Double-bundle reconstruction results in superior clinical outcome than single-bundle reconstruction.

PURPOSE: To compare the short- and long-term clinical outcomes of the double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with those of single-bundle (SB) ACL reconstruction. METHODS: An electronic search of the database PubMed (1966-September 2011), EMBASE (1984-September 2011), and Cochrane Controlled Trials Register (CENTRAL; 3rd Quarter, 2011) was undertaken to identify relevant studies. Main clinical outcomes were knee stability measurements including KT-1000 arthrometer measurement, Pivot shift test, and Lachman test, and clinical outcome measurements including International Knee Documentation Committee (IKDC), Lysholm knee score, Tegner activity score, and complications. RESULTS: Eighteen studies were finally included in this meta-analysis, which were all classified as high risk of bias according to the Collaboration's recommended tool. It is seen that compared to SB ACL reconstruction, DB ACL reconstruction results in a KT-1000 arthrometer outcome 0.63 and 1.00 mm closer to the normal knee in a short- and long-term follow-up, respectively. Our results also reveal that DB-treated patients have a significantly higher negative rate of the pivot shift test (p < 0.00001 and = 0.006 in a short- and long-term follow-up, respectively) and Lachman test (n.s. and p < 0.0001 in a short- and long-term follow-up, respectively) compared to SB-treated patients. As for the clinical outcome measurements, a significant difference is found between SB versus DB ACL reconstruction regarding the IKDC (p = 0.006 and < 0.0001 in a short- and long-term follow-up, respectively) and complications (p = 0.03), while there is no significant difference between the two groups regarding Lysholm knee score (n.s.) and Tegner activity score (n.s.). CONCLUSION: Overall, double-bundle ACL reconstruction yields better clinical outcomes when compared to single-bundle ACL reconstruction. LEVELS OF EVIDENCE: II.

Interleukin-18 promoter polymorphism and asthma risk: a meta-analysis.

Some studies have shown that IL-18 was associated with aetiology and progression of asthma. However, the association between single-nucleotide polymorphisms -607C/A (rs1946518) and -137G/C (rs187238) located in the IL-18 gene promoter and asthma risk was still controversial and ambiguous. To derive a more precise effect on the association between these polymorphisms and asthma risk, we performed a meta-analysis based on the currently available evidence of the literature. A total of 5 studies with 1411 cases and 1525 controls for -607C/A polymorphism and 5 studies with 1883 cases and 6645 controls for -137G/C polymorphism were identified to perform a meta-analysis, up to October 2010. Summary ORs and corresponding 95% CIs for IL-18 polymorphisms and asthma were estimated using fixed- and random-effects models when appropriate. Heterogeneity and publication bias were evaluated. We found that individuals carrying AC/CC genotype of -607C/A polymorphism were associated with an increased asthma risk in recessive model (OR = 1.278; 95% CI, 1.073-1.522). However, no significant association was observed between -137G/C polymorphism and asthma risk under different contrast models. There was no evidence of publication bias. The present meta-analysis suggested that IL-18 -607C/A polymorphism in promoter region was associated with asthma risk.

[Generation of Ayu17-449 gene knockout mice by gene trapping].

We report the generation of Ayu17-449 gene knockout mice in an effort to facilitate studies of its function during mouse development, A special gene trapping vector was transfected into mouse ES cells. The clone with the trapped gene trap was identified by 5' RACE and Southern blot analysis. Ayu17-449 trapped mice were then generated by using this ES clone. In addition, the expression of Ayu17-449 in this mutant line was analyzed with Northern blot. Results showed that in these mutant mice, the trapping vector was located upstream of the Ayu17-449 initiation site, and as a result, the transcription of Ayu17-449 gene was inhibited. Ayu17-449 trapped mice are a useful tool for the analysis of Ayu17-449 gene function in mouse development.

Evaluation of post-mortem heart blood culture in a Chinese population.

BACKGROUND: Post-mortem blood cultures have been used in a wide variety of research studies. However, their significance is still a matter of dispute among medico-legal experts. This study was aimed to determine the factors which influenced post-mortem blood culture results and to assess their value in determining the cause of death. METHODS: We retrospectively investigated 76 post-mortem cases with suspected infection and correlated pathological findings with heart blood culture results. RESULTS: We found that survival time after onset of illness was significantly associated with positive heart blood cultures (P=0.014). Blood culture results were not influenced by age, gender, prior antibiotic therapy, interval time from death to store or interval time from death to autopsy (P>0.05). In those who had heart blood cultures taken, 49 cases (64.5%) including four cases with mixed growth, showed positive results, and approximately one-third of blood cultures were sterile. The positive predictive value (PPV) was 77.6% (38/49) including two cases with mixed growth; most were genuine pathogens according to the clinical and pathological findings. However, the negative predictive value (NPV) was 59.3% (16/27). Escherichia coli, Streptococcus spp., Staphylococcus aureus, Streptococcus pneumoniae and Klebsiella spp. were isolated most often. CONCLUSION: These findings suggest that the results of post-mortem heart blood cultures, when combined with clinical and pathological findings, strengthen the understanding of the cause of death.

Can oral 5-aminosalicylic acid be administered once daily in the treatment of mild-to-moderate ulcerative colitis? A meta-analysis of randomized-controlled trials.

OBJECTIVES: Several trials have demonstrated that oral delayed-release mesalamine might be administered once daily. We aimed to conduct a meta-analysis to investigate this. METHODS: A comprehensive and multiple-source literature search was carried out. Only randomized-controlled trials (RCTs) were investigated by comparing a once daily-dosing regime with a divided (twice or thrice daily)-dosing regime of oral delayed-release mesalamine formulations for induction or maintenance of remission in patients with mild-to-moderate ulcerative colitis. The quality of RCTs was assessed using the Jadad scores. Meta-analysis of pooled odds ratios was carried out using Review Manager 5.1. RESULTS: Nine RCTs were finally included. With regard to meta-analyses for induction trials, there were no significant differences for all comparisons between the once daily and the divided groups, including maintenance of just clinical remission (P=0.52) and just endoscopic remission (P=0.23), maintenance of combined clinical and endoscopic remission (P=0.78), and the overall incidence of adverse events (P=0.61). With regard to meta-analyses for maintenance trials, there were also no significant differences for all comparisons between once daily and divided groups, including maintenance of just clinical remission (P=0.73) and just endoscopic remission (P=0.43), maintenance of combined clinical and endoscopic remission (P=0.43), the overall incidence of adverse events (P=0.12) as well as compliance with the prescribed medication (P=0.34). CONCLUSION: The present work showed that oral delayed-release mesalazine administered as a single or a divided dose demonstrated a good safety profile, which was well tolerated and effective as either maintenance or induction treatment. High clinical and/or endoscopic remission rates can be achieved with once-daily dosing.

Murine gamma herpes virus 68 infection promotes fatty liver formation and hepatic insulin resistance in C57BL/6J mice.

PURPOSE: Murine gamma herpes virus 68 (MHV68) is a naturally occurring mouse pathogen that is homologous to Epstein-Barr virus. This study was designed to determine the correlation between MHV68 infection and lipid accumulation and insulin resistance in livers of C57BL/6J mice, and to explore the underlying mechanisms. METHODS: C57BL/6J mice fed a high fat diet were randomly assigned to receive either MHV68 or phosphate buffered saline treatment. Insulin sensitivities were evaluated by glucose tolerance tests. Serum was analyzed for lipids and cytokines. Liver was taken for histology and lipid analysis. Quantitative RT-PCR and western blotting were used to measure expression of hepatic mammalian target of rapamycin (mTOR), ribosomal S6 kinase 1 (S6K1), insulin receptor substrate-1 (IRS-1), sterol regulatory element binding protein-1 (SREBP1), fatty acid synthase (FAS), and acetyl CoA carboxylase (ACC). RESULTS: MHV68 infection promoted fatty liver, hypertriglyceridemia, insulin resistance, and hyperinsulinemia in association with elevated inflammatory cytokines. In the livers of MHV68-infected C57BL/6J mice, SREBP1, FAS, ACC levels were increased. MHV68 infection also inhibited total IRS-1 expression and increased serine phosphorylation levels of IRS-1, which is parallel to the over activation of mTOR signaling pathway. Sirolimus, a specific inhibitor of mTOR pathway, inhibited MHV68-induced hepatic expression of serine p-IRS-1, increased total IRS-1 levels and improved MHV68-induced hepatic insulin resistance. CONCLUSION: In C57BL/6J mice, MHV68 infection promotes fatty liver formation and hepatic insulin resistance, which can be ameliorated by sirolimus.

Lack of an association between interleukin-6 gene promoter polymorphisms (-174G/C, -572G/C) and ischemic heart disease and/or ischemic stroke: a meta-analysis.

The association between single-nucleotide polymorphisms -174G/C (rs1800795) and -572G/C (rs1800796) in the interleukin-6 (IL-6) gene promoter region and ischemic heart disease (IHD)/ischemic stroke (IS) remains controversial and ambiguous. In this study, we performed a more precise estimation of the relationship by a meta-analysis based on currently available evidence from literature. To assess the effect of IL-6 polymorphisms (-174G/C, -572G/C) on IHD/IS susceptibility, a meta-analysis of 30 available studies was performed through May 2010. Summary odds ratios and their 95% confidence intervals for IL-6 polymorphisms and IHD/IS were estimated using fixed- and random-effects models when appropriate. Heterogeneity and publication bias were evaluated. When available studies were pooled into the meta-analysis, there was no significant association between IL-6 polymorphisms (-174G/C, -572G/C) and IHD/IS in any comparison model (CC vs GG, GC vs GG, dominant, and recessive models). Subgroup analyses results were consistent with the main analyses by ethnicity, ischemic types, quality score, and genotyping methods. Ethnicity (European studies) and quality score (low-quality studies) might be important sources of heterogeneity for -174G/C. However, metaregression analysis did not reveal that the foregoing characteristics could explain the τ(2) in any comparison model. We could not identify the sources of heterogeneity for -572G/C. The present meta-analysis suggests that IL-6 promoter polymorphisms (-174G/C, -572G/C) were unlikely to be associated with risk of IHD and/or IS.