摘要
BACKGROUND:Internal tension-reduction technique is to reconstruct the anterior cruciate ligament through high-strength suture system combined with tendon.It can effectively reduce graft relaxation and frets by sharing the internal load of the knee joint,and has achieved good biomechanical results and clinical efficacy.However,whether it can reduce cartilage degeneration after anterior cruciate ligament reconstruction through stress sharing reduction has not been studied. OBJECTIVE:To investigate the effect of internal tension-reduction technique on articular cartilage degeneration in southern Yunnan small-ear pigs undergoing anterior cruciate ligament reconstruction. METHODS:Ten adult female Yunnan small-ear pigs were selected,and the ipsilateral knee Achilles tendon was taken from the left knee joint for anterior cruciate ligament reconstruction(normal group,n=10),and the ipsilateral knee Achilles tendon from the right knee joint combined with internal tension-reduction and augmentation system for anterior cruciate ligament reconstruction(tension-reduction group,n=10).One year after surgery,the experimental pigs were sacrificed,and the left and right knee cartilage was taken for hematoxylin-eosin staining,Safranin O-fast green staining,Osteoarthritis Research Society International scoring,and immunohistochemistry staining of type Ⅱ collagen,interleukin-1β,and tumor necrosis factor-alpha in the cartilage. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that in the tension-reduction group,there were mild pathologic changes of osteoarthritis,with a low number of empty bone lacunae and no obvious pathological changes such as fibrosis or cell layer breakage;in the normal group,more severe cartilage damage,with an increased number of empty bone lacunae,loss of chondrocytes near the bone and even the formation of fissures.Safranin O-fast green staining indicated that the tension-reduction group had normal cartilage tissue thickness,flat cartilage surface,a neat cell arrangement in a polar pattern,and no swelling or apoptosis,while in the normal group,the thickness of cartilage tissue was obviously thinner,the cell arrangement was disordered with no polarity,the number of cells was reduced,obvious cartilage fractures and cartilage vacuoles formed,and the absence of cells near the central bone was obvious.The Osteoarthritis Research Society International score was significantly lower in the tension-reduction group than in the normal group(P＜0.05).Immunohistochemical findings showed that the protein expression of type Ⅱ collagen in cartilage tissue of the tension-reducing group was higher than that of the normal group(P＜0.05),and the protein expression of interleukin 1β and tumor necrosis factor ɑ in cartilage tissue was lower than that of normal group(P＜0.05).To conclude,internal tension-reduction technique can delay the degeneration of articular cartilage in Yunnan small-eared pigs following anterior cruciate ligament reconstruction.
摘要
Objective To study the efficacy and safety of bronchial artery embolization(BAE)with tris-acryl gelatin microspheres(TAGM)combined with platinum spring coil with fiber(microcoils)in the treatment of acute severe hemoptysis caused by bronchiectasis.Methods A retrospective analysis of 48 patients with bronchiectasis was performed.After the lesion vessels were confirmed by angiography,the distal capillary bed was embolized with TAGM(300-500 μm),the middle blood flow was embolized with microcoils according to the diameter of the small artery,and then the proximal vessels were embolized with TAGM(500-700 μm)again.In patients with pulmonary artery/vein fistula,appropriate TAGM(500-700 μm)was selected according to the size of the fistula and the blood flow velocity,followed by dense embolization with multiple microcoils.The complete occlusion of the lesion vessel was confirmed again by arteriography after embolization.Results The overall success rate of operation was 95.83％.There were 36 patients with immediately stopped bleeding,6 cases with effective treatment,4 cases with improved treatment,1 case with invalid treatment due to the leakage of the responsible blood vessel,which was improved after the second embolization.There was 1 case died in surgery due to sudden massive hemoptysis,choking and suffocation.During the 3-51 months follow-up,1 patient died due to sudden massive hemoptysis;4 patients had recurrent hemoptysis due to poor control of infection and collateral circulation,which were controlled after reemboliza-tion,and 1 patient with bronchiectasis and pulmonary tuberculosis had repeated hemoptysis caused by multiple pulmonary lesions and severe pulmonary infection,performing on four times embolization.There was no patient with recurrent hemoptysis occurring recanalization of primary embolized vessel.During the follow-up,the overall survival rate was 97.87％,and the hemoptysis control rate was 87.23％.Conclusion TAGM combined with microcoils is safe and effective in the treatment of acute massive hemoptysis,which has good short-term effect and long-term prognosis.