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Objective To evaluate the relationship between GATA-3 and T-bet and inhibition of the differentiation of human T helper cells by morphine.Methods Ten healthy volunteers,aged 20-50 yr,weighing 50-70 kg,were enrolled in the study.Peripheral venous blood samples were taken in the early morning.Peripheral blood mononuclear cells (PBMCs) were isolated and assigned into 5 groups (n=10 each).PBMCs were incubated routinely (group C).PBMCs were incubated in the presence of PMA and ionomycin (group P),morphine 50 μg/ml (group M),morphine 50 μg/ml + naloxone 50 μg/ml (group MN) or naloxone 50μg/ml (group N),and were then stimulated with PMA and ionomycin for another 4 h.The percentage of Th1 and Th2 cells was detected by flow cytometry.The Th1/Th2 ratio was calculated.Interferon (IFN)-γ and interleukin (IL)-4 concentrations in the supematant were determined using ELISA.The activities of GATA-3 and T-bet were analyzed by EMSA.Results Compared with group P,the percentage of Th1 and Th2 cells,Th1/Th2 ratio,IFN-γand IL-4 concentrations in the supernatant,and GATA-3 and T-bet activities were significantly decreased in group M,the percentage of Th1 cells,Th1/Th2 ratio,and IFN-γ concentration in the supernatant were significantly decreased in group MN (P ＜ 0.05 or 0.01).Compared with group M,the percentage of Th1 and Th2 cells,Th1/Th2 ratio,IFN-γ and IL-4 concentrations in the supernatant,and GATA-3 and T-bet activities were significantly increased in group MN (P ＜ 0.05 or 0.01).There was no significant difference in the indexes mentioned above between groups N and C (P ＞ 0.05).Conclusion Morphine inhibits the differentiation of human T helper cells by activating opioid receptors,which may be related to the inhibition of GATA-3 and T-bet activities.
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Objective To analyze the hidden blood loss following primary total hip arthroplasty (THA) and put forward corresponding treatment measures.Methods A retrospective study was done on the 138 patients with hip disease managed with THA for the preliminary unilateral replacement from January 2009 to January 2011.There were 48 males and 90 females,at age range of 45-71 years (mean,62 years).The pre-and post-operative blood routine and intra-and post-operative blood loss and transfusion were analyzed and hidden blood loss during peri-operation period was evaluated.Results All the patients were trnsfused with autologous blood intra-operatively.Intra-operative blood loss was (495 ± 105) ml and postoperative drainage volume was ( 121 ±29) ml.In addition,116 patients were given red cell suspension (RCS) and blood plasma to raise the level of hemoglobin and the RCS transfusion volume was (600 ± 225) ml.The total blood loss was (1 521 ±156) ml including hidden blood loss of (822 ±96) ml (57.2％).No obvious differences were observed in the indicators between males and females.Conclusions Hidden blood loss is an important factor that affects the prognosis of the patients treated by THA.In order to secure their safety in perioperative period and benefit their recovery,assessment of the amount of bleeding in THA should fully take the hidden blood loss into consideration and prompt treatment measures should be taken to fully and effectively recover their effective circulation blood volume.
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Objective To explore the isometric attachment site of the posterolateral structure in the femoral lateral condyle and introduce the method of knee posterolateral complex(PLC) reconstruction with the semitendinosus tendon. Methods Isometric reconstruction of the chronic PLC injury of knee joint in 18 cases, were performed with the semitendinosus tendon from February 2001 to February 2005. Of all patients, there were 12 males and 6 females, average age was 39 years old(range, 19-52 years old). All cases were chronic injuries, with duration of 1.5-14 months. 3 cases were simple PLC injury, 10 cases were PLC injury with posterior cruciate ligament(PCL) injury, 2 of which had undergone PCL reconstruction about 6.5 months. 3 cases combined with anterior cruciate ligament(ACL) injury, 2 cases combined with ACL and PCL injury. To put in the double semitendinosus tendon from the bony tunnel of anatomical insertion of the fibular collateral ligment in caput fibulae and put out from the bony tunnel of anatomical insertion of the popliterofibular ligment in the caput fibulae, then fix them respectively in the isometic bony tunnel of the femoral lateral condyle. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results It was relatively isometric from the femoral attachment site of the popliteal tendon to the anatomical insertion of the popliterofibular ligment in the caput fibulae. The better isometric attachment site was from the anatomical caput fibulae attachment site to 8-10 mm in front of the anatomical femoral attachment site of the lateral collateral ligament. The average follow-up period was 14 months(12-24 months). There was no varus knee instability in full extension. At 30? flexion, one-grade varus instability was found in 2. At 30? and 90? flexion, external rotation range increased by 6? in 3 cases, remained the same in 14 cases, and decreased in 1 case, all compared with the healthy side. Conclusion The method provided good stability for the knee and acquired satisfactory clinical results.
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Objective To evaluate the diagnostic value of the C 2 “hypertrophic sign” in the axis fracture.Methods 37 cases with C 2 fracture confirmed by radiography,CT and operation partly retrospectively analysed,there were 29 men and 8 woman.After trauma all cases were examined by X-ray and 11 cases by CT scan.27 cases underwent operation.Results The incidence rate of the C 2 “hypertrophic sign” was 53.13%.This sign characterized by the distance increased between the anterior and posterior of the axis on the lateral conventional radiography compared with that of C 3 vertebrae.The maximal increasing distance was 11 mm and minimal one was 2.3 mm with average 4.3 mm.Fracture line and swollen soft tissue in front of the vertebra were showed in some cases.Conclusion The C 2 “hypertrophic sign” is main radiographic sign of C2 fracture.