Adolescent ; Constriction, Pathologic ; Female ; Fibromatosis, Aggressive ; complications ; pathology ; Humans ; Pharyngeal Diseases ; etiology ; pathology

OBJECTIVETo figure out the incidence and etiology of knee extension limitation and then to find out the proper methods of arthroscopic assisted diagnosis and treatment.

METHODSWe reviewed 303 cases of arthroscopic assisted operation from January to October 2003, 95 cases of which suffered from knee extension limitation before operation, including 54 male and 41female and the mean age was 36.2 years old. The direct reasons of knee extension limitation were identified by routine arthroscopic examination and operations were carried out according to results of the examination.

RESULTSIncidence of knee extension limitation in this group of patients was 31.4%. Trauma, mainly meniscus and ligament injury accounted for 67.4%, which was the most common reason of knee extension limitation. Acute or chronic arthritis like degenerative arthritis, non-specific synovitis, synovial chondromatosis, rheumatoid arthritis, pigmented villonodular synovitis, gouty arthritis and acute pyogenic arthritis formed another common reason. The follow-up period ranged from 3 to 20 months, average 13.3 months. 82 cases gained full extension immediately after operation, 9 cases gained full extension after 3 weeks rehabilitation post-operation, 4 cases did not gain full extension 1 year after operation, recurrence was observed in 4 cases.

CONCLUSIONSArthroscopy is the best method for diagnosis of knee extension limitation at present. Satisfactory results can be expected after early arthroscopic assisted treatment.

Adolescent ; Adult ; Ankylosis ; diagnosis ; etiology ; surgery ; Arthroscopy ; Child ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the osteogenic potential of the nano-hydroxyapatite/collagen/calcium alginate composite implanted in animals.

METHODSEighteen 3-month-old New Zealand white rabbits were adopted to prepare 15 mm segmental defect model at the middle part of radius. Rabbit models were randomly divided into experimental group and blank control group. Nano-hydroxyapatite/collagen/calcium alginate was implanted into the defects of experimental group. Four, 8, and 12 weeks after operation, all specimens were examined by X-ray and histological methods.

RESULTSAll the 18 rabbit models entered the final analysis. X-ray showed that osteotylus was seen in the whole defect area in the experimental group 12 weeks after operation, during which osteogenesis was more obvious than in weeks 4 and 8 and the bridge grafting of defect area was obviously visible. In the blank control group, osteotylus was only observed at the two ends of the defects, and no osteogenesis was found in the central part of the defect area. Histological examination showed that new osteoid formation was seen in internal porous zone in the experimental group in weeks 4 and 8; in week 12, more woven bone-like tissues were visible and trabecular-like structure was formed.

CONCLUSIONThe nano-hydroxyapatite/ collagen/calcium alginate has good osteogenic potential.

Alginates ; chemistry ; Animals ; Collagen ; chemistry ; Durapatite ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Osteogenesis ; Rabbits ; Radius ; anatomy & histology ; Tissue Engineering ; Wound Healing

OBJECTIVETo explore the method to obtain good aesthetic and functional results in surgical management of craniomaxillofacial fibrous dysplasia and correct the grotesque deformity.

METHODSAccording to the type of the lesions, different excision and reconstruction methods were used.

RESULTS19 cases (4 monostotic cases and 15 polyostotic cases) were surgically treated. The period of follow-up range from 9 months to 5 years, all patients obtained satisfactory aesthetic and functional results. No relapse happened during follow up.

CONCLUSIONSBased on modern craniomaxillofacial techniques and computer aided design, extensive radical excision and craniomaxillofacial skeleton reconstruction could be safely accomplished, and the better results were obtained, both aestheticly and functionally.

Adolescent ; Adult ; Bone Transplantation ; Child ; Computer-Aided Design ; Craniofacial Abnormalities ; surgery ; Facial Bones ; Female ; Fibrous Dysplasia of Bone ; surgery ; Follow-Up Studies ; Humans ; Male ; Reconstructive Surgical Procedures ; Skull ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the related factors of portal vein tumor thrombosis (PVTT) in patients with HCC.

METHODSA total number of 234 patients with hepatocellular carcinoma (HCC) were included in this retrospective study. Uni-variate and multi-variate logistic regression analysis were employed to analyze the association between PVTT and 18 routine clinical parameters.

RESULTSAmong the 234 patients with HCC, 15% of patients (35/235) had PVTT. Univariate logistic regression analysis revealed significant association of age (P = 0.016), gamma glutamyl transferase (GGT, P = 0.003), number of segmental invasion (P = 0.007), microvascular invasion (P < 0.01), segment location of S2 (P = 0.001), S3 (P = 0.000), S4 (P = 0.004) and S6 (P = 0.016). Multivariate analysis shows potential significant predictors of PVTT in HCC were age (RR: 0.373; 95% CI: 0.146-0.954; P = 0.040), the tumor location of S3 (RR: 4.625; 95% CI: 1.916-11. 165;P = 0.001), GGT (RR: 4.091; 95% CI: 1.448-11.553; P = 0.008) and microvascular invasion (RR: 20.912; 95% CI: 4.745-92.172; P < 0.01).

CONCLUSIONSPVTT occurred more commonly in the younger (< 50 years old), and those with high level of GGT, segment location of S3 and microvascular invasion.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; pathology ; Child ; Embolism ; etiology ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; pathology ; Logistic Models ; Male ; Middle Aged ; Portal Vein ; Retrospective Studies ; Risk Factors

Biopsy ; methods ; standards ; Chronic Disease ; Humans ; Liver ; pathology ; Liver Diseases ; diagnosis ; pathology ; Quality Control

OBJECTIVETo investigate if a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) gene would inhibit the growth of hepatocellular carcinoma (HCC) in vivo.

METHODSUsing the recombinant adenoviral vector carrying antisense MMP2 gene (Ad-MMP2AS) which was constructed by us previously, to infect the human HCC cell line (Bel-7402). Then the invasiveness of the Bel-7402 cells was assayed in Matrigel, and the production of MMP2 in the Bel-7402 cells was detected with Western blotting analysis and Gelatin zymography. Then the Ad-MMP2AS-infected cells were subcutaneously inoculated in nude mice. After tumors developed, Ad-MMP2AS was injected intratumorally into pre-existing tumors. The tumors were removed, sectioned, and stained with H E.

RESULTSCompared with PBS or Ad-CMV-infected cells, the infected Bel-7402 cells with Ad-MMP2AS injections significantly reduced their MMP2 enzyme activity and invasiveness about 52.05% in Matrigel assays, and the tumor volumes in nude mice resulted in a 3.3-fold reduction. In addition, direct intratumoral injection of Ad-MMP2AS into pre-existing tumors significantly prevented further expansion of the tumor masses and resulted in a 63.06% reduction in tumor cell growth.

CONCLUSIONThe recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and growth of Bel-7402 cells in vitro and in vivo, and it has a therapeutic potential for HCC.

Adenoviridae ; genetics ; Animals ; Carcinoma, Hepatocellular ; pathology ; Gene Transfer Techniques ; Genetic Vectors ; genetics ; Humans ; Liver Neoplasms, Experimental ; pathology ; Male ; Matrix Metalloproteinase 2 ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Oligonucleotides, Antisense ; genetics ; Recombinant Proteins ; genetics ; Tumor Cells, Cultured

OBJECTIVESTo construct a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) and to study its inhibitory effects on the invasiveness and migratory capacity of hepatocellular carcinoma (HCC) cell line HepG2 in vitro.

METHODSTotal RNA was extracted from HCC. Then a 500 bp fragment at the 5' end of the human MMP2 cDNA sequence was synthesized by polymerase chain reaction (PCR) and was reversely inserted into the multiclone site (MCS) of the shuttle plasmid pAdTrack-CMV. With the resultant plasmid and the backbone plasmid pAdEasy-1, the homologous recombination took place in the E.coli BJ5183 and the recombinant adenoviral plasmid carrying the antisense MMP2 gene was constructed. The adenovirus (Ad-MMP2AS) was packaged and amplified in the HEK 293 cells and the viral titer was checked by GFP. Using the Boyden chamber model, the influence of Ad-MMP2AS on the invasion ability of HepG2 cells was determined in vitro.

RESULTSThe recombinant adenovirus vector carrying antisense MMP2 was constructed successfully and a strong green fluorescence was observed in HepG2 cells under a fluorescence microscope. The viral titer was 1 x 10(8); Ad-MMP2AS can effectively inhibit the penetrating capacity of HepG2 cells through Matrigel in vitro.

CONCLUSIONThe recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and migratory capacity of HepG2 in vitro and may have potential in treating HCC.

Adenoviridae ; genetics ; Carcinoma, Hepatocellular ; pathology ; Genetic Vectors ; Humans ; Liver Neoplasms ; pathology ; Matrix Metalloproteinase 2 ; biosynthesis ; genetics ; pharmacology ; Neoplasm Invasiveness ; Oligonucleotides, Antisense ; biosynthesis ; genetics ; pharmacology ; RNA, Antisense ; genetics ; pharmacology ; Recombinant Proteins ; biosynthesis ; genetics ; pharmacology ; Tumor Cells, Cultured

OBJECTIVETo investigate the feasibility of the classification of the spino-pelvic sagittal alignment in adluts according to lumbar lordosis (LL) and inflection point (IP).

METHODSWhole spine, standing radiographs of 223 adult volunteers were taken from July to August in 2011 .There were 111 cases(56 female and 55 male) enrolled in the study based on the inclusion criteria. The pelvic and spinal parameters, including thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), LL, sacral slope(SS), pelvic tilt(PT), pelvic incidence(PI), intervertebral endplate angle, sagittal vertical axis (SVA), spino-sacral angle (SSA) and IP were measured. The spino-pelvic sagittal alignment were classified in to 3 types according to LL and IP. Type I: LL > -40°, IP located below L2 ∼ 3; Type II: -60° ≤ LL ≤ -40°, IP located in L1 ∼ 2 or T12 ∼ L1; Type III: LL < -60°, P located above T11 ∼ 12. Pearson correlation analysis was used to test the correlation between the variables. The parameters in each type were compared by oneway-ANOVA respectively,then additional multiple comparisons were performed.

RESULTSThe mean value of LL was -49° ± 10°, TK was 36° ± 7°, TLK was 6° ± 7°, PT was 11° ± 7°, SS was 34° ± 8°, PI was 45° ± 9°, SSA was 127° ± 9° and SVA was (-2.7 ± 22.8)mm, respectively. Only LL had significant statistical correlation with all the other parameters. Negative correlation presented between LL and TK, PI, SS, SSA (r = -0.387, -0.536, -0.858, -0.801,P < 0.05). Positive correlation presented between LL and TLK, SVA, PT (r = 0.319, 0.296, 0.262, P < 0.05). All the volunteers were classified into the 3 types: Type I1 9 cases, Type II 75 cases,Type III 17 cases. Oneway-ANOVA results showed statistical difference in LL, TK, TLK, PT, SS, PI, SSA, SVA among the 3 types, (F = 164.559, 7.431, 14.099, 4.217, 53.856, 6.252, 35.995, 8.626, P < 0.05 ). Multiple comparisons showed that LL, SS, SSA, PI had statistical difference between each two types comparison (P < 0.05).

CONCLUSIONSLL is the central parameter of the spino-pelvic sagittal balance. The patterns of the spino-pelvic sagittal alignment in adults could be classified into three types, according to LL and IP. The classification could describe the morphological differences and balance of the spino-pelvic sagittal alignment.

Adult ; Analysis of Variance ; Anthropometry ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Pelvis ; anatomy & histology ; Postural Balance ; Radiography ; Spine ; anatomy & histology

BACKGROUNDImmune cells within a tumor microenvironment have shown modulatory effects on tumor angiogenic activity. Renal cell carcinoma (RCC) is a hypervascular tumor that reportedly increases the frequency of regulatory T cells (Tregs) in tumor tissues. This study investigated the correlation between Tregs infiltration and angiogenic status in RCC.

METHODSThirty-six patients with RCC were enrolled in the present study, and twenty age-matched healthy donors were included as the control. Tregs were defined as CD4(+)CD25(high)CD127(low/-) T cells. The frequency of Tregs in peripheral blood and tumor infiltrating lymphocytes (TILs) were determined by flow cytometry. The expression of vascular endothelial growth factor (VEGF) in surgical resection specimens were measured with a commercial enzyme-linked immunosorbent assay (ELISA) kit. Microvessel density (MVD) was calculated on slides stained with CD34 antibody. Spearman's rank correlation was performed to evaluate the correlation between the frequencies of Tregs in TILs and VEGF values, as well as between frequencies of Tregs and MVD determinations.

RESULTSCompared to healthy controls, the frequency of peripheral blood Tregs was significantly increased in patients with RCC (P < 0.05). The percentage of tumor-infiltrating Tregs was higher than that of peripheral blood Tregs in patients with RCC (P < 0.01). In addition, the frequency of tumor-infiltrating Tregs was shown to significantly correlate with the pathological stage (P < 0.05) and nuclear grade (P < 0.01). Importantly, a significant positive correlation was observed between the frequency of tumor-infiltrating Tregs and VEGF protein expression (r = 0.51, P < 0.05), as well as between frequencies of Tregs and MVD score (r = 0.39, P < 0.05).

CONCLUSIONSThese observations suggest that the high pro-angiogenic status of RCC may be associated with the accumulation of Tregs in the local microenvironment. Angiogenesis networks may be connected with immune tolerance units and cooperate with each other to facilitate tumor growth and progression.

Adult ; Aged ; Carcinoma, Renal Cell ; immunology ; metabolism ; Cells, Cultured ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Humans ; Immunohistochemistry ; Kidney Neoplasms ; immunology ; metabolism ; Lymphocytes, Tumor-Infiltrating ; immunology ; Male ; Middle Aged ; Neovascularization, Pathologic ; immunology ; metabolism ; T-Lymphocytes, Regulatory ; immunology