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Major depressive disorder (MDD) is a highly heterogeneous mental disorder, and its complex etiology and unclear mechanism are great obstacles to the diagnosis and treatment of the disease. Studies have shown that abnormal functions of the visual cortex have been reported in MDD patients, and the actions of several antidepressants coincide with improvements in the structure and synaptic functions of the visual cortex. In this review, we critically evaluate current evidence showing the involvement of the malfunctioning visual cortex in the pathophysiology and therapeutic process of depression. In addition, we discuss the molecular mechanisms of visual cortex dysfunction that may underlie the pathogenesis of MDD. Although the precise roles of visual cortex abnormalities in MDD remain uncertain, this undervalued brain region may become a novel area for the treatment of depressed patients.
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The synthesis of fine chemicals using multi-enzyme cascade reactions is a recent hot research topic in the field of biocatalysis. The traditional chemical synthesis methods were replaced by constructing in vitro multi-enzyme cascades, then the green synthesis of a variety of bifunctional chemicals can be achieved. This article summarizes the construction strategies of different types of multi-enzyme cascade reactions and their characteristics. In addition, the general methods for recruiting enzymes used in cascade reactions, as well as the regeneration of coenzyme such as NAD(P)H or ATP and their application in multi-enzyme cascade reactions are summarized. Finally, we illustrate the application of multi-enzyme cascades in the synthesis of six bifunctional chemicals, including ω-amino fatty acids, alkyl lactams, α, ω-dicarboxylic acids, α, ω-diamines, α, ω-diols, and ω-amino alcohols.
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Amino Acids , Biocatalysis , Amino Alcohols , Coenzymes/metabolism , DiaminesABSTRACT
Objective:To investigate the relationship between anterior tibial translation (ATT) and bony morphology around the knee after anterior cruciate ligament (ACL) injury.Methods:A total of 67 patients diagnosed with acute ACL injury without any meniscal lesions were enrolled in this study between September 2019 and August 2020. Preoperative magnetic resonance imaging (MRI) scans were used to measure the ATT of the lateral compartment, and bony morphology was assessed by measuring lateral femoral condyle (LFC) length, LFC height, lateral tibial plateau (LTP) length, LTP slope and by calculating the following ratios: LFC ratio (LFC length/LFC height), knee extension ratio (LFC length/LTP length), and knee flexion ratio (LFC height/LTP length). The status of the anterolateral ligament (ALL) was assessed by preoperative MRI scans and classified as completely injured (44 patients), partially injured (19 patients), or intact (4 patients). The ATT was compared between patients with completely injured ALL and those with partially injured or intact ALL. Pearson correlation analysis between the ATT and each bony variable was performed in ALL-completely-injured patients and ALL-partially-injured or intact patients.Results:Of the 67 patients, 33 were male and 34 were female, with a mean of age 31.7±9.7 years (range 15-47 years). The average of time interval between ACL injury and MRI examination was 26.0±22.0 days (95% CI: 20.7, 31.4 d). The ATT of the lateral compartment was 5.6±4.0 mm (range, -4.9-16.2 mm), the average of LFC length was 37.3±2.5 mm (range, 30.5-43.2 mm), the average of LFC height was 37.4±3.6 mm (range, 30.6-46.3 mm), the average of LTP length was 46.9±4.1 mm (range, 39.0-56.8 mm), the average of LTP slope was 6.3°±3.1° (range, -3.7°-11.6°), LFC ratio was 100.4%±8.1% (range, 84.1%-119.0%), knee extension ratio was 80.0%±5.8% (range, 66.1%-96.3%), and knee flexion ratio was 80.0%±6.0% (range, 66.4%-93.8%). The ATT was greater in patients with completely injured ALL than in patients with partially injured or intact ALL (6.4±4.3 mm vs. 3.9±2.8 mm, t=2.52, P=0.014). The ATT was negatively correlated with LFC height ( r=-0.43, P<0.001) and LTP length ( r=-0.35, P=0.004) and was positively correlated with LFC ratio ( r=0.48, P<0.001), knee extension ratio ( r=0.36, P=0.003), and LTP slope ( r=0.29, P=0.018). All these correlations were still statistically significant in patients with complete ALL injury ( P<0.05), but were no significant in patients with partial ALL injury or intact ALL ( P>0.05). Conclusion:Bony morphology of the distal femur and proximal tibia was associated with ATT after ACL injury. Such an association was more dramatic in patients with a complete ALL injury.
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Objective:To explore the effects of risk grading nursing on the prevention of postoperative deep vein thrombosis (DVT) and quality of life in patients undergoing knee arthroscopic surgery.Methods:A total of 1 140 patients undergoing knee arthroscopic surgery in Beijing Jishuitan Hospital were selected. The 529 cases with routine nursing from January to December 2018 were selected as the control group, while another 611 cases with risk grading nursing from January to December 2019 were selected as the observation group. The incidence of DVT, limbs swelling, quality of life and nursing satisfaction were compared between the two groups.Results:The incidence of DVT and the positive rates of Homan sign and Neuhof sign were 2.78% (17/611), 3.93% (24/611), 4.91% (30/611) in the observation group, and 5.10% (27/529), 10.02% (53/529), 11.72% (62/529) in the control group, the differences were statistically significant ( χ2=4.12, 16.70, 17.72, all P<0.05). The peripheral diameter and body surface temperature at 5 cm above the ankle, 10 cm below the patella and 15 cm above the patella were (21.30 ± 1.72) cm, (34.89 ± 2.75) cm, (46.69 ± 4.58) cm, (33.14 ± 1.40) ℃, (34.45 ± 1.52) ℃, (35.22 ± 1.36) ℃ in the observation group, and (22.88 ± 1.43) cm, (35.91 ± 1.81) cm, (49.18 ± 4.23) cm, (34.39 ± 1.22) ℃ (35.88 ± 1.49) ℃, (35.97 ± 1.31) ℃ in the control group, the differences were statistically significant ( t values were -16.74--7.25, all P<0.05). The scores of general health, physiological function, physiological function, mental health, social function, emotional function, body pain and body vitality were (75.84 ± 5.33), (79.78 ± 5.71), (76.71 ± 4.14), (84.91 ± 4.15), (75.53 ± 4.19), (78.80 ± 6.76), (74.85 ± 3.49), (78.61 ± 3.52) points in the observation group, and (71.39 ± 4.28), (75.44 ± 6.26), (73.05 ± 4.09), (80.15 ± 6.87), (71.66 ± 4.18), (74.89 ± 6.23), (71.14 ± 5.20), (74.66 ± 5.14) points in the control group, the differences were statistically significant ( t values were 10.10-15.57, all P<0.05). The satisfaction scores of nursing communication, safety, nursing technology, nursing, guidance and physical environment were (4.54 ± 0.42), (4.75 ± 0.46), (4.54 ± 0.52), (4.60 ± 0.48), (4.60 ± 0.53), (4.30 ± 0.64) points in the observation group, and (3.93 ± 0.34), (3.98 ± 0.37), (3.96 ± 0.41), (3.93 ± 0.38), (3.85 ± 0.36) (3.74 ± 0.38) points in the control group, the differences were statistically significant ( t values were 17.62-30.82, all P<0.05). Conclusions:Risk grading nursing is beneficial to alleviate postoperative limb swelling in patients after knee arthroscopic surgery, reduce incidence of DVT, improve quality of life and nursing satisfaction.
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Objective:To investigate the associations between small diffusion-weighted imaging (DWI) hyperintensities lesions and total cerebral small vessel disease (cSVD) burden and the influence on prognosis in patients with acute intracerebral hemorrhage (ICH).Methods:Consecutive patients with acute spontaneous ICH from January 2018 to June 2021 were recruited in the Stroke Center of Zhengzhou People′s Hospital. Magnetic resonance imaging was performed to quantify DWI hyperintensities lesions and cSVD imaging markers, including white matter hyperintensities, enlarged perivascular spaces, lacunes and cerebral microbleeds, which were calculated for the total cSVD burden (0-4 points). The prognosis was assessed with the modified Rankin Scale (mRS) at discharge and 90-day. Multivariable Logistic regression models were adopted to explore the associations between DWI lesions and total cSVD burden and clinical outcome.Results:Of 283 included patients, 59 (20.8%) had small DWI lesions, 32 (11.3%) had multiple lesions. They were mostly punctate, mainly located in the cortical and subcortical regions, and scattered in multiple vascular territories. With the increase of cSVD burden, the number of DWI lesions gradually increased. Spearman correlation analysis showed that the total cSVD burden was positively correlated with the number of DWI lesions ( r=0.21, P<0.001). In multivariable regression analyses, the total cSVD burden was independently associated with DWI lesions ( OR=1.63, 95% CI 1.23-2.15, P=0.001). The 90-day poor outcome (mRS scores≥4) in patients with DWI lesions was significantly higher than those without DWI lesions (39.3% vs 16.3%, χ 2=14.38, P<0.001), while there was no statistically significant difference in the poor outcome of discharge between the two groups (26.5% vs 17.7%, χ 2=3.06, P=0.080). With the increase in the number of DWI lesions, the 90-day poor outcome increased significantly (trend chi-squared test χ 2=11.50, P=0.001). Multivariable analyses showed that DWI lesions ( OR=4.39, 95% CI 1.92-10.03, P<0.001) and their number ( OR=1.42, 95% CI 1.06-1.90, P=0.018) were independently associated with the 90-day poor outcome. Conclusions:Higher total cSVD burden is an independent risk factor for small DWI lesions in patients with ICH. Small DWI lesions were independently associated with the 90-day poor outcome, but not with the discharge outcome.
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Leukoencephalopathy with vanishing white matter (VWM) is one of the most prevalent inherited childhood white-matter disorders, and the pathogenic gene has been confirmed as EIF2B gene. VWM is characterized by chronic progressive neurological deterioration with cerebellar ataxia, usually less prominent spasticity and relatively mild mental decline. There are episodes of rapid and major neurological deterioration provoked by stresses, such as fever, minor physical trauma and acute fright, which is a characteristic clinical feature of VWM. Brain magnetic resonance imaging findings are diagnostic in almost all patients,and the disappearance of the cerebral white matter occurs in a diffuse "melting away" pattern. The onset of VWM can be at any age from fetal stage to adult stage, and the clinical phenotypes vary immensely. Gene diagnosis is the golden standard for VWM. This article reported a patient with a course of 17 years, who was misdiagnosed as Wilson′s disease because of low serum ceruloplasmin, and was finally diagnosed as VWM by reinterpretation of whole exome sequencing, which is worthy of clinicians′ vigilance and consideration.
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Objective:To investigate the risk factors of rotator cuff tears combined with long head of bicep tendon (LHBT) lesion and its effects on preoperative function.Methods:From January 2016 to January 2020, there were 680 patients with rotator cuff tears, including 260 males and 420 females, were included. The average age was 56.1±8.7 (range 27-74 years). There were 250 cases on the left side and 430 cases on the right side. There were 436 cases on the main side, while 274 cases had definite trauma before operation. The following were the Post rotator cuff tears classification, 133 cases in partial injury, 473 cases in small and medium size of rotator cuff tears, 74 cases in large and massive size of rotator cuff tears. The Habermayer-Walch classification of LHBT lesions was as following, 302 cases in type 0 (normal), 216 cases in type 1 (tendonitis), 29 cases in type 2 (dislocation and subluxation), 104 cases in type 3 (partial tear), 20 cases in type 4 (complete tear) and 9 cases in type 5 (SLAP injury above type II). The patient with rotator cuff tears were divided into partial tears group, medium and small tears group, large and massive tears group according to the classification of Post. The visual analogue scale (VAS), simple shoulder test (SST), Constant-Murley function score and the score of the University of California Los Angeles (UCLA) were recorded. The differences in age, sex, main side, trauma and LHBT lesion in patients with three types of rotator cuff tears were analyzed. The preoperative pain and function scores of patients with or without LHBT lesions in various rotator cuff tears were compared among the groups by t-test. The age, sex, main side, with trauma or not, and the classification of rotator cuff tears were analyzed by Logistic regression to investigate the risk factors of patients with rotator cuff tears with LHBT lesions. Results:There were 378 cases (55.6%) with LHBT lesions in 680 patients with rotator cuff tears, including 216 cases of tendinitis (57.1%), 104 cases of partial tear (27.5%), 29 cases of dislocation and subluxation (7.7%), 20 cases of complete tear (5.3%) and 9 cases of SLAP injury (2.4%). The incidence of partial injury, small and medium injury, large and massive rotator cuff injury combined with LHBT lesions were 35.3% (47/133), 57.5% (272/473) and 79.7% (59/74) respectively. The preoperative VAS score, UCLA score, Constant-Murley score and SST score were 5.20±1.52, 14.81±4.12, 41.45±4.93 and 4.56±1.96 respectively in rotator cuff tears group and 5.29±1.65, 14.34±4.01, 41.60±5.88, 4.47±1.97 in LHBT group ( P>0.05). In the partial rotator cuff tears group, the VAS score was 5.16±1.41 in patients with simple rotator cuff tears and 5.68±1.46 in patients with LHBT lesion ( t=2.004, P=0.047). Regression analysis showed that age ≥60 years and rotator cuff tears degree were the risk factors for rotator cuff tears with LHBT ( P<0.001). Conclusion:It is common for patients to have rotator cuff tears with LHBT lesions. The more severe the rotator cuff tears are, the higher the incidence of LHBT lesions will be. Patients with rotator cuff tears aged 60 and above are more likely to have LHBT lesions. However, the complications of LHBT could not affect the preoperative pain and functional scores of patients with rotator cuff tears.
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The present study analyzes the use of the online teaching platform of China Medical University during the COVID-19 epidemic, excavates the teaching difficulties encountered in online teaching, and shares the experience of implementing "1+M" mode of mixed online teaching platform by introducing a variety of online teaching platforms. Monitoring of teaching quality has been initiated on time, and the key tasks of online teaching have been straightened out in time, which has effectively improved the quality of online teaching, providing references and basis for further advancing the reform of higher medical education in China.
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Objective:To explore the risk factors of primary anterior cruciate ligament (ACL) reconstruction failure.Methods:From November 2015 to May 2017, a total of 178 consecutive patients with clinically diagnosed non-contact ACL injury were treated and followed-up more than 2 years. Twenty-five patients (post-operative failure group) who underwent completely ruptured ACL graft confirmed by MRI, positive pivot-shift test, more than 5 mm side-to-side difference (SSD) measured by KT-1000 arthrometer, more than 5 mm static anterior tibial translation (ATT) measured on MRI were determined to be ACL reconstruction failure. They were matched in a 1∶2 fashion to 50 non-failure patients (post-operative non-failure group), who showed intact ACL graft 2 years after ACL reconstruction. The sex, age, body mass index (BMI), affected side, meniscal injury side, time from injury to surgery, KT-1000 SSD, pivot shift test under anesthesia, follow-up duration, posterior tibial slope (PTS) and ATT measured on the pre-operative weight-bearing whole leg radiographs between the two groups were compared using univariate analysis. Moreover, the predictors of ACL reconstruction failure were assessed by multivariable conditional Logistic regression analysis.Results:Post-operative failure group had a significantly higher PTS and ATT values than those in the post-operative non-failure group (17.21°±2.20° vs 14.36°±2.72°, t=4.395, P<0.001; 8.29±3.42 mm vs 4.09±3.06 mm, t=5.504, P<0.001). The sex, age, BMI, affected side, meniscal injury side, time from injury to surgery, KT-1000 SSD, pivot shift test under anesthesia, follow-up duration between the two groups showed no significant difference ( P>0.05). Multivariable Logistic regressions indicated that PTS≥17° ( OR=15.62, P=0.002) and ATT≥6 mm ( OR=9.91, P=0.006) were independent risk factors for primary ACL reconstruction failure. However, sex, age, BMI, meniscal lesions, degree of pivot shift test, KT-1000 SSD were not the independent risk factors. Conclusion:PTS≥17° and ATT≥6 mm could increase the risk of primary ACL reconstruction failure.
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Objective:To evaluate the clinical, radiological and arthroscopic outcomes after surgical repair for chronic lateral meniscus posterior root (LMPR) avulsion combined with anterior cruciate ligament (ACL) reconstruction.Methods:From July 2015 to June 2017, a total of 33 patients who underwent transtibial pull-out suture repair for chronic LMPR avulsion combined with anatomic single-bundle ACL reconstruction with hamstring graft were retrospectively reviewed. There were 30 males and 3 females with an average age of 27.7±7.5 years (range 17-45 years) and a mean BMI of 25.2±3.7 kg/m 2 (range 19.4-36.7 kg/m 2). All patients were available for at least two years of follow-up. A second-look arthroscopy was performed to evaluate the healing status of the repaired meniscus. Subjective knee function was assessed through Lysholm and Tegner scores. Objective knee stability was evaluated using KT-1000 arthrometer side-to-side difference (SSD) and pivot shift test under anesthesia. The tibiofemoral relationship was evaluated by anterior tibial subluxation (ATS) measured on axial MRI. Between patients with preoperative ATS ≥6 mm (18 patients in the ATS positive group) and <6 mm (15 patients in the ATS negative group), the postoperative ATS and the reduction of ATS was also compared. Results:After a mean follow-up of 27.5±4.0 months (range 24-39 months), the LMPR avulsion completely healed in 23 (70%) cases, partially healed in 9 (27%) cases, failed to heal in 1 (3%) case on second-look arthroscopy. The Lysholm score was increased from 60.4±13.6 to 82.7±11.1 at 1 year and to 91.4±9.1 at 2 years operatively ( F=155.996, P<0.001). The Tegner score was increased from 3(2, 5) to 4(3, 5) at 1 year and 6(4, 6) at 2 years postoperatively (χ 2=47.791, P<0.001). The KT-1000 SSD was decreased from 9.1±3.3 mm to 2.0±1.7 mm ( t=11.197, P<0.001). The result of pivot shift test was also improved (10 grade I, 20 grade II, 3 grade III, preoperatively vs 30 grade 0, 3 grade I, postoperatively, U=5.161, P<0.001). The ATS was reduced from 5.7±3.9 mm to 3.5±3.2 mm ( t=3.530, P=0.001). However, there was no statistically significant decrease in the ATS of the ATS negative group ( t=0.400, P=0.695). The ATS of the ATS positive group was reduced from 8.7±1.8 mm to 5.0±3.3 mm ( t=4.765, P<0.001), and the ATS reduction of the ATS positive group was greater than that of the ATS negative group (3.7±3.3 mm vs 0.3±2.8 mm, t=3.115, P=0.004). Conclusion:In patients undergoing ACL reconstruction, the transtibial pull-out suture repair for chronic LMPR avulsion yielded meniscus healing rate of 97% with improved subjective knee function and objective knee stability and better restored the tibiofemoral relationship for patients with excessive ATS.
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The parahippocampal gyrus-orbitofrontal cortex (PHG-OFC) circuit in humans is homologous to the postrhinal cortex (POR)-ventral lateral orbitofrontal cortex (vlOFC) circuit in rodents. Both are associated with visuospatial malfunctions in Alzheimer's disease (AD). However, the underlying mechanisms remain to be elucidated. In this study, we explored the relationship between an impaired POR-vlOFC circuit and visuospatial memory deficits through retrograde tracing and in vivo local field potential recordings in 5XFAD mice, and investigated alterations of the PHG-OFC circuit by multi-domain magnetic resonance imaging (MRI) in patients on the AD spectrum. We demonstrated that an impaired glutamatergic POR-vlOFC circuit resulted in deficient visuospatial memory in 5XFAD mice. Moreover, MRI measurements of the PHG-OFC circuit had an accuracy of 77.33% for the classification of amnestic mild cognitive impairment converters versus non-converters. Thus, the PHG-OFC circuit explains the neuroanatomical basis of visuospatial memory deficits in AD, thereby providing a potential predictor for AD progression and a promising interventional approach for AD.
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A deficit in spatial memory has been taken as an early predictor of Alzheimer's disease (AD) or mild cognitive impairment (MCI). The uncinate fasciculus (UF) is a long-range white-matter tract that connects the anterior temporal lobe with the orbitofrontal cortex (OFC) in primates. Previous studies have shown that the UF impairment associated with spatial memory deficits may be an important pathological change in aging and AD, but its exact role in spatial memory is not well understood. The pathway arising from the postrhinal cortex (POR) and projecting to the ventrolateral orbitofrontal cortex (vlOFC) performs most of the functions of the UF in rodents. Although the literature suggests an association between spatial memory and the regions connected by the POR-vlOFC pathway, the function of the pathway in spatial memory is relatively unknown. To further illuminate the function of the UF in spatial memory, we dissected the POR-vlOFC pathway in mice. We determined that the POR-vlOFC pathway is a glutamatergic structure, and that glutamatergic neurons in the POR regulate spatial memory retrieval. We also demonstrated that the POR-vlOFC pathway specifically transmits spatial information to participate in memory retrieval. These findings provide a deeper understanding of UF function and dysfunction related to disorders of memory, as in MCI and AD.
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Animals , Male , Glutamic Acid , Physiology , Mental Recall , Physiology , Mice, Inbred C57BL , Neural Pathways , Cell Biology , Physiology , Neuroanatomical Tract-Tracing Techniques , Neurons , Physiology , Prefrontal Cortex , Cell Biology , Physiology , Spatial Memory , Physiology , Temporal Lobe , Cell Biology , PhysiologyABSTRACT
In recent years,magnetic resonance imaging (MRI) has been widely used in the early diagnosis as well as long-term follow-up study of Alzheimer's disease (AD).The studies were reviewed which applied the structural MRI and arterial spin labeling MRI (ASL-MRI) in AD over the past 20 years,and found more gray matter volume loss in multiple brain structures in individuals with AD spectrum.Among them,medial temporal lobe atrophy and posterior cortical atrophy are the most diagnostic.Meanwhile,cerebral blood flow changes in various brain regions with the progression of the AD.More investigations combining the changes of gray matter volume and cerebral blood flow to explore pathophysiological mechanisms underlying cognitive decline in AD spectrum are necessary in the future.
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With the arrival of education informatization, the online elective courses have become an important means of teaching at universities. Problems, such as insufficient attentions from universities and low learning enthusiasm of students, are quite common. Based on the curriculum setting of online courses at a university, we performed a study to identify root causes of those common problems. Students' gender, major, current academic year and their school-year were collected and analyzed to detect any potential differences in the time spent in studying and course grades. With the results in hands, we propose that universities should promote online elective courses, guide students to scientifically plan study time, stimulate students' initiatives for study, shape out students' self-learning and life-long learning abilities, so as to fulfil the destiny of the online elective courses as a powerful complement to traditional teaching.
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Objective@#To investigate the association between high-grade pivot-shift and complete lateral meniscus posterior root (LMPR) tear in patients with anterior cruciate ligament (ACL) ruptures.@*Methods@#From January 2013 to December 2017, a total of 86 ACL injured patients with LMPR tears were reviewed retrospectively. There were 66 males and 20 females with an average age of 27.8±8.3 years (range 16-49 years) and an mean BMI of 25.1±3.2 kg/m2 (range 17.4-33.9 kg/m2). The average duration from injury to surgery was 33.5±79.4 weeks (range 3 days to 11 years). All patients were classified into high-grade pivot-shift group (60 patients of IKDC grade II-III) and low-grade pivot-shift group (26 patients of IKDC grade 0-I) according to the results of pivot-shift tests under anesthesia before ACL reconstructions. Predictive factors of high-grade pivot-shift were analyzed by multivariable Logistic regression, involving degree of LMPR tear, integrity of meniscofemoral ligament, width of lateral meniscal extrusion, KT-1000 arthrometer side-to-side difference, age, sex, and BMI.@*Results@#The prevalence of complete LMPR tear in high-grade pivot-shift group was higher than that in low-grade pivot-shift group. High-grade pivot-shift was associated to complete LMPR tear [OR=4.096, 95% CI(1.339, 12.371), P=0.013] and KT-1000 arthrometer side-to-side difference [OR=9.632, 95% CI (3.095, 29.975), P<0.001]. The association between high-grade pivot-shift and complete LMPR tear was more striking in patients with duration from injury to surgery ≥12 weeks [OR=8.343, 95%CI(1.224, 56.853), P=0.030]. High-grade pivot-shift did not associated with meniscofemoral ligament, lateral meniscal extrusion, age, sex and BMI (P>0.05).@*Conclusion@#In patients with ACL ruptures, complete LMPR tear was an independent risk factor of high-grade pivot-shift, especially for patients with 12 weeks at least duration from injury to surgery.
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Objective To investigate the association between high-grade pivot-shift and complete lateral meniscus posterior root (LMPR) tear in patients with anterior cruciate ligament (ACL) ruptures.Methods From January 2013 to December 2017,a total of 86 ACL injured patients with LMPR tears were reviewed retrospectively.There were 66 males and 20 females with an average age of 27.8±8.3 years (range 16-49 years) and an mean BMI of 25.1±3.2 kg/m2 (range 17.4-33.9 kg/m2).The average duration from injury to surgery was 33.5±79.4 weeks (range 3 days to 11 years).All patients were classified into high-grade pivotshift group (60 patients of IKDC grade Ⅱ-Ⅲ) and low-grade pivot-shift group (26 patients of IKDC grade 0-I) according to the results of pivot-shift tests under anesthesia before ACL reconstructions.Predictive factors of high-grade pivot-shift were analyzed by multivariable Logistic regression,involving degree of LMPR tear,integrity of meniscofemoral ligament,width of lateral meniscal extrusion,KT-1000 arthrometer side-to-side difference,age,sex,and BMI.Results The prevalence of complete LMPR tear in high-grade pivot-shift group was higher than that in low-grade pivot-shift group.High-grade pivot-shift was associated to complete LMPR tear [OR=4.096,95％CI(1.339,12.371),P=0.013] and KT-1000 arthrometer side-to-side difference [OR=9.632,95％CI (3.095,29.975),P＜0.001].The association between high-grade pivot-shift and complete LMPR tear was more striking in patients with duration from injury to surgery ≥12 weeks [OR=8.343,95％CI(1.224,56.853),P=0.030].High-grade pivot-shift did not associated with meniscofemoral ligament,lateral meniscal extrusion,age,sex and BMI (P＞0.05).Conclusion In patients with ACL ruptures,complete LMPR tear was an independent risk factor of high-grade pivot-shift,especially for patients with 12 weeks at least duration from injury to surgery.
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Objective To investigate the risk factors of J sign in patients with recurrent patellar dislocation, and to estab?lish a new grading system of J sign. Methods From January 2017 to August 2018, a consecutive case series of 111 recurrent pa?tellar dislocation patients were included in the present study. Among these patients, a total of 68 patients had positive J sign (J sign (+) group), and the remaining 43 patients had negative J sign (J sign (-) group). Caton index, Dejour classification, tibial tuber?osity?trochlear groove (TT?TG) distance and rotational parameters of the lower extremity (including femoral anteversion angle, ex?ternal tibial torsion angle and knee rotation angle) were measured to compare the differences of these parameters between the inter?vention group and control group. Furthermore, the risk factors of J sign were analyzed in detail. Meanwhile, a new grading system of J sign was introduced based on the extent and form of lateral patellar shift. Results The prevalence of J sign in recurrent patel?lar dislocation was 61.3% (68/111). Univariate analysis showed that femoral anteversion angle (t=3.376, P=0.001), knee rotation angle (t=4.886, P=0.001), TT?TG distance (t=3.177, P=0.002) and prevalence of patellar alta (χ2=9.809, P=0.002) were much high?er in the J sign (+) group, and the differences were statistically significant when compared with the J sign (-) group. Multivariate Logistic regressions demonstrated that increased femoral anteversion angle ( OR=1.118, P=0.012), enlarged knee rotation angle ( OR=1.178, P=0.016) and patella alta ( OR=3.229, P=0.040) were independent risk factors of J sign in patients with recurrent pa?tellar dislocation. Conclusion Increased femoral anteversion angle, enlarged knee rotation angle, and patellar alta were strongly associated with J sign. These factors may be independent risk factors of J sign in patients with recurrent patellar dislocation.
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Objective To explore the application effect of growth hormone in patients ≥35 years old with diminished ovarian reserve (DOR),and to analyze pregnancy outcome.Methods A total of 120 cases with diminished ovarian reserve (≥35 years old) in our hospital were randomly divided into observation group and control group,each group of 60 cases.The control group was given conventional treatment,while the observation group added growth hormone.Changes of follicle stimulatng homone (FSH) and luteinizing hormone (LH),FSH/LH,serum estradiol (E2) level were compared between the two groups before and after treatment,along with the pregnancy outcome of two groups such as normal fertilization rate,excellent embryo rate,quantity of egg,cleavage rate,cycle cancellation rate.Results After treatment,the FSH and FSH/LH of the observation group were significantly lower than those of the control group,the serum E2 was significantly higher than that of the control group (P ＜ 0.05);the normal fertilization rate,cleavage rate and excellent embryo rate in the observation group were 53.96％,86.67％ and 35.38％ respectively,which were significantly higher than those of 33.58％,71.11％ and 15.63％ in the control group (P ＜ 0.05);the cycle cancellation rate of the observation group was 6.67％,which was significantly lower than that of 21.67％ in the control group (P ＜ 0.05);the biochemical pregnancy rate and clinical pregnancy rate of the observation group were 38.33％ and 28.33％,which were significantly higher than those of 20％ and 13.33％ in the control group (P ＜ O.05).Conclusions Diminished ovarian reserve in patients ≥35 years old with growth hormone therapy,can promote the improvement of ovarian function,the biochemical pregnancy rate and clinical pregnancy rate,it is worthy of clinical promotion.
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Objective@#To investigate the influence of routine antagonist and optimization super-long termovulation promotion scheme on clinical outcome of patients with IVF-ET/ICSI and POR.@*Methods@#One hundred and thirty patients with IVF-ET/ICSI and POR were chosen in the period from October 2014 to May 2016 and randomly divided into two groups including control group (65 patients) with routine antagonist scheme and observation group (65 patients) with optimization super-long term scheme for ovulation promotion; and the number and total dose of Gn application, endometrium thickness and P levels in HCG day, the number of ovum retrieved, the incidence of premature LH peak, fertilization rate, quality embryo rate, cycle cancellation rate, implantation rate, clinical pregnancy rate, abortion rate and ectopic pregnancy rate of two groups were compared.@*Results@#The number and total doses of Gn application of observation group were significant higher than those of control group:(12.50 ± 1.78) d vs.(8.16 ± 1.25) d, (4 272.81 ± 547.95) U vs. (1 909.13 ± 341.48) U (P<0.05). The endometrium thickness and P levels in HCG day of observation group were significant lower than those of control group: (12.86 ± 1.39) mm vs. (10.08 ± 1.02) mm, (0.43 ± 0.17) nmol/L vs. (0.60 ± 0.22) nmol/L (P<0.05). There was no significant difference in the number of ovum retrieved, the incidence of premature LH peak and fertilization rate between two groups (P > 0.05). The quality embryo rate and cycle cancellation rate of observation group was significant lower than that of control group (P<0.05). The implantation rate and clinical pregnancy rate of observation group were significant higher than that of control group (P<0.05).There was no significant difference in the abortion rate and ectopic pregnancy rate between two groups (P > 0.05).@*Conclusions@#Compared with routine antagonist scheme, optimization super-long termscheme for ovulation promotion in the treatment of patients with IVF-ET/ICSI and POR can efficiently improve the ovulation effects and increase the long-term pregnancy rate, but has the higher overall treatment cost.
ABSTRACT
3-Deoxy-D-manno-octulosonate 8-phosphate synthase (KDO8PS) is the key enzyme to synthesize eight-carbon sugar in plant and gram-negative bacterial cell wall. To analyze the polymerization and characterization in plant KDO8PS, the candidate gene was cloned from fresh Phyllostachys edulis seedling by RT-PCR. The open reading frame of PeKDO8PS is 876 bp deduced into 291 amino acid residues. The target protein was overexpressed in Escherichia coli induced by IPTG and then lager amount of fusion protein was purified through two-step methods with affinity chromatography and size-exclusion chromatography (SEC). SEC analysis shows that PeKDO8PS protein existed mainly in the form of dime in solution. Glutaraldehyde cross-linking experiments confirmed that the enzyme could form dimers. Further we identified that KDO8PS at high concentration two dimers could form tetramer in aqueous solution by analytical ultracentrifuge (AUC) analysis. The pH of the catalytic reaction was between 4.0 and 9.0, the optimum pH value was 8, the thermal stability range was between 25 and 65 ℃, and the optimum temperature was about 55 ℃. The enzyme activity was inhibited by some metal ions at lower concentrations, especially in the presence of Fe3+metal ion and activated by metal protease inhibitor EDTA at low concentration.