Clinical study on core decompression in treating osteonecrosis of the femoral head of the necrotic bone-in different site / 中国骨伤

OBJECTIVE@#To analyze the clinical effect of decompression and bone grafting on osteonecrosis of the femoral head(ONFH) at different sites of necrotic lesions.@*METHODS@#A total of 105 patients with ARCOⅡstage ONFH admitted from January 2017 to December 2018 were retrospectively analyzed. There were 71 males and 34 females, with an average age of (55.20±10.98) years old. The mean course of all patients was(15.91±9.85) months. According to Japanese Inveatigation Committee (JIC) classification, all patients were divided into 4 types:17 cases of type A, 26 cases of type B, 33 cases of type C1 and 29 cases of type C2. All four groups were treated with decompression of the pulp core and bone grafting. Visual analogue scale(VAS) and Harris hip joint score were used before and at 3, 6, 12, and 24 months after the operation, and the collapse of the femoral head was observed by X-ray examination within 2 years.@*RESULTS@#All 105 patients were successful on operation without complications, and the mean follow-up duration was (24.45±2.75) months. Harris score showed that there was no statistical difference among four groups before surgery and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in intragroup Harris scores at preoperative and postoperative time points among four groups (P<0.01). VAS showed that there was no statistical difference among four groups before and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in VAS at preoperative and postoperative time points among four groups (P<0.01). None of the patients in four groups had femoral head collapse before and 3, 6 months after surgery. At 12 months after operation, there were 3 cases of femoral head collapse in group C and 4 cases in group C2(P>0.05);At 24 months after operation, 1 case of femoral head collapse occurred in group B, 6 cases in group C1 and 8 cases in group C2(P<0.05).@*CONCLUSION@#Core decompression and bone grafting can improve the effect of ONFH and hip preservation. The effect of hip preservation for ONFH is closely related to the location of the osteonecrosis lesion, so the influence of the location of lesion on the effect of hip preservation should be considered in clinical treatment, so as to make better preoperative hip preservation plan.

Case-control study on robot-assisted core decompression and conventional core decompression for early necrosis of femoral head / 中国骨伤

OBJECTIVE@#To compare clinical effect of robot-assisted core decompression and conventional core decompression in treating ARCO Ⅰ stage necrosis of femoral head.@*METHODS@#A retrospective analysis was performed on 60(unilateral operation) patients who underwent core decompression for femoral head necrosis from February 2018 to February 2020. Among them, 30 patients(30 hips) were underwent robot-assisted core decompression (RCD group), including 19 males and 11 females, aged from 17 to 58 years old with an average of(38.50±10.61) years old;30 patients(30 hips) were underwent traditional core decompression surgery (CCD group), including 20 males and 10 females, aged from 20 to 55 years old with an average of (40.63±10.63) years old. Intraoperative fluoroscopy times, intraoperative blood loss and operation time between two groups, and Harris score, visual analogue scale (VAS) before opertaion and 24 months after operation were compared.@*RESULTS@#All patients were followed up, RCD group followed up from 21 to 26 months with an average of(23.40±1.65) months, CCD group followed up from 21 to 26 months with an average of (23.30±1.66) months, and had no difference between two groups(P>0.05). The number of intraoperative X-ray fluoroscopy, intraoperative blood loss and operative time in RCD group were (9.43±1.14) times, (153.80±22.04) ml, (33.40±1.87) min, respectively;while(19.67±1.32) times, (165.04±20.41) ml and (54.75±3.46) min in CCD group respectively;and there were statistical difference between two groups(P<0.05). In addition, there were no statistical difference between two groups in Harris score and VAS at 24 months after operation(P>0.05).@*CONCLUSION@#Compared with conventional core decompression, robot-assisted core decompression could reduce the number of intraoperative fluoroscopy, shorten operation time, and reduce risk of surgery.

Efficacy of herb-separated moxibustion combined with sulfasalazine enteric-coated tablets for ankylosing spondylitis with cold-dampness obstruction type / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between herb-separated moxibustion and conventional moxibustion on ankylosing spondylitis (AS) based on oral administration of sulfasalazine enteric-coated tablets.@*METHODS@#A total of 64 patients with AS of cold-dampness obstruction type were randomly divided into an herb-separated moxibustion group and a conventional moxibustion group, 32 cases in each one. Based on oral administration of sulfasalazine enteric-coated tablets, the patients in the conventional moxibustion group were treated with moxibustion at the area with Dazhui (GV 14) to Changqiang (GV 1) as center and about 10 cm in width; the moxibustion was given for 1 hour. In the herb-separated moxibustion group, the gauze was soaked in the medicinal liquor and ginger juice, and placed on the same moxibustion area as the conventional moxibustion group, followed by moxibustion for 1 hour. The treatment in the two groups was given once a week, three treatments constituted a course and totally three courses were given. The symptom quantification score, occipital-wall distance, Schober test, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were observed before and after treatment in the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Compared before treatment, the symptom quantification score, occipital-wall distance, CRP and ESR levels were lower but the Schober test was higher after treatment in the two groups (all 0.05). The total effective rate was 90.0% (27/30) in the herb-separated moxibustion group, which was higher than 73.3% (22/30) in the conventional moxibustion group (<0.05).@*CONCLUSION@#The herb-separated moxibustion combined with sulfasalazine enteric-coated tablets has significant efficacy for AS with cold-dampness obstruction type, which could obviously relieve pain symptoms, improve occipital-wall distance, Schober test and other physical signs, and improve the quality of life.

Effect of naringin on oxidative stress and endoplasmic reticulum stress in diabetic cardiomyopathy / 中国中药杂志

To explore the protective effect of naringin(Nar) on the injury of myocardium tissues induced by streptozotocin(STZ) in diabetic rats and the relationship with oxidative stress and endoplasmic reticulum stress(ERS)， the male SD rats were intraperitoneally injected with streptozotocin(STZ， 60 mg·kg⁻¹) to establish the diabetic rat model and then randomly divided into the type 1 diabetic rat group(T1DR)， the low-dose Nar group(Nar25)， the middle-dose Nar group(Nar50) and the high-dose Nar group(Nar100). The normal rats were designed as control group(Con). Nar25， Nar50， Nar100 groups were orally administered with Nar at the doses of 25.0， 50.0， 100.0 mg·kg⁻¹ per day， respectively， while the normal group and the T1DR group were orally administered with saline. At the 8th week after treatment， fasting plasma glucose and heart mass index were measured. The pathological changes in myocardial tissues were observed by microscope. The cardiac malondialdehyde(MDA) level and superoxide dismutase(SOD) activities were measured. The gene and protein expressions of glucose-regulated protein 78(GRP78)， C/EBP homologous protein(CHOP)， cysteinyl aspartate-specific proteinase 12(caspase 12) were detected by qRT-PCR and Western blot. According to the results， compared with control group， the myocardial structure was damaged， the content of MDA was increased， while the activities of SOD were decreased(<0.05) in T1DR group. GRP78， CHOP and caspase 12 mRNA and protein expressions were increased significantly in T1DR group(<0.05， <0.01). Compared with T1DR group， myocardial structure damage was alleviated in Nar treatment group. The content of MDA was decreased， while the activities of SOD were increased significantly. The mRNA and protein expressions of GRP78， CHOP and caspase 12 were increased， especially in middle and high-dose groups(<0.05， <0.01). After treatment with Nar for 8 weeks， myocardial structure damage was obviously alleviated in Nar treatment groups. The content of MDA was decreased， while the activities of SOD were increased significantly in myocardial tissues. The mRNA and protein expressions of GRP78， CHOP and caspase 12 were increased， especially in middle and high-dose groups(<0.05， <0.01). The findings suggest that Nar may protect myocardium in diabetic rats by reducing mitochondrial oxidative stress injuries and inhibiting the ERS-mediated cell apoptosis pathway.

Effects of Fritillariae Cirrhosae Bulbus on MMP-2,MMP-9 and TIMP-1 in murine asthma model / 中国中药杂志

To investigate the effects of Fritillariae Cirrhosae Bulbus on airway remodeling and matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9), tissue inhibitor-1 of metalloproteinase(TIMP-1) of a murine asthma model, and explore its mechanism in treatment of asthma. BALB/C murines were randomly divided into the normal group, model group, high dose group, low dose group, and positive control group. Except for the normal group, all the other groups received ovalbumin(OVA) to establish murine asthma model. After successful modeling, the murines in high dose group and low dose group were orally administered with Fritillariae Cirrhosae Bulbus powder at the dose of 18.0 mg•kg⁻¹ and 9.0 mg•kg⁻¹, respectively; the murines in positive control group were injected intraperitoneally with dexamethasone at the dose of 0.5 mg•kg⁻¹; while the murines in normal group and the model group were orally administered with the same volume of normal saline. All the drugs were given to murines per day for 28 d. The variations of airway responsiveness, variations of the total cell count and leukocyte differential count in bronchoalveolar lavage fluid(BALF), and the variations of thicknesses of bronchial wall and airway smooth muscle of each group were observed. The levels of MMP-2, MMP-9 and TIMP-1 were measured by ELISA; and the expression levels of MMP-2, MMP-9 and TIMP-1 mRNA were detected by RT-PCR. The results showed that as compared with the normal group, the airway responsiveness, the count of total cells, neutrophils, macrophage, lymphocytes, eosinophils in BALF, and the thicknesses of bronchial wall and airway smooth muscle were increased significantly in the model group(P<0.01); as compared with the model group, the above indicators were decreased significantly in the high dose group, low dose group and positive control group (P<0.05 or P<0.01). As compared with the normal group, the levels and expressions of MMP-2, MMP-9 and TIMP-1 mRNA were increased significantly in the model group(P<0.01); while as compared with the model group, these levels were decreased significantly in the high dose group, low dose group and positive control group(P<0.01). In conclusion, Fritillariae Cirrhosae Bulbus can improve airway remodeling in a murine asthma model, and its mechanisms may be related to down-regulating MMP-2, MMP-9 and TIMP-1 levels.

Morphology of Hypertrophic Scar Tissues and Expressions of Vascular Endothelial Growth Factor and Transforming Growth Factor Beta Activated Kinase 1 in These Tissues / 中国医学科学院学报

<p><b>OBJECTIVE</b>To observe the morphology of hypertrophic scar tissue and explore the expressions and distribution of vascular endothelial growth factor (VEGF) and transforming growth factor beta activated kinase 1(TAK1 )in these tissues.</p><p><b>METHOD</b>Hematoxylin-eosin staining, Masson staining,immunofluorescence,and real-time polymerase chain reaction were used to detect the localization and expression of VEGF and TAK1 in 15 hypertrophic scar tissues and 10 normal skin tissues.</p><p><b>RESULTS</b>Morphological observation showed that the dermal fibroblasts in hypertrophic scar were disorderly and densely arranged (compared to the normal skin). Immunofluorescence displayed that the expressions of VEGF and TAK1 in hypertrophic scar tissue were higher than in normal skin tissues. Real-time polymerase chain reaction showed the mRNA expressions of both VEGF and TAK1 were significantly higher in hypertrophic scar tissue than in normal tissue (P<0.01, P<0.05,respectively).</p><p><b>CONCLUSIONS</b>Hypertrophic scar tissue has higher collagen fibrosis degree and higher TAK1 and VEGF expressions than the normal skin. VEGF and TAK1 can be used as the reference indicators for the diagnosis and differential diagnosis of hypertrophic scar and serve as new therapeutic targets.</p>

Research on construction of sheep lung adenomas virus pEGFP-C1/exJSRV-env and induction of malignant transformation in NIH3T3 / 病毒学报

This study aims to construct a eukaryotic expression system for envelope gene of Jaagsiekte sheep retrovirus, observes its localization in 293T cells, and investigates the potential in inducing malignant transformation of NIH3T3 cells. By RT-PCR, the full-length cDNA of envelope gene of Jaagsiekte sheep retrovirus (exJSRV-env) was amplified from the extract of naturally infected sheep lung. The clone of target gene was sub-cloned into eukaryotic expression system pEGFP-C1, and validated by PCR, restriction endonuclease, and sequencing. Bioinformatic analysis concerning biological function and cellular localiza tion of exJSRV-env was also performed. The recombinant clone of exJSRV-env was transfected into 293T cells and NIH3T3 cells by Lipofectamine LTX. The expression and celluar localization in 293T cells were validated by confocal microscopy. Soft agar colony formation assay was employed to test the anchorage-independent growth of NIH3T3. DNA sequencing and restriction enzyme digestion with Kpn I and Hind III indicated the correct construction of the recombinant plasmid, which was named pEGFP-C1/exJSRV-env. Amino acid sequence alignment of exJSRV-env with reference sequences found 85%-100% homogeneity. A YRNM motif was discovered at the cytoplasmic tail of envelope gene, which is exclusively found in exogenous viruses. Phylogenetic tree analysis showed that our clone of exJSRV-env clustered closely with pathogenic exogenous Jaagsiekte sheep retroviruses. Fluorescence microscopy indicated typical membrane localization of exJSRV-env protein. NIH3T3 cells transfected with exJSRV-env lost contact inhibition, and acquired colony forming ability in soft agar. This study indicated that envelope protein of Jaagsiekte sheep retrovirus can induce malignant transformation of mouse fibroblast cell NIH3T3. Discoveries of this study provide a basis for further structural and functional research on Jaagsiekte sheep retrovirus envelope protein.

Arthroscopic assisted diagnosis and treatment of knee extension limitation / 中华外科杂志

<p><b>OBJECTIVE</b>To figure out the incidence and etiology of knee extension limitation and then to find out the proper methods of arthroscopic assisted diagnosis and treatment.</p><p><b>METHODS</b>We reviewed 303 cases of arthroscopic assisted operation from January to October 2003, 95 cases of which suffered from knee extension limitation before operation, including 54 male and 41female and the mean age was 36.2 years old. The direct reasons of knee extension limitation were identified by routine arthroscopic examination and operations were carried out according to results of the examination.</p><p><b>RESULTS</b>Incidence of knee extension limitation in this group of patients was 31.4%. Trauma, mainly meniscus and ligament injury accounted for 67.4%, which was the most common reason of knee extension limitation. Acute or chronic arthritis like degenerative arthritis, non-specific synovitis, synovial chondromatosis, rheumatoid arthritis, pigmented villonodular synovitis, gouty arthritis and acute pyogenic arthritis formed another common reason. The follow-up period ranged from 3 to 20 months, average 13.3 months. 82 cases gained full extension immediately after operation, 9 cases gained full extension after 3 weeks rehabilitation post-operation, 4 cases did not gain full extension 1 year after operation, recurrence was observed in 4 cases.</p><p><b>CONCLUSIONS</b>Arthroscopy is the best method for diagnosis of knee extension limitation at present. Satisfactory results can be expected after early arthroscopic assisted treatment.</p>

Arthroscopic treatment of the giant cell tumor of tendon sheath in knee joint / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the technique of diagnosis and treatment of intra-articular giant cell tumor of tendon sheath (GCTTS) in knee joint, and to evaluate its clinical results.</p><p><b>METHODS</b>Twelve patients with GCTTS treated during 15 years were reviewed. Nine cases were misdiagnosed with meniscus injury (6 cases) and chronic synovitis (3 cases) before operation, only 3 cases were confirmed the diagnosis of GCTTS by MRI. Complete tumorectomy under arthroscope was performed on all 12 cases.</p><p><b>RESULTS</b>The results of clinical and radiographic followed-up of 9 patients for 1 to 10 years after operation was satisfactory. Clinical symptoms disappeared, range of motion and X-ray findings were normal. There was no recurrent case found.</p><p><b>CONCLUSIONS</b>Arthroscopic removal of GCTTS is an effective treatment. Tumor wide resection and debriding the channel which tumor passed through are the key point to prevent the recurrence after operation.</p>

Arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique / 中华创伤骨科杂志

Objective To evaluate arthroscopic PCL (posterior cruciate ligament) reconstruction with an implant fixaliun of hamstring tendon knot and bottle-neck technique.Methods Thirteen cases with PCL injury were treated with arthroscopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique between April,2002 to June,2005.The patients were followed up fur at least seven months to evaluate the clinical effects by means of ROM of the joint,post drawer test,Lachman test,Lysholm and IKDC (International Knee Documents Committee) scores.Results The patients were followed up for an average of 13.4 months.No limitation of knee extension was found six months after operation.Eleven patients had normal knee flexion(＞140?), one had knee flexion of 120?and one 100?.In posterior drawer test,11 patients were gradeⅠand two gradeⅡ.In Lachman test,11 patients were rated as within gradeⅠand two gradeⅡ.By Lysholm knee function scale,the average knee scores were 90.47?4.13 and 78.82?2.46 respectively before and after operation,and the dif- ference was of statistical significance (t=2.416,P=0.029).By IKDC scale,six were grade A,five grade B and one grade C.Conclusion Arthroseopic PCL reconstruction with an implant fixation of hamstring tendon knot and bottle-neck technique is a reliable method to restore knee function and will have a prospect of wide application be- cause of its good tissue biocompatibility,less invasion,and less operative expenditure.

Calbindin D-28k-containing neurons receiving visceral and somatic nociceptive information in interstitial nucleus of the spinal trigeminal tract project to the parabrachial nuclei in the rat / 生理学报

The calbindin D-28k (CB)-containing neurons in the interstitial nucleus of the spinal trigeminal tract (INV) that receive visceral and orofacial somatic nociceptive information and emanate projections to the parabrachial nuclei (PB) were investigated by the triple-labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry in the rat. The results showed (1) in the perioral stimulation group, a large number of FG-retrograde labeled and Fos-immunoreactive neurons were found in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of the INV ipsilateral to FG and formalin injection made to the PB and lips, respectively, while a lot of CB-immunoreactive neurons were distributed in the INV bilaterally; (2) a majority of the FG-retrograde labeled neurons (77.3%) were double-labeled with CB, and 40.7% of them were double-labeled with Fos; about 38.5% of FG/CB double-labeled neurons were FG/CB/Fos triple-labeled in the INV; and (3) in the upper alimentary tract stimulation group, the distribution and the numbers of FG-retrograde labeled, CB-immunoreactive neurons and FG/CB double-labeled neurons in the INV were similar to those of the perioral stimulation group as described above, except that the Fos immunoreactive neurons were distributed in the INV bilaterally, approximately 41.9% of the FG-retrograde labeled neurons were FG/Fos double-labeled, and over half (52.0%) of those double-labeled neurons were FG/CB/Fos triple-labeled. The results indicate that a part of CB-containing neurons in the INV receive orofacial somatic and visceral nociceptive information and that these neurons sent projections directly to the PB. The CB-containing neurons might play an important role in the transmission of the peripheral nociceptive information from INV to PB.