Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

Objective To observe the clinical effect of endovascular stent implantation in the treatment of patients with ischemic cerebrovascular disease (ICVD) and carotid artery stenosis. Methods A total of 83 patients with ICVD treatment were selected and divided into observation group with 43 cases and control group with 40 cases, and the hemodynamic indicators and degree of internal carotid artery stenosis, neural markers and vascular endothelial function, degree of neurological deficits, clinical efficacy, and adverse reactions were compared between the two groups. Results Peak systolic velocity (PSV), end-diastolic velocity (EDV), and degree of vascular stenosis in both groups showed a downward trend after treatment, and the declines in PSV, EDV and vascular stenosis in the control group were all significantly smaller than those in the observation group (P < 0.05). After treatment, the positive pentraxin-3 (PTX-3) and neuron-specific enolase (NSE) levels in both groups decreased significantly, while functional movement disorder (FMD) and vascular endothelial growth factor (VEGF) levels increased significantly, and the PTX-3 and NSE levels in the observation group were significantly lower than those in the control group, while the VEGF and FMD levels were significantly higher (P < 0.05). After treatment, scores of the National Institutes of Health Stroke Scale (NIHSS) and the Modified Edinburgh-Scandinavian Stroke Scale (MESSS) in both groups decreased, and the decline in NIHSS score and MESSS in the control group was smaller than that in the observation group. Clinical total effective rate was 80.00% in the control group, which was significantly lower than 97.67% in the observation group (P < 0.05). The incidence of adverse reactions in the observation group was 2.33%, which was significantly lower than 22.50% in the control group (P < 0.05). Conclusion Endovascular stent implantation can effectively improve the clinical efficacy of ICVD patients, relieve the degree of vascular stenosis, improve cognitive function, and has higher safety.

OBJECTIVE: Bo investigate the regulatory relationship between NKD1 and YWHAE and the mechanism of NKD1 for promoting tumor cell proliferation. METHODS: HCT116 cells transfected with pcDNA3.0-NKD1 plasmid, SW620 cells transfected with NKD1 siRNA, HCT116 cells with stable NKD1 overexpression (HCT116-NKD1 cells), SW620 cells with nkd1knockout (SW620-nkd1^-/- cells), and SW620-nkd1^-/- cells transfected with pcDNA3.0-YWHAE plasmid were examined for changes in mRNA and protein expression levels of YWHAE using qRT-PCR and Western blotting. Chromatin immunoprecipitation (ChIP) assay was used to detect the binding of NKD1 to the promoter region of YWHAE gene. The regulatory effect of NKD1 on YWHAE gene promoter activity was analyzed by dual-luciferase reporter gene assay, and the interaction between NKD1 and YWHAE was analyzed with immunofluorescence assay. The regulatory effect of NKD1 on glucose uptake was examined in the tumor cells. RESULTS: In HCT116 cells, overexpression of NKD1 significantly enhanced the expression of YWHAE at both the mRNA and protein levels, while NKD1 knockout decreased its expression in SW620 cells (P < 0.001). ChIP assay showed that NKD1 protein was capable of binding to the YWHAE promoter sequence; dual luciferase reporter gene assay showed that NKD1 overexpression (or knockdown) in the colon cancer cells significantly enhanced (or reduced) the transcriptional activity of YWHAE promoter (P < 0.05). Immunofluorescence assay demonstrated the binding of NKD1 and YWHAE proteins in colon cancer cells. NKD1 knockout significantly reduced glucose uptake in colon cancer cells (P < 0.01), while YWHAE overexpression restored the glucose uptake in NKD1-knockout cells (P < 0.05). CONCLUSION NKD1 protein activates the transcriptional activity of YWHAE gene to promote glucose uptake in colon cancer cells.
Humans ; Colonic Neoplasms ; HCT116 Cells ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; RNA, Messenger ; Glucose ; Calcium-Binding Proteins/metabolism* ; Adaptor Proteins, Signal Transducing/metabolism* ; 14-3-3 Proteins/metabolism*

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective To evaluate the effect of limited open reduction in the treatment of femoral shaft fractures with intramedullary nail.Methods The clinical data of 39 patients with femoral shaft fractures in the Department of Orthopedic Surgery,Southern Medical University Xiaolan Affiliated Hospital from January 2016 to December 2017 were retrospectively analyzed.All patients were treated with intramedullary nailing.Among them,25 cases were treated with limited open reduction (observation group) and 14 cases were treated with closed reduction (control group).The operation time,fluoroscopy frequency,blood loss volume,infection rate and curative effect were compared between 2 groups.Results The 39 patients were followed up for 7 to 25 (10.3 ± 2.8) months.The operation time and fluoroscopy frequency in observation group were significantly lower than those in control group:(111.4 ± 20.3) min vs.(129.3 ± 21.4) min and (7.0 ± 2.6) times vs.(22.6 ± 7.8) times,but the blood loss volume was significantly higher than that in control group:(454.0 ± 131.4) ml vs.(342.9 ± 120.7) ml,and there were statistical differences (P＜0.05 or ＜0.01);there was no statistical difference in the infection rate and excellent/ good rate between 2 groups (P＞0.05).Conclusions Limited open reduction simplifies the operation steps,shortens the operation time,and has fewer fluoroscopy times and less X-ray time.It can achieve the same effect as closed reduction,and can be used as an effective supplementary means when closed reduction equipment and technology are deficient.

Hypercalcemic crisis (HC) is a rare but critical electrolyte disorder, which may result in death if rapid correct management is not given due to the injury of the neurologic, cardiovascular and renal systems. Severe primary hyperthyroidism (PHPT) is listed as the most common cause of hypercalcemic crisis. Prompt surgical removal of the parathyroid glands is the most effective cure for HC. Nevertheless, hypercalcemic crisis after a successful parathyroidectomy is infrequent. Now, we report a case admitted to the Department of General Surgery of the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital about a successful therapy of hypercalcemic crisis postparathyroidectomy in Sep. 2019, aiming to remind clinicians of the individualized program of calcium supplement after surgery of hyperparathyroidism and emphasize the value of renal dialysis in HC.

Objective To evaluate the ELISA kit for detection of IgG antibodies against Taenia solium cysticercus in hu-mans,so as to provide a reference for its application in clinical practice. Methods The sera collected from the patients with neurocysticercosis,echinococcosis,taeniasis and healthy people,respectively,were checked by ELISA for specific IgG anti-bodies against T. solium cysticercus,as described in the instruction of the kit. Results Of the 30 patients with neurocysticerco-sis at active stage,28 showed seropositive reaction,indicating a sensitivity of 93.33%. There were no positive reactions in the 100 healthy people. Two of the 42 persons with taeniasis were seropositive with an infection rate of 4.76%. Forty-one of the 60 persons with echinococcosis showed positive reactions,suggesting that the cross reaction rate of the kit with echinococcosis was 68.33%. Conclusions The assessed ELISA kit has a reasonably high sensitivity but a poor specificity,and the cross reaction rate with echinococcosis is very high. It is urgent to improve the sensitivity and specificity of the diagnostic kit for detection of T. solium cysticercosis in China.

OBJECTIVETo study postoperative anorectal dynamic change in ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection.

METHODSClinical and follow-up data of 26 ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection in our department from January 2007 to January 2013 were retrospectively analyzed (observation group). Thirty rectal cancer patients undergoing laparoscopic low anterior resection by the same surgical team in the same period from the Medical Record Room were randomly extracted as control group. The observation indexes included preoperative and postoperative anal resting pressure(ARP), anal maximum squeeze pressure (AMSP), rectal maximum tolerable volume (RMTV), rectal anal inhibition reflex (RAIR) and Wexner anal function scores (0 means normal).

RESULTSThere were no significant differences in clinical baseline data between the two groups(all P>0.05), except the distance from lower edge of tumor to dentate line [(2.9±0.4) cm in observation group vs. (5.0±0.5) cm in control group, P=0.000]. There were no differences in preoperative anorectal manometry and Wexner anal function score between two groups (all P>0.05). The average follow-up time in observation group and control group was 14.5 months and 14.0 months respectively. Three months after operation, significant differences between observation group and control group (all P=0.000) were as follows: defecation frequency [(6.0±1.5) times/day vs. (2.5±1.0) times/day], Wexner anal function score(5.0±0.9 vs. 2.9±1.2), ARP [(32.0±6.7) mmHg vs. (45.0±8.2) mmHg], AMSP [(90.1±6.9) mmHg vs. (110.0±7.5) mmHg], RMTV [(61.0±7.2) ml vs. (91.1±7.5) ml] and positive rate of RAIR [11.5%(3/26) vs. 66.7%(20/30)]. One year after surgery, there were no significant differences in defecation frequency, Wexner anal function scores, ARP, AMSP and RMTV between the two groups (all P>0.05), however the difference in positive rate of RAIR was still significant[38.5%(10/26) vs. 93.3%(28/30), P=0.000].

CONCLUSIONLaparoscopic intersphincteric resection for ultra- low rectal cancer can achieve satisfactory anorectal dynamic effect.

Aged ; Anal Canal ; physiopathology ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Postoperative Period ; Pressure ; Rectal Neoplasms ; surgery ; Rectum ; physiopathology ; Retrospective Studies

Objective To explore the efficacy of process management on bladder function among traumatic brain injury (TBI) patients admitted to intensive rehabilitation and care unit (IRCU). Methods 33 cases were collected to control group who were cared with routing nursing during February, 2011 to December, 2012. Other 39 cases were recruited to trial group cared with process management of bladder function during January, 2013 to December, 2014. Process management of bladder function contained the establishment of process manage-ment guide, evaluation of removing catheter, nursing of bladder based on residue of urine volume and keeping a diary of urination, etc. Re-sults There were more cases with residue of urine volume less than 100 ml and less with catheter associated urinary tract infection in the tri-al group than in the control group (P<0.05). Conclusion Process management of bladder function can improve the recovery of bladder func-tion of TBI patients, shorten rehabilitation time and decrease the risk of catheter associated urinary tract infection.

OBJECTIVE: To investigate the strategies of posterior short-segment fixation and plant iliac fusion surgery, and the clinical efficacy of them on the treatment of upper cervical vertebra trauma. METHODS: Three hundred and thirty-four patients with upper cervical vertebra trauma admitted into our hospital from June, 2005 to April, 2010 were studied retrospectively. Thirty-six were treated by posterior short-segment fusion, which included 22 and 14 male and female patients, respectively. Among them, 23 or 6 patients were related to traffic or falling accident, 5 or 2 patients were related to crashing object or fight. The clinical efficacy was evaluated by head and neck pain VAS score, JOA scores of nerve function and the rate of graft bone fusion. RESULTS: The postoperative VAS scores were lower than that of pre-operation, and the difference was significant (P<0.001). The postoperative JOA scores of nerve function was superior to preoperative scores (P<0.05). During follow-up, no internal fixation failure happened while bony fusion could be seen. CONCLUSION The method of posterior short-segment fixation and bone graft fusion in treating patients with cervical spine injury is highly efficacy, which possesses great clinical value.
Bone Transplantation ; Cervical Vertebrae ; injuries ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome