ABSTRACT
Objective:To explore the application of 3D printing mirror models and segmentation models in preoperative planning for patellar fractures.Methods:Retrospectively analyzed were the data of 46 patellar fractures which had been treated at Department of Orthopedics, Liyang City People's Hospital from January 2016 to August 2020 using 3D printing mirror models and segmentation models in preoperative planning. There were 26 males and 20 females, aged from 19 to 79 years (average, 51.5 years). All the fractures belonged to AO type C. According to the design requirements of a solid model, the patients with DICOM CT data of bilateral lower extremities were assigned into the mirror model group (24 cases) while those with DICOM CT data of only a unilateral lower extremity into the segmentation model group (22 cases). In the mirror model group, CT scans of bilateral knee joints and the proximal tibia exceeding 15 cm were required, while in the segmentation model group, CT scans of only the affected knee joint were required. The original DICOM data were extracted and imported into software Mimics 19.0. In the mirror model group, after the "three-level long-short axis control" method was used to judge the symmetry, the original fracture model and the mirror model were created and printed respectively. During the operation, the fracture line drawn by the mirror model was used to find the fracture fragments with a similar shape which were to be assembled and fixated. The fracture fragments in the segmentation model group were divided into independent entities, converted into STL files and printed separately before the bone fragments were assembled and fixated in sequence. X-ray films were taken after operation. Recorded were the simulated operation time, visual analog scale (VAS) of the knee joint at one month after operation, and B?stman scores at one and 6 months after operation.Results:All patients were followed up for 6 to 24 months (mean, 13.6 months). In preoperative planning, only the mirror model was suitable for patients with comminuted fracture with compression and impaction, both models were suitable for fractures without impaction, compression or impaction, and the segmentation model was suitable for patients with bilateral fractures at the same site, poliomyelitis, one limb missing, and previous fracture. In the mirror model group in which the patients were controlled bilaterally using the "three-level long-short axis control" method, there was no significant difference among the 6 sets of data at 3 levels on both sides ( P>0.05). For the segmentation model group and the mirror model group, the time for preoperative simulated operation averaged 11.2 min and 9.2 min respectively, the VAS score at one month after operation was both lower than 3 points, and the B?stman scores at one and 6 months after operation were both larger than 20 points. Conclusions:The mirror image model of the unaffected patella can be used as the fracture recovery model for the affected side, but the symmetry needs to be verified in advance in case of severe degeneration. Both the 3D printed mirror model and the 3D segmentation model are suitable for preoperative planning for patellar fractures as they are complementary. Patients in both groups can obtain good joint function after treatment.
ABSTRACT
Objective To establish the finite element (FE) model of the anterior tibiofibular ligament injury by ankle fracture fixation, so as to compare the stress and deformation of the finite element model by using anchor-reinforced repair combined with screw fixation. Methods CT images of the ankle joint from a normal young male volunteer was selected to establish the FE model of the anterior tibiofibular joint injury by ankle fracture fixation. The injury models were divided into experimental group and control group, which were fixed by anchors or screws, respectively. The maximum stress distributions and the maximum deformation of the two models under various load conditions were observed through the FE analysis and calculation. Results Under the vertical load, the deformation of the experimental group was 6.8% higher than that of the control group. The deformation increased by 22.6% under external rotation load, while the deformation decreased by 5.1% under internal rotation load. Under the same load, differences in the maximum peak stress on the model between the control group and the experimental group was not significant. Due to the anchor fixation, the maximum stress of the experimental group were borne by the screw that fixed the distal tibial fracture, while the maximum stress of the control group was borne by strong fixation of the steel plate and the inferior tibiofibular screw. The maximum stresses on the anchor were distributed on the screw, and the suture mainly played the role of fixing. Conclusions The lower tibiofibular screw and anchor fixation could effectively treat the tibiofibular instability left by ankle fracture fixation. The anchor fixation dispersed the stress on the steel plate, and it showed greater ankle joint deformation ability while fixing the lower tibiofibula, so as to avoid the risk of broken nails.
ABSTRACT
Objective:To observe the effect of recombinant human vascular endostatin(ES) on retinal barrier related proteins in early streptozotocin (STZ)-induced diabetic rats.Methods:Diabetes rat model was induced by STZ.Two weeks after the model was successfully constructed, 36 diabetic model rats were randomly divided into the model group, 1.0 μl ES group, 2.5 μl ES group, 5.0 μl ES group, 2.5 μl bevacizumab group, and the combination therapy group, with 6 rats in each group.Different doses of recombinant human ES and 2.5 μl bevacizumab were injected into the vitreous cavity of the right eye according to the grouping.Six normal rats were selected as the blank control group.At 4 weeks after intravitreal injection, the retinal tissue of the right eye in each group was collected, and the expression levels of inter cellular cell adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1), occludin, claudin-5, vascular endothelial growth factor(VEGF) and other proteins in retinal tissue were detected by Western blot assay.The use and care of animals was in accordance with the regulations for the administration of experimental animals.Results:The diabetic model rats showed polydipsia, polyuria, polyphagia and other typical diabetic symptoms, the body quality decreased significantly, and the success rate of modeling was 100%.Western blot results showed that the expression levels of VCAM-1, ICAM-1 and VEGF in the blank group, the 2.5 μl ES group, the 5.0 μl ES group, the bevacizumab group, the combination therapy group were significantly lower than those in the model group, while the expression levels of claudin-5 and occludin were significantly higher than those in the model group, the differences were statistically significant (all at P<0.05). The relative expression of occludin protein in the 1.0 μl ES group was significantly higher than that in the model group(0.23±0.02 vs.0.13±0.02), while the relative expression of ICAM-1 and VEGF was significantly lower than that in the model group(0.53±0.01 vs.0.81±0.01; 0.57±0.00 vs.0.86±0.00), the differences were statistically significant (all at P<0.05). As the dose of ES increased, the relative expressions of claudin-5 and occludin protein tended to increase, while the relative expressions of VCAM-1, ICAM-1 and VEGF tended to decrease. Conclusions:Recombinant human vascular endostatin can directly or indirectly reduce the release of inflammatory factors VCAM-1 and ICAM-1 and inhibit the expression of VEGF, thereby reduce the loss of retinal tight junction.
ABSTRACT
Lung cancer is a global disease with high morbidity and mortality, which seriously affects human health. The long-term existence of chronic pulmonary inflammation is closely related to the occurrence and development of lung cancer, neutrophils are not only involved in acute and chronic inflammation, but also in the composition of tumor microenvironment (TME), which is closely related to the occurrence and development of tumors. Recent studies have found that tumor-associated neutrophils (TANs) play an important role in the occurrence and development of lung cancer. This article reviews the role, mechanism and clinical significance of tumor-related neutrophils in lung cancer.
ABSTRACT
Chronic obstructive pulmonary disease (COPD) and lung cancer are global high incidence and high mortality diseases, which seriously increase the socio-economic burden. Smoke exposure, genetic susceptibility and chronic inflammation are common susceptible factors. At present, abnormal inflammatory immune response plays an important role in the occurrence and development of the two diseases. In the process of immune response, tumor microenvironment (TME) is gradually produced, which is beneficial to angiogenesis and immunosuppression, and finally leads to immune escape of tumor cells, leading to tumor formation. In this paper, the present situation of COPD complicated with lung cancer and the relationship between abnormal immune response, especially Treg/Th17, and its occurrence and development are briefly reviewed.
ABSTRACT
Objective To study the willingness and influence factors related to "centralized slaughtering,fresh poultry listing and marketing" strategy,among the household chefs,and provide reference for government to adjust and optimize the strategy on avian influenza prevention.Methods According to the geographical characteristics and regional functions,6'monitoring stations' were selected from 12 residential districts of Guangzhou,respectively.Another 21 meat markets which selling live poultry,were selected in each station and 5 household chefs of each market were invited to attend a face to face interview.Basic information,personal cognitive,willingness and influencing factors to the policy were under study.Univariate and multivariate logistic regression methods were used.Results A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering,fresh poultry listing and marketing" strategy was 44.6％ (296/664).Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618,95％ CI:1.156-2.264,P=0.005),having received higher education (OR=1.814,95％ CI:1.296-2.539,P=0.001),or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918,95％CI:1.341-2.743,P＜0.001) were factors at higher risk.These household chefs also intended to avoid the use of live poultry stalls (OR =1.666,95％CI:1.203-2.309,P=0.002) and accept the "centralized slaughtering,fresh poultry listing and marketing" strategy.Conclusion Detailed study on this subject and,setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the'freezing-fresh poultry'policy.
ABSTRACT
Objective To study the willingness and influence factors related to "centralized slaughtering,fresh poultry listing and marketing" strategy,among the household chefs,and provide reference for government to adjust and optimize the strategy on avian influenza prevention.Methods According to the geographical characteristics and regional functions,6'monitoring stations' were selected from 12 residential districts of Guangzhou,respectively.Another 21 meat markets which selling live poultry,were selected in each station and 5 household chefs of each market were invited to attend a face to face interview.Basic information,personal cognitive,willingness and influencing factors to the policy were under study.Univariate and multivariate logistic regression methods were used.Results A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering,fresh poultry listing and marketing" strategy was 44.6％ (296/664).Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618,95％ CI:1.156-2.264,P=0.005),having received higher education (OR=1.814,95％ CI:1.296-2.539,P=0.001),or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918,95％CI:1.341-2.743,P＜0.001) were factors at higher risk.These household chefs also intended to avoid the use of live poultry stalls (OR =1.666,95％CI:1.203-2.309,P=0.002) and accept the "centralized slaughtering,fresh poultry listing and marketing" strategy.Conclusion Detailed study on this subject and,setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the'freezing-fresh poultry'policy.
ABSTRACT
Objective To study the relationship between gene mutation and clinical phenotype in patients with tuberous sclerosis complex (TSC).Methods The clinical data of 76 patients with TSC diagnosed in Guangdong 999 Brain Hospital were collected between May 2007 and May 2014 and then TSC gene mutation analysis was performed.Genotype-phenotype analyses for all the patients were also carried out.Results Fifty of the 76 (66％) patients were male,and 26 (34％) were female,in which 19 (31％) patients presented with cyst-like cortical tuber,69 (92％) with skin lesions,16 (30％) with renal lesions,50 (69％) with mental retardation and 39 still suffered seizures after a year.In this study,22 (29％) cases showed TSC1 gene mutation,31 (59％) presented TSC2 gene mutation,and 15 (20％)cases had no mutation identified.The mutation ratio of TSC1 ∶ TSC2 was approximately 3 ∶ 5,while the mutation ratio of TSC1 ∶ TSC2 was 1 ∶ 1 for familial TSC patients,and 1 ∶ 2 for sporadic TSC patients.Comparing to those with TSC1 gene mutation and no mutation identified,patients with TSC2 gene mutation exhibited statistical meaning on the aspects of the onset age of seizure (Z =1.688,P =0.007),seizure onset before l-year-old (x2 =10.584,P =0.001),epilepsy duration (x2 =4.996,P =0.025),spasms onset (x2 =10.111,P =0.001),cyst-like cortical tuber (x2 =9.182,P =0.002),skin lesions (x2 =9.016,P =0.003),as well as renal lesions (x2 =6.079,P =0.014).No apparent relation was found between genotype and intelligence outcome.Conclusions The patients with TSC2 gene mutations presented severer symptoms in seizure onset than those with TSC1 gene mutation and no mutation identified.The patients with TSC2 gene mutation were characterized by early onset of seizure,especially before 1-year-old,others like spasms onset,cyst-like cortical tuber,skin lesions,as well as renal lesions being more vulnerable.Therefore,more active treatment should be given to the patients with TSC2 gene mutation.
ABSTRACT
Objective The study systematically reviewed the therapeutic effect of the Kidney-Nourishing therapy on aromatase inhibitor-associated bone loss (AIBL).Methods The databases CNKI, CBM, VIP, Medline and the Cochrane Library were searched. Cochrane collaboration's tool for assessing risk of bias was adopted to assess the quality of trials. The Revman 5.3 software was used for the analysis on the outcome index such as bone minernal density and the level of serum estradiol.Results Meta-analysis was conducted on 11 randomly controlled clinical trials. All 11 studies were concducted in China, and the quality of researches was low. Meta-analysis revealed that the decrement of bone mineral density in the group receiving kidney-nourishing herbs was significantly smaller than that in the control group(P<0.001), theMD was -0.070, 95%CI was (-0.087, -0.053), but there was no significant difference between two groups in the outcome of the serum estradiol level (P=0.159), theMD was -2.622, 95%CIwas(-6.273, 1.030).Conclusion Kidney- Nourishing herbs can delay the process of aromatase inhibitor-associated bone loss, but may not influence the serum estrogen level.
ABSTRACT
Objective To explore the common causes of epilepsy and the etiologic characteristics in different age groups of patients with epilepsy.Methods A retrospective survey was made in 5572 epilepsy patients in Epileptic Center of Guangdong 999 Brain Hospital from January 2003 to December 2009.According to the diagnostic criteria published in 2005 from ILAE,all the diagnoses of 5572 cases were made by epileptic specialists.Based on history,cranial MRI or CT and pathologic data,causes of epilepsy were classified into idiopathic,symptomatic and cryptogenic epilepsy.The cases of symptomatic epilepsy were further arranged into different categories in different age grades,such as head trauma,perinatal injuries,infection in central nervous system, cerebral vascular disease, brain tumor, disorders of cortical development,neurocutaneous syndrome and others.The cases with febrile seizures and family history were collected,and positive ratio of febrile seizures and family history were contrasted in different categories of cases by Kruskal-Wallis test ( nonparametric test ).Results In 5572 cases,66 were idiopathic,2834 symptomatic,2672 cryptogenic,and the ratio of these causes was 1％,51％,48％ respectively.Among 2834 cases of symptomatic epilepsy,822 were head trauma,497 were perinatal injuries,360 were infection in central nervous system,249 were brain tumor,150 were cerebral vascular disease,135 were disorders of cortical development,62 were neurocutaneous syndrome and 559 were others. In brief,head trauma,perinatal injuries,infection in central nervous system,brain tumor and cerebral vascular disease were top 5 causes of symptomatic epilepsy. Hippocampal sclerosis was found in 744 cases in those of eryptogenic epilepsy.The importance of febrile seizures( idiopathic:15.2％ ( 10/66 ),symptomatic:6.5％ ( 185/2834 ),cryptogenic:9.4％ ( 250/2672 ) ; x2 =181.393,P =0.000 ) and family history ( idiopathic:83.3％ ( 55/66 ),symptomatic:1.1％ (31/2834),cryptogenic:0.4％ (12/2672) ; x2 =68.354,P =0.000) was statistically different in different causes of epilepsy.Febrile seizures was the most frequent in cases with hippocampal sclerosis than those with other causes,and family history was the most frequent in neurocutaneous syndrome in symptomatic cases.Perinatal injurics was thc first causc in cases of infancy and childhood,head trauma was the top one in those of juvenile and adulthood,and cerebral vascular disease was the main cause in senile cases. Conclusions In the whole epileptic cases of 5572, 1％ was idiopathic,51％ was symptomatic,and 48％ cryptogenic. The main causes of them were head trauma,perinatal injuries,infection in central nervous system,brain tumor,and cerebral vascular disease.
ABSTRACT
Objective To study the effect of magnetic stimulation on the expression of B cell lymphoma/leukemia gene 2 ( Bcl-2 ) and caspase-3 genes, and the apoptosis of neurons in rats with spinal cord injury (SCI).Methods Sixty rats were randomly divided into a magnetic stimulation group, a model group and a sham-operation group. An SCI model was established in the magnetic stimulation and model groups. The magnetic stimulation was applied at the 6th, 12th, 24th and 72nd hour after the operation to the rats in the magnetic stimulation group, and sham magnetic stimulation was given to the model group and sham-operation group rats at the same time points. Two hours after treatment, 5 rats of each group were sacrificed and their injured spinal cords were sectioned. The gene expressions were detected using immunohistochemical techniques, and apoptosis of neurons was observed by the TUNEL method. Results Few apoptotic cells were found in the sham-operation group, but more were found in the model group. Apoptotic cells in the magnetic stimulation group were significantly fewer than in the model group. The expression of both Bcl-2 and caspase-3 in the magnetic stimulation and model groups was significantly higher than in the sham-operation group at the different time points. Expression of Bcl-2 in the magnetic stimulation group was significantly higher than in the model group, but expression of caspase-3 in the magnetic stimulation group was significantly lower than in the model group. Conclusions Magnetic stimulation up-regulates the expression of Bcl-2 genes and down-regulates the expression of caspase-3 in injured neurons. Magnetic stimulation might have protective and rehabilitative effects after human SCI.
ABSTRACT
Objective Based on the result of evaluating the nutritional state of in-patients using the methodologies of European Nutritional Risk Screening 2002(NRS 2002),we judged the rationality of nutritional therapy,and the rate of accepting nutritional therapy in hospital patients.Methods Totally 3567 inpatients consisted with the requirement of NRS2002 were investigated nutritional state and the situation of nutritional therapy within 2 weeks in hospital.Except BMI used as the standard of China,all the other methods were from NRS2002.Nutritional therapy included parenteral and enteral nutrition.Results In all objects,834 patients' number score was≥3(23.39%),and 256 got nutritional therapy among them(30.70%).The number of accepting nutritional therapy was 661(18.53%),and only 38.73% of them had a patient number score≥3.Conclusion NRS2002 is a good method to evaluate the nutritional state of in patients.The nutritional therapy should be on the basis of patient's nutritional state,but there isn't one specification in clinical nutrition-support.Many malnourished patients were ignored,while a lot of nutritional therapies were not suitable.Now one of method to solve this question is to set up Nutrition Support Team(NST).
ABSTRACT
0.05).The ideal body mass index of undernutrition and obesity prevalence was relatively high,while overweight rate was relatively low (P