Risk factors and functional evaluation of recurrence after resection of thigh soft tissue malignant tumor / 中华骨科杂志

Objective:To explore the risk factors of recurrence after resection of thigh soft tissue malignant tumors and the evaluation of the postoperative lower limb function.Methods:A total of 211 patients who underwent thigh soft tissue malignant tumor resection in the Department of Orthopaedics of the second affiliated Hospital of Medical College of Zhejiang University from May 2011 to May 2021 were retrospectively analyzed, including 117 males and 94 females, aged 53 (43, 65) years. There were 59 cases of atypical/well-differentiated liposarcoma, 30 cases of other types of liposarcoma, 33 cases of malignant fibrous histiocytoma, 19 cases of fibrosarcoma, 12 cases of rhabdomyosarcoma, 12 cases of leiomyosarcoma, 9 cases of synovial sarcoma, and 37 cases of others. The tumor involvement of muscle, bone, blood vessel, nerve tissue and intermuscular compartment, postoperative Musculoskeletal Tumor Society (MSTS) functional score and recurrence were recorded. The relationship between anatomical structure and postoperative recurrence was analyzed by Cox logistic regression to determine risk factors; the cumulative recurrence rate of different compartment groups (medial compartment, anterior compartment, and posterior compartment) were compared; The Box plot was used to compare the postoperative function of patients with resection of different anatomical structures (e.g., vastus lateralis, biceps femoris, femur, etc.).Results:A total of 34 out of 211 patients relapsed, with a recurrence rate of 16.1%. The recurrence time ranged from 2.6 months to 91.6 months after operation, with a median recurrence time of 37.0 (18.2, 52.8) months. Three independent risk factors were found to be associated with recurrence, namely: pathological grade [ HR=3.86, 95% CI(1.75, 8.51)], involvement of vastus intermedius [ HR=3.05, 95% CI(1.53, 6.06)], and involvement of vastus medialis [ HR=3.17, 95% CI(1.56, 6.41)]. The recurrence rate of patients with anterior chamber tumor resection was 35.3%, which was higher than that of patients without tumor resection (16.2%), and the difference was statistically significant ( P=0.020). There was no significant difference in recurrence rate between patients with medial chamber tumor resection and patients without tumor resection ( P>0.05). The recurrence rate of patients with posterior compartment tumor resection was 12.3%, which was lower than that of unresectable patients (37.6%), and the difference was statistically significant ( P=0.002).The postoperative MSTS score of 167 patients averaged 26±3.2 points (9-30 points). After intraoperative resection of part of the femur, vastus intermedius, vastus medialis, and rectus femoris, the patient's function was relatively poor [corresponding median MSTS score: 25 (23, 28), 26 (24 28), 26 (24,28), 26(24, 27)]. Conclusion:The risk factors for local recurrence after resection of thigh soft tissue malignant tumors include: pathological grade of the tumor, and whether the vastus intermedius or vastus medialis is involved. Anterior compartment tumors have a higher recurrence rate after surgery. If the tumor involves the above-mentioned anatomical structures, more attention should be paid to the risk of local recurrence after surgery.

Mini-open excision of osteoid osteoma using burrs with the guidance of O-arm navigation / 中华骨科杂志

Objective:To investigate the surgical method and clinical effect of O-arm navigation mini-open burring for osteoid osteoma.Methods:Eighteen patients with osteoid osteoma were treated with O-arm guided grinding drill from June 2021 to May 2022, including 15 males and 3 females, the age was (18.4 ±10.9) years (range 2 to 44 years), and the course of disease ranged from 1 week to 3 years (mean 14.2 months). The lesions sites included 6 cases of proximal femur, 3 cases of distal femur, 4 cases of proximal tibia, 1 case of distal tibia, 2 cases of proximal fibula and 1 case of distal and proximal humerus. During the operation, the O-arm navigation was used to determine the location of the focus, the muscle and soft tissue was peeled off to the bone surface through a 1-4 cm small incision, the channel retractor was placed, and the burr was registered as a navigation recognition device to gradually remove the bone on the surface of the tumor nest, and the tumor nest was scraped with a curette for pathological examination; according to the navigation image, the focus was enlarged removed with burr and the grinding range was confirmed by the O-arm X-ray machine before the end of the operation. The patients were followed up for 6 to 15 months (mean 9.5 months). CT scans were performed before and after surgery for imaging comparison in order to figure out whether it had residual lesions or recurrence. The visual analogue score (VAS) of pain was used as a parameter for evaluating the clinical efficacy.Results:The operation time of 18 cases was 40-175 min, with an average of 89.3 min. The time required to establish navigation image was 18.0 ±4.1 min (range 13 ~ 22 min). The length of the incision was 2.7±1.1 cm (range 1-4 cm). All patients achieved complete curettage of the lesions, and osteoid osteoma was confirmed by pathology after operation. All the patients could move to the ground 24 hours after operation, and the pain was significantly relieved from 3 to 7 d after operation, and the pain almost disappeared 3 months after operation. The VAS score of 18 cases was 5.33±1.24 before surgery, 2.79±1.32 on the 3rd day, 1.86±1.21 on the 7th day, 0.86±0.93 on the 1st month, 0.33±0.48 on the 3rd month, and 0.09±0.29 on the 6th month after operation, and the difference was statistically significant ( F=58.50, P<0.001). There were no serious complications during and after operation, and the success rate of treatment (no recurrence of symptoms, no residual recurrence of imaging lesions, no serious complications after operation) was 100%. Conclusion:Treatment of osteoid osteoma with mini-open excision using burrs under the navigation of O-arm is a simple, safe, minimally invasive and efficient technique. Intraoperative precise positioning and the use of burr with navigation to remove a larger area than the tumor nest are the keys to successful treatment.

Clinical features and prevention of dislocation after resection and reconstruction of tumors involving pelvic area II / 中华骨科杂志

Objective:To explore the clinical characteristics of dislocation after resection and reconstruction of tumors involving pelvic area II, and to try to propose intraoperative and postoperative techniques to prevent its occurrence.Methods:From March 2011 to March 2021, 122 patients with resection and reconstruction involving pelvic area II were retrospectively analyzed. Among them, 17 had postoperative dislocation, 32 had pelvic area II, and 31 had pelvic area I+II. There were 40 cases in the pelvic area II+III, and 19 cases in the pelvic area I+II+III. There were 49 female patients and 73 male patients; the mean age was 47 years (9-73 years). The Musculoskeletal Tumor Society (MSTS) score of lower extremity patients after reduction was evaluated, and the clinical characteristics of dislocation, such as dislocation direction, dislocation time and reduction method, were counted and analyzed, and feasible prevention measures were analyzed based on the imaging characteristics after resection and reconstruction. dislocation method.Results:Among the 122 patients, there were 17 cases of dislocation, and the dislocation rate was 13.7%. Among them, 12 cases were anterior dislocation, accounting for 70.6% of anterior dislocation; 5 cases were posterior dislocation, and the proportion of posterior dislocation was 29.4%, difference (χ 2=4.52, P=0.033). There were 12 cases of dislocation within 3 months after operation, accounting for 70.6%; 1 case of dislocation occurred in 5 months after operation, and the other 4 cases of dislocation occurred for more than one year. The MSTS score of the dislocation patients after reduction was 56.1±15.6% (20%-80%). Combined with postoperative imaging examinations, the feasible methods for preventing dislocation include: The anteversion angle of the acetabular cup can be appropriately reduced (0°-10°); The acetabular cup can be appropriately shifted to the rear of the rotation center; Appropriately reducing the anteversion angle of the femoral neck prosthesis, the combination of the three can reduce the occurrence of femoral-acetabular prosthesis impingement; at the same time, the affected limb is controlled in a neutral position with strict nail shoes after surgery to avoid the occurrence of external rotation. Conclusion:The dislocation after tumor resection and reconstruction in pelvic area II is mostly anterior dislocation. Postoperative CT scan of the pelvis shows that the space between the neck of the femoral stem prosthesis and the lower edge of the acetabulum is small, which is prone to impingement. If the anteversion angle of the acetabular cup is appropriately reduced, the acetabular prosthesis is appropriately displaced posteriorly, and the anteversion angle of the femoral neck is reduced by 5°, the possibility of femoral-acetabular impingement can be reduced, thereby reducing the risk of postoperative dislocation.

Clinicopathological features in predicting pCR of NAC for breast cancer based on Logistic regression and Nomogram / 中华内分泌外科杂志

Objective:To investigate the predictive value of the clinicopathological features of breast cancer for pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) and to establish a predictive model based on the clinicopathological features.Methods:Clinicopathological data collected from 182 patients who underwent NAC and surgical treatment in Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine from Jan. 2013 to Dec. 2019 were retrospectively analyzed. The univariate and multivariate analysis were used to analyze the relationship between clinicopathological features and pCR after neoadjuvant chemotherapy. The predictive value in predicting the efficacy of NAC was evaluated, the receiver operating characteristic (ROC) curve and Nomogram prediction model were constructed.Results:Multivariate Logistic regression analysis showed that progesterone receptor (PR) , human epidermal growth factor 2 (HER2) and platelet distribution width (PDW) were independent predictors of pCR after NAC for breast cancer. The area under the curve (AUC) of model for predicting efficacy of NAC was 0.810 (95% CI:0.745-0.864) and the sensitivity and specificity was 68.75% and 82.67% respectively when the Jordan Index is at its maximum. Conclusion:ER-, HER2+ and PDW≤13.4% show better efficacy of NAC. The Nomogram model based on them can accurately predict the efficacy of NAC and can provide a reference for the selection of treatment options in clinical diagnosis and treatment.

The Initial Experience of Video-assisted Thoracic Surgery Segmentectomy for Early Stage Lung Cancer / 中国肺癌杂志

BACKGROUND@#Segmentectomy can retains more healthy lung tissue than lobectomy, but it remains controversial in oncology for early stage lung cancer. The aim of this study is to discuss the problems of video-assisted thoracic surgery (VATS) segmentectomy in early stage lung cancer, by analyzing the clinical and pathological data of 35 cases and reviewing the literature.@*METHODS@#There were 35 patients who received segmentectomy by complete video-assisted thoracic surgery, from May 2013 to July 2017, in single operation group in the Third Hospital of Peking University. We analyzed the patient's clinical and pathological data, intraoperative and postoperative complications, lymph node number and metastasis its situation, and compared postoperative pathology and preoperative computed tomography (CT) imaging type. In 35 cases of segmentectomy, there were 11 males and 24 females, with an average age of 57.7 years old. The lesions located in the right upper lobe were 8 cases, in the right lower lobe were 8 cases, in the left upper lobe were 13 cases, in the left lower lobe were 6 cases. The mean maximum diameter of CT imaging was 12.7 mm, and the largest diameter of hilar and mediastinal lymph nodes was less than 10 mm. 23 of them were ground glass predominating and 12 were solid components predominating.@*RESULTS@#All 35 cases were successfully completed VATS anatomical segmentectomy. The average operation time was 153 minutes, the amount of bleeding was 51 mL. There were 10 cases of air leakage after operation, all of which were not more than 3 days. There was contralateral atelectasis in 1 case, chylothorax in 1 case. The average length of hospitalization was 6.1 days. There was no other complications outpatient related to surgery, in 30 days after discharge. The pathological changes were as follow, 2 cases of metastatic tumor, 8 cases of benign lung disease and 25 cases of primary lung cancer. In the 25 cases of primary lung cancer, there were 14 cases of invasive lung adenocarcinoma (7 cases were groundglassopacity (GGO) predominating in CT imaging), 4 cases of micro-invasive adenocarcinoma (3 cases were GGO predominating in CT imaging), 6 cases of adenocarcinoma in situ (all were pure GGO in CT imaging), 1 case of lung squamous cell carcinoma (mainly composed of solid in CT imaging). An average of 7.2 lymph nodes were removed in 25 cases of lung cancer, and all lymph nodes had no metastasis.@*CONCLUSIONS@#VATS anatomical segmentectomy is technically safe and reliable, and the indications for lung cancer need to be strictly controlled. Its advantages still need to be confirmed by prospective randomized controlled trials.

Clinical significance of serum microRNA-222-3p expression in papillary thyroid carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of serum miR-222-3p in papillary thyroid carcinoma and its clinical significance.METHODS Total RNA in serum was extracted from 121 patients of papillary thyroid carcinoma and benign thyroid diseases.The reverse transcription quantitative real-time polymerase chain reaction(qRT-PCR) method was used to detect the expression of miR-222-3p,and then the potential correlation between serum miR-222-3p and clinical pathological characteristics of papillary thyroid carcinoma was analyzed.The receiver operating characteristic area under the curve(ROCAUC) and their index for diagnosis evaluation were also calculated.RESULTS The median expression level of serum miR-222-3p in papillary thyroid carcinoma patients was significantly higher than that of control group (2.2188 vs 0.7022,P=0.002).Although the expressions of serum miR-222-3p was not associated with the gender,age,capsule invasion,TNM stage,but it was positively correlated with tumor size,bilateral involvement,lesion quantity and lymph node status.ROC curve analysis showed that the specificity and sensitivity of the miR-222-3p diagnosis of papillary thyroid cancer were 79.75％ and 61.90％,respectively,while the ROC-AUC was 0.717.CONCLUSION The serum miR-222-3p is over expressed in papillary thyroid carcinoma and its expression is significantly correlated with tumor progression.It will be helpful for PTC diagnosis.

Progress study of miRNA in papillary thyroid carcinoma / 中华内分泌外科杂志

MiRNAs represent a class of short endogenous non-coding RNAs regulating gene expression at mRNA post-transcriptional level in many biological processes,including differentiation,proliferation,development and apoptosis.The deregulation of miRNA expression is believed to be an important regulator of tumor development.Increasing evidence has revealed the abnormal expression of miRNA in papillary thyroid carcinoma,indicating the important role in PTC invasion mechanism,clinical diagnostic value,efficacy evaluation,recurrence monitoring and prognosis judgement.

Changes in portal vein and hepatic vein blood flow volume and their ratio in SD rats during induced carcinogenesis of hepatocellular carcinoma / 南方医科大学学报

<p><b>OBJEVTIVE</b>To explore the feasibility and reliability of ultrasonic monitoring of portal vein (PV) and hepatic vein (HV) blood flow volume changes in the process of induced carcinogenesis of hepatocellular carcinoma and the correlation of PV/HV blood flow volume ratio (Qpv/Qhv) with the severity of liver cirrhosis.</p><p><b>METHODS</b>SD rats with diethylnitrosamine-induced liver carcinogenesis underwent regular liver ultrasound examinations including color flow imaging and pulsed Doppler examination. The main PV and HV blood flow parameters were measured to calculate Qpv/Qhv until successful induction of liver cancer.</p><p><b>RESULTS</b>The PV diameter increased significantly with the severity of liver cirrhosis in the rats (P<0.05), and the PV blood flow velocity reduced but the blood flow volume increased significantly in liver cancer and cirrhosis stages (P<0.05). Normal hepatic vein blood flow was significantly greater than that measured in liver cirrhosis and hepatocellular carcinoma stages. The Qpv/Qhv measured in normal rats was significantly lower than that in liver cirrhosis and liver cancer stages, but the ratios were comparable between the latter two stages.</p><p><b>CONCLUSION</b>Ultrasonography is reliable to monitor the change of liver hemodynamics in rats with induced liver carcinogenesis, in which the changes of Qpv/Qhv are correlated with the severity of liver cirrhosis.</p>

Preparation and clinical application of a novel monoclonal antibody against Mycobacterium tuberculosis culture filtrate protein 10 / 中华临床感染病杂志

Objective To prepare a novel monoclonal antibody (mAb) that specifically against Mycobacterium tuberculosis culture filtrate protein 10 (CFP-10).Methods The BALB/c mice were immunized by a peptide with 14 amino acids (aa residues 53 to 66) of CFP-10,and then the splenocytes of mice were fused with myeloma cell line SP2/0.The resultant fused cells were subjected to screening culture,enzyme linked immunosorbent assay (ELISA) assay and subcloning by limited dilution to establish hybridoma cell lines of stable secreting anti-the peptide of CFP-10 antibody.The antibody was purified,and its isotypes were analyzed.Then,the antibody was further evaluated by Western blotting,immunoprecipitation and ELISA in 38 culture supernatant samples of Mycobacterium tuberculosis,20 culture supernatant samples of non-Mycobacterium tuberculosis,32 samples of tuberculous pleural effusion,24 samples of non-tuberculous pleural effusion,and 20 serum samples from healthy controls.Results The isotype of the mAb against the specific peptide of CFP-10 was an IgG1 with κ chain,and it was applicable for Western blotting and immunoprecipitation analysis.ELISA quantitative test showed that the sensitivity and specificity for diagnosis of Mycobacterium tuberculosis were 78.6％ (55/70) and 92.2％ (59/64),respectively.Conclusion The mAb generated against the specific peptide of CFP-10 is high in sensitivity and specificity,and it might be used in the early diagnosis of tuberculosis.

Quantitative studies on the dynamically apparent diffusion coefficient of MR diffusion weighted imaging in the rabbit VX-2 tumor model / 中国医师杂志

Objective To investigate dynamically characteristics of apparent diffusion coefficient (ADC) of MR diffusion-weighted imaging (DWI) in the rabbit VX-2 tumor model.Methods Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.DWI was carried out periodically and respectively on seventh,fourteenth,and twenty-first day after implantation.Part samples of VX-2 tumors were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their ADC values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS12.0 software,respectively.Results ADC values of 47 VX-2 tumors in the area of tumor periphery,tumor center,and normal parenchyma around tumor were greater when b-value was 100 s/mm2 than those when b-value was 300 s/mm2 and the distinction of VX-2 tumor ADC in the area of tumor periphery,tumor center,and normal parenchyma around tumor between different b-value groups was significant,respectively( F =17.964,P ＜0.01 ; F =13.986,P ＜0.01 ; F =128.681,P ＜0.01 ).The ADC values in the area of normal liver parenchyma around tumor were greater than those in the area of VX-2 tumor periphery and tumor center when the b-value was 100 or 300 s/mm2.When b-value was the same( 100 or 300 s/mm2),the distinction of VX-2 tumor ADC between different areas was significant( F =176.586,P ＜0.01 ; F =55.089,P ＜0.01 ).The ADC of VX-2 tumor in the area of tumor periphery and tumor center became gradually low from seventh to fourteenth or twenty-first day after implantation and the distinction of ADC between different time groups but the area same (?) was significant( b =100 s/mm2,F =48.211,P ＜0.01 ;b =300 s/mm2,F =20.955,P ＜0.01 ).There were not obvious cellular necrosis in VX-2 tumors on seventh and fourteenth day after implantation but ADC of VX-2 tumor decreased unobviously because of cellular edemata in or around tumors.There were obvious cellular necrotic areas in VX-2 tumors on the twenty-first day after implantation.ADC of viable tumor cells in VX-2 tumors were lower on DWI than that in the area of normal liver parenchyma around tumor and ADC of dead tumor cells in VX-2 tumors were unequal,including high values,equal values,and low values but they were higher than that in the area of normal liver parenchyma around tumor after dead tumor cells had been liquified or had become cystic.Conclusions ADC is able to reflect objectively the diffusion of water molecules in the tumor and to reflect indirectly the degree of the growth and liquified necrosis of a tumor.ADC has an important and potential value in monitoring dynamical tumor growth and in evaluating malignant degree and therapeutic effect.

Study on the dynamic characteristics and pathological mechanism of magnatic resonance diffusion weighted imaging after chemoembolizaiton in rabbit liver VX-2 tumor model / 中国医师杂志

ObjectiveTo investigate its dynamic characteristics and pathological mechanism on magnatic resonance diffusion weighted imaging (DWI) after chemoembolization in rabbit liver VX-2 tumor model.MethodsForty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.Forty VX-2 tumor models from them were divided into four groups.DWI was performed periodically and respectively for each group after chemoembolization.All VX-2 tumor samples of each group were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS 12.0 software.ResultsWhen b-value was 100 s/mm2,ADC values in the area of VX-2 tumor periphery,VX-2 tumor central,or normal liver parenchyma around tumor became gradually low in sixteen hours after chemoembolization,and were the lowest at sixteenth hour,and then they increased gradually from sixteenth hour to fourty-eighth hour after chemoembolization.The distinction of ADC between different time groups was significant,respectively ( F =7.325,P ＜ 0.01 ; F =2.496,P ＜ 0.05 ; F =6.856,P ＜0.01 ).Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor increased quickly in sixteen hours after chemoembolization; however,from sixteenth hour to forty-eighth hour,cellular edema in the area of normal liver parenchyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at first and then increased continually.Cellular necrosis in the area of VX-2 tumor periphery after chemoembolization was more significant than that before chemoembolization.The areas of dead cells in VX-2 tumors manifested low signal and high ADC value while the areas of viable cells manifested high signal and low ADC value.ConclusionsDWI is able to detect and discriminate tumor necrotic areas from viable cellular areas before and after chemoembolization.ADC of normal liver parenchyma and VX-2 tumor are influenced by intracellular edema,tissue cellular death,and microcirculation disturbance after chemoembolization.

Efficacy of mIL-18BP and mIL-4 adenoviral coexpression gene therapy for cyclooxygenase-2 and inducible nitric oxide synthetase in murine collagen-induced arthritis / 中华风湿病学杂志

Objective A recombinant adenoviral vector containing mIL-18BP and mIL-4 fusion gene(AdmIL-18BP/mIL-4) was constructed and used to investigate the role of mIL-18BP and mIL-4 in medula-ring the expressions of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthetase (iNOS) and their inducing products PGE2, NO in murine collagen-induced arthritis. Methods Male DBA-1/BOM mice were used in this study. Mice with CIA were intra-articularly injected with 107 pfu/6μl of AdmIL-18BP/mIL-4.Intra-articular injections of AdLacZ or PBS were used as controls. The mRNA expression of COX-2, iNOS in synovial tissue was analyzed by semi-quantitative RT-PCR. Expression of COX-2 and iNOS protein was estimated by Western blot method. The production of PGE2 and NO in synovia was detected by competitive ELISA and enzyme reduction of nitrate. Results The expression of COX-2, iNOS mRNA in routine synovial tissue of AdmIL-18BP/mIL-4 treatment group was significantly lower than that of AdLacZ group (0.15 vs 0.42,P<0.01 ; 0.05 vs 0.77, P<0.01) and PBS group (0.15 vs 0.65, P<0.01; 0.05 vs 0.64, P<0.01 ). And the protein expression of COX-2, iNOS from AdmIL-18BP/mIL-4 treatment group was also obviously lower than that of AdLacZ group (0.08 vs 0.92, P<0.01; 0.11 vs 1.00, P<0.01) and PBS group (0.08 vs 0.77, P<0.01; 0.11 vs 0.84, P<0.01 ). The PGE2 and NO production in synovia of AdmIL-18BP/mIL-4 treatment group was significantly lower than that of AdLacZ group [(0.68x0.06) vs (2.58±0.21)ng/mL, P<0.01; (23.4+2.5) vs (60.0±11.3)μmol/L, P<0.01 ] and PBS group [(0.68±0.06) vs (2.57±0.20)ng/mL, P<0.01; (23.4+2.5) vs (60.3±13.4)μmol/L, P<0.01]. Conclusion These data indicat that local over-expre-ssion of mIL-18BP and mIL-4 can down-regulate COX-2, iNOS and their induced product PGE2, NO in CIA mice. The combination treatment with mIL-18BP and mIL-4 is a promising therapeutic target for RA.

Function Analysis of Immunocytes in Synovial Fluid in Patients with Rheumatoid Arthritis / 医学研究杂志

Objective To study the function of immunocytes in synovial fluid and the mechanisms of immune function disorder in patients with rheumatoid arthritis(RA).Methods The synovial fluid of 20 patients with RA and 10 healthy amputees because of traumatism in the affiliated hospital of Zhejiang university were collected in this syudy.Monoclonal antibodies against CD28,CD154(CD40L),CD80,CD86,CD40,CD69,CD25,HLA-DR,CD71 were used for flow cytometry and the expressions of costimulatory molecule CD28,CD154,CD80,CD86,CD40 on immunocytes and lymphocyte activation markers CD69,CD25,HLA-DR,CD71 in synovial fliud were studied in these patients.We also used enzyme linked immunosorbent assay(ELISA) to detect the cytokines level of Th1 cell including interleukine 2(IL-2),interferon-gamma(IFN-?) and those of Th2 cell including interleukine 6(IL-6),interleukine 10(IL-10) in the synovial fliud.Results Compared with control group,the expressions of CD80[(2.09?0.59)%vs(0.67?0.57)%,P

Video-assisted thoracoscopic thymectomy (a report of 9 cases) / 中国微创外科杂志

Objective To study the feasibility of Video-assisted thoracoscopic thymectomy and the long term result of thoracoscopic thymectomy for myasthenia gravis. Methods 9 cases of thymus related disease were selected to undergo thymectomy though thoracoscopic approach from August 1996 to April 2001.Patients were followed up through outpatient service and telephone consultation. Results Of the 9 cases 2 cases were diagnosed as thymus cysts,1 cases thymoma,1 case malignant thymoma,1cases thymus carcinoma and 4 cases myasthenia gravis.Of the 4 cases of myasthenia gravis,3 cases were typeⅠ and 1 case was typeⅡb according to the modified Osserman classification.After thoracoscopic thymectomy 75% of patients had long-term good responses to surgery.The operation of one case of malignant thymoma was converted to lateral thoracotomy.One case of malignant thymoma with myasthenia gravis relapsed and reoperated through open thoracotomy . Conclusions video-assisted thoracoscopy can be usd to treat seleted thymic diseases .The results of video-assisted thoracoscopic thymectomy for mysthenia gravis is almost comparable with traditional open thoracotomy

Comparison of Two Operations for Spontaneous Pneumothorax in Middle-Aged or Elderly Patients / 中国微创外科杂志

0.05). Sixteen patients in the video-assisted thoracic surgery group were followed up for a mean of 42.9 months (20-88 months), during which no recurrence was detected. In the minithoracotomy group, 18 patients received an 18-to 71-month follow-up (mean, 41.2 months), none of them had recurrence. Conclusions The outcomes of both the operations are satisfying for middle-aged or elderly patients with spontaneous pneumothorax. However, video-assisted thoracic surgery should be the first choice.

Thoracoabdominal Mini-incision Surgery for the Treatment of Gastric Cardia Cancer / 中国微创外科杂志

Objective To investigate the efficacy of thoracoabdominal mini-incision surgery for the treatment of gastric cardia cancer. Methods Radical resection of gastric cardia cancer was performed on 60 patients from January 2002 to January 2007. Thoracoabdominal mini-incision was used in 30 cases, and posterolateral thoracotomy was carried out in the other 30 patients. The data of the two groups were retrospectively analyzed. Results The operations were accomplished without death or severe complications in all the patients. Compared with the posterolateral thoracotomy group, thoracoabdominal mini-incision group had shorter incisions [(12.4?0.7) cm vs (19.2?2.0) cm, t=-17.577, P=0.000], shorter operation time [(207.3?76.1) min vs (260.0?85.6) min, t=-2.519, P=0.015], earlier postoperative ambulation [(2.3?0.5)d vs (3.4?0.5) d, t=-8.521, P=0.000], less thoracic drainage [(276.7?58.7) ml vs (308.7?59.5) ml, t=-2.097, P=0.040], less analgesic (pethidine) requirement [(66.7?27.3) mg vs (113.3?45.4) mg, t=-4.818, P=0.000], shorter duration of oxygen use [(3.8?2.0) d vs (5.1?2.6) d, t=-2.171, P=0.034], and higher arterial oxygen saturation[(97.6?2.7)% vs (96.1?2.7)%,t=2.152,P=0.036]. No significant difference was observed between the two groups in the number of dissected thoracic lymph nodes (1.87?0.43 vs 1.93?0.37, t=-0.579, P=0.565), number of dissected celiac lymph nodes (4.00?0.45 vs 3.97?0.49, t=0.247, P=0.806), postoperative hospital stay [(11.8?1.0) d vs (12.0?1.2) d, t=-0.701, P=0.486), pulmonary infection (2 vs 5, ?2=0.647, P=0.421), atrial fibrillation (2 vs 4, ?2=0.185, P=0.667) and positive surgical margins (0 vs 1, ?2=0.000, P=1.000). The two groups were followed up for (36.3?13.9) months and (36.3?16.5) months, respectively (t=0.024, P=0.981), no significant difference was detected between them in the 1- and 3-year survival cases (19 vs 22, ?2=0.487, P=0.485; and 10 vs 12, ?2=0.194, P=0.660) and chest pain (2 vs 3, ?2=0.000, P=1.000) during the period. Conclusions By using a thoracoabdominal mini-incision, gastric cardia cancer can be resected completely with less trauma. The approach is ideal for clinical application.

Selecting EGF-binding Clones From a pⅧ-based Phage Display Library / 生物化学与生物物理进展

Angiogenesis-related diseases involving EGF include acherosclerotic plaques, haemangioma, angiofibroma, tumor growth and arthritis. EGF may serve as a drug target and its antagonists may have important clinical applications.Peptide phage display libraries have been successfully applied in areas of finding ligands for enzymes, receptors, and many other molecules. A pⅧ-based peptide phage display library was panned with the cytokine EGF and several EGF-binding clones were selected based on ELISA and micropanning assays. The selected EGF-binders from peptide phage display library may be utilized in affinity chromatography in EGF downstream processing and even act as potential antagonists of EGF if their affinity is further improved through secondary library strategy.

Application of phage-displayed peptide libraries / 中国药理学通报

Phage display is a new technology developed in recent years. Random peptides displayed on the filamentous phage surface offer a rich source of molecular diversity in searching for ligands that bind an antibody, receptor and other proteins. The phage display system has been effective in the discovery of various ligands. Potential applications of the peptide library include investigation of the protein protein interactions and discovery of mimetic drug candidates.

Search for enzyme inhibitors from the ocean / 第二军医大学学报

Some enzyme inhibitors derived from the ocean were described briefly in this review.