Objective To study the therapeutic mechanism of medication p erfusion by femoral artery for the femoral head necrosis induced by glucocortico id experimentally. Methods Forty eight of New Zealand rabbits were used for esta blishing the model of femoral head necrosis. The rabbits were injected 50 ? g/ kg LPS in 24h twice intravenously, and methy prednisolone intramuscularly thre e times. The animals were divided into three groups: arterial group which was pe rfused urokinase 30 thousands units and 2 ml red sage root by left femoral arter y; venous group which was perfused urokinase 30 thousands units and 2 ml red sa ge root by era marginal vein; control group which was perfused normal saline. Mi crovessels ink perfusion and pathological examination were adopted to observed t he changes of the femoral head.The ratio of empty lacuna, fatty embolism, thromb us, VEGF positive osteoblast, chondrocyte and blood vessel in the subchondral pl ate were measured by means of HE, sudanⅢ , PTAH and immunohistochemistry in dif ferent periods (1,2,3,4weeks) after the medication perfusion.Results The treatme nt of urokinase and methyl- prednisolone could reduce the ratio of empty lacuna , fatty embolism, thrombus and increase the ratio of VEGF positive osteoblast, c hondrocyte and blood vessel, but the effects of femoral medication perfusion wer e more efficiency and quickly than vein injection. Conclusion The mechanisms con sist in re passing the blocked vessel by dissolving fatty embolism and thrombu s, accelerating the vascular developing and ossification by promoting the exudat ion of VEGF. [

Objective To study the distribution of TCM constitution of patients with postmenopausal osteoporosis to analyze the correlation between constitution and osteoporosis.Methods The pre-designed questionnaire and the method of case-control were used to classify and analyze the constitution of postmenopausal osteoporosis patients and normal population for comparison to understand the correlation between constitution and osteoporosis.Results The ratio of constitution type in two groups had statistical difference(P

[Objective] To investigate the difference of bone Absorption function of the rat osteoclast(OC) in different cultural methods, and the difference in the levels of mRNA expression of bone Absorption key gene, ATPase a3 gene, and provide the basis for further investigation on the OC in vitro. [Methods] with mechanical separation method, mature osteoclast was separated from inner wall of 24 hours newborn rat long bones medullary cavity; and induction culture methods, bone marrow cell was induced to osteoclast like cell(OLC) by using 1,25(OH)2D3.The morphological and functional change of osteoclast was observed and the difference in the level of ATPase a3 mRNA expression was determined.[ Result]OC and OLC are multinucleated giant cells, which can be stained positive by potartrate resistant acid phosphatase(TRAP), and can form bone Absorption lacuna. The number of OLC in induction method is more than in mechanical separation method, but bone Absorption lacuna is smaller and shallower than the early stage of induction. The late stage of OCL is extremely similar to OC. There is no significant difference of ATPase a3 mRNA expression from the cells between mechanical separation 8 hour and induction culture 6 days, but either of them is significantly less than inducing 8 days. [Conclusion]Induction method can produce a large number of OLC which is superior to mechanical separation method, but its bone resorption function is weaker in the earlier stage, because bone resorption function is associated with the number of nucleus. The late stage of OCL is extremely similar to OC of mechanical separation method. And it can be used in any experiments.

Objective Get a primary culture method of osteoblast which is simple to operate and has many pure cells. Method Get osteoblast with improved I collagenase, and test the form of osteoblast, the alkaline phosphatase dyeing and formation of mineralization node. Result The improved rats primary culture method of osteoblast can get most cells in normal shape, alkaline phosphatase secretion and mineralization. Conclusion The improved rats primary culture method of osteoblast is convenient to operate, and can get most cells.

Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.

OBJECTIVETo study the association between single nucleotide polymorphisms of thioredoxin reductase-2 (TrxR2) gene and the susceptibility to Kashin-Beck disease (KBD).

METHODSPolymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to analyze the genotype frequencies of rs5748469 in TrxR2 gene in 84 KBD patients and 109 healthy control subjects.

RESULTSThe genotype frequencies of A/A, A/C, and C/C in the KBD patients were 83.33%, 15.48% and 1.19%, as compared with the frequencies of 74.31%, 25.69%, and 0.00% in the healthy control, respectively, showing no significant difference in the single nucleotide polymorphisms of TrxR2 gene between the two groups (P=0.13).

CONCLUSIONNo obvious correlation can be found between rs5748469 polymorphisms in TrxR2 gene and the susceptibility to KBD.

Adult ; Alleles ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Kashin-Beck Disease ; genetics ; Male ; Middle Aged ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Thioredoxin Reductase 2 ; genetics

OBJECTIVETo explore the effect of arterial perfusion of marrow multifunctional stem cells (MFSC) in treating femoral head necrosis and its mechanism.

METHODSThe rabbit model of femoral head necrosis was established by large dose of methyl-prednisone through Shwartzman response. Bone marrow was extracted from femoral bone of model rabbit and isolated in vitro for culturing and proliferating MFSC. The experimental rabbits were randomly divided into 4 groups, treated with normal saline (A), Salvia + urokinase (B), MFSC (C) and MFSC + Salvia + urokinase (D), respectively, they were sacrificed in batches at 2 and 4 weeks after treatment, and changes in various parameters, including molybdenum target roentgenogram, routine pathology with HE staining, tetracycline labeled fluorescent microscopy and ultrastructure alteration by scanning electron microscope (SEM), were observed.

RESULTSTypical appearance of femoral head necrosis was shown in the successfully modeled rabbits. Two and 4 weeks after treatment by high selective drug via medial and lateral femoral circumflex arterial perfusion, the X-ray examination showed significant improvement of bone density; pathohistologic manifestation showed decrease of empty bone lacuna, increase of osteoblast and new bone formation; tetracycline fluorescent labeled microscopic picture showed bright fluorescent band of increased osteoblasts in necrosis repairing region with widened border; SEM displayed irregularly arranged fibrosis in necrosis region, abundant organelles in osteoblasts with few empty bone lacuna. The above-mentioned improvement was more significant in rabbits treated by MFSC.

CONCLUSIONHigh selective femoral drug arterial perfusion in treating femoral head necrosis could accelerate the process of revascularization and re-ossification in rabbits. As compared with Salvia, MFSC showed quicker and more potent effect.

Animals ; Bone Marrow Transplantation ; methods ; Femur Head ; blood supply ; Femur Head Necrosis ; chemically induced ; physiopathology ; therapy ; Infusions, Intra-Arterial ; Male ; Methylprednisolone ; Osteogenesis ; Rabbits ; Stem Cell Transplantation ; methods

Objective:To investigate the status quo of spiritual nursing needs and its influencing factors of patients with permanent enterostomy, and analyze its correlation with disability acceptance and stigma, so as to provide a reference for the construction of targeted spiritual nursing intervention programs.Methods:A total of 351 patients with permanent enterostomy in Xiangya Hospital Central South University and Hunan Cancer Hospital were selected by convenience sampling from January 2021 to March 2022. A cross-section by using the self-made general information questionnaire, Nurse Spiritual Therapeutics Scale (NSTS), Acceptance of Disability Scale (ADS), and Stigma Scale for Chronic Illness (SSCI). And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs of patients with permanent enterostomy.Results:The total score of spiritual nursing needs of patients with permanent enterostomy was 30.15 ± 6.46, and the average score of items was 2.51 ± 0.78. Among the five dimensions, the highest average score was creating a good atmosphere 3.10 ± 0.98, and and the lowest was helping religious practice 1.65 ± 0.70. The total score of disability acceptance was 81.94 ± 13.86; the total score of stigma was 64.03 ± 14.28. The total scores of spiritual nursing needs were positively correlated with the total scores of disability acceptance ( r=0.703, P<0.01), and negatively correlated with the total scores of stigma ( r=-0.516, P<0.01). Multivariate linear regression analysis showed that religious beliefs, educational level, residence, course of disease, disability acceptance, and stigma were the main influencing factors for the spiritual nursing needs of patients with permanent enterostomy ( t values were -13.26-13.56, all P<0.01), accounting for 52.5% of the total variation. Conclusions:The spiritual nursing needs of patients with permanent enterostomy were moderate. It is suggested that nurses can develop targeted spiritual nursing measures according to the individualized characteristics of patients, improve their disability acceptance and reduce their stigma level, so as to meet their spiritual nursing needs and realize their spiritual safety.

Objective:To compare the efficacy and safety of venetoclax (VEN) combined with azacitidine (AZA) versus CAG regimen combined with decitabine (DAC) in elderly patients with relapsed acute myeloid leukemia (AML).Methods:From January 2018 to August 2020, the clinical data of forty-five elderly patients with relapse AML at the First Affiliated Hospital of Soochow University were retrospectively analyzed, including 31 males and 14 females. The median age was 66 (60-80) years old. Eighteen patients were administrated with VEN and AZA, while the other 27 were in CAG with DAC. The complete remission (CR) rate, partial remission (PR) rate, total remission rate (ORR), adverse events and overall survival (OS) were compared between the two groups.Results:At the end of the treatment, the ORR in VEN with AZA group was 77.8% (14/18); including 11 CR and 3 PR. In CAG with DAC group, the ORR was 37.0% (10/27); including 8 CR and 2 PR ( P=0.007). Subgroup analysis suggested that VEN with AZA had a higher ORR in patients stratified as intermediate and poor-risk ( P=0.013) or with DNA methylation mutations ( P=0.007). Main adverse events in both groups were bone marrow suppression, infections, nausea and vomiting, anorexia and fatigue. Grade Ⅲ-Ⅳ cytopenia developed in lower incidence of VEN with AZA group, such as leukopenia (66.7% vs. 100%, P=0.002), anemia (50.0% vs. 92.6%, P=0.002), thrombocytopenia (72.2% vs. 96.3%, P=0.031) and neutropenia (61.1% vs. 92.6%, P=0.014). In addition, less grade Ⅲ-Ⅳ infections occurred in VEN with AZA group (66.7% vs. 33.3%, P=0.028), as well as grade Ⅲ-Ⅳ gastrointestinal events (40.7% vs. 11.1%, P=0.032), grade Ⅲ-Ⅳ fatigue (55.6% vs.11.1%, P=0.003) compared with CAG with DAC group. The 1-year OS in VEN with AZA group versus CAG with DAC group was 42.9% and 31.6% respectively ( P=0.150). Conclusion:VEN combined with AZA proves favorable efficacy and tolerablity in elderly patients with relapsed AML.