Low-intensity treadmill exercise promotes rat dorsal wound healing / 华中科技大学学报（医学）（英德文版）

In order to investigate the promoting effect of low-intensity treadmill exercise on rat dorsal wound healing and the mechanism, 20 Sprague-Dawley rats were randomly divided into two groups: exercise group (Ex) and non-exercise group (non-ex). The rats in Ex group were given treadmill exercise for one month, and those in non-ex group raised on the same conditions without treadmill exercise. Both groups received dorsal wound operation with free access to food and water. By two-week continuous observation and recording of the wound area, the healing rate was analyzed. The blood sample was collected at day 14 post-operation via cardiac puncture for determination of the number of endothelial progenitor cells (EPCs) by flow cytometry, and the concentrations of relevant cytokines such as basic fibroblast growth factor (bFGF), endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) were measured by ELISA. The skin tissue around the wound was dissected to observe the vascular density under the microscope after HE staining, to detect the mRNA level of VEGFR2 and angiopoietin-1 (Ang-1) receptor using RT-qPCR, and protein expression of a-smooth muscle actin (αSMA) and type III collagen (ColIII) using Western blotting. It was found that the wound area in Ex group was smaller at the same time point than in non-ex group. The number of circulating EPCs was greater and the concentrations of vasoactive factors such as VEGF, eNOS and bFGF were higher in Ex group than in non-ex group. HE staining displayed a higher vessel density in Ex group than in non-ex group. Moreover, the mRNA expression of VEGFR2 and Ang-1 detected in the wound tissue in Ex group was higher than in non-ex group. Meanwhile, the protein expression of αSMA and ColIII was more abundant in Ex group than in non-ex group. Conclusively, the above results demonstrate Ex rats had a higher wound healing rate, suggesting low-intensity treadmill exercise accelerates wound healing. The present work may provide some hint for future study of treating refractory wound.

Low-intensity treadmill exercise promotes rat dorsal wound healing / 华中科技大学学报（医学）（英德文版）

In order to investigate the promoting effect of low-intensity treadmill exercise on rat dorsal wound healing and the mechanism, 20 Sprague-Dawley rats were randomly divided into two groups: exercise group (Ex) and non-exercise group (non-ex). The rats in Ex group were given treadmill exercise for one month, and those in non-ex group raised on the same conditions without treadmill exercise. Both groups received dorsal wound operation with free access to food and water. By two-week continuous observation and recording of the wound area, the healing rate was analyzed. The blood sample was collected at day 14 post-operation via cardiac puncture for determination of the number of endothelial progenitor cells (EPCs) by flow cytometry, and the concentrations of relevant cytokines such as basic fibroblast growth factor (bFGF), endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) were measured by ELISA. The skin tissue around the wound was dissected to observe the vascular density under the microscope after HE staining, to detect the mRNA level of VEGFR2 and angiopoietin-1 (Ang-1) receptor using RT-qPCR, and protein expression of a-smooth muscle actin (αSMA) and type III collagen (ColIII) using Western blotting. It was found that the wound area in Ex group was smaller at the same time point than in non-ex group. The number of circulating EPCs was greater and the concentrations of vasoactive factors such as VEGF, eNOS and bFGF were higher in Ex group than in non-ex group. HE staining displayed a higher vessel density in Ex group than in non-ex group. Moreover, the mRNA expression of VEGFR2 and Ang-1 detected in the wound tissue in Ex group was higher than in non-ex group. Meanwhile, the protein expression of αSMA and ColIII was more abundant in Ex group than in non-ex group. Conclusively, the above results demonstrate Ex rats had a higher wound healing rate, suggesting low-intensity treadmill exercise accelerates wound healing. The present work may provide some hint for future study of treating refractory wound.

Induction of chondrogenesis of adipose-derived stem cells by novel recombinant TGF-β3 fusion protein / 华中科技大学学报（医学）（英德文版）

A new type of TGF-β3 fusion protein with targeted therapy function was constructed, and its feasibility and target specificity of inducing chondrogenesis were investigated by transfecting LAP-MMP-mTGF-β3 gene into adipose-derived stem cells (ADSCs). The recombinant pIRES-EGFP-MMP was constructed by inserting the sense and antisense DNA of encoding the amino acid of the synthetic MMP enzyme cutting site into the eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained by using RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, and the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was constructed, which was transferred to ADSCs. The ADSCs were cultured and divided in three groups: experimental group (MMP group), negative control group (no MMP) and non-transfection group. The morphological changes were observed microscopically, and the expression of proteoglycan and type II collagen (ColII) was detected by using Alcian blue staining and immunohistochemistry staining at 7th, 14th and 21st day after culture. The recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was correctly constructed by methods of enzyme cutting and sequencing analysis. The mTGF-β3 fusion protein was successfully expressed after transfection, and in the presence of the MMP, active protein mTGF-β3 was generated, which significantly promoted differentiation of ADSCs into chondrocytes and the expression of cartilage matrix. The novel fusion protein LAP-MMP-mTGF-β3 can targetedly induce differentiation of ADSCs into chondrocytes, which would open up prospects for target therapy of cartilage damage repair in future.

Induction of chondrogenesis of adipose-derived stem cells by novel recombinant TGF-β3 fusion protein / 华中科技大学学报（医学）（英德文版）

A new type of TGF-β3 fusion protein with targeted therapy function was constructed, and its feasibility and target specificity of inducing chondrogenesis were investigated by transfecting LAP-MMP-mTGF-β3 gene into adipose-derived stem cells (ADSCs). The recombinant pIRES-EGFP-MMP was constructed by inserting the sense and antisense DNA of encoding the amino acid of the synthetic MMP enzyme cutting site into the eukaryotic expression vector pIRES-EGFP. LAP and mTGF-β3 fragments were obtained by using RT-PCR and inserted into the upstream and downstream of MMP from pIRES-EGFP-MMP respectively, and the recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was constructed, which was transferred to ADSCs. The ADSCs were cultured and divided in three groups: experimental group (MMP group), negative control group (no MMP) and non-transfection group. The morphological changes were observed microscopically, and the expression of proteoglycan and type II collagen (ColII) was detected by using Alcian blue staining and immunohistochemistry staining at 7th, 14th and 21st day after culture. The recombinant plasmid of pIRES-EGFP-LAP-MMP-mTGF-β3 was correctly constructed by methods of enzyme cutting and sequencing analysis. The mTGF-β3 fusion protein was successfully expressed after transfection, and in the presence of the MMP, active protein mTGF-β3 was generated, which significantly promoted differentiation of ADSCs into chondrocytes and the expression of cartilage matrix. The novel fusion protein LAP-MMP-mTGF-β3 can targetedly induce differentiation of ADSCs into chondrocytes, which would open up prospects for target therapy of cartilage damage repair in future.

Lipopolysaccharide induced activin A-follistatin imbalance affects cardiac fibrosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Inflammation plays a pivotal role in cardiac remodeling, especially in myocardial fibrosis. Abnormal growth of cardiac fibroblasts is critically involved in the pathophysiology of cardiac hypertrophy/remodeling. Previous study has demonstrated that many inflammation stimulating factors trigger transforming growth factor-β (TGF-β) induction and reactive myocardial fibrosis. Activin A (ACT A) is a member of TGF-β superfamily, and follistatin (FS) is an activin-binding protein, i.e. an antagonist of ACT A. Our previous studies have shown that ACT A-FS imbalance occurs in rats with heart failure (HF), and overexpression of ACT A can lead to ventricular remodeling, and resultant HF. Low expression of FS after myocardial infarction further exacerbated HF. The pathogenic change resulting from overexpression of ACT A is consistent with that of overexpression of angiotensin II (AngII). Ventricular remodeling includes cardiocyte remodeling and myocardial interstitial collagen deposition and fibrosis. Therefore, the present study was designed to investigate the effects of inflammatory factors on the ACT A-FS and the secretions of cardiac fibroblasts in order to explore in depth the mechanism of myocardial fibrosis.</p><p><b>METHODS</b>A rat model with HF was established, and the results showed that there was a greater degree of cardiac fibrosis in HF rats. In addition, we found that there was an imbalance of the ACT A/FS system in HF rats, which was characterized by increased levels of ACT A. Further, primary rat cardiac fibroblasts were cultured and the MTT assay was performed to determine the effect of the inflammatory factor-bacterial endotoxin lipopolysaccharide (LPS) on cardiac fibroblast proliferation.</p><p><b>RESULTS</b>The results showed that LPS can stimulate the cardiac fibroblasts to proliferate in a dose-dependent manner. Cellular immunohistochemical staining showed that the rat cardiac fibroblasts themselves could express ACT A and FS proteins, and stimulation by LPS could apparently promote the cultured primary rat cardiac fibroblasts to secrete ACT A, but inhibit the secretion of FS. The results also showed that ACT A promoted, in a dose-dependent manner, the proliferation of the cultured primary rat cardiac fibroblasts, and the expression of collagen types I and III. Moreover, ACT A promoted, in a dose dependent manner, the cardiac fibroblasts to secrete nitric oxide (NO), and unregulated the expression of inducible nitric oxide synthase (iNOS) mRNA.</p><p><b>CONCLUSIONS</b>These results suggest that the inflammatory mediator LPS can promote ACT A-FS imbalance in cardiac fibroblasts, mainly overexpression of ACT A. Overexpression of ACT A promotes the proliferation and the secretion of collagens in cardiac fibroblasts through autocrine/paracrine stimulation of NO, and is involved in the pathological process of myocardial fibrosis.</p>

IFN-gamma enzyme-linked immunospot assay versus PPD tuberculin skin test in the diagnosis of tuberculous epididymitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the potential application of IFN-gamma enzyme-linked immunospot (ELISPOT) assay in the diagnosis of tuberculous epididymitis (TE) by comparing ELISPOT assay with the traditional purified protein derivative (PPD) tuberculin skin test.</p><p><b>METHODS</b>We examined 13 TE patients using an in-house ELISPOT kit, another 11 TE patients by PPD skin testing, and 57 healthy male volunteers by parallel test with both the methods.</p><p><b>RESULTS</b>Twelve (92.3%) of the 13 TE cases were positive on ELISPOT assay, and 10 (90.9%) of the 11 TE cases positive on PPD skin test, with no statistically significant differences between the two groups (P > 0.05). Among the 57 healthy male volunteers, 8 (14.0%) were positive on ELISPOT, and 28 (49.1%) positive on PPD test, the latter significantly higher than the former (P < 0.001).</p><p><b>CONCLUSION</b>In terms of sensitivity, ELISPOT assay is similar to PPD test in the examination of tuberculous epididymitis. As for specificity, ELISPOT assay seems better than PPD test in differentiating tuberculous epididymitis patients from healthy males.</p>

Clinical study to the cannulated screws with fluoroscopy in the operation of femoral neck fractures / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the safe distance from the tip of the cannulated screw to the apex of the femoral head, and to avoid cutting out of the cannulated screws from the femoral head.</p><p><b>METHODS</b>From November 2007 to April 2008, the placement configuration of the cannulated screws in the femoral head on the anteroposterior (AP) and lateral view was investigated. And the relation between the three-dimensional configuration and the two-dimensional perpendicular view of the femoral head to establish a solid geometry formula was analyzed. According to the configuration, the distances from the tips of different cannulated screws to the apex of the femoral head to confirm the screws placement within the femoral head was measured.</p><p><b>RESULTS</b>The actual risk of cutting out of the cannulated screws varied according to the different placement of the cannulated screws in the femoral head, even if the screw tips were within the femoral head on the AP and lateral radiograph. The mean diameter of femoral head was 49.8 mm. If the cannulated screw is in the center of femoral head on the lateral view, the cannulated screw would not cut out as long as it was in the femoral head on the AP view. When the angle was 22.5°on the lateral view, and under 22.5°on the AP view, the distance from the screw tip to the apex of the femoral head would exceeded 2.2 mm. If the angle > 45°on the AP view, the distance would exceed 9.6 mm. When the angle was 45°on the lateral view, and under 22.5°on the AP view, the distance would exceed 8.2 mm. When the angle > 45°on the AP view, the distance would exceed 17.7 mm. When the angle was 67.5°on the lateral view, the distance would exceed 23.1 mm on AP view.</p><p><b>CONCLUSIONS</b>If the cannulated screw is in the center of femoral head on the lateral view, the cannulated screw won't cut out as long as it is in the femoral head on the AP view. The angle is larger on the AP and lateral view (especially on the lateral view), and the distance is longer.</p>

Shoulder hemiarthroplasty for the treatment of complex proximal humeral fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the indication, perioperative announcements, selection of prosthesis and clinical results of shoulder hemiarthroplasty for the treatment of complex proximal humeral fractures.</p><p><b>METHODS</b>A total of 55 patients who suffered from complex proximal humeral fractures were treated by shoulder hemiarthroplasty. The mean age was 55.6 years and mean follow-up period was 25.1 months. The scoring system modification for hemiarthroplasty (SSMH) had been adopted for evaluation at the latest follow-up.</p><p><b>RESULTS</b>The pain was obviously relieved in all patients. Fifty patients were painless and 5 patients had slight pain. The mean range of motion was 100 degrees (90 degrees-110 degrees) in abduction, 95 degrees (80 degrees-100 degrees) in forward flexion, 35 degrees (30 degrees-40 degrees) in external rotation and internal rotation was confined at L2 level (L1-L3). The mean SSMH score was 27.9 (24-29). Fifty patients (90.1%) were satisfied with the clinical outcome.</p><p><b>CONCLUSIONS</b>Shoulder hemiarthroplasty is an effective method to treat complex proximal humeral fractures. The proper selection of patients and prosthesis, good operation skill and enough functional exercise are the key points of successful treatment.</p>

Application of contrast-enhanced ultrasound in the diagnosis of renal cystic lesion / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of renal cystic lesion.</p><p><b>METHODS</b>Totally 88 patients with 97 atypical cystic lesions of kidneys were examined by conventional ultrasound (color Doppler flow imaging and power Doppler flow imaging), CEUS, and contrast-enhanced computed tomography (CECT), respectively. The results from the three imaging approaches were classified by Bosniak classification system and compared with each other. In patients who underwent surgeries, the pathological results were used to validate the imaging results.</p><p><b>RESULTS</b>The results of CEUS and CECT on atypical cystic lesions were not significantly different (P > 0.05). The results gained by conventional ultrasound were significantly different from those of CEUS and CECT (P < 0.05). Compared with the pathological results of 32 patients who underwent surgery, the sensitivities of CEUS in the diagnosis of benign, doubtfully malignant, and malignant cystic tumors of kidney were 63.2%, 95.0%, and 94.7%, respectively, the specificities were 92.9%, 76.9%, and 85.7%, respectively, and the accuracies were 75.8%, 87.9%, and 90.0%, respectively.</p><p><b>CONCLUSIONS</b>The classification of atypical cystic lesions using CEUS is highly consistent with CECT. CEUS is valuable in the diagnosis of benign and malignant renal cystic lesions.</p>

Clinical observation of particulate cancellous bone impaction grafting in combination with total hip arthroplasty for acetabular reconstruction / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of particulate cancellous bone impaction grafting in combination with total hip arthroplasty (THA) for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fractures.</p><p><b>METHODS</b>Totally 15 consecutive cases with unilateral acetabular fracture were treated with bone impaction grafting in combination with THA in our department. There were 10 males and 5 females with mean age of 48.2 years (ranging from 36 to 73 years). Eight cases had the fracture at left hips, 7 at right hips. The average age at injury was 28 years (ranging from 18 to 68 years). The mean follow-up period was 4.3 years (ranging from 2 to 7 years).</p><p><b>RESULTS</b>Compared with mean 42 points (ranging from 10 to 62) of the preoperative Harris score, the survival cases at the final follow-up had mean 84 points (ranging from 58 to 98). One patient had mild pain in the hip. No revision of the acetabular or femoral component was undertaken during the follow-up. Normal rotational centre of most hips was recovered except 2 cases in which it was 0.8 mm higher than that in opposite side. All of them had a stable radiographic appearance. Progressive radiolucent lines were observed in I, III zones in 2 cases. One patient had a nonprogressive radiolucent line in zone III. The cup prosthesis was obviously displaced (6 mm) in one patient, but had not been revised.</p><p><b>CONCLUSION</b>Particulate cancellous bone impaction grafting in combination with THA as a biological solution is an attractive procedure for acetabular reconstruction in patients with posttraumatic arthritis and bone loss after acetabular fracture, which can not only restore acetabular bone stock but also repair normal hip anatomy and its function.</p>

Early total hip arthroplasty for severe displaced acetabular fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.</p><p><b>METHODS</b>Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).</p><p><b>RESULTS</b>At the final follow-up the Harris hip score averaged 82 (69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.</p><p><b>CONCLUSIONS</b>In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.</p>

Causes and revision endoscopic sinus surgery for recurrent sinusitis / 中南大学学报(医学版)

OBJECTIVE@#To investigate the causes of revision endoscopic sinus surgery (RESS), and to evaluate the clinical effect and experience of RESS in the patients with recurrent sinusitis.@*METHODS@#Before the revision surgery, 168 patients (225 sides) with recurrent sinusitis were examed by CT scans and nasal endoscopy. All patients were operated by revision endoscopic sinus surgery.@*RESULTS@#Among the 168 patients, 95 cases (121 sides) had incomplete middle turbinate, 51 cases (75 sides) had maxillary sinus ostium stenosis, 85 cases (117 sides) had nasal cavity adhesion, 48 cases (57 sides) had uncinate process residual, 38 cases (65 sides) had ethmoid hyperostosis, and 25 cases had nasal septum deviation. One hundred and six patients (134 sides) were cured, 40 patients (56 sides) were improved, useful 22 patients (35 sides) were ineffective.@*CONCLUSION@#The most common surgical causes of failures in endoscopic sinus surgery are the disease area remnant, nasal cavity adhesion, maxillary sinus ostium stenosis, uncinate process residual, ethmoid hyperostosis, and nasal septum deviation. Revision endoscopic sinus surgery is a useful way to treat recurrent sinusitis. Preoperative CT scan, correct choice of the anatomic marks of orientation and direction function are the key to operation successful.