Objective To explore the clinical significance of systemic rehabilitation training on knee functional recovery after anterior cruciate ligament (ACL) reconstruction. Methods Patients who underwent arthroscopic knee ACL reconstruction and met the inclusion criteria were included from January 2015 to October 2016. A 4-phase, 16-week systemic rehabilitation training was given individually according to surgical conditions, sports and other factors. Visual Analogue Scale (VAS), knee range of motion (ROM), knee circumference, and 10-meter walking time were measured before surgery, and 3, 6, and 12 months after surgery. At the same time, the function and stability of the knee joint were graded by Lysholm score, Holden walking score, International Knee Documentation Committee (IKDC) score, and KT-1000 test. The postoperative one-year scores were compared with the other side, and the patient satisfaction was evaluated one year after surgery. Results All patients were followed up for at least one year. The VAS pain score, ROM, knee circumference, 10-meter walking time, Lysholm score, Holden score, IKDC score, and KT-1000 of all patients were significantly better than their preoperative levels (P<0.05), and there was no significant difference in joint function from the contralateral side (P>0.05). No serious complications such as infection occurred. Conclusion Systemic rehabilitation exercises can help patients with well-restored knee joint function after ACL reconstruction.
Mussel foot proteins (MFp) could cure rapidly under water and adhere to different substrates. It has broad application prospects as an biocompatible bioglue. The soluble recombinant SUMO-MFp fusion protein (SFp3) was efficiently expressed inE.coli, and about 5% of tyrosine of SFp3 were converted into DOPA by using mushroom tyrosinase. The adhesion strength of the mixture of DOPA-containing SFp3 (DSFp3) and hyaluronic acid (MW = 1 500 kD) was more than twice that of the cyanoacrylate-based tissue adhesives, Dermabond®, and it reached 52% of its maximal strength within 5 minutes on cowhide. A layer-by-layer assembly of hyaluronic acid with DSFp3 was observed to form compact sheet structures through biofilm interferometry assay and scanning electron microscopy. This work provides a solution and theoretical basis for the low adhesion strength and slow curing of protein-based bioglue.
ObjectiveTo introduce the surgical method and effectiveness of repairing skin and soft tissue defect in the palm or dorsum of the hand and forearm with epigastric bilobed flap. MethodsBetween October 2010 and December 2013, 4 male patients with skin and soft tissue defect in the palm or dorsum of the hand and forearm were treated, aged from 36 to 62 years. Of them, 3 cases had degloving injury caused by machines and 1 case had necrosis of fingers and skin after surgery of crush injury. The time from injury to hospitalization was from 3 hours to 15 days. Among the 4 cases, the size of palmar defect was 7 cm×4 cm to 16 cm×6 cm, and the size of dorsal defect was 10 cm×7 cm to 20 cm×10 cm. The epigastric bilobed flap was designed based on the axial vessel which was formed by inferior epigastric artery, superior epigastric artery, and intercostals arteries. The size of flap ranged from 12 cm×4 cm to 18 cm×6 cm in the vertical direction, 15 cm×8 cm to 22 cm×11 cm in the oblique direction. The donor site was directly closed. The pedicles were cut at 22 to 24 days after repairing operation. ResultsAll the flaps survived well with the wound healing by first intention. Four patients were followed up 3 months to 1 year and 2 months. The other flaps had good appearance and texture except 1 bulky flap. The flap sensation basically restored to S2-S3. The function of the hands recovered well. ConclusionSkin and soft tissue defect in the palm or dorsum of the hand and forearm can be repaired with the epigastric bilobed flap, because it has such advantages as big dermatomic area and adequate blood supply. Besides, the operation is practical, safe, and simple.
Objective To establish model of thymectomy in adult rats. Methods The animal models were built by resection of the thymus and simultaneously emptying the air under xiphoid in the rats underwent thoracotomy. Results Of 30 rats, 1 died of postoperative atelectasis, 1 died of excessive bleeding because of puncturing the pulmonary vein by mistake during the operation. Twenty-eight rats survived more than 30 days. A successful rate of 93.3% was achieved in the making of thymectomy model. Conclusion The results show that the model is easy to operate and the success rate is very high, and can be used in the experiment of thymectomy in the rats.
ObjectiveTo compare the different effects of ubiquitin(UB) on human umbilical vein endothelial cells (HUVECs) and macrophages under normal circumstances,and analyze whether UB could protect HUVECs from lipopolysaccharide(LPS) induced injury. MethodsThe morphologic changes of HUVECs in vitro with up-rising concentrations of UB interventions were observed. HUVECs and human macrophages in vitro were divided into 4 groups according to UB concentration (0.01 μg/mL,0.1 μg/mL, 1 μg/mL, and 10 μg/mL). Supernatant and cells of each group were collected in 24 h after UB intervention. The levels of TNF-α and VCAM-1 in supernatant were measured by ELISA while NF-κB protein level in cells was detected by Western blot. HUVECs were divided into a LPS group(LPS 10 μg/mL) and an UB+LPS group(UB 0.1 μg/mL,LPS 10 μg/mL). The supernatant of the two groups were collected in 8,16 and 24 h after LPS and UB intervention. The levels of TNF-α and VCAM-1 in supernatant were measured by ELISA. ResultsThe injury of HUVECs got worse with the ascending concentrations of UB.At the concentration of 50 μg/mL,UB induced HUVECs got ballooned and died massively. With the increase of UB concentration,the levels of TNF-α and VCAM-1 in HUVECs' supernatant ascended firstly and then descended,while those in human macrophages' supernatant ascended gradually. zHowever,the tendency of the NF-κB protein level in the two kinds of cells was similar when the concentration of UB increased.At the consentration of 0.1 μg/mL or 1 μg/mL,ubiquitin induced NF-κB protein level obviously increased.At the concentration of 0.01 μg/mL or 10 μg/mL,UB induced the protein level was similar with those of the control group and even decreased slightly. There was no significant difference in TNF-α or VCAM-1 levels at each time point between the LPS group and the UB+LPS group. ConclusionsUB injuries HUVECs obviously at a low concentration but injuires human macrophages at much higher concentraton. UB can not protect HUVECs from LPS-induced injury in vitro.
Scoliosis is a complex three-dimensional spinal deformity, characterized by lateral curvature and vertebral rotation. Radiology plays important roles in the assessments of lateral curvature and vertebral rotation of the patients with scoliosis, as well as the prediction of progression and treatment outcomes of scoliosis. The reliable and validity of radiological assessments have been proved in the coronal, transverse, and sagittal planes of scoliotic spine. With the application of the stereoradiography, three dimensional nature of the scoliosis has been disclosed. This review aims to summarize the radiological methods for the assessments of scoliotic spine, the reliability and validity of each method, as well as the stereoradiography, providing the basis for accurate diagnosis and assessments for the patients with scoliosis.
ObjectiveTo study the characteristics of carotid atherosclerotic plaque and investigate the relationship between visfatin and plaque stabilization. Methodsfifty-six patients with carotid stenosis were divided into symptomatic group (n=31) and asymptomatic group (n=25) based on the clinical manifestation and onset time.All plaque specimens were stained with HE and Masson trichrome staining and studied pathologically.The plaques were grouped into stable and unstable plaques based on thickness of the fibrous cap and the area of lipid-rich core in the plaques.The expression of visfatin was detected by immunohistochemistry staining. Results①The proportion of unstable plaques were significantly higher in symptomatic group than in asymptomatic group (67.74% vs 36.00%, P < 0.05).②Compared with stable plaques, unstable plaques had thinner fibrous cap, larger lipid necrotic core, and higher proportion of hemorrhage: (49.87±8.75)μm vs (74.54±6.80)μm (P < 0.001), (65.63±12.97)% vs (31.81±5.13)% (P < 0.001), and 63.33% vs 30.77% (P < 0.05).③The integral optical density value of expressed visfatin in unstable plaques was significantly more than in stable plaques (84 165.47±9 183.12 vs 55 694.08±4 818.57, P < 0.001). ConclusionsThe plaque destabilization is closely related to the clinical symptoms of atherosclerosis.The thickness of fibrous cap, area of lipid-rich core, and hemorrhage play an important role in the plaque stabilization.The visfatin is related to atherogenesis and plaque destabilization.
ObjectiveTo systematically review the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in China. MethodsWe searched PubMed, The Cochrane Library (Issue 4, 2015), EMbase, CNKI, CBM, VIP and WanFang data from inception to April 2015, to collect diagnostic studies about HLA-B27 for AS in China. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. Pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Subgroup analysis was stratified by detection methods of HLA-B27. ResultsA total of 18 studies involving 22 comparisons, with 3 670 AS patients and 28 389 health controls were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.92 (95%CI 0.90 to 0.93), 0.94 (95%CI 0.94 to 0.95), 16.22 (95%CI 13.63 to 19.29), 0.08 (95%CI 0.06 to 0.10), and 256.49 (95%CI 168.25 to 391.00), respectively. The AUC of SROC was 0.98. The result of subgroup analysis showed that there was no significant difference for flow cytometry (FCM) and Polymerase Chain Reaction with Sequence-Specific Primer (PCR-SSP) in HLA-B27 detection for AS (Z=7.915, P=0.960). ConclusionCurrent evidence indicates that HLA-B27 detection is of great diagnostic value for AS. At present, FCM and PCR-SSP shows no significant difference in HLA-B27 detection for AS. Due to the limitation of the quality of included studies, and the exclusion of the suspected patients, higher quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy and safety of traditional Chinese medicine (TCM) therapies versus non-steroidal anti-inflammatory drugs (NSAIDs) for knee osteoarthritis (KOA). MethodsWe electronically searched databases including PubMed, The Cochrane Library (Issue 5, 2015), EMbase, CNKI, CBM, VIP and WanFang Data from inception to 14 June 2015, to collect randomized controlled trials (RCTs) about TCM therapies for KOA. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then network meta-analysis was performed using Stata 12.0 and WinBUGS 1.4.3 softwares. ResultsA total of 56 RCTs involving 7256 patients were included, in which 19 different treatment strategies were investigated. All were short-term efficacy studies. Our work yielded 33 direct and 138 indirect comparisons, among which 76 were demonstrated statistically significant. The result of meta-analysis showed that, the TCM-based therapy group had lower complication rates, compared with the NSAIDs group. TCM internal application+acupuncture+fumigation, internal application+fumigation+moxibustion, acupuncture+massage, TCM extra-apply+massage, massage+fumigation+moxibustion, and massage+fumigation were the top six in terms of treatment effect. NSAIDs ranked 18th. ConclusionThe safety and effectiveness of TCM therapies are generally better than NSAIDs except moxibustion, particularly more remarkable for the top six TCM therapies. TCM comprehensive therapies are superior over mono-modality therapies. Due to the limitation of the present studies, the long-term efficacy of TCM therapies needs further investigation, and our findings also need to be verified by large-scale and well-designed RCTs.