Comparison of the effectiveness and safety of one-stage versus two-stage bilateral total knee arthroplasty.

This study aims to evaluate the effectiveness and safety of the patients receiving simultaneous bilateral TKA (BTKA). A total of 93 consecutive patients with bilateral knee degenerative osteoarthritis from January 2008 to November 2013 were divided into two groups--one-stage group (bilateral TKA under a single anesthetic, n = 54) and two-stage group (bilateral TKA performed during two separate admissions, n = 39). The patients in the both group have a similar incidence of postoperative complications (p = 0.544). The one-stage BTKA can significantly (p < 0.05) decrease the operative time, length of stay, and hospital charges, when compared to two-stage BTKA. The patients in one-stage group have a significantly (p < 0.05) higher postoperative drainage, amount of hidden blood loss, amount of blood loss, allogeneic transfusion and rate of blood transfusion, compared with those in two-stage group. Patients in both groups had a similar KSS (p = 0.839) and ROM (p = 0.383). The findings suggests that one-stage BTKA may be safely performed with similar knee function to those of two-stage procedure, and has the added benefit of single anaesthetic, reduced costs and decreased hospital stay when compared to two-stage BTKA.

Does PGA external stenting reduce compliance mismatch in venous grafts?

BACKGROUND: Autogenous vein grafting is widely used in regular bypassing procedures. Due to its mismatch with the host artery in both mechanical property and geometry, the graft often over expands under high arterial blood pressure and forms a step-depth where eddy flow develops, thus causing restenosis, fibrous graft wall, etc. External stents, such as sheaths being used to cuff the graft, have been introduced to eliminate these mismatches and increase the patency. Although histological and immunochemical studies have shown some positive effects of the external stent, the mechanical mismatch under the protection of an external stent remains poorly analyzed. METHODS: In this study, the jugular veins taken from hypercholesterolemic rabbits were transplanted into the carotid arteries, and non-woven polyglycolic acid (PGA) fabric was used to fabricate the external stents to study the effect of the biodegradable external stent. Eight weeks after the operation, the grafts were harvested to perform mechanical tests and histological examinations. An arc tangent function was suggested to describe the relationship between pressure and cross-sectional area to analyse the compliance of the graft. RESULTS: The results from the mechanical tests indicated that grafts either with or without external stents displayed large compliance in the low-pressure range and were almost inextensible in the high-pressure range. This was very different from the behavior of the arteries or veins in vivo. The data from histological tests showed that, with external stents, collagen fibers were more compact, whilst those in the graft without protection were looser and thicker. No elastic fiber was found in either kind of grafts. Furthermore, grafts without protection were over-expanded which resulted in much bigger cross-sectional areas. CONCLUSION: The PGA external extent contributes little to the reduction of the mechanical mismatch between the graft and its host artery while remodeling develops. For the geometric mismatch, it reduces the cross-section area, therefore matching with the host artery much better. Although there are some positive effects, conclusively the PGA is not an ideal material for external stent.

[Study on PI3K inhibitor LY294002 for chemotherapeutic sensitization in diffuse large B cell lymphoma cell lines].

OBJECTIVE: To investigate the effects on chemotherapeutic sensitization of the PI3K inhibitor LY294002 in diffuse large B cell Lymphoma (DLBCL) cell lines ly1, ly8, ly10. METHODS: The three cell lines were treated with LY294002, or doxorubicin alone or combined or sequentially respectively. Western blotting was used to detect the level of phospho-AKT after the treatment. Flow cytometry combined with annexin V-FITC assay and Brdu incorporation assay were used to analyze the alterations of cell cycle, proliferation, and apoptosis, respectively. RESULTS: LY294002 decreased the level of phospha-AKT efficiently in the three DLBCL cell lines. The ratio of S phase cells was significantly decreased (P < 0.05). Sequential use of LY294002 and doxorubicin increased the ratio of apoptosis and there was significant difference between the sequential group and the other four groups (P < 0.05) at 24, 48, 72(ly1), 48, 72 (ly8) or 24 h (ly10). CONCLUSION: LY294002 can sensitize doxorubicin-induced apoptosis and may be a potential molecular therapeutic agent targeted at AKT signaling pathway in DLBCL.