ObjectiveTo investigate the expression of miRNA-1 in denervated skeletal muscle at different periods, and to explore effects of passive movement on the expression of miRNA-1 and differentiation of myoblasts in denervation-induced skeletal muscle atrophy in rats. MethodsTwenty-seven Sprague Dawley rats, weighing (200±10) g, were randomly divided into sham-operated group (group A, n=3), denervated group (group B, n=12), and passive movement group (group C, n=12). After the right sciatic nerve was exposed and dissociated, the sciatic nerve of 1 cm in length was removed in groups B and C; resection was not performed in group A. At 1 day after operation, passive flexion and extension movement was performed on the right hind limb in group C. At 6 hours in group A and at 3, 7, 14, and 28 days in groups B and C, 3 rats were sacrificed to measure the wet weight ratio of gastrocnemius muscle, to observe the diameter of the gastrocnemius muscle cell and evaluate the muscle atrophy by HE staining; RT-PCR was used to detect the mRNA expression of miRNA-1 and myocyte differentiation factor (MyoD), and immunohistochemistry to determine the protein expression of MyoD. ResultsAtrophy in various degrees was observed in denervated gastrocnemius muscle of groups B and C. The muscle fiber arranged in disorder and the diameter of the muscle cells decreased gradually with the time, without normal structure and morphology. The wet weight ratio and the cell diameter of the gastrocnemius in groups B and C were significantly less than those in group A (P<0.05); the wet weight ratio at 7, 14, 28 days and the cell diameter at 7, 14 days of group B were significantly greater than those of group A (P<0.05). The expressions of miRNA-1 and MyoD mRNA gradually increased with time in groups B and C, but were significantly less than those of group A at each time point (P<0.05). At 7, 14, and 28 days after operation, the expressions of miRNA-1 and MyoD mRNA in group C were significantly higher than those in group B (P<0.05). Immunohistochemical staining showed positive expression of MyoD in groups A, B, and C at each time point, but higher expression was observed in groups B and C than group A; the expression increased with time in groups B and C, and it was significantly higher in group C than group B. The correlation analysis results showed that the overall change trend of miRNA-1 and MyoD had no relation with the gastrocnemius wet weight ratio at 3 and 7 days (P>0.05), and had positive correlation at 14 and 28 days (P<0.05); positive correlation was found between the relative expression of MyoD and miRNA-1 mRNA (P<0.05). ConclusionPassive movement can prevent amyotrophy by increasing the expression of miRNA-1 and promoting the differentiation of myoblasts.
Objective To investigate the effectiveness of modified Ishiguro technique with strengthening pressure in the treatment of bony mallet finger by comparing with the traditional Ishiguro technique. Methods Between May 2013 and May 2015, 31 cases of bony mallet finger were treated with traditional Ishiguro technique in 16 cases (control group) and with modified Ishiguro technique in 15 cases (improved group, the two Kirschner wires were bound, which were used to fix the distal interphalangeal joint and blocking avulsion fracture block in the classical Ishiguro technique, and play a continuous elastic compression). Difference was not significant in gender, age, cause of injury, injury finger, and the time from injury to operation between 2 groups (P > 0.05). Results The wound healing was delayed in 2 cases of the control group and 1 case of the improved group, and the other patients obtained healing by first intension. The follow-up time was 8-23 months (mean, 11 months) in the improved group and was 9-24 months (mean, 12 months) in the control group. Bending deformation of the Kirschner wire occurred in 2 cases of the control group, obvious separation was found between fracture fragment and the distal phalanx; after manual reduction, brace was used to fix, and distal interphalangeal arthritis occurred during follow-up. The fracture healing time was (6.8±0.8) weeks in the control group, and was (5.7±1.5) weeks in the improved group. There was significant difference in the healing time between 2 groups (t=-2.439, P=0.021). At last follow-up, according to Crawford criteria, the results were excellent in 9 cases, good in 4 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 81.25% in the control group; the results were excellent in 10 cases, good in 3 cases, and fair in 2 case with an excellent and good rate of 86.67% in the improved group. There was no significant difference in excellent and good rate between 2 groups (Z=-0.636, P=0.525). Conclusion Compared with traditional Ishiguro technique, the modified Ishiguro technique with strengthening pressure in treatment of bony mallet finger can facilitate the fracture healing, reduce Kirschner wire loosening and deformation, and decrease the rates of operation failure and complications.
Objective To explore the effectiveness and failure causes of large-head metal-on-metal total hip arthroplasty (large-head MoM THA). Methods Between March 2007 and May 2010, 159 patients (183 hips) underwent large-head MoM THA, and the clinical data were analyzed. There were 50 females (54 hips) and 109 males (129 hips) with an average age of 50 years (range, 20-78 years). Single hip was involved in 135 cases (left hip in 69 cases and right hip in 66 cases) and double hips in 24 cases. The causes included femoral head necrosis in 74 cases (93 hips), Legg-Calve-Perthes in 1 case (1 hip), osteoarthritis in 18 cases (19 hips), developmental dysplasia of the hip in 17 cases (18 hips), osteoarthritis after hip septic infection in 8 cases (8 hips), traumatic arthritis of the hip in 6 cases (6 hips), femoral neck fracture in 17 cases (17 hips), ankylosing spondylitis in 8 cases (11 hips), rheumatoid arthritis of hip in 9 cases (9 hips), and adult onset Still’s disease in 1 case (1 hip). Before operation, visual analogue scale (VAS) was 6.59±0.87; Harris score was 45.99±8.07. Results Healing of incisions by first intention was achieved, and no operative complication occurred. The patients were followed up 1.2-8.2 years (mean, 6.1 years). Implant failure was observed in 15 cases (17 hips), and the 5-year survival rate of large-head MoM THA was 91.80% (168/183). The causes of implant failure after THA were inflammatory pseudotumor in 4 cases (4 hips), acetabular aseptic loosening in 3 cases (3 hips), osteolysis in 4 cases (5 hips), acetabular aseptic loosening combined with inflammatory pseudotumor in 3 cases (3 hips), and functional disused in 1 case (2 hips). Of them, 9 cases (11 hips) did not receive revision surgery for various reasons, while 6 cases (6 hips) underwent revision surgery at 1.2-5.4 years (mean 3.7 years) after large-head MoM THA. At last follow-up, VAS and Harris score were 1.72±1.48 and 81.37±10.75 respectively, showing significant differences when compared with preoperative scores (t=–35.547，P=0.000；t=33.823，P=0.000). The function was excellent in 44 hips, good in 89 hips, fair in 33 hips, and poor in 17 hips. Conclusion Large-head MoM THA has a high revision rate during mid- and long-term follow-up because of inflammatory pseudotumor, acetabular aseptic loosening, and osteolysis. Early revision can effectively improve the function of the hip and improve patients’quality of life.