Objective: To assess the reproducibility of high resolution MR imaging(MRI) in measuring the vascular wall area in atherosclerotic carotid artery. Methods: Twenty four subjects (male 18, female 6, aged 60 78 years) with 50% 79% stenosis (confirmed by Doppler ultrasound) were recruited for the study. Two independent MRI examination were conducted within 2 weeks using high resolution imaging on a 1.5 T scanner (Signa, GE Medical Systems). Three slices were selected (4 mm distal to the bifurcation, just under the bifurcation and 4 mm proximal to the bifurcation) from the bilateral carotid artery to measure the luminal, outer wall boundary and wall area. The above process was done by 2 observers blinded to each other's results. The Interscan and Interobserver variations were assessed by paired Student's t test. Results: There was no significant difference in lumen, outer wall boundary and wall area measurement for both Interscan and Interobserver comparison. Conclusion: High resolution MRI of the human carotid artery in measuring the vessel lumen and wall areas has high reproducibility. MRI can also be used to monitor the progression of atherosclerotic plaque of carotid artery.

OBJECTIVETo study mechanical affect of knee joint of reasonable positioning of femoral tunnel during knee posterior cruciate ligament (PCL) double-bundle reconstruction and graft fixation after reconstruction by virtual reality interactive technology and evaluate the biomechanical response of knee after reconstruction by finite element analysis.

METHODSKnee specimens from five fresh frozen cadavers were used. Computer simulations and biomechanical experiments were used in this study. Experiments on flexion and extension movements of the knee joint were performed on specimens of fresh human knee joint. Laser three dimensional scanning was used to record and calculate the indexes of movements. Three-dimensional models of knee joint bone structure were then reconstructed on computer with the experimental data. Simulations of flexion and extension movements were carried out on the models to show the spatial positions of femur and tibia and label the attachment sites of PCL. Ten test points in the anterior,posterior, proximal, distal at the femoral attachment area of anterior and lateral bundle (ALB) and postoperior medial bundle (PMB) were selected and the central points of tibial en attachment areat anchored. The distance btween each two points of two article surface was calculated and contacted by software of Geomagic. Model was import software Ansys, adopting the tetrahedron unit a finite element model of complex tibial and femoral was set up to simulat human walking in one leg,on this condition the the joint surface force of model under weight impact load were analyzed.

RESULTSThe three-dimensional models could demonstrate the spatial positions of the bone structure of the knee in different flexions and extensions. The models could be used to measure the spatial distance between 2 points on the femoral and tibial planes by software Geomagic. There was significantly difference among the length changes of anterolateral bundle and posteromedial bundle at every fixed point with different flexion angles (P<0.05), so the fixed angle with different points. The length changes of anterior lateral bundle's A2, A1 and posterior medial bundle's B3, B1 points were (1.35±0.19) mm, (5.41±1.22) mm, (1.95±0.04) mm and (5.23±2.21) mm, respectively. The A2 and B3 points' length changes were the less, and that of the Al and B1 points were the more. It had no significant difference between the length changes of anterior lanteral bundle's A2 and A3 point (P=0.913>0.05). All of the maximal length changes of anterior lateral bundle's A2, A3 and postterior medial bundle's B3 points were less than 2 mm.

CONCLUSIONThe models of knee joint were builded through computer technology and it can be measure the lenth of cruciate ligament with software Geomagic exactly. The femoral tunnel for the PCL double-bundle reconstruction should be located as follows: ALB at the middle point of upper edge of femoral attachment site (proximal point),while PMB at the middle point of femoral attachment site (proximal point). This model provides a satisfactory method for the evaluation of the biomechanical response of knee after cruciate ligament reconstruction.

Adult ; Aged ; Biomechanical Phenomena ; Computer-Aided Design ; Female ; Femur ; surgery ; Humans ; Knee Joint ; physiology ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; methods

To investigate the role of ion channels in the coupling responses of neutrophils to extracellular stimulus, it is necessary to study the membrane ion channel activities using patch-clamp technique. However, little has been known about the ion channel activities in neutrophils due to the difficulties in forming giga-seal with pipettes because of small diameter of neutrophils and the easily developed polarization. Some studies indicated that favorable results could be achieved through pretreatment at low temperature before electrophysiological recordings. But it remains unclear whether the pretreatment affects the membrane current and why the seal rate increases after low temperature pretreatment. The purpose of this study was to investigate the effects of 4 degrees C pretreatment on the membrane current and cell polarity in human neutrophils. In the experiments, human neutrophils were isolated from fresh peripheral blood of healthy volunteers and divided into two groups (room temperature group and 4 degrees C pretreatment group). Voltage-dependent K(+) (Kv) currents were recorded in whole-cell voltage-clamp mode and large-conductance Ca(2+)-activated K(+) (BK(Ca)) currents were recorded using inside-out patches. The results showed that 4 degrees C pretreatment significantly inhibited cell polarity (P<0.05), and it took more time for neutrophils to form a polarity-cycle [(534+/-32) s, n=20] compared with those at room temperature [(257+/-24) s, n=20]. Meanwhile, seal rate significantly increased in 4 degrees C pretreatment group (64%) compared with that in the room temperature group (27.5%). The seal rate and cell polarity rate during 0 approximately 1 min after 4 degrees C pretreatment were significantly different from those at room temperature, while no significant difference was found during 9 approximately 10 min between the two groups. Our results suggest that 4 degrees C pretreatment can inhibit cell polarity and increase seal rate, but has no effects on membrane currents. It is also suggested that 0 approximately 1 min after 4 degrees C pretreatment is a more suitable time for electrophysiological recording in neutrophils.
Cell Polarity ; Cold Temperature ; Humans ; Large-Conductance Calcium-Activated Potassium Channels ; physiology ; Membrane Potentials ; Neutrophils ; physiology ; Potassium Channels, Voltage-Gated ; physiology

OBJECTIVETo study short-term results and clinical application of Tri-lock BPS in total hip arthoplasty.

METHODSFrom May 2010 to July 2011, 32 hips in 31 patients (18 males and 13 females, ranging in age from 50 to 77 years old, with an average of 60.5 years old) were treated by total hip arthroplasty with Tri-lock BPS, including 8 patients with osteonecrosis (ON), 13 patients with fresh femoral neck fracture, 10 patients with developmental dysplasia of the hip (DDH). The therapeutic effects were evaluated by self assessment form, preoperative and postoperative Harris hip score, radiographs, Engh score and bone in growth of femoral side described by Gruen. Based on the short-term results,its design characteristic and clinical properties were analyzed.

RESULTSAll the incisions healed well and there were no complications such as femoral fracture, infection, dislocation and neurovascular injuries. All the patients were followed up with an average time of 12.2 months (ranged, 10 to 14 months). All the joints had good or excellent clinical results. The Harris score increased from preoperative 38.3 +/- 4.9 to 92.5 +/- 11.2 at the latest follow-up (t = 27.53, P < 0.01). Radiographically, the positions of the prostheses were normal,the average limbs length and femoral eccentricity recovered to normal. X-ray of the hips showed that the femoral stem prosthesis was in line with good initial fixed standard. At 3 months after surgery, X-ray of the hips showed that bone in growth in Gruen II and VI of femoral side.

CONCLUSIONShort-term results show that the design of Tri-lock BPS is more in line with human anatomy, and has the advantages in rapid recovery of hip function and retains more bone mass. It offers a newly valuable technology for the treatment of osteonecrosis, femoral neck fracture and DDH and so on.

Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Recovery of Function ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo evaluate clinical efficacy of suture anchors in treating acute injuries of medial collateral ligament (MCL) of knee at degree III.

METHODSTwenty-seven patients with degree III acute MCL injuries of knee were treated with suture anchors from January 2007 to June 2011. There were 15 males and 12 females, aged from 19 to 56 (averaged 32.6) years old. The time from injury to operation was 3 to 10 days, averaged 6 days. Symptoms and physical signs before and after treatment were observed, Lysholm scoring were used to evluated clinical efficacy.

RESULTSAll patients were followed up from 16 to 30 months with an average of 21.6 months. The stability of knee joints was good in all patients. Abduction stress test was negative when the knee joint was straightened at 0 degrees and flexed at 30 degrees. The average degree of flexed knee (67.00 +/- 5.80) degrees preoperatively was lower than that of postoperatively (136.50 +/- 6.30) degrees at 1 year. According to Lysholm scoring, preoperative scores ranged from 30 to 43 points, averaged 36.46 +/- 1.48; 1 year after operation ranged from 87 to 100 with an average of 91.50 +/- 3.80 and higher than postoperative. Twenty patients got an excellent results, 5 good and 2 fair.

CONCLUSIONSuture anchors in treating acute injuries of medial collateral ligament of knee at degree III has following advantages: small range of tissue dissection, easy to operate, reliable fixation and less complications.

Acute Disease ; Adult ; Collateral Ligaments ; injuries ; surgery ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Middle Aged ; Suture Anchors

Cartilage oligomeric matrix protein (COMP) is a potential biomarker for joint destruction associated with osteoarthritis, which is first and best investigated biomarkers to reflect osteoarthritis occurs, progress and the prognosis. In this article, multiple uses and related reports of COMP are summarized briefly to promote further investigation of COMP.
Biomarkers ; blood ; Cartilage Oligomeric Matrix Protein ; Extracellular Matrix Proteins ; blood ; chemistry ; metabolism ; Glycoproteins ; blood ; chemistry ; metabolism ; Humans ; Matrilin Proteins ; Osteoarthritis ; blood ; diagnosis ; Prognosis

OBJECTIVETo explore selection and efficacy assessment for membranous urethral trauma caused by pelvic fracture.

METHODSFrom June 2000 to August 2010, 72 patients with membranous urethral trauma caused by pelvic fracture were selected. There were 46 males and 26 females,ranging age from 26 to 62 years (averaged 35.2 years). The time from injury to hospitalization time was 1 to 3 hours. According to Tile pelvic fracture classification, there were 8 patients with type A, 45 patients with type B, 19 patients with type C. Thirty of the 35 patients with partial rupture of posterior urethral were treated by catheterization,5 patients treated by rupture anastomosis on the stage I combined with cystostomy; 25 of the 37 patients with complete rupture of posterior urethra were treated by early realignment, and 12 patients were treated by cystostomy. Urinary incontinence, impotence and urethrostenosis were evaluated.

RESULTSAll patients were followed up for 5 to 10 years (mean 7.7 years). Incidence of urethrostenosis, impotence and urinary incontinence in patients treated by cystostomy were significantly higher than rupture anastomosis on the stage I and early realignment (P < 0.05); while incidence in patients treated by catheterization was significantly lower than other groups (P < 0.05).

CONCLUSIONFor patients with partial rupture of posterior urethral, catheterization and rupture anastomosis on the stage I are preferred methods; while patients with complete rupture of posterior urethra, early realignment is a preferred method with advantages of simple operation and less complications.

Adult ; Female ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; Retrospective Studies ; Urethra ; injuries ; surgery

The purpose of this study was to investigate the molecular mechanisms whereby hydrogen sulfide (H2S) exerts the promoting effect on vascular endothelial cells migration. We used wound healing assay to study the effect of NaHS (H2S donor) on the migration ability of rhesus retinal pigment epithelial cell line, RF/6A cells, under normoxic conditions. Real-time PCR was used to measure hypoxia-inducible factor 1α (HIF-1α) mRNA level. Western blot was used to measure the expression of HIF-1α protein. The probe 2',7'-dichlorofluorescein diacetate (DCFH-DA) was used to measure intracellular reactive oxygen species (ROS) level. The results showed that NaHS (10-100 μmol/L) could significantly promote RF/6A cells migration under normoxic conditions, and this effect could be inhibited by 50 µmol/L HIF-1 inhibitor, CdCl2. NaHS increased the protein level of HIF-1α in a dose- and time-dependent manner, and up-regulated the mRNA level of HIF-1α quickly and continuously. Moreover, NaHS could significantly decrease ROS levels in RF/6A cells under normoxic conditions. These results suggest HIF-1 may mediate the promoting effect of H2S on vascular endothelial cells migration under normoxic conditions. ROS, as an upstream regulator of HIF-1α, may be involved in the migration-promoting effect of H2S.
Animals ; Cell Line ; Cell Movement ; physiology ; Endothelial Cells ; cytology ; Hydrogen Sulfide ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Macaca mulatta ; RNA, Messenger ; genetics ; metabolism ; Reactive Oxygen Species ; metabolism ; Retinal Pigment Epithelium ; cytology ; Sulfides ; pharmacology

Objective To explore the perinatal outcomes of women with pulmonary hypertension complicating congenital heart disease(CHD).Methods Clinical data of 45 cases of pregnant women with pulmonary hypertension complicating CHD from Apr 1995 to May 2007 were analyzed and they were divided into three groups:29 cases of slight group[pulmonary hypertension of 30 mm Hg(1 mm Hg=0.133 kPa) to 49 mm Hg],8 cases of moderate group(pulmonary hypertension of 50 mm Hg to 79 mm Hg)and 8 cases of severe group(pulmonary hypertension equal to or higher than 80 mm Hg).The types of CHD,cardiac functional status(New York heart association,NYHA),gestational weeks of pregnancy termination,mode of delivery,pregnancy after CHD operation and outcomes of infants were compared between the groups. Results(1)The highest incidence of CHD were atrial septal defect and ventricular septal defect(58%, 26/45).The rate of pregnant women after CHD operation was 29%(13/45),they were mainly in slight group and their NYHA class were in Ⅰ-Ⅱ.(2)The occurrence rate of NYHA class Ⅲ-Ⅳ was 7/8 in severe group.The rate of NYHA class Ⅰ-Ⅱ as 6/8 in moderate group.The rate of NYHA class Ⅰ- was 97%(28 /29)in slight group.(3)The rate of term delivery was 93%(27/29),preterm labor 3% (1/29),abortion 3%(1/29),and the birth weight was(3153?399)g on average in slight group.The rate of term delivery was 5/8,preterm labor occurred in 3 cases in moderate group.The rate of term delivery was 5/8,preterm labor occurred in 2 cases,and iatrogenic abortion in 1 case in severe group.The average birth weight between slight group and moderate or severe group had a significant difference.(4)Caesarean section rate was 78 %(35/45)among all patients.The rate of cesarean section delivery was 76%(22/29)in slight group,6/8 in moderate group,and 7/8 in severe group.(5)The rate of pregnant women who had portent heart failure or heart failure was 24%(11/45),overall maternal mortality was 4%(2/45).Conclusions The higher the pulmonary hypertension,the worse the outcome of the mother and fetus;The pregnant women with good heart function after cardiac operation would have a good perinatal outcome.Cesarean section is more suitable for those women.