Objective To discuss the clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy.Methods Forty-eight cases with ankle osteoarthritis patients admitted at the Orthopaedic Hospital of Zhengzhou from January 2012 to June 2014 were selected and all of them were given the treatment of focal cleaning under arthroscopy.The clinical effect of surgical treatment were judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system respectively.Results At the time of the last follow-up,modified McGuire ankle rating system((85.64±16.52)points vs.(52.46±10.25)points,t=-8.465),the United States after ankle surgery AOFAS ankle-full score [(85.24±11.46)points vs.(53.68±9.48)points,t=-7.548)and Mazur ankle rating system((86.45±12.57)points vs.(58.49±8.64)points,t=-6.596)all increased than that of pre-operation,the differences were statistically significant(P＜0.05).The modified McGuire ankle rating system of patients with low-grade lesion at pre-operation((62.45±7.63)points vs.(49.58±6.35)points,t=3.685)and the time of the last follow-up((93.68±11.54)points vs.(68.54±9.68)points,t=8.695)were all higher than that of patients with high-grade lesion,the differences were statistically significant(P＜0.05).The clinical effect of surgical treatment judged by modified McGuire ankle rating system,the United States after ankle surgery AOFAS ankle-full score and Mazur ankle rating system were respectively 91.67％(44/48),89.58％(43/48)and 89.58％(43/48),the differences were no statistically significant(x2=0.824,P＞0.05).Conclusion The clinical effect of surgical treatment for ankle osteoarthritis under arthroscopy is remarkable and it causes light damage to the body.It is especially suitable for patients with low-grade lesions and is worth popularization and application.

OBJECTIVE: To summarize the clinical effect of TPF regimen in the treatment of hypopharyngeal carcinoma and explore various clinical factors affecting treatment efficacy. METHOD: The clinical data of 20 cases with hypopharyngeal carcinoma, who received TPF treatment, were analyzed retrospectively. After two courses of chemotherapy, based on radiographic outcomes, next treatment plan was developed. To sum up the clinical information, including the clinical type, patterns of tumor growth, pathologic type, tumor stage, lymph node metastasis, age and so on. To analyze possible influencing factors affecting curative effect. RESULT: (1) After 20 cases with hypopharyngeal carcinoma received two courses of TPF treatment, the effect was evaluated. Objective response rate was 65%. (2) In patients with hypopharyngeal carcinoma, the efficacy of TPF therapy was significantly related to the clinical type, patterns of tumor growth and pathologic type; there was no statistical significance in tumor stage, lymph node metastasis and age. CONCLUSION According to the clinical type, patterns of tumor growth and pathologic type of hypopharyngeal carcinoma, resistance to chemotherapy in hypopharyngeal carcinoma can be assessed, which provides important basis for designing individualized treatment plan.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome

Objective:To investigate the correlation between endothelial dysfunction and cardiomyocyte apoptosis during myocardial ischemia-reperfusion.Methods:A total of 63 male rats were selected to establish the rat model of myocardial ischemia-reperfusion by the ligation of the left anterior descending(LAD)coronary artery to simulate myocardial ischemia.Rats were divided into the control group and group Ⅰb, group Ⅰa, group Ⅱb, group Ⅱa, group Ⅲb and group Ⅲa.Control rats were treated only with LAD threading without ligation.In observation group, at 30, 90, 120 min after LAD ligation(marked as Ⅰ, Ⅱ, Ⅲ group respectively), loosen the ligation to simulate ischemia-reperfusion.In the observation group, captopril sublingual injection of 0.25 mg/kg before ligation were marked as group b, and as group a with no captopril injection.The circulating endothelial cells(CEC), endothelin(ET), nitric oxide(NO)and the apoptosis rate of cardiomyocytes in each group were measured.Results:The CEC and ET levels showed a continuous upward trend, and a NO level showed a continuous downward trend from group Ⅰa to Ⅱa to Ⅲa as compared with the control group( P<0.05). After using preventive intervention of captopril, the CEC and ET levels were lower and NO levels were higher in group Ⅱb and Ⅲb than in group Ⅱa and Ⅲa, respectively( P<0.05). The apoptotic rate of cardiomyocytes was higher in group Ⅰa than in the control group, and the apoptotic rate from high to low were from group Ⅲa[(235.71±40.25)%]to group Ⅱa[(197.28±43.56)%]to group Ⅰa[(138.55±32.87)%]and to the control group[(5.81±2.02)%]( P<0.05). The apoptotic rate of cardiomyocytes was lower in group Ⅱb[(125.67±26.51)%]and Ⅲb[(124.91±33.28)%]than in group Ⅱa and Ⅲa, respectively( P<0.05). Conclusions:The ischemia-reperfusion can cause endothelial dysfunction and the apoptosis of cardiomyocytes, and there is a close relationship between the degree of this lesions and the duration of ischemia-reperfusion.While, the appropriate application of angiotensin converting enzyme inhibitor can inhibit the damage of cardiomyocytes to a some extent.

Objective To systematically compare the efficacy of three-dimensional conformal radiotherapy (3D-CRT) versus intensity-modulated radiotherapy (IMRT) in the treatment of prostate cancer (PCa).Methods Clinical comparative studies of IMRT and 3D-CRT in the treatment of PCa were collected from PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang Data after two independent researchers developed the strategy and inclusion and exclusion criteria for the literature search.Articles published up to February 2017 were searched for, and the languages of publications were restricted to English and Chinese.Clinical meta-analysis of the data from the relevant studies was performed using the RevMan5.3 software.Results A total of 15 relevant retrospective cohort studies were collected from the databases in strict accordance to the search strategy and inclusion and excluding criteria.There were 4608 PCa patients, including 2229 in the IMRT group and 2379 in the 3D-CRT group.IMRT and 3D-CRT had similar adverse effects in terms of early-stage (odds ratio[OR]=0.77, 95% confidence interval[CI]:0.43-1.40, P=0.390) and late-stage (OR=0.75, 95%CI:0.55-1.04, P=0.080) urinary tract injury.However, IMRT led to reduced early-stage (OR=0.47, 95%CI:0.27-0.82, P=0.008) and late-stage (OR=0.52, 95%CI:0.35-0.78, P=0.001) intestinal injury compared with 3D-CRT.Meanwhile, the biochemical recurrence-free survival rate was also significantly higher in the IMRT group than in the 3D-CRT group (OR=1.87, 95%CI:1.51-2.32, P=0.000).Conclusions IMRT is more protective against intestinal injury with a higher biochemical recurrence-free survival rate compared with 3D-CRT during the treatment of PCa.

Objective To evaluate the feasibility , safety, therapeutic effects and adverse reactions of CT-guided radiofrequency ablation (RFA)for adrenocortical adenoma with Cushing's syndrome.Methods From Jan.2009 to Dec.2013, 24 patients with 24 tumors diagnosed as adrenocortical adenoma with Cushing's syn-drome received CT-guided percutaneous RFA.The average tumor size was(2.1 ±0.7)cm(ranging from 1.1 to 3.9 cm) .RFA was performed under real-time computed tomography guidance .Technical success was defined as disappearance of tumor enhancement on contrast CT imaging 1 week after RFA .Clinical success was defined as improvement in serum cortisol, adreno-cortico-tropic-hormone(ACTH)and symptoms within the follow-up.Patho-logical diagnosis was acquired through the needle biopsy after RFA procedure .Results RFA was technically successful in all the 24 patients.No conversion occured.During operation, patients suffered blood pressure fluc-tuation but no one experienced a hypertensive crisis .Mild postoperative lumbar pain occurred in 6 patients . Tumor enhancement disappeared in CT scan .The mean follow-up was 18 months, ranging from 3 to 36 months. Both serum cortisol and ACTH basically returned to normal levels , and the symptoms related to Cushing's syn-drome gradually disappeared .No severe complications occurred during this procedure .Histopathology results showed all were adrenal cortical adenomas .No serious complication occurred to any patient during RFA .Conclu-sion CT-guided RFA for adrenocortical adenoma with Cushing's syndrome is a feasible , safe, effective and mini-mally invasive treatment with few complications .

Objective To evaluate the effects of 'patch-skill'in the management of refractory bleeding during the process of open heart surgery.Methods Between May 2007 to Oetober 2008,7 patients undergoing open-heart surgery experienced active bleeding.Autologous perieardial patches were used in 6 patients, and polyester patch in the other one.The patches were sutured continuously by 5-0 Prolene suture.Results The 24 hour chest tube output was less than 500 ml in all 7 cases after operation.There were no death, secondly active bleeding,or mediastinal in-faction.Conclusion The'patch-skill' can effectively control the refractory bleeding during open heart surgery.Au-tologous perieardial patehe is the first choice because it has multiple advantages.The polyester patch ean be used al-ternatively when autologous pereardiurn cannot be used (for various reasons such as edema and infection).

NONMEM

The purpose of this study was to investigate the effects of porcine interleukin (IL)-2 and IL-4 genes on enhancing the immunogenicity of a porcine reproductive and respiratory syndrome virus ORF5 DNA vaccine in piglets. Eukaryotic expression plasmids pcDNA-ORF5, pcDNA-IL-2, and pcDNA-IL-4 were constructed and then expressed in Marc-145 cells. The effects of these genes were detected using an indirect immunofluorescent assay and reverse transcription polymerase chain reaction (RT-PCR). Characteristic fluorescence was observed at different times after pcDNA-ORF5 was expressed in the Marc-145 cells, and PCR products corresponding to ORF5, IL-2, and IL-4 genes were detected at 48 h. Based on these data, healthy piglets were injected intramuscularly with different combinations of the purified plasmids: pcDNA-ORF5 alone, pcDNA-ORF5 + pcDNA-IL-2, pcDNA-ORF5 + pcDNA-IL-4, and pcDNA-ORF5 + pcDNAIL-4 + pcDNA-IL-2. The ensuing humoral immune responses, percentages of CD4+ and CD8+ T lymphocytes, proliferation indices, and interferon-gamma expression were analyzed. Results revealed that the piglets co-immunized with pcDNA-ORF5 + pcDNA-IL-4 + pcDNA-IL-2 plasmids developed significantly higher antibody titers and neutralizing antibody levels, had significantly increased levels of specific T lymphocyte proliferation, elevated percentages of CD4+ and CD8+ T lymphocytes, and significantly higher IFN-gamma production than the other inoculated pigs (p < 0.05).
Animals ; Cell Line ; Escherichia coli/genetics ; Haplorhini ; Immunity, Cellular ; Interleukin-2/genetics/*metabolism ; Interleukin-4/genetics/*metabolism ; Neutralization Tests/veterinary ; Plasmids ; Porcine Reproductive and Respiratory Syndrome/*prevention & control ; Porcine respiratory and reproductive syndrome virus/*immunology ; Recombinant Proteins/genetics/metabolism ; Swine ; Vaccines, DNA/immunology ; Viral Envelope Proteins/*genetics/metabolism ; Viral Vaccines/*immunology

Objective:To investigate the expression of p21-activated kinase 2 (PAK2) in laryngeal squamous cell carcinoma and its relationship with the clinicopathological characteristics and chemosensitivity of patients.Methods:Transcriptome sequencing (RNA-seq) data for laryngeal squamous cell carcinoma were downloaded from the Cancer Genome Atlas (TCGA) database, and 123 patients were included in the study (12 cases had cancer tissues and normal tissues data, and the remaining 111 only had cancer tissues data). Differential expression of PAK2 in cancer and para-cancer tissues was analyzed by using R software, and the potential function of PAK2 in laryngeal squamous cell carcinoma was investigated by using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database signaling pathway enrichment. A total of 34 patients with primary laryngeal squamous cell carcinoma tissues and corresponding para-carcinoma 34 tissue specimens who underwent surgical resection were retrospectively selected from Chaoyang Central Hospital between April 2016 and June 2021, and 20 cases of normal laryngeal mucosa tissues were selected as the controls. Immunohistochemistry was used to detect the expression of PAK2 in various tissues, and its correlation with clinicopathological factors was analyzed. A total of 35 supraglottic primary laryngeal squamous cell carcinoma patients were retrospectively collected before induction chemotherapy during the same period, including 20 patients sensitive to chemotherapy and 15 patients resistant to chemotherapy. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of PAK2 mRNA in cancer tissues.Results:Analysis of TCGA database data showed that PAK2 expression was increased in cancer tissues compared with that in para-cancer tissues ( P = 0.012); KEGG database signaling pathways showed that the high expression of PAK2 in laryngeal squamous cell carcinoma was related to signal transduction pathways, cell cycle, and cancer. Immunohistochemistry showed that the proportion of PAK2 positive in 34 cases of laryngeal squamous cell carcinoma tissues was higher than that in adjacent tissues and normal tissues [58.82% (20/34) vs. 0.03% (1/34), 0 (0/20), all P < 0.001]. There were statistically significant differences in the proportion of PAK2 positive patients stratified with different degrees of differentiation [high differentiation vs. low or middle differentiation: 33.33% (6/18)vs. 87.50% (14/16)], lymph node metastasis [presence vs. absence: 90.91% (10/11) vs. 43.48% (10/23)], TNM staging [stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 82.35% (14/17) vs. 35.29% (6/17)] (all P < 0.05), and PAK2 positive patients were not associated with clinical type, tumor size, smoking history, drinking history, and age (all P > 0.05). qRT-PCR showed that the relative expression level of PAK2 mRNA in the chemotherapy-resistant group was higher than that in the chemotherapy-sensitive group (3.89±0.12 vs. 0.78±0.23, P < 0.001). Conclusions:The expression level of PAK2 in laryngeal squamous cell carcinoma tissues is increased, and the high expression of PAK2 is closely related to the malignant clinical characteristics of patients with laryngeal squamous cell carcinoma. The high expression of PAK2 may indicate the insensitivity to traditional chemotherapy regimens, and PAK2 may be a potential gene that targets and regulates the chemosensitivity of laryngeal squamous cell carcinoma.

Objective To explore the risk factors and awareness level of deep vein thrombosis(DVT)in elderly outpatients in Shanghai community hospitals.Methods A total of 710 elderly outpatients were subjected with random sampling from 10 community hospitals in Shanghai.Au-tar deep vein thrombosis risk assessment scale and venous thromboembolism(VTE)self-manage-ment ability related knowledge scale were used to conduct questionnaire investigation.The influ-encing factors for risk level of DVT and for VTE self-management ability score were analyzed in these patients.Results The high-risk DVT group had significantly larger proportions of aged 65 years,primary school education or below,chronic diseases,BMI≥28 kg/m2,and suburban resi-dents than the low-risk DVT patients(88.0％vs 50.9％,65.5％vs 26.5％,94.8％vs 86.2％,12.9％vs 5.2％,58.2％vs 43.9％,P＜0.01).Multivariate logistic regression analysis showed that age,education level,chronic disease,multimorbidity,BMI and residential area were independent risk factors for risk level of DVT in the elderly outpatients in community hospitals(P＜0.05,P＜0.01).Hypertension,cerebral infarction,cerebral hemorrhage and malignant tumors were inde-pendent risk diseases of DVT in the patients with multimorbidity(P＜0.01).Age,education lev-el,chronic diseases,BMI,smoking,residential area and other factors were related to the score of VTE self-management(P＜0.05,P＜0.01).Conclusion General practitioners should pay close attention to the elderly outpatients in community hospitals,with characteristics of advanced age,obesity,lower education level,chronic disease,multimorbidity and living in suburban area,espe-cially those with multiple diseases.What's more,awareness of risk for DVT and self-management ability should be improved simultaneously.