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Objective To investigate the efficacy of arthroscopic rotator cuff repair plus Bankart repair for anterior shoulder dislocations combined with rotator cuff rupture in patients above 40 years old.Methods A retrospective case series study was conducted to analyze the clinical data of 23 patients above 40 years old with anterior dislocation of shoulder joint and rotator cuff tear in Honghui Hospital Affiliated to Medical College of Xi'an Jiaotong University from January 2010 to September 2015.There were 10 males and 13 females,aged 40-71 years [(58.1 ± 10.3) years].All patients underwent arthroscopic rotator cuff repair plus Bankart repair.The visual analogue scale (VAS) was used to evaluate pain,the Oxford shoulder instability score (OSIS) was used to evaluate shoulder stability,and ConstantMurley shoulder score was used to evaluate shoulder function.Meanwhile,the range of motion (ROM) of shoulder joint,complications and subjective efficacy feedbacks from the patients were recorded.Results All patients were followed up for 13-46 months [(24.2 ± 10.1) months].Before operation and at the last follow-up,there was significant decrease in the VAS score [(0.6 ± 0.2) points vs.(3.8 ± 1.2)points] and the mean OSIS score [(19.7 ± 5.5) points vs.(47.1 ± 14.1) points];significant increase was found in the Constant-Murley score [(79.1 ± 10.8) points vs.(36.6 ± 6.4) points],the ROM of ante-flexion [(149.1 ± 22.0) vs.(65.8 ± 14.7)],abduction [(119.4 ± 23.2) ° vs.(69.1 ± 16.7) °] and external rotation [(45.0 ± 11.4) ° vs.(8.9 ± 2.7) °] (all P ＜ 0.05).No significant difference was found in the ROM of internal rotation (P ＞ 0.05).There were no significant differences in the mean VAS score and OSIS score between the affected and unaffected shoulders (P ＞ 0.05),but the former had a significantly lower Constant-Murley score than the latter [(79.1 ± 10.8)points vs.(87.7 ± 9.3) points,P ＜ 0.05].In terms of the comparison of ROM,there was no significant difference in joint ante-flexion and internal rotation (P ＞ 0.05),but the affected shoulder had significantly lower ROM of external rotation and abduction [(45.0 ± 11.4) °and (119.4 ± 23.2) °] than the unaffected one [(55.9 ± 13.8) °and (153.1 ± 23.7)°] (P ＜ 0.05).The excellent-good rate of efficacy based on the subjective feedbacks from patients was 78％.Up to the last follow-up,none of the patients had wound infection or recurrent dislocation.Conclusions Arthroscopic rotator cuff repair plus Bankart repair can significantly relieve the pain,improve joint function and range of motion.Compared with the unaffected shoulder,the affected one had slight loss of function and decreased mobility in abduction and external rotation.
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BACKGROUND:An ideal animal model is important for studying gouty arthritis. However, a lack of perfect animal model of gouty arthritis delays the progress in searching for a novel drug and treatment method. OBJECTIVE:To evaluate the effectiveness of the modified rabbit model of gouty knee arthritis. METHODS:New Zealand white rabbits were selected and randomly divided into four groups. Except bIank control group received no intervention;the rabbit greater omentum was removed, which was wrapped with nothing (sham operation group), impIanted with 0.1 g/L monosodium urate crystal suspension (conventionaI group), or 100 mg/kg monosodium urate crystal (modified group) into the suprapatellar cyst of the rabbit right knee. The swelling degree, motor function, and inflammatory response of the knee joint were observed at 1, 2 and 3 days, 1, 2, 3, and 4 weeks after modeling to evaluate the advantages and disadvantages of the modified model. RESULTS AND CONCLUSION:The movement function in the modified group was significantly decreased within
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Anterior shoulder instability is a very difficult issue to treat,especially with glenoid bone defect.When the defect is small,there is little influence on shoulder instability.The larger the defect is,the more influence there will be.Most authors agree that glenoid bone reconstruction should be considered when glenoid bone defect is more than 20％-25％.In this condition soft tissue procedures alone are not enough to provide stability to the shoulder.To date,there is still not an ideal typing of glenoid bone defect.There are many methods of assessing the size of bone defect.Pico system is one of the most common methods,as it is easier and more precise.Numerous surgical procedures have been described to address the bone defect.The Bristow procedure,the Latarjet procedure and the Eden-hybinette procedure are effective and most popular around the world.The Latarjet procedure can provide more bone blocking than the Bristow procedure,and is more popular.The Eden-hybinette procedure dose not need coracoid transfer and then has no damage of normal anatomical structure.But it also lack the hanging effect of the conjoint tendon.After all,each procedure has its advantage and disadvantage in treating anterior shoulder instability associated with glenoid bone defect and should be chosen depending on the characteristics of each patient and the preference of each surgeon.Furthermore,more new and effective treatments are still needed.
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ObjectiveTo investigate the mechanism of anti-inflammatory effect of diallyl sulfide (DAS) in protection against acute lung injury (ALI) in rats with paraquat poisoning.Methods Eighty male Wistar rats were randomly divided into four groups, namely: control group, model group, dexamethasone (DXM) treatment group, and DAS treatment group, with 20 rats in each group. The model of paraquat poisoning was reproduced by single does of 70 mg/kg given by gavage, while the same volume of normal saline (NS) was given in same manner in control group. 100 mg/kg of DAS, the same volume of NS, or 1 mg/kg DXM injection were given respectively in DAS treatment group, model group, or DXM treatment group intraperitoneally after exposure to paraquat, once a day for 14 days. Five rats in each group were sacrificed at 1, 3, 7, 14 days, respectively. The inferior lobe of right lung was harvested, and the degree of lung injury was observed with hematoxylin and eosin (HE) staining under optical microscope; the upper lobe of right lung was used to determine the lung wet/dry weight (W/D) ratio and for evaluation of the degree of pulmonary edema. The expression of nuclear factor -κB (NF-κB) in the middle lobe of right lung was assessed with immunohistochemistry. The expression of tumor necrosis factor -α (TNF-α) mRNA in the left lung was determined with the reverse transcription-polymerase chain reaction (RT-PCR).Results① The pulmonary structure in control group was found to be intact. However, in the model group there were progressive pathological changes in lung, including marked edema and thickening of alveolar walls, collapse of alveoli, infiltration of inflammatory cells, alveolar wall, and obvious bleeding in the local lung tissue, and formation of transparent membrane in alveolar space. Less infiltration of inflammatory cells and no obvious destruction were found in alveolar structure in the DAS and DXM treatment groups.② Lung W/D ratio: lung W/D ratio of model group was apparently higher than that in control group at every time point, and peaking on the 3rd day (6.15±0.54 vs. 4.15±2.10,P< 0.05), and the ratio of lung W/D of DAS and DXM treatment groups was obviously lower than that in model group at every time point, especially on the 3rd day (3.99±1.26, 4.30±0.70 vs. 6.15±0.54, bothP< 0.05), but there was no significant difference between DAS and DXM treatment groups in this regard.③ The immunocytochemistry analysis revealed minimal NF-κBp65 expression in the cell nuclei of the control group, while extensive NF-κBp65 expression was found in model group. Minimal NF-κBp65 positive expression in the cytoplasm and even less positive expression in the nucleus was found in the DAS and DXM treatment groups, and integralA value was significantly lower in the DAS and DXM treatment groups than that of the model group, especially on the 3rd day [(17.98±0.06)×107, (18.53±0.04)×107 vs. (28.85±0.61)×107, bothP< 0.01], but there was no significant difference between DAS and DXM treatment groups.④ It was shown by RT-PCR that the expression of TNF-α mRNA in lung tissue of the model group was significantly higher than that in the control group on the 3rd day (gray value: 3.63±0.62 vs. 0.51±0.13, P< 0.05). The expression of TNF-α mRNA in lung tissue was significantly decreased in DAS and DXM treatment groups compared with model group (gray value: 2.49±0.57, 2.02±0.26 vs. 3.63±0.62, bothP< 0.05), but there was no significant difference between DAS and DXM treated groups.ConclusionTreatment with an intraperitoneally injection of DAS is capable of attenuate the extent of PQ-induced ALI in rats by alleviating pulmonary edema, inhibiting the expression of NF-κB and TNF-α in lung tissue, and ameliorating pathological changes in lung tissue.
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ObjectiveTo compare the effectiveness of ω-3 fatty acids and middle/light fatty acids in the intervention of rats model of bleomycin-induced pulmonary fibrosis.MethodsTotally 120 rats were randomly divided into 4 groups: normal saline (NS) group,bleomycin-induced pulmonary fibrosis without treatment group ( BLM group),middle/light fatty acids group,ω-3 fatty acids group.Lung tissues were obtained on the 7th,14th,and 21st day after modeling.The left lung were measured by using immunohistochemical methods for transforming growth factor β1 (TGF-β1) and interferon garmma ( IFN-γ).The lower lobe of the right lung underwent HE staining.Serum TGF-β1,IFN-γ,and interleukin-4 (IL-4) were measured using double-antibody sandwich ELISA.ResultsThe pulmonary alveolitis and fibrosis in the ω-3 fatty acids group was significantly milder than in middle/light fatty acids group and BLM group.On the 7th,14th,and 21st day after modeling,stronger TGF-β1 protein expression was detected in the bronehiolar epithelia of middle/light fatty acids group and BLM group and poorer IFN-γexpression in both groups.However,the opposite results were found in the ω-3 fatty acids group: on the 7th,14th,and 21st day after modeling,TGF-β1 protein expression ( 13.60 ± 5.90,10.53 ± 4.21,and 7.23 ± 2.21 )was lower ( P =0.047) and IFN-γ ( 13.85 ± 7.48,15.32 ± 2.12,and 18.74 ± 2.65 ) was stronger in ω-3 fatty acids group (P =0.041).On the 7 ,14,and 21st day after modeling,the serum IL-4 levels in the middle/light fatty acids group and BLM group became significantly higher,while the IFN-γ level in both groups was significantly lower than in ω-3 fatty acids group ( P =0.008 ) ; meanwhile,in the ω-3 fatty acids group,the serum IL-4 levels [ (8.73 ± 1.20),(5.73 ±2.03),and (4.98 ± 1.89) pg/ml] were significantly lower (P =0.044) and serum IFN-γlevels [ (5.67 ± 0.13 ),( 6.58 ± 0.64 ),and ( 7.05 ± 0.52 ) pg/ml ] were significantly higher ( P =0.048 ) on the 72,14th,and 21st day after modeling.Conclusionsω-3 fatty acids can lower TGF-β1 protein expression in rat lung tissue and reduce the surum TGF-β1 and IL-4 levels.Compared with the middle/light fatty acids,it can more effectively upregulate the expression of IFN-γ in lung tissue and increase its serum level,and thus alleviate pulmonary fibrosis in rats.