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Objective:To investigate the changes of glutathione peroxidase 4 (GPX4) in retinal photoreceptor cells, and the related mechanism correlated with retinal photoreceptor cell damage.Methods:The posterior segment tissues of 8 age-matched male donors were collected from the Body (Organ) Donation Register and Corneal Receiving Station of Tongji Hospital of Wuhan Red Cross from 2018 to 2021, including 4 non-diabetic donors and 4 diabetic donors.The tissues were divided into diabetes group and control group according to their donors.A total of 14 healthy SPF 8-week-old male C57BL/6 mice were selected and randomly divided into diabetes group and control group by the random number method, with 7 mice in each group.The mice in diabetes group were intraperitoneally injected with streptozotocin at a dose of 50 mg/kg for 5 days, and no intervention was given to mice in control group.Mouse photoreceptor cells 661W were divided into advanced glycation end products (AGEs) group and control group.AGEs group was treated with 100 μg/ml AGEs for 24 hours to simulate diabetic injury, and no intervention was given to control group.The outer segment morphology of retinal photoreceptors in human and mouse retinas was observed by hematoxylin-eosin staining.The expressions of glial fibrillary acidic protein (GFAP), rhodopsin and GPX4 in human and mouse retinas were detected by immunofluorescence staining.The expressions of GFAP, rhodopsin and GPX4 in mouse retina and the expression of GPX4 in 661W cells were determined by Western blot.The activity of 661W cells was detected by cell counting kit-8 (CCK8) method.The concentration of malondialdehyde (MDA) in mouse retina and cells was detected by TBA method.The activity of superoxide dismutase (SOD) in mouse retina and cells was detected by hydroxylamine assay.The use of human tissues was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (No.TJ-C20230301). The animal experiments were conducted with reference to the Standards Guide for the Care and Use of Laboratory Animals of the National Institutes of Health, and the study protocol was approved by the Experimental Animal Ethics Committee of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (No.TJH-2016001).Results:Hematoxylin-eosin staining showed that retinal photoreceptor outer segments were deformed or broken in diabetic donors and diabetic mice compared with control groups.GFAP fluorescent signal mainly appeared in the inner retina of human and mice, and the stained cells were spindle or polygonal, which was consistent with the shape of glial cells.The retinal GFAP fluorescent signal of diabetic tissue and mouse groups was stronger than that of respective control groups.Rhodopsin was only expressed in the outer segment layer of photoreceptors with clear boundaries, and GPX4 was expressed in the whole retina with strong signal in the outer segment layer of photoreceptors.The fluorescent signals of rhodopsin and GPX4 in diabetic tissue and mouse groups were weaker than those in respective control groups.The relative expressions of GFAP were significantly higher and the relative expressions of rhodopsin and GPX4 were significantly lower in diabetic tissue and mouse groups than in respective control groups (all at P<0.05). The cell viability of AGEs group was significantly lower than that of control group ( t=13.490, P<0.001). The relative expression of GPX4 protein in AGEs group was 0.42±0.12, which was significantly lower than 1.00±0.04 in control group ( t=9.041, P<0.001). MDA concentration was higher and SOD activity was lower in retinal tissue of diabetic mice and AGEs group than those in respective control groups, and the differences were statistically significant (all at P<0.05). Conclusions:Diabetes can reduce the GPX4 level in retinal photoreceptor cells and cause the imbalance of oxidation-antioxidant system, which may be the mechanism of the damage to retinal photoreceptor cells caused by diabetes.
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There are more than 60 million alcoholic liver disease (ALD) patients in China, which has become a public health problem that cannot be ignored. Moreover, the social problem of "alcohol culture" is still hardly to solve, so that safe and effective prevention and treatment for ALD are in urgent need clinically. Previous studies on ALD have focused on the direct damaging effects of alcohol and its toxic metabolites, while recent studies have shown that the pathogenesis of ALD also include alcohol metabolic reprogramming and endogenous metabolites disorder. Although the endogenous metabolites have no direct toxicity, its long-term effect should not be ignored. These endogenous metabolites could change epigenetic modifications, cause widespread and persistent abnormal gene expression and signal pathway activation abnormally to promote metabolic reprogramming and stamp it as "metabolic memory", which manifest pathological changes and promote ALD, especially liver fibrosis/cirrhosis and liver cancer. Based on this, the article reviews the important epigenetic modifications caused by related metabolites in ALD and their associated effects. The role of traditional Chinese medicine (TCM) and its active ingredients in regulating epigenetics was also analyzed. The results suggest that regulation of epigenetics and alteration of "metabolic memory" may be a novel mechanism of TCM in the prevention and treatment of ALD.
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Physiological parameter monitoring is essential to medical staff to evaluate, diagnose and treat patients in neonatal intensive care unit (NICU). Monitoring in NICU includes basic vital signal monitoring and functional monitoring. Basic vital signal monitoring (including ECG, respiration, SpO2, blood pressure, temperature) is advanced and focus on study of usability, continuity and anti-interference. Functional monitoring (including respiratory function, circulatory function, cerebral function) still focus on study of monitoring precision and reliability. Meanwhile, video monitoring and artifact intelligence have presented well performance on improving monitoring precision and anti-interference. In this article, the main parameters and relevant measurement technology for monitoring critical neonates were described.
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Humans , Infant, Newborn , Intensive Care Units, Neonatal , Monitoring, Physiologic , Reproducibility of Results , Respiration , Technology , Vital SignsABSTRACT
Physiological parameters monitoring is essential to direct medical staff to evaluate, diagnose and treat critical patients quantitatively. ECG, blood pressure, SpO2, respiratory rate and body temperature are the basic vital signs of patients in the ICU. The measuring methods are relatively mature at present, and the trend is to be wireless and more accurate and comfortable. Hemodynamics, oxygen metabolism and microcirculation should be taken seriously during the treatment of acute critical patients. The related monitoring technology has made significant progress in recent years, the trend is to reduce the trauma and improve the accuracy and usability. With the development of machine vision and data fusion technology, the identification of patient behavior and deterioration has become hot topics. This review is focused on current parameters monitoring technologies, aims to provide reference for future related research.
Subject(s)
Humans , Intensive Care Units , Monitoring, Physiologic , Oxygen Saturation , Technology , Vital SignsABSTRACT
Objective:To explore the diagnosis, surgical methods and therapeutic effect of primary duodenal malignant tumor.Methods:The clinical data of 116 patients with primary duodenal malignant tumor from January 2010 to December 2018 were retrospectively analyzed.Results:Among 116 patients, adenocarcinoma was in 74 cases, interstitial tumor was in 25 cases, carcinoid was in 9 cases, the others was in 8 cases. Before operation, duodenoscopy was performed in 107 cases, and CT examination was performed in 76 cases. There were 57 cases of pancreaticoduodenectomy, 15 cases of duodenal segmental resection, 13 cases of subtotal gastrectomy and duodenal bulbar resection, 13 cases of duodenal partial resection, and 18 cases of palliative short circuit operation. The total incidence of postoperative complication was 31.9% (37/116), including pancreatic fistula in 8 cases (grade B 5 cases, grade C 3 cases), biliary fistula in 6 cases, abdominal infection in 5 cases, pulmonary infection in 4 cases, intestinal fistula in 3 cases, delayed gastric emptying in 3 cases, and hemorrhage in 8 cases. Four cases (3.4%) died during the perioperative period. Single factor Cox regression analysis result showed that the postoperative survival time was related to the tumor differentiation degree, operation method, tumor infiltration degree and lymphatic metastasis ( P<0.05 or <0.01); multi-factor Cox regression analysis results showed that the operation method, tumor infiltration degree and lymphatic metastasis were the independent risk factors for the postoperative survival time of patients with primary duodenal malignant tumor ( P<0.05). The patients were followed up until June 2021, and 9 cases were lost to follow-up. Kaplan-Meier survival curve analysis result showed that the postoperative overall 1-,3- and 5-year survival rates were 82.11%, 57.56% and 33.11%, respectively. Conclusions:Adenocarcinoma is the main primary malignant tumor of duodenum. Duodenoscopy and CT are the main examination methods. Radical resection is the most effective treatment for primary duodenal malignant tumor, and pancreaticoduodenectomy is the first choice. Surgical method, tumor infiltration degree and lymphatic metastasis are the independent risk factors affecting the prognosis of patients.
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Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations, laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6％), abdominal pain(50.0％), weight loss(31.2％), loss of appetite(25.0％), tiredness/weakness(21.9％), and nausea/vomiting(20.3％). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.
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Objective To understand the clinical features of splenic tuberculosis. Methods The clinical manifestations, laboratory tests, treatment outcomes of a case of splenic tuberculosis caused by hematogenous pulmonary tuberculosis were analyzed. Related literatures about splenic tuberculosis were also reviewed. Results The patient was a 19-year-old male. Cough, fever, night sweats, and weight loss were the main manifestations. Thoracoscopy revealed tuberculosis and imaging suggested splenic tuberculosis and tuberculosis in multiple body sites. Anti-tuberculosis treatment was effective in improving patient conditions. According to literature review, there are two types of splenic tuberculosis: primary splenic tuberculosis or as part of hematogenous pulmonary tuberculosis.The clinical manifestations of primary splenic tuberculosis are usually atypical. Immune deficiency is a significant risk factor of splenic tuberculosis. The main clinical manifestations of splenic tuberculosis are splenomegaly, fever, digestive system symptoms, and occasionally spontaneous splenic rupture (3/32). Most of the patients with splenic tuberculosis (28/32) were cured or improved by anti-tuberculosis treatment and/or splenectomy. Conclusions The onset of splenic tuberculosis is mostly insidious and clinical symptoms usually atypical. The diagnosis relies on radiographic findings, biopsy and pathological examination. Anti-tuberculosis and selective splenectomy are the effective treatment. The outcome of splenic tuberculosis is good in most patients.
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Objective To investigate the effect of fibronectin type Ⅲ and SPRY domain containing 1 (FSD1) protein on the invasion of glioma stem cells (GSCs), so as to probe into the new biomarkers or potential therapeutic targets for gliomas. Methods The Cancer Genome Altas (TCGA) database data were used to analyze and compare the FSD1 gene expression (the FSD1 mRNA level) in the glioblatoma (also known as glioblastoma multiforme, GBM) and normal brain tissues as well as in the different grade glioma tissues, and the correlation of the FDS1 gene expression (mRNA level) with the survival prognosis of patients was also analyzed using the TCGA database data. The lentivirus was used to overexpress the FSD1 protein in the GSCs, T4121 and D456. The effect of the overexpressed FSD1 protein on the invasive ability of the GSCs, T4121 and D456 was evaluated by Transwell invasion assay. Results The FSD1 gene expression (mRNA level) was significantly lower in GBM than in normal brain (P＜0.01). The FSD1 gene expression (the mRNA level) in gliomas significantly decreased with the increase of the gliomas grade (gradeⅡvs Ⅲ, P＜0.05;gradeⅢvs Ⅳ, P＜0.01). The survival prognosis of patients with gilomas was well associated with the level of FSD1 gene expression (the FSD1 mRNA level), as indicated by the overall survival rate of the patients, which was significantly lower in the patients with the low FSD1 mRNA level than in the patients with the high FSD1 mRNA level (P＜0.01). In the Transwell invasion assay, the count of the invasive cell numbers significantly decreased in the FSD1 protein-overexpressed T421 and D456 groups than in the corresponding control group (P＜0.01 in both T4121 and D456 cell lines). Conclusion There is a clinical relevance of the FSD1 expression for the malignant progression of gliomas (the grade of gliomas). The low level FSD1 is favorable for keeping the invasive ability in GSCs.
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Objective To observe the effects of Fuzheng Qingfei Decoction combined with Western medicine basic treatment in pulmonary infection of AIDS patients.Methods A total of 154 cases of AIDS pulmonary infection treated in the Affiliated Hospital of Southwest Medical University from November 2013 to December 2016 were selected.Among them,86 cases in the observation group adopted Fuzheng Qingfei Decoction combined with the Western medicine routine treatment;68 cases in the control group only adopted the Western medicine therapy.The levels of procalcitonin (PCT) and C-reactive protein (CRP),CD4+ T cells count and improvement situation of clinical symptoms in the two groups were observed before and after treatment.Results The CD4+ T cells count,levels of PCT and CRP before treatment had no statistical difference between the two groups (P＞0.05),the levels of PCT and CRP after 7 d treatment in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05),and the CD4+T cell count after 3-month treatment in the observation group was higher than that in the control group and the PCT and CRP levels were lower than those in the control group,the differences were statistically significant (P＜0.05);the total effective rate in the observation group was 87.21％,which was better than 76.74 ％ in the control group,the difference was statistically significant (P＜0.05).Conclusion Fuzheng Qingfei Decoction combined with routine Western medicine therapy for treating AIDS complicating pulmonary infection can increase the anti-infection effect,reduce the inflammatory response,enhance CD4+ T cells count,relieve the clinical symptoms and improve their living quality.
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Objective:To explore the relation between psychological capital and life quality in elderly people.Methods:Total 409 elderly people aged 60 years and above in urban and rural areas of Hubei Province,Jiangsu Province,Shanxi Province and Chongqing municipality were surveyed with the Positive Psychological capital Questionnaire (PPQ) and Genetic Quality of Life Inventory-74(GQOLI-74).Results:The PPQ total score was (118 ± 21),the GQOLI-74 total score was (54 ± 10).The PPQ total score and its dimension scores were positively correlated with the GQOLI-74 total score and its dimension scores (r =0.15-0.53,Ps ＜ 0.01).The PPQ total score positively predicted GQOLI-74 total score (β =0.46,P ＜ 0.001).Conclusion:Psychological capital may be closely related to life quality of elderly people.Developing and promoting the psychological capital may be beneficial to improving the life quality and psychological health level of elderly people.
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Objective To establish a method for the determination of the content and dissolution of isophenylcyclopentyl?amine hydrochloride capsules. Methods The HPLC analysis was performed on a Diamonsil C18 column(150 mm×4.6 mm,5μm). A mixture of 0.02 mol/L KH2PO4 solution containing 0.1%triethylamine with pH adjusted to 3.0 by phosphoric acid-methanol-acetonitrile (30:35:35)was used as the mobile phase with the flow rate at 1.0 ml/min. The detection wavelength was 224 nm. Dissolution was de?termined by the basket method,using the 500 ml of 0.1 mol/L hydrochloric acid solution,pH 4.5 acetic acid buffer,water and pH 6.8 phosphoric acid buffer as dissolution media under the 50,75 and 100 r/min rotation speeds to select the dissolution condition. Re?sults This method had high specificity. The linear range for the quantitative determination was 20.74-155.58 μg/ml(r=1.0000), and the average recovery was 100.1%. The linear range for the determination of dissolution was 2.08-24.90μg/ml(r=0.9998),with the average recovery of 98.9%. The method of dissolution tests was established:0.1 mol/L hydrochloric acid solution was used as disso?lution medium and rotation speed was 50 r/min. The determined content and dissolution of three batches of capsules fulfilled the re?quirements. Conclusion The method is simple,accurate and reproducible for the determination of the content and dissolution of iso?phenylcyclopentylamine hydrochloride capsules.
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Objective To study the influence of isoniazid on lymphocyte factor expression and macrophage function of rats.Methods Healthy male SD rats were randomly divided into three groups,which was treated for one month,three months and withdrawal for one month after treated for three months,and each group was randomly divided into isoniazid group and control group.The isoniazid groups were ig with isoniazid at dose of 120 mg/kg every other day and control groups were fed on normal saline.At the corresponding time points,the level of interleukin-12 (IL-12) and interferon-γ (IFN-γ) was detected with ELISA method,detected serum lysozyme content by agar plate method,and Comori method was used for the detection of acid phosphatase levels in peritoneal fluid.Results At all the time points,levels of IL-12,IFN-γ and lysozyme in isoniazid group were not significantly different compared with control group.There were statistically significant differences in acid phosphatase between isoniazid group and control group after treated for one month (P ＜ 0.05),but the significant differences disappeared at the next two time points.Conclusion Isoniazid of 120 mg/kg may have no obvious influence on the immune function of rat.We don't detect the immune injury.
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Objective To analyze the correlation between the pressure volume parameters and cardiac function in terms of New York Heart Association(NYHA) classification in patients with pulmonary arterial hypertension. Methods Among 36 patients with pulmonary hypertension admitted in our center between April 2015 to June 2016, right heart catheterization recording right atrial pressure curve,right ventricular pressure curve,pulmonary arterial pressure and oxygen saturation curve in different parts was performal.All patients recived underwent cardiac MRI examination to obtain a single cardiac cycle and the use of Mass software to measure right ventricular volume continuously and right ventricular pressure-volume loop parameters were then obtained. Patients were divided into different groups according to the NYHA functional classification, and the correlation between the parameters of each group and the cardiac function classes a were analyzed. Results Compare to patients with NYHA class Ⅰheart function,patients with NYHA heart function class Ⅱ and class Ⅲ had significantly higher right ventricular end diastolic pressure(P < 0.05)and higher right ventricular systolic pressure (P < 0.01). Spearman correlation analysis showed that cardiac function of NYHA classⅠ,Ⅱ and Ⅲhad position correlation with RVESV,RVEDP and RVESP wheras negative correlation with RVEDV. ROC curve analysis showed that,when the patients were divided into 2 groups as NYHAⅠvs. NYHA class Ⅱ + Ⅲ,NYHA classification for predicting the outcome of the NYHA class Ⅱ + Ⅲ level, pulmonary artery elasticity and right ventricular end systolic pressure had larger area under curves respectively. Conclusions Pressure-volume parameters of right ventricles are more objective indicators for cardiac function assessment for pulmonary hypertension patients and evaluation of disease progression especialy in patients with mild symptoms.
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Objective To study the influence of isoniazid on lymphocyte factor expression and macrophage function of rats.Methods Healthy male SD rats were randomly divided into three groups,which was treated for one month,three months and withdrawal for one month after treated for three months,and each group was randomly divided into isoniazid group and control group.The isoniazid groups were ig with isoniazid at dose of 120 mg/kg every other day and control groups were fed on normal saline.At the corresponding time points,the level of interleukin-12 (IL-12) and interferon-γ (IFN-γ) was detected with ELISA method,detected serum lysozyme content by agar plate method,and Comori method was used for the detection of acid phosphatase levels in peritoneal fluid.Results At all the time points,levels of IL-12,IFN-γ and lysozyme in isoniazid group were not significantly different compared with control group.There were statistically significant differences in acid phosphatase between isoniazid group and control group after treated for one month (P ＜ 0.05),but the significant differences disappeared at the next two time points.Conclusion Isoniazid of 120 mg/kg may have no obvious influence on the immune function of rat.We don't detect the immune injury.
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Objective To analyze the correlation between the pressure volume parameters and cardiac function in terms of New York Heart Association(NYHA) classification in patients with pulmonary arterial hypertension. Methods Among 36 patients with pulmonary hypertension admitted in our center between April 2015 to June 2016, right heart catheterization recording right atrial pressure curve,right ventricular pressure curve,pulmonary arterial pressure and oxygen saturation curve in different parts was performal.All patients recived underwent cardiac MRI examination to obtain a single cardiac cycle and the use of Mass software to measure right ventricular volume continuously and right ventricular pressure-volume loop parameters were then obtained. Patients were divided into different groups according to the NYHA functional classification, and the correlation between the parameters of each group and the cardiac function classes a were analyzed. Results Compare to patients with NYHA class Ⅰheart function,patients with NYHA heart function class Ⅱ and class Ⅲ had significantly higher right ventricular end diastolic pressure(P < 0.05)and higher right ventricular systolic pressure (P < 0.01). Spearman correlation analysis showed that cardiac function of NYHA classⅠ,Ⅱ and Ⅲhad position correlation with RVESV,RVEDP and RVESP wheras negative correlation with RVEDV. ROC curve analysis showed that,when the patients were divided into 2 groups as NYHAⅠvs. NYHA class Ⅱ + Ⅲ,NYHA classification for predicting the outcome of the NYHA class Ⅱ + Ⅲ level, pulmonary artery elasticity and right ventricular end systolic pressure had larger area under curves respectively. Conclusions Pressure-volume parameters of right ventricles are more objective indicators for cardiac function assessment for pulmonary hypertension patients and evaluation of disease progression especialy in patients with mild symptoms.
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<p><b>BACKGROUND</b>Wear debris of polyethylene has become a restraining factor of the durability for total hip arthroplasty (THA). Ceramic on ceramic (COC) has better wear resistance while the squeaking sound and prosthesis fracture are of concern. It is still a controversy that bearing couples are better for THA.</p><p><b>METHODS</b>We performed a systematic review of all English articles identified from PubMed (1966-), Embase (1980-) and the Cochrane Library. Clinical outcomes, complications, revision rates, and radiographic outcomes of COC-THA and ceramic on polyethylene (COP)-THA were compared and evaluated.</p><p><b>RESULTS</b>Eight prospective randomized trials enrolling a total of 1508 patients and 1702 THA surgeries were identified. Our results demonstrated the prosthesis fracture and the squeaking sound is significantly higher in COC group and higher wear rate of the COP. Hip function, loosening rate, dislocation rate, revision rate, and the osteolysis rate were comparable between two groups. According to Grading of Recommendations Assessment, Development and Evaluation system assessment, the strength of evidence was high for prosthesis fracture, dislocation, osteolysis, and moderate for radiolucent line or loosening, hip noise, and revision.</p><p><b>CONCLUSIONS</b>Up to now, there is insufficient evidence to identify any clinical advantage of COC compared with COP. Longer follow-up of larger randomized trial is needed to clarify the outcomes.</p>
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Humans , Arthroplasty, Replacement, Hip , Methods , Ceramics , Therapeutic Uses , Hip Prosthesis , Polyethylene , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To establish the rat models of glucocorticoid-induced osteonecrosis and evaluate the osteonecrosis by high-resolution micro-CT and histomorphology.</p><p><b>METHODS</b>Totally 30 Sprague-Dawley male adult rats (age:12 weeks; body weight:400-450 g) were randomized into two groups:one group received two doses of intraperitoneal injection of lipopolysaccharide (20 μg/kg) at an interval of 24 hours, 24 hours later, the rats received three doses of intramuscular injection of methylprednisolone (40 mg/kg) at an interval of 24 hours; in the control group,the rats received same amount of normal saline. Four weeks later, 5 rats in each group were sacrificed randomly.Eight weeks later, all the remaining rats were sacrificed and the femur specimens were scanned by micro-CT. The trabeculae parameters of the femoral head were calculated. The hematoxylin and eosin staining were performed to calculated the success rate.</p><p><b>RESULTS</b>The incidence of osteonecrosis was 80% in the experimental group. The micro-CT demonstrated broken and cystic degeneration. The quantitative analysis showed that the bone volume/total volume (experimental group:0.55 ± 0.13 vs.</p><p><b>CONTROL GROUP</b>0.68 ± 0.12;P<0.05), bone surface area / bone volume (experimental group:20.45 ± 5.13 vs.</p><p><b>CONTROL GROUP</b>24.00 ± 5.20;P<0.05), and trabeculae number(experimental group: 5.67 ± 0.50 vs.</p><p><b>CONTROL GROUP</b>6.24 ± 0.96; P<0.05) were significantly lower in experimental group than those in control group.</p><p><b>CONCLUSIONS</b>A rat model of glucocorticoid-induced osteonecrosis was successfully established by lipopolysaccharide and methylpredniso- lone. High-resolution micro-CT is useful for the qualitative and quantitative analyses of the morphology and structure of trabeculae, showing good consistence with the histomorphological findings.</p>
Subject(s)
Animals , Male , Rats , Disease Models, Animal , Femur Head , Femur Head Necrosis , Glucocorticoids , Lipopolysaccharides , Methylprednisolone , Rats, Sprague-DawleyABSTRACT
<p><b>BACKGROUND</b>Controversy still exists regarding whether medial parapatellar approach (MP) or midvastus approach (MV) is preferable in total knee arthroplasty (TKA) up to now. The aim of this meta-analysis was to compare the clinical and radiological outcomes following the MV or MP for TKA.</p><p><b>METHODS</b>A comprehensive search of unrestricted-language literature of all studies comparing MP with MV was conducted through the electronic literature databases of PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WANFANG. Retrieval time was from the time when databases were built to October 2013. Manual search of relevant trials, reviews, and related articles was also performed. Outcomes of interest included postoperative knee extensor and flexor function, postoperative pain, patella tilt, and complications. Relative risk (RR) and weighted mean differences (WMD) from each trial were pooled using random-effects or fixed-effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.</p><p><b>RESULTS</b>Twenty-one randomized controlled trials (RCTs) comprising 1 188 patients (1 450 knees) were eligible. Our results showed that MV was associated with better early postoperative extension (WMD = -1.26, 95% CI -2.36 to -0.16, P = 0.02) and flexion (WMD = 10.13, 95% CI 5.36 to 14.90, P < 0.01), less postoperative pain (WMD = -0.21, 95% CI -0.34 to -0.07, P = 0.002) , and no greater risk for complications than MP. The patella tilt did not differ significantly between the two groups (WMD = -0.70, 95% CI -1.94 to 0.54, P = 0.27).</p><p><b>CONCLUSIONS</b>MV may be a better approach than MP, as it improves postoperative early joint function and decreases pain. Future multi-center randomized controlled studies with large sample sizes are required to verify the current findings.</p>
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Humans , Arthroplasty, Replacement, Knee , Methods , Knee Joint , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To assess the value of three-dimensional (3D) visualization technique in preoperative diagnosis, preoperative evaluation and surgical guidance for hepatolithiasis.</p><p><b>METHODS</b>The 64-slice spiral CT data of 30 hepatolithiasis cases were imported in a self-designed medical image processing system for 3D reconstruction of the intrahepatic bile duct. The preoperative diagnosis and pathological classification were derived from the reconstructed model, with which the feasibility and safety of the surgical plan were assessed by simulation of the surgical procedures. The consistency between the simulated procedure and the actual operation was evaluated, and the residual stones were detected using cholangiography with a T-shaped tube.</p><p><b>RESULTS</b>When the model setting was configured to render the liver translucent, the system clearly displayed the site and number of the bile duct calculi as well as the expansion or narrowing of the intrahepatic bile duct. A total consistency (100%) was found between the surgical findings and the preoperative findings based on the 3D model, and also between the actual surgical procedures and the preoperative simulation in 30 cases. The consistency rate between the actual surgical protocols and the preoperative surgical plan was 90%. Follow-up of 27 of the patients for 6 months showed a recurrence rate of 7.4% (2/27) after the operation.</p><p><b>CONCLUSION</b>The 3D visualization system allows accurate preoperative diagnosis and precise surgical operation to reduce the postoperative recurrence rate, and can be of value as a new diagnostic and treatment modality in biliary surgery.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bile Ducts, Intrahepatic , Diagnostic Imaging , General Surgery , Cholangiography , Gallstones , Diagnostic Imaging , General Surgery , Imaging, Three-Dimensional , Tomography, Spiral Computed , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the application of digitized three-dimensional (3D) image reconstruction in living-related kidney transplantation.</p><p><b>METHODS</b>The image data of 16-slice spiral CT in 5 cases of living-related kidney transplantation were collected to reconstruct the 3D model of the donor and recipient, which were then imported in the FreeForm Modeling System. The optimal surgical approach for each individual case was planned and simulated for verification. During the actual surgeries, the surgical findings were compared against the reconstructed model and the results of simulated surgery.</p><p><b>RESULTS</b>The 3D model clearly displayed the anatomy of the kidney and the variation of the related vessels. The optimal surgical approaches were planned through the simulated surgery. The anatomy of the kidney and the related vessels found in the actual surgeries were consistent with that displayed by the reconstructed 3D model. All the operations were completed successfully according to the surgical plan, and the patients recovered uneventfully without obvious complications.</p><p><b>CONCLUSION</b>Three-dimensional reconstruction and simulated surgery allow optimization of the surgical approaches of living-related kidney transplantation to ensure successful operation and minimize the surgical risks.</p>