Objective To explore the effects of human urine-derived stem cells (hUSCs) and hUSCs combined with chondroitinase ABC (chABC) on the expressions of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in the spinal cord injury (SCI) of rats, and to investigate the underlying mechanism. Methods hUSCs were cultured from human urine, and their phenotypes were detected by flow cytometry. The SCI model of rats were made via Allen method. Sixty Sprague Dawley rats were divided into 5 groups (n=12): the sham operation group (group A), SCI group (group B), SCI+hUSCs group (group C), SCI+chABC group (group D), and SCI+hUSCs+chABC group (group E). Basso, Beattie, Bresnahan (BBB) score was used to measure the lower extremity motor function of rats in each group at 10, 20, and 30 days after operation. Real-time fluorescent quantitative PCR was used to detect the relative mRNA expressions of NGF and BDNF at 30 days. Meanwhile, the protein expression of NGF and BDNF were confirmed by immunohistochemistry staining. The relative protein expressions of Bax and Bcl-2 were detected by Western blot. Results The hUSCs were identified to have multipotential differentiation potential. At 10, 20, and 30 days, BBB score was significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Real-time fluorescent quantitative PCR and immunohistochemistry staining demonstrated that the expressions of NGF and BDNF were significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05); but there was no significant difference between groups C and D (P>0.05). Western blot results indicated that the protein expression of Bax was significantly higher in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Meanwhile, the protein expression of Bcl-2 was significantly lower in group B than in groups A, C, D, and E, in groups C, D, and E than in group A, in groups C and D than in group E (P<0.05). Conclusion hUSCs can protect SCI and this positive effect can be enhanced by chABC; this neuro-protective effect may depend on promoting the expressions of NGF and BDNF, and suppressing the neuronal apoptosis.
Objective To review the research progress in the repair and reconstruction of isolated traumatic radial head dislocation with annular l igament injury in children. Methods In recent years, the related l iterature concering isolated traumatic radial head dislocation with annular l igament injury in children was reviewed. Results For isolated traumatic radial head dislocation with annular l igament injury in children, the surgery should be chosen as the main treatment, includingopen reduction and annular l igament reconstruction surgery. Triceps aponeurosis is usually used as reconstruction materials of annular l igament, mainly because the position of taking material of annular l igament is at the operative incision with less surgery trauma and short operative time; aponeurosis is tough and thick with rigid fixation and low risk of re-dislocation. Artificial materials are paid attention to increasingly because they are easy to get, have rigid fixation, and can avoid operative injury caused by taking material of annular l igament. Conclusion Currently active annular l igament reconstruction surgery should be taken; triceps aponeurosis is widely adopted as reconstruction materials of annular l igament and artificial materials have come to be a new research trend.
Objective To review the basic research and cl inical progress of elbow heterotopic ossification after injury. Methods The recent l iterature concerning heterotopic ossification of the elbow was reviewed. Results Heterotopic ossification was caused by variety of stimul i and conditions. The current methods of prevention and treatment were to improve surgical techniques, to reduce trauma and bleeding, to rinse the area with bone fragments with plenty of salt water, and to use non-steroidal anti-inflammatory drugs. Conclusion Once heterotopic ossification occurred, surgical treatment is unique treatment method, so emphasis is to prevent heterotopic ossification.
Objective To understand the effect of estradiol in different concentrations on proliferation of diverse mammary primary cells in vitro. Methods The primary cells of cancer tissue, the adjacent tissue to tumors and normal mammary tissue from patiens with breast cancer were obtained using collagenase digesting method. All the tissue samples were cultivated in vitro, and were given estradiol in different concentrations. The effect of estradiol on the proliferation of those primary cells was measured by MTT. Results Estradiol remarkedly promoted the proliferation of primary cells of cancer tissue and peritumor tissue in vitro, whose ER expression were positive. Whereas, the promotion effect of estradiol on the proliferation of normal mammary primary cells was relatively weak, and there was no correlation between the promotion effect with the expression of ER in cancer tissue. Conclusion The risks of occurrence and relapse of breast cancer would increase significantly when the concentration of estradiol is no less than 103 pmol/L in vivo.
Arrhythmia is a kind of common cardiac electrical activity abnormalities. Heartbeats classification based on electrocardiogram (ECG) is of great significance for clinical diagnosis of arrhythmia. This paper proposes a feature extraction method based on manifold learning, neighborhood preserving embedding (NPE) algorithm, to achieve the automatic classification of arrhythmia heartbeats. With classification system, we obtained low dimensional manifold structure features of high dimensional ECG signals by NPE algorithm, then we inputted the feature vectors into support vector machine (SVM) classifier for heartbeats diagnosis. Based on MIT-BIH arrhythmia database, we clustered 14 classes of arrhythmia heartbeats in the experiment, which yielded a high overall classification accuracy of 98.51%. Experimental result showed that the proposed method was an effective classification method for arrhythmia heartbeats.
Objective To evaluate the safety and ascendancy of small caliber stapler application for anterior resection in ultra-low rectal cancer with anal sphincter preservation. Methods A retrospective analysis of the data of 60 cases of ultra-low rectal cancer treated by anterior resection with anal sphincter preservation by double stapling technique according to TME principle between June 2006 and June 2009 were undertaken. The 60 patients were divided into two groups, each group included 30 cases. One group adopted 33 mm stapler and another group adopted 29 mm stapler, and then the profiles of medi-operation, post-operation, and prognosis were assessed. Results Time of simple anastomose in operation was (9.0±3.3) min in 33 mm stapler group and (6.0±2.6) min in 29 mm stapler group, and there was significant difference between them (P=0.022 5). There were 6 cases needed to be restored because of lesion during operation or dys-anastomosis in 33 mm stapler group, while 2 cases in 29 mm stapler group, there was significant difference between them (P=0.030 1). No significant differences were observed between the two groups in terms of the time for operation, leakage, bleeding, stenosis, anastomotic recurrence, and fecal incontinence after operation or length of stay. Conclusion The application of 29 mm stapler not only can shorten time for anastomose and step down the degree of difficulty, but also dosen’t increase stenostomia and other complications.
Atrial fibrillation (AF) is a common arrhythmia disease. Detection of atrial fibrillation based on electrocardiogram (ECG) is of great significance for clinical diagnosis. Due to the non-linearity and complexity of ECG signals, the procedure to manually diagnose the ECG signals takes a lot of time and is prone to errors. In order to overcome the above problems, a feature extraction method based on RR interval is proposed in this paper. The discrete degree of RR interval is described with the robust coefficient of variation (RCV), the distribution shape of RR interval is described with the skewness parameter (SKP), and the complexity of RR interval is described with the Lempel-Ziv complexity (LZC). Finally, the feature vectors of RCV, SKP, and LZC are input into the support vector machine (SVM) classifier model to achieve automatic classification and detection of atrial fibrillation. To verify the validity and practicability of the proposed method, the MIT-BIH atrial fibrillation database was used to verify the data. The final classification results show that the sensitivity is 95.81%, the specificity is 96.48%, the accuracy is 96.09%, and the specificity of 95.16% is achieved in the MIT-BIH normal sinus rhythm database. The experimental results show that the proposed method is an effective classification method for atrial fibrillation.
Objective To summarize the influencing factors on the effectiveness of reverse total shoulder arthroplasty (RTSA), so as to provide reference for clinical treatment. Methods The related research literature of RTSA at home and abroad was extensively consulted, and the factors that may affect the effectiveness were summarized from the aspects of surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. Results For surgical techniques, different surgical approaches have their own advantages. The glenoid notch, poor bone ingrowth, increased bone resorption, and infection would lead to the loosening of glenoid prosthesis. In addition, the neck shaft angle and inclination angle of humeral prosthesis affect the occurrence of glenoid notch and the range of motion of joint internal/external rotation after operation, respectively. For muscle condition, the quality of teres minor and deltoid muscle has an important influence on joint stability after operation. Moderate increase of deltoid muscle tension can improve joint mobility after operation, and suture repair of subscapular tendon during operation can relieve joint pain and improve function, range of motion, and strength. For the general condition of patients, gender, age, and body mass index are all related to postoperative joint function and complications, and different occupations and postoperative exercise levels affect the recovery. The patients with severe degenerative diseases, poor preoperative function, and long disease duration have lower expectations and higher satisfaction with the effectiveness, and bad lifestyle has a negative impact on the effectiveness. Conclusion The effectiveness of RTSA is related to surgical technique, muscle condition, general condition of patients, psychological expectation, and lifestyle. In order to avoid the loosening of glenoid prosthesis, the operator should choose humeral prosthesis with small neck shaft angle and large glenoid ball and put them down and inclined inferiorly during operation, and choose appropriate approach to eliminate space with drainage to reduce the risk of infection. After operation, patients should avoid activities that generate high anterior and posterior shear forces. In addition, the humeral prosthesis with a inclination angle of 10°-20° can achieve the best balance between the range of internal rotation and external rotation after operation. Proper deltoid tension can maintain joint stability and good range of motion. Suture of subscapular tendon is recommended.
Objective To review the research on different surgical approaches and MRI evaluation of total hip arthroplasty (THA), to clarify the possible muscle damage caused by different approaches, and to help clinicians avoid intraoperative muscle damage and identify the causes of certain muscle-related complications after operation. MethodsThe research literature on different surgical approaches and MRI evaluation of THA at home and abroad was extensively reviewed to summarize the MRI performance of the posterior approach, modified direct lateral approach, direct anterior approach, and minimally invasive anterolateral approach (also called Orthopadische Chirurgie Munchen approach). Results The traditional posterior approach mainly damages the short external rotator muscle group and increases the incidence of postoperative dislocation; the piriformis-keeping posterior approach significantly improves the quality of the pyriformis tendon in the postoperative period, but it may lead to damage to the intrapelvic portion of the piriformis muscle. The modified direct lateral approach mainly damages the gluteus medius muscle, which increases the risk of postoperative claudication. The direct anterior approach mainly damages the vastus tensoris muscle and may result in damage to the short external rotator muscle group and the muscles around the incision. The minimally invasive anterolateral approach primarily damages the superior gluteal nerve, which subsequently leads to denervation of the broad fascial tensor fasciae latae, and this approach may also result in injury to the gluteus medius and gluteus minimus muscles. The muscle damage status significantly affects prognosis, and the minimally invasive approach is more suitable for elderly patients. ConclusionMRI can clarify the different types of muscle damage caused by different surgical approaches. Minimally invasive approaches can reduce muscle damage and improve postoperative function compared with traditional approaches, and can benefit elderly patients more, but due to the small field, forcing to expand the surgical field will lead to unintended muscle damage and reduce postoperative function.
Objective To identify related factors of anxiety and depression in spinal cord injury (SCI) patients based on patient-environment-occupation (PEO) model, and provide evidences for clinical practice. Methods A total of 241 patients with SCI treated between April 2014 and April 2015 were collected as the study subjects. All the patients were confirmed with SCI through CT or MRI, and had physical dysfunction. Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were applied in all the 241 SCI patients to measure their psychological state. Meanwhile, PEO factors such as demographic information as well as ability of activities of daily living (ADL) and relatives’ stress were assessed by self-made questionnaire, Modified Barthel Index (MBI) and Relatives’ Stress Scale (RSS). Then, multiple stepwise regression was applied to identify significant covariance with SAS/SDS as dependent variables and other 14 factors as independent variables. Results The regression equation showed that only SDS, MBI, living environment and disease course were significantly associated with SAS. Only SAS, MBI and RSS were significantly associated with SDS. Conclusions The ability of ADL and environment are significantly correlated with psychological state of SCI patients. Early intervention of ADL and decreasing environmental barriers are needed to improve patients’ psychological state.