BACKGROUND:Amputation is a special type of trauma. Mechanism of trauma-induced damage to the liver and the effects of hydrogen sulfide (H 2 S) on the liver remain unclear.
OBJECTIVE:To explore the mechanism of hepatic damage in rats of postoperative amputation, and how H 2 S exerts effects on liver function.
METHODS:Wistar rats and Sprague-Dawley rats were equal y and randomly divided into normal group, postoperative 6-, 12-, 24-and 72-hour groups, sodium hydrosulfide (NaHS) group, and propargyl glycine group, as wel as normal group, postoperative 6-hour group, HaHS group, and propargyl glycine group. Except the normal group, the structure 1.2-1.4 cm above the left knee was completely transected in rats of other groups. Blood vessels were ligated, and then left femoral vein and femoral artery were cut to establish rat models of amputation in the left hind limb. In the NaHS and propargyl glycine groups, 28 μmol/kg NaHS and 50 mg/kg propargyl glycine were intraperitoneal y injected immediately after amputation.
RESULTS AND CONCLUSION:Compared with the normal group, traumatic changes in rat liver cel s and mitochondrial structure were seen, and plasma and liver myeloperoxidase, malondialdehyde, H 2 S/cystathionineγ-lyase levels, liver mitochondrial respiratory control rate, membrane potential and ATP activity were significantly lower in the postoperative 6-hour groups (P<0.05). After NaHS intervention, H 2 S/cystathionineγ-lyase level and above indicators were significantly higher in the postoperative 6-hour groups (P<0.05), but plasma transaminase did not significantly alter (P>0.05). After treatment with propargyl glycine, above indicators except mitochondrial indexes were further decreased, and transaminase was significantly reduced (P<0.05). These findings suggest that H 2 S can reduce lipid peroxidation, inflammatory reaction, and make the mitochondrial function improved significantly, but did not reduce the damage of liver function in rat models after amputation.

Objective To investigate the protective mechanism of hydrogen sulfide(H2S) on inflammatory and oxidative damage of myocardium due to stress after amputation,and explore the relationship between H2S signal pathway and inflammatory and oxidative damage.Methods Twenty-eight adult male Wistar rats(weighing 260-300g) were randomly divided into 4 groups(7 each):control group,trauma group,NaHS group and PPG group.Rat model of traumatic stress was established in the rats in the 3 latter groups,and the animals were sacrificed 6 hours after modeling.The rats in control group were also sacrificed at the same time point.Rats in NaHS and PPG group respectively received intraperitoneal injection of NaHS(28?mol/kg) or PPG(50mg/kg).The level of H2S in plasma was measured by sensitive sulphur electrode,the activity of CSE in myocardium was determined by methylene blue method,myeloperoxidase(MPO) in plasma and myocardium was measured with ultraviolet spectrophotometry,and malondialdehyde(MDA) in plasma and myocardium was measured by TBA method.Results Compared with the control group,the content of H2S in plasma decreased,MPO and MDA in plasma and myocardium increased 6 hours after amputation(trauma group).Compared with the trauma group,the contents of H2S and MPO in plasma and the activity of CSE in myocardium increased,MDA in plasma and MPO and MDA in myocardium decreased in NaHS group,while the contents of H2S and MPO in plasma and the activity of CSE in myocardium decreased,MDA in plasma and MPO and MDA in myocardium increased in PPG group.Conclusion Inflammatory and oxidation injuries may occur in rat's myocardium after amputation,and H2S can offer a protective effect on myocardium by decreasing inflammatory and oxidative damage.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.

Objective To explore the clinical results of the arthroscopic acromioplasty in the rotator cuff repair.Methods Sixty-five patients (42 males and 23 females) to receive suture bridge repair under the arthroscopy between May 2012 and May 2014 were selected and randomly divided into an experimental group and a control group.The experimental group was given suture bridge repair with acromioplasty,while the control group underwent the suture bridge repair without acromioplasty.The time of operation was recorded.The range of motion (ROM) of the shoulder,the UCLA shoulder scoring system (ULCA) score,American orthopedic surgeon scoring system (ASES) score,the visual analogue scale (VAS) score and Constant score were observed 3 and 12 months after the operation.Results There were no significant differences in age,sex and the affected side between the two groups.Significant differences were found between the two groups in the duration of the operation (t=-18.5,P＜0.05).There were no significant differences in the ROM and the ULCA,ASES,VAS and constant scores of the shoulder 3 and 12 months after the operation.Conclusion No significant differences were found in the ROM and the shoulder function scoring between giving acromioplasty under the arthroscopy or not.However,the operation time of undergoing acromioplasty under the arthroscopy was longer.

BACKGROUND:Recently, studies on three-dimensional reconstruction and biomechanics became more and more. Three-dimensional models of organs were established by modeling software based on image data using computer. Mechanical analysis was conducted using finite element analysis software. After literature retrieval, we found that the principle of three-dimensional reconstruction of human organs is not clear, and the process description is relatively simple. Some is not accorded with the fact. Above studies cannot guide related research. OBJECTIVE:To explore the principle, process, results and further application of three-dimensional reconstruction models of organs, and to provide evidence for future studies. METHODS:We retrieved China National Knowledge Infrastructure for representative literatures about three-dimensional reconstruction of human organs using the computer, and analyzed the principle, process, results and further application of three-dimensional reconstruction models of organs. RESULTS AND CONCLUSION:In combination with established three-dimensional bone models, we explained the principle, process, and application of three-dimensional reconstruction in detail, and laid the theoretical foundation for subsequent biomechanical research. With continuous development of tissue engineering technology, scholars have begun to study the pathogenesis of bone injury from various angles and different aspects so as to better prevent and treat this disease. The related research is stil in its primary stage, and stil needs further investigations. 

Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.

Objective To synthesize miRNA carrier PEG-b-PLL and to testify the stability , encapsulation efficiency and cyto-toxicity of its complexes .Methods H1 NMR was used to determine the degree of polymerization of PLL , 4%agarose gel electrophore-sis was used to determine entrapment of the polyer to the miRNA;then dynamic light scattering ( DLS) was used to measure the hydro-dynamic parameter such as size , polydispersity index ( PDI) and zeta potential of the polyplexes .The entrapment efficiency was deter-mined by ultraviolet-visible spectrophotometer , and finally , the cyto-toxicity of PEG-b-PLL was evaluated by CKK-8 kit with K562 cell lines.Results The characteristics indicated polyplexes prepared by PEG-b-PLL and miRNA fulfill the demand of being the gene carri-er of miRNA because of low cyto-toxicity , high encapsulation efficiency and stability .Conclusion The miRNA carrier PEG-b-PLL had good character and low cyto-toxicity.It showed considerable potential as an efficient miRNA carrier .

OBJECTIVETo explore the mechanism of kidney injury in rats following amputation and the protective effects of sodium hydrosulfide (NaHS) on kidney structure and function.

METHODSMale Wistar rats were randomly divided into normal control, 6 h after operation, NaHS intervention, and propargyl glycine (PPG) intervention groups (n=7). Plasma level of H2S, kidney injury molecule-1 (KIM-1), myeloperoxidase enzyme (MPO), malondialdehyde (MDA), nitric oxide (NO), urea nitrogen, creatinine, and renal tissue MPO, MDA, and KIM-1 levels, and activity of CSE were measured and the renal histological and mitochondrial structural changes were observed using optical and electron microscopy. In another experiment with SD rats, the rats were randomized also into these 4 groups (n=8) for measurement of renal mitochondrial respiratory control ratio, membrane potential and ATP activity.

RESULTSTraumatic changes in rat kidney cells and mitochondrial structure occurred in the rats 6 h after amputation with significantly increased plasma and renal KIM-1 (P<0.01) but significantly decreased H2S/CSE levels (P<0.01). Plasma H2S/kidney CSE level was significantly increased following NaHS intervention (P<0.01), which reduce the damage of the kidney tissue and significantly lower plasma and renal KIM-1, NO, BUN, Cr, MPO, and MDA (P<0.01). Rat kidney mitochondrial respiratory control ratio, membrane potential and ATP activity all decreased significantly after amputation (P<0.01) increased significantly after the application of NaHS; such improvements did not occur following PPG treatment.

CONCLUSIONSAmputation can lead to damage to the structure and function of the rat kidneys, and NaHS can significantly improve mitochondrial function and further reduce renal structural and functional impairments, suggesting that H2S, as an endogenous mediator, may act on the mitochondria through several pathways to regulate energy metabolism and participate in the pathophysiological processes of tissue damage and repair.

Acute Kidney Injury ; metabolism ; pathology ; prevention & control ; Amputation ; adverse effects ; Animals ; Creatinine ; blood ; Kidney ; metabolism ; pathology ; Male ; Malondialdehyde ; blood ; Nitric Oxide ; blood ; Peroxidase ; blood ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Sulfides ; therapeutic use

Objective To study the short-term effectiveness of robotic-assisted laparoscopic radical prostatectomy in high-risk prostate cancer.Methods From March 2012 to March 2017,400 patients with high-risk prostate who underwent robotic-assisted laparoscopic radical prostatectomy were reviewed.The median age was 68 years old(ranged from 49 to 83 years),and the median PSA was 23.1 ng/ ml(ranged from 5.2 to 999.0 ng/ml).Preoperative parameters,surgical interventional data,postoperative pathology and follow-up data were collected.Logistic regression was used to analyze the risk factors of positive surgical margin in postoperative pathology.Results All the operations were successfully completed.Median operation time was 115 min(ranged 50-555 min),and median estimated blood loss was 110 ml(ranged 30-500 ml).Six patients had perioperative complications,among which two were rectal injury,two were cardio-cerebrovascular disease and two were hemorrhage.There was no perioperative death.Positive surgical margin was detected in 151 patients,accounting for 37.8％.A total of 345 cases (86.3％) underwent lymphadenectomy,of which 253 cases (63.3％) were performed standardized resection and 92 cases (23％) were performed extensive resection.The median number of resected lymph nodes was 9 (ranged 3-36).Eighty cases (23.2％,80/345) were positive in resected lymph nodes.Regression analysis showed that preoperative PSA ＞ 20 ng / ml or clinical stage ≥ T2c were risk factors for positive surgical margins.After a median follow-up of 14.4 months (ranged 2.0-58.8 months),the overall incidence of biochemical recurrence was 33.4％ (107/320),and the urinary continence rate one year after operation was 86.6％ (277/320).Conclusions Robotic-assisted laparoscopic radical prostatectomy in patients with high-risk prostate cancer was a feasible,safe and effective approach.Preoperative PSA and clinical stage were the risk factors for positive surgical margin.

Objective:To analyze the cytopathologic and sonographic features of false-positive diagnosis in fine-needle aspiration (FNA) of thyroid nodules.Methods:The false-positive diagnosis of thyroid nodules FNA which was confirmed by histopathology in the Affiliated Hospital of Sun Yat-sen University from Jan 2016 to Sep 2020 were collected and analyzed.Results:A total of 2, 626 patients with 2, 971 thyroid nodules were performed ultrasonography (US)-guided FNA, and 1, 061 thyroid nodules (35.7%) were confirmed by histopathology.Among these 1, 061 nodules, 817 (77.0%) were histopathologic malignancy, and 748(70.5%) were cytopathologic malignancy (TBSRTC Ⅴ-Ⅵ). Twenty-one patients with 23 thyroid nodules were false-positive diagnosis, showing TBSRTC Ⅴ, with a false-positive rate of 9.4%. In these false-positive cases, 18 patients showed normal thyroid function and 13 showed negative thyroid antibodies. All the false-positive nodules showed part of cytopathologic features of papillary thyroid carcinoma, but were insufficient to diagnose TBSRTC Ⅵ. In sonographic features, 16 nodules (69.6%) were classified as ACR TI-RADS 2-4, 12 (52.2%) were classified as C-TIRADS 3-4A or sonographic benign, and none of the nodules were found suspicious cervical lymph nodes metastasis.Conclusions:The overlapping of cytopathologic features is the main cause of false-positive diagnosis in thyroid nodules FNA. Sonographic features may play a role in decreasing the false-positive diagnosis.