Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hamstring (HS) autograft and bone-patellar tendon-bone allograft are the most common choice for reconstruction of anterior cruciate ligament (ACL). There was a little report about the clinical outcome and difference of arthroscopic ACL reconstruction using allograft and autograft. This study aimed to compare the clinical outcome of autograft and allograft reconstruction for ACL tears.</p><p><b>METHODS</b>A total of 106 patients who underwent surgery because of ACL tear were included in this study. The patients were randomly divided into two groups, including 53 patients in each group. The patients in group I underwent standard ACL reconstruction with HS tendon autografts, while others in group II underwent reconstruction with bone-patellar tendon-bone allograft. All the patients were followed up and analyzed; the mean follow-up was 81 months (range: 28-86 months). Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm scores, physical instability tests, and patient satisfaction questionnaires. The complication rates of both groups were compared. Tibial and femoral tunnel widening were assessed using lateral and anteroposterior radiographs.</p><p><b>RESULTS</b>At the end of follow-up, no significant differences were found between the groups in terms of IKDC, Lysholm scores, physical instability tests, patient satisfaction questionnaires, and incidences of arthrofibrosis. Tibial and femoral tunnel widening was less in the HS tendon autografts. This difference was more significant on the tibial side.</p><p><b>CONCLUSIONS</b>In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly.</p>

Dingxin recipe ( ) prevents ischemia/reperfusion-induced arrhythmias via up-regulating prohibitin and suppressing inflammatory responses / 中国结合医学杂志

<p><b>OBJECTIVE</b>To identify the underlying mechanisms of the protective effects of Dingxin Recipe (: , DXR), a Chinese compound prescription that has been used clinically in China for more than 20 years, on ischemia/reperfusion (I/R)-induced arrhythmias in rat model.</p><p><b>METHODS</b>A total of 30 rats were randomly divided into three groups: sham group, I/R group, and DXR-pretreated I/R (DXR-I/R) group. Rats in the DXR-DXRI/R group were intragastrically administrated with DXR (12.5 g/kg per day) for consecutive 7 days, while rats I/in the sham and I/R groups were administrated with normal saline. Arrhythmias were introduced by I/R and electrocardiograms (ECG) were recorded. Two-dimensional (2-D) polyacrylamide gel electrophoresis and matrix-matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) were used to identify assisted differentially expressed proteins. Immunohistochemistry, real-time quantitative polymerase chain reaction (RQ-RQPCR), Western blot, and enzyme-linked immunosorbent assay (ELISA) were performed to analyze proteins PCR), obtained in the above experiments.</p><p><b>RESULTS</b>DXR significantly reduced the incidence and mean duration of ventricular tachycardia and ventricular fibrillation and dramatically decreased the mortality, as well as arrhythmia score, compared with those of the I/R group. Among successfully identified proteins, prohibitin (PHB) and heart fatty acid binding protein (hFABP) were up-regulated in DXR-pretreated I/R rats compared with those of the I/R rats. In addition, compared with the I/R group, the level of glutathione (GSH) was elevated accompanied by reduced expressions of interleukin-6 (IL-6) and neutrophil infiltration in I/R rats with DXR pretreatment.</p><p><b>CONCLUSIONS</b>DXR could alleviate I/R-induced arrhythmias, which might be related to increased expression of PHB. The enhanced expression of PHB prevented against the depletion of GSH and consequently inhibited apoptosis of cardiomyocytes. Furthermore, up-regulation of PHB might ameliorate I/R-induced cell death and leakage of hFABP by suppressing neutrophil infiltration and IL-6 expressions.</p>

Preliminary evaluation of posterior dynamic lumbar stabilization in lumbar degenerative disease in Chinese patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There has been some controversy related to the use of the Wallis system, rather than disc fusion in the treatment of patients with degenerative spine disease. Furthermore, there are no reports concerning the application of this dynamic stabilization system in Chinese patients, who have a slightly different lifestyle with Western patients. The aim of this study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases in Chinese patients.</p><p><b>METHODS</b>The clinical outcomes of 20 patients with lumbar degenerative disease treated by posterior decompression with the Wallis posterior dynamic lumbar stabilization implant were studied. All of the patients completed the visual analogue scale and the Chinese version of the Oswestry Disability Index. The following radiologic parameters were measured in all patients: global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion was then calculated.</p><p><b>RESULTS</b>Nineteen patients (95%) were available for follow-up. The mean follow-up period was (27.25 ± 5.16) months (range 16 - 35 months). The visual analogue scale decreased from 8.55 ± 1.21 to 2.20 ± 1.70 (P < 0.001), and the mean score on the Chinese version of the Oswestry Disability Index was improved from 79.58% ± 15.93% to 22.17% ± 17.24% (P < 0.001). No significant changes were seen in the range of motion at the stabilized segments (P = 0.502) and adjacent segments (above, P = 0.453; below, P = 0.062). The good to excellent result was 94.4% at the latest follow-up. No complications related to the use of the Wallis posterior dynamic lumbar stabilization occurred.</p><p><b>CONCLUSIONS</b>It was found to be both easy and safe to use the Wallis posterior dynamic lumbar stabilization implant in the treatment of degenerative lumbar disease, and the early therapeutic effectiveness is good. The Wallis system provides an alternative method for the treatment of lumbar degenerative disease.</p>

Reconstruction of distal radius by fibula following excision of grade III giant cell tumour: follow-up of 18 cases.

The purpose of this study was to evaluate the long-term results of vascularised fibular graft for reconstruction of the wrist after excision of grade III giant cell tumour in the distal radius. From January 1998 to September 2003, 18 patients with wrist defects due to distal radius grade III giant cell tumour resection were treated with vascularised fibular graft and were followed-up. The limb function was restored to an average 80% of normal function and bone union was achieved within six months in 18 patients with vascularised fibular graft. MSTS score averaged 25.6 and ranged between 21 and 29; Mayo wrist score averaged 56 with a range from 40 to 65. It is appropriate to use the head of the fibula as a substitute for the distal radius. The healing of vascularised fibular graft is very quick and without bone resorption. Thus, in the procedure for reconstruction and limb salvage after bone tumour resection of distal radius, the free vascularised fibular graft with fibular head is an ideal substitute.

Material base on Chinese medical theory of 'Fei and Dachang being interior-exteriorly correlated' / 中国中西医结合杂志

By reviewing pertinent literatures, we found that there existed some defects in studying material base on Chinese medical theory of "Fei and Dachang being interior-exteriorly related", such as the low efficacy of research methods; the neglect of intestinal and respiratory microhabitat and Chinese medical functional condition; and the unconformity of research design with evidence-based medicinal requirements. Thereby, the authors offered that the researches method of initiating merely from sole material or line linkage path should be rejected. The new research strategy should be established based on the feature of the lung and large intestine network connective structure, cutting-in from correlative changes in the two terminals (respiratory system and intestinal tissue), and the intermedial key knot of connection (blood serum), screen out in high throughput the relevant materials adopting microecological, proteomic and metabonomic techniques, and catch hold of the knots of network as much as possible. Based on these to perfect the researches on coordinating mechanism of the network, and to establish a new strategy for future researching.

Cervical disc prosthesis replacement and interbody fusion: a comparative study.

The purpose of this paper is to compare the new functional intervertebral cervical disc prosthesis replacement and the classical interbody fusion operation, including the clinical effect and maintenance of the stability and segmental motion of cervical vertebrae. Twenty-four patients with single C5-6 intervertebral disk hernias were specifically selected and divided randomly into two groups: One group underwent artificial cervical disc replacement and the other group received interbody fusion. All patients were followed up and evaluated. The operation time for the single disc replacement was (130 +/- 50) minutes and interbody fusion was (105 +/- 53) minutes. Neurological or vascular complications were not observed during or after operation. There was no prosthesis subsidence or extrusion. The JOA score of the group with prosthesis replacement increased from an average of 8.6 to 15.8. The JOA score of the group with interbody fusion increased from an average of 9 to 16.2. The clinical effect and the ROM of the adjacent space of the two groups showed no statistical difference. The short follow-up time does not support the advantage of the cervical disc prosthesis. The clinical effect and the maintenance of the function of the motion of the intervertebral space are no better than the interbody fusion. At least 5 years of follow-up is needed to assess the long-term functionality of the prosthesis and the influence on adjacent levels.

Identification of the binding site on glycophorin A for Plasmodium falciparum EBA-175 / 南方医科大学学报

<p><b>OBJECTIVE</b>To identify the binding site on glycophorin A (GPA) for EBA-175 to provide clue for developing short peptide vaccine and therapeutic agents against Plasmodium falciparum.</p><p><b>METHODS</b>With the recombinant protein of EBA-175 as the target molecule, the mimetic peptides of GPA were screened from a 12-mer random peptide library. Three rounds of biopanning were carried out, and enzyme-linked immunosorbent assay (ELISA), competitive ELISA, Dot-ELISA and Western blotting used to evaluate the binding between the phage-borne peptides and EBA-175. The insert DNA sequences of positive clones were determined and their amino acid sequences deduced.</p><p><b>RESULTS</b>Thirty clones from the third round were randomly selected, of which 27 were found positive by sandwich ELISA. Competitive ELISA proved that most of the phage-borne peptides could competitively inhibit the binding of antibody (EBA-175 Ab) with EBA-175. Analysis of DNA and amino acid sequences indicated that 24 positive phage clones contained the conservative sequence of IRR, which was highly homologous with the 114-116 amino acids of GPA.</p><p><b>CONCLUSION</b>These phage-displayed peptides can bind with EBA-175, and the amino acid sequence IRR might play an important role in the binding between EBA-175 and GPA.</p>