ABSTRACT
Objective:To investigate the efficacy of single locked-plate internal fixation combined with autologous iliac bone graft in the treatment of Rorabeck type II periprosthetic distal femural fracture (PDFF) after total knee arthroplasty (TKA).Methods:A retrospective case series study was made on 13 patients suffering from Rorabeck type II PDFF after primary TKA together with severe osteoporosis (T value≤ -2.5 SD) admitted to 940th Hospital of Joint Logistics Support Force of PLA from January 2016 to December 2020, including 4 males and 9 females, aged 65-85 years [(75.2±6.5)years]. All patients were treated with single locked-plate internal fixation combined with autologous iliac bone graft. Anti-osteoporosis and early standardized joint function rehabilitation were undertaken postoperatively. The operation time and intraoperative blood loss were recorded. The range of motion of knee joint was compared before operation, at postoperative 3, 6 and 12 months and at the last follow-up. The Hospital for Special Surgery (HSS) knee score was assessed at postoperative 3, 6 and 12 months and at the last follow-up to evaluate the recovery of knee joint function. The bone mineral density was reexamined at postoperative 6 months and 12 months to evaluate the therapeutic effect of anti-osteoporosis. Complications were detected as well.Results:All patients were followed up for 12-72 months [(43.2±19.9)months]. The operation time was 90-135 minutes [(103.8±12.6)minutes], with the intraoperative blood loss of 100-250 ml [(150.0±45.6)ml]. The range of motion of knee joint was (114.6±7.8)°, (90.4±8.0)°, (97.3±4.8)° and (98.1±6.3)° before operation and at postoperative 3, 6 and 12 months (all P<0.05). The HSS knee score was (80.2±2.2)points, (84.6±2.9)points and (87.3±3.3)points at postoperative 3, 6 and 12 months (all P<0.05). The knee joint function was excellent in 10 patients and good in 3 at postoperative12 months, and the excellent and good rate was 100%. The T value of bone mineral density was (-3.8±0.6)SD, (-3.4±0.6)SD and (-2.9±0.6)SD preoperatively and at postoperative 6 months and 12 months (all P<0.05). One patient experienced nonunion and was cured after secondary autologous iliac bone grafting combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) bone grafting. Three patients developed venous thrombosis of lower limbs and were cured with oral administration of rivaroxaban. One patient had mild knee flexion and extension limitation and was improved after manual release under femoral nerve block anesthesia and subsequent functional rehabilitation. Conclusion:For patients with Rorabeck type II PDFF after TKA, single locked-plate internal fixation combined with autologous iliac bone graft has advantages of short operation time, few intraoperative bleeding, satisfactory knee range of motion and functional recovery as well as significant improvement of bone mineral density.
ABSTRACT
We investigated the third-generation cephalosporins-resistant Shigella and its genotype in Ningbo,China,providing a basis for disease prevention and control.Pathogenic bacteria were analyzed by direct isolation combined with enrichment culture isolation.Antimicrobial susceptibility was determined by K-B disk diffusion method and PCR was used for detecting multidrug resistance genes like CTX-M,OXA,TEM and SHV.BLAST analysis was used to determine the genotype.Results showed that 69 strains of third-generation cephalosporins-resistant Shigella were detected by drug sensitivity screening,accounting for 74.19％ of ESBLs Shigella.Drug resistance gene CTX-M(CTM-M-1 and CTM-M-9),OXA and TEM were detected.The detection rate were 79.71％,79.01％ and 26.09％ respectively.With no CTX-M-2 and SHV,DNA sequence alignment showed CTX-M-1 group were mainly of CTX-M-15 type besides seven other types;CTX-M-9 group were mainly of CTX-M-14 type besides six other types;49 strains of OXA and 18 strains of TEM were sequenced to be type 1 (OXA-1 and TEM-1 type).The 21 Shigella strains carrying more than two drug resistance genes accounts for 30.43 ％.Shigella in Ningbo has high third-generation cephalosporins-resistance rate and many kinds of ESBLs enzymes were detected.The mainstream enzyme type was CTX-M,meanwhile they also carried a variety of drug resistance genes,which could bring difficulties to disease prevention and control.The high carrying rate of OXA-1 type suggests that we should pay more attention.The detection rate of group B was higher than that of group D,including not only the phenotype resistance but also the drug-resistance genes;these findings will be useful in the study of the drug resistance prevalence of Shigella.
ABSTRACT
Objective To measure the transcription level of thermostable direct hemolysin gene (TDH)in 24 strains of Vibrio parahaemolyticus.Methods Total RNA was extracted from strains of Vibrio parahaemolyticus which were isolated from patients,seafood and environment.The RNA was proved TDH positive with routine PCR method;then the real -time fluorescent quantitative PCR was carried out to obtain the cycle of threshold (Ct)of THD and internal standard of 16s rRNA.Transcription level of THD compared with 16s rRNA was designated as ΔCt which was calculated as Ct value of THD minus Ct value of 16s rRNA.Results Ct values of THD,16s rRNA and the difference between them of the 24 strains was 18.04 ~25.95,8.30 ~10.93 and 8.28 ~15.34 respectively.The difference between the maximum and the minimum of ΔCt was 7.06;the highest transcription level was 133 (ΔΔCt =27.06 )times of the lowest one.Conclusion A great difference of transcription level of THD in Vibrio parahaemolyticus has been proved and further study is needed to clarify the possible molecular mechanisms and relationship between the transcription level of THD and pathogenic mechanism.
ABSTRACT
BACKGROUND:Studies have shown that theβ-tricalcium phosphate can be combined with other macromolecular compounds to improve the mechanical strength and histocompatibility, meeting the requirements of clinical application. ＜br> OBJECTIVE:To evaluate the selection and preparation methods of composite scaffold in bone tissue engineering, and to describe the problems we are facing. ＜br> METHODS:The first author retrieved PubMed, Google Scholar, CNKI, Wanfang, and VIP databases by computer using the keywords of“β-tricalcium phosphate,β-TCP, PLGA, PLA, scaffold, prepare”in English and Chinese, respectively. ＜br> RESULTS AND CONCLUSION:β-tricalcium phosphate combined with polylactic acid-glycolic acid/polylactic acid as bone tissue engineering scaffolds has achieved a great progress. At present, the organic polymer composite scaffolds can be prepared by microsphere sintering, fiber bonding, solvent casting/particulate leaching, emulsification/freeze drying technology, gas foaming method, phase separation technology, rapid prototyping technology and electrostatic spinning method.β-tricalcium phosphate composite scaffolds with polylactic acid-glycolic acid/polylactic acid can be customizable so as to meet different requirements for bone tissue engineering, which can improve the porosity, mechanical properties and biodegradation by improving fabrication techniques and processings, ratio of raw materials and fil er proportion.