OBJECTIVETo evaluate the applicability of Porthsmouth modified physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) in predicting the mortality of the patients undergoing hip joint arthroplasty.

METHODSA total of 141 patients (75 males and 66 females, aged 63.22 years+/-14.45 years on an average) undergoing hip joint arthroplasty during January 2002 and March 2005 were studied retrospectively with P-POSSUM. Their average physiological score and operative severity score were 17.48+/-5.16 and 12.43+/-3.05, respectively. The predicted postoperative mortality with P-POSSUM was compared with the observed value. Subgroup analysis was performed to investigate the predictive capability of P-POSSUM. POSSUM scoring system was used as the control.

RESULTSThree patients died after operation in this study actually. The average physiological scores were 32.33+/-9.87 in the death group and 17.16+/-4.56 in the survival group. The former was obviously higher than the latter, which showed statistical difference between the two groups (Wilcoxon rank sum test, P<0.05). Perfect agreement was found between the observed death number and the predicted death number calculated by P-POSSUM (Cochran-Mantel-Haenszel chi(2) test, P>0.05), though POSSUM overestimated the overall mortality.

CONCLUSIONSP-POSSUM can predict the mortality accurately in the patients undergoing hip joint arthroplasty, which is superior to POSSUM.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; mortality ; Chi-Square Distribution ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Severity of Illness Index

OBJECTIVETo evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achilles tendon-bone allografts.

METHODSAssociated meniscus injuries were treated according to established methods prior to ligament reconstructions during arthroscopic surgery. Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively.

RESULTSwere analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (larger than 3-8 weeks), 3 for acute ligamentous deficiencies (less than or equal to 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the difference was statistically significant (t- test, P less than 0.001) before and after operation.

CONCLUSIONSAchilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

Achilles Tendon ; transplantation ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Transplantation ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Posterior Cruciate Ligament ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Transplantation, Homologous

Animals ; Cadherins ; metabolism ; Catenins ; metabolism ; Estradiol ; pharmacology ; Estrogen Receptor Modulators ; pharmacology ; Female ; Ovariectomy ; Rats ; Uterus ; drug effects ; metabolism

OBJECTIVETo investigate the diagnostic value of acoustic radiation force impulse (ARFI) imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients.

METHODSOne-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis. The correlation between liver fibrosis grades determined by the two approaches was analyzed. The cut-off values for diagnosis by ARFI (S more than 2, S more than 3 and S = 4) were determined by generating a receiver operating characteristic (ROC) curve.

RESULTSThe spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26+/-0.27) m/s (n = 36), S2 at (1.45+/-0.51) m/s (n = 31), S3 at (2.01+/-0.54) m/s (n = 27), and S4 at (2.28+/-0.82) m/s (n = 14). The ARFI values were significantly different among the four different stages of liver fibrosis (P less than 0.001). The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient: 0.61, P less than 0.001). Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S more than 2 patients, of 0.863 for S more than 3 patients, and of 0.0880 for S = 4 patients.

CONCLUSIONThe real-time ultrasound elastography ARFI technology can show the elasticity modulus of liver, and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients. ARFI technology is easy to operate, non-invasive, and quantitative, and has potential clinical value for assessing liver fibrosis in CHC.

Adolescent ; Adult ; Aged ; Elasticity Imaging Techniques ; Female ; Hepatitis C, Chronic ; complications ; diagnostic imaging ; Humans ; Liver Cirrhosis ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Young Adult

OBJECTIVETo observe the effect of burn on cytokines in lymph and T lymphocyte subsets in lymph node of rats.

METHODSEighteen Wistar rats were used in the experiment. One of the hind limbs of each rat was immersed in 70 °C hot water for 30 s to reproduce 4%TBSA deep partial-thickness scald model (burn group), while the other hind limb was immersed in 22 °C warm water for 30 s to simulate scald (sham injury group). On post injury hour (PIH) 6, 24, and 72, 6 rats were chosen according to the random number table. Lymph fluid in the lymph vessel of each animal (two groups) was obtained for determination of levels of tumor necrosis factor α (TNF-α), interferon-γ (IFN-γ) and interleukin-4 (IL-4) by ELISA, and IFN-γ/IL-4 ratio was calculated. Common iliac lymph node of each animal (two groups) was obtained for determination of ratios of CD4(+), CD8(+)T lymphocytes with flow cytometry, and CD4(+)/CD8(+) ratio was calculated. Data were processed with t test.

RESULTS(1) On PIH 6, 24, and 72, TNF-α level in burn group was respectively (51.6 ± 5.4), (27.4 ± 2.6), (23.0 ± 2.7) pg/mL, which were significantly higher than those in sham injury group [(17.8 ± 1.6), (16.4 ± 1.2), (17.2 ± 2.0) pg/mL, with t value respectively 15.346, 11.854, 4.189, P values all below 0.01]. (2) On PIH 6, 24, and 72, there was no significant statistical difference between burn group and sham injury group in IFN-γ level (with t value respectively 2.059, -0.805, -0.415, P values all above 0.05); IL-4 level in burn group was respectively higher than that in sham injury group (with t value respectively 9.141, 11.669, 6.940, P values all below 0.01); IFN-γ/IL-4 ratio in burn group (2.27 ± 0.34, 1.54 ± 0.19, 1.60 ± 0.16) was respectively lower than that in sham injury group (3.33 ± 0.25, 3.34 ± 0.22, 2.52 ± 0.24, with t value respectively -6.298, -11.313, -8.893, P values all below 0.01). (3) On PIH 6 and 24, there was no significant statistical difference between burn group and sham injury group in ratios of CD4(+) and CD8(+)T lymphocytes and also CD4(+)/CD8(+) ratio (with t values from -2.486 to -0.215, P values all above 0.05). On PIH 72, ratio of CD4(+)T lymphocytes and CD4(+)/CD8(+) ratio in burn group was respectively (38.6 ± 2.3)% and 2.13 ± 0.16, which were significantly lower than those in sham injury group [(48.9 ± 2.9)% and 2.68 ± 0.12, with t value respectively -7.551, -5.068, P values below 0.01]; there was no significant statistical difference between burn group and sham injury group in ratio of CD8(+)T lymphocytes (t = 0.845, P > 0.05).

CONCLUSIONSBurn may decrease IFN-γ/IL-4 ratio in locally drained lymph and CD4(+)/CD8(+) ratio in locally drained lymph node of rat, which may indicate lowering of local immune function.

Animals ; Burns ; immunology ; metabolism ; CD4-CD8 Ratio ; Flow Cytometry ; Interferon-gamma ; metabolism ; Interleukin-4 ; metabolism ; Lymph Nodes ; immunology ; metabolism ; Lymphatic Vessels ; immunology ; metabolism ; Male ; Rats ; Rats, Wistar ; T-Lymphocytes ; cytology ; immunology

OBJECTIVETo investigate the influences of bicortical anchorage on values of natural frequencies of dental implants utilizing the 3-dimensional finite element analysis.

METHODSUsing the commercial code of Solidworks, 3-D models of a screw-shaped dental implant and a mandibular bone segment were generated. After the 3-D implant-bone complex was meshed by ABAQUS software, effects of bicortical anchorage on the buccolingual and axial first-order natural frequencies of the implant were computed.

RESULTSBicortical anchorage increased both the buccolingual and axial natural frequencies remarkably. As the bicortical anchorage got deeper, the frequencies correspondingly got higher.

CONCLUSIONBicortical anchorage can increase the buccolingual and axial primary stability of dental implants.

Dental Implantation, Endosseous ; Dental Implants ; Dental Stress Analysis ; Finite Element Analysis ; Humans ; Mandible

OBJECTIVETo research the diagnosis and effective treatment of penetrating anorectal wounds.

METHODSRetrospective analysis was done in 16 cases of penetrating anorectal wounds from 1985 to 2004. Debridement and suture of anorectal and vesical wounds, effective diversion of fecal and urinary stream and sufficient presacral drainage were performed in all cases.

RESULTSAll the 16 cases were cured. Among them, 2 cases with infection in presacral space were cured by sufficient drainage after operation, one case was cured by secondary repair after anal sphincter was repaired unsuccessfully and one case with rectovesical fistula was cured with conservative treatment. None of them suffered from complications such as anal stenosis, dysuria or impotence etc.

CONCLUSIONSFor penetrating anorectal wound, to master early recognition of concomitant injures, to select appropriate surgical intervention and to strengthen perioperative treatment are the keys to improve the curative effects.

Adolescent ; Adult ; Anal Canal ; injuries ; Humans ; Male ; Middle Aged ; Rectum ; injuries ; Treatment Outcome ; Wounds, Penetrating ; diagnosis ; surgery

OBJECTIVETo study the effect of bitter-cold herbs easing dampness method (BCHEDM) plus Sanhuang Yilong Decoction (SYD) combined with methotrexate (MTX) on expression levels of interleukin-1 (IL-1), IL-6, and IL-17 in rheumatoid arthritis (RA) patients of accumulated dampness-heat syndrome (ADHS).

METHODSFrom January 2011 to January 2013 recruited were 90 RA inpatients of ADHS at Department of Integrative Medicine on Rheumatoid Disease, General Hospital of Chengdu Military Region. They were assigned to the treatment group (45 cases) and the control group (45 cases) according to the random digit table produced by SPSS 11.5 Software. Patients in the treatment group were treated by heavy bitter-cold herbs plus SYD combined with MTX, while those in the control group were treated by MTX alone. Expressional levels of IL-1, IL-6, and IL-17 in serum were detected by enzyme linked immunosorbent assay (ELISA) before treatment, at week 2 and 4 after treatment. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and disease activity score in 28 joints (DAS28) were detected as well.

RESULTSAfter two or four weeks of treatment, ESR, CRP, and DAS28 decreased more in the treatment group than in the control group with statistical difference (P < 0.05, P < 0.01). After four weeks of treatment, IL-1, IL-6, IL-17, ESR, CRP, and DAS28 in the treatment group were all lower than before treatment and those of the control group at corresponding time points with statistical difference (P < 0.01).

CONCLUSIONSYD combined MTX could play roles of improving inflammatory indices within 2 weeks, and inhibiting the expression of IL-1, IL-6, and IL-17 within 4 weeks.

Arthritis, Rheumatoid ; blood ; drug therapy ; immunology ; Blood Sedimentation ; C-Reactive Protein ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Hot Temperature ; Humans ; Interleukin-1 ; blood ; Interleukin-17 ; blood ; Interleukin-6 ; blood ; Methotrexate ; therapeutic use ; Syndrome ; Treatment Outcome

OBJECTIVETo study the loss of heterozygosity (LOH) at chromosomes 1p or 19q in oligodendroglial tumors.

METHODSTwenty-eight cases of oligodendroglial tumors were enrolled into the study. Real-time quantitative polymerase chain reaction-based microsatellite analysis was performed on paraffin-embedded tumor tissues in order to study the status of chromosomes 1p and 19q.

RESULTSAmong the 28 cases of oligodendroglial tumors, 24 cases (85.7%) showed 1p LOH, while 18 cases (64.3%) showed 19q LOH and 17 cases (60.7%) showed LOH of both 1p and 19q. LOH at 1p or 19q was present in 25 (89.3%) of the 28 cases.

CONCLUSIONSReal-time quantitative polymerase chain reaction-based microsatellite analysis is a rapid and specific way in detecting LOH in paraffin-embedded tumor tissues. LOH at 1p or 19q is present in majority of the oligodendroglial tumors studied.

Adult ; Brain Neoplasms ; genetics ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 19 ; Female ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged ; Oligodendroglioma ; genetics ; Polymerase Chain Reaction ; methods

OBJECTIVETo study the feasibility of regenerating a whole menisci using poly-(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) scaffolds loaded with meniscal cells in rabbits undergoing total meniscectomy, and to explore its protective effect on cartilage degeneration.

METHODSA solvent casting and particulate leaching technique was employed to fabricate biodegradable PHBV scaffolds into a meniscal shape. The proliferated meniscal cells were seeded onto the polymer scaffolds, transplanted into rabbit knee joints whose lateral menisci had been removed. Eight to 18 weeks after transplantation, the rege- nerated neomenisci were evaluated by gross and histological observations. Cartilage degeneration was assessed by Mankin score.

RESULTSEighteen weeks after transplantation, the implants formed neomenisci. Hematoxylin and eosin (HE) staining of the neomenisci sections revealed regeneration of fibrocartilage. Type I collagen in the neomenisci was also proved similar to normal meniscal tissue by immunohistochemical analysis and Sirius scarlet trinitrophenol staining. Articular cartilage degeneration was observed 8 weeks after implantation. It was less severe as compared with that in total meniscectomy controls and no further degeneration was observed at 18 weeks. At that time, the regenerated neomenisci strongly resembled normal meniscal fibrocartilage in gross and histological appearance, and its mechanical property was also close to that of normal meniscus.

CONCLUSIONSThe present study demonstrates the feasibility of tissue-engineering a whole meniscal structure in total meniscectomy rabbit models using biodegradable PHBV scaffolds together with cultured allogeneic meniscal cells. Cartilage degeneration is decreased. But long-term in vivo investigations on the histological structure and cartilage degeneration of the neomenisci regenerated by this method are still necessary to determine the clinical potential of this tissue engineering avenue.

Animals ; Cartilage, Articular ; Cells, Cultured ; Knee Joint ; Menisci, Tibial ; Polymers ; Regeneration ; Tissue Engineering