ABSTRACT
Objective To evaluate the spontaneous closure of isolated fetal ventricular septal defect (VSD) in uterus and follow-up during the first year after birth using echocardiography. Methods From January 2012 to June 2017, 51 cases with isolated VSD without chromosome abnormality were observed in uterus and followed-up during the first year after birth using echocardiography in People's Hospital of Daxing District in Beijing City. The location, size, closure time of the VSD were recorded. The closure rate was calculated. The closure rate of the VSD in utero and in infant during the first year after birth were compared by Fisher exact probability method. The relation of closure rate and location and size were also analyzed (P＜0.05 was significant). The comparison between groups one by one were performed by Fisher exact probability method (P＜0.0167 was significant). Results In 51cases, 30 had perimembranous VSD, 16 with muscular VSD and 5 with infundibular VSD. In 20 closure cases (39.2%), 9 fetuses (17.6%) were closed in utero, 11 infants (21.6%) were closed during the first year after birth. There was no significant difference between the closure rate of the VSD in utero and the closure rate of VSD in infant during the first year after birth (P=0.804). In 16 with muscular VSD, 11 cases (68.8%) were closed, in whom 4 fetuses (25.0%) were closed in utero and 7 infants (43.8%) were closed during the first year after birth. In 30 perimembranous VSD, 9 cases (30.0%) were closed, in whom 5 fetuses (16.7%) were closed in utero and 4 infants (13.3%) were closed during the first year after birth. The closure rate of muscular VSD were significant higher than that of the closure rate of perimembranous VSD and infundibular VSD (P=0.007, 0.012). There were no significant difference between the closure rate of the perimembranous VSD and infundibular VSD (P=0.297). The infundibular VSD remained unclosed in all cases. In 35 cases with VSD≤3.0 mm, 19 cases (54.3%) were closed, in whom 9 fetuses (25.7%) were closed in utero and 10 infants (28.6%) were closed during the first year after birth. There was 1 closure case (7.6%) with VSD of 3.1-5.0 mm. The closure rate of VSD≤3.0 mm were significant higher than that of the VSD of 3.1-5.0 mm and the VSD＞5.0 mm (P=0.007, 0.013). There was no significant difference between the closure rate of the VSD of 3.1-5.0 mm and VSD＞5.0 mm (P=1.0). The VSD＞5.0 mm remained unclosed in all cases. Conclusions Isolated VSD has a high closure rate in utero and during the first year after birth. Echocardiography was a reliable method in diagnosis and follow-up of isolated VSD.
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Objective To evaluate the clinical results of posteromedial supine approach plus anterolateral approach for treatment of posteromedial condylar tibial plateau split fracture combined with lateral compartment depression.Methods A retrospective analysis was done on 48 cases of posteromedial condylar tibial plateau split fracture with lateral compartment depression operated through posteromedial supine plus anterolateral approaches from February 2011 through March 2013.There were 37 men and 11 women,aged 15-67 years (mean,42.5 years).Fracture occurred at the left side in 31 cases and at the right side in 17 cases.Interval between injury and operation ranged from 5 to 16 days (mean,8.7 days).Reconstructive or T-shaped plates were used for posteromedial condylar split tibial plateau fracture.Anatomical or locking compression plates were used for lateral compartment depression,but autogenous ilium bone grafting was performed laterally when bone defect was obvious.Results Average operation time was 2.8 hours (range,2-3.5 hours) and average length of stay was 21 days (range,12-45 days).All cases were followed up for mean 12.8 months (range,5-25 months).All fracture healed from 4 to 8 months (mean,6.7 months).Mean Rasmussen score for radiological results was 16.9 points (range,16-18 points) immediately after operation.Hospital for special surgery (HSS) knee score averaged 86.4 points (range,76-95 points) 8 months after bone healed,indicating the excellent results in 27 cases,good in 16 cases,fair in 4 cases and poor in 1 case with a good to excellent rate of 90％.At the last follow-up,postoperative knee range of motion averaged-5°-135°.All incisions healed primarily without vascular nerve injury and implant loosing or breakage.There was an extension lag in 1 case with knee range of motion of 20°-130° and osteoarthritis in 1 case,but both were improved with non-operation therapy.Conclusion Posteromedia] supine plus anterolateral approaches are suitable for posteromedial condylar tibial plateau split fracture with lateral compartment depression,for the combined approaches gain advantages of easy operation,good reduction,rigid fixation,few soft-tissue complications and satisfactory clinical results.
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The mobilization efficiency of granulocyte colony-stimulating factor (G-CSF) and stem cell factor (SCF) to bone marrow mononuclear cells (MNCs) in mice was observed, and the changes of CXCL12/CXCR4 signal were detected in order to find out the mobilization mechanism of stem cells. Kunming mice were randomly divided into two groups. The mice in treatment group were subjected to subcutaneous injection of G-CSF at a dose of 100 mug/kg and SCF at a dose of 25 mug/kg every day for 5 days, and those in control group were given isodose physiological saline. The MNCs were separated, counted and cultured, and the colony-forming unit-fibroblast (CFU-F) was evaluated. CD34(+)CXCR4(+) MNCs were sorted by flow cytometry. The expression of CXCL12 protein in bone marrow extracellular fluid was detected by ELISA, and that of CXCL12 mRNA in bone marrow was measured by RT-PCR. The results showed that the counts of MNCs in peripheral blood and bone marrow were increased after administration of G-CSF/SCF (P<0.01). The factors had a dramatic effect on the expansion capability of CFU-F (P<0.05). Flow cytometric of bone marrow MNCs surface markers revealed that CD34(+)CXCR4(+) cells accounted for 44.6%+/-8.7% of the total CD34(+) MNCs. Moreover, G-CSF/SCF treatment induced a decrease in bone marrow CXCL12 mRNA that closely mirrored the fall in CXCL12 protein. In this study, it is evidenced that G-CSF/SCF can effectively induce MNCs mobilization by disrupting the balance of CXCL12/CXCR4 signaling pathway in the bone marrow and down-regulating the interaction of CXCL12/CXCR4.
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To construct the antisense transforming growth factor beta 1 (TGF beta 1) gene and investigate the effect of TGF beta 1 autocrine loop blockage on the proliferation of osteosarcoma cells. TGF beta 1 cDNA was cloned by RT-PCR from human osteosarcoma cells (MG-63) and inserted into pcDNA3 to construct an antisense expression vector, which was dubbed pcDNA3-TGF beta 1(-). MTT was used to detect the proliferation of osteosarcoma cells transfected by antisense TGF beta 1 gene. Our results showed that the proliferation of the transfected osteosarcoma cells was suppressed markedly. It is concluded that TGF beta 1 autocrine loop blockage in osteosarcoma cells could inhibit cell proliferation, which might be helpful for gene therapy of osteosarcoma.