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OBJECTIVE@#To compare the effectiveness of supramalleolar osteotomy (SMOT) and ankle arthrodesis (AA) in the treatment of inverted ankle osteoarthritis (OA) in Takakura 3A stage with talus tilt.@*METHODS@#The clinical data of 41 patients with inverted ankle OA in Takakura 3A stage with talus tilt admitted between January 2016 to January 2020 and met the selection criteria were retrospectively analyzed, and they were divided into SMOT group (21 cases) and AA group (20 cases) according to the surgical method. There was no significant difference in baseline data such as gender, age, affected side, cause of injury, and preoperative talar tilt angle (TT), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, short-form 36 health survey scale (SF-36) score, and sagittal range of motion (ROM) between the two groups ( P>0.05). The operation time, intraoperative blood loss, partial weight-bearing time, and complications were recorded in the two groups. AOFAS ankle-hindfoot score, VAS score, SF-36 score, and sagittal ROM were used to evaluate the effectiveness. Bone healing was observed and the time of bony healing was recorded. In the SMOT group, the tibial lateral surface angle (TLS), TT, and the tibial articular surface angle (TAS) were measured on ankle joint weight-bearing anteroposterior and lateral X-ray films and compared with those before operation. And Takakura staging assessment was also performed.@*RESULTS@#The operation time and intraoperative blood loss in AA group were significantly less than those in SMOT group ( P<0.05). Patients in both groups were followed up 24-36 months, with an average of 28.9 months. Incision infection occurred in 2 patients in SMOT group and 1 patient in AA group, respectively, and no vascular or nerve injury occurred in both groups. The partial weight-bearing time of SMOT group was significantly less than that of AA group ( P<0.05), but there was no significant difference in bony healing time between the two groups ( P>0.05). At last follow-up, the difference of VAS score and SF-36 score before and after operation of AA group were less than those of SMOT group, and the difference of sagittal ROM before and after operation in SMOT group was less than that of AA group, with significant differences ( P<0.05). The difference of AOFAS ankle-hindfoot score before and after operation in AA group was slightly greater than that in SMOT group, but the difference was not significant ( P>0.05). The above scores in both groups significantly improved when compared with those before operation ( P<0.05). Sagittal ROM in AA group was significantly less than that before operation ( P<0.05), while there was no significant difference in SMOT group ( P>0.05). In the SMOT group, 17 patients (81.0%) showed improvement in imaging staging, 2 patients (9.5%) showed no improvement in staging, and 2 patients (9.5%) showed stage aggravation. TLS, TAS, and TT significantly improved when compared with those before operation ( P<0.05). At last follow-up, 2 patients in SMOT group received AA due to pain and stage aggravation, and 1 patient with bone nonunion underwent bone graft. Subtalar joint fusion was performed in 1 case of subtalar arthritis in AA group.@*CONCLUSION@#For inverted ankle OA in Takakura 3A stage with talus tilt, both SMOT and AA can significantly releave pain, improve foot function and quality of life, but AA has more definite effectiveness and better patient satisfaction.
Subject(s)
Humans , Ankle , Talus/surgery , Retrospective Studies , Blood Loss, Surgical , Quality of Life , Ankle Joint/surgery , Osteoarthritis/surgery , Osteotomy/methods , Arthrodesis , Pain , Treatment OutcomeABSTRACT
Objective:To investigate the mechanism of levosimendan on acute kidney injury after cardiopulmonary resuscitation (CPR) in rats.Methods:Twenty-five healthy adult male SD rats were randomly divided into three groups: control group ( n=5), levosimendan group ( n=10) and experimental group ( n=10). A cardiac arrest-cardiopulmonary resuscitation model was established using smothering method in the experimental group and levosimendan group. The levosimendan group was treated with levosimandan during and after resuscitation, while the experimental group was given equivalent volume of saline solution during and after resuscitation, and the control group was only given equivalent volume of saline without performance of CPR. The rats in the three groups were sacrificed at 6 h after resuscitation. The serum and kidney tissue samples were collected. Serum biochemical indicators [serum creatinine (Scr), blood urea nitrogen (Bun), interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)] were measured. HE staining and Paller score were used to identify the degree of kidney damage. Apoptosis was estimated by TUNEL staining. Western blot was used to detect the expression levels of phosphorylation of extracellular regulated protein kinases (p-ERK). One-way analysis of variance was used to compare the mean values of normally distributed measurement data between groups. Comparisons between groups were performed using the least significant difference t-test. Results:Scr (85.02±1.31) μmol/L, Bun (7.36±0.13) mmol/L, Paller score (7.3±0.2), IL-1β (302.20±17.35) pg/mL, IL-6 (564.60±23.24) pg/mL and TNF-α (1346±83.73) pg/mL in the experimental group were significantly higher than those of the control group [(15.94±0.96) μmol/L, (2.95±0.18) mmol/L, (0.7±0.2), (7.27±0.44) pg/mL, (51.30±2.87) pg/mL, and (10.39±0.52) pg/mL] (all P<0.01). Compared with the experimental group, Scr (63.88±2.01) μmol/L, Bun (5.45±0.47) mmol/L, paller score (4.8±0.2), IL-1β (78.61±3.66) pg/mL, IL-6 (297.90±13.64) pg/mL and TNF-α (276.2±20.18) pg/mL were significantly decreased in the levosimendan group (all P<0.01). TUNEL staining showed that levosimendan could improve the apoptosis of renal cells ( P<0.01). The expression of p-ERK protein in the levosimendan group was significantly higher than that in the experimental group ( P<0.01). Conclusions:Lovosimendan could attenuate acute kidney injury following cardiac arrest and cardiopulmonary resuscitation via suppression apoptosis. The mechanism of levosimendan protective effect might be associated with activation of ERK signaling pathway.
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Exosomes are nanovesicles actively secreted by cells, which selectively encapsulate biologically active molecules such as proteins, RNA, and cytokines. They play an important role in intercellular communication, immune regulation, and maintenance of homeostasis, which can also be used as carriers for targeted drug delivery. Retinal ischemia-reperfusion injury (RIRI) is a retinopathy that seriously threatens human vision. At present, the clinical treatment of these diseases are symptomatic treatments, and some patients have poor efficacy or even blindness. As extracellular vesicles rich in functional proteins and RNAs, exosomes can not only be used as drugs for the treatment of RIRI, but also be used as carriers for drug delivery to play synergistic therapeutic effects. In the future, with the deepening of the research on the molecular structure, contents and biological functions of exosomes, as well as the continuous development of ophthalmic biology and genetic engineering technology, exosomes are expected to exert their great potential as therapeutic drugs and carriers, and become an important means of treating RIRI.
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BACKGROUND: The common straight plate can affect the biomechanical conduction of fracture ends, and the combined variable stress plate can retain the continuous biomechanical stimulation of the fracture end, affect the changes of bone tissue cell function and bone mineral density, and promote fracture healing. OBJECTIVE: To investigate the effects of internal fixation with two kinds of plates on bone tissue cell function and bone mineral density in experimental goat femoral fracture healing. METHODS: Thirty healthy adult goats were raised in normal environment, and used to successfully construct the models of right lower limb femur fracture. The models were randomly divided into the experimental group (given the combined variable stress plate fixation) and the control group (given the common straight steel plate fixation) (n=15 per group). Serum levels of bone specific alkaline phosphatase, osteocalcin and tartrate resistant acid phosphatase activity were determined at 4, 8, and 12 weeks after surgery in both groups. The goats were sacrificed in batches, and the femoral stump tissue was taken for bone mineral density and histopathological observation. RESULTS AND CONCLUSION: (1) At 4 and 8 weeks, the serum bone specific alkaline phosphatase in the experimental group increased faster than that in the control group, but it was significantly lower than that in the control group at 12 weeks (P < 0.05). (2) At 4 weeks after surgery, the serum osteocalcin of the experimental group was higher than that of the control group, but lower than that of the control group at 12 weeks (P < 0.05). (3) At 4 and 8 weeks after operation, the serum tartrate resistant acid phosphatase activity of the experimental group was significantly higher than that of the control group, but lower than that of the control group at 12 weeks (P < 0.05). (4) At 8 and 12 weeks after operation, the bone mineral density of the fracture end in the experimental group was significantly higher than that of the control group (P < 0.05), while the bone mineral density of the experimental group and the control group increased gradually at 4, 8 and 12 weeks (P < 0.05). (5) At 4 and 8 weeks, the number of osteoblasts of the experimental group was significantly higher than that of the control group. At 8 weeks, the number of osteoclasts of the experimental group was significantly higher than that of the control group. At 12 weeks, the number of osteoblasts and osteoclasts of the experimental group was significantly lower than that of the control group (P < 0.05). (6) Combined variable stress plate fixation can produce continuous compressive stress at the fracture end of goat femur, stimulate the change of the number of bone tissue cells, lead to the secretion of corresponding bone tissue cell functional protein, promote the formation of callus, accelerate the reconstruction of callus, and promote the fracture healing.
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Background: Gastric cancer is one of the most commonly seen malignant tumors. Inhibiting the proliferation of gastric cancer cells is the key for the development of anticancer drugs. Aims: To investigate the effect of swertiamarin on proliferation of MGC803 cells in vitro and in vivo. Methods: MGC803 cells were cultured with different concentrations of swertiamarin (0, 30, 60 and 90 μg/mL) for 48 hours. The cell activity were detected by MTT. The apoptosis rate was measured by Annexin V-FITC/PI assay. The contents of Bax and Bcl-2 were detected by ELISA. MGC803 cell xenograft tumor in BALB/c nude mice was established, and different concentrations of swertiamarin (0, 40, 60 and 80 mg/kg) were injected through caudal vein. Nude mice were killed when the volume of tumor was 1 000 mm3. The initial and final body weights of nude mice were recorded. The protein expression of Ki-67 was detected by immunohistochemistry. Results: Compared with control group, different concentrations of swertiamarin effectively inhibited the proliferation of MGC803 cells, induced cell apoptosis, increased the content of Bax, while the content of Bcl-2 was significantly decreased (P<0.05). In BALB/c nude mice with MGC803 cell xenograft tumor, the volume of tumor, protein expression of Ki-67 decreased significantly in groups injected with different concentrations of swertiamarin than in control group (P<0.05). Conclusions: Swertiamarin is a safe and effective anti-gastric tumor plant agent.
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Objective To investigate the clinical significance of cell function changes of bone tissue in glucocorticoid-induced avascular necrosis of femoral head(GANFH),and the preventive and therapeutic effects of "Cugusugao" ointment,a mixture of traditional Chinese medicines,on GANFH.Methods Sixty-four New Zealand white rabbits were randomly divided into four groups(16 each): control group,model group,therapy group and prevention group.The contents of bone-specific alkaline phosphatase(BSAP) and bone gla protein(BGP),and the activity of tartrate-resistant acid phosphatase(TRAP) in serum were determined at the 0,2nd,4th,6th,8th and 12th week after treatment.Meanwhile,rabbits were sacrificed at the 4th,6th,8th and 12th week,and bilateral femoral heads were obtained for histopathological examination.Results Compared with control group,the contents of serum BSAP were elevated at the 4th and 6th week,while TRAP elevated from the 2nd week and BGP lowered from the 4th week in model group(P
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Objective To investigate the significance of bone mineral changes in the pathogenic process of glucocorticoid-induced avascular necrosis of femoral head(GANFH).Methods Thirty-two New Zealand rabbits were randomly divided into two groups(16 each).Animals in model group received an intramuscular injection of hydrocortisone acetate(8.0mg/kg) twice a week for 8 weeks totally,and animals in control group received an intramuscular injection with the same volume of normal saline,while 150kU penicillin were injected twice a week for preventing infection in both groups.The contents of serum calcium(Ca) and phosphorus(P) were determined,and the bone mineral densities of the femoral head and neck were measured at the 2nd,4th,6th,8th and 12th weeks after treatment.Meanwhile,the general condition such as weight,spirit and hair of rabbits was observed.Results Compared with the control group,the weight of rabbits in model group lost since the first week,and progressively aggravated;the bone mineral density of the femoral head and neck lowered since the 2nd and 4th week respectively(P
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Objective Randomly sampling survey was performed among the troops stationed in the monitoring sites during the period of 2006-2007 for understanding and analyzing the incidence,distribution and the epidemiological features of military training related injuries(MTRI).Methods Troops stationed in 9 monitoring sites were randomly selected for the survey,and soldiers participated in military training during the period of 2006-2007 served as the objects.The data concerning the military training injuries were collected and analyzed according to the "Diagnostic Criteria and Treatment Principle on Military Training Related Injury".Results 6262 out of 71836 soldiers who participated in assorted military training during the period of 2006-2007 suffered from military training related injuries.Among them 2455 out of 35582 soldiers who participated in military training in 2006 suffered the injuries,with an incidence of 6.9%;while 3807 out of 36254 soldiers who participated in military training in 2007 suffered the injuries,with an incidence of 10.5%.A significant difference existed in the incidence of military training related injuries between the years of 2006 and 2007(P