OBJECTIVETo evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODSFrom March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTSAll the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSIONThe technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; physiopathology ; surgery ; Patellofemoral Joint ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Objective To investigate the clinical application of the combined the anterior malleolus flap and anterior tibia flap. Methods Based on the dissection of the perforating branches of anterior tibial artery on the middle and inferior section, the combined the anterior malleolus flap and anterior tibia flap was designed to repair the necrotic skin of anterior foot for 5 patients. The sizes of the flaps ranged from 17 cm×10 cm-10 cm× 5 cm. And the area of the flap was from tibial tuberosity(upper bound) to the line between internal malleolus and external malleolus (lower bound), and from the median line of one side of leg to the other side. Results Postoperatively, all flaps survived, and the primary healing of transplanted skin in donor site was achieved. The texture of flaps were excellent, the phenomenon of abrasion did not happen, and the clinical therapeutic efficacy was satisfactory after a follow up of 2-24 months. Conclusion It's a good method that combined the anterior malleohls flap and anterior tibia flap, which not only could enlarge the area of the flap but also has reliable blood supply, in repair of large size skin defect of anterior foot.

Aim To study the modulation of KCNQ2/3 potassium cha nn els by extracellular pH.Methods In vitro transcription was used to synthesize cRNA of KCNQ2/3 potassium channels.The cRNA was injected into Xenopus oocytes to express the KCNQ2/3 channel.The modulation of KCNQ2/3 potass ium channels by extracellular pH was studied by two electrodes voltage clamp tec hniques.Results KCNQ2/3 currents were inhibited and current-vo ltage relationship of activation were shifted to the right with decreased extrac ellular pH. pH modulation of KCNQ2/3 currents was voltage dependent,with a more pronounced effect at more negative potentials above the activation threshold (-60 mV). Extracelluar pH also decreased activation and deactivation kinetics of KCNQ2/3 currents.Conclusion KCNQ2/3 channels, known to contr ibute to neuronal excitability, were modulated by extracelluar pH. The profound effects of the extracelluar pH exerted on KCNQ2/3 channel may play an important role during physiology neuronal activity and pathological events such a s epileptic seizures, cerebral ischemia and shock etc.

This article aimed to study the antigenicity of nucleocapsid proteins (NPs) in six pathogenic phleboviruses and to provide theoretical evidence for the development of serological diagnostic reagents. NPs of six pathogenic phleboviruses were expressed and purified using a prokaryotic expression system and rabbits were immunized with individual recombinant NPs. Cross-reactions among NPs and rabbit sera were determined by both indirect ELISA and Western blotting analyses, and the sera titer was determined by indirect ELISA. Furthermore, sera from SFTS patients were also detected by each recombinant NP as a coating antigen using indirect ELISA. The cross-reactions and the sera titer were subsequently determined. Both the concentration and purity of recombinant NPs of six pathogenic phleboviruses met the standards for immunization and detection. The results of indirect ELISA and Western blotting showed that each anti-phlebovirus NP rabbit immune serum had potential serological cross-reactivity with the other five virus NP antigens. Furthermore, the sera from SFTS patients also had cross-reactivity with the other five NP antigens to a certain extent. Our preliminary study evaluated the antigenicity and immune reactivity of six pathogenic phleboviruses NPs and laid the foundation for the development of diagnostic reagents.
Animals ; Antibodies, Viral ; immunology ; Antigens, Viral ; genetics ; immunology ; Cross Reactions ; Humans ; Nucleocapsid Proteins ; genetics ; immunology ; Phlebotomus Fever ; diagnosis ; immunology ; virology ; Phlebovirus ; classification ; genetics ; immunology ; isolation & purification ; Rabbits

The uracil in DNA comes from either the misincorporation of dUTP in place of dTTP or deamination of cytosine. In the latter case, it can result in a GC to AT transition mutation if the uracil is not removed before DNA replication. Base excision repair (BER) is a major pathway for removing DNA lesions arising from endogenous processes as well as those induced by exposure to exogenous chemicals or irradiation. BER is initiated by DNA glycosylases that excise aberrant bases from DNA by cleavage of the N-glycosidic bond linking to the base of its deoxyribose sugar. Uracil N-glycosylase (UNG) is the enzyme responsible for the first step in the BER pathway that specifically removes uracil from DNA. The UNG gene undergoes both temporal and spatial regulation mainly at the level of transcription. Normally cancer cells undergo over-proliferation and up-regulate their UNG during tumorigenesis. In this study we examine the correlation between UNG level and carcinogenesis, and explore the possibility of using UNG as a marker for cancer diagnosis. Human UNG gene was amplified from the total RNA of the human choriocarcinoma cell line, JEG-3, by RT-PCR. After purification, the 942bp full-length UNG cDNA coding sequence was digested with EcoR I and Sal I, and cloned into the digested pET-21 to construct a recombinant vector, pUNG. The UNG protein was expressed under the control of T7 promoter in E. coli BL21 (DE3) cells induced with IPTG. After ultrasonic treatment, the cell lysate and precipitate were analyzed by SDS-PAGE and a 39kD band was detected. The plasmid was serially diluted at appropriate concentrations and employed as standards in the subsequent quantification. Total RNAs were extracted from 18 pairs of clinical samples, each pair contains a sample of esophageal squamous cell carcinoma (ESCC) tissue and its surrounding normal esophageal epithelia. The copy numbers of UNG mRNA in these RNA samples were determined by real-time quantitative RT-PCR using a Lightcycler (Roche). UNG was present in 13 cases of ESCC (13/18, n = 18) but absent in all of the normal tissues. The results indicated that there was a correlation between high level of UNG expression and the carcinogenesis of ESCC.
Carcinoma, Squamous Cell ; genetics ; metabolism ; Cell Line, Tumor ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Esophageal Neoplasms ; genetics ; metabolism ; Humans ; In Vitro Techniques ; Reverse Transcriptase Polymerase Chain Reaction ; Uracil-DNA Glycosidase ; genetics ; metabolism

Objective To compare the surgical and functional outcomes of single-site (transumbilical two-port) intracorporeal purse-suturing (IP) and single-port extracorporeal knotting (EK) for laparoscopic pediatric inguinal hernia (PIH) repair.Methods Between June 2008 and December 2014,358 PIH children underwent lapamscopic inguinal herniorrhaphy,including 126 treated by single-site intracorporeal purse string stitching using a needle-holder (IP group),and 232 by single-port extracorporeal knotting using an inner two-hook needle with preperitoneal hydrodissection (EK group).Results In all patients laparoscopic procedures were completed successfully without conversion.The operating time in IP group was significantly longer than that in EK group [unilateral:(20.4 ± 2.1) min vs.(9.4 ± 1.3) min,t=-5.23,P＜0.01;bilateral:(31.3 ±2.9) min vs.(15.2±1.7) min,t=-4.22,P＜0.01)].The hospital stay were similar between the two groups [(2.35 ±0.25) d vs.(2.38 ±0.18) d,t =-0.062,P ＞ 0.05].Five cases had intraoperative hematoma in the IP group while none in the EK group.One each suffered from recurrence in IP group and EK group.Three postoperative hydroceles were seen in IP group and one in EK group.Subcutaneous knot granulomas were seen in two in EK group.Conclusions Both IP and EK laparoscopic procedures are safe and feasible.With the assistance of preperitoneal hydrodissection technique,single-port laparoscopic EK herniorraphy is superior to single-site IP repair in easy performance and shorter operation time.

ObjectiveTo investigate the protective effects and mechanism of ursodeoxycholic acid (UDCA) on α-naphthylisothi (ANIT)-induced cholestatic liver injury in rats.MethodsA total of 48 Sprague-Dawley (SD) rats were selected.Fouty-two rats were gavaged with ANIT (100 mg/kg) to induce acute liver injury,six rats were sacrificed 24 hours after the liver injury and the rats left were evenly divided into control group which were gavaged with saline and UDCA group which were gavaged with UDCA (20 mg/kg).Six rats were sacrificed at 48 hours,72 hours and 96 hours after modeling.The six untreated rats were set as blank control group.Serum and liver tissues of all rats were kept after sacrificed.Serum levels of alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil) and total bile acid (TBA) were tested,interleukin-10 (IL-10),interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay (ELISA).The expression of multidrug resistance associated protein2 (Mrp2) at mRNA level in liver tissue was measured by quantitative real-time polymerase chain reaction (qRT-PCR) and the inflammatory reaction activity of liver tissues was inspected with Haematoidin-Eosin (HE)staining under microscope.ResultsAt 48 hours after liver injury modeling,serum TBil (143.80± 12.08) μmol/L vs.(178.50±15.19) μmol/L,TBA (13.15±3.81) μmol/L vs.(21.68±7.93)mol/L,IL-10 (44.13±3.68,37.15±6.25 ng/L),IL-6(50.80±2.09,57.32±4.63 ng/L) and TNF-α (17.53±0.84) ng/L vs,(19.10±1.64) ng/L of UDCA group and control group were compared,and the differences were statistically significant (P ＜ 0.01 or P＜ 0.05).At 72 hours after liver injury modeling,serum ALT (721.67±97.54) U/L vs.(929.50±148.29) U/L and IL-10 (54.68±6.79)ng/L vs.(43.85±4.08) ng/L of UDCA group and control group were compared,and the differences were statistically significant (P＜0.01 or P＜0.05).At 96 hours after liver injury modeling,serum ALT (156.83±14.99) U/L vs.(250.67±42.29) U/L,AST (143.67±27.45) U/L vs.(206.00±63.94) U/L and TBil (23.53±5.08) μmol/L vs.(34.02±9.98) μmol/L of UDCA group and control group were compared,and the differences were statistically significant (P＜0.01 or P＜0.05).The differences of Mrp2 expression at mRNA level in liver tissues between UDCA group and control group at 48 hours (0.77 ± 0.21,0.46 ± 0.25),72 hours (2.27 ±0.84,1.10 ±0.38) and 96 hours (3.64±0.54,2.75±0.69) after liver injury modeling were statistically significant (P＜0.01 or P＜0.05).ConclusionThe mechanism of the protective effects of UDCA on ANIT-induced liver injury may be related with the regulation of serum cytokines and liver Mrp2 expression.

AIM: To compare the accuracy of intraocular lens(IOL)power calculations by using five formulas(Haigis, SRK-T, Hoffer Q, Holladay-1, SRK-Ⅱ)in eyes with long axial lengths in order to improve the accuracy of predicating IOL powers.METHODS: Fifty-one eyes of 51 cases of age-related cataract and with mild long axial(24.5mm27mm) were collected who`s optical biometry were performed by the Zeiss IOL Master500 before operation.They underwent regular phacoemulsification and posterior chamber IOL implantation.The actual postoperative refraction was measured with the methods of phoropter and subjective optometry 3mo after surgery.Then we compared the differences of the predicted and actual postoperative refraction of the five formulas in each group.RESULTS: In the mild axial lengths cases, the differences between SRK Ⅱ formula and the other four formulas were statistically significant (P<0.05), and the difference between Hoffer Q and SRK-T formula was statistically significant (P<0.05);there was no difference among the other formulas (P>0.05).In the moderate and severe long axial lengths cases, the differences between SRK Ⅱ formula and the other four formulas were statistically significant (P<0.05), and the difference between Hoffer Q and SRK-T formula, Hoffer Q and Haigis formula were statistically significant (P<0.05);there was no difference among the other formulas (P>0.05).The differences of all the five formulas between the two groups were statistically significant (P<0.05).CONCLUSION: In the mild axial lengths cases, Haigis, SRK-T, Hoffer Q, Holladay-1 performed well.In the moderate and severe long axial lengths cases, Haigis, SRK-T and Holladay-1 performed better than other formulas.The accuracy of all the five formulas decreases as the axial length getting longer.

Objective:To evaluate the safety and feasibility of the in-situ needle fenestration combined with the in vitro physician modified fenestration technique to reconstruct supra-aortic branches during thoracic endovascular aortic repair (TEVAR) for aortic arch lesions requiring landing at Z0 and Z1.Methods:From Nov 2017 to Dec 2019, eighteen patients who underwent both the in-situ needle fenestration and the in vitro physician modified fenestration techniques to extend the proximal landing zone to Z0 and Z1 during TEVAR were included in our study.Results:Sixteen patients underwent in vitro physician modified fenestration ,two patients underwent in vitro physician modified fenestration to reconstruct both the left common carotid artery and the innominate artery. All eighteen patients received in-situ needle fenestration to preserve the left subclavian artery. Supra aortic branches were preserved in all patients (38/38, 100%). There was no Type Ⅰ endoleak. Type Ⅱ endoleak was found in four paitnets (4/18). Type Ⅲ endoleak occurred in one patient (1/18). Type Ⅳ endoleak in four patients (4/18). Type Ⅲ endoleak needed open aortic arch repair 6 months later. The median follow-up time was 12 months. One (1/18) died in 12 months and the other patients were doing well.Conclusions:The joint application of the in-situ needle fenestration and the in vitro physician modified fenestration to reconstruct supra-aortic branches during TEVAR for aortic arch pathologies requiring landing at Z0 and Z1 was satisfactory.