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OBJECTIVE： To investigate the effect mechanism of diazoxide on the proliferation and apoptosis of chondrocytes with oxidative injury based on endoplasmic reticulum stress （ERS） pathway. METHODS： SD mice were selected for primary culture of articular chondrocytes. The 3rd generation chondrocytes were randomly divided into control group， injury model group and diazoxide group. Control group didn’t receive any treatment. The injury model group was incubated with 300 μmol/L hydrogen peroxide （H2O2） at 37 ℃ for 8 h. Diazoxide group was pretreated with 300 μmol/L diazoxide at 37 ℃ for 0.5 h，and then incubated with 300 μmol/L H2O2 for 8 h. The proliferation of chondrocytes was detected by CCK-8 assay. The apoptosis rate of chondrocytes was detected by flow cytometry. The expression of ERS-related proteins [Caspase-3， Bcl-2-associated X（Bax），C/EBP homologous protein （CHOP）] were detected by Western blotting assay. RESULTS： Compared with control group， the proliferation activity of chondrocytes in injury model group was significantly decreased， while apoptosis rate was increased significantly（P＜0.05）；the protein expression of Caspase-3， Bax and CHOP were increased significantly （P＜0.05）. Compared with injury model group， the proliferation activity of chondrocytes in diazoxide group was increased significantly， while the apoptosis rate was decreased significantly （P＜0.05）； the expression of above related proteins were decreased significantly （P＜0.05）. CONCLUSIONS： Diazoxide can improve the proliferation activity of chondrocytes with oxidative injury and inhibit their apoptosis by inhibiting ERS pathway.
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OBJECTIVE： To observe the efficacy and safety of fluorouracil combined with paracetamol in the treatment of knee osteoarthritis and its effects on related indexes. METHODS： Totally 115 patients with knee osteoarthritis admitted to our hospital from March 2015 to March 2018 were divided into control group （57 cases） and observation group （58 cases） according to medication plan. Control group was given Paracetamol tablets 0.3 g orally， 3 times a day， for consecutive 8 weeks. Observation group was additionally given intra-articular injection of Fluorouracil injection 0.075 g on the basis of control group， once a week， 4 times as a treatment course， for 2 courses in total. Clinical efficacies， VAS scores， Lysholm knee scores， Fugl-Meyer Assessment （FMA） scores， Barthel indexes， WHO QOL-BREF scores before and after treatment and the occurrence of ADR of 2 groups were observed. RESULTS： The total response rate of observation group was 94.83％， which was significantly higher than 78.95％ of control group （P＜0.05）. Before treatment， there was no statistical significance in VAS score， Lysholm knee scores， FMA scores， Barthel index or QOL-BREF scores between 2 groups （P＞0.05）. After treatment， VAS scores of 2 groups were significantly lower than before treatment， and the observation group was lower than the control group； Lysholm knee scores， FMA scores， Barthel indexes and QOL-BREF scores were significantly higher than the same group before treatment， and observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. No severe ADR was found in 2 groups during treatment. CONCLUSIONS： Fluorouracil combined with paracetamol can significantly improve therapeutic efficacy of patients with knee osteoarthritis， and can significantly improve knee function， motor function， self-care ability and quality of life without increasing the occurrence of ADR.
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Objective To investigate the clinical relevance of mannose-binding lectin 2 (MBL2) gene polymorphism with traumatic sepsis in Hainan Province. Methods A retrospective case control study was conducted to analyze the clinical data of 112 severe trauma patients admitted to the First Affiliated Hospital of Hainan Medical College and Haikou People's Hospital from June 2017 to June 2018. There were 73 males and 39 females, aged 17-83 years [(41. 8 ± 8. 9)years]. There were 48 patients in the sepsis group and 64 patients in the non-sepsis group. Multiplex single nucleotide extension polymorphism ( SNaPshot ) typing technique was used to detect the MBL2 gene polymorphism. The correlation between different genotypes and the risk of sepsis was analyzed. ELISA method was used to detect the level of MBL2 in plasma of each group. Results Among the three polymorphic loci of MBL2 gene (rs5030737, rs1800450 and rs1800451), the mutation frequency of rs1800450 was 27. 7％, while the mutation frequency of rs5030737 and of rs1800451 was 0. The genotype distribution in two groups was in accordance with Hardy-Weinberg equilibrium. The frequency of GA genotype in sepsis group was significantly higher than that in non-sepsis group (P<0. 05). A allele frequency in sepsis group was also much higher than that in non-sepsis group (P<0. 05). Patients with GA genotype had increased risk of traumatic sepsis when compared to GG genotype(OR=3. 442, 95％CI 1. 447-8. 187). Allele A increased the prevalence of sepsis significantly as well when compared to allele G(OR =2. 799, 95％CI 1. 270-6. 170). The MBL2 level in serum in sepsis patients with genotype GG and GA was significantly lower than that in non-sepsis group (P<0. 05). In sepsis group, the MBL2 serum level of patients with genotype GA was obviously lower than that in patients with genotype GG (P<0. 05). Conclusion MBL2 rs1800450G/A polymorphism is closely related to the occurrence of sepsis in Hainan province, and may be related to the decrease of serum MBL2 level in patients with mutant type.
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Objective To explore the feasibility and safety of emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation in the treatment of pelvic fracture combined with hemorrhagic shock.Methods A retrospective analysis of 21 patients with pelvic fractures and hemorrhagic shock who were treated with emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation was performed.The percutaneous minimally invasive screw fixation was performed immediately after embolization.Results There were 18 of 21 cases with obvious arterial bleeding confirmed by femoral artery angiography.And the corresponding interventional embolization was performed.No obvious arterial hemorrhage was found in the other 3 cases who received suspicious hemorrhagic internal iliac arterial prophylactic embolization.The time-consuming of percutaneous minimally invasive screw fixation was no more than 90 min for each patient.There was no servious complication associated with arterial embolization after intervention.Totall 18 cases were improved after discharge.Another 3 cases died,including 2 cases died for postoperative multiple organ failure or disseminated intravascular coagulation,1 case died for hemorrhagic shock caused by still continue bleeding after surgery.The postoperative follow-up was performed during 3-18 months with the average of (10.81 ± 2.62) months.The fractures in all the surviving cases achieved bone healing with good function.Conclusion The emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation is a safe,fast and effective method for the treatment of pelvic fractures and hemorrhagic shock with less complications.
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Objective To explore the feasibility and safety of emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation in the treatment of pelvic fracture combined with hemorrhagic shock.Methods A retrospective analysis of 21 patients with pelvic fractures and hemorrhagic shock who were treated with emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation was performed.The percutaneous minimally invasive screw fixation was performed immediately after embolization.Results There were 18 of 21 cases with obvious arterial bleeding confirmed by femoral artery angiography.And the corresponding interventional embolization was performed.No obvious arterial hemorrhage was found in the other 3 cases who received suspicious hemorrhagic internal iliac arterial prophylactic embolization.The time-consuming of percutaneous minimally invasive screw fixation was no more than 90 min for each patient.There was no servious complication associated with arterial embolization after intervention.Totall 18 cases were improved after discharge.Another 3 cases died,including 2 cases died for postoperative multiple organ failure or disseminated intravascular coagulation,1 case died for hemorrhagic shock caused by still continue bleeding after surgery.The postoperative follow-up was performed during 3-18 months with the average of (10.81 ± 2.62) months.The fractures in all the surviving cases achieved bone healing with good function.Conclusion The emergency interventional arterial embolization combined with percutaneous minimally invasive screw fixation is a safe,fast and effective method for the treatment of pelvic fractures and hemorrhagic shock with less complications.
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Objective To explore the effect of TGF-β microbubble targeting on the treatment of skeletal muscle injury in rats.MethodsEighty SD rats of 2 months old were randomly divided into experimental group(including TGF-β microbubble),pure drug group,microbubble group(exclusive drug) and control group,20 SD rats in each group.Four groups accepted ultrasonic transmission with consistent time and frequency.The contraction stress and stress relaxation of injured gastrocnemius muscle were measured,the changes of injured gastrocnemius muscle were observed by light microscope and electron microscope.Results There was no statistically significant difference in contraction stress of gastrocnemius muscle among all groups at 1,5,9 days after injury(P>0.05).And at 14 days,the contraction stress of gastrocnemius muscle of the experimental group and the pure drug group were obviously higher than those of the rest two groups,the differences were significant(P<0.05).The difference of gastrocnemius muscle contraction stress was statistically significant between the experimental group and the pure drug group(P<0.05).For the stress relaxation of gastrocnemius muscle,the experimental group was lower than the other three groups at 1 day after injury,the differences were significant(P<0.05).Light microscopy showed the number of muscle fiber in the experimental group increased obviously at 9 days after injury.There was no scarring at 14 days after injury.Electron microscope showed mitochondria and sarcoplasmic reticulum increased in the experimental group,and the new muscle cells and satellite cells were significantly more than those of the rest three groups.Conclusion TGF-β cell targeted therapy can obviously improve the shrinkage stress of skeletal muscle in rats after injury and recover the stress decay,which can obviously promote the injury repair and regeneration of skeletal muscle,and reduce scar formation at the same time.