[Early results of modified Bikini approach periacetabular osteotomy for the treatment of developmental hip dysplasia under 50 years of age].

Objective: To investigate the efficacy and safety of modified Bikini approach periacetabular osteotomy in the treatment of developmental hip dysplasia under 50 years of age. Methods: The clinical data of 39 patients with developmental hip dysplasia who underwent periacetabular osteotomy in the Department of Orthopedics, Guizhou Provincial People's Hospital from June 2016 to June 2021 were retrospectively analyzed.Among them, 20 patients (21 hips) underwent the improved Bikini approach (study group) and 19 patients (20 hips) underwent the improved Smith-Petersen approach (control group).In the study group, there were 3 males and 17 females, aged(M(IQR))27.5 (14.3) years (range:11 to 44 years).In the control group, there were 2 males and 17 females, aged 27.5 (19.3) years (range:17 to 47 years).Both groups were sutured in the same manner by the same physician.Incision length, operation time, intraoperative blood loss and complications were recorded.X-ray images, anterior central marginal angle (ACE), lateral central marginal Angle (LCE) and acetabulum tilt angle (Tonnis AI) were measured before and after the operation.The coverage rate of acetabulum to femoral head (AHI) was measured and calculated, and the healing time was observed.Harris Hip score, International Hip score (IHOT)-12 and visual analogue scale (VAS) were recorded before and after surgery.Vancouver Scar Scale (VSS) score and patient and observer scar assessment scale (POSAS) score were recorded 12 months after surgery.The independent sample t test,Wilcoxon rank sum test, χ2 test or Fisher exact test were used to compare the clinical efficacy between the two groups. Results: All patients successfully completed the operation.There was no significant difference in operation time and intraoperative blood loss between the two groups (all P>0.05).The incision length of the study group was smaller than that of the control group, and the difference was statistically significant (10.5(5.0)cm vs.15.0(3.0),W=309.000,P=0.007).Patients were followed up for (19.1±11.1) months (range:12 to 60 months).Femoral nerve stretching injury occurred in 2 cases and sciatic branch fracture occurred in 1 case in the study group, all of which recovered to normal at 3 months follow-up, while no corresponding injury occurred in the control group.Lateral femoral cutaneous nerve injury occurred in 3 cases in the study group and 2 cases in the control group.Delayed wound healing occurred in 1 case in each of the two groups, and both healed after re-operation debridement and suture.Pubic branch nonunion occurred in 4 patients in the study group and 5 patients in the control group.There were no serious complications such as sciatic nerve and femoral blood vessel injury between the 2 groups, and there was no statistical significance in the incidence of complications between the 2 groups (52.4%(11/21)vs.40.0%(8/20),χ2=0.631,P=0.427).The clinical healing time of the patient was (4.5±1.3) months after surgery (range:3.0 to 8.0 months).There were no significant differences in ACE, LCE, Tonnis AI and AHI between the 2 groups (all P>0.05).At the last follow-up, there were no significant differences in VAS,Harris hip score and IHOT-12 score between the two groups (all P>0.05).The incision scars in the study group were smaller than those in the control group, and the differences in VSS and POSAS were statistically significant (all P<0.05). Conclusion: Compared with the improved Smith-Petersen approach, the improved Bikini approach has the same early clinical efficacy in the treatment of patients with developmental hip dysplasia under the age of 50, and has the advantages of smaller postoperative incision scars, more hidden and beautiful incision, and no serious complications, which is worthy of further study and promotion.

[Modified capsular arthroplasty for young patients with developmental dislocation of the hip].

Developmental dislocation of the hip(DDH) is one of the most serious hip diseases. Patients with unilateral DDH are prone to secondary osteoarthritis, low back pain, gait disturbance and compensatory scoliosis because of the leg length discrepancy. Total hip arthroplasty(THA) is the highly effective treatment for patients with hip pain or dysfunction caused by unilateral DDH, thus decrease the demand for hip-preserving surgeries such as capsular arthroplasty which may postpone or avoid hip replacement. However, the failure rate of THA for young patients is high and the majority of young patients may require one or more revision arthroplasties throughout their lifetime. The basic principle of capsular arthroplasty is that the femoral head wrapped by capsule is placed into a newly reamed socket on the location of true acetabulum. Therefore, hip replacement for patients with previous capsular arthroplasty becomes easier and safer than primary THA. However, the early capsular arthroplasty have been abandoned due to the relatively high rates of femoral head necrosis and hip stiffness. Ganz modified the early procedure with the technique of surgical hip dislocation in 2012, and emphasized the importance of postoperative rehabilitation. The incidence of complication, therefore, decreased greatly due to the preservation of main blood supply of femoral head as well as the proper postoperative management. In order to improve the clinical outcomes of this modified procedure, the selection of indications and surgeons' experience should also be taken into consideration.

Hepatic local micro-environmental immune status in hepatocellular carcinoma and cirrhotic tissues.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumours in the world, especially in Guangxi, China. The causes and mechanism of its tumourigenesis and development have not been completely clarified Some studies revealed that the hepatic local cellular immune function was one of the factors. In the present study, the local micro-environmental immune status was explored by investigating the number, distribution and function of CD3, CD57, CD20, CD68, and granzyme B (GrB) positive cells in 60 patients with HCC and 62 patients with liver cirrhosis (LC) and its relationship with the prognosis of the patients. The results showed that the number of T and B lymphocytes and natural killer (NK) cells in the liver of HCC patients was significantly higher than that in the LC and normal controls; while the number of macrophages (Mphi) was significantly lower The number of Mphi in the tissues decreased successively with the decrease of HCC differentiation; GrB-expressing cells in the liver predominantly consisted of CD57 positive cells. The number of NK cells, B lymphocytes and GrB-expressing cells in the cancerous tissues of stage I and II was significantly higher than that of stages III and IV. The number of T lymphocytes, NK cells, Mphi, and GrB-expressing lymphocytes in HCC cases without metastasis in 15 months was significantly higher than in the metastatic counterparts. The number of T and B lymphocytes, NK cells, and GrB-expressing cells decreased in patients with the progression of the HCC. These results suggest that the number of T and B lymphocytes, NK cells, Mphi and GrB-positive lymphocytes might be important markers in the estimation of hepatic local immune status and be useful factors for predicting the prognosis of HCC patients.

Anti-angiogenic pathway associations of the 3p21.3 mapped BLU gene in nasopharyngeal carcinoma.

Zinc-finger, MYND-type containing 10 (ZMYND10), or more commonly called BLU, expression is frequently downregulated in nasopharyngeal carcinoma (NPC) and many other tumors due to promoter hypermethylation. Functional evidence shows that the BLU gene inhibits tumor growth in animal assays, but the detailed molecular mechanism responsible for this is still not well understood. In current studies, we find that 93.5% of early-stage primary NPC tumors show downregulated BLU expression. Using a PCR array, overexpression of the BLU gene was correlated to the angiogenesis network in NPC cells. Moreover, expression changes of the MMP family, VEGF and TSP1, were often detected in different stages of NPC, suggesting the possibility that BLU may be directly involved in the microenvironment and anti-angiogenic activity in NPC development. Compared with vector-alone control cells, BLU stable transfectants, derived from poorly-differentiated NPC HONE1 cells, suppress VEGF165, VEGF189 and TSP1 expression at both the RNA and protein levels, and significantly reduce the secreted VEGF protein in these cells, reflecting an unknown regulatory mechanism mediated by the BLU gene in NPC. Cells expressing BLU inhibited cellular invasion, migration and tube formation. These in vitro results were further confirmed by in vivo tumor suppression and a matrigel plug angiogenesis assay in nude mice. Tube-forming ability was clearly inhibited, when the BLU gene is expressed in these cells. Up to 70-90% of injected tumor cells expressing increased exogenous BLU underwent cell death in animal assays. Overexpressed BLU only inhibited VEGF165 expression in differentiated squamous NPC HK1 cells, but also showed an anti-angiogenic effect in the animal assay, revealing a complicated mechanism regulating angiogenesis and the microenvironment in different NPC cell lines. Results of these studies indicate that alteration of BLU gene expression influences anti-angiogenesis pathways and is important for the development of NPC.

Effects of high-energy shock waves on testes of Wistar rats.

The effects of high-energy shock wave (HESW) on testes are still unknown. We investigated Wistar rats at 3 months of age for morphologic and functional changes in the testes and in serum follicle-stimulating hormone (FSH), progesterone (Prog), and testosterone (T). In an initial study, 12 rats received 1000 shocks at 19 kV directed at their testes using the JDPN-IV lithotripter. Two animals were sacrificed, and their testes were step-sectioned for light and electron microscopic examination on the operation day and on postoperation days one, two, four, eight, and sixty. There was angiectasis and congestion (58%) and focal hemorrhage (42%) in the testicular tissue, as well as mitochondrial swelling, reduction or disappearance of mitochondrial cristae (42%), and degranulation of the rough endoplasmic reticulum (33%) in spermatocytes. In the definitive study, groups of 10 rats were exposed to the same power index directed at their testes. One week after this exposure in Group 1 and at 3 and 6 weeks in Group 2, the animals were allowed to mate (one male paired with two females). There was no statistically significant difference in pregnancy rate or fetal number and weight in the female rats mated with the two groups of treated males at 3 weeks' gestation or in serum FSH, Prog, and T, or compared with the control group. Although there were temporary histologic changes in testicular tissue, the rat testes appeared to be functionally resistant to the shock wave energy levels used in this experiment.

[Genetic diversity of Fagoyrum tataricum cultivated in north Liangshan Prefecture of Yi Nationality, Sichuan, China].

In the present paper is stated the accomplishment of the studies of 17 populations of cultivated Fagopyrum tataricum (L.) Gaertn. from the counties of Yuexi and Ganluo in North Liangshan Autonomous Prefecture of Yi Nationality, Sichuan Province, China by means of starch gel electrophoresis and cluster analysis of agrobiology features. Seven enzymes, and 15 loci were assessed. The result shows that the genetic diversity of F. tataricum within population is higher than in the South Prefecture and in species F. esculentum from other areas. The A, P, Ho and He are 1.9, 52.1%, 0.190 and 0.262 respectively. The FST is 0.199 which is close to the average level of wild plants. A conservation strategy of the genetic resource of F. tataricum is suggested. Two populations of local variety "Youchiqiao" have the richest genetic diversity, P = 60.0%, Ho = 0.260 and 0.301 and they should be protected particularly. Two populations of local variety "Xiaomiqiao" with higher genetic diversity, as well as three populations of local varieties of "Qiukuqiao", "Equkuqiao" and "Geluokuqiao" with special genetic position should be protected too.

[Genetic diversity and differentiation of cultivated Fagoyrum tataricum populations from three counties in south Liangshan Automomous Prefecture of Yi Nationality, Sichuan, China].

Genetic diversity and differentiation among 8 cultivated populations of Fagopyrum tataricum from the counties of Jinyang, Leibo and Miyi in south Liangshan Autonomous Prefecture of Yi Nationality, Sichuan Province, China were investigated using allozyme electrophoresis. The allozymic diversity is roughly correlated with agrobiological features. The results suggest that genetic diversity of F. tataricum is quite high. The mean number of alleles per locus A is 1.8; the percentage of polymorphic loci P is 46.6%, and the mean observed heterozygosities Ho and the mean expected heterozygosities He are 0.187 and 0.218 respectively, the ratios of gene diversities of heterozygosities Fsr is 0.22, which indicates that there is 22 percent of genetic differentiation among populations, and suggests that for protecting genetic resources all the populations should be included in.

Alteration of dopaminergic markers in gastrointestinal tract of different rodent models of Parkinson's disease.

Parkinson's disease (PD) is a progressive neurological disorder that is often associated with various gastrointestinal (GI) symptoms. The link between the alteration of dopaminergic system and the symptoms of the GI tract in PD is complicated. To determine the changes in the dopaminergic system in the GI tract in PD, two kinds of rodent PD models were used in the present study. One was 6-hydroxydopamine (6-OHDA) -treated rats in which 6-OHDA was microinjected in the bilateral substantia nigra (SN). The other was 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) -treated mice in which MPTP was injected intraperitoneally. Immunofluorescence, reverse transcription (RT)-real time polymerase chain reaction (PCR) and Western blot were used to evaluate and compare the levels of mRNA and protein expression of tyrosine hydroxylase (TH) and dopamine transporter (DAT) in the GI tract between normal and rodent PD models, as well as between 6-OHDA-treated rats and MPTP-treated mice. The results indicated that TH- and DAT-positive cells were widely distributed in the GI tract. There were significant differences in TH and DAT expression in the GI tract between normal and PD models, as well as between 6-OHDA-treated rats and MPTP-treated mice. The protein levels of TH and DAT in the GI tract were significantly increased in 6-OHDA-treated rats, but the protein level of TH was significantly decreased in MPTP-treated mice. In addition, there was visible atrophy of gastric epithelial parietal cells in MPTP-treated mice, although the protein level of DAT was not significantly changed. The different alterations of dopaminergic system in the GI tract of the two kinds of PD models might underline the differences in GI symptoms in PD patients and might be correlated with the disease severity and disease process affecting the GI tract.

Response of human femur to mechanical vibration.

The effect of mechanical vibration in the frequency range 0-500 Hz on the cadaveric human femur was assessed. It was found that when the bone was fixed at both ends, its resonant frequency was markedly affected by end loading and damping. If the conditions of the experiment were designed to simulate the condition of the femur when prepared for a total hip replacement, it was found that the bone did not resonate but behaved in a mass-like mode. The significance of this observation is that in the event of vibration being applied to enhance the penetration of bone cement, the movement induced in the bone will be proportional to the force applied regardless of frequency. This also demonstrates that the concept of designing a prosthesis so that it is isoelastic with the femur is complex and potentially flawed, since the stiffness of the femur will vary during the walking cycle.

Hepatic local micro-environmental immune status in hepatocellular carcinoma and cirrhotic tissues / Estatus inmune microambiental local hepático en el carcinoma hepatocelular y los Tejidos Cirróticos

Hepatocellular carcinoma (HCC) is one of the most common malignant tumours in the world, especially in Guangxi, China. The causes and mechanism of its tumourigenesis and development have not been completely clarified Some studies revealed that the hepatic local cellular immune function was one of the factors. In the present study, the local micro-environmental immune status was explored by investigating the number, distribution and function of CD3, CD57, CD20, CD68, and granzyme B (GrB) positive cells in 60 patients with HCC and 62 patients with liver cirrhosis (LC) and its relationship with the prognosis of the patients. The results showed that the number of T and B lymphocytes and natural killer (NK) cells in the liver of HCC patients was significantly higher than that in the LC and normal controls; while the number of macrophages (Mphi) was significantly lower The number of Mphi in the tissues decreased successively with the decrease of HCC differentiation; GrB-expressing cells in the liver predominantly consisted of CD57 positive cells. The number of NK cells, B lymphocytes and GrB-expressing cells in the cancerous tissues of stage I and II was significantly higher than that of stages III and IV. The number of T lymphocytes, NK cells, Mphi, and GrB-expressing lymphocytes in HCC cases without metastasis in 15 months was significantly higher than in the metastatic counterparts. The number of T and B lymphocytes, NK cells, and GrB-expressing cells decreased in patients with the progression of the HCC. These results suggest that the number of T and B lymphocytes, NK cells, Mphi and GrB-positive lymphocytes might be important markers in the estimation of hepatic local immune status and be useful factors for predicting the prognosis of HCC patients.