OBJECTIVETo construct a clinical database for laparoscopic colorectal surgery in Chinese population using computerized technique.

METHODSA clinical database system was constructed and used in multi-/single-center studies on laparoscopic colorectal surgery.

RESULTSThe data of more than 1200 cases in the Nanfang Hospital during the past year were collected retrospectively. The database was used as the platform for "Southern China Laparoscopic Colorectal Surgery Study Group (SCLCSG)" and was used in the first stage of the clinical research of "Multicenter retrospective study of laparoscopic and open procedure for colorectal cancer" among 11 hospitals in Southern China. In order to test the system, the database was also used in "comparative study on oncologic results of laparoscopic versus open radical resection for rectal carcinoma".

CONCLUSIONSThe evaluation system is reliable and efficient. This system has established a clinical database for laparoscopic colorectal cancer surgery and can be widely applied for the clinical research for colorectal cancer.

Colectomy ; Colorectal Neoplasms ; surgery ; Colorectal Surgery ; Data Mining ; Databases, Factual ; Humans ; Laparoscopy ; Treatment Outcome

Based on the deletion information of high virulent PRRSV genome, 3 oligonucleotide primer were designed and synthesized. Specific and sensitive reverse transcription-PCR (RT-PCR) assays were de-veloped for the detection of high virulent PRRSV. The sensitivity and specificity of RT-PCR assays were evaluated, the results showing that the detection limit of the assay was found to be 0.265 pg of tissue total RNA, and the protocol have no cross-reaction with classical swine fever virus, porcine circovirus type 2,pseudorabies virus, streptococcus, haemophilus parasuis and Escherichia coli. Then 36 cell cultures, two PRRSV live vaccine strains and 184 clinical specimens from 52 farms were tested. Five PRRSV field iso-lates were the high virulent PRRSV; two PRRSV live vaccine strains from normal PRRSV, and 123 speci-mens from 42 farmer were positive (only 1 specimen was normal PRRSV). This RT-PCR method proved to be accurate differential diagnosis of the high virulent PRRSV and normal PRRSV with the characteristics of rapidity, sensitivity and specificity, and has a strong clinical relevance.

OBJECTIVETo establish a NOD/SCID mouse model with human immune reconstitution and observe its immune response to human triple-negative breast cancer xenograft.

METHODSTwenty-four NOD/SCID mice without immune leakage were subjected to cyclophosphamide (CTX) treatment 3 days prior to immune reconstitution with human peripheral blood mononuclear cell (PBMC) injection and subcutaneous transplantation of human triple-negative breast cancer MDA-MB-231 cells, CTX treatment and PBMC injection without tumor cell transplantation, MDA-MB-231 cell transplantation only, or no treatments. The tumor growth and immune responses of the mice were observed at regular intervals.

RESULTSCompared with the tumor-bearing mice, the tumor-bearing mice with immune reconstitution showed prolonged incubation period of tumor formation, slower tumor growth rate and increased survival rate. Human IgG and CD3(+) T cells were detected in the peripheral blood of the mice 1 week after human PBMC injection. The percentage of CD3(+) T cells in the spleen cells was 55.3% at 9 weeks in tumor-bearing mice with immune reconstitution and 52.7% in tumor-bearing mice without immune reconstitution. The spleen index of the tumor-bearing mice with immune reconstitution was much higher than that in mice with only immune reconstitution and the control mice (9.64 vs 3.82∓0.31 and 1.51∓0.14 mg/g).

CONCLUSIONA stable NOD/SCID mouse model with immune reconstitution has been established successfully, which shows immune responses to triple-negative breast cancer xenografts and allows studies of immunological therapy study of triple-negative breast cancer.

Animals ; Disease Models, Animal ; Humans ; Leukocytes, Mononuclear ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Neoplasm Transplantation ; Spleen ; immunology ; Triple Negative Breast Neoplasms ; immunology

OBJECTIVEClinical application of autologous fat grafting (AFG) is quickly expanding. Despite the widely acceptance, long-term survival rate (SR) of AFG remains a question not yet solved. Meanwhile, although rare, severe complications related to AFG including vision loss, stroke even death could be seen in the literature.

DATA SOURCESA comprehensive research of PubMed database to June 2013 was performed according to guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology. Articles were screened using predetermined inclusion and exclusion criteria.

STUDY SELECTIONData collected included patient characteristics, surgical technique, donor site, recipient site, graft amount, and quantified measurement methods. Patient cohorts were pooled, and SR was calculated. All the severe complications were also summarized according to the different clinical characteristics.

RESULTSOf 550 articles, 16 clinical articles and 10 animal studies met the inclusion criteria and provided quantified measurement methods. Totally, 596 patients were included. SR varied from 34% to 82% in breast and 30-83% in the facial area. Nude mice were applied to investigate human fat grafting SR (38.3-52.5% after 15 weeks). Rabbits were commonly used to study animal AFG SR (14.00-14.56% after 1-year). Totally, 21 severe complications were reported, including death (2), stroke (10), vision loss (11, 8 of which accompanied with stroke), sepsis (3), multiple abscess (1) and giant fat necrotic cyst (2). Ten of these complications happened within 10 years.

CONCLUSIONSThere is no unified measurement method to evaluate fat graft SR until now and no clinical evidence to show better SR according to different donor and recipient cite. Body mass index change between pre- and postoperation may be the bias factor in evaluating fat SR. Fat embolisms of the ophthalmic artery and the middle cerebral artery are the most severe complication of AFG and still lack of effective treatment.

Adipose Tissue ; transplantation ; Animals ; Autografts ; Humans ; Survival Rate

OBJECTIVETo compare the clinical effects of isthmic spondylolisthesis by a single cage or double cages interbody fusion combined with pedicle screw fixation.

METHODSThe clinical data of 172 patients with isthmic spondylolisthesis underwent surgery from March 2000 to August 2008 were retrospectively analyzed. All cases underwent posterior pedicle screw fixation and interbody fusion, 89 cases with single cage fusion and 83 cases with double cages fusion. In single cage group, there were 56 males and 33 females, aged from 18 to 63 years old with an average of(41.60±8.20) years;25 cases were in L4 segment and 64 cases were in L5;according to the Meyerding standard, 32 cases were I degree, 46 cases were II degree and 11 cases were III degree. In double cage group, there were 49 males and 34 females, aged from 20 to 65 years old with an average of(43.30±6.39) years;21 cases were in L4 and 62 cases were in L5;according to the Meyerding standard, 25 cases were I degrees, 45 cases were II degree, and 13 cases were III degree. The operative time, intraoperative blood loss, postoperative drainage volum, bone fusion rate, intervertebral space height and the improvement of clinical symptoms were compared between two groups.

RESULTSAll the operations were successful and all patients were followed up for 18 to 83 months with an average of 4 years and 3 months. The operative time, intraoperative blood loss, postoperative drainage volume in single cage group were less than of double cage group(<0.05). Two weeks after operation, the intervertebral space height was significantly increased in two groups(<0.05), and there was no significant difference at the last follow-up between two groups. At 16 months after operation, all bone grafts of patients got bony fusion by X-rays. At the last follow-up, there were no statistically significant difference in JOA, ODI and VAS score between two groups, no pedicle screw loosening and breaking were found.

CONCLUSIONSSingle cage interbody fusion combined with pedicle screw fixation is as effective as with double cages interbody fusion in treatment of isthmic spondylolisthesis, it has the advantages of short operative time and less blood loss.

While overweight and obesity have gradually became global concerns. Bariatric surgery is an effective and safe option for improving quality of life and alleviating psychosocial distress in obese individuals. However,body contouring is required to solve skin problems associated with massive weight loss after bariatric surgery. This article reviews the indications,importance,and postoperative complications of body contouring after bariatric surgery.

Objective: To evaluate clinical characteristics and prognosis of primary myelofibrosis (PMF) patients with thrombocytopenia in varied degrees. Methods: Clinical features and survival data of 1 305 Chinese patients with PMF were retrospectively analyzed. The prognostic value of thrombocytopenia in patients with PMF was evaluated. Results: 320 subjects (47%) presented severe thrombocytopenia (PLT<50×10(9)/L), 198 ones (15.2%) mild thrombocytopenia [PLT (50-99)×10(9)/L] and 787 ones (60.3%) without thrombocytopenia (PLT ≥ 100×10(9)/L). The more severe the thrombocytopenia, the higher the proportions of HGB<100 g/L, WBC<4×10(9)/L, circulating blasts ≥ 3%, abnormal karyotype and unfavourable cytogenetics (P<0.001, P<0.001, P=0.004, P<0.001 and P<0.001, respectively) were observed in this cohort of patients. The more severe the thrombocytopenia, the lower the proportion of JAK2V617F positive (P<0.001) was also noticed. Platelet count was positively correlated with splenomegaly, HGB and WBC (P<0.001, correlation coefficients were 0.131, 0.445 and 0.156, respectively). Platelet count was negative correlated with constitutional symptoms and circulating blasts (P=0.009, P=0.045, respectively; correlation coefficients were -0.096 and -0.056, respectively). The median survival of patients with severe thrombocytopenia, mild thrombocytopenia and without thrombocytopenia were 32, 67 and 89 months, respectively (P<0.001). Multivariate analysis identified thrombocytopenia in varied degrees (HR=1.693, 95%CI 1.320-2.173, P<0.001) and Dynamic Internation Prognostic Scoring System(DIPSS) prognostic model (HR=2.051, 95%CI 1.511-2.784, P<0.001) as independent risk factors for survival. Conclusion: PMF patients with severe thrombocytopenia frequently displayed anemia, leucopenia, circulating blasts and short survival, so active treatment measures should be taken especially in these patients.
Humans ; Primary Myelofibrosis ; Prognosis ; Retrospective Studies ; Thrombocytopenia

Objective: To explore the clinical implications and prognostic value of TP53 gene mutation and deletion in patients with myelodysplastic syndromes (MDS) . Methods: 112-gene targeted sequencing and interphase fluorescence in situ hybridization (FISH) were used to detect TP53 mutation and deletion in 584 patients with newly diagnosed primary MDS who were admitted from October 2009 to December 2017. The association of TP53 mutation and deletion with several clinical features and their prognostic significance were analyzed. Results: Alterations in TP53 were found in 42 (7.2%) cases. Of these, 31 (5.3%) cases showed TP53 mutation only, 8 (1.4%) cases in TP53 deletion only, 3 (0.5%) cases harboring both mutation and deletion. A total of 37 mutations were detected in 34 patients, most of them (94.6%) were located in the DNA binding domain (exon5-8) , the remaining 2 were located in exon 10 and splice site respectively. Patients with TP53 alterations harbored significantly more mutations than whom without alterations (z=-2.418, P=0.016) . The median age of patients with TP53 alterations was higher than their counterparts[60 (21-78) years old vs 52 (14-83) years old, z=-2.188, P=0.029]. TP53 alterations correlated with complex karyotype and International prognostic scoring system intermediate-2/high significantly (P<0.001) . Median overall survival of patients with TP53 alterations was shorter than the others[13 (95%CI 7.57-18.43) months vs not reached, χ(2)=12.342, P<0.001], while the significance was lost during complex karyotype adjusted analysis in multivariable model. Conclusion: TP53 mutation was more common than deletion in MDS patients. The majority of mutations were located in the DNA binding domain. TP53 alterations were strongly associated with complex karyotype and always coexisted with other gene mutations. TP53 alteration was no longer an independent prognostic factor when complex karyotype were occurred in MDS.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Genes, p53 ; Humans ; In Situ Hybridization, Fluorescence ; Middle Aged ; Mutation ; Myelodysplastic Syndromes/genetics* ; Prognosis ; Tumor Suppressor Protein p53 ; Young Adult

Chest wall reconstruction is a key approach to restoring the structure and function of the defective chest wall after tumor excision. While autologous flaps have been ideal materials for soft tissue reconstruction,the optimal skeletal reconstructive material still remains controversial. Currently,besides autologous bones,non-biodegradable materials have been used widely,which offer sufficient strength and stability but with some inevitable complications. Many studies have explored the clinical applications of biodegradable materials and the improvements in their characteristics,and some of these materials may be clinically feasible. This article reviews the recent advances in the applications of reconstructive materials.

Objective To investigate the effect of hypoxia on the proliferation of nucleus pulposus-derived mesen-chymal stem cells ( NPMSCs) in vitro and explore its possible mechanism .Methods NPMSCs were isolated from nucleus pulposus of Sprague-Dawley rats.Cellular morphology was observed and expression of CD 11b, CD45, CD73, CD90 and CD105 was detected using flow cytometry .The third generation NPMSCs were cultured under nor-moxia (20%O2) and hypoxia (2%O2) for 14 days.Cell viability was determined by the annexin-V-FITC/propidi-um iodide doublestaining assay and cell proliferation was measured by MTT assay .The expressions of hypoxia-in-ducible factor-1α( HIF-1α) , glucose transporter 1( GLUT-1) , vascular endothelial growth factor ( VEGF) , silent information regulator protein 1( SIRT1) and silent information regulator protein 6 ( SIRT6) at the mRNA level were examined by semi-quantitative reverse transcription polymerase chain reaction ( RT-qPCR ).Results NPMSCs formed sunflower-like colony and the third passage NPMSCs became homogeneous and exhibited spindle -like mor-phology .Meanwhile , high expression level of stem cell-related positive antigen molecules and low expression levels of negative antigen molecules .Hypoxia promoted proliferation of NPMSCs and promoted gene expression of HIF-1α, GLUT-1, VEGF, SIRT1 and SIRT6 significantly(P<0.05).Conclusions Hypoxia has a significant impact on the proliferation of NPMSCs and SIRT 1, SIRT6 mediated HIF-1αpathway is potentially involved in the mechanism .