CHD1 deletion stabilizes HIF1α to promote angiogenesis and glycolysis in prostate cancer / 亚洲男科学杂志(英文版)

Chromodomain-helicase-DNA-binding protein 1 (CHD1) deletion is among the most common mutations in prostate cancer (PCa), but its role remains unclear. In this study, RNA sequencing was conducted in PCa cells after clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9)-based CHD1 knockout. Gene set enrichment analysis (GSEA) indicated upregulation of hypoxia-related pathways. A subsequent study confirmed that CHD1 deletion significantly upregulated hypoxia-inducible factor 1α (HIF1α) expression. Mechanistic investigation revealed that CHD1 deletion upregulated HIF1α by transcriptionally downregulating prolyl hydroxylase domain protein 2 (PHD2), a prolyl hydroxylase catalyzing the hydroxylation of HIF1α and thus promoting its degradation by the E3 ligase von Hippel-Lindau tumor suppressor (VHL). Functional analysis showed that CHD1 deletion promoted angiogenesis and glycolysis, possibly through HIF1α target genes. Taken together, these findings indicate that CHD1 deletion enhances HIF1α expression through PHD2 downregulation and therefore promotes angiogenesis and metabolic reprogramming in PCa.

Anterolateral ligament reconstruction in treating anterior cruciate ligament injury with grade 2 pivot-shift / 中华骨科杂志

Objective:To evaluate the clinical outcomes in anterior cruciate ligament (ACL) patients undergoing ACL reconstruction combined with anterolateral ligament (ALL) reconstruction in treating patients with Grade 2 pivot-shift.Methods:From October 2015 to August 2018, a total of 59 patients with Grade 2 pivot shift were allocated into ALL reconstruction group underwent combined ACL and ALL reconstruction ( n=29) and control group underwent isolated ACL reconstruction ( n=30). Lachman, pivot-shift and KT-1000 side-to-side difference test were used to determine the knee laxity. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were used to assess the knee function. The results of Lachman test and pivot-shift test were classified into -, 1+, 2+, 3+. Results:All patients were followed up for 1 year. The average age was 30.5±8.3 years (range, 15-48 years) in ALL reconstruction group with 5 months duration from injury. The left knee was involved in 11 cases, while 18 cases in right knee in ALL reconstruction group. There were 15 cases with injury in medial meniscus and 8 cases in lateral meniscus. In control group, the average age was 32.2±9.7 years (range 17-51 years) with 14 cases in left knees and 16 in right knees. In these patients, 18 of them had medial meniscus injury, while other 11 patients had lateral meniscus injury. The average duration from injury to surgery was 7 months. The Lachman test (-: 25, 1+: 4 vs. -: 25, 1+: 4, Z=-0.91, P=0.361), KT-1000 arthrometer (1.9±1.3 mm vs. 2.2±1.3 mm, t=0.66, P=0.513), IKDC subjective score (92.4±5.6 vs. 90.2±6.7, t=1.37, P=0.176) and Lysholm score (91.0±6.2 vs. 89.1±5.0, t=1.29, P=0.201) did not show significant difference between the two groups. Pivot-shift test (-:27, 1+: 2 vs. -: 20, 1+: 8, 2+: 2, Z=-0.66, P=0.507). Pivot-shift test was significantly superior in ALL reconstruction group compared with that in control group (6.5% vs.33.3%, χ 2=21.70, P<0.001). Conclusion:Patients with preoperative Grade 2 pivot shift had significant improvement in rotatory knee laxity after ACL reconstruction combined with ALL reconstruction compared with isolated ACL reconstruction. However, there was no significant difference in anterior laxity and knee function scores between the two groups.

Research advances of music therapy and its application in the field of burn treatment / 中华烧伤杂志

Different from other trauma, the scar and pigmentation formed after healing of burn wound not only hinder beauty but also easily lead to a series of sequential psychological problems, such as depression and anxiety. Music therapy, as a supplementary treatment, is widely used in many fields including medical and health care and psychological regulation. However, affected by factors such as medical resources, the awareness and acceptance of music therapy among burn treatment workers in China are still low. Based on the clinical characteristics of burns, this paper matches the applicability of music therapy with it, summarizes the supplementary application of music therapy in the field of burn treatment, expounds this natural science with both science and aesthetics, and puts forward feasible suggestions for its future development.

Screening and identification of potential long non-coding RNA for the prognosis evaluation of glioma patients based on bioinformatics analysis / 肿瘤研究与临床

Objective:To investigate the possibility of screened long non-coding RNA (lncRNA) as a prognostic marker in evaluating glioma.Methods:A total of 694 glioma samples and 5 tumor-adjacent tissues were selected in the Cancer Genome Atlas (TCGA) database from the establishment of the database to December 2018. The differential lncRNA, microRNA (miRNA) and mRNA between glioma tissues and 5 tumor-adjacent tissues were screened out, the correlation between the three and the prognosis of glioma patients was analyzed, and a competitive endogenous RNA (ceRNA) network was constructed. The biological functions of mRNA were enriched and analyzed based on Gene Ontology (GO) database and Kyoto encyclopedia of genes and genomes (KEGG) database. The survival analysis of patients with different expression levels of lncRNA, miRNA or mRNA were performed by using Kaplan-Meier method to obtain lncRNA, miRNA and mRNA related to prognosis. Univariate and multivariate Cox proportional hazards regression models were used to analyze the different lncRNAs in the ceRNA network, and an lncRNA prognosis model for predicting the 5-year overall survival rate of patients was constructed. According to the constructed model, the risk value of each sample in 694 samples in TCGA database was calculated. Taking the median risk value as the critical value, patients were divided into high-risk group (≥ median risk value) and low-risk group (< median risk value), and the survival curves of the two groups were drawn. The receiver operating characteristic (ROC) curve was drawn for predicting the 5-year overall survival rate of glioma patients in TCGA database according to the risk value of lncRNA prognosis model. The heat map of lncRNA gene expression levels in the prognostic model of patients in high-risk and low-risk groups was drawn with pheatmap R software package.Results:A total of differential 44 lncRNAs, 19 miRNAs and 54 mRNAs between glioma and tumor-adjacent tissues were obtained from TCGA database, and the ceRNA network map was drawn. Kaplan-Meier method showed that among them, 22 differential lncRNAs, 7 miRNAs and 38 mRNAs were related to the overall survival of patients. The univariate Cox regression analysis obtained 28 lncRNAs related to prognosis. After multivariate Cox regression analysis, Akaike information criterion (AIC) was used to seek the optimal prognostic risk model involving 16 lncRNAs, that was, risk value = ARHGAP31-AS1×(-0.357 7)+LY86-AS1×(0.155 1)+WARS2-IT1×(0.206 4)+PART1×(-0.110 0)+AC110491.1×(-0.142 6)+CACNA1C-IT2×(-0.381 3)+HAS2-AS1×(0.128 8)+AC092171.1×(-0.161 3)+CCDC26×(-0.144 2)+HCG15×(0.384 0)+AL359541.1×(-0.289 2)+GRM5-AS1×(0.120 5)+LINC00237×(-0.085 1)+LINC00310×(-0.213 0)+VCAN-AS1×(-0.090 3)+ LINC00303×(0.091 5). The median risk value was 0.758 calculated by the constructed model. The 5-year overall survival rate in the high-risk group was 16.8% (95% CI 11.4%-24.7%) and 75.7% (95% CI 68.5%-83.7%) in the low-risk group. The area under of ROC curve of 5-year overall survival predicted by lncRNA model was 0.893. Through the heat map, it can be found that the expression level of all lncRNAs in the model was different between high-risk and low-risk patients. Conclusions:The prognostic risk model constructed based on the screened lncRNAs can better evaluate the prognosis of glioma patients. These lncRNAs are expected to become new candidate biomarkers related to the prognosis of glioma.

Comparison of postoperative analgesic effect of flurbiprofen axetil and parecoxib sodium in patients with humeral shaft fracture in painless ward / 中国医师进修杂志

Objective:To compare postoperative analgesic effect of flurbiprofen axetil and parecoxib sodium in patients with humeral shaft fracture in painless ward.Methods:All of 200 hospitalized humeral fractures patients were retrospectively studied in the painless ward of the Forth Medical Center of PLA General Hospital from January 2017 to September 2019 , the clinical effects of flurbiprofen axetil and parecoxib were compared.Results:Postoperative visual analogue scale (VAS) scores after 3 d of two groups of patients were significantly lower, compared with preoperative results: (4.26±0.96) scores vs. (6.09±1.38) scores, (4.04±1.19) scores vs. (6.04±1.11) scores, and the differences were statistical significantly ( P<0.01). Postoperative VAS score after 3 d of two groups had no statistical significance ( P>0.05). Two groups had different degree of adverse reactions after operation, and flurbiprofen axetil group had singnificant gastrointestinal adverse reaction: 22 patients vs. 3 patients( P<0.05). The number of patients in the parecoxib group were more than that in the flubiprofen axetil group without troubled sleep: 20 patients vs. 8 patients. Two groups of patients were satisfied with the pain care during hospitalization. Conclusions:Two analgestic drugs can obtain obvious analgesic effect in the treatment of bones surgery. The side effects and sleep disturbance in the flurbiprofen axetil group are higher than those in the parecoxib group. Good pain control can improve patients satisfaction with pain care.

Cathepsin D knockdown regulates biological behaviors of granulosa cells and affects litter size traits in goats / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Cathepsin D (CTSD), the major lysosomal aspartic protease that is widely expressed in different tissues, potentially regulates the biological behaviors of various cells. Follicular granulosa cells are responsive to the increase of ovulation number, hence indirectly influencing litter size. However, the mechanism underlying the effect of CTSD on the behaviors of goat granulosa cells has not been fully elucidated. This study used immunohistochemistry to analyze CTSD localization in goat ovarian tissues. Moreover, western blotting was applied to examine the differential expression of CTSD in the ovarian tissues of monotocous and polytocous goats. Subsequently, the effects of CTSD knockdown on cell proliferation, apoptosis, cell cycle, and the expression of candidate genes of the prolific traits, including bone morphogenetic protein receptor IB (

Comparative study of femoral head replacement and internal fixation in the treatment of unstable intertrochanteric fractures in the elderly / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of femoral head replacement and internal fixation in the treatment of unstable intertrochanteric fractures in the elderly.@*METHODS@#Retrospective analysis of 70 cases of unstable intertrochanteric fractures treated from January 2016 to January 2019 and meeting the inclusion and exclusion criteria, 39 cases were fixed with closed reduction and new proximal femoral intramedullary nail(InterTAN), and 31 cases were treated with open trochanter reconstruction and artificial femoral head replacement. The operation time, intraoperative bleeding, hospital stay, weight bearing time, postoperative complication rate and hip function recovery (Harris score) were compared between two groups.@*RESULTS@#All cases were followed up for 12 to 24 months. There were no significant differences in intraoperative bleeding and hospital stay between the two groups (@*CONCLUSION@#InterTAN and femoral head replacement can treat unstable intertrochanteric fractures in the elderly, but femoral head replacement can move down early, improve the quality of life at the end of life, reduce postoperative complications and facilitate the treatment of coexisting diseases in internal medicine.

An improved maximal information coefficient algorithm applied in the analysis of functional corticomuscular coupling for stroke patients / 生物医学工程学杂志

The functional coupling between motor cortex and effector muscles during autonomic movement can be quantified by calculating the coupling between electroencephalogram (EEG) signal and surface electromyography (sEMG) signal. The maximal information coefficient (MIC) algorithm has been proved to be effective in quantifying the coupling relationship between neural signals, but it also has the problem of time-consuming calculations in actual use. To solve this problem, an improved MIC algorithm was proposed based on the efficient clustering characteristics of K-means ++ algorithm to accurately detect the coupling strength between nonlinear time series. Simulation results showed that the improved MIC algorithm proposed in this paper can capture the coupling relationship between nonlinear time series quickly and accurately under different noise levels. The results of right dorsiflexion experiments in stroke patients showed that the improved method could accurately capture the coupling strength of EEG signal and sEMG signal in the specific frequency band. Compared with the healthy controls, the functional corticomuscular coupling (FCMC) in beta (14~30 Hz) and gamma band (31~45 Hz) were significantly weaker in stroke patients, and the beta-band MIC values were positively correlated with the Fugl-Meyers assessment (FMA) scale scores. The method proposed in this study is hopeful to be a new method for quantitative assessment of motor function for stroke patients.

Advance in Interleukin-6 in Central Nervous System (review) / 中国康复理论与实践

The central nervous system can produce a variety of neuroimmune factors including interleukin-6. This article reviewed the expression and signaling pathways of interleukin-6 and its receptors in the central nervous system, and advances in interleukin-6 in the regulation of central nervous system related diseases, cognitive behaviors and synaptic function, which suggested that interleukin-6 involves in various physiological or pathological functions in the central nervous system and affects central nervous system in multiple layers such as protein expression, signal transduction, neurological function, and synaptic transmission. Interleukin-6 is expected to be a biological marker in the specific state of the central nervous system. In addition, interleukin-6 can regulate the function of neurons and synapses and is an important molecule involved in synaptic transmission, synaptic plasticity, and learning and memory. Strengthening the research on the biological function and mechanism of interleukin-6 and timely regulating the interleukin-6 expression will provide a new perspective for the treatment of the central nervous system related diseases.

Advance in Interleukin-6 in Central Nervous System (review) / 中国康复理论与实践

The central nervous system can produce a variety of neuroimmune factors including interleukin-6. This article reviewed the expression and signaling pathways of interleukin-6 and its receptors in the central nervous system, and advances in interleukin-6 in the regulation of central nervous system related diseases, cognitive behaviors and synaptic function, which suggested that interleukin-6 involves in various physiological or pathological functions in the central nervous system and affects central nervous system in multiple layers such as protein expression, signal transduction, neurological function, and synaptic transmission. Interleukin-6 is expected to be a biological marker in the specific state of the central nervous system. In addition, interleukin-6 can regulate the function of neurons and synapses and is an important molecule involved in synaptic transmission, synaptic plasticity, and learning and memory. Strengthening the research on the biological function and mechanism of interleukin-6 and timely regulating the interleukin-6 expression will provide a new perspective for the treatment of the central nervous system related diseases.

Exosomes in the Pathogenesis of Rheumatoid Arthritis / 中国医学科学院学报

Exosomes are 30-100 nm vesicles secreted from almost all types of cells.They contain various molecular constituents,including proteins,lipids,and RNA.As important mediators of cell-to-cell communication,exosomes are involved in a variety of physiological and pathological processes such as inflammatory reaction,cell proliferation and differentiation,tissue repair,immune signal transduction,and stress response.Exosomes can regulate and maintain the initiation and progression of many autoimmune diseases,especially rheumatoid arthritis.Meanwhile,exosomes may be a new biomarker for the diagnosis of rheumatoid arthritis and a potential treatment vector for this disease.

Expression and Clinical Significance of Late Endosomal/Lysosomal Adaptor,Mitogen-activated Protein Kinase and Mammalian Target of Rapamycin Activator 3 in Bladder Carcinoma / 中国医学科学院学报

Objective To investigate the expression and clinical significance of late endosomal/lysosomal adaptor,mitogen-activated protein kinase and mammalian target of rapamycin activator 3(LAMTOR3)in bladder carcinoma.Methods Oncomine and Expression Atlas were used to extract the useful mining gene chip database for analyzing the expression of LAMTOR3 in bladder carcinoma tissues and cell lines,and the correlation of LAMTOR3 with the clinicopathological features were analyzed.RT-PCR,Western blot,and immunohistochemistry were performed to detect the expression of LAMTOR3 in bladder carcinoma cell lines,specimens,and adjacent normal tissues for verifying the results exploited from the above databases.Results The Expression Atlas showed that LAMTOR3 had high expressions in Hs172.T,HT-1376,RT4,JMSU-1,and T24 cell lines among 20 bladder carcinoma cell lines,among which the LAMTOR3 expression was different.Oncomine reported that LAMTOR3 expression in bladder carcinoma,including invasive(=2.857,=0.005)and non-invasive carcinoma(=3.105,=0.003),was significantly higher than that in adjacent normal tissues.The expression of LAMTOR3 was positively correlated with pathological grade(<0.05).The expressions of LAMTOR3 mRNA in bladder carcinoma cell lines,including UMUC3(=10.84,=0.0084),J82(=21.75,=0.0021),5637(=45.88,=0.0005),and T24(=87.58,=0.0001)were significantly higher than that in normal bladder cell line SV-HUC-1,while its expression in bladder carcinoma tissues was significantly higher than that in adjacent normal tissues(<0.05),so was its protein level in tissues(<0.05).Immunohistochemistry showed that LAMTOR3 protein was over-expressed in bladder carcinoma tissues;its level in invasive carcinoma tissues was higher than that in no-invasive carcinoma tissues and was related closely with the clinical stages(=9.189,=0.002),pathological grades(=4.746,=0.029),and lymphatic metastasis(=6.210,=0.013)but had no significant correlation to sex(=0.965,=0.326),age(=2.126,=0.145),and distant metastasis(=1.261,=0.261).Conclusion LAMTOR3 is highly expressed in bladder carcinoma cell lines and tissues and plays a key role in the development and progression of bladder carcinoma.

Anterolateral Ligament Reconstruction in ACL Insufficient Knee with High-grade Pivot Shift——Surgical Technique and Early Follow-up Results / 中国运动医学杂志

Objective To evaluate the effectiveness of anterior cruciate ligament (ACL) reconstruction combined with anterolateral ligament(ALL)reconstruction in ACL injury patients with high-grade pivot shift.Methods From May 2015 to April 2016,156 patients underwent ACL reconstruction by the same surgeon,and 22 of them with grade 2/3 pivot shift were included in this study.Anteroposterior knee stability was evaluated using KT1000 measurement,and the rotatory stability was assessed using the pivot-shift test.The Lysholm score was used to monitor the clinical function.Results There were 14 male subjects and 8 females,with an average age of 29.3 years.The mean follow-up period was 8.6 months.The mean side-to-side difference of anteroposterior knee laxity was 2.1 ± 0.6 mm,significantly improved compared with the preoperative 8.9 ± 3.1 mm.The preoperative pivot-shift indicated 2+ in 20 patients and 3+ in 2 patients,while at the final follow-up,21 patients had negative pivot shift with 1 of 1+ pivot shift.The difference was significant.The average Lysholm score improved significantly from 60.5 ± 12.3 preoperatively to 79.2 ± 7.8 at the final follow-up.Conclusion The rotatory instability can be effectively restored through the ACL reconstruction combined with ALL reconstruction in patients with high-grade pivot shift.The early-stage knee stability and functional outcomes indicate significant improvement postoperatively.

Research progress of GLUT1 in urinary tumor / 医学研究生学报

Glucose transporters protein (GLUTs) is the main carrier of glucose transport in mammalian cells, in which GLUT1 is the most widely distributed in glucose transporter in vivo. Studies have shown that GLUT1 has abnormally high expression in urinary tract tumors such as renal cell carcinoma,prostate cancer,bladder cancer and nephroblastoma,cleading to increased intracellu-lar glucose uptake,which is closely related to tumor occurrence,evolution,invasion,prognosis and drug resistance. As a new target of tumor therapy,GLUT1 has attracted extensive attention. This review summarizes the recent advances on the expression of GLUT1 in tumor and its mechanism,which can provide a new perspective for the treatment and prognosis evaluation of tumor.

Study on lateral less invasive stabilization system plate combined with medial buttress plate in distal femoral fractures patients with comminuted medial cortex / 中国医师进修杂志

Objective To study the methods and clinical effect of lateral less invasive stabilization system(LISS)plate combined with medial buttress plate in distal femoral fractures patients with comminuted medial cortex.Methods The clinical data of 25 distal femoral fractures patients with comminuted medial cortex from June 2014 to December 2015 were retrospectively analyzed, and all patients were treated with lateral LISS plate combined with medial buttress plate. According to the AO fracture classification,A3 type was in 10 cases,C2 type was in 9 cases,and C3 type was in 6 cases.The knee joint function at 3,6 and 12 months after operation was evaluated according to American hospital for special surgery (HSS) knee joint function score, and the clinical effect was evaluated 12 months after operation.Results The patients were followed up 18-36 months,with an average of 23.4 months.The operation time was (80 ± 22) min, intraoperative bleeding was (395 ± 56) ml, and the average hospitalization time after operation was 5.6 d.All patients got bone union,and the bone union time was 16-30 months,with an average of 18.7 months.All patients had no incision infection,no fracture and delayed union.The HSS knee joint function scores at 3,6 and 12 months were(84.3 ± 7.8),(89.3 ± 7.2) and(97.9 ± 4.3)scores.The incidence of complications was 24%(6/25),and the excellent and good rate was 84%(21/25).Patients felt satisfied.Conclusions The clinical effect of lateral LISS plate combined with medial buttress plate in distal femoral fractures patients with comminuted medial cortex is good.

Clinical classification and surgical treatment of habitual dislocation of the patella in adult / 中华骨科杂志

Objective To explore the efficacy of the 3 types classification and the surgical technique included intensive lateral release,vastus lateralis oblique (VLO) tendon lengthening,tibia1 tubercle proximalization combined with MPFL reconstruction for habitual patellar dislocations in adults.Methods Date of 36 patients with habitual dislocation of patella who were operated between January 2011 and January 2016 were retrospectively analyzed.There were 12 males and 24 females,with an average age of 24 years old (range,15-44 years).All the cases were followed-up for more than 2 years,and 26 of which was primary surgery,while the other 10 was revision surgery.According to the flexion angle when the patella dislocation occurred and difficulty to reduce the patella,the patients were divided into 3 types.The mild type means patellar dislocation angle was more than 90°,and the treatment was lateral release (LR) combined with MPFL reconstruction.The moderate type means the patellar dislocation angle was about 60° to 90°,and the treatment was LR combined with VLO lengthening and MPFL reconstruction.The severe type means the patellar dislocation angle was less than 60°,and the treatment was LR+VLO combined with proximalization of tibial tubercle.Based on this surgical algorithm,all the patients reveived the surgical treatment.Results All 36 patients had been sucessfully followed up.The mean follow-up period was 38.6 (range,23-78) months.All the patients gained stable patella with no recurrence of dislocation.There was 1 patient in the mild group,6 patients in the moderate group and 29 patients in the severe group.The patient in the mild group showed that the congruence angle of was improved from 72° preoperatively to 5° postoperatively,with 0.82 of Caton-Deschamps index,and 28mm of tibial tubercle-trochlear Groove,and the sulcus angle was 150°.The 6 patients in the moderate group showed that the congruence angle of was improved from mean 82.2°±11.7° preoperatively to 6.9°±26.4° postoperatively.The changes of Caton-Deschamps index,TT-TG and the sulcus angle were not significantly.The 29 patients in the severe group showed that the congruence angle of was improved from mean 75.0°±27.3° preoperatively to 0.0°±21.0° postoperatively.The Caton-Deschamps index was improved from mean 0.76±0.24 preoperatively to 1.06±0.24 postoperatively.TT-TG was decreased form mean 22.9±5.1 mm preoperatively to 6.0±4.9 mm.The change of sulcus angle was not significantly.The Lysholm score was improved from 59 preoperatively to 100 postoperatively in the mild group,61 to 93 in the moderate group,and 66.0±8.0 to 93.7± 3.0 in the severe group.The Kujala score was improved from 55 preoperatively to 83 postoperatively in the mild group,55.0±4.1 to 83.8±1.9 in the moderate group,and 66.0±8.0 to 93.7±3.0 in the severe group.There was no flexion limited in the mild and moderate groups.The average flexion loss was 17.5°±7.6° in 6 patients postoperatively in the severe group.No extension limited.The consistency of the 3 types classification method by two observers was good (Kappa=0.918,P=0.000).Conclusion These results suggest that the 3 types classification provides an efficient method for habitual patellar dislocation.The surgical techniques included intensive lateral release,VLO lengthening,tibial tubercle proximalization combined with MPFL reconstruction are effective for treatment of habitual patellar dislocation in adults.In our opinion,lateral release and proximalization of tibial tubercle play an important role in the surgical treatment.

Renal Ewing's sarcoma/primitive neuroectodermal tumor: a case report and literature review / 北京大学学报(医学版)

Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET) in the kidney is a rare but high-grade malignant tumor that affects predominantly elder children and adolescents.Patients mostly present with nonspecific symptoms such as abdominal pain and gross hematuria.Since EWS/PNET has a rapid clinical progression with early metastasis and death,it is essential to make an accurate and early diagnosis.Once diagnosed,multimodality treatment,including radical surgery combined with adjuvant chemotherapy,and radiotherapy if necessary,is recommended.Unfortunately,there are no characteristic signsthat have been described in ultrasonography or any other imaging modalities so far.The diagnosis of EWS/PNET is now based on a classical histological and immunohistochemical investigation complemented by a demonstration of specific chromosomal changes.Strong immunoreactivity to CD99 is ubiquitous,and t(11;22) translocation is seen in approximately 90％ of EWS/PNET.Herein,we report a patient with such condition.The patient was a young woman,and she presented with sudden right flank pain clinically.Ultrasonography revealed a large heterogeneous mass in the lower pole of her right kidney.The tumor compressed the renal pelvis and led to upper pole caliectasis.Color Doppler demonstrated blood flow with a pulsatile arterialized waveform within the mass.The patient received radical nephrectomy with right renal vein and vena cava thrombectomy.A search for other sites of tumor involvement yielded negative results.And six cycles of chemotherapy were sequentially performed.The diagnosis of EWS/PNET was confirmed based on primitive small round cell histology and characteristic immunohistochemical results.She was still alive with no evidence of recurrence five years after initial diagnosis.We would like to point out that ultrasound is still a useful method for initial assessment,and ultrasound-guided fine needle aspiration may play an important role in determining preoperative diagnosis.

Role of Hes1 in malignant transformation of human bronchial epithelial cells induced by tobacco / 中国病理生理杂志

AIM: To investigate the role of transcription factor hairy and enhancer of split 1 (Hes1) in the malignant transformation of human bronchial epithelial cell line BEP2D induced by tobacco.METHODS: The BEP2D cells were chronically exposed to cigarette smoke condensate (CSC) at 1 cigarette per L until the 70th generation.The phenotype of malignant transformation of the cells induced by CSC was detected by soft agar clony formation assay.RT-PCR and Western blot were used to determined the expression of Hes1 at mRNA and protein levels in each generation of the cells.The proliferation and apoptosis of the BEP2D cells exposed to CSC were analyzed with the methods of MTT assay, flow cytometry and cell colony formation assay after treatment with Notch pathway bloker DAPT or liposome transfection with Hes1-siRNA.The expression of Hes1 in the peripheral small airway tissues of the smoking rats was evaluated by immunohistochemical staining.The expression of Hes1 in non-small-cell lung cancer and normal airway tissues was also detected by the methods of immunohistochemistry and RT-PCR.RESULTS: The BEP2D cells in the 70th generation had a malignant transformation phenotype.The expression of Hes1 in the BEP2D cells exposed to CSC for different time showed an increa-sing trend.DAPT and liposome transfection with Hes1-siRNA down-regulated the expression of Hes1, inhibited the cell proliferation and induced cell apoptosis.The expression of Hes1 in the airway mucosa of the rats exposed to cigarette smoke for 1 month and 6 months was significantly higher than that in control group.Cigarette smoking induced the expression of Hes1 in lung cancer and normal airway tissues.CONCLUSION: Hes1 may be involved in smoking-induced lung cancer by promoting the imbalance between apoptosis and proliferation.

Anterior Cruciate Ligament Reconstruction Combined with Anterolateral Tenodesis Procedure Treating Patient with High Grade Pivot-shift after ACL Injuries / 中国运动医学杂志

Objective To evaluate the early clinical outcomes of anterior cruciate ligament(ACL)reconstruction combined with anterolateral tenodesis procedure in patient with high grade pivot-shift after ACL injuries.Methods Among the 140 patients diagnosed as ACL injury and undergoing operations in our hospital between June and December 2015,18 presenting high grade pivot-shift 2+ or 3+ under anesthesia were included into this study.During their surgeries,the anterolateral tenodesis procedure using iliotibial tract ITB was applied together with ACL reconstruction.The anteroposterior stability of the knee was examined and pivot-shift test was conducted right after the operation as well as 6 and 12 months after that.The Lysholm score was used to evaluate the clinical function of their knees.Results The mean follow-up period of the 18 patients was 12.7 ± 2.4 months.There were 14 males and 4 females,with an average of 28.3 ± 7.1 years.No patients complained about unstable symptoms during the follow-up.The mean side-to-side difference of anteroposterior knee laxity assessed using KT1000 at 30 degree knee flexion was 2.3 ± 0.7 mm,which was significantly improved compared with preoperative assessment(9.2 ± 2.6 mm)(P＜0.01).For the preoperative examination,the pivot-shift examination indicated 2+ in 13 patients and 3+ in 5 patients.However,all were negative right after the operation.Seventeen patients presented negative pivot-shift at the final follow-up,while 1 had 1+ rotational laxity.Significant differences were found in the Pivot-shift test before and after the operation.The average Lysholm score improved significantly from 67.7 ± 5.9(ranging from 55 to 78)before the operation to 89.0-± 4.6(ranging from 75 to 95)after that.Conclusion The high grade pivot-shift rotational instability could be effectively restored using the anterolateral tenodesis procedure,in addition to ACL reconstruction.The early stage clinical outcomes indicate significant improvement of the knee stability postoperatively.

A prospective randomized control trial of arthroscopic surgery for stable ramp lesion of the medial meniscus / 中华外科杂志

Objective@#To evaluate the necessity of arthroscopic suture repair for the stable ramp lesion.@*Methods@#From August 2008 to April 2012, 91 patients of consecutive cases were diagnosed as anterior cruciate ligament (ACL) injury associated with stable ramp lesion in Department of Sports Medicine Service of Beijing Jishuitan Hospital. All of the diagnosis was confirmed during arthroscopic surgeries. The patients were randomized into suture repair group and control group. The ACL was reconstructed using auto grafts of hamstring. MRI was used for evaluation of the healing of the ramp lesion during the follow-up period. The stability of the knee joint was evaluated using KT-1000 device. The clinical functional outcomes were analyzed with Lysholm and International Knee Documentation Committee(IKDC) score. t test and χ2 test were used to analyze the data, respectively.@*Results@#There were 73 patients (80%) were available for final follow-up. The follow-up period was 24 to 72 months (mean (38.9±16.1) months). The suture repair group included 40 patients, while the control group included 33 patients. There were no statistically difference in age(t=0.458, P>0.05), gender(χ2=0.222, P>0.05), time interval from injury(t=0.643, P>0.05) and associated injuries(χ2=0.658, P>0.05). At the final follow-up, the healing rate of ramp lesion in suture repair group was 97.5% (95% of complete healed, 2.5% of partial healed, and 2.5% of non-healed), in control group the healing rate was 93.9% (87.8% of complete healed, 6.1% of partial healed, and 6.1% of non healed), there were no significant differences between the two groups (χ2=0.446, P>0.05). There was no statistically significant difference of postoperative knee stability (t=-0.510, P>0.05). The healing status of ramp area from MRI evaluation had statistically significant correlation with the ACL stability (χ2=11.919, P<0.01). For the analysis of postoperative Lysholm scores and IKDC scores, there was no significant difference between the two groups (t=-0.166, P>0.05; t=0.032, P>0.05).@*Conclusions@#Stable ramp lesion could be well healed after arthroscopic treatment of all-inside suture repair as well as refreshment only. For patients with ACL injury and stable ramp lesion, there was no significant difference between the results of MRI evaluation in the early postoperative stage.The postoperative healing status of ramp area had statistically significant correlation with the stability of knee joint.