Effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament tibial insertion fracture in adults / 中国修复重建外科杂志

OBJECTIVE@#To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults.@*METHODS@#Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing.@*RESULTS@#All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( P<0.05).@*CONCLUSION@#For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.

Arthroscopic double-row anchor suture fixation versus open reduction and internal plating in treatment of simple humeral fracture of the greater tuberosity / 中华创伤骨科杂志

Objective:To compare clinical outcomes of arthroscopic double-row anchor suture bridge fixation versus open reduction and internal plating in the treatment of simple humeral fracture of the greater tuberosity.Methods:From March 2013 to March 2017 at Department of Orthopaedics, Jianhu Hospital Affiliated to Nantong University, 40 patients were treated for simple humeral fracture of the greater tuberosity. They were 23 men and 17 women, aged from 25 to 70 years (mean, 53.2 years). All the fracture displacements were larger than 5 mm and the fracture blocks smaller than 3 cm × 3 cm. They were complicated with no other injuries like rotator cuff tear, superior labrum anterior posterior (SLAP) injury or Bankart injury. Of them, 18 were treated by arthroscopic double-row anchor suture bridge fixation and 22 by open reduction and internal plating. The 2 groups were compared postoperatively in terms of joint activity, visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeon (ASES) score at the last follow-up.Results:There were no significant differences in the preoperative general data between the 2 groups ( P>0.05), indicating they were comparable. The arthroscopy and open reduction groups were followed up for an average of 19 and 20 months, respectively. All the patients obtained bony union within 3 months after surgery. At the last follow-up for the arthroscopy and open reduction groups, respectively, the shoulder flexion was 152.7°±13.3° and 137.7°±19.2°, the abduction 146.0°±16.4° and 132.4°±20.5°, the VAS score 0.8±0.4 and 1.3±0.6 and the ASES score 91.8±4.1 and 87.4±5.8, showing significant differences in the above items between the 2 groups ( P<0.05). In the open reduction group, 2 patients developed subacromial impingement syndrome which was relieved after removal of the plate following fracture union. Shoulder stiffness was observed in one case but improved after manipulative release under anesthesia. Conclusion:In the treatment of simple humeral fracture of the greater tuberosity, arthroscopic double-row anchor suture fixation has advantages over open reduction and internal plating because it can lead to less invasion, quicker recovery and better functional recovery of the shoulder after operation.

Clinical study of autologous platelet rich plasma gel in arthroscopic rotator cuff repair:a randomized, controlled trial / 中华骨科杂志

Objective To investigate the effect of autologous platelet rich plasma (PRP) gel in arthroscopic rotator cuff re?pair. Methods All of 44 patients with rotator cuff tear undergent arthroscopic rotator cuff repair were randomly divided into two groups:PRP group (22 patients were received autologous PRP and hemocoagulase) and normal saline (NS) group (22 patients were received NS and hemocoagulase). All patients had the same accelerated rehabilitation protocol and were followed up in 1, 3, 12 months. Evaluation consisted of inflammatory reaction, wound healed, visual analogue scores (VAS), University of California at An?geles (UCLA) Shoulder Scores and American Shoulder and Elbow Surgeons (ASES) Scores. Results After operation, no inflam?matory reaction was in 20 cases of PRP group and 19 cases of NS group, mid inflammatory reaction 1 case in PRP group and 2 cas?es in NS group, moderate inflammatory reaction 1 case in PRP group and 1 case in NS group. Wound healed by first intention in all of PRP group and 21 patients of NS group. In PRP group, the preoperative, 3 months and 12 months postoperative VAS were 6.6±2.0, 3.4±1.8, 1.8±1.3, UCLA were 15.2±2.9, 24.3±2.7, 32.4±2.1, ASES were 35.6±12.4, 63.4±10.4, 92.3±7.5. In NS group, the preoperative, 3 months and 12 months postoperative VAS were 6.7 ± 1.9, 4.6 ± 1.9, 2.0 ± 1.2, UCLA were 14.8 ± 3.0, 21.2 ± 2.5, 31.7 ± 2.3, ASES were 32.7 ± 13.8, 55.8 ± 11.8, 90.7 ± 8.1. Three months postoperative VAS, UCLA, ASES were statistically signifi?cant differenece in PRP group and NS group. Twelve months postoperative VAS, UCLA, ASES were not statistically significant dif?ferenece in the two groups. Conclusion Using autologous PRP gel in arthroscopic rotator cuff repair can speed up the healing of operation incision with no adverse effect, reduce pain in the postoperation three months, accelerate the rotator cuff repair and re?covery of the function of shoulder joint. It has good short?term clinical effect.

Clinical study of platelet-rich plasma gel in total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of platelet-rich plasma (PRP) gel in total knee arthroplasty.</p><p><b>METHODS</b>From January 2011 to January 2013, 30 patients of total knee arthroplasty were received PRP (PRP group) and 30 patients won't received PRP(normal saline group).Routine drainage and functional exercise were applied to the two groups after operation. Postoperative drainage volume, inflammatory reaction, grade of wound healed, Hospital for Special Surgery (HSS) Score for knee, the Feller Score for patella and range of motion (ROM) for knee were evaluated.Independent samples t-test, grade data used rank sum test were used to compared two groups.</p><p><b>RESULTS</b>Postoperative drainage volume was (152 ± 22) ml in PRP group and (432 ± 35) ml in normal saline group. Postoperative drainage volume were statistically significant difference between two groups (t = 37.098, P < 0.05). At 4 days after operation, no inflammatory reaction was observed in 27 cases of PRP group and in 24 cases of normal saline group, mid inflammatory reaction in 2 cases of PRP group and in 4 cases of normal saline group, moderate inflammatory reaction in 1 cases of PRP group and in 2 cases of normal saline group.Wound healed by first intention in 30 patients of PRP group and in 29 patients of normal saline group (29/30), by second intention after 3 days of dressing change in 1 patient of normal saline group using 75% alcohol wet compressed. The adverse reaction rate was 3.3%. The average follow-up period was 16 months, ranging from 10 to 24 months. Three months postoperative HSS score for knee, scores of patellar, scores of anterior knee pain and ROM for knee were statistically significant difference in PRP group and normal saline group (t = 2.288, 2.097, 2.630, 2.104; all P < 0.05). Inflammatory reaction, grade of wound healed, final follow-up HSS score for knee, scores of patellar, scores of anterior knee pain and ROM for knee had no statistically significant difference between PRP group and normal saline group (P > 0.05).</p><p><b>CONCLUSIONS</b>Using PRP gel in total knee arthroplasty can reduce postoperative drainage volume, accelerate the healing of operation incision with no extra complications.It has good short-term clinical effect.</p>

The effect of platelet-rich plasma in anterior cruciate ligament reconstruction / 中华骨科杂志

Objective To investigate the effect of platelet-rich plasma (PRP) in anterior cruciate ligament (ACL) reconstruction.Methods From January 2010 to January 2013,40 patients with ACL ruptures who underwent arthroscopic ACL reconstruction with gracilis and semitendinosus tendon were randomly divided into two groups:PRP group and normal saline group.20 patients received graft soaked with PRP and hemocoagulase while 20 patients received graft soaked with normal saline and hemocoagulase.All patients were followed up in 1,3 and 12 months.Evaluation consisted of postoperative drainage volume,inflammatory reaction,grade of wound healed,anterior drawer test,Lachman test,pivot shift,Lysholm knee score and KNEELAX3.Results The average follow-up period was 18 months.Postoperative drainage volume was 142±24 ml in PRP group and 324±22 ml in saline group.The difference was statistically significant.At 4 days after the operation,no inflammatory reaction was observed in 18 cases of PRP group and in 16 cases of saline group,mid inflammatory reaction in 1 case of PRP group and 2 cases of sa line group,and moderate inflammatory reaction in 1 case of PRP group and 2 cases of saline group.Wound healed by first intention in 20 patients of PRP group and in 19 patients of saline group.The preoperative results of anterior drawer test,Lachman test and pivot shift were positive,while postoperative results were negative in both two groups.In PRP group,the preoperative and postoperative Lysholm knee scores of patients in 12 months were 39.8±8.9 and 92.1±2.7 points respectively.In saline group,the preoperative and postoperative Lysholm knee scores of patients in 12 months were 38.7±9.8 and 89.9±4.1points respectively.The differences were not statistically significant.KNEELAX3 measuring results:in PRP group,preoperative measurement was 9.4±1.2 mm in average,while measurement in 12 months postoperatively was 1.2±1.1 mm.In saline group,preoperative measurement was 9.6±1.3 mm,while measurement in 12 months postoperatively was 2.2±1.2 mm.The differences were statistically significant.Conclusion Using graft soaked with PRP in ACL reconstruction could reduce postoperative drainage volume,accelerate the healing of tendon-bone interface in the bone tunnel and the recovery of knee joint function.

Hypoxia decreases K_V1.5 expression by 15-LO/15-HETE in rat / 中国药理学通报

Aim To test the contribution of 15-HETE on expression of KV1.5 channel under hypoxia condition,using CDC or NDGA to block 15-LO/15-HETE,and to observe the effect of hypoxia on KV1.5 channel protein,mRNA expressions in cultured rat pulmonary arterial smooth muscle cells(PASMCs)and pulmonary arterials(PAs).Methods Western blot,RT-PCR and 15-LO blockers,cinnamyl 3,4-dihydroxy-[alpha]-cyanocinnamate(CDC)or nordihydroguiairetic acid(NDGA)were used to identify the role of endogenous 15-HETE on expression of KV1.5 channel in cultured rat pulmonary arterial smooth muscle cells(PASMCs)and PAs.Results(1)The expressions of KV1.5 channel protein and mRNA in PASMCs and PAs preteated with CDC or NDGA greatly increased than those of PASMCs under hypoxia group.(2)Exogenous 15-HETE added to PASMCs pretreated with CDC or NDGA greatly decreased the expression of KV1.5 than that of adding PASMCs pretreated with CDC or NDGA under hypoxia condition.Conclusion The down-regulation of KV1.5 channel expression caused by hypoxia is through endogenous 15-HETE.

Staurosporine aglycone at high concentration causes ERK1/2 phosphorylation in rat pulmonary artery smooth muscle cells / 中国药理学通报

Aim To investigate the effect of SA on induction of ERK1/2 activity in rat pulmonary smooth muscle cells(PASMCs).Methods Western blot analysis was employed to identify the activation of ERK1/2 stimulated by SA at different time points and concentrations in cultured rat PASMCs.Results An unexpected observation showed that ERK1/2 phosphorylation was seen after treatment of SA for 2h at a high concentration(30 ?mol?L-1) but not at lower concentration(from 1 nmol?L-1 to 1 ?mol?L-1).Activation of ERK1/2 pathway could be inhibited by an ERK1/2 inhibitor PD98059 or a protein kinase A(PKA) activator isoproterenol.Conclusion Together,these results suggest that SA has a strong dual regulating effect upon ERK1/2 through PKC and/or PKA pathways in rat PASMCs.

Interaction between regulatory proteins related to the activation of eNOS and CYP4A/20-HETE / 中国药理学通报

Aim To investigate the interaction between regulatory proteins related to the activation of eNOS and CYP4A/20-HETE.Methods The endothelia of pulmonary artery of new born bovine were cultured and divided into four groups: controlling group: ethanol solvent as vehicle (the volume is the same with 1?10~ -6 mol?L~ -1 20-HETE) was added to culture dish and incubated for 10 min; 20-HETE 5 min treatment group:1?10~ -6 mol?L~ -1 20-HETE was added to culture dish and incubated for 5 min; 20-HETE 10 min treatment group:1?10~ -6 mol?L~ -1 20-HETE was added to culture dish and incubated for 10 min; VEGF 10 min treatment group: 1?10~ -8 mol?L~ -1 VEGF was added to culture dish and incubated for 10 min. CYP4A,eNOS and proteins related to the activation of eNOS were measured by Immunoprecipitating and immunobloting.Results Expressions of eNOS and phospho-eNOS(Ser1177)in PAECs were upregulated after the cells were treated with 20-HETE, and similar phenomena were observed when 20-HETE was replaced by VEGF; 20-HETE increased the binding of Hsp、Akt and eNOS.Conclusions ①20-HETE phosphorylates eNOS at Ser1177 site which activates the eNOS to catalyze L-aginine to produce nitric oxide.②eNOS binds with Hsp90 and Akt in endothelial cell of pulmonary artery and 20-HETE increase the binding. ③eNOS binds with CYP4A in endothelial cell of pulmonary artery.