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Objective:To compare the clinical efficacy of robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures.Methods:China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Medical Journal Full-text Database, PubMed, Web of Science and ScienceDirect were searched for literature on robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures. The search time was from the establishment of each database to March 2023. Meta-analysis was performed on the included literature. The random-effects model was used when the heterogeneity between groups was large, and the fixed-effects model was used when the heterogeneity between groups was small.Results:A total of 15 studies were included in the meta-analysis, including 465 patients in the robot-assisted group and 396 patients in the fluoroscopy-assisted group. Meta-analysis showed that the number of fluoroscopies [ SMD=-3.12, 95% CI (-4.34, -1.89), P<0.001], the number of guide pin adjustments [ SMD=-3.75, 95% CI (-6.77, -0.72), P=0.015], intraoperative blood loss [ SMD=-0.83, 95% CI (-1.18, -0.49), P<0.001], and operative time [ SMD=-2.59, 95% CI (-4.11, -1.08), P<0.001] were smaller than those in the fluoroscopy-assisted group. The rate of excellent screw implantation [ OR=10.13, 95% CI (3.67,27.98), P<0.001] of the robot-assisted was larger than the fluoroscopy-assisted group. There was no significant difference in Majeed functional score [ SMD=0.28, 95% CI (-0.0003, 0.55), P=0.050] and fracture healing time [ SMD=-0.14, 95% CI (-0.46, 0.17), P=0.367] between the two groups. Conclusion:Robot-assisted percutaneous sacroiliac screw fixation for posterior pelvic ring fractures has the advantages of less fluoroscopy, less guide pin adjustment, less intraoperative blood loss, shorter operation time, and higher rate of excellent screw position. However, there is no difference in Majeed score and fracture healing time between robot-assisted percutaneous sacroiliac screw fixation and fluoroscopy-assisted percutaneous sacroiliac screw fixation.
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Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.
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OBJECTIVE@#To assess the association between myeloperoxidase (MPO) gene polymorphism and coronary artery disease (CAD).@*METHODS@#Several databases were used to retrieve relevant literature up to March 2013 by keywords. A Meta-analysis was performed by Stata12.0 software to estimate the pooled odds ratio (OR) and the 95% confidence interval (CI). Heterogeneity among studies was tested and sensitivity analysis was applied. Publication bias was examined using Begg's funnel plot and Egger's linear regression test.@*RESULTS@#A total of 17 studies were included in this Meta-analysis. For MPO -463 G/A polymorphism, the pooled OR of A allele vs G allele was 0.58 [95% CI (0.47-0.72)] and the pooled OR of genotypes AA+AG vs GG was 0.58 [95% CI (0.46-0.72)]. In subgroup analysis of study population, AA and AG genotypes were significantly associated with CAD in Asians but not in Europeans. The MPO -463 G/A polymorphism in the stable angina pectoris subgroup was evaluated in 3 studies and the pooled OR of A allele vs G allele and genotypes AA+AG vs GG for proven CAD was 0.45 [95% CI (0.15-1.37)] and 0.57 [95% CI (0.19- 1.65)]. For MPO -129 A/G gene polymorphism, the pooled OR of genotype GG vs AA+AG was 0.91 [95% CI (0.74-1.10)].@*CONCLUSION@#A allele of MPO -463 G/A gene is associated with decreased risk of CAD except in the Europeans. There is no association between MPO -129 A/G gene polymorphisms and CAD risk.
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Humans , Alleles , Asian People , Coronary Artery Disease , Genetics , White People , Genetic Predisposition to Disease , Genotype , Odds Ratio , Peroxidase , Genetics , Polymorphism, Single NucleotideABSTRACT
Objective A link between homocysteine (Hcy) and left ventricular ejection fraction(LVEF) emerged from re-cent studies but was yet not explored specifically in type 2 diabetic patients. This study aimed to assess the relationship between LVEF and Hcy in type 2 diabetic patients. Methods A total of 72 type 2 diabetic patients were selected for this study and were divided into two groups (40 examples with coronary heart disease, 32 examples without coronary heart disease) javascript:Serum Hcy,glycosylated hemoglobin,cholesterol(TC) and triglyceride(TG) were analyzed.LVEF was assessed by echocardiography. Results There was no difference in systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin,total cholesterol and triglyceride in two groups of patients (P>0.05);The serum Hcy was obvi-ously higher in type 2 diabetic patients with coronary heart disease compared to those without (P<0.05);Factors signifi-cantly associated with a LVEF<55%were serum Hcy OR=1.211(95%CI 1.041~1.408) in type 2 diabetic patients with coronary heart disease.The serum Hcy had significant negatively correlation with LVEF (r=-0.706,P=0.000) in type 2 diabetic patients with coronary heart disease. Conclusion This study highlights an inverse relationship between Hcy and LVEF in type 2 diabetic patients with coronary artery disease.The serum Hcy is a risk factor associated with a LVEF<55%.
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OBJECTIVE@#To purify and identify HMGB1 secreted by liver cells HepG2 and immune cells U937.@*METHODS@#We cultured the liver cell lines HepG2 and immune cell lines U937, and stimulated them with HMGB1 (400 ng/mL) for 20 h. Then the supernatant was collected. Ultrafiltration centrifugation, CM-Sepharose cation, DEAE-Sepharose anion exchange chromatography, Sephadex G75-gel filtration chromatography, and immunoprecipitation were used for purification. The molecular weight and identity of HMGB1 was confirmed by SDS-PAGE and Western blot.@*RESULTS@#A sharp stained protein band with a molecular weight of about 26 kD was obtained by SDS-PAGE analysis and shown to be HMGB1 confirmed by Western blot.@*CONCLUSION@#High purified HMGB1 can be separated from these two cell lines.
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Humans , Cell Culture Techniques , Electrophoresis, Polyacrylamide Gel , Methods , HMGB1 Protein , Metabolism , Hep G2 Cells , Hepatocytes , Metabolism , Monocytes , Metabolism , U937 CellsABSTRACT
Objective To study the role of peripheral blood T regulatory cells (Treg) markers, as well as different Treg cells in the pathogenesis of systemic lupus erythematosus (SLE) and explore the correla-tion betweenCD127 and Foxp3. The immunosuppressive effect of CD4~+CD25~+CD127~(low/-) T cell is explored. Methods ①Four-color direct fluorescence-labeled and multi-parameter flow cytometry were used to detect peripheral blood CD4~+CD25~+ T cells and other Treg cells accounted for the proportion of CD4~+ T cells in 40 SLE patients (19 cases with active disease 21 cases in remission) and 15 healthy controls. Meanwhile, its correlations with anti-dsDNA antibodies among 7 groups were analyzed.②Flow cytometry sorting combined with cell culture were applied to detect and analyze the proliferation inhibition effect of CD4~+CD25~+CD127~(low/-)regulatory T cells to CD4~+CD25~-effector T cell.Two independent samples t test,ANOVA for repeated measures,Pearson's correlation and Spearman's correlation were used for statistical analysis.Results ①The cell ratio of the 7 groups of SLE patients was(6.1±1.7)%,(3.1±1.3)%,(2.1±1.0)%,(1.6±0.3)%(0.97±O.28)%,(0.69±0.23)%and(O.71±0.35)%respectively.In the SLE group,the proportion of the first 6 groups was lower than the control group (P<0.05).For CD4~+CD127~(low/-)Foxp3~+,there wag no difference in the two groups(P>O.05).②CD4~+CD25~+Foxp3~+,CD4~+CD25~(high)Foxp3~+ T cells and IgA ratio Was positivelv correlated.While CD4~+CD25~(high)CD127~(low/-) T cells and anti-SSB antibodies was positively correlated in SLE patients.③The seven group of cells,in addition to CD4~+CDl27~(low/-)Foxp3~+ T cell ratio were lower in early-onset SLE patients than those in patients at remission(P<0.05).④The cell propor-tion of the first 6 groups was lower than that of post steroid treatment(P<0.05).⑤Foxp3 expression of CD4~+CD25~+T ceils and CD4~+CD25~(high) T cells was positively correlated with low expression of CDl27 in the early onset group,remission group and the control group.⑥The CD4~+CD25~- effect T cells could be suppressed by their own CD4~+CD25~+CDl27~(low/-) regulatonry T cells in vitro,and the inhibition of SLE patients was significantly lower than controls.Conclusion The immunological abnormality of SLE may be associated with the qnatity and functional defects of immune regulatory T cells.CDl27 may be a possible alternative to Foxp3 regulatory T cell-specific surface markers.
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Objective To investigate the expression of regulatory T cells in the peripheral blood of rheumatoid arthritis patients and to explore the possibility of using CD127 instead of FOXP3 in the study of regulatory T cells. Methods Thirty-two patients with active rheumatoid arthritis (RA) [ including 20 patients who hadn't been treated with disease modifying antirheumatic drugs (DMARDs) and 12 patients whose disease were poorly improved after DMARDs therapy], 25 patients with primary Sjogren's syndrome (pSS) and 24 healthy controls were selected. The percentages of CD4+CD25high, CD4+CD25+CD127low/'- and CD4+CD25+ FOXP3+T cells were analyzed by 3-color flow cytometry. Meanwhile, the levels of CRP, ESR, immunoglobulin and complement were measured. Results Percentages of CD4+CD25+CD127low/-T cells and CD4+CD25+FOXP3+ T cells in RA patients were significantly lower than those of healthy controls (P<0.01 for each category of T cells),but the percentage of CD4+CD25high T cells didn't show significant changes (P>0.05). The expression of CD4+CD25+CD127ow/- and CD4+CD25+FOXP3+T cells showed no difference between RA and pSS patients (P> 0.05 for each). Differences of the three group cells between untreated RA patients and poorly-improved RA patients were not significant (P>0.05 for each case). CD4+CD25+CD127low/-T cells were positively associated with CD4+CD25+FOXP3+T cells (r=0.698, P=0.001), but the two groups had no correlation with the levels of CRP, ESR and anti-CCP antibody and RF (P>0.05 for each case). Conclusion The percentage of CD4+CD25+CD127low/-T cells is decreased in the peripheral blood of active RA patients and positively correlates with CD4+CD25+FOXP3+T cells.It suggests that CD127 may be an ahemative marker of FOXP3 in the study of Treg cells.
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Objective To study the expressions of Toll-like receptor 9 protein (TLR9) in peripheral B and T lymphocytes in newly diagnosed, untreated patients with systemic lupus erythematosus (SLE) and their relationship with clinical parameters. Methods Blood samples were obtained from 35 newly diag-nosed, untreated patients with SLE and 16 healthy human controls. B, T lymphocytes and TLR9 protein were labeled with fluorescent antibodies, and the expressions of TLR9 protein were detected by flow cytometry in peripheral B and T lymphocytes. The relationship between TLR9 expression and clinical parameters was assessed. Results The proportions of B and T lymphocytes expressing TLR9 in newly diagnosed, untreated patients were (53.94±17.95)% and (49.33 ± 23.30)%, respectively, compared to (29.40 ± 10.54)% and (29.18 ± 14.78)%, respectively, in healthy controls (t = 6.11,3.73, respectively, both P < 0.01). Additionally,the proportion of B lymphocytes expressing TLR9 correlated negatively with SLE disease activity index (SLEDAI)(r = -0.39, P < 0.05), but positively with the level of serum IgA antibody (r = 0.74, P < 0.01).Condnsions The expression of TLR9 is elevated in peripheral T and B lymphocytes from patients with newly diagnosed, untreated SLE, and the proportion of TLR9-expressing B lymphocytes negatively correlates with SLEDAI, but positively correlates with the serum level of IgA antibody.
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Objective To evaluate the clinical significance of multi - tumor markers combined detection in patients with idiopathic pulmonary fibrosis. Methods The serum levels of alpha fetoprotein (AFP) , careinoembryonic antigen (CEA), cancer antigen 125 (CA125) ,carbohydrate antigen 153(CA153) .carbohydrate antigen 199(CA199) were determined in 27 patients of idiopathic pulmonary fibrosis and 24 healthy volunteers. At the same time,the clinical indicators, such as lung function,were also measured in 27 patients. Results In comparison to control group, the serum levels of AFP, CEA,CA125 , CA153, CA199 were obviously lower than those in control group(P0.05). Conclusion Tumor markers,CA199 in particular,reflect the severity and poor prognosis of IPF patients and may also indicate the progression of pulmonary fibrosis, but they have nothing to do with disease activity.