Hedgehog signaling pathway is excessive activated in breast cancer.LKBl is currently accepted as a tumor-suppressor gene,which can inhibit the proliferation of breast cancer.The overexpression of LKB1 can regulate the expression of CyclinDl series gene which is a target gene of Hedgehog signaling pathway.Meanwhile,the study found that PKA gene play an important role in Hedgehog signaling pathway,its activation is related with the cAMP state,and LKB1 genes can influence the cAMP state.Therefore,LKB1 gene and the Hedgehog signaling pathway may exist some inevitable connection.

Objective To analyze and compare images of radial head fracture of 50 patients acquired by computed radiology(CR),coronal plane and axial plane of CT scan.And to determine routine plane of CT scan for radial head fracture.Methods Images of of radial head were acquired by CR,coronal plane and axial plane of CT scan on 50 patients with radial head fracture initially diagnosed by orthopedists. classify all the cases of radial head fracture into type Ⅰ、Ⅱ、Ⅲ and Ⅳ according to the classification proposed by Mason.Results The positive incidence of CT and CR were 96%(48)and 78%(39) respectively.Cases of 94%o(47)through CT coronal scan and 82%(41)eases through CT axial scan were exactly classified.Conclusion The designation of the plane of CT scan is significant to the classification of the radial head fracture.Coronal plane CT scan can meet the need of imaging clinical classification and is recommended to be routine plane of radial head fracture.In order to ensure the exact classification axial plane and 3D reconstruction technique should be added for type Ⅲ and type Ⅳ of radial head fracture.

Animals ; Burns ; drug therapy ; metabolism ; physiopathology ; Interleukin-18 ; genetics ; metabolism ; Lactulose ; therapeutic use ; Lipopolysaccharides ; blood ; Liver ; metabolism ; physiopathology ; Lung ; metabolism ; physiopathology ; Male ; Multiple Organ Failure ; prevention & control ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo report the technique of reconstruction of large skin and soft tissue defects in the upper extremity using pedicled latissimus dorsi myocu-taneous flaps.

METHODSSix patients with large skin and soft tissue defects were included in this report. There were 5 trauma patients and the rest one needed to receive plastic surgery for his extremity scar. All wounds were in the upper extremity. The sizes of defects ranged from 15 cm multiply 6 cm to 30 cm multiply 18 cm. Pedicled latissimus dorsi myocutaneous flaps were designed according to the defect area and raised with part of latissimus dorsi. The thoracodorsal artery and its perforators were carefully protected during surgery.

RESULTSAll flaps healed primarily without flap congestion, margin necrosis or infection. The skin donor sites either received split-thickness skin graft (3 cases, mostly from the anterior thigh) or was closed primarily (3 cases) and had minimal morbidity. Follow-up of 6-12 months showed that the contour of flap was aesthetic and the function of limb was excellent.

CONCLUSIONOur experience indicates that the pedicled latissimus dorsi myocutaneous flap is favorable for reconstruction of large skin and soft tissue defects in the upper extremity.

Adult ; Arm Injuries ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Myocutaneous Flap ; blood supply ; Reconstructive Surgical Procedures ; methods ; Soft Tissue Injuries ; etiology ; surgery ; Superficial Back Muscles ; transplantation ; Treatment Outcome

Design space approach is applied in this study to enhance the robustness of first ethanol precipitation process of Codonopsis Radix (Dangshen) by optimizing parameters. Total flavonoid recovery, dry matter removal, and pigment removal were defined as the process critical quality attributes (CQAs). Plackett-Burman designed experiments were carried out to find the critical process parameters (CPPs). Dry matter content of concentrated extract (DMCE), mass ratio of ethanol to concentrated extract (E/C ratio) and concentration of ethanol (CEA) were identified as the CPPs. Box-Behnken designed experiments were performed to establish the quantitative models between CPPs and CQAs. Probability based design space was obtained and verified using Monte-Carlo simulation method. According to the verification results, the robustness of first ethanol precipitation process of Dangshen can be guaranteed by operating within the design space parameters. Recommended normal operation space are as follows: dry matter content of concentrated extract of 45.0% - 48.0%, E/C ratio of 2.48-2.80 g x g(-1), and the concentration of ethanol of 92.0% - 92.7%.
Chemical Precipitation ; Chemistry, Pharmaceutical ; methods ; Codonopsis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification

Objective To explore the risk factors of early traumatic coagulation(TIC)in elderly patients with chest trauma.Methods The data of 113 elderly patients with chest trauma admitted in a hospital from January 2016 to January 2022 were retrospectively analyzed.Patients were divided into TIC group and non-TIC group according to whether they had early TIC.The risk factors of early TIC in elderly patients with thoracic trauma were analyzed by single factor and multi factor methods.Analysis of the predictive value of early TIC in elderly patients with thoracic trauma using multifactor model.Result Of all the patients included in the study,27 were determined as TIC,and the rest 86 were non-TIC.The results of univariate analysis showed that there were statistically significant differences in the data of shock index,platelet count at admission and plasma fibrinogen at admission between patients in TIC group and non-TIC group(P＜0.05).Multivariate analysis showed that the shock index at admission,platelet count at admission,and plasma fibrin at admission were all independent influencing factors of early TIC in elderly patients with chest trauma(all P＜0.05).The P value of multivariate model and independent variables predict the early TIC of elderly patients with chest trauma.The Yoden index is 36.95％,42.89％,75.58％and 78.85％respectively.Conclusion The shock index,platelet count and plasma fibrin at the time of admission can affect the early occurrence of TIC in elderly patients with chest trauma.

OBJECTIVETo evaluate the safety and efficacy of individual cylindrical abdominoperineal resection (CAPR) for locally advanced low rectal cancer.

METHODSFrom June 2011 to February 2012, 11 patients with locally advanced low rectal cancer underwent individual CAPR. There were 7 male and 4 female patients, aged from 32 to 74 years with a median of 64 years. Forty-seven patients underwent classic CAPR from January 2008 to February 2012. Preoperative and postoperative parameters such as clinical information of patients, tissue morphometry and complications were compared.

RESULTSIn the individual surgical group, 6 patients were treated with one side levator ani muscle totally or partially reserved, 3 patients with sacrococcyx reserved, and 2 patients with dissection close to the anterior rectal wall. Compared with classical surgery, the individual surgical specimens of horizontal section area ((2197 ± 501) mm(2)) and intrinsic muscle layer outer area ((1722 ± 414) mm(2)) were small, but the difference was not statistically significant (P = 0.150 and 0.167). The operative time, intraoperative blood loss, circumferential resection margin, total cross sectional tissue area, cross sectional tissue area outside the muscularis propria and bowel perforation rate between the two groups were not significantly different. Individual CAPR showed less incidence of chronic perineal pain (2/11, χ(2) = 6.116, P = 0.013) and sexual dysfunction (2/9, χ(2) = 4.412, P = 0.036) compared with classic CAPR.

CONCLUSIONSIndividual CAPR has the potential to reduce the risk of chronic perineal pain and sexual dysfunction without influencing the radical effect when compare with classic CAPR for the treatment of low rectal cancer.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; epidemiology ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation.

METHODA multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed.

RESULTTwenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group.

CONCLUSIONThe integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.

Acquired Immunodeficiency Syndrome ; complications ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Multivariate Analysis ; Pneumonia ; complications ; drug therapy ; Treatment Outcome

OBJECTIVETo demonstrate the prognostic value of neuroendocrine clone on colorectal carcinoma.

METHODSThe immunochemistry methods were used to investigate the percent of neuroendocrine carcinoma in 73 human colorectal carcinoma. Retrospective analysis and follow-up were carried out in all patients.

RESULTSIn all 73 cases of colorectal carcinoma, the total percentage of neuroendocrine carcinoma was 17.8%. Neuroendocrine carcinoma included 11 synapse positive, 6 chromogranin positive and 4 both positive. The major factors related to the prevalence of neuroendocrine carcinoma were sex, age, tumor location and Dukes' stage. And the 1-year survival rate of the patients who suffered from neuroendocrine carcinoma is obviously lower than that of other colorectal carcinoma.

CONCLUSIONSThe neuroendocrine carcinoma is a special kind of human colorectal carcinoma, and neuroendocrine clone may be a new marker of the malignant potency. The neuroendocrine clone has its prognostic value and may be a novel therapeutic target.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Neuroendocrine ; metabolism ; mortality ; pathology ; Chromogranins ; biosynthesis ; Colorectal Neoplasms ; metabolism ; mortality ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; Synapsins ; biosynthesis

OBJECTIVETo explore the safety and curative effect of per anus intersphincteric rectal dissection and direct coloanal anastomosis (PIDCA) for patients with very low rectal cancer.

METHODSNineteen patients were prospectively studied from June 2002 to October 2004. There were 11 males and 8 females, with a median age of 56 (range, 41 - 74) years. Nineteen patients had T(1) to T(4) tumors (T(1), n = 4; T(2), n = 10; T(3), n = 4; T(4), n = 1) located between 3.5 and 5.0 cm above the anal verge.The rectum, including the entire width of the internal analsphincter, was transected circumferentially via the anal route to secure the surgical margin of safety under direct vision and was mobilized proximally as far as possible through the intersphincteric plane. Per anus coloanal anastomosis was performed following transabdominal resection of the rectum.

RESULTSThere was no operative mortality. Of nineteen patients, two (10.5%) had anastomotic leakage. Median follow-up duration was 16 (range, 3 - 29) months. Up to now, one patient developed recurrence (5.3%). Acceptable anal function results were obtained in most patients.

CONCLUSIONSCurability and anal function was obtained by PIDCA combined with preoperative or postoperative radiotherapy and postoperative chemotherapy. PIDCA is ideal and safe for selected patients with tumor located below 5 cm from the anal verge.

Adult ; Aged ; Anal Canal ; surgery ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Proctocolectomy, Restorative ; methods ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; surgery ; therapy ; Treatment Outcome