A comparative study of technique of humeral ending insertion of rotator cuff under arthroscopy and traditional techniques in the treatment of giant rotator cuff tear / 中国骨伤

OBJECTIVE@#To explore the feasibility of arthroscopic humeral ending insertion of rotator cuff, and to provide a scheme for the treatment of giant rotator cuff tears.@*METHODS@#From February 2014 to April 2018, 40 patients with giant rotator cuff tears were operated on and divided into two groups. The study group consisted of 20 patients, including 8 males and 12 females, aged 42 to 82(57.55±8.90) years, with a course of 1 h to 2 years;the treatment of giant rotator cuff tears was carried out by using the technique of rotator cuff moving inward at the humeral head stop and reconstructing complete rotator cuff. The control group consisted of 20 patients, including 10 males and 10 females, aged 45 to 75 (57.75±9.10) years, with a course of 1 h to 5 years;after traditional cleaning, part of the rotator cuff was sutured or in situ high tension suture was used to treat the huge rotator cuff tear. The clinical effect of the two groups was evaluated by VAS, constant and UCLA.@*RESULTS@#All patients were followed up for 12 to 14 months. The VAS, Constant score, UCLA score before operation of two groups were significantly improved compared with those before operation (<0.05);the VAS, Constant score, UCLA score and excellent effect of the study group were significantly better than those of the control group (<0.05).@*CONCLUSION@#Arthroscopic transposition of rotator cuff and humerus ending insertion is a feasible method for the treatment of giant rotator cuff tears, which relieves shoulder pain and improves function satisfactorily.

A comparative study of complete ablation rate of ifbroid with different grade of blood supply using radio frequency and high-intensity focused ultrasound / 中华医学超声杂志（电子版）

Objective To compare the complete ablation rate of radiofrequency (RF) ablation and high-intensity focused ultrasound (HIFU) in the treatment of uterine ifbroids with different blood supply. Methods One hundred and ten patients with 146 uterine ifbroids in Xijing Hospital of the Fourth Military Medical University from January 2009 to December were randomly divided into two groups and treated with HIFU or RF respectively. Each group had 55 patients. All patients were examined by color Doppler lfow imaging before the treatment. The blood supply of ifbroids were semi-quantitatively classiifed into three grades including G1, G2 and G3. The HIFU group had 15 patients with 20 ifbroids in which blood supply was G1, had 32 patients with 38 ifbroids in which blood supply was G2, and had 8 patients with 10 ifbroids in which blood supply was G3. The RF group had 14 patients with 18 ifbroids in which blood supply was G1, had 31 patients with 42 ifbroids in which blood supply was G2, and had 10 patients with 18 ifbroids in which blood supply was G3. The complete ablation rates of the two treatments were evaluated by contrast-enhanced ultrasound one week before and after treatments. Fibroids which had no contrast agent perfusion and smooth boundary were completely ablated. Statistical analyses were used to compare the complete ablation rates and postoperative complications rates of these two methods. Results When ifbroid′s blood supply was G1, the complete ablation rate was 80.0%(16/20) and 88.9%(16/18) in HIFU and RF group, respectively. The difference was not statistically signiifcant (χ2=0.563, P>0.05). When ifbroid′s blood supply was G2 and G3, the complete ablation rate in HIFU and RF group was 90.5%(38/42) vs 55.3%(21/38) and 72.2% (13/18) vs 20.0% (2/10), respectively. There was statistically difference between these two groups (χ2 =12.778, P < 0.05;χ2=7.049, P < 0.05, respectively). Postoperative complications included fever, abdominal pain, pelvic effusion and vaginal discharge and unilateral lower limb numbness. The incidence of complications was lower in HIFU group than that in RF group, which was 9.1%(5/55) and 27.3%(15/55) respectively, This difference was statistically signiifcant (χ2=6.111, P<0.05). Conclusions HIFU and RF are both effective in treating uterine ifbroids with few blood supply. However, RF can be more effective than HIFU in treating hypervascular ifbroids. Therefore, RF might be able to apply to majority of the ifbroids. As a non-invasive therapy, HIFU is more suitable for hypovascular ifbroids and could be the ifrst therapy in clinic.

Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography.

Inhibitory effects of rosiglitazone against endothelin-1-induced proliferation of rat cardiac myocytes: the role of PKC-c-fos pathway / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the mechanism of rosiglitazone (RSG, the activator of peroxisome proliferators activated receptor lambda) for inhibiting endothelin-1 (ET-1)-induced neonatal rat cardiac myocyte hypertrophy and the role of protein kinase C (PKC) and c-fos.</p><p><b>METHODS</b>In vitro cultured neonatal rat cardiac myocytes were treated with ET-1, phorbol ester (PMA, the PKC activator), ET-1+RSG, ET-1+chelerythrine (che, the PKC inhibitor), PMA+RSG, or without treatment (control), respectively. The effects of RSG on the protein content, (3)H-leucine incorporation, PKC activity and C-fos protein expression were observed in the cardiac myocytes stimulated with ET-1 or PMA.</p><p><b>RESULTS</b>After two days of culture, the intracellular protein content in ET-1 group and PMA group were increased by 15% (339-/+15 microg/ml) and 13% (329-/+14 microg/ml) as compared with the control cells (290-/+13 microg/ml), respectively (P<0.01). Compared with the ET-1 group, cells treated with ET-1+10(-8) mol/L RSG, ET-1+10(-7) mol/L RSG, and ET-1+che showed decreased intracellular protein content by 10% (303-/+14 microg/ml, P<0.05), 12% (292-/+11 microg/ml, P<0.05), and 13% (291-/+12 microg/ml, P<0.01), respectively. The intracellular protein content in PMA+10(-7) mol/LRSG group was decreased by 10% (P<0.05) in comparison with the PMA group. RSG inhibited protein synthesis enhancement and increased (3)H-leucine incorporation induced by ET-1 and PMA, and antagonized the effects of ET-1 and PMA in promoting PKC activity and c-fos protein expression in the myocytes.</p><p><b>CONCLUSION</b>The inhibitory effect of RSG on ET-1- or PMA-induced myocyte hypertrophy is associated with PKC-c-fos pathway.</p>

Treating later facial nerve palsy with the method of combining free graft of de-nerve short extensor muscle of toe with the technique of inducted undermined suture / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore a more effective operative method for later facial nerve palsy.</p><p><b>METHODS</b>A synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was used in 432 cases of later facial nerve palsy.</p><p><b>RESULTS</b>82% of 432 cases acquired satisfactory effect that consisted of static symmetry and dynamic rough symmetry in facial expression. 12% cases only acquired static symmetry in facial expression but the dynamic symmetry were insufficient. Unsatisfactory results were occurred in 6% cases as both the static and dynamic symmetry of their facial expression were insufficient, which acquired preferable results 2 another suspending operation 8 to 12 months later. 4 cases got post operation infection; through cases happel in foot and 2 in face. All of them were cured by the treatment of drain and antibiotic in 3 weeks. 46% cases were followed up by further consultation or telephone. The longest followed up was period 12 years, while the shortest was 1 year, and the average was 28 months. 93% patients were satisfactory with the results, and 7% patients thought that their facial expression symmetry were insufficient though their facial abnormality were improved obviously.</p><p><b>CONCLUSIONS</b>The synthetically operative method of combining free graft of short extensor of toe with the technique of undermined inducted suture was an effective method for later facial nerve palsy, and most of the patients could acquired satisfactory results. This operative method is good for popularize because of its simple operation, slight tissue injury and fews complication post-operation.</p>

Prognostic value of ventricular longitudinal systolic velocities and maximal oxygen consumption in patients with dilated cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the prognostic value of regional longitudinal ventricular systolic velocities with that of maximal oxygen consumption (VO(2max)) in patients with dilated cardiomyopathy (DCM).</p><p><b>METHODS</b>VO(2max) derived from cardiopulmonary exercise tests and regional longitudinal ventricular systolic velocities obtained from tissue Doppler imaging were compared in 18 DCM patients with cardiac events (death, cardiac transplantation, hospitalization, group A) and 24 patients without cardiac events (group B). Peak velocities during isovolumic contraction (is) and ejection (ez) were interrogated at the mitral or tricuspid annulus (site 1), at the mid parts of the walls (site 3, at the level of papillary muscle), and at the midpoints (site 2) between sites 1 and 3 of interventricular septum (S), lateral wall of LV (L) and of RV (R) in apical 4 chambers view.</p><p><b>RESULTS</b>R1is, R2is, R2ez, R3is, S1is, S1ez, S2ez, L1is, L1ez and L2ez of group A were significantly lower than those in group B (all P < 0.05). Independent of VO(2max), high sensitivity and specificity were shown for R3ez, S1ez, L1ez, L1is, L2is and L3is in predicting cardiac events of DCM patients.</p><p><b>CONCLUSION</b>LV and RV systolic velocities could independently predict cardiac events in DCM patients.</p>

Noninvasive assessment of left anterior descending and right coronary artery flow reserve by transthoracic Doppler echocardiography in patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the feasibility of evaluation of CFR for LAD and right coronary artery (RCA) as well as diagnostic accuracy for patency of each vessel by transthoracic Doppler echocardiography (TTDE).</p><p><b>METHODS</b>65 consecutive patients (age 58 +/- 14, ejection fraction 49% +/- 8%, 48 men and 17 women) were studied for CFR by TTDE with adenosine infusion (140 microg.kg(-1).min(-1)). LAD flow was interrogated nearby the apex in modified 2-ch apical view. RCA flow was interrogated at mid posterior wall on distal part of the posterior descending branch (PDA) in modified 2-ch apical view for PDA.</p><p><b>RESULTS</b>Flow for LAD was detected in all patients (4 with use of contrast agent) and for RCA in 55 patients (5 with contrast agent). Two patients had an occluded RCA. Feasibility of RCA flow detection was 55/63 (87%). In all patients maximal flow of each branch was detected in less than 2 min of adenosine infusion (140 mg.kg(-1).min(-1)). Total time for both CFR estimation was 7.3 +/- 1.6 min. Selecting 2.0 or 1.8 as CFR cut-off value for diagnosis of coronary stenosis (> or = 50% in diameter) or severe stenosis (> or = 70%) was found fitted for both LAD and RCA with similar diagnostic performance (sensitivity 89%/93%, specificity 86%/84%, area under curve 0.89/0.92 respectively, in stenosis diagnosis and sensitivity 88%/89%, specificity 90%/83%, area under curve 0.94/0.95 respectively in severe stenosis diagnosis).</p><p><b>CONCLUSIONS</b>CFR evaluation of both distal LAD and PDA is of high feasibility and can provide high diagnostic yield for relevant vessel patency.</p>

Associated risk factors of fatty liver in the patients with type 2 diabetes mellitus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To analyze the associated risk factors, clinical characteristics and laboratory abnormalities of type 2 diabetes patients with fatty liver.</p><p><b>METHODS</b>The data of type 2 diabetes cases with fatty liver were collected in our hospital. 63 cases of type 2 diabetes without fatty liver were selected randomly as control during the same period. The associated variables were analyzed by using logistic regression model. The clinical data and liver function were compared between two groups.</p><p><b>RESULTS</b>The proportion of obesity and hyperlipidemia was higher in type 2 diabetes patients with fatty liver than without fatty liver. Body mass index (BMI) (OR: 4.392) was positive correlation to fatty liver in the patients with type 2 diabetes. In contrast, insulin sensitivity index (ISI) (OR: 0.000) and regular insulin treatment (OR: 0.058) were negative correlation to it. The abnormal frequencies of aspartate aminotransferase (AST, 16.0%), alanine aminotransferase (ALT, 25.2%), the ratio of AST/ALT less than 1 (52.8%) and gamma-glutamyltransferase (GGT, 31.9%) of type 2 diabetes patients with fatty liver were significantly higher than those without fatty liver (3.2%, 6.4%, 36.5% and 11.1% respectively).</p><p><b>CONCLUSION</b>Obesity and insulin resistance might increase the risk of fatty liver in the patients with type 2 diabetes. Patients of type 2 diabetes with fatty liver show higher serum lipid level and more obvious damages of liver function than those without fatty liver</p>

Inhibitory effects of antisense focal adhesion kinase oligodeoxynucleotides on the invasion of Bel 7402 hepatocellular carcinoma cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the inhibitory effects of antisense focal adhesion kinase (FAK) oligodeoxynucleotides (ODN) on the invasion of Bel 7402 cells, and investigate the mechanisms.</p><p><b>METHODS</b>LipofecTAMINE-mediated antisense FAK ODN was transfected into Bel 7402 cells. Cell number and viability were evaluated every 24 hours by trypan blue dye exclusion. Cell attachment assay was carried out at intended time points in a microculture well pre-coated with fibronectin (FN). The invasive activity of tumor cells was assayed in a transwell cell culture chamber. Cell cycle and cell apoptosis analysis were performed with flow cytometry (FCM).</p><p><b>RESULTS</b>The expression of p125FAK in the group treated with antisense FAK ODN (6.49%+/-0.10%) significantly decreased, compared with those in the group treated with sense FAK ODN (14.33%+/-1.88%) and control group (16.68%+/-1.62%), F=7.66, P<0.01. Antisense FAK ODN significantly inhibited the growth of Bel 7402 cells by 30%-60%, the attachment by 25%-55%, and the invasion, 15%-25%. The decreased expression of FAK in Bel 7402 cells caused a G2/M cell cycle arrest, and the cells at S phase decreased significantly. The occurrence of apoptosis detected by FCM increased significantly in the group treated with antisense FAK ODN.</p><p><b>CONCLUSIONS</b>Inhibition of FAK expression significantly decreases the attachment between ECM and Bel 7402 cells, and the ability of Bel 7402 cells to invade the reconstituted basement membrane. In addition, FAK suppression significantly inhibits the proliferation of Bel 7402 cells in vitro, and increases their apoptosis.</p>

Intro-extro cranial approach treat serious post fronto-orbital fracture deformities / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the method of treating serious secondary fronto-orbital fracture deformities through intro-extra cranial approach.</p><p><b>METHODS</b>The fronto-orbital fracture was divided into two types according to whether there were any large scale fronto-orbital bone defects: type I: Large scale fronto-orbital bone defect; type II: Concave fronto-orbital fracture deformity without large scale bone defect. Both types were treated through intro-extra cranial approach to expose the fracture site. For type I deformity, the bone defects were repaired and reconstructed with outer table of cranial bone and artificial bone. For type II, the deformity was repaired by osteotomy, bone reposition and internal rigid fixation.</p><p><b>RESULTS</b>18 cases were treated from June 1998 to October 2000, include type I, 12 cases, and type II, 6 cases. All the patients recovered well and the post-operative appearance were greatly improved.</p><p><b>CONCLUSIONS</b>Intro-extra cranial approach can expose the fractured site better than the simple extrocranio approach, and make the operation more easily done. Combined with the technique of cranio maxillo facial surgery, the treatment can be more complete and the results can be more satisfactory.</p>