ABSTRACT
BACKGROUND@#The size of the glenoid bone defect is an important index in selecting the appropriate treatment for anterior shoulder instability. However, the reliability of glenoid bone defect measurement is controversial. The purpose of the present study was to investigate the reliabilities of measurements of the glenoid bone defect on computed tomography and to explore the predisposing factors leading to inconsistency of these measurements.@*METHODS@#The study population comprised 69 consecutive patients who underwent surgery for recurrent anterior shoulder dislocation in Peking University Fourth School of Clinical Medicine from March 2016 to January 2017. The glenoid bone defect was measured by three surgeons on 'self-confirmed' and 'designated' 3-D en-face views, and repeated after an interval of 3 months. Measurements included the ratio of the defect area to the best-fit circle area, and the ratio of the defect width to the diameter of the best-fit circle. The inter- and intra-observer reliabilities of the measurements were evaluated using intraclass correlation coefficients (ICCs). The maximum absolute inter- and intra-observer differences and the cumulative percentages of cases with inter- and intra-observer differences greater than these respective levels were calculated.@*RESULTS@#Almost all linear defect values were bigger than the areal defect values. The inter-observer ICCs for the areal defect were 0.557 and 0.513 in the 'self-confirmed' group and 0.549 and 0.431 in the 'designated' group. The inter-observer reliabilities for the linear defect were moderate or fair in the 'self-confirmed' group (ICC = 0.446, 0.374) and 'designated' group (ICC = 0.402, 0.327). The ICCs for intra-observer measurements were higher than those for inter-observer measurements. The respective maximum inter- and intra-observer absolute differences were 13.9% and 13.2% in the 'self-confirmed' group, and 15.8% and 9.8% in the 'designated' group.@*CONCLUSIONS@#The areal measurement of the glenoid bone defect is more reliable than the linear measurement. The reliability of the glenoid defect areal measurement is moderate or worse, suggesting that a more accurate and objective measurement method is needed in both en-face view and best-fit circle determination. Subjective factors affecting the glenoid bone loss measurement should be minimized.
ABSTRACT
Background@#The size of the glenoid bone defect is an important index in selecting the appropriate treatment for anterior shoulder instability. However, the reliability of glenoid bone defect measurement is controversial. The purpose of the present study was to investigate the reliabilities of measurements of the glenoid bone defect on computed tomography and to explore the predisposing factors leading to inconsistency of these measurements.@*Methods@#The study population comprised 69 consecutive patients who underwent surgery for recurrent anterior shoulder dislocation in Peking University Fourth School of Clinical Medicine from March 2016 to January 2017. The glenoid bone defect was measured by three surgeons on 'self-confirmed’ and 'designated’ 3-D en-face views, and repeated after an interval of 3 months. Measurements included the ratio of the defect area to the best-fit circle area, and the ratio of the defect width to the diameter of the best-fit circle. The inter- and intra-observer reliabilities of the measurements were evaluated using intraclass correlation coefficients (ICCs). The maximum absolute inter- and intra-observer differences and the cumulative percentages of cases with inter- and intraobserver differences greater than these respective levels were calculated.@*Results@#Almost all linear defect values were bigger than the areal defect values. The inter-observer ICCs for the areal defect were 0.557 and 0.513 in the 'self-confirmed’ group and 0.549 and 0.431 in the 'designated’ group. The inter-observer reliabilities for the linear defect were moderate or fair in the 'self-confirmed’ group (ICC = 0.446, 0.374) and 'designated’ group (ICC = 0.402, 0.327). The ICCs for intra-observer measurements were higher than those for inter-observer measurements. The respective maximum interand intra-observer absolute differences were 13.9% and 13.2% in the 'self-confirmed’ group, and 15.8% and 9.8% in the 'designated’ group.@*Conclusions@#The areal measurement of the glenoid bone defect is more reliable than the linear measurement. The reliability of the glenoid defect areal measurement is moderate or worse, suggesting that a more accurate and objective measurement method is needed in both en-face view and best-fit circle determination. Subjective factors affecting the glenoid bone loss measurement should be minimized.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the in vitro anti-tumor effect and mechanism of dendritic cell (DC) tumor vaccine induced by astragalus polysacharin (APS).</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMCs) isolated from human peripheral blood. DCs obtained from human peripheral blood were cultivated and added with culture solution for in vitro inducing them to immature DCs. On the 5th day of culture, 100 microg/mL (as the final concentration) APS was added to cells in the APS group. DCs were induced to mature in the cytokine groups by adding 20 ng/mL rhTNF-alpha (as the final concentration). Changes of morphology and phenotype of DCs were observed. Mature DCs were sensitized with tumor antigen SGC-7901 and co-cultured with allogeneic T cells. The proliferative function of T lymphocytes was detected by MTT assay. Levels of IL-12 and IFN-gamma in co-cultured supernatant were detected by ELISA. Cytotoxic lymphocytes (CTL) activated by DC were co-cultured with tumor cell SGC-7901. The specific killing capacity of CTL to target cells was detected by LDH release assay.</p><p><b>RESULTS</b>The morphological observation and phenotypic identification of APS induced DCs were in accordance with the characteristics of mature DCs. APS induced mature DCs could stimulate the proliferation of allogeneic T lymphocytes. The proliferation index of T cells increased with increased ratio of stimulator cells to effector cells (P < 0.05). Levels of IL-12 and IFN-gamma in co-culture supernatant significantly increased in a time-dependent manner (P < 0.05). CTL cells activated by sensitization of DCs could significantly kill tumor cells, and the killing effect increased along with increased effector-to-target ratio.</p><p><b>CONCLUSION</b>APS could in vitro induce DCs to mature, promote its antigen-presenting capacity, effectively activate CTLs, and enhance anti-tumor function of the organism.</p>