Objective To evaluate the relevant factors affecting prognosis of traumatic optic neuropathy. Methods Sixty-nine patients with traumatic optic neuropathy were enrolled. Multiple variable analysis was done to filter the risk factors to prognosis in traumatic optic neuropathy. Results At 3 months or more of followup,no light perception was found in 32 cases (46.4%); visual acuity were increased by≥1 lines in 33 cases (47.8%). The outcome of visual acuity was poorer in patients with the following conditions:no light perception after trauma （P=0.0031）, loss of consciousness （P=0.0262）, no pretreated common-dosage corticosteroids （P=0.0184）, and absence of VEP （P=0.0001）. Conclusion The initial visual acuity of no light perception, loss of consciousness, and no pretreated common-dosage corticosteroids were the risk factors to prognosis in traumatic optic neuropathy,and result of VEP was an effective prognosis indicator in traumatic optic neuropathy. (Chin J Ocul Fundus Dis, 2002, 18: 98-100)
Objective To explore the feasibility of single mediastinal drainage tube in treatment of esophageal carcinoma after thoracoscopic combined with laparoscopic surgery. Methods There were 90 esophagus cancer patients treated by surgery in our hospital between June 2015 and October 2016. The patients were allocated into two groups including a single-drainage tube group and a two-drainage tube group. There were 45 patients with 24 males and 21 females at age of 48-78 years in the two-drainage tube group and 45 patients with 23 males and 22 females at age of 45-84 years in the single-drainage tube group.The clinical effect of the two groups was compared. Results There was no statistical difference in gender and age, bleeding amount and surgical duration in operation, thoracic drainage amount, incidence of atelectasis, pneumothorax, and encapsulated effusion between the two groups(P<0.05). Discussion Single-drainage tube group displays less postoperative pain, faster recovery, and more convenient clinical care without complication.
Abstract： Objective To investigate the acute cardioprotective effect of 17b-estradiol (17b-E2) against severe myocardial ischemia/reperfusion (I/R) injury in rabbits and the mechanism of the effect. Methods We established the model of myocardial I/R in vivo by occluding the left anterior descending coronary artery of the rabbits (who underwent coronary occlusion for 40 minutes followed by 3 hours of reperfusion). Twentyfour New Zealand white male rabbits were randomly divided into two groups with 12 in each group. Before coronary occlusion, 1 ml of ethanol or 17b-E2 at 10 μg/kg was administered intravenously to the rabbits in the control group and the experimental group respectively. The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by enzymelinked immunosorbent assay (ELISA) at the following time points: before occlusion, 40 minutes after occlusion, 1 hour, 2 hours and 3 hours after reperfusion. Activation of p38 mitogen activated protein kinase(MAPK) was determined by Western blotting analysis, and apoptosis of cardiocytes was identified by terminal deoxynucleotidlyl transferase mediated deoxyuridinebiotin dUTP Nick End Labeline (TdT)mediated dNTP nick end labeling (TUNEL) staining. Results During myocardial ischemia, TNF-α decreased significantly in the experimental group compared with the control group (F=0.007,P=0.001), while there was no difference in IL-6 between the two groups (F=0.616,P=0.095). During the process of reperfusion, the levels of TNF-α and IL-6 in the experimental group were significantly lower than those in the control group (Plt;0.01). Besides, the activation of p38 MAPK and apoptotic index for the experimental group were also lower (45.07%±2.73% vs. 61.25%±2.41%, t＝－15.398, P=0.000; 11.21%±3.85% vs. 22.02%±4.49%, t＝－6.332, P=0.000). Conclusion The cardioprotective effect of 17b-E2 against myocardial I/R may be attributed to its antiinflammatory and antiapoptotic properties, which is probably associated with the inhibition of 17bE2 on p38MAPK activity.
Objective To review the research progress of promoting the bone formation at early stage by components of the extracellular matrix (ECM). Methods Recent literature concerning the influence of these components on new bone formation and bone/implant contact was extensively reviewed and summarized. Results Coating of titanium or hydroxyapatite implants with organic components of the ECM (such as collagen type I, chondroitin sulfate, and Arg-Gly-Asp peptide) offers great potential to improve new bone formation and enhance bone/implant contact, which in turn will shorten recovery time and improve implant stability. Conclusion The increasing knowledge about the role of the ECM for recruitment, proliferation, differentiation of cells, and regeneration of tissue will eventually deal to the creating of an artificial ECM on the implant that could allow a defined adjustment of the required properties to support the healing process.
【Abstract】 Objective To review the progress in the treatment of bone defect by porous tantalum implant. Methods Recent l iterature was extensively reviewed and summarized, concerning the treatment method of bonedefect by porous tantalum implant. Results By right of their unique properties, porous tantalum implants have achievedvery good results in the treatment of certain types of bone defects. Conclusion Porous tantalum implants have their ownadvantages and disadvantages. If the case is meet to its indications, this method can obtain a good effect. Porous tantalum implants provide a new way for the cl inical treatment of bone defects.
Objective To comprehend the pathological features and possible pathogenesis of avascular necrosis of the femoral head (ANFH) by morphology and immunohistochemical observation of osterix (OSX) and adiponectin through in vitro traumatic and non-traumatic ANFH specimens, so as to provide a theoretical basis for cl inical treatment. Methods Sixty-six ANFH specimens were collected from 66 cl inical cases undergoing hip replacement surgery. Twenty-four cases of traumatic ANFH (group A) included 17 males and 7 females, aged 21 to 70 years with an average of 56.5 years; 23 cases of steroid-induced ANFH (group B) included 16 males and 7 females, aged 56 to 72 years with an average of 61 years; and 19 cases of alcohol ic ANFH (group C) were males, aged 55 to 67 years with an average of 58.5 years. Bone tissue was got from weight-bearing and non-weight-bearing area of the femoral head respectively. The basic pathological changes was observed by HE staining under the optical microscope, and the percentage of empty bone lacuna and the percentage of trabecular bone area were calculated. The morphological changes of ANFH in different groups were observedby scanning electron microscope (SEM). OSX and adiponectin expression were detected by immunohistochemical technique. Results Gross of the femoral head surface in each group was rough, collapse, articular cartilage loss, osteophyte formation; cross section: dark red in group A, and yellow in groups B and C. HE staining showed that weight-bearing area of ANFH have similar morphological features in three groups. In non-weight-bearing area of groups B and C, the fat cells in bone marrow markedly increased and were hypertrophic; however there were more fibrous tissue in group A. There were statistically significant differences (P lt; 0.001) in the percentage of empty bone lacuna of the weight-bearing and non-weight-bearing area among three groups. There were no statistically significant differences (P gt; 0.05) in the percentage of trabecular bone area among three groups. The SEM observation showed that three groups had similar pathological changes. Brown granules for OSX and adiponectin positive substance were mainly located in the osteoblast of bone marrow of the femoral head. There was statistically significant difference (P lt; 0.05) in the average absorbency (A) value of OSX between group A and groups B, C, but there was no statistically significant difference (P gt; 0.05) between groups B and C. While there was no statistically significant difference (P gt; 0.05) in the A value of adiponectin among three groups. Conclusion Hormones and alcohol necrosis have more obviously fatty degeneration, but the repair capacity of traumatic femoral head necrosis is ber than that of hormones and alcohol necrosis. Alcohol and hormones have inhibitory action on the OSX-mediated osteogenic differentiation. Hormones and alcohol may not affect osteoblast expressing adiponectin and its receptors.
Objective To review the feature, biomechanics, and cl inical appl ication of percutaneous 360 degree axial lumbar interbody fusion (AxiaLIF) technique. Methods Recent l iterature on investigation and appl ication of percutaneous360 degree AxiaLIF technique was reviewed. Results Percutaneous 360 degree AxiaLIF technique mainly contained operative approach, axial technique, and posterior fixation. It was obviously different from other lumbar interbody fusion techniques due to its capabil ity of maintaining the integrity of the bilateral facet joints, the anterior/posterior longitudinal l igament, and the annulus fibrosus. Three-dimensional AxiaLIF RodTM provided axial support and firmly fixation, thereby rel ieving stenosis of lumbar intervertebral foramen and restoring the intervertebral disc height and the whole height and physiological curvature of the lumbar spine. The recovery of the intervertebral disc height could restore the folded or crumpled flavum, the posterior longitudinal l igament, and the herniated annulus, resulting in the improvement of stenosis symptoms of nerve root canal or central vertebral canal. Conclusion Percutaneous 360 degree AxiaLIF technique achieves satisfying therapeutic effects, although it has fairly narrow indication and needs long-term follow-up observation.
Objective To evaluate the effects of composite bone in strategy of tissue engineering on bone defect repair in rats. Methods Sixteen matured Wistar rats (male or female, weighing 250-300 g) were used to prepare platelet lysate (PL). PL/allogeneic decalcified bone granules (ADBG)/Col I (PAC) and ADBG/Col I (AC) were prepared by mixing Col Igel ADBG with or without PL. BMSCs of 8 Wistar rats (male or female, weighing 250-300 g) were isolated and cultured. The 5th passage of BMSCs were co-cultured with PAC at the density of 1 × 106 cells/mL to fabricate the tissue engineered composite PACB in vitro. Forty healthy Wistar rats were made bilateral bone defects in femoral condyles and divided into 4 groups (A, B, C and D, n=10). The defects were filled with equivalent PACB, PAC, AC and Col I in groups A, B, C and D respectively. At 4 weeks, the defect repair was evaluated with radiology, histology, ALP biochemical tests. Results At 4 weeks, the bone density measurement was (7.31 ± 0.54), (4.36 ± 0.67), (2.12 ± 0.47), and (1.09 ± 0.55) pixels in groups A, B, C, and D, respectively. The area of new bone formation in defect area under single view was (412.82 ± 22.31), (266.57 ± 17.22), (94.34 ± 20.22), and (26.12 ± 12.51) pixels in groups A, B, C and D respectively. The ALP contents in femoral condyles were (94.31 ± 7.54), (69.88 ± 4.12), (41.33 ± 3.46), and (21.03 ± 3.11) U/L, respectively. The above indexes of group A were significantly higher than those of groups B, C or D (P lt; 0.05). Three-color flow cytometry assay showed that the T lymphocyte subsets of CD3+CD4+CD8-, CD3+CD8+CD4-, and the ratio of CD4/CD8 displayed no significant difference among four groups (P gt; 0.05). Conclusion Tissue engineered bone PACB is capable to promote the bone defect repair.
Objective To review the recent research and clinical progress of artificial osteoconductive materials. Methods Recent and related literatures were extensively and comprehensively reviewed. Results Many achievements about the clinical application of the artificial osteoconductive materials were made. Ithad become one of the hotspots of bone tissue engineering research. Some were clinically applied and good clinical results were achieved. Conclusion As it provides new clinic method for treating bone defect, artificial osteoconductive material is of great potential in its application. To improve its microstructure, macroshape, mechanism of osteoinductive ability, and to accelerate new bone for mation will be the hotspots of the research on artificial osteoconductive material.
Objective To investigate the influence of clenbuterol on the expression of nerve growth factor (NGF) in denervated red and white muscles and the neurotrophism of the denervated muscles.Methods Sixty-four Wister rats, weighed 200-250 g, were divided into 8 groups(8 rats per group), including 4 experimental groups and 4 control groups. The denervated model was made in rats by dissection of sciatic nerves. Clenbuterol was given at a dose of 200 μg/kg per day in the experimental group, saline in the control group. The expression of NGF was measured with immunohistochemistry after 1, 3, 7 and 14 days of injury. The culture methods of dorsal root ganglions of the chick embryos were used to measure the neurotrophism of extracts of the muscles. Results Compared with the control groups, the NGF content of gastrocnemious(GAS) increased on the 1st day (Plt;0.05) and the NGF content of soleus(SOL) increased greatly on the 1st, 3rd and 7th dayafter injury in the experimental groups (Plt;0.01). In the experimental groups, the NGF amount of GAS reached the highest value on the 1st day after injury(Plt;0.01) and then decreased gradually. And the NGF amount of SOL had slight difference between different time. The NGF content of the SOL was higher than that of GASon the 7th day (Plt;0.05). The sensory neurotrophism of the extracts was similar between SOL and GAS.Conclusion Clenbuterol can change the expression of NGF in denervated muscles, but the change was different in SOL and GAS. The sensory neurotrophism of the denervated muscles were determined by all of the neurotrophic factors in them.