Arthroscopic irrigation combined with open debridement in the treatment of shoulder infection after arthroscopic rotator cuff repair / 中华骨科杂志

Objective@#To investigate the clinical efficacy of arthroscopic irrigation combined with surgical debridement in the treatment of shoulder infection after arthroscopic rotator cuff repair.@*Methods@#Data of 4 post-operative infected patients [(male 3 cases, female 1 case; 55 years (51-61 years)] after arthroscopic rotator cuff repair who underwent arthroscopic irrigation combined with surgical debridement from January 2016 to June 2019 were retrospectively analyzed. Less than 1 month after surgery, swelling, pain in the surgical area occurred and all patients had fever, abscess and sinus. Hematology and radiology were conducted immediately after admission. Antibiotic treatment was applied, and adjusted according to the culture results timely. All patients underwent arthroscopic irrigation combined with surgical debridement. Antibiotics continued accordingly after the operation. Blood routine, erythrocyte sedimentation rate, C-reactive protein, X-ray, etc. were rechecked regularly to evaluate the symptomatic relief of the infection and prognosis. Visual analogue scale (VAS) and American Shoulder and Elbow Surgeons (ASES) score were used to evaluate shoulder function during the pre-operative and post-operative follow-up period.@*Results@#The surgery was successfully completed in all 4 patients. One was treated with VSD for vacuum suction and the wound was closed one week later. The results of microbial culture showed that 2 cases were Mycobacterium tuberculosis positive, 1 case Pseudomonas aeruginosa positive, and 1 case was Staphylococcus aureus positive. After treatment, the shoulder sinuses of all patients were healed, without swelling, pain, etc. The follow-up time was 3, 4, 32, and 33 months, respectively. There was no recurrence of infection until the latest follow-up. The joint mobility and scores were better than the situation of preoperative. The VAS score and ASES score of 2 patients with early debridement (< 1 month duration of infected symptoms) were respectively improved significantly from 5 and 40, 6 and 23 before operation to 1 and 80, 1 and 73 respectively at the latest follow up. The VAS score and ASES score of other 2 patients (> 6 months duration of infected symptoms) were respectively improved from 6 and 28, 6 and 32 to 1 and 62, 2 and 65 respectively. All patients were satisfied with the results.@*Conclusion@#Early arthroscopic irrigation combined with surgical debridement is an effective method to treat the post-operative infections after arthroscopic rotator cuff repair.

Arthroscopic irrigation combined with open debridement in the treatment of shoulder infection after arthroscopic rotator cuff repair / 中华骨科杂志

Objective To investigate the clinical efficacy of arthroscopic irrigation combined with surgical debridement in the treatment of shoulder infection after arthroscopic rotator cuff repair.Methods Data of 4 post-operative infected patients [(male 3 cases,female 1 case;55 years (51-61 years)] after arthroscopic rotator cuff repair who underwent arthroscopic irrigation combined with surgical debridement from January 2016 to June 2019 were retrospectively analyzed.Less than 1 month after surgery,swelling,pain in the surgical area occurred and all patients had fever,abscess and sinus.Hematology and radiology were conducted immediately after admission.Antibiotic treatment was applied,and adjusted according to the culture results timely.All patients underwent arthroscopic irrigation combined with surgical debridement.Antibiotics continued accordingly after the operation.Blood routine,erythrocyte sedimentation rate,C-reactive protein,X-ray,etc.were rechecked regularly to evaluate the symptomatic relief of the infection and prognosis.Visual analogue scale (VAS) and American Shoulder and Elbow Surgeons (ASES) score were used to evaluate shoulder function during the pre-operative and post-operative follow-up period.Results The surgery was successfully completed in all 4 patients.One was treated with VSD for vacuum suction and the wound was closed one week later.The results of microbial culture showed that 2 cases were Mycobacterium tuberculosis positive,1 case Pseudomonas aeruginosa positive,and 1 case was Staphylococcus aureus positive.After treatment,the shoulder sinuses of all patients were healed,without swelling,pain,etc.The follow-up time was 3,4,32,and 33 months,respectively.There was no recurrence of infection until the latest follow-up.The joint mobility and scores were better than the situation of preoperative.The VAS score and ASES score of 2 patients with early debridement (＜ 1 month duration of infected symptoms) were respectively improved significantly from 5 and 40,6 and 23 before operation to 1 and 80,1 and 73 respectively at the latest follow up.The VAS score and ASES score of other 2 patients (＞ 6 months duration of infected symptoms) were respectively improved from 6 and 28,6 and 32 to 1 and 62,2 and 65 respectively.All patients were satisfied with the results.Conclusion Early arthroscopic irrigation combined with surgical debridement is an effective method to treat the post-operative infections after arthroscopic rotator cuff repair.

The incidence of rotator cuff tear in proximal humeral fractures and its correlation with fracture type and age distribution / 中华骨科杂志

Objective To evaluate the prevalence of full thickness rotator cuff tear in patients with proximal humeral fractures,and the relationships between different risk factors.Methods Data of 113 patients with proximal humeral fractures from January 2014 to January 2016 who underwent surgical treatment were retrospectively analyzed.The general characteristics of patients (age,sex,cause of injury) were recorded and the rotator cuff was evaluated preoperatively on MRI and explored intra-operatively.We calculated and compared the incidence rate of age,sex in patients with and without rotator cuff tear.And the incidence rate of rotator cuff tear in different types of fracture according to Neer classification was calculated.Results The full thickness ro tator cuff tear were indentified in 28 patients (24.8％),and 21 of them had been confirmed by MRI preoperatively.Statistical significant difference was found between patients with rotator cuff tear group (average of 75.11± 10.89 years old) and without rotator cuff tear group (64.68± 13.43) for the age of the patient.Full thickness rotator cuff tear was most common in Neer 3 GT fracture (33.3％,8/54),followed by Neer 2 GT (26.67％,4/15) and Neer 2 SN (17.65,6/34),however,no full thickness rotator was found in Neer 4 type fracture.There were 4 patients with total rotator cuff tear who had symptom of shoulder before the operation.The other 24 patients had no symptom of shoulder.Conclusion Patient age was found as a risk factor for full thickness rotator cuff tear in humeral proximal fractures with the rate of 24.8％.Full thickness rotator cuff tear was most common in Neer 3 GT fracture.

Diagnostic value of endoscopic ultrasound guided fine needle aspiration combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions / 中华消化杂志

Objective To study the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions (SPL) rapid on-site evaluation (ROSE).Methods From February 2011 to October 2014,225 patients with SPL who underwent EUS-FNA and obtained the cytological diagnosis were enrolled.The lesions were finally diagnosed according to pathological results,imaging and follow-up data,and then the sensitivity,specificity,and accuracy of EUS-FNA in the diagnosis of SPL were calculated based on the new papanicolaou society of cytopathology terminology.Logistic stepwise regression analysis was performed to analyze the risk factors.Results Among 225 patients with SPL,96 cases (42.7％)had uncertain cytological diagnosis,17.3％ (39/225) could not be diagnosed,8.0％ (18/225) were atypical lesions,and 17.3％ (39/225) were suspicious malignant carcinomas.Among 129 cases (57.3％)with certain cytological diagnosis,15.1％ (34/225) were benign lesions,14.7％ (33/225) were tumors (benign or others) and 27.6％ (62/225) were malignant tumors.When atypical lesions were added into non-tumor lesions or tumor lesions,the sensitivity,specificity and accuracy of diagnosis were 87.3 ％,91.7％,88.2％,and 94.7％,72.2％,90.3％,respectively.Serum CA125≥14 kU/L (odds ratio (OR) =7.13,95％ confidence interval (CI) 2.02 to 25.22,P=0.002) and history of biliary disease (OR=3.85,95％CI 1.22 to 12.51,P=0.022) were two independent risk factors of pancreatic tumors.Conclusions Despite of a high percentage of uncertain cytological diagnosis,EUS-FNA still has high diagnostic value in SPL when combined with the new papanicolaou society of cytopathology terminology.Furthermore,serum CA125≥14 kU/L and history of biliary disease may help to diagnose pancreatic tumors.

Endoscopic ultrasound guided fine needle aspiration in combination with flow cytometry in the diagnosis of gastrointestinal lymphoma / 中华消化杂志

Objective To evaluate the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in combination with flow cytometry (FCM) in lymphoma.Methods From January 2011 to December 2011,the cases of suspicious lymphoma with EUS-FNA examination at Shanghai Ruijin Hospital were retrospectively analyzed.The final diagnosis was according to pathological diagnosis of specimen from the surgery and follow up results.The sensitivity,specificity and accuracy of EUS-FNA combined with FCM in lymphoma diagnosis were initially analyzed.Results A total of 14 suspicious lymphoma patients were collected,eight cases were diagnosed as lymphoma by pathological examination of specimen from the surgery or.tissue from aspiration,four cases were non-lymphoma lesions and two cases still had no final diagnosis.The sensitivity and specificity of FCM alone in lymphoma diagnosis were 4/8 and 4/4 respectively.Six cases of lymphoma were detected by EUS-FNA with FCM.The sensitivity,specificity and accuracy of EUS FNA combined with FCM were 6/8,6/6 and 10/12 respectively.Conclusion EUS-FNA combined with FCM has better diagnostic value in lymphoma,especially for gastrointestinal lymphoma and those surrounding deep lesions.

Endoscopic ultrasound-guided fine needle aspiration with different needle types for solid pancreatic masses: a prospective and randomized comparative trial in two centers / 中华消化内镜杂志

Objective To compare the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for solid pancreatic masses performed with three different needle types through the cytological results.Methods All patients with solid pancreatic masses larger than 2cm from December 2010 to May 2011 were enrolled,and divided into two groups according to different access of EUS-FNA,trans-gastric approach with 19-,22-and 25-gauge needles (n =42) and trans-duodenal approach with 22-and 25-gauge needles (n =10).In both groups,EUS-FNA was performed with randomization of needle types.During the puncture,the suction,the number of movements,and the depth of insertion were fixed.At the end of the puncture,a liquid-based cytological (LBC) preparation was used to fix the specimen.One cytopathologists was assigned to make the diagnosis and comparison.Results Technical success was 100％ and no procedure related complications occurred.No statistically significant differences were observed in different needles in terms of all cytological parameters between two groups (P ＞ 0.05).However,the 25-gauge needle showed a trend towards a higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy.Conclusion There is no significant difference in yield of cytological results between different needle types,although 25-gauge needle shows a relative superiority.

EUS on diagnosis of gastric lesions with thickened gastric wall and negative pathological findings / 中华消化内镜杂志

ObjectiveTo evaluate the accuracy of EUS,EUS-guided fine needle aspiration ( EUSFNA) and targeted biopsy in the diagnosis of wall-thickened gastric lesions with negative malignant results ofendoscopic biopsies.MethodsA retrospective study was carried out in 57 patients who were found with thickened gastric wall of negative malignant endoscopic biopsies and underwent EUS from January 2008 to December 2010 in our hospital.Compared the EUS findings with the surgical results and follow-up status.The diagnostic yield of EUS was characterized by the disappearance of the layers or the changes of thickness of gastric wall,the characteristics of echo imaging,and the results of EUS-FNA or EUS targeted biopsy were recorded to evaluate the value of EUS.ResultsOf 57 cases,gastric cancer was confirmed in 19,lymphoma in 10,dysplasia in 1,Menetrier's disease in 1 and inflammatory changes in 26.EUS could clearly demonstrate the changes of gastric wall including the thickness and the changes of layers,with the accuracy rate of 73.07％ ( 14/19 ) on gastric cancer.EUS diagnosed gastric cancer in 26 cases,in which 14 (53.8％) were confirmed by pathology.Gastric lymphoma was suspected by EUS in 20 cases,in which 10 (50.0％ ) were proved.EUS-FNA was conducted in 19 cases,with positive result in 9 (accuracy rate 50％ ).EUS-guided targeted deep biopsy or piece-meal biopsy were performed in 10 cases,with 8 malignant results.ConclusionEUS with/without EUS-FNA is not a golden standard for the diagnosis of gastric lesions in thickened gastric wall,yet it still has some significance.

Endoscopic ultrasound guided fine needle aspiration in diagnosis of occupying lesions in upper digestive tract and peripheral areas / 中华消化内镜杂志

Objective To evaluate the accuracy and clinical application of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in diagnosis of occupying lesions in upper digestive tract and its pe-ripheral areas. Methods The data of 64 patients who underwent EUS-FNA for occupying lesions in upper di-gestive tract, between July 2006 and December 2007, were retrospectively analyzed. Results EUS-FNA was successfully performed on 62 patients, with a success rate of 96.88%. The overall diagnostic accuracy, sensi-tivity, specificity, positive predictive value and negative predictive value of EUS-FNA for occupying lesions in upper digestive tract and its peripheral areas were 88.71%, 86.54%, 100.00%, 100.00%, and 58.82%, respectively. There was no significant difference between the foei larger and smaller than 3cm (P > 0.05), re-garding the diagnostic accuracy and average puncture numbers. Diagnostic accuracy of those with real-time cy-tolngical evaluation was significantly higher than those without (P=0.029), and the puncture numbers were less (P=0.001). Among the total 99 punctures, the positive diagnostic accuracy of those with 5ml negative pressure suction was significantly higher than those of 10 ml (P = 0.044). Conclusion EUS-FNA is a safe and applicable approach to diagnosis of occupying lesions in upper digestive tract and its peripheral areas with higher diagnostic accuracy, sensitivity, specificity and positive predictive value. Moreover, the real-time cyto-logical evaluation and adequate negative pressure might facilitate the diagnosis accuracy.

Antibody Preparation and Expression Analysis of a New Protein Mimecan in Pituitary Tumors / 中国生物化学与分子生物学报

Mimecan belongs to a family of leucine-rich proteoglycans that are secreted into the extracellular matrix. In order to investigate the function of mimecan, the coding region of mimecan was amplifed from a human pituitary cDNA by PCR and the recombinant prokaryotic expression vector pGEX-M was constructed. The vactor was transformed into E.coli BL21(DE3)and the GST-M fusion protein of 38 Kd was ecpressed in the bacteria under induction of IPTG. After purification, the fusion protein was infucted into New Zealand rabbits to prepare polyclonal antibody. The antibody was tested by Western blotting for their specificity and sensitivity. Using the antibody it was found the mimecan was expressed highly in certain types of human pituitary tumor tissues. These results make it possible for studying the biological function of mimecan.

Dynamic expression of tenascin in rat liver during liver fibrogenesis induced by CCl(4) / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the expression of tenascin in normal and fibrotic rat liver.</p><p><b>METHODS</b>Liver fibrosis induced in rat with CCl(4) were divided into three stages: the stage of hepatic injury (4 weeks), early stage of hepatic fibrosis (8 weeks) and later stage of hepatic fibrosis (12 weeks). Tenascin expression in liver tissue was observed by immunohistochemical method and in situ hybridization using digoxigenin-labelled DNA probe.</p><p><b>RESULTS</b>In normal rat liver there was a weak staining for tenascin. In both liver injury stage and early stage of hepatic fibrosis, both mRNA signal and immunostaining for tenascin were significantly increased as compared to that in normal liver. In later stage of hepatic fibrosis, mRNA signal and immunostaining for tenascin were decreased compared with that in early stage of hepatic fibrosis. The cellular source of tenascin in liver mainly restricted in mesenchymal cells.</p><p><b>CONCLUSIONS</b>Tenascin is a component of the extracellular matrix of liver tissue. Plays a role in early matrix organization during liver fibrogenesis.</p>

Role of the macrophages and NO in fibrosis formation in transplanted kidneys with chronic rejection / 第二军医大学学报

Objective：To confirm the effects of the macrophages and NO in the fibrosis formation of transplanted kidneys with chronic rejection. Methods：The quantitive immunohistochemistry was employed to observe the changes of relative quantitiy of macrophages, NO, collagen Ⅲ andⅣ， and to reveal the association between the increases of macrophages， NO， histopathologic damages, deposition of collagen Ⅲ and Ⅳ, finally, to infer the roles of the macrophages and NO in the fibrosis formation of transplanted kidneys with chronic rejection. Results: The macrophages accumulated and increased in the glomeruli, the tubules and the intersiticia tissue of kidneys, which was companied by the increased expression of collagen Ⅲ and Ⅳ during the early and middle stages. However, the macrophages and NO could not be detected, which was companied by the decreased deposition of collagen Ⅲ and Ⅳduring the advanced stage. There were significant differences between the 3 types(glomerulus disease type,blocking vessel type and intersticial sclerostic type) (P<0.05 or P<0.01). Conclusion：The increase of macrophages and the NO may closely interrelated with the fibrosis formation in transplanted kidneys with chronic rejection.

A STUDY ON THE RELATIONSHIP BETWEEN THE CHANGES OF EXTRACELLUAR MATRIX INVADED BY COLORECTAL CARCINOMA AND ENDOTHELIAL CELLS / 中国癌症杂志

PURPOSE To investigate the relationship between the changes of extracellular matrix invaded by colorectal carcinoma and vascular endothelial cells,which will be useful to understand colorectal carcinoma biological behavior and may have clinical significance in the treatment of colorectal carcinoma.METHODS Immunohistochemistry technique and semi quantitative analysis were used.RESULTS As to the changes of ECM and endothelial cells,there were significant differences among the paracarcinoma groups,different invasive groups and normal group.THe increase of LN,CD34,F8 and actin were correlated with colorectal carcinoma invasion( P

Alterations of bcl-2, bcl-x and bax protein expressions in area CA-3 of rat hippocampus following fluid percussion brain injury / 中华创伤杂志(英文版)

OBJECTIVE: To investigate the alterations of bcl-2 gene family in the area of CA-3 in rats and the molecular mechanism of neuronal apoptosis following traumatic brain injury. METHODS: To investigate the alterations of bcl-2 gene family in the area of CA-3 in rats and the molecular mechanism of neuronal apoptosis following traumatic brain injury. RESULTS: The immunoreactivity of bcl-2 and bcl-x proteins decreased in the hippocampus ipsilateral impact site at 6 hours after injury, and this was the main cause of down-regulation of the value of (bcl-2+bcl-x)/ bax. During the period of 1-3 days after injury, bax protein expression increased significantly, while bcl-2 and bcl-x protein expressions decreased relatively slowly. The decreased value of (bcl-2+bcl-x)/ bax was mainly due to the bax up-regulation. CONCLUSIONS: The bcl-2 gene family is involved in neuronal apoptosis after traumatic brain injury, and the protein-expression alterations of the bcl-2 gene family members lead to apoptosis of the neuronal cells.

Expression of undulin in experimental rat liver fibrosis / 中国病理生理杂志

AIM: To observe the expression of undulin(Un) in liver tissue and to clarify the diagnostic significance of serum Un in experimental rat liver fibrosis. METHODS: Rat liver fibrosis was induced by carbon tetrachloride. The expression of Un in liver tissue was detected by immunohistochemical method. Serum Un levels was measured by enzyme immunoassay.RESULTS: Expression of Un increased in fibrotic liver than normal liver, and it was mainly distributed in portal tract stroma, central veins and fibrotic septa in fibrotic liver. Also, the level of serum Un was significantly higher in fibrotic liver than normal liver.CONCLUSION: These data suggest that Un should be a component of the hepatic extracellar matrix, and its expression could be increased greatly in fibrotic rat liver. Serum Un levels may be used as an indicator in liver fibrosis diagnosis.

Morphologic character of T cells in malignant ascites and pleural effusion / 第二军医大学学报

Objective:To investigate the significance of T cells morphologic character in ascites and pleural effusion in guiding tumor therapy. Methods: Totally 60 ascites and pleural effusion specimens were collected from patients with malignant tumor and were divided into 3 groups: chemotherapy group (18 cases), immunotherapy group (25 cases) and untreated group (17 cases). Ten benign specimens were taken as control.The T cell subtypes in ascites and pleural effusion were analyzed by EnVison~TM immunohistochemistry two-step technique. The T cells were analyzed semi-quantitatively and observed morphologically. Results: The lymphocytes were scattered around tumor cells and formed into petal-like structures. Most tumor cells surrouned by lymphocytes had morphologic changes. The positive rates of CD4, CD8, CD25, CD3, CD45_~RO ,S-100 and CD34 in malignant pleural and ascites effusion of immunotherapy group were significantly higher than those of chemotherapy group and untreated group (P

Experimental Study of the Mechanism of Autogenous Nerve Replantation in situ Inhibition of Traumatic Neuroma Formation / 第二军医大学学报

In this study, two experimental patterns of autogenous nerve replantation in situ and centrocentral nerve simple suture were performed on the rabbit median and ulnar nerves. By light and transmission electron microscopy and immunohistochemistry, the results showed that autogenous nerve replantation in situ could inhibit neuroma formation, and its mechanism might that two proximal stump axons could conjunct within interpolated graft segment, and the nerve simple suture could not inhibit neuroma development for lack of proper environment for conjunction of two proximal stump axons.

T cell immune phenotyping in patients with Hashimoto thyroiditis and its significance / 第二军医大学学报

Objective:To study the phenotypes of T cell in patients with Hashimoto thyrioditis (HT) and to analyze its relationship with the impairment of follicles, so as to provide evidence for clinical diagnosis and treatment. Methods: Totally 136 HT specimens were obtained by fine needle aspiration biopsy (FNAB) and were divided morphologically(L, P, O type). The serum parameters (TPOAb, TGAb, TSH) were tested, and 20 cases with nontoxic goiter were taken as control. Immuno-histochemical assay was performed with 60 specimens and FCM (Flow cytometry ) was used to study 23 specimens. The T cell infiltration and the distribution of CD3+ . CD4+ . and CD8+ T cells were compared between all types of HT tissues. The correlationship between the atrophic degree of follicle with T lymphocytes infiltration and phenotype was analyzed. Results: It was found that L type (n = 58) and P type (n = 28) had more serious follicle atrophy than that of O type (n = 20) (P