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OBJECTIVE@#To investigate the distribution of bone marrow lymphocyte subsets in patients with myelodysplastic syndrome(MDS),the proportion of activated T cells with immunophenotype CD3+HLA-DR+ in the lymphocytes and its clinical significance, and to understand the effects of different types of MDS, different immunophenotypes, and different expression levels of WT1 on the proportion of lymphocyte subsets and activated T cells.@*METHODS@#The immunophenotypes of 96 MDS patients, the subsets of bone marrow lymphocytes and activated T cells were detected by flow cytometry. The relative expression of WT1 was detected by real-time fluorescent quantitative PCR, and the first induced remission rate (CR1) was calculated, the differences of lymphocyte subsets and activated T cells in MDS patients with different immunophenotype, different WT1 expression, and different course of disease were analyzed.@*RESULTS@#The percentage of CD4+T lymphocyte in MDS-EB-2, IPSS high-risk, CD34+ cells >10%, and patients with CD34+CD7+ cell population and WT1 gene overexpression at intial diagnosis decreased significantly (P<0.05), and the percentage of NK cells and activated T cells increased significantly (P<0.05), but there was no significant difference in the ratio of B lymphocytes. Compared with the normal control group, the percentage of NK cells and activated T cells in IPSS-intermediate-2 group was significantly higher(P<0.05), but there was no significant difference in the percentage of CD3+T, CD4+T lymphocytes. The percentage of CD4+T cells in patients with complete remission after the first chemotherapy was significantly higher than in patients with incomplete remission(P<0.05), and the percentage of NK cells and activated T cells was significantly lower than that in patients with incomplete remission (P<0.05).@*CONCLUSION@#In MDS patients, the proportion of CD3+T and CD4+T lymphocytes decreased, and the proportion of activated T cells increased, indicating that the differentiation type of MDS is more primitive and the prognosis is worse.
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Humans , Lymphocyte Subsets , Myelodysplastic Syndromes/diagnosis , Bone Marrow , B-Lymphocytes , Killer Cells, Natural , Flow Cytometry , T-Lymphocyte SubsetsABSTRACT
Objective:To evaluate the clinical outcomes of patients with borderline developmental dysplasia of the hip (BDDH) and cam-type femoroacetabular impingement syndrome (FAIS) after hip arthroscopy.Methods:Data were retrospectively reviewed for patients with BDDH and cam-type FAIS who underwent hip arthroscopy surgery from June 2017 to December 2019. A total of 32 patients were enrolled, with a mean age of 36.13±8.67 years (range, 20-50 years), including 15 males and 17 females. The preoperative lateral center-edge angle was 22.3°±1.6° (range 20.1°-24.7°), while the preoperative α angle was 64.1°±4.6° (range, 56.0°-69.8°). All patients were treated with arthroscopic limited acetabular plasty, labral repair, femoral osteoplasty, and capsular plication after excluding from external hip diseases by ultrasound-guided hip blocking test. The visual analogue scale (VAS), modified Harris Hip Scores (mHHS) and International Hip Outcome Tool-12 (iHOT-12) scores were used to evaluate the clinical effects.Results:All patients were followed up, and the mean follow-up time was 2.5±0.8 years (range, 2.0-4.7 years). The VAS score decreased from 6.07±1.56 to 1.96±0.92 at 1 year and to 1.86±1.01 at 2 years after operation ( F=112.64, P<0.001); the mHHS score increased from 53.87±13.04 to 86.12±8.64 at 1 year and to 88.71±8.15 at 2 years after operation ( F=101.70, P<0.001); the iHOT-12 score was improved from 40.00±7.33 to 76.27±9.50 at 1 year and to 78.67±10.31 at 2 years after operation ( F=134.91, P<0.001). The α angle improved to 40.27°±4.52° (range, 34.8°-49.7°) with significant difference ( t=9.24, P<0.001). Conclusion:Hip arthroscopy can achieve satisfied short-term outcomes in treating BDDH and cam-type FAIS with few complications and less trauma.
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Developmental dysplasia of the hip (DDH) is a major cause of hip arthritis and ultimately total hip arthroplasty. Due to the dysplastic acetabulum, how to place the acetabular cup becomes a challenge in acetabular reconstruction for such patients. Especially in the acetabula classified as Crowe typeⅡand type Ⅲ, the dislocation of the femoral head causes bone defects above the true acetabulum, which will affect the stability of the acetabular cup when the acetabular reconstruction is performed at the true acetabulum. Many acetabular reconstruction methods such as bone grafting, the use of small acetabular cups, socket medialization technique, and high hip center technique are used to increase the host bone coverage of the cup. However, each method has its own shortcomings that can not be ignored so that there is no unified conclusion on the acetabular reconstruction methods for Crowe typeⅡand type Ⅲ hip dysplasia. This article summarized and evaluated various reconstruction methods in combination with the acetabular morphology of DDH, and put forward the research direction in the future.
Subject(s)
Humans , Acetabulum/surgery , Arthroplasty, Replacement, Hip , Developmental Dysplasia of the Hip , Hip Dislocation/surgery , Hip Dislocation, Congenital/surgery , Hip Prosthesis , Treatment OutcomeABSTRACT
Aim To obtain the active components and targets of ginseng in the prevention and treatment of traumatic stress disorder(PTSD) through the method of network pharmacology. Methods The active components and target information of ginseng with medicinal value were obtained by TCMSP research platform, and the gene information closely related to the pathogenesis of PTSD was obtained by searching GeneCard and OMIM database. The two were matched to obtain the medicinal components and target genes of ginseng in the prevention and treatment of PTSD. The drug-dis- ease-target network diagram was drawn by R and Perl computer languages, and the target genes were analyzed by PPI network analysis, gene ontology ( GO ) and signal transduction pathway ( KEGG) enrichment analysis. Results According to the general pharmacological research methods of traditional Chinese medi cine, the screening parameters of active components were set, and nine kinds of high value medicinal ingredients of Panax ginseng were obtained. There was a drug-target relationship between the nine medicinal components and sixteen target genes related to PTSD disease. Through PPI, GO and KEGG analysis, it was found that the target genes were mainly enriched in physiological functions such as neurotransmitters, syn-aptic plasticity, ion channels and so on. Conclusions Ginseng has the pharmacological effect of preventing and treating PTSD, which may play a role in regulating the metabolism and receptor activity of monoamine neurotransmitters.
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Objective To systematically identify, describe, and evaluate research evidence related to exercise intervention in patients with depression through the evidence mapping method. Methods Related studies on exercise intervention for patients with depression were searched in CNKI, Wanfang Data, CBM, VIP, Web of Science, EMBASE, Cochrane library, and PubMed from inception to July, 2021. The quality of the studies was assessed using the risk of bias (RoB) tool recommended by the Cochrane Handbook Version 5.1.0 and A Measurement Tool to Assess Systematic Review-2 (AMSTAR-2). Based on World Health Organization Family International Classifications (WHO-FICs) framework, an evidence mapping framework was established, using EPPI software and Microsoft Excel 2019 tools for data extraction and coding, and using bubble charts to comprehensively present the research population, intervention categories, original research sample size, and the number of studies included in the systematic review/meta-analysis, conclusion classification and other information. Results A total of 101 randomized controlled trials and 52 systematic reviews/meta-analyses were included. The randomized controlled trials involved three types of intervention strategies with 15 different interventions, mainly including unspecified exercise intervention (28, 27.72%) and yoga intervention (19, 18.81%). The main research outcomes included b1. Global mental functions (92, 91.09%) and d9. Community, social and civic life (19, 18.81%). Among the three types of intervention strategies, rehabilitation accounted for the highest proportion, with 47 studies in total, accounting for 46.53%. The main research population was patients with other specified depression (19, 40.42%), such as patients with major depression and elderly depression. Forty-six research conclusions (97.87%) were classified as "beneficial" or "probably beneficial". In 52 systematic reviews/meta-analyses, nine interventions were involved, mainly including unspecified exercise intervention (17, 32.69%) and yoga intervention (12, 23.08%). The main study outcomes included b1. Global mental functions (41, 78.85%) and adverse reactions (12, 23.08%). Among the three types of intervention strategies, the treatment type accounted for the highest proportion, with a total of 34 studies, accounting for 65.38%. The study population was mainly patients with other specific depression (27, 79.41%), such as adult depression and pregnant women with depression, 28 (82.35%) of the research conclusions were classified as "beneficial" or " probably beneficial". At the same time, the intervention environment/background was mainly outpatient and inpatient environment. Conclusion Exercise intervention may be beneficial for patients with depression. However, the effectiveness of walking, cycling, Qigong, resistance training, and sports game interventions, the optimal intervention duration or intensity, and the adverse effects of the intervention, still need to be further explored by high-quality study in the future.
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Objective To systematically identify, describe, and evaluate research evidence related to exercise intervention in patients with depression through the evidence mapping method. Methods Related studies on exercise intervention for patients with depression were searched in CNKI, Wanfang Data, CBM, VIP, Web of Science, EMBASE, Cochrane library, and PubMed from inception to July, 2021. The quality of the studies was assessed using the risk of bias (RoB) tool recommended by the Cochrane Handbook Version 5.1.0 and A Measurement Tool to Assess Systematic Review-2 (AMSTAR-2). Based on World Health Organization Family International Classifications (WHO-FICs) framework, an evidence mapping framework was established, using EPPI software and Microsoft Excel 2019 tools for data extraction and coding, and using bubble charts to comprehensively present the research population, intervention categories, original research sample size, and the number of studies included in the systematic review/meta-analysis, conclusion classification and other information. Results A total of 101 randomized controlled trials and 52 systematic reviews/meta-analyses were included. The randomized controlled trials involved three types of intervention strategies with 15 different interventions, mainly including unspecified exercise intervention (28, 27.72%) and yoga intervention (19, 18.81%). The main research outcomes included b1. Global mental functions (92, 91.09%) and d9. Community, social and civic life (19, 18.81%). Among the three types of intervention strategies, rehabilitation accounted for the highest proportion, with 47 studies in total, accounting for 46.53%. The main research population was patients with other specified depression (19, 40.42%), such as patients with major depression and elderly depression. Forty-six research conclusions (97.87%) were classified as "beneficial" or "probably beneficial". In 52 systematic reviews/meta-analyses, nine interventions were involved, mainly including unspecified exercise intervention (17, 32.69%) and yoga intervention (12, 23.08%). The main study outcomes included b1. Global mental functions (41, 78.85%) and adverse reactions (12, 23.08%). Among the three types of intervention strategies, the treatment type accounted for the highest proportion, with a total of 34 studies, accounting for 65.38%. The study population was mainly patients with other specific depression (27, 79.41%), such as adult depression and pregnant women with depression, 28 (82.35%) of the research conclusions were classified as "beneficial" or " probably beneficial". At the same time, the intervention environment/background was mainly outpatient and inpatient environment. Conclusion Exercise intervention may be beneficial for patients with depression. However, the effectiveness of walking, cycling, Qigong, resistance training, and sports game interventions, the optimal intervention duration or intensity, and the adverse effects of the intervention, still need to be further explored by high-quality study in the future.
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Osteoarthritis(OA) is one of the most common joint diseases. As Chinese society enters the age of aging, the incidence of OA has been soar year by year, and research on its pathogenesis has been continuously valued by researchers. Studies have found that inflammatory cytokines, mainly interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), were responsible for the construction of OA inflammatory networks. It was also found that the overexpression of proteases, mainly matrix metalloproteinases(MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS), was the direct cause of OA cartilage deficiency. What's more, signaling pathways such as stromal cell derived factor-1 (SDF-1) and Wnt, chondrocytic senescence and the senescence-associated secretory phenotype (SASP), chondrocyte apoptosis and autophagy, and estrogen all play significant roles in OA pathogenesis. This paper extensively reviews the research literature relevant to the pathogenesis of OA in recent years, and systematically expounds the pathogenesis of OA from two aspects:molecular level and cell level. At the end of the paper, we discussed and predicted some potential directions in the future clinical diagnosis and treatment of OA.
Subject(s)
Humans , Cartilage , Cartilage, Articular , Chondrocytes , Interleukin-1beta , Osteoarthritis/genetics , Signal Transduction , Tumor Necrosis Factor-alphaABSTRACT
Alternating hemiplegia of childhood is a rare neurodevelopmental disorder. Most cases are reported as sporadic disorder due to
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Background and Objectives@#The effective use of MSCs for the treatment of some B cell-mediated immune diseases is quite limited. The main reason is that the immunomodulatory effects of mesenchymal stem cells (MSCs) on B cells are unclear, and their underlying mechanisms have not been fully explored. @*Methods@#and Results: By co-culturing B cells with MSCs without (MSC/CTLsh) or with suppressor of cytokine signaling 1 (SOCS1) knockdown (MSC/SOCS1sh), we found that MSCs inhibited B cell proliferation, activation and terminal differentiation. Remarkably, the highest inhibition of B cell proliferation was observed in MSC/SOCS1sh co-culture. Besides, MSC/SOCS1sh reversed the inhibitory effect of MSCs in the last stage of B cell differentiation. However, MSC/SOCS1sh had no effect on inhibiting B cell activation by MSCs. We also showed that IgA+ B cell production was significantly higher in MSC/SOCS1sh than in MSC/CTLsh, although no difference was observed when both MSCs co-cultures were compared to isolated B cells. In addition, MSCs increased PGE2 production after TNF-α/IFN-γ stimulation, with the highest increase observed in MSC/SOCS1sh co-culture. @*Conclusions@#Our results highlighted the role of SOCS1 as an important new mediator in the regulation of B cell function by MSCs. Therefore, these data may help to develop new treatments for B cell-mediated immune diseases.
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Background@#The potential benefit of arthroscopic surgery for osteoarthritic knee associated with medial meniscus tear is controversial. This study was conducted to determine the effect of pre-operative medial meniscus extrusion (MME) on arthroscopic surgery outcomes in the osteoarthritic knee associated with medial meniscus tear during a minimum 4-year follow-up.@*Methods@#This was a retrospective review of a total of 131 patients diagnosed with osteoarthritic knee associated with medial symptomatic degenerative meniscus tear who underwent arthroscopic surgery from January 2012 to December 2014 and were observed for more than 4 years. Patients were classified into two groups: MME ≥3 mm (major MME group, n = 54) and MME <3 mm (non-major MME group, n = 77). Clinical assessments, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and radiographic assessments, including the Kellgren-Lawrence (K-L) grade and medial joint space width (JSW), were evaluated pre-operatively and at final follow-up. The longitudinal changes of clinical and radiographic parameters (WOMAC and the medial JSW change, K-L grade progression) were compared between groups unadjusted and adjusted for age, sex, and body mass index. Four-year survival rates (without progression to knee replacement [KR]) were also evaluated using a log-rank test and Cox proportional hazard regression model.@*Results@#Major MME was present in 41% of patients. After a minimum 4-year follow-up, the mean WOMAC total and pain scores improved significantly in both groups. However, the medial JSW and K-L grade worsened significantly. Patients with pre-operative major MME worsened more in WOMAC total (adjusted mean difference [MD] 3.800, 95% confidence interval [CI]: 0.900, 11.400; P = 0.037) and function (adjusted MD 3.100, 95% CI: 0.700, 6.300; P = 0.038) scores than patients with pre-operative non-major MME, and no significant difference was observed in WOMAC pain and stiffness score between groups. The group with major MME had significantly higher joint space narrowing (adjusted MD -0.630, 95% CI: -1.250, -0.100; P = 0.021) and K-L rate progression (adjusted mean relative risk [RR] 1.310, 95% CI: 1.100, 1.600; P = 0.038) than the group with non-major MME. There was a significantly more KR progression in patients with major MME compared with those with non-major MME (adjusted RR 3.100, 95% CI: 1.100, 9.200; P = 0.042 and adjusted hazard ratio 3.500, 95% CI 1.100, 9.500; P = 0.022).@*Conclusions@#Osteoarthritic knee patients associated with medial meniscus tear with non-major MME are more responsive to arthroscopic surgery in terms of the clinical and radiologic outcomes and survival for at least 4-year follow-up; however, in terms of pain relief, arthroscopic surgery in patients with major MME is also beneficial as well as in patients with non-major MME.
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BACKGROUND@#The potential benefit of arthroscopic surgery for osteoarthritic knee associated with medial meniscus tear is controversial. This study was conducted to determine the effect of pre-operative medial meniscus extrusion (MME) on arthroscopic surgery outcomes in the osteoarthritic knee associated with medial meniscus tear during a minimum 4-year follow-up.@*METHODS@#This was a retrospective review of a total of 131 patients diagnosed with osteoarthritic knee associated with medial symptomatic degenerative meniscus tear who underwent arthroscopic surgery from January 2012 to December 2014 and were observed for more than 4 years. Patients were classified into two groups: MME ≥3 mm (major MME group, n = 54) and MME <3 mm (non-major MME group, n = 77). Clinical assessments, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and radiographic assessments, including the Kellgren-Lawrence (K-L) grade and medial joint space width (JSW), were evaluated pre-operatively and at final follow-up. The longitudinal changes of clinical and radiographic parameters (WOMAC and the medial JSW change, K-L grade progression) were compared between groups unadjusted and adjusted for age, sex, and body mass index. Four-year survival rates (without progression to knee replacement [KR]) were also evaluated using a log-rank test and Cox proportional hazard regression model.@*RESULTS@#Major MME was present in 41% of patients. After a minimum 4-year follow-up, the mean WOMAC total and pain scores improved significantly in both groups. However, the medial JSW and K-L grade worsened significantly. Patients with pre-operative major MME worsened more in WOMAC total (adjusted mean difference [MD] 3.800, 95% confidence interval [CI]: 0.900, 11.400; P = 0.037) and function (adjusted MD 3.100, 95% CI: 0.700, 6.300; P = 0.038) scores than patients with pre-operative non-major MME, and no significant difference was observed in WOMAC pain and stiffness score between groups. The group with major MME had significantly higher joint space narrowing (adjusted MD -0.630, 95% CI: -1.250, -0.100; P = 0.021) and K-L rate progression (adjusted mean relative risk [RR] 1.310, 95% CI: 1.100, 1.600; P = 0.038) than the group with non-major MME. There was a significantly more KR progression in patients with major MME compared with those with non-major MME (adjusted RR 3.100, 95% CI: 1.100, 9.200; P = 0.042 and adjusted hazard ratio 3.500, 95% CI 1.100, 9.500; P = 0.022).@*CONCLUSIONS@#Osteoarthritic knee patients associated with medial meniscus tear with non-major MME are more responsive to arthroscopic surgery in terms of the clinical and radiologic outcomes and survival for at least 4-year follow-up; however, in terms of pain relief, arthroscopic surgery in patients with major MME is also beneficial as well as in patients with non-major MME.
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<p><b>OBJECTIVE</b>To investigate the clinical significance of RUNX1-RUNX1T1 expression level in bone marrow of patients with acute non-M3 myeloid leukemia (AML non-M3), and to understand the biological characteristics of RUNX1-RUNX1T1 positive AML expressing lymphoid antigens CD19, CD56 and its effect on the initially induced remission rate and prognosis.</p><p><b>METHODS</b>The expression level of RUNX1-RUNX1T1 in bone marrow of 200 patients with newly diagnosed AML (non-M3) was detected by real-time fluorescent Q-PCR, the expression level of lymphoid antigens was detected by flow cytometry, and the relationship of the initially induced remission rate (CR1) with the overall survival (OS) rate was analyzed, the CR1 and OS differences also were analyzed between CD56 and CD56 patients as well as CD19 and CD17 patients in RUNX1-RUNX1T1 positive patients with AML.</p><p><b>RESULTS</b>The CD56 patients at the initial diagnosis had lower CR1(P<0.05) in RUNX1-RUNX1T1 positive AML patients, the CR1 of CD19 patients was higher than that in CD19 patients at the initial diagnosis (P<0.05). The OS of CD56 patients was significantly high in comparison with CD56 patients (P<0.05), while the OS between CD19 patients and CD19 patients was not significantly different.</p><p><b>CONCLUSION</b>The bone marrow CD56 in RUNX1-RUNX1T1 positive AML patients suggests poor prognosis. The CD19 only correlates with CR1, but does not with OS.</p>
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Humans , Antigens, CD19 , CD56 Antigen , Core Binding Factor Alpha 2 Subunit , Leukemia, Myeloid, Acute , Mutation , Prognosis , RUNX1 Translocation Partner 1 ProteinABSTRACT
OBJECTIVE@#To analyze the relationship among the parameters by measuring the relevant parameters of the anteroposterior X-ray of both hips in patients after total hip arthroplasty, to discuss the reliable anatomical markers and reference standards of acetabulum placement in total hip arthroplasty, and finally to accurately control the abduction angle of acetabulum.@*METHODS@#From January 2016 to June 2017, 282 patients (235 hips) underwent total hip arthroplasty and 128 patients(157 hips) met the inclusion criteria. There were 91 males and 37 females, 82 cases of the left hip and 75 cases of the right hip; ranging in age from 22 to 78 years old, with a mean of 55.1 years old. The abduction angle(β), ilium thickness (a), acetabular cup insertion depth (b), ischial thickness (c), acetabular cup insertion depth(d), acetabular abrasion and contusion depth(e) were measured on the postoperative AP X-ray of both hips, and the data were compared.@*RESULTS@#There was a positive correlation between β and b (=0.424, =0.000), a negative correlation between β and d (=-0.407, =0.000), a positive correlation between β and b/a (=0.419, =0.000), a negative correlation between β and d/c (=-0.472, =0.000). There was a linear relationship between β and b/a (5.753, =0.000) and a linear relationship between β and d/c (-6.671, =0.000).@*CONCLUSIONS@#The outreach angle is mainly controlled by the distance between the outer edge of the cup and the outer edge of the cup in the inferior portion(d) during the operation. The distance b from the outer edge of the cup can be used as a reference.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acetabulum , Arthroplasty, Replacement, Hip , Hip Prosthesis , Postoperative Period , RadiographyABSTRACT
Objective To compare the efficacy of bismuth-containing quadruple therapy on H.pylori eradication for 10 days versus 14 days in a randomized controlled trial.Methods A total of 240 patients diagnosed with H.pylori infection were randomly assigned to two groups:treated with esomeprazole,bismuth,clarithromycin and amoxicillin for 10 days(n =117) and for 14 days (n =123).Eradication was defined by rapid urease test or 13C-urea breath test at 4 weeks after drug withdrawal.Results A total of 219 patients were complete the trial.Intention-to-treat(ITT) analysis showed that the eradication rate of 10 and 14 days were 77.8％ (91/117)and 76.4％ (94/123)respectively.Per protocol(PP) analysis indicated that the eradication rate of 10 and 14 days were 85.8％ (91/106) and 83.2％ (94/113) respectively.There was no statistically significant differences between the two groups(P ＞ 0.05).The incidence of adverse events were 7.7％ (9/117)and 9.8％ (12/123),respectively.There was no significant difference (P ＞ 0.05).Conclusion The eradication rate of bismuth-containing quadruple therapy for 10 days and 14 days were essentially identical,bismuth-containing quadruple therapy for 10 days has a higher potency ratio.
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Objective To investigate whether paraquat (PQ) induced rat alveolar type Ⅱ cells (RLE-6TN) epithelial-mesenchymal transition(EMT) and explore the underlying molecular mechanism.Methods RLE-6TN cells were treated by 20 μmol/L PQ for 24 hours,the morphology was observed by invert microscope.RT-PCR and Western blot were performed to detect the expression level of β-catenin,EMT related markers E-cadherin and vimentin.Then we performed the Transwell invasion assays to detect the ability of cell invasion.Results The results demonstrated that PQ was able to induce the transition of RLE-6TN cells from epithelial morphology to fibroblast-like morphology,associated with the acquisition of migratory properties.Furthermore,knockdown of β-catenin by using specific siRNA could reverse PQ triggered EMT process and attenuated cell migration ability.Conclusion PQ promotes RLE-6TN epithelial-mesenchymal transition by upregulating the expression of Wnt/β-catenin.
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<p><b>BACKGROUND</b>Avascular necrosis of femoral head (AVNFH) typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone.</p><p><b>METHODS</b>This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients (98 hips) with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips (Group A) or drilling decompression alone in 34 cases/55 hips (Group B). Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test.</p><p><b>RESULTS</b>All patients were followed up for an average of 57.6 months (range: 17-108 months). Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris' scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 (t = -7.21, P = 0.001) than Group B with mean Harris' scores improved from 69.46 ± 9.71 to 75.79 ± 4.13 (t = -9.47, P = 0.037) (significantly different: t = -2.54, P = 0.017). The total surgery effective rate was also significantly different between Groups A and B (86.0% vs. 74.5%; χ2 = 3.69, P = 0.02).</p><p><b>CONCLUSION</b>For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.</p>
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<p><b>OBJECTIVE</b>To evaluate the early clinical effects of treating the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique.</p><p><b>METHODS</b>Total 20 patients with the avulsed fracture of the greater tuberosity of the humerus were treated from September 2009 to January 2013. There were 12 males and 7 females, with an average age of 46.8 years old(24 to 69 years old). Eleven patients had injuries on right shoulder joint and 8 patients had injuries on left side. The injury mechanism included 10 cases of traffic accident, 6 cases of sports injury, and 3 cases of falls. The mean interval from injury to surgery was 34.9 d (ranged, 3 to 72 d). The affacted arm was suspended and fixed within 3 weeks after operation. The swing exercise of shoulder joint was performed from the 2nd day after operation. The strap was removed 3 weeks after operation, and painless active exercise was performed 6 weeks after operation. The patients were followed up in the outpatient department 6, 12 and 24 weeks after operation, and then every 6 months. AP and lateral X-ray films were taken at each follow-up time. At the latest follow-up, protractor was used to measure activity of patients; and VAS pain score, California University of Losangeles(UCLA) standard, American Shoulder and Elbow Surgeons (ASES) score were used to evaluate therapeutic effects.</p><p><b>RESULTS</b>All the patients were followed up, with a mean duration of 35.2 months (ranged, 24 to 48 months). All the incisions were healed on the first stage without secondary acromion impingement and other complications. All the patients had bony union within 12 weeks. The movements of shoulder joints including flexion, abduction, external rotation, internal rotation were increased obviously(<0.05). The UCLA score was increased from preoperative 15.2±5.3 to 35.6±6.1 at the latest follow-up. The ASES score was increased from preoperative 31.2±5.4 to 91.2±6.8 at the latest follow-up (<0.05).</p><p><b>CONCLUSIONS</b>It has satisfactory curative effects for the avulsed fracture of humerus greater tuberosity using the double-row suture anchor fixation technique, especially the cases of small or comminuted fractures. It has several advantages such as firm fixation, simple and secure operation as well as quick postoperative recovery. Finally, patient should take exercises actively after operations.</p>
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<p><b>OBJECTIVE</b>To isolate platelet-rich plasma(PRP) from the white slurry(WS), a depleted fraction of the clinical blood supply, so as to provide an easier method to harvest PRP for related studies and clinical use.</p><p><b>METHODS</b>The protocols preparing PRP from whole blood and WS were compared. The morphological characteristics of the different PRPs were observed under transmission electron microscope; the expression of the platelet markers CD41a and CD42b were detected by the flow cytometry. Moreover, the ingredients of the PRPs were measured by using cytoanalyzer. for detecting the physiological function of the PRP, the harvested PRP were added to MSC culture and the cell proliferation was detected by using CCK-8 method.</p><p><b>RESULTS</b>a large amount of PRP from WS was easier harvested. the WS-derived PRP shared similar morphological characteristics and ingredients as compared with whole blood-derived PRP. Importantly, the WS-derived PRP exhibited a higher expression of CD41a and CD42b than that of traditional PRP, which indicate that the WS is a promising reservoir for PRP.</p><p><b>CONCLUSION</b>The WS can be used to prepare PRP, and the novel PRP share similar biological characteristics as traditional PRP prepared from whole blood. The present study provides an easier and economical method to harvest PRP and this findings may be helpful for PRP related studies.</p>
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<p><b>OBJECTIVE</b>To explore the effects of the shock wave on the capacity of mesenchymal stem cells(MSCs) to proliferate and differentiate into osteoblasts.</p><p><b>METHODS</b>MSCs were isolated from the bone marrow of healthy donors. The human bone marrow MSCs(BM-MSCs) were divided into 3 groups including blank control group,osteoinduced group and shock wave group. The MSCs in blank control group were cultured with common mediam; the MSCs in osteoinduced group were treated with osteogenic agents and cultured; the MSCs in shock wave group were cultured with common medium and stimulated by shock wave. The morphology of MSCs in each groups were observed by micoscopy; the CCK-8 was used to detect the proliferation ability of MSCs; the alkaline phosphatase staining and von Kossa staining were used to evaluale the differentiation potential of MSCs in each groups.</p><p><b>RESULTS</b>The results of CCK-8 revealed the shock wave could promote cell proliferation as compared with blank control group. The results of alkaline phosphatase and Von Kossa staining showed that the shock wave displayed a stronger ability to promote the human BMMSC differentiation into osteoblasts cells in comparison with the osteoinduced group. The blank control group was weakly positively stainined.</p><p><b>CONCLUSION</b>The shock wave treatment can promote proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the early clinical effects of suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy.</p><p><b>METHODS</b>From July 2012 to January 2015, 22 patients with the avulsion fracture of tibial intercondylar eminence were treated with arthroscopic suture anchor fixation. There were 12 males and 10 females, with an average age of 22.8 years old(ranged, 18 to 33 years old). Nine patients had the fractures in the right knee and 13 patients had the fractures in the left knee. The mean duration from injury to surgery was 6.8 days(ranged, 3 to 11 days). According to the improved Meyers-McKeever classification, 13 cases were type II, 7 cases were type III, and 2 cases were type IV. The clinical outcomes were evaluated by the range of motion, the Lysholm score, the IKDC 2000 subjective knee score, the axial shift test, and the anterior drawer test.</p><p><b>RESULTS</b>All the incisions healed by first intention, and no complications occurred. All the patients were followed up, and the mean duration was 32.8 months (ranged, 18 to 42 months). The knee range of motion was improved from preoperative (49.37±7.69) ° to (126.38±5.58) °at the latest follow-up(<0.01). Lysholm score was improved from preoperative 43.4±5.6 to 79.2±6.2 at the latest follow-up(<0.01). And the IKDC 2000 score was improved from preoperative 52.6±6.2 to 81.4±5.7 at the latest follow-up(<0.01). At the latest follow-up, the patient underwent physical examination. One patient had a positive result of axial shift test at the 18th month after operation with grade II laxity of anterior cruciate ligament. One patient had a weakly positive result of anterior drawer test at the 24th month after operation.</p><p><b>CONCLUSIONS</b>Absorbable suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy can provide accurate reduction and stable fixation, which can be applied to treat all types of fractures including comminuted fracture, and it is not necessary to remove the implant in the second operation.</p>