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Objective:To compare the location and efficacy of femoral tunnel near-isometric reconstruction of anterior cruciate ligament (ACL) between the transtibial and assisted medial approaches.Methods:The clinical data of 47 patients were retrospectively analyzed who had been admitted by Department of Orthopaedics, The 904 Hospital of PLA for ACL rupture from January 2018 to December 2019. They were divided into 2 groups according to different surgical approaches. In groups A of 21 cases, there were 15 males and 6 females with an age of (29.5 ± 4.8) years and their ACL was reconstructed through the transtibial approach with adjustable Endobutton plate; in group B of 26 cases, there were 18 males and 8 females with an age of (31.2 ± 9.6) years and their ACL was reconstructed through the assisted medial approach with adjustable Endobutton plate. The 2 groups were compared in terms of location of femoral tunnel, Lysholm score and International Knee Documentation Committee (IKDC) score at the last follow-up, and anterior-posterior and rotational stability of the knee joint.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The 47 patients were followed up for 18 to 27 months (average, 22.3 months). As for the center of the inner opening of the femoral tunnel located by the four grid table method, the X-axis loci was 25.6% ± 2.5% and 26.7% ± 1.8% respectively in groups A and B, showing no statistically significant difference ( P>0.05) while the Y-axis loci 19.8% ± 2.0% and 30.6% ± 1.5% respectively in groups A and B, showing a statistically significant difference ( P<0.05). At the last follow-up, the lyholm scores were 90.9 ± 3.4 and 92.4 ± 3.9 and the IKDC scores 89.9 ± 3.5 and 90.2 ± 3.8 respectively in groups A and B, showing no significant difference between the 2 groups ( P>0.05). There was no significant difference either in the results of front drawer test, Lachman test or axial displacement test between the 2 groups ( P>0.05). Conclusion:In femoral tunnel near-isometric reconstruction of ACL, the transtibial approach can result in a tunnel location which is closer to the top of the condyle than the assisted medial approach, but both approaches can lead to satisfactory curative efficacy in the short postoperative period.
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Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.
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Objective@#To explore the effect of microRNA-21 (miR-21) on myocardial fibrosis in mice with chronic viral myocarditis (CVMC) and related mechanisms.@*Methods@#Forty 4-week-old Balb/c male mice were randomly divided into 4 groups (n=10 each): phosphate buffer saline (PBS) group, CVMC group, CVMC+miR-21 inhibitor group, CVMC+isotype control group. The first injection of Coxsackie virus B3 (CVB3) or PBS was performed on day 0, and the total study time was 42 days. Each mouse in CVMC group, CVMC+miR-21 inhibitor group and CVMC+isotype control group was intraperitoneally (i.p) injected with 100TCID50 CVB3 0.1, 0.15, and 0.2 ml on day 0, 14, and 28, respectively. The mice in PBS group were i.p injected with the same dose of PBS at the same time point. After the initial infection, each mouse in CVMC+miR-21 inhibitor group and CVMC+isotype control group was intravenously injected with 0.1 ml miR-21 inhibitor or 0.1 ml isotype control, on day 14 and 28. Cardiac function was measured on surviving mice of 4 groups by echocardiography on day 42. Then, the hearts were removed aseptically to observe the expressions of green fluorescence protein (GFP). The myocardial pathological changes were examined with HE, Masson staining and the myocardial pathological scores (PS), the collagen volume fraction (CVF) were calculated respectively. The levels of miR-21, collagen typeⅠ-A1 (COL1-A1) and collagen type Ⅲ-A1 (COL3-A1) mRNA in heart were detected by quantitative real-time polymerase chain reaction (RT-qPCR). Furthermore, the expressions of transforming growth factor-β1 (TGF-β1) and mothers against decapentaplegic homolog 7(Smad7) in heart were determined with Western blot assay.@*Results@#(1) Cardiac function in 4 groups: Compared with PBS group, left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) were markedly increased in CVMC group and CVMC+isotype control group (all P<0.05), whereas the left ventricular ejection fraction (LVEF) was decreased (P<0.05). LVESD and LVEDD were significantly decreased, and LVEF was increased in CVMC+miR-21 inhibitor group compared with those in CVMC group and CVMC+isotype control group (all P<0.05). (2) Myocardial pathological changes: The expressions of GFP in CVMC+miR-21 inhibitor group and CVMC+isotype control group were visible in heart tissues frozen sections. The hearts in CVMC group and CVMC+isotype control group were enlarged and stiff, inflammatory cells were visible and significantly increased myocardial fibrosis was evidenced in mice of these two groups. Higher PS and CVF were evidenced in CVMC group (PS: 1.14±0.69 vs. 0, CVF: (17.86±2.61)% vs. (5.70±1.42)%, all P<0.05) and CVMC+isotype control group(PS: 1.00±0.63 vs. 0, CVF: (16.78±2.58)% vs. (5.70±1.42)%, all P<0.05) compared to PBS group. Compared with CVMC group and CVMC+isotype control group, degree of cardiac fibrosis was reduced in mice of CVMC+miR-21 inhibitor group (CVF: (11.01±2.55)% vs. (17.86±2.61)%, (11.01±2.55)% vs. (16.78±2.58)%, all P<0.05), whereas PS were similar between them (PS: 0.89±0.60 vs. 1.14±0.69, 0.89±0.60 vs. 1.00±0.63, all P>0.05). (3) Cardiac expressions of miR-21, COL1-A1 and COL3-A1 mRNA: The cardiac expressions of miR-21, COL1-A1 mRNA, COL3-A1mRNA in CVMC group and CVMC+isotype control group were markedly higher than those in PBS group (all P<0.05), which were significantly downregulated in CVMC+miR-21 inhibitor group (all P<0.05 vs. CVMC group and CVMC+isotype control group). (4) The cardiac expressions of TGF-β1 and Smad7 protein: The cardiac expressions of TGF-β1 protein in CVMC group and CVMC+isotype control group were markedly higher, whereas the cardiac Smad7 protein expressions were significantly lower (all P<0.05) than those in PBS group (all P<0.05), these changes could be reversed in CVMC+miR-21 inhibitor group (P<0.05 vs. CVMC group and CVMC+isotype control group).@*Conclusions@#Our results suggest that miR-21 contributes to the myocardial fibrosis in CVMC mice through modulating TGF-β1/Smad7 signaling pathway.
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Objective:To investigate the expressions of Th 1-Th2-Th17 cytokines in the coxsackievirus B 3-induced mice chronic viral myocarditis(VMC).Methods:BALB/c mice were intraperitoneally(i.p) infected with increased CVB3 for establishing chronic VMC models.Control mice were treated with phosphate-buffered saline(PBS)i.p.Cardiac tissues were obtained 8 weeks after CVB3 in-jection,myocardial histopathologic changes were observed by HE and Masson staining .Th1-Th2-Th17 cytokines in plasma were detected by protein array technology , and their cardiac mRNA expressions were measured by RT-PCR.Results: Compared with the control group,levels of IL-2,IL-5,IL-10,IL-13,IL-17,IL-6,IL-22,IL-21 and TGF-βobviously increased in chronic VMC group (P all<0.05). Conclusion:The imbalance of Th1-Th2-Th17 cytokines may play an important roles in the pathogenesis of chronic VMC .
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Objective To explore the correlation between CD4+CD29+T cells and the pathological typing and staging for patients with primary pulmonary carcinoma. Methods Flow cytometry was used to detect peripheral blood CD4+CD29+T cells, gamma interferon (IFN-γ) and tumor necrosis factor alpha (TNF-α) of 60 patients with lung cancer. The relationships between them and the pathological typing and staging were studied. Results (1) The CD4+CD29+T cellsand TNF-α percentages in thecancer patients were significantly higher than those of the control group (P 0.65, P < 0.05). Conclusion Theincreased CD4+CD29+T cells and TNF-α, together with decreased IFN-γ arehighly indicative of immunological characteristics of lung cancer , and closely related to the pathological typing and staging.
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Objective To explore the susceptibility differences of ventricular arrhythmia (VA ) in SHR rats with/without left ventricular hypertrophy(LVH) and the significance .Methods The experiments were performed on isolated hearts of 8‐week(the non‐LVH control group ,n=12) ,16 week‐old SHR(the LVH group ,n=12) and age‐matched Wistar Kyoto rats(Wistar ,the blank control group ,n=12) ,which were perfused in Langendorff mode with oxygenated Krebs‐Henseleit solution followed by a K+‐defi‐cient solution .The epicardial electrocardiogram was continuously monitored during all experiments .HE staining and collagen vol‐ume fraction(CVF)was used to evaluate the condition of LVH .Results Compared with the non‐LVH control group and the blank control group ,the low K+ induced ventricular arrhythmia occurred earlier with increased incidences and duration in the hearts of the LVH Group ,the incidences of ventricular tachycardia(VT) ,transient ventricular fibrillation(TVF) ,sustained ventricular fibrillation (SVF) and CVF were higher in the hearts of the LVH Group(P<0 .05) ,myocardial cell hypertrophy and myocardial cells intersti‐tial increased .Conclusion The ventricular arrhythmia occurred earlier with increased incidences and duration in the LVH tissue of SHR rats ,which implies that LVH is associated with VA .
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<p><b>OBJECTIVE</b>Interleukin-27 (IL-27) has been reported to reduce the levels of interleukin-17 (IL-17) and alleviate the severity of experimental autoimmune myocarditis. IL-17, an important tissue-protective cytokine in viral myocarditis (VMC), has been reported to increase synovial expression of IL-27 in rheumatoid arthritis. However, the influence of IL-17 on IL-27 expression in murine model of VMC remains unknown.</p><p><b>METHODS</b>Wild-type (WT) and IL-17A-deficient (IL-17A(-/-)) mice on the BALB/c background were intraperitoneally (i.p) injected with coxsackievirus B3 (CVB3) for establishing VMC models. Cardiac tissue was obtained on day 7 after CVB3 injection. Myocardial histopathologic changes were observed by hematoxylin-eosin (HE) stained myocardial sections.Expression of IL-27 in heart and serum was measured by real-time reverse transcription-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA), respectively. Furthermore, splenic lymphocytes and peritoneal macrophages were purified 1 week after injection from WT mice.Isolated lymphocytes were cultured in the presence of different concentrations (0 and 25 ng/ml) of recombinant IL-17 (rIL-17) for 24 h. Macrophages were cultured with different concentrations of rIL-17 (0 and 10 ng/ml) for 48 h.IL-27 mRNA expression of cultured cells was assayed by RT-PCR, and their protein level in the culture supernatant was measured by ELISA.</p><p><b>RESULTS</b>Compared with WT mice, significantly less cardiac inflammation was evidenced in the heart of IL-17A-/- mice (0.9 ± 0.3 vs.1.9 ± 0.5) , relative cardiac IL-27 p28 mRNA expressions (1.11 ± 0.24 vs.3.1 ± 0.8) and serum IL-27 protein[(72 ± 18) pg/ml vs.(95 ± 25) pg/ml] were also significantly lower in IL-17A-/- mice (all P < 0.05).In the culture lymphocytes, the relative mRNA (1.02 ± 0.13 vs.1.32 ± 0.21) and protein [(49 ± 9) pg/ml vs.(52 ± 11) pg/ml]expressions of IL-27 p28 and were similar post treatment with 0 and 25 ng/ml rIL-17 (all P > 0.05). Compared with 0 ng/ml rIL-17 culture with macrophages, higher relative mRNA (8.5 ± 3.1 vs.2.2 ± 0.7) and protein [(368 ± 95) pg/ml vs.(150 ± 38) pg/ml] expressions of IL-27 p28 were detected in 10 ng/ml rIL-17 group (all P < 0.05).</p><p><b>CONCLUSION</b>Our data indicates that cytokine IL-17 may contribute to the secretion of IL-27 in VMC mice.Furthermore, macrophages but not lymphocytes may be the important IL-27-producing immune cells and major target cells for IL-17. Thus,IL-27 and IL-17 might be actively involved in the pathogenesis of VMC.</p>
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Animals , Male , Mice , Coxsackievirus Infections , Allergy and Immunology , Metabolism , Disease Models, Animal , Interleukin-17 , Allergy and Immunology , Interleukin-27 , Metabolism , Macrophages , Metabolism , Mice, Inbred BALB C , Myocarditis , Allergy and Immunology , MetabolismABSTRACT
Objective To investigate the correlations between ambulatory arterial stiffness index and intracranial/extracranial arterial stenosis.Methods One hundred and twenty-eight cases of ischemic cerebrovascular disease were collected in our hospital from January 2010 to March 2012.Joint diagnosis of cranial computer tomography(TCD) and magnetic resonance angiography (MRA) and,or CT angiography (CTA) were used to detect the degree and number of intracranial arteries,and in accordance with the lesions level,patients were divided into stenosis group,the mild stenosis group,the moderate stenosis group and severe stenosis group.24 h ambulatory blood pressure was monitored and ambulatory arterial stiffness index (AASI) was calculated and statistically analyzed.Results (1) Age,sex,hypertension proportion of diabetes,body mass index(BMI) of different Intracranial arterial stenosis in four groups did not have significant differences (P ＞0.05),but in AASI the without stenosis group is 0.48 ± 0.15 ; the mild stenosis group 0.62 ± 0.16,the moderate stenosis group 0.61 ± 0.17,severe stenosis group 0.64 ± 0.15,and there was significant difference (F =3.955,P =0.001).(2) Age,sex,hypertension proportion of diabetes,BMI of different extracranial arterial stenosis in four groups did not have significant differences (P ＞ 0.05),but in AASI the without stenosis group was 0.48 ± 0.01 ; the mild stenosis group 0.57 ± 0.11,the moderate stenosis 0.59 ± 0.12,and severe group 0.60 ±0.15,and there was significant difference (F =3.643,P =0.002).In comparison between any two group:light,moderate and severe stenosis AASI were significantly higher than those without stenosis,and there was significant difference (P ＜ 0.05).And there was significant different in AASI among different intracranial and extracranial arterial lesions (F =7.395,P ＜ 0.001).Compared to 0 branch pathological changes,1 branch,2 branch,3 branch and above,there was was significant difference(P ＜ 0.05).Conclusion Based on a 24-hour ambulatory blood pressure monitoring indicators,AASI was mainly reflecting the impact of atherosclerosis on blood pressure,associated with intracranial and extracranial artery stenosis.AASI would play a major role in clinical diagnosis and treatment of ischemic cerebrovascular and forecast.
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Objective To observe the effect of telbivudine combined with adefuvir dipivoxil in the treatment of Hepatitis B patients with decompensated cirrhosis.Methods 56 Hepatitis B patients with decompensated cirrhosis were divided into two groups:treatment group (30 cases) and control group (26 cases).During 24 weeks,the control group received adefuvir dipivoxil( 10mg daily),supportive and symptomatic treatments,while the treatment group received telbivudine therapy(600mg daily) combiled with adefuvir dipivoxil ( 10mg daily) based on the regular treatments.After 24 weeks,the effect was observed and compared between the two groups.Results After treatment,the biochemical markers,Child-Pugh score of the treatment group was (33.2 ± 13.8) μmol/L,(44.5 ± 16.4) U/L,(36.1 ±1.5) g/L,(6.1 ± 1.8) points,respectively,and was better than those of the control group[ (71.8 ±18.6) μ mol/L,(89.9 ±44.9) U/L,(29.7 ± 1.3)g/L,(8.1 ±2.2) points] (t=15.32,15.20,23.37,6.09,all P＜0.05) ;HBV-DNA negative rate,HBeAg seroconversion rates of the treatment group was 93.3％ (28/30),43.3％(13/30),and was higher than that of the control group[76.9％ (20/26),7.6％ (2/26) ] (x2 =4.87,9.08,all P＜0.05).Conclusion Telbivudine combined with adefuvir dipivoxil was effective and safe for the treatment of Hepatitis B patients with decompensated cirrhosis.
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Objective To approach the effect on mechanical barricade of the mucous membrane of small intestine caused by non-steroidal anti-inflammatory drugs(NSAIDs).Methods Thirty-two male SD rats were randomly divided into control group and model group.The rats of the model group were given 7.5 mg/kg diclofenac by gavage,bid;the rats of the control group were given the same dose of saline.Then thev were further randomly divided into two subgroups(n=8)at the first day and the fifth day after making the models to observe the scores of anatomical lesion on stomach and small intestine and the scores of tissue damage of mucous membrane and to quantitatively analyze the height of villi,as well as the thickness and the section area of mucous membrane with Carl Zeiss Imaging Systems.Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission electron microscope.Results The mucous membrane of stomach of the model groups was slightly edematous.There was no difference between the scores of the model groups and control groups.It was seen that the mucous membrane of small intestine of the first day model group presented with erythema,anabrosis and ulcer.The ulcer was distributed along mesentery.The mucous membrane of small intestine of the fifth day model group showed bleeding,perforation and sinus tract formation,and the scores of anatomical lesion was higher than that of the control group(P＜0.05).The scroes of the lesions of the first and fifth day model groups were 3.5 and 5.0.The difference had statistical significance when compared with those of the control groups(the scores were O)(P＜0.05).Cell degeneration and cellular necrosis of epithelial mueosa of small intestine wag also seen in the first day model group.The top of villi was ablated.The height of the pile on jejunum was (126.9±32.0)μm and that on ileum wag(118.6±22.9)μm They were lower than those of the control group(P＜0.05).However there was no difference of the thickness and section area between them,but the thickness and section area showed a tendency of decrease.It was also seen that there were apomorphosis and sphacelism of epithelial cells in the fifth day model group.Some villi were ablated and laminae propna exposed.The height of villi on jejunum[(73.4±25.4)μm]and that on ileum[(109.3±17.6)μm]decreased significantiy.The thickness of mucous membrane[(123.8±51.6)μm and(165.7±37.4)μm]decreased alnd the section area[(2.48±1.01)mm2 and(3.27±0.76)mm2]became smaller(P＜0.05 vs control group).The mucous membrane of the villi on small intestine wag continuous but arranged disorderly.Cytochondriome swelled,endocytoplasmic reticulia expanded with different degrees,intercellular junction widened Dartly.The microviili in the fifth day model group were ablated more obviously and intercellular iunctions were broken and destroyed gravely.Conclusions Diclofenac can cause damage to the function of mucous membrane barricade of small intestine.It could also lead to shortening of the villi,thinning of the mucous membrane,ablation of the microvilli,and widening of the tight intercellular junction as the characteristic morphological change.
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lso.This result suggested that Th17 subset is differentiated in chronic stage of viral myocarditis.
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Objective To establish rat model of small intestinal damage by administrating low dose of diclofenac in short-term and to observe the preventive effect on non steroidal anti-inflammatory drugs (NSAIDs) induced small intestinal damage by metronidazole and rabeprazole.Methods Sixty-four rats were randomly divided into control,model,metronidazole and rabeprazole groups with 16 each.The rats in four groups were then further separated into acute stage (T1) and subacute stage (T2) groups.The rats were lavaged with metronidazole (50 mg/kg) and rabeprazole (15 mg/kg) before modeling.The rats in control,model,metronidazole and rabeprazole groups were lavaged with 1ml of distilled water, 7.5 mg/kg diclofenac,50 mg/kg of metronidazole plus 7.5mg/kg of diclofenac,15 mg/kg of rabeprazole plus 7.5mg/kg of diclofenac twice a day,respectively.The rats in T1 group were sacrificed on day 1 and T2 group on day 5.Results Administration of diclofenac induced multiple lesions in the small intestine, such as obviously erythema,erosion,ulcer and cystoid expansion.The lesions in T2 of model group was more seriously than that in T1 group(P＜0.05).And the lesions in model group was also more seriously than that in metronidazole and rabeprazole groups (both T1 and T2 groups,P < 0.05).Serum concentration of NO in T1 of model group was obviously lower than that in control group (P＜0.05),but it was higher in T2 of model group compare to the control group (P＜0.05).There were no significant difference among metronidazole,rabeprazole and model groups in serum level of NO (P>0.05). Conclusions The lesions of small intestinal can be induced by administration of diclofenac.The serum level of NO presents a tendency with decrease before increase afterwards.The metronidazole or rabeprazole has preventive effect on small intestinal lesions.
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Objective To investigate the molecular mechanisms for the development of cardiac hypertrophy in hypertension by scanning the expression profile of microRNA (miRNA) in the left ventricular hypertrophic tissue in spontaneously hypertensive rats(SHR)using miRNA microarray chip technique.Methods 17-week-old male SHR with left ventricle hypertrophy (LVH) (n=10) and 8-week-old male SHR without LVH were employed in this study (n=10).Left ventricular mass index (LVMI),HE staining and measurement of transverse diameter of myocardium (TDM) were used to evaluate LVH.The mRNAs of the two groups were extracted from left ventricle tissue and the differential expression of miRNA was detected by using miRNA microarray chip.Results LVMI and TDM were greater in rats with LVH vs without [LVMI(2.87?0.15)vs(2.17?0.14)mg/g;TDM(15.32?0.61)vs(12.01?0.43)?m,P
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OBJECTIVE:To observe the therapeutic effect of IF ?-2b plus compound glycyrrhizin on chronic hepatitis C. METHODS:56cases of chronic hepatitis C were divided into trial group(30cases)and control group(26cases).Trial group received IF ?-2b +compound glycyrrhizin and control group received IF ?-2b alone.The therapeutic course was24weeks in both groups.RESULTS:There was significant difference in recoversion rate of ALT between two groups either at the end of ther?apeutic course or24weeks after treatment(P
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AIM: To establish the Wistar rat model of furazolidone-induced dilated cardiomyopathy (Fz-DCM). METHODS: The Wistar rat model of Fz-DCM was established by feeding the animals with furazolidone. The left ventricular dimension and cardiac function were detected by echocardiogram. Aortic and right atrial pressure were measured by invasive catheter. Left ventricular interior diameter and the thickness of left ventricular free wall were measured after the rats were killed. Myocardial collagen network remodeling was observed and collagen volume fraction (CVF) was calculated by Van Gieson stain. RESULTS: ①The total incidence rate of DCM was 66.6% (20/30) in DCM group. ②Compared the corresponding subgroups to control group, the left ventricular end-diastolic diameter (LVED), left ventricular end-systolic diameter (LVES), the right atrial pressure, the left ventricular interior diameter and the ratio of left ventricle weight and body weight were increased significantly. The fraction shortening (FS), the left ventricular ejection fraction (LVEF) and the thickness of left ventricular free wall were decreased significantly. ③In FZ-DCM rat, the myocyte hypertrophy and degeneration, interistial fibrous tissue hyperplasia, the quantity of typeⅠand type Ⅲ collagen fibers and the collagen volume fraction (CVF%) were increased significantly. CONCLUSIONS: The rat model of DCM can be induced successfully by feeding the animals with furazolidone. In the rats with Fz-DCM, there are left ventricular dilation, the thinness of ventricular wall, the interistial fibrous tissue hyperplasia, and the decrease in left ventricular contractic function, indicating that the Fz-DCM rat model represents the pathophysiological characters of dilated cardiomyopathy.
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To advocate cadaver donation is to advocate the spirit of devotion and scientific research.It has been proved in the development of modern medicine that many problems of medical education and stubborn diseases were solved by necrospy.However,currently the cadavers donated cannot satisfy practical need,mainly because that few people would voluntarily register to donate their bodies,and those among the registered who actually donated are even fewer.This paper analyzes three factors that contribute to the bottleneck in the cadaver donation.And on the basis of present situation,countermeasures are presented to solve the problems.