Objective To investigate the appl ication of anti-rotation screw after dynamic hi p screw (DHS) in treatment of intertrochanteric fracture. Methods Between April 2006 and January 2010, 22 cases of intertrochanteric fractures underwent DHS fixation operation with an anti-rotation screw, including 15 males and 7 females with an average ageof 66.3 years (range, 54-83 years). Fractures were caused by sl ipping in 16 cases, traffic accident in 5 cases, and fall ing from height in 1 case. All cases showed closed fractures, including 13 cases in the left and 9 cases in the right. Eighteen cases were simple intertrochanteric fracture, 4 cases were intertrochanteric fractures compl icated with Colles fractures. According to Evans classification standard, there were 14 cases of type I, 6 cases of type II, 1 case of type III, and 1 case of type IV. The time from wound to operation was 3-7 days (mean, 4.5 days). Results The operation time ranged from 51-95 minutes (mean, 72 minutes). The intraoperative blood loss was 150-350 mL (mean, 270 mL). The hospital ization days were 12-35 days (mean, 16.8 days). Primary heal ing was observed in all cases. All cases were followed up 6-17 months (mean, 14 months). Union of fracture was observed at 12-16 weeks (mean, 13.6 weeks); no fracture or internal fixation loosening occurred. According to HUANG Gongyi’s standard of efficacy assessment, the results were excellent in 19 cases and good in 3 cases. Conclusion Appl ication of an anti-rotation screw can help to improve the strength of the DHS for the internal fixation of intertrochanteric fracture, especially the anti-rotation abil ity, which does not increase the operation time obviously.
Objective To investigate the possibility of constructing eukaryotic expression vector for human glial derived neurotrophic factor （hGDNF）, transfecting it to spinal cord tissue of rats so as to treat acute spinal cord injury. Methods The eukaryotic expression vector pcDNA3-hGDNF was constructed by recombinant DNA technique, transfected into glial cell and neuron of spinal cord by liposome DOTAP as experimental group. In control group, mixture of empty vector and liposome was injected. The mRNA and protein expressions of hGNDF were detected by RT-PCR and Western blot. Results After the recombinant eukaryotic expression vector for hGDNF was digested with Hind III and XbaⅠ, electrophoresis revealed 400 bp fragment for hGDNF gene and 5 400 bp fragment for pcDNA3 vector. In the transfected spinal cord tissue, the mRNA and protein expressions of hGDNF gene were detected with RT-PCR and Western blot. Conclusion The constructed eukaryotic expression vector pcDNA3hGDNF could be expressed in the transfected spinal cord tissue of rat, so it provide basis for gene therapy of acute spinal cord injury.
The aim of this study is to explore the effects of continuous theta-burst transcranial magnetic stimulation (cTBS) on functional brain network in emotion processing. Before and after the intervention of cTBS over left dorsolateral prefrontal cortex (DLPFC) of ten participants who were asked to perform the emotion gender recognition task, we recorded their scalp electroencephalograms (EEG). Then we used the phase synchronization of EEG to measure the connectivity between two nodes. We then calculated the network efficiency to describe the efficiency of information transmission in brain regions. Our research showed that after the intervention of cTBS and the stimulation of the emotion face picture, there was an obvious enhancement in the event-related spectral perturbation after stimuli onset in beta band in 100–300 ms. Under the stimulation of different emotion picture, the values of global phase synchronization for negative and neutral stimuli were enhanced compared to positive ones. And the increased small-worldness was found in emotional processing. In summary, based on the effect of activity change in the left DLPFC on emotion processing brain network, the emotional processing mechanism of brain networks were preliminary explored and it provided the reference for the research of emotion processing brain network in the future.
ObjectiveTo detect the metabolites of the serum and joint fluid from rabbits’ osteoarthritis model with 1H nuclear magnetic resonance spectroscopy (NMR) technique, study the metabolic differences and connections of serum, synovial and cartilage of rabbits after the articular cavity injection of sodium hyaluronate, and explore osteoarthritis and metabolic mechanism in the process of treating sodium hyaluronate using sodium hyaluronate, thus provide new ideas and basis of the specific mechanisms in the treatment of osteoarthritis via sodium hyaluronate.MethodsWe selected 30 healthy New Zealand white rabbits, 6 months old, and randomly divided them into three groups as follows: blank control group, model phosphate buffer saline (PBS) liquid injection group and model injection of sodium hyaluronate group, with 10 rabbits in each group. Ten weeks after surgery, all experimental animals were put to death and observed in correlation studies regarding general condition, imaging examination, and histological examination. Metabolites 1H NMR detection and data preprocessing were performed in the serum and joint fluid samples.ResultsThe results considering general condition, general sample observation, imaging examination and histology indicated advantages in sodium hyaluronate group over PBS group. Metabolomics analysis showed statistically significant changes of metabolites in the serum and joint fluid compared with the PBS group and the blank control group (P<0.05). According to the relevant ways of differences metabolites retrieval, analysis found that the effect of sodium hyaluronate on osteoarthritis might be related to protein biosynthesis, amino acid circulation, the metabolic process of pyruvic acid, gluconeogenesis and other metabolic pathways.ConclusionsBased on the research of 1H-NMR metabolomics, the results suggest that the effect of sodium hyaluronate on osteoarthritis is mainly related with the activation of protein metabolism, abnormal lipid and energy metabolic pathways. This study provides new ideas and basis on the concrete mechanism in the treatment of knee osteoarthritis using sodium hyaluronate.
ObjectiveTo review the current status and progress of sterilization and preservation for allograft in anterior cruciate ligament reconstruction.MethodsThe related literature about the sterilization and preservation of allografts in anterior cruciate ligament reconstruction was extensively reviewed and summarized.ResultsThere are many sterilization methods for allografts, the most commonly used method is γ-ray irradiation, but the optimal irradiation dose is still unclear. Electron beam irradiation is also available, but excessive dose is harmful to graft shaping. A combined sterilization method combining physics and chemistry methods is still being explored. Cryopreservation is the most commonly used method of preservation. In order to reduce the influence of crystals, the principle of " slow cooling and rapid rewarming” should be adhered to as far as possible.ConclusionThe processing methods of allograft can affect the effectiveness of anterior cruciate ligament reconstruction. The clinical doctors should consider the sterilization and preservation methods in practice.
ObjectiveTo investigate the correlation between TLR5 rs5744174 gene polymorphism and Streptococcus pneumoniae pneumonia.MethodsOne-hundred and six patients with Streptococcus pneumoniae pneumonia admitted to this hospital from January 2014 to October 2018 were selected as an observation group, and 85 healthy subjects were selected as a control group during the same period. The clinical and pathological data of the subjects were collected, polymorphism of TLR5 rs5744174 gene was analyzed by PCR and sequencing, and the relationships between cell classification count, C-reactive protein (CRP) level in bronchoalveolar lavage fluid (BALF) and TLR5 rs5744174 gene polymorphism in the patients with Streptococcus pneumoniae pneumonia were analyzed.ResultsThere were significant differences in age, smoking, alcoholism, diabetes and the other general data between the observation group and the control group (P<0.05). The distribution of TLR5 rs5744174 genotype in the observation group and the control group was in accordance with Hardy-Weinberg equilibrium test level (χ2=16.89 for the observation group, χ2=10.76 for the control group, both P>0.05). There was no significant difference in the distribution frequency of TLR5 rs5744174 (C < T) genotype and allele between the two groups (P>0.05). There were significant differences in the proportion of diabetes mellitus among the three genotypes (CC, CT, TT) of the patients with Streptococcus pneumoniae pneumonia (P<0.05). The percentage of neutrophils and CRP levels in BALF were significantly different (P<0.05).ConclusionThe polymorphism of TLR5 rs5744174 gene may not be related to the occurrence of Streptococcus pneumoniae pneumonia, but is related to the proportion of complicated diabetes mellitus, the percentage of neutrophils and the level of CRP in patients with Streptococcus pneumoniae pneumonia, which may affect the degree of inflammation.
ObjectiveTo systematically review the progress of different methods for femoral tunnel positioning in anterior cruciate ligament (ACL) reconstruction and provide a clinical reference for treatment of ACL rupture.MethodsThe literature about the femoral tunnel positioning in ACL reconstruction was widely reviewed. The advantages and disadvantages and the clinical results of each method were summarized.ResultsCurrently in ACL reconstruction, methods for femoral tunnel positioning include transtibial technique (TT), anteromedial technique (AM), outside-in (OI), modified TT (mTT), and computer assisted surgery. There is no significant difference in the postoperative effectiveness between TT technique and AM technique. Compared with the TT technique, the OI technique has higher rotational stability of knee, but there is no significant difference in clinical results. The femoral tunnel located by mTT technique is closer to the anatomical placement than that of TT technique, but mTT technique is not effective for systematically anatomic femoral tunnel positioning, and further research is needed to prove its advantages.ConclusionDifferent femoral tunnel positioning methods have their own advantages and disadvantages, and there is no definite evidence that one is superior than the rest.
Biliary tract cancer is characterized by occult onset, highly malignancy and poor prognosis. Traditional medical imaging is an important tool for surgical strategies and prognostic assessment, but it can no longer meet the urgent need for accurate and individualized treatment in patients with biliary tract cancer. With the advent of the digital imaging era, the advancement of artificial intelligence technology has given a new vitality to digital imaging, and provided more possibilities for the development of medical imaging in clinical applications. The application of radiomics in the diagnosis and differential diagnosis of benign and malignant tumors of biliary tract, assessment of lymph node status, early recurrence and prognosis assessment provides new means for the diagnosis and treatment of patients with biliary tract cancer.
ObjectiveTo summarize the diagnosis and treatment progress in the femoral insertion injury of the medial collateral ligament (MCL) of knee, and to provide a clinical reference for diagnosis and treatment. MethodsThe literature on the femoral insertion injury of the MCL of knee was widely reviewed. The incidence, mechanisms of injury and anatomy, the diagnosis and classification, and status of treatment were summarized. ResultsThe mechanism of the femoral insertion injury of the MCL of knee is related to its anatomical and histological characteristics, as well as the abnormal valgus of the knee joint, excessive external rotation of the tibial platform and it is classified according to the injury characteristics to guide the refined and individualized clinical treatment. ConclusionDue to different understanding of femoral insertion injury of MCL of knee, the treatment methods are different, and thus is the healing effect. Additional studies are still needed to promote the healing of insertion injuries.
ObjectiveTo investigate the risk factors of contralateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction. Methods A retrospective review was conducted on the 716 patients with ACL injury who received primary ACL reconstruction surgery and met the selection criteria between January 2012 and September 2018. After a mean follow-up period of 7.6 years (range, 4-10 years), 65 patients (9.1%) experienced contralateral ACL injury (injured group) and 651 patients (90.9%) did not (uninjured group). There was no significant difference in age, body mass index, and preoperative Lachman test degree between groups (P>0.05). However, the proportion of female in the injured group was significantly higher than that of male (P<0.05), and the preoperative posterior tibial slope (PTS) was significantly higher than that of the uninjured group (P<0.05). Using the outcome of contralateral ACL injury as the dependent variable, the clinical data of the patient was first used as the independent variable, and univariate COX regression was used to analyze the prognostic influencing factors. Then, the indicators with differences in univariate COX regression were used as the independent variable, and multivariate COX regression was used to analyze the independent risk factors affecting prognosis. Log-Rank (Mantel-Cox) test was used to test and analyze the occurrence time of contralateral ACL injury in patients of different genders; X-tile software was used to analyze the occurrence time of contralateral ACL injury in patients with different PTS using Log-Rank (Mantel-Cox) test and PTS cut-off values. ResultsUnivariate COX regression analysis showed that gender and PTS were influence factors for contralateral ACL injury (P<0.05); further multivariate COX regression analysis showed that female and increased PTS were independent risk factors for contralateral ACL injury (P<0.05). The Log-Rank (Mantel-Cox) test results showed that the contralateral ACL injury occurred in female at 8.853 (8.600, 9.106) years, which was significantly shorter than that in male [9.661 (9.503, 9.819) years] (χ2=20.323, P<0.001). Using X-tile software to analyze the cut-off value of PTS, it was found that the cut-off value of PTS for contralateral ACL injury was 10.92°. According to the Log-Rank (Mantel-Cox) test, it was found that the contralateral ACL injury occurred in 5.762 (4.981, 6.543) years in patients with PTS≥10.92°, which was significantly shorter than patients with PTS<10.92° [9.751 (9.650, 9.853) years](χ2=302.479, P<0.001). ConclusionFemale and PTS≥10.92° after primary ACL reconstruction are independent risk factors for contralateral ACL injury.