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1.
Altern Ther Health Med ; 29(3): 120-126, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36735709

RESUMO

Context: Associations between genes and diseases manifest as the influence of gene expression on disease development as well as the impact of variations in the disease-related genes themselves. It's important to determine the genetic variations that can lead to compressed fractures of osteoporotic, thoracic lumbar vertebrae to develop personalized clinical methods to prevent or delay the disease's development. Objective: The study intended to explore the correlations between the gene polymorphisms and gene expressions of the interleukin-6 (IL-6) gene and the transforming growth factor-beta (TGF-ß) gene and osteoporotic, thoracolumbar, vertebral compression fracture. Design: The research team performed an observational study using data from medical records. Setting: The study took place at Xuzhou Medical University in Xuzhou, China. Participants: Participants were 200 patients with an osteoporotic, thoracolumbar, vertebral compression fracture who had been admitted to the hospital at the university between 2019 and 2021 prior to the study and 200 healthy people The research team divided the participants into two groups. The patients became participants in the disease group, and the healthy individuals became participants in the control group. Outcome Measures: The research team: (1) collected peripheral blood from the two groups, (2) extracted genomic deoxyribonucleic acids (DNAs) from karyocytes, (3) examined the IL-6 and TGF-ß gene polymorphisms, and (4) analyzed and correlated participants' clinical data with the gene polymorphisms and expressions. The team used a quantitative polymerase chain reaction (qPCR) to examine the expression levels of IL-6 and TGF-ß. Results: Compared to the control group, the disease group: (1) had allele distributions that were significantly different at the rs2069829 locus of the IL-6 gene (P < .001) and at the rs3087453 of the TGF-ß gene (P = .004); (2) had significantly higher frequencies of allele T at the rs2069829 locus of the IL-6 gene and of allele G at the rs3087453 locus of the TGF-ß gene; (3) had genotype distributions that were significantly different at the rs2069829 locus (P < .001) and the rs2069857 locus (P = .048) of the IL-6 gene and at the rs3087453 locus (P < .001) of the TGF-ß gene; (4) had frequencies that were significantly higher of the TT genotype at the rs2069829 locus, the CC genotype at the rs2069857 locus, and the GC genotype at the rs3087453 locus of the IL-6 gene and the TGF-ß gene; (5) had dominant models that were significantly different at the rs2069829 locus of the IL-6 gene (P = .009) and at rs3087453 locus of the TGF-ß gene (P = .026) and had a recessive model that was significantly different at the rs2069857 locus of the IL-6 gene (P = .040); (6) had significantly different haplotypes CC (P < .001) and TC (P < .001) at the rs2069829 locus and the rs2069857 locus of the IL-6 gene and a significantly different haplotype AC (P = .011) at the rs1800469 locus and the rs3087453 locus of the TGF-ß gene; (7) had an IL-6 gene polymorphism at the rs2069857 locus that was related to the expression of the IL-6 gene (P < .05) and an expression of the IL-6 gene for participants with the AA genotype that was significantly lower than for other genotypes; (8) had a TGF-ß gene polymorphism at the rs1800469 locus that was associated with the expression of the TGF-ß gene (P < .05), and an expression for participants with the GG genotype that was significantly higher than for other genotypes; (9) had an IL-6 gene polymorphism at the rs2069857 locus with an overt correlation with the genotype of osteoporotic, thoracolumbar, vertebral compression fracture (P < .001). Also, participants in the disease group with the genotype CC mainly had type 2 and 3 fractures, while those with genotype AA primarily had type 0 and 1 fractures. Conclusions: IL-6 and TGF-ß gene polymorphisms and expressions are significantly related to osteoporotic, thoracolumbar, vertebral compression fracture.


Assuntos
Fraturas por Compressão , Interleucina-6 , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Fator de Crescimento Transformador beta , Humanos , Fraturas por Compressão/genética , Frequência do Gene , Interleucina-6/genética , Fraturas por Osteoporose/genética , Polimorfismo Genético , Fraturas da Coluna Vertebral/genética , Fator de Crescimento Transformador beta/genética , Vértebras Torácicas/metabolismo , Vértebras Torácicas/patologia , Vértebras Lombares/metabolismo , Vértebras Lombares/patologia
2.
Molecules ; 28(4)2023 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-36838594

RESUMO

The overall objective of this study was to investigate the mechanism of inflammation on chondrocyte injury and the protective effect of catalpol on chondrocytes in an inflammatory environment. Chondrocytes were isolated and cultured from the knee joints of three-day-old newborn mice. Alcian Blue staining and the immunocytochemistry staining of type II collagen were used to identify the purity of chondrocytes. Primary chondrocytes were stimulated by IL-1ß (10 ng/mL) and subjected to transcriptome analysis. Differentially expressed genes (DEGs) were further analyzed based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. In this experimental study, we performed the viability assay to determine the effects of different concentrations of catalpol on the cell viability of chondrocytes. Chondrocytes were seeded in six-well plates and exposed to 10 µM catalpol 2 h prior to treatment with IL-1ß (10 ng/mL). Quantitative real-time (qPCR) and Western blotting were performed to evaluate the RNA and protein expression, respectively. Based on the results of transcriptomics analysis, we found the NOD2 signaling pathway, the NF-kappa B signaling pathway, and the MAPK signaling pathway showed significant changes in chondrocyte damage caused by inflammation. Catalpol (10 µM and 100 µM) could significantly reduce NO, IL-6, IL-1ß, and TNF-α in supernatant of chondrocytes. Catalpol significantly inhibited the mRNA expression of IL-1, IL-6, and IL-12 in chondrocytes induced by IL-1ß. Catalpol markedly inhibited MMP3, MMP13 mRNA, and protein levels. Catalpol could significantly reduce TNF-α mRNA levels in inflammatory chondrocytes. Inflammation causes significant increases in mRNA levels and protein levels of NOD2, mRNA levels, and protein levels were markedly suppressed by catalpol. In addition, catalpol could significantly increase IKBα protein levels and significantly lower intranuclear P65 levels. Catalpol significantly lowered the phosphorylation protein levels of ERK, p38, and JNK. Our transcriptomic analysis demonstrated that the activation of NOD2 and its downstream pathways, NF-κB and MAPK, is an important cause of the inflammatory injury to chondrocytes induced by IL-1ß. Catalpol inhibited the activation of the NOD2 signaling pathway, which reduced the phosphorylation of ERK, p38, and JNK, inhibited the degradation of IκBα, inhibited p65 translocation into the nucleus, reduced the release of inflammatory cytokines, and attenuated the inflammatory damage to chondrocytes.


Assuntos
NF-kappa B , Osteoartrite , Camundongos , Animais , NF-kappa B/metabolismo , Condrócitos , Fator de Necrose Tumoral alfa/metabolismo , Transcriptoma , Interleucina-6/metabolismo , Osteoartrite/genética , Transdução de Sinais , Inflamação , Perfilação da Expressão Gênica , RNA Mensageiro , Interleucina-1beta/metabolismo , Células Cultivadas
3.
Crit Rev Food Sci Nutr ; : 1-21, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36239319

RESUMO

As living standards rise, the demand for high-quality chilled meat among consumers also grows. Researchers and enterprises have been interested in ensuring the quality of chilled meat in all links of the downstream industry. Nanozyme has shown the potential to address the aforementioned requirements. Reasons and approaches for the application of nanozymes in the freshness assessment or shelf life extension of chilled meat were discussed. The challenges for applying these nanozymes to ensure the quality of chilled meat were also summarized. Finally, this review examined the safety, regulatory status, and consumer attitudes toward nanozymes. This review revealed that the freshness assessment of chilled meat is closely related to mimicking the enzyme activities of nanozymes, whereas the shelf life changes of chilled meat are mostly dependent on the photothermal activities and pseudophotodynamic activities of nanozymes. In contrast, studies regarding the shelf life of chilled meat are more challenging to develop, as excessive heat or reactive oxygen species impair its quality. Notably, meat contains a complex matrix composition that may interact with the nanozyme, reducing its effectiveness. Nanopollution and mass manufacturing are additional obstacles that must be overcome. Therefore, it is vital to choose suitable approaches to ensure meat quality. Furthermore, the safety of nanozymes in meat applications still needs careful consideration owing to their widespread usage.

4.
BMC Musculoskelet Disord ; 23(1): 694, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35869453

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is a common disease based on degenerative pathological changes. Total knee arthroplasty (TKA) is an effective treatment for end-stage of KOA. However, only volume adaptation can be achieved with current knee prostheses, and it is difficult to achieve weight adaptation. This study focused on the weight difference of knee joints and initially explored the impact of this change on knee joint functional recovery and gait changes in patients after surgery. METHODS: From October 2015 to June 2019, patients who underwent primary unilateral TKA were enrolled in this prospective cohort study with the same brand of knee prostheses. General data were collected from patients who met the criteria. The resected bone and soft tissues were collected and weighed precisely during TKA, and multivariate regression analysis was used to determine the factors affecting the weight of the removed knee tissues. We compared the weight of excised tissues and the total weight of the knee prosthesis, and the weight difference was defined as the increased weight of the knee joint (IWKJ). All patients were evaluated by HSS score, gait analysis, and affected side knee X-ray at two weeks, three months, and the last follow-up after the operation. To further determine the influence of IWKJ on postoperative functional recovery, the relationship between IWKJ, HSS score, and gait analysis was analyzed by univariate regression. RESULTS: In total, 210 patients were eventually included in observation. All patients underwent postoperative follow-up for no less than two years. Multiple regression analysis showed that the course of the disease, body weight, and kellgren-Larencen stage(K-L stage)of the affected knee joint were independent factors affecting the weight of the removed knee tissues and were positively correlated with it. Univariate analysis showed that IWKJ was negatively correlated with HSS score at two weeks and three months after the operation. In addition, the values of spatiotemporal parameters and knee rotation ROM were negatively correlated with IWKJ two weeks after surgery, while outside food load response was positively correlated with IWKJ. Cadence, knee rotation ROM, and Ankle rotation ROM were negatively correlated with IWKJ, while outside food was positively correlated with IWKJ three months after surgery. At the last follow-up, only the hip rotation ROM was positively correlated with IWKJ. CONCLUSIONS: All Patients underwent TKA had varying degrees of increased knee weight. The increased weight was 298.98 ± 63.77 g. Patients' body weight, K-L staging, and disease duration are important factors that cause differences in resected knee tissue. Three months after the operation, the changes in knee joint weight had a negative correlation with the HSS score, which at the same time, it had varying degrees of linearity with gait parameters. However, the influence of weight diminished over time.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Artroplastia do Joelho/efeitos adversos , Peso Corporal , Marcha , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Estudos Prospectivos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento
5.
Eur J Neurosci ; 53(3): 720-731, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33022764

RESUMO

Peripheral nerve injury (PNI) is a common and incurable disease in the clinic, but the effects of available treatments are still not satisfactory. Therefore, it is necessary to explore new treatment methods. To explore the effect and mechanism of melatonin in peripheral nerve regeneration, we administered melatonin to mice with PNI by intraperitoneal injection. We applied microarray analysis to detect differentially expressed genes of mice with sciatic nerve injury after melatonin application. Then, we conducted gene ontology and protein-protein interactions to screen out the key genes related to peripheral nerve regeneration. Cell biology and molecular biology experiments were performed in Schwann cells in vitro to verify the key genes identified by microarray analysis. Our results showed that a total of 598 differentially expressed genes were detected after melatonin subcutaneously injecting into mice with sciatic nerve injury. Bioinformatics analysis showed that Shh may be the key gene for the promotion of peripheral nerve regeneration by melatonin. In vitro, the proliferation and migration abilities of schwann cells in the melatonin group were significantly higher than those of Schwann cells in the control group; while after treating with both melatonin and luzindole (a Shh signalling pathway inhibitor), the proliferation and migration abilities of Schwann cells decreased compared with the melatonin group. Our study suggests that melatonin might improve the proliferation and migration of Schwann cells via the Shh signalling pathway after PNI, thus promoting peripheral nerve regeneration. Our study provides a new approach and target for the clinical treatment of PNI.


Assuntos
Melatonina , Traumatismos dos Nervos Periféricos , Animais , Movimento Celular , Proliferação de Células , Melatonina/farmacologia , Camundongos , Regeneração Nervosa , Traumatismos dos Nervos Periféricos/tratamento farmacológico , Células de Schwann , Nervo Isquiático
6.
BMC Musculoskelet Disord ; 22(1): 588, 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34174859

RESUMO

BACKGROUND: Here we compared the clinical efficacy of bilateral percutaneous kyphoplasty (PKP) and percutaneous curved kyphoplasty (PCKP) in the treatment of osteoporotic vertebral compression fractures (OVCF). METHODS: Seventy-two patients with single-level thoracolumbar OVCF were randomly divided into 2 groups (36 patients in each) and were subjected to either PCKP or bilateral PKP. The intraoperative fluoroscopy time, total surgical time, bone cement injection volume, bone cement leakage, preoperative and postoperative anterior vertebral height, Cobb angles, visual analog scales (VAS) and oswestry disability index questionnaire (ODI) were recorded. RESULTS: Both groups of patients had a trend towards improvements in VAS and ODI scores 24 h and 6 months after surgery, when compared to preoperative results, despite lack of statistical significance. The total surgical and intraoperative fluoroscopy times and intraoperative bone cement injection volume were significantly decreased in the PCKP group than those in the PKP group. The anterior edge height and Cobb angle of the injured vertebra were similarly improved after operation in both groups. CONCLUSION: PCKP is safer, less invasive and quicker than traditional bilateral PKP despite similar short-term effects for the treatment of OVCF. TRIAL REGISTRATION: ChiCTR, ChiCTR2100042859 . Registered 25 January 2021- Retrospectively registered.


Assuntos
Fraturas por Compressão , Cifoplastia , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Cimentos Ósseos , Humanos , Estudos Retrospectivos , Resultado do Tratamento
7.
Int Orthop ; 45(12): 3091-3100, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34191090

RESUMO

STUDY DESIGN: Prospective study. PURPOSE: The main purpose of this study was to investigate whether the use of a tourniquet changes the blood coagulation state following primary total knee arthroplasty (TKA) by means of conventional coagulation tests and thromboelastography (TEG) analyses. METHODS: A total of 154 patients who underwent primary unilateral TKA from January 2018 to October 2020 were enrolled. Seventy-nine patients were randomized into a tourniquet group, and 75 were randomized into a no-tourniquet group. Demographic data, surgical time, intra-operative blood loss, transfusion rate, and wound complications were collected. Complete blood count, conventional coagulation tests, and TEG were performed the day before surgery, one day after surgery, three days after surgery, and seven days after surgery. Lower extremity Doppler ultrasound was performed the day before surgery and seven days after surgery. RESULTS: The baseline characteristics of the patients were similar between the two groups. Hidden blood loss, transfusion rate, and wound complications were similar between the two groups, but the intra-operative blood loss of the tourniquet group was lower than that of the no-tourniquet group. The calculated total blood loss of the tourniquet group was higher than that of the no-tourniquet group. In terms of conventional coagulation tests and TEG, the tourniquet group had higher values of fibrin degradation products, D-dimer, maximum amplitude, and coagulation index (p < 0.001). The incidence of deep vein thrombosis (DVT) in the tourniquet group was higher than that in the no-tourniquet group (21.5% compared with 8%; p = 0.019). CONCLUSION: The application of a tourniquet during TKA significantly increases the amount of calculated total blood loss and does not decrease the post-operative transfusion rate. Using a tourniquet in routine TKA exacerbates the early post-operative hypercoagulable status together with a higher incidence of below-knee asymptomatic DVT observed via conventional coagulation tests, TEG, and ultrasonic Doppler.


Assuntos
Artroplastia do Joelho , Artroplastia do Joelho/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Humanos , Estudos Prospectivos , Tromboelastografia , Torniquetes
8.
J Orthop Traumatol ; 22(1): 46, 2021 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-34773489

RESUMO

BACKGROUND: Several studies have compared clinical results of the direct anterior approach (DAA) and the posterolateral approach (PLA) in total hip arthroplasty (THA); however, the effect of the surgical approach on outcome of THA remains controversial. Most of these studies used two distinct groups of patients, and THAs were performed by different surgeons, using different designs of prosthesis. These confounding factors may limit the strength of the conclusions. The purpose of this prospective, simultaneous bilateral randomized study was to investigate whether patients would perceive the difference between the direct anterior approach (DAA) and the posterolateral approach (PLA) after THA. MATERIALS AND METHODS: Among 20 patients scheduled to undergo same-day bilateral THA between October 2017 and August 2019, one hip was randomly assigned to DAA and the other to PLA. Patient-reported outcome measures [Hip disability and Osteoarthritis Outcome Score (HOOS), patients' hip pain on mobilization] and physician-assessed measures [Harris Hip Score (HHS), operative time, intraoperative blood loss, cup abduction, cup anteversion, stem orientation, and incidence of complications (intraoperative fracture, nerve damage, incisional problem, or postoperative dislocation)] were compared. RESULTS: All patients were followed up for 12 months. Hip pain was significantly less with DAA-THA compared with PLA-THA at postoperative 1, 3, and 7 days (p < 0.05). There was no clinical difference between DAA-THA and PLA-THA in terms of the VAS, HOOS, or HSS at 6 weeks and 3, 6, and 12 months postoperatively (p > 0.05). DAA-THA had a longer operative time and shorter length of incision compared with PLA-THA. There was no statistical difference between DAA-THA and PLA-THA in terms of intraoperative blood loss, cup abduction, cup anteversion, stem orientation, and perioperative complications (p > 0.05). CONCLUSIONS: This study demonstrates that DAA-THA and PLA-THA could provide comparable HHS and HOOS at all follow-ups. Compared with PLA-THA, DAA-THA is associated with less hip pain within postoperative 7 days and shorter incision length, but longer operative time. LEVEL OF EVIDENCE: Level I, therapeutic study. Trial registration Chinese Clinical Trail Registry, ChiCTR1800019816. Registered 30 November 2018-retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=30863.


Assuntos
Artroplastia de Quadril , Prótese de Quadril , Articulação do Quadril/cirurgia , Humanos , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Resultado do Tratamento
9.
Artigo em Inglês | MEDLINE | ID: mdl-30932160

RESUMO

OBJECTIVE: Growing evidence indicates that microRNAs (miRNA) play a critical role in the pathogenesis of OA, and overexpressing or silencing miRNA expression in OA models can contribute to the development of miRNA-based therapeutics. The objective of this study was to determine whether intra-articular injection of miRNA can inhibit OA progression. METHODS: The miRNA expression profile was determined in OA cartilage tissues and controls. Functional analysis of the miRNAs on extracellular matrix degradation was performed after miRNA mimic or inhibitor transfection. Luciferase reporter assays and western blotting were employed to determine miRNA targets. To investigate the functional mechanism of miR-21-5p in OA development, miR-21-5pfl/flCol2a1-CreER and wild-type mice were subject to surgical destabilization of the medial meniscus. Therapeutically, wild-type mice undergoing surgical destabilization of the medial meniscus were treated with intra-articular injection of agomir- and antagomir-21-5p. RESULTS: We found that expression of miR-21-5p was significantly up-regulated in OA cartilage tissues. The articular cartilage degradation of miR-21-5p conditional knockout mice was significantly alleviated compared with that of wild-type mice in spontaneous and destabilization of the medial meniscus models. Through gain-of-function and loss-of-function studies, miR-21-5p was shown to significantly affect matrix synthesis genes expression, and chondrocyte proliferation and apoptosis. Further, fibroblast growth factor 18 (FGF18) was identified as a target of miR-21-5p. Intra-articular injection of antagomir-21-5p significantly attenuated the severity of experimental OA. Clinically, FGF18 expression level was correlated with miR-21-5p expression and a modified Mankin scale. CONCLUSION: Our findings reveal a miRNA functional pathway important for OA development, highlighting miRNA-21-5p silencing as an attractive therapeutic regimen in future clinical trials involving patients with OA.

10.
Med Sci Monit ; 25: 3655-3661, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31097682

RESUMO

BACKGROUND This retrospective study compared the effects of total hip arthroplasty (THA) and traditional surgery using internal screw fixation for the treatment of avascular necrosis (AVN) of the femoral head. MATERIAL AND METHODS A total of 270 patients with bilateral ANFH were retrospectively analyzed. Among them, 176 underwent THA (THA group); and 94 underwent closed reduction screw fixation (traditional group).  RESULTS The mean operation time in the traditional surgery group (82.6±15.6 min) was significantly less compared with the THA group (104.8±14.2 min) (P=0.001). Intraoperative blood loss in the traditional surgery group (219.8±21.6 mL) was significantly less compared with the THA group (339.4±29.4 mL) (P=0.001). After treatment, the mean HHS score of the THA group (76.5±9.2 points) was significantly increased when compared with the traditional surgery group (61.4±10.5 points) (P=0.001). Disease recurrence rate in the THA group was significantly reduced compared with the traditional surgery group (P=0.001). The mean quality of life score of the THA group (85.5±6.4 points) was significantly higher than that of the traditional surgery group (73.4±8.8 points) (P=0.001). CONCLUSIONS Compared with closed reduction screw fixation, THA for AVN of the femoral head effectively reduced the length of hospital stay, time to recovery, and achieved an improved clinical outcome.


Assuntos
Artroplastia de Quadril/métodos , Necrose da Cabeça do Fêmur/cirurgia , Adulto , Parafusos Ósseos , China , Feminino , Fraturas do Colo Femoral/cirurgia , Cabeça do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Período Pós-Operatório , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
11.
Med Sci Monit ; 25: 5068-5074, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31285414

RESUMO

BACKGROUND Tranexamic acid (TXA) is safe and effective in total knee arthroplasty (TKA) for the prevention of bleeding. However, the role of TXA during unicompartmental knee arthroplasty (UKA) remains unclear. This study aimed to compare operative blood loss in patients undergoing UKA treated with an intra-articular injection of TXA with controls undergoing UKA without TXA. MATERIAL AND METHODS The prospective study included 101 patients who underwent UKA between January 2014 to March 2018. All patients completed a preoperative routine examination and were randomized to the study group (n=54) and the control group (n-47). The study group was given an articular injection of TXA (1.5 g in 50 ml normal saline) after the fascia was closed; the control group was injected with the same volume of normal saline. Blood volumes were measured from the drainage tube of the two groups during 48 hours. Total blood loss, postoperative drainage, hidden blood loss, blood transfusion rates, postoperative hemoglobin values, indicators of coagulation function, and the rates of wound complications were recorded. RESULTS Total blood loss in the study group was 745.6±105.1 ml, total drainage volume was 353.9±79.5 ml, and the hidden blood loss was 391.7±80.5 ml, which were all significantly lower when compared with the control group (P<0.05). None of the patients in the two groups suffered complications of surgery. CONCLUSIONS Intra-articular injection of TXA significantly reduced the total blood loss in patients who underwent UKA and did not increase the rate of complications.


Assuntos
Hemorragia Pós-Operatória/tratamento farmacológico , Ácido Tranexâmico/uso terapêutico , Idoso , Antifibrinolíticos/uso terapêutico , Artroplastia do Joelho/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Transfusão de Sangue , Drenagem , Feminino , Hemoglobinas/análise , Humanos , Injeções Intra-Articulares/métodos , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/prevenção & controle , Estudos Prospectivos
12.
BMC Musculoskelet Disord ; 20(1): 340, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31351465

RESUMO

BACKGROUND: To compare the efficacy and safety of simultaneous vs staged unicompartmental knee arthroplasty (UKA) for bilateral unicompartmental osteoarthritis of the knee. METHODS: We performed a retrospective analysis of prospectively collected data on 93 patients with bilateral knee medial compartment arthritis underwent simultaneous UKA (Group A, 39) or staged UKA (Group B, 54 cases) from January 2008 to December 2015. Group A: 6 males and 33 females aged 64.9 ± 7.7 years; Group B: 5 males and 49 females aged 64.2 ± 6.4 years. There were no statistically significant differences in pre-operative age, sex ratio, or body weight index between the groups (P > 0.05). Groups were compared in terms of total anesthesia time, volume of drainage, blood transfusion rate, hemoglobin level on post-operative day 3, total post-operative inpatient days, treatment expenses, post-operative therapeutic effect (KSS scores), and complications. RESULTS: All patients had follow-up visits post-operatively. The follow-up visit interval was 32-133 months and 41.9 months on average. Total anesthesia time, postoperative length of hospital stay, and hospitalization expenses in Group A were significantly less than those of Group B (P < 0.05). Hemoglobin levels in Group A were significantly lower than those of Group B at post-op day 3 (P < 0.05). However, no significant differences in volume of drainage, the rate of transfusion, complications, and KSS scores were detected between Groups A and B (P > 0.05). CONCLUSIONS: Both simultaneous and staged UKA achieved the desired therapeutic effect in treatment of bilateral knee medial compartment arthritis. However, simultaneous UKA reduced the cost and the postoperative length of hospital stay without increasing post-operative complications.


Assuntos
Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Complicações Pós-Operatórias/epidemiologia , Idoso , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/economia , Feminino , Seguimentos , Gastos em Saúde/estatística & dados numéricos , Humanos , Articulação do Joelho/fisiopatologia , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
13.
Surg Radiol Anat ; 41(1): 117-124, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30488299

RESUMO

BACKGROUND: Several anatomical studies regarding the value of hip rotation center (HRC) and femoral offset (FO) have been performed in Western populations. However, there are a few data on hip morphological values in the Chinese population based on CT scans. This study measured the values of the hip and pelvis, especially HRC and FO, in a Chinese population and compared them with the published values obtained from Western populations. PATIENTS AND METHODS: One hundred patients (50 females and 50 males) were included in the present study, and 3D-CT reconstructions of the hip and pelvis were generated. The mean age was 51.4 ± 8.9 years and mean body mass index (BMI) was 23.5 ± 2.6 kg/m2. All the morphologic measurements were compared between genders and sides, and the relationships between different parameters were analyzed. RESULTS: The mean FO values were 38.4 ± 4.7 mm and 35.6 ± 4.4 mm for the males and females, respectively. A significant negative correlation was noted between FO and neck shaft angle (NSA) in both genders (r = - 0.262, P = 0.009 for the males, r = - 0.350, P ≤ 0.001 for the females). A significant positive correlation was found between horizontal distance (HD) and diameter of the femoral head (DFH) in both genders (r = 0.734, P ≤ 0.001 for the males, r = 0.658, P ≤ 0.001 for the females). A significant positive correlation was noted between HD and pelvic width (PW) in males (r = 0.455, P ≤ 0.001). A significant positive correlation was also noted between HD and pelvic height (PH) in males (r = 0.318, P ≤ 0.001). A significant positive correlation was observed between FO and pelvic cavity height (PCH) in males (r = 0.411, P ≤ 0.001), and a significant positive correlation was observed between VD and PCH in females (r = 0.497, P ≤ 0.001). The tip of the greater trochanter was, on average, 7.0 mm higher than the femoral head center. Relationships between DFH and pelvic morphometric parameters were also observed. CONCLUSION: The present morphological data and the relationships between them can be applied to design better ethnic-specific THA prostheses and preoperative plans.


Assuntos
Artroplastia de Quadril , Cabeça do Fêmur/anatomia & histologia , Cabeça do Fêmur/diagnóstico por imagem , Articulação do Quadril/anatomia & histologia , Articulação do Quadril/diagnóstico por imagem , Imageamento Tridimensional , Tomografia Computadorizada por Raios X , Adulto , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rotação
14.
BMC Musculoskelet Disord ; 19(1): 289, 2018 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30115057

RESUMO

BACKGROUND: Total hip arthroplasty (THA) with failure of tantalum rod implant for osteonecrosis of the femoral head (ONFH) will be the only choice for patients. However,it remains unknown whether tantalum rod implantation has an adverse effect on the survival time of implants following conversion to THA. The aim of this study was to retrospectively evaluate the clinical and radiographic outcomes of conversion to THA in patients who were previously treated with implantation of a tantalum rod. METHODS: This study included 31 patients (39 hips), who underwent conversion to THA due to failure of core decompression with an implanted tantalum rod. Among these 31 patients, 26 patients were male and five patients were female. The mean age of these patients was 49.3 years old (range: 36-64 years old). The control group included 33 patients (40 hips), who underwent total hip replacement without tantalum rod implantation. The hip Harris score, implant wear, osteolysis, radiolucencies and surgical complications were recorded during the follow-up. The distribution of tantalum debris in the proximal, middle and distal periprosthetic femoral regions, radiolucent lines and osteolysis were analyzed on post-operative radiographs. RESULTS: There were no significant differences in Harris score, liner wear and complications between the two groups (P > 0.05). Osteolysis and radiolucent lines more likely occurred in patients with tantalum debris distributed in three regions than in one or two regions (P < 0.05). CONCLUSIONS: The mid-term clinical outcome of patients who underwent THA with tantalum rod implantation was not different from those without a tantalum rod, suggesting that tantalum debris did not increase the liner wear rate. However, the distribution of periprosthetic tantalum debris in the proximal, middle and distal femoral regions may increase the risk of femoral osteolysis and radiolucent lines.


Assuntos
Artroplastia de Quadril , Descompressão Cirúrgica/instrumentação , Necrose da Cabeça do Fêmur/cirurgia , Articulação do Quadril/cirurgia , Falha de Prótese , Tantálio , Adulto , Idoso , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/instrumentação , Descompressão Cirúrgica/efeitos adversos , Remoção de Dispositivo , Feminino , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/fisiopatologia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Prótese de Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Reoperação , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Falha de Tratamento
15.
Int Orthop ; 42(3): 513-518, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28986675

RESUMO

OBJECTIVES: The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing. METHODS: We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013. Patients were assessed by the Outerbridge classification for CMP, visual analog scale for AKP, the Knee Society clinical scoring system of knee score (KS), function score (FS), the patellar score (PS) for clinical function, and patients' satisfaction. RESULTS: The intra-operative grading of CMP: grade I in 30 patients, grade II in 68 patients, grade III in 97 patients, and grade IV in 95 patients. The incidence of AKP at 36-month follow-up was 10.3% (30/290). No statistical difference was detected among the different CMP grades in terms of the incidence of AKP (p = 0.995), patients' satisfaction (p = 0.832), KS (p = 0.228), FS (p = 0.713), and PS (p = 0.119) at 36-month follow-up. CONCLUSIONS: The findings may suggest no relevant influence of CMP grading on the incidence of AKP after TKA without patellar resurfacing.


Assuntos
Artroplastia do Joelho/efeitos adversos , Condromalacia da Patela/complicações , Dor Pós-Operatória/etiologia , Idoso , Idoso de 80 Anos ou mais , Condromalacia da Patela/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Medição da Dor , Dor Pós-Operatória/epidemiologia , Patela/cirurgia , Satisfação do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
16.
BMC Musculoskelet Disord ; 18(1): 489, 2017 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-29178856

RESUMO

BACKGROUND: Elderly patients have more special medical needs when compared with young ones; thus, the results of open reduction and internal fixation (ORIF) for acetabular fractures should be stratified by age in these patients. This study seeks to determine whether the age of the patient influences the results of the ORIF for acetabular fractures. METHODS: We performed a retrospective analysis of prospectively collected data on 53 elderly patients with displaced acetabular fractures who underwent ORIF between May 2004 and May 2011. Patients were divided into two groups by age: young-old group (60-74 years) and old-old group (75-90 years). The number of patients in each group was 28 and 25. The reduction quality and clinical function was evaluated using the Matta criteria and modified Postel Merle D'Aubigne Score, respectively. Operative time, bleeding amount, and complications were recorded. RESULTS: Patients in old-old group had significantly lower anatomical reduction rate (p = 0.024), less operative time (p = 0.021), and less bleeding amount (p = 0.016) than those in the young-old group. The reduction quality in the young-old group was strongly associated with clinical function (p < 0.05). However, no difference in clinical function was detected among the different reduction qualities in the old-old group (p > 0.05). Moreover, no significant difference in clinical functions (p = 0.787) and complications (p = 0.728) was detected between the two groups. CONCLUSIONS: Old-old patients may expect comparable clinical functions and complications with young-old patients. The reduction quality in old-old patients may be not significantly associated with clinical function. Different treatment strategies may be applied for acetabular fractures with ORIF in different age groups.


Assuntos
Acetábulo/diagnóstico por imagem , Acetábulo/cirurgia , Fixação Interna de Fraturas/tendências , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Acetábulo/lesões , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
17.
J Arthroplasty ; 31(8): 1761-6, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26948130

RESUMO

BACKGROUND: The medial protrusio technique may be used during total hip arthroplasty (THA) on patients with developmental dysplasia. However, studies have yet to determine whether a cementless cup can be sufficiently stable to withstand loading forces. This study aimed to assess the clinical and radiographic outcomes of this technique. Furthermore, we sought to determine the relationship between the rate of medial protrusion and the incidence of cup loosening. METHODS: Thirty-nine patients (43 hips) underwent cementless THA between April 2006 and March 2009 by using the medial protrusio technique. These patients participated in a 6- to 9-year follow-up. Their clinical and radiographic data were gathered prospectively. RESULTS: The average Harris Hip Score improved from 43.1 ± 15.4 points preoperatively to 91.9 ± 12.8 points at the final follow-up (P < .001). The mean height of hip center and the distance of hip center medialization were 2.4 ± 0.6 and 2.5 ± 0.9 cm, respectively. The rate of medial protrusion and the rate of cup coverage were 42.1 ± 12.4% and 96.8 ± 5.1%, respectively. The rate of medial protrusion ranged from 18.3% to 58.3% in 38 hips (group A) and from 61.3% to 68.9% in 5 hips (group B). None of the cups in group A loosened or failed, 2 failures occurred in group B (0% vs 40.0%; P = .011). CONCLUSIONS: Developmental dysplasia was treated through THA using the medial protrusio technique, which easily achieves a sufficient superolateral host bony coverage of the cup and promotes socket reconstruction at the true acetabulum. The rate of medial protrusion of <60% may be necessary to obtain excellent clinical and radiographic midterm results.


Assuntos
Artroplastia de Quadril/métodos , Luxação Congênita de Quadril/cirurgia , Articulação do Quadril/cirurgia , Acetábulo/cirurgia , Adulto , Idoso , Artroplastia de Quadril/estatística & dados numéricos , Feminino , Seguimentos , Quadril/cirurgia , Articulação do Quadril/diagnóstico por imagem , Prótese de Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Resultado do Tratamento , Adulto Jovem
18.
Int J Mol Sci ; 17(5)2016 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-27187377

RESUMO

Pigment epithelial-derived factor (PEDF) is known as a widely expressed multifunctional secreted glycoprotein whose biological actions are cell-type dependent. Recent studies demonstrated that PEDF displays cytoprotective activity in several cell types. However, it remains unknown whether PEDF is involved in glucocorticoid-induced osteoblast death. The aim of this study was to examine the role of PEDF in osteoblast survival in response to dexamethasone, an active glucocorticoid analogue, and explore the underlying mechanism. In the present study, dexamethasone (DEX) was used to induce MC3T3-E1 pre-osteoblast apoptosis. PEDF mRNA and protein levels and cell apoptosis were determined respectively. Then PEDF receptor (PEDF-R)- and lysophosphatidic acid (LPA)-related signal transductions were assessed. Here we show that DEX down-regulates PEDF expression, which contributes to osteoblast apoptosis. As a result, exogenous recombinant PEDF (rPEDF) inhibited DEX-induced cell apoptosis. We confirmed that PEDF-R was expressed on MC3T3-E1 pre-osteoblast membrane and could bind to PEDF which increased the level of LPA and activated the phosphorylation of Akt. Our results suggest that PEDF attenuated DEX-induced apoptosis in MC3T3-E1 pre-osteoblasts through LPA-dependent Akt activation via PEDF-R.


Assuntos
Apoptose , Proteínas do Olho/metabolismo , Fatores de Crescimento Neural/metabolismo , Osteoblastos/metabolismo , Receptores de Neuropeptídeos/metabolismo , Serpinas/metabolismo , Animais , Linhagem Celular , Dexametasona/toxicidade , Proteínas do Olho/genética , Camundongos , Fatores de Crescimento Neural/genética , Osteoblastos/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Ligação Proteica , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serpinas/genética , Transdução de Sinais
19.
Mol Cell Biochem ; 399(1-2): 131-41, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25292314

RESUMO

The type-2 cannabinoid receptor (CB2) is expressed in osteoblasts and plays a role in bone metabolism through regulation on bone mass and bone turnover, but the functional importance of CB2 in osteoblasts under Titanium (Ti) stimulation is incompletely understood. This study aimed to investigate the CB2 expression in osteoblasts under Ti stimulation and the effects of CB2 activation on proliferation, apoptosis, differentiation, mineralization, OPG, and RANKL expression of MC3T3-E1 cells exposed to Ti particles. MC3T3-E1 cells were incubated in the presence of Ti particles with or without CB2-specific agonist HU-308 and antagonist SR144528. Ti particles treatment obviously induced the CB2 expression in MC3T3-E1 cells, and reduced the cell survival in a dose- and time-dependent manner (p < 0.05). Addition of HU-308 could dose-dependently alleviate the Ti-induced decrease of cell survival (p < 0.05). The flow cytometry assay showed that comparing with the control group, the apoptosis rate and caspase-3 activity in the Ti group were significantly elevated (p < 0.05), which could be alleviated by HU-308. Moreover, HU-308 effectively attenuated the decrease of cell mineralization capability, alkaline phosphates (ALP) and osteocalcin activity, and increase of OPG/RANKL ratio induced by Ti particles treatment (p < 0.05). These effects were partially counteracted by combined treatment of CB2 antagonist SR144528 (p < 0.05). In conclusion, CB2 activation has a favorable inhibitory effect on Ti-induced reactions in MC3T3-E1 cell through modulating proliferation, apoptosis, differentiation, and RANKL expression. These findings suggest that activation of CB2 might be an effective therapeutic strategy to promote bone formation and reduce bone dissolution.


Assuntos
Apoptose , Diferenciação Celular , Proliferação de Células , Receptor CB2 de Canabinoide/fisiologia , Titânio/farmacologia , Células 3T3 , Fosfatase Alcalina/metabolismo , Animais , Calcificação Fisiológica , Sobrevivência Celular/efeitos dos fármacos , Colágeno Tipo I/metabolismo , Camundongos , Osteocalcina/metabolismo , Osteoprotegerina/metabolismo , Falha de Prótese , Ligante RANK/metabolismo
20.
Med Sci Monit ; 21: 3948-54, 2015 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-26681388

RESUMO

BACKGROUND This study aimed to evaluate the clinical efficacy of use of a 3D printing guide plate in posterior lumbar pedicle screw fixation. MATERIAL AND METHODS We enrolled 43 patients receiving posterior lumbar pedicle screw fixation. The experimental group underwent 3D printing guide plate-assisted posterior lumbar pedicle screw fixation, while the control group underwent traditional x-ray-assisted posterior lumbar pedicle screw fixation. After surgery, CT scanning was done to evaluate the accuracy of screw placement according to the Richter standard. RESULTS All patients were followed up for 1 month. The mean time of placement for each screw and the amount of hemorrhage was 4.9±2.1 min and 8.0±11.1 mL in the experimental group while 6.5±2.2 min and 59.9±13.0 mL in the control group, respectively, with significant differences (p<0.05). The fluoroscopy times of each screw placement was 0.5±0.4 in the experimental group, which was significantly lower than that in the control group 1.2±0.7 (p<0.05). The excellent and good screw placement rate was 100% in the experimental group and 98.4% in the control group, without any statistical difference (P>0.05). No obvious complications were reported in either group. CONCLUSIONS Compared with the traditional treatment methods, the intra-operative application of 3D printing guide plate can shorten the operation time and reduce the amount of hemorrhage. It can also reduce the fluoroscopy times compared with the traditional fluoroscopy, which cannot improve the accuracy rate of screw placement.


Assuntos
Vértebras Lombares/cirurgia , Parafusos Pediculares , Impressão Tridimensional , Humanos
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