Objective To determine whether Rb gene is involved in the genesis of primary hepatocellular carcinoma(HCC). MethodsForty paraffin specimens of primary HCCs with corresponding adjacent liver tissues and normal liver tissues were investigated for Rb protein expression by tissue chip and SP immunohistochemical technique. ResultsLoss of Rb protein expression occurred in 17 of 40 tumor samples, whereas in 4 of 40 adjacent liver tissue samples, only 1 of 40 normal liver tissue specimens showed negative Rb staining.Rb protein deletion in HCC was higher than that in adjacent tissues and normal liver tissues (P＜0.05).Rb protein deletion rate doesn’t correlated remarkably with tumor size or phathology grade of HCC （Pgt;0.05）. ConclusionRb protein deletion may play an important role in the tumorigenesis of HCC.Tissue chip is an effective highthroughput technique platform for the study of tumor molecular pathology.
Objective To evaluate the clinical effectiveness and safety of tranexamic acid (TXA) in arthroscopic rotator cuff repair by meta-analysis. Methods Randomized controlled trials evaluating the clinical effectiveness and safety of TXA use in the perioperative period of arthroscopic rotator cuff repair were identified from the Cochrane Library, PubMed, Embase, VIP Chinese Science and Technology Periodical Database, Chinese National Knowledge Infrastructure, and Wanfang database, with a search time span from the inception of the database to August 2024. Meta-analysis was conducted using RevMan 5.3 software, and mean difference (MD) and risk difference (RD) were used as measures of effect size. Results A total of 7 randomized controlled trials were included. Meta-analysis demonstrated significant differences in good visual clarity [MD=9.10, 95% confidence interval (CI) (4.05, 14.15), P=0.0004] and operative time [MD=−12.07 min, 95%CI (−17.21, −6.93) min, P<0.00001]. There was no significant difference in mean arterial pressure [MD=−1.08 mm Hg (1 mm Hg=0.133 kPa), 95%CI (−3.13, 0.98) mm Hg, P=0.30] or adverse event rate [RD=0.02, 95%CI (−0.01, 0.06), P=0.22] between the two groups. Conclusion TXA is effective and safe in enhancing visual clarity and significantly reducing operative time in arthroscopic rotator cuff repair, without increasing the incidence of adverse events.
Objective To compare the effects of hypoxia-inducible drugs using deferoxamine (DFO) and accordion technique (AT) on activating the hypoxia-inducible factor 1α (HIF-1α)/vascular endothelial growth factor (VEGF) signaling pathway to promote bone regeneration and remodelling during consolidation phase of distraction osteogenesis (DO). Methods Forty-five specific-pathogen-free adult male Sprague-Dawley (SD) rats were randomly divided into the control group, DFO group, and AT group, with 15 rats in each group. All rats underwent osteotomy to establish a right femur DO model. Then, continuous distraction was started for 10 days after 5 days of latency in each group. During the consolidation phase after distraction, no intervention was performed in the control group; DFO was locally perfused into the distraction area in the DFO group starting at the 3rd week of consolidation phase; cyclic stress stimulation was given in the AT group starting at the 3rd week of consolidation phase. The general condition of rats in each group was observed. X-ray films were conducted at the end of the distraction phase and at the 2nd, 4th, and 6th weeks of the consolidation phase to observe the calcification in the distraction area. At the 4th and 6th weeks of the consolidation phase, peripheral blood was taken for ELISA detection (HIF-1α, VEGF, CD31, and Osterix), femoral specimens were harvested for gross observation, histological staining (HE staining), and immunohistochemical staining [HIF-1α, VEGF, osteopontin (OPN), osteocalcin (OCN)]. At the 6th week of the consolidation phase, Micro-CT was used to observe the new bone mineral density (BMD), bone volume/tissue volume (BV/TV), trabecular separation (Tb.Sp), trabecular number (Tb.N), and trabecular thickness (Tb.Th) in the distraction area, and biomechanical test (ultimate load, elastic modulus, energy to failure, and stiffness) to detect bone regeneration in the distraction area. Results The rats in all groups survived until the termination of the experiment. ELISA showed that the contents of HIF-1α, VEGF, CD31, and Osterix in the serum of the AT group were significantly higher than those of the DFO group and control group at the 4th and 6th weeks of the consolidation phase (P<0.05). General observation, X-ray films, Micro-CT, and biomechanical test showed that bone formation in the femoral distraction area was significantly better in the DFO group and AT group than in the control group, and complete recanalization of the medullary cavity was achieved in the AT group, and BMD, BV/TV, Tb.Sp, Tb.N, and Tb.Th, as well as ultimate load, elastic modulus, energy to failure, and stiffness in the distraction area, were better in the AT group than in the DFO group and control group, and the differences were significant (P<0.05). HE staining showed that trabecular bone formation and maturation in the distraction area were better in the AT group than in the DFO group and control group. Immunohistochemical staining showed that at the 4th week of consolidation phase, the expression levels of HIF-1α, VEGF, OCN, and OPN in the distraction area of the AT group were significantly higher than those of the DFO group and control group (P<0.05); however, at 6th week of consolidation phase, the above indicators were lower in the AT group than in the DFO group and control group, but there was no significant difference between groups (P>0.05). Conclusion Both continuous local perfusion of DFO in the distraction area and AT during the consolidation phase can activate the HIF-1α/VEGF signaling pathway. However, AT is more effective than local perfusion of DFO in promoting the process of angiogenesis, osteogenesis, and bone remodelling.
目的:归纳分析42例隐球菌脑膜炎的发病情况、临床特点并总结抗真菌药物的治疗经验,以提高对隐球菌脑膜炎的诊治水平。方法:回顾分析四川大学华西医院2001～2007年所收治42例隐球菌脑膜炎病例的临床表现、实验室检查结果、抗真菌药物的疗效及预后,并对两性霉素B联合5氟胞嘧啶抗真菌治疗的药物剂量、疗效、不良反应以及疗程与预后的关系加以剖析。结果:临床以发热、头痛、颅内压升高、脑膜刺激征为主要表现,采用两性霉素B联合5氟胞嘧啶治疗,总有效率78.5%,42例患者治愈9例,好转24例,死亡5例,自动出院后失访4例。结论:隐球菌脑膜炎由于临床表现、脑脊液常规和生化检查以及影像学检查无明显特异性,易于误诊;脑脊液墨汁染色有助于早期诊断本病,对疑似病例反复进行脑脊液墨汁染色有利于确诊;两性霉素B联合5氟胞嘧啶治疗治疗隐球菌脑膜炎效果良好。但需注重合理应用并密切监测不良反应。
Objective To study the efficacy and safety of bone channeling in arthroscopic rotator cuff repair. Methods China National Knowledge Infrastructure, Cochrane Library, Chongqing VIP, PubMed, Wanfang database and Embase were searched to collect all randomized controlled trials of the application of bone channeling in arthroscopic rotator cuff repair. The search time was from the establishment of databases to October 15, 2025. RevMan 5.3 software was used for meta-analysis to explore the differences in postoperative functional score, pain, complications, reoperation and 2-year postoperative re-tear between the bone channeling group and the control group. Results Nine randomized controlled trial studies were finally included. The results of meta-analysis showed that there were no significant differences in the postoperative Constant Function Score [mean difference (MD)=1.27], American Shoulder and Elbow Surgeons score (MD=1.26), postoperative pain score (MD=0.27), 2-year postoperative incidence of re-tear [relative risk (RR)=1.22], reoperation rate (RR=1.19) and complication rate (RR=1.37) between the bone channeling group and the control group (P>0.05). Conclusions Existing evidence shows that the application of bone channeling in arthroscopic rotator cuff repair failed to improve the postoperative re-tear of patients, but also did not lead to pain and complications.
【摘要】 目的 对季也蒙念珠菌感染患者的临床及微生物学特征进行分析，为临床诊治提供参考。 方法 收集2006年1月-2008年12月病原菌培养为季也蒙念珠菌的10例住院患者资料进行回顾性分析。 结果 季也蒙念珠菌感染患者存在多种基础疾病，大多数患者（8/10）有易感因素，其中7例使用广谱抗菌药物。10例中有8例为深部真菌感染。其临床表现与感染部位有关，主要累及泌尿道、呼吸道和皮肤软组织。多数深部感染患者（6/8）在感染前存在同部位细菌感染，部分患者（3/8）在相同部位还可分离出其他真菌。全部季也蒙念珠菌菌株对两性霉素B敏感，大多数菌株（9/10）对氟康唑敏感。仅1例患者因肺部感染、呼吸衰竭死亡，其余患者经氟康唑、伊曲康唑或特比萘芬等抗真菌药物治愈。 结论 季也蒙念珠菌感染多发生于有基础疾病、存在真菌易感因素者，感染部位多为原细菌感染部位，常合并其他细菌或真菌感染。部分菌株对氟康唑和伊曲康唑中敏或耐药，治疗应根据药敏进行选择。【Abstract】 Objective To analyze the clinical and microbiologic characters of candida guilliermondii to improve the clinical diagnosis and treatment. Methods The clinical data of 10 patients with candida guilliermondii infection diagnosed in our hospital from January 2006 to December 2008 were retrospectively analyzed. Results All the patients had several underlying conditions; eight patients had predisposing factors and seven patients were prescribed with broad-spectrum antibacterials. Eight patients had deep mycoses, whose clinical manifestation was associated with the infectious sites, mainly involved in urinary tract, respiratory tract and skin-soft tissues. Most deep mycoses (6/8) had prior bacterial infection at the candida guilliermondii infection site; some patients (3/8) had other fungous infection at the same time. All the strains were sensitive to amphotericin B; most fungous strains (9/10) were sensitive to fluconazole. One patient died of pulmonary infection and respiratory failure, and the others were cured by fluconazole, itraconazole or terbinafine. Conclusion Candida guilliermondii infection mainly occurs in patients with underlying conditions and predisposing factors. The infectious sites have prior bacterial infection and bacterial infection or fungous infection at the same time. Since some candida guilliermondii strains were not sensitive to fluconazole and itraconzole, drug sensitive test should be consulted.
OBJECTIVE To review the progress of the relation between transforming growth factor beta (TGF-beta) and repair of tissue injury. METHODS The recent articles about TGF-beta and tissue reconstruction were extensively reviewed. The gene identification, production, activation of TGF-beta and its role in the repair course of tissue injury were investigated. RESULTS TGF-beta belongs to a family of multifunctional polypeptides, its gene structure is highly conservative. Many animal models about TGF-beta and tissue injury have been established. The research mainly focuses on the classification, distribution of TGF-beta receptors and their signal pathway. CONCLUSION TGF-beta plays an important roles in the regulation of repair of tissue injury.
Objective To investigate the improved reduction technique for depression fractures of the lateral tibial plateau and its effectiveness. Methods Between January 2008 and December 2010, 48 patients (48 knees) with depression fractures of the lateral tibial plateau (Schatzker II or III fractures) were treated. There were 32 males and 16 females with an average age of 45.8 years (range, 16-79 years). All fractures were fresh closed fractures, which were caused by traffic accident in 27 cases, by falling from height in 5 cases, by crushing in 8 cases, and by sustained falls in 8 cases. According to Schatzker classification, 29 cases were classified as type II and 19 cases as type III. The lateral cortex was cut off to expose the depression and compacted cancellous bone was elevated to reset the articular surface. After reduction, autologous iliac bone graft and locking plate internal fixation were used. Results Healing of incision by first intention was achieved in all patients, and no complication occurred. All patients were followed up 1.7 years on average (range, 1-3 years). At last follow-up, the knee extension was ( — 0.5 ± 0.3)°, and the knee flexion was (136.9 ± 8.8)°. X-ray films showed that the fracture healing time was 52 weeks and no breakage of internal fixation occurred. According to Rasmussen clinical score, the results were excellent in 35 cases, good in 10 cases, and fair in 3 cases. According to Rasmussen radiographical score, the results were excellent in 41 cases, good in 7 cases; there were 41 excellent scores and 7 good scores of articular reduction; all gained good recovery of coronal and sagittal alignment and condylar width. The articular surface collapse was (1.0 ± 0.7) mm at immediate postoperatively and (1.2 ± 0.7) mm at last follow-up, showing no significant difference (t= — 1.42, P=0.20), but significant differences were found when compared with that at preoperation [(12.2 ± 8.0) mm, P lt; 0.05]. Conclusion This improved technique can provide a satisfactory effectiveness of fracture reduction and can avoid loss of reduction. The short-term effectiveness is good, but futher follow-up is necessary to determine the long-term results.
Objective To compare the efficacy and safety of aspirin and rivaroxaban in the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA). Methods Eight databases were searched, including Cochrane Library, Embase, Web of Science, PubMed, SinoMed, Wanfang, Chongqing VIP, and China National Knowledge Infrastructure. The search period was from the establishment of databases to June 2023. All randomized controlled trials of aspirin and rivaroxaban for the prevention of VTE after TKA were collected, and meta-analysis was conducted using RevMan 5.3 software. Results A total of 7 articles were included, with a publication period from 2014 to 2022, including a total of 714 patients, including 356 in the aspirin group and 358 in the rivaroxaban group. The meta-analysis results showed that the incidence of deep venous thrombosis in the lower limbs of the aspirin group was higher than that of the rivasarb group [relative risk (RR)=1.53, 95% confidence interval (CI) (1.09, 2.16), P=0.01], and the incidence of bleeding complications was lower than that of the rivaroxaban group [RR=0.66, 95%CI (0.52, 0.82), P=0.0003]. There was no statistically significant difference in the incidence of wound complications between the two groups (P>0.05). Conclusion The efficacy of rivaroxaban in preventing VTE after TKA is better than that of aspirin, but there is an increased risk of bleeding complications.