOV3/TR cell lines were assessed using the methyl thiazolyl tetrazolium (MTT).The 50% inhibiting concentration ( IC50 ) was defined as the paclitaxel concentration required to decrease the A490 value to 50%.Results ( 1 ) There were significantly difference in IL-6 staining density and the positive rate of IL-6 protein stained among the metastatic, and drug-resistant recurrent tumors,and matched primary tumors [69%(18/26)] vs.77% (20/26)vs.23% (6/26), P＜0.05].(2)A clear increase in Stat3 phosphorylation levels was observed in the IL-6-treated SKOV3 cell lines as compared to the SKOV3 cell lines.When the IL-6-treated SKOV3 cells were incubated with siltuximab with a range of concentrations of 0.001,0.01,0.1, 1.0 and 10 μg/ml, there were trends toward reduced pStat3 expression in the treated cell lines.Compared without treatment with siltuximab, the expression of the anti-apoptotic proteins MCL-1, bcl-XL and survivin in SKOV3/TR and CAOV3/TR cell lines were significantly decreased after treated with siltuximab.(3) In resting cells, the majority of pEGFPStat3 was cytoplasmic until the addition of human IL-6, which promptly induced the translocation of fluorescent Stat3 molecules to the nucleus.Exposure of cells to siltuximab with a range of concentrations of 0.001, 0.01,0.1, 1.0 and 10 μg/ml, followed by an incubation in IL-6 significantly reduced pEGFP-Stat3 nucleocytoplasmic translocation.(4) MTT cytotoxicity assay demonstrated that siltuximab increased paclitaxel-induced cell death and partially overcame paclitaxel resistance.Treated with siltuximab ( 1 and 10 μg/ml) ,the paclitaxel IC50 value of siltuximab in SKOV3/TR (0.49, 0.19 μg/ml) and CAOV3/TR (0.0010, 0.0008 μg/ml) cells were significantly lower than those in untreated cells (0.71,0.0021 μg/ml;all P ＜ 0.05).Conclusions These results demonstrated that siltuximab effectively block the IL-6 signaling pathways, which .Blockage of IL-6 signaling may provide benefits for the treatment of ovarian cancer.

Objective:This study aims to investigate the protein expression of coxsackie-virus and adenovirus receptor (CAR) in partial subtypes of pulmonary adeno-carcinoma, as well as its expression with clinico-pathological factors and prognosis. Methods:CAR expression was immunohistochemically assessed in 137 cases of lung cancer with bronchiole-alveolar carcinoma (PWBF) fea-tures, and analyzed in relation to various clinico-pathological parameters. All data were analyzed using SPSS statistics software, and Ka-plan-Meier survival curves were constructed. A Log-rank test was also conducted. Results: The CAR positive rates in PWBF, other types of lung cancer, and normal lung tissue were 71.5%, 50.0%, and 13.3%, respectively. The difference was statistically significant (P<0.05). In addition, a statistically significant difference was observed between the positive expression of CAR and other clini-co-pathologic parameters, such as pathological type and histological differentiation. No statistical significance was observed in other pa-rameters, such as gender, age, smoking, and tumor diameter. Patients with CAR positivity were characterized by longer survival times than the others;however, this difference did not reach statistical significance. Conclusion:CAR is related to the occurrence and devel-opment of lung cancer, especially PWBF. The higher expression of CAR in PWBF for gene therapy with adenovirus vectors opened a broader space. The conspicuous regulation of CAR may be reliable evidence and may bright future for the gene therapy of other types of lung cancer.

Objective To explore the long-time clinical results and effection of free anterolateral thigh musculocutaneous flap for repairing the complex defects involving lateral or medial malleolar of the ankle and heel,especially for reconstructing stability of the ankle joints. Methods Thirteen patients with complex tissue defects,involving lateral or medial malleolar of the ankle and heel,were treated by free anterolateral thigh fasciomusculocutaneous flap.The fascia lata which was involved in the flap was fixed with the adjacent tissue of the recipient area.The descending branches of the lateral circumflex femoral vessels were anastomosed with the vessels in the recipient area.The largest area of the flap was 20 cm × 12 cm.The ankle joint was fixed in functional position with plaster in the early 3 months post-operatively.The following time ranged from 1.5 years to 20 years.The stability of the ankle joint were evatuated with the patients' objective feeling and clinical symptoms and imaging study.Results The stability of the ankle should be protected by external fixation in the early 3 months postoperatively,and was restored at 6 months usually.In all cases,ten cases were followed over 10 years,six cases were followed over 6 years,three cases were followed over 15 years.Though radiological discovering suggesting traumatic esteoarthritis exited in 3 cases with a follow-up more than 5 years,the clinical manifestations were fair and no one need undergo arthredesis. Conclusion Using ant erolateral thigh musculocutaneous flap for reconstructing the complex defects involving lateral or medial malleolar of the ankle and heel repairing stability of the joint and ovoiding off early arthrodosis of the joint is one of the favorable choice,especially for the teen-agers.

Objective To analyze the reason of post-operative infection of tibial plateau fracture, the therapeutic effect of using pedicle musculocutaneous flaps of proximal leg was researched and summarized. Methods There were 52 patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis from January 2005 to May 2009. After pre-operative physical examination, laboratory examination, X-ray, CT scan and bacterial culture of the secretion,the operation, such as debridement, dead bone moving, medullary cavity cleaning, transferring to the external fixation when the internal fixation lost efficacy and bacterial culture of granulation tissue of different levels. The cavity was filled with RBK combined with vancomycin or tobramycin. If the cavity was rather large, autografts from the iliac bone were combined. The tissue defects were covered with pedicle musculocutaneous flaps of proximal leg, and the wound had effective drainage. The antibiotic was used for 3-4 weeks, and the X-rays were given at fixed period until the fracture was cured. Results The soft tissue defects of all 52 patients were repaired well. They were followed from 1 year to 5 years, and the time of bone union ranged from 4 months to 1 year. Two patients of osteomyelitis had a relapse after 3,4 months, then they were cured by the second operation. Three patients had unhealed fracture after 6 months, then they were cured by bone grafting again after 4-6 months. Conclusion Patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis should be cured by comprehensive treatments, one of the crucial treatment for success is using pedicle musculocutaneous flaps of proximal leg to fill in lacuna, close wound, improve the local blood supply and promote bone union.

Objective To summary and discuss the curative effect and experience of repairing serious and complicated soft tissue defects of traumatic shank by flap or musculocutaneous flap by anatomosis.MethodsFrom October 2009 to December 2011, the wounds of 59 patients suffering from serious and complicated soft tissue defects of traumatic shank were covered by VSD after repeated debridement,when the conditions of the whole bodies were stable and the local acute infection was controlled in the main. Fifty-six patients were repaired by a single flap or musculocutaneous flap attributing to the fresh granulation, three patients were repaired by compound tissue flaps because a single flap was insufficient. Five patients who had no available blood vessels at recipient site were repaired by flaps with bridge cross vascular anatomosis. The compound flaps were no more than 2 pieces, the maximum area of flap was 32 cm × 13 cm, the minimum was 15 cm × 8 cm.Results The flaps of all of 59 cases survived, fifty-seven cases were healed in one stage, two in two stage, one case had complication of infection at donate site due to the hematocele, and was cured by debridement and skin graft. Serious and complicated soft tissue defects of shanks were repaired by reconstruction,damaged limbs were salvaged,the functions of the legs were reserved. Conclusion It is the most effective and irreplaceable way that using flaps and musculocutaneous flaps,by anatomosis with the microsurgery technique, repairs the serious and complicated soft tissue defects of shank, which can shorten course and salvage the damaged limbs.