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Objective:To study the risk factors of complications after bowel resection for acute mesenteric ischemic disease.Methods:Retrospective case-control study was used to analyze the case data of 68 patients diagnosed with acute mesenteric ischemic disease (AMI) with bowel resection at the First Medical Center of the PLA General Hospital from January 2010 to January 2020, including 43 males and 25 females. The patients were divided into complication group ( n=21) and the non-complication group ( n=47) according to whether they had complications after surgery. The risk factors associated with the development of postoperative complications were analyzed by multivariate Logistic stepwise regression method to determine the risk factors with clinical significance. Measurement data with normal distribution were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups. Chi-square test was used for comparison between count data groups. Results:Univariate analysis showed that age >60 years, Marshall score≥2, type of resected bowel, pathology suggestive of irreversible transmural necrosis, length of ICU stay >6 d, length of mechanical ventilation >2 d, American Society of Anesthesiologists (ASA) classification, and preoperative procalcitonin≥2 ng/mL were the risk factors affecting the development of complications after bowel resection for acute mesenteric ischemic disease risk factors ( P<0.05). Multivariate Logistic regression analysis showed that age>60 years ( HR=12.364, 95% CI: 1.135-134.662, P=0.039) and preoperative procalcitonin ≥2 ng/mL ( HR=14.144, 95% CI: 1.280-156.303, P=0.031) were independent risk factors for the development of postoperative complications after AMI parallel bowel resection. Conclusion:The rate of complications after combined bowel resection for AMI is high. When patients are combined with age>60 years and preoperative procalcitonin≥2 ng/mL, preoperative prevention of postoperative complications should be emphasized to improve the prognosis of patients.
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Objective:To analyze the effectiveness and safety of Morinidazole combined laparoscopic appendectomy for acute purulent appendicitis and acute gangrene appendicitis.Methods:We retrospectively retrieved 387 acute appendicitis patients who have received surgery or conservative treatment from Jan 2017 to Jun 2019. Firty four patients with Morinidazole + Etimicin bigeminy combined laparoscopic surgery were set to experimental group. The other 54 cases using ornidazole + levofloxacin bigeminy combined laparoscopic appendectomy were enrolled into control group after Propensity Score Matching.Results:After 1∶1 propensity score matching, there was no statistically significant difference between the two groups and control group in clinical features. The white blood cell count, C-reactive protein and calcitonin original inflammation index change were higher in experimental group than in the control group,both preoperatived and on post-op day1 and day 3 (all P<0.05). In the experimental group the length of hospital stay and analgesic drug usetime were shorter than in the control group (all P<0.05). Conclusion:Morinidazole combined laparoscopic appendectomy can effectively control the intra-abdominal infection caused by acute purulent appendicitis and acute gangrene appendicitis with less adverse reactions.
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Objective:To investigate the thyroid function changes and clinical significance after acute traumatic and infectious abdominal surgery.Methods:The clinical data of patients admitted to the intensive care unit (ICU) for acute traumatic and infectious abdominal surgery during the period from January 1, 2012 to December 31, 2021 in the First Medical Center of People′s Liberation Army General Hospital were retrospectively analyzed using retrospective case-control study. Eligible cases were obtained according to the inclusion and exclusion criteria, and an observation group was set ( n=65). According to the factors such as gender, age, body mass index, and surgical site (organ), a 1∶1 propensity score matching method was used to match the same number of non-traumatic non-infectious abdominal surgery patients admitted in the same time interval, and they were set as the control group ( n=65). The preoperative white blood cells, neutrophils, interleukin -6, c-reactive protein, and procalcitonin were collected, and the thyroid function index for the first time after operation was calculated. The incidence of postoperative thyroid dysfunction was calculated. The thyroid function changes of patients with thyroid dysfunction after exogenous thyroid hormone replacement therapy and the effects on complications and mortality within 30 days were observed. Measurement data of normal distribution were expressed as mean standard deviation( ± s), and t-test was used for comparison between groups. Enumeration data were compared between groups using chi-square test. Results:In the observation group, there were 50 patients with thyroid dysfunction (76.9%). After a 1∶1 match, the baseline of the observation group and the control group was level and comparable. The preoperative inflammatory indexes such as leukocyte, neutrophil ratio, interleukin -6, C-reactive protein and procalcitonin in the observation group were (23.7±5.7)×10 12/L, 0.86±0.13, (66.7±16.3) ng/L, (365.8±77.9) mg/L and (17.9±3.5) μg/L, respectively. Those in the control group were (12.3±2.7)×10 12/L, 0.71±0.04, (8.5±4.7) ng/L, (14.3±6.5) mg/L and (1.3±0.6) μg/L, respectively. The elevations in the observation group were different from those in the control group( P<0.05). In the first postoperative thyroid function test, T3 and FT3 in the observation group were (1.07±0.54) nmol/L and (2.23±1.02) pmol/L, respectively, and those in the control group were (1.61±0.34) nmol/L and (4.36±1.25) pmol/L, respectively. These values in the observation group were significantly lower than those in the control group( P<0.05). On the 10th day after surgery, T3 and FT3 levels in the exogenous thyroid supplementation group rapidly increased and gradually returned to the normal level. In addition, the total hospitalization time of patients in the observation group was significantly shortened, and the incidence and mortality of postoperative complications were reduced. The results in the observation group were (13.47±4.66) d, 17.6% and 11.8%, respectively. The corresponding results in the control group were (16.33±5.18) d, 36.4% and 21.2%, respectively. The difference between the two groups was statistically significant( P<0.05). Conclusion:The incidence of thyroid dysfunction after acute traumatic and infectious abdominal surgery is high, and exogenous thyroxine supplementation can improve the outcome of patients.
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Objective:To investigate the influence of all-trans-retinoic acid (ATRA) on the proliferation and invasion of osteosarcoma 143B cells and its possible regulatory mechanism.Methods:Different concentrations of ATRA were used to treat human osteosarcoma 143B cells, and the optimal concentration and treatment time those affected cell proliferation were selected. The MTS method, Transwell migration and invasion experiments were used to detect the changes in the proliferation, migration and invasion of 143B cells after ATRA treatment. The real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the expression changes of miRNA-34a (miR-34a), E2F1 and Eag1 in osteosarcoma 143B cells after ATRA treatment. Then miR-34a was interfered and E2F1 was overexpressed, and the abilities of cell proliferation, invasion and migration abilities as well as the expression changes of miR-34a, E2F1 and Eag1 in 143B cells were detected.Results:The proliferation inhibition of 143B cells was most obvious when 143B cells were treated with 10 μmol/L ATRA for 72 h. The cell migration and invasion numbers when 143B cells were treated with 10 μmol/L ATRA for 72 h were lower than those in the negative control group [(73±3) cells vs. (182±5) cells, t = 21.46, P<0.01; (94±3) cells vs. (203±7) cells, t = 13.70, P<0.01]. 10 μmol/L ATRA could promote the expression of miR-34a in 143B cells and inhibit the expressions of Eag1 and E2F1 (all P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+miR-34a interference group was restored after 72 h of treatment [cell survival rate (41.0±2.2)% vs. (25.0±3.6)%, t = 108.68, P<0.01]. Compared with ATRA group, the abilities of cell migration and invasion in ATRA+miR-34a interference group were restored [(122±14) cells vs. (64±10) cells, t = 21.06, P<0.01; (103±10) cells vs. (59±8) cells, t = 24.27, P<0.01), and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Compared with ATRA group, the ability of cell proliferation in ATRA+E2F1 overexpression group was restored [cell survival rate (40.0±3.4)% vs. (24.0±3.1)%, t = 108.74, P<0.01]; the abilities of cell migration and invasion in ATRA+E2F1 overexpression group were restored [(78±12) cells vs. (29±8) cells, t = 13.52, P<0.01; (75±12) cells vs. (49±10) cells, t = 6.28, P<0.01], and the mRNA and protein expressions of Eag1 and E2F1 in cells were promoted (both P<0.01). Conclusion:ATRA inhibits the proliferation and invasion of osteosarcoma cells via regulating miR-34a-E2F1-Eag1 signaling pathway, and it may become one of the effective treatment drugs for osteosarcoma.
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Objective:To evaluate the day-surgery unit-based training of laparoscopic cholecystectomy (LC).Methods:Perioperative data of 438 patients (187 males and 251 females) with a median age of 54 (aged 17 to 91) years undergoing LC during January 2019 to April 2021 in the day-surgery unit of Chinese PLA General Hospital were retrospectively collected and subdivided according to the training methods of surgeons [Group A( n=260): conventional training vs. Group B ( n=178): protocoled stepwise training]. The protocoled stepwise training consists of the rotation in open biliary surgery unit, the stimulator-based laparoscopic training, and the stepwise procedural tutoring. The conventional training features the traditional surgical practice following senior surgeons. The technical data involving operation time, blood loss, the percentages of intraoperative decision-making by senior surgeons and the handing-over of procedure to senior surgeons, etc. were statistically analyzed. Results:The operation time was shortened in Group B [(55±30) min vs. (61±33) min], with significantly decreased percentages of intraoperative decision-making by senior surgeons [7.9% (14/178)vs. 16.9%(44/260), P<0.05] and the handing-over of procedure to senior surgeons [3.4%(6/178) vs. 11.2%(29/260), P<0.05]. Conclusion:Based on the protocoled stepwise training and the consecutive, high-volumed and standardized procedures, the laparoscopic technical proficiency and competency of the trainee surgeons have been improved.
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Objective:To investigate the antibacterial effect of iodophor on Staphylococcus aureus biofilm (BBF).Methods:Staphylococcus aureus were cultured in vitro and 480 pieces of titanium alloy plates were selected. On the surface of titanium plates, in vitro models of Staphylococcus aureus biofilms were established at days 7, 14, 21 and 28 respectively with 120 pieces of titanium plates at each time points. The biofilms at each time point were assigned to no iodophor immersion (PBS group), 5 g/L iodophor immersion for 5 minutes (5-min group) and 5 g/L iodophor immersion for 10 minutes (10-min group), according to the random number table method. FITC-ConA, propidium iodide (PI) and SYT09 were used to dye Staphylococcus aureus in PBS group. After dyeing, confocal laser scanning microscopy and scanning electron microscopy were used to observe the morphological structure of bacterial biofilms, and the Colony forming unit (CFU) was counted by the viable count method. In the other two groups, PI and SYT09 were applied to dye Staphylococcus aureus, and then confocal laser scanning microscopy and scanning electron microscopy were used to observe the changes of biofilms and bacterial viability after iodophor immersion. The antibacterial effect of iodophor was evaluated by the viable count method.Results:After dyeing Staphylococcus aureus with FITC-ConA and PI in PBS group, confocal laser scanning microscopy showed that the extracellular polymers of the bacteria increased gradually with the extension of culture time. The space structure of biofilm was gradually mature, changed significantly at day 21 and became mature at day 28. After staining Staphylococcus aureus with PI and SYT09 in PBS group, confocal laser scanning microscopy showed that the number of bacteria increased, and had a mountain-like shape. Scanning electron microscopy showed that the number of bacterial extracellular polymers increased gradually with the extension of culture time and a structured microenvironment was formed and gradually matured. In 5-min and 10-min groups, all bacteria were killed at days 7 and 14 [0(0, 0)CFU/ml], the antibacterial effect was weakened at 21 days, but the antibacterial effect of iodophor immersion in 10-min group [100 (100, 125)CFU/ml] was better than that in 5-min group [300 (275, 425)CFU/ml] ( P<0.05). There was no significant difference in iodophor immersion in 5-min group [500 (375, 700)CFU/ml] and 10-min group [250 (175, 400)CFU/ml] at 28 days ( P>0.05). Conclusions:The maturation of biofilm is the overall maturation of bacteria and bacterial extracellular polymers and the formation of a spatialized microenvironment. Bounded by the 21st day, biofilms are divided into young biofilms and mature biofilms. The main difference between them lies in the maturation of extracellular polymers and microenvironment. For the bacterial biofilm with culture time less than 21 days, the antibacterial effect of the iodophor immersion for 10 min is better than that of 5 min. However, for the bacterial biofilm with culture time greater than 21 days, there is no significant difference in the antibacterial effect of the bacterial biofilm of prolonged iodophor immersion time.
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We retrieved the PDTC patient medical record in our center who have received multi-disciplinary comprehensive treatment in March 2019. By reviewing his treatment process, we hope to improve the recognition of this disease and provide reference for individualized programs.
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Objective@#To detect the effect and regulatory mechanism of human ether à go-go related gene 1 (Herg 1) knockdown on the proliferation and invasion of osteosarcoma (OS).@*Methods@#We constructed a recombinant adenovirus vector (Ad5-Herg1-shRNA) expressing short hair RNA (shRNA) against Herg1 and tested the knockdown efficiency. Then, the effects of Herg 1 knockdown on the proliferation, growth and invasion of osteosarcoma were measured by using cell counting kit-8 (CCK-8), wound healing assay, Transwell assay and xenograft model of nude mice, respectively. Tandem affinity purification, mass spectrometry and dual luciferase reporter assay were used to find out the molecules interacted with Herg1. Western blot was used to detect the expressions of large tumor suppressor gene (LATS1), p-LATS1, Yes-associated protein (YAP) and p-YAP in cells after infection of Ad5-Herg1-shRNA.@*Results@#Compared to Ad5-control-shRNA, Ad5-Herg1-shRNA dramatically inhibited the expression of Herg1 in OS cells. The result of CCK8 array demonstrated that 143B cell vitalities of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were (65.47±3.90)% and (79.90±1.52)%, significantly lower than (100.00±6.14)% of Ad5-control-shRNA group. Meanwhile, U2OS cell vitality of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were (69.69±1.36)% and (76.72±2.75)%, significantly lower than (100.00±3.01)% of Ad5-control-shRNA group (all P<0.001). The results of wound healing array showed that 143B cell migration rates of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were (33.03±2.88)% and (36.47±4.16)%, significantly lower than (97.78±2.28)% of Ad5-control-shRNA group. Meanwhile, U2OS cell migration rates of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were (68.07±0.90)% and (73.97±1.25)%, significantly lower than (96.50±1.12)% of Ad5-control-shRNA group (all P<0.001). The results of Transwell showed that 143B cell invasion numbers of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were 36.50±12.15 and 44.83±7.62, significantly lower than 195.33±19.68 of Ad5-control-shRNA group. Meanwhile, U2OS cell migration rates of Ad5-Herg1-shRNA1 and Ad5-Herg1-shRNA2 group were 21.83±7.99 and 22.85±7.08, significantly lower than 83.33±12.36 of Ad5-control-shRNA group (all P<0.001). The results of xenograft model of OS showed that the tumor volume and weight of Ad5-Herg1-shRNA group were significantly smaller than of Ad5-control-shRNA group after 14 days and 5 weeks of inoculation, respectively (P<0.001). Moreover, knockdown of Herg1 inhibited the metastasis of OS cells. In mechanism, Herg1 protein interacted with NF2 protein. Knockdown of Herg1 significantly suppressed the expression levels of LATS1 and YAP protein, and promoted the phosphorylation of LATS1 and YAP in OS cells (all P<0.001).@*Conclusion@#Our findings suggest that Herg1 participates in the proliferation and motility of OS cells and may serve as a potential therapeutic target for osteosarcoma patients.
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Objective@#To investigate the efficacy of posterior decompression pedicle screw fixation and single pedicle screw fixation for thoracolumbar fracture with greenstick lamina fracture.@*Methods@#A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fractures combined with greenstick lamina fractures admitted to the 909th hospital from January 2011 to May 2016. There were 68 males and 38 females, aged 21-58 years [(39.5±7.1)years]. The fracture was located at T11 in 9 patients, at T12 in 6, at L1 in 28, at L3 in 11. A total of 58 patients underwent posterior decompression pedicle screw fixation including 37 males and 21 females, aged 23-58 years [(38.7±6.6)years]. The preoperative neurological function was evaluated according to ASIA grade: grade A for three patients, grade B for nine, grade C for 14, grade D for 27, and grade E for 53 patients. A total of 48 patients were treated with single posterior pedicle screws fixation including 31 males and 17 females, aged 21-57 years [(41.4±5.8)years]. Statistical indicators included operation time, intraoperative blood loss, anterior height ratio of injured vertebrae, sagittal Cobb angle, visual analogue scale (VAS), ASIA grading, dural tears and/or cauda equina entrapment, and complications.@*Results@#All patients were followed up for 24-72 months [(30.2±4.7)months]. The operation time ranged from 105 to 137 minutes [(113.5±21.3)minutes], and the intraoperative blood loss was 235-310 ml [(252.2±28.6)ml] in the posterior decompression and pedicle screws fixation group. In the posterior pedicle screw fixation group, the operation time ranged from 52 to 85 minutes [(65.3±9.6)minutes], and the intraoperative blood loss was 72-125 ml [(90.2±23.6)ml]. The anterior height ratio of injured vertebrae, sagittal Cobb angle and VAS score of the two groups were significantly improved immediately after operation and at the last follow-up (all P<0.01). At one year follow up, the ASIA grading in patients treated with single posterior pedicle screw fixation remained the same while the ASIA grading of patients treated with posterior decompression pedicle screw fixation was significantly improved compared with before operation. Dural tears were found in 12 patients and cauda equina entrapment were found in five patients during decompression. Three patients had neurological function injury after posterior pedicle screw internal fixation surgery, and they received a second decompression operation. Dural tears and/or cauda equina entrapment were subsequently found in all of the three patients. No complications related to internal fixation occurred during follow-up.@*Conclusions@#Both posterior decompression pedicle screw fixation and single pedicle screw fixation can effectively correct the kyphosis deformity, restore vertebral body height, and relieve pain in the treatment of thoracolumbar fracture with greenstick lamina fracture. Dural tears and/or cauda equina entrapment might be subsequently found in greenstick lamina fracture. Posterior pedicle screw fixation can not release the entrapped cauda nerve, so attention should be paid to the risk of secondary surgery.
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Objective To investigate the efficacy of posterior decompression pedicle screw fixation and single pedicle screw fixation for thoracolumbar fracture with greenstick lamina fracture.Methods A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fractures combined with greenstick lamina fractures admitted to the 909th hospital from January 2011 to May 2016.There were 68 males and 38 females,aged 21-58 years [(39.5 ±7.1)years].The fracture was located at T11 in 9 patients,at T12 in 6,at L1 in 28,at L3 in 11.A total of 58 patients underwent posterior decompression pedicle screw fixation including 37 males and 21 females,aged 23-58 years [(38.7 ± 6.6)years].The preoperative neurological function was evaluated according to ASIA grade:grade A for three patients,grade B for nine,grade C for 14,grade D for 27,and grade E for 53 patients.A total of 48 patients were treated with single posterior pedicle screws fixation including 31 males and 17 females,aged 21-57 years [(41.4 ± 5.8) years].Statistical indicators included operation time,intraoperative blood loss,anterior height ratio of injured vertebrae,sagittal Cobb angle,visual analogue scale (VAS),ASIA grading,dural tears and/or cauda equina entrapment,and complications.Results All patients were followed up for 24-72 months [(30.2 ± 4.7) months].The operation time ranged from 105 to 137 minutes [(113.5 ± 21.3)minutes],and the intraoperative blood loss was 235-310 ml [(252.2 ± 28.6)ml] in the posterior decompression and pedicle screws fixation group.In the posterior pedicle screw fixation group,the operation time ranged from 52 to 85 minutes [(65.3 ±9.6)minutes],and the intraoperative blood loss was 72-125 ml [(90.2 ± 23.6) ml].The anterior height ratio of injured vertebrae,sagittal Cobb angle and VAS score of the two groups were significantly improved immediately after operation and at the last follow-up (all P ＜ 0.01).At one year follow up,the ASIA grading in patients treated with single posterior pedicle screw fixation remained the same while the ASIA grading of patients treated with posterior decompression pedicle screw fixation was significantly improved compared with before operation.Dural tears were found in 12 patients and cauda equina entrapment were found in five patients during decompression.Three patients had neurological function injury after posterior pedicle screw internal fixation surgery,and they received a second decompression operation.Dural tears and/or cauda equina entrapment were subsequently found in all of the three patients.No complications related to internal fixation occurred during follow-up.Conclusions Both posterior decompression pedicle screw fixation and single pedicle screw fixation can effectively correct the kyphosis deformity,restore vertebral body height,and relieve pain in the treatment of thoracolumbar fracture with greenstick lamina fracture.Dural tears and/or cauda equina entrapment might be subsequently found in greenstick lamina fracture.Posterior pedicle screw fixation can not release the entrapped cauda nerve,so attention should be paid to the risk of secondary surgery.
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Objective To analyze the occurrence and clinical significance of hypophosphatemia after mod-erate-to-major abdominal surgery. Methods A total of 120 patients who had received moderate to major abdominal surgery and then transferred to the intensive care unit ( ICU) from January 2008 to October 2018 were retrospectively analyzed. The peri-operative parameters of serum inorganic phosphate and calcium levels were recorded and analyzed. The incidence of hypophosphatemia after the operation was calculated. The effect of phosphorus-supplement infusion on the complications and mortality within 30 days after the operation were observed. Results After moderate-to-major surgery, the phosphorus concentration significantly decreased [ (1. 21±0. 27) vs. (0. 83±0. 24) mmol/L, P<0. 05];the incidence of hypophosphatemia was 58. 3％, especially in patients with nutritional risk assessed before the operation. The post-operative complications were less in the phosphorus-supplement infusion group than in the control group (17. 5％vs. 41. 3％, P=0. 028). Conclusion The incidence of hypophosphatemia is relatively high after moderate-to-major abdominal surgery, especially in patients with nutritional risks. The treatment of phosphorus-sup-plement infusion can benefit the patients in their short-term prognosis.
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Objective To investigate the efficacy and safety of indocyanine green fluorescence imaging in the lymph node dissection of radical thyroidectomy.Methods Radical thyroidectomy was performed using indocyanine green fluorescence imaging technology for two patients at the Department of General Surgery of Chinese People's Liberation Army (PLA) General Hospital in July 2018.Indocyanine green was injected into the thyroid glands after bilateral thyroid glands were exposed during operation.Bilateral total thyroidectomy plus central lymph node dissection was performed in case 1,and bilateral total thyroidectomy plus central area and left lateral area(area Ⅱ a,Ⅲ,Ⅳ) lymph node dissection was performed in case 2.Both operations were performed under the guidance of real-time fluorescence imaging system.The total number of lymph nodes detected,the number of small lymph nodes (diameter less than 3 mm),the level of parathyroid hormone(PTH),the incidence of complications such as hypocalcemia,hoarseness and short-term recurrence were observed.Results After excitation by the near-infrared light of the fluorescence detector probe,the display showed that the parathyroid gland and surrounding tissues were not visualized,and the thyroid glands and lymph nodes were brightly illuminated.The number of lymph nodes dissected in the central region of the two patients was 20 (13 with diameter less than 3 mm) and 10(6 with diameter less than 3 mm),respectively.For case 2,13 lymph nodes were dissected in the left lateral area (area Ⅱ a,Ⅲ,Ⅳ),and 8 lymph nodes with diameter less than 3 mm were dissected.There were no complications such as hypocalcemia and hoarseness after operation.The levels of parathyroid hormone and serum calcium were normal on the first day and 3 months after operation.There was no recurrence or metastasis of the tumors by ultrasonography 3 months after operation.Conclusion Indocyanine green fluorescence real-time imaging technology can help to identify lymph nodes specifically during radical thyroidectomy,and can achieve real-time dynamic imaging,which can make lymph node dissection more thorough and can be used as a new method for lymph node tracing in thyroid cancer surgery.
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Objective To explore the clinical significance of laparoscopic exploration in non-traumatic acute abdomen disease.Methods Four hundred and fourteen cases of non-traumatic acute abdomen disease patients with unknown determine diagnosis from June 2016 to May 2018 in Department of General Surgery,First Medical Center of Chinese PLA General Hospital were reviewed,among which 278 were males and 136 were females,aged (47.6 ± 7.3) years (range,7-96 years).According to the case for natural order,the patients can be divided into laparoscopic and open surgery group in accordance with the operation records,in which included laparoscopic group 297 examples and open surgery group 117 examples.Operation methods of two groups were chosen on the basis of clear pathogeny and patient condition.Then the outcome of intraoperative and postoperative of two groups were compared and analyzed.Intraoperative outcome index mainly includes:operation time,blood loss and surgical incision length,etc..Postoperative outcome index mainly includes:length of hospital stay,ICU transition time,days of analgesic drug used,hospitalization expenses,intestinal ventilation timing and incision infection rate,etc..Measurement data with normal distribution were represented as mean ± standard deviation (Mean ± SD) and analyzed by matching t test after logistic correction.Comparison between groups of count data was done using the chi-square test.Results In laparoscopic group,intraoperative blood loss,surgical incision length,length of hospital stay,days of analgesic drug used,hospitalization expenses,intestinal ventilation timing,liquid timing,postoperative incision infection rate were:(23.881 ± 12.164) ml,(4.561 ± 1.343) cm,(5.419±0.732) d,(2.831 ±1.453) d,(3.895 ±1.842) ten thousandyuan,(1.891 ±0.654) d,(2.218± 0.395) d,2.02％ (6/297),respectively.The same index of open surgery group were:(84.673 ± 27.662) ml,(12.385 ±3.492) cm,(7.356 ± 1.342) d,(5.676 ± 2.335) d,(5.781 ± 2.467) ten thousand yuan,(2.772 ± 1.033) d,(3.091 ± 0.578) d,17.95％ (21/117),respectively.The indexes of the laparoscopic group were better than those of the open surgery group.The difference between the two groups was statistically significant(P ＜ 0.05).Conclusion For its timely diagnosis,minimally invasive treatment and fast recovery,laparoscopic exploration is of great value in non-traumatic acute abdomen disease patients with unknown determine diagnosis,which is worthy of popularization and application.
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Objective To study the effect of applying a new intravenous resuscitation solution to electrolyte imbalance in miniature pigs after seawater immersion injury.Methods A total of 20 Guizhou Ⅲ type miniature pigs aged 4 months were randomly divided to A and B groups,10 in each.The seawater immersion injury model was used to soak sea water for 3 hours.The changes of electrolytes in miniature pigs before and after soaking wererecorded.A group with intravenous infusion of 0.9％ sodium chloride solution,and B group with new type ofrecovery liquid intravenous rehydration.Electrolyte changes after infusion were recorded and analyzed.Data ofnormal distribution measurement data were expressed as ((x) ± s).The data of electrolyte before and after immersionwere analyzed by paired t test.After soaking,the relative data of electrolyte after sub-group rehydration wereanalyzed by independent sample t test.Results After seawater immersion,pH value were dropped from 7.39 ±0.06and 7.39 ±0.04 to 7.32 ±0.05 and 7.33 ±0.05,serum K + concentration elevated from (3.93 ±0.38) mmol/Land (3.93±0.42) mmol/L to (4.35 ±0.33) mmol/L and (4.37 ±0.14) mmol/L.Clconcentration increased from (93.38 ± 4.29) mmol/L and (92.88 ± 3.79) mmol/L to (102.80 ± 4.29) mmol/Land (103.50±2.46) mmol/L.Na+ concentration in serum were dropped from (140.64 ± 4.99) mmol/L and(140.69 ±4.72) mmol/L to (136.80 ±4.32) mmol/L and (136.90 ±3.03) mmol/L.After normal saline andnew type of recovery liquid rehydration respectively,group B with new recovery liquid,pH increased from 7.33 ±0.05 to 7.38 ±0.04 (P ＜0.05),serum concentration of K+ and Cl-concentration were dropped from (4.37 ±0.14) mmol/L and (103.50 ±2.46) mmol/L to (3.87 ±0.25) mmol/L and (94.15 ±4.23) mmol/L (P =0.005,P =0.007).The concentration of serum Na + back up from (136.90 ± 3.03) mmol/L to (139.30 ±3.06) mmol/L (P =0.038).A group of saline infusion after the various indicators did not change significantly.Conclusion The new intravenous resuscitation solution of miniature pigs electrolyte imbalance correction effect issignificant,that the resuscitation solution has some clinical value for seawater immersion iniurv.
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Objective: To discuss the effectiveness of posterior short-segment fixation including the fractured vertebra for severe unstable thoracolumbar fractures using pedicle screw fixation.
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Objective To investigate the clinical efficacy of our self-designed adjustable weight-bearing brace for AO type B tibial shaft fractures managed by interlocking intramedullary nail.Methods A total of 68 consecutive patients with AO type 42-B tibial shaft fracture who had been managed from April 2013 to March 2015 hy interlocking intramedul]ary nail were recruited into our study.They were randomized into 2 equal groups (n =34).Group A received conventional therapy after operation while group B received auxiliary mauagement with our self-designed adjustable weight-bearing brace after conventional postoperative therapy for one week.The 2 groups were compared at postoperative 1,3 and 6 months and at the final follow-up in terms of visual analogue scale (VAS),weight-bearing status of the affected limb,time for fracture union,Radiographic Union Score for Tibial Fractures (RUST) and Johner-Wruhs scale.Results Of this series,62 cases were followed up for 12 to 18 months (average,14.7 months),5 ones were lost to the follow-up and one withdrew.The mean VAS scores at 3-month and 6-month follow-ups for group B were 2.5 ± 0.8 and 0.9 ± 0.6 respectively,significantly lower than those for group A (3.0 ± 0.9 and 1.4 ± 0.8 respectively) (P ＜ 0.05).In group A at 1-month,3-month and 6-month follow-ups,the weight-bearing status was 44.1％ ± 17.5％,72.0％ ±17.4％ and 86.4％ ±12.5％ while the mean RUST scores were 5.4±1.4,8.7±1.1 and 10.3 ± 1.1,respectively.In group B at 1-month,3-month and 6-month follow-ups,the weight-bearing status was 53.8％ ± 11.0％,84.1％ ± 12.2％ and 94.4％ ± 10.6％ while the mean RUST scores were 6.5 ± 0.8,9.9 ± 0.9 and 11.3 ± 0.8,respectively.There were significant differences between the 2 groups in the above indexes (all P ＜ 0.05).Group B achieved clinical fracture union after an average of 3.3 ±0.7 months,significantly faster than group A (3.9 ± 1.0 months) (P ＜ 0.05).According to the Johner-Wruhs scoring,group A had 19 excellent cases and 12 good ones while group B had 27 excellent ones and 4 good ones,showing a significant difference between the 2 groups (P ＜ 0.05).Conclusions Early application of our self-designed adjustable weight-bearing brace for patients with AO type B tibial shaft fracture managed by interlocking intramedullary nail can reduce postoperative pain,accelerate callus growth,shorten bony healing time and achieve satisfactory functional recovery.
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Objective To detect the influence of miRNA-34a (miR-34a) on the proliferation of osteosarcoma and the mechanisms responsible for miR-34a regulation.Methods The osteoblastic cell line MG-63 and Saos-2,human osteoblastic cell line hFOB 1.19,10 osteosarcoma tissues and 10 normal bone tissues were selected.The expression of miRNA-34a in osteosarcoma cells and tissues was detected by quantitative real-time polymerase chain reaction (qPCR).Next,a eukaryotic expression vector named pcDNA/miR-34a was constructed.Then,osteosarcoma cells were transfected with this eukaryotic expression vector and the effects of miR-34a overexpression on the proliferation and growth of osteosarcoma were measured using CCK-8,colony formation and xenograft model of nude mice.Finally,Western blot analysis was used to detect the expression of ether-à-go-go 1 (Eag1) gene in osteosarcoma cells after transfected with pcDNA/miR-34a or a miR-34a inhibitor miR-34a-2'-O-Methyl antisense oligoribonucleotide (miR-34a-2'-O-Me).Results Compared with normal bone tissues and osteoblastic cell line,miR-34a was down-regulated in osteosarcoma cell lines and tissues.Compared with the blank group and the control group,the cell survival rates of miR-34a group of the two cell lines were significantly lower [MG-63 72 h:blank group (40.05±4.82) ％,control group (36.88± 4.66) ％,miRNA-34a group (26.24±6.22) ％;MG-63 96 h:blank group (83.55±5.95) ％,control group (80.13± 4.48) ％,miRNA-34a group (30.21±7.26) ％;Saos-2 72 h:blank group (46.45±8.15) ％,control group (43.33± 6.89) ％,miRNA-34a group (26.81±3.17) ％;Saos-2 96 h:blank group (84.79±4.10) ％,control group (80.14± 3.11) ％,miRNA-34a group (31.77±5.17) ％].The similar results were obtained from colony formation assay (MG-63:blank group 83.40±3.29,control group 80.00±3.06,miR-34a group 24.40±2.71;Saos-2:blank group 85.00±3.32,control group 80.60±3.29,miR-34a group 30.40±4.94).The tumor volumes of osteosarcoma xenograft in the miR-34a group was significantly smaller than that in the blank group and control group after 21 days treatment (all P ＜ 0.001).Overexpression of miR-34a could decrease Eag1 expression in osteosarcoma cell lines while inhibition of miR-34a induced the of expression Eag1 (P ＜ 0.001).Conclusion MiR-34a plays a tumor suppressor role in osteosarcoma and could suppress the proliferation and growth of osteosarcoma through the regulation of Eag1.Moreover,it may be a novel target for osteosarcoma therapy.
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Objective To detect the expression of HERG (human ether-à-go-go-related gene ) potassium channel in human osteosarcoma,and explore the effects of silencing HERG by small interfering RNA (siRNA)on the proliferation and apoptosis of osteosarcoma cells and the mechanisms responsible for HERG regulation.Methods The expressions of HERG in osteosarcoma MG-63 cells and tissues were detected by reverse transcription polymerase chain reaction (RT-PCR),Western blotting and immunohistochemistry.Next, osteosarcoma cells were divided into three groups:HERG-siRNA group,control-siRNA group and blank group. CCK-8,colony formation,flow cytometry and Tunel assay were used to measure the proliferation and apoptosis of the osteosarcoma cells.Finally,Western blotting analysis was performed to detect the expression of nuclear factor-κB (NF-κB)pathway in osteosarcoma cells treated with HERG siRNA.Results Osteosarcoma cells and tissues were found to highly express HERG.Inhibition of HERG in the osteosarcoma cells significantly inhibited the cell proliferation and induced cell apoptosis.Compared to control-siRNA group or blank group,HERG-siRNA could inhibit the proliferation of MG-63 cells significantly [HERG-siRNA group:(75.34 ± 4.45)%;compared to control-siRNA group:(100.60 ±5.31)%;t =3.64,P =0.007;compared to blank group:(100.00 ±5.66)%;t =3.43,P =0.009].The similar results were obtained from colony formation assay (HERG-siRNA group:134.30 ±11.82;compared to control-siRNA group:225.30 ±11.56;t =5.51, P =0.002;compared to blank group:232.80 ±12.21;t =5.80,P =0.001).HERG-siRNA transfected MG-63 cells demonstrated a significant increase of apoptotic rate compared to control-siRNA transfected cells or untreated cells [HERG-siRNA group:(28.10 ±2.21 )%;compared to control-siRNA group:(9.36 ± 2.42)%;t =5.72,P =0.005;compared to blank group:(10.92 ±2.51)%;t =5.14,P =0.007].This resultwas further confirmed by Tunel assay.The cells transfected with HERG-siRNA (31.57 ±2.08)% dem-onstrated extensive apoptosis,compared with the control-siRNA group [(10.35 ±1.82)%;t =7.69,P =0.002)]or blank group [(7.96 ±0.88)%;t =10.48,P =0.001].Silencing HERG gene down-regulated the cIAP-1,XIAP,Bcl-2,Survivin,P-IκBαand NF-κB p65 expression,compared to the control groups. Conclusion HERG is highly expressed in osteosarcoma.HERG silencing can suppress osteosarcoma progres-sion through NF-κB pathway and suggest that HERG may be a novel molecular target for osteosarcoma therapy and diagnosis.
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Objective To detect the effect of E6AP on gastric cancer cell proliferation and migration.Methods The expression of E6AP in different gastric cancer cell lines and normal gastric mucosa epithelial cell lines was detected by Western blotting.Gastric cancer cells BGC-823 stably expressing E6AP short hairpan RNA(shRNA) were obtained by lentiviral vector of E6AP.The effect of E6AP on BGC-823 cell growth and migration was determined by CCK-8 kit, Tran-swell and wound healing assay.Results Gastric cancer cell line BGC-823 in which E6AP was stably knocked down was established.Knockdown of E6AP inhibited the proliferation and migration of BGC-823 cells.Conclusion E6AP plays a key role in gastric cancer proliferation and migration.
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The voltage-gated potassium channels Kvl.5 is widely expressed in the plasma membranes of numerous tumor cells and it can contribute to a variety of cellular functions such as proliferation,ap optosis,and cell cycle.Several types of antineoplastic drugs can change the expression of Kv1.5 and then affect the biological processes.Kv1.5 is identified as a novel target for therapy in human cancer.The researches of Kv1.5 will contribute to gain a further understanding of the molecular mechanism of tumor and provide therapeutic opportunity for the prevention and treatment of cancer.