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1.
Cell Mol Life Sci ; 80(11): 317, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37801106

RESUMO

Hox genes orchestrate the segmental specification of the muscular circulatory system in invertebrates but it has not proven straightforward to decipher segmental parallels in the vertebrate heart. Recently, patients with HOXB gene cluster deletion were found to exhibit abnormalities including atrioventricular canal defects. Using CRISPR, we established a mutant with the orthologous hoxbb cluster deletion in zebrafish. The mutant exhibited heart failure and atrioventricular regurgitation at 5 days. Analyzing the four genes in the hoxbb cluster, isolated deletion of hoxb1b-/- recapitulated the cardiac abnormalities, supporting hoxb1b as the causal gene. Both in situ and in vitro data indicated that hoxb1b regulates gata5 to inhibit hand2 expression and ultimately is required to pattern the vertebrate atrioventricular boundary. Together, these data reveal a role for segmental specification in vertebrate cardiac development and highlight the utility of CRISPR techniques for efficiently exploring the function of large structural genomic lesions.


Assuntos
Proteínas de Peixe-Zebra , Peixe-Zebra , Animais , Humanos , Peixe-Zebra/genética , Peixe-Zebra/metabolismo , Proteínas de Peixe-Zebra/genética , Proteínas de Peixe-Zebra/metabolismo , Coração , Fatores de Transcrição/metabolismo , Regulação da Expressão Gênica no Desenvolvimento
2.
J Environ Manage ; 329: 117089, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36565499

RESUMO

Efficient electrode materials are essential to convert salinity gradient energy into oxidative degradation energy and electrical energy by reverse electrodialysis reactor (REDR). In this context, comparative experiments of REDR using different anodes (Ti/IrO2-RuO2, Ti/PbO2 and Ti/Ti4O7) were conducted. The effects of output current and electrode rinse solution (ERS) flowrate on mineralization efficiency and energy output were discussed. Results demonstrated that the COD removal rate(ηCOD) rose almost linearly with output current and ERS flowrate when using Ti/Ti4O7 anode, but excessive operating conditions caused a slow increase or even decrease of ηCOD when using Ti/IrO2-RuO2 or Ti/PbO2 anodes. The order of electrode system potential loss (Eele) for the three anodes was Ti/Ti4O7> Ti/PbO2> Ti/IrO2-RuO2. High Eele was beneficial to ηCOD but had a negative effect on the net output power (Pnet) of REDR. Regardless of the applied anodes, increasing the current and decreasing the ERS flowrate was detrimental to Pnet due to higher Eele. Based on these findings, four energy efficiency parameters were defined to evaluate energy recovery from multiple perspectives by linking energy output with mineralization capacity. They were electrode efficiency (ηele), energy efficiency (EE), general current efficiency (GCE) and energy consumption (EC), respectively. Results showed that REDR with Ti/Ti4O7 anodes and suitable operating conditions achieved the optimal energy indicators and mineralization efficiency, which provided an efficient and economical option for wastewater treatment and energy recovery.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Fenol , Fenóis , Oxirredução , Eletrodos , Titânio
3.
Environ Res ; 214(Pt 4): 114064, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35977587

RESUMO

In this paper, the synthetic methyl orange (MO) dyeing wastewater treated by a reverse electrodialysis reactor (REDR) with 40 member pairs was investigated first. The boron-doped diamond (BDD) and carbon felt were adopted as an anode and a cathode in the REDR. The influences of operation parameters on the chemical oxygen demand (COD) removal efficiency were detected and explored. Then, a mathematical model of organic mineralizing was developed for the REDR to predict the variation of COD removal efficiency with treating time under the different operation conditions. Finally, the energy consumption of the wastewater treated by the REDR was analyzed. The results showed that raising the working fluid flowing velocity and electrode rinse solution flowrate improved the COD removal efficiency and instantaneous current efficiency (ICE), and reduced the total energy consumption (TEC) of the REDR. Raising the initial MO concentration could significantly reduce the TEC despite the COD removal efficiency being near. Since the main energy consumed by the REDR was salinity gradient energy (SGE) from waste heat conversion or the natural environment, the energy cost of REDR treating wastewater has been reduced significantly.


Assuntos
Águas Residuárias , Poluentes Químicos da Água , Compostos Azo , Análise da Demanda Biológica de Oxigênio , Corantes , Oxirredução , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/análise
4.
BMC Musculoskelet Disord ; 21(1): 573, 2020 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-32828132

RESUMO

Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish a profound strategy for the effective surgical management of these fragile patients. Salvage options are determined according to patient physiological age, functional level, life expectancy, nonunion anatomical site, fracture pattern, remaining bone quality, bone stock, and hip joint competency. In physiologically young patients, care should be taken to preserve the vitality of the femoral head with salvage internal fixation; however, for the elderly population, conversion arthroplasty can result in early weight bearing and ambulation and eliminates the risks of delayed fracture healing. Technical challenges include a difficult surgical exposure, removal of broken implants, deformity correction, critical bone defects, poor bone quality, high perioperative fracture risk, and prolonged immobilization. Overall, the salvage of failed internal fixations of IT fractures with properly selected implants and profound techniques can lead to the formulation of valuable surgical strategies and provide patients with satisfactory clinical outcomes.


Assuntos
Artroplastia de Quadril , Fraturas do Quadril , Idoso , Artroplastia de Quadril/efeitos adversos , Fixação Interna de Fraturas/efeitos adversos , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Humanos , Reoperação , Estudos Retrospectivos , Terapia de Salvação , Resultado do Tratamento
5.
Int Orthop ; 44(12): 2529-2536, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32712789

RESUMO

PURPOSE: Timing of surgery is the most critical prognostic factor for hip osteonecrosis treated with free vascularized fibular grafting (FVFG). Bone marrow lesion (BML) on MRI usually occurs immediately before femoral head collapse. We conducted a retrospective cohort study to evaluate whether the noncollapsed hips with BML can benefit from FVFG. METHODS: Consecutive patients undergoing modified FVFG were identified from our clinical repository between January 2014 and December 2014. Based on whether BML was pre-operatively detected, the four year radiographic and clinical outcomes were compared. RESULTS: In the BML cohort, 22 of 53 hips (42%) showed radiographic signs of osteonecrosis progression, which was significantly higher than that in the control cohort (8 of 49, 16%; P = 0.005). The BML hips showed a significantly lower pre-operative Harris Hip Score (HHS) than those without BML (77.8 vs. 85.5, P = 0.046), whereas no such difference was observed in the final HHS or its post-operative improvement (HHS 90 vs. 94, P = 0.397; HHS improvement 12 vs. 8, P = 0.067). In the subgroup of patients with a pre-operative HHS lower than 80, BML hips were associated with a slightly lower final HHS than hips without BML. Four of 5 (80%) failed hips with BML had a poor pre-operative hip function. CONCLUSION: BML indicates the last chance for a reproducible improvement in the treatment of hip osteonecrosis with FVFG before collapse. However, the concomitant lower pre-operative HHS (< 80) is a poor prognostic factor for BML-positive hips.


Assuntos
Medula Óssea , Necrose da Cabeça do Fêmur , Medula Óssea/diagnóstico por imagem , Transplante Ósseo , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/diagnóstico por imagem , Fíbula/cirurgia , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Resultado do Tratamento
6.
J Clin Lab Anal ; 29(3): 235-41, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-24799293

RESUMO

BACKGROUND: Biochemical substances relating to renal and hepatic function are influenced not only by individual factors such as gender, lifestyle, and age but also by ecological factors, such as altitude, climate, and ethnic background. The purpose of the present study was to establish reference intervals for 16 biochemical substances relating to renal and hepatic function in healthy Chinese adults. METHODS: A total of 2,405 apparently healthy individuals (18-77 years of age) were chosen as reference individuals in the present study. The 16 biochemical substances relating to renal and hepatic function were analyzed using a HITACHI RL7600 analyzer. The reference intervals were established using nonparametric methods to estimate the 2.5 and 97.5 percentiles of the distribution as the lower and the upper limits, respectively. RESULTS: Age- and gender-appropriate reference intervals were established for some biochemical substances relating to renal and hepatic function in healthy Chinese adults. CONCLUSION: The reference intervals established in this study can provide a useful clinical tool for the assessment of the kidney and liver damage. In addition, the established reference intervals can be adopted in other clinical laboratories after further validation.


Assuntos
Rim/fisiologia , Fígado/fisiologia , Adolescente , Adulto , Fatores Etários , Idoso , Análise Química do Sangue , China , Feminino , Humanos , Testes de Função Hepática/instrumentação , Testes de Função Hepática/métodos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , Estatísticas não Paramétricas , Adulto Jovem
7.
iScience ; 27(4): 109332, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38500832

RESUMO

Identification and differentiation of appropriate indications on hip preserving with bone grafting therapy remains a crucial challenge in the treatment of osteonecrosis of the femoral head (ONFH). A prospective cohort study on bone grafting therapy for ONFH aimed to evaluate hip survival rates, and to establish a risk scoring derived from potential risk factors (multivariable model) for hip preservation. Eight variables were identified to be strongly correlated with a decreased rate of hip survival post-therapy, and a comprehensive risk scoring was developed for predicting hip-preservation outcomes. The C-index stood at 0.72, and the areas under the receiver operating characteristics for the risk score's 5- and 10-year hip failure event predictions were 0.74 and 0.72, respectively. This risk score outperforms conventional methods in forecasting hip preservation. Bone grafting shows sustained benefits in treating ONFH when applied under the right indications. Furthermore, the risk scoring proves valuable as a decision-making tool, facilitating risk stratification for ONFH treatments in future.

8.
J Arthroplasty ; 28(3): 531-6, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23122874

RESUMO

Between June 2007 and May 2008, 21 patients with bilateral osteonecrosis of the femoral head were surgically treated with implantation of free vascularized fibula obtained from the unilateral donor site. All patients were followed up clinically and radiographically for an average of 3.5 years. The evaluation included operative duration, blood loss, Harris hip score, incidence of complications, and radiological examinations. The time for fibular harvesting was 20min on average. Total operative duration was 100-240min, with an average of 150min. Blood loss averaged 300ml. All transplanted fibula integrated well to the femoral head 3.5years postoperatively with no severe complications observed. The results revealed that unilateral free vascularized fibula is effective for the treatment of bilateral osteonecrosis of the femoral head.


Assuntos
Transplante Ósseo , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/transplante , Adolescente , Adulto , Feminino , Fíbula/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
9.
Microsurgery ; 33(8): 646-51, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23907776

RESUMO

The goal for treatment of osteonecrosis of the femoral head (ONFH) is to relieve pain, preserve the contour of the femoral head, and delay the need for total hip arthroplasty. The free vascularized fibular grafting (FVFG) has been shown to support the subchondral architecture as well as restore local circulation for the necrotic femoral head in treatment of ONFH. This report aimed to present the clinical results of the use of a modified surgical technique of FVFG for treatment of ONFH. Four hundred and seven patients with 578 hips of ONFH were included. The patients' average age was 36.7 years old (ranging 19-55 years old). The disease was staged from II to V based on the Steinberg classification system. By the modified procedure, the vascularized fibular graft was harvested via a lateral incision with fibular osteotomy prior to the exposure of the vascular pedicle, and the removal of necrotic tissue and inset of graft were performed through an anterior approach. The operative time averaged 90 min for unilateral ONFH (ranging 75-110 min) and 190 min for simultaneous treatment of bilateral ONFH (ranging 160-230 min). The average length of follow-up was 5.0 years (ranging 3-10 years). The complications included one infection in one case, temporary loss of sensation of the thigh in eleven cases, and restricted motion of the great toe in nine cases. The Harris hip score of patients improved from 65.0 to 86.9 on average. Radiographic evaluation showed no changes in 331 hips (57.3%), improvement in 195 hips (33.7%) and necrosis progression in 52 hips (9.0%). Twenty-three hips (4.0%) in 20 patients had total hip arthroplasty during the period. These results show that the modified technique of the use of FVFG for treatment of ONFH yields similar postoperative results in comparison to the traditional method.


Assuntos
Transplante Ósseo/métodos , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/transplante , Retalhos de Tecido Biológico/transplante , Adulto , Artroplastia de Quadril/estatística & dados numéricos , Feminino , Fíbula/irrigação sanguínea , Seguimentos , Retalhos de Tecido Biológico/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
10.
J Reconstr Microsurg ; 29(6): 387-92, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23588546

RESUMO

Although free vascularized fibular grafting (FVFG) has been successfully employed for precollapsed osteonecrosis of the femoral head (ONFH), there are few reports concerning its radiographic and functional results for ONFH concomitant with osteoarthritis (OA) of the hip. In the current study, 12 patients with OA induced by traumatic ONFH were enrolled, with FVFG employed as the treatment protocol. The collapsed step of the cartilage surface was measured and compared with the postoperative value, and the Merle d'Aubigné scoring system was used to evaluate preoperative and postoperative status of the hip joint. The collapsed step disappeared, and sphericity of the femoral head could be restored at an average duration of 56 months postoperatively in seven patients. With regard to the severity of hip OA, six were improved to Grade 1 and one to Grade 2. In terms of functionality, all patients with a restored femoral head experienced postoperative improvement in pain relief, mobility, and functional capacity. The average Merle d'Aubigné score increased from 6.0 to 16.9 postoperatively (p < 0.001). In conclusion, for traumatic ONFH concomitant with OA, FVFG can confer benefits in the form of restoration of the contour of the femoral head and improvement in joint function.


Assuntos
Transplante Ósseo/métodos , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/irrigação sanguínea , Retalhos de Tecido Biológico/irrigação sanguínea , Osteoartrite do Quadril/cirurgia , Adolescente , Adulto , Fatores Etários , Transplante Ósseo/efeitos adversos , Estudos de Coortes , Feminino , Necrose da Cabeça do Fêmur/complicações , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Fíbula/transplante , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Masculino , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/diagnóstico por imagem , Medição da Dor , Estudos Prospectivos , Amplitude de Movimento Articular/fisiologia , Recuperação de Função Fisiológica , Medição de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
11.
Med Sci Monit ; 18(7): BR259-64, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22739725

RESUMO

BACKGROUND: It is controversial whether an early reduction and internal fixation can reduce the occurrence of femoral neck fracture-induced osteonecrosis of the femoral head (ONFH). This prospective study was designed to reflect the relationship between injury-to-surgery interval (ISI) and traumatic ONFH based on a canine model of femoral neck fractures. MATERIAL/METHODS: Twenty-four dogs were equally divided randomly into 3 groups. A lateral L-shape approach centered left great trochanter was used for exposure of the femoral neck. A low-speed drill was used for making displaced fractures in the narrow femoral neck, with the femoral head kept in situ with ligamentum teres intact. In Group A, the fracture was immediately reduced and fixed with 3 parallel pins; while the operation was done 3 days later in Group B, and 3 weeks later in Group C. Another 2 dogs had their fractures untreated. Postoperatively, all dogs were fed separately and received regular x-ray examination. Left femoral heads were harvested for histological examination with a postoperative follow-up of 3.5 months. RESULTS: The canine model of femoral neck fractures could be achieved successfully. Radiological signs of post-fracture ONFH could not be detected at intervals of 2 weeks, 4 weeks, 1 month and 2 months. Histologically, there were 2 cases with ONFH in Group A, 1 case in Group B, and 2 cases in Group C. The difference had no statistical significance. For untreated fractures, obvious ONFH could be found radiologically. CONCLUSIONS: A shorter ISI may not reduce the incidence of fracture-induced ONFH, which suggests that intrinsic factors play an important role in the occurrence of ONFH.


Assuntos
Modelos Animais de Doenças , Fraturas do Colo Femoral/complicações , Fraturas do Colo Femoral/cirurgia , Necrose da Cabeça do Fêmur/etiologia , Necrose da Cabeça do Fêmur/cirurgia , Animais , Cães , Fraturas do Colo Femoral/patologia , Cabeça do Fêmur/irrigação sanguínea , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Cabeça do Fêmur/cirurgia , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Distribuição Aleatória , Fatores de Tempo
12.
J Orthop Surg Res ; 17(1): 108, 2022 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-35184732

RESUMO

OBJECTIVES: Internal fixation with multiple cannulated compression screws is an optional treatment for femoral neck fracture. Recently, fully threaded cannulated compression screws (FTCCS) have been introduced to fix fresh femoral neck fractures (FNF). The purpose of this study was to investigate the effectiveness of FTCCS. PATIENTS AND METHODS: Patients with FNF fixed by multiple FTCCS from February 1st, 2014 to August 31st, 2017 were included in this study. They were followed for at least 12 months postoperatively. Nonunion, osteonecrosis of the femoral head (ONFH), fixation failure, reoperation, and femoral neck shortening (FNS) were used to evaluate the outcomes. Risk factors including age, sex, fracture side, fracture displacement, fracture stability, fixation configuration, and screw numbers were analyzed. RESULTS: A total of 113 patients including 67 males and 46 females with an average age of 48.4 ± 13.4 years were included. The mean duration of follow-up was 27.1 months (range: 12-51 months). The incidence of nonunion, ONFH, fixation failure, and reoperation was 15.9%, 22.1%, 8.8%, and 24.8%, respectively. The rates of nonunion and reoperation were significantly higher in displaced fractures and unstable fractures. And patients with an unstable fracture had a higher risk of internal fixation failure. The median length of FNS was 2.9 mm (interquartile range: 0.9-6.5 mm, range: 0-17.5 mm). Age was a significant risk factor for FNS. CONCLUSIONS: The screw fixation method with FTCCS provided encouraging clinical results which may be a rational choice for the treatment of fresh FNF. Displaced fractures and unstable fractures were attributed to the higher incidence of complications. TRIAL REGISTRATION: ChiCTR, ChiCTR1800017200. Registered 17 July 2018-Retrospectively registered, http: www.chictr.org.cn/showprojen.aspx?proj=29182 .


Assuntos
Parafusos Ósseos , Fraturas do Colo Femoral/cirurgia , Colo do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Adulto , Idoso , Feminino , Fraturas do Colo Femoral/diagnóstico por imagem , Colo do Fêmur/diagnóstico por imagem , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
13.
J Bone Joint Surg Am ; 104(23): 2108-2116, 2022 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-36325763

RESUMO

BACKGROUND: There is currently no ideal treatment for osteochondral lesions of the femoral head (OLFH) in young patients. METHODS: We performed a 1-year single-arm study and 2 additional years of follow-up of patients with a large (defined as >3 cm 2 ) OLFH treated with insertion of autologous costal cartilage graft (ACCG) to restore femoral head congruity after lesion debridement. Twenty patients ≤40 years old who had substantial hip pain and/or dysfunction after nonoperative treatment were enrolled at a single center. The primary outcome was the change in Harris hip score (HHS) from baseline to 12 months postoperatively. Secondary outcomes included the EuroQol visual analogue scale (EQ VAS), hip joint space width, subchondral integrity on computed tomography scanning, repair tissue status evaluated with the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, and evaluation of cartilage biochemistry by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping. RESULTS: All 20 enrolled patients (31.02 ± 7.19 years old, 8 female and 12 male) completed the initial study and the 2 years of additional follow-up. The HHS improved from 61.89 ± 6.47 at baseline to 89.23 ± 2.62 at 12 months and 94.79 ± 2.72 at 36 months. The EQ VAS increased by 17.00 ± 8.77 at 12 months and by 21.70 ± 7.99 at 36 months (p < 0.001 for both). Complete integration of the ACCG with the bone was observed by 12 months in all 20 patients. The median MOCART score was 85 (interquartile range [IQR], 75 to 95) at 12 months and 75 (IQR, 65 to 85) at the last follow-up (range, 24 to 38 months). The ACCG demonstrated magnetic resonance properties very similar to hyaline cartilage; the median ratio between the relaxation times of the ACCG and recipient cartilage was 0.95 (IQR, 0.90 to 0.99) at 12 months and 0.97 (IQR, 0.92 to 1.00) at the last follow-up. CONCLUSIONS: ACCG is a feasible method for improving hip function and quality of life for at least 3 years in young patients who were unsatisfied with nonoperative treatment of an OLFH. Promising long-term outcomes may be possible because of the good integration between the recipient femoral head and the implanted ACCG. LEVEL OF EVIDENCE: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Cartilagem Costal , Humanos , Feminino , Masculino , Adulto , Adulto Jovem , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/cirurgia , Qualidade de Vida
14.
Int Orthop ; 35(4): 475-81, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20012040

RESUMO

The aim of this study was to compare the safety and efficacy of OsteoSet®2 DBM with autologous cancellous bone in free vascularised fibular grafting for the treatment of large osteonecrotic lesions of the femoral head. Twenty-four patients (30 hips) with large osteonecrotic lesions of the femoral head (stage IIC in six hips, stage IIIC in 14, and stage IVC in ten, according to the classification system of Steinberg et al.) underwent free vascularised fibular grafting with OsteoSet®2 DBM. This group was retrospectively matched to a group of 24 patients (30 hips) who underwent free vascularised fibular grafting with autologous cancellous bone during the same time period according to the aetiology, stage, and size of the lesion and the mean preoperative Harris hip score. A prospective case-controlled study was then performed with a mean follow-up duration of 26 months. The results show no statistically significant differences between the two groups in overall clinical outcome or the radiographic assessment. Furthermore, no adverse events related to the use of the OsteoSet®2 DBM were observed. The results demonstrate that OsteoSet®2 DBM combined with autograft bone performs equally as well as that of autologous bone alone. Therefore, OsteoSet®2 DBM can be used as a safe and effective graft extender in free vascularised fibular grafting for large osteonecrotic lesions of the femoral head.


Assuntos
Artroplastia/métodos , Matriz Óssea/transplante , Transplante Ósseo/métodos , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/transplante , Adulto , Artroplastia/instrumentação , Técnica de Desmineralização Óssea , Feminino , Necrose da Cabeça do Fêmur/patologia , Fíbula/irrigação sanguínea , Nível de Saúde , Articulação do Quadril/fisiopatologia , Articulação do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Amplitude de Movimento Articular , Resultado do Tratamento , Adulto Jovem
15.
Int Orthop ; 35(8): 1125-30, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20467741

RESUMO

The purpose of this study was to assess the outcomes of treatment of femoral head osteonecrosis using free vascularised fibular grafting in patients with Hodgkin's disease and non-Hodgkin's lymphoma. We retrospectively reviewed seven patients (14 hips) with lymphoma who underwent free vascularised fibular grafting for osteonecrosis of the femoral head, evaluating pre- and postoperative Harris hip scores, visual analog scale (VAS) pain scores, hip range of motion and radiographs. Patients were followed up for a minimum of 1.5 years (mean, 3.3 years). All these patients exhibited good recovery without severe life-threatening complications. The mean Harris hip score improved from 69 to 88, while average VAS pain score decreased from 54 to 18. At the latest follow-up, we found improvement or unchanged radiographs in all three hips with initial Steinberg stage II osteonecrosis and in nine of 11 hips with stage III or IV osteonecrosis. No hips failed treatment and underwent total hip arthroplasty. The clinical data demonstrated that free vascularised fibular grafting can slow or even halt progression of necrosis, and improve the function of the hip and quality of life in lymphoma patients.


Assuntos
Transplante Ósseo/métodos , Necrose da Cabeça do Fêmur/cirurgia , Fíbula/transplante , Linfoma/cirurgia , Adolescente , Adulto , Feminino , Necrose da Cabeça do Fêmur/etiologia , Necrose da Cabeça do Fêmur/fisiopatologia , Fíbula/irrigação sanguínea , Nível de Saúde , Articulação do Quadril/fisiopatologia , Articulação do Quadril/cirurgia , Humanos , Linfoma/complicações , Linfoma/fisiopatologia , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Qualidade de Vida , Recuperação de Função Fisiológica , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
16.
Biology (Basel) ; 11(1)2021 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-35053026

RESUMO

Folic acid, one of the 13 essential vitamins, plays an important role in cardiovascular development. Mutations in folic acid synthesis gene 5,10-methylenetetrahydrofolate reductase (MTHFR) is associated with the occurrence of congenital heart disease. However, the mechanisms underlying the regulation of cardiac development by mthfr gene are poorly understood. Here, we exposed zebrafish embryos to excessive folate or folate metabolism inhibitors. Moreover, we established a knock-out mutant of mthfr gene in zebrafish by using CRISPR/Cas9. The zebrafish embryos of insufficient or excessive folic acid and mthfr-/- mutant all gave rise to early pericardial edema and cardiac defect at 3 days post fertilization (dpf). Furthermore, the folic acid treated embryos showed abnormal movement at 5 dpf. The expression levels of cardiac marker genes hand2, gata4, and nppa changed in the abnormality of folate metabolism embryos and mthfr-/- mutant, and there is evidence that they are related to the change of methylation level caused by the change of folate metabolism. In conclusion, our study provides a novel model for the in-depth study of MTHFR gene and folate metabolism. Furthermore, our results reveal that folic acid has a dose-dependent effect on early cardiac development. Precise dosage of folic acid supplementation is crucial for the embryonic development of organisms.

17.
Int Orthop ; 34(3): 425-30, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19308407

RESUMO

Treatment of skeletal defects secondary to osteomyelitis is a challenging problem. The purpose of this study was to present our experience of the use of free vascularised fibular grafts to treat such defects. Ten patients with a mean age of 31 years (range 16-50 years) and a skeletal defect with a mean length of 9.5 cm (range 6-17 cm) were managed with a protocol which included radical debridement of the lesion and a vascularised fibular graft. The mean follow-up time was 26 months. Union of the graft occurred in all patients, at a mean of 4.5 months. No recurrence of osteomyelitis was observed. The mean time to full weight bearing was ten months, and all patients were pain-free and able to walk without supportive devices. A free vascularised fibular graft is a viable option for the management of large skeletal defects resulting from osteomyelitis.


Assuntos
Transplante Ósseo/métodos , Fêmur/cirurgia , Fíbula/transplante , Osteomielite/cirurgia , Tíbia/cirurgia , Adolescente , Adulto , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Humanos , Salvamento de Membro , Masculino , Pessoa de Meia-Idade , Osseointegração , Osteomielite/patologia , Radiografia , Recuperação de Função Fisiológica , Tíbia/diagnóstico por imagem , Tíbia/patologia , Resultado do Tratamento , Adulto Jovem
18.
Arch Orthop Trauma Surg ; 130(4): 473-9, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19471948

RESUMO

BACKGROUND: Reconstruction of large skeletal defects secondary to osteomyelitis or open fracture is a challenging problem. The purpose of this study was to evaluate the results of using free vascularized fibular graft (FVFG) combined with locking plate in the treatment of large skeletal defects from open fracture and infection. METHODS: Ten patients with a mean age of 34 years (ranged 13-57 years) and a mean length of 8.7 cm (range 6-17 cm) skeletal defect were treated with FVFG and locking plate. The mean follow-up time was 26 months. RESULTS: Grafting union occurred in all patients, with a mean healing time of 4.5 months. No recurrence of osteomyelitis and stress fractures was observed. The mean time to full weight-bearing was 10 months, and all patients were pain-free and able to walk without supportive devices. CONCLUSIONS: FVFG combined with locking plate is a viable option for the management of large skeletal defects from open fracture and infection.


Assuntos
Placas Ósseas , Transplante Ósseo , Fíbula/transplante , Fraturas Expostas/cirurgia , Fraturas não Consolidadas/cirurgia , Osteomielite/cirurgia , Adolescente , Adulto , Feminino , Fraturas Expostas/complicações , Fraturas não Consolidadas/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/complicações , Adulto Jovem
19.
J Reconstr Microsurg ; 26(9): 631-5, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20922655

RESUMO

Above-knee amputations are rare injuries that need emergent replantation or primary amputation. Although survival could be achieved in selective cases, postoperative function of the affected limb is usually unsatisfactory and a late amputation has to be performed for poor prognosis or severe complications. Experience of the surgical team may play an important role in primary decision making, which leads us to report one case of above-knee replantation with poor postoperative function and needing a late amputation. Scoring systems, expected results based on our case, and a brief review of literature concerning above-knee replantations are discussed.


Assuntos
Amputação Cirúrgica/métodos , Amputação Traumática/cirurgia , Fraturas do Fêmur/cirurgia , Complicações Pós-Operatórias/cirurgia , Reimplante/efeitos adversos , Amputação Cirúrgica/reabilitação , Amputação Traumática/diagnóstico , Membros Artificiais , Seguimentos , Humanos , Escala de Gravidade do Ferimento , Traumatismos da Perna/cirurgia , Complicações Pós-Operatórias/diagnóstico , Reoperação/métodos , Reimplante/métodos , Fatores de Risco , Coxa da Perna/cirurgia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(4): 451-454, 2019 Apr 15.
Artigo em Zh | MEDLINE | ID: mdl-30983193

RESUMO

OBJECTIVE: To assess the mid-term effecitveness of femoroacetabular impingement (FAI) treated by surgical hip dislocation. METHODS: Between April 2014 and August 2015, 15 patients (16 hips) with FAI were enrolled in the study and treated with surgical hip dislocation. There were 12 males and 3 females with an average age of 36.6 years (range, 22-59 years). Among them, 14 cases involved in unilateral hip and 1 in bilateral hips. The mean disease duration was 28 months (range, 4-120 months). Preoperative visual analogue scale (VAS) score and Harris hip score were 7.9±1.0 and 44.1±9.3, respectively. RESULTS: All incisions healed by first intention. There was no main complication, such as vessel and nerve injuries and infection. All 15 patients were followed up 30-46 months (mean, 39.5 months). The VAS score was 2.5±1.6 at 3 months and 0.5±0.7 at last follow-up. The Harris score was 85.5±4.4 at 3 months and 95.6±3.9 at last follow-up. There were significant differences in two scores between pre- and post-operation and between 3 months and last follow-up ( P<0.05). The satisfaction rate of hip function was 93.8% (15/16) at last follow-up. X-ray examination showed that there was no sign of impingment at the femoral head and neck and acetabulum forming site of the affected hip joint, and no complication such as loosening of internal fixator, nonunion of osteotomy, avascular necrosis of femoral head, and heterotopic ossification occurred during follow-up. CONCLUSION: The surgical hip dislocation is a safe and effective way to treat FAI in the mid-term follow-up, which can repair torn labrum and trim acetabulum and femoral neck.


Assuntos
Artroplastia de Quadril , Impacto Femoroacetabular , Quadril , Acetábulo , Adulto , Feminino , Impacto Femoroacetabular/cirurgia , Quadril/cirurgia , Articulação do Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
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