[Double plating through different approaches for periprosthetic femoral fracture following total knee arthroplasty].

OBJECTIVE: To study clinical effects of double plating through different approaches for communicated and obvious osteoporosis periprosthetic femoral fracture following total knee arthroplasty(TKA). METHODS: From July 2010 to June 2017, 21 patients with periprosthetic femoral fracture following TKA were divided into two groups according to operative approach. Fifteen patients in medial and lateral double approaches group, including 5 males and 10 females aged from 63 to 79 years old with an average of (67.2±5.9) years old; 11 patients were type 33-A2 and 4 patients were type 33-A3 according to AO-OTA classification; 12 patients injured by falling down and 3 patients by traffic accident; treated with double plating. Six patients in medial parapatellar approach group, including 3 males and 3 females, aged from 61 to 74 years old with an average of (64.6±6.0) years old; 3 patients were type 33-A2 and 3 patients were type 33-A3 according to AO-OTA classification; 5 patients injured by falling down and 1 patient by traffic accident; treated with double plating. Operative time, blood loss, postoperative drainage, fracture healing time were compared between two groups; HSS score and radiology at 3 and 12 months were compared between two groups. RESULTS: All patients were followed up, and the follow-up time of bilateral approaches group ranged from 12 to 18 months with an average of (14.2±2.6 ) months, while the follow-up time of single approach group ranged from 12 to 16 months with an average of (12.6±2.5) months, and there was no statistical difference between two groups. The operative time and postoperative drainage in bilateral approaches group were (107.2±10.4) min and (213.9±30.4) ml, while in sigle approach group was (95.4±12.8) min and (256.8±34.2) ml, and the differences were significant(P<0.05). There were no significant difference in blood loss and fracture healing time(P>0.05). HHS score at 3 and 12 months after operation in bilateral approach were 82.9±5.7 and 84.8±7.1, while in single approach group were 83.6±6.1 and 86.3±6.8; there was no statistical difference in HSS score between two groups(P>0.05). According to HSS score at 12 months after operation, 2 cases got excellent results and 13 good in bilateral approaches group; 1 case got excellent result and 4 good and 1 moderate in single approach group; but there was no statistical difference between two groups (χ²=2.625, P=0.105). There wase no significant differences in complications between bilateral approaches group(2 cases) and single approach group (1 case)(P>0.05). CONCLUSIONS: Double plating technique for communicated and obvious osteoporosis periprosthetic femoral fracture following TKA could obtain good function of knee joint. The medial parapatellar approach has shorter operative time, while the bilateral approaches had less drainage.

[Application of greater trochanteric slide osteotomy in total hip arthroplasty for stiff hip].

OBJECTIVE: To study the effect of greater trochanteric slide osteotomy(GTSO) in total hip arthroplasty (THA) for the treatment of stiff hip, as well as the potential complications. METHODS: There were 12 cases enrolled in the study from April 2010 to December 2014, including 9 males and 3 females. The mean age was 49.9 years old (ranged, 37 to 62 years old). The clinical result was evaluated according to the Harris evaluation system, and the radiological evaluations included the healing of the osteotomy, the stability of the prosthesis, and occurrence of heterotopic ossification (HA). RESULTS: The mean follow-up period was 17.3 months (ranged, 15 to 22 months). The mean postoperative Harris score was 88.00±6.11, which was significantly higher than the preoperative mean score which was 43.96±8.46(t=-18.34, P=0.00). All the osteotomy site abtained good healing without prosthesis loosening or HA. There was 1 patient with infection and 1 patient with pain in greater trochanter. CONCLUSIONS: GTSO is an effective exposure technique in THA for stiff hip, and no marked complication associated with the osteotomy is found in the study.

Angiotensin-Converting Enzyme Inhibitor (ACEI)-Mediated Amelioration in Renal Fibrosis Involves Suppression of Mast Cell Degranulation.

BACKGROUND/AIMS: The mechanism by which angiotensin-converting enzyme inhibitors (ACEIs) attenuate renal fibrosis has not been fully uncovered. METHODS: Renal fibrosis in rats was triggered by unilateral ureteral obstruction (UUO) and treated with Enalapril. RESULTS: Enalapril attenuated renal fibrosis, as evidenced by the fibrosis scores (1.07±0.73 versus 2.18±0.75 for 200 mg/ml Enalapril versus control, p<0.01) of Enalapril-treated UUO rats compared to mock-treated UUO rats. The amelioration was mast cell dependent, as Enalapril exhibited no effects on mast cell-deficient Kit(wsh/wsh) mice developing renal fibrosis. We detected lower levels of transforming growth factor ß (TGF-ß) and alpha-smooth muscle actin (α-SMA, a fibroblast activation marker) in the kidney tissue of Enalapril-treated UUO rats relative to the control UUO rats. Enalapril-treated UUO rats exhibited far fewer mast cells infiltrating per area in the kidney tissue than the control UUO rats (8.00±0.65 versus 29.00±0.57, p<0.01). Electron microscopy images revealed that mast cell degranulation was inhibited by Enalapril treatment. Further, IgE-mediated passive cutaneous anaphylaxis demonstrated that Enalapril blocked mast cell degranulation in vivo. CONCLUSION: Enalapril attenuated renal fibrosis in UUO rats, possibly by a mechanism involving the suppression of mast cell degranulation.

miR-20a promotes prostate cancer invasion and migration through targeting ABL2.

The aberrant expression of microRNAs (miRNAs) has been found in various types of cancer. The present study found miR-20a was significantly up-regulated in prostate cancer compared with normal prostate tissues. Patients with a higher miR-20a expression had a Gleason score of 7-10 and shorter survival time. The transwell and wound healing assays revealed that blocking expression of miR-20a by miR-20a ASO suppresses the invasion and migration of PC-3 and DU145 cells in vitro and also inhibits tumor growth in vivo. Furthermore, we identified miR-20a directly targets the ABL family non-receptor tyrosine kinases ABL2 and negatively regulates the phosphorylation of its downstream gene p190RhoGAP. Knockdown of ABL2 promoted cell invasion and migration and we identified miR-20a-induced cell invasion and migration can be rescued by ABL2. In conclusion, our findings show that miR-20a significantly contributes to the progression of prostate cancer by targeting ABL2.

Expression and role of miR-34a in bladder cancer.

To investigate the biological function of microRNA-34a (miR-34a) in bladder cancer, the expression of miR-34a was determined using quantitative real-time polymerase chain (qRT-PCR) reaction in 42 cases of bladder cancer. The relationship between the expression of miR-34a and development of bladder cancer was also studied. The mature mimics of miR-34a were chemically synthesized and transiently transfected into human bladder cancer T24 cells. The effects of miR-34a on apoptosis, cell cycle and proliferation in T24 cells were evaluated by flow cytometry and MTT, respectively. The results showed that the low expression rate of miR-34a was correlated with the malignancy and tumor size of bladder cancer. The up-regulation of miR-34a in T24 cells contributed to cell growth and cell cycle arrest, but not caspase-3 pathway. These findings suggest that the relative low expression of miRNA-34a might be involved in the tumorigenesis of bladder cancer.

[Observation of carbon-bear free radicals using far infrared laser magnetic resonance spectroscopy].

The principle and technical characters of far infrared laser magnetic resonance (FIRLMR) spectrometer built up in China are introduced. A CO2 transversely pumped far infrared laser is adopted. In order to obtain high sensitivity, the sample absorption cell is placed in the FIR laser cavity and separated from laser gain cavity with thin polypropylene film. The spectrometer can be employed to study short lived free radicals. The spectra of many transient free radicals including CCH, CF and CH2 have been detected by the spectrometer. These transients are generated by mixing CH4 with the fluorine atoms produced with microwave discharge.