ABSTRACT
Objective:To compare the effect and biotoxicity of tert-butyl acetate (TBA) and ethyl butyrate (EB) on stone dissolution in vitro.Methods:Ten gallstone samples from patients with multiple gallbladder stones were selected and the cholesterol content was analyzed by HPLC. Stone dissolution tests of TBA and EB were performed on cholesterol gallstone in vitro, and the weight of stone at each time point was recorded, meanwhile, methyl tert-butyl ether (MTBE) was used as the control. The inhibitory effects of MTBE, TBA and EB on proliferation of human normal liver cell line LO2 were analyzed by cell proliferation inhibition assay. Flow cytometry was used to analyze the effects of MTBE, TBA and EB on the early and late apoptosis of LO2 cells, and the changes of reactive oxygen species level in LO2 cells were also analyzed.Results:Of the 10 gallbladder gallstones, 6 were cholesterol gallstones and 4 were non-cholesterol gallstones. Stone dissolution experiment showed that the remaining stones of MTBE, TBA and EB groups were (47.83±3.84)%, (58.12±4.53)% and (75.75±4.61)% 30 minutes later. The remaining stones were (18.38±6.47)%, (33.82±6.22)% and (56.38±3.91)% 90 minutes later. MTBE had the best stone dissolution effect in vitro, the stone dissolution effect of TBA was slightly weaker than MTBE, and the stone dissolution effect of EB was relatively weak in all ( P<0.05). The cell proliferation inhibition experiment showed that the cell viability of the control group, MTBE group and TBA group were (100.00±4.46)%, (96.79±4.32)% and (93.72±3.51)%, respectively, and there were no significant differences among the three groups ( P>0.05). However, the cell viability of EB group (87.57±5.29)% was lower than the above three groups, and the differences were statistically significant ( P<0.001). The early apoptosis and late apoptosis of the control group were (1.67±0.15)% and (1.27±0.06)%, respectively. EB induced early apoptosis (15.90±0.53)% ( P<0.001) and late apoptosis (5.13±0.76)% ( P<0.05). However, MTBE and TBA had no significant effect on cell apoptosis ( P>0.05). Compared with control group, MTBE, TBA and EB all significantly inhibited the level of reactive oxygen species ( P<0.05), and the inhibitory effect of EB was the most obvious. Conclusions:TBA has good stone dissolution effect and biosafety for gallbladder cholesterol stones in vitro, while EB has relatively poor performance. TBA is a potential drug for gallstone dissolution.
ABSTRACT
Objective:To investigate the surgical techniques and advantages of Ti-Robot-assisted surgery for pelvic fragility fractures in the elderly.Methods:A retrospective review was performed on geriatric patients presenting with pelvic fractures at the Orthopedics Department of Trauma, China-Japan Union Hospital of Jilin University from September 2019 to December 2022. Minimally invasive procedures were executed with the assistance of the Ti-Robot, and the therapeutic outcomes were appraised. The cohort comprised 24 patients aged ≥60 years, consisting of 6 men and 18 women, with a mean age of 66.1±4.9 years (range, 60-77 years). Fourteen patients sustained high-energy trauma, while 10 encountered low-energy trauma. Fracture classification utilized the FFP system proposed by Rommens and Hofmann. The cohort included 20 patients with FFP II fractures (5 males, 15 females; 4 of type IIa, 12 of type IIb, and 4 of type IIc) and 4 patients with FFP III fractures (1 male, 3 females; all type IIIa). The Matta standard assessment scale gauged fracture reduction, while the Gras classification, with Ti-Robot assistance, assessed screw positioning. Postoperative functionality was holistically assessed based on the Majeed quantitative evaluation system, focusing on pain intensity, sitting, standing, walking, and daily activities. The visual analogue scale (VAS) gauged pain levels in patients with type II fractures, pre and 72 hours post-surgery.Results:According to the Matta standard assessment scale, postoperative fracture reduction quality in 24 elderly patients showed 18 as excellent, 4 as good, and 2 as fair, yielding a 92% (22/24) combined excellent and good rate. Based on the Gras classification, 52 screws were rated as excellent and 7 as good, achieving a 100% positive rate. Utilizing Majeed's modified pelvic fracture evaluation system, postoperative functional recuperation revealed 19 patients as excellent and 5 as good. There were no reports of severe internal disease exacerbations, neurological manifestations, infections, or intraoperative extensive hemorrhaging, with all patients remaining stable. Fractures exhibited robust healing during follow-ups, averaging a recovery time of 3.5±0.7 months (range, 3-5 months). The VAS for 20 patients with FFP type II fractures decreased from 6.3±2.0 pre-surgery to 4.1±1.4 post-surgery ( t=6.14, P=0.003), signifying substantial pain mitigation. Conclusion:In the elderly with pelvic fragility fractures, particularly type II, securing with channel screws is viable. The Ti-Robot-assisted minimally invasive approach is advocated due to its potential to diminish surgical risks and expedite postoperative recuperation.
ABSTRACT
Objective To investigate the expressions of peroxisome proliferator activated receptor-γ (PPAR-γ) and β-catenin in 5-aminosalicylic acid （ASA) intervened colitis carcinogenesis mouse model induced by azoxymethane (AOM) and dextran sulfate sodium (DSS).Methods Thirtysix BALB/c mice were evenly divided into control group,model group,and intervention group.For model group and intervention group,mice were intraperitoneally injected with AOM (10 mg/kg) one day before experiment,then drank 4％ DSS solution freely for one week and followed with common drinking water for another two weeks.Taking 4％ DSS solution and common drinking water repeated for three cycles.For intervention group,5-ASA (150 mg/kg) was given from three days before experiment to the end of research.For control group,mice were intraperitoneally injected with 0.9％NaCl solation and then given common drinking water for nine weeks.The symptoms of the disease were monitored in mice and pathological changes of tissues were evaluated at the end of first week and ninth week.At the end of the ninth week,the expressions of PPAR-γ,β-catenin protein and PPAR-γat mRNA level in colon tissue were detected.The data were analyzed by t test.Results The colitis disease activity index (DAI) index of intervention group was 1.81 ±0.59 after drinking DSS solution for one week and the number of tumor was 4.11 ± 1.05 at the end of the ninth week,both were significantly lower than those of model group (2.47 ± 0.53 and 9.71±2.29 respectively,t=2.88 and 6.55; both P＜0.01).The expression of PPAR-γ at protein level (2.11±1.36) and mRNA level (1.45±0.10) in colon tissue of intervention group significantly increased compared with those of model group (0.43±0.53 and 0.57±0.08 respectively,t=3.07 and 18.99,both P＜0.01).There was no significant difference of β-catenin expression among groups (P＞0.05).Conclusions 5-ASA can efficiently improve the inflammatory reaction and tumor load in AOM and DSS induced colitis carcinogenesis mouse model,and at the same time can promote the expression of PPAR-γ in colon.However,there was no significant influence on the expression of β-catenin.