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BACKGROUND:In recent years,computer-assisted navigation has gradually attracted attention in the medical field.Some scholars have reported that the clinical effects of computer navigation in total knee arthroplasty vary.To explore the clinical effect of the new generation of Brainlab Knee 3 navigation system,this study is conducted. OBJECTIVE:To analyze the application effect of computer navigation system(Brainlab Knee 3)combined with gap balance technology in total knee arthroplasty. METHODS:A total of 71 patients received total knee arthroplasty at the Department of Joint Surgery of Dalian Second People's Hospital from November 2020 to May 2021.In the navigation group,35 patients underwent total knee arthroplasty by computer navigation combined with gap balance.In the traditional group,36 patients underwent osteotomy with traditional surgical instruments.The difference between medial and lateral joint spaces,knee range of motion,hospital for special surgery knee score,hip-knee-ankle angle,deviation values of coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle were compared between the two groups. RESULTS AND CONCLUSION:(1)In the navigation group,the differences of intraoperative medial and lateral joint gap at knee extension 0,1,and 2 mm were found in 19,14,and 2 cases,respectively.The gap difference was 0 mm in 18 cases,1 mm in 15 cases and 2 mm in 2 cases at 90° degree knee flexion.In the traditional group,the gap difference at knee extention was 0 mm in 10 cases,1 mm in 20 cases,and 2 mm in 6 cases.The gap difference at 90 degree knee flexion was 0 mm in 10 cases,1 mm in 15 cases and 2 mm in 8 cases.(2)The operation time in the navigation group was longer than that in the traditional group(P<0.05),and two patients in the navigation group developed lower limb intermuscular vein thrombosis after surgery,and none of the patients in the traditional group had complications.(3)The range of motion between the two groups increased significantly at 6 and 12 months after surgery,and the range of motion in the navigation group was higher than that in the traditional group(P<0.05).(4)At 12 months after surgery,the hospital for special surgery knee scores of both groups increased significantly,and the hospital for special surgery knee score in the navigation group was higher than that in the traditional group(P<0.05).(5)At 6 months after surgery,the deviation values of hip-knee-ankle angle,coronal femoral component angle,coronal tibial component angle,and sagittal tibial component angle of navigation group were significantly lower than those in the traditional group(P<0.05).(6)The results showed that computer navigation technique combined with gap balance in total knee arthroplasty had advantages in postoperative range of motion,lower limb alignment and the accuracy of tibial prosthesis component position,and joint function recovered well.
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BACKGROUND:Percutaneous kyphoplasty is the main treatment for senile osteoporotic thoracolumbar fractures, but increasing number of patients who have not been treated with anti-osteoporosis therapy after operation develop secondary fractures due to decreased bone mineral density and changes of stress. OBJECTIVE:To investigate the feasibility of consecutive 2-year zoledronic acid treatment following percutaneous kyphoplasty for preventing secondary vertebral fracture. METHODS: 186 elderly patients with thoracolumbar compressive fractures were divided into experimental (n=84) and control (n=102) groups based on their willingness to receive zoledronic acid treatment or not after percutaneous kyphoplasty. The experimental group was treated with calcium and alfacalcidol fololwed by 2 years of zoledronic acid treatment, while only calcium and alfacalcidol treatment was done in the control group. The bone mineral density, pain and function were respectively assessed by dual energy X-ray absorptiometry, visual analogue scale and Oswestry disability index, and the number of refractures was calculated at baseline and at the 2nd year after the second injection of zoledronic acid. RESULTS AND CONCLUSION:The bone mineral density, visual analogue scale and Oswestry disability index scores at 2 years after treatment in both two groups were significantly superior to those at baseline (P < 0.05). The number of refractures in the experimental group (n=1) was significantly less than that in the control group (n=9) (P < 0.05). These results suggest that zoledronic acid can prevent secondary fractures after percutaneous kyphoplasty in the elderly with osteoporotic thoracolumbar fractures, improve long-term function and clinical effectiveness.
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Objective To detect the correlation between the periodontal bone loss and carotid calcifications by using MSCT.Methods Imaging materials of 270 patients who were suspected atherosclerosis and underwent MSCT were retrospectively studied.According to the score of carotid calcification,the patients were divided into three groups:slight calcification group (carotid calcification score <100),severe calcification group (carotid calcification score ≥100),and normal control group (carotid calcification score=0).The original images were post-processed with volume rendering(VR),multi planar reformation(MPR),curved planar reformation(CPR)and maximum intensity projection (MIP)by using EBW4.5 workstation,and then the residual teeth number and the periodontal bone loss teeth were recorded in different groups.Results On MSCT,the carotid calcification score and the number of periodontal bone loss were displayed clearly.The number of the periodontal bone loss teeth in the calcification groups were significantly higher than those in the normal control group(P<0.01).Furthermore,the number of the periodontal bone loss teeth was positively correlated with the severity of carotid calcification.Conclusion The periodontal bone loss is highly correlated with the severity of the carotid calcification.The volume reconstruction technique of MSCT is a non-invasive diagnostic testing to detect the periodontal desease and to quantify carotid calcifications.
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Objective To evaluate the diagnostic performance of the histogram analysis of mono-exponential and intravoxel incoherent motion(IVIM) models to the dualistic model of epithelial ovarian cancer(EOC). Methods Forty female patients with histopathologically proven epithelial ovarian cancer underwent preoperative MR examination. Scanning sequences included conventional imaging, diffusion-weighted magnetic resonance imaging with 11 b values (0, 30, 50, 100, 150, 200, 400, 600, 800, 1 000, 1 500 s/mm2) and dynamic contrast enhanced MRI (DCE-MRI). Based on the dualistic model of EOC, all patients were divided into two groups:typeⅠ(low grade, n=16) and typeⅡ(high grade, n=24). ADC, D, D*and f maps and their corresponding histograms were generated by post-processing software. Based on an entire-tumour measurement, the following histogram parameters were recorded, respectively: (a) Mean; (b) the 10th percentile (10th);(c) the mean of the top 10 percent (MeanL);(d) the 90th percentile (90th);(e) the mean of the bottom 10 percent (MeanR). Two types were compared using independent sample t test or Mann-Whitney U test. And areas under ROC curve between two groups were assessed. Results For ADC , D, and f, all indices(Mean,10th,MeanL,90th,MeanR) of the histogram were significantly lower in typeⅡthan in type Ⅰ(P0.05). D demonstrated a comparable accuracy with ADC in differentiating the grade of EOC (area under curve: Mean, 0.898 vs. 0.893; 10th, 0.880 vs. 0.846; MeanL, 0.878 vs. 0.858; 90th, 0.895 vs. 0.839; MeanR, 0.872 vs. 0.814), and both ADC and D have better performance than f. Conclusion It is feasible to stratify the grade of EOC by mono-exponential and IVIM models with histogram metrics,diagnositic efficiency of ADC and D values are higher.
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Objective To investigate the role of silent mating type information regulation 2 homologue 1(SIRT1) in renal ischemia-reperfusion(IR) injury and its effect on NF-κBp65-peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1α) signal pathway in mice.Methods Seventy-two healthy C57BL/6 male mice were randomly divided into four groups:control group(n=18),sham-operated group(n=18),IR group(n=18),resveratrol group(n=18).Bilateral renal pedicle were clamped for 45 min was adopted to establish the model of acute ischemic renal injury,to give 2% dimethyl sulfoxide or resveratrol by intraperitoneal injection for 7 days before modeling.Determination techniques included routine biochemical methods for the the levels of Scr and BUN,spectrophotometry for the level of superoxide dismutase (SOD),HE staining for the histological changes as well as immunohistochemical method and Western blotting for the expressions of SIRT1,NF-κBp65 and PGC-1α,respectively.Results Compared with that in control and sham-operated groups,the levels of serum Scr and BUN were higher and SOD levels in renal tissues were lower at 12 h and 24 h after operation in IR groups(P < 0.05).HE staining revealed evident pathological lesions including necrosis of renal tubular epithelial cells in IR group.Compared with that in IR group,resveratrol attenuated the above-mentioned changes.Western blotting revealed the up-regulated SIRT1 expression and the activated NF-κB signal pathway,the up-regulated p65 expression and the down-regulated PGC-1αexpression subsequent to IR(P < 0.05).Both Western blotting and immunohistochemistry showed that the expressions of SIRT1 and PGC-1α in resveratrol group were up-regulated compared to that in IRgroup(P < 0.05),while the NF-κBp65 expression in resveratrol group was down-regulated(P < 0.05).Conclusions In mouse model of renal ischemia-reperfusion injury,the activation of SIRT1 can inhibit the NF-κBp65 expression and accordingly up-regulated PGC-1α level,contributing to inhibiting inflammatory reactions and attenuating oxidative stress-induced injury in the protection of the kidneys.
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Objective To evaluate the association between interleukin-10(IL-10 )polymorphisms and endometriosis suscepti-bility by meta-analysis.Methods Computer retrieval Pubmed,Embase,Chinese HowNet,Chinese biomedical and Wanfang database.Published data relating to case-control studies reporting the link between IL-10 polymorph-isms and endometriosis were retrieved.Meta-analysis was conducted to determine whether the IL-10 gene polymorphisms were associated with endo-metriosis.Results Six studies were finally accepted for analysis.There were five studies focused on-819T/C polymorphism and six studies focused on-592A/C polymorphism.The odds ratio of each genetype for endometriosis:TT/CC,TC/CC,AA/CC and AC/CC were 0.90(0.81~0.99),P0.05;0.92(0.79~1.07),P>0.05;0.98(0.90~1.06),P>0.05.No significant publication bias was found regarding TT/CC,TC/CC,AA/CC and AC/CC genotypes(P=0.81,0.81,0.71,0.26).Conclusion IL-10 gene-819TT genotypes may be a protetive factor of endometriosis.There was no related to show that other genotypes in position-819 and-592 were associated with endometriosis.
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Objective To explore the possible correlation between periodontal disease and carotid arteries atherosclerosis in old people,and to study the diagnostic value for periodontal disease using three-dimensional (3D) reconstruction technique of multi-slice spiral CT (MSCT).Methods Patients underwent multi-detector row CT angiography with carotid arteries atherosclerosis (control group) and without carotid arteries atherosclerosis (case group) were evaluated with the stereoscopic configuration of teeth,and the number of decayed teeth and lost teeth were recorded.Results Bythe 3D reconstruction technique,the number of decayed teeth and lost teeth between two groups were significantly different (P<0.05).The number of dental integrity patients was higher in control group (19 cases) than in case group(7 cases).The mean of dental caries was higher in control group(7.3±3.0) than in case group(6.0±2.1).The mean of hypodontia was higher in control group(45 cases) than in case group(39 cases) (P<0.05).Conclusions The 3D reconstruction technique of MSCT is a new method to display the stereoscopic configuration of teeth.The periodontal disease is significantly related with carotid arteries atherosclerosis in old people.
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This study examined the inhibitory effect of topical cyclosporine (CsA) treatment on conjunctiva epithelial apoptosis in a murine model of xerophthalamia. Dry eye was induced in 3 groups of C57BL6 mice by subcutaneous injection of scopolamine (t.i.d) and exposure to an air draft and low-humidity environment for 16 h each day for 12 days. The dry eye control group received no topical treatment; another group received 1 microL of 0.05% CsA topically (t.i.d, dry eye+CsA); and the third group received 1 microL of the castor oil vehicle of CsA topically (t.i.d, dry eye + vehicle). Normal mice were used as untreated controls. Twelve days later, the mice were killed, and their conjunctivas were excised. The number of the conjunctival goblet cells was counted in tissue sections stained with periodic acid Schiff (PAS) reagent. Their conjunctiva epithelium had been investigated by immuno-histochemical staining to detect the goblet cells and the expression of Caspase-3, Bax and bcl-2. Our results showed that compared with dry eye control and dry eye mice + vehicle groups, the number of conjunctival epithelial goblet cells was significantly greater in the untreated controls and dry eye mice receiving CsA (P < 0.01 for both groups). There was no significant difference in the number of conjunctival epithelial goblet cells between the dry eye control and dry eye+vehicle group. It was also true of the number of conjunctival epithelial goblet cells when comparison was made between the normal group and the dry eye+CsA group. Expressions of Caspas-3 and Bax were increased and ex-pression of bcl-2 was decreased in conjunctival epithelial cells in dry eye control and dry eye mice+vehicle groups. There was a significant positive correlation between goblet cell number and the number of cells that expressed bcl-2, and a negative correlation between goblet cells and Caspase-3 and Bax expression. It is concluded that the topical use of CsA could significantly reduce conjunctival epithelial apoptosis and protect goblet cell against the loss in experimental murine xerophathalamia. Inhibition of apoptosis appears to be a key mechanism responsible for the therapeutic effect of CsA on xerophthalamia.
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This study examined the inhibitory effect of topical cyclosporine (CsA) treatment on conjunctiva epithelial apoptosis in a murine model of xerophthalamia. Dry eye was induced in 3 groups of C57BL6 mice by subcutaneous injection of scopolamine (t.i.d) and exposure to an air draft and low-humidity environment for 16 h each day for 12 days. The dry eye control group received no topical treatment; another group received 1 μL of 0.05 % CsA topically (t.i.d, dry eye+CsA); and the third group received 1 μL of the castor oil vehicle of CsA topically (t.i.d, dry eye + vehicle). Normal mice were used as untreated controls. Twelve days later, the mice were killed, and their conjunctivas were excised. The number of the conjunctival goblet cells was counted in tissue sections stained with periodic acid Schiff (PAS) reagent. Their conjunctiva epithelium had been investigated by immuno-histochemical staining to detect the goblet cells and the expression of Caspase-3, Bax and bcl-2.Our results showed that compared with dry eye control and dry eye mice + vehicle groups, the number of conjunctival epithelial goblet cells was significantly greater in the untreated controls and dry eye mice receiving CsA (P <0.01 for both groups). There was no significant difference in the number of conjunctival epithelial goblet cells between the dry eye control and dry eye+vehicle group. It was also true of the number of conjunctival epithelial goblet cells when comparison was made between the normal group and the dry eye+CsA group. Expressions of Caspas-3 and Bax were increased and ex-pression of bcl-2 was decreased in conjunctival epithelial cells in dry eye control and dry eye mice+vehicle groups. There was a significant positive correlation between goblet cell number and the number of cells that expressed bcl-2, and a negative correlation between goblet cells and Caspase-3 and Bax expression. It is concluded that the topical use of CsA could significantly reduce conjuncti-val epithelial apoptosis and protect goblet cell against the loss in experimental murine xerophathala-mia. Inhibition of apoptosis appears to be a key mechanism responsible for the therapeutic effect of CsA on xerophthalamia.
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In this study, the effect of cyclosporin A (CsA) eye drop on keratoconjunctivitis Sicca (KCS) and its mechanism were studied. The KCS models were established by injecting Pertussis vaccine, complete freunds adjuvant (CFA) and antigen of conjunctiva from isotype mice. Then the KCS models were treated with cyclosporin A eye drop. Changes in breaking-up time (BUT), lacrimal secretion in 30 min and diversion in 24 h were measured. The percentage of beaker cells, the lymphocytic infiltration in conjunctiva were observed. The expression levels of Aquaporin-3(AQP3) in conjunctiva epithelial cells, beaker cells and accessory lacrimal gland were immunohistochemically detected. The results showed that there were significant differences in BUT, the percentage of beaker cells, lacrimal secretion in 30 min, the lymphocytic infiltration and the expression of AQP3 between the experimental group and an control group. It was concludedthat CsA eye drop exerts marked therapeutic effect on KCS by inhibiting T lymph cells, increasing the goblet cells and AQP3 expression in conjunctiva.
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The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated. Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC. Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package. Plasma concentrations of E and NE were increased to (569 +/- 123) ng/L and (721 +/- 104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects (P < 0.01), and decreased to normal in convalescent stage. RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness (t = 2.173, P < 0.05). Also, central macular thickness measured by RTA was significantly correlated with the visual acuity (r = -0.8046, P < 0.001) in CSC eyes. RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients. The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC.
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Coriorretinitis , Sangre , Edema , Epinefrina , Sangre , Fisiología , Angiografía con Fluoresceína , Mácula Lútea , Patología , Norepinefrina , Sangre , Fisiología , Retina , Patología , Agudeza VisualRESUMEN
The effects of different doses of nitric oxide (NO) on the proliferation and apoptosis of the cultured bovine trabecular meshwork (TM) cells were studied. L-arginine and NG-nitro-L-arginine methyl (L-NAME) were incubated with TM cells for 48 h. In the control group, no medicine was given. In the experimental groups, concentrations of L-arginine and L-NAME were 1 x 10(-7) mol/L, 1 x 10(-6) mol/L, 1 x 10(-5) mol/L, 1 x 10(-4) mol/L, 1 x 10(-3) mol/L and 1 x 10(-2) mol/L, respectively. NO2- in supernate, the proliferation and apoptosis of TM cells and mRNA expression of bcl-2 and bax were measured by Griess reagent, terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL), MTT assay and in situ hybridization, respectively. The results showed that L-arginine with concentration > or = 1 x 10(-4) mol/L could induce apoptosis of the TM cells and inhibit the proliferation of TM cells through increasing the NO levels, down-regulating bcl-2 mRNA expression and up-regulating bax mRNA expression; L-NAME with concentration > or = 1 x 10(-5) mol/L could induce the proliferation of the TM cells through suppressing the production of NO. It was concluded that NO in high level could induce apoptosis of the TM cells and suppress the proliferation of the TM cells.
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Animales , Bovinos , Apoptosis , División Celular , Células Cultivadas , Medios de Cultivo , Ciclina D1 , Genética , NG-Nitroarginina Metil Éster , Farmacología , Óxido Nítrico , Farmacología , Proteínas Proto-Oncogénicas , Genética , Proteínas Proto-Oncogénicas c-bcl-2 , ARN Mensajero , Genética , Malla Trabecular , Biología Celular , Proteína X Asociada a bcl-2RESUMEN
The clinical data of 109 patients with rhegmatogenous retinal detachment were retrospectively analyzed and the relationships among retinal detachment,refraction and the shapes of hole in different age groups discussed. The results showed that myopia was more commonly seen in the patients less than 40 years old and the occurrence of myopia was gradually decreased in the patients over 40 years old. Round hole was more commonly seen in the patients less than 40 years old and horseshoe-shaped tears were more often found in the age group of over 40 years old.
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Objective To investigate the polymorphism of the vitamin D receptor gene (VDR)TaqⅠin relation to diabetic retinopathy. Method Fragment length discrepant allele specific PCR(FLDAS-PCR) were used to determine VDR genetypes in 158 patients with diabetic retinopathy and in 198 normal subjects. Results The frequency distribution of VDR genotypes in diabetic retinopathy patients was 106 (67.1%) in TT, 33(20.9%) in Tt, 19(12.0%) in tt; and in normal persons was 165 (83.3%) in TT, 23(11.6%) in Tt, 10 (5.1%) in tt. There was a significant difference between diabetic retinopathy patients and normal persons in distribution of VDR gene TaqⅠgenotypes(P
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Objective To evaluate the long-term results of balloon dilatation for benign esophageal stricture and stent implantation for malignant esophageal stricture.Methods Balloon dilatation and stent implantation were performed in 156 cases,of which 12 cases received balloon dilatation in benign esophageal stricture and 134 cases received metallic stents,9 cases received balloon dilatation in malignant esophageal stricture of 143 cases.Results During a follow-up period of 1~48 months,61 cases died with a mean survival period of 8.9 months(1~33 months).Recurrent stenosis occurred in 63 cases(47%)who had to receive ballon dilatation or another stent implantation procedure,the stent was obstructed due to food and mucus in 3 cases,stricture at the upper end in 19 cases and the both ends in 8 cases.Conclusion Stent implantation is an effective palliative treatment for esophageal carcinoma with severe dysphagia.Tumor and hamartoplasia are the main cause of recurrent stricture.Covered stents can reduce the rate of recurrent stricture.