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OBJECTIVE@#To investigate the effectiveness of "hybrid" suture with en masse combined with double-layer repair under arthroscopy in repair of delaminated rotator cuff tear by comparison with en masse suture.@*METHODS@#Fifty-six patients with delaminated rotator cuff tears met selection criteria between June 2020 and January 2022 were included in the study. Patients were divided into two groups ( n=28) using a random number method. The patients in trial group underwent arthroscopic "hybrid" suture with the combination en masse and double-layer suture. The patients in control group underwent en masse suture under arthroscopy. There was no significant difference between the two groups ( P>0.05) in terms of gender, age, rotator cuff tear side, tear size, cause of injury, disease duration, and preoperative American Association of Shoulder and Elbow Surgeons (ASES) score, the University of California at Los Angeles (UCLA) shoulder scoring, visual analogue scale (VAS) score, and shoulder range of motion (forward flexion and lateral external rotation). The operation time, the difference of ASES score, UCLA score, VAS score, and shoulder range of motion (forward flexion and lateral external rotation) between pre- and post-operation were recorded and compared between the two groups ( P>0.05). The rotator cuff healing was examined by MRI and evaluated based on the classification criteria of rotator cuff healing proposed by Sugaya et al.@*RESULTS@#Three cases (1 case in the trial group and 2 cases in the control group) were excluded from the study due to loss of follow-up. Twenty-seven cases in the trial group and 26 cases in the control group were included in the final study analysis. All operations of the two groups were completed successfully. There was no significant difference in the operation time between groups ( P>0.05). The follow-up time was 10-12 months (mean, 10.9 months) in the trial group and 10-13 months (mean, 11.4 months) in the control group. All incisions healed by first intention. No surgery-related complications occurred. The UCLA score, ASES score, VAS score, and shoulder range of motion (forward flexion and lateral external rotation) of both groups at 9 months after operation were significantly superior to those before operation ( P<0.05). The difference of UCLA score, ASES score, and VAS score between before and after operation in the trial group were significantly better than those in the control group ( P<0.05). There was no significant differences between the two groups in the difference of shoulder range of motion (forward flexion and lateral lateral rotation) ( P>0.05). At 9 months after operation, according to the classification criteria of rotator cuff healing proposed by Sugaya et al, MRI showed that the rotator cuff healing of the trial group was significantly better than that of the control group ( P<0.05).@*CONCLUSION@#Compared with en masse suture, arthroscopic "hybrid" suture for the repair of delaminated rotator cuff tear has advantages in relieving pain and improving shoulder joint function, and the rotator cuff healing is better.
Assuntos
Humanos , Lesões do Manguito Rotador/cirurgia , Estudos Prospectivos , Articulação do Ombro/cirurgia , Resultado do Tratamento , Artroscopia/métodos , Suturas , Amplitude de Movimento Articular , Imageamento por Ressonância MagnéticaRESUMO
Gastric adenocarcinoma (GC) is one of the most common malignancies in the world and one of the most frequent causes of cancer-related death.Autophagy is a highly regulated catabolic pathway responsible for the degradation of long-lived proteins and damaged intracellular organelles.However,the mechanism and guiding significance of autophagy in the development and progression of GC have remained to be elucidated.This study aimed to explore the clinicopathological significances and prognostic values of autophagy-related proteins AMBRA1 and Beclin-1 in GC.Quantum dots based immunofluorescence histochemistry (QDs-IHC) was performed to observe the expression of AMBRA1 and Beclin-1 proteins in the tissue rmicroarrays including 163 specimens of GC and 20 noncancerous gastric tissues.Simultaneously,AMBRA1 and Beclin-1 proteins were detected by Western blotting in the 10 fresh GC and corresponding normal gastric tissues.The results showed that the expression levels of both AMBRA1 and Beclin-1 proteins were higher in GC tissues than in noncancerous gastric tissues by QDs-IHC and Western blotting (P＜0.05).High AMBRA1 expression was detected in 90 of 163 (55.2％) GCs and high Beclin-1 expression was detected in 83 of 163 (50.9％) GCs.High AMBRA1 expression was closely related to depth of invasion,and lymph nodes metastasis (P＜0.05).High expression of Beclin-1 protein was correlated with tumor grade (P＜0.05).Positive correlation was observed between AMBRA1 and Beclin-1.Survival analysis indicated the high expression of AMBRA1 and Beclin-1 was an independent factor in predicting poor overall survival (OS) of GC patients.These findings suggest the high expression of AMBRA1 and Beclin-1 proteins is significantly correlated with GC progression.High AMBRA1 and Beclin-1 expression heralds worse outcome of GC patients,suggesting a novel candidate prognostic marker and a therapeutic target for GC.
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Objective To evaluate the clinical efficacy of flexible ureteroscopy combined with physical vibration lithecbole in treatment of massive upper urinary calculi. Methods The clinical data of 62 cases with massive upper urinary calculi from Feb 2016 to Mar 2017 were analyzed retrospectively. The average diameter of stones were (656.70 ± 275.40) mm2. The removal rate of stones, general conditions during the operation, the postoperative adverse reactions and renal function changes were observed. Results All 62 patients had successfully completed flexible ureteroscopy operation, and had physical vibration stone removal treatment after 1 week. The rate of stone removal was 61.29％ in the next day (38/62), 85.48％ (53/62) in the next 1 week and 96.77％ (60/62) in the next 3 weeks. Postoperative fever occurred in 2 cases, the overall complication rate was 3.23％. 18 patients had improved renal function while 4 patients keep stable after operation. Conclusion The flexible ureteroscopy combined with physical vibration lithecbole is a safe and effective therapeutic method for massive upper urinary calculi. It has high stone removal rate, less complications, little impact on renal function. It is valuable to advocate clinically.
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OBJECTIVE CYP2 family including CYP2C and CYP2J is the predominant arachidonic acid (AA) epoxygenase, and the epoxidation of AA produces four regioisomeric cis-epoxyeicosatrienoic acids (5,6-, 8,9-, 11,12-, and 14,15-EET). Human CYP2J2 is one of the main CYP isoforms expressed in brain, but CYP2C8 was present at a low level. The aim of this study is to investigate the roles of brain CYP2J in Parkinson disease. METHODS Rats received the right-unilaterally injection with concentrated LV-CYP2J3 or LV-EGFP in the substantia nigra (SN) at 3 d before LPS or 6-OHDA treatment. The animals were tested for rotational behavior with the dopaminergic agonist apomorphine dissolved in sterile saline at 14 and 21 d after LPS injection. The influence of CYP2J-dependent derivative, 14,15-EET, on the genes related with oxidative stress was assayed in SH-SY5Y cells. RESULTS CYP2J overexpression or 14,15-EET treatment significantly increased the levels of SOD1, CAT, GPX1, NRF2 and KEAP1 in neurons. TLR4- MyD88 signaling pathway was involved the down- regulation of CYP2J by LPS. The binding of p-CREB with the promoter of CYP2J was inhibited by the LPS treatment. The loss of dopami?nergic neurons in the right SN induced by LPS or 6- OHDA was significantly decreased by CYP2J3 transfection at 21 d after LPS injection. Compared with LPS or 6-OHDA group, the number of the rotation of rats was decreased by 42.6% and 60.7% by CYP2J3 transfection at 14 d after LPS or 6-OHDA injection;meanwhile, the rotation number was decreased by 12.7% and 21.3% at 21 d. The accumulation of alpha synuclein induced by LPS was significantly decreased by CYP2J3 transfection. The mRNA levels of SOD1, CAT, GPX1, NRF2 and KEAP1 in SN were decreased by LPS, which was attenuated by the injection of LV-CYP2J3. CONCLUSION Brain CYP2J can play a protective role in the damage of the inflammation and oxidative stress to the dopaminergic neurons. Brain CYP2J- dependent derivatives from AA may have therapeutic effects in Parkinson disease via the up- regulation of the antioxidant system in neurons.