Objective To prepare the silk fibroin (SF)-chitosan (CS) scaffolds by adjusting the mass ratio between CS and SF, and test and compare the properties of the scaffolds at different mass ratios. Methods According to the mass ratios of 6 ∶ 4 (group A), 6 ∶ 8 (group B), and 6 ∶ 16 (group C) between SF and CS, CS-SF scaffolds were prepared by freeze-drying method, respectively. The material properties, porosity, the dissolubility in hot water, the modulus elasticity, and the water absorption expansion rate were measured; the aperture size and shape of scaffolds were observed by scanning electron microscope (SEM). Density gradient centrifugation method was used to isolate the bone marrow mesenchymal stell cells (BMSCs) of 4-week-old male Sprague Dawley rats. The BMSCs at passage 3 were seeded onto 3 scaffolds respectively, and then the proliferation of cells on the scaffolds was detected by MTS method. Results The results of fourier transform infrared spectroscopy proved that with the increased content of CS, the absorption peak of random coil/α helix structure (1 654 cm-1 and 1 540 cm-1) constantly decreased, but the absorption peak of corresponding to β-fold structure (1 628 cm-1 and 1 516 cm- 1) increased. The porosity was 87.36% ± 2.15% in group A, 77.82% ± 1.37% in group B, and 72.22% ± 1.37% in group C; the porosity of group A was significantly higher than that of groups B and C (P lt; 0.05), and the porosity of group B was significantly higher than that of group C (P lt; 0.05). The dissolubility in hot water was 0 in groups A and B, and was 3.12% ± 1.26% in group C. The scaffolds had good viscoelasticity in 3 groups; the modulus elasticity of 3 groups were consistent with the range of normal articular cartilage (4-15 kPa); no significant difference was found among 3 groups (F=5.523, P=0.054). The water absorption expansion rate was 1 528.52% ± 194.63% in group A, 1 078.22% ± 100.52% in group B, and 1 320.05% ± 179.97% in group C; the rate of group A was significantly higher than that of group B (P=0.05), but there was no significant difference between groups A and C and between groups B and C (P gt; 0.05). SEM results showed the aperture size of group A was between 50-250 μm, with good connectivity of pores; however, groups B and C had structure disturbance, with non-uniform aperture size and poor connectivity of pores. The growth curve results showed the number of living cells of group A was significantly higher than that of groups B and C at 1, 3, 5, and 7 days (P lt; 0.05); and there were significant differences between groups B and C at 3, 5, and 7 days (P lt; 0.05). Conclusion The CS-SF scaffold at a mass ratio of 6 ∶ 4 is applicable for cartilage tissue engineering.
【Abstract】 Objective To review the basic and clinical research progress of lateral column lengthening (LCL).Methods The recent literature concerning LCL at home and abroad was extensively reviewed, and the research and development were summarized. Results LCL is one of the important surgical procedures for flatfoot deformity, and it has two procedures. There are some disputes in surgical selection of the Evans osteotomy and calcaneocuboid distraction arthrodesis for the treatment of flatfoot deformity. Conclusion Lateral column lengthening has been used more widely in clinical practice, but biomechanical and the long-term follow-up are needed.
Objective To investigate efficacy and safety of laparoscopic lymphadenectomy combined with pelvic autonomic nerve preservation in patients with rectal cancer. Methods Seventy-three patients underwent D3 radical resection of rectal cancer with pelvic autonomic nerve preservation from March 2015 to October 2016 in the People’s Hospital of Pengzhou City were collected, then were divided into a laparoscopic surgery group (38 cases) and an open surgery group (35 cases) according to the choice of operation. The intraoperative and postoperative indexes were compared between these two groups, and the urination and sexual functions at preoperation and on month 1 after operation for male patient with rectal cancer were evaluated. Results ① The age, gender, tumor diameter, TNM stage, and tumor location had no significant differences between these two groups (P>0.05). ② Compared with the open surgery group, the intraoperative blood loss was less (P<0.05), but the operation time was longer (P<0.05) in the laparoscopic surgery group. The number of lymph node dissection had no significant difference between these two groups (P>0.05). ③ The anal exhaust time and hospitalization stay in the laparoscopic surgery group were significantly shorter than those in the open surgery group (P<0.05), and the incidences of postoperative infection, intestinal adhesion, and intestinal obstruction were significantly lower in the laparoscopic surgery group as compared with the open surgery group (P<0.05). ④ The IPSS score of urination function and the IIEF-5 score of sexual function on month 1 after operation had no significant differences between these two groups (P>0.05), but compared with the preoperative points, the IPSS score was significantly increased, the IIEF-5 score was significantly decreased in the same group (P<0.05). Conclusion The preliminary results of limited cases in this study show that laparoscopic lymphadenectomy combined with pelvic autonomic nerve preservation in patients with rectal cancer is safe and effective, it has some advantages of mild invasion, lower complication rate, and fast covery.
The severe visual impairment caused by neovascular age-related macular degeneration (nAMD) is associated with macular neovascularization (MNV) invasion and subretinal fibrosis (SF). Excessive SF can lead to subretinal scarring, irreversible damage to photoreceptors, retinal pigment epithelium, and choroid tissue, resulting in permanent visual impairment in nAMD patients. The pathogenesis of SF is complex, involving many pathological processes such as tissue repair after injury, inflammation, and related signaling pathways and cytokine complex. Current experimental treatments for SF only target inhibition of a single cytokine. Timely and effective inhibition of the formation and progression of MNV and early identification of risk factors for SF are crucial to improving the prognosis of nAMD patients.
Objective To summarize the status of tumor stem cells investigations in gastrointestinal carcinoma. Methods Domestic and international publications online involving tumor stem cells of gastrointestinal carcinoma in recent years were collected and reviewed. Results There are a small quantity of cancer cells shown some stem cell characteristics. They are named tumor stem cell and play an important role in tumorigenesis, proliferation, metastasis and recurrence. And also, tumor stem cells can resist the effect of antineoplastic drugs and lead to tumor recurrence. These tumor-initiating cells are CD133-positive in the gastrointestinal carcinomas, especially in colorectal cancers. CD133-positive colorectal cancer cells have the abilities of clone, proliferation, differentiation and form metastases. And a high CD133 mRNA content was found in the blood of patients who suffered from bone metastases. Conclusion The characteristics of CD133-positive cancer cell and the mechanisms of stem cell-niche system are the basis of developing better methods to tumor diagnosis and treatment, and provide theoretical basis of new methods, such as targeted therapy.
目的降低远端胰腺切除术后胰漏的发生率。方法对34例患者施行远端胰腺切除时，近端稍外凸，呈“gt;”形，然后结扎主胰管，断面缝扎止血，联合应用带血管蒂胃浆肌瓣或空肠浆肌瓣与纤维蛋白胶粘合缝闭胰腺残端。结果34例患者均未发生胰漏、腹腔感染、脓肿及胰腺假性囊肿。结论带血管蒂胃、空肠浆肌瓣有利于促进胰断面愈合，联合应用纤维蛋白胶能有效地预防胰漏。
Objective To investigate prognostic factors of surgery treatment for pulmonary metastasis from rectal cancer. Methods From September 1973 to September 2007,43 patients, 12 women and 31 men with mean age of 58 years (ranged 36-77 years) were diagnosed and performed 45 curative resections of pulmonary metastases from rectal cancer in this hospital.Followup informations were collected including：the clinical parameters include age, sex, pTNM/UICC stage,the number, maximum diameter of lung metastases，the preoperative serum carcinoembryonic antigen(CEA) levels, the interval between resection of primary tumor and diagnosis of lung metastasis (disease-free interval (DFI)，the presence of hilar/mediastinal tumorinfiltrated lymph nodes，intraoperative blood loss and postoperative chemotherapy schemes. After lung metastasectomy，probability of survival was calculated according to the method of KaplanMeier.All factors that may have affected the survival were entered into Cox’s proportional hazards regression model to identify significant variables associated with survival. Results Fourty-three patients were selected fully follow-up cases, with mean period ranged from 1-103 months (median 54 months). There was 1 early postoperative mortality from cardiac complications (2.3%). The probability of survival at 1, 3, and 5 years was 91.3％，56.4% and 32.2%, respectively，Median overall survival was 42.6 months. The DFI was found to be 28.6 months（ranged 0-114 months）. Hilar or mediastinal tumorinvolvedlymph nodes were found in 9 patients. Fiveyear survival was 42.6% for patients with CEA＜5ng／ml and 18.0% for those with CEA≥5ng／ml (P=0.009).Fiveyear survival rate was 53.3% for patients with DFI≥3 years, 32.3% for those with1 year＜DFI＜3 years and 15.1% for those with DFI ≤1 year (P=0.036). In the multivariate analysis,the overall survival was significantly correlated with the preoperative serum CEA level and DFI (P=0.013,0.016),respectively. Conclusion Patients with pulmonary metastases from colorectal carcinoma will benefit from pulmonary metastasectomy. Patients with preoperative serum CEA ＜5ng／ml and DFI ≥3 years have an significantly long-term survival.