ObjectiveTo explore effectiveness of reduction and internal fixation via modified anterolateral supra-fibular-head approach in treatment of tibial plateau fractures involving posterolateral column.MethodsBetween January 2016 and September 2018, 19 patients diagnosed as tibial plateau fractures involving posterolateral column were treated with reduction and internal fixation via modified anterolateral supra-fibular-head approach. There were 11 males and 8 females with an average age of 43.2 years (range, 28-65 years). The causes of tibial fracture were traffic accident (12 patients), falling injury (5 patients), and falling from height (2 patients). According to the Schatzker typing, the tibial fractures were rated as type Ⅱ in 9 cases, type Ⅲ in 4 cases, type Ⅴ in 4 cases, and type Ⅵ in 2 cases. The time from injury to operation was 5-13 days (mean, 8.5 days). There were 2 patients with osteoporosis. The operation time, intraoperative blood loss, and postoperative complications were recorded. The knee X-ray film was reviewed regularly to observe the fracture healing. At last follow-up, the fracture reductions were evaluated by Rasmussen radiological score. The knee joint function was evaluated by Hospital for Special Surgery (HSS) score system.ResultsThe average operation time was 95 minutes (range, 65-130 minutes). The average intraoperative blood loss was 220 mL (range, 150-350 mL). All incisions healed by first intention. No complications such as infection or deep venous thrombosis occurred. All patients were followed up 12-20 months (mean, 15.4 months). X-ray films showed that the fractures healed with the healing time of 12-20 weeks (mean, 14.5 weeks). No complications such as loosening or breakage of internal fixation occurred. At last follow-up, according to the Rasmussen radiological score, the fracture reductions were evaluated as excellent in 13 cases, good in 4 cases, fair in 1 case, and poor in 1 case. HSS scores of knee joint function were excellent in 14 cases, good in 3 cases, fair in 1 case, and poor in 1 case. The knee joint range of motion was 90°-135°, with an average of 113.4°.ConclusionApplication of modified anterolateral supra-fibular-head approach in reduction and internal fixation for tibial plateau fractures involving posterolateral column has the advantages of full exposure, less trauma, safety, and reliable reduction and fixation.
Objective To investigate the suppression effect and mechanism of Astilbin on lung allograft rejection in rats, in order to know the function of Astilbin on rats’ lung acute rejection. Methods The model of rat left lung transplantation was set up. Sixty lung transplanted rats were divided into two groups randomly, control group: rats were fed with normal saline 1ml per day, experimental group: rats were fed with Astilbin 1mg/kg per day. Survival time, transforming rate of T cells in spleen, activity of interleukin 2 (IL-2) in spleen lymph cells and apoptosis of T cells were observed. Changes in ultrastructure of pulmonary arteries were observed by electron microscope. Results The survival time in experimental group was prolonged than that in control group (25.4±2.1 d vs. 13.4±1.2 d;t=2.042, Plt;0.05）. Transforming rate of T cells of spleen in experimental group was significant lower than that in control group (23 465.8±8 783.4 cpm vs. 74 567.3±12 874.6 cpm; t=2.284，Plt;0.05）.Activity of IL-2 of spleen lymph cells in experimental group was significant lower than that in control group (425±2.65U/ml vs. 23.46±1.82U/ml; t=3.165, Plt;0.01).Effectively derive apoptosis of activated T cells in acute rejection were observed in experimental group, the ultrastructure of pulmonary arteries showed attenuated injury in experimental group. Conclusion Astilbin decreased the IL-2 concentration in plasma and induced the apoptosis in activated T cells, then suppressed the acute rejection of lung allograft and prolonged the survival period of lung transplantation rats.
Objective To investigate the expression of phosphate and tension homology deleted on chromsome ten (PTEN) and Basigin1, as well as their relationships with clinicopathological factors and molecular subtypes in invasive ductal carcinoma of breast. Methods The expressions of PTEN and Basigin1 protein were examined in 76 invasive ductal carcinoma of breast tissues by immunohistochemical method, and 20 breast benign hyperplasia tissues as control. These 76 patients underwent surgery in our hospital from Jan. 2014 to Dec. 2015. Results The high-expression rate of PTEN protein in invasive ductal carcinoma of breast tissues was lower than that in benign hyperplasia tissues [56.6% (43/76) vs. 85.0% (17/20), χ2=5.457, P=0.019], while the high-expression rate of Basigin1 protein was higher than that of the benign hyperplasia tissues [51.3% (39/76) vs 25.0% (5/20), χ2=4.417, P=0.036]. The high-expression of PTEN protein was positively correlated with WHO grade and lymph node metastasis status (P<0.05). The high-expression of Basigin1 protein was positively correlated with WHO grade, lymph node metastasis status, and TNM stage (P<0.05). In addition, the high-expression of PTEN protein was associated with molecular subtypes of breast cancer (P<0.001), and its high-expression rate was higher in Luminal A and Luminal B patients; the high-expression of Basigin1 protein was associated with molecular subtypes of breast cancer too (P<0.001), and the high-expression rate of Basigin1 protein was higher in Her-2 overexpression and basal-like subtypes of breast cancer patients. Spearman correlation analysis shown that expression of PTEN protein was negatively correlated with expression of Basigin1 protein (rs=–0.481, P<0.001). Conclusion PTEN and Basigin1 protein may have some mechanisms to promote the occurrence and development of breast cancer, which provide a new basis for targeted treatment of breast cancer.
ObjectiveTo detect the expression of centromere protein F (CENPF) and programmed death-ligand 1 (PD-L1) in colorectal cancer (CRC) tissues, analyze their associations with clinicopathologic characteristics, and assess their correlation and prognostic significance. MethodsThe CRC surgical specimens and their matched adjacent normal tissues, archived at the Department of Pathology, the Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People’s Hospital) from January 2019 to January 2023, were retrospectively collected. The expression levels of CENPF and PD-L1 were detected by immunohistochemistry. The positive unit (PU) of CENPF was measured using Image-Pro Plus image analysis software, and the combined positive score (CPS) of PD-L1 was calculated. The associations of CENPF and PD-L1 expression with clinicopathologic parameters were analyzed, and the correlation between CENPF and PD-L1 expression was evaluated using Spearman rank correlation coefficient. Furthermore, disease-free survival curves were plotted using the Kaplan-Meier method. Multivariable Cox proportional hazards regression models were further constructed to evaluate the independent associations of CENPF and PD-L1 expression with disease-free survival in CRC patients. ResultsA total of 122 patients were enrolled in this study. Significantly higher expression levels of both CENPF and PD-L1 were observed in CRC tissues as compared with their matched adjacent normal tissues (11.75±4.83 vs. 3.77±0.85, P<0.001; 13.65±10.58 vs. 0.88±0.60, P<0.001). A positive correlation between CENPF and PD-L1 expression was identified by Spearman analysis (rs=0.534, P<0.001). CENPF and PD-L1 expression were associated with multiple adverse clinicopathologic features of CRC. Both biomarkers were elevated in patients with advanced TNM stage (stage Ⅲ?Ⅳ), lymph node metastasis, and moderate-to-high-grade tumor budding (For CENPF: F=37.067, P<0.001; t=?4.693, P<0.001; t=?2.527, P=0.013, respectively. For PD-L1: H=11.080, P=0.004; t=2.057, P=0.042; t=?3.765, P<0.001, respectively). However, their associations with tumor differentiation and lymphovascular invasion differed: CENPF expression was higher in poorly differentiated CRC and those with lymphovascular invasion (F=8.006, P=0.001; t=2.361, P=0.020), whereas PD-L1 expression showed no significant association with these features (H=5.380, P=0.068; t=1.553, P=0.123). Survival analysis was performed on the 122 CRC cases (73 with high and 49 with low CENPF expression; 66 with high and 56 with low PD-L1 expression). Lower disease-free survival rate was observed in patients with high CENPF or high PD-L1 expression as compared to those with low expression (P<0.001, P=0.016). Further analysis based on combined expression patterns (54 cases with dual-high expression, 37 with dual-low expression, 19 with CENPF-high expression/PD-L1-low expression, and 12 with CENPF-low expression/PD-L1-high expression) revealed that the dual-high expression group had the lower disease-free survival rate (vs. dual-low expression and CENPF-low expression/PD-L1-high expression groups, both P<0.001). Additionally, significantly lower disease-free survival rate was detected in the CENPF-high expression/PD-L1-low expression group than in the CENPF-low expression/PD-L1-high expression and dual-low expression groups (all P<0.001). Finally, multivariate Cox proportional hazards regression analysis demonstrated that poor tumor differentiation, positive lymphovascular invasion, and high CENPF expression were identified as independent risk factors for shortened disease-free survival [HR (95%CI)=2.212 (1.106, 4.423), 3.205 (1.410, 7.285), and 12.295 (2.568, 58.855), respectively], whereas PD-L1 expression was not confirmed as an independent risk factors for shortened disease-free survival [HR (95%CI)=0.879 (0.462, 1.672)]. ConclusionsCENPF and PD-L1 are upregulated and positively correlated in CRC, potentially contributing to tumor progression and immune evasion. Combined detection of CENPF and PD-L1 may aid in risk stratification and immunotherapy strategy selection for CRC.