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Objective:To explore the application of a 3D printed patient-specific guider (3D-PSG) in complex total knee arthroplasty (TKA).Methods:A retrospective analysis was performed of the data of 44 patients who had received complex artificial TKA for articular and extra-articular deformities of the knee from January 2016 to October 2019 at Department of Orthopaedic Surgery, Nanjing First Hospital. According to whether a 3D-PSG had been applied, the patients were divided into 2 groups. In the 3D-PSG group of 23 patients, there were 11 males and 12 females, with an age of 63.7 years ± 10.2 years (from 53 to 81 years); in the conventional group of 21 cases, there were 10 males and 11 females, with an age of 64.2 years ±12.1 years (from 51 to 79 years). In the 3D-PSG group, the preoperative CT data were 3D reconstructed for measurement of a full lower limb and design of a 3D-PSG and TKA was assisted by a 3D-PSG which had been manufactured by a 3D printer using the STL files of the 3D-PSG imported. In the conventional group TKA was performed in a standard manner. In the 3D-PSG group, the TKA surgical parameters in the preoperative plan were compared with actual surgical measurements. The 2 groups were compared in terms of operation time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, visual analogue scale (VAS), Knee Society Score (KSS), hip knee ankle (HKA), frontal femoral component (FFC), frontal tibial component (FTC), lateral femoral flexion (LFF) and lateral tibial component (LTC).Results:There were no significant differences between the 2 groups in the preoperative general data, showing comparability ( P>0.05). In the 3D-PSG group, no significant differences were found between preoperative parameters designed and actual intraoperative measurements in the prosthetic type of femoral condyle (3.4±1.1 versus 3.5±0.9) or of tibial plateau (3.1±0.9 versus 3.3±1.2), or in the filler thickness (10.6 mm ± 3.2 mm versus 10.9 mm ± 4.7 mm) ( P>0.05). The 44 patients were followed up for an average of 10.8 months (from 7 to 13 months). The 3D-PSG group had significantly less operation time (65.7 min ± 10.5 min), intraoperative blood loss (19.8 mL ±7.3 mL), postoperative drainage volume (124.6 mL ± 27.9 mL) and hospital stay (7.3 d ± 2.5 d) than the conventional group (82.4 min ± 11.7 min, 86.5 mL ± 35.7 mL, 154.6 mL ± 21.3 mL and 10.6 d ± 3.1 d) ( P<0.05). The VAS and KSS scores at postoperative day 1, week 1 and week 2 in the 3D-PSG group were significantly better than those in the conventional group ( P<0.05). Significantly more patients in the 3D-PSG group achieved approximately ideal values in HKA, FFC, FTC, LFF and LTC than those in the conventional group ( P<0.05). Conclusion:A 3D printed patient-specific guider may improve surgical accuracy, reduce operation time and achieve better surgical outcomes in complex total knee arthroplasty.
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Nitroreductases (NTRs) are known to be able to metabolize nitro-substituted compounds in the presence of reduced nicotinamide adenine dinucleotide (NADH) as an electron donor. NTRs are present in a wide range of bacterial genera and, to a lesser extent, in eukaryotes hypoxic tumour cells and tumorous tissues, which makes it an appropriate biomarker for an imaging target to detect the hypoxic status of cancer cells and potential bacterial infections. To evaluate the specific activation level of NTR, great efforts have been devoted to the development of fluorescent probes to detect NTR activities using fluorogenic methods to probe its behaviour in a cellular context; however, NTR-responsive MRI contrast agents are still by far underexplored. In this study, -nitrobenzyl substituted -weighted magnetic resonance imaging (MRI) contrast agent Gd-DOTA-PNB (probe ) has been designed and explored for the possible detection of NTR. Our experimental results show that probe could serve as an MRI-enhanced contrast agent for monitoring NTR activity. The response and mechanism of the NTR catalysed reduction of probe have been investigated through LC-MS and MRI. -nitrobenzyl substituted probe was catalytically reduced by NTR to the intermediate -aminobenzyl substituted probe which then underwent a rearrangement elimination reaction to Gd-DOTA, generating the enhanced -weighted MR imaging. Further, LC-MS and MRI studies of living have confirmed the NTR activity detection ability of probe at a cellular level. This method may potentially be used for the diagnosis of bacterial infections.
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Objective@#To compare the application of iASSIST assisted total knee arthroplasty (TKA) and three-dimentional(3D) printing personal specific instrument (PSI) assist TKA in the treatment of osteoarthritis (OA).@*Methods@#Clinical data of 47 patients with OA admitted at Department of Orthopaedic Surgery in Nanjing Medical University Nanjing Hospital between April and September 2016 were retrospectively reviewed, including 20 males and 27 females, aging from 57 to 77 years with mean age of (63.8±8.2) years. They were randomly divided into iASSIST-TKA group (23 patients) and PSI-TKA group (24 patients). The data such as hip knee ankle (HKA) angle, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, lateral femoral component (LFC) angle, lateral tibial component (LTC) angle, time of operation, post-operative wound drainage, period of hospitalization, visual analog scale (VAS) and Knee Society Score (KSS) at 1 day, 7 days, 14 days, 1 month and 3 months were recorded and compared between the two groups. T test was used to compare measurement data, Fisher exact test and χ2 test were applied to enumeration data in comparison among groups, and Kruskal-Wallis test was applied to ranked data.@*Results@#The deviation values of HKA, FFC, LFC, FTC and LTC angles were all below 3°(-2° to 2°), and there were no significant difference between iASSIST-TKA group and PSI-TKA group (Z=-0.610 to 0.000, P=0.542 to 1.000). Compared to PSI-TKA group, the time of operation was long((80.7±8.8) minutes vs.(60.2±7.8) minutes), the amount of post-operative wound drainage was increased((210.7±32.1) ml vs.(185.5±30.2)ml) and the period of hospitalization decreased((5.4±2.4) d vs.(6.7±1.6) d) in iASSIST-TKA group, there were significant difference(t=-2.190 to 8.460, P=0.000 to 0.033). There were no significant difference in intra-operative blood drainage((18.4±5.4) ml vs.(17.3±6.2) ml) between the two groups(t=0.650, P=0.521). PSI-TKA group had a superior VAS score(4.8±0.6 vs. 5.5±0.9, 3.6±0.8 vs. 4.3±0.9), KSS clinical score(49.3±5.5 vs. 44.2±6.4, 54.9±4.0 vs. 50.8±4.2) and KSS function score(44.1±2.9 vs. 41.2±3.5, 49.6±3.8 vs. 46.6±3.2) in 1 day and 7 days post-operation(t=-3.420 to 3.150, P=0.001 to 0.007). There were no significant difference in VAS and KSS score in 14 days, 1 month and 3 months post-operation(t=-1.390 to 0.530, P=0.170 to 1.000) between the two groups.@*Conclusions@#The iASSIST-TKA and PSI-TKA can help to make TKA procedure more accurately. iASSIST-TKA may take longer time of operation and have slower recovery, PSI-TKA may need more X-ray input and longer period of hospitalization. The long-term research of both techniques may be valuable for the further clinical usage.
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A method was proposed to determine kaempferol and quercetin in Hippophae rhamnoides L medicinal preparation xindakang tablet by beta-cyclodextrin modified micellar electrokinetic capillary chromatography. Under the optimized conditions: buffer solution of 20 mmol/L Na[2]B[4]O[7]-KH[2]PO[4] [pH 9.0]-20mmol/L SDS-6mmol/L beta-CD-5%[v/v] MeCN, applied voltage of 16 kV and injection time of 8s, the two analytes were separated well within 10 minutes. The calibration was linear in the 0.02-0.80 and 0.02-0.70 mg/mL range for kaempferol and quercetin, respectively. The reproducibility based on migration time and peak height were 0.47% and1.87% for kaempferol, 0.55% and 2.02% for quercetin. The detection limits based on three times noise were 0.010 mg/mL and 0.008 mg/mL for kaempferol and quercetin, respectively. The developed method was utilized to analyze real samples and running recovery experiments with satisfactory results.
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Quercetin , beta-Cyclodextrins , Chromatography, Micellar Electrokinetic Capillary , TabletsABSTRACT
OBJECTIVE: To understand the research on the development and application of non-fusion inter-spinous stabilization devices.DATA SOURCES: Using the key terms of "inter-spinous and low back pain", relevant articles on non-fusion inter-spinous stabilization devices and low back pain in English were retrieved from Medline between January 1966 and October 2004 and the Ovid database between January 2003 and June 2007.STUDY SELECTION: Titles and most abstracts of all articles on the types of non-fusion inter-spinous stabilization devices and action mechanisms of non-fusion inter-spinous stabilization devices were selected. Duplicated researches and meta analytic papers were excluded.DATA EXTRACTION: A total of 351 articles met the inclusion criteria and 322 were excluded. Among them, 29 papers were analyzed. The major exclusion factor was duplicate studies.DATA SYNTHESIS: Non-fusion inter-spinous stabilization devices can improve mechanism of low back pain and cause certain effects on the biodynamic environment of degenerative lumbar vertebrae, such as relieving loading of the posterior border of the anulus fibrosus of the intervertebral disc and opening the intervertebral foramen. At present,non-fusion inter-spinous stabilization devices, such as X-STOP, Wallis and DLAM, have been tested for a long time;therefore, the effects of their effectiveness, utility and risk of complications will be proved by clinical experiments as soon as possible.CONCLUSION: Non-fusion inter-spinous stabilization devices have good effects on the treatment of degenerative low back pain originating in the anulus fibrosus of the intervertebral disc and can reduce complications caused by the fusion technique.
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Objective: To analyze the effects of technetium99 conjugated with methylene diphosphonate(99Tc-MDP) on adjuvant arthritis in rats.Methods: Thirty SD rats were randomly and equally divided into a normal control group an adjuvant arthritis control group and a 99Tc-MDP treatment group.Intraperitoneal injection of 99Tc-MDP(2.5?10-3?g/kg) was given to the rats in the treatment group on the tenth day and repeated every other day after arthritis induction.The left-right diameter of the left hind ankle,arthritic index,serum TNF and IL-1? levels,articular radionuclide imaging and histopathological changes were observed.Results: Compared with the adjuvant arthritis group,the diameter of the left hind ankle,arthritic index,the serum TNF and IL-1? levels and the T/NT value were decreased in the treatment group,and histopathology showed less synovium hyperplasia and fewer infiltration of inflammatory cells in the group treated with 99Tc-MDP intraperitoneal injection than in the adjuvant arthritis control group.Conclusion: 99Tc-MDP intraperitoneal injection is effective for adjuvant arthritis in rats.
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AIM To study the metabolic pathway of chiral clausenamide in the rat and understand its stereoselectivity. METHODS The urine, feces and blood of rat were gathered after the drug was administered, the known metabolites were analyzed by HPLC-DAD and one unknown metabolite was elucidated by using LC-MS analysis. Metabolic stereoselectivity was determined by comparing the metabolic results of (+)- and (-)-clausenamide. RESULTS Six known metabolites were determined and one unknown metabolite was elucidated as N-demethylclausenamide. The metabolic stereoselectivity was shown distinctly. CONCLUSION Chiral clausenamide was mainly metabolized by hydroxylation in liver and the biotransformation exhibited pronounced substrate stereoselectivity.
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Objective To study the chemical constituents of Dysosma pleiantha.Methods Acidic resins were precipitated by 1% HCl solution, then the constituents were isolated and purified on repeated silica gel column.They were identified and structurally elucidated by physicochemical constants and spectral analysis.Results Ten compounds were obtained and identified: podophyllotoxone (Ⅰ), dehydropodophyllotoxin (Ⅱ), podophyllotoxin (Ⅲ), 4′-demethylpodophyllotoxin (Ⅳ), 4′-demethyldehydropodophyllotoxin (Ⅴ), kaempferol (Ⅵ), quercetin (Ⅶ), n-hexadecanoic acid (Ⅷ), ?-sitosterol (Ⅸ), and daucosterol (Ⅹ).Conclusion Compound Ⅴ is a new compound, compounds Ⅷ-Ⅹ are first separated from the plants of Dysosma Woodson and other compounds are first separated from D.pleiantha.