Effect of Daizongfang on Insulin Resistance of 3T3-L1 Adipocytes Induced by Different Methods / 中国实验方剂学杂志

Objective:To investigate the effects of Daizongfang （DZF） on insulin resistance （IR） of adipocytes induced by different methods. Method:The cocktail induction method was adopted to induce the differentiation and maturity of 3T3-L1 preadipocytes. An IR model in mature adipocytes was established by the induction of palmitic acid （PA）， high-concentration glucose （HG）， and dexamethasone （DEX）. DZF extracts at different concentrations （2.0， 0.5， 0.1 g·L^-1） intervened for 24 hours. A model group， a rosiglitazone （RSG） group， and a blank control group were set up at the same time. The glucose concentration in the culture supernatant was measured by the glucose oxidase-peroxidase （GOD-POD） method. Glucose consumptions under basic conditions （G_Basic） and insulin stimulation （G_Ins） were calculated to evaluate the insulin sensitivity index （ISI）. The mRNA expression of glucose transporter 4 （GLUT4） was detected by the real-time polymerase chain reaction （PCR）. Result:Compared with the model group， the DZF （2.0 g·L^-1） showed increased G_Basic， G_Ins， and ISI in three IR models （<italic>P</italic><0.05， <italic>P</italic><0.01）. In addition， for the PA-induced IR model， G_Basic and G_Ins in the DZF （0.5 g·L^-1） group were elevated （<italic>P</italic><0.01）， and G_Basic， G_Ins， and ISI in the RSG group increased （<italic>P</italic><0.05， <italic>P</italic><0.01）. For the HG-induced IR model， G_Ins and ISI increased in the DZF （0.5 g·L^-1） group （<italic>P</italic><0.05）， and G_Basic， G_Ins， and ISI were elevated in the RSG group （<italic>P</italic><0.01）. For the DEX-induced IR model， G_Ins and ISI increased in the RSG group （<italic>P</italic><0.01）. In the three models， there were differences among groups with different doses. G_Basic， G_Ins， and ISI in the high-dose DZF group increased in varying degrees compared with those in the medium- and low-dose DZF groups （<italic>P</italic><0.05）. In the three models， the DZF （2.0 g·L^-1） group and the RSG group both increased GLUT4 mRNA expression （<italic>P</italic><0.05）. Conclusion:DZF can reduce IR of adipocytes induced by HG， DEX， or PA in a dose-dependent manner and increase glucose uptake in an insulin-independent manner， which may be related to the increase in GLUT4 expression.

Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation / 中国骨伤

OBJECTIVE@#To explore the application value and clinical effect of three-dimensional printing combined with composite plate internal fixation in the treatment of old acetabular posterior wall fracture.@*METHODS@#From May 2010 to October 2016, Mimics 19.0 software was used to plan preoperatively according to a 1:1 print pelvic 3D model. At the same time, 23 patients with old acetabular posterior wall fractures were treated with combined plate internal fixation, including 15 males and 8 females, aged 20 to 63 (43.0±5.1) years old, and the time from injury to operation was 23 to 101(47.0±10.5) days. According to Letournel-Judet classification, 11 cases were posterior wall fracture, 7 cases were transverse with posterior wall fracture, and 5 cases were posterior column with posterior wall fracture. All patients were treated with single Kocher-Langenbeck approach combined plate internal fixation, and the evaluation indexes were recorded during operation, after operation and during follow-up.@*RESULTS@#The operation time of 23 patients was (113.5±11.5) min, bleeding was (550.0±104.7) ml and fluoroscopy was (12.7±0.8) s. Matta radiographic reduction criteria were used: excellent in 14 cases, good in 7 cases and poor in 2 cases; 23 patients were followed up for 10 to 24 (16.0±5.6) months. The hip function was evaluated according to the modified Merle d'Aubingne and Postal scoring system at the last follow-up: excellent in 11 cases, good in 8 cases, fair in 3 cases and poor in 1 case. There were 3 cases of traumatic arthritis, 1 case of femoral head necrosis, 2 cases of heterotopic ossification and 5 cases of sciatic nerve irritation.@*CONCLUSIONS@#3D printing technique is an effective and fast method for the treatment of old acetabular posterior wall fractures. In addition, the printing model can provide three-dimensional morphological structure for the operator, combined with preoperative simulation, facilitate intraoperative reduction, and effectively improve the efficiency of surgery.

Stability analysis of the pelvis and fracture fixation in standing position / 医用生物力学

Objective To develop the three-dimensional (3D) finite element (FE) models of pelvis and fracture fixation, and test their validity. Methods Based on CT scan images, the 3D FE model of the pelvis was built by software of Mimics, ANSYS ICEM, Hypermesh and ABAQUS. A uniformly distributed load of 600 N was applied in vertical direction on the upper lamina of S1 vertebrae to simulate the stresses on the pelvis in standing position and to verify the validity of the pelvis model. T-shaped acetabular fracture models with 3 types of fixation were also established to verify the validity of internal fixation. ResultsBoth the stress and displacement distributions were found to be bilaterally symmetrical on the pelvis in standing position, with the Von Mises stresses mainly distributed in the beginning of arcuate line, pubic branch and posterior-superior area of acetabulum. The largest displacement occurred in the center of the sacral crest, and became relatively smaller in iliac fossa and femur, which was reduced gradually to the femur. Each of the three fixation types in acetabulum showed good biomechanical stability. Conclusions The established hexahedral grid-3D FE model can accurately simulate mechanical properties of the femur in standing position, which would provide an intuitive basis for clinical study.

Surgical strategy for upper cervical vertebrae instability through the anterior approach / 中国骨伤

<p><b>OBJECTIVE</b>To explore the choice and effect of internal fixation in treating upper cervical vertebrae instability through anterior approach.</p><p><b>METHODS</b>From March 2000 to September 2010,83 patients with upper cervical vertebrae instability were treated with internal fixation through anterior approach. There were 59 males and 24 females with a mean age of 42 years old (ranged, 20 to 68). Among these patients, 36 patients were treated with odontoid screw fixation, 16 patients with C1,2 transarticular screw fixation, 23 patients with C2,3 steel plate fixation, 5 patients with odontoid screw and transarticular screw fixation,2 patients with odontoid screw and C2.3 steel plate fixation, 1 patient with C1,2 transarticular screw and C2,3 steel plate fixation.</p><p><b>RESULTS</b>One patient with completely cervical vertebrae cord injury died of pulmonary infection after C1,2 transarticular screw fixation. Other patients were followed up from 8 to 36 months with an average of 15 months. Upper cervical vertebrae stability were restored without vertebral artery and spinal cord injury. Thirty-six patients were treated with odontoid screw fixation and 5 patients were treated with screw combined with transarticular screw fixation obtained bone union in the dentations without bone graft. Among the 16 patients treated with C1,2 transarticular screw fixation, 13 patients obtained bone union after bone graft; 1 patient died of pulmonary infection after surgery; 1 patient with comminuted odontoid fracture of type II C and atlantoaxial anterior dislocation did not obtain bone union after bone graft,but the fibrous healing was strong enough to maintain the atlantoaixal joint stability; 1 patient with obsolete atlantoaxial anterior dislocation were re-treated with Brooks stainless steel wire fixation and bone graft through posterior approach, and finally obtained bone union.</p><p><b>CONCLUSION</b>It could obtain satisfactory effects depending on the difference of cervical vertebrae instability to choose the correctly surgical method.</p>

Retrospective study on staged treatment of long bone shaft fractures with severe thoracic trauma / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the feasibility and efficacy of staged treatment of patients with long bone shaft fractures and severe thoracic trauma.</p><p><b>METHODS</b>A retrospective study was performed on 41 patients with long bone shaft fractures and severe thoracic trauma who underwent staged treatment under the guidance of damage control orthopedics from January 2005 to October 2009 in our department. Among the patients,29 patients were male and 12 patients were female,with an average age of (37.2 +/- 6.1 ) years (ranged, 17 to 65 years). On admission, the value of injury severity score (ISS) for these patients was above 16 and the average value was 27.4. The therapy process included three stages: first stage,controlling thoracic symptoms and provisionally fixing fracture; second stage, resuscitating and optimizing physiological condition in intensive care unit;third stage, operating for fractures when pathogenic condition was equable.</p><p><b>RESULTS</b>There was no dead case. Pathogenic condition of thorax in all patients regained equable in 5 d to 23 d and long bone shaft fractures were fixed in 10 d to 25 d after injury. There was no seriously operative or postoperative complication. All the patients were followed up, the duration ranged from 6 to 36 months, with an average of 19.4 months. Their respiratory functions were good. The long bone shaft fractures were healed in 10 to 16 weeks among 38 patients. The bone nonunion happened in 1 patient with closed fracture and 2 patients with opened fracture.</p><p><b>CONCLUSION</b>Damage control orthopedics is a safe strategy for treatment of long bone shaft fractures with severe thoracic trauma. It is suggested that the surgeons should take a staged approach to perform damage control and definitive surgery.</p>

Effect of glucocorticoid with traditional Chinese medicine in severe acute aespiratory syndrome (SARS) / 中国中药杂志

<p><b>OBJECTIVE</b>To evaluate the effects of traditional Chinese medicine in 461 cases of severe acute respiratory syndrome(SARS) on glucocorticoid's dosage.</p><p><b>METHOD</b>By using the polycentric nonrandomized concurrent controled trial and under the condition of glucocorticoid use, the patierts were divided into two groups: the integrated traditional Chinese and western mendicine(ITCWM) and simplicity western mendicine alone(WM). The observation indexes were time in hospital, pneumonia duration, mortality, glucocorticoid's gross dosage, glucocorticoid's average dosage of days and glucocorticoid use time.</p><p><b>RESULT</b>In the ITCWM group, average time in hospital was shortened (P = 0.058), pneumonia duration was shortened (P = 0.057), mortality fell (P = -0.001). The median of glucocorticoid' s gross dosage was 1,277.0 mg x d(-1) in the ITCWM group, and that was 1,680.0 mg x d(-1) in the WM group (P = 0.083). The median of glucocorticoid's average dosage of days was 84.40 mg x d(-1) in the ITCWM group, and that was 115.33 mg x d(-1) in the WM group (P = 0.025). According to the analysis of 461 cases divided by stages and different ponderance, within 7 days after illness, in the ITCWM group, the glucocorticoid' s average dosage decreased. In the common type, the dosage in the ITCWM and in the WM was 146.43 mg x d(-1), and 183.64 mg x d(-1), respectively (P = 0.057), in the severe type, that was 137.71 and 177.86 mg x d(-1), respectively (P = 0.001).</p><p><b>CONCLUSION</b>Compared with the group of simplicity western mendicine, in the group of integratived Chinese and western mendicine, time in hospital shorten, pneumonia duration shorten, mortality fall, simultaneity, glucocorticoid's average dosage is decreased. The use of TCM in the forepart of treatment can be capable of decreasing glucocorticoid's dosage.</p>