BACKGROUND: Critical organ hypofunction and complications are common in elderly patients, so perioperative treatment becomes important for the success of total knee replacement (TKR).OBJECTIVE: To explore clinical perioperative complications of TKR in the patients over 70 years old. DESIGN, TIME AND SETTING: Retrospective analysis of case data was performed at First Hospital of Gannan Medical University and People's Hospital of Peking University from January to December 2002.PARTICIPANTS: 109 patients (168 knees), including 29 males and 80 females, underwent TKR. Of them, 50 underwent single knee surgery, aged (74.2±15.1) years (range 70-85 years), and 59 underwent bilateral knee surgery, aged (73.4±13.2) years (range 70-85 years). In addition, 92 cases (84.4%) were obesity, and 88 were complicated by internal diseases. METHODS: The surgery was performed by the same operator. All patients underwent patellar replacement with Scorpio posterior stable knee prosthesis. Knee anterior median incision and medial patellar approach was applied, and anterior and posterior cruciate ligaments were excised during the surgery, osteophyma and corpus liberum of posterior articular capsule were cleared. Patellofemoral joint track was tested until meeting the requirements. The prosthesis was fixed using antibiotics mixed with bone cement, and the incision was sutured at flexed position.MAIN OUTCOME MEASURES: Early complications following replacement; knee joint and functional evaluation.RESULTS: During surgery and 24 hours after replacement, 8 cases developed hypertension, 7 cases hypotension, and 6 cases arrhythmia. All patients safely passed the perioperative period under treatment of related departments. One case developed pulmonary embolism, 1 case deep infection, 3 cases pulmonary infection, 5 cases urinary system infection, 1 case rapid reduction of platelet caused by Subining, 1 case cognitive disturbance, and 1 case dislocation of knee joint (Charcot arthritis). According to standards of HSS, the knee joint scores were significantly improved from 26.1 prior to replacement to 82.0 at discharge, and function scores were significantly improved from 32.1 prior to replacement to 89.1 at discharge. During 12.4-month follow-up (range 3-22 months), 18 cases lost the follow up; the retention rate was 83.5%. Of 91 retention patients, knee pain disappeared or relieved, restored self-care ability, and no prosthesis loosening or infection was found. At the final follow up, the HSS knee joint scores were significantly improved from 82.0 at discharge to 85.4, and function scores were improved from 89.1 at discharge to 92.3 at discharge.CONCLUSION: Skilled operative technique and positive treatment of complication can effectively prevent perioperative infection, dislocation and other complications following total knee replacement.

ObjectiveTo observe the serum levels of IL-6,IL-10 and IL-1 in children with Kawasaki disease and its clinical significance.Methods38 childrey with of Kawasaki disease were selected as observction group,then selected 38 cases of normal children as control group.Serum IL-6,IL-10 and IL-1 levels were observed two groups.ResultsObservation group IL-6,IL-10 and IL-1 levels were higher(t =10.3877,15.1010,15.1243,all P＜0.05),acute phase of observation group IL-6,IL-10,IL-1,etc.levels were significantly higher than the sub-acute phase patients ( t =9.7594,11.6486,11.6622,all P ＜ 0.05 ) and control group ( t =11.7032,11.7718,11.8267,all P ＜0.05 ).48h apoptosis rate in the control group( 2.8 ± 0.8 )％ was significantly lower than in children with Kawasaki disease(38.3 ±7.9)％ (t =38.59,P ＜0.01 ).Platelets increased[ (464.0 ± 110.2) × 109/L] of the IL-1 level in children with Kawasaki disease(663 ±94)ng/L was significantly higher than those without elevated platelet [ (307.0 ±104.9) × 109 /L ] of children( 492 ± 92 ) ng/L ( t =13.1044,P ＜ 0.05 ).ConclusionThedetection of serum IL-6,IL-10 and IL-1 levels may aid clinical diagnosis of the condition of children with Kawasaki disease,complications and treatment,have important clinical significance.

Animals ; Gene Silencing ; physiology ; Gene Targeting ; Genetic Therapy ; methods ; Genomics ; Humans ; RNA Interference ; RNA, Small Interfering ; genetics ; therapeutic use ; RNA-Induced Silencing Complex

Objective To investigate the effects of cobalt chloride(COCl2)induced rat alveolar epithelial cell apoptosis and the significance of related apoptosis protein hypoxia inducible factor-lalpha(HIF-1 a)expression. Methods Alveolar epithelial cells were cultured in vitro and divided into four groups with 6 samples in each.Hypoxia 4 h group:added 500μmol/L COCl2 for 4 hours inducing alveolar epithelial cell hypoxia;hypoxia 24 h group:co-cultured with COCl2 for 24 hours;hypoxia 48 h group:co-cultured with CoCl2 for 48 hours;control group:no CoCl2 added.The apoptosis rates were detected by fluorescent microscope and flow cytometry.The apoptosis morphological changes of the cell were observed by transmission electron microscopy.The protein expression of HIF-la was detected bv Western Blot. Results (1)Fluorescent microscope results showed that apoptosis rate in hypoxia 4 h、24 h、48 h group[(5.83±0.76)%,(15.00±3.28)%and(51.50±3.00)%],were higher than control group[(1.50±0.50)%](P＜0.05).(2)Flow cytometry analysis reached the same results as with fluorescent microscope.(3)Typical morphological changes of apoptosis were observed in hypoxia 24 h group.(4)HIF-1α expression in hypoxia 4 h、24 h and 48 h groups[0.69±0.035,1.02±0.044 and 0.71±0.046],were higher than control group(0.21±0.026)(P＜0.01).(5)Positive correlations were found between relative amount of HIF-1αprotein and apoptosis rate by fluorescent microscope and flow cytometry analysis(r=0.484,P=0.016;r=0.713,P=0.009).Conclusions Hypoxia could induce apoptosis of alveolar epithelial cells,which may participate in the pathogenesis of hypoxia-induced lung injury.

Objective To estabolish the ALDH2 Glu504Lys genotyping technique for oral swab sample type based on PCR-gold magnetic nanoparticle chromatographyl.Methods According to the ALDH2 Glu504Lys gene the specific primers were designed by ARMS-PCR technique.Optimized the optimal ALDH2 Glu504Lys oral swab reaction system and PCR reaction procedures based on the routine reaction conditions and reaction procedure of laboratory PCR.60 samples of oral swabs were collected and tested by gold magnetic nano-chromatography.The results were verified by sequencing.Results The detected 60 cases of oral swab samples contain 16 cases heterozygous mutation,wild type 42 cases,homozygous mutation 2 cases and then the results by Goldmag nanoparticle detection was perfectly matched with sequencing results.Conclusion The Goldmag nanoparticles chromatographic detection technique of ALDH2 Glu504Lys buccal swabs system was established.With accuracy,fastness,reliability,it is worthy of clinical promotion.

The goal of this work was to explore the prospect of standardized application of an in-vitro bioactivity assay for recombinant human follicle-stimulating hormone based on a reporter gene. The relative accuracy, intermediate precision, linearity and applicable range of the method were validated according to the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Three laboratories used this method to determine the in-vitro biological activities of six batches of drug product and three batches of drug substance manufactured by two different companies. The consistency of the potency determined by three laboratories, the intra-laboratory precision and inter-laboratory precision were analyzed. The method was optimized during the collaborative validation. The results of method validation meet the requirements of the General Rules of Chinese Pharmacopoeia 2020 edition Volume IV (9401). Aiming to resolve the problems found in the collaborative validation, the medium for cell seeding, the pre-diluted buffer solution of standard and sample, and the means of removing and discarding supernatant after stimulation were optimized. After optimization, there was no significant difference in the bioactivity among the different laboratories (P > 0.05), indicating statistical equivalency. Intra-laboratory and inter-laboratory precision were good and the geometric coefficient of variation (GCV%) were both less than 15%. In conclusion, the reporter gene assay has good intra-laboratory repeatability and inter-laboratory reproducibility and is suitable for analyzing recombinant human follicle-stimulating hormone drug product and drug substance by different manufacturers. It is expected to be used as a standardized method for the determination of the in-vitro bioactivity of such products.

Vectors used to carry foreign genes play an important role in gene therapy, among which, the adeno-associated virus (AAV) has many advantages, such as nonpathogenicity, low immunogenicity, stable and long-term expression and multiple-tissue-type infection, etc. These advantages have made AAV one of the most potential vectors in gene therapy, and widely used in many clinical researches, for example, Parkinson's disease. This paper introduces the biological characteristics of AAV and the latest research progress of AAV carrying neurotrophic factor, dopamine synthesis related enzymes and glutamic acid decarboxylase gene in the gene therapy of Parkinson's disease.
Animals ; Aromatic-L-Amino-Acid Decarboxylases ; genetics ; Dependovirus ; genetics ; Gene Transfer Techniques ; Genetic Therapy ; Genetic Vectors ; Glial Cell Line-Derived Neurotrophic Factor ; genetics ; Glutamate Decarboxylase ; genetics ; Humans ; Nerve Growth Factors ; genetics ; Neurturin ; genetics ; Parkinson Disease ; therapy

Purpose To describe the normal appearances of skull on 3D-reconstruction of Multi-slice CT in adult.Materials and Methods 130 patient data of Volume CT digital subtraction angiography (VCTDSA) with cephalocervical and cephalic vessel that were checked at our hospital from May to July 2009 were analyzed.All of them were subjected to 3D reconstruction of the skull by volume render (VR) and maximum intensity projection (MIP).The anatomy of skull,vascular grooves,pacchionian impressions,the types and closure status of cranial sutures were observed.Results 27 pacchionian impressions (20.77%,27/130) and 51 vascular grooves (39.23%,51/130) were detected.There were three types of the general shapes of cranial sutures:Ⅰconventional type(86.15%,112/130),Ⅱfontanelle ossification type(5.38%,7/130) and Ⅲcranial suture within a cranium (8.46%,11/130).Furthermore,Status of each suture closure were divided into five types:typeⅠcomplete closure(3.0%,16/531);typeⅡgomphosis(78.3%,416/531);typeⅢ sutural bone (7.0%,37/531);typeⅣincomplete closure(3.6%,19/531),the average width of non-closed suture was 1.41mm±0.70mm;typeⅤmixed type (8.1%,43/531).Conclusion 3D reconstruction of multi-slice computed tomography is proved to be a reliable technique capable of defining anatomy of skull.Better than MIP to displays three-dimensional structure VR,but to display cranial sutures,vascular grooves,pacchionian impressions MIP is more definite and hypersensitive.Status of each suture closure may be divided into five types,and the general shapes of cranial sutures may be divided into three types.

Because of the changed metabolic behaviors of cancer cells, tumor cells uptake a corresponding larger amount of glucose in physiological condition when compared with normal cells. And they were prone to metabolize glucose for generating energy in anaerobic glycolysis ways in order to grow quickly. Anaerobic glycolysis consumes more glucose than aerobic way when the same amount of energy is obtained, which also results in large demand of glucose in tumor cells. This review briefly describes therapy methods related to characteristic mentioned above, and summarizes the research progress of drugs, diagnostic reagents and carriers conjugated with glucose, glucose derivatives or other kinds of sugars for cancer targeting. Furthermore, typically relative research reports from 2012 till now were listed and analyzed.

Objective To investigate the effect of Helicobacter pylori (Hp) on the degranulation of mast cells and the permeability of gastric mucosa in BALB/c mice, in order to provide further evidence for the important role of Hp in the pathogenesis of chronic urticaria (CU). Methods Seventy healthy BALB/c mice were randomly classified into 3 different groups, namely, Hp group (n = 30), fed with Hp liquid once every 3 days for a total of 7 times, and two control groups, alcohol group (n = 20) fed with 45 percent alcohol solution, and bovine serum albumin (BSA) group (n = 20) fed with BSA 2% solution. Alteration in the blood sucrose level was used to assess the permeability of gastric mucosa. Toluidine blue staining of gastric mucosa was used to assess the total number of mast cells, the amount of degranulated mast cells and the per-centage of degranulated cells after feeding. Results There was a statistically significant difference between the total number of mast cells (F = 207.59, P < 0.01 ) and the percentage of degranulated mast cells (F = 108.16, P <0.01 ) among the three groups, with the highest number and percentage observed in the Hp group followed by the alcohol group. In both groups, the concentration of blood sucrose was increased after feed-ing, with a higher increase in the alcohol group; no significant change occurred in the concentration of blood sucrose in the BSA group (F = -4.06, P > 0.05 ), which differed significantly from the other two groups (F =277.03, P< 0.01 ). Conclusions Hp infection could increase the number and degranulation of mast cells in gastric mucosa, resulting in the release of histamines and vasoactive mediators, which may be related to the manifestation of urticaria.