Effect of propofol postconditioning on necroptosis during hypoxia-reoxygenation injury in diabetic cardiomyocytes / 中华麻醉学杂志

Objective To evaluate the effect of propofol postconditioning on necroptosis during hy-poxia-reoxygenation (H∕R) injury in diabetic cardiomyocytes. Methods Normally cultured H9C2 cardio-myocytes were divided into 5 groups (n= 19 each) using a random number table: control group (group C), high glucose group (group HG), H∕R group, propofol postconditioning (group P) and solvent dimethyl sulfoxide (DMSO) control group (group DMSO). H9C2 cells were incubated for 48 h in DMEM culture medium containing 5. 5 and 25 mmol∕L glucose in group C and group HG, respectively. In group H∕R, H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then un-derwent H∕R. H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then underwent H∕R, and propofol at the final concentration of 50 μmol∕L was added at the onset of reoxygenation in group P. In group DMSO, H9C2 cells were incubated for 48 h in DMEM culture medium containing 25 mmol∕L glucose and then underwent H∕R, and DMSO at the final concentration of 150μmol∕L was added at the onset of reoxygenation. The model of cardiomyocyte H∕R injury was established by subjecting cardiomyocytes to 6 h of hypoxia followed by 12 h of reoxygenation. At 12 h of reoxygenation, the cell viability was measured by CCK8 assay, the product of lactate dehydrogenase (LDH) in culture medium was measured, the level of reactive oxygen species (ROS) was determined by flow cytometry, cardiomyo-cyte apoptosis was detected by TUNEL, and the expression of receptor-interacting protein 1 ( RIP1), RIP3, Bax, Bcl-2, activated caspase-3 and caspase-3 was determined by Western blot. The apoptotic rate and ratio of activated caspase-3∕caspase-3 were calculated. Results Compared with group C, the cell via-bility was significantly decreased, the product of LDH was increased, the level of ROS and apoptotic rate were increased, the expression of RIP1, RIP3 and Bax was up-regulated, the expression of Bcl-2 was down-regulated, and the ratio of activated caspase-3∕caspase-3 was increased in group HG ( P < 0. 05). Compared with group HG, the cell viability was significantly decreased, the product of LDH was increased, the level of ROS and apoptotic rate were increased, the expression of RIP1, RIP3 and Bax was up-regula-ted, the expression of Bcl-2 was down-regulated, and the ratio of activated caspase-3∕caspase-3 was in-creased in group H∕R (P<0. 05). Compared with group H∕R, the cell viability was significantly increased, the product of LDH was decreased, the level of ROS and apoptotic rate were decreased, the expression of RIP1, RIP3 and Bax was down-regulated, the expression of Bcl-2 was up-regulated, and the ratio of acti-vated caspase-3∕caspase-3 was decreased in group P (P<0. 05), and no significant change was found in the indexes mentioned above in group DMSO (P>0. 05). Conclusion The mechanism by which propofol post-conditioning ameliorates H∕R injury in diabetic cardiomyocytes may be related to inhibiting necroptosis.

Influence of Notch 1 in expression of EGFR in tongue squamous cell carcinoma Tca8113 cells / 吉林大学学报(医学版)

Objective:To transfect the tongue squamous cell carcinoma Tca8113 cells with NICD, and to investigate the effects of Notch 1 on Tca8113 cells and the expression of epidermal growth factor receptor (EGFR) in tongue squamous cell carcinoma.Methods: The Notch plasmid pRAMIC-IRES2-EGFP encoding exogenous and control plasmid pIRES2-EGFP were transiently transfected into the Tca8113 cells by LipofectamineTM 2000. In the experiment, target plasmid pRAMIC-IRES2-EGFP transfection group, control plasmid pIRES2-EGFP transfection group and non-transfection group were set up.RT-PCR, Western blotting and immunocytochemical method were used to observe the mRNA and protein expression levels of Notch 1 and EGFR.The proliferation activities of Tca8113 cells were detected by MTT assay,and the survival rates were calculated.Results:Compared with non-transfection group and control plasmid pIRES2-EGFP transfection group, the mRNA and protein expression levels of Notch 1 in Tca8113 cells in pRAMIC-IRES2-EGFP group was significantly increased(P0.05).Conclusion:The effect of Notch 1 on the proliferation of Tca8113 cells may be related to down-ragulatoin of expression level of EGFR.

Application of computer-assisted pre-operation plan for the treatment of geriatric intertrochanteric femoral fractures / 中华骨科杂志

Objective To discuss the curative effect of computer assisted pre-operation plan (CAPP) in treating the geriatric intertrochanteric femoral fracture.Methods The data of intertrochanteric fractures treated with PFNA-Ⅱ between March 2012 and June 2015 were retrospectively analyzed.They were divided into two groups by preoperative design.One group was the CAPP group consisting of 53 patients with a mean age of 75.3 years (range,60-92 years).According to the Evans Classification,there were 12 Evans type Ⅰb,9 Evans type Ⅰc,15 Evans type Ⅰd and 17 Evans type Ⅱ fractures.The other group was the non-CAPP group consisting of 74 patients with a mean age of 76.6 years (range,62-95 years).There were 18 Evans type Ⅰb,15 Evans type Ⅰc,20 Evans type Ⅰd and 21 Evans type Ⅱ fractures.Operation time,intraoperative blood loss,times of fluoroscopy during operation and days of hospital stay were compared.The hip joint function was evaluated by Harris score at the final follow-up.Results The CAPP meanly cost 24.7 min.The consistency of the surgery and CAPP was up to 100％.In the CAPP group,the average operation time was 46.8±6.5 min;the average times of fluoroscopy during operation were 12.0±2.3 times;and the average blood loss was 154.4±27.6 ml.In the non-CAPP group,the average operation time was 57.8±10.3 min;the average times of fluoroscopy during operation was 20.9±3.2;and the average blood loss was 235.0±65.8 ml.All above data in the CAPP group were significantly lower than those in the non-CAPP group.The mean days of hospital stay were 13.9±1.3 days in the CAPP group and 14.3±1.4 days in non-CAPP group.The days of hospital stay had no significant difference between the two groups.Forty-five patients with an average follow-up period of 18.3 months were reviewed in the CAPP group.Fifty patients were followed up with an average period of 19.2 months in the non-CAPP group.At the final follow-up,the average Harris score was 88.6±2.8 points (range,84-96 points) in the CAPP group and 87.5±3.2 points (range,80-95 points) in the non-CAPP group.Conclusion CAPP system is convenient and efficient.It can facilitate the treatment of intertrochanteric fracture effectively.

Morphological study of tibial plateau based on three-dimensional computed tomography image and its clinical significance / 中华创伤杂志

Objective To investigate the three-dimensional morphological characteristics of tibial plateau based on CT image post-processing technique and analyze its significance in preoperative planning of tibial plateau fractures.Methods Multi-slice spiral CT data of 98 humans (56 males and 42 females) with normal tibial plateau and 30 patients (15 males and 15 females) with tibial plateau fractures were extracted.Morphological measurements of the tibial plateau were achieved by means of a three-dimensional measurement method based on points,lines and surfaces.Differences in threedimensional parameters between genders in normal tibial plateau and differences between normal tibial plateau and tibial plateau fractures were analyzed.Results Differences of males and females were significant in width of tibial plateau [(73.2 ± 3.7) mm,(65.5 ± 3.7) mm],anteroposterior dimension of medial tibial plateau [(39.8 ± 3.5) mm,(34.8 ± 2.6) mm] and anteroposterior dimension of lateral tibial plateau [(34.0 ± 3.3) mm,(29.8 ± 3 5) mm] (P ＜ 0.05),but not in varus inclination of tibial plateau [(3.19 ± 1.98) °,(3.16 ± 1.89) °],medial plateau posterior slope [(7.31 ± 3.04) °,(8.16 ± 2.46)°] and lateral plateau posterior slope [(5.23 ±2.35)°,(5.60 ±2.55)°] (P ＞0.05).Above parameters in three-dimensional morphological measurements of tibibial plateau fractures varied compared to the normal reference value (P ＜ 0.05).Intraclass correlation coefficient (ICC) for intra-observe and inter-observer agreement in normal tibial plateau measurement was excellent.Conclusions Present research provides a series of scientific and objective data for preoperative planning of tibial plateau fractures.Measurements of tibial plateau can assist the evaluation of reduction of tibial plateau fractures.

Morphological characteristics of distal fibula and their clinical relevance: a research based on computer-assisted orthopaedic techniques / 中华创伤骨科杂志

Objective To provide references for anatomical reduction and correct implantation in treatment of distal fibular fracture by analyzing morphological characteristics of distal fibula on three-dimensional (3D) modes.Methods 16-row spiral CT scans of 126 normal ankle structures from May 2009 to June 2014 were collected.Surface shaded display technique was used to reconstruct 3-D images of bones around the ankle.The distal fibula was extracted using 3D segmentation technique.The parameters of distal fibula were measured by selecting points,lines and surfaces on the 3D models.Results The morphological characteristics of distal fibula were complicated.Significant differences were observed between males and females in most parameters (P ＜ 0.05),but not in the length between the plane of the most lateral point of the tibial anterior node and the most distal point of the fibula,the length between the midpoint of lateral border of the fibula and its opposite cortex on the plane of the most proximal border of the fibular fossa or the mean angle of posterior crest of the fibula (P ＞ 0.05).The intra and interclass correlation coefficients (ICC) were excellent.Conclusions When a lateral plate is used for internal fixation of distal fibula,the plate should be placed as proximally as possible.When a posterior-lateral plate is used,the screws to be inserted on the plane proximal to the initial point of anterior node of the tibia can be fixed bi-cortically.When a posterior plate is used,pre-contour of the plate before insertion is required.

Three-dimensional measurement of articular surface injury severity due to posterior malleolus fracture / 中华创伤杂志

Objective To establish a way to measure the injury severity of articular surface due to posterior malleolus fracture and investigate its clinical significance based on three-dimensional reconstruction technique.Methods Between May 2009 and March 2014,138 cases of peri-ankle injury combined with posterior malleolus fracture were treated.Lateral radiographs were reviewed to measure the ratio of posterior fragment area to distal tibial plafond area using the common method.Three-dimensional CT images were examined to measure ratio of the area of injury using the three-dimensional measuring method.Statistical comparison was made using the t-test and intraclass correlation coefficient (ICC).Results Measurement failed on 33 lateral radiographs and 13 three-dimensional CT images.Six cases cannot be measured by both imaging technology,so results of 98 cases were compared.Ratio of posterior fragment area to tibial plafond area was (16.2 ± 7.2) ％ measured by radiographs and was (29.6 ±10.1) ％ by three-dimensional CT scans (P ＜ 0.05).Three-dimensional CT measurements showed higher intra and inter-observer agreement (ICC of 0.973 to 0.942) than that in radiographic measurements (ICC of 0.875 to 0.860).Conclusion Three-dimension CT assessment of the extent of injury to articular surface because of posterior malleolus fracture is reliable and reproducible,but radiographic assessment may underestimate the injury and influence the choice of surgical indications.

Deoxyadenosine antagonized methotrexate-induced suppression of osteoclastogenesis / 实用口腔医学杂志

Objective:To study the mechanism of the effectiveness loss of methotrexate(MTX)in the treatment of rheumatoid arthri-tis.Methods:The culture system of rat whole bone marrow cells(WBMCs)and tartrateresistant acid phosphatase(TRAP)staining were utilized to evaluate osteoclastogenesis.The mRNA expression of osteoclastogenesis factors in the WBMCs culture system was examined by semi-quantitative RT-PCR.Results:Deoxyadenosine(dAdo)decreased MTX-induced suppression of osteoclastogenesis.The recov-ery effect of dAdo on MTX was partially prevented by caffeine.MTX significantly reduced mRNA expression of receptor activator of nu-clear factor kappa-B ligand(RANKL),dAdo partially recovered RANKL mRNA expression and inhibited osteoprotegerin(OPG)expres-sion.Conclusion:The accumulation of dAdo may induce the effectiveness loss of methotrexate in rheumatoid arthritis treatment.Com-bination of MTX and caffeine can be a potential therapeutic strategy.

Effect of sustentaculum tali screw placement after open reduction and internal fixation of intraarticular calcaneal fractures / 中华创伤杂志

Objective To investigate the effect of sustentaculum tali screw placement on outcomes following open reduction and internal fixation (ORIF) of intraarticular calcaneal fractures.Methods A retrospective analysis was made on 139 patients with intraarticular calcaneal fractures treated by ORIF from April 2008 to January 2012.According to Sanders classification,there were 9 patients with type Ⅱ fractures,87 with type Ⅲ fractures and 43 with type Ⅳ fractures.Fracture reduction followed by placement of calcaneal anatomic plate or anatomic locking plate was performed via calcaneal lateral L-shape incision.All the patients received X-rays and CT scans within postoperative 2 weeks.Placement of screws in sustentaculum tail was detected by CT volume rendering to visualize implants combined with multiplanar reconstruction imaging (MPR).Patients were divided into accurate fixation group (Group A,n =28),marginal fixation group (Group B,n =58),and non-fixation group (Group C,n =53) based on radiological results.Intra-and peri-operative parameters,time to partial weight-bearing,time to full weight-bearing,fracture healing time,and clinical outcome were compared among groups.Functional outcome was assessed using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale.Results Postoperative X-rays indicated accurate fixation of sustentaculum tail in 64 patients,marginal fixation in 22,and non-fixation in 53,but CT images manifested accurate fixation in 28 patients,marginal fixation in 58,and non-fixation in 53.Group A had operation duration of (93 ±11) min and intraoperative blood loss of (252 ± 27) ml,longer or higher than those in Group B [(85 ±8) min,(194±16) ml] and Group C [(57±6) min,(136 ±13) ml] (P＜O.05).There was no significant difference in mean hospital stay among the three groups (P ＞ 0.05).Ninety-two patients were followed-up for 12-38 months (mean 18.5 months) and 85 patients completed foot and ankle exercise as planned.Moreover,no significant differences were observed among groups concerning time to partial and full weight-bearing,fracture healing time and AOFAS score at the final follow-up (P ＞ 0.05).Conclusion Sustentaculum tali screw placement has no apparent effect on the short-term outcome of surgical treatment for calcaneal fractures.

Effects of hypertonic sodium chloride hydroxyethyl starch solution on cerebral vasospasm following subarachnoid hemorrhage and its mechanism / 中华危重病急救医学

Objective To investigate the protective effect and potential mechanisms of hypertonic sodium chloride hydroxyethyl starch solution (HSH) against the cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH).Methods Twenty-four male Sprague-Dawley (SD) rats were randomly assigned to four groups according to the random number table,with 6 rats in each group.The SAH-CVS model was reproduced by injection of the blood twice through the cisterna magna.Rats in both model and HSH treatment groups received 8 mL/kg normal saline (NS) or HSH treatment everyday via caudal vein.Rats in sham group were injected with 1.5 mL/kg NS into cisterna magna followed by 8 mL/kg NS treatment.Rats in normal group received no treatment.Rats were sacrificed to harvest basilar artery after 7 days.The thickness of vessel wall and lumen area were measured using hematoxylin-eosin (HE) staining.The rate of apoptosis of vascular smooth muscle cell (VSMC) was assessed using flow cytometry.Caspase-3 activity was measured by a fluorometric assay.The expressions of Bax and Bcl-2 were determined by Western Blot.Intracellular reactive oxygen species (ROS) was detected by H2DCFDA.Results Compared with normal group,increased thickness of vessel wall (μm:27.72 ± 1.94 vs.18.30 ± 1.10,P＜0.05),decreased lumen area (μm2:26 115 ± 1 991 vs.55 080 ± 2 091,P＜0.05),and elevation of rate of apoptosis of VSMCs [(35.05 ± 5.54) ％ vs.(5.93 ± 1.53) ％,P＜ 0.05] were found in model group.Compared with model group,decreased thickness of vessel wall (μm:22.55 ± 1.50 vs.27.72 ± 1.94,P＜0.05),increase of lumen area (μm2:48 115 ±2 460 vs.26 115 ± 1 991,P＜0.05),and depressed rate of apoptosis of VSMCs [(16.54 ± 5.94) ％ vs.(35.05 ± 5.54) ％,P＜ 0.05] were found in HSH treatment group.Caspase-3 activity,intracellular ROS level,Bax and Bcl-2 expressions in model group were (188.40 ± 19.35)％,(163.50 ± 17.02)％,(208.71 ± 26.04)％ and (44.52 ± 9.61) ％ of those of normal group,and the differences of these parameters between model and normal groups were statistically significant (all P＜0.05).Caspase-3 activity,intracellular ROS level,Bax and Bcl-2 expressions in HSH treatment group were (135.05 ± 19.52)％,(119.44 ± 11.50)％,(139.20 ± 18.04)％ and (85.35 ± 13.12)％ of those of normal group,respectively,and the differences of these parameters between HSH treatment and model groups were statistically significant (all P＜0.05).The differences of all measurements between sham and normal groups were not statistically significant.Conclusion The current results demonstrate that HSH attenuates the SAH-induced CVS,alleviates thickness of vessel wall,and increases lumen area via inhibition of VSMCs apoptosis.

Computer-assisted preoperative planning for proximal humeral fractures by minimally invasive plate osteosynthesis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Accurate and precise preoperative planning can provide information instrumental for performing less invasive articular fracture surgery. The purpose of this study was to determine that computer-assisted preoperative planning (CAPP) has the potential to improve efficiency and time in the operating room.</p><p><b>METHODS</b>Sixty-four patients with proximal humeral fractures were treated using locking plates by minimally invasive plate osteosynthesis (MIPO) with CAPP. The time needed for virtual segmentation, reduction, and fixation of the fracture fragments were recorded. Intra and interobserver reliabilities were analyzed using the intraclass correlation coefficient. The clinical function was analyzed using Constant Score and radiology.</p><p><b>RESULTS</b>The mean total time required for CAPP of two-part, three-part, and four-part proximal humeral fractures were (13.63 ± 1.38) minutes, (23.14 ± 2.18) minutes, and (39.61 ± 3.01) minutes, respectively. The intra and interobserver reliabilities for all variables were high, ranging from 0.785 to 0.992. The mean operation time was (50.1 ± 6.7) minutes. Fifty-two patients were followed up with an average time of 34.2 months. The mean Constant Score of the injury side was (82.5 ± 9.9). Three of the fifty-two patients had four complications.</p><p><b>CONCLUSION</b>The application of CAPP was efficient and reliable, and provided excellent clinical and radiographic outcomes for the treatment of proximal humerus fractures by MIPO.</p>

morphology of medial malleolus and its clinical relevance

To provide morphological data of medial malleolus to decrease the possibility of posterior tibial tendon injury and inadvertent ankle penetration. Computed tomography scans of the ankle in 215 patients were reviewed. Then parameters in the 3-D reconstruction images were measured by three independent, qualified observers on two separate occasions. The average angle between tibia plafond and the articular facet of the medial malleolus was 55.88 +/- 4.11°. The distance from the most anterior point of the anterior colliculus to the center of the intercollicular groove was 11.68 +/- 1.13 mm. And the average angle between the bimalleolar axis and the articular facet of the medial malleolus was 76.61 +/- 2.04°. Significant differences were observed in the distance from the most anterior point of the anterior colliculus to the center of the intercollicular groove between males and females. [P < 0.05] All of the parameters exhibited moderate to excellent intra-class correlation coefficient [ICC]. According to this study, the insertion angle is much smaller than previously believed, and adequate space only exists for two 4.0-mm screws in some large cases. The second screw will probably be near the posterior tibial tendon, especially in some small cases