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Objective:To investigate the association between quantified CT (QCT)-measured body composition and metabolic syndrome (MS) components in obese populations before bariatric surgery.Methods:A cross-sectional study. A retrospective analysis was conducted on a cohort of 97 obese patients scheduled for weight-loss surgery at the First Affiliated Hospital of Wannan Medical College from January 2021 to March 2023. The patients′ body mass index (BMI), biochemical parameters and body composition measurements obtained by QCT were recorded. The patients were stratified into groups based on gender, obesity severity and the number of MS components. Differences in body composition among the groups were compared. Additionally, the correlations between each body composition parameter and metabolic indicators were analyzed. The diagnostic efficacy of each body composition parameter for identifying obese individuals with different MS components was assessed using receiver operating characteristic (ROC) curve analysis.Results:There were 75 females (77.3%). Male obese patients had higher total abdominal fat area [(693.23±148.90) vs (574.99±114.89) cm 2, t=-3.958, P<0.001], visceral fat area [(289.65±57.67) vs (195.60±57.37) cm 2, t=-6.753, P<0.001], fat content of pancreatic head [27.45%(21.65%, 45.48%) vs 21.60%(17.6%, 26.9%), Z=-2.675, P=0.007], and skeletal muscle index [73.36(68.74, 81.26) vs 61.52(55.74, 66.41) cm 2/m 2, Z=-5.246, P<0.001]. With the increase of obesity, abdominal fat mainly increases in subcutaneous fat. With the increase of MS components (MS2 group, MS3 group, MS4 group, MS5 group), the abdominal fat area, abdominal fat/subcutaneous fat, liver fat content, pancreatic head fat content, and skeletal muscle index of patients all increased accordingly. In diagnosing the presence of two components of MS, area under the curve of visceral fat area was the largest (AUC=0.706, 95% CI=0.577-0.834). For diagnosing the presence of three, four and five components of MS, area under curve of liver fat content were all the largest (MS3=0.712, 95% CI=0.605-0.818; MS4=0.652, 95% CI=0.537-0.766; MS5=0.706, 95% CI=0.576-0.836). Conclusion:There are differences in QCT body composition among obese patients with different MS components, and there is a correlation between each body composition and MS component. Among them, intra-abdominal fat area and liver fat content are of great value in evaluating obese patients with different MS components.
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Objective:To investigate the effect and mechanism of RNaseH-1 on the radiosensitivity of the osteosarcoma cells via the alternative lengthening of telomeres (ALT) mechanism to maintain the telomere length.Methods:ALT osteosarcoma cell U2OS and telomerase-positive osteosarcoma cell 143B over-expressing RNaseH-1 were constructed by lentiviral transfection. After cell transfection, cell proliferation and cell cycle were determined using CCK-8 assay and flow cytometry. The effect of RNaseH-1 on the radiosensitivity of osteosarcoma cells was examined by colony formation assay. DNA injury (γ-H 2AX foci) was assessed by immunofluorescent assay. The expression levels of related proteins were detected by Western blot. Results:The proliferation abilities of U2OS cells were significantly declined following the over-expression of RNaseH-1, and G 1 cell cycle arrest was noted (all P<0.05). Over-expression of RNaseH-1 in U2OS cells increased the phosphorylated levels of ATM and Chk 2, down-regulated the expression of homologous recombination (HR)-related proteins RAD51 and BRCA1significantly aggravated DNA damage and remarkably enhanced the radiosensitivity (all P<0.05). Over-expression of RNaseH-1 exerted no inhibitory effect upon the telomerase-positive 143B cells ( P>0.05). Conclusion:RNaseH-1 over-expression suppresses telomerase-negative osteosarcoma cells and enhances the radiosensitivity probably via the role of RNaseH-1 in inhibiting the homologous recombination repair and activating the ATM signaling pathway.
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OBJECTIVE:To investigate the contents of 5 kinds of heavy metal as copper (Cu),arsenic(As),cadmium (Cd),mercury(Hg)and lead (Pb)in Yougui pills ,and to evaluate its safety risk. METHODS :Using yttrium (89Y),indium (115In)and bismuth (209bi)as internal standard ,the contents of each element were determined by ICP-MS. ICP-MS condition included that atomization gas flow rate was 0.95 L/min,auxiliary gas flow rate was 1.2 L/min,plasma gas (argon)flow rate was 18 L/min,pump speed was 30 r/min. RF power of inductively coupled plasma was 1 200 W,the voltage in simulation stage was 1 750 V,the voltage in pulse stage was 1 300 V,the voltage of deflection device was -12 V,and the detector was in analog and pulse dual-mode. The determination methods of various elements were investigated ,and 45 batches of marketed Yougui pills were determined. Hazard index (HI)was used to analyze the non-carcinogenic risk of each element and calculate the maximum residual limit(MRL)of each element. RESULTS :The linear range of Cu ,As,Cd,Hg and Pb ranged from 10-200,1-50,0.4-30,0.2-6 and 2-100 μg/L(all r>0.999 0),respectively. The limits of quantitation were 0.67,0.23,0.20,0.07,0.27 μg/L. The limits of detection were 0.20,0.07,0.06,0.02,0.08 μg/L. RSDs of precision,stability and reproducibility tests were all lower than 3.5% (n=6 or n=5). Average recoveries were 92.96%-100.89%(RSD=2.23%-3.62%,n=3). Average contents of Cu ,As,Cd,Hg and Pb in 45 batches of Yougui pills were 2.72,0.28,0.07,0.05,0.62 mg/kg,and superimposed HI of each element was less than 1. The contents of 5 kinds of heavy metals in Yougui pills were lower than the proposed MRL (MRL of Cu ,As,Cd,Hg and Pb were 20,2,1,0.2,5 mg/kg or 111.11,4.44,2.22,1.48,8.89 mg/kg respectively ). CONCLUSIONS :Established method can be used for the determination of content of 5 kinds of heavy metal in Yougui pills ;the heavy metal pollution rate of marketed Yougui pills is low and the safety risk is small.
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Objective:To explore the value of blood-brain barrier permeability (BBBP) parameters based on CT perfusion (CTP) in predicting delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH) within 24 hours of admission.Methods:Totally 69 patients underwent whole-brain CTP within 24 h after aneurysm rupture from July to November 2020 in Yijishan Hospital of Wannan Medical College. The volume transfer constant (K trans) reflecting BBBP, the time to drain (TTD) and transit time to the center of the impulse response function (TMax) reflecting cerebral perfusion were obtained. Patients were divided into DCI and non-DCI groups. Quantitative and qualitative CTP parameters, clinical data were compared between the two groups. On the basis of univariate analysis, the multivariate logistic regression analysis was used to determine the independent risk factors of DCI using the stepwise regression method. The predictive efficiency of clinical data and CTP parameters were evaluated by ROC analysis. Results:Twenty-one of 69 aSAH patients developed DCI. Whole brain average values of K trans (mK trans) in the DCI group [(0.67±0.16)ml/(100 ml·min)] were significantly higher than those in the non-DCI group [(0.41±0.15)ml/(100 ml·min), t=-6.454, P<0.001]. mK trans in the diffused hypoperfusion patients [(0.61±0.18)ml/(100 ml·min)] was significantly higher than that in the normal perfusion group [(0.36±0.15)ml/(100 ml·min), P<0.001] and localized hypoperfusion group [(0.43±0.16)ml/(100 ml·min), P<0.001]. Multivariate logistic regression analysis showed mK trans (OR=1.13, 95%CI 1.05-1.21, P=0.001), World Federation of Neurosurgery Scale (OR=5.35, 95%CI 1.12-25.65, P=0.036) and modified Fisher Score (OR=5.32, 95%CI 1.02-27.80, P=0.048) were significantly independent predictors of DCI. ROC curve analysis revealed that mK trans produced the highest AUC of 0.875 (95%CI 0.78-0.97), with a threshold of 0.545 ml/(100 ml·min) had sensitivity of 85.7%, specificity of 79.2% and Youden index of 64.9% for prediction of developing DCI. Conclusion:It is feasible to evaluate cerebral perfusion and BBBP status and predict the risk of developing DCI in aASH patients who admitted within 24 h after aneurysm rupture using whole-brain CTP.
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Objective To compare the outcomes of bone marrow stimulation techniques-drilling by a Kirschner needle versus microfracturing technique in the treatment of small osteochondral lesions of the talus.Methods From February 2014 to June 2017,57 patients were treated at Department of Orthopaedics,Sun Yat-sen Memorial Hospital for small osteochondral lesions of the talus.Of them,26 were treated by arthroscopic drilling with a Kirschner needle.They were 15 males and 11 females,aged from 20 to 57 years.The areas of osteochondral lesion ranged from 0.6 to 1.4 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 9 cases of stage Ⅰ,8 cases of stage Ⅱ,6 cases of stage Ⅲ and 3 cases of stage Ⅳ.The other 31 patients of them were treated by arthroscopic microfracturing technique.They were 17 males and 14 females,aged from 24 to 55 years.The areas of osteochondral lesion ranged from 0.5 to 1.5 cm2.By the Berndt & Harty classification of ankle osteochondral lesions based on X-ray films,there were 10 cases of stage Ⅰ,11 cases of stage Ⅱ,8 cases of stage Ⅲ and 2 cases of stage Ⅳ.The 2 groups were compared in terms of visual analogue scale (VAS),the American Orthopaedic Foot and Ankle Society (AOFAS) score,the ankle activity score (AAS) and the Berndt & Harty staging of osteochondral lesions based on ankle X-ray films at the final follow-up.Results All the 57 patients were followed up for 13 to 27 mouths.The VAS,AOFAS and AAS scores and Berndt & Harty stages at the final follow-up were significantly improved in all the patients compared with their preoperative values (P < 0.05).There were no significant differences between the 2 groups in the VAS (2.2 ± 1.6 versus 2.1 ± 1.4),AOFAS (89.1 ±6.3versus 90.4±5.8) or AAS scores (6 versus 6) at the final follow-up (P > 0.05).There was no significant difference between the 2 groups either in the excellent and good rate by the AOFAS ankle-hindfoot scoring [88.5% (23/26) versus90.3% (28/31)] at the final follow-up (x2 =0.052,P=0.820).Conclusion In the treatment of small osteochondral lesions of the talus,both arthroscopic drilling with a Kirschner needle and microfracturing technique can achieve satisfactory short-term curative effects,but the long-term effects need to be further studied.
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Objective:To investigate the expression of Pyruvate dehydrogenase kinase 1(PDK1), phosphorylated Pyruvate dehydrogenase (p-PDH) and Pyruvate kinase isozyme type M2 (PKM2) based on Warburg effect pathway in cervical cancer tissues, and explore the roles of these molecules on prognosis and recurrence after postoperative radiation.Methods:The expressions of PDK1, p-PDH and PKM2 in primary tissues of 102 patients with cervical cancer were detected by immunohistochemistry, including 63 patients receiving postoperative radiation. The expression of the three molecules on prognosis and the efficacy of postoperative radiation on cervical cancer were analyzed separately and corporately.The level of mRNA were verified by using the 300 patients from GEO database. Kaplan-Meier method and COX proportional hazards regression model were used for univariate and multivariate analysis.Results:High expression of PDK1 and all the three indicators (PDK1 high/p-PDH high/PKM2 high) were positively correlated with pelvic lymphnode metastasis ( χ2=10.890, 7.407, P<0.05). PDK1 high/p-PDH high/PKM2 high, Federation International of Gynecology and Obstetrics (FIGO) staging, pelvic lymph node metastasis and postoperative radiation could affect the overall survival (OS) and disease-free survival (DFS) ( P<0.05). Multivariate analysis showed that PDK1 high /PDH high/PKM2 high, FIGO staging and postoperative radiation were the independent prognosis factors for OS and DFS( P<0.05). The verification result of the GEO dataset showed that PDK1 high/PDH high/PKM2 high was the risk factor for DFS( P<0.05). Pathological type, pelvic lymph node metastasis and PDK1 high/p-PDH high/PKM2 high could affect the DFS of those patients with postoperative radiation ( P<0.05). In addition, the multivariate analysis showed that pathological type and PDK1 high /p-PDH high/PKM2 high were the independent prognosis factors for DFS( P<0.05). Conclusions:The patients of PDK1 high /p-PDH high/PKM2 high phenotype have poor prognosis and DFS with postoperative radiation, which may be a high-risk group with poor prognosis and high recurrence rate after postoperative radiotherapy of stageⅠ-Ⅱ B cervical cancer.This study provides a novel strategy for stratified treatment of cervical cancer.
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Objective To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.Methods A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017.A total of 28 cases were treated with autologous semitendinosus tendon (autologous group),including 19 males and 9 females,with an average age of 28.5±8.03 years (range,16-46 years).A total of 27 cases were treated with allogenic tendon (allogenic group),including 17 males and 10 females,with an average age of 27.48±7.89 years (range,16-46 years).ATFL/CFL was reconstructed by the same method in both groups.The reconstruction methods were the same between the groups.The talus and calcaneus were fixed with absorbable compression nails.Results The operation duration in the autologous group was 94.07±7.83 min,which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51,P<0.001).Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55,P<0.001).Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01,P<0.001).In the autologous group,28 cases were followed up for 34.54± 16.04 months,and 27 cases in the allograft group were followed up for 42.74± 17.79 months.The mean AOFAS score improved from 63.64± 11.20 before operation to 90.21 ±4.48 after operation in the autologous group,and that improved from 63.93± 10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506,P=0.615).The mean VAS score decreased from 5.79± 1.79 before operation to 1.54± 1.35 after operation in the autologous group,and from 5.89± 1.78 before operation to 2.04± 1.32 after operation in the allogeneic group.There was no significant difference between the two groups after operation (t=-1.396,P=0.168).Tegner score increased from 4.07± 1.39 to 6.43± 1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333,P=0.740).Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group,16.99°±3.78° to 7.14°±3.34° in the allogeneic group,and there was no significant difference between the two groups after operation (t=-1.382,P=0.171).Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group,from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group,and there was no significant difference between the two groups after operation (t=-0.326,P=0.746).No donor tendon dysfunction was found in the autologous group.At the end of follow-up,there was no difference in ankle dorsiflexion,plantar flexion and hind foot mobility between autologous group and allogeneic group.Conclusion Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results.The autologous tendon group was superior to the allogeneic group in terms of fever,wound healing time.However,there was no significant difference in clinical effects between the two groups.
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Primary central nervous system lymphoma (PCNSL) is a type of extranodal non-Hodgkin lymphoma.Whole brain radiation therapy (WBRT) combined with high-dose methotrexate is the standard treatment.Although PCNSL patients are sensitive to radiation therapy,the duration of response is relatively short and it is likely to provoke delayed neurotoxicity,especially in the elderly patients.Reduced-dose WBRT and autologous stem cell transplantation (ASCT) can lower the risk of neutotoxicity,whereas the clinical efficacy remains to be validated.For the elderly patients with PCNSL,application of WBRT in the first-line treatment should be cautiously considered.
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Objective@#To compare the clinical effects of autologous semitendinosus tendon and allogenic tendon arthroscopic anatomical reconstruction of anterior talofibular ligament (ATFL) combined with calcaneofibular ligament (CFL) in the treatment of chronic lateral ankle instability.@*Methods@#A retrospective analysis was made of 55 patients with chronic lateral ankle instability who underwent arthroscopic reconstruction of ATFL combined with CFL from January 2012 to June 2017. A total of 28 cases were treated with autologous semitendinosus tendon (autologous group), including 19 males and 9 females, with an average age of 28.5±8.03 years (range, 16-46 years). A total of 27 cases were treated with allogenic tendon (allogenic group), including 17 males and 10 females, with an average age of 27.48±7.89 years (range, 16-46 years). ATFL/CFL was reconstructed by the same method in both groups. The reconstruction methods were the same between the groups. The talus and calcaneus were fixed with absorbable compression nails.@*Results@#The operation duration in the autologous group was 94.07±7.83 min, which was longer than that in the allogeneic group 63.56±7.96 min (t=14.51, P<0.001). Fever days 5.26±0.90 days in allogeneic group were longer than 2.46±0.74 days in autologous group (t=-12.55, P<0.001). Wound healing duration in allogeneic group was 13.44±3.33 days longer than that in autologous group 10.32±2.34 days (t=-4.01, P<0.001). In the autologous group, 28 cases were followed up for 34.54±16.04 months, and 27 cases in the allograft group were followed up for 42.74±17.79 months. The mean AOFAS score improved from 63.64±11.20 before operation to 90.21±4.48 after operation in the autologous group, and that improved from 63.93±10.59 before operation to 89.56±5.15 after operation in the allogeneic group with no significant difference between the two groups after operation (t=0.506, P=0.615). The mean VAS score decreased from 5.79±1.79 before operation to 1.54±1.35 after operation in the autologous group, and from 5.89±1.78 before operation to 2.04±1.32 after operation in the allogeneic group. There was no significant difference between the two groups after operation (t=-1.396, P=0.168). Tegner score increased from 4.07±1.39 to 6.43±1.14 in the autologous group and from 3.85±1.06 to 6.52±0.85 in the allogeneic group with no significant difference between the two groups after operation (t=-0.333, P=0.740). Stress radiographic showed that the talar tilt angle decreased from 15.60°±3.86° to 6.01°±2.64° in the autologous group, 16.99°±3.78° to 7.14°±3.34° in the allogeneic group, and there was no significant difference between the two groups after operation (t=-1.382, P=0.171). Anterior talar displacement reduced from 10.82±3.12 mm to 4.03±1.69 mm in the autologous group, from 10.10±2.02 mm to 4.17±1.52 mm in the allogeneic group, and there was no significant difference between the two groups after operation (t=-0.326, P=0.746). No donor tendon dysfunction was found in the autologous group. At the end of follow-up, there was no difference in ankle dorsiflexion, plantar flexion and hind foot mobility between autologous group and allogeneic group.@*Conclusion@#Arthroscopic autologous tendon and allogeneic tendon reconstruction of AFTL combined with CFL can obtain satisfactory short-term results. The autologous tendon group was superior to the allogeneic group in terms of fever, wound healing time. However, there was no significant difference in clinical effects between the two groups.
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Objective To evaluate the clinical application value of a novel immobilization system in total marrow irradiation ( TMI) with MVCT image. Methods From 2016 to 2017, a retrospective analysis of the setup errors of 22 patients receiving TMI in two groups ( twelve patients were immobilized with the novel immobilization system in group 1, ten patients were immobilized with the combinatorial immobilization devices in group 2) was performed in this study on Zhongnan Hospital of Wuhan University. Two-sample t-test was used to analyze the differences of setup errors and the consistency of setup between two groups. Results In group 1, the setup errors on left-right, superior-inferior, anterior-posterior and rotation directions were ( 1.06±0.79) , ( 1.34±0.66) , ( 2.45±1.48) mm and ( 0.63°±0.65°) for the head and neck position, ( 1.58±1.13) , ( 2.38±1.99) , ( 2.05± 1.68) mm and ( 0.31°± 0.32°) for the chest position, ( 1.67± 1.24) , ( 3.88±2.20) , ( 1.96± 1.32) mm and ( 0.48°± 0.53°) for the pelvis position, and ( 0.95± 0.73) , ( 1.99± 1.35) , ( 3.66±2.13) mm and ( 0.24°±0.31°) for the lower limb, respectively. In group 2, the setup errors were ( 2.59±2.58) , ( 3.28±1.85) , ( 3.71±2.43) mm and ( 1.15°±1.18°) for the head and neck position, ( 4.38±3.69) , ( 5.64±3.78) , ( 2.72± 1.91) mm and ( 1.55°± 0.86°) for the chest position, ( 4.14± 2.97) , ( 6.97±3.68) , ( 2.21±2.26) mm and ( 1.23°±0.74°) for the pelvis position, ( 2.28± 1.15) , ( 5.97± 3.00) , ( 3.44±1.93) mm and ( 1.09°±0.94°) for the lower limb, respectively. The setup errors significantly differed between two groups on the left-right, superior-inferior and rotation directions for all positions ( all P<0.05) . The setup consistency significantly differed between two groups on the left-right, superior-inferior and rotation directions for the chest and pelvis positions ( all P<0.05) . Conclusion The novel immobilization system can significantly improve the setup accuracy and setup consistency, and enhance the precision of treatment for patients.
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Objective The objective of this study was to investigate the effect and mechanism of novel multi-target kinase inhibitor ON123300 on the proliferation,cycle and apoptosis of ER-positive and HER2 -negative human breast cancer MCF-7 cells. Methods MCF-7 cells in logarithmic growth phase were treated with ON123300 or palbocilib for 48 h. DMSO was used as the control. The cellular morphology of MCF-7 cells was observed by optical microscope and the cell proliferation was measured by CCK8 assay. Flow cytometry(FCM) was used to detect cell cycle and apoptosis. Western blot was used to examine the expression of cy-clinD1,CDK4,pRb1,survivin and PI3K protein in MCF-7 cells. Results No cell morphological changes of MCF-7 cells were ob-served in the control group. In the palbocilib group,MCF-7 cells showed slight inhibition of cell proliferation and a small amount of cell shedding. In the ON123300 group,cell proliferation was significantly inhibited and cell morphology changes,showing a shedding phenomenon. The inhibitory rate increased with increasing drug concentration,showing a dose-dependent manner. The cells in the ON123300 treated group were significantly arrested at the G1/S phase of cell cyde and were associated with increased apoptosis,with a statistically significant difference(P<0. 05). The protein expression of cyclinD1,CDK4,pRb1,survivin and PI3K in the ON123300-treated group were obviously reduced than those in the control group(P<0. 05). Conclusion ON123300 can significantly inhibit proliferation,promote cell cycle arrest and apoptosis of MCF-7 cells. The mechanism may be related to the inhibition of survivin/cy-clinD1/CDK4/Rb1/PI3K signaling pathways.
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Ubiquitinating enzyme damaged-DNA binding protein 2 (DDB2) is a rind of DDB1 and CUL4-associated factors (DCAF), and identifies belonging to the family of ubiquitinating E3 enzymes. DDB2 combines with CUL4-DDB1 to form the ubiquitin ligase complex, and identifies targets protein substrate specificity to make the substrate ubiquitin and degradation. It affects the development of tumors through various pathways, such as DNA damage repair, cell cycle regulation and apoptosis, cell invasion and metastasis, cell premature senescence, cell proliferation and cancer stem cell population. This paper reviews the progress of the relationship between DDB2 and the development, treatment and prognosis judgment of tumors.
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Objective To evaluate the clinical results of arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament for treatment of chronic ankle instability. Methods From June 2012 to August 2016, 27 patients with chronic ankle instability (28 ankles) were treated with arthroscopic anatomical reconstruction of anterior talofibular ligament and calcaneofibular ligament. All the patients were evaluated preoperatively and at the last follow-up using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score. The talar tilt angle and anterior translation were assessed radiographically in pre- and postoperative ankle stress views.Results The operations lasted for 75.8 minutes (from 72 to 104 minutes). The 27 patients received a mean follow-up of 14.8 months (range, from 12 to 25 months). All the wounds healed by the first intention. No neurovascular complications were observed and no patient reported ankle stiffness or pain in motion. On average, the anterior talar trans-lation was reduced from 10.82 ± 3.32 mm preoperatively to 4.03 ± 1.70 mm at the last follow-up, the talar tilt angle decreased from 15.60°± 3.86°to 6.01°± 2.64°, the VAS pain score decreased from 5.79 ± 1.79 to 1.54 ± 1.35, and the AOFAS ankle-hindfoot score improved from 63.64 ± 11.20 to 90.21 ± 4.48. All the above differences were statistically significant (P <0.01). Conclusion Arthroscopic anatomical re-construction of anterior talofibular ligament and calcaneofibular ligament can improve function and stability of the ankle joint effectively, providing a valid option for treatment of chronic ankle instability.
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Objective KV-CBCT was utilized to evaluate the setup errors in lung SBRT with R624-SCF immobilization equipment,quantitatively analyze the percentage of all types of errors in the cumulative errors and unravel the main sources of setup errors.Methods The CBCT data weekly and QA data monthly from 32 patients diagnosed with lung neoplasms were collected to quantitatively analyze the setup errors.The cumulative errors were calculated by statistical model.The proportion and source of each type of setup error was analyzed.Results All 32 patients received a total of 420 times of CBCT.The setup errors of immobilization equipment in the lateral,supine-inferior,anterior-posterior directions were (0.03±0.72) mm,(0.73± 1.16) mm and (0.21±0.95) mm,respectively.The errors of tumor motion in three directions were (0.71±2.61) mm,(-0.80±2.60) mm and (0.075± 1.77) mm,respectively.According to the calculation formula proposed by Vance Keeling,the proportion of the cumulative error was 54.55%,9.21% for immobilization equipment,12.97% for tumor motion,2.55% for couch sagging,5.70% for Gantry radiation isocenter,4.73% for Collimator radiation isocenter,4.61% for couch radiation isocenter and 5.70% for Xray field isocenter,respectively.Conclusions The main factors of setup errors during SBRT treatment for lung cancer are setup random,tumor motion,immobilization equipment,couch sagging and machine isocenter.During radiotherapy,targeted control of tumor motion is of significance for minimizing the cumulative errors.
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Rupture of anterior cruciate ligament (ACL) is a common sports injury.It will cause knee osteoarthritis because of joint instability and acceleration of degenerative changes after injury.Arthroscopic reconstruction with a tendon graft is a common procedure to achieve function recovery.A series of histological changes and structural modification happened between the tendon and bone tunnel after ACL reconstruction and complete tendon-bone healing was achieved finally.A number of factors affects the healing process which determined the long-term result of the treatment.Published literatures reported that about 11%-32% patients underwent ACL reconstruction were not satisfied with the results and 10% of them required reoperation.Studies on the tendon-bone healing have long been a research hotspot in sports medicine.Controversy still remains not only on the fundamental healing process but also on the stimulating factors despite of a large amount of researches on its physiological basis,influencing factors,et al.This article provides a review of the basis and influence factors of the healing process,and summarizes the methods to accelerate the process of tendon-bone healing.
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Objective To investigate the relationship between adhesion molecule CD44v6,intercellular adhesion molecule-1 (ICAM-1) and lymph node metastasis in early stage of cervical squamous cell carcinoma.Methods Seventy-four specimens of cervical cancer stage Ⅰ b1,20 specimens of normal cervical tissue and 20 specimens of cervical squamous cell in situ carcinoma were collected from Jiangxi Provincial Maternal and Child Health Care Hospital.The expression of CD44v6 and ICAM-1 in cervical tissue was detected by real-time PCR and immunohistochemistry.The lymphatic vessel density (LVD) labeled by D2-40 was detected by immunohistochemistry.The relationship of CD44v6,ICAM-1 and LVD with the differentiation degree and lymph mode metastasis was investigated.Results The positive expression rate of CD44v6 and ICAM-1 in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma tissues was gradually increased,which were 0,75.00%,87.84% and 10.00%,45.00%,81.08% respectively.Their mRNA expression amount was gradually increased,which were 0,0.24±0.02,1.02±0.11 and 0.10 ± 0.00,0.19±0.02,1.03 ± 0.10 respectively,the differences were statistically significant (P<0.01).LVD was gradually increased in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma (P<0.01).The expression of CD44v6,ICAM-1 and LVD in low differentiated cervical carcinoma tissue was higher than that in high and middle differentiated cervical carcinoma (P<0.01).The expression of CD44v6,ICAM-1and LVD in lymph node metastasis was higher than that in non-lymph node metastasis (P<0.01).The expression of CD44v6,ICAM-1 and LVD in cervical cancer tissue had each two positive correlation (P<0.01).Conclusion CD44v6 plays a promoting role in the progression of cervical cancer,which with ICAM-1 and LVD synergically promote the cervical cancer development,and could be used as an effective indicator for judging lymph node metastasis and diagnosis of cervical cancer.
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Objective To divide computed tomography (CT) values into different ranges and investigate the influence of CT value division on dose calculation, and to propose a method to combine magnetic resonance imaging (MRI) with assigned CT values.Methods Ten CT images each were collected from patients with head and neck, chest, and pelvic tumors.Random sampling was performed for the CT values of main tissues or organs at the three parts, and then the mean CT value of each tissue or organ was calculated to divide the CT values into different ranges.A virtual phantom was built in the Varian Eclipse treatment planning system, and for the prescribed dose of 100 cGy, the machine output was recorded at different CT values.The influence of different CT value ranges on dose calculation was analyzed.The treatment plans of intensity-modulated radiotherapy were selected from 5 cervical cancer patients, and new CT values were assigned to the planning target volume (PTV) and organs at risk to obtain new CT images.The plans were transferred to the new CT images and compared with the results on the original CT images in terms of dosimetric parameters.Results After dividing the CT values into different ranges and verifying the results in dose calculation, the CT values corresponding to different human tissues or organs were-100 to 100 HU.The influence of CT value variation on dose calculation was within 3%.In the same treatment plan, there were small differences in dosimetric parameters between new CT images and original CT images.Dmax, Dmean, D98%, D95%, D5%, and D2% of PTV were all below 3%, and Dmax and Dmean of the bladder, rectum, small intestine, femoral head, and bone marrow were below 2%.Conclusions The influence of CT value division on dose calculation in the treatment planning for pelvic tumors is acceptable, so it can be used in combination with MRI.
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Objective To investigate the surgical methods and short-term effects of Internal-braceTM technology combined with modified Brostrom procedure for treatment of chronic ankle instability.Methods A retrospective case series study was made on 17 patients with chronic ankle instability treated using the Internal-braceTM technology combined with modified Brostrom procedure from May 2015 to April 2016.There were 10 males and 7 females,at age of 24 and 36 years (mean,31.8 years).A left ankle injury occurred in 6 patients and a right ankle injury in 11 patients.Operation time,postoperative complications and incision healing was documented after operation.Ankle stability was tested using the anterior drawer test and lateral stress test,and ankle range of motion was detected.American orthopedic foot and ankle society (AOFAS) score was used for postoperative efficacy evaluation.Results Operation time was 45 to 84 minutes (mean,64.5 minutes).None of the patients revealed neurological deficits after operation.All incisions healed by the first intension.Full weight bearing was started two weeks after operation.All patients were followed up for mean 3.5 months (range,1-6 months).At the final follow-up,both anterior drawer test and lateral stress test were negative.All patients had a normal range of motion of the ankle after operation.AOFAS score was increased from preoperative (36.2 ± 13.4)points to (91.2 ± 6.7) points at the final follow-up (P < 0.01).According to the AOFAS score,the results were excellent in 15 patients and good in 2 patients,with the good rate of 100%.Conclusion For chronic ankle instability,Internal-braceTM technology comnbined with modified Brostrom procedure benefits wound healing and functional recovery,reduces incidence of complications and exhibits satisfactory short-term outcome.
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Aim To investigate the protective effect of astragaloside IV (AS-Ⅳ) on human retinal pigment epithelium injury induced by methylglyoxal (MGO), and explore its molecular mechanism.Methods The injury of ARPE-19 cells was induced by MGO and the cell viability was measured by CCK-8 method.The morphology of cell nucleus was analyzed by Hoechst 33342 staining and the cell apoptosis was analyzed by flow cytometry to detect labbled Annexin V-FITC/PI.JC-1 staining and fluorescence probe DCFH-DA were employed to evaluate the change of mitochondrial membrane potential and reactive oxygen species (ROS).The levels of SOD, MDA, caspase-9 and caspase-3 were determined by respective kits.Western blot was used to analyse the expression of Bcl-2, Bax and PARP.Results AS-Ⅳ could significantly inhibit the decrease of cell viability induced by MGO, improve the morphology of cell nucleus, reduce the ARPE-19 cell apoptosis rate and the level of ROS and MDA, and increase the activity of SOD.Furthermore, AS-Ⅳ could enhance mitochondrial membrane potential, the ratio of Bcl-2/Bax and the expression of PARP, and inhibit the activation of caspase-9 and caspase-3.Conclusion AS-Ⅳ may protect ARPE-19 cells from the injury induced by MGO by increasing the antioxidant ability of ARPE-19 cells and inhibiting cell apoptosis.
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Objective To evaluate the clinical efficacy and prognostic factors of stereotactic body radiotherapy(SBRT)for pulmonary oligometastases,and to further explore the patients most suitable for SBRT. Methods From 2012 to 2105,51 patients with 76 oligometastatic lung tumors were treated with SBRT.In those patients,27 had primary lung tumors and the others had extrapulmonary tumors. Seven patients had squamous cell carcinoma,thirty-five had adenocarcinoma, and the rest had other types of cancer. The patients received radiotherapy at a dose of 50 Gy in five fractions or 60 Gy in three fractions. Survival analysis was made by the Kaplan-Meier method. A multivariate analysis was made by the Cox model. Results The 1-and 2-year local control rates were 86%(65/76)and 80%(61/76),respectively. The 1-and 2-year overall survival(OS)rates were 80%(41/51)and 55%(28/51),respectively. The median survival time was 30(2-57)months,while the median progression-free survival time was 8(1-32)months. Twenty-one patients had grade 1 radiation pneumonitis(RP),while one patient had grade 2 RP. The multivariate analysis revealed that no more than 2 oligometastatic lung tumors,progression-free interval(PFI), and a performance score(PS)no higher than 1 were independent factors for OS(all P<0.05). Conclusions SBRT is effective and safe for treating pulmonary oligometastases. The number of oligometastatic lung tumors,PFI,and PS are independent prognostic factors for OS. Suitable patients and the appropriate timing of treatment are key to the efficacy of SBRT.