Correlation between spatial inclination of Blumensaat line and anterior cruciate ligament injury based on EOS biplanar 3D imaging system / 中国骨伤

OBJECTIVE@#To explore correlation between femoral mechanical axis and Blumensaat line (FMBL) angle of knee joint (angle between Blumensaat line and femoral mechanical axis), α angle (angle between Blumensaat line and axis of distal femur in sagittal plane) on EOS biplane imaging and non-contact anterior cruciate ligament(ACL) injury, and evaluate angle for its accuracy in predicting the populations prone to non-contact ACL injury.@*METHODS@#From February 2018 to October 2020, EOS imaging and clinical data from 88 patients (176 knees) with unilateral non-contact ACL injury were retrospectively analyzed, including 53 males and 35 females, aged from 18 to 45 years old with an average of (30.3±6.2) years old, 48 patients on the left side and 40 patients on the right side. The patients were divided into ACL-affected group and ACL-health group according to side of ACL injuries, and 51 patients (51 knees) with non-ACL identified from EOS database were included in normal control group, including 28 males and 23 females, aged from 20 to 44 years old with an average of (31.6±5.5) years old, 26 patients on the left side and 25 patients on the right side. Full-length EOS imaging of skeleton extremitatis inferioris among three groups were reconstructed to 3D images of skeletal system with EOS software, and then FMBL angle and α angle were measured on the images. Univariate binary Logistic regression analysis was performed to determine the influence of the univariate(FMBL angle or α angle) on ACL status(normal or torn). And the angle cutoff value for univariate was selected based on receiver operating characteristics curve (ROC) to got the best accuracy.@*RESULTS@#There was no statistically significant difference in age, gender and side distribution between ACL-injured group and normal control group(P>0.05). Statistical analyses (one-way ANOVA) indicated no significant difference in FMBL angle between ACL-injured knee group (32.8±2.3)° and ACL-injured contralateral knee group(32.5±2.3)°(P>0.05), but the values between two groups were significantly lower than that in normal control group (37.0±2.0)°(P<0.001). There was no statistically significant difference in α angle among three groups (P>0.05). Univariate binary Logistic regression analysis demonstrated that FMBL angle was risk factor for non-contact ACL injury[OR=0.433, 95%CI(0.330, 0.569), P<0.001]. The area under ROC curve for FMBL angle was 0.909[95%CI(0.861, 0.958), P<0.001], and the sensitivity and specificity were 70.5% and 98.0% respectively, cut-off value was 33.7°.@*CONCLUSION@#FMBL angle formed by Blumensaat line and femoral mechanical axis is one of the risk factors for non-contact ACL injury and has good predictive accuracy. The general population with FMBL angle below 33.7° may be increased risk for ACL injury.

Research progress of signaling pathways involved in expression of hypoxia-inducible factor-la in rheumatoid arthritis / 中国药理学通报

Rheumatoid arthritis (RA) is a systemic autoimmune disease whose development is closely related to the hypoxic mi-croenvironment of joints. Hypoxia-inducible factor-1 a (HIF-la) is a nuclear transcription factor that regulates cellular responses to hypoxia and plays an important role in promoting synovial inflammation, angiogenesis, pannus formation, cartilage destruction and bone erosion. In addition to regulation by oxygen receptors, its expression is regulated by multiple signal transduction pathways, including PI3K/Akt, Ras-Raf-MEK-ERK, JAK/STAT and NF-kB , etc. This article provides an overview of the signaling pathways involved in the regulation of HIF-la expres-sion, in order to provide new ideas and evidence for the treatment of RA and the search for new disease modifying antirheumatic drugs.

Introduction of EOS imaging system and its current research status in evaluating clinical value of lower limb force line / 中国骨伤

The principle and technical background of EOS imaging system are introduced. Combining with the publicity of this technology and the existing literature reports, it is known that low dose EOS technology can reduce radiation dose by 5 to 10 times in the course of examination, and micro dose EOS can even reduce radiation dose by 45 times. The image quality is only high or low; the system has EOS 2D and 3D workstations, which can help clinicians to measure and evaluate coronal and sagittal force lines of lower limbs easily. The tilt and torsion of limbs can be measured three-dimensional after three-dimensional model reconstruction in the three-dimensional workstation. Using these results, preoperative evaluation can be carried out. It is helpful for clinicians to evaluate and improve preoperative planning and post-operative measurement and evaluation of surgical effect. In terms of measurement accuracy, a large number of literatures reported that the accuracy of EOS 2D measurement is comparable to that of general radiology measurement, while the accuracy of EOS 3D reconstruction measurement is comparable to that of CT and MRI. Based on the technical characteristics and advantages of EOS, this paper reviews the literature reports and research progress of EOS in evaluating the accuracy of lower limb alignment.

Influence of vancomycin on inflammatory factor and PCT in elderly patients with heart failure combined with pulmonary infection / 药物评价研究

Objective To investigate the influence of vancomycin on inflammatory factor and PCT in elderly patients with heart failure combined with pulmonary infection.Methods 64 cases with heart failure combined with pulmonary infection from Jan.2015 to Dec.2016 in our hospital were chosen,who were randomly divided into two groups,who were taken with cephalosporin and vancomycin,the clinical efficacy of two groups after treatment were compared,the BNP,inflammatory factor and PCT level before and after treatment of two groups were compared.Results The total effective rate of vancomycin group was 84.37％,which was significantly higher than that of ceftazidime group,and the difference was statistically significant (P ＜ 0.05).After treatment,the BNP,TNF-a,IL-6,PCT were significantly reduced in the two groups,and the difference was statistically significant (P ＜ 0.05).And the BNP,TNF-a,IL-6,PCT of vancomycin group was decreased more significantly,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusion Vancomycin had great antibacterial action,which had great efficacy in treatment of heart failure combined with pulmonary infection patients.

Removal of heavy metals from extract of Angelica sinensis by EDTA-modified chitosan magnetic adsorbent / 中国中药杂志

The concentrations of heavy metals in the extracting solutions of traditional Chinese medicine are usually very low. Furthermore, a vast number of organic components contained in the extracting solutions would be able to coordinate with heavy metals, which might lead to great difficulty in high efficient removal of them from the extracting solutions. This paper was focused on the removal of heavy metals of low concentrations from the extracting solution of Angelica sinensis by applying an EDTA-modified chitosan magnetic adsorbent (EDTA-modified chitosan/SiO2/Fe3O4, abbreviated as EDCMS). The results showed that EDCMS exhibited high efficiency for the removal of heavy metals, such as Cu, Cd and Pb, e.g. the removal percentage of Cd and Pb reached 90% and 94.7%, respectively. Besides, some amounts of other heavy metals like Zn and Mn were also removed by EDCMS. In addition, the total solid contents, the amount of ferulic acid and the HPLC fingerprints of the extracting solution were not changed significantly during the heavy metal removal process. These results indicate that EDCMS may act as an applicable and efficient candidate for the removal of heavy metals from the extracting solution of A. sinensis.

Effects of low-magnitude high-frequency vibration on osteoporotic fracture complicated by closed arterial injuries / 医用生物力学

Objective To investigate the effects of low-magnitude high-frequency vibration (LMHFV) on osteoporotic fracture healing and blood supply of distal injured limbs based on osteoporosis fracture model of the ovariectomized (OVX) rats. Methods Ovariectomy was performed in 32 six-month-old female SD rats. 3 months later, closed transverse fractures were created at the right femoral midshafts complicated by femoral artery injuries. The rats were then randomly divided into vibration group and control group. Radiographs were performed in each week to assess the callus size and the status of fracture healing. At 2nd, 4th and 8th week after treatment, pulsed-wave Doppler ultrasonography was utilized to evaluate the blood flow velocity and the resistance index (RI) of the distal femoral artery in injured limbs. The peri-fracture region was reconstructed by Micro-CT for both qualitative and quantitative analysis. Results Pulsed-wave Doppler indicated a significantly higher peak systolic velocity of distal femoral artery in vibration group at 2nd and 4th week (P<0.05) and a lower RI as compared with control group.Radiography and Micro-CT analysis demonstrated that vibration group had better callus formation, mineralization, remodeling, and bridging rate during fracture healing as compared with control group. Conclusions LMHFV can effectively improve the blood supply of distal injured limbs and promote the osteoporotic fracture healing.

Effects of hyperglycemia and oxidized low density lipoprotein on differentiation of macrophage derived THP-1 monocytes / 上海第二医科大学学报

Objective To explore the effects of hyperglycemia and oxidized low density lipoprotein (ox-LDL) on the differentiation of macrophage derived THP-1 monocytes. Methods THP-1 human monocytic leukemia cell line was cultured in vitro, and the differentiation of THP-1 cells into macrophages was induced by phorbol esters. The macrophages were then incubated with the absence of D-glucose and ox-LDL (control group), 30 mmol/L D-glucose (hyperglycemia group), 100 μg/mL ox-LDL (ox-LDL group) or 30 mmol/L D-glucose and 100 μg/mL ox-LDL(G-ox-LDL group) for 24 h. High performance liquid chromatography was used for qualitative and quantitative analysis of intracellular cholesterol and cholesteryl esters. Both light microscope with red oil O staining technique and transmission electron microscope were employed to observe the morphology of treated and control THP-1 cells. Results A large number of intracellular red oil O stained granules and lipid vacuoles were observed in ox-LDL group and G-ox-LDL group, the contents of total cholesterol and cholesteryl esters were significantly higher than those of control group (P<0.05), and the contents of cholesteryl esters were higher than 50% of total cholesterol in both groups. However, only a few intracellular red oil O stained granules and lipid vacuoles were observed in control group and hyperglycemia group, there was no significant difference in the contents of total cholesterol and choleateryl esters between control group and hyperglycemia group (P>0.05), and the contents of cholesteryl esters were less than 50% of total cholesterol in both groups. Conclusion Foam cells form when THP-1 cells are incubated with ox-LDL, while hyperglycemia alone can not convert THP-1 cells to foam cells, indicating that ox-LDL is necessary for the macrophages derived THP-1 monocytes to turn into foam cells.