OBJECTIVETo evaluate effects of arthroscopic debridement and visco supplement for the treatment of degenerative osteoarthropathy of ankle.

METHODSFrom October 2008 to May 2012, 30 patients with degenerative osteoarthropathy of ankle were treated with arthroscopy after ineffective treatment with conservative methods. Two patients lost follow-up. Among the patients, 19 patients were male and 9 patients were female, ranging in age from 28 to 56 years old, with a mean of (40.0+ 5.9)years old. Patients who had inflammatory or postinfectious arthritis,rheumatoid,gout,tuberculosis were excluded. Other exclusion criteria included previous arthroscopic treatment for ankle osteoarthropathy, intraarticular corticosteroid injection within the previous 6 months, a major neurologic deficit, serious medical illness and pregnancy. Articular cartilage iijuries were classified according to Outerbridge by the same doctor. Follow procedures were involved in the surgery: synovectomy,debridement or excision of fragments of articular cartilage or chondral flaps and osteophytes that prevented full extension. Microfracture of chondral defects was not performed. Ogilvie-Harris criteria was used to evaluate therapeutic effects.

RESULTSAccording to Ogilvie-Harris criteria, 10 patients got an excellent results, 14 good, 3 poor and 1 bad. The mean VAS score of pain decreased from preoperative 7.5+/-1.3 to postoperative 2.4+/-2.3. The score of dorsiflexion range (ROM-D) had no obvious change after operation [preoperative(27.0+/-7.3)degree and postoperative(29.0+/-5.6)degree]. The mean Tegner score increased from preoperative 2.7+/-1.3 to postoperative 5.6+/-2.2.

CONCLUSIONSynovectomy, debridement or excision of chondral flaps and osteophytes under arthroscopy, as well as scheduled intraarticular sodium hyaluronate injection should be recommened to treat ankle degenerative osteoarthropathy.

Adult ; Ankle Joint ; physiopathology ; surgery ; Arthroscopy ; methods ; Debridement ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; physiopathology ; surgery ; Range of Motion, Articular

OBJECTIVETo observe the influence of chemotherapy with FOLFOX protocol (CT-F) on sex hormones of male patients, and the protective and detoxifying effect of herbal medicines for reinforcing Shen and supplementing qi (HM) on it.

METHODSThe randomized block control and self-control design was adopted to retrospectively investigate the changes of sex hormones in 61 patients with cancer of colon, rectum or stomach. They were assigned to four groups, A: treated simply with HM; B: treated with CT-F; C: treated with CT-F combined with HM; D: the blank control group. One course of CT-F composed of 1 month treatment, and 6 courses totally were applied on each patients. The levels of luteinizing hormone (LH), estradiol (E2), prolactin (PRL), progesterone (P), testosterone (T) and follicle-stimulating hormone (FSH) were determined before treatment (T0), at the end of the 6th month treatment (T1) and the 12th month (T2) after starting treatment.

RESULTSLevels of LH, PRL and T were significantly lowered in the group B at T1, being 4.6 +/- 0.4 IU/L, 8.6 +/- 0.7 microg/L and 13.1 +/- 1.4 IU/L, respectively, which were significantly different to those in the other 3 groups at the corresponding time; they were somewhat raised after chemotherapy but still lower at T2 than those at T0, being 5.0 +/- 0.4 IU/L, 9.9 +/- 1.1 microg/L and 14.1 +/- 1.4 IU/L respectively, also lower than the corresponding levels in the other 3 Groups (P<0.05 or P<0.01). In group C, LH significantly lowered at T1 (P<0.05) to 5.1 +/- 0.4 IU/L, but it was restored to the levels of T0 and that in Group D, reaching 6.1 +/- 0.5 IU/L; while PRL and T were changed insignificantly in the chemotherapeutic course, and restored at T2 to the level of T0, comparable to that in group D. Contrarily, levels of E2 and FSH increased significantly (P <0.01) in group B after chemotherapy (at T1) to 135 +/- 14 pmol/L and 9.1 +/- 1.1 IU/L respectively, and till T2, being 140 +/- 15 pmol/L and 9.1 +/- 1.o IU/L, they were lower than those at T0 and higher than those in group D, A and C ( all P <0.01), but the two indexes were not significantly increased in group C, being 116 +/- 12 pmol/L and 7.1 +/- 0.9 IU/L at T1. However, all the parameters showed no significant change in group A and D, and the level of P showed insignificant change in all the groups in the whole observation period.

CONCLUSIONCT-F could induce multiple sex hormonal abnormalities in male patients with post-operational gastrointestinal cancer, and HM shows protective and detoxifying effects on them in different degrees.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fluorouracil ; therapeutic use ; Gastrointestinal Neoplasms ; drug therapy ; metabolism ; physiopathology ; Gonadal Steroid Hormones ; metabolism ; Humans ; Kidney ; drug effects ; physiopathology ; Leucovorin ; therapeutic use ; Male ; Middle Aged ; Organoplatinum Compounds ; therapeutic use ; Qi

OBJECTIVETo investigate histomorphological feature of silicotic nodules under Warthin-Starry (WS) silver staining and its value in the histopathological examination.

METHODSSix cases with silicosis obtained by autopsy and 21 cases with sarcoidosis were collected (among which 3 cases were obtained by autopsy and 18 cases were obtained by biopsy). The serial sections of those paraffin embedded samples were applied respectively for (1) hematoxylin and eosin (HE) staining, (2) WS staining, (3) streptomyces avidin-peroxidase (SP) immunohistochemical staining for mouse anti-human CD68 monoclonal antibody, (4) observing under transmission electron microscope (TEM), (5) X-ray spectrum chemical element analysis(X-RSA). The emphasis of observation and analysis were the dust particles in silicotic nodules and granulomas cells (dust cells, epithelioid cells and multinucleated giant cells in the granulomas). The dust particles deposit in the granulomas were graded under the HE and WS staining.

RESULTSUnder the HE staining the dust particles deposit degrees were (+++) in cellular silicotic nodules, (+) in the fibrous ones, and (-) in the sarcoid nodules; under the WS staining and the dust particles deposit degrees were (+++) in both silicotic nodules whose dust particles were characteristically black, and (+/++) in sarcoid nodules. The dust particles deposit degrees in silicotic nodules were markedly higher than those in sarcoidosis (P < 0.01). The results of immunohistochemical staining indicated that the expression of CD68 in both cells of silicotic nodules and sarcoid nodules were positive. The positive degrees decreased successively with the content of the dust particles. The dust particles of silicotic nodules could be more readily observed than those of sarcoidosis in size and electronic density under TEM. The results of X-RSA indicated that the main chemical element in both dust particles was silicon.

CONCLUSIONWS staining is better than HE staining in showing the dust particles of silicotic nodules, which appear characteristically black, especially in the fibrous ones. Together the TEM observation and X-RSA, the silicotic nodules may be prompted.

Aged ; Aged, 80 and over ; Female ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Silicosis ; pathology ; Silver Staining ; methods

OBJECTIVETo investigate the impact of preoperative radiochemotherapy on postoperative complications in patients with mid-low rectal carcinomas.

METHODSClinicopathologic data of T3 and T4 patients with mid-low rectal carcinomas in the Department of Colorectal Surgery at the Changhai Hospital of The Second Military Medical University from January 2009 to December 2010 were analyzed retrospectively. This cohort included 81 patients treated with preoperative radiochemotherapy followed by operation(radiochemotherapy group) and 93 cases who underwent surgery alone(control group).

RESULTSBoth resection rate and sphincter preservation rate were higher in the radiochemotherapy group(100% and 86.4%) than those in the control group(94.6% and 73.1%), and the difference in sphincter preservation rate was statistically significant(P=0.039). There were no significant differences in the mean operative time [(130±15) min vs.(125±20) min, P>0.05] and mean amount of bleeding [(100±15) ml vs. (95±10) ml, P>0.05] between the two groups. The overall incidence of postoperative complications was similar(9.9% vs. 9.7%, P>0.05).

CONCLUSIONSPreoperative radiochemotherapy can significantly increase sphincter preservation rate of mid-low rectal carcinomas, and does not increase the difficulty in surgical procedure and postoperative complications.

Adult ; Aged ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Preoperative Care ; Rectal Neoplasms ; drug therapy ; radiotherapy ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore factors influencing acetabular development after closed reduction in developmental dislocation of the hip (DDH), to provide theoretical basis for improving the therapeutic effects of closed reduction treatment of DDH.

METHODSA total of 100 children with single side DDH who were treated by closed reduction from January 2002 to December 2005 were followed up, and the AI and AI (D/W) of dislocation hip were measured at the 12th month after reduction. Ten factors such as gender, side, age, AI and AI (D/W) of dislocation hip before reduction, degree of dislocation, the rate of width of femoral head, femoral neck anteversion of dislocation hip before reduction, h/b rate,cut off adductor and skeletal traction et al were taken as independent variable, AI and AI (D/W) at the 12th month after reduction were taken as dependent variable,then multiple linear stepwise regression analysis was used to screen the major influencing factors.

RESULTSAge, gender, degree of dislocation, h/b rate, the rate of width of femoral head and femoral neck anteversion exerted obviously influence on AI and AI (D/W),and then age,degree of dislocation and FNA had positive correlation with AI and negative correlation with AI (D/W); the rate of width of femoral head and h/b rate had negative correlation with AI and positive correlation with AI(D/W). The development of acetabular of female patients was faster than that of male patients.

CONCLUSIONAge, gender,degree of dislocation, concentric reduction or not, the development degree of femoral head before reduction and proximal femoral shape are the major factors influencing acetabular development.

Acetabulum ; abnormalities ; growth & development ; surgery ; Age Factors ; Child, Preschool ; Female ; Hip Dislocation ; surgery ; Humans ; Infant ; Male ; Sex Factors ; Treatment Outcome

OBJECTIVETo observe the images of early lesions of condylar cartilage of osteoarthritic rats in synchrotron radiation diffraction enhanced imaging (DEI).

METHODSThe animal model of temporomandibular joint osteoarthrosis was established in rat following the method of partial resection of the joint disc. The changes of osteoarthritic condylar cartilage in different pathological stages were observed by DEI and compared with those in situ histopathological sections.

RESULTSWith DEI, straight and orbicular lines were detected in condylar cartilage 45 to 60 days after discs resection. The lines were confirmed by histopathology to be collagen degradation and tiny fissure formation inside the cartilage.

CONCLUSIONSDEI is capable of imaging the early stages of pathological changes of excised condylar cartilage such as collagen degradation and tiny fissure formation, and this technique is of potential value to clinical application.

Animals ; Cartilage, Articular ; diagnostic imaging ; pathology ; Male ; Mandibular Condyle ; diagnostic imaging ; pathology ; Radiography ; Rats ; Rats, Wistar ; Temporomandibular Joint Disorders ; diagnostic imaging ; pathology ; X-Ray Diffraction ; methods

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder. Pseudoaneurysms formation and rupture is an unusual complication of neurofibromatosis. To date, pseudoaneurysm of the internal pudendal artery associated with NF-1 has not been reported. In this article, we present a 62-yr-old man with NF-1 suffering from spontaneous hematoma of the perinea and scrotum. A digital substraction angiography disclosed a ruptured pseudoaneurysm of the right internal pudendal artery, which was successfully managed with transcatheter embolization.
Aneurysm, False/pathology/*therapy ; Angiography, Digital Subtraction ; Arteries/*pathology ; Embolization, Therapeutic/*methods ; Humans ; Male ; Middle Aged ; Neurofibromatosis 1/*complications/pathology ; Perineum/blood supply/pathology ; Scrotum/blood supply/pathology ; Treatment Outcome

OBJECTIVETo investigate unusual pathological features of olfactory neuroblastoma (ONB) and its correlation with the clinical prognosis.

METHODSTotally 40 cases of ONB were studied using histology and immunohistochemistry techniques. All the cases of ONB were graded according to Hyams Grading system.

RESULTSONB consisted of small round tumor cells growing in nests or lobules separated by fibrovascular septa. Characteristically, there were neurofibrillary intercellular matrices and Homer-Wright or Flexner-Wintersteiner rosette formation. The unusual structures including epithelial components such as mucous or squamous cell nests which were found in 45.0% (18/40), and 15.0% (6/40) respectively. In addition, 3 cases showed an in-situ form with invasion of tumor into olfactory epithelium, and there was exogenous papillary proliferation seen in 2 cases. Log-rank survival analysis demonstrated that Hyams Grading had no statistical correlation with the prognosis. The presence of necrosis was correlated with a poor prognosis (P = 0.016) while the presence of mucous cells was correlated with a good prognosis (P = 0.011).

CONCLUSIONSUnusual pathological structures including epithelial structures, in-situ invasion of tumor tissue into the involving olfactory epithelium and exogenous papillary proliferation can be found in ONB, suggesting that ONB may originate from the undifferentiated basal cells of olfactory epithelium, through bipotential differentiation. The presence of tumor necrosis in ONB is a poor prognostic indicator while the presence of mucous cells suggests a good prognosis.

Adolescent ; Adult ; Aged ; Child ; Chromogranin A ; metabolism ; Esthesioneuroblastoma, Olfactory ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Nasal Cavity ; Necrosis ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Nose Neoplasms ; metabolism ; pathology ; Olfactory Mucosa ; pathology ; Phosphopyruvate Hydratase ; metabolism ; Survival Rate ; Synaptophysin ; metabolism ; Young Adult

The aim of this study was to establish an efficient method for expansion in vitro of natural killer (NK) cells highly purified from human peripheral blood. The CD3-CD56+CD16+ NK cells purified by the negative sorting method of MACS (magnetic microbeads activated cells sorting) were expanded with the different combinations of IL-2, SCF, IL-15 in SCGM (stem cell growth medium) supplemented with 10% human AB serum for 18 days. Cultures were fed with fresh medium and cytokines every 3 days. The sum of cells was counted for evaluating the efficiency of expansion. Then the purity of the CD3-CD56+CD16+ NK cells were determined by flow cytometry and the cytotoxicity to K562 targets was detected by CCK-8 assay in the end. Furthermore, the same way was used to explore the relationship between the efficiency of expansion, cytotoxicity to K562 targets of NK cells and the dose of IL-2. The results showed that after peripheral blood mononuclear cells (PBMNC) were purified by the negative sorting method of MACS, the purity of CD3-CD56+CD16+ NK cells increased from (12.70±2.66)% to (93.03±1.72)%. The CD3-CD56+CD16+ NK cells purified by MACS were expanded with the different combinations of IL-2, SCF, IL-15 in SCGM supplemented with 10% human AB serum for 18 days. The expanding multiple of IL-2/IL-15/SCF group was significantly higher than other groups (p<0.05). The purity of NK cells in the groups with cytokines was not significantly lower than that before expansion (p>0.05). The cytotoxicity of the groups with cytokines was significantly higher than that before expansion. Especially, the cytotoxicity (%) of NK cells in IL-2/IL-15 group and IL-2/IL-15/SCF group was more than 90%. The expanding multiples of low-dose group, medium-dose group and high-dose group were significantly higher than that of zero-dose group (p<0.05), but no significant difference was found between themselves (p>0.05). The cytotoxicity of the groups with IL-2 was significantly higher than that before expansion. Cytotoxicity to K562 cells in high-dose group was significantly higher than that in others (p<0.05); there was no significant difference between low-dose group and medium-dose group (p>0.05). It is concluded that cytokines in the 4 groups were efficient for expansion and the cytotoxicity of highly purified NK cells in vitro. IL-2/SCF/IL-15 combination is the most efficient one among different combinations, and enhanced significantly the cytotoxicity of NK cells against K562 targets. The efficiency of expansion and the cytotoxicity in vitro of NK cells are not related with the dose of IL-2, when IL-2<1,000 U/ml. It is indicated that IL-2 of high-dose (≥1,000 U/ml) may enhance the cytotoxicity of NK cells in vitro more efficiently.
CD3 Complex ; immunology ; CD56 Antigen ; immunology ; Cell Culture Techniques ; methods ; Cell Separation ; methods ; Cells, Cultured ; Humans ; Immunophenotyping ; Interleukin-2 ; pharmacology ; K562 Cells ; Killer Cells, Natural ; cytology ; immunology ; Receptors, IgG ; immunology

Objective To determine the prevalences and risk factors of hyperuricemia(HUA)and gout among residents aged≥20 years in Shandong coastal areas.Methods A random stratified cluster sampling was conducted,and 5003 inhabitants were investigated for prevalences of HUA and gout in Qingdao,Yantai,Weihai, Rizhao and Dongying.Results (1)The prevalence of HUA was 13.19%,after standardization according to the Shandong population in 2000,standardized rate was 13.27%,in which the prevalence in males was 18.32% and females 8.56%.The prevalence of gout was 1.14% and the standardized rate was 1.10%,in which the prevalence in males was 1.94% and females 0.42%;(2)Serum uric acid was(343.4?84.5)?mol/L in normal males and (258.9?70.9)?mol/L in normal females.Serum uric acid was(469.4?48.1)?mol/L in males with HUA and (399.7?104.9)?mol/L in females with HUA.In gout group,serum uric acid in males and females was respectively(502.4?106.8)?mol/L and(403.5?52.7)?mol/L;(3)The prevalence of gout in patients with HUA was 8.64%;(4)Non-conditional logistic regression analysis showed that frequency and quantity of alcohol intake were independent risk factors for males in the HUA group,while HDL-C and farming were protective factors. As for females,age and hypertension were independent risk factors of HUA.Similarly,HDL-C was a protective factor;(5)In HUA patients,65% had hypertension,53% hyperlipidemia,30% glucose metabolic disorder,48% overweight and 10% obesity.In gout patients,57% had hypertension,61% hyperlipidemia,20% glucose metabolic disorder,56% overweight and 7% obesity.Conclusion The prevalences of HUA and gout are significantly increased in Shandong coastal areas in recent years.Restricting the intake of sea foods rich in purine such as seashell,reducing the intake of alcohol especially beer,reducing body weight and abdominal obesity, correcting lipid metabolic disorder and controlling hypertension are important measures in preventing and treating hyperuricemia and gout.