Prostatic stromal fibroblasts were obtained from human fetal prostate and the effect of androgen (DHT) , estrogen (E2) , and human prostatic growth factor (hPGF) on the proliferation of the cultured fibroblasts was studied. The results showed that: 1) DHT and hPGF had significant stimulatory effect on proliferation of the cells; DHT had a delayed stimulatory effect, while hPGF had an immediate one. 2) E2 had no effect on proliferation of the cultured fibroblasts. 3) Used jointly, E2 and DHT had no stimulating effect on the proliferation of the fibroblasts. The results suggest that the effect of DHT on the proliferation of human prostatic stromal fibroblasts may be indirect. It possibly regulates the growth of prostate by stimulating autocrine or paracrine function of the prostatic cells.

ObjectiveThe aim of this study was to establish women previously undergoing cesarean section again puerperal ways.Methods170 pregnant women who had previously undergone 1 or 2 cesarean section were studied. ResultsAmong the 170 cases, 93 cases were trial of labor. The success was 81 cases, the success rate was 87%. One patient with preuterine scar ruptured. There was no maternal death. When the repeat cesarean group was compared with the trial of labor group, in the blood loss and after delivery febrile morbidity were significantly higher in women with repeat cesarean (P＜0.05). The Apgar score of newborns was no difference (P＞0.05). ConelusionWe should control the indications for cesarean section. A trial of labor after previous cesarean is safe, less damage and can be rceommended in the majority of cases. All eligible women would allowed to deliver vaginally after previous cesarean.

Axillary reverse mapping (ARM) is a technique used to map and preserve arm lymphatic drainage during axillary lymph node dissection (ALND) and/or sentinel lymph node dissection (SLND). As a result, the risk of arm lymphedema is reduced. ARM is an emerging technology for breast cancer surgery and currently in the clinical trial phase. In this article, related clinical trials conducted in recent years were reviewed and the displaying methods of ARM lymph nodes and lymphatic vessels were analyzed. The feasibility of retained ARM lymph nodes and lymphatic vessels was also evaluated. Furthermore, the clinical significance of ARM was evaluated in terms of the reduction of the incidence of upper extremity lymphedema after breast cancer surgery.

Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.

Objective To explore the clinical characteristics and outcome of correction with Ilizarov fixator for the knee deformities.Methods From May 2003 to April 2010,21 patients (22 knees) underwent knee deformity correction with Ilizarov fixator,including 12 males and 9 females with an average age of 20.3 years (range,8-48).Causes of the deformities included poliomyelitis in 4,burn in 2,osteomyelitis in 2,trauma in 9,Blount diseases in 2,and multiple osteochondromatosis in 2.Five patients had fixed flexion contracture due to soft tissue,they were corrected through a combination of Ilizarov's frame crossover the joint with a pair of hinges by gradual posterior distraction.Eight patients (9 limbs) had one way bony deformities and 7 patients had complex deformations.The frame with 4 hinge-posts was used for correction by restoring the alignment firstly,and then gradual lengthening to correct bone shortening.Additionally,an overlay frame of the above mentioned combinations was applied for correction of bony deformity combined with soft tissue contracture for 1 patient.Results The average time in frame was 22.3 weeks (range,12-36).At the time of removing frame,satisfactory alignment was achieved in all of the affected knees,and solid bony healing was obtained in osteotomy or bone lengthening area in 16 patients (17 limbs) with bony correction.All patients were followed up for an average of 32.1 months (range,6-86).The range of motion was improved from 102.14°±49.36° preoperatively to 126.90°±24.31° at the final follow-up.Additionally,the Japanese Orthopaedic Association knee score was also increased from 50.24±23.64 before operation to 85.71±10.52 at the final follow-up.All of them were able to walk without crutches,deal with daily life independently.Only 2 patients with the range of motion of the knee less than 90° were not able to squat.Conclusion Ilizarov fixator has advantages of minimal intervention to local tissue in operation and nimble adjustment at any time,and disadvantages related to a longer time in frame.

Objective:To retrospectively evaluate the prognostic risk factors of T1-2 stage breast cancer patients with one to three positive node(s) and their effects on the benefits of post-mastectomy radiation therapy (PMRT). Methods:We retrospectively analyzed 457 breast cancer patients with T1-2 stage and one to three positive axillary lymph nodes treated in our hospital between 2000 and 2002. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The patients were fur-ther classified into high-risk and low-risk subgroups according to the risk factors to explore the benefit of PMRT on the prognosis of dif-ferent subgroups using survival analysis. Results:PMRT was not an independent beneficial factor of overall survival (OS) (HR=0.949;CI:0.435-2.074;P=0.896) or loco-regional recurrent free survival (LRRFS) (HR=0.611;CI:0.231-1.614;P=0.320) in all patients. Ex-tracapsular extension (ECE) and pathological grades were independent prognostic risk factors, and the benefits of PMRT were signifi-cantly different on the prognosis of high-risk subgroup patients (group ECE+OS:P=0.020, LRRFS:P=0.014;group GradeⅢOS:P=0.002, LRRFS:P<0.001). Meanwhile, PMRT failed to prolong the OS and LRRFS of low-risk subgroup patients (group ECE+OS:P=0.353, LRRFS:P=0.796;group GradeⅠtoⅡOS:P=0.267, LRRFS:P=0.589). Conclusion:ECE and gradeⅢwere the independent risk factors of death and loco-regional recurrence in the T1-2 breast cancer patients with one to three positive lymph node(s). PMRT was an effective adjuvant therapy to improve the prognosis of patients with high-risk factors. However, the benefit of PMRT had no sig-nificance in patients with ECE-or gradeⅠ-Ⅱ.

Objective:To compare the effects of 3 different crystalloid fluids at different osmotic concentrations on blood-brain barrier(BBB) and brain edema in severe hemorrhagic shock rats.Methods: A total of 150 male SD rats were equally randomized into a lactated Ringers(LR) group,a 7.2% hypertonic saline(HS) group and a plasmalyte A(PA) group.LR,PA and HS were administered after an hour of severe hemorrhagic shock induced by drawing out about 40% of total blood and maintaining MAP at 35-45 mmHg.Serum S100B,cerebra1 Evans Blue(EB) and water content were determined before(T_0) and 1 h after bleeding(T_1) and immediately(T_2),1 h(T_3) and 2 h(T_4) after administration.The changes of BBB in the hippocampus CA1 area were observed by electron microscopy.Results: The serum S100B level was obviously higher at T_1,T_2,T_3 and T_4than at T_0 in all groups(P0.05).The cerebra1 water content was significantly increased at T_1,T_2,T_3 and T_4in the LR group,at T_1in the HS and at T_1,T_2 and T_3 in the PA as compared with T_0(P

Objective:To analyze the selection of outcome indicators for randomized controlled trials (RCT) on exercise rehabilitation in patients with atrial fibrillation (AF), promote the construction of the core outcome set and provide reference for the research design of subsequent RCT.Methods:The RCT literature related to exercise rehabilitation of patients with atrial fibrillation was systematically searched from CNKI, Wanfang, VIP, PubMed, Web of Science, Embase and Cochrane Library databases, and the search period was from establishment of the databases until July 31, 2023. After literature screening, Cochrane Risk of Bias Assessment Tool was used for quality evaluation, information extraction, classification of outcome indicators, frequency of use statistics, analysis and extraction of current shortcomings in the selection of outcome indicators, and corresponding suggestions were proposed.Results:A total of 32 articles were included, and 19 RCT were evaluated twice for outcome measures. The number of outcome measures ranged from 2 to 17, with 10 RCT setting outcome measures according to primary and secondary criteria and 6 RCT setting safety outcome measures. A total of 96 outcome indicators were extracted in this study, total 266 frequency, which could be divided into 4 categories, such as safety evaluation (18 times), clinical response (75 times), patient-reported outcomes (68 times) and laboratory and other examination (105 times) .Conclusions:Existing RCT outcome indicators of exercise rehabilitation in patients with atrial fibrillation emphasize the changes in subjective feelings and objective indicators of individuals, covering four aspects such as the physical condition, exercise ability, quality of life and psychological status of individuals. However, there is a lack of uniform standards and the safety evaluation indicators are fewer. The categories of exercise rehabilitation indicators for atrial fibrillation patients extracted in this paper can provide a reference for the design of future RCT studies and promote the generation of higher quality evidence-based medical evidence.

Objective:To investigate the effect of esculin on the proliferation of triple negative breast cancer cells and its molecular mechanism.Methods:MDA-MB-231 cells were treated with 28, 56, 112, 225, 450 and 900 μmol/L of esculin for 24, 48 and 72 h, respectively, and the cell viability was detected by cell counting kit 8 (CCK-8) assay. In addition, MDA-MB-231 cells were treated with 0, 225, 450 and 900 μmol/L of esculin for 48 h. And then the changes in cell morphology were observed by inverted microscope. The clone-forming ability was detected by colony formation assay. The mRNA expression levels of FBI-1, p53 and p21 were detected using real-time fluorescence quantitative polymerase chain reaction. The protein expression levels of FBI-1, p53, p21 and Ki67 were detected by western blot.Results:Compared with the blank control group, the cell viability of MDA-MB-231 cells that treated with esculin significantly decreased in a dose-dependent and time-dependent manners. After treatment with esculin, MDA-MB-231 cells shrunk, flattened, adhered poorly to the culture dish and the cell spacing became larger. Meanwhile, shedding and incomplete cells appeared, of which 900 μmol/L of esculin treatment group showed the most dramatic changes. In addition, the colony formation ratios were decreased to (77.18±5.13)%, (65.94±4.98)% and (45.92±3.70)% in the 225, 450 and 900 μmol/L of esculin treatment groups compared with blank control, respectively ( P<0.01). Furthermore, the mRNA and protein expressions of FBI-1 increased, while the levels of p53 and p21 mRNA and protein, as well as the protein expression of Ki67 decreased in a concentration-dependent manner ( P<0.01). Conclusion:Esculin may regulate cell cycle-related p53-p21 pathway via FBI-1 mediated DNA replication, thus inhibit the proliferation of triple negative breast cancer cells.

Objective:To investigate the effect of esculin on the proliferation of triple negative breast cancer cells and its molecular mechanism.Methods:MDA-MB-231 cells were treated with 28, 56, 112, 225, 450 and 900 μmol/L of esculin for 24, 48 and 72 h, respectively, and the cell viability was detected by cell counting kit 8 (CCK-8) assay. In addition, MDA-MB-231 cells were treated with 0, 225, 450 and 900 μmol/L of esculin for 48 h. And then the changes in cell morphology were observed by inverted microscope. The clone-forming ability was detected by colony formation assay. The mRNA expression levels of FBI-1, p53 and p21 were detected using real-time fluorescence quantitative polymerase chain reaction. The protein expression levels of FBI-1, p53, p21 and Ki67 were detected by western blot.Results:Compared with the blank control group, the cell viability of MDA-MB-231 cells that treated with esculin significantly decreased in a dose-dependent and time-dependent manners. After treatment with esculin, MDA-MB-231 cells shrunk, flattened, adhered poorly to the culture dish and the cell spacing became larger. Meanwhile, shedding and incomplete cells appeared, of which 900 μmol/L of esculin treatment group showed the most dramatic changes. In addition, the colony formation ratios were decreased to (77.18±5.13)%, (65.94±4.98)% and (45.92±3.70)% in the 225, 450 and 900 μmol/L of esculin treatment groups compared with blank control, respectively ( P<0.01). Furthermore, the mRNA and protein expressions of FBI-1 increased, while the levels of p53 and p21 mRNA and protein, as well as the protein expression of Ki67 decreased in a concentration-dependent manner ( P<0.01). Conclusion:Esculin may regulate cell cycle-related p53-p21 pathway via FBI-1 mediated DNA replication, thus inhibit the proliferation of triple negative breast cancer cells.