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BACKGROUND@#Legg-Calvé-Perthes disease (LCPD) is still a refractory disease in children’s orthopedics. With the introduction of the concept of ‘‘osteoimmunology’’, the immune-inflammatory mechanisms between bone and immune system have become a research focus of LCPD. However, few studies have reported on the pathological role of inflammation-related receptors such as toll-like receptors (TLRs) as well as immune cells such as macrophages in LCPD. This study was for investigating the mechanism of TLR4 signaling pathway on the direction of macrophage polarization and the repair of avascular necrosis of femoral epiphysis in LCPD. @*METHODS@#With GSE57614 and GSE74089, differentially expressed genes were screened. Through enrichment analysis and protein–protein interaction network, the functions of TLR4 were explored. Furthermore, immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), hematoxylin & eosin (H&E) staining, micro-CT, tartrate-resistant acid phosphatase (TRAP) dyeing and western blotting were performed for determining the influences of TAK-242 (a TLR4 inhibitor) on the repair of avascular necrosis of femoral epiphysis in rat models. @*RESULTS@#Totally 40 co-expression genes were screened as well as enriched in TLR4 signaling pathway. Immunohistochemistry and ELISA analyses certified that TLR4 facilitated macrophage polarization toward the M1 phenotype and prevented macrophage polarization toward the M2 phenotype. Besides, the results of H&E and TRAP staining, micro-CT, and western blotting showed that TAK-242 can inhibit osteoclastogenesis and promote osteogenesis. @*CONCLUSION@#Inhibition of TLR4 signaling pathway accelerated the repair of avascular necrosis of femoral epiphysis by regulating macrophage polarization in LCPD.
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Objective To investigate the distribution of Rh blood type phenotype in unpaid blood donors in Tongchuan area and establish a Rh blood type phenotype database to provide a strong guarantee for clinical safe blood transfusion.Methods The Rh blood group antigens of 3 419 cases of blood donors samples were detected by the method of card column weak gel in the Tongchuan Blood Center from June 2015 to March 2017,and identification of RhD negative specimens were confirmed fordetermining the phenotype of its Rh blood group with indrect antiglobulin test.The cassification statistics were carried out and filed with computer.Rh distribution with other parts of the domestic distribution of blood type was compared using t test.Results The negative rate of RhD in 3 419 unrelated donors was 0.55％.The positive rates of other antigens in Rh were 99.45％,90.41％ in C,55.10％ in E,45.51％ in E and 92.19％ in E,respectively.D:0.921,C:0.673 7,c:0.320 7,E:0.275 5 and e:0.730 6.The distribution of Rh phenotype was:CCDee＞ CcDEe＞ CcDee＞ ccDEE＞ ccDEe＞ CcDEE＞ ccDee ＞ RhD negative.Statistical analysis showed that there was significant difference between the composition ratio of CCDee and ccDEE in Tongchuan and that in Nanning and Qiannan (x2 =21.552,P=0.016;x2=18.519,P=0.001).There was no significant difference between Shenyang,Xingtai and Tianjin Binhai (x2 =0.227～1.31,all P＞0.05).Conclusion The distribution of Rh phenotype in Tongchuan area has the characteristics of northern region[1～4].The RhD negative rate is in line with the distribution characteristics of Chinese Han population.Rh and Rh genotypes differ in southern and northern China,Phenotypic distribution of the investigation for the safety of blood transfusion is of great significance.
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OBJECTIVE: To make a summary evaluation of methods for monitoring occupational exposure to antineoplastic drugs. METHODS: Recent literatures were reviewed, and the key information was extracted, classified and summarized. RESULTS: So far biological monitoring and environmental monitoring are the main sensitive and specific methods to assess occupational exposure to antineoplastic agents. CONCLUSION: It is inevitable for many healthcare workers being exposed to antineoplastic drugs which are mostly cytostatic. Owing to the potential occupational hazard, it is critical to assess this kind of risk precisely. This article is to review the progress of studies on nowadays related assessing methods.
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<p><b>BACKGROUND</b>Double plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.</p><p><b>METHODS</b>Between March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.</p><p><b>RESULTS</b>All patients were followed up. The mean duration of follow-up was 16 months (range 12 - 25 months) in group I and 15.5 months in group II (range 12 - 25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.</p><p><b>CONCLUSIONS</b>Perpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Bone Plates , Fracture Fixation, Internal , Methods , Humeral Fractures , General Surgery , Retrospective StudiesABSTRACT
Research on peripheral nervous injuries, especially the stretched injuries, is important to improve the clinical effectiveness and alleviate the patients's pain. In recent years, the biological changes and mechanics of stretched axons have been hot topics. This article reviews the recent advances in the morphological changes of axons as well as changes in cellular membrane, cytoskeleton, cellular metabolism, and action potential after axonal stretch.
Subject(s)
Animals , Humans , Action Potentials , Axons , Metabolism , Pathology , Cell Membrane , Pathology , Cytoskeleton , Pathology , Stress, MechanicalABSTRACT
ObjectiveTo discuss the clinical application of the temporary balloon occlusion of the common iliac artery in the control of hemorrhage in the operations of the old pelvic fractures.Methods From January 2006 to June 2009,twelve patients (10 males,2 females; mean age 33.9 years) with old pelvic fractures of Tile C type were treated operatively.Three cases were treated with external fixator.Operative treatments were delayed for the treatment of the life-threatening visceral injuries in six nonunions and three malunions.A balloon catheter was placed through intravascular intervention in the common iliac artery of the affected side.The balloon catheter was infolded when the osteotomy was performed and the operations were undertaken under temporary and total occlusion of the common iliac artery.Osteotomies and internal fixations were performed in 12 cases.Decompressions of lumbosacral trunk were undertaken in 4 cases complicated with injuries of sciatic nerve.ResultsThe mean time of operations was 290 min(range,210-367min).The mean time of occlusions was 65 min (range,45-90 min).The loss of blood ranged from 700 ml to 2800 ml,with an average of 1833 ml.All cases were followed up for 12-48 months,with an average of 35 months.The mean time of bone healing was 20.6 weeks (range,16-24 weeks).No thrombosis of the common iliac artery and deep venous thrombosis of the lower extremity or ischemic necrosis happened.In the four cases complicated with injuries of sciatic nerve,three recovered partly and could walk with a crutch and one recovered completely and could walk normally.Two cases limped and other six cases could walk normally.ConclusionThe effect of temporary balloon catheter occlusion of common iliac artery is reliable.It drastically reduces hemorrhage during the operation and avoid the complications of selective arterial embolism and ligation and makes the operations of the old pelvic fractures more safer.
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<p><b>OBJECTIVE</b>To evaluate the differentially expressed genes between the Stress fracture (SF) cases and controls.</p><p><b>METHODS</b>Total RNA was extracted and purified from peripheral blood sample of 3 SF cases and 3 controls who conducted a 1:1 matched case-control study, then used for Human Genome Array analysis. The hybridization data were analyzed using SAM software. Parts of these genes were analyzed and identified by real-time PCR.</p><p><b>RESULTS</b>Upregulated and downregulated genes were 22 and 1, respectively. Thus the highest ratio and most significant cytokine was tumor necrosis factor receptor superfamily, member 10c (TNFRSF10C). The result of real-time PCR shows that TNFRSF10C was over-expressed in 3 cases and low-expressed in 1 case.</p><p><b>CONCLUSION</b>Obvious difference exists in gene expression between SF cases and controls, showing there may be a lot of genes involving in the occurrence and development of SF. Meanwhile, the identification of the specific genes is helpful for biomechanics study, early diagnosis and screening of SF.</p>