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BACKGROUND: TDP43 may be a negative regulator of MAPK signaling pathway under hypoxic-ischemic conditions. However, its effect on JNK and p38 MAPK signaling pathways in osteoarthritis remains unclear.OBJECTIVE: To investigate the expression of chondrocyte lesion-related gene RACK1 in wild type TDP43 involved in osteoarthritis, and to analyze its stress effect. METHODS: Human umbilical cord mesenchymal stem cells were transfected by TDP43 lentivirus, and the ability to differentiate into chondrocytes in vitro was analyzed. Umbilical cord mesenchymal stem cells transfected by TDP43 lentivirus, empty vector and without transfection were co-cultured with chondrocytes for 12 days. The chondrocyte proliferation was detected at 0, 3, 6, 9 and 12 days of co-culture. The chondrocyte apoptosis rate was detected by flow cytometry at 3 days of co-culture. The expression levels of TDP43, RACK1, p38, JNK, AP-1 and cl-xl in chondrocytes were detected by qRT-PCR at 3 days of co-culture. RESULTS AND CONCLUSION: (1) After TDP43 lentivirus transfection, human umbilical cord mesenchymal stem cells could differentiate into chondrocytes. (2) The morphology of chondrocytes co-cultured with TDP43 lentivirus transfected-umbilical cord mesenchymal stem cells showed significant change, and the cells became large with abundant branches. Chondrocytes co-cultured with empty vector transfected- or non-transfected umbilical cord mesenchymal stem cells were spindle-shaped in appearance and showed adherent growth with no morphological changes. (3) After co-cultured with TDP43 lentivirus transfected-umbilical cord mesenchymal stem cells, the apoptosis of chondrocytes was promoted, and the cell proliferation was inhibited (P < 0.05). (4) The expression levels of TDP43, RACK1, p38, JNK, AP-1 and Bcl-xl in the chondrocytes co-cultured with TDP43 lentivirus transfected-umbilical cord mesenchymal stem cells were significantly higher than those in the chondrocytes co-cultured with non-transfected- and empty vector-transfected-umbilical cord mesenchymal stem cells. (5) To conclude, high expression of TDP43 in chondrocytes can activate the expression of RACK1, and further regulate chondrocyte proliferation and apoptosis.
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BACKGROUND: Platelet-rich plasma has been used in the treatment of wounds in orthopedics, burn and plastic surgery, and has achieved good results. But its therapeutic effect in diabetic foot ulcers is still controversial. OBJECTIVE: To systematically evaluate the efficacy and safety of platelet-rich plasma in diabetic foot ulcer. METHODS: PubMed, EMbase, The Cochrane Library, CBM, CNKI, and VIP databases were searched for a randomized controlled trial of platelet-rich plasma for treating diabetic foot ulcers published before September 2018. Meta-analysis was performed using RevMan 5.3 software after two investigators independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, including 925 patients. The trial group was treated with platelet-rich plasma alone or platelet-rich plasma combined with conventional therapy (debridement, vacuum sealing drainage, or dressing coverage) . The control group received routine treatment, blank control or placebo treatment. (2) Meta-analysis showed that the healing rate in the trial group was higher than that in the control group [OR=3.05, 95％CI (2.25, 4.13) , P < 0.000 01]; effective rate was higher than that in the control group [OR=3.84, 95％CI (2.44, 6.06) , P < 0.000 01]; the ulcer healing time was shorter than that in the control group [MD=-11.39, 95％CI (-13.45, -9.34) , P < 0.000 01]; the cost of treatment was lower than that in the control group [MD=-5 927.76, 95％CI (-10 413.04, -1 442.49) , P=0.010]; and the hospitalization time was less than that in the control group [MD=-14.77, 95％CI (-18.82, -10.73) , P < 0.000 01]. (3) Four studies reported adverse reactions, but adverse reactions were not associated with platelet-rich plasma. (4) These results suggest that platelet-rich plasma has a good clinical effect in promoting the healing of diabetic foot ulcers, and no adverse reactions occur. Due to limitations in the quantity and quality of the studies, the above conclusions are yet to be verified by more high-quality studies.
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Objective To explore the therapeutic effect of laparoscopic surgery for complicated ureteral strictures after Holmium laser lithotripsy.Methods There were 67 patients with ureteral stenosis after ureteroscopic lithotripsy or percutaneous nephrolithotomy Holmium laser lithotripsy from January 2009 to September 2017.There were 38 males and 29 females.The average age of patients was 37 years old(rang 21-62 years).47 cases were hospitalized because of osphyalgia,among whom 8 cases had fever.There were 19 cases of upper ureteral calculi postoperative stenosis,18 cases of middle ureteral calculi postoperative stenosis and 30 cases of lower ureteral calculi postoperative stenosis,17 cases of whom had complete atresia.6 patients had received twice Holmium laser lithotripsy.Two patients had received triple Holmium laser lithotripsy.In 67 cases,11 cases had received a ureteral stent placement to dilate the affected ureter.2 cases had received twice ureteral stent placements,two double-J tubes were placed in the two stage surgery.2 cases had received treatment of incision inside the ureteral stricture by ureteroscope,but symptoms recurred after removal of the double-J tube.There were 15 cases of mild hydronephrosis before surgery,moderate hydronephrosis in 27 cases,severe hydronephrosis in 25 cases.The depth of separation of the renal collecting system was (3.85 ± 0.58) cm,preoperative serum creatinine was 115μmol/L on average (range 46-258 μmol/L).The surgery was done by the abdominal pathway or posterior abdominal pathway.52 patients had ureteral stenosis resection plus ureter end anastomosis,15 patients had ureteral bladder replantation.Results All the patients had successful surgery.The operation time was 65-160 min,and the average operation time was 82 min;the intraoperative blood loss was about 20-300 ml,and the average blood loss was about 56 ml;Postoperative fever occurred in two patients and were successfully treated by re-indwelling catheter and antibiotic.The stent was removed after 2-3 months and patients were followed up for 5-24 months after removing the double-J tube,with an average of 12 months.The patients with osphyalgia were significantly relieved.The separation of the renal collecting system was reduced to(3.85 ± 0.58)cm,postoperative serum creatinine was 75.8 μmol/L on average (range 47-165 μmol/L).Renal function stop deterioration in 67 patients.Conclusion The operation of laparoscopic ureteral strictures resection plus ureter end anastomosis or ureteral bladder replantation after ureteral strictures due to the use of Holmium laser lithotripsy is the minimally invasive,safe and effective treatment.
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Objective@#To evaluate the effectiveness and safety of intelligent pressure control flexible ureteroscope for management of renal stones ≤2 cm.@*Methods@#The clinical data of 267 cases of renal calculi treated with flexible ureteroscope lithotripsy at Department of Urology, Ganzhou People′s Hospital from June 2015 to December 2017 were analyzed retrospectively. There were 129 male and 138 female patients, with a mean age of 51.2 years (ranging from 19 to 76 years). Among them, 145 patients underwent intelligent pressure control flexible ureteroscope (intelligent control group) and 122 patients underwent flexible ureteroscope ordinary (ordinary group). The t test, χ2 test or Fisher exact test were used for statistical analysis. The success rate of stone seeking, the stone free rates, the incidence of complications, the average operation time, the average hospital stay after operation were compared between the two groups.@*Results@#The average mean operative time of the patients with intelligent control group was (26.17 ± 8.64) minutes, significantly shorter than (47.23±18.35) minutes of the ordinary group (t=1.968, P=0.000). The stone free rate of the patients with intelligent control group was 97.2%, it was higher than 86.0% of ordinary group (χ2=0.069, P=0.004). The complication rate of the patients with intelligent control group was 2.7%, which was significantly shorter than 18.0% of the ordinary group (χ2=17.586, P=0.000). However, there was no significant difference between the two groups in the success rate of stone seeking and postoperative hospital stay (P>0.05).@*Conclusion@#Intelligent controlled pressure ureteral flexible ureteroscope has the advantages of short operation time, high stone free rate and less complications in the treatment of renal calculi ≤2 cm compared with flexible ureteroscope ordinary.
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A valve-free continuous flow method and instrument were established,with only a multi-channel pump for delivering the sample and reagent,and without any injection or solenoid valves and sample loop for selecting and adding the sample or reagent.Nitrate was reduced to nitrite with Cu-Cd reductant column,and then detected with spectrophotometric detector.The proposed method was suitable for determination of nitrate at normal level in most of estuary and coastal seawaters.With the optimum parameters,the linear range and detection limit were 5-180 μmol/L and 0.27 μmol/L,respectively.The samples of 10 and 80 μmol/L nitrate were continually measured for 11 times,and the relative standard deviations were 1.4％ and 1.3％,respectively.The recovery of real samples at different salinity ranged between 99.4％ and 106.1％.There was no significant difference in the analytical results between the proposed method and the flow injection analysis (FIA).In comparison with FIA,the method and instrument were less cost and easy to operate,and was suitable to be applied in general laboratories and field for continuous monitoring.The method was successfully used to measure the nitrate in seawater samples in Xiamen's Western Harbor and monitor nitrate in Jiulongjiang estuary.
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BACKGROUND:Periprosthetic femoral fracture after total knee arthroplasty is related with the osteoporosis, bone defects, prosthesis, frail patients and high complication rate, so it is difficult to prevent and treat. OBJECTIVE:To explore the risk factor, classification, treatment, rehabilitation and prophylaxis of periprosthetic femoral fracture after total knee arthroplasty based on the reviewed and summarized articles published in recent years. METHODS:A computer-based online search was conducted in PubMed database from January 1, 1990 to December 31, 2011 and in SpringerLink database from 1980 to 2011 for the related articles with the key words of“periprosthetic fracture, knee”in English. A total of 626 articles were retrieved. RESULTS AND CONCLUSION:According to inclusion and exclusion criteria, the articles were screened and 40 articles were included final y. The results showed that with the extensive development of total knee arthroplasty, the incidence of periprosthetic femoral fracture was increased gradual y;due to the poor prognosis, we should pay attention to the prevention. The risk factors of periprosthetic femoral fracture included patients’ internal factor that was hard to control, and some external factors such as the surgical techniques. Rorabeck classification was commonly applied for periprosthetic femoral fracture after total knee arthroplasty, but it was not perfect in clinical application. Kim classification wil be better for clinical guidance. The treatment of periprosthetic femoral fracture included nonoperative treatment, open reduction and internal fixation, retrograde intramedul ary nailing and revision arthroplasty. An appropriate treatment is chosen depending on fracture classification, local bone quality, patients’ medical and nutritional status. At present, however, there is not a perfect guideline for the selection of appropriate treatment method. But the early functional exercise is beneficial to prevent the related complications caused by longtime immobilization and the loss of joint function. Therefore, the indications must be under strict control in the treatment of periprosthetic femoral fracture after total knee arthroplasty. Except the firm fixation, early exercise for the patients should be encouraged at the same time.