AIM: To investigate the angiogenesis status,the expression of vascular endothelial growth factor(VEGF),angiopoietin-1(ANG-1),angiopoietin-2(ANG-2),thrombospondin-1(TSP-1) in cholangiocellular carcinoma(CCC) and relationship with tumor angiogenesis,differentiation,invasion and metastasis.METHODS: 33 specimen of surgically resected CCC were investigated.Immunohistochemical staining of CD34,VEGF,ANG-1,ANG-2 and TSP-1 was carried out.RESULTS: The mean MVD was(87.2?52.6)/mm2.VEGF positive expression was found in 75.6% cases;ANG-1 positive expression was observed in 36% cases;ANG-2 positive was detected in 57.6% cases and 45.5% cases exhibited positive TSP-1 expression.VEGF and ANG-2 expressions were found to be associated with significant higher level of MVD(P

Objective To investigate the CT imaging findings of thymus and thyroid gland involved in Langerhans cell histiocytosis(LCH) of pediatric patients. Methods CT image findings in pediatric patients with LCH confirmed by pathology and clinical diagnosis from January 2006 to February 2015 were retrospectively analyzed. By radiography, 38 cases' thymus gland were involved and 8 cases' thyroids gland were involved. Results Plain CT scan for thymus gland involved patients revealed 9 cases were shown as hyperplasia, 17 cases were shown as calcification, 9 cases were shown as hyperplasia with calcification, 1 case was shown as cavity, 1 case was shown as hyperplasia with calcification and cavity and 1 case was shown as hyperplasia with calcification and low density. Enhanced CT scan for thyroid gland involved patients showed bilateral or unilateral enlargement of thyroid gland with heterogeneous low density and unobvious enhancement. Conclusions Finely calcifications were the most common CT findings on thymus gland involved in LCH and might without hyperplasia. CT imaging of thyroid LCH exhibited an enlarged or normal size and abnormal density in the thyroid gland with adjacent soft tissues involved.

Adjuvants, Immunologic ; biosynthesis ; therapeutic use ; Animals ; Antigen Presentation ; immunology ; Antigens, Neoplasm ; metabolism ; Antigens, Tumor-Associated, Carbohydrate ; biosynthesis ; immunology ; therapeutic use ; Cancer Vaccines ; Humans ; Neoplasms ; immunology ; therapy ; Vaccines, Synthetic

Objective To investigate the effect of statin on trabecular bone microstructure by using trabecular bone score (TBS), a new type of bone microstructure evaluation index. Methods A total of 253 middle and aged patients hospitalized in the First Affiliated Hospital of Nanjing Medical University between January 2014 and March 2016 were retrospectively analyzed. According to whether statin was used or not, patients were divided into two groups: 90 patients in the statin use group (statin was use for more than 1 year) and 163 in the control group (not taken any statin). Serum biochemical indicators, such as triacylglycerol, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, alkaline phosphatase, fasting blood glucose and 25 hydroxy vitamin D, were compared between the two groups. Dual energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of lumbar spine and femoral neck. TBS was calculated with TBS iNsight? software, and the DXA image of lumbar spine were analyzed. Results Values of total cholesterol and low density lipoprotein cholesterol were significantly lower in statin group compared with those of control group (P<0.001), while no significant differences in other biochemical indicators between two groups (P>0.05). There was higher lumbar spine BMD statin group compared to that of control group (g/cm2:1.04 ± 0.19 vs. 0.96 ± 0.14, P<0.01). There was higher lumbar spine BMD and higher TBS (1.31±0.09 vs. 1.26±0.09, P<0.01) in statin group than that of control group. There was no difference in the femoral neck BMD between the two groups (P>0.05). Conclusion Statin increases lumbar spine BMD and improves trabecular bone microstructure in middle and aged people.

Animals ; Cardiomegaly ; Constriction ; Heart ; Mice

OBJECTIVETo discuss the clinical results of hook plate internal fixation for the treatment of distal traumatic injuries of clavicle,and to analysis the mechanism of the complications.

METHODSFrom 2001.9 to 2008.2, 36 patients with fresh distal clavicle fractures of Neer type II and 14 patients with dislocation of Acromioclavicular joint of Tossy type III were treated with hook plate internal fixations. Among the patients, 36 patients were male and 14 patients were female, ranging in age from 19 to 77 years, with an average of 43 years. After the operation, the range of motion of shoulder joint was measured and the complications were studied. The Karlsson and Constant-Murley criteria were used to evaluate the therapeutic effects.

RESULTSAll the patients were followed up with a mean duration of 12 months (7 to 18 months). All the patients could move shoulder joint actively 1 week after operation, and recover to the normal ROM at the 6th week after operation. According to Karlsson criteria, 44 patients got an excellent result, 6 good. According to Constant-Murley criteria, the average score of wound shoulder was (73.8 +/- 8.3) before operation, and (59.6 +/- 6.7) after operation, and the postoperative score was higher than preoperative score. No incision infections were found and 5 patients with complications were cured. No re-dislocation of acromioclavicular joint occurred.

CONCLUSIONIt is advocated that hook plate for the treatment of distal clavicular fractures of Neer type II and acromioclavicular dislocation of Tossy type III could provide sufficient stability to allow early functional rehabilitation, and to decrease the rate of complications.

Adult ; Aged ; Bone Plates ; Clavicle ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the effects of the fat flap tissues after delay operation on free fat-graft survival rate and duration.

METHODSThe delay operation of fat flaps was performed in the inguinal region of a rabbit. Expression of VEGF was assayed using Elisa method after 12 hours of flap delay. The fat flaps were harvested and cut into pieces after 21 days. A subdermal pocket was created in each side of the dorsal midline of a rabbit, the fat pieces were grafted randomly into a pocket and the normal fat pieces into the other pocket as control. After 1, 3, 6, 9 and 12 months of implantation, the grafted fats were harvested, gross observation, weight measurement and histology were carried out. Number of the vessels stained with anti-CD34 antibody was counted out.

RESULTSVEGF concentrations in flaps were significantly higher (P < 0.05). The density of vessels in experimental groups increased significantly compared with that in control groups at 1 and 3 months, respectively (P < 0.01), and no significant differences in the survival rate of fat tissues between experimental and control groups were observed at 1 and 3 months (P > 0.05). The fat cells from the flaps survived after 12 months of fat plantation, while those in control groups disappeared after 6 months.

CONCLUSIONSThe survival rate and duration of grafted fat could be increased implanting the fat tissues from delayed fat flap, which may provide researchers with a new method for fat graft.

Adipocytes ; transplantation ; Adipose Tissue ; transplantation ; Animals ; Graft Survival ; Male ; Rabbits ; Surgical Flaps

OBJECTIVETo evaluate the factors affecting the efficacy of extracorporeal shock wave lithotripsy (ESWL) and establish a model for predicting the success rate of a single ESWL session in the treatment of single renal calculus.

METHODSBetween January 2008 and February 2010, 325 patients underwent ESWL monotherapy and were followed up for at most 3 months. The correlations between the outcome of a single ESWL session and the patients' age, gender, body mass index (BMI), disease duration, pretreatment renal colic, hematuria, urinary irritation symptoms, stone location, stone laterality, stone length and stone width were analyzed. The statistically significant factors identifies were further analyzed by multivariate logistic regression, and the predictive model was established.

RESULTSThe stone-free rate of ESWL was 76.9%. Univariate analysis found that the patients' age, stone laterality, stone location, disease duration, pretreatment hematuria, stone length and width all significantly affected the outcome of the treatment. Logistic regression analysis indicated the factors including disease duration, pretreatment hematuria, stone length and stone width determined the success rate of the treatment. Hosmer and Lemeshow Test showed a good fitting of the predictive model (Χ(2)=18.144, df=8, P=0.168) with an overall accuracy of 87.4%.

CONCLUSIONDisease duration, pretreatment hematuria, stone length and width are independent factors affecting the outcome of a single ESWL session for single renal calculus.

Adult ; Female ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; Logistic Models ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo study the potentiality of osteanagenesis of the hematomas formed around the fractures and that of the marrow stroma cells, evaluate the effect of the combined trans-plantation of the hematoma and the marrow stroma cells, to explore a new method to accelerate the union of fracture.

METHODSThe bone defect models were made on the tibias of the New-Zealand's rabbits. The hematomas formed around the fracture were taken out 3 days latter after the operation, the marrow stroma cells were abstracted from the femoral marrow simultaneously. And then the mixture of the hematoma and the marrow stroma cells were transplanted to the defects of the tibias in the experiment group, and the hematoma transplanted simply to the same place in the control group. The radio-graph and the histological observation of the osteotylus were carried out regularly post-operation.

RESULTS1) There was a significant difference in osteotylus quantity between the two groups: more osteotylus and obvious periosteal proliferation were found in the experiment group than that in the control group which accepted the transplantation of the hematomas alone. 2) There was a significant difference in osteoblast number between the two groups: more sclerotomal-like cells were observed under the microscope in the experiment group than that in the control group.

CONCLUSIONMarrow stroma cells have great potentiality of osteoanagenesis. The result of combined transplantation of the marrow stroma cells and the hematomas is more effective than that of simple transplantation of the bone hematoma.

Animals ; Blood Cells ; transplantation ; Bone Marrow Transplantation ; Female ; Fracture Healing ; Hematoma ; surgery ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Rabbits ; Random Allocation ; Stromal Cells ; transplantation ; Tibia ; injuries ; physiopathology ; surgery ; Tibial Fractures ; physiopathology ; surgery ; therapy ; Transplantation, Autologous

Objective To investigate the effect of low pH on acid-sensing ion channel 1a( ASIC1a) expression in vascular endothelial cells induced by serum IgA 1 from Henoch-Sch?nlein purpura ( HSP ) children and regulatory role of ASIC1a in it.Methods Human dermal microvascular endothelial cells ( HDMECs) treated by serum IgA1 from children with HSP were incubated in different pH medium .ASIC1a, destrin and α-SM mRNA expressions in HDMECs were evaluated by real-time quantitative polymerase chain reaction (q-PCR).The level of inflammatory cytokines released by vascular endothelial cells was detected by ELISA .Moreover destrin and α-SM protein expres-sion in HDMECs was evaluated by Western blot .Results The results showed that in low pH condition , IgA1 from HSP children could induce the upregulation of ASIC 1a mRNA expression , stimulate IL-8, NO and TM release of vascular endothelial cells of HSP children .And blockers of ASICs could reduce acid-induced cytokine release of vascular endothelial cells .Moreover destrin and α-SM mRNA and protein expression in HDMECs of HSP children significantly decreased when exposure to extracellular acidosis .However blockers of ASICs increased destrin and α-SM mRNA and protein expression in vascular endothelial cells of HSP children .Conclusions These findings showed that activation of ASIC 1a could be involved in the vascular endothelial cell injury of HSP children .Blocking ASIC1a may have a significant protective effect on the inflammatory injury of vascular endothelial cells .