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BACKGROUND:At present,measurement osteotomy technique and gap balance technique are the two main surgical methods in total knee arthroplasty.Both methods have their advantages and disadvantages.By adjusting the osteotomy angle,the gap balance technique can reduce the release of soft tissue and obtain a more balanced flexion and extension space.The clinical efficacy of gap balance technique is superior,but this surgical method lacks tools and is easily influenced by the surgeon's surgical experience and subjective judgment,with more errors.Measurement osteotomy technique has a short learning curve,but it relies on anatomic markers and is prone to many complications due to inaccurate positioning.In recent years,many instrument companies have successively developed and launched tools that can improve the quality of surgery.However,there are still few reports about the tool. OBJECTIVE:To compare the clinical efficacy of gap balance technique and measurement osteotomy technique under Offset Repo-Tensor in total knee arthroplasty,and explore the value of Offset Repo-Tensor in total knee arthroplasty. METHODS:The medical records of 85 patients with total knee arthroplasty were collected and divided into two groups according to the operation method.Group A consisted of 44 patients who underwent total knee arthroplasty using a gap balance technique combined with Offset Repo-Tensor.Group B consisted of 41 patients who underwent total knee arthroplasty using measurement osteotomy technique.Surgical time,American Knee Society Score,knee range of motion,changes in lower limb alignment,and postoperative complications were compared between the two groups to evaluate the clinical efficacy of gap balance technique combined with Offset Repo-Tensors in total knee arthroplasty. RESULTS AND CONCLUSION:(1)All 85 patients were followed up.(2)Postoperative knee range of motion in both groups was higher than that before surgery(P<0.05),and the improvement in group A was more significant than that in group B(P<0.05).(3)American Knee Society Score in both groups after surgery was higher than that before surgery(P<0.05),and the American Knee Society Score in group A was higher than that in group B at 2 weeks,1,3 months,and the last follow-up(P<0.05).(4)The operation time of group A was slightly shorter than that of group B,but the difference was not significant(P>0.05).(5)The lower limb alignment in both groups was improved after operation,but there was no significant difference between the two groups(P>0.05).(6)The complication rate of group A(2%)was lower than that of group B(7%),but there was no significant difference between the two groups(P>0.05).(7)It is indicated that compared with the measurement osteotomy technique,the combination of Offset Repo-Tensor and gap balance technique can elevate the clinical effect and improve the function and motion range of the knee joint.
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AIM: High-density lipoprotein (HDL) can be divided into several subfractions based on density, size and composition. Accumulative evidence strongly suggests that the subfractions of HDL have very different roles in the pathogenesis of atherosclerosis. The purpose of this study was to further delineate the relationship between HDL subfractions extracted by microfluidic chip electrophoresis and the vulnerability of plaques in patients with intracranial atherosclerosis with a high-resolution magnetic resonance imaging (HRMRI) study. METHODS: We prospectively enrolled patients with single atherosclerotic plaque in the middle cerebral artery (MCA) or basilar artery (BA) between July 2020 and Dec 2022 and performed 3-tesla HRMRI on the relevant artery. The HDL cholesterol concentration and HDL subfractions (HDL-2a, HDL-2b and HDL-3) percentage were analyzed in serum samples from the same patients by electrophoresis on a microfluidics system. RESULTS: A total of 81 MCA or BA plaques [38 (46.9%) symptomatic and 43 (53.1%) asymptomatic] in 81 patients were identified on HRMRI. Patients with symptomatic plaques had a significantly lower HDL-2b level than asymptomatic plaques [symptomatic vs. asymptomatic: 0.16 (0.10-0.18) vs. 0.27(0.21-0.34), p = 0.001]. After adjusting for demographics and vascular risk factors, logistic regression showed that HDL-2b was inversely associated with asymptomatic plaques (B = -0.04, P = 0.017). According to receiver operating characteristic (ROC) curve model analysis, the cutoff point of HDL-2b in predicting asymptomatic plaques was 0.21 mmol/L (Area under curve: 0.719, specificity: 73.7%, sensitivity: 72.1%). Furthermore, plaque enhancement on HRMRI (P < 0.001), positive remodeling (P < 0.001), plaque load (P < 0.001) and luminal stenosis (P < 0.001) were superior among patients with HDL-2b < 0.21 mmol/L. CONCLUSIONS: Our data showed that serum HDL-2b levels may serve as a biomarker for predicting vulnerability in intracranial atherosclerotic plaques.
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Aterosclerose , Placa Aterosclerótica , Humanos , Placa Aterosclerótica/diagnóstico por imagem , Placa Aterosclerótica/patologia , Microfluídica , Imageamento por Ressonância Magnética/métodos , HDL-ColesterolRESUMO
Objective:To explore the application of collaborative nursing combined with medical integration model in minimally invasive surgery for pediatric urinary calculi, to provide clinical guidance for minimally invasive surgical nursing of urinary calculi in children.Methods:From December 2020 to July 2022, 90 children who underwent minimally invasive surgery for urinary calculi in Children′s Hospital Affiliated to Zhejiang University Medicine College were selected as subjects by quasi experiment. According to the time sequence of enrollment, they were divided into observation group ( n = 45) and control group ( n = 45). The control group was given routine nursing mode nursing, and the observation group was given collaborative nursing combined with medical integration mode nursing. The clinical related indicators, pain, anxiety and complications were compared between the two groups. Results:In the observation group, the operation time, the amount of bleeding during operation, the first time to get out of bed after operation, the rate of stone removal immediately after operation and the rate of stone removal 1 month after operation were (75.48 ± 5.92) min, (168.75 ± 17.28) ml, (6.12 ± 1.05) h, 84.44%(38/45) and 97.77%(44/45), respectively. The control group was (78.39 ± 6.75) min, (178.30 ± 19.25) ml, (6.84 ± 1.23) h, 64.44 % (29/45) and 82.22 %(37/45), respectively, the differences were statistically significant ( t/ χ2 = 2.17, 2.48, 2.99, 4.73, 6.05, all P<0.05). The Face, legges, Activity, Cry, Consolability Behavioral Tool scores of the observation group at 1 d, 3 d and 7 d after operation were 6.28 ± 1.21, 5.35 ± 1.37 and 2.87 ± 0.65, respectively, and those of the control group were 7.05 ± 1.55, 5.95 ± 1.25 and 3.21 ± 0.73, respectively, the differences were statistically significant ( t = 2.63, 2.17, 2.33, all P<0.05). The Modified Yale Preoperative Anxiety Scale and Frankl Compliance Scale Scores in the observation group at the day before discharge hospital were 55.28 ± 5.52, 3.60 ± 0.40, while in the control group were 60.02 ± 8.56, 2.82 ± 0.61, the differeces were significat ( t = 3.12, 3.02, both P<0.05). The incidence of complications was 2.22 %(1/45) in the observation group and 15.56 %(7/45) in the control group, the difference was significant ( χ2 = 4.94, P<0.05). Conclusions:The application of collaborative nursing combined with medical care integration model in minimally invasive surgery of urinary calculi in children has a significant effect.
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@#Coronavirus is an important pathogen of humans and animals. Among them, the novel coronavirus disease (COVID-19) breaking out in 2019 has brought a fatal threat to human health. The host"s innate immune response is the host"s first line of defense against pathogen invasion, but an excessive immune response can also aggravate viral infection and pathological damage. The immune escape of coronavirus is a critical pathogenic mechanism causing death. This work mainly reviews the pathogenic mechanism of coronavirus immune escape from several aspects such as host immunosensor, interferon, cytokine and coronavirus antagonizing host immune response, which provide a theoretical reference for the development of anti-coronavirus drugs.
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BACKGROUND: Intra-calcaneal fractures involving subtalar joints account for about 75% of all calcaneal fractures. Surgical treatment of displaced intra-articular calcaneal fractures is superior to non-surgical treatment. However, the timing of treatment, surgical indications, incision selection, and bone grafting are still controversial. The classical “L” approach is gradually replaced by minimally invasive internal fixation because of its high incision complications. OBJECTIVE: To compare the clinical effect of minimally invasive internal fixation and “L” incision for the treatment of Sanders II and III calcaneal fractures. METHODS: Sixty patients with Sanders II or III calcaneal fractures from January 2016 to January 2019 in the Second Department of Orthopedics, Shantou Hospital of Traditional Chinese Medicine were randomly divided into minimal invasion group (n=32) and “L” incision group (n=28). The patients in the minimal invasion group and “L” incision group received percutaneous reduction by leverage combined with minimally invasive internal fixation and “L” incision internal fixation treatment, respectively. At 6 months after operation, the curative effect of the two groups was evaluated according to the American Orthopedic Foot and Ankle Society score. Preoperative waiting days, the operation time, the length of stay and the complication incidence were compared between the two groups. Bfihler angle and Gissane angle were measured and compared preoperatively, postoperatively and during the final follow-up. RESULTS AND CONCLUSION: (1) The excellent and good rate of American Orthopedic Foot and Ankle Society score was 91% in the minimal invasion group and 93% in the “L” incision group (P > 0.05). (2) The postoperative Bohler angle and Gissane angle were significantly improved in both groups (P 0.05). Bohler angle was better in the “L” incision group than in the minimal invasion group (P 0.05). (3) The preoperative waiting days and the length of stay were longer in the “L” incision group than those in the minimal invasion group (P < 0.05). The operation time was shorter in the “L” incision group than in the minimal invasion group (P < 0.05). (4) The incidence of complications was lower in the minimal invasion group (9%) than in the “L" incision group (32%) (P < 0.05). (5) Compared with the traditional “L” incision open reduction and internal fixation, the treatment of Sanders II and III calcaneal fractures with percutaneous reduction by leverage combined with minimally invasive internal fixation are satisfactory, with less trauma and complications. It is worth being recommended in clinic.
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BACKGROUND: Tranexamic acid has been shown to effectively reduce dominant and hidden blood loss in patients undergoing proximal femoral nail antirotation fixation, and it is safe and effective. At present, the use of tranexamic acid in this operation is mainly divided into intravenous infusion and local intramedullary perfusion; intravenous infusion can be divided into single use or multiple uses, and most of the local use is single use. For the combined local use with intravenous infusion is rarely reported. However, the combined use of tranexamic acid in hip and knee arthroplasties has been proven to be safe and effective. OBJECTIVE: To explore the effectiveness and safety of intravenous combined with local application of tranexamic acid on the perioperative blood loss in proximal femoral nail antirotation. METHODS: Ninety patients with intertrochanteric fracture who underwent proximal femoral nail antirotation in Shantou Hospital of Traditional Chinese Medicine from January 2016 to December 2018 were enrolled, and randomly divided into combined, intravenous and local groups (n=30/group). All patients signed the informed consents and the study was approved by the hospital ethical committee. In the combined group, tranexamic acid (20 mg/kg dissolved in 20 mL normal saline) was injected intravenously at 30 minutes before surgery, followed by femoral intracavitary injection of tranexamic acid (1 g, dissolved in 20 mL normal saline) after proximal femoral nail antirotation. Intravenous group only underwent intravenous injection of tranexamic acid. Local group only received femoral intracavitary injection of tranexamic acid. The total blood loss, dominant blood loss, hidden blood loss, International Normalized Ratio, prothrombin time, activated partial thromboplastin time, blood transfusion rate and the incidence of deep venous thrombosis were counted and compared in the three groups. RESULTS AND CONCLUSION: (1) The total blood loss in the combined group was significantly less than that in the intravenous and local groups (P 0.05). (2) The hidden blood loss in the combined group was significantly less than that in the intravenous and local groups (P 0.05). (3) There was no significant difference in the dominant blood loss among groups (P > 0.05). (4) The International Normalized Ratio, prothrombin time, and activated partial thromboplastin time before and after surgery showed no significant difference among groups (P > 0.05). (5) The blood transfusion rate showed no significant difference among groups (P > 0.05). (6) None presented with deep venous thrombosis. (7) These results suggest that compared with single intravenous and intracavitary injection of tranexamic acid, their combination can obviously reduce total and hidden blood loss of proximal femoral nail antirotation without increasing the risk of deep venous thrombosis. In addition, single intravenous and intramedullary injection of tranexamic acid has no significant difference in total or hidden blood loss.
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Objective To observe the clinical efficacy of Xiezhuo Zhubi Decoction combined with Etoricoxib for the treatment of acute gout arthritis.Methods Seventy acute gout arthritis patients were randomly divided into treatment group and control group,35 cases in each group.Based on the fundamental treatment,the control group were given oral use of Etoricoxib and the treatment group was treated with Xiezhuo Zhubi Decoction combined with Etoricoxib.The treatment for both group lasted for 7 days.Before and after treatment,the changes of blood uric acid,C-reactive protein and erythrocyte sedimentation rate in both groups were observed.After treatment,the clinical efficacy was evaluated,and the toxic and adverse effects were also monitored.Results (1) In the treatment group,the total effective rate was 91.4%;in the control group,the total effective rate was 71.4%.There were significant differences between the two groups(P < 0.05).(2) After treatment,blood uric acid,C-reactive protein and blood sedimentation rate were much improved in both groups (P < 0.05 compared with those before treatment),and the treatment group had better effect on improving blood uric acid and C-reactive protein(P < 0.05).(3) The control group had 3 cases of nausea,while no adverse reactions occurred in the treatment group.Conclusion Xiezhuo Zhubi Decoction combined with Etoricoxib is effective for the treatment of acute gout arthritis,and its effects on relieving clinical symptoms and decreasing blood uric acid and erythrocyte sedimentation rate are better than Etoricoxib alone.
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Objective To study deletion mutations and polymorphism of PINK1 gene exons in patients with Parkinson' s disease (PD) in the littoral of Zhejiang Province,and analyze the association between these changes and the etiology of PD.MethodsAll exons of PINK1 gene in 200 PD patients( 112early-onset PD and 88 late-onset PD) and 220 controls (68 young controls and 152 old controls ) were amplified by polymerase chain reaction (PCR). All the positive PCR products were sequenced,and genotypes were detected by dot blot allele and genotype frequencies of PINK1 were compared by the Chisquare test.ResultsNo deletion mutations of the exons were found in all patients and controls.However,a known heterozygote point mutation G12169A in exon 5 was identified in 2 patients with early-onset PD.And G12164A polymorphism and G12101A polymorphism were located on PINK1 gene of exon 5. There were G/G and G/A genotypes in G12164A polymorphism,no A/A genotype.There were G/A and A/A genotypes in G12101A polymorphism,no G/G genotype. The chain relation polymorphism A/A genotype frequency was significantly higher in the PD group 84/200 (42.0% ) than the control group (52/220,23.6%,x2 =4.034,P =0.045 ).The frequency was also significantly higher in the late-onset PD (40/88,45.5% ) than the old control (32/152,21.1%,x2 =3.951,P =0.047 ).There were no significant differences in alleles frequencies of other groups.ConclusionThe deletion mutation and point mutation are rare in PD patients in littoral of Zhejiang Province.Chain relation polymorphism at G12164A and G12101A in PINK1 gene might be a susceptible factor for PD patients.
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To study the coumarins of Anemone raddeana Regel, the compounds were separated by silica gel column chromatography and HPLC. Their structures were identified by their physicochemical property and spectral analysis. Two new compounds were isolated and identified as 4, 7-dimethoxyl-5-methyl-6-hydroxy coumarin (1) and 4, 7-dimethoxyl-5-formyl-6-hydroxycoumarin (2). The bioassays indicated that compounds 1 and 2 could significantly inhibit the proliferation of cancer cell, and showed the agonist effect on the transactivity of retinoic acid receptor-alpha (RARalpha). In addition, the two compounds had inhibitory effect against human leukocyte elastase (HLE).
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BACKGROUND: There are many criteria used to evaluate the curative effects of hip-preserving treatment for osteonecrosis of the femoral head (ONFH), and there have been no consistent criteria, so the curative effects of hip-preserving treatment lack comparability to some extent. OBJECTIVE: To review and analyze a variety of criteria for evaluating the curative effects of hip-preserving treatment and to develop a specific quality of life scale of hip-preserving treatment. METHODS: A computer-based retrieval of Pubmed database using key words "osteonecrosis, femoral head, quality of life", or "osteonecrosis, femoral head, curative effect" for manuscripts published from August 2000 to August 2010 and of CNKI database for manuscripts published from January 1994 to December 2009 using key words "femoral head necrosis, curative effect" or "femoral head necrosis, quality of life". Manuscripts that address hip-preserving treatment of ONFH and related quality of life or manuscripts that were recently published or in the high-impact journals were included in this paper. Finally, 31 manuscripts were reviewed.RESULTS AND CONCLUSION: The current criteria for evaluating the curative effects of hip-preserving treatment focus on pain, function, and range of motion of hip joints, but do not lay emphasis on the local changes of hip joints or lower limbs, which can not sufficiently reflect the overall quality of life of patients. The SF-36 scale lack specificity to some extents and cannot be used to evaluate the curative effects of hip-preserving treatment systemically and specifically. Therefore, it is necessary to develop a specific quality of life scale for evaluating the curative effects of hip-preserving treatment of ONFH.
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To study the chemical constituents of Bauhinia glauca subsp. pernervosa, eleven phenolic acids were isolated from a 95% ethanol extract by using a combination of various chromatographic techniques including column chromatography over silica gel, ODS, MCI, Sephadex LH-20, and semi-preparative HPLC. By spectroscopic techniques including 1H NMR, 13C NMR, 2D NMR, and HR-ESI-MS, these compounds were identified as isopropyl O-beta-(6'-O-galloyl)-glucopyranoside (1), ethyl O-beta-(6'-O-galloyl)-glucopyranoside (2), 3, 4, 5-trimethoxyphenyl-(6'-O-galloyl)-O-beta-D-glucopyranoside (3), 3, 4, 5-trimethoxyphenyl-beta-D-glucopyranoside (4), gallic acid (5), methyl gallate (6), ethyl gallate (7), protocatechuic acid (8), 3, 5-dimethoxy-4-hydroxybenzoic acid (9), erigeside C (10) and glucosyringic acid (11). Among them, compound 1 is a new polyhydroxyl compound; compounds 2, 10, and 11 were isolated from the genus Bauhinia for the first time, and the other compounds were isolated from the plant for the first time. Compounds 6 and 8 showed significant protein tyrosine phosphatase1B (PTP1B) inhibitory activity in vitro with the IC50 values of 72.3 and 54.1 micromol x L(-1), respectively.
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Estrogen Receptor (ERalpha) is a member of superfamily of ligand-activated transcription factors which play critical roles in many biological processes. To screen novel modulators of ERalpha for drug development and biological function research, we developed a mammalian one-hybrid-based high-throughput screening model for ERalpha modulator. We cloned the ERalpha LBD gene from the total mRNA of fat tissue by RT-PCR and fused it with the GAL4 DNA binding domain of pBIND-GAL4 plasmid to construct a chimara expression plasmid pBIND-GAL4-Eralpha(LBD). The L02 cells was cotransfected with pBIND-GAL4-ERalpha(LBD) and a GAL4-responsive luciferase reporter plasmid pGL3-GAL4, and following treatment with test compounds for 24 h, the activities of luciferase were detected to evaluate the transactivities of ERalpha modulators. After manner optimizations of transfection conditions, Estradiol, an agonist control, induced the expression of luciferase in a dose-dependent with EC50 of 0.17 micromol/L, the maximum folds of induction was about 28.1. Tamoxifen, an antagonist control, efficiently suppressed the estradiol-mediated luciferase induction with EC50 of 0.10 micromol/L. Using this screening model, we discovered four ERalpha agonists from 2000 natural and synthetic compounds.