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Objective:To explore the feasibility and clinical effect of emergency lateral thigh muscle transfer in functional reconstruction of major traumatic muscle defects.Methods:Emergency surgeries for 8 patients(7 males and 1 female) with muscle defects were carried out subject to emergently reconstruct the power of lateral femoral muscle superficial region, between March 2020 and December 2021, in the Department of Hand and Foot Microsurgery Hospital, Xi'an Fengcheng Hospital. The 8 patients were 23 to 52 years old with an average of 37.6 years old. Five patients injured by machine crush, 2 by heavy object crush and 1 by traffic accident. Five patients were in Gustilo III B injury in forearm, including 2 with flexor muscle group defects, 2 with extensor muscle group defects and 1 with defect of dorsal metacarpal flexor muscle and extensor muscle. Among the 5 patients, 2 patients had the defects in left forearm and 3 in right forearm. One patient had defect of right 1st metacarpal bone and skin and thenar muscle. One patient suffered a complete right upper arm detachment with musculocutaneous nerve being drawn out from the bicipital muscle. One patient had Gustilo III C injury in the right calf with defects of extensor hallucis longus and extensor digitorum. The areas of soft tissue defect were 10.0 cm×8.0 cm-36.0 cm×11.0 cm and the size of flaps was 12.0 cm×6.0 cm-38.0 cm×12.0 cm with the volumes of excised muscle at 18.0 cm×9.0 cm×1.5 cm-10.0 cm×2.0 cm×1.0 cm. The anatomical cross-section and length of the corresponding muscle on the healthy side were measured by musculoskeletal ultrasound. The chimeric tissue flap was designed on the anterolateral side of the thigh. The flap was designed according to the size of the wound and the corresponding flap. Then 1 or 2 muscle tissue blocks were designed and cut from the superficial region of the lateral femoral muscle according to the condition of the muscle defect, to cover the wound and reconstruct the muscle power. Postoperative follow-ups were conducted by scheduled hospital visit. The contents of follow-up included dynamic observation, evaluation and record through musculoskeletal ultrasound, electromyography and strength of muscle.Results:For the 8 patients who were subject to a muscle reconstruction, the transferred muscles and flaps survived in stage-one without vascular event. Postoperative follow-ups lasted for 10 to 32 months with an average of 19.6 months. The strength of muscle was evaluated according to the M 4 strength of muscle. Strength of muscle restored to M 4 or above in 7 patients who could lift, hook or push a heavy object in 5-30 kg of weight, with free joint movement. One patient restored the strength of muscle to M 3+. Muscle contraction was detected 2-4 months after surgery by musculoskeletal B ultrasound. The average ratio of contraction to resting cross sectional area in 5 cases was 1.45±0.42. The shape of limb was bilaterally symmetrical. There was no discomfort in the donor site and knee joint. The flaps were soft and glossy, with protective sensation restored. Conclusion:Muscle transfer from the lateral femoral muscle superficial region in emergency surgery for functional reconstruction of traumatic muscle defects is feasible and effective with a good clinical effect.
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Objective:To evaluate the value of 18F-prostate specific membrane antigen (PSMA)-3Q PET/CT imaging in prostate cancer patients with serum prostate specific antigen (PSA) less than 1.00 μg/L after radical prostatectomy. Methods:From May 2021 to August 2022, 18F-PSMA-3Q PET/CT images and clinical data of 58 patients with prostate cancer (age 52-82 years) after radical prostatectomy with PSA less than 1.00 μg/L in Chinese PLA General Hospital were analyzed retrospectively. According to the level of PSA, patients were divided into three groups (0-0.19 μg/L group, 0.20-0.49 μg/L group, and 0.50-0.99 μg/L group). 18F-PSMA-3Q PET/CT images were analyzed according to the standardized evaluation criteria of molecular imaging, and lesions with the scores of molecular imaging PSMA (miPSMA)≥1 were defined as recurrent or metastatic lesions. The detection rates of 18F-PSMA-3Q PET/CT for patients in different PSA level groups were compared ( χ2 test). The PSA levels of patients with positive and negative scans were compared by using independent-sample t test. Results:Of the 58 patients, 36(62.1%, 36/58) patients and 85 lesions were found by 18F-PSMA-3Q PET/CT. There was 91.7%(33/36) with oligofocal lesions (1≤number of foci≤3) and 8.3%(3/36) with multiple lesions (number of foci>3). According to the location, 5.2%(3/58) of the recurrent lesions were found in the prostatic bed, 39.7%(23/58) in the bone lesions, 37.9%(22/58) in the pelvic lymph nodes, 12.0%(7/58) in the retroperitoneal lymph nodes and 5.2%(3/58) in the left clavicular lymph node metastases. There were 15 cases in 0-0.19 μg/L group, 22 cases in 0.20-0.49 μg/L group, and 21 cases in 0.50-0.99 μg/L group. The detection rates of 18F-PSMA-3Q PET/CT in the above groups were 5/15, 59.1%(13/22) and 85.7%(18/21), respectively ( χ2=10.33, P=0.006). There was significant difference in PSA level between patients with positive ( n=36) and negative ( n=22) 18F-PSMA-3Q PET/CT scans ((0.48±0.28) vs (0.28±0.25) μg/L; t=2.67, P=0.010). Conclusions:18F-PSMA-3Q PET/CT can be used to detect the recurrence or metastasis in prostate cancer patients with PSA level lower than 1.00 μg/L after radical prostatectomy. In this kind of patients, the common sites of lesions are bone, pelvic lymph nodes, retroperitoneal lymph nodes, left clavicular lymph nodes and prostatic bed, and oligofocal patients are more common.
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We have discovered and synthesized a series of indole-based derivatives as novel sigma-2 (σ 2) receptor ligands. Two ligands with high σ 2 receptor affinity and subtype selectivity were then radiolabeled with F-18 in good radiochemical yields and purities, and evaluated in rodents. In biodistribution studies in male ICR mice, radioligand [18F]9, or 1-(4-(5,6-dimethoxyisoindolin-2-yl)butyl)-4-(2-[18F]fluoroethoxy)-1H-indole, was found to display high brain uptake and high brain-to-blood ratio. Pretreatment of animals with the selective σ 2 receptor ligand CM398 led to significant reductions in both brain uptake (29%-54%) and brain-to-blood ratio (60%-88%) of the radioligand in a dose-dependent manner, indicating high and saturable specific binding of [18F]9 to σ 2 receptors in the brain. Further, ex vivo autoradiography in male ICR mice demonstrated regionally heterogeneous specific binding of [18F]9 in the brain that is consistent with the distribution pattern of σ 2 receptors. Dynamic positron emission tomography imaging confirmed regionally distinct distribution and high levels of specific binding for [18F]9 in the rat brain, along with appropriate tissue kinetics. Taken together, results from our current study indicated the novel radioligand [18F]9 as the first highly specific and promising imaging agent for σ 2 receptors in the brain.
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Objective:To compare the prognosis of patients with unilateral sporadic medullary thyroid carcinoma treated by different surgical selection, and analyze the independent risk factors affecting the prognosis.Methods:One hundred and twenty-six patients at Tianjin Medical University Cancer Institute and Hospital from Feb 2011 to Oct 2018 were retrospectively divided into group A (total thyroiclectomy) and group B (unilateral lobectomy).Results:There were no significant differences in postoperative recurrence rate ( χ2=0.394, P=0.530), mortality ( χ2=3.175, P=0.146), biochemical cure rate ( χ2=0.613, P=0.434), progression free survival and overall survival ( P=0.278, 0.175) between group A and group B; Tumor diameter ≥4 cm and lateral cervical lymph node metastasis were independent risk factors affecting the overall survival. The incidence of postoperative temporary hypocalcemia ( χ2=5.068, P=0.024) and permanent hypocalcemia ( χ2=6.590, P=0.010) in group A was higher than that in group B. Conclusions:Ipsolateral thyroidectomy can be applied to patients with unilateral sporadic medullary thyroid carcinoma with similar long term prognosis and tower incidence of temporary hypocalcemia and permanent hypocalcemia compared to total thyroidectomy.
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Objective:To analyze the results of external quality assessment (EQA) of Shanghai Nuclear Medicine Quality Control Center, in order to further strengthen the quality control and management of in vitro testing laboratories. Methods:The EQA results of 41 units evaluated by Shanghai Nuclear Medicine Quality Control Center from 2004 to 2018 were summarized and retrospectively analyzed. The overall qualified rate of all items (total triiodothyronine, TT 3; total thyroxine, TT 4; free triiodothyronine, FT 3; free thyroxine, FT 4; thyroid stimulating hormone, TSH; alpha fetoprotein, AFP; carcinoembryonic antigen, CEA; total prostate specific antigen, TPSA) and the qualified rate of singe item over the years were calculated respectively. Results:From 2004 to 2018, the overall qualified rates of all items of the laboratories were 84.0%(356/424), 90.1%(381/423), 94.8%(399/421), 94.8%(291/307), 96.6%(308/319), 97.2%(280/288), 96.6%(224/232), 97.8%(225/230), 98.7%(224/227), 100.0%(221/221), 99.5%(218/219), 98.6%(215/218), 99.5%(217/218), 99.5%(189/190), 100.0%(90/90), respectively; and the qualified rate of singe item showed an upward trend, but there were still some laboratories′ EAQ results did not reach " qualified" , and there may be potential risk factors affecting the test results during the test process.Conclusions:The qualified rates of in vitro testing laboratories evaluated by Shanghai Nuclear Medicine Quality Control Center show an upward trend from 2004 to 2018. Analyzing the EQA results can help to find the potential risks in the laboratory and improve the detection ability.
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Objective:To investigate the role of signal lymphocyte activating molecule family member 5 (SLAMF5) in liver transplantation rejection in SD rats.Methods:Forty-five male SD rats without special pathogens, weight 260-300 g, aged 10-12 weeks were included. Among them, forty male SD rats (20 donors and 20 recipients respectively) were established with reference to the " two cuff" method. 15 liver transplantation model rats were randomly divided into 1 week (LT-1W) group, 2 weeks (LT-2W) group and 3 weeks (LT-3W) group, with 5 rats in each group, and 5 normal rats were taken as the normal control group. The expressions of SLAMF5, CD4 and CD8 were detected by polymerase chain reaction (PCR), Western blot and immunohistochemistry. The correlations between SLAMF5 expression in the lymphocyte infiltration area and the rejection activity index was analyzed.Results:The levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin were significantly higher in LT-1W group, LT-2W group and LT-3W group than those in the normal control group (all P<0.05). PCR results showed that the relative expression of SLAMF5 mRNA were (5.44±1.11), (4.69±1.12), (2.18±0.68) respectively, which were increased in LT-1W group, LT-2W group and LT-3W group than those in normal control group (1.01±0.23), and the differences were statistically significant (all P<0.05). Immunohistochemical staining showed that SLAMF5 and CD4, CD8 positive T cells were mainly distributed in the portal area, hepatic lobule area and around the proliferative bile duct, and there was a certain overlap. Correlation analysis showed that there was a positive correlation between the expression of SLAMF5 in the lymphocyte infiltration area and the rejection activity index ( r=0.519, P=0.048). Conclusion:The expression of SLAMF5 is increased after liver transplantation in SD rats, and there is a correlation between SLAMF5 expression and liver transplantation rejection in rats.
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Objective:To investigate the feasibility of positron apoptosis radioactive tracer 18F-labeled 5-fluoropentyl-2-methyl-malonic acid ( 18F-ML-10) in the detection of cisplatin inducing apoptosis of lung adenocarcinoma A549 cells. Methods:Lung adenocarcinoma A549 cells were divided into the control group, cisplatin time groups and cisplatin dose groups. Cisplatin was not added to the control group. Cisplatin time groups with added 50 μg/ml cisplatin were used for 12, 18, 24, 30, 36, 42 and 48 h, respectively, and the cells of the control group were cultured for 48 h; cisplatin dose groups were treated with 10, 20, 30, 40, 50, 60, 70, 80, 90 and 100 μg/ml cisplatin, respectively for 30 h. The apoptosis was detected by using flow cytometry, and the 18F-ML-10 uptake rate of apoptotic cells in each group was calculated. Results:With the prolongation of the action time of 50 μg/ml cisplatin, the apoptosis rate of A549 cells was increased gradually ( F = 66.87, P < 0.01), and the standavd uptate value of 18F-ML-10 was also increased gradually ( F = 86.47, P < 0.01). When cisplatin was treated for 48 h, the apoptosis rate [(63.10±14.00)%] and 18F-ML-10 standard uptake value (4.97±1.03) reached the highest (all P < 0.01). After cisplatin treatment for 30 h, with the increase of cisplatin dose, the apoptosis rate and 18F-ML-10 standavd uptate value were gradually increased (all P < 0.01), and the apoptosis rate of cisplatin 100 μg/ml group was the highest [(37.31±2.48)%], and the 18F-ML-10 standavd uptate value was the highest (3.08±0.20). Conclusions:18F-ML-10 is feasible in the detection of cisplatin inducing the apoptosis of A549 cells.
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Objective:To investigate the neuroimaging relationship between tau protein deposition and brain atrophy, and assess their relationships with cognitive decline in Alzheimer′s disease (AD) patients.Methods:From April 2017 to October 2019, 26 AD patients (12 males, 14 females, age (70.7±12.2) years) and 19 cognitively normal controls (CN; 9 males, 10 females, age (65.6±8.1) years) in Chinese PLA General Hospital were retrospectively enrolled. All subjects received (S)-6-[(3- 18F-fluoro-2-hydroxy)propoxy]-2-(4-methylaminophenyl)quinoline ( 18F-THK5317) PET/MR and the standardized uptake value ratio (SUVR) and gray matter volume (GMV) were measured. General linear model (GLM) was used to evaluate the differences of SUVR and GMV between two groups. Pearson correlation analysis was used to assess the relationships between SUVR and GMV, and relationships of SUVR and GMV with Mini-Mental State Examination (MMSE) scores in AD patients. Results:Compared with CN, the AD patients showed significantly increased 18F-THK5317 retention in lateral temporal, frontal, posterior cingulated/precuneus and occipital cortex with significant differences of SUVR between two groups (2.18±0.54 vs 1.78±0.09, 2.13±0.50 vs 1.82±0.06, 2.03±0.45 vs 1.69±0.08, 2.18±0.57 vs 1.76±0.10, t values: 2.58-6.57, all P<0.001). The AD patients also showed decreased GMV in medial temporal, posterior cingulated/precuneus and orbitofrontal cortex ( t values: 3.67-8.85, all P<0.001). In AD patients, SUVR was negatively associated with GMV in bilateral lateral temporal cortex, pre-frontal cortex and orbital frontal cortex ( r values: from -0.52 to -0.43, all P<0.05). Both SUVR ( r=-0.599, P=0.001) and GMV ( r=0.443, P=0.023) were significantly correlated with MMSE scores in AD patients. Conclusion:AD patients have neocortical 18F-THK5317 abnormal uptake and GMV reduction, which are significantly correlated with cognitive decline.
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Objective:To explore the correlations between 11C-2β-carbomethoxy-3β-(4-fluorophenyl)tropane (CFT) microPET/CT imaging and the degree of damage to dopamine neurons in the substantia nigra of midbrain and the severity of Parkinson′s disease (PD). Methods:Sixty male Sprague-Dawley (SD) rats were divided into PD model group ( n=48) and control group ( n=12) by random number table method. The PD model was established by injecting 6-hydroxydopamine (6-OHDA) into the right striatum. The rotational behavior test and 11C-CFT microPET/CT imaging were performed at 1, 2, 3 and 4 weeks after the establishment of PD model. The radioactivity uptake values of bilateral striatum were analyzed and the radioactivity uptake ratio of injured side to healthy side was calculated. The number of tyrosine hydroxylase (TH) immunoreactive positive neurons in the pars compacta of substantia nigra was counted by immunofluorescence staining, and the ratio of total number of TH positive neurons in injured side to healthy side was calculated. Data were analyzed by one-way analysis of variance, the least significant difference t test and Pearson correlation analysis. Results:At 1, 2, 3 and 4 weeks after the establishment of PD model, the rotation speed of PD model to the healthy side was (4.55±1.37), (8.64±1.64), (9.96±1.83) and (11.67±2.77) r/min, respectively, while there was no rotation behavior in the control group. Meanwhile, the ratios of 11C-CFT uptake and the number of TH positive neurons in the PD model group were 0.658±0.038, 0.580±0.094, 0.513±0.042, 0.394±0.065 and 0.698±0.066, 0.604±0.062, 0.546±0.064, 0.315±0.082, respectively, which were significantly lower than those in the control group (0.997±0.048 and 0.996±0.054; F values: 167.50, 169.20, both P<0.05). Correlation analysis showed that 11C-CFT uptake ratio was correlated with rotation behavior (rotation speed) and TH positive neuron ratio ( r values: -0.877, 0.897, both P<0.001). Conclusion:In the PD animal model, the ratios of 11C-CFT uptake has a good correlation with the degree of damage to dopamine neurons in the substantia nigra of the midbrain (TH positive neuron ratio) and the severity of PD.
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Fibroblast activation protein (FAP) is highly expressed in most epithelial tumors, and FAP inhibitors (FAPIs) have been used in tumor diagnosis and treatment. Taking FAP as the target, new kinds of tumor imaging and therapeutic radiopharmaceuticals can be developed. FAPIs have been used in the preclinical and clinical researches as the carrier of tumor imaging and treatment. This article reviews the research progress of FAPIs in nuclear medicine imaging and treatment.
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Objective:To compare the accuracy of visual qualitative assessment and semi-quantitative analysis for 18F-florbetaben ( 18F-FBB) β-amyloid (Aβ) imaging in the diagnosis of Alzheimer′s disease (AD) and to explore their clinical application value. Methods:From January 2019 to October 2019, 17 patients (8 males, 9 females, age (74.1±8.5) years) with mild/moderate-stage clinically probable AD and 17 cognitive normal control (NC; 9 males, 8 females, age (64.5±6.3) years) were prospectively enrolled in this study. All patients underwent dynamic 18F-FBB PET/CT brain imaging in the Chinese PLA General Hospital. Visual qualitative assessment and semi-quantitative analysis methods were used to analyze PET brain imaging results. The difference of standardized uptake value ratio (SUVR) between the two methods was analyzed by using independent sample t test. The consistency of the two methods and clinical results was analyzed by Kappa test. The cut-off value of SUVR for the diagnosis of AD was determined by receiver operating characteristic (ROC) curve. Results:The sensitivity, specificity and accuracy of visual qualitative assessment to diagnose AD were 14/17, 16/17 and 88.2% (30/34). The global SUVR of NC and AD group were 1.09±0.85 and 1.75±0.25 ( t=-10.263, P<0.001), and the composite SUVR were 1.16±0.57 and 1.89±0.15 ( t=-10.789, P<0.001), respectively. The cut-off value of SUVR for the diagnosis of AD was 1.47, with the sensitivity of 15/17, the specificity of 16/17 and the accuracy of 91.2%(31/34). The visual qualitative assessment and semi-quantitative analysis had good consistency with clinical diagnosis results with Kappa value of 0.765 and 0.824 respectively (both P<0.001). Conclusion:The visual qualitative assessment and semi-quantitative analysis methods used in 18F-FBB Aβ imaging to diagnose AD patients show high accuracy and can provide effective value for clinical diagnosis, but the visual qualitative assessment method is concise and easy to grasp, which is worth further promotion and use in clinical.
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Objective:To investigate the effect of the timing of intra-aortic balloon counterpulsation (IABP) treatment on the clinical efficacy of patients after severe cardiac surgery.Methods:A prospective study was conducted on 64 patients with IABP after cardiac surgery in Gaozhou People′s Hospital of Guangdong Province from March 2018 to March 2020.According to the time of IABP treatment, 33 patients were divided into early treatment group (severe cardiac surgery<6 h) and late 31 cases in treatment group (≥6 h after severe cardiac surgery): two groups of mean arterial pressure(MAP), left ventricular ejection fraction (LVEF), mechanical ventilation time, IABP indwelling time, ICU stay time, central venous oxygen saturation(ScvO2), N terminal pro B type natriuretic peptide(NT-proBNP), lactate clearance rate, complications and follow-up.Results:After 48 hours of IABP, MAP and LVEF in the early treatment group were (79.47±7.07) mmHg and (45.20±3.86)%, respectively, and those in the late treatment group were (71.38±6.26) mmHg and (41.66±4.49)%.There were significant differences between the two groups ( t value was 34.604, 29.375 respectively all P<0.01). The mechanical ventilation time (71.56±5.98) h, IABP indwelling time (68.31±10.10) h, ICU stay time (5.84±1.04) d in the early treatment group, and those in the late treatment group (82.79±4.96) h, (89.49±9.97) h, (6.82±1.07) d. There were significant differences between the two groups ( t value was 70.093, 72.855, 31.859 respectively, all P<0.01). The ScvO 2, NT-pro BNP and lactate clearance rate in the early treatment group were (71.66±5.45)%, (1 698.36±1 032.98) ng/L and (30.12±2.29)%, respectively at 48 hours after IABP, and those in the late treatment group (66.03±4.61)%, (2 898.43±1 383.29) ng/L and (20.47±1.92)%.There were significant differences between the two groups ( t value was 38.279, 34.379 respectively, all P<0.01). The incidence of complications were 18% (6/33) and 41.94%(13/31) in the early treatment group and the late treatment group.There was significant difference between the two groups( P=0.038). Conclusion:Early use of IABP treatment can improve the patients′ hemodynamic and serological indicators, reduce the patient′s mechanical ventilation time, IABP time, ICU monitoring time and complications.
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Objective:To analyze the treatment of scapular glenoid fractures via the modified Judet approach.Methods:A retrospective study was conducted of the 25 patients who had been treated for scapular glenoid fractures via the modified Judet approach and completely followed up at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2014 to January 2020. They were 19 males and 6 females with an average age of 46 years (from 29 to 66 years). According to the Goss-Ideberg classification, 8 cases were diagnosed as type Ⅱ, 2 cases as type Ⅳ, 10 cases as type Ⅴ and 5 cases as type Ⅵ. 3D reconstruction of the CT scans by software Mimics 16.0 was made to confirm the diagnoses and classifications of the fractures. Articular step-off and displacement of the scapular glenoid were calculated and recorded. The functional outcomes were evaluated by Constant-Murley scoring system at 6 months postoperatively.Results:Preoperatively, the mean articular step-off was 5.8 mm (from 1.2 to 6.3 mm) and the mean displacement 7.7 mm (from 2.1 to 12.9 mm). All fractures obtained bony union within postoperative 6 months. The mean follow-up period was 58.8 months (from 7 to 92 months). The forward flexion was 158.6° (from 125° to 180°) and the external rotation 39.0° (from 30° to 45°) at 6 months postoperatively. The mean Constant-Murley score was 92.6 (from 75 to 100) at 6 months post-operatively; 19 cases were excellent (76%), 5 were good (20%) and one was fair (4%), giving an excellent to good rate of 96% (24/25).Conclusion:For scapular glenoid fractures of Goss-Ideberg types Ⅱ/Ⅳ/Ⅴ/Ⅵ, surgery via the modified Judet approach may promise satisfactory reduction and fixation and fine clinical outcomes.
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Objective:To investigate a 3D method of radiological evaluation of extra-articular scapular fracture and the treatment outcomes.Methods:A total of 19 patients with extra-articular scapular fracture were operatively treated and completely followed up at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2014 to January 2020. They were 17 males and 2 females with an average age of 41 years (from 24 to 65 years). The medial-lateral displacement, antero-posterior angulation and glenopolar angle were measured on images of 3D reconstruction of the fractured scapulae by Mimics software. 3D reconstructions of the intact scapulae were made as controls in the patients with proximal humerus fracture matched in time and age (17 males and 2 females with an average age of 41 years). Operations were carried out via the modified Judet approach in the experimental group. The treatment outcomes in the experimental group were evaluated by the Constant-Murley absolute value scoring at 6 months after operation.Results:All the patients in the experimental group obtained a mean follow-up of 48 months (from 11 to 73 months). All fractures in the experimental group acquired anatomical reduction and fixation intraoperatively and bony union within 6 months after operation. In the experimental group, the medial-lateral displacement averaged 17.9 mm and the antero-posterior angulation 26.9° before operation while the anteflexion lifting angle 162.2°, the lateral external rotation 41.6°, and the Constant-Murley absolute value scores 93.2 points at 6 months after operation. Pre-operatively, the glenopolar angles were 34.4°±6.3° and 40.6°±6.6° for the experimental and control groups respectively, showing a significant difference between the 2 groups ( P<0.05). At 6 months after operation, the glenopolar angle was 38.4°±5.0° for the experimental group, showing a significant difference between pre- and post-operation ( P<0.05). Conclusions:3D reconstruction measurements with Mimics software help accurate characterization of extra-articular scapular fracture and evaluation of surgical indications. Open reduction and internal fixation of scapular fractures via the modified Judet approach may promise a satisfactory union rate and functional outcomes.
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Objective:To investigate the operative treatments of old displaced fractures of humeral greater tuberosity and their related factors.Methods:A retrospective study was conducted of the 16 patients who had received operative treatment at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital for old displaced fractures of humeral greater tuberosity from November 2010 to March 2019 and whose complete follow-up data were available. They were 9 males and 7 females with an average age of 61 years(from 40 to 77 years). The original injury was accompanied by shoulder dislocation in 12 cases; the original displaced fracture of humeral greater tuberosity was not surgically treated in time in 8 cases; the primary surgical treatment did not lead to effective fracture reduction in 4 cases; the fracture of humeral greater tuberosity was displaced again after surgical treatment in 4 cases. Anterior displacement was observed in 2 cases, posterior displacement in 3 cases and superior displacement in 11 cases. The duration between the onset of displacement and the last operation averaged 5 months, and the displacement distance 16.5 mm. The Constant-Murley and visual analogue scale(VAS) scores were compared between preoperation and 6 months postoperation.Results:This group of patients obtained a mean follow-up of 55 months(from 16 to 118 months). Anatomical reduction of the greater tuberosity was achieved in 15 cases, leading to uneventful union. Mal-reduction occurred in one patient whose greater tuberosity was found displaced superiorly again by follow-up. For the 16 patients, the Constant-Murley absolute value scores were 37.0±11.7 and 91.0±9.9, and the flexion elevation ranges 33.0°±26.7° and 144.0°±38.5°, respectively for preoperation and 6 months postoperation, showing significant improvements between preoperation and 6 months postoperation( P<0.05). The VAS scores were 0.7±1.3 at 6 months postoperation, significantly improved than the preoperative value 4.5±1.0 ( P<0.05). Postoperatively, good shoulder function scores were not obtained by one patient who could still manage to fulfill daily life tasks. Conclusion:Open reduction and internal fixation can result in satisfactory functional outcomes in the treatment of old displaced fractures of the humeral greater tuberosity, depending on different features of fracture displacement.
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Objective To evaluate the advantages of reconstructing by mimics software before operation a three-dimensional model of talar posterior process fracture which is to be used in the treatment of talar posterior process fracture through the posteromedial malleolar approach.Methods From May 2015 to February 2019,7 patients with talar posterior process fracture were treated at Department of Orthopaedic Trauma,Jishuitan Hospital.They were 5 men and 2 women,aged from 20 to 70 years (mean,39 years).They underwent routine CT examination preoperatively.Their posterior process of talus was reconstructed by Mimics software based on their CT scanning data before operation to determine the size,number and displacement of fracture fragments.Their fractures of posterior process of talus were treated by open reduction and screw fixation in prone position through the posterior ankle approach.The American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot scoring system was used to evaluate functional recovery.Results The operation time for this group ranged from 70 min to 105 min,averaging 87.1 min.Early after operation,the wounds healed well with no injury to nerves or tendons.All patients were followed up for 4 to 24 months (average,12 months).Follow-up by X-ray examination after 10 to 16 weeks revealed fracture union with no complications like screw breakage,nonunion,malunion or traumatic arthritis.Their AOFAS ankle-hindfoot scores at the final follow-up ranged from 80 to 98 points.Conclusion Preoperative three-dimensional reconstruction of talar posterior process fracture based on CT images using Mimics software can accurately determine the entry point and direction of screw insertion,yielding advantages of clear exposure,easy reduction and convenient screwing in the treatment of talar posterior process fracture through the posteromedial malleolar approach.
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Objective:To prepare nanosilver-hybridized polylactic acid-glycolic acid copolymer (PLGA) microspheres loaded with simvastatin (SIM), and to evaluate its sustained release effect in vitro. Methods:The emulsification-solvent evaporation method was used to prepare SIM-loaded PLGA microspheres. Silk fibroin (SF) was used to modify the surface of SIM-loaded PLGA microspheres by hydrophobic interaction. Then, the microspheres were continually modified by electrostatic adsorption to chitosan (CTS) and nano-silver (AgNPs) to prepare SF-AgNPs-CTS-SF-SIM-PLGA microspheres. Scanning electron microscope, Fourier transform infrared spectrometer, energy spectrometer, Zeta potential meter were used to analyze the SIM-loaded microspheres. The external release properties of the SIM-loaded microspheres were also investigated.Results:The average diameter of the prepared PLGA microspheres was about 9.67 μm. The results of Fourier transform infrared spectroscopy and energy spectroscopy showed that the AgNPs-CTS-SF-SIM-PLGA microspheres have been successfully constructed. The Zeta potential results indicated that the SIM-loaded microspheres were all in a stable state. The in vitro release results showed that the SF-AgNPs-CTS-SF-SIM-PLGA microspheres had a good in vitro release effect, could delay the drug release rate and prolong the drug release time. Conclusions:The SF-AgNPs-CTS-SF-SIM-PLGA microspheres have antibacterial and osteogenic effects, and exhibit a good in vitro release effect. They can be used for local sustained-release administration in the oral cavity, which make makes them potentially useful in the treatment of periodontitis.
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The clinical application of triptolide (TPL) in tumor therapy has been greatly limited by its toxicity and inefficient delivery. Herein, a localized and sustained-release thermo-sensitive hydrogel was developed for the intra-tumor administration of TPL. Based on the amphiphilic structure of poly (
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OBJECTIVE@#To investigate the effect of miR-186 inhibition on the expression of hypoxia-inducible factor-1α (HIF-α) and mitochondrial function in hypoxic vascular endothelial cells.@*METHODS@#Human umbilical vein endothelial cells (HUVECs) cultured in routine or hypoxic conditions for 6 h were examined for the expression of miR-186. A miR-186 inhibitor was transfected in the HUVECs, and the cells were subsequently cultured in hypoxic condition for 6 h to observe the changes in the mitochondrial structure under an electron microscope. The changes in the mRNA and protein expressions of HIF-1α in response to miR-186 interference were tested using real-time fluorescent quantitative PCR and Western blotting.@*RESULTS@#The expression of miR-18 was mildly increased in HUVECs after hypoxic exposure for 6 h (=0.0188). Interference of miR-186 expression obviously promoted the mRNA and protein expressions of HIF-1α in HUVECs. In hypoxic conditions, miR-186 interference significantly reduced mitochondrial damage in HUVECs as observed under electron microscope (=0.0297).@*CONCLUSIONS@#Inhibition of miR-186 protects vascular endothelial cells against hypoxic injuries by promoting HIF-α expression to lessen mitochondrial damage, suggesting the possibility of targeted miR-186 interference for treatment of hemorrhagic shock.
Subject(s)
Humans , Cell Hypoxia , Human Umbilical Vein Endothelial Cells , Hypoxia , Hypoxia-Inducible Factor 1, alpha Subunit , MicroRNAs , Mitochondria , Umbilical VeinsABSTRACT
Objective@#To explore the feasibility and clinical effect of autologous fat concentrate combined with split-thickness skin grafts in the repair of venous ulcer.@*Methods@#From January 2015 to December 2018, a total of 16 patients diagnosed with venous ulcer were admitted to our department, and all patients received symptomatic and supportive treatment such as local debridement and dressing change. After the granulation tissue grew well, all patients received autologous adipose concentrate combined with spilit-thickness skin graft for repair.@*Results@#All the grafted skin survived well, and the survival rate of grafted skin at 2 weeks after surgery was 86% to 99%. All patients were followed up to 6 months after surgery. The wounds of all patients were healed during the follow-up period. One patient suffered local ulcer recurrence due to repeated friction after healing and the ulcer recovered after dressing changing treatment. All the other patients had no recurrence during the follow-up period. The scar hyperplasia in the skin transplantation area was not obvious and the healing quality was good. No significant surgical complications occurred.@*Conclusions@#Autologous lipoconcentrate combined with split-thickness skin grafts is an effective and safe method in the repair of venous ulcer, and the application of autologous lipoconcentrate can effectively improve the survival rate and healing quality of skin grafts.