One-stage reconstructing the anterior and posterior cruciate ligaments injuries with autologous hamstring tendon using TightRope devices all inside / 中华骨科杂志

Objective To analyze the feasibility and curative effects of one-stage reconstructing the anterior and posterior cruciate ligaments injuries with autologous hamstring tendon using TightRope devices all inside.Methods Thirty-four patients who suffered from the anterior and posterior cruciate ligaments injuries referred to our center from July 2013 to July 2015.Thirty-two of them with the average age 37.4±9.2 years old (range:18-61 years old),including 23 male and 9 female,were followed up over 2 years.According to the anatomy classification for knee dislocation,14 patients were KD Ⅱ type,11 patients KD Ⅲ M type,7 patients KD Ⅲ L type.The interval from injury to surgery was 4-6 weeks.One-stage reconstruction of the anterior and posterior cruciate ligaments was conducted by using autologous hamstring tendon with TightRope device all inside under arthroscopy.Ipsilateral hamstring tendon was taken in the patients of KD Ⅱ type,while opposite hamstring tendon was used in the patients of KD Ⅲ.The semitendinosus graft acted as posterior cruciate ligament,and gracilis graft acted as anterior cruciate ligament.Fold the tendon graft in half into four strands,with the length 6-7 cm,diameter 7-9 mm,and link together with two TightRope devices.The anterior and posterior cruciate ligaments injuries were reconstructed in one-stage with autologous hamstring tendon using TightRope all inside.The medial or lateral collateral ligament in patients of KD Ⅲ type was repaired.The anterior and posterior drawer test,Lachman test,valgus stress test,IKDC classification,Lysholm scores were recorded before and after surgery to evaluate the efficacy of reconstruction.Results Thirty-two patients who were treated with surgery were followed up 2-4 years with average 2.6 years.Preoperative symptoms relieved apparently in the last follow-up in all patients.The anterior and posterior drawer test and Lachman test were negative.The IKDC score of 27 patients at two years after surgery were rated as normal (84％),while that of 4 patients were rated as near normal (13％),1 patients as abnormal (3％).The rates of the normal and near normal were up to 97％.The overall score was improved from preoperation (36.4±4.6) to postoperation (90.1± 10.7,t=27.96,P=0.000).The knee function Lysholm scores was significantly increased from preoperation (52.7±5.3) to postoperation (91.5±9.2,t=23.26,P=0.000).Conclusion The one-stage reconstructing the anterior and posterior cruciate ligaments injuries with autologous hamstring tendon using TightRope devices all inside can recover the stability of knee joint with satisfied joint function postoperatively.

Vacuum sealing drainage combined with discontinuous windowing technique for repairing large area exposed wound of Achilles tendon / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effect of vacuum sealing drainage (VSD) combined with discontinuous windowing technique for repairing large area exposed wounds of Achilles tendon.</p><p><b>METHODS</b>From July 2009 to May 2014, 11 patients with large exposed wounds of Achilles tendon were treated, including 5 males and 6 females with an average age of 43 years old (aged from 7 to 65 years old). Among them, 4 cases were skin necrosis caused by heavy objects abrasion and contusion; 3 cases were caused by distal tibiofibula fractures; 3 cases were caused by bicycle-spoke injuries; 1 case was caused by diabetes. Areas of exposed Achilles tendon were from 6 cmx3 cm to 14 cmx5 cm without tendon rupture or bone exposed. After debridement, discontinuous fenestration on Achilles tendon was made by knife blade parallel with longitudinal axis of Achilles tendon, combined with Vacuum Sealing Drainage (VSD) treatment.</p><p><b>RESULTS</b>After drainage treatment with one VSD cycle (5 to 7 days), abundant fresh granulation tissues were growing on all wounds and survived well after the second phase dermatoplasty. All patients were followed up for 12 to 24 months, the color of skin flap was good, the texture was soft without burst. At 3 to 4 months after operation, subcutaneous fat was appeared under the flap, the skin was sliding, movement of ankle joints was good. No delayed Achilles tendon rupture were occurred.</p><p><b>CONCLUSION</b>Vacuum sealing drainage (VSD) combined with discontinuous fenestration is a simple, safe and effective method for repairing large area exposed wounds of Achilles tendon,which could minimize the secondary damage caused by wounds of skin flap grafting.</p>

Cervical mucinous adenocarcinoma:a pathologic analysis of twenty-one cases / 临床与实验病理学杂志

Purpose To improve the early correct diagnosis and avoid misdiagnosis of cervical mucinous adenocarcinoma.Methods Twenty-one cases of cervical mucinous adenocarcinoma were reviewed and analyzed retrospectively.The expression of CEA and Ki-67 was detected in the tumor by immunohistochemical staining (LABC method).Results Of the twenty-one cases, three cases (14.3%) were missed out, in which one was missed out by TCT and the others by biopsy; four cases (19.0%) were diagnosed by biopsy as adenocarcinoma in situ with invasion not be excluded, and then further confirmed as invasive adenocarcinoma by LEEP; one case (4.8%) was diagnosed as cervicitis at first and was further detected as adenocarcinoma by LEEP; twelve cases (57.1%) were directly diagnosed as adenocarcinoma by biopsy; one case (4.8%) was diagnosed as adenocarcinoma with unknown origin, and then as cervical adenocarcinoma after hysterectomy. Immunohistochemically, ten cases were CEA positive (47.6%) and the expression of Ki-67 was increased (>20%).Conclusions Understanding of the cytologic and histologic features of adenocarcinoma in cervix might improve its early detection and correct diagnosis, so that timely treatment is guaranteed for patients.

Effects of aldose reductase transfection on the proliferation of rat mesangial cells in vitro / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the effects of aldose reductase (AR) on the proliferation of rat mesangial cells (MsC) in vitro and to investigate its mechanism.</p><p><b>METHODS</b>Cell proliferation was assessed by MTT colorimetric assay. Cell cycle and apoptosis were analyzed by flow cytometry. The growth of normal MsC and AR transfected MsC was compared. The proliferation of PDGF-BB and cellular growth stimulation by 10% NBS were investigated using AR inhibitors (ARI) Sorbinil and Zopolrestat. The effects of PDGF-BB on the expression of AR, p65 and c-Jun were assessed by Western blot. Activation of AP-1 was measured by EMSA.</p><p><b>RESULTS</b>AR expression of transfected MsC was distinctly higher than that of the control. Transfected MsC grew quicker than normal cells. ARI partially inhibited the proliferation of transfected MsC under the stimulation of PDGF-BB and 10% NBS, whereas 10% NBS had no effect on normal MsC. PDGF-BB upregulated the expression of AR and c-Jun, but had no effect on p65. The upregulation of c-Jun and the activation of AP-1 could be attenuated by ARI.</p><p><b>CONCLUSION</b>AR may participate in the pathological proliferation of MsC through the pathway related to the activation of AP-1.</p>

Effects of aldose reductase on the expression of fibronectin and collagen IV in cultured rat renal mesangial cells / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the effect of aldose reductase (AR) on expression of fibronectin and collagen IV in cultured rat renal mesangial cells (MsC).</p><p><b>METHODS</b>AR expression plasmid vector (pCDNA3-AR) was constructed by restriction endonuclease digestion and ligation procedures. Stable expression of AR in MsC was established by Lipofectin transfection. Western blot and immunofluorescence analyses were performed to verify the transfection efficiency. Expression of fibronectin and collagen IV proteins were analyzed using Western blot.</p><p><b>RESULTS</b>Expression of fibronectin and collagen IV in naive MsC treated with TGF-beta1 was upregulated in comparison to that of the untreated naive MsC (P < 0.01). MsC transfected with pCDNA3-AR showed a remarkable increase of expression of fibronectin and collagen IV (P < 0.01). Aldose reductase inhibitors (Sorbinil and Zopolrestat) significantly inhibited the expression of fibronectin and collagen IV in naive MsC (P < 0.05).</p><p><b>CONCLUSIONS</b>Overexpression or inhibition of AR activity significantly alters the expression of fibronectin and collagen IV proteins in cultured rat MsC, suggesting that AR plays a significant role in the pathogenesis of glomerulosclersis.</p>