ABSTRACT
Objective:To investigate the influence of joint line alteration on the mid-term clinical effects of primary medial pivot total knee arthroplasty (MP-TKA).Methods:Data of a total 189 patients (233 knees) with 30 males (30 knees) and 159 females (203 knees) with age 66.42±6.12, diagnosed as knee osteoarthritis and underwent primary MP-TKA from January to December 2015, were retrospectively analyzed. All cases were followed up for at least 4 years. The patients were divided into four groups according to the extent of alteration, namely <-4 mm, -4- mm, 0- mm and >4 mm. Range of motion (ROM), Knee Society's Knee Scoring System (KSS), the Western Ontario and McMaster University (WOMAC) osteoarthritis index score were compared preoperatively and at 4 years postoperatively.Results:The postoperative follow-up duration was 52.20± 2.94 months (48-59 months). A total of 133 knee (57%) had joint line raised and 100 cases (43%) joint line distal shifted. The overall height of joint line before surgery was 16.56±3.54 mm (7.33-25.32 mm) and 17.34±2.92 mm (7.25-25.43 mm) postoperatively. The average alteration was 0.78±3.17 mm (-6.00-9.91 mm) with statistically significant difference ( t=-2.596, P=0.010). There was no statistical difference among the four groups in terms of gender, body mass index, pre-operative tibia slope and post condylar offset. The overall preoperative ROM of the all groups was 90.45°±20.44°, which increased from baseline to 108.95°±12.55° at 4 years postoperatively ( t=-22.381, P<0.001). There was statistical difference in term of ROM among each group ( F=7.101, P<0.001). The ROM in group 0- mm and >4 mm was significantly higher than that in group <-4 mm and -4- mm ( P<0.05). The KSS function score and clinic score at 4 years postoperatively were significantly higher that those before surgery, the WOMAC score was statistically lower at 4 years postoperatively ( F=0.723, P<0.001; F=1.138, P<0.001; F=2.502, P<0.001). There was no significant difference among the four groups in terms of KSS score and WOMAC ( P>0.05). One case in >4 mm group had gasket prolapse at 6 month after surgery and 3 cases with immediate anterior knee pain occurred in <-4 mm group. Conclusion:MP-TKA can lead to significant joint line alteration. The overall ROM after surgery is positively correlated with the quantity of joint line alteration. However, there was no correlation between quantity of joint line alteration and the joint function scores. Thus, MP-TKA can achieve good mid-term clinical effects.
ABSTRACT
Objective:To evaluate the curative effect of 3D printing titanium trabecular metal （TTM） acetabular cups in revision of total hip arthroplasty （THA）.Methods:A retrospective case series study was conducted on the clinical data of 24 patients （25 hips） undergoing THA revision in Affiliated Hospital of Qingdao University from May 2016 to September 2019. There were 10 males and 14 females，aged 43-78 years ［（63.0 ± 11.4） years］. According to Paprosky classification，5 patients（5 hips） were classified as type Ⅰ，9 patients （10 hips） as type ⅡA，5 patients （5 hips） as type ⅡB，1 patient （1 hip） as type ⅡC and 4 patients （4 hips） as type ⅢC. All patients used 3D printing TTM cups. Seven patients （7 hips） were combined with 3D printing TTM pads，and 3 patients （3 hips） were combined with structural bone grafts. The visual analogue scale （VAS），Harris score and quality of life Health Survey Scale （SF-36） score were evaluated before operation，3 months after operation，12 months after operation and at the last follow-up. The X-ray film of hip joint was performed to evaluate the upward movement distance of hip center of rotation （HCOR），limb-length discrepancy （LLD） before operation，1 day after operation and at the last follow-up. The position of cups and bone ingrowth were evaluated at the last follow-up. The postoperative complications were observed.Results:All patients were followed up for 14-54 months ［（34.2 ± 9.3）months］. The VAS was （4.0 ± 0.7）points，（2.3 ± 0.8）points and （0.9 ± 0.2）points at postoperative 3 months，12 months and the last follow-up，significantly lower than that preoperatively ［（6.1 ± 1.0）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative VAS at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The Harris score was （64.6 ± 5.3）points，（80.5 ± 3.7）points，and （90.3 ± 3.6）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（38.8 ± 6.2）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative Harris score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The SF-36 score was （556.3 ± 21.9）points，（711.6 ± 15.9）points and （752.8 ± 23.0）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（326.3 ± 30.7）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative SF-36 score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The upward movement distance of HCOR was （13.5 ± 2.6）mm and （13.6 ± 2.6）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（34.1 ± 3.5）mm］ （ P < 0.05）. The LLD was （6.2 ± 1.8）mm and （5.3 ± 1.5）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（31.6 ± 5.2）mm］ （ P < 0.05）. All the cups were stable. Good bone ingrowth was found in 23 hips. There was no postoperative complication except for one patient with poor wound healing. Conclusion:For THA revision，the use of 3D printing TTM cups can effectively relieve pain，improve hip function，provide satisfactory biological fixation and and reduce complications.
ABSTRACT
Acute pancreatitis (AP) is one of the common diseases of the digestive system mainly characterized by acute inflammation of the pancreas and acinar cell destruction, and it can often develop into severe acute pancreatitis (SAP). Acute respiratory distress syndrome (ARDS) is one of the most common and serious complications of SAP and a common cause of death in patients with SAP. In recent years, there have gained new understanding of the pathogenesis, diagnosis, and treatment of SAP-related ARDS, however, a variety of drugs that have been shown to prevent ARDS in SAP animal models have not improved the prognosis of SAP-related ARDS patients in clinical researches. At present, the treatment of SAP-related ARDS still follows the general treatment principles of ARDS, such as treatment of primary disease, lung protective ventilation strategy, prone position ventilation, early short-term use of neuromuscular blockers and extracorporeal membrane oxygenation (ECMO), and so on. However, the influence of high intra-abdominal pressure, intestinal function failure, abdominal incision, and drainage tube on the treatment measures should also be considered for patients with SAP-related ARDS. This article reviews the recent progress in diagnosis and treatment of SAP-related ARDS.
ABSTRACT
Objective:To evaluate the diagnostic values of serum fibrinogen and D-dimer for periprosthetic joint infection (PJI).Methods:The medical records were retrospectively analyzed of the 175 patients who had undergone hip or knee revisions at Department of Joint Surgery, Affiliated Hospital to Qingdao University from August 2013 to June 2019. Of them, 59 were diagnosed as PJI (31 knees and 28 hips), including 33 males and 26 females with an age of (67.4±11.7) years and a body mass index (BMI) of (26.1±3.6) kg/m 2 while 116 as aseptic loosening (AL) (19 knees and 97 hips), including 67 males and 49 females with an age of (70.3±8.9) years and a BMI of (25.0±3.6) kg/m 2. The plasma levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen and D-dimer in the 2 groups were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to calculate the sensitivity and specificity of each indicator; the diagnostic value for each indicator was calculated according to the area under the curve (AUC). Results:There was no significant difference between the PJI and AL groups in gender, age or BMI ( P>0.05), but there was a significant difference in the joint type ( P<0.05). Compared with the AL group, the PJI group had significantly higher levels of CRP, ESR, fibrinogen and D-dimer ( P<0.05). The AUCs for CRP, ESR, fibrinogen and D-dimer were 0.830, 0.850, 0.848 and 0.664, respectively. By the Youden index, the optimal predictive cutoffs for CRP, ESR, fibrinogen and D-dimer were 8.06 mg/L, 17.60 mm/h, 3.73 g/L and 685.00 ng/mL, giving sensitivities of 79.2%, 85.4%, 81.3% and 64.6% and specificities of 85.7%, 76.2%, 79.8% and 61.9%. Conclusions:The diagnostic value of serum fibrinogen may be high for PJI, similar to that of CRP or ESR. However, D-dimer may be of limited value for diagnosis of PJI.
ABSTRACT
Objective To compare the perio-perative effects of modified bikini minimally invasive approach versus direct lateral approach for total hip arthroplasty(THA).Methods A total of 60 patients(70 hips),including 45 males (49 hips) and 15 females (21 hips) aged (54.9 ± 6.1) years (range from 38 to 63 years)who underwent THA for the first time at joint surgery department of our hospital were retrospectively analyzed from October 2015 to May 2017.Thirty patients(34 hips) underwent modified bikini approach THA(the modified bikini group),and 30 patients(36 hips) received direct lateral approach THA(the direct lateral group).The comparisons were performed between the two groups in the orthopaedic pelvic films,disease stages,Harris scores before and after operation,intra-operative blood loss,postoperative drainage,blood transfusion rate,24-h visual analog scale(VAS) scores for pain after operation,operation time and incision length.The straight leg elevation time,recovery time of hip abduction muscle strength,average hospitalization days and subjective satisfaction of patients were evaluated.Relevant surgical complications were recorded.Results Postoperative X-ray examinations showed that the position of prosthesis was good in both groups.There were no statistically significant difference between the two groups in operation time,intraoperative blood loss,postoperative drainage,blood transfusion rate,straight leg elevation time and subjective satisfaction(P＞0.05).There were statistically significant differences between the modified bikini group and the direct lateral group in the incision length[(9.2±1.9) cm vs.(18.5±3.3) cm],recovery time of hip abductor muscle strength [(1.6 ± 0.8) d vs.(12.1 ± 3.9) d],Harris scores [(87.1±5.9) vs.(86.8 ± 7.1)],24-hour VAS scores [(4.6 ± 2.3) vs.(7.0 ± 3.6)] and average hospitalization days[(7.4 ±1.8) vs.(10.8 ±2.4)]after operation between the modified bikini group and the direct lateral group(P＜0.05).One case with lateral femoral cutaneous nerve injury and 1 case of posterior cortical perforation of proximal femur were found in the modified bikini group,and 1 case of dislocation of hip prosthesis was observed in the direct lateral group.Conclusions Both of the modified bikini minimally invasive approach and direct lateral approach for THA can achieve better postoperative effect,while the modified bikini approach achieves faster recovery.
ABSTRACT
The clinical efficacy and pharmacoeconomics of Xiaozhong Zhitong Decoction on preventing deep venous thrombosis in major orthopaedic operation are observed and analyzed. The 160 patients who are implemented major orthopaedic operation in our hospital are selected as the subjects, which are randomly divided into research group applying Xiaozhong Zhitong decoction and reference group using low molecular heparin with same cases in each group for observing their treatment efficacy and analyzing pharmacoeconomics. Through observing and comparing the rate of deep venous thrombosis in two groups, the results show that study group is significantly lower than reference group with p<0.05. The incidence of adverse reactions in study group is significantly lower than that of reference group with P<0.05; after observing the postoperative quality of life and analyzing cost-effectiveness in two groups, it shows that study group has more significant advantage than reference group with p<0.05. The Xiaozhong Zhitong decoction has a better clinical effect on preventing deep venous thrombosis in major orthopaedic operation with higher safety and reliability and has a better cost effect ratio at the same time
ABSTRACT
Objective To explore the protective effects of short-acting β31 receptor blocker esmolol on lung injury in septic rats and explore its mechanism.Methods Fifty-four male SpragueDawley rats were randomly(random number) divided into three groups (n=18 in each),namely sham operation group(Sham),sepsis group(Spesis),esmolol group(ES).Each group were further divided into three subgroups of 6 h,12 h and 24 h(n=6 in each subgroup).The sepsis models were established with cecal ligation and puncture (CLP) in rats of Sepsis group and ES group,while rats of SH group were treated with laparotomy without CLP.Dwelled cannulation in the left internal jugular vein was performed after the model establishment.Saline in the rate of 1 mL/h was continuously pumped intravenously into the rats of SH group and Sepsis group by micro pump for 6 h,and esmolol solution in the rate of 1 mL/h [15 mg/(kg·h)]was continuously pumped into the rats of ES group for 6h.Rats in each subgroup were sacrificed at 6h,12h and 24 h after modeling,separately.The levels of catecholamine (CA) in plasma and levels of NF-κB in lung tissue were measured by ELISA.The protein levels of TLR4 and NF-κB in lung tissue were detected by Western Blot.The protein content of alveolar lavage fluid,wet/dry weight ratio(W/D) of lung tissue,lung coefficient and lung water content were measured.The pathological changes of lung tissues were observed under an optical microscope.Results (①) The levels of CA in plasma in Sepsis and ES groups at 6 h after modeling was significantly increased compared with Sham group (P＜0.05),and the level of CA in plasma increased significantly in ES group compared with Sham and Sepsis groups (P＜0.05).At 12 h after modeling,level of CA in plasma was still significantly increased in ES group compared with SH group (P＜0.05);At 24 h after modeling,level of CA in plasma was increased significantly in ES group compared with Sepsis group (P＜0.05).(②) At 6 h,12 h and 24 h after modeling,levels ofNF-κ B in lung tissue were significantly increased in Sepsis group and ES group compared with SH group (P＜0.05),and levels of NFκ B in lung tissue in ES group were also significantly lower than those in Sepsis group at given intervals (P＜0.05).③ At 6 h,12 h and 24 h after modeling,protein content of alveolar lavage fluid,wet/dry weight ratio (W/D) in lung tissue,lung coefficient and lung water content in Sepsis group and ES group were significantly increased compared with SH group (P＜0.05),and protein content of alveolar lavage fluid,wet/ dry weight ratio (W/D) in lung tissue,lung coefficient and lung water content in ES group also significantly lower than those in Sepsis group at given intervals (P＜0.05).④ Western Blot revealed at 6 h,12 h and 24 h after modeling,the protein levels of TLR4 and NF-κ B in lung tissue in Sepsis group and ES group were significantly increased compared with SH group (P＜0.05),and the protein levels of TLR4 and NF-κ B in lung tissue of ES group were also significantly lower than those in Sepsis group at all given intervals (P＜0.05).⑤ The lightest degree of pathological change was observed in SH group,the most serious degree of pathological change was found in Sepsis group,and the pathological change was significantly alleviated in ES group compared with Sepsis group whereas the pathological change was significantly increased compared with SH group at all given intervals.Conclusions Esmolol can promote the secretion of catecholamine,inhibit the release of inflammatory cytokines,reduce lung permeability,reduce pulmonary edema,and thus play an important role in protecting the lungs.The mechanism may be that esmolol improves the responsiveness of β-adrenergic receptor to catecholamine,and regulates the level of inflammatory cytokines by inhibiting TLR4-NF-κB-TNF-α signaling pathways,thus exerting protective effect on the lungs.
ABSTRACT
Objective To explore the clinical characteristics of and surgical strategies for distal tibiofibular syndesmosis separation based on ankle axial CT scan.Methods From January 2009 to January 2016,63 patients with injury to the distal tibiofibular syndesmosis were treated.Their injuries were characterized according to the anatomic characteristics on their ankle axial CT scan images as pronation-extorsion type (28 cases),supination-extorsion type (11 cases) and abduction type (24 cases).Specific strategies of reduction and fixation depended on the specific characteristics of distal tibiofibular syndesmosis separation.After 12 months postoperatively,the reduction quality was assessed by Burwell-Charnley's radiological evaluation system and the function of ankle joint was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score system.Results The patients were followed up for 6 to 48 months (average,19.3 months).Anatomical reduction was achieved in 19 cases,good reduction in 7 and fair reduction in 2 in the pronation-extorsion type,yielding an excellent to good rate of 92.8％;anatomical reduction was achieved in 6 cases,good reduction in 4 and fair reduction in one in the supination-extorsion type,yielding an excellent to good rate of 90.9％;anatomical reduction was achieved in 17 cases,good reduction in 6 and fair reduction in one in the abduction type,yielding an excellent to good rate of 95.8％.By the AOFAS system,the pronation-extorsion type scored 88.6 points,the supination-extorsion type 89.4 points and the abduction type 86.6 points.Conclusion In the treatment of distal tibiofibular syndesmosis separation,reduction and fixation strategies should depend on analysis of the characteristics on the ankle axial CT scan,so as to achieve positive outcomes.
ABSTRACT
BACKGROUND:Ankle joint fracture combined with triangular ligament injury is a common type of injury, and is easy to have an impact on the anatomy of the ankle joint, leading to the occurrence of joint instability; the treatment is extremely easy to lead to a variety of complications. For injured triangular ligament, it is controversial whether it is necessary to repair in the clinic. OBJECTIVE:To investigate the effect of a wire anchor for repairing triangular ligament in ankle joint fracture fixation. METHODS:The clinical data of 36 cases of ankle fractures combined with triangular ligament injury, who were treated in the Department of Orthopedics of the Seventh People’s Hospital of Zibo City from May 2013 to May 2014, were retrospectively analyzed. The ankle fractures combined with triangular ligament injury were treated with open reduction plate fixation. The patients were folowed up for 12 months. The recovery of ankle joint function was evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and foot function score. Gravity stress X-ray examination was performed before and after treatment. Space of medial maleolus was measured. Adverse events were observed. RESULTS AND CONCLUSION:The patients were folowed up 3, 6 and 12 months after treatment. AOFAS score of the ankle joint was increased and significantly higher at 12 months than that before surgery (P< 0.05). Gravity stress X-ray examination revealed that the space of medial maleolus of the affected side was smaler at 12 months than that before treatment (P < 0.05). No injuries to nerves and blood vessels were found during surgery, and the incision was healed in the first stage, and no infection was observed. Adverse events such as fixator breakage and loosening were not visible. However, partial function of the ankle joint was limited after repair in triangular ligament injury. Results confirmed that open reduction and internal fixation combined with a wire anchor obtained good effects in the repair of ankle joint fracture with triangular ligament injury.
ABSTRACT
BACKGROUND: Cyclooxygenase 2, aggrecanase 1, and insulin-like growth factor 1 are involved in pathological injury of the articular cartilage. OBJECTIVE:To observe the expression of shRNA vectors carrying cyclooxygenase 2, aggrecanase 1 and overexpression vectors carrying insulin-like growth factor 1 in bone marrow mesenchymal stem cels. METHODS:Lentiviral vectors carrying the silencing gene cyclooxygenase 2, aggrecanase 1, the over-expressing gene insulin-like growth factor 1 and binding green fluorescent protein were constructed with recombinant lentiviral technology, and then the recombinant lentiviral vectors were used to transfect passage 3 human bone marrow mesenchymal stem cels culturedin vitro (experimental group). The human bone marrow mesenchymal stem cels transfected with no target gene lentivirals were used as negative control group. The human bone marrow mesenchymal stem cels transfected with no treatment served as blank group. RESULTS AND CONCLUSION:Cyclooxygenase 2 and aggrecanase 1 transfected in human bone marrow mesenchymal stem cels were significantly inhibited at gene and protein levels, while the expression of insulin-like growth factor 1 was increased significantly at gene and protein levels. We confirmed that cyclooxygenase 2 and aggrecanase 1 were successfuly silenced while insulin-like growth factor 1 overexpressed by using lentiviral vectors in human bone marrow mesenchymal stem cels, which brings a new hope for the systemic gene treatment of arthritis.
ABSTRACT
Objective To investigate the effects of aggrecanase-2 knockdown in chondrocytes from rheumatoid arthritis patient by shRNA infection.Methods Cartilage harvested from rheumatoid arthritis patients who underwent total knee arthroplasty was digested by pancreatin and type Ⅱ collagen enzyme to obtain chondrocytes.Then chondrocytes were cultured and passaged to second or third generation.After aggrecanase-2 shRNA5,aggrecanase-2 shRNA6,aggrecanase-2 shRNA7,aggrecanase-2 shRNA8 infection,growth and morphological changes of the chondrocytes were examined.To select the best target sequence,mRNA expression of aggrecanase-2 and aggrecan was detected by RT-qPCR assay on day 2,5,10,represented with Ct (Cycle threshold) value.Expression of aggrecan protein was detected by immunocytochemistry,represented with IOD (integral optical density) value.Results aggrecanase-2 knockdown had no obvious effects on the morphology and growth of the chondrocytes.MOI (multiplicity of infection) was 100,50,25,and infection efficiency was 90％,60％,30％ with the corresponding viral load of 200 μl,100 μl,50 μl after transfection.mRNA expression of aggrecanase-2 was suppressed significantly,especially the group of shRNA5 which suppressed aggrecanase-2 expression from 0.876 3±0.115 6 to 0.069 9±0.015 1 (P ＜ 0.05).mRNA and protein expression of aggrecan were significantly upregulated after infection.mRNA expression of aggrecan increased from 0.992 1±0.201 3 to 3.049 2±0.278 2 (P ＜ 0.05) and protein expression of aggrecan increased from 496.160 5± 225.673 7 to 4 525.433 0±1 131.813 0 (P ＜ 0.05).Conclusion aggrecanase-2 suppression in chondrocytes by lentivirius infection is an effective method to protect the expression of aggrecan.
ABSTRACT
Objective To establish a model of full-thickness avascular meniscal defect to assess outcome of bone-marrow mesenchymal stem cells (BMSCs) modified with human insulin-like growth factor Ⅰ (hIGF-Ⅰ) gene and compounded with injectable calcium alginate gel in repair of meniscal defect.Methods Models of full-thickness defect were created in the anterior comer of meniscus in goats,an area lacking of blood supply.The trial categorized the models to four groups:gene-ehanced tissue engineering (GETE) group (hIGF-Ⅰ transfected BMSCs were mixed with calcium alginate gel),BMSCs group (BMSCs were mixed with calcium alginate gel),empty group (calcium alginate gel was used alone) and control group (the defect was excluded from repair).Macroscopy was done at 4,8,and 16 weeks after operation.Variation of repair tissue was observed by light and scanning electric microscopy and aggrecan in repair tissue was determined as well.Results Meniscal defect was on the mend at 4-16 weeks after operation in GETE group,with the defect area being thoroughly filled with the white,elastic and tight repair tissue similar to normal meniscal tissue.Macroscopic examination showed a better result in GETE group than that in other groups.Light microscopy showed that repair tissue which was mainly fibrochondrocytes was arranged in line with calcium alginate fibers and that space between the fibers was mostly crammed with the matrix secreted by those cells.At the same time,those cells were tightly arranged and the matrix secreted by those cells was equally distributed according to light microscopy.Electroscopy demonstrated neat and tight arrangement of fibers and tight extracellular matrix in fiber space in GETE group.Aggrecan concentration in GETE group was relatively higher than in other groups,but still had difference from the normal meniscus.Conclusion hIGF-Ⅰ gene-transfected BMSCs combined with injectable calcium alginate gel can improve the effect in repair of full-thickness meniscal defect.
ABSTRACT
BACKGROUND: Bone morphogenetic protein 2 and transforming growth factor β are important factors in bone regeneration, increasing the expressions of bone morphogenetic protein 2 and transforming growth factor β can promote the osteogenic differentiation of bone marrow mesenchymal stem cells. OBJECTIVE: To construct the lentivirus vector carrying bone morphogenetic protein 2 and transforming growth factor β3, and to observe the expression of lentivirus vector in bone marrow mesenchymal stem cells. METHODS: The recombinant lentiviral vectors carrying transforming growth factor β3, bone morphogenetic protein 2 and green fluorescent protein were constructed with recombinant lentiviral technology, and then the recombinant lentiviral vectors were used to transfect the passage 3 rabbit bone marrow mesenchymal stem cells in vitro cultured (transfection group). The bone marrow mesenchymal stem cells transfected with single gene lentivirals (single gene transfection group) carrying transforming growth factor β3 and bone morphogenetic protein 2 or single lentivirals were as control (control group). At 1 week after trasfection, the total RNA and protein were extracted from each group for detection. RESULTS AND CONCLUSION: The green fluorescence bone marrow mesenchymal stem cells transfected with transforming growth factor β3 and bone morphogenetic protein 2 gene for 3 days could be observed under fluorescence microscope, and the transfection efficiency was over 90%. Reverse transcription-PCR and Western blot results showed the mRNA and protein expressions of transforming growth factor β3 and bone morphogenetic protein 2 in the transfection group were higher than those in the single gene transfection group and the control group. The results indicate that lentivirus can successful y transfect transforming growth factor β3 and bone morphogenetic protein 2 into the bone marrow msenchymal stem cells and achieve its high expression, and these two genes have the synergistic effect of promoting expression.
ABSTRACT
Objective To observe the modulatory effects of NF-κB on dynamic changes of TNF-α、IL-1β and ICAM-1 in rats with severe acute pancreatitis (SAP),and to assess the effects of pretreatment with mycophenolate mofetil (MMF) on them.Methods A total of 104 male Wistar rats were randomly divided into normal group,sham operation group,SAP group and MMF group.(1) In normal group,rats had just an incision on abdomen wall and sutured (n =8) ; (2) In sham operation group,rats underwent laparotomy with flipping over the pancreas and gendy striking five times by using blunt instrument and abdomen was closed (n =32); (3) In SAP group,SAP in rats was induced by the retrograde injection of sodium taurocholate (STC) into the pancreatic duct (n =32) ; (4) In MMF group,MMF (250mg/kg)was injected intraperitoneally one hours after injection of STC (n =32).Rats were saerificed by abdominalaorta exsanguination separately at intervals of 3,6,12 and 24 h after modeling of pancreatitis.Histologic score of pancreatic tissue was assessed,and serum amylase (AMS) and serum C-reactive protein (CRP)were measured by automatic biochemical detector.The serum levels of inflammatory cyctokines (TNF-α,1L-1β and 1CAM-1 ) were measured by using ELISA,and expression of NF-κB mRNA in pancreatic tissue was measured by using quantitative PCR.Results Compared with sham operation group,histologic score of pancreatic tissue,serum amylase,TNF-α、IL-1β and ICAM-1 in SAP group were increased significantly (P ＜ 0.05 ).Pretreatment with MMF obviously deceased histologic score,and the serum levels of amylase,TNF-α,IL-1β and ICAM-1 and the expression of NF-κB mRNA were higher than those in SAP group in early stage (P ＜0.05 ).Conclusions Cytokines play an important role in early stage of SAP.MMF could attenuate the severity of inflammatory response through inhibiting cellular immunity and modulating the proinflammatory cytokines produced.
ABSTRACT
BACKGROUND: Bone morphogenetic protein (BMP) and its derived scaffold or vector here been widely used in experiment and gradually applied in the clinic. However, the tracing method challenges the therapeutic effect, The discovery and application of enhanced green fluorescent protein (EGFP) can solve this problem.OBJECTIVE: To construct the bicistronic eukaryotic vector pIRES2-EGFP-hBMP-2 and to observe its expression in human embryo kidney (HEK) 293 cells.METHODS: hMBP-2 gene was extracted from human osteosarcoma by RT-PCR and inserted into PMD18-T vector. Following the DNA sequence verification, it was then sub-cloned into the eukaryotic vector pIRES2-EGFP. After restriction enzyme analysis the pIRES2-EGFP-BMP-2 was transfected into HEK 293 cells. Then its expression was observed using fluorescence microscopy and Western blot.RESULTS AND CONCLUSION: hBMP-2 gene was amplified and the eukaryotic vector plRES2-EGFP-hBMP-2 was constructed successfully. At 48 hours after tranfection of pIRES2-EGFP-hBMP-2 into HEK 239 cells, approximately 30% of cells emitted green fluorescence under a fluorescence microscope. Western blot results demonstrated that there was a specific BMP strap at Mr46×10s side, which indicated that the target gene could be expressed in constructed pIRES2-EGFP-hBMP-2 vector.
ABSTRACT
Objective To investigate the effects of exogenous IGF- Ⅰon apoptosis, bax,bcl-2 and caspase-3 gene mRNA transcription in intestinal mucosal epithelial cell of SAP rats. Method Seventy-two male Wistar rats were randomly divided into sham operation group (SO),SAP group(SAP) and IGF-Ⅰ treatment (SAP + IGF-Ⅰ) group.Every group was randomly divided into 3 time units (6,12,24 h),8 rats as each time unit. SAP was induced in the rats by injecting adversely 5.0 % sodium taurocholate into biliary-pancreafic duct. The SO rats were infused with NS by the same way. The rats in IGF-Ⅰgroup were injected with IGF-Ⅰ by subcutano at half an hour before operation and three hours after operation,respectively. Animals in each group were killed separately at 6,12 and 24 hours after operation.The apoptosis in mucesal cells of small intestine was detected by TUNEL, and histo pathological changes of the small intestine was observed. The expressions of bax and bcl-2 and caspase-3 mR-NA gene in small intestine were measured by reverse transcription polymerase chain reaction(RT-PCR). Results Compared with the SAP group,the serum amylase were lower in IGF-Ⅰ group,and there existed significant at 12 h and24 h (P < 0.05).The pathological score of small intestinal was significantly reduced in IGF-Ⅰ group com-pared with SAP group,and there were statistical differences at 12 h and 24 h.ln IGFo-Ⅰ group,the apoptosis index of intestinal epithelial decreased significantly compared with SAP group[6 h: (13.88±1.73) vs. (19.00±2.78) ;12h:(10.13±1.55) vs. (17.63±.60);24 h:(9.50±1.07) vs. (17.25±2.76)] (P <0.05); the histopathdogical changes were more improved compared wit SAP group under the electronic microscope; the expres-sion of bax mRNA [6 h:(1.35±0.18) vs.(0.85±0.12);12 h:(1.21±0.21) vs. (0.86±0.24);24 h:(1.14±0.24) vs. (0.95±0.22)] and caspese-3 mRNA[6 h:(0.78±0.01) vs. (0.55±0.04);12 h:(0.79±0.04) vs. (0.57±0.05) ;24 h: (0.81±0.06) vs. (0.55±0.01) (P < 0.01)] were higher in three time units in SAP group than those in SO group (P < 0.01) ,and in IGF-1 group it was weakened significantly compared with the SAP group at each time point (P <0.05). bcl-2 mRNA expression was weak and have no difference between the SO group and SAP group (P > 0.05), but increased signifycantly in the IGF-± group at each time point [6 h:(0.65±0.07) vs. (0.54±0.04) vs. (0.57±0.06);12 h:(0.69±0.04) vs. (0.56±0.05) vs. (0.53±0.05);24h:(0.72±0.05) vs. (0.54±0.07) vs. (0.58±0.08)] (P <0.05). Conclusions Exogenous IGF-Ⅰ could rivalry SAP induced apoptosis to mucosal cells of small intestine , then could alleviate SAP induced injury to intestinal mucosal, It may be associated with the mechanisms that IGF-Ⅰ could improve the expression of bcl-2 mRNA and inhibit the expression of bax,caspase-3 mRNA.
ABSTRACT
BACKGROUND: The existed repair method for cartilage defects has shortcomings of insufficient repairing tissue numbers, poor biomechanical properties, as well as donor site complication. Thus it is deficient to repair large-sized osteochondral defects using one method.OBJECTIVE: To investigate the therapeutic effect of tissue engineering modified Mosaicplasty on repairing large-sized osteochondral defects.DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Center Laboratory of Qingdao University Medical College from January to September 2009.MATERIALS: The hircine bone mesenchymal stem cells (BMSCs) were in vitro cultured, and resuspended with algin solution to obtain BMSCs-calcium alginate gel.METHODS: Totally 12 goats were prepared for osteochondral defects models and were divided into 3 groups.BMSCs-Mosaicplasty group, BMSCs compound with injectable alginate calcium gel was then applied to fill the "dead space" after Mosaicplasty. In the Mosaicplasty group, the defects were repaired by Mosaicplasty. There was no treatment in the control group.From 4 to 16 weeks postoperatively, the animals were sacrificed and the in gross and under electromicroscopy.MAIN OUTCOME MEASURES: ①Gross observation: the joint was exposed to observe the repair effect at weeks 4, 8,16 after operation. ②Histological examination: specimens were harvested at 16 weeks after operation and observed by haematoxylin-eosin staining, toluidine blue staining under light microscopy. ③Transmission electron microscope was used at 16 weeks after operation.RESULTS: The transplanted subchondral bone and superficial cartilage was integrated hardly with each other or with recipient sites in tissue engineering modified Mosaicplasty groups at 16 weeks after operation. The quality and appearance of the transplanted and regenerated cartilage was similar to normal hyaline cartilage. Under microscopy, the regenerated cartilage was integrated with neighbor tightly in regular arrange. ECM distributed evenly and deeply stained by alcian blue. There was no obviously repaired in the control group.CONCLUSION: Tissue engineering can ameliorate the outcome of Mosaicplasty to repair the osteochondral defects.
ABSTRACT
Objective To explore the effect of hatroxobin and Buyanghuanwu Tang on the serum]evels of in-terleukin-8 (IL-8) and leptin in patients with acute cerebral infarction (ACI). Methods 85 cases with cerebral in-farction were randomly.divided into control group of 43 cases and treatment group of 42 cases. 85 cases were given routine treatment, the treatment group were given hatroxobin ,20BU and Buyanghuanwu Tang, 14d. The serum levels of IL-8 and leptin were investigated before treatment and 14d after treatment. Results After treatment,the serum levels of IL-8 and leptin in the treatment group were improved than that of control group (P < 0.05). Conclusion The treatment of batroxobin and Buyanghuanwu Tang could improve the production of IL-8 and leptin and interrupt the Ieu-kecyte infiltrating ischemic region.
ABSTRACT
Objective To explore the clinical effect of Chaihu Jiebiao Chongji in treatment of acute upper respiratory tract infection.Methods To analyse curative effect of Chaihu Jiebiao Chongji(ten grams of chaihu,guizhi,lianqiao,baishao and huangqin and thirty grams of yinhua) in treatment of acute upper respiratory tract infection and take empirical study of relieving fever and anti-inflammatory action in 169 cases.Results Cured of treatment group 44 cases , obvious effective of treatment group 62 cases, effective of treatment group 48 cases, ineffective of treatment group 15 cases,total effective rate 91.12%.Conclusion The effect of Chaihu Jiebiac Chongji in treatment of upper respiratory tract infection is satisfactory.
ABSTRACT
0.05).[Conclusion]Periarticular drug injection during TKA and intra-articular drug injection after operation can relieve pain early after TKA,improve the range of motion of the knee and rehabilitation,no further side effect has been noted.