ABSTRACT
Objective:To investigate the clinical value of thromboelastogram in early diagnosis of deep vein thrombosis (DVT) in patients undergoing free flap surgery of lower extremity.Methods:A retrospective study was conducted to analyze the 192 patients undergoing surgical repair of soft tissue defects at lower extremity with free anterolateral femoral flap at Department of Orthopaedics, Tongji Hospital from January 2018 to June 2022. There were 117 males and 75 females, with an age of (45.6±12.7) years and an area of skin defects ranging from 5 cm × 3 cm to 18 cm × 9 cm. The patients were divided into 2 groups according to whether DVT occurred on the first day after surgery. In the DVT group of 22 patients, there were 14 males and 8 females, with an age of (47.7±14.3) years; in the DVT-free group of 170 patients, there were 103 males and 67 females, with an age of (45.3±12.5) years. The 2 groups were compared in terms of reaction time, coagulation time, maximum amplitude and coagulation angle in the thromboelastogram. Diagram of receiver operating characteristic (ROC) curves was used to evaluate the predictive value of thromboelastography in assessing the risk of DVT after surgery.Results:The 2 groups were comparable because there was no significant difference in the baseline information or operation time between them ( P>0.05). The reaction time [(5.21±0.85) min] and coagulation time [(1.12±0.30) min] in the DVT group were significantly shorter than those in the DVT-free group [(6.48±0.06) min and (1.60±0.03) min], and the maximum amplitude [(71.45±1.17) mm] and coagulation angle [69.54° (64.59°, 76.64°) ] in the DVT group were significantly larger than those in the DVT-free group [(66.63±0.40) mm and 64.92°(54.11°, 74.21°)] (all P<0.05). The optimal cut-off points in the ROC diagram were 5.46 min at reaction time, 1.52 min at coagulation time, 72.31 mm at maximum amplitude and 59.89° at coagulation angle. The sensitivity and specificity of detecting DVT on the first day after surgery were 80.7% and 71.6%, respectively, according to the combination of the best cut-off points in the ROC diagram and all the indexes in the thromboelastogram. Conclusion:Thromboelastogram is of a great value for the diagnosis of lower extremity DVT, and of a positive significance for the prevention of serious complications after surgery in patients undergoing free flap surgery of lower extremity.
ABSTRACT
OBJECTIVE@#To explore the clinical efficacy of percutaneous vertebroplasty(PVP) combined with nerve block in the treatment of lumbar osteoporotic vertebral compression fractures under the guidance of traditional chinese medicine "theory of equal emphasis on muscle and bone".@*METHODS@#Total of 115 patients with lumbar osteoporotic vertebral compression fractures were treated by percutaneous vertebroplasty from January 2015 to March 2022, including 51 males and 64 females, aged 25 to 86 (60.5±15.9) years. Among them, 48 cases were treated with PVP operation combined with erector spinae block and joint block of the injured vertebral articular eminence (intervention group), and 67 cases were treated with conventional PVP operation (control group). The visual analogue scale(VAS) and Oswestry disability index(ODI) before operation, 3 days, 1 month and 6 months after operation between two groups were evaluated. The operation time, number of punctures and intraoperative bleeding between two groups were compared.@*RESULTS@#The VAS and ODI scores of both groups improved significantly after operation compared with those before operation(P<0.05). Moreover, the VAS and ODI scores of 3 days and 1 month after operation of the intervention group improved more significantly than that of the control group(P<0.05). The difference of VAS and ODI scores before operation and 6 months after operation between two groups had no statistical significances(P>0.05). There was no statistically significant difference in the number of punctures and intraoperative bleeding between the two groups (P>0.05).@*CONCLUSION@#Based on the theory of "equal emphasis on muscles and bones", PVP combined with nerve block can effectively relieve paravertebral soft tissue spasm and other "muscle injuries", which can significantly improve short-term postoperative low back pain and lumbar spine mobility compared to conventional PVP treatment, and accelerate postoperative recovery, resulting in satisfactory clinical outcomes.
Subject(s)
Male , Female , Humans , Fractures, Compression/surgery , Vertebroplasty/methods , Spinal Fractures/surgery , Spinal Puncture , Lumbar Vertebrae/injuries , Muscles , Treatment Outcome , Osteoporotic Fractures/surgery , Retrospective Studies , Bone CementsABSTRACT
The most toxic DNA damage is DNA double strand breaks (DSBs), which are mainly repaired by non-homologous end joining (NHEJ). DNA-dependent protein kinase (DNA-PK) belongs to phosphatidylinositol-3-kinase-related protein kinase family (PIKK) and plays a key role in NHEJ. DNA-PK is overexpressed in a variety of cancer cells and is related to the occurrence, development and drug resistance of malignant tumors. In this article, the representative DNA-PK inhibitors with anticancer effects are reviewed, in order to provide a reference to discovery novel DNA-PK inhibitors.
ABSTRACT
Objective To analyze the clinical features and prognosis of adult optic neuritis patients with positive serum myelin oligodendrocyte glycoprotein antibody (MOG-ON) or aquaporin 4 antibody (AQP4-ON).Methods A retrospective study. From December 2015 to February 2018, in the Beijing Chaoyang Hospital of Capital Medical University and Chinese PLA General Hospital, 162 eyes of 132 patients with positive serum MOG antibody and AQP4 were included in the study. There were 42 MOG-ON patients (49 eyes, 31.8％), 90 AQP4-ON patients (113 eyes, 68.2％). The clinical features of optic neuritis (annual recurrence frequency, incidence of optic disc edema), brain and optic nerve enhanced MRI, serum autoimmune antibodies and cerebrospinal fluid test results were compared between MOG-ON and AQP4-ON patients. All patients were treated with intravenous methylprednisolone sodium succinate in the acute phase and then switched to oral prednisone acetate tablets. The average follow-up time was 15 months. The glucocorticoid dependence, visual prognosis, spinal cord symptoms, and myelitis at the last follow-up were comparatively analyzed between MOG-ON and AQP4-ON patients. The comparison of the count data was performed by χ2 test, and the measurement data were compared byt test.Results Compared with AQP4-ON patients, MOG-ON patients had higher annual recurrence frequency (t=3.760,P=0.005), higher incidence of optic disc edema (χ2=14.777,P<0.001), higher incidence of hormone dependence (χ2=25.496,P<0.001), and better visual prognosis (χ2=28.759, P<0.001). MOG-ON patients were more likely to involve the optic nerve, AQP4-ON patients were more likely to involve the optic chiasm and the optic tract. There was a significant difference in the location of lesions between MOG-ON and AQP4-ON patients (χ2= 5.447,P= 0.015). The proportion of AQP4-ON patients with autoimmune antibodies was significantly higher than that of MOG-ON patients (χ2 = 20.453,P<0.001). The results of cerebrospinal fluid test showed that the white blood cell count of patients with MOG-ON and AQP4-ON were within the normal range, but the IgG level of AQP4-ON patients was significantly higher than that of MOG-ON patients (t=8.669,P<0.001). At the last follow-up, there were 7 and 29 patients of myelitis in MOG-ON and AQP4-ON patients respectively (χ2=3.494,P=0.046).Conclusions The clinical characteristics of MOG-ON were different from AQP4-ON. The incidence of optic disc edema and recurrence rate were higher, but the proportion of autoimmune antibodies was lower. MOG-ON was more likely to show hormone dependence, but the visual prognosis was better. AQP4-ON was easily involved in optic chiasm and optic tract, and the incidence of myelitis was higher.
ABSTRACT
Objective The number of children with polydactyly is increasing.In addition to genetic factors,an influence of maternal behavior or environmental effects during pregnancy is becoming increasingly apparent.However,epidemiological data on these effects are lacking.Methods This hospital-based,case-control study enrolled 143 infants with polydactyly and 286 controls without genetic diseases to evaluate the association between active and passive maternal smoking during pregnancy and the likelihood of giving birth to a child with polydactyly.Results Active and passive maternal smoking during pregnancy was associated with an increased risk of giving birth to a child with polydactyly (active smoking:OR=4.74,95％CI:1.43-15.65,P=0.011;passive smoking:OR=2.42,95％CI:1.32-4.44,P=0.004).After adjusting for confounders,smoking during pregnancy remained significant influence on polydactyly (active smoking:aOR=7.27,95％ CI:1.72-30.72,P=0.007;passive smoking:aOR=2.41,95％ CI:1.11-5.23,P=0.026).Conclusion Active and passive maternal smoking during pregnancy appears to be a risk factor for polydactyly in newborns.
ABSTRACT
Objective The number of children with polydactyly is increasing.In addition to genetic factors,an influence of maternal behavior or environmental effects during pregnancy is becoming increasingly apparent.However,epidemiological data on these effects are lacking.Methods This hospital-based,case-control study enrolled 143 infants with polydactyly and 286 controls without genetic diseases to evaluate the association between active and passive maternal smoking during pregnancy and the likelihood of giving birth to a child with polydactyly.Results Active and passive maternal smoking during pregnancy was associated with an increased risk of giving birth to a child with polydactyly (active smoking:OR=4.74,95％CI:1.43-15.65,P=0.011;passive smoking:OR=2.42,95％CI:1.32-4.44,P=0.004).After adjusting for confounders,smoking during pregnancy remained significant influence on polydactyly (active smoking:aOR=7.27,95％ CI:1.72-30.72,P=0.007;passive smoking:aOR=2.41,95％ CI:1.11-5.23,P=0.026).Conclusion Active and passive maternal smoking during pregnancy appears to be a risk factor for polydactyly in newborns.
ABSTRACT
Objective To investigate prognosis and related factors of infectious pancreatic necrosis(IPN) caused by multidrug-resistant organisms(MDROs).Methods Clinical data of 53 IPN patients admitted to a hospital between October 2010 and March 2016 were analyzed retrospectively,patients were divided into MDRO infection group and common bacterial infection group according to antimicrobial resistance of pathogens isolated from peripancreatic drainge fluid,prognosis and related factors of two groups were compared.Results Among 53 IPN patients with confirmed evidence for pathogenicity,33(62.3％)were in MDRO infection group,and 20(37.7％)were in common bacterial infection group,the most common MDROs isolated from peripancreatic drainage was multidrug-resistant Acinetobacter baumannii (MDRO-AB) (37.5％,18/48).The mortality of IPN patients was 30.2％ (16/53),mortality of MDRO infection group was higher than common bacterial infection group(39.4％ [13/33] vs 15.0％ [3/ 20],P＜0.05);the severity score,length of intensive care unit (ICU) stay,and hospitalization expenses in MDRO infection group were all higher than common bacterial infection group(all P＜0.05).The mortality of IPN patients were closely associated with MDRO infection and severity score of acute pancreatitis (all P ＜ 0.05).Conclusion Prognosis of patients with MDRO infection is poor,treatment is difficult,MDRO infection has become one of the most important challenge to the treatment of severe acute pancreatitis.
ABSTRACT
SRT1720, a new discovered drug, was reported to activate silent information regulator 1 (SIRT1) and inhibit the chondrocyte apoptosis. However, the underlying mechanism remains elusive. In the present study, the chondrocytes were extracted from the cartilage tissues of New Zealand white rabbits, cultured in the presence of sodium nitroprusside (SNP) (2.5 mmol/L) and divided into five groups: 1, 5, 10, and 20 μmol/L SRT1720 groups and blank control group (0 μmol/L SRT1720). MTT assay was used to detect the chondrocyte viability and proliferation, and DAPI staining and flow cytometry to measure the chondrocyte apoptosis. The expression levels of SIRT1, p53, NF-κB/p65, Bax, and peroxisome proliferator-activated receptor gamma coactivator 1-α (PGC-1α) were detected by Western blotting and the expression levels of SIRT1, type II collagen, and aggrecan mRNA by RT-PCR. The results showed that in the SRT1720-treated groups, the nuclei of chondrocytes were morphologically intact and had uniform chromatin. In the blank control group, nuclear rupture into debris was observed in chondrocytes. With the SRT1720 concentration increasing, the chondrocyte viability increased, the apoptosis rate decreased, the protein expression levels of SIRT1 and PGC-1α and the mRNA expression levels of type II collagen and aggrecan increased ({ptP}<0.05), and the expression levels of p53, NF-κB and bax decreased (P<0.05). It was suggested that SRT1720 inhibits chondrocyte apoptosis by activating the expression of SIRT1 via p53/bax and NF-κB/PGC-1α pathways.
Subject(s)
Animals , Rabbits , Aggrecans , Genetics , Metabolism , Apoptosis , Cartilage, Articular , Cell Biology , Metabolism , Cell Proliferation , Cell Survival , Chondrocytes , Cell Biology , Metabolism , Chromatin , Chemistry , Metabolism , Collagen Type II , Genetics , Metabolism , Gene Expression Regulation , Heterocyclic Compounds, 4 or More Rings , Pharmacology , Nitroprusside , Toxicity , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha , Genetics , Metabolism , Primary Cell Culture , Signal Transduction , Genetics , Sirtuin 1 , Genetics , Metabolism , Transcription Factor RelA , Genetics , Metabolism , Tumor Suppressor Protein p53 , Genetics , Metabolism , bcl-2-Associated X Protein , Genetics , MetabolismABSTRACT
The clinical results of the application of pedicled vascularized bone graft (VBG) from Lister's tubercle vs. traditional bone graft (TBG) were evaluated and compared. Thirteen cases of symptomatic scaphoid nonunion were treated between January 2011 and December 2012, including 7 cases subject to VBG and the rest 6 cases to TBG, respectively. Outcomes were assessed by modified Mayo wrist score system. All cases were followed up for an average period of 3.5 months after operation. The results showed that total scores in VBG group were 86.4±9.4 after operation with excellent result in 4 cases, good in 2 and acceptable in one, and those in TBG group were 71.7±9.3 after operation with good result in 2 cases, acceptable in 3 and disappointing in one. Total score of wrist function was significantly improved in VBG group as compared with TBG group (P<0.05). Our study suggests that VBG method is more effective for treating scaphoid nonunion than TBG method.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Transplantation , Methods , Fractures, Ununited , General Surgery , Hand Strength , Physiology , Pain , Range of Motion, Articular , Physiology , Retrospective Studies , Scaphoid Bone , Wounds and Injuries , General Surgery , Surgical Flaps , Treatment Outcome , WristABSTRACT
The clinical results of the application of pedicled vascularized bone graft (VBG) from Lister's tubercle vs. traditional bone graft (TBG) were evaluated and compared. Thirteen cases of symptomatic scaphoid nonunion were treated between January 2011 and December 2012, including 7 cases subject to VBG and the rest 6 cases to TBG, respectively. Outcomes were assessed by modified Mayo wrist score system. All cases were followed up for an average period of 3.5 months after operation. The results showed that total scores in VBG group were 86.4±9.4 after operation with excellent result in 4 cases, good in 2 and acceptable in one, and those in TBG group were 71.7±9.3 after operation with good result in 2 cases, acceptable in 3 and disappointing in one. Total score of wrist function was significantly improved in VBG group as compared with TBG group (P<0.05). Our study suggests that VBG method is more effective for treating scaphoid nonunion than TBG method.
ABSTRACT
This study investigated the protective effect of EGB761 on blood vessels of denervated gastrocnemius of rat and its possible mechanism. Fifteen male adult SD rats were randomly divided into three groups: normal control group (n=3), control group (n=6) and EGB761-treated group (n=6). The rats in the control and EGB761-treated group underwent a neurotomy to bilateral sciatic nerves. Then, they were administered EGB761 [100 mg/(kg·d)] and isovolumic normal saline, respectively by gavage everyday. No treatment was given to the rats in the normal control group. Gastrocnemius was harvested at 1 and 3 week(s) postoperatively in each group. Immunohistochemical method was used to detect the ratio of capillary/fiber (CFR) of denervated gastrocnemius and the expression of VEGF, fetal liver kinase -1(Flk-1) receptor and HSP70 in the vascular wall. The results showed that in the normal control group, VEGF, Flk-1 and HSP70 were expressed in the vessel wall of gastrocnemius, with Flk-1 expressed only in the endothelial cell of vessels. CFR in the EGB761-treated group was significantly higher than that in the control group at 1 week and 3 week(s) after neurotomy. The expression of VEGF and Flk-1 in the vessel wall of both control and EGB761-treated group was much lower than that in the normal control group, and the expression of these proteins in the EGB761-treated group was decreased as compared with that in the control group. The expression of HSP70 in the vessel wall of both control and EGB761-treated groups was enhanced when compared with that in the normal control group, and it was substantially augmented in the EGB761-treated group in comparison to the control group. It was concluded that EGB761 has a protective effect on blood vessels of denervated gastrocnemius, which is related to the increased HSP70 expression but not the expression of VEGF and its receptor Flk-1.
ABSTRACT
Background It is very important for us to understand retinal function change in the patient with diabetic mellitus in clinic. At present,the study about diabetic mellitus associated with macular edema includes fundus fluorescense angiography ( FFA) and multifocal electroretinogram ( mfERG) etc.. However, seldom research is performed in the mfERG findings for different types of diabetic macular edema. Objective This study aimed to investigate the mfERG change in different types of diabetic macular edema compared with normal population. Methods Fifty-seven eyes with diabetic macular edema from 40 patients and 35 eyes from age-and gender-matched normal subjects were enrolled in this study. The eyes with diabetic macular edema were assigned to local macular edema group (n=16) ,diffuse macular edema group (n = 22) and cystoid macular edema ( n = 17 ) based on the manifestation of FFA. MfERG was recorded in all the individuals. The informed consent was obtained from each subject prior to any the medical examination. Results In focal diabetic macular edema group,the response density of P1 wave was significantly attenuated in ring 1 , showing a statistical difference in comparison with controls (t =2. 170,P = 0.038) ,and the latencies of P1 and N1 waves showed obvious prolong in ring 4 and 5 (t = 2.519,P = 0. 017 ;t = 2. 451 ,P = 0. 020). In diffuse diabetic macular edema group,the response densities of P1 and N1 waves were declined in ring 1,3,5 and ring 1,3,4,5 respectively,and the latencies of P, in ring 3,4 were significantly delayed respectively in comparison with controls (all P < 0. 05 ). In cystoid diabetic macular edema group, the response densities of P1 and N1 waves were lowed from ring 1 through 5 respectively, and the latencies of P1 and N1 waves were significantly longer from ring 3 through 5 and ring 4 respectively with the statistically significant difference from controls (all P<0. 05). The visual function of fovea was badly damaged. Conclusion These studies indicate that the most serious damage of visual function is in foveal area in cystoid diabetic macular edema group, and is then parafoveal area of diffuse diabetic macular edema group and perifoveal area in focal diabetic macular edema group. The outcome of mfERG presents a good consistency with FFA findings in the patients with diabetic macular edema.
ABSTRACT
@#Objective To introduce the clinical application of a extensive revense peroneal artery flap in repairing big soft tissue defect in foot, especially in repairing a big defect in distal foot and the exposure of one or more metatarsophalangeal joint. Methods The skin flaps were used in 11 cases to repair the big soft tissue defect in foot, including the distal part of foot. The flap upper boundary may surpass the capitulum fibulae; The lower boundary may reach the back line between external malleolus and internal malleolus; Lat-eral boundary could overrun anterior margin of fibula about 2 cm; Inboard boundary could get to medial mar-gin of gastrocnemius muscle. In attention: the two branch vessels from peroneal vessel in the site of 11-13 cm and of 5-7 cm above the outer anker would be included in the flap. Results Ten of 11 skin flaps survived satisfactory. A small, marginal portion of one flap in one case presented necrosis. Conclusion The reverse peroneal artery flap is easy to elevate and safety, which is an ideal flap for a huge soft tissue defect in foot, especial in the distal part of foot.
ABSTRACT
Adult stem cells from skeletal muscle cells were induced to differentiate into cardiocytes to see if stem cells from another different but histologically-comparable tissues can differentiate to the target cells. Skeletal muscles-derived stem cells (MDSCs) were isolated from adult skeleton muscle tissues by differential adhesion, and immunocytochemically identified by using Sca-1. In order to induce the proliferation but not differentiation of MDSCs, the cells were cultured in Dulbecco's modified Eagle's medium/F12 (DMEM/F12) supplemented with 1:50 B27, 20 ng/mL basic fibroblast growth factor (bFGF), 20 ng/mL epidermal growth factor (EGF) in a suspension for 6 days. Then these stem cells were treated with 5 mumol/L 5-azacytidine for 24 h in an adherence culture. The characteristics of induced cells were examined by immunocytochemistry, quantitative real time RT-PCR and morphological observation of cell phenotype. Our results showed that the appearance of some cells gradually changed from spindle-shape into polygonal or short-column-shape. Some of these post-treated cells could contract spontaneously and rhythmically. The expression of GATA-4 and cTnT was increased 1 and 2 week(s) after the treatment. And about 16.6% of post-treated cells were cTnT-positive. Therefore, we are led to conclude that skeletal muscle-derived stem cells could differentiate into cardiocyte-like cells, which exhibited some characteristics of cardiocytes.
ABSTRACT
Pleiotrophin, discovered in 1989, was thought as a muhi-funetional growth factor; It plays an important role in tumor occurrence and central neural system. The latest research showed pleiotrophin signal pathway probably takes part in neural repair after peripheral nerve injury, especially in the followed crisis point, such as the protection of spinal cord neuron, the promotion of the speed of neuron axon regeneration, the guidance of neuron axon regeneration, skeleton muscle reirmervation. It potentially makes a key role in the guidance of neural axon regeneration in peripheral neural system and muscle reianervation. Along with the related researches go deep, pleiotrophin gene might become a controllable target for promoting the result of peripheral neural repair and reconstructing the neuromuscular junction.
ABSTRACT
BACKGROUND: In repair of nerve defect with allogenic nerve graft, to reduce immune rejection is one of the key problems. At present, the main approach is to reduce antigenicity of grafted nerve segment and apply generally immune inhibitor.OBJECTIVE: To observe the effects of freeze/thaw treatment and local application of transforming growth factor beta 1 (TGF-β1) plasmid on frozen nerve allograft.DESIGN: Randomized controlled animal experiment was designed.SETTING: Department of Hand Surgery, Union Hospital, Tongji Medical College Affiliated to Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Tongji Medical College of Huazhong University of Science and Technology from January 2003 to December 2004, in which 40 Wistar healthy and adult rats were employed,from different delivery and were randomized into experimental group and control, 20 rats in each one.METHODS: Transforming growth factor-β1 (TGF-β1) plasmid and frozen allogenic sciatic nerve were prepared. In experimental group and control,sciatic nerve was cut off 2.0 cm in length, in the foramen 0.5 cm beneath piriformis. The nerve defect was repaired with pre-frozen allogenic nerve 2.0 cm in length. In experimental group, TGF-β1 plasmid was injected in local muscle and two broken ends of nerve. In the control group, physiological saline of equal volume was injected. In the 6th and 12th weeks, the samples were collected from 10 rats in each group for sectioning, staining,axonal counting and statistical analysis.RESULTS: No any animal was died in experiment and all of animals entered result analysis. In the 6th weeks, in the control group, mild edema appeared among axons on the grafted segment of nerve and in the experimental group, there was no edema among axons and the regenerated nerve numbers were close to the normal. In the 12th week, in the experimental group, the entire grafted nerve segment was basically filled up by the regenerated axons;myelinated nerve fiber was arranged in order and both axons and myelins were developed well. The regenerated axonal count in experimental group was more significantly than the control, indicating extremely significant difference [(98.6±4.8), (75.8±5.1) counts/μm2, t=2.962, P ＜ 0.01].CONCLUSION: Freeze/thaw treatment can decrease antigenicity of allogenic nerve, which provides the possibility of repair of nerve defect. Local application of TGF-β1 plasmid can provide immune inhibition locally and reduce immune rejection in the host.
ABSTRACT
BACKGROUND: Auto-neural transplantation is used widely on peripheral neurological defect, but it also has some difficulties. So some scholars try to use xenoma-neural transplantation; however, it is hard todeal with immunological rejection.OBJECTIVE: To study the effect of transforming growth factor-β1 (TGFβ1) used in local area on neural regeneration after transplantation of fresh nerve allograft.DESIGN: Randomized controlled study.SETTING: Hand Surgery Department of Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and TechnologY.MATERIALS: The experiment was conducted in the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between August 2001 and October 2002. Totally 60healthy adult Wistar rats from different confinements were randomly divided into three groups including experimental group, blank group and control group with 20 in each group.METHODS: TGF-β1 plasmid was prepared for using. Establishment of animal model: Sciatic nerve at the 0.5 cm deep of piriformis muscle of rats in the two groups was cut with disinfectant razor into chip regularly about 2.0 cm. The excisional nerve segment was exchanged to transplant plerosis neurological defect. TGF-31 was injected into the local muscles and bisection of nerve in the experimental group, and equal volume of saline was injected into rats in the blank group and the control group. In addition, rats in the experimental group and the blank group were not treated with any drugs, but cyclosporine A (15 mg/kg) was used to feed rats in the control group. Ten rats from each group were taken for section and staining at the 6th and the 12th week: ① Glees-luxot fast blue staining method; ② myelin sheath fast blue staining method. Axonal amount: Fields were randomly taken from the middle staining samples 12 weeks later and 1.0 mm2 interaxis-cylinder was counted under light microscope of 400 times. Comparisons among groups were analyzed with i test.MAIN OUTCOME MEASURES: Morphological observation and axonal amount of transplanted area in each group.RESULTS: Quantitative analysis of the experimental animals: Totally 60rats entered the final analysis without any loss. ① Infiltration of monocytes was observed widely in various areas of graft in the blank group;meanwhile, desiccation of myelin sheath and plenty of vacuolations were also observed, especially at the sixth week. The whole graft was infiltrated by monocyte with severe rejection. Few axis-cylinders were regenerated in the transplanted segment. At the 12th week, graft was slender, plenty of scar tissues were proliferated, edema was observed obviously, few Schwann cells and regenerated axis-cylinders were observed, and lots of regenerated axis-cylinders did not pass the whole graft. A few infiltrative monocytes were observed, and edema was observed obviously, but new vessel was formed in transplanted nerve, and regenerated axis-cylinders passed the whole graft in the experimental group and the control group.Lots of Schwann cells were observed at the 6th week; meanwhile, regenerated axis-cylinders passed the whole graft at the 12th week, a quantitative myelinization was formed, Schwann cells proliferated obviously, and edema between axis-cylinder was relieved. Numbers of peripherally regener ated axis-cylinder of nerve and remyelination in each ransplanted area were more than those in the central area, and edema between peripheral axis-cylinder was milder than that in the central area in the experimental group. ② Twelve weeks after operation, 5 rats in each group were selected to observe their fields, which were taken randomly from neural graft,under the microscope of 400 times to count 1.0 mm2 inter-axis-cylinders.Number of axis-cylinder was higher in the experimental group and the control group than that in the blank group, and the differences were significant [(78.3±4.6), (76.1±4.2) , (15.0±3.5) ,t=3.056, t=2.948, P ＜ 0.01];however, number in the experimental group was similar to that in the control group, and differences were not significant [(78.3±4.6), (76.1±4.2),t=1.982 P ＞ 0.05].CONCLUSION: TGF-β1 used in local area plays an immunosuppressive action locally, decreases host immunological rejection, increases the number of axis-cylinder, and accelerates growth of nerve.
ABSTRACT
BACKGROUND: At present, the repair by means of suture is still commonly used to repair the peripheral nerve injury and rupture, while the adhesion of the fibrin glue repairing peripheral nerve injury has been considered as a new topic of study.OBJECTIVE: To study the countertraction intensity of peripheral nerve and its dynamic changes after repaired with the adhesion of fibrin glue.DESIGN: A randomized controlled experimental study.SETTING and MATERIALS: The study was completed in the Laboratory of Biodynamics, Department of Orthopaedics, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. The healthy adult male Wistar rats weighing 250- 300 g were selected for the experiment.INTERVENTIONS: Totally 96 Wistar rats were completely randomized into the suture group and the adhesion group. Their sciatic nerves were cut, and the incisions were well lined. The fibrin glue was adopted in the adhesion group, while 11 -0 suture was adopted in the suture group. On the very day and 3, 7, 14, 21, 28 days after the operation, 8 rats were respectively taken each from the suture group and the adhesion group. The free sciatic nerves of them were detected immediately by the biodynamic test.MAIN OUTCOME MEASURES: The peak load and the power consumption were measured when the nerves ruptured and the nerve stress-strain curve was described.RESULTS: In normal countertraction intensity curve of the nerve, the elastic peculiarity can be manifested. Between the suture group and the adhesion group, there were no notable significances of the maximal countertraction intensity and power consumption on the very day and 14, 21, 28 days after the operation( P ＞ 0.05). While 3 days after the operation, the maximal countertraction intensity of the two groups was(1.35± 0. 27),( 1.97 ± 023) N/mm2 respectively, the power consumption was (0. 028 ± 0.007), (0.040 ± 0.003) J/mm2 respectively. Seven days after the operation, the maximal countertraction intensity was( 1.93 ± 0.26), (2.74± 0.30) N/mm2 respectively, the power consumption was(0.047±0.009), (0.063±0.007) J/mm2 respectively. The differences both had the notable significance ( P ＜ 0.05).CONCLUSION: The fibrin glue has enough countertraction intensity and can gratify the need of such nerve repairs.
ABSTRACT
To study the characteristics of acute rejection after limb allotransplantation, 29 male Sprague-Dawley rats were randomly divided into 2 groups, with 15 rats in control group and 14 rats in experimental group. Each rat in control group underwent limb replantation. Each rat in experimental group received limb transplantation from Wistar rat. No immunosuppressive drugs were used after operation. The circulation of the transplanted limb, time and signs of rejection, histopathological changes in the tissues of the limb graft when rejected and survival time of limb grafts were evaluated. In the control group, no signs of rejection were observed, the circulation of each replanted limb was normal, it could survive for a longer time. The experimental group showed clinical signs of rejection (sub dermal edema and erythema) after a mean time of 3.36+/-1.15 days, and the mean survival time of the allografts was only 7+/-0.78 days. Histopathological examination showed most violent rejection reaction in skin. It is concluded that with Wistar-to-SD limb transplantation without use of immunosuppression, rejection of the grafts would occur after a mean time of 3.36+/-1.15 days; the earliest signs of rejection were edema and erythema of the skin, skin being the most representative component of limb graft rejection.
Subject(s)
Animals , Male , Rats , Acute Disease , Extremities , Transplantation , Graft Rejection , Graft Survival , Random Allocation , Rats, Sprague-Dawley , Rats, Wistar , Skin , Allergy and Immunology , Transplantation, HomologousABSTRACT
To study the characteristics of acute rejection after limb allotransplantation, 29 male Sprague-Dawley rats were randomly divided into 2 groups, with 15 rats in control group and 14 rats in experimental group. Each rat in control group underwent limb replantation. Each rat in experimental group received limb transplantation from Wistar rat. No immunosuppressive drugs were used after operation. The circulation of the transplanted limb, time and signs of rejection, histopathological changes in the tissues of the limb graft when rejected and survival time of limb grafts were evaluated. In the control group, no signs of rejection were observed, the circulation of each replanted limb was normal, it could survive for a longer time. The experimental group showed clinical signs of rejection (sub dermal edema and erythema) after a mean time of 3.36+/-1.15 days, and the mean survival time of the allografts was only 7+/-0.78 days. Histopathological examination showed most violent rejection reaction in skin. It is concluded that with Wistar-to-SD limb transplantation without use of immunosuppression, rejection of the grafts would occur after a mean time of 3.36+/-1.15 days; the earliest signs of rejection were edema and erythema of the skin, skin being the most representative component of limb graft rejection.