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SUMMARY: This study aimed to determine the benefits of a combined technique of muscle energy with and myofascial release more effective than using each in isolation in glenohumeral internal rotator deficits. An interventional study was designed for this study. Thirty-eight patients were diagnosed with painful shoulder syndrome. Patients were randomly allocated into 4 groups where Group A was treated with combined muscle energy and myofascial release; Group B with muscle energy technique; Group C with myofascial release and Group D used as control. The evaluation of the passive joint range of the glenohumeral internal rotation and sociodemographic data for each of the groups were measured, before and after interventions. Despite the use of myofascial release and muscle energy techniques being significantly beneficial in their respective groups, when both were combined; it outcomes were highly successful. A combination therapy treatment applied with the Muscle Energy and Myofascial Release Techniques in patients with painful shoulder syndrome will be more effective in increasing the range of motion of the glenohumeral internal rotation joint than any of the techniques applied individually.
Este estudio tuvo como objetivo determinar los beneficios de una técnica combinada de energía muscular con liberación miofascial más efectiva que usar cada una de manera aislada en los déficits de los músculos rotadores internos glenohumerales. Para este estudio se diseñó un protocolo de intervención. En 38 pacientes se diagnosticó síndrome de hombro doloroso. Los pacientes fueron asignados aleatoriamente a 4 grupos; el grupo A fue tratado con energía muscular combinada y liberación miofascial; Grupo B con técnica de energía muscular; Grupo C con liberación miofascial y Grupo D utilizado como control. Se midió la evaluación del rango articular pasivo de la rotación interna de la articulación glenohumeral y datos sociodemográficos de cada uno de los grupos, antes y después de las intervenciones. A pesar de que el uso de técnicas de liberación miofascial y energía muscular resultó significativamente beneficioso en sus respectivos grupos, cuando ambas se combinaron; Sus resultados fueron muy exitosos. Un tratamiento de terapia combinada aplicado con las Técnicas de Energía Muscular y Liberación Miofascial en pacientes con síndrome de hombro doloroso será más efectivo para aumentar el rango de movimiento de la articulación de rotación interna glenohumeral que cualquiera de las técnicas aplicadas individualmente.
الموضوعات
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Shoulder Joint/physiopathology , Range of Motion, Articular , Physical Therapy Modalities , Combined Modality Therapy , Myofascial Release Therapyالملخص
@#Objective To analyze the trend of the hemagglutinin(HA) and ovalbumin contents in the lot release of influenza virus split vaccines in 2021,and evaluate the quality and quality control level of the vaccines.Methods The HA and ovalbumin content data of influenza virus split vaccines from two domestic enterprises in 2021 were collected and collated. The mean value and standard deviation were calculated according to the first 40 batches of data of the enterprise in the year,and the warning limit and action limit were established. The trend analysis of the above indexes was carried out to evaluate the stability and consistency of the product quality of the enterprise. Statistical data comparison and consistency analysis were made between the test results of the batch inspected by the lot release institution and the results of the enterprise.Results Through the retrospective data analysis of quadrivalent influenza virus split vaccines from two vaccine enterprises A and B,it was found that the content of H1N1 subtype HA and ovalbumin in the two enterprises and the content of Bv HA in the B enterprise had out of trend(OOT)situations,while the trend of other items was stable. The results of paired student's t test or Wilcoxon signed-rank test of the samples inspected by the lot release institution showed that except Bv subtype HA(t = 1. 094 and 0. 742 respectively)and ovalbumin(w =-64 and 36 respectively)contents showed no statistically significant difference(P > 0. 05),the HA contents of H1N1(t = 3. 862,w = 232),H3N2(t = 8. 225 and3. 473 respectively)and By(t = 5. 616 and 4. 934 respectively)of the two enterprises had significant differences(P <0. 05). The results of enterprises were generally higher than the lot release institution. Bland-Altman test analysis found that the consistency between the test data of enterprise A's HA content and the data of the lot release institution was better than that of enterprise B.Conclusion The stability and consistency of data trends of active ingredients and main impurity ingredients of quadrivalent influenza virus split vaccine batches in 2021 were generally good. The trend analysis can identify potential problems in vaccine production,and enterprises should carefully implement trend analysis and effectively monitor the product quality of vaccines.
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This guideline aims to provide comprehensive and practical guidance for clinical management of tuberculosis in kidney transplant recipients. First, it summarizes the particularity of tuberculosis in kidney transplant recipients, and highlights the high incidence and diverse clinical manifestations. To better understand the patients' conditions, relevant assessment of tuberculosis is recommended before kidney transplantation. Extensive attention should be paid to the monitoring of tuberculosis after kidney transplantation. Regarding the diagnosis, the guideline explicitly introduces common diagnostic approaches for tuberculosis, and evaluates the applicability in kidney transplant recipients. After the diagnosis is confirmed, it discusses how to balance the treatment and rejection of tuberculosis under the background of immunosuppressants, and focuses upon the potential drug interaction. In terms of prevention, it emphasizes the screening of tuberculosis prior to kidney transplantation. This guideline is designed to deepen the understanding of medical staff for tuberculosis management in kidney transplant recipients, promote more effective clinical practice and improve the quality of life of the recipients.
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Objective To preliminarily explore the efficacy of chimeric antigen receptor T cells(CAR-T)targeting CD 123 in the treatment of acute myeloid leukemia(AML)and the role of dasatinib in the treatment of CD123 targeting CAR-T induced side effects.Methods Clinical data of 1 patient with relapsed AML admitted to No.920 Hospital of PLA Joint Logistic Support Force in September,2019 were collected.The patient relapsed after previous multi-line chemotherapy and was treated with CD123 targeting CAR-T therapy.The routine blood changes of the patient after treatment were observed.Dasatinib was used when agranulocytosis occurred,40 mg orally 3 times per day,and was stopped when agranulocytosis was relieved.Changes in blood cells,CAR-T amplification,and disease control were observed.The patient was followed up for over 1 year.Results Flow cytometry for bone marrow showed that minimal residual disease negative result was observed in 30 d after infusion.The patient remained disease-free for over 1 year.After CD 123 CAR-T cells infusion,significant expansion of CAR-T cells was observed,accompanied by granulocyte deficiency and cytokine release syndrome(CRS).After using dasatinib,inhibition of CAR-T cell expansion was observed,accompanied by blood cell recovery,and CRS symptoms were alleviated.After stop of dasatinib,CAR-T cells expanded again and blood cells decreased again.Conclusion CAR-T cells targeting CD 123 have certain efficacy in the treatment for relapsed AML.Dashatinib has a blocking effect on the amplification and function of CAR-T,which can alleviate bone marrow suppression caused by CD 123 targeting CAR-T and avoid severe CRS.
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Objective To explore the effects of small incision in situ release on surgical indications,nerve conduction velocity and upper limb function in patients with carpal tunnel syndrome(CTS).Methods A total of 100 CTS patients admitted to our hospital from January 2018 to January 2022 were selected,they were randomly divided into the control group(50 cases,treated with traditional carpal tunnel release)and the observation group(50 cases,treated with small incision in situ release),the clinical data of CTS patients were collected and surgical indications,nerve conduction velocity,upper limb function and the incidence of complications were compared between the two groups.Results The total effective rate was 98.00％in the observation group and 84.00％in the control group(P＜0.05).In the observation group,the length of incision was(1.65±0.29)cm,the time of opening and closing incision was(4.85±1.02)min,the hospitalization time was(3.24±0.62)d,the intraoperative blood loss was(17.88±3.53)mL,and the VAS score was(3.03±0.56)points one day after operation.The control group were(4.02±0.81)cm,(10.06±2.28)min,(7.11±1.34)d,(24.37±5.27)ml,(4.04± 0.89)points,the differences were statistically significant(P＜0.05).After treatment,The thumle-wrist sensory conduction velocity of CTS patients in the study group was(46.05±8.39)m/s,the middle finger-wrist sensory conduction velocity was(45.05±8.95)m/s,the thenar muscles-wrist motor conduction velocity was(53.94±11.47)m/s,the FIM ADL score was(34.38±7.22)points,and FMA The upper limb score was(34.23±7.25)points,and the control group was(41.86±8.22)m/s,(40.88±8.28)m/s,(49.05±10.01)m/s,(27.81±6.01)points,(41.05±9.19)points.The difference between the two groups was statistically significant(P＜0.05).The total incidence of complications was 4.00％in the observation group and 20.00％in the control group(P＜0.05).Conclusion Small incision in situ release is effective in the treatment of CTS patients,which can improve the surgical indications and nerve conduction velocity,help patients recover upper limb function,and reduce the incidence of postoperative complications.
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Objective To study the safety and effectiveness of arc edge needle therapy for moderate to severe tenosynovitis of the flexor digitorum tendon in the thumb.Methods A total of 62 patients with moderate to severe stenosing tenosynovitis of the flexor digitorum thumb who met the inclusion criteria were collected.The patients were randomly assigned 1:1 to the arc edge needle group and the needle knife group using a random number table method.Among them,31 patients in the arc edge needle group were treated with arc edge needles,while 31 patients in the needle knife group were treated with traditional needle knife release surgery.Both groups were treated once.Record the number rating scale(NRS),range of motion(ROM),Quinell grade,and disease efficacy score(WDES)of patients before and after treatment at various stages(1 week,2 weeks,4 weeks),and at follow-up after 24 weeks to evaluate the treatment effect.Results During the 24 weeks follow-up of 62 patients after treatment,the Quinell grading comparison between the two groups showed that the arc edge needle group was better than the needle knife group(P<0.05);The total effective rate of disease efficacy score(WDES)was 96.77%in the arc edge needle group and 83.87%in the needle knife group.The clinical total effective rate of the arc edge needle group was better than that of the needle knife group(P<0.05);After treatment,both groups showed significant improvement in pain numerical score(NRS)and joint range of motion(ROM),and the degree of improvement increased over time(P<0.05);And the inter group comparison at 1 week,2 weeks,4 weeks and 24 weeks time points after treatment showed that the curved blade needle was superior to the needle knife group in improving pain and joint mobility(P<0.05).Conclusion Both the 45° tenosynovitis incision and release surgery with arc edge needle and traditional needle knife release surgery are effective in treating moderate to severe tenosynovitis of the thumb flexor digitorum tendon.However,the 45° tenosynovitis incision and release surgery with arc edge needle has significant advantages in improving pain,interphalangeal joint mobility,and safety.
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Objective:Using atenolol as a model drug,the aim of this study was to develop a sustained and controlled transdermal drug delivery system(TDDS)based on polyethyleneimine-modified MoS2 nanoparticles(PEI-MoS2 NPs)that were responsive to near infrared(NIR)laser irradiation.Methods:The three-dimensional flower-like PEI-MoS2 NPs were successfully synthesized and further characterized by attenuated total reflection Fourier transform infrared spectroscopy,X-ray diffraction measurements,scanning electron microscopy,and transmission electron microscopy.The controlled release capacity of PEI-MoS2 NPs was examined using in vitro drug release and skin penetration experiments.Results:The PEI-MoS2 NPs exhibited a drug loading efficiency of 53.86% and high photothermal conversion ability.Moreover,the release of atenolol was enhanced by NIR stimulation with an enhancement ratio of 1.56.Conclusion:NIR-controlled PEI-MoS2 NPs was essential for the control and sustained release of drugs in TDDS.
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BACKGROUND:As a member of bone morphogenetic proteins,growth differentiation factor-5 shows promising potential in the application of cartilage and bone repair.The affinity of growth differentiation factor-5 onto bone tissue determines protein use efficiency,so it is of great significance to prepare growth differentiation factor-5 with bone targeting capability. OBJECTIVE:To modify growth differentiation factor-5 using bisphosphonates and investigate the effects of modified protein on the growth of preosteoblasts in mice. METHODS:Pamidronate disodium/growth differentiation factor-5 complex was prepared using chemical crosslinking to couple growth differentiation factor-5 with pamidronate disodium.The functional groups and structures of the complex were characterized using Fourier transform infrared spectroscopy and circular dichromatography.To determine the bone targeting in vitro,the binding of the modified growth differentiation factor-5 with calcium phosphate and in vitro release amount of growth differentiation factor-5 were measured with an ELISA kit.Growth differentiation factor-5(control group)and the pamidronate disodium/growth differentiation factor-5 complex(experimental group)were co-cultured with preosteoblasts MC3T3-E1.Individually cultured cells were blank controls.The effect of the complex on cell proliferation and differentiation was evaluated. RESULTS AND CONCLUSION:(1)The infrared spectroscopy and circular dichromatography results indicated that the bisphosphonate/growth differentiation factor-5 complex was successfully prepared without significant changes in the protein secondary structure.In vitro protein adsorption results showed that growth differentiation factor-5 adsorption on calcium phosphate was increased by about one time after coupling with a bisphosphonate.In the presence of cysteine,growth differentiation factor-5 could be released from the bisphosphonate/growth differentiation factor-5 complex.(2)CCK-8 assay results showed that the absorbance value of the experimental group cultured for 4 and 7 days was higher than that of the control group and blank control group(P<0.000 1).After 7 days of culture,the expression of alkaline phosphatase in the experimental group was significantly higher than that in the control group and blank control group(P<0.000 1).After 13 days of culture,the content of calcium nodules in the experimental group was significantly higher than that in the control group and the blank control group(P<0.000 1).The results of qRT-PCR showed that the mRNA expression of alkaline phosphatase,osteocalcin and Runx2 in the experimental group was higher than that in the control group and the blank control group after 7 days of culture(P<0.01,P<0.001,P<0.000 1).(3)These findings exhibit that bisphosphonate modification can enhance the binding capacity of growth differentiation factor-5 to calcium phosphate as well as improve its biological activity.
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BACKGROUND:Due to the sudden release and the rapid removal by proteases,platelet-rich plasma hydrogel leads to shorter residence times of growth factors at the wound site.In recent years,researchers have focused on the use of hydrogels to encapsulate platelet-rich plasma in order to improve the deficiency of platelet-rich plasma hydrogels. OBJECTIVE:To prepare self-assembled polypeptide-platelet-rich plasma hydrogel and to explore its effects on the release of bioactive factors of platelet-rich plasma. METHODS:The self-assembled polypeptide was synthesized by the solid-phase synthesis method,and the solution was prepared by D-PBS.Hydrogels were prepared by mixing different volumes of polypeptide solutions with platelet-rich plasma and calcium chloride/thrombin solutions,so that the final mass fraction of polypeptides in the system was 0.1%,0.3%,and 0.5%,respectively.The hydrogel state was observed,and the release of growth factors in platelet-rich plasma was detected in vitro.The polypeptide self-assembly was stimulated by mixing 1%polypeptide solution with 1%human serum albumin solution,so that the final mass fraction of the polypeptide was 0.1%,0.3%,and 0.5%,respectively.The flow state of the liquid was observed,and the rheological mechanical properties of the self-assembled polypeptide were tested.The microstructure of polypeptide(mass fraction of 0.1%and 0.001%)-human serum albumin solution was observed by scanning electron microscope and transmission electron microscope. RESULTS AND CONCLUSION:(1)Hydrogels could be formed between different volumes of polypeptide solution and platelet-rich plasma.Compared with platelet-rich plasma hydrogels,0.1%and 0.3%polypeptide-platelet-rich plasma hydrogels could alleviate the sudden release of epidermal growth factor and vascular endothelial growth factor,and extend the release time to 48 hours.(2)After the addition of human serum albumin,the 0.1%polypeptide group still exhibited a flowing liquid,the 0.3%polypeptide group was semi-liquid,and the 0.5%polypeptide group stimulated self-assembly to form hydrogel.It was determined that human serum albumin in platelet-rich plasma could stimulate the self-assembly of polypeptides.With the increase of the mass fraction of the polypeptide,the higher the storage modulus of the self-assembled polypeptide,the easier it was to form glue.(3)Transmission electron microscopy exhibited that the polypeptide nanofibers were short and disordered before the addition of human serum albumin.After the addition of human serum albumin,the polypeptide nanofibers became significantly longer and cross-linked into bundles,forming a dense fiber network structure.Under a scanning electron microscope,the polypeptides displayed a disordered lamellar structure before adding human serum albumin.After the addition of human serum albumin,the polypeptides self-assembled into cross-linked and densely arranged porous structures.(4)In conclusion,the novel polypeptide can self-assemble triggered by platelet-rich plasma and the self-assembly effect can be accurately adjusted according to the ratio of human serum albumin to polypeptide.This polypeptide has a sustained release effect on the growth factors of platelet-rich plasma,which can be used as a new biomaterial for tissue repair.
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BACKGROUND:Previous research by the research team found that domestically produced porous tantalum is beneficial for early adhesion and proliferation of MG63 cells,and can be used as a scaffold material for bone tissue engineering. OBJECTIVE:To investigate the effect of domestic porous tantalum modified by osteogenic induction factor slow-release system on the adhesion,proliferation,and differentiation of MG63 cells. METHODS:Osteogenic induction factor slow-release system was constructed by adding 15%volume fraction of osteogenic factor solution to poly(lactic-co-glycolic-acid)gel.The passage 3 MG63 cells were inoculated on a porous tantalum surface(control group),porous tantalum surface coated with poly(lactic-co-glycolic-acid)copolymer gel(gel group),and porous tantalum surface coated with osteoblastic induction factor slow-release system(slow-release system group),and co-cultured for 5 days.The surface cytoskeleton of the material was observed by phalloidine staining.Cell proliferation was detected by flow cytometry.Western blot assay and RT-qPCR were used to detect the protein and mRNA expressions of type Ⅰ collagen,osteopontin,and RUNX-2 on the surface cells of the material. RESULTS AND CONCLUSION:(1)Phalloidine staining showed that MG63 cells adhered to and grew on the surface and inside of the three groups of porous tantalum,and the matrix secreted by the cells covered the surface of the material.(2)Flow cytometry showed that the cell proliferation in the slow-release system group was faster than that in the control group and the gel group(P<0.05).(3)Western blot assay and RT-qPCR showed that the protein and mRNA expressions of type Ⅰ collagen,osteopontin,and RUNX-2 in the slow-release system group were higher than those in the control group and gel group(P<0.05).(4)The results showed that the domestic porous tantalum modified by the osteogenic induction factor slow-release system was beneficial to the adhesion,proliferation,and differentiation of MG63 osteoblasts.
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BACKGROUND:Polylactic acid has good biocompatibility and biodegradability,and has become a new orthopedic fixation material.However,the lack of cell recognition signal of this material is not conducive to cell adhesion and osteogenic differentiation,which limits its application in biomaterials. OBJECTIVE:3D-printed polylactic acid-nano-hydroxyapatite(nHA)/chitosan(CS)scaffold to evaluate its drug sustained-release and biological properties. METHODS:The porous polylactic acid scaffold(recorded as PLA scaffold)with interporous pores was printed by fused deposition modeling technique,and the scaffold was soaked in dopamine solution to prepare polylactic acid-dopamine scaffold(recorded as PLA-DA scaffold).Nano-hydroxyapatite was immersed in chitosan solution,and then the PLA-DA scaffold was immersed in it to prepare polylactic acid-nano-hydroxyapatite/chitosan scaffold(recorded as PLA-nHA/CS scaffold).The micro-morphology,porosity,water contact angle,and compressive strength of the three scaffolds were characterized.PLA-nHA/CS scaffold loaded with doxycycline(recorded as PLA-nHA/CS-DOX scaffold)was prepared by freeze-drying method,and its drug release was characterized.PLA,PLA-DA,PLA-nHA/CS,and PLA-nHA/CS-DOX scaffolds were co-cultured with MC3T3-E1 cells,separately,to detect cell proliferation and osteogenic differentiation.Staphylococcus aureus suspensions of different concentrations were co-cultured with four groups of scaffolds.The antibacterial performance of scaffolds was detected by inhibition zone test. RESULTS AND CONCLUSION:(1)Under scanning electron microscopy,the surfaces of PLA and PLA-DA scaffolders were dense and smooth,and nHA particles were observed on PLA-nHA/CS scaffolders.The porosity of PLA,PLA-DA and PLA-nHA/CS scaffolds decreased gradually,and the compressive strength increased gradually.The elastic modulus of PLA-nHA/CS scaffolds met the requirements of cancelous bone.The water contact angle of PLA-DA and PLA-nHA/CS brackets was smaller than that of PLA scaffolds.The PLA-nHA/CS scaffold sustainably released drugs in vitro for 8 days.(2)CCK-8 assay showed that the proliferation of MC3T3-E1 cells was not significantly affected by the four groups of scaffolds.The activity of alkaline phosphatase in PLA-DA group,PLA-nHA/CS group,and PLA-nHA/CS-DOX group was higher than that in PLA group.Alizarin red staining showed that compared with PLA group,the cells in PLA-nHA/CS group and PLA-nHA/CS-DOX group showed higher mineralized water level.(3)Inhibition zone test exhibited that PLA and PLA-DA scaffolds had no antibacterial properties.PLA-nHA/CS scaffolds had certain antibacterial properties.PLA-nHA/CS-DOX scaffolds had super antibacterial properties.(4)The results showed that the PLA-nHA/CS-DOX scaffold had good drug release performance,cell compatibility,osteogenic properties,and antibacterial properties.
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BACKGROUND:In the treatment strategy of chronic osteomyelitis,the local antibiotic slow-release system has attracted much attention in the clinic due to the long-term release of effective concentrations of antibiotics to control the infection,and at the same time,the ability to repair bone defects caused by debridement. OBJECTIVE:To summarize the research status of antibiotic sustained-release carriers prepared from biodegradable polymer-based materials for the treatment of osteomyelitis,and analyze the limitations and challenges. METHODS:Chinese and English key words were"polymer,composite material,osteomyelitis,infectious bone defect,drug delivery systems,antibiotic sustained-release system,3D printing".Relevant articles were searched in PubMed,Web of Science,CNKI,and WanFang databases from January 2015 to August 2023.4 351 articles were obtained in the initial examination,and 87 articles were analyzed after screening. RESULTS AND CONCLUSION:Polymer-based materials have been widely studied in the preparation of antibiotic sustained-release carriers due to their good biocompatibility,biodegradability,thermal stability,and easy processing.However,the antibiotic slow-release carrier composed of a single polymer material cannot meet the standard of infectious bone defect repair materials due to the lack of biomechanical properties.The organic-inorganic composite material carrier,which simulates the formation of natural bone tissue structure,is expected to meet this standard.3D printing technology can precisely control the size,geometry,and spatial distribution of the interconnecting pores of the carrier,and can load the effective concentration of antibiotics to achieve controlled release.The polymer material is the most suitable for 3D printing because of its good thermal stability and plasticity.Therefore,the author believes that on the basis of new biodegradable organic-inorganic composite materials and combined with 3D printing technology,the material-structure-function integrated composite antibiotic slow-release carrier to simulate the extracellular matrix microenvironment is expected to become a novel research direction in the treatment of chronic osteomyelitis.
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BACKGROUND:Bioactive glass is a multifunctional synthetic composite material that releases active ions slowly and exhibits certain biological activities after affinity with tissues.Their versatility stems from the versatility of their preparation processes and components,allowing them to be applied in different clinical scenarios. OBJECTIVE:To review the main application forms,application fields of bioactive glass,as well as the influence of doping different elements on its function. METHODS:A literature search was conducted across WanFang Medical Database,CNKI Database,PubMed Database,and Web of Science Database,using the search terms"bioactive glass,slow-release ions,bone tissue engineering,composite scaffold,tissue regeneration and repair,biomedical engineering"in Chinese and English.The timeframe was limited from 2000 to 2023.Finally,88 articles were included for review. RESULTS AND CONCLUSION:(1)In terms of application forms,bioactive glass can be fabricated as coatings,particles,bone cements,and scaffolds according to needs.Coatings have the potential to enhance the biological activity of implants,yet they are susceptible to instability as a result of degradation.Particles offer a viable solution for the repair of irregular bone defects;however,particles produced through traditional methods often possess limited functionality.Bone cement provides the benefits of minimal invasiveness and injectability,yet its application is restricted to smaller bone defects.Scaffolds exhibit excellent mechanical properties and are commonly used for larger-sized bone defects,yet they have limited toughness.(2)In terms of applications,bioactive glass can be used in a variety of tissue regeneration and repair and disease treatment fields,including dentistry,orthopedics,soft tissue engineering,and cancer.(3)In terms of element doping,the addition of specific elements to bioactive glass not only improves its mechanical properties but also endows it with special biological functions such as bioactivity,degradability,and antibacterial properties.(4)Biologically active glass is a versatile material that can be used in different forms and functions by adjusting the preparation process and element doping to meet various clinical needs in bone tissue engineering and is widely used in the field of biomedical engineering.
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BACKGROUND:Atlantoaxial dislocation is often facilitated by interlaminar bone grafting.However,there are relatively few reports on the treatment of complex atlantoaxial dislocation with posterior atlantoaxial lateral mass interarticular release and fusion. OBJECTIVE:To explore the safety and effectiveness of atlantoaxial dislocation treated by simple posterior atlantoaxial lateral block interarticular release and fusion. METHODS:We retrospectively analyzed the clinical data of 30 patients with atlantoaxial dislocation who were treated from January 2017 to July 2021,all of whom suffered from reducible atlantoaxial dislocation.Posterior atlantoaxial lateral mass interarticular release and fusion were performed in all patients.During the surgery,patented instruments were used to release the atlantoaxial lateral mass joint,and posterior screw reduction and fixation were used with bone grafting in the lateral mass joint space.The postoperative follow-up period was 6 to 24 months,mean(13.0±5.4)months.During the follow-up period,cervical MRI was reviewed to observe the decompression of the upper cervical spine.X-ray films and CT scans were reviewed to observe the reduction of the upper cervical spine,as well as the internal fixation for looseness and breakage.CT scans were reviewed to assess interlateral block implant fusion.The Japanese Orthopaedic Association score was used to evaluate the improvement of spinal cord function.The neck disability index and the quality of life scale were used to assess the improvement of daily life function.The atlanto-anterior interspace and atlanto-planar spinal effective space were used to evaluate atlantoaxial repositioning and decompression. RESULTS AND CONCLUSION:(1)The surgery of 30 patients went smoothly,and no serious complications such as spinal nerve and vertebral artery injuries occurred during the operation.Postoperative review of cervical MRI showed that the spinal cord compression was lifted.X-ray film and CT showed that the atlanto-anterior gap was significantly reduced;the effective space of atlantoaxial spinal cord was significantly increased,and neurological dysfunctional symptoms were significantly reduced.(2)During the follow-up period,X-ray film and CT showed that the internal fixation was solid;no broken nails or rods occurred,and there was no recurrence of atlantoaxial dislocation.(3)The Japanese Orthopaedic Association scores,neck disability index,and quality of life scores were significantly improved at the last follow-up compared with the preoperative period(P<0.05).The average improvement rate of Japanese Orthopaedic Association scores at the last follow-up was 73.1%.The average neck disability index was 8.80%.All of the patients had a continuous bone-scalp connection between atlantoaxial lateral block joints to achieve osseous fusion.(4)These findings indicate that the use of simple posterior atlantoaxial lateral block interarticular release and fusion for the treatment of atlantoaxial dislocation can significantly increase the fusion rate and shorten the fusion time.
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BACKGROUND:Critical energy release rate is a global fracture parameter that could be measured during the failing process,and its value may change under different failure modes even in the same structure. OBJECTIVE:To propose an approach to predict the critical energy release rate in the femoral cortical bone structure under different failure modes. METHODS:Three-point bending and axial compression experiments and the corresponding fracture simulations were performed on the rat femoral cortical bone structures.Different critical energy release rates were repeatedly assigned to the models to perform fracture simulation,and the predicted load-displacement curves in each simulation were compared with the experimental data to back-calculate the critical energy release rate.The successful fit was that the differences in the fracture parameters between the predicted and experimental results were less than 5%. RESULTS AND CONCLUSION:(1)The results showed that the cortical bone structure occurred tensile open failure under three-point bending load,and the predicted critical energy release rate was 0.16 N/mm.(2)The same cortical bone structure occurred shear open failure under axial compression load,and the predicted critical energy release rate was 0.12 N/mm,which indicates that the critical energy release rate of the same cortical bone structure under different failure modes was different.(3)A comprehensive analysis from the perspectives of material mechanical properties and damage mechanism was conducted to reveal the reasons for the differences in the critical energy release rate in the cortical bone structure under different failure modes,which provided a theoretical basis for the measurement of the energy release rate and the accurate fracture simulation.
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AIM:To investigate the influence of fat mass and obesity-associated(Fto)gene on the aberrant contraction of aortic smooth muscle in diabetes mellitus(DM)mice,and to explore the mechanism of Fto gene underlying the calcium regulation.METHODS:Smooth muscle-specific Fto gene knockout(FtoSMKO)mice were generated using Cre-loxP technology.The experiment involved 3 groups of mice:wild-type(WT)group,DM model group and FtoSMKO-DM group,with 15 mice in each group.In DM group and FtoSMKO-DM group,type 1 DM was induced by intraperitoneal injec-tion of streptozotocin.The mice in WT group were injected with equal volume of citric acid-sodium citrate buffer solution.The influences of different drugs on the contraction responses of aortic smooth muscle in mice were analyzed using a multi-myograph system.The expression level of FTO protein in the aortic tissues was detected by Western blot.RESULTS:(1)Compared with WT mice,the expression levels of FTO protein in the aortic tissues of DM mice were significantly in-creased(P＜0.01).(2)The expression level of FTO protein in smooth muscle was significantly decreased after knockout of Fto gene(P＜0.01).Compared with WT group,the mice in DM group exhibited a significant decrease in body weight and a marked increase in fasting blood glucose level(P＜0.05).There were no noticeable differences in body weight or fasting blood glucose level between FtoSMKO-DM group and DM group(P＞0.05).(3)The contraction responses of aortic smooth muscle in DM group were substantially increased by phenylephrine compared with WT group.Specifically,vaso-constriction responses mediated by non-L-type calcium channels and store-operated calcium channels(SOCC)were signifi-cantly enhanced in DM group.In addition,the responses mediated by inositol 1,4,5-trisphosphate receptors(IP3R),which facilitate calcium release from the sarcoplasmic reticulum,were significantly enhanced.However,the responses mediated by caffeine-activated ryanodine receptors(RyR),which also facilitate calcium release from the sarcoplasmic re-ticulum,were significantly inhibited(P＜0.05).(4)Compared with DM group,the phenylephrine-induced contraction re-sponses of aortic smooth muscle in FtoSMKO-DM group were greatly weakened(P＜0.05).In particular,the vasoconstriction responses mediated by non-L-type calcium channels and SOCC in FtoSMKO-DM group were greatly suppressed(P＜0.05),while those mediated by caffeine-activated RyR were dramatically boosted(P＜0.05).However,IP3R-mediated responses were not affected(P＞0.05).CONCLUSION:Smooth muscle-specific Fto gene knockout suppresses contractile hyperre-sponsiveness in the aortic smooth muscle of DM mice,which may be attributed to involvement of FTO protein in calcium regulation in the vascular smooth muscle.
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Objective:To analyze the clinical efficacy of arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip.Methods:A total of 30 patients (12 males and 18 females) with bilateral external snapping hip underwent arthroscopic transverse release of the iliotibial band through peritrochanteric space in Department of Sports Medicine, Senior Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital were retrospectively analyzed from May 2021 and June 2022. The average age was 32.5±8.2 years (range, 17-51 years). At the same time, 30 patients who underwent arthroscopic external release of the iliotibial band through the external surface of the iliotibial band (external iliotibial band group) were selected as control group, including 13 males and 17 females, aged 29.5±6.8 years (range, 11-45 years). The visual analogue scale (VAS), modified Harris hip score (mHHS), and gluteal muscle contracture disability scale (GDS) were compared between the two groups at preoperative, 6 months postoperative, and final follow-up.Results:All patients successfully completed the operation and were followed up for 17.5±3.3 months (range, 12-25 months). The VAS scores of the two groups at the last follow-up were lower than those before operation ( P<0.05). The mHHS scores before operation, 6 months after operation and at the last follow-up in the peritrochanteric space group were 76.5 (67.0, 85.5), 98.5 (94.8, 100.0) and 100.0 (97.0, 100.0), respectively, and those in the external iliotibial band group were 80.5 (70.0, 86.0), 100.0 (96.0, 100.0) and 100.0 (99.5, 100.0). The differences in mHHS scores between the two groups were statistically significant for intragroup comparisons ( P<0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in mHHS scores between groups at different time points ( P>0.05). The GDS before operation, at 6 months after operation and at the last follow-up were 47.0 (35.8, 64.5), 90.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the peritrochanteric space group, and 51.0 (38.0, 64.5), 50.0 (81.0, 94.0) and 93.5 (89.8, 98.0) in the external iliotibial band group, respectively. The differences in GDS between the two groups were statistically significant for intragroup comparisons ( P< 0.05); of these, 6 months postoperatively and at the last follow-up were greater than preoperatively, with statistically significant differences ( P<0.05); the differences at 6 months postoperatively and at the last follow-up were not statistically significant ( P>0.05). There was no significant difference in GDS between groups at different time points ( P>0.05). Conclusion:Arthroscopic transverse release of the iliotibial band through peritrochanteric space for the treatment of external snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to transverse release through the external surface of the iliotibial band.
الملخص
To summarize the nursing experience of a patient with gastric cancer who developed cytokine release syndrome after using immune checkpoint inhibitors.Key points of nursing care:development of nursing assessment decisions with a holistic view to guide safe nursing care;taking into account the contradiction between bleeding and thrombosis and providing good care for upper gastrointestinal bleeding;implementing a nursing strategy focusing on cleaning and anti-infection for IV oral mucositis;implementing risk management for severe pulmonary lesions;providing good hormone medication care and discharge follow-up management.The patient was successfully discharged on 52nd day with a 3-month follow-up in good condition.
الملخص
Objective:To evaluate the role of ryanodine receptor 2 (RyR2) in postoperative cognitive dysfunction (POCD) in aged rats.Methods:Sixty SPF healthy male Sprague-Dawley rats, aged 20 months, weighing 600-650 g, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), POCD group (group P) and dantrolene group (group D). A rat POCD model was prepared by closed reduction and internal fixation of left tibial fractures with sevoflurane anesthesia in P and D groups. RyR inhibitor dantrolene 2 mg/kg was injected via a tail vein at 30 min before surgery in group D. Morris water maze tests were conducted on day 1 before surgery and day 7 after surgery to evaluate the cognitive function. An open field test was conducted to detect the spontaneous motor function starting from day 7 after surgery. The rats were sacrificed after the end of Morris water maze tests and hippocampal tissues were taken for determination of the expression of RyR2 and cleaved caspase-3 (by Western blot), apoptosis rate and cytoplasmic calcium ion concentrations (by flow cytometry) and for microscopic examination of the pathological changes in hippocampal CA1 area (using HE staining). Results:There was no significant difference in the speed, distance and duration of stay in the center in the open field test among the three groups ( P>0.05). Compared with group C, the escape latency was significantly prolonged after surgery, the number of crossing the original platform was reduced, the expression of RyR2 and cleaved caspase-3 was up-regulated, and the neuronal apoptosis rate and cytoplasmic calcium ion concentration were increased ( P<0.05), and the pathological changes were found in the hippocampal CA1 area in group P. Compared with group P, the escape latency was significantly shortened after surgery, the number of crossing the original platform was increased, the expression of RyR2 and cleaved caspase-3 was down-regulated, and the neuronal apoptosis rate and cytoplasmic calcium ion concentration were decreased ( P<0.05), and the pathological changes were significantly reduced in the hippocampal CA1 area in group D. Conclusions:RyR2 activation is involved in the process of POCD in aged rats, which may be associated with increased calcium overload-induced hippocampal neuronal apoptosis.
الملخص
Objective:To investigate the factors influencing phytohemagglutinin (PHA) response in the detection of Mycobacterium tuberculosis infection by gamma interferon release assay (IGRA). Methods:A retrospective case-control study was conducted on 360 hospitalized patients who received IGRA in West China Hospital of Sichuan University from January 2019 to December 2021. According to PHA response (IFN-γ level), they were divided into three groups: negative mitogen response group (IFN-γ<2 pg/ml), weak positive mitogen response group (IFN-γ: 2-100 pg/ml), and normal mitogen response group (IFN-γ>400 pg/ml).Results:Immune diseases were independently associated with negative (OR=0.34, 95%CI: 0.17-0.72, P=0.004) and weak positive mitogen responses (OR=0.29, 95%CI: 0.16-0.55, P<0.001). Infections caused by pathogens other than Mycobacterium tuberculosis was independently associated with negative mitogen response (OR=0.266, 95%CI: 0.09-0.83, P=0.023), while immunodeficiency was independently associated with weak positive mitogen response (OR=0.280, 95%CI: 0.12-0.63, P=0.002). Mitogen response was significantly correlated with the levels of albumin and hemoglobin in serum and the counts of neutrophils and lymphocytes ( P<0.001). Conclusions:Immune diseases and immunodeficiency can affect mitogen response. Therefore, clinicians should give attention to mitogen response in the interpretation of IGRA test results to prevent misdiagnosis and underdiagnosis. Besides, to a certain extent, mitogen response can reflect the infection status of hospitalized patients.