Objective To determine the short-term effectiveness of matrix-induced autologous chondrocyte implantation (MACI) for femoral trochlea cartilage injury. Methods A retrospective analysis was performed on the clinical data of 10 patients with femoral trochlea cartilage injury treated with MACI between June 2012 and October 2014. There were 6 males and 4 females, aged from 15 to 48 years (mean, 33 years). The left knee was involved in 3 cases and the right knee in 7 cases. Nine patients had a history of trauma, and 1 case suffered from osteochondritis dissecans. Combined injuries included meniscus injury in 1 case, anterior cruciate ligament injury in 3 cases, and lateral collateral ligament tear in 2 cases. The mean lesion depth was 2.80 mm (range, 2-7 mm), with the mean defect size of 84.85 mm2 (range, 28.26-153.86 mm2). The mean duration of definite diagnosis was 14 days (range, 5 days to 3 months). By using arthroscopic biopsy, 200-300 mg healthy articular cartilage at non weight-bearing area of the knee femoral trochlea was collected as a source of seed cells, which were isolated and cultured to prepare MACI membrane. The adhesion activity, growth rate, and mechanical properties of the chondrocytes on the Bio-gide collagen scaffold were evaluated. In addition, the stretch rate, tensile strength, and suture strength of scaffold were tested. MACI membrane was implanted after 2 weeks to 6 months. The visual analogou scale (VAS), Lysholm score, and Tegner movement level score at preoperation and last follow-up were used to assess the function. Results The MACI membrane was successfully prepared, and the human chondrocytes adhered and grew well on the Bio-gide collagen scaffold. Mechanical test showed that MACI membrane had the stretch rate of 65.27%, the tensile strength of 26.81 MPa, and the suture strength of 6.49 N, indicating good mechanical properties. MACI membrane was successfully implanted. The mean operation time was 58.5 minutes (range, 43-99 minutes), and the mean hospitalization time was 7 days (range, 6-15 days). All incisions healed well. Ten cases were followed up 9 to 16 months (mean, 12 months). Four cases underwent iliac bone graft surgery. The mean healing time was 14 weeks (range, 12-16 weeks). No complications of osteochondrolysis, knee pain, nerve and vascular injury, deep vein thrombosis, and knee adhesion occurred during follow-up. The VAS score, Lysholm score, and Tegner score at last follow-up were significantly improved when compared with preoperative scores (t=12.060,P=0.000;t=–9.200,P=0.000;t=–14.000,P=0.000). Conclusion MACI for femoral trochlea cartilage injury has good short-term effectiveness, with less injury and fast function recovery.
Objective The study was performed to compare the efficacy and effect on quality of life of sodium valproate (VPA) sustained-release tablets versus topiramate (TPM) in newly diagnosed adult symptomatic epilepsy. Methods This is aprospective, randomized controlled trial on 200 patients newly diagnosed as adult symptomatic epilepsy in Sichuan Province People’s Hospital druing September 2014 to December 2016. The patients were randomly divided into VPA group (n=110) and TPM group (n=90). Then we evaluated the efficacy, retention rate, adverse reactions, and quality of life of the two groups after one year of treatment. Results The total effective rate of VPA group was 69.1%, and the rate of no seizures was 38.2%; the total effective rate of TPM was 62.2%, and the rate of no seizures was 42.2%. No statistically significant difference in the effective rate and no seizure rate was found between the two groups. There was no statistical difference in the retention rate between the two groups(69.1% vs. 65.6%, P>0.05) . The incidence of adverse reactions of VPA was significantly lower than that of TPM (9.1%vs. 20%, P<0.05). The quality of life of the two groups was significantly improved from baseline before treatment. VPA group showed significantly better performance than TPM group on mood and cognitive improvement (P<0.05). Conclusion ① There was no significant difference in efficacy and retention rate between VPA sustained-release tablet and TPM on adult patients with symptomatic epilepsy after one year's treatment; ② The incidence of adverse reactions of TPM group was significantly higher than that of VPA group; ③ VPA sustained-release tablets and TPM can significantly improve the overall quality of life of patients, and VPA sustained-release tablets is significantly better than topiramate on the improvement of emotional and cognitive function.