Clinical Protocols ; standards ; Humans ; Orthopedic Procedures ; methods ; standards ; Patellar Dislocation ; surgery

Objective To verify the significance of the morphological changes of the macula and its relationship to visual function by using optical coherence tomography (OCT) after scleral buckling procdure. Methods The macula of retinae of 68 patients (70 eyes) with reattached retinae after scleral buckling operation for retinal detachment were examined by OCT to scan the macula through fovea vertically and horizontally. Results Among the 70 eyes, 22 eyes revealed normal macula with thickness of neurosensory retina meant (146.47?20.59) ?m. In the other 48 eyes (68.60%) with abnormal macula, 19 eyes showed extensive subretinal interspace, 9 eyes showed local subretinal interspace, 8 eyes showed macula edema, 4 eyes showed thin macula, 4 eyes showed subretinal proliferation and 4 eye showed epiretinal membrane over macula. In the normal macular structure group under the OCT, the visual acuity (VA) of the operated eyes was more than 0.3 in 6 eyes 2 weeks after operation and in 14 eyes 3 mons after operation. In the macula edema group, the VA was more than 0.3 in 1 eye 2 weeks after opoeration and 2 eyes 3 mons after operation. In the subretinal interspace group, the VA was more than 0.3 in 5 eyes 2 weeks after operation and in 23 eyes 3 mons after operation. The proportions of the numbers of operated eyes with the VA more than 0.3 after 3 mons of the operation in macular normal group subretinal interspace group and other macular disease group were significantly different (? 2=18.91, P

Objective To evaluate the intensity-modulated radiation therapy(IMRT)for the whole pelvis in the treatment for cervix cancer with the method of ionization chamber verification and fluence map verification.Methods IMRT plan was designed with Pinnacle 7.0 inversed treatment planning system,and the planning parameter was copied to the solid water phantom.The dose of the reference points in the phantom was calibrated with ionization chamber,and compared with those in IMRT plan.Then the gantry angle was set as 0 degree.The solid water phantom was irradiated with film,and the actual fluence maps were obtained 2cm below the phantom surface,and then the delivered films were compared with those fluence maps in plan.Results The error percentage at 4 points was less than 3% in absolute dose calibration,at 2 points was less than 5%,at another 2 points was less than 5%,at 1 point was over 10%,and at another 1 point was over 15%.It was found that the last two calibrated points were set in a region with a high dose gradient,resulting in high error.In fact they were impertinent.So another two points were chosen in uniformity area of dose distribution.The percentage of error were both less than 3%.The fluence maps between films and plan were consistent.Conclusion It is feasible to evaluate IMRT plan for whole pelvis in the treatment of cervix cancer with the method of ionization chamber verification and fluence map verification.The results can meet the clinical requirement.

Total hip arthroplasty (THA) is a vital therapeutic tool for hip terminal disease. Frequently, hidden blood loss exists in the postoperation, which seriously affect the postoperative rehabilitation of patients. It is urgent need to solve the problem that how to fundamentally prevent and reduce hidden blood loss after THA. Although THA has its own operational reason in blood loss, and also relates to a variety of risk factors, the mechanism of hidden blood loss is not clear. Tranexamic acid has a significant role in preventing perioperative blood loss, and the correlation of hidden blood loss and fibrinolytic mechanism would be confirm necessarily in the future,which will produce positive significance in completing the mechanism of hidden blood loss.
Arthroplasty, Replacement, Hip ; adverse effects ; Humans ; Postoperative Hemorrhage ; etiology

Osteoclast, a huge coenocytes,originates from mononuclear macrophages or monocytic series hematopoietic precursor cell, plays an important role in the progree of bone resorption. Formation and abnormal activity of osteoclast may cause osteoprosis, rheumatoid arthritis and aseptic loosening after arthroplasty. Therefore, osteoclast is the target for treating these disease. At present, a lot of study on formation of osteoclast were reported, but the study on how to identify and degradation of bone tissue is not yet reported. Bone mineral are seen as important component of identifing osteoclast, and the research suggested that bone matrix is not the essential ingredients of activiting osteoclast, petri dish covered by vitronectin also can make osteoclast occure certain form of bone resorption, vitronectin plays an significant role in activiting osteoclast. Otherwise, the research found that swallowing and secretion of bone matrix degradation products is benefit for differentiation of osteoclast and maintain of function, and this may be therapeutic target for treatment of musculoskeletal disorders.
Animals ; Bone Matrix ; metabolism ; Bone Resorption ; Humans ; Osteoclasts ; physiology

OBJECTIVETo explore the effect of Shenxiong Huayu Capsule (SHC) on the cerebral ischemia-reperfusion (IR) injury and the expression of growth associated protein 43 (GAP43) after total cerebral IR in the hippocampal CA1 region of rats.

METHODSTotally 100 male adult SD rats were randomly divided into five groups, i.e., the control group, the model group, the group A (by taking SHC once daily), the group B (by taking SHC twice daily), and the group C (by taking SHC thrice daily), 20 in each group. The total IR model was prepared by improved Pulsinelli's 4-vessel occlusion method. Morphological changes of the hippocampal CA1 region were observed by HE staining at day 1, 3, 7, and 14. The expression of GAP43 in the hippocampal CA1 region was detected using immunohistochemical assay at day 1, 3, 7, and 14. Meanwhile, the behavioral score was determined. The expression of GAP43 in the hippocampal CA1 region was detected using Western blot at day 14.

RESULTSCompared with the control group, the expression of GAP43 increased in the model group, the behavioral score was elevated, degenerated neurons increased, and survival neurons decreased in the model group (all P < 0.05). Compared with the model group, the expression of GAP-43 increased (with the most significant difference seen in the group C, P < 0.01), the behavioral score significantly decreased, degenerated neurons decreased, and survival neurons increased in each HSC group (all P < 0.05). Survival neurons obviously increased at day 14, of which, most number of survival neurons and highest contents of GAP43 protein could be seen in the group C, showing statistical difference when compared with those of the group A and the group B (P < 0.01).

CONCLUSIONSHC had protective effect on total cerebral IR in the hippocampal CA1, which might be associated with increased expression of GAP43.

Animals ; Brain Ischemia ; metabolism ; CA1 Region, Hippocampal ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; GAP-43 Protein ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism

MicroRNA(miRNA) is a class of non-coding RNA that plays an important role in gene expression and controlling. In recent years,the role of miRNA in the development of the disease has aroused great interest. Abnormal osteoclastogenesis and persistent inflammatory response induced by wear particles or osteoblast differentiation and maturation is the main cause of aseptic loosening in joint replacements. New researches shows that persistent inflammatory response, osteoclastogenesis and osteoblast differentiation are closely associated with miRNA, suggesting that there are certain relations between miRNA and aseptic loosening of prostheses. Additionally, the alteration of the expression levels of some miRNA may be curative for aseptic loosening. With the findings of the new miRNA targets, the important role of miRNA is further confirmed.
Animals ; Arthroplasty, Replacement ; Cell Differentiation ; Humans ; Joint Diseases ; genetics ; metabolism ; surgery ; MicroRNAs ; genetics ; metabolism ; Osteoblasts ; cytology ; metabolism ; Prostheses and Implants

OBJECTIVETo systematically evaluate the efficacy and safety of preoperative administration of cyclooxygenase-2 (COX-2) inhibitor on pain occurring with total knee arthroplasty (TKA).

METHODSWe electronically searched PubMed, Cochrane Library, EMBASE, CNKI, CBM, Wanfang data from inception to March 15, 2014 and manual searched journal of library collection to identify randomized controlled trials (RCTs) about preoperative administration of COX-2 inhibitor on pain occurring with TKA. The methodological quality of the included RCTs was assessed and the data were extracted according to the Cochrane Handbook 5.1.0. Meta-analysis was performed by using RevMan 5.2 software.

RESULTSA total of 6 RCTs involving 228 patients were included. The results of meta-analyses showed that: (1) Efficacy: The visual analog scale (VAS) of post-operation at 12-hour (WMD = -0.60, 95% CI -0.83 to -0.37, P < 0.000 01) and 24-hour (WMD = -0.74, 95% CI -1.29 to - 0.19, P = 0.008) was decreased when COX-2 inhibitor was used before operation. And compared with control group, experimental group decreased the modified numerical pain rating scale (MNPRS) at 24-hour (WMD = -0.50, 95% CI -0.70 to -0.30, P < 0.000 01), 48-hour (WMD = -0.55,95% CI -0.65 to -0.45,P < 0.000 01) under quiescent conditions, and the same result at 24-hour (WMD = -0.82, 95% CI -1.26 to -0.38, P <0.000 01), 48-hour (WMD = -0.71, 95% CI -0.82 to -0.60, P < 0.000 01) under active conditions. The morphine consumption postoperatively were fewer in experimental group at the first day (WMD = - 1.35, 95% CI -1.92 to -0.79, P < 0.000 01) and the second day (WMD = -1.60, 95% CI -2.68 to -0.52, P = 0.004). (2) Safety: COX-2 inhibitor could lessen the incidence of postoperative pruritus (RR = 0.35, 95% CI 0.15 to 0.84, P = 0.02), but not statistically decrease of nausea and vomiting (RR = 0.83, 95% CI 0.54 to 1.28, P = 0.40) and exhaustion (RR = 0.63, 95% CI 0.05 to 7.67, P = 0.72).

CONCLUSIONThe current evidence indicated that preoperative administration of COX-2inhibitor can effectively improve the effect of postoperative analgesia, reduce the consumption of morphine and lessen the incidence of pruritus. Due to the limited quantity of the included studies and the evidence with limited strength,further high-quality RCTs are needed to verify the aforementioned conclusion.

Arthroplasty, Replacement, Knee ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Pain, Postoperative ; drug therapy ; Postoperative Complications ; prevention & control ; Pruritus ; prevention & control

Objective:To observe the influence of radiofrequency catheter ablation of the fat pad at the right pulmonary vein- atria junction(RPV fat pad)on Bezold-Jarisch reflex(BJR)induced by veratridine in canine.Methods:Ten mongrel dogs were anesthetized and their chest were opened through a right thoracotomy to expose the RPV fat pad.Veratridine was injected into the left ventricle at bolus doses of 10?g/kg through a catheter to induce BJR.The sinus cycle length(SCL),systolic arterial pressure(SAP),diastolic arterial pressure(DAP),mean arterial pressure(MAP),left ventricle systolic pressure(LVSP), left ventricle diastolic pressure(LVDP)and mean left ventricle pressure(MLVP)were measured under the baseline and after ablation of the RPV fat pad;the changes of the above parameters(?SCL,?SAP,?DAP,?MAP,?LVSP,?LVDP,and?MLVP)were calculated.Then the same dose of veratridine was injected under the pad after ablation and the changes of the a- bove parameters were observed.Results:BJR was successfully induced in the 8 animals;the animals has prolonged sinus cycle length(SCL)and decreased MAP and MLVP.After ablation,the prolongation of SCL after injection of veratridine was markedly reduced([229.2?92.3]ms vs[39.3?14.1]ms,P

Bone Nails ; adverse effects ; Bone Plates ; adverse effects ; Hip Fractures ; physiopathology ; surgery ; therapy ; Humans ; Prostheses and Implants ; adverse effects