Objective To review the research progress of ultrasound in the diagnosis and treatment of shoulder diseases, in order to provide a theoretical basis for the further development of ultrasound in shoulder surgery. Methods The recent literature on the application of ultrasound in the shoulder joint was extensively reviewed. The application of ultrasound in the diagnosis and treatment of shoulder joint diseases, and the advantages and disadvantages of ultrasound were analysed, and the development trend of ultrasound technology in the shoulder joint area was prospected. Results At present, the diagnosis of shoulder joint diseases mainly relies on MRI, however, with the development of ultrasound technology, ultrasound with the characteristics of convenient, reliable, and real-time dynamic evaluation is more and more recognized in the diagnosis process of shoulder joint diseases, combined with three-dimensional ultrasound, ultrasound intervention, and elastography can improve the accuracy, sensitivity, and specificity of the diagnosis, and is suitable for the diagnosis and treatment of various shoulder joint diseases, which is expected to carry out early prevention of shoulder joint diseases in the future and achieve more refined and minimally invasive treatment. ConclusionUltrasound technology has wide application prospect in shoulder joint diseases, but it is still in the developing stage, and the subjective dependence needs to be solved further.
ObjectiveTo investigate the expression of extracellular signalregulated kinase (ERK) and p38 mitogenactivated protein kinase （p38 MAPK） in autogenous vein grafts during vascular remodeling.MethodsAn autogenous vein graft model was established by transplanting the right jugular vein to infrarenal abdominal aorta in 80 Wistar rats. Vein graft samples were harvested 6 hours, 24 hours, 3 days, 7 days, 2 weeks, 4 weeks, 6 weeks and 8 weeks after surgery. Gene expression of ERK and p38 MAPK was measured by reverse transcriptionPCR. Western blot was used to detect the expression of protein products and phosphorylation protein products of ERK and p38 MAPK. Apoptosis of vascular smooth muscle cells (VSMCs) was determined by TUNEL. Proliferating cell nuclear antigen(PCNA) of VSMCs also was studied.ResultsThe expression of ERK1 mRNA and p38 MAPK mRNA increased considerably after surgery. ERK1 mRNA reached the peak on the 7th day 〔（33.2±14.2）%, P＜0.01〕, but p38 MAPK mRNA reached the peak on the second week after surgery 〔(58.8±26.2）%, P＜0.01〕. The expression of ERK1/2 detected by western blot reached the peak during 1 to 2 weeks and decreased gradually to normal level 6 weeks after surgery. The expression of p38 MAPK reached the peak during 2 to 4 weeks and decreased to 1/4 to 1/2fold 8 weeks after surgery. There was a positive relationship between ERK1 and PCNA(r=0.759 6，P＜0.01) and a positive relationship between p38 MAPK and apoptosis(r=0.892 2，P＜0.01). ConclusionActivation of MAPK system exists in autogenous vein grafts and it may become a new target for the therapy of stenosis after vein grafts.
Objective To investigate the relationship between adipocyte fatty acid binding protein ( A-FABP) and obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods A total of 120 patients were recruited and underwent polysomnography. The groups were allocated according severity of OSAHS and obesity. Plasma A-FABP ( ng/mL) levels were measured by ELISA. The associations between A-FABP and AHI, BMI, LSaO2 , MSaO2 , neck collar, waist /hip ratio, insulin resistance index were analyzed. Results Plasma A-FAPB levels were significantly higher in the OSAHS group than in the non-OSAHS group of same weight, independent of age and gender. In the non-OSAHS group and the severe OSAHS group, plasma A-FABP levels of obesity persons were significantly higher than those without obesity, independent of age and gender. Plasma A-FAPB level was positively correlated with AHI, BMI, insulin resistance index, neck collar, SLT90% , and waist/hip ratio, but negatevely correlated with LSaO2 and MSaO2 in the OSAHS group. In the non-OSAHS group, plasma A-FAPB level was positively correlated with BMI and insulin resistance index. Conclusions Plasma A-FABP level is higher in patients with severe OSAHS. Plasma A-FABP level is positively correlated with BMI and insulin resistance index both in OSAHS and non-OSAHS patients.
Objective To review the progress of a disintegrin and metalloproteinase with thrombospondin motif 4 (ADAMTS-4) and ADAMTS-5 in osteoarthritis. Methods Recent literature about the ADAMTS-4 and -5 in osteoarthritis was analyzed; the structure, function, inhibitors of the ADAMTS-4 and -5, and the relationship between the proteases and osteoarthritis were analyzed and summarized. Results ADAMTS-4 and -5 can reduce chondrocyte and extracellular matrix by degrading aggrecan and cartilage oligomeric matrix protein, which induced the pathogenesis of osteoarthritis. Conclusion ADAMTS-4 and -5 have been demonstrated to play important roles in osteoarthritis. It can better guide treatment and prevention of osteoarthritis to further study related mechanism of ADAMTS-4 and -5, and to promote the establishment of a clinical drug targets.
Objective To review the progress of in vivo study on degradable magnesium alloys application as bone-implant materials. Methods Recent literature was extensively reviewed and summarized, concerning the in vivo study on degradable magnesium alloys as orthopaedic implants. Results Magnesium alloys possess a natural ability to degrade via corrosion in vivo, which is promising candidate material for orthopaedic medical device applications. A great progress has been made to improve in vivo performance and integration with bone tissue. However, the degradation mechanism of magnesium-based materials in the physiological environment and long-term effect on body are not available. The modulation of the corrosion rate of magnesium alloys must also be accomplished. Conclusion Magnesium alloys have the potential to serve as degradable implants for orthopaedic applications, but a great deal of further investigation is still necessary.
Objective To investigate the influence of RNA interference targeting c-Jun gene on the proliferation of rat vascular smooth muscle cells (VSMCs). Methods The experiment was performed with c-Jun siRNA （c-Jun siRNA group）, control reverse sequence siRNA (control siRNA group) or no siRNA (control group). VSMCs were transfected with siRNA targeting c-Jun gene by liposome. Effects of c-Jun siRNA on mRNA and protein expressions of c-Jun were examined by RT-PCR analysis and Western blot respectively. MTT test and 3H-TdR incorporation were used to detect VSMCs proliferation. Cell cycle analysis of VSMCs in vitro was determined by flow cytometer. Results The expression levels of mRNA and protein of c-Jun in c-Jun siRNA group were significantly lower than those in control group （P＜0.05， P＜0.01). There was no significant difference between control group and control siRNA group （Pgt;0.05）. Proliferation activity of VSMCs decreased significantly in c-Jun siRNA group compared with that in control group （P＜0.05） and VSMCs was blocked in the G0/G1 phase of cell cycle significantly （P＜0.05）. There was no significant difference between control group and control siRNA group （Pgt;0.05）. Conclusion c-Jun gene silenced by RNA interference can inhibit VSMCs proliferation effectively in vitro.
Objective To investigate the effect of adenovirus vector mediated transfer of human herpes simplex virus thymidine kinase (HSVtk) gene inhibits intimal hyperplasia of vein grafts. Methods Auto vein graft models of Wistar rats were established. Adenovirus vector dwelled in cervical veins which were transplanted into inferior renal abdominal aorta. The combination of HSVtk (4×109 plaque forming units) and ganciclovir (GCV) was applied to test the inhibition effect. GCV was infused 〔60 mg/(kg·d), IP, Bid〕 from day 3 to day 21 after transplantation. Vein samples were harvested and the existence of HSVtk DNA was measured by PCR and the mRNA of it was studied by in situ hybridization. Van gieson (VG) and proliferating cell nuclear antigen (PCNA) stains were carried out in paraffin sections to study the thickness of neointima and smooth muscle cells (SMCs) proliferation with a computer-assisted analysis system. The apoptosis of SMCs also was detected by TUNEL. Results The existence of HSVtk gene in veins and its transcription were demonstrated. Morphometric analysis demonstrated a reduced intima thickness in the group receiving combination therapy (HSVtk/GCV) compared with HSVtk alone 〔(17.2±3.2) μm versus (31.1±2.5) μm, P＜0.05〕. GCV per se had no effect on intimal hyperplasia after vein transplantation. The apoptosis of SMCs increased significantly and expression of PCNA decreased in HSVtk/GCV gene therapy group versus blank control group 〔(9.1±2.3)% vs (28.7±3.6)%, P＜0.05; (38.7±5.6)%vs (18.5±2.6)%, P＜0.05〕. Conclusion GCV conditions reduction of intimal hyperplasia after intraluminal delivery of HSVtk in transplanting vena veins involving SMCs apoptosis.
Objective To explore mechanism of gastric bypass in treating obesity with type 2 diabetes mellitus (T2DM) and its relationship with c-Jun N-terminal kinase (JNK) signaling pathway. Methods The INS-1 cells were divided into 4 groups according to the different treatment: control group (complete medium), high glucose group (30 mmol/L glucose medium), exendin-4 group (high glucose+100 nmol/L exendin-4), and JNK agonist group (high glucose+100 nmol/L exendin-4+JNK agonist). When these cells were cultured on day 7, the cell activity was assessed by the MTT staining. The cell apoptosis was determined by the fluorescence microscopy analysis after the Hoechst/PI staining and flow cytometric assay after the Annexin V-FITC/PI staining. The expressions of the human immunoglobulin binding protein (Bip), CCAAT/enhancer-binding protein homologous protein (CHOP), P-SAPK/JNK, and caspase-3 protein were detected by the Western blot. Results Compared with the control group, the cell activities were significantly decreased (P<0.05), the cell apoptosis rates and the P-SAPK/JNK and caspase-3 protein expression levels were significantly increased (P<0.01) in the high glucose group and the JNK agonist group, but the Bip and CHOP protein expression levels were significantly increased (P<0.01) in the high glucose group. Compared with the high glucose group, the cell activity was significantly increased (P<0.05), the cell apoptosis rate and the Bip, CHOP, P-SAPK/JNK, and caspase-3 protein expression levels were significantly decreased (P<0.01) in the exendin-4 group, the Bip and CHOP protein expression levels were significantly decreased (P<0.01) in the JNK agonist group. Compared with the exendin-4 group, the cell activity was significantly decreased (P<0.05), the cell apoptosis rate and the P-SAPK/JNK and caspase-3 protein expression levels were significantly increased (P<0.01) in the JNK agonist group. Conclusion Gastric bypass can inhibit endoplasmic reticulum stress of pancreatic islet β-cells by regulating secretion of glucagon like peptide-1, thereby inhibiting JNK signaling pathway, protecting pancreatic islet β-cells and inhibiting apoptosis, so as to achieve effect of treating T2DM.
ObjectiveTo analyze the effect of indocyanine green (ICG) fluorescence dual-visualization technique on evaluating tumor margins during the thoracoscopic segmentectomy. MethodsA total of 36 patients who underwent thoracoscopic anatomical segmentectomy using ICG fluorescence dual-visualization technique in our hospital from December 2020 to June 2021 were retrospectively included. There were 15 males and 21 females aged from 20 to 69 years. The clinical data of the patients were retrospectively analyzed. ResultsThe ICG fluorescence dual-visualization technique clearly showed the position of lung nodules and the plane boundary line between segments during the operation. There was no ICG-related complication. The average operation time was 98.6±21.3 min, and the average intraoperative bleeding amount was 47.1±35.3 mL, the average postoperative drainage tube placement time was 3.3±2.8 d, the average postoperative hospital stay was 5.4±1.8 d, and the average tumor resection distance was 2.6±0.7 cm. There was no perioperative period death, and one patient suffered a persistent postoperative air leak. ConclusionThe ICG fluorescence dual-visualization technique is safe and feasible for evaluating the tumor margins during thoracoscopic segmentectomy. It simplifies the surgical procedure, shortens the operation time, ensures sufficient tumor margins, and reserves healthy pulmonary parenchyma to the utmost extent, providing reliable technical support for thoracoscopic anatomical segmentectomy.
Objective To explore the application of Body Tom® mobile CT combined with basic anesthesia in preoperative painless positioning of small pulmonary nodules, and evaluate its safety and effectiveness. Methods Patients using mobile Body Tom® CT to accurately locate pulmonary nodules in the Department of Thoracic Surgery of Affiliated Nanjing Brain Hospital, Nanjing Medical University from August to October 2022 were retrospectively included. Clinical data of the whole patient group were analyzed. ResultsWe finally included 30 patients with 12 males and 18 females at age of 23-71 years. The position success rate of 30 patients with small pulmonary nodules was 100.0%. Location time was 14.20±4.07 min. There was one patient of intrapulmonary hemorrhage, with no other complications such as pneumothorax, positioning needle shedding, or pleural reaction. The time from the end of positioning to the start of surgery was 12.63±5.68 min. There was no needle migration or indocyanine green overflow. All patients completed resection of small pulmonary nodules under single-port thoracoscopy, no transit to opening chest. The average operation time was 85.32±12.60 min. There was no postoperative complications, and the average postoperative chest tube retention time was 2.12±1.34 days. And the average length of hospital stay was 3.52±1.45 days. The postoperative pathological results showed that the distance from the nodules was greater than 2 cm. Conclusion Body Tom® mobile CT combined with basic anesthesia can achieve the preoperative painless, precise positioning of pulmonary nodules, effectively reduce the incidence of preoperative positioning complications, shorten the operation waiting time, ensure the safety and effectiveness of patients with preoperative pulmonary nodules positioning, and further improve the surgical comfort of patients, which has certain clinical application value.