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One case of knee infection after anterior cruciate ligament reconstruction caused by the gram-positive anaerobic bacterium Finegoldia magna was reported. The patient was admitted to hospital due to fever and knee joint swelling and pain after anterior cruciate ligament reconstruction. Through medical history, physical examination, imaging examination and next-generation sequencing, it was confirmed that the infection was caused by Finegoldia magna. Through literature review, 37 literatures on infectious diseases caused by Finegoldia magna was retrieved and analyzed, and the identification points of anaerobic bacteria, the application of second-generation sequencing technology and the treatment status of infection after anterior cruciate ligament reconstruction were reviewed. The incidence of infection after arthroscopic anterior cruciate ligament reconstruction is low, while anaerobic infection is even more rare and difficult to culture. The next-generation sequencing can be used to assist the diagnosis. On the basis of giving priority to the preservation of the reconstructed ligament, the combined use of arthroscopic debridement, irrigation and sensitive antibiotics is the main treatment method.
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Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.
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BACKGROUND:Elderly patients with hip surgery in the department of orthopedics are often associated with a variety of diseases, and easily suffer from complications after implantation. OBJECTIVE:To analyze the characteristics and the factors of complications and mortality of the elderly patients with hip disease by different orthopedic implants. METHODS:249 patients accepted total hip arthroplasty, femoral head replacement, proximal femoral nail, Gamma nail, and holow screw fixation. We analyzed patients’ age, sex, hip disease type, anesthesia risk assessment, psychological and psychiatric factors, admission hemoglobin, preoperative albumin, Charlson comorbidity index, ways of anesthesia, orthopedic implants, operation time, intraoperative bleeding, length of stay, postoperative complications, mortality and survival. RESULTS AND CONCLUSION:Hip disease in the elderly was repaired with five kinds of implants. (1) There were significant differences in age, anesthesia risk assessment, hemoglobin on admission and preoperative albumin, length of stay, duration and intraoperative bleeding. No significant difference in complications and death was found. (2) The most significant indicators affecting complications were length of stay and albumin on admission and preoperative Charlson comorbidity index. The most significant indicators affecting death were age and hemoglobin on admission and preoperative Charlson comorbidity index. (3) Significance of comprehensive assessment of patients before placement: during hip operation, implants were not the factors that affected the complications and mortality after placement, patients with artificial joint replacement could get out of bed early, and complications and mortality could be reduced. Elderly patients with anemia, hypoalbuminemia and Charlson comorbidity index≥3 should be given a high degree of attention. We should assess Charlson comorbidity index as early as possible, positively treat complications, correct anemia and hypoproteinemia, prevent the occurrence of complications, shorten the length of hospital stay, and reduce the mortality after placement.
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BACKGROUND:The pathogenesis of tendinopathy remains unclear and hence treatment of tendinopathy is usualy paliative. OBJECTIVE:To investigate the effects of bone morphogenetic protein 2 on the osteogenic and chondrogenic differentiation of patelar tendon-derived stem cels isolated from colagenase-induced tendinopathy ratsin vitro. METHODS: Patelar tendon-derived stem cels were isolated from patelar tendons of colagenase-induced tendinopathy rats. The multi-differentiation potential of patelar tendon-derived stem cels at passage 3 was identified by osteogenic, adipogenic and chondrogenic differentiation assays. The patelar tendon-derived stem cels were cultured to the 3rd passage in complete culture medium, and then the cels were divided into two groups with (experimental group) or without recombinant human bone morphogenetic protein 2 (control group) until the cels reached confluence for 7 days. Their osteogenic response to bone morphogenetic protein 2in vitro was examined by alizarin red S staining of calciumnodule formation and quantification assay. The patelar tendon-derived stem cellpelets were cultured in complete culture medium with (experimental group) or without bone morphogenetic protein 2 (control grup) for 21 days. Chondrogenic differentiation of the cellpelets was evaluated by hematoxylin-eosin staining, alcian blue staining, immunohistochemical staining for Sox9 and colagen type II. RESULTS AND CONCLUSION:Primary patelar tendon-derived stem cels from the tendinopathy rats culturedin vitro showed clonal growth; after passage, spindle fibroblast-like and flat-like cels were detectable. The cels were positive for oil red O staining at 10 days after adipogenic induction, positive for alizarin red staining at 7 days after osteogenic induction, and positive for hematoxylin-eosin staining and immunohistochemical staining of colagen type II at 14 days after chondrogenic induction. After patelar tendon-derived stem cels were induced with recombinant human bone morphogenetic protein 2 for 7 days, the result of alizarin red staining was positive in the experimental group, but negative in the control group without recombinant human bone morphogenetic protein 2. The difference in the result of alizarin red staining between the two groups was statisticaly significant. After patelar tendon-derived stem cels were induced with recombinant human bone morphogenetic protein 2 for 21 days, the results of hematoxylin-eosin staining, alcian blue staining, immunohistochemical staining for Sox9 and colagen type II were al positive. In conclusion, bone morphogenetic protein 2 could stimulate the osteogenic and chondrogenic differentiation of patelar tendon-derived stem cels isolated from colagenase-induced tendinopathy rats in vitro, which can help to better understand the pathogenesis of tendinopathy.
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BACKGROUND:Chronic tendinopathy is a tendon disorder extremely common in athletes and in the general population with repetitive strain injuries of tendons. The pathogenesis of tendinopathy remains unclear and hence treatment of tendinopathy is usual y pal iative. OBJECTIVE:To investigate the of adipogenic and tenogenic ability of patel ar tendon-derived stem cel s isolated from chronic tendinopathy and healthy rats in vitro. METHODS:Tendon-derived stem cel s were isolated from patel ar tendons of chronic tendinopathy and healthy rats respectively. The tendon-derived stem cel s were cultured to the 3rd passage in complete culture medium, and cel morphology was observed. The cel s were divided into adipogenic induction group and control group. Cel s in the adipogenic induction group were cultured in adipogenic induction medium, while those in the control group cultured in complete culture medium. The ability of adipogenic differentiation between tendon-derived stem cel s isolated from the tendon of chronic tendinopathy and healthy rats in vitro was examined by oil red O staining and quantification assay. The mRNA expressions of C/EBPαand PPARγ2 were detected by real-time quantitative PCR. When 70%-80%cel s were confluent, the mRNA expressions of Col1a1, Scx, Tnmd and Dcn were also detected by real-time quantitative PCR. RESULTS AND CONCLUSION:At the third passage, slender spindle-shaped cel s were seen in both two groups, but there was a little change in the cel morphology in the chronic tendinopathy group. Lipid droplets were formed after the cel s were cultured in adipogenic induction medium for 21 days. This was not observed in the control group. We observed more oil red O-positive oil droplets in tendon-derived stem cel s from the tendons of chronic tendinopathy rats than healthy rats. The difference between them was statistical y significant (P=0.004). The results of real-time quantitative PCR showed that the mRNA expressions of C/EBPαand PPARγ2 in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly higher than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.004);the mRNA expressions of Col1a1, Scx, Tnmd and Dcn in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly lower than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.009). In conclusion, tendon-derived stem cel s from chronic tendinopathy rats showed a higher ability of adipogenic differentiation, but a lower capacity of tenogenic differentiation compared to tendon-derived stem cel s from healthy rats, which might contribute to better understand the pathogenesis of tendinopathy.
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BACKGROUND:Currently, cellular composition and the features of the nucleus pulposus are stil not to be clarified. OBJECTIVE:To establish the in vitro culture system of rat nucleus pulposus-derived mesenchymal stem cells and to identify their multi-lineage differentiation potential. METHODS:Mesenchymal stem cells from the nucleus pulposus tissues of Sprague-Dawley rats were cultured in vitro. Then, cells at passage 3 were induced to differentiate into osteoblasts, adipocytes and chondrocytes as experimental group. cells cultured with basic culture medium served as controls. RESULTS AND CONCLUSION:cells isolated from rat nucleus pulposus could form the sunflower-like colonies and exhibit clone-like growth when they cultured at a low density. cells at passage 3 became homogeneous and exhibited fibroblast-like morphology. After 28 days of osteogenic induction, arizarin red positive signals were detected in the experimental group. The mRNA expressions of RunX2, osteopontin and osteocalcin were significantly increased in the experimental group, compared to the control group (P<0.05). After 21 days of adipogenic induction, oil red-O positive cells were detected in the experimental group. The mRNA expressions of C/EBPαand PPARγ2 were significantly increased in the experimental group, compared to the control group (P<0.05). After 21 days of chondrogenic induction, safranin O/fast green staining was positive in the experimental group. The mRNA expressions of aggrecan and Col2a1 were significantly increased in the experimental group, compared to the control group (P<0.05). Our findings in this study suggested that nucleus pulposus-derived mesenchymal stem cells could be isolated from the Sprague-Dawley rat nucleus pulposus and exhibited clonal-like growth when they were cultured in vitro. These cells were confirmed to have the potential to differentiate into adipocytes, osteoblasts and chondrocytes in vitro.
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BACKGROUND:Mesenchymal stem cells are commonly used in tissue engineering, while whether synovium-derived mesenchymal stem cells from human knee joints can make a role in repair and regeneration of bone tissue as the appropriate seed cells need to be further verified. OBJECTIVE:To study the osteogenic differentiation potential of synovium-derived mesenchymal stem cells which were harvested from human knee joint with end-stage osteoarthritis in vitro. Meanwhile, to identify the osteogenic characteristics of these induced synovium-derived mesenchymal stem cells. METHODS:cellpopulations were enzymatical y released from the synovial membrane obtained from total knee arthroplasty. Nucleated cells were plated at an appropriate density (200 cells/cm2) for expansion at the maximum rate without colony-to-colony contact. Monoclone was obtained by selecting as primary synovium-derived mesenchymal stem cells. After primary cultured in control medium and expanded to three passages, synovium-derived mesenchymal stem cells were subjected to in vitro assays to investigate their osteogenesis potential in osteogenic medium containing dexamethasone,β-glycerophosphate and ascorbic acid. RESULTS AND CONCLUSION:Nucleated cells from the synovial membrane formed single cel-derived colonies, which were of polygon shape and star shape, uniform in size. After three passages, homogeneous populations of fibroblast-like cells were observed. Under appropriate culture conditions, synovium-derived mesenchymal stem cells were induced to differentiate to the osteocyte lineages which had typical“slabstone”appearance of osteoblasts. Osteogenesis was stained positively for alkaline phosphatase staining at day 7 and formed mineralized nodular structures at day 21, which was confirmed by Alizarin red staining. Alkaline phosphatase activity assay showed a rise after the osteogenesis induction and reached the peak at day 7. Expressions of osteocyte specific genes, such as col agen type Ⅰ, Runx2, bone-binding protein and osteopontin, were al detected. These genes were expressed positively in osteogenic medium, and the mRNA expressions of col agen type Ⅰ, Runx2, bone-binding protein and osteopontin were enhanced significantly after 21 days. Our study demonstrates that synovium-derived mesenchymal stem cells isolated from knee joint of end-stage osteoarthritis patients could be induced into osteoblasts in vitro, and these induced cells have typical osteogenesis characteristics. Synovium-derived mesenchymal stem cells may play a role in the regenerative response during the process of bone injury, which are promising candidates for bone tissue engineering.
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Background and purpose: The patients with nasopharyngeal carcinoma(NPC) are staged according to Chinese 1992 staging system that is mainly based on clinical symptoms and CT image.Since MRI has been widely used in the clinic,the results were reported to be more accurate than the CT scan.The purpose of this study was to compare the diversity in tumor extension of NPC by computerized tomography(CT) versus magnetic resonance imaging(MRI) and to evaluate if the difference has any impacts on the '92 staging system.Methods:The MRI and CT were taken and compared prior to radiotherapy for 78 cases with histologically proved NPC from Aug.2005 to Aug.2006.Clinical staging was estimated according to '92 staging system based on both of CT or MRI data and clinical information.Results:MRI was significantly superior to CT in the detection of invasion in anterior-styloid space(82.0% vs 65.4%),oropharynx(34.6% vs 20.5%),retropharyngeal lymphatic metastasis(74.4% vs 55.1%),base of skull(51.3% vs 30.8%),cavernous sinus(19.2% vs 5.1%),nasal sinuses(33.3% vs 19.2%) and pterygopalatine fossa(16.7% vs 6.4%.),all the difference showed statistical significance.There were no statistical differences between CT and MRI in the evaluation of involvement of nasal cavity(28.2% vs 21.8%),post-styloid space(65.4% vs 67.9%),pharynx cavity(2.6% vs 1.3%) and cervical lymph node metastasis.According to MRI data,42.3% of T classification,25.6% of N classification,and 28.2% of clinical stages were changed compared to CT scan.Conclusions:There is remarkable advantage of MRI in the detection of infiltration of NPC,especially in the base of skull,cavernous sinus,and retropharyngeal lymphatic metastasis.The '92 stage system should be changed to adapt MRI information into clinical stage and it might impact on the prognosis of NPC.