68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy / 亚洲男科学杂志(英文版)

To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.

Meniscus repair with simultaneous anterior cruciate ligament reconstruction: Clinical outcomes, failure rates and subsequent processing / 中华创伤杂志(英文版)

PURPOSE@#To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair.@*METHODS@#From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant.@*RESULTS@#Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both).@*CONCLUSION@#The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.

Mid-to-long term clinical outcomes and predictors after anterior cruciate ligament revision / 北京大学学报(医学版)

OBJECTIVE@#To assess the mid-to-long term clinical outcomes after anterior cruciate ligament (ACL) revision surgery and to analyze their predictors.@*METHODS@#The medical records of 235 patients undergoing ACL revision surgery between Jan. 2001 and Dec. 2015 at Department of Sports Medicine, Peking University Third Hospital were reviewed. Data were collected including demographic information, information related to revision surgery (time and cause of graft failure, date of revision surgery, surgical technique, combined injuries and management, etc.), as well as information related to primary ACL reconstruction (time, cause and mechanism of first-time ACL rupture, date of primary ACL reconstruction, surgical technique, combined injuries and management, etc.). Patients were followed up at least 2 years after revision surgery for clinical outcomes [Tegner score, Lysholm score, and International Knee Documentation Committee (IKDC) subjective knee score]. Post-revision surgeries on the involved knee and the contralateral knee joint were also documented. Multivariate regression model was used to analyze the predictors of clinical outcomes after ACL revision surgery.@*RESULTS@#A total of 166 (70.63%) patients were followed up at a mean of (4.44±2.40) years (2.03-14.63 years). Clinical outcomes improved significantly at the last follow-up from pre-operative level, with the Lysholm, Tegner, and IKDC scores improving from 70.51±21.25, 3.39±1.77, 63.78±15.04 to 88.64±14.36, 4.67±1.739, 80.23±13.31 (P < 0.05), respectively. Three (1.81%) patients experienced infection while 39 (23.49%) patients underwent surgery after revision surgery during the follow-up. Compared with that those occurred during sports, graft failure that occurred during daily activities or due to surgical technical errors that led to poorer clinical outcomes, with the Lysholm, Tegner, and IKDC scores of 9.90 (95%CI: 1.49-18.31), 1.41 (95%CI: 0.10-2.72), 10.35 (95%CI: 0.17-20.54), and 8.53 (95%CI: 1.31-15.75), 1.28 (95%CI: 0.14-2.43), 9.39 (95%CI: 1.03-17.74) lower, respectively. Compared with antero-medial portal, transtibial technique for placement of the femoral bone tunnel showed poorer Lysholm scores of 11.18 (95%CI: 4.73-17.63, P=0.001). Concurrent repair of medial meniscus yielded higher IKDC scores of 11.06 (95%CI: 1.21-20.92, P=0.029) than those with intact medical meniscus. Other factors showed no significant effect.@*CONCLUSION@#ACL revision surgery is able to restore knee stability and improve knee function. Graft failure caused by sports, concurrent repair of medical meniscus and antero-medial portal technique predicts better outcomes after revision surgery.

Electrochemical Detection of Dopamine Based on MnO2 Nanowires/Reduced Graphene Oxide Composites Modified Glassy Carbon Electrode / 分析化学

MnO2nanowires-reduced graphene oxide composite (MnO2-RGO) was used to modify glassy carbon electrodes (GCE) and applied for the electrochemical determination of dopamine (DA). The microstructure of MnO2nanowires and MnO2-RGO nanocomposite material was characterized by scanning microscope and X-ray powder diffraction. Then the electrochemical reduction condition for preparing MnO2-RGO/GCE and experimental conditions for determining DA were optimized systematically. The electrochemical behavior of DA on the bare electrode and RGO or MnO2-RGO modified electrodes was also investigated in pH 3.5 phosphate buffer solution (PBS) by cyclic voltammetry. The results shows that the oxidation peaks of ascorbic acid (AA), dopamine (DA) and uric acid (UA) can be well separated and the peak to peak separations were 268 mV (AA-DA) and 128 mV (DA-UA), respectively. Moreover, the linear response ranges for the determination of DA were 0.06-1.0 μmol/L and 1.0-80 μmol/L with the detection limit of 1.0 nmol/L (S/N=3). The proposed method has been applied to the determination of dopamine in human blood serum sample with satisfactory results.

Microsurgical transverse 2-suture intussusception vasoepididymostomy: effectiveness and rationality / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>2-Suture longitudinal vasoepididymostomy shows superiority to transverse technique in an animal study; to date, this has not been consistently confirmed in human body. In the present study, we evaluated the effectiveness of 2-suture transverse intussusception vasoepididymostomy and compared the rationality between transverse and longitudinal techniques.</p><p><b>METHODS</b>From May 2007 to December 2008, we performed 2-suture transverse vasoepididymostomy in 19 consecutive patients, as described by Marmar with modification. Between March 2009 and January 2010, the internal diameter of the vas lumen and the outer diameter of the epididymal tube were measured using microruler (21 patients and 37 sides).</p><p><b>RESULTS</b>Three patients lost to follow-up. At the first follow-up period (ranged from 10 to 24 months), the patency rate was 56.3% (9/16) and the natural pregnancy rate was 25% (4/16). At the second follow-up period (ranged from 46 to 63 months), the patency rate was 68.8% (11/16), the natural pregnancy rate was 37.5% (6/16), respectively, and the take-home baby rate was 31.3% (5/16). The diameter of the vas lumen and the outer diameter of the epididymal tubule were (0.512 ± 0.046) mm and (0.572 ± 0.051) mm (P < 0.001), respectively.</p><p><b>CONCLUSION</b>Transverse 2-suture intussusception vasoepididymostomy is still an effective technique in treating obstructive azoospermia.</p>

The denitrogenation by breathing oxygen-rich gas to prevent altitude decompression sickness / 中国应用生理学杂志

<p><b>OBJECTIVE</b>While the technology of the molecular sieve oxygen generation system(MSOGS) onboard was used, pilots could not breathe pure oxygen to eliminate nitrogen during a high altitude flight. There is no report whether it is a threat to altitude decompression sickness(ADS) or not in that condition. This experiment was intended to observe the effects of breathing different oxygen-rich gases of MSOGS on denitrogenation, so that we could make the medical physiological requirements for MSOGS on-board and provide experimental basis for aeromedical supply.</p><p><b>METHOD</b>Eight healthy males were breathed oxygen-rich gases (60%,70%,80%,90%and 99.6%) in turn for 60 min, and the concentration of nitrogen, oxygen, carbon dioxide and argon at the end of expiration interval in the oxygen mask were continuously measured by a flight mass spectrometer through the oxygen mask. According to the variety of the denitrogenation rate by breathing different oxygen-rich gases, its change law was analyzed.</p><p><b>RESULTS</b>There were significant differences (P < 0.05) about denitrogenation rate in different oxygen-rich gases due to different oxygen concentration and breathing time. The denitrogenation rate of pure oxygen was higher than that of the others. It was indicated that the concentration of nitrogen in lung would decrease along with the increase in oxygen concentration of oxygen-rich gases, and the nitrogen concentration in the lung almost decreased by 50% or even more if people were breathed 60%-90% oxygen-rich gas longer than 60 s.</p><p><b>CONCLUSION</b>The man-made respiration environment of low nitrogen can be provided by breathing oxygen-rich gases, although the denitrogenation velocity of breathing oxygen-rich gases is lower than that of breathing pure oxygen. So it can be used as a measure to eliminate and lower the nitrogen in the body to prevent from ADS.</p>

Influence of mesenchymal stem cells on proliferation of HL-60 / 中国实验血液学杂志

The objective of this study was to explore the effect of mesenchymal stem cells (MSC) on HL-60 proliferation and its molecular mechanism. HL-60 cells co-cultivated with MSC were used as experiment group, and the cells cultivated solely were taken as control group. HL-60 cells in the two groups were counted at different time. The time-quantity curve was drawn. The cell cycle and apoptosis ratio of HL-60 cells were compared between the two groups and expressions of Survivin and Bcl-2 protein were detected by flow cytometry. The results showed that HL-60 cells cultivated with MSC were obviously inhibited, especially on day 5 and 7 (P < 0.01). HL-60 cells were distributed on the phase of G(0)/G(1) [control group (47.0 ± 9.0)% vs experiment group (70.0 ± 16.0)%, P = 0.003], and apoptotic peak appeared. Both of Survivin and Bcl-2 protein expressions in HL-60 cells decreased [Bcl-2 protein in control group (63.0 ± 9.1)% vs experiment group (50.0 ± 14.1)%, P = 0.045; Survivin in control group (94.0 ± 9.3)% vs experiment group (77.0 ± 11.8)%, P = 0.006]. It is concluded that the MSC can inhibit HL-60 cell proliferation, and promote HL-60 cell apoptosis.

Morphologic diagnosis and onset characteristics of acute leukemia: a retrospective analysis of 233 cases in 10 years / 中国实验血液学杂志

The objective of this study was to evaluate the value of morphologic diagnosis for acute leukemia (AL), to explore the relation of morphologic diagnosis with immunology, cytogenetics and molecular biology diagnosis of AL and to analyze the onset characteristics of AL in 10 years. The samples of bone marrow and peripheral blood from 233 newly diagnosed cases of AL were collected during 2001-2011 years; the morphologic examination and immunologic, cytogenetic and molecular biologic examination (ICM) were carried out, the consistency of morphologic diagnosis with ICM diagnosis was compared, the onset characteristics of AL was analyzed. The results showed that: (1) the consistent rate of immunology, cytogenetics, molecular biology diagnosis with morphologic diagnosis was 84.3%. The order of consistent rat was AUL, M0 < M1 < HAL < M4 < M2 < M3 < M5 < ALL < M6, M7, AP; (2) Misdiagnosis always occurred among AUL, M0, M1, ALL and HAL or among M2a, M3v, M4 and M5. (3) In 233 cases, the highest ratio of blast was observed in M1 (92.5%), while the lowest ratio of blast was observed in M2 (49.5%). (4) AL occurred more frequently in males than that in female (147:86). (5) AL occurred in patients aged from 1 to 88 years. The median age was 41.5 for AUL, 40.8 for M0, 43.4 for M1, 46.3 for M2, 33.8 for M3, 42.6 for M4, 48.8 for M5, 77.3 for M6, 2.5 for M7, 65.0 for AP, 29.1 for ALL and 40.3 for HAL. (6) The number of patients in the later five years (139 cases) was significantly greater than that in the first five years (94 cases), especially the patients with M1, M2, M3, M4, and M5. It is concluded that morphologic diagnosis has important clinical value in the MICM diagnosis of AL. Attaching importance to the confusing cell morphology and onset characteristics of AL can improve the diagnostic accuracy.

Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft with moderate to long term follow-up / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the 4- to 10-year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction.</p><p><b>METHODS</b>From May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated, using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5 - 10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment.</p><p><b>RESULTS</b>The mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4 +/- 8.1, 94.5 +/- 9.2, and 6.9 +/- 2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P < 0.01). The average posterior displacement measured with KT2000 was (4.9 +/- 1.1) mm (90 degrees flexion) and (4.3 +/- 1.2) mm (30 degrees flexion) respectively. At the final follow-up, KT2000 examination revealed >or= 6 mm of posterior laxity in 6 patients (group A), and <or= 5 mm posterior laxity in 16 patients (group A). A statistically significant improvement was noted in comparing the mean final follow-up IKDC score, Lysholm score, and Tegner score between the group A and B (P < 0.01). The average time from injury to surgery of group A and B was (17.6 +/- 3.9) months and (2.9 +/- 2.1) months respectively, the difference was statistically significant (P < 0.01). The data was received from the Biodex dynamometer for the 22 patients who were followed up in clinic service. Patients achieved (90 +/- 22)% (60 degrees /s) and (87 +/- 19)% (120 degrees /s) recovery of the extensor peak torque respectively, for the flexor peak torque patients achieved (93 +/- 16)% (60 degrees /s) and (92 +/- 20)% (120 degrees /s) respectively, the difference between the peak torque of extensor and flexor in the same condition was statistically significant (P < 0.01). X-ray findings: 8 of the 22 patients (36.4%) were assessed as mild grade change (3 case in medial compartment isolated, 1 case in patellofemoral joint isolated, and 4 case in both compartments) and 2 patients (9.1%) as moderate grading in final follow-up radiographs (in both anterior and medial compartments), and 12 of the 22 patients (54.5%) revealed normal X-ray findings. The average time from injury to surgery of patients who revealed joint degeneration and patients who revealed normal X-ray findings was (16.6 +/- 2.7) months and (3.3 +/- 1.7) months respectively, the difference was statistically significant (P < 0.01).</p><p><b>CONCLUSIONS</b>Arthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft produces well results with moderate to long term follow-up. For the patients with III or IV PCL injury, PCL reconstruction should be done as soon as possible.</p>

Comparison of biological characteristics of bone marrow mesenchymal stem cells in acute myeloid leukemia with those from non-leukemia / 中国实验血液学杂志

This study was aimed to compare partial biological characteristics of bone marrow mesenchymal stem cells (BMMSCs) in AML patients, AML patients with complete remission (CR) and non-leukemia patients. The bone marrow (BM) MSCs were divided into 3 groups: group of MSCs from AML patients, group of MSCs from AML patients with CR, group of MSCs from non-leukemia patients. The morphologic features of MSCs were observed by light microscopy; CFU-F numbers of MSCs were counted after Wright-Giemsa staining in situ; the fusion times of MSCs were determined; the growth curves of MSCs were drawn by counting cell numbers; the immunophenotypes and cell cycle of MSCs were detected by flow cytometry; the DI values of MSCs were calculated. The results showed that the morphologic features of MSCs in 3 groups did not display difference; there was significant difference (p < 0.01) of CFU-F numbers in 3 groups, while CFU-F number of MSCs in AML group was minimal; there was significant difference of MSC fusion time in 3 groups, while fusion time of MSCs in AML group was most long; the growth curves of MSCs in 3 groups were similar; MSCs in 3 groups highly expressed CD105 and CD106, but not expressed CD45; the cell distribution ratios at phase of G(0)/G(1) for MSCs in 3 groups were 89.9 +/- 4.0%, 90.2 +/- 3.0% and 91.0 +/- 3.0% respectively; the DI values of MSCs in 3 groups were between 0.9 and 1.1. It is concluded that no significant difference of biological characteristics of the second generations of MSCs is found between those in leukemia and non-leukemia patients.

Compare the clinical results of double-bundle with single-bundle anterior cruciate ligament reconstruction / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the clinical results of double and single bundle anterior cruciate ligament (ACL) reconstruction.</p><p><b>METHODS</b>From 2005 May to December the data of 33 patients (4 lost follow) with double-bundle and 41 patients (8 lost follow) with single-bundle reconstruction of ACL using auto-hamstring tendons was retrospectively investigated. The follow-up was 14-22 months (average 18 months) of double-bundle group and 14-21 months (average 18 months) of single-bundle group. The IKDC, Lysholm and Tegner scores, KT-2000 and Biodex were used to evaluate the clinical results.</p><p><b>RESULTS</b>The IKDC, Lysholm and Tegner scores were increased significantly from 60, 66, 4 before the operation to 85, 94 and 6 respectively after the double-bundle reconstruction. The KT-2000 results showed that at 30 and 90 degree 134 N the anterior-posterior translations were significantly decreased from 5.8 and 2.4 mm to 1.2 and 1.1 mm respectively of the double-bundle group (P < 0.01). The peak torques of the extend and flex muscles of the involved knee at 60 degrees/s and 120 degrees/s were only at 81%, 87%, 76% and 85% of the contralateral knee of the double-bundle group. And the differences were statistically significant (P < 0.01). There were no differences between the two groups of any index, but the KT value at 30 degree and the extensor peak torque of the double-bundle group manifested a better tendency.</p><p><b>CONCLUSIONS</b>Both double-bundle and single-bundle ACL reconstruction can restore the stability and improve the function of the knee, and the double-bundle group shows a better tendency at the 30 degree stability and the extensor strength.</p>