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Objective:To investigate the role of TiRobot combined with O-arm assisted closed reduction and percutaneous screw fixation in unstable pelvic fracture surgery.Methods:Twelve patients with unstable pelvic fractures, 7 males and 5 females, aged 39.41±12.56 years (range 25-60 years), admitted from January 2020 to January 2021, were retrospectively analyzed. The duration between injury and surgery was 9.67±5.81 d (range 4-24 d). The following are the causes of injury, namely traffic injury in 6 cases, fall from height injury in 4 cases, crush injury in 2 cases. Tile type of pelvic fractures were 3 cases of type B (2 cases of type B2, 1 case of type B3), 9 cases of type C (4 cases of type C1, 3 cases of type C2, 2 cases of type C3). Sacral fractures with Denis division were 5 cases of zone I, 7 cases of zone II. Seven patients were repositioned by intraoperative traction on the injured side of the limb and maintained by fixation with a Starr frame. Two cases were repositioned by intraoperative longitudinal bone traction on each lower limb for fracture displacement. The other 3 B-type fractures were repositioned by inserting Schanz nails into the anterior inferior iliac spine bilaterally. Then, the fractures were maintained with external pelvic fixators. The fractures were assessed by O-arm fluoroscopy. Hollow screws were placed with the aid of orthopedic robotic guidance, and the screw positions were verified by O-arm fluoroscopy again after the nail placement. The duration of each screw placement and operation were recorded. The quality of fracture repositioning, hip function and postoperative complications were observed at the follow-up.Results:All patients were followed up for 8.17±1.99 months (range, 6-12 months). There were 27 screws inserted in 12 patients, with a single screw insertion duration of 19.9±1.8 min (range, 9-31 min). In all patients, one O-arm fluoroscopy was performed in each row after closed reduction and after completion of nail placement. The operative duration was 257.78±80.63 min (range, 160-450 min). The O-arm fluoroscopy after nail placement verified that 23 screws were placed in a satisfactory position at one time, with satisfactory rate of 85% (23/27) for the first nail placement. Two patients with preoperative grade II sacral plexus nerve injury recovered to grade I in one case and grade II in one case. However, the numbness was reduced after operation. No further aggravation of nerve injury occurred after surgery. The quality of fracture repositioning was evaluated according to the Matta score, including excellent in 9 cases, good in 2 cases, and acceptable in 1 case, with an excellent rate of 92% (11/12). At the last follow-up, the Majeed pelvic fracture quantitative assessment system scored 85.75±5.82 (range, 74-96). There were 8 cases in excellent and 4 cases in good. Twelve patients had one-stage wound healing. No complications, such as incision infection, nerve injury, loosening and breaking of the internal fixation occurred during the follow-up.Conclusion:TiRobot combined with O-arm assisted closed reduction and percutaneous screw fixation for unstable pelvic fractures has some advantages, including safety, precision, convenient nail placement, and less fluoroscopic radiation.
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Objective@#To explore the application of Doppler ultrasound to assess the stability of pelvic ring in treatment of lateral-compression-1 (LC-1) pelvic fractures.@*Methods@#For this prospective study 38 patients with LC-1 pelvic fracture were enrolled who had been admitted to the Department of Orthopedic Trauma, Honghui Hospital from July 2016 to November 2017. They were 22 men and 16 women with an age of 55.2±16.1 years. After the patient's condition was stable, they underwent a Doppler ultrasound examination in the pelvic compression separation test. According to the criteria preset: those with a left-right mobility ≥ 0.3 cm were assigned as an unstable group (16 cases) and those with a mobility<0.3 cm as a stable group (22 cases). The stable group received conservative treatment while the unstable group surgical treatment. The 2 groups were compared in terms of mobility of fracture ends, follow-up time, weight-bearing time, fracture healing time, and the Majeed scores of pelvic function at the last follow-up.@*Results@#The 2 groups were compatible due to their insignificant differences in baseline data(P>0.05). The mobility of fracture ends (left-right distance: 0.45±0.22 cm; anterior-posterior distance: 0.26±0.16 cm; oblique distance: 0.50±0.23 cm) in the unstable group was all significantly greater than in the stable group (left-right distance: 0.11±0.03 cm; anterior-posterior distance: 0.05±0.04 cm; oblique distance: 0.11±0.07 cm) (P<0.05). The weight-bearing time in the stable group (0.9±0.5 months) was significantly shorter than that in the unstable group (1.9±2.0 months) (Z=-2.353, P=0.019). There were no significant differences between the 2 groups in follow-up time (13.9±3.8 months versus 15.1±3.0 months), fracture healing time (4.6±1.3 months versus 4.5±1.2 months) or the Majeed scores (84.8±6.4 versus 80.3±12.2) (all P>0.05).@*Conclusions@#Since ultrasonography is helpful in assessment of the stability of LC-1 pelvic fractures, a proper treatment strategy can be decided. Stable ones can be treated conservatively and unstable ones surgically.
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Objective To explore the application of Doppler ultrasound to assess the stability of pelvic ring in treatment of lateral-compression-1 (LC-1) pelvic fractures.Methods For this prospective study 38 patients with LC-1 pelvic fracture were enrolled who had been admitted to the Department of Orthopedic Trauma,Honghui Hospital from July 2016 to November 2017.They were 22 men and 16 women with an age of 55.2 ± 16.1 years.After the patient's condition was stable,they underwent a Doppler ultrasound examination in the pelvic compression separation test.According to the criteria preset:those with a left-right mobility ≥ 0.3 cm were assigned as an unstable group (16 cases) and those with a mobility ＜ 0.3 cm as a stable group (22 cases).The stable group received conservative treatment while the unstable group surgical treatment.The 2 groups were compared in terms of mobility of fracture ends,follow-up time,weight-bearing time,fracture healing time,and the Majeed scores of pelvic function at the last follow-up.Results The 2 groups were compatible due to their insignificant differences in baseline data(P ＞ 0.05).The mobility of fracture ends (left-right distance:0.45 ± 0.22 cm;anterior-posterior distance:0.26 ± 0.16 cm;oblique distance:0.50 ±0.23 cm) in the unstable group was all significantly greater than in the stable group (left-right distance:0.11 ± 0.03 cm;anterior-posterior distance:0.05 ± 0.04 cm;oblique distance:0.11 ±0.07 cm) (P ＜ 0.05).The weight-bearing time in the stable group (0.9 ±0.5 months) was significantly shorter than that in the unstable group (1.9 ±2.0 months) (Z =-2.353,P=0.019).There were no significant differences between the 2 groups in follow-up time (13.9 ± 3.8 months versus 15.1 ± 3.0 months),fracture healing time (4.6 ± 1.3 months versus 4.5 ± 1.2 months) or the Majeed scores (84.8 ± 6.4 versus 80.3 ± 12.2) (all P ＞ 0.05).Conclusions Since ultrasonography is helpful in assessment of the stability of LC-1 pelvic fractures,a proper treatment strategy can be decided.Stable ones can be treated conservatively and unstable ones surgically.
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Objective To evaluate the clinical treatment of unstable pelvic fractures by posterior ring fixation using percutaneous minimally invasive pedicle screws following anterior ring fixation.Methods From January 2010 to January 2016,31 patients with unstable pelvic fracture were treated at our department.They were 20 males and 11 females,with an average age of 44.4 years (range,from 18 to 65 years).According to the Tile classification,6 cases were type B2,8 cases type B3,12 cases type C1,and 5 cases type C2.The anterior pelvic ring was fixated in supine position first,and the posterior pelvic ring was fixated next using percutaneous minimally invasive pedicle screws.The operation time,intraoperative bleeding,and frequency of fluoroscopy needed for the posterior ring fixation were recorded.Reduction quality,complications like loss of reduction and pelvic function at the final follow-up were also assessed.Results For the posterior ring fixation in the 31 patients,the operation time ranged from 40 to 60 minutes (average,50.7 minutes),blood loss from 30 to 80 mL (average,42.9 mL),and fluoroscopic frequency from 7 to 12 times (average,9.7 times).By the Tornetta evaluation,the reduction was rated postoperatively as excellent in 15 cases and as good in 16 ones,yielding an excellent and good rate of 100％.Twenty-nine patients obtained complete follow-up for 12 to 83 months (average,34.7 months),and they achieved bone union after an average of 14.5 weeks (range,from 12 to 16 weeks).According to the Majeed criteria for pelvic function at the final follow-up,10 cases were rated as excellent,16 cases as good,and 3 cases as fair,giving an excellent and good rate of 89.7％.No reduction loss,incision infection,vascular or nerve injury,screw loosening or breakage,or fracture displacement was observed during follow-up.Conclusion In the treatment of unstable pelvic fractures,posterior ring fixation using percutaneous minimally invasive pedicle screws following anterior ring fixation can lead to less operation time,intraoperative bleeding and fluoroscopic radiation,and satisfactory fracture reduction and functional recovery of the pelvis as well.
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Objective To assess the effect of preoperative administration of tranexamic acid (TXA) on the hidden blood loss in the surgery of intertrochanteric fractures with proximal femoral nail anti-rotation (PFNA).Methods Eighty patients with intertrochanteric fracture were treated with PFNA in our hospital from November 2015 to July 2016.They were 15 men and 65 women,with a mean age of 72.6 years.Of them,39 were included into TXA group where TXA was administered preoperatively and 41 were assigned into the control group where no TXA was used preoperatively.Blood routine examinations were carried out on one day before operation,the first and third days after operation.The surgical blood loss,operative blood transfusion,24-hour drainage after operation,and postoperative 3-day blood transfusion were recorded.The total and hidden blood losses were calculated according to the formula.The 2 groups were compared in terms of blood loss and complications.Results In TXA group,the total blood loss (1,632.3 ± 849.2 mL),the hidden blood loss (1,270.9 ± 623.3 mL) and the transfusion rate (28.2％) were significantly lower than those in the control group (2,014.8 ± 924.7 mL,1,549.1 ± 624.9 mL and 56.1％) (P ＜ 0.05).There was no significant difference between the 2 groups in visible blood loss (361.4 ± 154.3 mL for TXA group versus 465.7 ± 191.3 mL for the control group) (P ＞ 0.05).Deep venous thrombosis occurred in 2 patients,limb swelling in one patient and wound dehiscence in one patient in TXA group while deep venous thrombosis occurred in one patient,limb swelling in 3 patients and wound dehiscence in none in the control group,showing no significant differences between the 2 groups (P ＞ 0.05).No infection was observed in either group.Conclusion Preoperative administration of TXA can reduce surgical hidden blood loss and transfusion rate as well but will not increase the risk of deep vein thrombosis in the surgery of intertrochanteric fractures with PFNA.
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Objective To explore the mechanism of the formation of glioma cells derived vessels (GCDV).Methods The tubular formation assay was performed on 3D cell cultures of U87,U251,U373,SF295,T98G,SKMG-4 and C6 glioma cell lines.The expression of Notch1 、Dll4 were examined by western blot analysis.Result The mean number of vasculogenic channels of cell lines C6,U373,U87,T98G,SF295,U251 and SKMG-4 per area (100×) were 25.2±5.0,36.4±3.2,19.0±2.2,12.6±2.4,4±2.2,0.2±0.4 and 0,respectively.The relative protein densities of Notchl in U87,U251,T98G,SF295,SKMG-4,C6 and U373 were 0.34,0.21,0.79,0.04,0.28,1.75 and 1.19,which were significantly related with the tubular formation ability (P＜0.05).However,the expression of Dll4 was not associated with tubular formation ability (P＞0.05).Conclusion Notch1 may play a key role in tubular formation of glioma cells while the role of Dll4 in the process needs further study.
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The present study was designed to isolate and characterize the analgesic compounds of Artemisa sacrorum Ledeb. The EtOAc crude extracts from the aerial parts of Artemisa sacrorum Ledeb were separated by chromatography and the structures of new compounds were elucidated based on spectral analyses. Analgesic activities of the isolated compounds were assessed in rats with hot plate test and paw pressure assay. Two new flavone C-glycosides, named as Sacroroside A and B (Compounds 1 and 2) were isolated from the EtOAc crude extract of the aerial parts ofArtemisa sacrorum Ledeb. They showed significant analgesic effects. In conclusion, Compounds 1 and 2 are new natural products, which show significant analgesic effects in a dose-dependent manner.
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Animals , Male , Analgesics , Chemistry , Pharmacology , Therapeutic Uses , Artemisia , Chemistry , Disaccharides , Chemistry , Pharmacology , Therapeutic Uses , Flavanones , Chemistry , Pharmacology , Therapeutic Uses , Flavones , Chemistry , Pharmacology , Therapeutic Uses , Hot Temperature , Molecular Structure , Pain , Drug Therapy , Phytotherapy , Plant Components, Aerial , Plant Extracts , Chemistry , Pharmacology , Therapeutic Uses , Pressure , Rats, WistarABSTRACT
Objective To discuss Bushen Huoxue Prescription mechanism of action on follicular granulosa cell apoptosis of premature ovarian failure (POF) mice. Methods The mouse zona pellucida 3 as the antigen, multi-point injection of subcutaneous immunization BALB/c to female mice was used to establish autoimmune POF model. Forty clean female mice were randomly divided into blank group, model group, Estradiol Valerate group and Bushen Huoxue Prescription group. All medicine groups were given relevant medicine for gavage, while model and blank groups were given normal saline with the same amount for gavage for 15 days. After the treatment, ovary, uterus, and thymus were weighed, and the viscera index was calculated. An ovarian slice was taken and HE staining was used to observe granulosa cell apoptosis. The levels of E2, LH, and FSH were detected by using the radioimmunoassay method. RT-PCR was used to analyze Fas and Fas-L mRNA expressions in ovarian granulosa cells. Results Compared with blank group, the weight of ovary, thymus, and uterus decreased significantly (P<0.05, P<0.01);Serum E2 level dropped (P<0.01);levels of FSH and LH, and expressions of Fas and Fas-L mRNA increased significantly (P<0.01). Compared with model group, granulosa cell apoptosis significantly decreased, and ovary index, uterus index, and thymus index increased (P<0.05);serum E2 level increased (P<0.01);levels of FSH and LH, and expressions of Fas and Fas-L mRNA significantly decreased (P<0.05). Conclusion Bushen Huoxue Prescription can decrease expressions of Fas and Fas-L mRNA to inhibit cell apoptosis by adjusting the hormone level of hypothalamus-pituitary-ovarianaxis.
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Objective To explore the correlation between environmental selenium(Se) levels and cognitive ability among rural elderly population, and the effect of Se on cognitive skill of the elderly. Methods Two study sites(Zichuan district and Gaomi city of Shandong) with different environmental Se levels were selected according to rural elderly people ≥ 65 years were extracted by stratified random sampling method in each site. A retrospective survey was carried out using dietary intake questionnaire for the elderly for the past 1 year, and their daily total Se intake was calculated. Questionnaire was also used to obtain cognitive skill information in the elderly people. The Community Screening Instrument for Dementia, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test, the Indiana University (IU) Story Recall Test, the Animal Fluency Test, and the IU Token Test were applied to assess the cognitive ability. Se level in these samples was analyzed. Correlation between the Se levels of environment and those of human body were analyzed statistically. Results There were 0.163), (0.405 ± 0.086)]mg/kg and nail Se[(147.44 ± 17.42), (117.38 ± 22.48)μg/L]between the two groups (U = 31.59, 25.00, 23.67, all P ＜ 0.01 ). There were positive correlation among the nail Se, environmental Se and Se in all subjects(r = 0.51,0.46, 0.60, all P ＜ 0.01 ). The differences of the CSID total score, the CERAD Word List Learning Test, the CERAD Word List Recall Test and the IU Story Recall Test between the two sites were statistically significant(F = 2.56, 9.18, 7.48, 4.42, all P ＜ 0.05), excluding the Indiana University Story Recall Test.After eliminating possible confounding factors, the Se levels and the CSID total score, the IU Story Recall Test, the Animal Fluency Test and the IU Story Token Test had a significantly positive correlation (r = 0.076, 0.138, 0.042,0.107, P ＜ 0.05 or ＜ 0.01 ), excluding the CERAD Word List Learning Test. Conclusions This study supports the hypothesis that a life long low Se level is associated with lower cognitive ability. The cognitive abilities in the elderly population lived in areas with high environmental selenium levels are significantly higher than that of the elderly lived in areas with low environmental selenium levels.
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<p><b>BACKGROUND</b>Study of the relationship between mast cells and atherosclerosis is mostly dependent on pathological observation and cytology experiments. To investigate the effects of mast cells degranulation on plaque and their possible mechanisms we used apolipoprotein E knockout mice which had been placed perivascular common carotid collar with mast cells degranulator compound 48-80.</p><p><b>METHODS</b>Forty apolipoprotein E knockout mice were fed a western-type diet and operated on with placement of perivascular right common carotid collar. Four weeks after surgery, the mice were intraperitoneally injected with compound 48-80 (0.5 mg/kg) or D-Hanks every other day for 4 times. The serum lipids and activity of tryptase were measured. Tissue sections were stained with hematoxylin and eosin. Corresponding sections were stained with toluidine blue and immunohistochemically with antibodies against macrophage-specific antigen, alpha-smooth muscle actin, interleukin-1beta and von Willebrand factor. Simultaneously, basic fibroblast growth factor was detected by in situ hybridization and immunofluorescence.</p><p><b>RESULTS</b>No pathological change was observed in common carotid non-collar placement but atherogenesis in common carotid collar placement of both groups. There was a significant increase in plaque area ((5.85+/-0.75) x 10(4) vs (0.86+/-0.28) x 10(4) microm(2), P<0.05), the degree of lumen stenosis ((81+/-15)% vs (41+/-12)%, P<0.05), the activity of tryptase in serum ((0.57+/-0.13) U/L vs (0.36+/-0.10) U/L, P<0.05), and the percentage of degranulated mast cells ((80.6+/-17.8)% vs (13.5+/-4.1)%, P<0.05). The expressions of macrophage-specific antigen, alpha-smooth muscle actin, interleukin-1beta, basic fibroblast growth factor and the density of neovessel in plaque were more in the compound 48-80 group than in the control group.</p><p><b>CONCLUSIONS</b>Perivascular common carotid collar placement can promote atherosclerotic plaque formation in apolipoprotein E knockout mice. Compound 48-80 increases plaque area and the degree of lumen stenosis by the mechanism that compound 48-80 promotes proliferation of smooth muscle cells and aggregation of macrophages. Compound 48-80 promotes angiogenesis in plaque. The mechanism is potentially that compound 48-80 increases the expressions of basic fibroblast growth factor mRNA and protein in plaque. Compound 48-80 enhances the expression of interleukin-1beta in plaque.</p>
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Animals , Male , Mice , Apolipoproteins E , Genetics , Atherosclerosis , Genetics , Metabolism , Pathology , Carotid Arteries , Pathology , Fluorescent Antibody Technique , Immunohistochemistry , In Situ Hybridization , In Vitro Techniques , Mast Cells , Metabolism , Mice, Knockout , p-Methoxy-N-methylphenethylamine , PharmacologyABSTRACT
Objective To know the apolipoprotein E(APOE)genotypes frequency of Chinese old people in the rural area. Methods 2000 Chinese aged 65 years or older from four sites in China were enrolled in this study in 2004-2008.Two sites were from the Sichuan province in southwestern China,and another two sites were from the Shandong province in eastern China.The finger blood samples on filter paper were collected from all the investigated people in the end of the interview.The genotype for apolipoprotein E(gene symbol,APOE)was determined by eluting DNA from a dried blood spot,followed by HhaI digestion of amplified products.Results Through statistical analysis,APOE genotypes frequency of Chinese people aged 65 years or older in the rural area,as for ?/?2,?2/?3,?2/?4,?3/?3,?3/?4,?4/?4,they were 1.1%,13.55%,2.05%,68.80%,13.35% and 1.15% respectively.4 carriers and no 4 carriers were 16.55% and 83.45%.Conclusion The distribution of APOE 4 genotype is more widely in Chinese people aged 65 years or older in the rural area.
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To test the hypothesis that concentration polarization of atherogenic lipids may occur in the arterial system and play an important role in localization of atherosclerosis, we simulated and measured in vitro the luminal surface concentration of low density lipoprotein (LDL) in local stenosis at the distal end of carotid artery by number simulation and laser scanning confocal microscopy, then we designed carotid stenosis model to test the role of LDL concentration polarization in atherogenesis. The in vitro experiment showed that the luminal surface LDL concentration was higher than the bulk concentration as predicted by the concentration polarization theory. The relative luminal surface LDL concentration changed with the flow velocity and ratio of stenosis. The wall concentration of LDL was highest in the round tube with 40% stenosis at the same velocity, while the wall concentration of LDL was higher when Re was 250 than Re was 500 at the same extent of narrowness. The animal experiment also revealed that general atherogenic plaques obviously occurred at the distal end of local stenosis where concentration polarized. The results strongly support our hypothesis that concentration polarization of lipoproteins occurs in local stenosis at the distal end of carotid artery, and this in turn promotes the localization of atherosclerosis which develops in the arterial system.
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Animals , Atherosclerosis , Carotid Stenosis , Disease Models, Animal , Lipoproteins, LDL , MetabolismABSTRACT
ATP-binding cassette transporter Al (ABCAl) is a kind of membrane intergrate protein and may have multiple and diverse functions. It mediates the cellular efflux of phospholipids and cholesterol to lipid-poor apolipoproteinA- Ⅰ (apoA- Ⅰ ) and plays a significant role in high density lipoprotein (HDL) metabolism. Mutations in human ABCAl cause severe HDL deficiencies characterized by the virtual absence of apoA- Ⅰ and HDL and prevalent atherosclerosis. ABCAl expression is highly regulated and implies a variety of molecular actors. All of the nuclear receptors which involve in regulation of ABCAl expression act via the DR4 element in the ABCAl promoter. cAMP up-regulates ABCAl expression by acting both at the transcriptional and translational level. Cytokines have been shown to exert pleiotropic and antinomic effects on ABCAl transcription, In addition to these, some of enzymes and proteins such as protein kinase A, protein kinase CK2, cathepsin D are involved in the regulation of ABCAl expression. The recent progress in the structure, function and regulation of ABCAl transporter is reviewed.