Efficacy of intravenous versus topical administration of tranexanmic acid in primary total knee arthroplasty / 中国组织工程研究

BACKGROUND: Blood loss is a significant concern for patients undergoing total knee arthroplasty (TKA). Increasing evidence has shown that tranexamic acid is effective in decreasing perioperative blood loss in TKA. OBJECTIVE: To compare the efficacy of two methods of tranexanmic acid administration on the perioperative blood loss in primary TKA. METHODS: Totally 105 patients with unilateral knee osteoarthritis undergoing TKA were randomly allocated to three groups: 1 g of tranexanmic acid was administered intravenously before and after wound closure (group A); 2 g of tranexanmic acid in 20 mL of normal saline was injected into the articualr cavity through the drainage after wound closure and the tube was clamped for 4 hours (group B); no tranexanmic acid administration (group C). The intraoperative blood loss, hemoglobin level at postoperative 24 and 48 hours, postoperative drainage volume and incidence of deep venous thrombosis were recorded. RESULTS AND CONCLUSION: (1) The intraoperative blood loss and postoperative drainage volume in the groups A and B were significantly less than those in the group C (P < 0.05); the postoperative hemoglobin level in the group A was higher than that in the group B; the postoperative drainage volume in the group B was less than that in the group A; the total blood loss in the group A was significantly less than that in the group B (P < 0.05). (2) None patient appeared with lower limb deep venous thrombosis. (3) These findings indicate that intravenous and topical administration of tranexamic acid can significantly reduce the perioperative blood loss in primary TKA, and cannot increase the risk of thrombosis.

Pedicle Subtraction Osteotomy with a Cage Prevents Sagittal Translation in the Correction of Kyphosis in Ankylosing Spondylitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sagittal translation (ST) is an accidental event that surgeons commonly encounter during a spinal osteotomy in the correction of kyphosis in ankylosing spondylitis (AS). However, there is a paucity of effective techniques to prevent ST. The purpose of this study was to propose a pedicle subtraction osteotomy (PSO) with a cage as a method to prevent ST and to explore the efficacy and feasibility of this method in the treatment of kyphosis in AS.</p><p><b>METHODS</b>We retrospectively reviewed 89 consecutive patients with AS kyphosis who underwent a PSO (Group B, 46 patients) or a PSO with a cage (Group A, 43 patients) from February 2009 to December 2013. Pre- and post-operative radiographic results were reviewed. ST and complications were analyzed in both groups. Clinical assessment was performed using the Scoliosis Research Society-22 (SRS-22) outcomes metric. The patients were followed up for at least 2 years.</p><p><b>RESULTS</b>Group A achieved the same re-alignment of the kyphotic spine as Group B. Two (4.7%) of the 43 patients in Group A and 14 (30.4%) of the 46 patients in Group B had intraoperative ST (χ2 = 10.020, P = 0.002). Significant differences were identified between the two groups in the height change of the osteotomized column. SRS-22 scores improved significantly in both groups. Seven patients experienced neurologic complications (1 in Group A and 6 in Group B). Eight patients had cerebrospinal fluid leakage (2 in Group A and 6 in Group B).</p><p><b>CONCLUSION</b>PSO with a cage significantly avoided ST during the osteotomy procedure and might represent a new, safe, and feasible choice for treating patients with AS kyphosis.</p>

Meta-analysis on elemene injection combined with cisplatin chemotherapeutics in treatment of non-small cell lung cancer / 中国中药杂志

To research databases of Cochrane library, Web of Science, PubMed, FMJS, CBM, VIP, CNKI and Wanfang Data Konwledge Service Platform by computers as at July 5, 2012, which was supplemented with other search results. The findings were included into randomized controlled trials (RCTs) of elemene injection combined with cisplatin chemotherapeuties in treating small cell lung cancer (NSCLC). Data was separately collected by two researchers for literature quality evaluation, and a Meta analysis was made with RevMan 5. 2 software, in order to assess the efficacy and safety of elemene injection combined with cisplatin chemotherapeutics in treating NSCLC. Totally 11 RCTs or 844 cases were included. Meta analysis results suggested that compared with cisplatin chemotherapy alone, the combination of elemene injection and cisplatin chemotherapeutics showed a higher clinical benefit rate ( OR = 2. 03, 95% CI:1.43-2. 88, P <0. 000 1) and a better quality of life (OR = 3.23, 95% CI:2. 20-4. 74, P <0. 000 01). Besides,the combination could also reduce leucopenia (OR =0. 50, 95% CI:0. 33-0. 76, P <0. 001) , and thrombocytopenia (OR =0. 38, 95% CI:0. 16-0. 85, P <0. 02), increase CD4 (MD = 3.32, 95% C1:2. 94-3.70, P <0. 000 01), and CD4/CD8 (MD = 0. 36, 95% CI:0. 28-0. 44, P < 0. 000 01) , and relieve gastrointestinal reactions such as nausea and vomiting (OR = 0. 37, 95% CI: 0. 19-0. 71, P = 0. 003). The analysis indicates that elemene can enhance the chemotherapeutic effect on NSCLC, improve the quality of life, and reduce adverse effect of platinum-contained chemotherapeutics, thereby being worth promoting in clinic.

Notch1 mRNA and protein expression in human breast cancer and normal mammary gland tissues / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the Notch1 mRNA and protein expression in human breast cancers and normal mammary tissues, and their relationship with the clinical indicators of breast cancers were analyzed.</p><p><b>METHODS</b>Notch1 gene of human breast invasive ductal carcinoma (IDC) and normal mammary gland tissues were amplified by RT-PCR, and the expression of Notch1 protein was detected by immunohistochemical Streptavidin-Biotin Complex (SP) stain in 60 IDC, 30 ductal carcinoma in situ (DCIS) and 60 normal mammary tissues.</p><p><b>RESULTS</b>Notch1 gene of human IDC and normal mammary tissues both could express in a transcription level; the positive rates of Notch1 protein expression in normal mammary tissues and DCIS were 55% and 70%. Respectively, which did not differ statistically (P > 0.05), while the positive rate in IDC was 90%, significantly higher than that of the normal mammary tissues and DCIS (P < 0.05). The high expression of Notch1 protein in IDC correlate significantly with lymph node metastasis, pathological grades and TNM stages.</p><p><b>CONCLUSIONS</b>Notch1 protein was over expressed in breast IDC. A high Notch1 protein expression is considered associating with the evolution and malignant transformation of the breast tumor. The expression of Notch1 gene maybe impact the effect of on the progression of breast cancers.</p>

Study on clinicopathologic features and immunophenotype of 114 cases of renal cell carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and immunophenotype of renal cell carcinomas, and to discuss their diagnostic value.</p><p><b>METHODS</b>The clinicopathologic features of 114 cases of renal cell carcinoma were reviewed and categorized on the basis of 2004 WHO classification. Immunohistochemical study for a panel of antibodies (including CK, CD10, vimentin, CD117, AMACR, CK7 and TFE3) was carried out. The follow-up data, if available, were also analyzed.</p><p><b>RESULTS</b>The cases were reclassified into 5 subtypes, including 77 cases (67.5%) of clear cell carcinoma (CCRCC), 11 cases (9.6%) of papillary renal cell carcinoma (PRCC), 14 cases (12.3%) of chromophobe renal cell carcinoma (chrRCC), 10 cases (8.8%) of renal carcinoma associated with Xp11.2 translocations/TFE3 gene fusions (Xp11.2RCC) and 2 cases (1.8%) of unclassified renal cell carcinoma (unRCC). Immunohistochemical study showed that the expression rates of CK, CD10 and vimentin in CCRCC were 93.5% (72/77), 93.5% (72/77) and 75.3% (58/77), respectively. On the other hand, all the 11 cases of PRCC studied were positive for AMACR. The expression rate of CD117 in chrRCC was 78.5% (11/14). In the 10 cases of Xp11.2 RCC studied, the expression rates of TFE3, AMACR, CD10 and CK were 100% (10/10), 100% (10/10), 90% (9/10) and 70% (7/10), respectively.</p><p><b>CONCLUSIONS</b>The various subtypes of renal cell carcinomas are heterogeneous in histologic appearance and demonstrate distinctive immunophenotype. The expressions of CD10, vimentin, CD117, AMACR, CK7 and TFE3 are helpful in the differential diagnosis.</p>

Analysis of the mutation of BRCA1 gene in 70 Uigur women breast cancer patients in Xinjiang / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the mutations of BRCA1 in breast cancer patients of Uigur women in Xinjiang.</p><p><b>METHODS</b>By using single strand conformation polymorphism (SSCP) and DNA sequencing, BRCA1 mutations were detected in 70 Uigur women breast cancer cases and 32 cases of benign breast diseases and non-tumor tissue next to carcinoma.</p><p><b>RESULTS</b>(1) 12 new loci of BRCA1 gene mutation were detected firstly in 70 Uigur women breast cancer patients. (2)The frequency of BRCA1 mutation in 70 Uigur women breast cancer cases was 12.86% (9/70). The frequency of BRCA1 mutation in Uigur women early onset breast cancer was 31.82% (7/22), which was significantly higher than that in late onset group (2/48, 4.16%) (chi(2) =10.295, P<0.01). (3) There were BRCA1 gene polymorphisms in 9 of 70 Uigur women breast cancer patients. The loci of polymorphisms in 8 of 9 cases were 3232A>G. (4)In the research group two cases of bilateral breast cancer were found with BRCA1 gene mutation.</p><p><b>CONCLUSION</b>The mutation of BRCA1 gene may be related to Uigur women breast cancer and bilateral breast cancer.</p>

Detection of ASPL-TFE3 fusion gene by reverse transcriptase polymerase chain reaction in paraffin-embedded tumor tissues of alveolar soft part sarcoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the significance of detecting chimeric mRNA resulting from t(X;17)(p11.2;q25) in paraffin-embedded tumor tissues of alveolar soft part sarcoma (ASPS).</p><p><b>METHODS</b>Formalin-fixed, paraffin-embedded tumor tissues from 8 cases of alveolar soft part sarcoma and 15 cases of controls (including 6 alveolar rhabdomyosarcomas, 6 renal cell carcinomas, 2 paragangliomas and 1 granular cell myoblastoma) were retrieved from the archival materials. ASPL-TFE3 fusion transcripts were analyzed in all samples by reverse transcriptase-polymerase chain reaction (RT-PCR). The quality of the mRNA was assessed using the house-keeping gene beta-actin.</p><p><b>RESULTS</b>ASPL-TFE3 fusion transcripts were detected in 6 of the 8 ASPS cases (4 being type 2 and 2 being type 1). The remaining 2 cases were negative for both beta-actin and ASPL-TFE3. No ASPL-TFE3 mRNA expression was detected in all the controls. PAX3/7-FKHR fusion transcripts were also detected in 4 of the 6 alveolar rhabdomyosarcoma samples.</p><p><b>CONCLUSIONS</b>The expression of ASPL-TFE3 fusion transcripts in paraffin-embedded tumor tissues can serve as an useful molecular marker in the diagnosis of ASPS. It may also be helpful in elucidating the underlying pathogenesis of ASPS in subsequent retrospective studies.</p>

Detection of COL1A1/PDGFB fusion transcripts in dermatofibroscoma protuberans by revers transcriptase-polymerase chain reaction using paraffin-embedded tissues / 中华病理学杂志

<p><b>OBJECTIVE</b>To detect the COL1A1/PDGFB fusion transcripts and discuss its clinicopathological significance in dermatofibroscoma protuberans.</p><p><b>METHODS</b>Formalin fixed, paraffin-embedded tumor specimens from 12 patients with DFSP were reviewed by light microscope and the expression of COL1A1/PDGFB mRNA resulting from the reciprocal translocation t(17;22) (q22;q13.1) was detected by one-step revers transcriptase-polymerase chain reaction. The following tumor specimens were included as controls: 2 fibrosarcoma, 2 malignant fibrous histocytoma, 3 leiomyosarcoma, 1 dermarofibroma and 1 nerve shealth tumor.</p><p><b>RESULTS</b>The COL1A1/PDGFB fusion transcripts were detected in 8 (67%) of 12 samples from patients with DFSP. Nucleotide sequence analysis using the PCR products confirmed that different regions of the COL1A1 gene, respectively, were fused with of PDGFB gene. No COL1A1/PDGFB fusion transcripts were detected in the control tumors.</p><p><b>CONCLUSION</b>Detection of specific COL1A1/PDGFB fusion transcripts in DFSP will help to diagnose the nature of DFSP and research the mechanism of its molecular histogenesis.</p>

Study on the diagnostic significance of detecting the expression of AChR-gamma mRNA in rhabdomyosarcoma tissues / 中华病理学杂志

<p><b>OBJECTIVE</b>To detect over-expression of AChR-gamma mRNA in rhabdomyosarcoma tissues by duplex RT-PCR and discuss its potential in diagnosis of rhabdomyosarcoma.</p><p><b>METHODS</b>Duplex RT-PCR was applied to the simultaneous detection of AChR-alpha and gamma subunit messenger RNA in 17 cases of rhabdomyosarcoma (9 ERMS, 6 ARMS, 2 PRMS). 20 cases of non-rhabdomyosarcomous small round cell tumors (6 poorly differentiated synovial sarcomas, 6 ES/PNET, 6 lymphomas, 2 neuroblastomas) and three normal muscle samples were also detected for AChR-alpha and gamma mRNA by the same method.</p><p><b>RESULTS</b>AChR-alpha and AChR-gamma mRNA were expressed in all the cases of rhabdomyosarcoma. The rate of quantity in both transcripts was AChR-gamma/AChR-alpha >or= 1, but the rate for three normal muscle samples was < 1. Cases of non-rhabdomyosarcomous small round cell tumors were all negative for AChR-gamma.</p><p><b>CONCLUSION</b>AChR-gamma mRNA expression detected by molecular genetic methods is useful in diagnosis and differential diagnosis of rhabdomyosarcoma.</p>