Alternating levels versus all levels mini-plate fixation in open door cervical laminoplasty for treatment of degenerative cervical myelopathy

Objectiveː To investigate clinical and radiological results of alternating levels compared with all levels mini-plate fixation in open door cervical laminoplasty for treatment of degenerative cervical myelopathy. METHODSː From January 2011 to April 2014, 64 patients sustained degenerative cervical myelopathy, who underwent cervical laminoplasty with alternating levels (31 patients in group A) or all levels plate fixation (33 patients in group B) were included in this retrospectively study. Clinical and radiological results were calculated.  RESULTSːThe mean cost for group B was higher than group A(P < 0.05). No statistical difference was found in the mean operation time, blood loss, axial symptoms，C5 palsy, improvement in JOA and NDI score between group A and B. Open angle in mini-plate fixed levels was significantly more than that in suture fixed levels(P < 0.05). No statistical difference was found in drift back of spinal cord, APD, Pavlov's ratio, CCI and ROM between mini-plate fixed levels and suture fixed levels.CONCLUSIONSː Open door laminoplasty at alternating levels mini-plate fixation is an economical surgical method and can obtain similar satisfactory clinical and radiological results compared to all levels mini-plate fixation. 

Application of CPI cutoff value based on parentage testing of duos and trios typed by four autosomal kits.

In this study, we analyzed the application of four autosomal kits and the sensitivity of the combined paternity index (CPI) cutoff value (CPI≥10000) in parentage testing. First, 1442 real trios and 803 real duos were tested using the Goldeneye 25A kit. The Goldeneye 25A kit covers the autosomal short tandem repeat (STR) loci of the other three kits, so we calculated the CPI value of every case for the four kits. Second, three complex close relative kinship cases were also analyzed to evaluate the application of the CPI cutoff value. The CPI values of all trio cases were higher than 10000 using the four kits; the CPI values of all duo cases were higher than 10000 using the Goldeneye 25A kit; and the CPI values of a portion of the duo cases were lower than 10000 using the other three kits. In the three complex close relative cases, the alleged father or mother was not excluded using 40 autosomal STRs. Adding X chromosome short tandem repeats (X-STR) and samples of biological fathers or mothers, the conclusions were confirmed. The four kits were adequate to draw conclusions in the trio cases; the Goldeneye 25A Kit was adequate to draw conclusions in the duo cases; and the other three kits were not sufficient for a portion of the duo cases. The CPI cutoff value was sensitive for real trio and duo cases. In complex close relative kinship cases, high CPI values may result in false conclusions

Expression of AFP and STAT3 is involved in arsenic trioxide-induced apoptosis and inhibition of proliferation in AFP-producing gastric cancer cells.

Alpha-fetoprotein (AFP)-producing gastric cancer (AFPGC), represented by the production of AFP, has a more aggressive behavior than common gastric cancer. The underlying mechanisms are not well understood. Arsenic trioxide (As(2)O(3)) is used clinically to treat acute promyelocytic leukemia(APL) and has activity in vitro against several solid tumor cell lines, with induction of apoptosis and inhibition of proliferation the prime effects. Signal transducer and activator of transcription 3 (STAT3) has an important role in tumorigenesis of various primary cancers and cancer cell by upregulating cell-survival and downregulating tumor suppressor proteins. Here, we found decreased expression of AFP and STAT3 after induction of apoptosis by As(2)O(3) in the AFPGC FU97 cells. Also, the level of the STAT3 target oncogene Bcl-2 was decreased with As(2)O(3), and that of the tumor suppressor Bax was increased. Furthermore, STAT3 expression and depth of invasion and lymph node metastasis were associated. Survival of patients with gastric cancer was lower with AFP and STAT3 double overexpression than with overexpression of either alone. Downregulation of AFP and STAT3 expression plays an important role in As(2)O(3)-induced apoptosis of AFPGC cells, which suggests a new mechanism of As(2)O(3)-induced cell apoptosis. As(2)O(3) may be a possible agent for AFPGC treatment

Primer sequences for real-time PCR.

<p>Primer sequences for real-time PCR.</p

Schematic illustration of As2O3-induced growth inhibition and apoptosis of FU97 cells.

<p>Inactivation of the ATBF1 gene in AFPGC, through mutation or reduced expression, may allow AFPGC cells to produce AFP protein and overexpress STAT3, which contributes to aggressive behavior and poor prognosis of AFPGC. As2O3 can inhibit AFPGC cell growth and induce cell apoptosis. The underlying mechanisms may involve downregulation of AFP and STAT3 expression and STAT3 downregulating the expression of anti-apoptotic Bcl-2 and upregulating that of the tumor suppressor Bax. Furthermore, AFP can dimerize with other proteins such as nuclear receptors, transcription factors and caspases, all of which can promote growth of tumor cells. AFP may dimerize with the transcription factor STAT3 to promote AFPGC growth. Therefore, AFP may interact with STAT3 in the signal pathway for chemotherapeutic efficiency of agents on AFPGC.</p

Representative immunohistochemical staining in serial sections of poorly differentiated adenocarcinoma of the stomach from patients positive for AFP (magnification ×100).

<p>(A) Immunostaining for AFP. (B) Strong STAT3 immunostaining with brown granular deposits in the cytoplasm and nuclei. (C) Negative control immunohistochemical staining for AFP. (D) Negative control immunohistochemical staining for STAT3.</p

Effect of As2O3 on AFP concentrations in cell culture supernatant of FU97 cells.

<p>As₂O₃ decreased AFP protein level concentration dependently. Data are representative of 3 independent experiments with similar results. *p<0.05 compared with 0 µmol/L.</p

Effect of As2O3 on expression of STAT3 target genes Bcl-2 and Bax in FU97 cells.

<p>(A) Quantitative RT-PCR and (B) western blot analysis and quantification of cells treated with As₂O₃ at 5 µmol/L for 72 h. The mRNA and protein expression of Bcl-2 was downregulated in As₂O₃ treated cells, but that of Bax was upregulated. All experiments were performed in triplicates. *<i>p</i><0.05 compared with control.</p

Arsenic trioxide (As2O3)-induced growth inhibition and apoptosis of gastric cancer FU97 cells.

<p>(A<b>)</b> Cellular growth inhibition measured by MTT assay. Data are mean ± SD of 3 independent experiments. (B) Agarose gel analysis of DNA fragmentation in FU97 cells treated with As2O3 for 72 h.(C) Apoptotic nuclei stained with Hoechst 33258 show intense fluorescence corresponding to chromatin condensation and fragmentation.(D) Western blot analysis of caspase3 protein in total cell extracts of FU97 cells treated with the indicated concentration of As2O3 for 72 h. GAPDH expression served as loading control.</p