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Acute kidney injury (AKI) is a common clinical critical illness, and ischemic kidney injury is the main type. The mortality rate of ischemic kidney injury is high, because the efficacy of treatment is limited due to symptomatic and supportive treatment. Establishing a reliable animal model of ischemic AKI is an important prerequisite for conducting research on physiological, pathological and pharmacological researches, so as to explore effective prevention methods and strategies. In recent years, the establishment methods of animal models of ischemic AKI have been continuously improved. The article summarizes the common methods and model characteristics of animal models of ischemic AKI in order to provide a reference for researchers to choose a reasonable modeling method.
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Objective To observe the effects of fecal microbiota transplantation on intestinal microbiota and brain function in sepsis rats. Methods Sixty male Sprague Dawley (SD) rats were divided into sham operation group, model group and fecal microbiota transplantation (FMT) group by random number table, each group 20 rats. The rat model of sepsis was established by injection of lipopolysaccharide (LPS) 10 mg/kg in tail vein. FMT group received nasogastric infusion of feces from healthy donor. Fecal samples were collected on the 6th day after the modeling to detect the levels of intestinal microbiota composition; the brain function was also evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats in different groups, the brain tissues were taken, the levels of protein expression and positive cells of Iba-1 in brain tissue were detected by Western Blot and immunohistochemistry method. Results ① Intestinal flora analysis showed that: the diversity index and Chaol index of the intestinal microbiota in model group were significantly lower than that in sham operation group (observed species:282±40 vs. 473±37, Chao1 index: 730±21 vs. 837±27, both P < 0.05); compared with the model group, the diversity index and Chaol index in FMT group were obviously higher (observed species: 461±20 vs. 282±40, Chao1 index:840±16 vs. 730±21, both P < 0.05). At phylum, family, genus level analysis showed that the proportion of Firmicutes phylum and Fusobacterium were obviously lower than those of sham operation group [Firmicutes phylum (22.12±1.34)% vs. (78.01±1.23)%, Fusobacterium: (2.03±0.17)% vs. (5.03±0.19)%, both P < 0.05], and the proportions of Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae, Alistipes were markedly higher in model group [Proteobacteria: (70.21±2.35)% vs. (19.45±2.17)%, Bacteroidetes phyla: (4.12±0.19)% vs. (2.50±0.64)%, Acidaminococcaceae: (12.51±0.87)% vs. (1.01±0.12)%, Fusobacteriaceae: (13.62±1.27)% vs. (2.31±0.19)%, Enterbacteriacecae: (18.24±2.13)% vs. (4.15±1.51)%, Alistipes: (4.53±0.27)% vs. (1.47±0.33)%, all P < 0.05]; compared with the model group, the proportion of Firmicutes phylum and Faecalibacterium in FMT group were significantly higher [Firmicutes phylum: (72.14±2.31)% vs. (22.12±1.34)%, Faecalibacterium: (5.01±0.27)% vs. (2.03±0.17)%, both P < 0.05], and Proteobacteria, Bacteroidetes phyla and Acidaminococcaceae, Fusobacteriaceae, Enterbacteriacecae in FMT group were obviously lower [Proteobacteria: (14.23±1.98)% vs. (70.21±2.35)%, Bacteroidetes phyla: (3.15±0.18)% vs. (4.12±0.19)%, Acidaminococcaceae: (0.91±0.11)% vs. (12.51±0.87)%, Fusobacteriaceae: (1.25±0.15)% vs. (13.62±1.27)%, Enterbacteriacecae: (3.50±0.21)% vs. (18.24±2.13)%, all P < 0.05]. ② EEG analysis showed that the percentages of δ wave in EEG in model group was significantly higher after modeling than that in sham operation group [(16.86±0.50)% vs. (10.67±0.65)%, P < 0.05]; the ratios of δ wave in EEG was significantly lower in FMT group than that in the model group [(12.87±0.60)% vs. (17.35±0.41)%, P <0.05]. The incidence of abnormal EEG in sham operation group was 0, the incidence of abnormal EEG in model group was significantly increased [the ratios of δpredominant wave, θpredominant wave, low-voltage were 66.7% (6/9), 66.7% (6/9), 77.8% (7/9) respectively], the ratios of above abnormal waves in EEG in FMT group were obviously lower than those in model group [the ratios of above abnormal waves in FMT group were respectively 9.1% (1/11), 9.1% (1/11), 18.2%(2/11)]. ③ Western Blot analysis showed that the protein expression of Iba-1 in cortex in model group obviously was higher than that in sham operation group (Iba-1/β-actin: 1.39±0.16 vs. 0.67±0.18, P < 0.05); the expression of Iba-1 in cortex tissue of FMT group was markedly lower than that in model group (Iba-1/β-actin: 0.51±0.14 vs. 1.39±0.16, P < 0.05). ④ Immunohistochemistry of Iba-1 in cortex analysis showed that there were no Iba-1 positive cells in the cortex in sham operation group; Iba-1 positive cells were found in the cortex in model group; the number of Iba-1 positive cells in FMT group was less than that in model group. Conclusion FMT can improve the construction of intestinal microbiota, and ameliorate the brain dysfunction in SAE.
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Objective@#To investigate the effects of fecal microbiota transplantation on septic gut flora and the cortex cholinergic anti-inflammatory pathway in rats.@*Methods@#Sixty clean grade male Sprague-Dawley (SD) rats were divided into normal saline (NS) control group, sepsis model group and fecal microbiota transplantation group by random number table, with 20 rats in each group. The rat model of sepsis was reproduced by injection of 10 mg/kg lipopolysaccharide (LPS) via tail vein, the rats in the NS control group was given the same amount of NS. The rats in the fecal microbiota transplantation group received nasogastric infusion of feces from healthy donor on the 1st day, 2 mL each time, for 3 times a day, the other two groups were given equal dose of NS by gavage. Fecal samples were collected on the 7th day after modeling, the levels of intestinal microbiota composition was determined using the 16SrDNA gene sequencing technology. The brain function was evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats, the brain tissues were harvested, the levels of protein expression of α7 nicotinic acetylcholine receptor (α7nAChR) were determined by Western Blot, and positive cells of Iba-1 in brain tissue were detected by immunohistochemistry method. The levels of interleukins (IL-6 and IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA).@*Results@#Seven days after the reproduction of the model, all rats in the NS control group survived, while 10 rats and 8 rats died in the sepsis model group and fecal microbiota transplantation group, respectively, with mortality rates of 50% and 40% respectively. Finally, there were 20 rats in the NS control group, 10 in the sepsis model group and 12 in the fecal microbiota transplantation group. Compared with the NS control group, the diversity and composition of intestinal flora were changed, the incidence of abnormal EEG increased significantly, the expression of α7nAchR in the cortex decreased significantly, and the levels of Iba-1, TNF-α, IL-6 and IL-1β were significantly increased in the model group, suggested that the intestinal flora was dysbiosis, and severe inflammatory reaction occurred in the cerebral cortex, and brain function was impaired. Compared with the model group, the diversity of intestinal flora in the fecal microbiota transplantation group was significantly increased (species index: 510.24±58.76 vs. 282.50±47.42, Chao1 index: 852.75±25.24 vs. 705.50±46.50, both P < 0.05), the dysbiosis of intestinal flora at phylum, family, genus level induced by LPS were also significantly reversed, and with the improvement of intestinal flora, the incidence of abnormal EEG waveforms was lower in the fecal microbiota transplantation group compared with that in the model group [25.0% (3/12) vs. 80.0% (8/10), P < 0.05], and the expression of α7nAChR protein in the cerebral cortex was significantly increased (α7nAChR/β-actin: 1.56±0.05 vs. 0.82±0.07, P < 0.05), immunohistochemistry analysis showed that Iba-1 positive expression of microglia decreased significantly, and cerebral cortex TNF-α, IL-6, IL-1β levels were significantly decreased [TNF-α (ng/L): 6.28±0.61 vs. 12.02±0.54, IL-6 (ng/L): 28.26±3.15 vs. 60.58±4.62, IL-1β (ng/L): 33.63±3.48 vs. 72.56±2.25, all P < 0.05].@*Conclusion@#The results reveal that fecal microbiota transplantation has remarkably modulated the dysbiosis of intestinal microbiota and activated cholinergic anti-inflammatory pathway, and ameliorate the brain dysfunction in septic rats.
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Objective To investigate the effects of fecal microbiota transplantation on septic gut flora and the cortex cholinergic anti-inflammatory pathway in rats. Methods Sixty clean grade male Sprague-Dawley (SD) rats were divided into normal saline (NS) control group, sepsis model group and fecal microbiota transplantation group by random number table, with 20 rats in each group. The rat model of sepsis was reproduced by injection of 10 mg/kg lipopolysaccharide (LPS) via tail vein, the rats in the NS control group was given the same amount of NS. The rats in the fecal microbiota transplantation group received nasogastric infusion of feces from healthy donor on the 1st day, 2 mL each time, for 3 times a day, the other two groups were given equal dose of NS by gavage. Fecal samples were collected on the 7th day after modeling, the levels of intestinal microbiota composition was determined using the 16SrDNA gene sequencing technology. The brain function was evaluated by electroencephalogram (EEG), and the proportion of each waveform in EEG was calculated. After sacrifice of rats, the brain tissues were harvested, the levels of protein expression of α7 nicotinic acetylcholine receptor (α7nAChR) were determined by Western Blot, and positive cells of Iba-1 in brain tissue were detected by immunohistochemistry method. The levels of interleukins (IL-6 and IL-1β) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA). Results Seven days after the reproduction of the model, all rats in the NS control group survived, while 10 rats and 8 rats died in the sepsis model group and fecal microbiota transplantation group, respectively, with mortality rates of 50% and 40% respectively. Finally, there were 20 rats in the NS control group, 10 in the sepsis model group and 12 in the fecal microbiota transplantation group. Compared with the NS control group, the diversity and composition of intestinal flora were changed, the incidence of abnormal EEG increased significantly, the expression of α7nAchR in the cortex decreased significantly, and the levels of Iba-1, TNF-α, IL-6 and IL-1β were significantly increased in the model group, suggested that the intestinal flora was dysbiosis, and severe inflammatory reaction occurred in the cerebral cortex, and brain function was impaired. Compared with the model group, the diversity of intestinal flora in the fecal microbiota transplantation group was significantly increased (species index: 510.24±58.76 vs. 282.50±47.42, Chao1 index: 852.75±25.24 vs. 705.50±46.50, both P < 0.05), the dysbiosis of intestinal flora at phylum, family, genus level induced by LPS were also significantly reversed, and with the improvement of intestinal flora, the incidence of abnormal EEG waveforms was lower in the fecal microbiota transplantation group compared with that in the model group [25.0% (3/12) vs. 80.0% (8/10), P < 0.05], and the expression of α7nAChR protein in the cerebral cortex was significantly increased (α7nAChR/β-actin: 1.56±0.05 vs. 0.82±0.07, P < 0.05), immunohistochemistry analysis showed that Iba-1 positive expression of microglia decreased significantly, and cerebral cortex TNF-α, IL-6, IL-1β levels were significantly decreased [TNF-α (ng/L): 6.28±0.61 vs. 12.02±0.54, IL-6 (ng/L): 28.26±3.15 vs. 60.58±4.62, IL-1β (ng/L): 33.63±3.48 vs. 72.56±2.25, all P < 0.05]. Conclusion The results reveal that fecal microbiota transplantation has remarkably modulated the dysbiosis of intestinal microbiota and activated cholinergic anti-inflammatory pathway, and ameliorate the brain dysfunction in septic rats.
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Objective To explore the diagnostic value of dual-energy CTA in detection of intracrania[aneurysms by using Meta-analysis.Methods Taking "Dual energy"," intracranial aneurysms" or "subarachnoid hemorrhage" as key words,related literatures of diagnostic accuracy of intracrania[aneurysms by using dual-energy CTA compared with DSA were extracted from Wanfang database,CNKI,Chinese biomedical database and PubMed from January 2006 to January 2017.The quality of included literatures was assessed.MetaDISC1.4 was used for Meta-analysis to examine the heterogeneity among the studies and to analyze the diagnostic accuracy index.The forest map was drawn.The summary operating characteristic curve was analyzed.Results Fifteen studies without heterogeneity were considered for analysis.The pooled sensitivity,specificity,positive likelihood ratio and negative likelihood ratio was 0.97 (95 ％CI [0.96,0.99]),0.99 (95 ％ CI [0.97,1.00]),21.71 (95％CI [12.10,38.96]) and 0.04 (95％CI [0.03,0.07]),respectively.The value of OR was 703.4 (95％CI [303.96,1 627.74]).The area under the curve of summary ROC was 0.990 8.The maximum value (Q value) of sensitivity and specificity was 0.992 5.Conclusion Dual-energy CTA has high sensitivity and specificity in diagnosis of intracranial aneurysms,therefore can be taken as the first choice for patients with suspected intracranial aneurysms.
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Objective To investigate the correlation between admission hyperglycemia and clinical prognosis in elderly patients with community-acquired pneumonia.Methods Based on the electrical medical record (EMR),information of the patients with pneumonia was retrospectively collected and the necessary data were prepared and arranged.Based on clinical outcomes,demographic characteristics and clinical indicators were compared between groups in order to screen potential variables affecting clinical outcomes.Then,the random blood glucose level 8.6 mmol/L was considered to be the cutoff point for grouping patients,with clinical outcomes as outcome variables,random blood glucose levels as grouping variables,propensity score value analysis method was applied along with the ratio of 1:1 nearest neighbor matching method to generate paired samples in order to assess the impact of blood glucose level on mortality rate;With hospitalization time serving as time variable,survive analysis method was used to analyze COX proportional model.Results Five hundred and fifty-eight patients were enrolled in the analysis,197 patients of which were recorded dead during hospitalization (the dead group).After the correction of demographic characteristics,past medical history and blood test indexes,white blood cells,C reactive protein,random blood glucose at admission and triglyceride levels were regarded as potential factors for the deaths of patients (P<0.05).However,the propensity score analysis method suggested that there was no significant difference between the blood glucose levels and mortality.The survival analysis showed that the mortality in the high blood glucose group was higher than that in the normal blood glucose group (HR=1.68,95%CI(1.22,2.31)).Conclusion Admission hyperglycemia is an important indicator of adverse prognosis in elderly patients with pneumonia.It may be of significance for screening and identifying high-risk patients.
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Eight-weeks old C57BL/6J male mice were treated with normal or high fat diet for4 weeks,and then bone mass,number and activity of osteoclasts,differentiation of osteoblasts from bone marrow mesenchymal cells and the change in lipid genes expression were studied.Compared with the normal diet treated group,bone mass of femur from high fat diet treated animal was decreased,but there were increased number and activity of osteoclasts and raised lipid genes expression levels.Besides,no obvious change was found in differentiation of osteoblasts from bone marrow mesenchymal cells.The loss of bone mass induced with high fat diet in young mice was mainly due to increased activity of osteoclasts and bone resorption.
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This study was aimed to explore the clinical efficacy of Shen-Kang Injection (SKI) combined with hemodialysis in the treatment of chronic renal failure (CRF) patients. A total of 41 end-stage CRF patients under the hemodialysis treatment were randomly divided into the SKI treatment group of 19 cases and a control group of 22 cases. Both groups were treated with standard dialysis and the hemodialysis was maintained in the same symp-tomatic treatment conditions. Patients in the control group underwent three hemodialysis treatments in one week, while those in the treatment group were given hemodialysis twice a week based on the symptomatic treatment. And SKI was given after each time of hemodialysis in the treatment group. Indexes and changes in serum creati-nine (Scr), blood urea nitrogen (BUN) level, dialysis adequacy, nutrition status, traditional Chinese medicine ( TCM ) syndrome and other aspects of both groups were observed . The results showed that in the treatment group and control group, there were no significant differences in the renal function, dialysis adequacy, nutrition indica-tors and electrolyte ( P > 0 . 05 ) . In the treatment group , the total efficiency of TCM syndrome was 84 . 21%. And the total efficiency of TCM syndrome in the control group was 45.45%. The treatment group was better than the control group (P 0 . 05 ) . Symptoms such as fatigue , shortness of breath, poor appetite, dizziness, headache, lower back pain and spontaneous sweating were improved significantly. And there was statistical significance ( P < 0 . 05 ) . The treatment group was better than the control group . There were no abnormalities in the routine tests of blood, urine and stool, electrocardiogram, liver function, renal func-tion and electrolyte. In the treatment group, there was no significant adverse reactions during patients received SKI. The SKI has good safety. It was concluded that SKI combined with hemodialysis in the treatment of CRF is able to improve the clinical symptoms of patients and improve the patients' quality of life. When patient received adequate dialysis, SKI may reduce the dialysis frequency per week.
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This article was aimed to review and make a commentary on modern medicine and traditional Chinese medicine (TCM) treatment for intracerebral hemorrhage. This article introduced applications and evaluations on medi-cations to reduce intracranial pressure, blood pressure control medications, ultra-early hemostatic medications, hy-pothermia and neuroprotective agents from modern medicine treatment on acute intracerebral hemorrhage. The article also introduced the current large-scale TCM clinical trials for acute intracerebral hemorrhage treatment and some systematic reviews on medications in order to provide theoretical evidences for the clinical treatment of acute intrac-erebral hemorrhage.
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BACKGROUND: There is no any mature and complete system to repair nerve tissue after segmental injury due to particularity of nerve tissue regeneration. Using tissue-engineering technique to solve this problem is difficult and challenged.OBJECTIVE: To research an artificial nerve bridging substance in application of repairing nerve injury on clinic and obverse its microcosmic spatial structure at the same time.DESIGN: Open experiment.SETTING: Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERTALS: The experiment was carried out in the Orthopaedic Research Institute, Xijing Hospital of the Fourth Military Medical University of Chinese PLA from November 2001 to January 2003. CollagenⅠ, collagen Ⅳ and gelatin were provided by Sigma-aldrich Company, USA.METHODS: Establishment of bridging substance: Collagen Ⅰ (65.53%) and collagen Ⅳ (32.77%) were added into 0.05 mol/L acetic acid solution, respectively; and then, two suspensions were mixed together and stirred at 4℃. The suspension of collagen and heparin sulfate was pumped, held still and poured into silica gel tube with bore of 3 mm.Continuously, two ends of tube were enclosed and suffered from cold drench and mold at five various speeds. General observation was done. Composites were intercepted cross section, vertical section and 45° section for observation by optic microscope at different speeds of 10×10-5 m/s, 5×10-5 m/s, 2.5×10-5 m/s, 1.0×10-5 m/s and 1.0×10-6 m/s; meanwhile, interior structure of microtubule was observed with scanning electron microscope. Interior diameter of microtubule was calculated as the following formula: actual aperture = (magnification × area of microtubule) ÷ (length of guage × perimeter of aperture).MAIN OUTCOME MEASURES: ① General observation; ② observation with microscope; ③ observation with scanning electron microscope and interior diameter of microtubule.RESULTS: ① General observation: Models were regular cylinders and had symmetrical features. Flexility was wonderful,texture was well-proportioned, and elasticity was strong. ② Results of optic microscope: Structure of external surface was completely blocking without any poricidal dehiscence. Surface was smooth and had good continuity. ③ Results of electron microscope: External surface shaped like terrace tile; asides, interior structure of microtubule was average and its courser was coincident and parallel to each other. Microtubules with longitudinal courser were independence on each other. The structure was blocking and did not connect to each other. This was as the same as courser of nerve fibrous bands of organis. Cross section of interior microtubule was general round and regular, and the diameter was average. Interior microtubule had groat continuity without breaks or transection. Trabeculae of microtubule also had groat continuity,and its surface was smooth. Interior diameter of microtubule ranged from 197.3 μm to 258.8 μm.CONCLUSION: Nerve bridging substance is made of collagen and gelatin which are characterized by groat compatibility and degradation after mixture, lysis and cold drench, It has singly longitudinal microtubule and microstructure of high imitation by normal nerves, so nerve bridging substance can be used in basic researches and repair nerve injury on clinic.
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BACKGROUND: For xenogeneic bone transplantation, immune rejection is the major problem that affects the prognosis. However, the understanding about the expression and regulation of the immune factors in heterogenic bone transplantation is limited. Interleukin-1 (IL-1), interleukin-6 (IL-6)and tumor necrosis factor alpha (TNF-α) are important immune factors, and are closely related with post-transplantation rejection.OBJECTIVE: To observe the regional expressions of mRNA and protein of IL-1α, IL-6 and TNF-α in xenogeneic bone transplantation, and to in vestigate the effect of transforming growth factor (TGF)-β on these immune factors.DESIGN: A randomized controlled experiment. SETTING: The Orthopaedic Institute of Xijing Hospital of the Fourth Military Medical University of Chinese PLA MATERIALS: Totally 72 male Balb/c mice, with a body mass of 20 to 25 g, were randomly divided into 3 groups: combined bovine cancellous bone (bCB) granule group (Group A), simple bCB granule group (Group B) and blank control group (Group C) with 24 mice in each group.INTERVENTIONS: This experiment was conducted at the Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical Univessity of Chinese PLA from June 2003 to June 2004. In Group A, one bCB combined TGF-β was implanted into the muscles of left thigh of each mouse. In Group B, one bCB alone was implanted, and in Group C, no bCB was implanted. The number of proliferation of cells in bone implantation area or adjacent tissues of the operated area was observed at postoperative 4, 7, 14 and 21 days; and the regional expressions of several immune factors in im plants were detected with in situ hybridization and immunocytochemistry methods.MAIN OUTCOME MEASURES: Histological observation and detection of regional cellular density of the implants of the mice in each group; the regional expressions of mRNA and protein of IL-1α,IL-6 and TNF-α in the implants RESULTS: ①) Histological observation and detection of regional cellular density of the implants of the mice in each group: on day 7, the cellular density of the proliferated tissues was significantly higher in the Group A than in the Group B [(470.63±132.89), (311.46±93.69)/field,P ＜ 0.01];But on days 14 and 21, there was no significant difference. ②The regional expressions of mRNA and protein of IL-lα, IL-6 and TNF-α of the im plants of the mice in each group. On days 7 and 14 after xenografts were implanted, the regional expressions of IL-1α, IL-6 was respectively lower the xenografts combined with TGF-βthan in the simple xenogeneic bone (day 7: IL-1α 42.55±9.65 vs 67.95±17.82,IL-6 48.26±11.17 vs 77.21±15,16;day 14: IL-1α mRNA 84.77 ±7.42 vs 112.94±7.02,78.1 ±17.22 vs 121.18±15.44,P ＜ 0.01) ,but for the TNF-α, there was no significant difference (P ＞ 0.05).CONCLUSION: In the region of bone xenograft, a variety of cells express mRNAs and proteins of IL-1α, IL-6 and TNF-α, and their expressions are regulated by TGF-β. It may imply a kind of regulation of the immunity of bone xenograft by TGF-β.
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Objective To investigate the mechanisms of oridonin inducing apoptosis on acute leukeamia NB4 cells and its mechanism. Methods NB4 cells in culture medium in vitro were given with different concentrations (8, 16, 24, and 32 μmol/L) of oridonin. The inhibitory rate of the cells was measured by MTT assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of apoptosis was observed by Hoechst 33258 fluorescence staining, DNA fragmentation was assayed by agarose gel electrophoresis, caspase-3 expression was detected by Western blotting, and caspase-3 activity was assayed with colorimetric assay kit before and after apoptosis occurred. Results Oridonin (over 16 μmol/L) could inhibit the growth of NB4 cells and cause apoptosis significantly, the suppression was both in a timeand dose-dependent manner. Marked changes of apoptosis including condensation of chromatin and nuclear fragmentation were observed very clearly by Hoechst 33258 fluorescence staining and a characteristic "ladder" of DNA fragments was elicited by agarose gel electrophoresis; Western blot analysis revealed that caspase-3 was activated by the loss of caspase-3 proenzyme (32 kDa) and the appearance of its 20 kDa subunit, and that along with the apoptotic process caspase-3 activity was increased concurrently. Conclusion Oridonin can induce apoptosis in NB4 cells via activation of caspase-3. These results will provide laboratory evidence for the clinical treatment of acute leukemia with oridonin.
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Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.
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Objective To summarize complications of knee arthroscopic surgery and the prevention and treatment for the complications. Methods A review of 679 knee arthroscopic operations in 658 patients from March 1997 to March 2002 was carried out. Results The incidence of all complications was 6.8% (46 of 679). Incidences of hemarthrosis, superficial infection, fibroarthrosis, tourniquet paresis, instrument breakage and accidental damage were 2.7% (8 of 679), 0.4%(3 of 679), 1.5%(10 of 679), 0.6%(4 of 679), 1.2% (8 of 679) and 0.4% (3 of 679), respectively. No popliteal vessel injury, intra-articular infection, neurological injury, deep venous thrombosis or compartment syndrome occurred in this group. Conclusions The incidence of complications of knee arthroscopy is relatively low. Most of them are mild and curable, if prompt treatment is given.
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Objective To investigate the therapeutic effect of anti-infecti ve reconstituted bone xenograft(ARBX)on osteomyelitis. Methods A proximal tibia os teomyelitis rabbit model was used. Twenty animals were randomly assigned to 4 gr oups and all of them were injected with staphylococcus aureus through a bone win dow. Two weeks postoperatively the animals underwent clearance of the focal lesi on, followed by implant of 3 pellets of ARBX containing 30 mg of gentamicin in g roup Ⅰ, 3 pellets of reconstituted bone xenograft (RBX) in conjunction with 30 mg of intramuscular gentamicin for 5 days in group Ⅱ, 3 pellets of RBX without antibiotic in group Ⅲ, and those in group Ⅳ were left without bone grafting. S pecimens were harvested 8 weeks after the above procedures and were then subject ed to gross observation, radiological, histological and bacteriological examinat ions to compare their therapeutic effect on osteomyelitis. Results 1) In group Ⅰ the bacteria counting and modified Norden scoring were by far the smallest am ong all 4 groups (P
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Objective To evaluate the effects of various resection and reconstruction method on pain relief and function restoration for periacetabular metastatic destruction in different grade. Methods This study involved 20 patients, 11 males and 9 females, with the average age of 52 years(range, 43-82 years). The original tumor consisted of 5 renal cell carcinoma, 4 breast carcinoma, 3 lung carcinoma, 2 thyroid carcinoma, 1 prostate carcinoma, 1 rectum carcinoma and 4 unknown primary cancers. A solitary periacetabular metastatic lesion was demonstrated in 14 patients and multi-metastases were seen in 6 patients, and accompanying periacetabular pathologic fractures in 4 patients. As to the Harrington grading system for the periacetabular metastatic destruction, there were 8 grade Ⅰ, 5 grade Ⅱ, and 7 grade Ⅲ. And according to grade Ⅰ, curettage and cement packing (5 cases) as well as stability reconstruction in iliac and acetabulum (3 cases) were performed; grade Ⅱ, curettage, cement packing and total hip arthroplasty with reinforcement ring was performed; grade Ⅲ, en bolc resection of acetabular lesion and modular prosthesis reconstruction was performed. The average score was 5.4(ranged from 3 to 9) according to Tomita scoring system. The pain relief and functional recovery were investigated from the regular follow up postoperatively. Results All patients showed the improvement in pain relief and mobility postoperatively. No prosthetic dislocation, deep infection and leg length discrepancy occurred. The prosthesis or internal fixation loosening happened in 5 of 15 patients at different stage. The median survival time of all patients was 16.5 months (range from 4.2 to 63 months). 2 patients survived over 5 years, 3 over 2 years, 6 over 1 year, 6 over 6 months, and 3 less than 6 months. According to the Enneking functional scoring system, the patients were rated as excellent in 10 cases, good in 8, fair 1 and poor 1 at the 3rd month postoperatively, and for the 7 cases with grade Ⅲ, excellent 2, good 2, and poor 2. The functions of 11 patients survived one year after surgery were excellent in 3, good 4, fair 2 and poor 2. Conclusion The favorable resections and reconstructions for periacetabular metastatic destruction could lead to remarked improvement in pain relief, functional recovery and quality of life.
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Objective To test the strength of different suture fixation of tendon or ligament end and evaluate appropriate stitches number in cruciate ligament reconstruction. Methods Twenty-four specimens of patellar tendon with free ends, which was, divided into 3 groups according 2 or 3 stitches and 6 subgroups using different suture materials, either with No1 Ethilon or 0.4 mm diameter stainless steel wire, fixed with Krackow locking stitch, the tensile test were undertaken respectively, so as to find out the least stitches and efficient suture pattern. Results Two Krackow locking stitches had more strength than that of 0.4 mm diameter stainless steel wire itself, the fixation strength of 2 stitches which used No1 Ethilon was more than 80 N, superior to the failure strength of material itself, it still maintained the same strength if the first stitch was across the tendon tissue transversely. On the basis of testing results, this modified stitches pattern was used in 17 cases, all could be well withstand an accelerated postoperative ROM rehabilitation program in clinical practice. Conclusion There is no significant difference between 2 and 3 Krackow locking stitches in suture strength statistically, the fixation strength is superior to the suture material, it can lessen the suture exposure when the first stitch is across the tendon tissue while maintains a comparable strength to other suture. If attempt to make a higher strength of suture, one should focus on selecting a stronger materials or adding the suture materials in number, therefore, a rapid early ROM rehabilitation is possible and reliable in practice.
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0.05). However, there was significant difference between the "open-window" or hemilaminectomy group and total laminectomy group. The time of returning to work and the rate of returning to previous work were 4.3 months and 84.6% in "open-window" group, 4.6 months and 86.4% in hemilaminectomy group and 4.4 months and 77.8% in total laminectomy group respectively. The height loss of involved disc spaces was discovered in the postoperative radiographs in all the patients. However, no segmental instability was found in the majority of these patients. Conclusion 1) "Open-window" or hemilaminectomy may achieve satisfactory long-term results for treatment of lumbar disc herniation. 2) No definite correlation exists between the height loss of involved disc space and segmental instability or nerve root entrapment. 3) Discectomy is still a reliable and effective surgical procedure for the treatment of lumbar disc herniation before the reliability of any disc replacement is confirmed in the long-term follow-up survey.
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Objective To investigate the influence of knee joint instability induced by the rupture of anterior cruciate ligament (ACL) on the meniscus and cartilage. Methods Forty-eight consecutive patients with rupture of ACL from 1998 to 2002 were retrospectively studied upon the relationship of distribution, severity and incidence of meniscal tears and cartilage injuries with different period of time post injury. Results The incidence of meniscal injury was increased from six cases (55%, 6/11) in acute period, 13 (68%, 13/19) in subchronic period to 17 (94%, 17/18) in chronic period with a significant difference (P