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OBJECTIVE：To study the repa ir effect and mechanism of Taohong siwu decoction on rotator cuff injury in rabbits. METHODS：New Zealand rabbits were randomly divided into blank control group ，model group ，Taohong siwu decoction low-dose，medium-dose and high-dose groups （2.75，5.5，11 g/kg），and Taohong siwu decoction+LY 294002 group [ 5.5 g/kg Taohong siwu decoction+ 6.4 μg/kg LY294002（pathway inhibitor ）]，with 11 rabbits in each group. Except for blank control group ， other groups underwent right subscapularis muscle detachment to establish rotator cuff injury model. After modeling ，blank control group and model group were given normal saline intragastrically ；Taohong siwu decoction groups were given relevant medicine intragastrically；Taohong siwu decoction+LY 294002 group was given Taohong siwu decoction intragastrically ，and then injected with LY 294002 at the ear edge ，once a day ，for 12 weeks. After last intragastric administration （injection），the pathological changes of tendon-bone interface was observed ；the levels of TNF-α，IL-10 and IL- 6 in serum were detected ；mRNA and protein expressions of PI 3K，Akt and mTOR in tendon-bone interface were detected ；the expression of autophagy related protein （Beclin1， LC3Ⅱ）were detected. RESULTS ：Compared with blank control group ，the tendon-bone interface was uneven and the intima was swollen in model group. Serum levels of TNF-α and IL-6，mRNA and protein expressions of PI 3K，Akt and mTOR in tendon-bone interface were increased significantly （P＜0.05 or P＜0.01），while the level of IL- 10 and protein expression of Beclin 1 and LC 3Ⅱ were decreased significantly （P＜0.01）. Compared with model group ，the tendon-bone interface of rabbits in Taohong siwu decoction low-dose and medium-dose groups still had certain intimal damage ，while the tendon-bone interface of rabbits in high-dose group was smooth and flat without an obvious intimal tear ；the levels of most indexes in serum and tendon-bone interface of rabbits were significantly reversed in each dose group （P＜0.05 or P＜0.01）. Swollen tendon-bone interface and obvious intimal tear were obse rved in Taohong siwu decoction + LY group；compared with model group ，there w as no significant difference in above indexes of serum and tendon-bone interface （P＞0.05）. CONCLUSIONS ：Taohong siwu decoction may repair the rotator cuff injury of rabbits ，the mechanism of which may be associated with inhibiting PI3K/Akt/mTOR signaling pathway，activating autophagy and inhibiting inflammatory response.
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Objective To study correlation between biochemical markers of bone metabolism and postmenopausal osteoporot-ic vertebral fractures.Methods The clinical data of 100 cases with postmenopausal osteoporotic were study retrospectively.Fifty patients were postmenopausal osteoporotic,the rests were postmenopausal osteoporotic vertebral fractures.Lumbar spine,hip BMD,serum P1NP,β-CTX,N-MID,25-(OH)VitD and Ca2 + were recorded.Results There was a significant difference among ser-um P1NP,β-CTX and 25-(OH)VitD(P 0.05).Conclusion Serum P1NP and 25-(OH)VitD could predict risk of postmenopausal osteoporotic vertebral fractures.Biochemical markers of bone metabolism combined with BMD could reduce postmenopausal osteoporosis fractures.
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BACKGROUND: Heterotopic ossification (HO) is common following primary total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS), which may cause certain influence on functional recovery.OBJECTIVE: To explore the risk factors for HO after primary THA in AS patients.METHODS: The clinical and radiological data from 87 patients (132 hips) with AS undergoing primary THA between June 2011 and December 2015 were retrospectively analyzed, and followed up for more than 6 months. The radiological information included preoperative and postoperative hip anteroposterior and lateral radiographs. The presence of HO surrounding the prosthesis was evaluated on the radiographs at the last follow-up and graded according to the Brooker classification. Risk factors for HO were divided into invariable factors (age, sex, course and with or without ankylosed hip) and variable factors (preoperative C-reactive protein level, preoperative erythrocyte sedimentation rate, intraoperative blood loss, operation time, prosthesis types and anesthesia methods) to determine the pertinent risk factors.RESULTS AND CONCLUSION: (1) Totally 43 hips (32.6%) were found to have developed into HO. (2) Invariable risk factors including male (P=0.029), preoperative ankylosed hip (P < 0.001), and course (P=0.029) increased the prevalence of HO. Among the variable risk factors, prolonged operation time (P=0.031) and general anesthesia (P=0.003)were associated with the increased occurrence of HO. Age, preoperative C-reactive protein level and erythrocyte sedimentation rate, intraoperative blood loss, and prosthesis types had no obvious correlation with HO. (3) These results suggest that to prevent the formation of HO following THA in AS, efforts to reduce the operation time and avoid general anesthesia should be considered.
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BACKGROUND:Tranexamic acid is extensively used in the primary total knee replacement, but there are many different methods. OBJECTIVE:To explore the efficacy and safety of the intra-articular injection of tranexamic acid with pressurization in reducing the blood loss of primary total knee replacement. METHODS:Total y 56 patients undergoing unilateral total knee arthroplasty were enrol ed and randomly divided into two groups. Patients were given the intra-articular injection of 100 mL of saline solution dissolving 2.0 g of tranexamic acid with large pad pressure bandaging the knee, and 4-hour drainage tube close, and then underwent negative pressure suction (experimental group);differently, the controls were given the normal pad bandage group. The drainage tube was removed within 48 hours after replacement. The patient blood routine examination was performed at the 3rd day, and at the same time, the volume of drainage was recorded;and the color Doppler ultrasound in ipsilateral lower extremity veins was conducted to observe the incidence of thrombosis at 4-5 days. RESULTS AND CONCLUSION:(1) The total blood loss, postoperative dominant blood loss, and hidden blood loss in the experimental group were significantly less than those in the control group (P0.05). (3) These results indicate that the intra-articular injection of tranexamic acid with pressurization can significantly reduce the postoperative blood loss in the primary total knee arthroplasty, without increasing the risk of deep vein thrombosis.
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BACKGROUND:Jumonji domain-containing histone demethylase (JMJD) can promote osteoblast differentiation, and estrogen-related receptor alpha (ERRα) can promote osteoblast differentiation and increase bone formation. However, little is reported on the association between postmenopausal osteoporosis andJMJD and ERRα. OBJECTIVE: To study the changes in the JMJD2 family expression in patients with postmenopausal osteoporosis. METHODS: Postmenopausal patients with osteoarthritis of the hip scheduled for total hip arthroplasty, aged 50-70 years, were enroled, including 10 postmenopausal osteoporosis patients (experimental group) and 10 patients with no postmenopausal osteoporosis (control group). During the arthroplasty, the cancelous bone specimens from the femoral head were colected. Then, immunohistochemistry and western blot assay were used to detect expression of histone demethylase (JMJD2A, JMJD2B), histone methylation (H3K9me3, H3K36me3) and ERRα. RESULTS AND CONCLUSION:In the experimental group, the expressions of JMJD2A, JMJD2B and ERRαwere from weakly positive to positive; these expressions were significantly lower in the experimental group than the control group (P < 0.05). The expressions of H3K9me3 and H3K36me3 were significantly higher in the experimental group than the control group (P < 0.05). These findings indicate that the expression of JMJD2A and JMJD2B is consistent with the expression of ERRα in the patients with postmenopausal osteoporosis, and JMJD is likely to serve as an antagonistic enzyme of osteoporosis.
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<p><b>OBJECTIVE</b>To investigate the clinical efficacy of laparoscopic ventriculoperitoneal shunt with temporary external drainage in the treatment of hydrocephalus.</p><p><b>METHODS</b>Fifty-two cases of hydrocephalus randomized into two groups to receive laparoscopic assisted ventriculoperitoneal shunt with temporary external drainage (19 male and 7 female patients) and conventional ventriculoperitoneal shunt (20 male and 6 female patients). The catheterization time in the abdominal cavity, release time of intracranial hypertension, average hospital stay, postoperative pains, and postoperative complications were compared between the two groups.</p><p><b>RESULTS</b>Laparoscopic ventriculoperitoneal shunt with temporary external drainage was performed successfully in all the cases without intraoperative conversion to open surgery. Compared with the conventional ventriculoperitoneal shunt, laparoscopic ventriculoperitoneal shunt with temporary external drainage was associated with significantly shortened catheterization time in the abdominal cavity, release time of intracranial hypertension, and average hospital stay (P<0.01) as well as lowered postoperative pain score at 4, 8, 16, and 24 h after the operation. The pain scores at 48 and 72 h postoperatively were comparable between the two groups. During the follow-up 3 months, the patients receiving laparoscopic ventriculoperitoneal shunt were found to have significantly lower rates of peritoneal end obstruction and abdominal cavity infection than those having conventional shunt (3.8% vs 19.2%, P<0.01; 1.0% vs 23.1%, P<0.01).</p><p><b>CONCLUSION</b>Laparoscopic ventriculoperitoneal shunt with temporary external drainage is feasible and produces better clinical therapeutic effect for management of hydrocephalus.</p>