Biomechanical Analysis of the Knee after Unicompartmental Knee Arthroplasty during Stair Ascent / 医用生物力学

Objective To investigate the effect of medial unicompartmental knee arthroplasty (UKA) surgery on knee biomechanics during stair ascent. Methods Nine osteoarthritis patients who received fixed-bearing medial UKA participated in this study. All patients completed pre-surgical (3 weeks before UKA surgery) and post-surgical ［(7±2) months after UKA surgery］ test. Their synchronized biplane radiographs during stair ascent were collected. Motion of the femur, tibia, and implants were tracked using an automated volumetric model-based tracking process that matched subject-specific 3D models of the bones and prostheses to the biplane radiographs with sub-millimeter accuracy. Anatomic coordinate systems were created within the femur and tibia and used to calculate tibiofemoral kinematics. Additional outcome measures included the center of contact in the medial and lateral compartments, and the lateral compartment dynamic joint space. Results The UKA knee was in 4.8° varus compared with the pre-surgical contralateral knee. The post-surgical UKA knee was in 3.1°valgus compared with the pre-surgical knee. The post-surgical UKA knee was 4.4° externally rotated compared with the pre-surgical contralateral knee. However, the medial tibia contact center of the UKA knee moved posteriorly 2.5 mm compared with that of the contralateral knee (P0.05). Conclusions UKA can effectively improve varus of the knee joint and restore biomechanical characteristics of UKA knee rotation, without affecting lateral compartment joint space. However, changes are found in contact center of the medial tibia compartment of the UKA knee after surgery.

Treatment of talar cartilage injury and bone cyst with modified biplane Chevron osteotomy and autogenous osteochondral transplantation / 中华创伤骨科杂志

Objective:To evaluate the clinical efficacy of the modified biplane Chevron osteotomy and autogenous osteochondral transplantation for the treatment of talar cartilage injury with bone cyst.Methods:From February 2016 to February 2019, 26 patients with talar cartilage injury and bone cyst were treated at Department of Orthopaedics, The First Affiliated Hospital to Guangxi Medical University. They were 16 males and 10 females, aged from 22 to 50 years (average, 36.2 years). According to the Hepple classification, there were 5 cases of type Ⅳ and 21 cases of type Ⅴ. The extent and range of talar cartilage injury were evaluated by arthroscopy, the modified biplane Chevron osteotomy of medial malleolus was performed to expose cartilage defects medial to the talus, unstable cartilage was removed thoroughly, sclerotic wall of the bone cyst was freshly treated, and an osteochondral column taken from the non-weight-bearing area of the ipsilateral femoral medial condyle was implanted into the injured area of talar cartilage. The clinical efficacy was evaluated by comparing the ankle-hindfoot scores of American Orthopedic Foot and Ankle Society (AOFAS), Karlsson ankle scores, visual analogue scale (VAS) and Lysholm ankle scores between preoperation and one year post-operation.Results:All the 26 patients were followed up for an average of 20.6 months (from 12 to 30 months). Follow-up did not observe any postoperative complications like incision infection, cyst recurrence or malunion, or any obvious pain or movement limitation at the donor knee joint. The AOFAS ankle-hindfoot scores were significantly increased from preoperative 64.3±3.9 to 89.5±5.1 one year postoperation, the Karlsson scores were significantly increased from preoperative 60.5±5.5 to 85.2±6.9 one year postoperation, and the VAS scores were significantly decreased from preoperative 6.2±1.1 to 1.8±0.9 one year post-operation (all P<0.05). The Lysholm ankle scores before and after operation were 94.7±1.9 and 94.1±1.8, respectively, showing no significant difference ( P>0.05). Conclusion:In the treatment of talar osteochondral injury and bone cyst, the modified biplane Chevron osteotomy of medial malleolus and autogenous transplantation of osteochondral column can effectively relieve ankle pain and improve ankle function, leading to satisfactory clinical efficacy.

The therapeutic effects of total hip arthroplasty with combined anteversion angle of femoral neck-acetabu lam in Crowe Ⅳ developmental dysplasia of the hip / 实用医学杂志

Objective To evaluate the clinical efficacy of combined anteversion angle of femoral neck-acetabulam in Crowe Ⅳ developmental dysplasia of the hip (DDH) with Wagner Cone total hip arthroplasty. Methods From June 2013 to February 2016,45 cases of CroweⅣDDH were treated with no femoral shortening osteotomy in THA ,including 25 females and 20 males. The outcomes of anteversion angle of femoral neck and acetabulam were measured in CT scan of hip jiont. The outcomes of abduction angle ,hip center were measured radiologically in X-ray of pelvis. Postoperative function was scored by Harris scoring system. Results The mean follow-up time of the 45 patients was(3.2 ± 0.8)years. Using loosening or revision as the end point ,the survival rate was 100%. The outcomes of preoperative anteversion angle of acetabulam,femoral neck,acetabulam-femoral neck was(27.70 ± 5.35)°,(47.76 ± 7.25)°,and(74.90 ± 8.43)° in CroweⅣgroup,and those of postoperative anteversion angle was(19.82 ± 2.41)° ,(23.35 ± 3.84)° and(44.90 ± 5.18)° ,respectively. There was significant difference between the two groups(P < 0.05). The average height of preoperative dislocation in femoral head was (5.8 ± 1.2)cm and the postoperative average displacement of femoral lesser trochanter was (3.6 ± 0.8)cm. The Harris hip score was improved from preoperative(46.66 ± 7.28)to(90.36 ± 4.72). For most patients,hip pain were significantly relieved ,range of motion of the hip was improved ,and the gait returned to normal. Femoral nerve injury occurred in 2 cases and the case recovered after 3 months respectively. Conclusions The deformity of hip and the stability and matching degree of the prosthesis was evaluated with the combined anteversion angle of femoral neck-acetabulam in CroweⅣDDH. The Wagner Cone can effectively maintain the stability of the hip joint in the non-amputated total hip replacement.

Pulmonary Toxicity in Rats Caused by Exposure to Intratracheal Instillation of SiO2 Nanoparticles / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The effect of the silica nanoparticles (SNs) on lungs injury in rats was investigated to evaluate the toxicity and possible mechanisms for SNs.</p><p><b>METHODS</b>Male Wistar rats were instilled intratracheally with 1 mL of saline containing 6.25, 12.5, and 25.0 mg of SNs or 25.0 mg of microscale SiO2 particles suspensions for 30 d, were then sacrificed. Histopathological and ultrastructural change in lungs, and chemical components in the urine excretions were investigated by light microscope, TEM and EDS. MDA, NO and hydroxyproline (Hyp) in lung homogenates were quantified by spectrophotometry. Contents of TNF-α, TGF-β1, IL-1β, and MMP-2 in lung tissue were determined by immunohistochemistry staining.</p><p><b>RESULTS</b>There is massive excretion of Si substance in urine. The SNs lead pulmonary lesions of rise in lung/body coefficients, lung inflammation, damaged alveoli, granuloma nodules formation, and collagen metabolized perturbation, and lung tissue damage is milder than those of microscale SiO2 particles. The SNs also cause increase lipid peroxidation and high expression of cytokines.</p><p><b>CONCLUSION</b>The SNs result into pulmonary fibrosis by means of increase lipid peroxidation and high expression of cytokines. Milder effect of the SNs on pulmonary fibrosis comparing to microscale SiO2 particles is contributed to its elimination from urine due to their ultrafine particle size.</p>

Arthroscopically assisted double Endobutton fixaton technique for the treatment of acute acromioclavicular joint dislocation / 医学研究生学报

Objective With the development of minimally invasion and the popularization of arthroscopy the technology of ar-throscopy has been widely applied for the treatment of acute and the safety of this has been validated.To analyze the clinical effect of ar-throscopically assisted double Endobutton plate reconstruction of coracoclavicular ligament in the treatment of acute acromioclavicular joint dislocation. Methods From November 2013 to December 2014, a total of 23 patients with Rockwood type III,Ⅳ,Ⅴshoulder joint dis-location were included, all cases was treated by arthroscopic double Endobutton fixaton technique.Patients were followed up for 6 to 18 months.The changes of shoulder joint forward elevation and external rotation, Japanese Orthopaedic Association score(JOA), and Visual Analogue score( VAS) of acromioclavicular joint in both perioperative and postoperative were recorded. Results The mean follow-up time was (9.3 ±2.4) months ( range from 6 to 18 months),and mean time from injury to surgery was(10.1 ±3.2)days.The therapeutic effects were achieved in all patients after the arthroscopically assisted double Endobutton plate reconstruction.All the measurements, in-cluding the mean forward elevation JOA scores before and after fixation (71.0 ±5.4 vs 93.5 ±3.6), and mean VAS scores (4.6 ±1.0 vs 1.9 ±0.9), mean forward elevation [(102.5 ±8.6) degrees vs (144.3 ±6.3) degrees], and mean external rotation[(107.1 ±6.2) de-grees vs (149.6 ±7.5) degrees] improved significantly (P<0.05) after the treatment. Conclusion Arthroscopic double Endobutton fixaton technique could provide an effective immobilization of shoulder and acromioclavicular joint, thus improving the function of the joint and achieving an excellent effect in the treatment of acute acromiocla-vicular joint dislocation.

Bone marrow mesenchymal stem cell transplantation combined with lithium chloride treatment for avascular necrosis of the femoral head in rabbits / 中国组织工程研究

BACKGROUND:Lithium chloridecan promote the proliferation and osteogenic capacity of bone marrow mesenchymal stem cels in the necrotic region after avascular necrosis of the femoral head, which has become an issue of concern. OBJECTIVE:To compare the advantages and disadvantages of bone marrow stem cel transplantation combined with lithium chloride in the treatment of rabbit femoral head necrosis. METHODS: Passage 2 bone marrow mesenchymal stem cels from 1-week-old New Zealand rabbits were cultured in 0, 5, 10, 20, 40 mmol/L lithium chloride. Forty-eight healthy adult New Zealand rabbits were selected to make femoral head necrosis models in the right femoral head using liquid nitrogen freezing method and then randomized into four groups: model group with no implantation; lithium chloride group given lithium chloride treatment at 3 days after modeling; cel transplantation group given gelatin sponge implantation and bone marrow mesenchymal stem cel suspension injection into the femoral head after modeling; combined group given bone marrow mesenchymal stem cel suspension injection and lithium chloride treatment. Intraperitoneal injection of lithium chloride (45.2 mg/kg) was given daily beginning at the postoperative 3rdday, and the treatment duration was 4 weeks. RESULTS AND CONCLUSION:Lithium chloride at 10 mmol/L had the maximum effect on the proliferation of rabbit bone marrow mesenchymal stem cels, and if the concentration of lithium chloride was > 10 mmol/L, the promotion role of lithium chloride began to decline. After combined treatment, the morphology of the femoral head was restored a little, with increased bone density and thickened trabecular bone; the level of β-catenin in the femoral head was significantly increased in the combined group compared with the cel transplantation group or the lithium chloride group. These findings show that bone marrow stem cel transplantation combined with lithium chloride treatment can promote the recovery from femoral head necrosis by increasing bone mass of the trabecular bone and bone density of the femoral head in the necrotic region.

A review for function of Wnt protein family in osteocyte / 医学研究生学报

Wnt signaling pathway has a critical role in differentiation, proliferation, supersession and metabolism of osteocyte. Although the principal components are relatively simple, however, the numerous components consisted of Wnt signaling participate in the reaction, including several LRPs ( low density lipoprotein receptor-related protein,LRP) , 19 different Wnt proteins and 19 different FZDs( frizzled receptor, FZD) , and non-canonical Wnt signaling and multiple inhibitors of Wnt signaling.The Wnts linked to mem-brane coreceptor and activated downstream of canonical Wnt signaling or non-canonical Wnt signaling, In addition, different Wnts had different roles in differentiation, bone formation and bone absorption of osteocyte.This review aims to understand the relationship be-tween Wnt signaling and osteocyte metabolism and bone diseases, by analyzing a variety of factors and the process of Wnt protein and Wnt signaling pathway in activity of osteocyte.

Ilizarov bone transport for repair of diabetic foot：a functional and imaging evaluation / 中国组织工程研究

BACKGROUND:Previous therapies for diabetic foot are not ideal with large cost, and moreover, amputation is often required. OBJECTIVE: To perform the Ilizarov bone transport in the treatment of patients with diabetic foot (Wanger grades 3-4), and to observe the limb salvage conditions. METHODS: Eighteen patients with diabetic foot, Wanger grades 3-4, admitted in the Department of Bone and Joint Surgery, First Affiliated Hospital of Guangxi Medical University from December 2013 to June 2015 were enroled in this trial. Al of patients were subjected to Ilizarov bone transport. RESULTS AND CONCLUSION: Al the 18 patients were folowed up for 3 to 20 months, and presented with ulcer healing. Scores on ankle-brachial index and 10-g nylon line test were both increased significantly in the patients after treatment, but the visual analog scale scores were reduced. These findings indicate that the Ilizarov bone transport is an effective method for treating ulcer of diabetic foot at Wanger grades 3-4.

Clinical Pharmacists' Experience with the Use of Antibacterials in Retinopathy Surgical Department / 中国药房

OBJECTIVE:To discuss the working method for clinical pharmacists in the use of antibacterials in retinopathy surgical department. METHODS:The utilization of antibacterials in surgical department and the experience of the author in the use of antibacterials were analyzed. RESULTS & CONCLUSION:Clinical pharmacists can play an important role in the rational use antibacterials by participating in the perioperative use of antibacterials,treatment of infection cases,and sample collection etc in surgical department.

On relationship between intraoperative findings during joint replacement and clinical manifestations in elderly patients with knee osteoarthritis / 中国微创外科杂志

Objective To study the relationship between intraoperative findings during knee joint replacement and clinical manifestations in elderly patients with knee osteoarthritis.Methods A total of 150 cases of senile knee osteoarthritis(182 knee joints) was selected for total knee replacement.Their X-ray examination results were gathered for recording the impairment of the articular surface,the joint space narrowing,and the location and amount of osteophytes.An MRI examination was performed in some of the cases for recording changes of fibrocartilage and locations of meniscus.Results Out of the 150 cases,there were 108 cases of genu varum(mean inversion angle,12.5?;range,0?~25?),21 cases of genu valgum(mean eversion angle,18.3?;range,15?~25?),and 21 cases of flexion contracture (mean angle,15.3?;range,0?~40?).The X-ray findings showed varying degrees of joint space narrowing in all the 150 cases,and osteophytes on the posterior border or at lateral part of the knee joint in 131 cases(152 joints).MRI examinations were performed in 11 cases(15 joints),in which discontinuous,cystoid,and worn-out fibrocartilages were seen.Radial displacement of the meniscus was found.Intraoperative findings proved that the fibrocartilage on the articular surface on the side with joint space narrowing was severely worn away,the collateral ligaments were contracted,the osteophytes were seen at the posterior part of the tibia and the femur,and abrasion or radial displacement of the meniscus on the side with joint space narrowing.Conclusions Joint space narrowing,varus or valgus deformity,osteophytes,and radial displacement of the meniscus are usually found in aged patients with knee osteoarthritis.

The investigation and significance of the radial displacement of meniscus in knee joint / 中华骨科杂志

Objective To investigate the presence of radial displacement of the meniscus in knee joint, and discuses its clinical significance. Methods From January 2000 to February, 398 cases underwent MRI because of different symptoms, and were analyzed retrospectively. Of them, 312 were recruited to the study, whose age was more than 18 years without knee operation, serious deformity, bone destruction, fracture, dislocation and tumor. Non-weight-bearing magnetic resonance images (MRI) of 312 patients with symptoms, including 125 males and 187 females aging from 19 to 85 years, were used to evaluate retrospectively for the radial displacement of the meniscus in knees by Kenny's method. The macroscopic observation for menisci were noted separately during total knee replacement(TKR) and knee arthroscopy in 21 and 35 patients respectively. Results In the 312 cases, MRI examinations demonstrated that 52 patients were found with the radial displacement of the meniscus(16.7%),including 47 medial menisci and 6 lateral menisci. There was a statistically difference among each age group (?2=10.18,P