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1.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(2): 160-165, 2021 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-33624467

RESUMO

Objective: To investigate the effectiveness of modified patellar tendon reconstruction using hamstring autograft in the treatment of chronic patellar tendon rupture and defects. Methods: The clinical data of 11 patients with chronic patellar tendon rupture and defects admitted between January 2015 and August 2018 were retrospectively analyzed. The patient were treated with inverted U-shaped reconstruction technique using hamstring autografts, in which 2 bone tunnels were created at the level of 1/2 and lower 3/4 of the patella, and 1 bone tunnel was created beneath the tibial tuberosity. There were 8 males and 3 females with an average age of 30.1 years (range, 10-61 years). The average interval from the primary injury to the operation was 9.5 months (range, 2-36 months). According to Yousef classification, there were 7 cases of type A2, 3 cases of type B2, and 1 case of type C2. The length of the patella tendon defect was measured when the patella was reducted intraoperatively with an average of 4.5 cm (range, 2.7-7.1 cm). Subjective function scores [including International Knee Documentation Committee (IKDC) subjective score, Tegner activity level, and Lysholm score] were evaluated before operation and at last follow-up. The loss of knee extension, Caton index, and thigh circumference difference at 15 cm above the patella between bilateral limbs were also measured. Results: All patients were followed up 24-66 months (mean, 34.2 months). All incisions were primary healing, and there were no complications such as wound infection, venous thrombosis of the lower extremities, stiffness of the knee joint, graft failure, neurovascular injury, etc. No second revision surgery was performed during the follow-up. At last follow-up, the subjective function scores (IKDC subjective score, Tegner activity level, Lysholm score), loss of knee extension, thigh circumference difference, and Caton index were significantly improved when compared with those before operation ( P<0.05). Two patients still had patella alta, with Caton indexes of 1.29 and 1.32, respectively. Conclusion: In the treatment of chronic patellar tendon ruptures and defects, the modified patellar tendon reconstruction using hamstring autograft can significantly improve the postoperative knee function, restore the normal range of knee extension, enhance the extensor and correct the patella alta.


Assuntos
Ligamento Patelar , Adolescente , Adulto , Autoenxertos , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Patela , Ligamento Patelar/cirurgia , Estudos Retrospectivos , Coxa da Perna , Adulto Jovem
2.
J Vasc Res ; : 1-16, 2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33535226

RESUMO

MicroRNAs and sirtuins are important epigenetic regulators of gene expression and both contribute significantly to postnatal vascular development. However, the crosstalk between miRNAs and sirtuins in the modulation of angiogenesis has rarely been discussed. Here, we investigated the interactions between miR-138 and sirtuins in the process of angiogenesis. We found that overexpression of miR-138 markedly suppressed the proliferation, migration, and tube-forming capacities of the endothelial cells. And, miR-138 inhibitor-treated endothelial cells showed a reversed phenotype. Furthermore, miR-138 plays a negative role in vascular development in vivo. Western blot and qPCR assays demonstrated that SIRT1 was silenced by miR-138, and a luciferase reporter assay showed that miR-138 bound to the 3'-UTR of SIRT1. The re-expression of SIRT1 alleviated miR-138-mediated suppression of angiogenesis. Furthermore, silencing SIRT1 could boost the level of miR-138. And, upon miR-138 inhibitor treatment, SIRT1 silencing no longer reduced the angiogenic ability of endothelial cells significantly. These results demonstrated that the circuitry involving miR-138 and SIRT1 may participate in vascular homeostasis and also offered the possibility of identifying a new approach in the treatment of angiogenic diseases.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33543339

RESUMO

BACKGROUND: T cell with chimeric antigen receptors (CAR-T) has presented remarkable efficacy for blood cancer as an emerging immunotherapy. However, for solid tumors, the therapeutic efficacy is much impaired due to the lack of infiltration and persistence of CAR-T in tumor tissue. Thus, we constructed an interleukin-7-loaded oncolytic adenovirus and combined the use of oncolytic virus and CAR-T to improve the therapeutic outcome. METHODS: We constructed an interleukin-7-loaded oncolytic adenovirus (oAD-IL7) and a B7H3-targeted CAR-T and explored the efficacy of the single use of oAD-IL7, B7H3-CAR-T, or the combined therapy for glioblastoma in vitro and in vivo. The improved CAR-T anti-tumor efficacy was evaluated according to the proliferation, survival, persistence, exhaustion of T cells, and tumor regression. RESULTS: Constructed oAD-IL7 and B7H3-CAR-T presented moderate cytotoxicity during in vitro study, but failed to induce a thorough and persistent anti-tumor therapeutic efficacy in vivo. The combination of oAD-IL7 and B7H3-CAR-T in vitro resulted in enhanced T cell proliferation and reduced T cell apoptosis. The joint efficacy was further confirmed using tumor-bearing xenograft mice. During in vivo study, the mice treated with both oAD-IL7 and B7H3-CAR-T showed prolonged survival and reduced tumor burden. According to the ex vivo study, oAD-IL7 improved the proliferation and persistence of tumor-infiltrating B7H3-CAR-T, but failed to reverse the exhaustion. CONCLUSIONS: Our results indicated that oAD-IL7 is a promising auxiliary therapy to improve the therapeutic efficacy of B7H3-CAR-T in glioblastoma by providing the activating signals for tumor-infiltrating T cells. Our results also lay the basis for the future clinical trials for the combination of IL7-loaded oncolytic adenovirus and CAR-T therapy for glioblastoma.

4.
Dig Dis Sci ; 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33433813

RESUMO

BACKGROUND AND AIMS: The high incidence of osteopathy among patients with chronic pancreatitis (CP) has garnered increased attention over recent years. The aims of this study were to assess the prevalence and risk factors for osteopathy in Chinese patients with CP. METHODS: This was a cross-sectional study of CP patients from a large center in China; patients were recruited between 31 January 2017 and 31 January 2018. Bone density and laboratory tests, including bone-related biochemical, inflammatory, and hormone parameters, were assessed prospectively. Differences between patients with and without osteopathy were analyzed. Logistic regression analysis was used to investigate associations between variables. RESULTS: In total, 104 CP patients were enrolled in this study (68.3% idiopathic and 31.7% alcoholic). According to the M-ANNHEIM classification, 87.5% of the patients were at an early stage (0-II). Osteopenia was diagnosed in 30.8% of patients and osteoporosis in 5.8%; thus, a total of 36.5% of patients presented with osteopathy. In multivariate analysis, the independent risk factors for osteopathy in CP patients were age (OR = 1.04; 95% CI = 1.00-1.08; P = 0.030), BMI (OR = 0.72; 95% CI = 0.58-0.89; P = 0.003), and PTH (OR = 0.96; 95% CI = 0.93-1.00; P = 0.022). CONCLUSIONS: This study is the first to report the prevalence of osteopathy in Chinese patients with CP. It found that age and low BMI are significant risk factors for osteopathy. Low PTH (but within the normal range) showed a weak association with osteopathy, which warrants further exploration.

5.
J Exp Bot ; 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33481006

RESUMO

Although plant-specific NAC transcription factors play crucial roles in response to abiotic stress, few reports have described the regulation of ZmNAC genes by the cis-natural antisense transcripts (cis-NATs). In the study, 521 NAC genes from Gramineae were classified, of which 51 NAC genes contained cis-NATs. ZmNAC48 and cis-NATZmNAC48 were co-localized to the same cell nuclei and both transcripts responded to drought stress. Arabidopsis overexpressing ZmNAC48 had improved drought tolerance, with lower rate of water loss, enhanced stomatal closure, and higher rates of plant survival. Transient expression in both maize protoplasts and tobacco leaves indicated that cis-NATZmNAC48 reduced ZmNAC48 expression. Western blotting and ribosome profiling analyses confirmed that cis-NATZmNAC48 lacks protein coding potential. Furthermore, the cis-NAT-derived small-interfering RNAs (nat-siRNAs) generated from the overlapping regions of ZmNAC48 and cis-NATZmNAC48 were detected in maize and transgenic Arabidopsis. Cis-NATZmNAC48 overexpressed maize showed higher water loss rate and dead leaves, increased stomatal opening, and decreased expression of ZmNAC48 and nat-siRNA. Taken together, our study indicates that both ZmNAC48 and cis-NATZmNAC48 are involved in plant drought stress response, and that the double-stranded RNA-dependent mechanism is involved in the interaction between cis-NATZmNAC48 and ZmNAC48. Additionally, cis-NATZmNAC48 may negatively regulate ZmNAC48 to affect stomatal closure of maize.

6.
Medicine (Baltimore) ; 100(1): e22393, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429725

RESUMO

ABSTRACT: Calcaneal fractures are rare in pediatric population, with more displaced intra-articular fractures encountered due to the increasing number of high-energy trauma. Operative interventions are gaining popularity because of the unsatisfactory outcomes of traditional conservative methods. This study investigated the clinical outcomes of a minimally invasive technique using the sinus tarsi approach and external fixator in the treatment of intra-articular calcaneal fractures in pediatric patients.Patients who underwent open reduction between January 2010 and January 2018 at our institute were included in this study and reviewed retrospectively. Radiological and clinical parameters were all recorded and analyzed.Overall, 29 patients were included in the study, including 23 boys and 6 girls (10.2 ±â€Š2.2 years old). The average follow-up was 29.5 months postoperatively (range, 26-72 months). Bohler angle was 15.2 ±â€Š3.3° preoperatively, and 34.0 ±â€Š3.8° postoperatively (P < .001); Gissane angle was 101.8 ±â€Š6.2 degrees preoperatively, and 129.7 ±â€Š6.2° postoperatively (P < .001). The average length of incision was 3.4 ±â€Š0.7 cm. At the last follow-up, all patients showed satisfactory clinical outcomes and the score was 90.0 ±â€Š2.3 according to American Orthopedic Foot and Ankle Society Scale.Minimally invasive approach with external fixator is an effective method for treating displaced intra-articular calcaneal fractures in pediatric patients, with a lower incidence of wound-related complications and good cosmetic outcomes.


Assuntos
Calcâneo/lesões , Calcâneo/cirurgia , Fixadores Externos/normas , Adolescente , Criança , Pré-Escolar , Fixadores Externos/efeitos adversos , Fixadores Externos/tendências , Feminino , Pé/cirurgia , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/cirurgia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Resultado do Tratamento
7.
Cancer Lett ; 503: 69-74, 2021 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-33476650

RESUMO

Chimeric antigen receptor (CAR) T cell therapy is one of the most promising immunotherapies in the past decade. It brings hope for cure to patients with previously refractory hematological malignancies. However, when translating this strategy into non-hematologic malignancies, the antitumor activity from multiple clinical studies seemed to be subtle or transient. The less satisfying efficacy in solid tumors might at least due to antigen heterogeneity, suboptimal CAR-T cell trafficking and tumor immunosuppressive environment. Here, we will review the updating strategies to challenge the therapeutic impediments of CAR-T therapy in non-hematologic malignancies. We mainly focus on the combination with oncolytic viruses (OV), the born allies for CAR-T cells. In addition to previously reported OVs-arming strategy, we discuss recently proposed tumor-tagging concept by OVs as CAR-T targets, as well as the possible improvements. Overall, tumor-tagging strategy by OVs combination with CAR-T would be a novel and promising solution for the heterogeneity and immunosuppressive microenvironment of solid tumors.

8.
J Cell Physiol ; 236(2): 1345-1361, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32657446

RESUMO

Fibroblast growth factor 21 (FGF21) as a metabolic stress hormone, is mainly secreted by the liver. In addition to its well-defined roles in energy homeostasis, FGF21 has been shown to promote remyelination after injury in the central nervous system. In the current study, we sought to examine the potential roles of FGF21 in the peripheral nervous system (PNS) myelination. In the PNS myelin development, Fgf21 expression was reversely correlated with myelin gene expression. In cultured primary Schwann cells (SCs), the application of recombinant FGF21 greatly attenuates myelination-associated gene expression, including Oct6, Krox20, Mbp, Mpz, and Pmp22. Accordingly, the injection of FGF21 into neonatal rats markedly mitigates the myelination in sciatic nerves. On the contrary, the infusion of the anti-FGF21 antibody accelerates the myelination. Mechanistically, both extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (MAPK) were stimulated by FGF21 in SCs and sciatic nerves. Following experiments including pharmaceutical intervention and gene manipulation revealed that the p38 MAPK/c-Jun axis, rather than ERK, is targeted by FGF21 for mediating its repression on myelination in SCs. Taken together, our data provide a new aspect of FGF21 by acting as a negative regulator for the myelin development process in the PNS via activation of p38 MAPK/c-Jun.

9.
J Adolesc ; 86: 77-89, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33360420

RESUMO

INTRODUCTION: The present study investigated whether grit can mitigate the associations between school burnout, loneliness, and depressive symptoms among adolescents. It also examined gender differences. METHODS: This study included 1296 seventh and 1166 eighth graders from Finland. The study variables were self-reported and regression analysis was performed. RESULTS: This study found that two grit facets - consistency of interest and perseverance of effort - played resilient roles in school burnout. A high level of grit substantially reduced reported depressive symptoms when adolescents experienced high school burnout. Our further analysis showed that the role of grit was more pronounced among boys than among girls. When male adolescents were at risk of school burnout, both consistency of interest and perseverance of effort protected them and they had only low levels of loneliness and depressive symptoms. CONCLUSIONS: This study demonstrates that grit can act as a resilience factor among adolescents.

10.
Sci Total Environ ; 757: 144158, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33316520

RESUMO

In China, the growing amount of digestate from anaerobic digestion produced by animal husbandry is an emerging challenge. A common treatment used to eliminate this digestate is long-term stabilization ponds. However, this process can lead to a shortage of digestate storage space and loss of nitrogen nutrients within the digestate. To alleviate those shortcomings, this study developed an efficient stabilization pond using biochar and persulfate (BC/PS treatment). Using this treatment, the germination index (GI) of the digestate increased from 56% to 85% and the stabilization efficiency increased nearly 2.7 times. In addition, the dehydrogenase activity (DHA) in the BC/PS treatment remained between 0.47 and 0.91 µg/(g·h) across the 40 days, which indicated that BC/PS had a positive effect on microbial inactivation. In the traditional stabilization process (CK treatment), dissolved organic nitrogen (DON) decreased from 47.77 mg/L to 0.81 mg/L and ammonium nitrogen almost disappeared. The BC/PS treatment led to the promotion of nitrogen nutrient composition. Particulate total nitrogen (21.49% of total nitrogen) decomposed into dissolved total nitrogen and the DON increased from 47.77 to 58.89 mg/L. The BC/PS treatment showed a faster stabilization time, good microbial inactivation, lower toxicity, and stable nitrogen nutrient composition of the digestate compared to traditional methods.


Assuntos
Compostos de Amônio , Carvão Vegetal , Anaerobiose , Animais , China , Nitrogênio/análise
11.
J Nanosci Nanotechnol ; 21(1): 284-295, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33213630

RESUMO

This paper studies the characteristics and controlling factors of nanopores in organic-rich shale in the Niutitang Formation. Six samples were collected from the bottom of the formation at the Jiumen Outcrop, Guizhou Province. Experiments were conducted to investigate the pore structures of these high-maturity shale samples. The TOC contents vary between 4.81-17.51% with an average of 10.18%. The XRD data show that these samples are dominated by quartz (44%-71%), with a significant amount of clay minerals, such as illite, with a content of 8%-27.5%. Based on the low-pressure liquid N2 sorption measurements, the pore structures can be divided into two groups. Group A including samples of N-2, N-3 and N-4, mainly develop slit-shaped pores, mesopores and macropores. Group B shown from samples N-1, N-5 and N-6, are mainly composed of narrow slitlike pores, which may provide more space for shale gas than slit-shaped pores. The mesopores, macropores, porosity and specific surface areas of group B are more developed than those of group A. With the comparison of pore structures in shales with various organic matter and mineral contents, the dissolution of quartz and feldspar can be the important factor controlling pore development. The evolution of diagenesis is closely related to pore evolution. This diagenesis has various types and complex effects on the pores, mainly including compaction, dissolution and cementation.

12.
Biomed Res Int ; 2020: 1923172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33282939

RESUMO

Purpose: The purpose of this study was to compare the accuracy and clinical outcomes of the medial open wedge high tibial osteotomy (MOWHTO) using a three-dimensional (3D-) printed patient-specific instrumentation (PSI) with that of conventional surgical techniques. Methods: A prospective comparative study which included 18 patients who underwent MOWHTO using 3D-printed PSI technique (3D-printed group) and 19 patients with conventional technique was conducted from Jan 2019 to Dec 2019. After the preoperative planning, 3D-printed PSI (cutting guide model) was used in MOWHTO for 3D-printed group, while freehand osteotomies were adopted in the conventional group. The accuracy of MOWHTO for each method was compared using the radiological index obtained preoperatively and postoperatively, including mechanical femorotibial angle (mFTA) and medial mechanical proximal tibial angle (mMPTA), and correction error. Regular clinical outcomes were also compared between the 2 groups. Results: The correction errors in the 3D-printed group were significantly lower than the conventional group (mFTA, 0.2° ± 0.6° vs. 1.2° ± 1.4°, P = 0.004) (mMPTA, 0.1° ± 0.4° vs. 2.2° ± 1.8°, P < 0.00001). There was a significantly shorter duration (P < 0.00001) and lower radiation exposures (P < 0.00001) for the osteotomy procedure in the 3D-printed group than in the conventional group. There were significantly higher subjective IKDC scores (P = 0.009) and Lysholm scores (P = 0.03) in the 3D-printed group at the 3-month follow-up, but not significantly different at other time points. Fewer complications occurred in the 3D-printed group. Conclusions: With the assistance of the 3D-printed patient-specific cutting guide model, a safe and feasible MOWHTO can be conducted with superior accuracy than the conventional technique.

13.
Exp Mol Pathol ; : 104589, 2020 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-33290799

RESUMO

OBJECTIVE: Androgenetic alopecia (AGA), a common alopecia, is often accompanied by abnormal expression of multiple miRNAs. This study aims to investigate abnormally expressed miRNAs in patients with AGA and their specific molecular mechanism. METHODS: miRNA microarray profiling and qRT-PCR validation were used to screen and verify abnormally expressed miRNAs in patients with AGA. Human hair follicles (HFs) were treated with different concentrations of dihydrotestosterone (DHT, 10-5, 10-6, 10-7 and 10-8 mol/L) for 10 days. The effects of DHT on HF growth, proliferation, and miRNA expression in cultured HFs were investigated using immunofluorescence staining and qRT-PCR. Moreover, human dermal papilla cells (HDPCs) were treated/transfected with a Wnt/ß-catenin pathway activator and/or miR-133b mimic, and then the CCK-8 assay was used to evaluate HDPC proliferation. qRT-PCR and Western blotting were used to measure the expression of Versican, ALP and ß-catenin RESULTS: miRNA microarray profiling identified 43 miRNAs that were significantly differentially expressed in AGA patients, and qRT-PCR verified that 8 miRNAs were significantly differentially expressed. The expression of miR-133b was abnormally high in AGA patients. DHT (10-5 mol/L) inhibited human HF growth and upregulated miR-133b expression, and DHT (10-7 mol/L) induced human HF growth and downregulated miR-133b expression. HDPC proliferation was inhibited, and the expression of ß-catenin was downregulated in the miR-133b mimic-transfected group compared with the control group (P < 0.05). Wnt/ß-catenin pathway activator treatment significantly promoted HDPC proliferation and upregulated the expression of ß-catenin (P < 0.05). In addition, the proliferation of HDPCs was not significantly different between the group cotreated with a Wnt/ß-catenin pathway activator and miR-133b mimic, and the control group (P > 0.05), but the expression of Versican and ALP was suppressed in the cotreatment group (P < 0.05) CONCLUSION: Our data indicated that patients with androgenic alopecia have specific miRNA expression profiles and that the abnormal expression of miR-133b may inactivate the Wnt/ß-catenin pathway and ultimately regulate hair growth.

14.
J Orthop Surg Res ; 15(1): 581, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33267906

RESUMO

BACKGROUND: The optimal dosage and administration approach of tranexamic acid (TXA) in primary total knee arthroplasty (TKA) remains controversial. In light of recently published 14 randomized controlled trials (RCTs), the study aims to incorporate the newly found evidence and compare the efficacy and safety of intra-articular (IA) vs. intravenous (IV) application of TXA in primary TKA. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for RCTs comparing IA with IV TXA for primary TKA. Primary outcomes included total blood loss (TBL) and drain output. Secondary outcomes included hidden blood loss (HBL), hemoglobin (Hb) fall, blood transfusion rate, perioperative complications, length of hospital stay, and tourniquet time. RESULT: In all, 34 RCTs involving 3867 patients were included in our meta-analysis. Significant advantages of IA were shown on TBL (MD = 33.38, 95% CI = 19.24 to 47.51, P < 0.001), drain output (MD = 28.44, 95% CI = 2.61 to 54.27, P = 0.03), and postoperative day (POD) 3+ Hb fall (MD = 0.24, 95% CI = 0.09 to 0.39, P = 0.001) compared with IV. There existed no significant difference on HBL, POD1 and POD2 Hb fall, blood transfusion rate, perioperative complications, length of hospital stay, and tourniquet time between IA and IV. CONCLUSION: Intra-articular administration of TXA is superior to intravenous in primary TKA patients regarding the performance on TBL, drain output, and POD3+ Hb fall, without increased risk of perioperative complications. Therefore, intra-articular administration is the recommended approach in clinical practice for primary TKA.

15.
J Breath Res ; 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33339013

RESUMO

PURPOSE: The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) can cause multiple system damage, and the main physiological mechanisms are continuous hypoxia and intermittent hypoxia (IH). Airway mucus hypersecretion is an important clinical feature of COPD, which can cause a progressive decline of lung function, acute COPD aggravation, and disease progression. The purpose of our study is to determine the influence of the coexistence of mild OSA on airway mucus hypersecretion. PATIENTS AND METHODS: Clinical data and airway epithelial samples were collected. The average fluorescence intensity of MUC5AC and the number of goblet cells were measured through immunofluorescence staining. MUC5AC expression was measured in human bronchial epithelial (HBE) cells exposed to normoxia, IH, particulate matter (PM), and PM+IH using real-time quantitative polymerase chain reaction and western blotting. RESULTS: FEV1% pred and FEV1/FVC were higher in patients with COPD-OSA overlap syndrome(OS) than in patients with COPD alone. Patients with OS had less sputum volume than patients with COPD alone.MUC5AC expression and the number of goblet cells in the airway epithelium in the COPD alone group were significantly higher than those in the OS groups. The PM+IH group had lower MUC5AC mRNA and protein expression in HBE cells than the PM group. CONCLUSIONS: The coexistence of mild OSA may reduce goblet cell proliferation and MUC5AC expression in the airway epithelium of patients with COPD. Mild IH inhibited PM-induced up-regulation of MUC5AC expression in the mRNA and protein levels in HBE cells.

16.
Zhongguo Gu Shang ; 33(12): 1134-41, 2020 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-33369321

RESUMO

OBJECTIVE: To investigate the clinical effects of individualized repair and reconstruction surgery for multiple ligament injury and dislocation of knee joint based on stage classification diagnosis. METHODS: From January 2018 to January 2019, 42 patients with multiple ligament injury and dislocation of the knee joint were treated. There were 27 males and 15 females, aged from 30 to 63 (47.35±11.90) years old, including 17 left knees, 23 right knees and 2 bilateral knees. All patients with multiple ligament injuries and dislocations of the knee joint were classified by stages and improved Schenck diagnosis. Among them, 23 cases were in acute stage (≤3 weeks), 19 cases were in old stage (>3 weeks), 27 cases were type Ⅲ dislocation and type Ⅳ dislocation. There were 9 cases of dislocation and 6 cases of type Ⅵ dislocation. The corresponding repair methods such as closed manipulation and open release reduction, direct suture of ligament, anchor suture, bone penetrating suture, and routine ligament reconstruction were performed. The corresponding "progressive progressive excitation" rehabilitation program was adopted after the operation. After 2, 4, 6, 8 weeks and 3, 6, 9, 12 months after operation, the outpatient consultation and evaluation of knee joint function and stability were completed. The knee joint stability, excellent and good rate, disability rate and complication rate were compared before and after operation. Internation Knee Documentation Committee (IKDC) grade, IKDC subjective score, Lysholm score and Tegner score were used to evaluate knee joint function. RESULTS: All patients completed the outpatient follow-up and follow-up on schedule. All patients had gradeⅠwound healing, 4 patients had lower extremity venous thrombosis after operation, and there were no serious complications after anticoagulant treatment; 5 patients with common peroneal nerve injury were treated with release surgery and active postoperative rehabilitation, and neurological function gradually recovered. At 12 months after operation, the muscle strength of the affected limb reached grade Ⅴ and the active and passive range of motion recovered to more than 120 degrees. In the acute stage, the IKDC subjective scores were 20.46±12.61, 22.58±16.83, 0.71±1.14, 69.55±16.57, 77.73±15.14 and 3.14±1.67, respectively. One year after operation, IKDC subjective score was 67.04±19.07, Lysholm was 74.87±14.58, Tegner was 3.06±1.70, and 6 of them were grade A. After 12 months, the knee function scores of all patients were significantly improved compared with those before operation(P<0.01). CONCLUSION: According to the classification of multiple ligament injuries and dislocations of the knee joint, the corresponding surgical repair and reconstructiontreatment were adopted, and the corresponding rehabilitation program was adopted after the operation. The patients achieved good clinical treatment effect 12 months after operation, and the patients' satisfaction was high, which improved the excellent and good rate of treatment and reduced the disability rate.


Assuntos
Lesões do Ligamento Cruzado Anterior , Luxação do Joelho , Ligamento Cruzado Posterior , Procedimentos Cirúrgicos Reconstrutivos , Adulto , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Feminino , Humanos , Luxação do Joelho/cirurgia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Ligamento Cruzado Posterior/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
17.
Dev Med Child Neurol ; 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33326122

RESUMO

AIM: To investigate the efficacy of a virtual reality rehabilitation system of wearable multi-inertial sensors to improve upper-limb function in children with brain injury. METHOD: Eighty children (39 males, 41 females) with brain injury including cerebral palsy aged 3 to 16 years (mean age 5y 8mo, SD 2y 10mo) were assessed as part of a multicentre, single-blind, randomized controlled trial. The intervention group received a 30-minute virtual reality intervention and a 30-minute session of conventional occupational therapy while the control group received 60 minutes of conventional occupational therapy per session, with 20 sessions over 4 weeks. The virtual reality rehabilitation system consisted of games promoting wrist and forearm articular movements using wearable inertial sensors. The Melbourne Assessment of Unilateral Upper Limb Function-2 (MA-2), Upper Limb Physician's Rating Scale, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and computerized three-dimensional motion analysis were performed. RESULTS: Both groups (virtual reality, n=40; control, n=38) significantly improved after treatment compared to baseline; however, the virtual reality group showed more significant improvements in upper-limb dexterity functions (MA-2, virtual reality group: Δ=10.09±10.50; control: Δ=3.65±6.92), performance of activities of daily living, and forearm supination by kinematic analysis (p<0.05). In the virtual reality group, children with more severe motor impairment showed significant improvements compared to those with less severe impairment. INTERPRETATION: The virtual reality rehabilitation system used in this study, which consists of wearable inertial sensors and offers intensive, interactive, and repetitive motor training, is effective in children with brain injury.

18.
J Youth Adolesc ; 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33201368

RESUMO

Grit has recently been challenged for its weak predictive power and the incompleteness of its measurement. This study addressed these issues by taking a developmental, person-oriented approach to study academic-related goal commitment and grit and their effects on academic achievement. Using longitudinal data among Finnish eighth and ninth graders (n = 549, 59.4% female, age = 14-16), the longitudinal changes in grit and academic goal commitment profiles were investigated through latent profile and latent transition analyses. Four profiles were identified across two grades: High committed-persistent and moderate consistency (~17%), Moderate (~60%), Low committed-persistent and moderate-low consistency (~8%) and Extremely low committed-persistent and moderate-low consistency (~12%). The students in the High committed-persistent and moderate consistency profile had the highest academic achievement of all the profiles when controlled for gender, socioeconomic status, conscientiousness, and academic persistence. The results revealed that students' profiles changed between the eighth and ninth grades, with more than one-third of the High committed-persistent and moderate consistency adolescents dropping from this group. Further analysis showed that the profiles varied by educational aspiration, gender, and socioeconomic status. These findings imply that the combination of grit and academic goal commitment influences academic achievement; however, this combination is less common, unstable, and affected by internal and external factors. The study provided important implications on the weak grit effect and the ways to improve it.

19.
Artigo em Inglês | MEDLINE | ID: mdl-33201657

RESUMO

As an important method to further improve the storage density of resistive memory, multistage resistive switching devices have become an important research direction. However, no stable and controllable multistage resistive switching device has been prepared, and the working mechanism is still unclear. Here, a sandwich-structured device is simply prepared by spin coating, with the work layer is the Bi2FeCrO6 thin film. The device can realize bidirectional controllable multistage resistive switching behavior, the biggest on/off ratio is 104, and it can maintain stability without attenuation at 100 times slow loop and 104 times pulse cycle. The analyzes showed that the charged ions formed by defects in the device migrated under the action of an external electric field lead to the Schottky barrier height reversible changed. Which is the key to cause multistage resistive switching behavior. This work is the first report about the voltage control of bidirectional adjustable multistage resistive switching behavior in the Bi2FeCrO6 thin film. The principle of generation is analyzed, and important ideas and insights are provided for the preparation and treatment of related multistage resistive problems.

20.
BMC Cancer ; 20(1): 1095, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176731

RESUMO

BACKGROUND: Hypopharyngeal squamous cell carcinoma (HSCC) is a rare type of head and neck cancer with poor prognosis. However, till now, there is still no model predicting the survival outcomes for HSCC patients. We aim to develop a novel nomogram predicting the long-term cancer-specific survival (CSS) for patients with HSCC and establish a prognostic classification system. METHODS: Data of 2021 eligible HSCC patients were retrieved from the Surveillance, Epidemiology and End Results database between 2010 and 2015. We randomly split the whole cases (ratio: 7:3) into the training and the validation cohort. Cox regression as well as the Least absolute shrinkage and selection operator (LASSO) COX were used to select significant predictors of CSS. Based on the beta-value of these predictors, a novel nomogram was built. The concordance index (C-index), the calibration curve and the decision curve analysis (DCA) were utilized for the model validation and evaluation using the validation cohort. RESULTS: In total, cancer-specific death occurred in 974/2021 (48.2%) patients. LASSO COX indicated that age, race, T stage, N stage, M stage, surgery, radiotherapy and chemotherapy are significant prognosticators of CSS. A prognostic model based on these factors was constructed and visually presented as nomogram. The C-index of the model was 0.764, indicating great predictive accuracy. Additionally, DCA and calibration curves also demonstrated that the nomogram had good clinical effect and satisfactory consistency between the predictive CSS and actual observation. Furthermore, we developed a prognostic classification system that divides HSCC patients into three groups with different prognosis. The median CSS for HSCC patients in the favorable, intermediate and poor prognosis group was not reached, 39.0-Mo and 10.0-Mo, respectively (p < 0.001). CONCLUSIONS: In this study, we constructed the first nomogram as well as a relevant prognostic classification system that predicts CSS for HSCC patients. We believe these tools would be helpful for clinical practice in patients' consultation and risk group stratification.

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