Research progress on preparation of lateral femoral tunnel and graft fixation in anterior cruciate ligament reconstruction.

Anterior cruciate ligament (ACL) injury is one of the most common types of sports injuries. People's need to participate in sports and desire for a high quality of life promotes the continuous development of ACL reconstruction technology. Arthroscopic ACL reconstruction has been recognized as an effective method for the treatment of ACL injuries. This review analyses and summarizes the advantages and limitations of each surgical procedure for arthroscopic ACL reconstruction reported in the relevant literature so as to promote the future development of more relevant techniques.

Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature.

BACKGROUND: We report a case of Intracardiac, pulmonary, and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone, which was successfully managed by conservative treatment. We describe the treatment and outcome of the patient, hoping to shed light on the management of bone cement embolism. CASE SUMMARY: A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years. She was diagnosed with L4 and L5 spondylolisthesis, spinal stenosis, and osteoporosis. The patient underwent spinal canal decompression, an interbody fusion of L4/5 and L5/S1, cement-augmented pedicle screw instrumentation in L4-L5 segments, and regular pedicle screw in S1 segments. Three days postoperatively, a sudden drop in oxygen saturation occurred. Computerized tomography scan confirmed Intracardiac, pulmonary, and intravenous embolism. The patient was treated conservatively by continuous low-flow oxygen inhalation, anti-coagulation, and antibiotic therapy for 1 mo and continued anticoagulation treatment for 6 mo. The patient showed no further symptoms in a 30-mo follow-up. CONCLUSION: Intracardiac, pulmonary cement embolism after cement-augmented pedicle screw instrumentation is extremely rare. Careful clinical and radiographic evaluation is required in multiple sites of bone cement embolism. Conservative treatment may be a primary consideration in scattered emboli without life-threatening conditions, but a clinical decision should be made on an individualized basis.

[Percutaneous transforaminal endoscopic TESSYS technique for the treatment of bilateral lumbar disc herniation in single segment].

OBJECTIVE: To investigate the early clinical effects of transforaminal endoscopic spine system (TESSYS) for the treatment of bilateral lumbar disc herniation in single segment. METHODS: The clinical data of 38 patients with single-segment bilateral lumbar disc herniation treated by TESSYS technique from February 2016 to February 2018 were retrospectively analyzed. There were 26 males and 12 females, aged from 30 to 55 years old with an average of(35.2±6.4) years, 6 cases of L3,4, 22 cases of L4,5, and 10 cases of L5S11. Using the intervertebral foramen endoscope produced by Joimax GmbH, Germany, under local anesthesia, bilateral puncture to the outside of the intervertebral foramen of the diseased segment, four-stage dilatation catheter to complete the progressive enlargement of the intervertebral foramen, and the ring saw progressively enlarge the intervertebral foramen. The bilateral foramen was placed and the herniated nucleus was removed until the nerve root was completely released. Postoperatively, the patients were reviewed on regular outpatient visits and telephone follow-ups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were compared before operation and after operation at 1, 3, 6, 12 months respectively. At the final follow-up, according to modified MacNab criteria to evaluate the clinical effect. RESULTS: Thirty-six patients underwent successful surgery and were followed up for more than 12 months. The ODI score and VAS score of the lower extremities pain at 1, 3, 6, 12 months after operation were obviously improved (P<0.05), there was significant difference between 1, 3 months and 6, 12 months after operation(P<0.05), there was no significant difference between 1 and 3 months, between 6 and 12 months after operation (P>0.05). At the final follow-up, according to MacNab criteria, 14 cases got excellent results, 16 good, 4 fair, 2 poor. CONCLUSIONS: Using TESSYS technique to remove the bilateral herniated nucleus from single segment can fully decompress for the nerve root, and can be effectively applied to patients with single-segment bilateral lumbar disc herniation.

LanCL1 attenuates ischemia-induced oxidative stress by Sirt3-mediated preservation of mitochondrial function.

Lanthionine synthetase C-like protein 1 (LanCL1) is homologous to prokaryotic lanthionine cyclases, and has been shown to have novel functions in neuronal redox homeostasis. A recent study showed that LanCL1 expression was developmental and activity-dependent regulated, and LanCL1 transgene protected neurons against oxidative stress. In the present study, the potential protective effects of LanCL1 against ischemia was investigated in an in vitro model mimicked by oxygen and glucose deprivation (OGD) in neuronal HT22 cells. We found that OGD exposure induced a temporal increase and persistent decreases in the expression of LanCL1 at both mRNA and protein levels. Overexpression of LanCL1 by lentivirus (LV-LanCL1) transfection preserved cell viability, reduced lactate dehydrogenase (LDH) release and attenuated apoptosis after OGD. These protective effects were accompanied by decreased protein radical formation, lipid peroxidation and mitochondrial dysfunction. In addition, LanCL1 significantly stimulated mitochondrial enzyme activities and SOD2 deacetylation in a Sirt3-dependent manner. The results of western blot analysis showed that LanCL1-induced activation of Sirt3 was dependent on Akt-PGC-1α pathway. Knockdown of PGC-1α expression using small interfering RNA (siRNA) or blocking Akt activation using specific antagonist partially prevented the protective effects of LanCL1 in HT22 cells. Taken together, our results show that LanCL1 protects against OGD through activating the Akt-PGC-1α-Sirt3 pathway, and may have potential therapeutic value for ischemic stroke.

Can tranexamic acid reduce blood loss in cervical laminectomy with lateral mass screw fixation and bone grafting: a retrospective observational study.

To assess the safety and efficacy of tranexamic acid (TXA) for decreasing perioperative blood loss in cervical laminectomy with lateral mass screw fixation and bone grafting (CLF), in which all surgical procedures are identical.From November 2014 to April 2016, we performed a retrospective comparative analysis of 119 patients with multilevel cervical spondylotic myelopathy who had undergone a CLF from C3 to C6 in our center. All surgeries were performed on the patients using a consistent, standard procedure. Patients were divided into control (46) and TXA (73) groups according to whether or not they had received TXA treatment before and during surgery. Demographic profiles of patients such as gender, age, body weight, height, and body mass index were collated and differences between the 2 groups compared. Preoperative and postoperative hematological data in addition to intraoperative and postoperative blood loss were compared between the 2 groups. Additionally, any complications of TXA were also evaluated to assess safety.There was no statistically significant difference in demographic traits between the 2 groups. Intraoperative blood loss in the TXA group (179.66 ±â€Š81.45 mL) was significantly lower than that of the control group (269.13 ±â€Š94.68 mL, P < 0.001), as was postoperative blood loss (108.08 ±â€Š44.31 and 132.83 ±â€Š49.39 mL, respectively; P = 0.005). Total blood loss in the TXA group (287.74 ±â€Š115.40 mL) was also significantly lower than that of the control group (401.96 ±â€Š127.88, P < 0.01). No major intraoperative complications occurred in any of the cases.TXA significantly reduced perioperative blood loss in CLF with no major side effects.

CTRP6 inhibits fibrogenesis in TGF-ß1-stimulated human dermal fibroblasts.

Skin fibrosis is characterized by excessive proliferation of fibroblasts and overproduction of extracellular matrix (ECM). C1q/tumor necrosis factor-related protein 6 (CTRP6), a member of CTRPs, has been involved in the development of cardiac fibrosis. However, the function and detailed regulatory mechanism of CTRP6 in skin fibrosis remain unclear. The aim of this study was to investigate the effect of CTRP6 on the activation of human dermal fibroblasts. Our results showed that CTRP6 was lowly expressed in scar tissues and transforming growth factor-ß1 (TGF-ß1)-treated dermal fibroblasts. CTRP6 overexpression significantly inhibited the proliferation of dermal fibroblasts, as well as suppressed the expression of ECM in TGF-ß1-treated dermal fibroblasts. Furthermore, CTRP6 overexpression markedly inhibited TGF-ß1-induced phosphorylation of Smad3 in dermal fibroblasts. In conclusion, the data reported here demonstrate that CTRP6 is able to inhibit the proliferation and ECM expression in human dermal fibroblasts through suppressing the TGF-ß1/Smad3 signaling pathway. These findings suggest that CTRP6 may be a potential therapeutic target for the prevention of skin fibrosis.

[Detection of respiratory viruses in children with acute lower respiratory tract infection: an analysis of 5,150 children].

OBJECTIVE: To investigate the distribution of respiratory viruses on throat swabs in hospitalized children with acute lower respiratory tract infection (ALRTI). METHODS: A total of 5,150 children with ALRTI who were admitted to Hebei Children's Hospital between March 2014 and February 2015 were enrolled to investigate the distribution of respiratory viruses in children with ALRTI. Direct immunofluorescence assay was performed for throat swabs from these children to detect influenza virus A (FA), influenza virus B (FB), adenovirus (ADV), respiratory syncytial virus (RSV), and parainfluenza virus types 1, 2, and 3 (PIV-1, PIV-2, and PIV-3). RESULTS: Of all the 5,150 throat swabs from hospitalized children, 2,155 (41.84%) had positive virus detection results. RSV had the highest detection rate (1,338 cases/25.98%), followed by PIV-3 (439 cases/8.52%) and FA (166 cases/3.22%), and 29 patients had mixed infection with 2 viruses. With the increasing age, the detection rates of viruses tended to decrease (χ2=279.623; P<0.01). The positive rate of RSV increased gradually from September, and reached the peak value (60.09%) in November; the lowest positive rate occurred in June (1.51%). The positive rate of PIV-3 was the highest in May (21.38%) and the lowest in November (1.77%). CONCLUSIONS: The distribution of viruses in children with ALRTI varies with age and season, with RSV prevalence in autumn and winter and PIV-3 prevalence in spring and summer. RSV is the most common viral pathogen that causes ALRTI in hospitalized children.

[Comparative analysis of conventional pulmonary function test results in children with asthma or cough variant asthma].

OBJECTIVE: To compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA). METHODS: A total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured. RESULTS: The mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups. CONCLUSIONS: There is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.

[Epidemiological effects of the A (H1N1) influenza vaccine immunization program on students].

OBJECTIVE: To evaluate the epidemiological effects of vaccine immunization program related to A (H1N1) influenza in the middle school students. METHODS: Non-randomized clinical trial was designed to assess the A (H1N1) influenza vaccine on its efficacy. 14 883 students from 8 middle schools in Zhejiang province were recruited and classified into vaccinated or control groups, based on the status of immunization with A (H1N1) influenza vaccine. All subjects were followed up through one epidemic period (6 months) and the incidence rates of influenza-like illnesses, A (H1N1) influenza, and seasonal influenza in these two groups were compared to evaluate the efficacy of the vaccine. RESULTS: There were 6334 subjects in the vaccinated group and 8549 in the control group. 7441.75 person-years were followed from these two groups. The incidence rate of A (H1N1) influenza in vaccinated group was 1.64‰ per person-year, lower than that of the control group. The rate difference (RD) was -1.64‰ per person-year (95% confidence interval value from -3.04‰ to -0.23‰ per person-year), and the difference was significant (P = 0.010). The incidence rate of influenza-like illnesses in vaccinated group was 21.47‰ per person-year, lower than that of the control group (22.69‰ per person-year) and the difference was not significant (P > 0.05). The incidence rate of B influenza in vaccinated group was 6.63‰ per person-year, higher than that of control group (7.02‰ per person-year) but the difference was not significant (P > 0.05). CONCLUSION: This vaccine demonstrated a good epidemiological effect against the A (H1N1) influenza virus infection, observed through a student-immunization program. The cross-protection effect against the influenza-like illnesses and other seasonal influenzas was not noticed in this study.