1. Reconstruction finger web with dorsal two wing-shaped advancement flap for the treatment of congenital syndactyly
Chinese Journal of Reparative and Reconstructive Surgery 2019;33(2):195-198
Objective: To discuss the effectiveness of using dorsal two wing-shaped advancement flap to reconstruct finger web for treatment of congenital syndactyly. Methods: Between August 2014 and August 2017, 30 cases of congenital syndactyly were treated, including 18 males and 12 females with an average age of 2.5 years (range, 1.5-5 years). Eight cases were of bilateral hands syndactyly and 22 cases of single hand syndactyly. There were 39 webs of syndactyly (including 1 case of syndactyly of middle finger, ring finger, and little finger). Among them, 11 webs were complete and 28 webs were incomplete. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle was designed and was just sewed up with an anchor-shaped incision at the palm. Distal end of fingers were separated by serrated flap and were sutured after removal of fatty tissue. In 11 cases with tight skin connection, the defect area at lateral and distal end of fingers was repaired by small pieces of full-thickness skin graft. Results: All the flaps survived completely after operation, and no flap necrosis occurred. The skin grafts on the distal side of the finger survived and the wound healed by first intension. All 30 cases were followed up 6-12 months, with an average of 9 months. Postoperative flexion and extension function of fingers were good, and the web depth and width were normal. At last follow-up, according to the Swanson et al. standard, 20 fingers were graded as excellent, 8 as good, and 2 as fair, with an excellent and good rate of 93.3%. Conclusion: The effectiveness of using dorsal two wing-shaped advancement flap to reconstruction finger web for treatment of congenital syndactyly is satisfactory.
2.Effects of Liuwei Shunji Capsule on Visceral Hypersensitivity and Content of 5-HT of Rats with Liver Depression and Spleen Deficiency-type Irritable Bowel Syndrome
Guiqiu DENG ; Bei ZHANG ; Zhe ZHANG ; Feiyan CHEN ; Zizhao LAO ; Geng LI ; Qingguang WU ; Honghui CHENG
Chinese Journal of Information on Traditional Chinese Medicine 2014;(8):46-48
Objective To observe the therapeutic effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT of model rats with liver depression and spleen deficiency-type irritable bowel syndrome (IBS), and explore its mechanism.Methods SD rats were randomly divided into normal group, model group, pinaverium bromide group and Liuwei Shunji Capsule of high, medium and low dose groups. Senna with restraint stress was used in duplicating liver depression and spleen deficiency-type IBS model. From the second day after the model was established, each drug treatment group was administered with corresponding drugs once a day for two weeks. The effects of Liuwei Shunji Capsule on survival state, visceral hypersensitivity, the content of 5-HT in serum and hypothalamus were observed.Results Compared with model group, Liuwei Shunji Capsule could raise weight growth rate of model rats with liver depression and spleen deficiency-type IBS (P<0.05), improve their diarrhea, fatigue demeanor, fur quality, irritability and other symptoms, significantly decrease their visceral hypersensitivity, the content of 5-HT in serum and hypothalamus (P<0.01).Conclusion Liuwei Shunji Capsule can effectively improve survival state and intestinal disorders of rats with liver depression and spleen deficiency-type IBS, and the mechanism of treatment could be realized through regulating 5-HT level.
3.Expression changes of inflammatory cytokines of tendon-derived stem cells in response to uniaxial stretching
Shengnan QIN ; Wen WANG ; Shiquan FU ; Yushan CHENG ; Qiming CHEN ; Honghui CHEN
Chinese Journal of Trauma 2015;31(3):269-272
Objective To observe the expression changes of inflammatory cytokines of human tendon-derived stem cells (TDSCs) under uniaxial stretching.Methods TDSCs were isolated from human gracilis tendon by collagenase digestion at very low density.Cells were detected for surface markers by flow cytometry,and tested for multi-differentiation potential in vitro.Repetitive uniaxial stretching was applied on the cells at 0%,4%,8% or 10% strain.Under the microscopy,cell alignment was observed after mechanical stretching.Expressions of inflammation factors COX-2 and MMP-1 were detected by qPCR and western blotting.Results TDSCs were successfully isolated from human gracilis tendon.Inflammatory cytokines CD29,CD44 and CD105 were positive,but CD45 and CD14 were negative.TDSCs could differentiate into osteocytes,adipocytes and chondrocytes in vitro.Cells were not realigned4 hours after mechanical stretching.MMP-1 mRNA expression was significantly down-regulated at 4% strain (0.090 ± 0.007) compared to that at 0% strain (0.247 ± 0.032,P < 0.05).No significant difference was found in COX-2 mRNA expression at 4% and 8% strain (both was 0.005 ±0.001,P >0.05).MMP-1 and COX-2 mRNA expressions at 8% strain (0.168 ± 0.040 and 0.007 ± 0.001)revealed no significant differences from those at 0% strain (0.134 ±0.075 and 0.006 ±0.003) (P >0.05),whereas at 10% strain MMP-1 and COX-2 mRNA expressions were significantly up-regulated (0.047 ± 0.003 and 0.496 ± 0.036) compared to those at 0% strain (0.011 ± 0.003 and 0.005 ± 0.003)(P < 0.05).Changes in MMP-1 and COX-2 protein expressions revealed similar trend as their mRNA expressions.In contrast to the setting of 0% strain,4% strain induced down-regulated MMP-1 and COX-2 proteins,8% strain induced no significant changes in MMP-1 and COX-2 proteins,and 10% strain induced up-regulated COX-2 protein despite minor increase in MMP-1 protein.Conclusions Mechanical stretching can affect the secretion of inflammatory cytokines.Low tensile stretch is associated with decreased expression of inflammatory cytokines while high tensile stretch promotes secretion of inflammatory cytokines.
4.Anterolateral or Posteromedial Plate-Assisted Intramedullary Nailing for Fixation of Proximal Third Tibia Fractures: A Biomechanical Study
Yibo XU ; Yao LU ; Teng MA ; Cheng REN ; Ming LI ; Liang SUN ; Qiang HUANG ; Qian WANG ; Hanzhong XUE ; Zhong LI ; Kun ZHANG
Journal of Medical Biomechanics 2023;38(1):E104-E109
Objective To study the stability of plate-assisted intramedullary nailing for fixing proximal third tibiafractures, compare and observe biomechanical characteristics of anterolateral or posteromedial plate-assisted intramedullary nailing after fixation of proximal third tibia fractures. Methods Eight artificial tibia of 4th-generation sawbones were divided into two groups based on location of the assisted plate, namely, anterolateral plate group and posteromedial plate group, with 4 specimens in each group. Each two locking bolts were fixed to theintramedullary nail proximally and distally, and each three bicortical screws were fixed to the plate proximally and distally. The specimens were osteotomized with a 10-mm defect which located 0. 5 cm to the proximal locking bolt of intramedullary nail or 5-6 cm distally to the knee joint line, in order to simulate an AO/ OTA 41-A2 type proximal third tibia fracture after fixation of intramedullary nail. After osteotomy was finished, axial compression test, three point bending test, cyclic loading and overstress test were conducted by mechanical testing machine. The results of axial stiffness and three-point stiffness between two groups were compared and analyzed. Results Axial compression test showed that the average axial stiffness in posteromedial plate group was lower than that in anterolateral plate group, but no significantly statistical differences were found between the two groups. Three point bending test showed that the average bending stiffness in posteromedial plate group was significantly higher than that in anterolateral plate group when stimulating either varus stress (plate located at pressure side of the fracture, t = 3. 679, P<0. 05) or valgus stress (plate located at tension side of the fracture, t = 8. 975, P<0. 05). Conclusions Plate-assisted intramedullary nailing for fixation of proximal third tibia fractures can minimize the angulation malalignment, improve the stability of nailed proximal tibial fragment and allow the early weight bearing. Both anterolateral and posteromedial plate-assisted intramedullary nail can provide satisfactory axial stability for proximal third tibia fractures, while posteromedial plate-assisted intramedullary nail shows better bending stability than anterolateral plate in countering varus or valgus stress deformity. This study provides an essential basis for clinical decision making about plate-assisted intramedullary nailing for fixing proximal third tibia fractures.
5.MiR-101-3p alleviates IL-1β-induced chondrocyte injury by targeting stanniocalcin 1.
Xiaoju LIANG ; Lijun ZHANG ; Deliang CHENG ; Xiaodi LIANG
Journal of Central South University(Medical Sciences) 2019;44(9):976-984
To explore the effects of miR-101-3p on IL-1β-induced chondrocyte injury and its underlying mechanisms.
Methods: Chondrocytes were divided into 4 groups: a control group (NC group), a IL-1β group, a negative control group (IL-1β+miR-NC group), and a miR-101-3p group (IL-1β+miR-101-3p group), which were treated with IL-1β after transfecting with miR-101-3p mimic or negative mimic. The expressions of miR-101-3p-5p and stanniocalcin 1 (STC1) at different concentrations of IL-1β (1, 5, 10 ng/mL)-induced chondrocytes were detected by Western blotting and real-time PCR. MTT assay was used to detect cell proliferation rate, while caspases assay kits and flow cytometry were used to measure the cell caspase and apoptosis level. Western blotting assay was used to detect the expression levels of pro-inflammatory and ECM-related protein, such as matrix metalloproteinase 9 (MMP9) and collagen Type II. In addition, 3'-untranslated regions (UTR) of wild-type STC1 (STC1-3'-UTR-WT) or 3'-UTR of mutant STC1 (STC1-3'-UTR-MUT) were co-transfected with miR-101-3p mimic or miR-NC, respectively, while luciferase reporter assay was used to examine the regulative role of miR-101-3p in STC1. In order to detect whether STC1 was involved in the effect of miR-101-3p on chondrocytes, miR-NC (miR-NC group), miR-101-3p (miR-101-3p group), anti-NC (anti-NC group) and anti-miR-101-3p (anti-miR-101-3p group) were respectively transfected into the cells, and the expression of STC1 protein was detected by Western blotting. Subsequently, the cells were randomly divided into a miR-101-3P group (IL-1β+miR-101-3p group), an over-expression control group (IL-1β+miR-101-3p+ad-GFP group), and an over-expression STC1 group (IL-1β+miR-101-3p+ad-STC1 group) to investigate whether STC1 was involved in the role of miR-101-3p in chondrocyte. Similarly, MTT assay was used to detect cell proliferation rate, caspases assay kits and flow cytometry were used to measure the cell caspase and apoptosis level. Western blotting assay was used to detect the expression levels of pro-inflammatory and ECM-related protein MMP9 and collagen Type II.
Results: Compared with the 0 ng/mL IL-1β, the expression of miR-101-3p was decreased in chondrocyte at different concentration of IL-1β (1, 5, 10 ng/mL) (all P<0.05), while the level of STC1 was increased (P<0.05). Compared with the NC group, the chondrocyte proliferation rate was down-regulated (P<0.05), while the apoptosis rate, the levels of caspases, IL-6 and TNF-α were increased in the IL-1β group (P<0.05). Moreover, the MMP9 levels were increased obviously, and the protein levels of collagen Type II were decreased in the IL-1β group compared with the NC group (both P<0.05). Compared with the IL-1β+miR-NC group, the proliferation rate was increased (P<0.05), whereas the apoptosis rates, the caspase-3/9 levels, the IL-6 and TNF-α levels were increased in the IL-1β+miR-101-3p group (all P<0.05). Then MMP9 levels were decreased obviously (P<0.05), and the protein levels of collagen Type II were increased in IL-1β+miR-101-3p group compared with the IL-1β+miR-NC group (both P<0.05). In addition, the double luciferase assay showed that the STC1 levels could be inhibited in the miR-101-3p group compared with the miR-NC group (P<0.05). STC1 levels were decreased in the miR-101-3p group compared with the miR-NC group (P<0.05), and the STC1 levels were increased in the anti-miR-101-3p group compared with those in the anti-NC group (P<0.05). The results of miR-101-3p+ad-STC1 group showed that compared with the miR-101-3p+ad-GFP group, the STC1 could reverse the effects of miR-101-3p on IL-1β-induced proliferation, apoptosis, inflammatory responses and ECM protein of chondrocytes.
Conclusion: The regulation of miR-101-3p/STC1 signal pathway may have a role in reducing the IL-1β-induced chondrocyte injury.
Cell Proliferation
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Chondrocytes
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Glycoproteins
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metabolism
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Interleukin-1beta
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metabolism
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MicroRNAs
6.Influence factors of deep venous thromboembolism after knee arthroplasty and significance of changes of serum nets and sVCAM-1 levels.
Cheng-Lin CHEN ; Shu-Guo HUI ; Zhi-Yuan WANG ; Li-Qiang ZHI
China Journal of Orthopaedics and Traumatology 2022;35(11):1053-1059
OBJECTIVE:
To investigate the relationship between the changes of serum neutrophil extracellular traps (NETs), soluble vascular cell adhesion molecule-1(sVCAM-1) and deep venous thromboembolism after knee arthroplasty.
METHODS:
From May 2017 to April 2020, 30 patients with deep venous thromboembolism after knee arthroplasty were retrospectively selected as the observation group, and 60 patients without deep venous thromboembolism after knee arthroplasty in the same period were randomly selected as the control group. The clinical data, serum levels of nets and sVCAM-1 before and 1, 3 and 5 days after operation were compared between the two groups. Logistic regression model was used to analyze the influencing factors of deep venous thromboembolism after knee arthroplasty; Pearson correlation was used to analyze the relationship between serum nets and sVCAM-1 levels;Draw the receiver operating characteristic curve(ROC) to obtain the area under the curve(AUC), and analyze the diagnostic value of serum nets and sVCAM-1 levels for deep vein thromboembolism after knee arthroplasty.
RESULTS:
There were statistically significant differences between two groups in age, body mass index, and postoperative knee elevation and flexion ratio(P<0.05). The level of serum NETs and sVCAM-1 on the 1st and 3rd day after surgery of the observation group were higher than the control group(P<0.05). Logistic regression analysis showed that age, body mass index, knee flexion position, serum nets and sVCAM-1 levels at 1 and 3 days after operation were all the influencing factors of DVT after knee arthroplasty (P<0.05);Pearson correlation analysis showed that there was a positive correlation between the levels of serum NETs and sVCAM-1 in patients with deep venous thromboembolism after knee arthroplasty 1 and 3 days after operation(P<0.05). The ROC curve of predicting deep venous thromboembolism after knee arthroplasty by serum nets and sVCAM-1 levels at 1 and 3 days after operation was drawn, the results showed that the AUC of serum nets and sVCAM-1 levels at 1 day after operation was higher than that at 3 days after operation, which had a good predictive effect.
CONCLUSION
The influencing factors of deep vein thromboembolism after knee arthroplasty are age, body mass index, postoperative knee elevation and flexion, postoperative serum NETs and sVCAM-1 levels, especially postoperative serum NETs and sVCAM-1 levels. Changes can be used as potential biomarkers for predicting postoperative deep vein thromboembolism, and clinical attention should be paid to it.
Humans
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Infant, Newborn
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Arthroplasty, Replacement, Knee/adverse effects*
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Body Mass Index
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Postoperative Complications/etiology*
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Retrospective Studies
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Venous Thromboembolism/etiology*
7.Expressions and its prognostic value research of MMP-11 and cathepsin-D in gastric adenocarcinoma
Aidong LIU ; Shifei LIU ; Xudong SONG ; Luyang CHENG ; Hui TANG ; Yanjie XIONG ; Deyan LI ; Feng YAN ; Jianyang ZHAO ; Honghui GUO
Clinical Medicine of China 2019;35(1):22-25
Objective To detect the expressions of Matrix Metalloprotein-11 ( MMP-11 ) and Cathepsin-D(Cath-D),and investigate their relationship and prognostic significance. Methods The study included 95 cases′ clinical date and postoperative specimens of gastric adenocarcinoma ( North China University of Science and Technology Affiliated Hospital,2010. 01-2013. 12) as observation group,70 cases of normal gastric tissue(from observation group) as control group. Expressions of MMP-11 and Cath-D were detected by IHC methods in two groups. Results The positive rate of MMP-11 was 51. 6%( 49/95) in observation group,5. 7%(4/70)in control group(χ2=38. 884,P<0. 05). The positive rate of Cath-D was 73. 7%(70/95) in observation group,28. 6%(20/70) in control group(χ2=33. 082,P<0. 05). The positive rate of MMP-11 was correlated with metastasis and vascular invasion(χ2=7. 193、15. 566,P<0. 05). The positive rate of Cath-D was correlated with maximal diameter,lymph node metastasis,vascular invasion and proliferation index(χ2=7.431、5.654、6.569、6.801,P<0.05).There was positive relationship between MMP-11 and Cath-D in observation group(r=0. 46,P<0. 05). The expressions of MMP-11 and Cath-D were correlated with prognosis in gastric adenocarcinoma ( P<0. 05) . Conclusion The higher expressions and synergistic effect of MMP-11 and Cath-D may promote the occurrence and development in gastric adenocarcinoma. The joint detection of MMP-11 and Cath-D may be helpful to predict the prognosis of gastric adenocarcinoma.
8. Application of bone transport external fixation with locking plate internal fixation in segmental tibial bone defect
Yao LU ; Teng MA ; Cheng REN ; Zhong LI ; Kun ZHANG ; Ming LI ; Congming ZHANG ; Qian WANG
International Journal of Surgery 2019;46(11):754-757
Objective:
To explore the effect of bone transport external fixation combined with locking bone plate internal fixation technology in the treatment of segmental tibial defects.
Methods:
The clinical data of 12 patients with segmental tibial defects treated with annular external fixator and long locking plate in the Honghui Hospital, Xi′an Jiaotong University College of Medicine from January 2013 to March 2017 were analyzed retrospectively. There were 10 males and 2 females with an average age of 45 years (aged range from 20 to 65 years). External fixation time, external fixation index, healing time, mean healing index and complications were recorded. The follow-up time was 12-48 months, and the Paley bone and functional scores were used to evaluate the efficacy at the last follow-up.
Results:
All the patients achieved union at the distraction callus and docking site. The average external fixation time was 112.1 d, the average external fixation index was 16.5 d/cm, the average healing time was 299.5 d, and the average healing index was 44.9 d/cm. Seven cases had pain and 4 cases had pin-site infections as minor complications. The bony outcomes were excellent in all patients. The functional outcomes were excellent in eight cases and good in four.
Conclusion
Bone transport with external fixation combined with locking plate internal fixation in the treatment of segmental bone defects of tihia can shorten external fixation time and is beneficial to functional rehabilitation after operation.
9.Relationship between fibrinogen and microalbuminuria in elderly patients with type 2 diabetes mellitus
Kunwei WANG ; Yueyue WU ; Xinmei HUANG ; Min YANG ; Honghui SHEN ; Lili CHENG ; Ming YU ; Jun LIU
Chinese Journal of Endocrinology and Metabolism 2020;36(4):309-314
Objective:To analyze the relationship between plasma fibrinogen(FIB) within normal range and microalbuminuria in elderly patients with type 2 diabetes mellitus.Methods:A total of 869 elderly subjects with type 2 diabetes mellitus admitted to the Department of Endocrinology of Shanghai Fifth People′s Hospital from October 2012 to October 2014 were included in the study. The patients were divided into four groups based on the quartile level of FIB: Q1 group(<2.42 g/L), Q2 group(2.42-2.89 g/L), Q3 group(2.90-3.61 g/L), and Q4 group(≥3.62 g/L). The relationship between FIB and urinary albumin/creatinine ratio(UACR) was analyzed.Results:With the increasing of FIB, the level of UACR was significantly elevated( P<0.05). Pearson correlation analysis showed that FIB was positively associated with age, duration of diabetes, creatinine(Cr) and UACR in men and women( P<0.01). Multiple regression analysis showed that FIB was an independent factor of UACR( P<0.01). Logistic regression analysis showed that the risks of microalbuminuria and macroalbuminuria were respectively 4.536 folds(95% CI 2.516-8.175, P<0.01) and 13.314 folds(95% CI 2.925-60.612, P<0.01) in Q4 group, and 2.177 folds(95% CI 1.273-3.724, P<0.01) and 4.098 folds(95% CI 1.101-19.226, P<0.05) in Q3 group as compared with Q1 group after adjused by following factors: gender, age, duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting plasma glucose(FPG), HbA 1C, total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol(LDL-C), Cr, alanine aminotransferase(ALT), as well as smoking and drinking behavior. Based on the cut off values to UACR 30 mg/g and 300 mg/g, the receiver operating characteristic curve(ROC) was used to evaluate the value of FIB for UACR. The optimal cut-off value of FIB was 3.18 g/L and 3.22 g/L respectively. Conclusions:Plasma FIB was closely associated with microalbuminuria in elderly patients with type 2 diabetes mellitus, which may be considered as one of the predictors for diabetic nephropathy.
10.Analysis of high-risk factors for failure of autologous arteriovenous fistula in hemodialysis patients.
Tao WANG ; Yue CHENG ; Zhaoxia HE ; Yawei REN ; Jie LONG
Chinese Critical Care Medicine 2023;35(12):1281-1285
OBJECTIVE:
To investigate the high risk factors of failure of autologous arteriovenous fistula (AVF) in hemodialysis patients.
METHODS:
A retrospective study was conducted, patients with maintenance hemodialysis (MHD) undergoing AVF admitted to General Hospital of Western Theater Command from January 2021 to December 2022 were enrolled, including 107 patients with normal AVF and 168 patients with AVF dysfanction. According to the causes of AVF failure, the patients were divided into AVF stenosis group (n = 103) and AVF thrombosis group (n = 65). Age, gender, body mass index (BMI) and comorbidities (hypertension, diabetes, coronary heart disease) and other clinical data of all patients were collected. Hemoglobin, hematocrit, white blood cell count, neutrophil count, lymphocyte count, platelet count, C-reactive protein (CRP), high density lipoprotein, low density lipoprotein, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) within 1 month of AVF use in normal dialysis patients and 1 week before AVF failure. Multivariate Logistic regression was used to analyze the independent risk factors of AVF dysfuction in MHD patients. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of risk factors on AVF dysfuction in MHD patients.
RESULTS:
(1) There were significant differences in age, BMI, hypertension, hemoglobin, hematocrit, PLR and CRP [age (years): 56.94±14.32, 58.83±14.05, 51.57±13.19; BMI (kg/m2): 22.83±3.10, 21.27±4.98, 23.35±2.72; hypertension: 93.20%, 64.62%, 86.92%; hemoglobin (g/L): 110.82±22.16, 88.70±24.00, 87.95±23.45; hematocrit: 0.350±0.069, 0.282±0.076, 0.275±0.071; PLR: 197.35±113.59, 192.55±138.25, 162.12±73.25; CRP (mg/L): 10.01±4.02, 8.18±5.42, 3.17±1.30, all P < 0.05], among AVF stenosis group, AVF thrombosis group and AVF normal group, there were statistically significant differences no statistically significant difference was found in other indexes among three groups. (2) Multivariate Logistic regression analysis showed that hypertension [odds ratio (OR) = 4.849, 95% confidence interval (95%CI) was 1.278-18.397, P = 0.020], elevated CRP levels (OR = 2.104, 95%CI was 1.533-2.888, P = 0.000) were associated with AVF stenosis. Elevated CRP levels (OR = 1.984, 95%CI was 1.442-2.730, P = 0.000) was an independent risk factor for AVF thrombosis. Analysis of ROC curve showed that the area under the curve (AUC) of AVF dysfunction predicted by CRP was 0.712, 95%CI was 0.637-0.786, P = 0.000; CRP cut-off value was 1.8 mg/L, the sensitivity was 67.0%, the specificity was 83.7%.
CONCLUSIONS
Elevated CRP is an independent risk factor for AVF failure in hemodialysis patients, which can be used to predict the occurrence of AVF failure.
Humans
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Retrospective Studies
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Constriction, Pathologic
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Renal Dialysis/adverse effects*
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Lymphocytes
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C-Reactive Protein
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Risk Factors
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Hypertension
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Hemoglobins
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Thrombosis
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ROC Curve
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Prognosis