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1.
Chinese Journal of Orthopaedics ; (12): 195-200, 2021.
Article in Chinese | WPRIM | ID: wpr-884698

ABSTRACT

Traumatic fracture accounts for about 50% of the total of traffic accidents. The incidence of fracture in postmenopausal women is significantly higher than that in men. About 5%-10% of patients with bone fracture will suffer from complications such as delayed union or nonunion, which seriously affects the recovery of patients after operation and increases the economic burden of families and society, however, the specific regulatory mechanism has not been fully defined. Immune cells play an important regulatory role in fracture healing, and innate immune response is the first to initiate and participate in fracture healing. Macrophages are innate immune cells which widely exist in various tissues of the body. They play a complex and precise regulatory role in fracture healing by participating in inflammatory response, osteogenic and osteoclast differentiation, mineralization and angiogenesis. Nevertheless, macrophages can be polarized into different subsets and perform different or even opposite functions under different immune microenvironments. At present, it is believed that there are three main polarization states of macrophages: non-activated M0 macrophages, classically activated M1 macrophages and selectively activated M2 macrophage. It has been shown that each subset was positively involved in the regulation process of fracture healing at different stages. Herein, in this paper, the role of different subsets of macrophages in different stages of fracture healing and the related experimental studies are reviewed, helpfully to clarify the immunological mechanism of fracture in-depth and provide new strategies for the research on the immunological intervention of fractures targeting macrophages.

2.
Chinese Journal of Orthopaedics ; (12): 137-140, 2021.
Article in Chinese | WPRIM | ID: wpr-884697

ABSTRACT

Tibial plateau fracture is a common acute trauma of the knee joint. At present, there are many studies on its classification and treatment, and minimally invasive treatment has become a research hotspot and mainstream direction of tibial plateau fracture. We summarized the clinical results of minimally invasive treatment of more than 300 cases of tibial plateau fractures, and proposed the concept of core weight-bearing area on tibial plateau, that is, the core weight-bearing area of the tibial plateau of the knee joint under normal motion statuswhile walking and moderate-intensity running. We performed thinsection CT scanning of the knee joint in a male volunteer for three-dimension finite element modeling.The results showed that during the walking state (the load was twice that of gravity), the core weight-bearing area of the medial and lateral plateaus was 389 mm 2 and 363 mm 2, accounting for 33.2% and 42.9% of tibial plateau, respectively;during the moderate-intensity running state (the load was four times that of gravity), the core weight-bearing area of the medial and lateral plateaus was 418 mm 2 and 406 mm 2, accounting for 35.6% and 48.0%of tibial plateau, respectively. Accordingly, tibial plateau fractures are supposed to be divided into core weight-bearing fracture and non-core weight-bearing fracture, and there are significant differences in the treatment ofthese twokinds of fractures: reduction is more demanding for core weight-bearing fracture,and the fracture involves the core area closely, the anatomical reduction is sought; for non-core weight-bearing area, the reduction requirements can be appropriately low demanded, and even in some cases , for example simple avulsion fracture, marginal fracture, some tibial plateau Hoffa fractures,can be treated conservatively. In summary, during clinical diagnosis and treatmentpractice, orthopedic surgeons should take the core weight-bearing area fracture as the core of diagnosis and treatment, strictly evaluate the extent of fracture involvement, select targeted internal fixation materials, and target to promote more accurate, minimally invasive, and individualized treatment of tibial plateau fractures.

3.
Article in Chinese | WPRIM | ID: wpr-884284

ABSTRACT

Objective:To investigate the contrast-enhanced ultrasound (CEUS) features of inflammatory hepatocellular adenoma (I-HCA).Methods:The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively analyzed, including arterial phase enhancement pattern, the homogeneity of enhancement, subcapsular enhancement, and the internal perfusion defect. All I-HCA lesions were divided into >5 cm group( n=9) and ≤5 cm group( n=19), the CEUS features between the two groups were compared. Results:All I-HCA lesions were hyper-enhanced in the arterial phase, among which 39.3% (11/28) showed diffuse filling, 39.3%(11/28) showed centripetal filling, and 21.4%(6/28) showed centrifugal filling pattern. Twenty-five percent (7/28) of I-HCAs showed heterogeneous enhancement, 10.7% (3/28) revealed unenhanced areas within the lesions. Subcapsular vessels were observed in 67.7 (21/31) of I-HCA lesions. Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions >5 cm ( P=0.020, 0.026, respectively), while there was no difference in the enhancement pattern and subcapsular vessels between the two groups ( P>0.05). Inportal venous phase, 42.9%(12/28) of I-HCAs showed hypo-enhancement, and 57.1%(16/28) of lesions showed washout in late phase. According to "hyper-enhancement in arterial phase, sustained hyper- or iso-enhancement in portal venous and late phase" by CEUS, the diagnostic accuracy of benign lesion was 42.9%(12/28). According to any of hyper-enhancement pattern in arterial phase, subcapsular vascular enhancement, and sustained hyper- or iso-enhancement in portal venous and late phase, the diagnostic accuracy of I-HCA was 71.4% (20/28). Conclusions:CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.

4.
Chinese Journal of Endemiology ; (12): 279-282, 2021.
Article in Chinese | WPRIM | ID: wpr-883709

ABSTRACT

Objective:To investigate the drug resistance of Yersinia pestis to 11 kinds of antibiotics in the natural foci of plague in Inner Mongolia Autonomous Region, and to provide a theoretical basis for scientifically and effectively selecting antibiotics for treatment of the plague. Methods:A total of 137 strains of Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region at different times, regions, hosts and vectors were collected. According to Clinical and Laboratory Standard Institute (CLSI), the agar plate dilution method was used to determine the minimum inhibitory concentration (MIC) of the 11 kinds of antibiotics against 137 strains of Yersinia pestis, including ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. The MIC 50 and MIC 90 (the minimum concentration of drug which could inhibit 50% and 90% of bacterial growth) were calculated, and their sensitivity was determined according to CLSI standards. Results:Among 137 strains of Yersinia pestis tested, no strains of Yersinia pestis had single or multiple resistance to ofloxacin, ciprofloxacin, kanamycin, streptomycin, ceftriaxone, ampicillin, chloramphenicol, spectinomycin, cefuroxime, tetracycline and sulfamethoxazole-trimethoprim. According to CLSI standards, 137 strains of Yersinia pestis were all sensitive to the 11 kinds of antibiotics; among them, ofloxacin, ciprofloxacin, ceftriaxone and sulfamethoxazole-trimethoprim had higher antibacterial activity, with MIC 90 < 0.250 μg/ ml; the antibacterial activity of spectinomycin was the lowest, with MIC 90 of 16.000 μg/ml. Conclusions:The Yersinia pestis isolated from the natural foci of plague in Inner Mongolia Autonomous Region is not found to have single or multiple resistance to the 11 kinds of antibiotics. Continuous drug resistance monitoring of Yersinia pestis should be carried out to provide a basis for clinical medication.

5.
Article in Chinese | WPRIM | ID: wpr-883664

ABSTRACT

Objective:To understand whether there are drug resistant and disinfectant resistant Yersinia pestis strains in China, and to provide accurate information for clinical treatment of plague. Methods:A total of 2 753 Yersinia pestis strains isolated from 10 natural plague foci in China from 1943 to 2016 were collected. According to National Center for Biotechnology Information (NCBI) released sequences of aminoglycoside streptomycin resistant genes strA, strB, β-lactam antibiotics resistant genes TEM, SHV and CTX-M, sulfamilamide resistant genes sul1, sul2 and sul3, and disinfectant resistant gene qacE△1-sul1, a pair of primers of each gene was designed for above-mentioned genes. Genomic DNA of 2 753 strains of Yersinia pestis was extracted, and the 9 target genes of all DNA samples were amplified by PCR. Results:Negative and positive controls of PCR detection were established. No corresponding target bands of aminoglycoside streptomycin resistant genes strA, strB, β-lactam antibiotics resistant genes TEM, SHV and CTX-M, sulfamilamide resistant genes sul1, sul2 and sul3, and disinfectant resistant gene qacE△1-sul1 were found in the DNA samples of 2 753 strains of Yersinia pestis.Conclusion:The above-mentioned genes of drug resistance and disinfectant resistance have not been detected in Yersinia pestis of China, but the monitoring of drug resistance of Yersinia pestis still needs to be carried out continuously.

6.
Article in Chinese | WPRIM | ID: wpr-883424

ABSTRACT

Objective:To compare the clinical characteristics and prognosis of children with necrotizing pneumonia (NP) infected by bacteria and Mycoplasma pneumoniae (MP). Methods:The clinical data of 69 children with NP from January 2012 to June 2019 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, there were 27 cases of bacterial infection NP (bacterial infection group) and 42 cases of MP infection NP (MP group). The clinical symptoms and signs, extrapulmonary complications, laboratory examination, imaging examination, treatment, outcome and follow-up were compared between 2 groups.Results:There were no significant differences in the rale rate, respiratory tone reduction rate and total fever time between 2 groups ( P>0.05); the incidence of shortness of breath in bacterial infection group was significantly higher than that in MP group: 77.8% (21/27) vs. 14.3% (6/42), and there was statistical difference ( P<0.01). There were no significant differences in the incidence of extrapulmonary complications between 2 groups ( P>0.05). The white blood cell, C-reactive protein (CRP), procalcitonin (PCT) and interleukin (IL) -10 in bacterial infection group were significantly higher than those in MP group, the tumor necrosis factor (TNF)-α and interferon (IFN) -γ in bacterial infection group were significantly lower than those in the MP group, and there were statistical differences ( P<0.05). There were no significant differences in neutrophils, lactate dehydrogenase (LDH) and IL-6 between 2 groups ( P>0.05). The time of necrosis in bacterial infection group was significantly earlier than that in MP group: (14.5 ± 4.2) d vs. (21.7 ± 6.4) d, and there was statistical difference ( P<0.05); there was no significant difference in the incidence of pleural effusion between 2 groups ( P>0.05), but the incidence of pleural effusion separation in bacterial infection group was significantly higher than that in MP group: 70.4% (19/27) vs. 2.4% (1/42), and there was statistical difference ( P<0.01). There were no significant differences in antibiotic application time, CRP recovery time and hospital stay between 2 groups ( P>0.05); the oxygen uptake rate and closed thoracic drainage rate in bacterial infection group were significantly higher than those in MP group: 88.9% (24/27) vs. 35.7% (15/42) and 25.9% (7/27) vs. 11.9% (5/42), the recovery times of WBC and PCT in bacterial infection group were significantly longer than that in MP group: (12.8 ± 4.1) d vs. (9.2 ± 2.0) d and (10.5 ± 2.5) d vs. (7.6 ± 1.9) d, the bronchoalveolar lavage rate was significantly higher than that in MP group: 25.9% (7/27) vs. 76.2% (32/42), and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the absorption time of necrotic lesions between 2 groups ( P>0.05). Conclusions:Compared with MP infection, the clinical process of bacterial infection NP is serious, the necrosis time appears earlier, and the course of disease is longer. However, most of the children with NP can obtain a good prognosis after active symptomatic and antiinfective treatment.

7.
Article in Chinese | WPRIM | ID: wpr-906005

ABSTRACT

Gegen Qinliantang, a classic traditional Chinese medicine(TCM) compound, has been verified in modern research to possess various pharmacological effects such as anti-inflammation,anti-oxidative stress,protecting intestinal mucosal barrier, and regulating intestinal flora and immune response. Ulcerative colitis (UC) is a chronic idiopathic inflammatory disease involving the colorectal mucosa, which mainly results from genetic susceptibility, intestinal mucosal barrier damage, abnormal immune response, intestinal flora disturbance, and bile acid metabolism disorders. By reviewing the literature published in recent years, this paper sorted out the relevant pathways and mechanisms involved in the treatment of UC by Gegen Qinliantang to provide ideas for further clinical and basic research. This literature review uncovered that Gegen Qinliantang exerted the therapeutic effects against UC mainly via interleukin-6(IL-6)/Janus tyrosine kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3) signaling pathway, Toll like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB) signaling pathway,Notch signaling pathway, and matrix metalloproteinase-9(MMP-9)/p38 mitogen-activated protein kinase(p38 MAPK) signaling pathway. Gegen Qinliantang regulates the intercellular molecular transmission in multiple pathways to protect the intestinal mucosal barrier, adjust the immune response and anti-oxidative stress, and relieve UC, demonstrating the multi-target, multi-mechanism, and multi-pathway advantages of TCM compounds.

8.
Article in Chinese | WPRIM | ID: wpr-905840

ABSTRACT

Objective:To quickly analyze and identify the components in raw and wine-processed products of <italic>Polygonatum cyrtonema</italic> (PC) dried rhizomes by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS), and then find out the differential components before and after processing. Method:The ACQUITY UPLC BEH C<sub>18</sub> column (2.1 mm×100 mm, 1.8 μm) was used with 0.1% formic acid aqueous solution-acetonitrile as the mobile phase for gradient elution at a flow rate of 0.25 mL·min<sup>-1</sup>. Electrospray ionization was selected for collection and detection in positive and negative ion modes, and the data were analyzed by PeakView 1.2.0.3. According to the retention time, accurate relative molecular weight and fragmentation ion information provided by MS, and combined with the reference substance and literature, the components were identified. After normalized treatment, the MS data of each sample were analyzed with principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA), and then the differential components before and after processing were screened according to the principle that variable importance in the projection (VIP) value was >1. Result:A total of 38 components were identified from raw and wine-processed products of PC dried rhizomes, including 15 steroidal saponins, 6 alkaloids, 3 flavonoids, 2 amino acids, 2 organic acids and 10 others. The results of PCA and OPLS-DA showed that there were significant differences in the contents of components in PC dried rhizomes before and after processing, and 16 differential components such as kingianoside Z, disporopsin and linoleic acid were screened. Conclusion:UPLC-Q-TOF-MS technique can accurately and comprehensively identify the components in PC dried rhizomes, these components are mainly steroidal saponins, flavonoids and alkaloids. It takes a great difference in the contents of components before and after processing, and transformation of the same category components is the main reason for the differences of raw and wine-processed products, which will provide reference for the researches on material basis and processing chemistry of PC dried rhizomes.

9.
Article in Chinese | WPRIM | ID: wpr-905066

ABSTRACT

Objective:To investigate the effect of Huangjingwan (HW) on the activities of glycogen synthase kinase-3β (GSK-3β), protein phosphatase 2A (PP2A) and the mechanism in inhibiting tau protein hyperphosphorylation in the hippocampal neurons of mice with Alzheimer's disease. Method:After subcutaneous injection with 1.0% D-galactose (0.14 g·kg-1·d-1) into the back and neck of mice for 4 weeks, the right ventricle of mice was injected with 2 μL (75 ng) of okadaic acid for one time to make AD model, and the successfully modeled AD mice were selected by Morris water maze. Then, the selected AD mice were randomly divided into AD model group, memantine group (1.3×10-3 g·kg-1·d-1) and HW group (2.5 g·kg-1·d-1). In addition, the sham model control group and the normal control group were set up. At the same time, 2 μL normal saline was injected into the right ventricle of mouse in the sham model control group for modeling control. Two weeks after modeling, the mice in the two experimental drug groups were given the corresponding dose of the experimental drug by gavage for 4 weeks. In addition, after 2 weeks of AD modeling, mice in control group and AD model group were intragastrically administrated with the same amount of normal saline daily for 4 weeks. The mice in normal control group were only given daily feed. At the end of gavage, all the mice were tested by the open field experiment and jumping platform experiment to evaluate the differences in exploratory activity ability, anxiety level and learning and memory ability. The number of neurons in CA1 and CA3 areas of hippocampus in all the mice was detected by Nissl staining. Quantitative real-time polymerase chain reaction (Real-time PCR) was used to detect mRNA expressions of GSK-3β and PP2A in hippocampus of mice in each group. Protein expressions of GSK-3β, PP2A, phosphorylated tau (p-tau) and total tau protein (t-tau) in hippocampus of mice in each group were detected by Western blot. Result:Compared with the normal control group, mice in AD model group showed an obvious dementia state, which was characterized by a lower spontaneous activity, lower exploration behavior ability, higher anxiety level, less movement and easier to stay and hide, longer learning response time, significantly increased number of learning and memory errors, and decreased numbers of hippocampal neuron in CA1 and CA3 areas, and reduced mRNA and protein expressions of PP2A, mRNA and protein expressions of GSK-3β, p-tau protein and the ratio of p-tau/t-tau were all increased significantly (P<0.01), while expression of t-tau protein was decreased, with no significant difference. Compared with the AD model group, mice in the HW group showed a higher spontaneous activity, higher exploration ability, lower anxiety level, higher learning and memory performance, and the numbers of hippocampal neuron in CA1 and CA3 areas increased, while mRNA and protein expressions of PP2A increased, and the mRNA and protein expressions of GSK-3β, the expression of p-tau protein and the ratio of p-tau/t-tau were all decreased significantly (P<0.01), but with no significant difference in the protein expression of t-tau. Conclusion:HW can inhibit tau hyperphosphorylation in hippocampal neurons of AD mice, restore tau protein function, protect hippocampal neurons, and exert an anti-AD effect, which may be related to the regulatory mechanism in the activity balance between GSK-3β and PP2A in hippocampal neurons.

10.
Article in Chinese | WPRIM | ID: wpr-905065

ABSTRACT

Objective:To explore the effect of Huangjingwan (HW) on the expressions of Wnt/β-catenin signal pathway-associated proteins in the hippocampus of mice with Alzheimer's disease (AD) induced by D-galactose and okadaic acid with learning and memory disorders, as well as its mechanism. Method:After subcutaneous injection with 1.0% D-galactose (0.14 g·kg-1·d-1) into the back and neck of mice for 4 weeks, the right ventricle of mice was injected with 2 μL(75 ng) of okadaic acid for one time to make AD model, and the successfully modeled AD mice were selected by Morris water maze. Then, the selected AD mice were randomly divided into AD model group, memantine group (1.3×10-3 g·kg-1·d-1) and HW group (2.5 g·kg-1·d-1). In addition, the sham model control group and the normal control group were set up. At the same time, 2 μL normal saline was injected into the right ventricle of mouse in the sham model control group as the modeling control. Two weeks after molding, the mice in the two experimental drug groups were given the corresponding dose of the experimental drug by gavage for 4 weeks. In addition, after 2 weeks of AD modeling, mice in sham model control group and AD model group were intragastrically administrated with the same amount of normal saline daily for 4 weeks. There was no special treatment in the normal control group. At the end of gavage, the shuttle experiment was performed to detect the differences in learning and memory levels of mice in each group. The changes of β-catenin and GSK-3β positive neurons in CA1 area of hippocampus in each group were tested by immunohistochemistry. Quantitative real-time polymerase chain reaction (Real-time PCR) was used to measure the mRNA expressions of GSK-3β, β-catenin and CyclinD1 in hippocampus of mice in each group. The Western blot was used to detect the expressions of total GSK-3β (t-GSK-3β), phosphorylation of GSK-3β at Ser9 (p-Ser9-GSK-3β), phosphorylation of GSK-3β at Tyr216 (p-Tyr216-GSK-3β), total β-catenin (t-β-catenin), phosphorylation of β-catenin (p-β-catenin) and CyclinD1 proteins in hippocampus of mice in each group. Result:Compared with the normal control group, mice in AD model group showed an obvious dementia state, which was characterized by significant declines in learning and memory ability, the number of β-catenin immunoreactive neurons in hippocampal CA1 area, the mRNA and protein expressions of t-β-catenin and CyclinD1, the protein expressions of p-Ser9-GSK-3β, and the ratio of p-Ser9-GSK-3β/t-GSK-3β and p-Tyr216-GSK-3β/t-GSK-3β in hippocampal region (P<0.01), and significant increases in the number of GSK-3β immunoreactive neurons in hippocampal CA1 area, the mRNA and protein expressions of t-GSK-3β, the protein expressions of p-Tyr216-GSK-3β and p-β-catenin, the ratio of p-β-catenin/t-β-catenin in hippocampal region (P<0.01 respectively). Compared with the AD model group, the dementia symptoms of mice in HW group were significantly alleviated, and the number of β-catenin immunoreactive neurons in hippocampal CA1 area, the mRNA and protein expressions of t-β-catenin and CyclinD1, the protein level of p-Ser9-GSK-3β, the ratio of p-Ser9-GSK-3β/t-GSK-3β in hippocampal region were all significantly increased (P<0.01 respectively), whereas the number of GSK-3β immunoreactive neurons in hippocampal CA1 area, the mRNA and protein expressions of t-GSK-3β, the proteins expressions of p-Tyr216-GSK-3β and p-β-catenin, the ratio of p-β-catenin/t-β-catenin in hippocampal region were all significantly decreased (P<0.01 respectively), but the ratio of p-Tyr216-GSK-3β/t-GSK-3β has no significant statistical difference. Conclusion:HW shows the role of AD treatment, which can down-regulate the expression of GSK-3β in the hippocampus of AD mice and reduce its protein activity, and up-regulate the expression of β-catenin as well as increase its protein activity, so as to enhance the expression of downstream CyclinD1 and promote the transcription of the target genes. Its mechanism may be related to the activation of Wnt/β-catenin signal pathway.

11.
Article in English | WPRIM | ID: wpr-890394

ABSTRACT

BackgroundSkeletal muscle is the largest tissue in the human body, and it plays a major role in exerting force and maintaining metabolism homeostasis. The role of muscle transcription factors in the regulation of metabolism is not fully understood. MondoA is a glucose-sensing transcription factor that is highly expressed in skeletal muscle. Previous studies suggest that MondoA can influence systemic metabolism homeostasis. However, the function of MondoA in the skeletal muscle remains unclear.MethodsWe generated muscle-specific MondoA knockout (MAKO) mice and analyzed the skeletal muscle morphology and glycogen content. Along with skeletal muscle from MAKO mice, C2C12 myocytes transfected with small interfering RNA against MondoA were also used to investigate the role and potential mechanism of MondoA in the development and glycogen metabolism of skeletal muscle.ResultsMAKO caused muscle fiber atrophy, reduced the proportion of type II fibers compared to type I fibers, and increased the muscle glycogen level. MondoA knockdown inhibited myoblast proliferation, migration, and differentiation by inhibiting the phosphatase and tensin homolog (PTEN)/phosphoinositide 3-kinase (PI3K)/Akt pathway. Further mechanistic experiments revealed that the increased muscle glycogen in MAKO mice was caused by thioredoxin-interacting protein (TXNIP) downregulation, which led to upregulation of glucose transporter 4 (GLUT4), potentially increasing glucose uptake.ConclusionMondoA appears to mediate mouse myofiber development, and MondoA decreases the muscle glycogen level. The findings indicate the potential function of MondoA in skeletal muscle, linking the glucose-related transcription factor to myogenesis and skeletal myofiber glycogen metabolism.

12.
Article in Chinese | WPRIM | ID: wpr-879453

ABSTRACT

OBJECTIVE@#To explore clinical effect of locking plate external fixation combined with membrane induction technology in treating open and comminuted tibial fractures with bone defects.@*METHODS@#Totally 92 patients of open and comminuted tibial fractures with bone defects were chosen form January 2018 to July 2019, and randomly divided into external fixation group and internal fixation group, 46 patients in each group. In external fixation group, there were 29 males and 17 females, aged from 25 to 62 years old, with an average of (37.45±10.92) years old;according to AO classification, 15 patients were type A, 22 patients were type B and 9 patients were type C;according to Gustilo classification, 21 patients were typeⅡ, 10 patients were type ⅢA, 10 patients were type ⅢB, 5 patients were type Ⅲ C;treated by fracture reduction with locking plate external fixation. In internal fixation group, there were 31 males and 15 females, aged from 23 to 60 years old, with an average of(36.88±10.64) years old;according to AO classification, 18 patients were type A, 20 patients were type B and 8 patients were type C; according to Gustilo classification, 22 patients were typeⅡ, 11 patients were type ⅢA, 7 patients were type ⅢB, 6 patients were type Ⅲ C;treated by traditional open reduction with plate internal fixation. Operation time, intraoperative blood loss, incision length, hospital stay, fracture healing time and lower limb full weight-bearing time and postoperative complications between two groups were observed and compared, bone mineral density, osteocalcin, blood calcium and phosphorus before operation and 1 month after operation.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (14.92±2.46) months. Operation time, intraoperative blood loss, incision length, hospital stay, fracture healing time and lower limb full weight-bearing time of external fixation group were significantly better than that of internal fixation group(@*CONCLUSION@#Locking plate external fixation combined with membrane induction technology in treating open and comminuted tibial fractures with severe post-traumatic bone defects has advantages of less trauma, reliable fixation, shorter fracture healing time, and could improve bone metabolic activity with less postoperative complications.


Subject(s)
Adult , Bone Plates , External Fixators , Female , Fracture Fixation , Fracture Fixation, Internal , Fractures, Comminuted/surgery , Humans , Male , Middle Aged , Technology , Tibial Fractures/surgery , Treatment Outcome , Young Adult
13.
Article in Chinese | WPRIM | ID: wpr-912676

ABSTRACT

Objective:To determine the clinical effect of sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser for hypertrophic scar. Methods:A total of 80 hypertrophic scar patients, including 45 male and 35 female, in our clinic were randomly divided into test ( n=40) and control ( n=40) groups from March 2019 to May 2020. Patients aged from 18-42 years with average age 28.1. Patients in test groups were treated with triamcinolone acetonide and lattice CO 2laser sequentially. After final treatments, third-party blind evaluation, Vancouver scar scale, visual analog scale and dermatology life quality index were performed. Results:Test group acquired more satisfied result in third-party blind evaluation (82.5% vs. 52.5%, χ2=8.216, P<0.05). Vancouver scar scale, visual analog scale and dermatology life quality index were not significantly different before treatment for both groups while test group acquired better improvement after treatment ( P<0.05). Conclusions:Sequential therapy by local injection of triamcinolone acetonide and lattice CO 2laser is effective for hypertrophic scar and worths wide application in the clinic.

14.
Chinese Journal of Anesthesiology ; (12): 1212-1217, 2021.
Article in Chinese | WPRIM | ID: wpr-911344

ABSTRACT

Objective:To evaluate the role of reactive oxygen species (ROS)-mediated mitochondrial pathway of apoptosis in long-term cognitive impairment induced by multiple exposures to sevoflurane in the neonatal rats.Methods:Sixty SPF healthy neonatal Sprague-Dawley rats, weighing 12-20 g, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), multiple exposures to sevoflurane for anesthesia group (group S) and ROS inhibitor group (group A). Group S and group A inhaled 3% sevoflurane for 2 h starting from 6, 7 and 8 days after birth, while group C inhaled air.In group A, ROS inhibitor N-acetylcysteine (NAC) 150 mg/kg was intraperitoneally injected before each anesthesia with sevoflurane.The spontaneous activity was evaluated by open field test on day 35 after birth.The cognitive function was determined by Morris water maze test on day 36 after birth.The rats were sacrificed after the end of Morris water maze test, and the hippocampal tissues were obtained for determination of the apoptosis rate of hippocampal neurons, reactive oxygen species (ROS) and mitochondrial membrane potential (MMP) (by flow cytometry) and levels of Cyt c and cleaved caspase-9 and caspase-3 (by Western blot). The expression of Bcl-2 and Bax mRNA was detected by real-time polymerase chain reaction.The ultrastructure of mitochondria in hippocampal neurons was observed with a transmission electron microscope. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the apoptosis rate of hippocampal neurons and levels of ROS and MMP were increased, the expression of Cyt c, cleaved caspase-9, cleaved caspase-3 and Bax mRNA was up-regulated, the expression of Bcl-2 mRNA was down-regulated, the ratio of Bax/Bcl-2 was increased ( P<0.05), mitochondria were swollen, and mitochondrial cristae structure was broken in group S. Compared with group S, the escape latency was significantly shortened, the number of crossing the original platform was increased, the apoptosis rate of hippocampal neurons and levels of ROS and MMP were decreased, the expression of Cyt c, cleaved caspase-9, cleaved caspase-3 and Bax mRNA was down-regulated, the expression of Bcl-2 mRNA was up-regulated, the ratio of Bax/Bcl-2 was decreased ( P<0.05), and the mitochondrial swelling and rupture of cristae structure were improved in group A. Conclusion:The mechanism by which multiple exposures to sevoflurane induce long-term cognitive impairment may be related to activating the ROS-mediated mitochondrial pathway of apoptosis in neonatal rats.

15.
Chinese Journal of Anesthesiology ; (12): 1087-1091, 2021.
Article in Chinese | WPRIM | ID: wpr-911322

ABSTRACT

Objective:To evaluate the effect of pre-infusion of young rat plasma on cognitive dysfunction induced by sevoflurane in aged rats and the role of extracellular regulated protein kinase (ERK)-cyclic adenosine monophosphate effector binding protein (CREB) signaling pathway.Methods:One hundred and twenty SPF healthy male Wistar rats, aged 18 months, weighing 550-650 g, were divided into 4 groups ( n=30 each) using a random number table method: control group (group C), sevoflurane anesthesia group (group S), young rat plasma group (group P) and ERK inhibitor SL327 group (group SL). The teated plasma 100 μl from 3-month-old young rats was injected via the tail vein in group P and group SL, while the equal volume of normal saline was given via the tail vein in group C and group S, twice a week, for 4 weeks.In S, P and SL groups, 3% sevoflurane was inhaled for 3 h at the end of injection, and ERK inhibitor SL327 50 mg/kg was injected via the tail vein before anesthesia in group SL.The cognitive function was evaluated by Morris water maze test at 1 day before anesthesia and at 3 and 7 days after anesthesia.The rats were sacrificed, and their hippocampi were isolated for determination of the expression of phosphorylated ERK (p-ERK), p-CREB, synapsin, synapsin Ⅰ and synaptophysin and for examination of the ultrastructure of neurons (by transmission electron microscopy). The number of synapses was recorded. Results:Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of p-ERK, p-CREB, synapsin, synapsin Ⅰ and synaptophysin was down-regulated, and the number of synapses was decreased at each time point after anesthesia in the other 3 groups ( P<0.05). Compared with group S, the escape latency was significantly shortened, the number of crossing the original platform was increased, the expression of p-ERK, p-CREB, synapsin, synapsin Ⅰ and synaptophysin was up-regulated, and the number of synapses was increased at each time point after anesthesia in P and SL groups ( P<0.05). Compared with group P, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of p-ERK, p-CREB, synapsin, synapsin Ⅰ and synaptophysin was down-regulated, and the number of synapses was decreased in group SL ( P<0.05). Conclusion:Pre-infusion of young rat plasma can reduce cognitive dysfunction induced by sevoflurane in aged rats, and the mechanism is related to activation of ERK-CREB signaling pathway and improvement of synaptic plasticity.

16.
Chinese Journal of Urology ; (12): 819-823, 2021.
Article in Chinese | WPRIM | ID: wpr-911126

ABSTRACT

Objective:To investigate the feasibility and safety of the transvesical approach of robot-assisted radical prostatectomy.Methods:From June 2017 to May 2020, 41 patients underwent transvesical approach of robot-assisted radical prostatectomy. The patients’ mean age was 62.5(51-69)years. The mean prostate volume was 36.3(22.0-57.8)ml. The mean preoperative PSA value was 7.3(3.7-12.3)ng/ml. All preoperative Gleason score was less than or equal to 7 points and preoperative TNM stage ranged from T 2a to T 2b . All patients were diagnosed by prostate biopsy before surgery or pathological diagnosis after prostate enucleation. Robot-assisted radical prostatectomy through the longitudinal incision of the bladder neck was used. It was easy to identify and preserve the bladder neck during the operation. The bladder was opened with a small longitudinal incision, and the prostate was removed intrafascial. The pubic prostatic ligament and pudendal artery were fully preserved to achieve complete reduction of the anatomical structure. Results:All the operations were completed by robot-assisted radical prostatectomy with no transition to open surgery. The mean surgery time was 111.3(105-131)min. The mean estimated blood loss was 95.5 (50-220) ml. The mean postoperative hospital stay was 5.2(3-8)d. The time of postoperative catheter removal was 6.3(5-7)d. After 6 to 24 months of follow-up, 35 patients (85.4%, 35/41) received immediate recovery of continence, 4 patients had no urine leakage after 1 week, and 2 patients had no urine leakage after 1 month. All patients had regained continence 6-month postoperatively. No tumor biochemical recurrence (tPSA<0.2 ng/ml).Conclusions:The transvesical approach of robot-assisted radical prostatectomy was a safe and effective surgical technique, which was beneficial in early continence recovery, and also suitable for prostate cancer patients after prostate enucleation.

17.
Chinese Journal of Urology ; (12): 717-720, 2021.
Article in Chinese | WPRIM | ID: wpr-911102

ABSTRACT

Prostate cancer (PCa) is one of the most common invasive cancers in men. Radical prostatectomy is the gold standard for localized prostate cancer, but the postoperative biochemical recurrence rate can reach 20%-50%. In some cases, salvage lymph node dissections (SLND) seem to improve cancer control and delay systemic treatment. In this article, we review the current state of diagnostic imaging, accurate patient selection criteria, exploration of SLND surgical procedures, as well as the safety and tumor outcomes of SLND. Overall, although there is still a lack of strong prospective evidence to support the role of SLND, advances in preoperative imaging techniques and the widespread use of minimally invasive surgery have led to encouraging tumor outcomes with SLND. However, further large-scale and high quality trials are needed to confirm the effectiveness and safety of SLND.

18.
Chinese Journal of Urology ; (12): 581-585, 2021.
Article in Chinese | WPRIM | ID: wpr-911076

ABSTRACT

Objective:To explore the detection rate of prostate cancer and clinically significant prostate cancer (CsPCa) in three puncture methods: targeted biopsy fusion with MRI and ultrasound imaging, system puncture, and combined puncture.Methods:The clinical data of 164 patients who underwent both targeted biopsy and systematic biopsy in Zhejiang Provincial People's Hospital from April 2019 to April 2020 were retrospectively analyzed. The median age was 67(33-90)years. Preoperative serum tPSA was 8.97(0.64-95.63)ng/ml and fPSA was 1.31(0.29-9.25)ng/ml. There were 96 patients result in tPSA<10 ng/ml, 65 and 3 patients result in 10≤tPSA<50 ng/ml and tPSA≥50 ng/ml. The prostate volume was 34.9(11.6-152.0) cm 3. According to result of PI-RADS score, there were 42 patients got 3 points and 66, 56 patients got 4 and 5 points respectively in PI-RADS score of suspicious nodules. First, a targeted puncture (targeted biopsy) was performed on the suspected lesions by fusion imaging of magnetic resonance and ultrasound. Then 12-needle systematic prostate biopsy was performed under the guidance of ultrasound. Those two methods performed together was called combined biopsy. This study compared the detection rates of prostate cancer and CsPCa among the three popular methods in all cases, different PI-RADS cases, and different tPSA cases. Results:In this study, patients was detected as positive result in 126 of 164 patients. The detection rates of prostate cancer in targeted biopsy and systematic biopsy were 66.46%(109/164) and 64.02%(105/164), respectively, the result reveals no statistical significance ( P=0.64). In contrast, the positive rate of combined biopsy [76.83%(126/164)] was higher than targeted biopsy ( P=0.04) and systematic biopsy ( P=0.01), and the difference was statistically significant. In the detection rate of CsPCa, the positive detection rates of targeted biopsy group, systematic biopsy group and combined biopsy group were 50.61%(83/164), 45.12%(90/164) and 54.88% (126/164), respectively. Moreover, there was no significant statistical significance among the three groups ( P>0.05). Group comparison was analyzed according to PI-RADS score. In PI-RADS 4 group and PI-RADS 5 group, combined biopsy was[90.91%(60/66), 100.00%(56/56)] and systematic biopsy was [71.21%(47/66), 87.50%(49/56)] which reveals significant difference in prostate cancer detection rates ( P=0.00, P=0.01). In PI-RADS 4-5 groups, the detection rate of prostate cancer by targeted biopsy [86.89%(106/122)] was significantly higher than systematic biopsy [78.69%(96/122), P=0.01], but still lower than that by combined biopsy [95.08%(116/122), P=0.03]. The CsPCa detection rates of PI-RADS 3 group targeted biopsy, systematic biopsy and combined biopsy were 2.38%(1/42), 7.14%(3/42) and 7.14%(3/42), respectively. There were 59.09%(39/66), 46.97%(31/66) and 62.12%(41/66) in PI-RADS 4 groups, respectively; There were 78.57%(44/56), 71.43%(40/56) and 82.14%(46/66) in PI-RADS 5 groups, respectively, with no statistical significance ( P>0.05). However, in PI-RADS 4-5 groups, the CsPCa detection rate of combined biopsy [71.31%(87/122)] was higher than that of systematic biopsy [58.20%(71/122)], with statistical significance ( P=0.03). In the tPSA<10 ng/ml group, the prostate cancer detection rate of combined biopsy[72.92%(70/96)] was higher than that of systematic biopsy[59.38%(57/96)], and the difference was statistically significant ( P<0.05). There was no significant difference between the detection rate of targeted biopsy[61.43%(59/96)]and combined biopsy ( P=0.09). In the group of 10ng/ml≤tPSA<50ng/ml, the prostate cancer detection rates of targeted biopsy, systematic biopsy and combined biopsy were 72.31%(47/65), 69.23%(45/65) and 81.54%(53/65), respectively, and there was no statistical significance ( P>0.05). In tPSA≥50 ng/ml group, the prostate cancer detection rate of the three biopsy methods was 100.00% (3/3), and there was no statistical significance ( P>0.05). Conclusion:For patients with highly suspected prostate cancer on multiparameter MRI(PI-RADS 4-5) or tPSA<10 ng/ml, combined biopsy was an appropriate method to diagnose the prostate cancer.

19.
Chinese Journal of Orthopaedics ; (12): 1361-1366, 2021.
Article in Chinese | WPRIM | ID: wpr-910723

ABSTRACT

Objective:To compare the biomechanical properties of triangular supporting fixation and Gamma nail fixation for intertrochanteric fractures of the femur.Methods:The femoral CT imaging data provided by a healthy adult male volunteer aged 40 years, height 172 cm, and weight 75 kg were used to reconstruct the femur model using Mimics 21.0 software and Geomagics 2013 software. Evans type I intertrochanteric fracture models were established using UG12.0 software, and Gamma nail and triangular supporting intramedullary nail models were reconstructed to simulate intertrochanteric fracture internal fixation, respectively. In Abaqus software, two internal fixation models of Gamma nail and triangular supporting intramedullary nail in standing state are simulated, and the stress peaks of the main nail, fixation screw and bone substance were collected, also the stress peak of supporting screw of the triangular supporting intramedullary nail is obtained. Additionally, the maximum displacement of the fracture model fixed by Gamma nail and triangular supporting intramedullary nail is measured.Results:Under the load of 1 200 N, the peak stress of the two fracture internal fixation models was located in the main nail, in which the peak stress of the triangular supporting intramedullary nail was 233.73 MPa, which was 11.9% lower than that of the Gamma nail (265.21 MPa); the peak stress of the fixation screw was located in the contact area between the pressure screw and the main nail, which was 23.2% lower in triangular supporting intramedullary nail than that of the Gamma nail (138.86 MPa vs. 180.75 MPa); the peak stress of the bone model was located in the medial cortex of the femur, which was 61.67 MPa and 32.38 MPa, respectively, 47.5% lower in the triangular supporting intramedullary nail than that of the Gamma nail; the peak stress of the supporting screw in the triangular supporting intramedullary nail was 92.04 MPa. The maximum displacement of the fracture model fixed with triangular supporting intramedullary nail was 17.34 mm, which was 10.5% less than the maximum displacement of the fracture model fixed with Gamma nail (19.37 mm). Conclusion:Compared with Gamma nail, triangular supporting intramedullary nail fixation can significantly improve the stability of intertrochanteric fractures and stress distribution as well as reduce stress peak and stress concentration area, which is helpful to improve the efficacy of intertrochanteric fractures.

20.
Article in Chinese | WPRIM | ID: wpr-910308

ABSTRACT

Objective:To analyzes the current status of radiation protection in non-medical sectors, together with the vulnerable spots in the prevention and control of occupational radiation sickness in China in order to provides both technical basis for occupational health management in non-medical radiation sectors and the better protection of occupational health benefits for radiation workers.Methods:The monitoring plan for this survey was worked out on the part of the National Institute for Radiological Protection, China CDC. Survey and monitoring of the current status of radiation protection and occupational health management were, under the monitoring the plan, completed by the relevant agencies of all provincial-level regions for the key industries of non-medical sectors countrywide, involving occupational health monitoring, personal dose monitoring, radiation protection monitoring instruments equipped, and radiation protection monitoring in workplace. Based on the survey result , the deficiencies in radiation protection and occupational health monitoring in non-medical sectors were analyzed.Results:The survey of non-medical sectors was divided into general investigation and detailed monitoring, with the general investigations covering 9 075 non-medical institutions in 31 provincial-level regions across the country. Of them, a total of 4 911 institutions within 329 district-level regions received detailed investigation and radiation protection monitoring. As survey result , the X, γ ambient dose equivalent rates for the institutions using ray-generator are greater than 2.5 μSv/h, about 2.35% of the total, with a maximum of 817 μSv/h. The values for those using radioactive sources were greater than 2.5 μSv/h, about 9.57%, with a maximum of 1 700 μSv/h. The frequencies of personal dose monitoring and occupational health examination were 72.9% and 82.1%, respectively.Conclusions:There is still a gap in radiation protection between the current status and the national regulations and standards in non-medical sectors, so both regulation and management of radiation protection should be further strengthened.

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