Objective To evaluate the early effects of bone cement prostheses versus cementless prostheses in very elderly patients undergoing total hip arthroplasty.Methods A total of 110 patients aged 70 years and over who had undergone hip replacement because of hip disease from March 2011 to March 2013 were selected.104 cases were followed up for 3 years,with 46 cases treated with the bone cement prostheses(Group A) and 58 cases with cementless prostheses(Group B).The conditions before and after surgery were recorded.Postoperative Harris scores were collected to evaluate the function of the hip joint,and the loosening of hip prostheses was detected by x-ray.Results Intraoperative blood loss and postoperative drainage volume were lower in Group A than in Group B [(236.0±26.3) ml vs.(296.0±34.5) m1,(123.0±20.3) ml vs.(156.0±26.4) ml,both P ＜0.05].Harris scores before,6 months,1,2 and 3 years after surgery were(40.2±7.2),(80.3±5.2),(90.2±4.5),(90.6±4.2),and(90.8±3.5) in Group A,and(39.8±6.3),(76.5±8.7),(86.5±5.1),(89.3± 4.8),and(91.0± 4.1) in Group B,respectively.Harris scores 6 months and 1 year after surgery were higher in Group A than in Group B,and there was no significant difference in Harris scores between the two groups 2 and 3 years after surgery(P＞0.05).Pain scores before,6 months,1,2 and 3 years after surgery were(13.5± 5.3),(37.5± 6.2),(38.4±5.3),(39.1 ±2.5) and(39.0±2.1) in Group A and(12.9±6.2),(30.2±8.7),(35.9±6.5),(38.6±4.8) and(39.2±2.6) in Group B,respectively.Pain scores 1 year after surgery was better in Group A than in Group B,and there was no significant difference in pain scores between the two groups 2 and 3 years after surgery(P＞0.05).Bone cement implantation syndrome occurred in 6 cases in Group A,of which 1 case had respiratory and cardiac arrest and was successfully rescued after cardiopulmonary resuscitation.In addition,in Group A,1 case had osteolytic disease 2 years after surgery,and,in Group B,4 cases had proximal femoral fractures and 1 case had osteolytic disease 3 years after surgery.Conclusions For very elderly patients undergoing total hip replacement,satisfactory early therapeutic effects can be achieved by using bone cement or cementless prostheses.Intraoperative blood loss,postoperative drainage volume and Harris scores 1 year after surgery are better with bone cement prostheses than with cementless prostheses.Close attention should be paid to possible development of bone cement implantation syndrome during operation.

Objective To explore the inhibitory effect of pulsed ultrasound on skeletal muscle fibrosis after injury.Methods Thirty elderly male rats with gastrocnemius muscle injury were divided into an ultrasound group (UG) and a control group (CG) using a random number table.The injured muscles in the UG were treated using pulsed ultrasound (frequency 1 MHz,average strength 40 mW/cm2,duty cycle 20％) for 10 min daily from day 3 after the injury.The CG was given no treatment.On days 3,7,14,21 and 28 after the injury,histological and immunohistochemical analyses of the gastrocnemius muscles of both groups were performed.Results The collagen fiber mean optical density of the muscles increased gradually after the injury and reached its peak on day 21.It was significantly lower in the UG than in the CG on each test day.The expression of α-SMA increased gradually after the injury,but it too remained significantly lower in UG than that in CG.Conclusion Pulsed ultrasound may reduce collagen formation and α-SMA expression in injured skeletal muscle,and then inhibit muscle fibrosis.

As one branch of epigenetics, the sirtuins family ( ClassⅢ histone deacetylase) receive much attention in recent years. SIRT1 as the most famous of the sirtuins family members has been verified involved in a variety of age-related diseases. While the SIRT1 formation is paid more and more attention in age-related cataract. Now, we briefly overviewed the research progress on the role of SIRT1 in age-related cataract.

OBJECTIVETo explore the expression of Ghrelin and high mobility group protein B1 (HMGB1) in the serum and the intestinal tissue of sepsis model rats, and to evaluate the effect of electro-acupuncture (EA) at Zusanli (ST36) on the expression of HMGB1 and Ghrelin.

METHODSForty-eight male Wistar rats were randomly divided into four groups, i.e., the sham-operation (sham), the cecal ligation and puncture group (CLP), the CLP + EA at Zusanli (ST36) group (EA), and the CLP + Ghrelin receptor blocking agent + EA group (GHSRA), 12 in each group. A sepsis rat model was prepared by CLP. The incision of the abdominal wall was immediately sutured along the ventral midline for rats in the Sham group. In the EA group EA at Zusanli (ST36) was performed 20 min after CLP surgery with the constant voltage (2 - 100 Hz, 2 mA) for 30 min. In the GHSRA group, Ghrelin receptor blocking agent, [D-Arg1, D-Phe5, D-Trp79, Leu11]-substance P (700 nmol/kg), was administered through intravenous injection immediately after CLP, and 20 min later, EA at Zusanli (ST36) was performed in the same way as for rats in the EA group. Blood samples were withdrawn 12 h after CLP. The serum levels of Ghrelin and HMGB1 were detected using ELISA. Ghrelin expressions and the number of Ghrelin immunopositive cell in the jejunum were determined by immunohistochemistry. HMGB1 contents of the jejunum tissue were detected by Western blotting.

RESULTSCompared with the Sham group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased and levels of Ghrelin and the expression rate of immunopositive cells significantly decreased in the CLP group (P < 0.05). Compared with the CLP group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly decreased, but levels of Ghrelin and the expression rate of immunopositive cells significantly increased in the EA group (P < 0.05). Compared with the EA group, the number of serum immunopositive cells and the expression of HMGB1 in the jejunum tissue significantly increased in the GHSRA group (P < 0.05), but there was no statistical difference in levels of Ghrelin between the two groups (P > 0.05). The serum level of HMGB1 was negatively correlated with Ghrelin in the Sham group, the CLP group, and the EA group (r = -0. 528, P < 0.01).

CONCLUSIONSEA at Zusanli (ST36) could inhibit the expression of HMGB1 in the jejunum of septic rats, and promote the expression of Ghrelin. The expression of HMGB1 was inhibited by Ghrelin receptor blocking agent, which suggested that the anti-inflammation of EA at Zusanli (ST36) might be associated with Ghrelin.

Animals ; Disease Models, Animal ; Electroacupuncture ; Ghrelin ; metabolism ; HMGB1 Protein ; metabolism ; Jejunum ; metabolism ; Male ; Rats ; Rats, Wistar ; Sepsis ; metabolism

Background The diagnosis of central serous chorioretinopathy (CSC) is mainly dependent onfluorescine fundus angiography (FFA). However, the combination of optical coherence topography (OCT) with FFA offers a new approach to the research of the pathogenesis of CSC. Objective This clinical study was designed to study the combined application of the FFA and OCT for the research of the pathogenesis of central serous chorioretinopathy (CSC). Methods Forty-four eyes of 44 patients with CSC were included in this study with 36 cases of males and 8 cases of female. The patients were aged 39.3 ± 5.3 years and the visual acuity was 0. 64 ±0. 27. FFA and OCT examinations were performed in all patients and the FFA images were imported into the Topcon 3D OCT 1000 device to locate the conformity of OCT lesions with the leakages of FFA. The neuroepithelial layer thickness at the fovea and the height of the neuroepithelial layer detachment were measured using 3-D OCT. Results OCT showed serous REP detachment in 34 eyes (77.3%) and rough surfaces of RPE in 10 eyes (22. 7% ). In thirtyfour eyes with RPE detachment, the OCT lesions and FFA leakage spots conformed to the same locations in 31 eyes, but the other three eyes did not. The mean foveal neuroepithelial thickness was (138.5±19.4) μm in CSC eyes and that of normal eyes was ( 131.35±5. 01 ) μm ,showing a significant difference between them( t=0. 39 ,P＞0. 05 ). The mean height of neuroepithelial detachment was (263.3 ± 126.7 ) μm in CSC eyes. Conclusion RPE detachment occurs in CSC eyes and further induces macular neuroepithelial detachment. Leakage lesion of fluorescine corresponds to RPE detachment. CSC without RPE detachment may be related to the increase in RPE permeability. OCT can accurately measure the thickness of the macular neuroepithelial layer and the height of the neuroepithelial detachment.

Anesthetics, Intravenous ; administration & dosage ; pharmacology ; Animals ; Animals, Newborn ; Cerebral Cortex ; cytology ; metabolism ; Drug Synergism ; Female ; Fentanyl ; administration & dosage ; pharmacology ; Male ; Midazolam ; administration & dosage ; pharmacology ; Neurons ; metabolism ; Patch-Clamp Techniques ; Primary Cell Culture ; Rats ; Rats, Sprague-Dawley ; Voltage-Gated Sodium Channels ; drug effects

Objective　To establish animal model for hypertrophic scar and study the characters of its morphology and collagen metabolism. Methods　A total of 64 round wounds (diameter of 6 mm each) with total skin loss were made on the ventral side of rabbit ear using a trephine. Morphology and collagen metabolism of scar wounds were studied at 14,21,35,70 and 98 days after operation, respectively. Results　There were 76% elevated scars developed (45/59 wounds) on the ventral side of rabbit ear at 21 days and 46% elevated scars disappeared (11/24) at 98 days after operation. There were numerous fibroblast proliferation and whorl-arranged collagen fibers at 21 and 35 days. The number of fibroblast decreased, but irregular-arranged fibers still presented in the elevated scars at 70 and 98 days after operation. Hydroxyproline content in elevated scars at 21 days was higher than that in normal skin (P<0.05), and at 35 days was 3 times as that in normal skin and at 98 days was also markedly higher than that in normal skin (P<0.05). Conclusion　Excessive deposition of collagen is a characteristic of hypertrophic scar in rabbits. The conversion of normal scarring to hypertrophic scarring in rabbits occurs at 14～21 days after operation. Both development and regression of hypertrophic scar in rabbit are quicker than that in human.

Anemia, Hemolytic ; etiology ; Child ; Female ; Humans ; Insecticides ; poisoning ; Trichlorfon ; poisoning

Adult ; Electrocoagulation ; methods ; Female ; Humans ; Injections ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Ozone ; administration & dosage ; Radio Waves ; therapeutic use

Objective To study in vitro the effects of low-intensity pulsed ultrasound (LIPUS) on the proliferation and differentiation of cultured myoblasts,and to explore the cellular and molecular mechanisms behind any therapeutic effect of LIPUS.Methods Myoblasts were isolated from the skeletal muscles of mice and cultured in vitro.Treatment and control groups of proliferating and differentiating myoblasts were defined.The treatment groups were exposed to LIPUS at 1.5 MHz and a spatial and temporal average intensity of 30 mW/cm2,for 20 min daily,the proliferation group for 6 consecutive days and the differentiation group for 4 consecutive days.The cell proliferation kinetics of the proliferation group were analyzed using flow cytometry.The expression of myogenic regulation factor MyoD and heme oxygenase-1 (HO-1) in the proliferation group,and of myosin heavy chain (MHC) in the differentiation group were examined by immunofluorescent staining.Myoblast fusion indexes were analyzed.Results In the LIPUS treatment groups the proliferating myoblasts had a higher ratio of active cells in the G2 and S phases (19.30％ ±5.14％,37.00％ ±8.72％),compared with the controls (10.33％ ± 1.53％,25.00％ ±4.36％),and the proliferation index increased significantly.The expression of HO-1 was up-regulated,while MyoD staining was unchanged.During the induction of differentiation,the myoblasts of the treatment group fused into smaller myotubes and the myoblast fusion index (18.73％ ± 6.81％) was significantly lower than that of the control group (37.52％ ± 11.23％),while MHC expression did not change markedly.Conclusion LIPUS can promote myoblast proliferation while inhibiting their differentiation,but it does not affect the cells' myogenic properties.HO-1 may be involved in the regulation process.