The therapeutic effect between metal augment and impacted bone grafting in the hip revision of acetabular bone defect / 医学研究生学报

Objective The application of metal augments in the revision of total hip arthroplasty(THA)has achieved re-markable results in the treatment of bone defects.However,there are limited studies compared this effective method with the traditional treatment.The purpose of this article is to investigate the curative effect of both metal augmentation and impacted bone grafting in the revision of acetabular bone defect. Methods We retrospectively analyzed 20 patients(20 hips)with bone defects after THA in Au-thority of Nanjing General Hospital of Nanjing Military Region from August 2010 to February 2017.These 20 patients were allocated into 2 groups:impacted bone grafting group(n=11,filling acetabular bone defect with autogenous iliac bone and artificial bone)and metal aug-mentation group(n=9,filling acetabular bone defect with metal aug-ment).The duration of surgery,blood loss and the hospital for special surgery knee score(HSS)were compared between these two groups and the Harris score was applied to evaluate the hip function and full weight bearing. Results The surgery duration and blood loss of impacted bone grafting group were significantly increased when compared with the metal augmentation group(44.5±7.82 min vs 36.22±5.19 min and 431.82±57.76 mL vs 333.33±72.80 mL respec-tively).there were 3 cases showed mild bone resorption in the I regions in the impacted bone grafting group, while only one case showed mild bone resorption in the II region in the metal augmentation group.The HSS scores in the metal augmentation group were higher than those in the impacted bone grafting group at the time of postoperative 2 weeks(43.89±2.76 vs 40.82±4.42), 3 months (49.89±2.03 vs 45.27±3.90)and 6 months(53.44±2.46 vs 50.55±3.67), the differences were statistically significant(P<0.001). The Harris scores in the metal augmentation group were higher than those in the impacted bone grafting group(P<0.01).The metal augmentation group had a shorter time of getting out of bed compared with the impacted bone grafting group(P<0.01). Conclusion For those patients with upper acetabular bone defect,revision surgery using metal augments can save the operation time.Meanwhile, it is also superior to the impacted bone grafting in the early prosthesis stability and bone ingrowth,and thus enables to shorten the time on getting out of bed and promote functional.

Qualitative analysis of platelet rich plasma prepared by acute plateletpheresis in patients undergoing heart surgery / 中国实验血液学杂志

This study was aimed to evaluate the efficiency and effectiveness of platelet-rich plasma(PRP) prepared by acute plateletpheresis in patients undergoing open heart surgery, and to analyze the quality of prepared platelet-rich plasma. Whole blood from 20 patients with ASAII-III was collected and PRP was harvested by machine after induction of anesthesia. Platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW), plasma pH, plasma lactic acid (LA) concentration, and lactic dehydrogenase (LDH) concentration, germiculture result, CD62p and PAC-1 positive rate of inactivated and activated platelets by ADP in the whole blood before plateletpheresis (T1) , in the PRP after plateletpheresis (T2) and PRP before back-transfusion (T3) were determinated. The results showed that as compared with whole blood the platelet count in the PRP at T2 was (783 ± 184) ×10(9)/L, MPV, PDW and pH significantly decreased (P < 0.01) , while the plasma LDH, LA concentration, CD62p and PAC-1 positive rate of inactivated platelets were not significantly different from the whole blood at T1. In the PRP at T3, the platelet count, MPV, PDW and pH significantly decreased (P < 0.01) , while plasma LDH concentration, CD62p and PAC-1 positive rate of inactivated platelet significantly increased (P < 0.05 or P < 0.01) compared with the whole blood at T1. There were no significant difference among the CD62p and PAC-1 positive rate of activated platelets in the whole blood and PRP. It is concluded that PRP can be efficiently obtained from the patients undergoing open heart surgery by acute plateletpheresis, and the platelets in PRP are not activated during the preparing process. Some platelets in PRP are activated during the preserving process, but the whole activating function of platelets keeps normal.

Regular intermittent bolus provides similar incidence of maternal fever compared with continuous infusion during epidural labor analgesia

To compare the effects of regular intermittent bolus versus continuous infusion for epidural labor analgesia on maternal temperature and serum interleukin-6 [IL-6] level. This randomized trial was performed in Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China between October 2012 and February 2014. Either regular intermittent bolus [RIB, n=66] or continuous infusion [CI, n=66] was used for epidural labor analgesia. A bolus dose [10 ml of 0.08% ropivacaine + 0.4 microg·ml[-1] sufentanil] was manually administrated once an hour in the RIB group, whereas the same solution was continuously infused at a constant rate of 10 ml·h[-1] in the CI group. Maternal tympanic temperature and serum IL-6 level were measured hourly from baseline to one hour post partum. The incidences of fever [>/= 38°C] were calculated. The incidence of maternal fever was similar between the 2 groups. There was a rising trend in mean temperature over time in both groups, but no statistical difference was detected between the groups at respective time points; maternal serum IL-6 showed similar changes. Compared with continuous infusion, regular intermittent bolus presents with the same incidence of maternal fever for epidural labor analgesia. Interleukin-6 elevation could be involved in mean maternal temperature increase

Clinical Study on the Treatment of Adriamycin-induced Cardiotoxicity with the Method of Nourishing Yin / 国际中医中药杂志

Objective To investigate the preventive effect of treating cardiotoxicity induced by adriamycin (ADM) with the method of nourishing yin. Methods 90 cancer patients underwent adriamycin therapy were randomly recruited intoa treatment group (45 cases) and a control group (45 cases). The treatment group was treated with Wushen decoction, while the control group was treated with antioxidant drugs. The changes of ECG, blood SOD, GSH-Px, MDA content etc were observed after one course of four weeks' treatment. Results The incidence of cardiactoxicity was 15.56% in the treatment group and 40.00% in the control group, showing significant difference ( U=2.02, P<0.05 ) ; the incidence of ECG abnormalities was 13.33% in the treatment group and 37.78%, in the control group, showing significant difference (U= 2.18, P< 0.05 ) : the effective rate was 82.22% in the treatment group and 62.22% in the control group, showing significant difference ( U=2.18, P <0.05) ; and SOD, GSH-Px, MDA content at the 1, 7, 14, and 28days between the two groups also demonstrated significant differences (P<0.05) . Conclusion The method of nourishing yin has excellent attenuation to adriamycin-induced cardiotoxicity, besides it enhances therapeutic effects of chemotherapy.

Heat shock protein 27 regulates oxidative stress-induced apoptosis in cardiomyocytes: mechanisms via reactive oxygen species generation and Akt activation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Increased reactive oxygen species (ROS) formation, which in turn promotes cardiomyocytes apoptosis, is associated with the pathogenesis and progression of various cardiac diseases such as ischemia and heart failure. Recent studies have shown that over expression of heat shock protein 27 (Hsp27) confers resistance to cardiac ischemia/reperfusion injury. However, not much is known about the regulation of myocyte survival by Hsp27.</p><p><b>METHODS</b>The rat cardiac cell line H9c2, with a stable overexpression of Hsp27, was established, with empty vector transfected H9c2 cells as controls. Following the cells challenged by Hydrogen Peroxide (H2O2), lactate dehydrogenase (LDH) release, apoptosis, intracellular ROS, cell morphology, mitochondrial transmembrane potential and the activation of serine/threonine kinase Akt were determined.</p><p><b>RESULTS</b>Along with marked suppression of H2O2-induced injury by Hsp27 overexpression in H9c2 cells, ROS generation and the loss of mitochondrial membrane potential were also significantly depressed. Furthermore, augmented Akt activation was observed in Hsp27 overexpressed H9c2 cells following H2O2 exposure.</p><p><b>CONCLUSIONS</b>Hsp27 inhibits oxidative stress-induced H9c2 damage and inhibition of ROS generation and the augmentation of Akt activation may be involved in the protective signaling.</p>