Objective To investigate the methodology and efficacy evaluation of ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients. Methods The cl inical data from 65 patients (75 hips) who received ceramic on ceramic hip prosthesis for total hip arthroplasty between February 2004 and September 2006, including unilateral replacementin 55 cases and bilateral replacement in 10 cases. Of 65 patients, there were 41 males and 24 females with an average age of 43.2 years (range, 18-56 years), including 6 cases of femoral head comminuted fractures, 44 cases of aseptic necrosis femoral head, 7 cases of developmental dysplasia of hip with osteoarthritis, 3 cases of congenital dislocation of hip, 2 cases of traumatic arthritis secondary to postoperative acetabulum fracture, 1 case of rheumatoid arthritis, and 2 cases of ankylosing spondyl itis. The Harris score was 54.3 ± 6.7. The disease duration was 1 year and 4 months to 10 years and 7 months with an average of 3 years and 2 months. Results Heal ing of incision by first intention was achieved in all patients; no dislocation, infection, and deep venous thrombosis of lower l imbs occurred. All patients were followed up 3 years and 2 months to 5 years and 7 months with an average of 4 years and 9 months. The Harris score was significantly improved to 89.0 ± 9.4 at last follow-up, showing significant difference when compared with preoperative one (P lt; 0.01). The mean eversion angle and anteversion angle of the acetabular component were (43.6 ± 8.4)° and (21.5 ± 3.5)°, respectively. In follow-up period, no prosthetic loosening, subsidence, dislocation, and ceramic component fracture occurred. Osteolysis was not found in all the cases. Conclusion Ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients can effectively decrease the compl ications of prosthetic loosening and subsidence caused by wearing of joint interface; the surgical skill is important in decreasing dislocation and fraction of ceramic on ceramic hip prosthesis.
Objective To investigate the preparation of decellularized Achilles tendons and the effect of co-culture of human fibroblasts on the scaffold so as to provide a scaffold for the tissue engineered ligament reconstruction. Methods Achilles tendons of both hind limbs were harvested from 10 male New Zealand white rabbits (5-month-old; weighing, 4-5 kg). The Achilles tendons were decellularized using trypsin, Triton X-100, and sodium dodecyl sulfate (SDS), and then gross observation, histological examination, and scanning electron microscope (SEM) observation were performed; the human fibroblasts were seeded on the decellularized Achilles tendon, and then cytocompatibility was tested using the cell counting kit 8 method at 1, 3, 5, 7, and 9 days after co-culture. At 4 weeks after co-culture, SEM, HE staining, and biomechanical test were performed for observing cell-scaffold composite, and a comparison was made with before and after decellularization. ResultsAfter decellularization, the tendons had integrated aponeurosis and enlarged volume with soft texture and good toughness; there was no loose connective tissue and tendon cells between tendon bundles, the collagen fibers arranged loosely with three-dimensional network structure and more pores between tendon bundles; and it had good cytocompatibility. At 4 weeks after co-culture, cells migrated into the pores, and three-dimensional network structure disappeared. By biomechanical test, the tensile strength and Young’s elastic modulus of the decellularized Achilles tendon group decreased significantly when compared with normal Achilles tendons group and cell-scaffold composite group (P lt; 0.05), but no significant difference was found between normal Achilles tendons group and cell-scaffold composite group (P gt; 0.05). There was no significant difference in elongation at break among 3 groups (P gt; 0.05). ConclusionThe decellularized Achilles tendon is biocompatible to fibroblasts. It is suit for the scaffold for tissue engineered ligament reconstruction.
Objective The anterior cruciate l igament (ACL) is the important stable structure of the knee. To evaluate the method and outcome of bone-ACL-bone (B-ACL-B) allograft under arthroscope in reconstruction of ACL. Methods Between October 2007 and February 2010, arthroscopic ACL reconstruction with deep-freezing B-ACL-B allograft was performed on 22 patients with ACL ruptures. There were 15 males and 7 females with an average age of 27.6 years (range, 19-55 years). The causes of ACL rupture were sport trauma in 12 cases, fall ing injury in 1 case, heavy crush in 2 cases, and traffic accident in 7 cases. The locations were the left knee in 14 cases and the right knee in 8 cases. The disease durationwas 7 days to 12 months (median, 65 days). Nineteen patients showed the positive results of anterior drawer test and pivot shift test, and 21 patients showed the positive results of Lachman test. According to International Knee Documentation Committee (IKDC) criteria, there were 5 abnormal and 17 severely abnormal. The subjective IKDC score was 49.6 ± 6.9. The Lysholm score was 48.5 ± 5.3. The Tegner scale scores were 6.8 ± 1.2 before injury and 2.1 ± 0.5 before operation. The MRI showed the ACL injuries in 18 of 20 patients. Results The mean operative time was 75 minutes (range, 65-85 minutes); the mean blood loss was 110 mL (range, 80-150 mL). All incisions healed by first intention. No immunologic rejection and deep vein thrombosis of lower l imbs occurred. All patients were followed up 7-34 months (mean, 18 months). At last follow-up, the flexion of the knee ranged from 125 to 135° (mean, 130.5°). Two patients showed the positive results of anterior drawer test, 1 patient showed the positive result of pivot shift test, and 3 patients showed the positive results of Lachman test. According to the IKDC criteria, 10 patients rated as normal, 11 patients as nearly normal, 1 patient as abnormal. The subjective IKDC score was 90.0 ± 5.8, showing significant difference when compared with preoperative one (t=4.653, P=0.021). The Lysholm score was 91.6 ± 7.1, showing significant difference when compared with preoperative one (t=4.231, P=0.028). The Tegner scale score was 6.1 ± 1.5, showing no significant difference when compared with one before injury (t=1.321, P=0.070) and showing significant difference when compared preoperative one (t=3.815, P=0.033). The arthroscopic examination showed no rupture of grafts in 19 patients, 17 grafts showed normal tension, and 2 showed sl ight relaxation at 6 months after operation. Conclusion Reconstruction of the ACL with B-ACL-B allograft under arthroscope is a safe and effective method, which can anatomically reconstruct ACL and obtain a good recovery of the knee function after operation.
ObjectiveTo evaluate the clinical efficacy of flupentixol and melitracen tablets on the treatment of chronic obstructive pulmonary disease (COPD) with anxiety and/or depression.MethodsRandomized controlled trials of flupentixol and melitracen tablets in the treatment of COPD with anxiety and/or depression were retrieved from PubMed, Sciencedirect Database, China National Knowledge Infrastructure, Wanfang Database, and CQVIP Journal Database, with retrieval time from January 2010 to December 2019. Two researchers screened literature and extracted data independently, and meta-analyzed the results using RevMan 5.3 software.ResultsA total of 9 articles with 1 123 patients were included. There were 567 patients in the trial group receiving flupentixol and melitracen tablets plus symptomatic support therapy and 556 patients in the control group receiving simple symptomatic treatment. After treatment, the Hamilton Anxiety Scale score [mean difference (MD)=−5.10, 95% confidence interval (CI) (−7.67, −2.54), P<0.000 1] and Hamilton Depression Scale score [MD=−3.94, 95%CI (−6.64, −1.23), P=0.004] in the trial group were lower than those in the control group, while the forced expiratory volume in one second as percentage of predicted volume [MD=4.89%, 95%CI (0.59%, 9.19%), P=0.03] and COPD Assessment Test score [MD=−3.21, 95%CI (−3.76, −2.66), P<0.000 01] in the trial group were better than those in the control group.ConclusionFlupentixol and melitracen tablets plus symptomatic support therapy has a better effect than simple symptomatic support treatment on COPD with anxiety and/or depression.
Objective To survey and analyze the epidemiological and distribution situation of echinococcosis for human and livestock in Aba Prefecture of Sichuan Province. Methods According to the Standard WS257-2006 of Diagnose Hydatidosis which was published by the WHO, the residents from 141 countrysides of 13 counties where echinococcosis prevailed were examined by B-ultrasound. Sera anti-echinococcosis IgG of children under 12 years old and dejecta-antigen of dogs were examined by ELISA. Visceral of yaks and sheep were examined in slaughter places to make sure their infection. Results Human surveillance: 48 288 people were examined by B-ultrasound, 470 of which were patients. The positive rate was 0.97%; 19 people was Alveolar Echinococcus, and 451 people was Cystic Echinococcus. Sera of 5 372 children was examined, 358 of which were positive. The positive rate was 6.67%. Livestock surveillance: 5814 dejecta-antigens of dogs were examined, 989 of which were positive. The positive rate was 17.01%. 3 336 yaks and sheep were examined, 113 of which were positive. The rate was 3.39% (113/3 336). Conclusion Alveolar and Cystic Echinococcus exist and prevail among humans and cattles in Aba Prefecture of Sichuan Province, with a larger proportion of Cystic Echinococcus.
目的 探讨甲状腺疾病患者血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白(TG)含量水平变化与临床意义。 方法 采用电化学发光法对2009年1月-6月诊断的725例甲状腺疾病患者的FT3、FT4、TSH、TG进行检测，对各类甲状腺疾病的激素含量进行统计分析。 结果 血清中此类激素的水平与甲状腺的功能状态呈平行关系。 结论 在不同甲状腺疾病患者血清FT3、FT4、TSH、TG变化各有特点，有助于临床鉴别诊断。
Objective To observe the level of vitamin D in patients with steroid resistant (SR) asthma, and investigate the effect of 1,25-(OH)2D3 on JNK/AP-1 and glucocorticoid receptor of T lymphocytes in SR asthmatics. Methods Sixty-two outpatients and inpatients with asthma with acute exacerbation between 2014 and 2015 were recruited in the study, including 26 cases of steroid sensitive (SS) asthmatics and 36 cases of SR asthmatics. Meanwhile 25 healthy volunteers were recruited as control. Clinical data were collected and peripheral venous blood was sampled for measuring the level of 25-(OH)D and separating the T lymphocytes. T lymphocytes were assigned to six groups, ie. a healthy control group (Group A), a SS asthmatics control group (Group B), a SR asthmatics control group (Group C), a SR asthmatics with JNK inhibitor (SP600125)+1,25-(OH)2D3 group (Group D), a SR asthmatics with JNK inhibitor (SP600125) group (Group E), and a SR asthmatics with 1,25-(OH)2D3 group (Group F). T lymphocytes were cultured for 48 hours. By the end of culture, the expression of phospho-JNK (p-JNK) and phospho-glucocorticoid receptor (p-GR) of T lymphocytes were detected by Western blot method, and the expression of c-Jun mRNA was detected by RT-PCR method. Results The level of 25-(OH) D was lower in Group B and Group C than Group A (P<0.05), and lower in Group C than Group B (P<0.05). The level of p-JNK was higher in Group B and Group C than Group A (P<0.05), higher in Group C than Group B (P<0.05), lower in Group E and Group F than Group C (P<0.05), lower in Group D than Group F (P<0.05). The level of p-GR was lower in Group C than Group A and Group B (P<0.05), higher in Group E and Group F than Group C (P<0.05), higher in Group D than Group F (P<0.05). The level of c-Jun mRNA was higher in Group B and Group C than Group A (P<0.05), higher in Group C than Group B (P<0.05), lower in Group E and Group F than Group C (P<0.05), and lower in Group D than Group F (P<0.05). The 25-(OH) D level was negatively correlated with the expression of p-JNK and c-Jun mRNA in Group C (r=–0.69, r=–0.65, P<0.05). However, there was a positive correlation between the 25-(OH) D level and p-GR (r=0.72, P<0.05). Conclusions There is a high prevalence of vitamin D deficiency or lack in SR asthmatics. 1,25-(OH)2D3 can promote the expression of p-GR by inhibiting the JNK/AP-1 signaling pathway of T lymphocytes in SR asthmatics, which may be one of the mechanisms of vitamin D to improve glucocorticoid resistance in SR asthmatics.
ObjectiveTo explore the effect of rehabilitation training focusing on early exercise on the time of first getting out of bed after surgery, pain during early activities, postoperative infection rate and the length of hospital stay for renal transplant recipients.MethodsThe clinical data of patients undergoing allogeneic renal transplantation in West China Hospital of Sichuan University from June to August 2020 were analyzed retrospectively. According to the time of multidisciplinary postoperative management and the time of early rehabilitation intervention, the patients were divided into the conventional group (from June 2020 to the beginning of multidisciplinary postoperative management) and the rehabilitation group (after multidisciplinary postoperative management). The time to get out of bed for the first time after surgery, the Visual Analogue Score (VAS) during weight monitoring on the second day post operation, the number of days required to complete an independent walk of 100 meters, postoperative complications, the incidence of postoperative infection and the length of hospital stay were compared between the two groups.ResultsA total of 79 patients were included. There were 46 cases in the conventional group and 33 cases in the rehabilitation group. Among the included patients, 14 patients had postoperative infection, 1 patients in the conventional group developed thrombosis, no catheter shedding or bleeding after exercise occurred. The differences between the rehabilitation group and the conventional group in the time to get out of bed for the first time after surgery [(1.1±0.2) vs. (2.2±0.4) d; t=13.224, P<0.001], the VAS during weight monitoring on the day post operation (2.5±0.9 vs. 3.4±1.4; t=3.267, P<0.001), the number of days required to complete an independent walk of 100 meters [(2.2±0.4) vs. (4.0±0.8) d; t=11.312, P<0.001], and the incidence of postoperative infection (6.1% vs. 26.1%; χ2=5.285, P=0.022) were statistically significant. There was no significant difference in the length of stay between the rehabilitation group and the conventional group [(19.8±5.8) vs. (20.7±7.4) d; t=0.584, P=0.561].ConclusionEarly postoperative rehabilitation training reduces the time required for renal transplant recipients to get out of bed for the first time post operation and to walk 100 meters independently, reduce the pain response during early activities, and reduce the incidence of postoperative infection.
Objective To study the variation of CD105+/CD166+ cells and its multilineage potential in early osteoarthritis (OA) cartilage so as to lay a foundation for cartilage repair and pathologic cartilage remodeling in arthritis. Methods The knee OA model was established in the right knee of 30 adult New Zealand rabbits (8-12 months old). The chondrocytes were harvested from normal cartilage of the left knee (group A), OA cartilage of the right knee at 2 weeks (group B), at 4 weeks (group C), and at 8 weeks (group D) after modeling, and BMSCs were used in group E for the expression of CD105 and CD166. The percentage of CD105+/CD166+ cells in each group was counted by flow cytometry, and CD105+/CD166+ cells were isolated and purified by magnetic-activated cell sorting. The expressions of CD105 and CD166 were observed in 5 groups by laser scanning confocal microscope. Chondrogenesis, osteogenesis, and adipogenesis were evaluated with Alcian blue cytochemistry and collagen type II immunohistochemistry, by detecting the deposition of calcium, and with oil red O staining, respectively. Results The percentage of CD105+/CD166+ cells in group A, B, C, and D was significantly lower than that in group E (P lt; 0.05); it was significantly higher in groups B, C, and D than in group A (P lt; 0.05), and in group D than in groups B and C (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05). Laser scanning confocal microscope results confirmed the expressions of CD105+ and CD166+ cells in groups A, B, C, D, and E, no obvious difference in expression was shown among 5 groups. At 1 week after chondrogenic induction, positive expressions of proteoglycan and collagen type II were observed in 5 groups, no obvious difference was noticed among 5 groups. At 2 weeks after osteogenic induction, calcium level in group E was significantly higher than that in groups A, B, C, and D (P lt; 0.05), but no significant different was found among groups A, B, C, and D (P gt; 0.05). At 4 weeks after adipogenic induction, there were more red lipid droplets in group E than in groups A, B, C, and D. Conclusion CD105+/CD166+ cells in early OA cartilage increase, which show chondrogenic differentiation potential.
Objective To investigate the treatment and therapeutic efficacy of intra-articular meniscal cysts by arthroscopy. Methods From January 2005 to December 2009, 9 cases of intra-articular meniscal cysts were treated by arthroscopy, including 5 males and 4 females, with an average age of 33.8 years (range, 24-46 years). Six patients suffered in left knees, 3 in right ones. Just 1 case had trauma history, the others had no obvious predisposing causes. The average course of the disease was 24.2 months (range, 4-36 months). The Lysholm score was (74.2 ± 11.6) points. Arthroscopy showed that the locations of cysts were the anterior horn of lateral meniscus in 8 cases and the anterior horn of medial meniscus in 1 case; all being single cyst (of them, 3 being multilocular cyst). Results All incisions healed primarily with no compl ications of infection and joint effusion. All 9 patients were followed up from 3 to 48 months with an average of 12.7 months. Preoperative symptoms disappeared or reduced and the range of motion of the knee returned to normal. TheLysholm score was (95.1 ± 3.4) points after 3 months of operation, showing significant difference (P lt; 0.01) when compared with the socre before operation. According to assessment standard described by Choy, the treatment outcome was excellent in 6 cases, good in 2 cases, and general in 1 case; the excellent and good rate was 88.9%. No recurrence was found during follow-up. Conclusion Arthroscopic surgery shows the advantages to maintain good function of knee for the treatment of meniscal cyst, it is the best choice for intra-articular meniscal cysts because of its mini-trauma, rapid recovery, thorough treatment and less recurrence. Simultaneously, partial or tatol meniscectomy or menicus repairing under arthroscopy is performed.