Objective:To explore any effect of using extracorporeal shockwave therapy (ESWT) on the gastrocnemius muscle or the myotendinous junction on spasticity and the walking ability of stroke survivors.Methods:A total of 84 stroke survivors were randomly divided into a control group, a muscle belly group, and a myotendinous junction group, each of 28. In addition to conventional rehabilitation, the muscle belly and myotendinous junction groups received ESWT applied to the belly of the gastrocnemius muscle or the myotendinous junction. Before as well as one, two and three weeks after the treatment, all were evaluated using the Modified Ashworth Scale (MAS), passive range of motion (PROM), a visual analogue scale (VAS) for pain rating, and 10m maximum walking speed (10m MWS). Stride frequency and length were also measured and compared among the 3 groups.Results:After three weeks of ESWT treatment the average MAS, PROM and VAS scores of the belly and the junction group were significantly improved compared to before the treatment. The average MAS, PROM and VAS scores of the belly group and the average MAS score of the junction group were then significantly superior to the control group′s averages, and the average VAS score of the belly group was significantly better than that of the junction group. After one and two weeks of treatment, the average 10MWSs of the belly and junction groups were significantly better than the control group′s average, and after 3 weeks the belly group′s average speed was significantly better than the junction group′s. The stride frequency of the belly group had improved significantly compared with the control group after 2 weeks, and after 3 weeks both experimental groups had significantly better frequency than the control group. The average stride length of both the belly and junction groups was significantly better than the control group′s average throughout the testing.Conclusion:ESWT applied to the belly of the gastrocnemius muscle or the myotendinous junction can relieve muscle spasticity and pain and improve walking ability. Applying ESWT to the muscle belly is superior to on the myotendinous junction in terms of therapeutic efficacy.

Conversion therapy has become the core in the treatment of borderline resectable or unresectable liver cancer, which provides resectable opportunities for more advanced liver cancer patients. In accordance with the first-choice treatment regimen recommended by the guidelines, the authors reported a successful case of Atezolizumab and Bevacizumab (T+A regimen) conversion therapy. The patient with initially borderline resectable advanced liver cancer was performed liver segment resection sucessfully after conversion therapy, and non-tumor recurrence was observed at postoperative 9 months. Postoperative pathological examination showed combined hepatocellular-cholangiocarcinoma, which also indicated the important value of T+A regimen in the conversion therapy of combined hepatocellular-cholangiocarcinoma.

Objectives: To propose a novel clinical classification system of gallbladder cancer, and to investigate the differences of clinicopathological characteristics and prognosis based on patients who underwent radical resection with different types of gallbladder cancer. Methods: The clinical data of 1 059 patients with gallbladder cancer underwent radical resection in 12 institutions in China from January 2013 to December 2017 were retrospectively collected and analyzed.There were 389 males and 670 females, aged (62.0±10.5)years(range:22-88 years).According to the location of tumor and the mode of invasion,the tumors were divided into peritoneal type, hepatic type, hepatic hilum type and mixed type, the surgical procedures were divided into regional radical resection and extended radical resection.The correlation between different types and T stage, N stage, vascular invasion, neural invasion, median survival time and surgical procedures were analyzed.Rates were compared by χ² test, survival analysis was carried by Kaplan-Meier and Log-rank test. Results: Regional radical resection was performed in 940 cases,including 81 cases in T1 stage,859 cases in T2-T4 stage,119 cases underwent extended radical resection;R0 resection was achieved in 990 cases(93.5%).The overall median survival time was 28 months.There were 81 patients in Tis-T1 stage and 978 patients in T2-T4 stage.The classification of gallbladder cancer in patients with T2-T4 stage: 345 cases(35.3%)of peritoneal type, 331 cases(33.8%) of hepatic type, 122 cases(12.5%) of hepatic hilum type and 180 cases(18.4%) of mixed type.T stage(χ²=288.60,P<0.01),N stage(χ²=68.10, P<0.01), vascular invasion(χ²=128.70, P<0.01)and neural invasion(χ²=54.30, P<0.01)were significantly correlated with the classification.The median survival time of peritoneal type,hepatic type,hepatic hilum type and mixed type was 48 months,21 months,16 months and 11 months,respectively(χ²=80.60,P<0.01).There was no significant difference in median survival time between regional radical resection and extended radical resection in the peritoneal type,hepatic type,hepatic hilum type and mixed type(all P>0.05). Conclusion With application of new clinical classification, different types of gallbladder cancer are proved to be correlated with TNM stage, malignant biological behavior and prognosis, which will facilitate us in preoperative evaluation,surgical planning and prognosis evaluation.

Objective To evaluate the safety, feasibility and clinical efficacy of one-stage anterior transplantation with ili-ac crest allograft or autologous in the treatment of thoracolumbar tuberculosis. Methods From January 2012 to June 2015, 235 cases of thoracolumbar tuberculosis were treated with allogeneic or autologous iliac crest graft combined with internal fixation dur-ing one-stage after radical debridement, which were reviewed retrospectively. These cases were divided into two groups:allograft group (162 cases) and autograft group (73 cases). In allograft group, there were 87 males and 75 females, with a mean age of 42.5 (range 2-80) years. In autograft group, there were 41 males and 32 females, with a mean age of 40.3 (range 14-68) years. The oper-ation time, bleeding volume, hospital stay, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, visual ana-logue scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, the changes of American Spinal Injury Association (ASIA) scale for neurological classification of spinal and graft fusion satisfaction rate in each groups were evaluated respectively before and after surgery. Results The operation time was (122.41±30.55) min in allograft group and (141.56±25.69) min in auto-graft group, the difference was statistically significant. The average hospital stay and bleeding volume were no significant differ-ence between the two groups. In each group, VAS scores, JOA scores, ESR and CRP level and the changes of ASIA scale were sig-nificant difference between pre-and post-operation, but these index showed that there were no significant differences between the two groups. The mean ESR level was (16.46±7.39) mm/h in allograft group, and (13.61±6.85) mm/h in autograft group 3 months af-ter the operation. The fusion time (8.13 ± 1.97) months in allograft group was significantly longer than that in autograft group (5.37± 1.72) months, the difference was statistically significant. At final follow-up, the graft fusion satisfaction rate and the changes of ASIA showed no significant difference. Perioperative complications including gastrointestinal dysfunction in 5 cases (allograft group in 3cases;autograft group in 2cases), and pulmonary infection in 6 cases (allograft group in 4cases;autograft group in 2cas-es). Postoperative complications including kyphosis in 4 cases (allograft group in 3cases;autograft group in 1case), tuberculosis re-currence in 5 cases (allograft group in 3cases;autograft group in 2cases), sinus formation in 5 cases (allograft group in 3cases;auto-graft group in 2cases), chronic pain of the donor site in 6 cases (group autograft). Conclusion There was no significant difference between allogeneic iliac graft and autologous iliac graft in the treatment of thoracolumbar tuberculosis. Allogeneic iliac bone may be the ideal substitute of autologous iliac bone for the clinical treatment of thoracolumbar tuberculosis.

Objective To construct the recombinant adeno-associated virus vector carrying cancerous inhibitor of PP2A (CIP2A)short hairpin RNA (shRNA)for preparation of high-titer viruses.Methods The small hairpin RNA of CIP2A (CIP2A shRNA)was designed,synthesized and cloned into pDC31 6-EGFP-U6 plasmid which was double digested by Bam HⅠ and Hin dⅢ.The resultant plasmid pDC31 6-EGFP-shRNA was confirmed and served as template to appraise primers.EGFP-CIP2A shRNA sequence was amplified by PCR,double digested with Eco RⅠand Sal Ⅰ and ligated to pSNAV2.0 plasmid digested with the same enzyme pair.pSNAV2.0-EGFP-CIP2A shRNA plasmid DNA was prepared,purified,identified and transfected into BHK-21 cells.BHK-21 cells expressing CIP2A shRNA (BHK-21/CIP2A-shRNA ) were obtained and subsequently infected with VGTC’s proprietary AAV packaging system to package the rAAV2-CIP2A shRNA.After purification,the functional and infectious virus was obtained and the titer of virus was detected.Real-time PCR and Western blot methods were used to detect the expression of CIP2A after infection with HepG2 cells,and the empty viral vector rAAV2-EGFP was used as control. Results A recombinant adeno-associated virus-2 vector carrying CIP2A shRNA was constructed successfully.The presence of the target sequence in the vector was confirmed by double enzyme digestion and sequencing.By transfecting the pSNAV2.0-EGFP-CIP2A shRNA plasmid into BHK-21 cells,BHK-21/CIP2A shRNA cells were infected with helper virus HSV1-rc/ΔUL2 to package the rAAV2-CIP2A shRNA to obtain a functional and infectious virus.The titer of the recombinant virus was 0.25×10 1 2 v.g./mL.The expression of CIP2A mRNA and screening value of 1×10 5 MOI effected HepG2 cells.Conclusion A high-titer recombinant adeno-associated virus-2 vector carrying CIP2A shRNA has been constructed successfully.

This study was aimed to improve the sensitivity of magnetic induction phase shift detection system for cerebral hemorrhage. In the study, a cerebral hemorrhage model with 13 rabbits was established by injection of autologous blood and the cerebral hemorrhage was detected by utilizing magnetic induction phase shift spectroscopy (MIPSS) detection method under the feature band. Sixty five groups of phase shift spectroscopy data were obtained. According to the characteristics of cerebral hemorrhage phase shift spectroscopy under the feature hand, an effective method, B-F distribution, to diagnose the severity of cerebral hemorrhage was designed. The results showed that using MIPSS detection method under feature band, the phase shift obviously growed with increase of injection volume of autologous blood, and the phase shift induced by a 3-mL injection reached -7.750 3 degrees ± 1.420 4 degrees. B-F distribution could effectively diagnose the severity of cerebral hemorrhage. It can be concluded that the sensitivity of the cerebral hemorrhage magnetic induction detection system is improved by one order of magnitude with the MIPSS detection method under the feature band.
Animals ; Cerebral Hemorrhage ; diagnosis ; Magnetic Phenomena ; Magnetics ; Rabbits ; Spectrum Analysis ; methods

Objective To evaluate the feature of level Ⅱaxillary lymph nodes from breast cancer detected by ultrasound. Methods Eighty-nine cases of breast cancers with level Ⅱaxillary lymph nodes diagnosed in Sun Yat-sen University Cancer Center from January 2008 to October 2013 were retrospectively studied, including 66 cases of breast cancer patients pre-operatively, 23 cases of breast cancer post-operatively, all cases were female. The number, size, long/short ratio, presence of a hilum, and Doppler features of the lymph nodes were observed. The accuracy sensitivity, speciifcity, positive predictive value (PPV), and negative predictive value (NPV) of each signiifcant parameter were analyzed. Results Ultrasound examination revealed more than axillary lymph nodes, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 71.9%, 56.8%, 89.7%, 87.9%and 61.4%respectively. The maximum diameter of levelⅡaxillary lymph node was more than or equal to 10 mm, the accuracy sensitivity, specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 67.4%, 58.0%, 79.5%, 78.4%and 59.6%respectively. If there were two ultrasonographic characteristics simultaneously, the diagnostic sensitivity (87.8%) and accuracy (78.6%) could be significantly improved, the specificity, positive predictive value and negative predictive value of diagnosing lymph nodes were 60.0%, 72.3%and 80.0%. Conclusion The number and size of lymph nodes in level Ⅱaxillary area are valuable sonographic characteristics for the diagnosis of benign and malignant lymph nodes.

The study investigated the effects of heat shock protein 70 (HSP70) antisense oligonucleotide (ASODN) on the proliferation and apoptosis of a human hepatocellular carcinoma cell line (SMMC-7721 cells) in vitro. HSP70 oligonucleotide was transfected into SMMC-7721 cells by the mediation of Sofast transfection reagent. Inhibition rate of SMMC-7721 cells was determined by using MTT method. Apoptosis rate and cell cycle distribution were measured by flow cytometry. Immunocytochemistry staining was used to observe the expression of HSP70, Bcl-2 and Bax. The results showed that HSP70 ASODN at various concentrations could significantly inhibit the growth of SMMC-7721 cells, and the inhibition effect peaked 48 h after transfection with 400-nmol/L HSP70 ASODN. Cytometric analysis showed the apoptotic rate was increased in a dose- and time-dependent manner in the HSP70 ASODN-treated cells. The percentage of cells in the G(2)/M and S phases was significantly decreased and that in the G(0)/G(1) phase increased as the HSP70 ASODN concentration was elevated and the exposure time prolonged. Immunocytochemistry showed that treatment of SMMC-7721 cells with HSP70 ASODN resulted in decreased expressions of HSP70 and Bcl-2 proteins, and an increased expression of Bax protein. It was concluded that the HSP70 ASODN can inhibit the growth of the SMMC-7721 cells and increase cell apoptosis by down-regulating the expression of HSP70. HSP70 ASODN holds promise for the treatment of hepatocellular carcinoma.

The study investigated the effects of heat shock protein 70(HSP70)antisense oligonucleotide (ASODN)on the proliferation and apoptosis of a human hepatocellular carcinoma cell line(SMMC-7721 cells)in vitro.HSPT0 oligonucleotide was transfected into SMMC-7721 cells by the mediation of SofastTM transfection reagent.Inhibition rate of SMMC-7721 cells was determined by using MTT method.Apoptosis rate and cell cycle distribution were measured by flow cytometry.Immunocytochemistry staining was used to observe the expression of HSP70,Bcl-2 and Bax.The results showed that HSP70 ASODN at various concentrations could significantly inhibit the growth of SMMC-7721cells,and the inhibition effect peaked 48 h after transfection with 400-nmol/L HSP70 ASODN.Cytometric analysis showed the apoptotic rate was increased in a dose-and time-dependent manner in the HSP70 ASODN-treated cells.The percentage of cells in the G2/M and S phases was significantly decreased and that in the G0/G1 phase increased as the HSP70 ASODN concentration was elevated and the exposure time prolonged.Immunocytochemistry showed that treatment of SMMC-7721 cells with HSP70 ASODN resulted in decreased expressions of HSP70 and Bcl-2 proteins,and an increased expression of Bax protein.It was concluded that the HSP70 ASODN can inhibit the growth of the SMMC-7721 cells and increase cell apoptosis by down-regulating the expression of HSP70.HSP70ASODN holds promise for the treatment of hepatocellular carcinoma.

Objective: To observe the therapeutic effects of effective compounds which were extracted from TongMai. Methods: SD rats experimential model with MsPGN were induced by subcutaneously injection rabbit anti-rat thymocyte serum(ATS) and forced swim. The rats were respectively ig with different dose(1.2,0.6,0.3 g'kg-1) of effective compound of TongMai for 4 weeks. Then the proliferative degree of mesangium was examined by HE stain, PAS stain and immunfluorescent respectively. Mesagium area proportion in glomerular capillaries area was calculated using image analyzing system. The expression of PCNA in the glomeruli was examined by immunohis to chemistry. Results: The effective compounds of TongMai can control the hyperplasia of the glomemlar mesangial cells (GMG)and the mainifold of the mesangial matrix, and prevent the deposit of IgG in mesangium. The proportions in glomerular capillaries area in model control group were significantly higher than that in the treatment groups; The express of proliferative cell nuclear antigen (PCNA) were ascended either. Conclusion: The effective compound of TongMai can improve the damage s of pathology in glomerular.