Ning Li

BACKGROUND/AIMS: To study the effect of high intensity focused ultrasound on vascular endothelial growth factor and microvessel density in the rabbit VX-2 hepatocellular carcinoma models. METHODOLOGY: Rabbit VX-2 hepatocellular carcinoma models were built by implanting VX-2 tumor cells into the hepatic left lobes of 40 rabbits. After that, the rabbits were randomly divided into four groups: the control group (n=10), the postoperative one-day group (n=10), the postoperative three-day group (n=10) and the postoperative seven-day group (n=10). The expression of VEGF and the MVD in the HCC tissues were observed and measured by immunohistochemistry. RESULTS: After the HIFU treatment, the MVD and the expression of VEGF in the HCC tissues in the postoperative one-day group and post-operative three-day group decreased significantly as compared with the sham-HIFU group (p<0.01). The MVD and the expression of VEGF in the postoperative seven-day group were higher than those of the sham-HIFU group (p<0.05). No obvious difference was shown between the postoperative one-day group and the postoperative three-day group (p>0.05), while the two groups MVD and the expression of VEGF were different with those of the postoperative seven-day group (p<0.01). CONCLUSIONS: HIFU causes damage to the microvessels in the HCC tissues, effectively inhibits angiogenesis and reduces blood supply in these tissues.

BACKGROUND: The purpose of this research is to evaluate the effects of a tourniquet in total knee arthroplasty (TKA). METHODS: The study was done by randomized controlled trials (RCTs) on the effects of a tourniquet in TKA. All related articles which were published up to June 2013 from Medline, Embase, and Cochrane Central Register of Controlled Trails were identified. The methodological quality of the included studies was assessed by the Physiotherapy Evidence Database (PEDro) scale. The meta-analysis was performed using Cochrane RevMan software version 5.1. RESULTS: Thirteen RCTs that involved a total of 689 patients with 689 knees were included in the meta-analysis, which were divided into two groups. The tourniquet group included 351 knees and the non-tourniquet group included 338 knees. The meta-analysis showed that using a tourniquet in TKA could reduce intraoperative blood loss (weighted mean difference (WMD), -198.21; 95% confidence interval (CI), -279.82 to -116.60; P<0.01) but did not decrease the calculated blood loss (P=0.80), which indicates the actual blood loss. Although TKA with a tourniquet could save the operation time for 4.57 min compared to TKA without a tourniquet (WMD, -4.57; 95% CI, -7.59 to -1.56; P<0.01), it had no clinical significance. Meanwhile, the use of tourniquet could not reduce the possibility of blood transfusion (P>0.05). Postoperative knee range of motion (ROM) in tourniquet group was 10.41° less than that in the non-tourniquet group in early stage (≤ 10 days after surgery) (WMD, -10.41; 95% CI, -16.41 to -4.41; P<0.01). Moreover, the use of a tourniquet increased the risk of either thrombotic events (risk ratio (RR), 5.00; 95% CI, 1.31 to 19.10; P=0.02) or non-thrombotic complications (RR, 2.03; 95% CI, 1.12 to 3.67; P=0.02). CONCLUSIONS: TKA without a tourniquet was superior to TKA with a tourniquet in thromboembolic events and the other related complications. There were no significant differences between the two groups in the actual blood loss. TKA with a tourniquet might hinder patients' early postoperative rehabilitation exercises.

Abstract Oral squamous cell carcinoma (OSCC) in the background of oral submucous fibrosis (OSF) caused by areca nut chewing has a high incidence in Asia-Pacific countries. However, the molecular mechanism remains unclear. Here, we performed circRNA microarray analysis to screen the circRNA expression profiles in OSCC and OSF. We identified circEPSTI1 as a circRNA with consistent, sequential upregulation from normal buccal mucosa (NBM) to OSF to OSCC. Functionally, circEPSTI1 significantly promoted OSCC cell proliferation and invasion, as evidenced by the CCK8, colony formation, wound healing, and transwell assays with circEPSTI1 overexpression and silencing. OSCC patients with circEPSTI1 high status exhibited poor prognoses. CircEPSTI1 sponged miR-942-5p and accelerated epithelial-mesenchymal transition (EMT) to increase LTBP2 expression in OSCC through phosphorylation of PI3K/Akt/mTOR signaling pathway components. Blocking the PI3K/Akt/mTOR signaling pathway with the dual PI3k/mTOR inhibitor BEZ235 reversed OSCC progression induced by overexpression of circEPSTI1 and LTBP2. Collectively, these results indicate that the circEPSTI1/miR-942-5p/LTBP2 axis affects OSCC cell proliferation and invasion via the acceleration of EMT and the phosphorylation of PI3K/Akt/mTOR signaling pathway components. CircEPSTI1 may be an independent diagnostic and prognostic marker and a potential therapeutic target for OSCC patients with OSF.