Objective To analyze and evaluate the safety and efficacy of modified Pie-crusting ( PC) technique for releasing medial tightness during primary total knee arthroplasty ( TKA) . Methods We completed primary TKA by the same performer with modified PC technique in 30 patients (34 knees) with genu varus from March 2014 to June 2016.By using a special curved scalpel with width limit of 3 mm and depth limit of 5 mm to poke the tension parts , we released the anterion bondle of superficial medial collateral ligament ( sMCL) and posteromedial corner structures ( PMCS) during tension happened in extension , and we released the posterior bondle of sMCL during tension happened in flexion .According to the gap value measured intraoperatively , we divided these cases into three groups: extension with flexion tension group ( 10 knees ) , extension tension group ( 13 knees ) , and flexion tension group (11 knees).The difference between medial and lateral gap value no more than 1 mm was defined as gap balance.We calculated the gap balance rate of each group .Series of weighted frontal X-ray were conducted at fixed period to evaluate the varus angle of the knee postoperatively.The range of motion (ROM), HSS scores and WOMAC scores were also recorded at the same time . Results Among the 34 knees , 31 knees reached the medial and lateral gap balance at both extension and flexion .There was a difference of 2 mm in medial and lateral gap value at extension in 1 knee and the same difference at flexion in the other 2 knees.The total postoperative gap balance rate was 91.2%( 31/34 ).The constrained inserts were implanted in 3 cases.No technical-related complications happened after the surgery.After the releasing procedure, the flexion gap value had an increase of 1 mm (range, 1-3mm) in the extension tension group , and the extension gap value had an increase of 1 mm ( range, 1-2 mm) in the flexion tension group, without significant difference (Z=-1.118, P=0.264).The ROM was 83.3°±14.7°preoperatively and 100.7°±14.2° postoperatively (t=-7.714, P=0.000).The median alignment of the knee was 11.5°(range, 7°-32°) preoperatively and 1° (range, 0°-4°) postoperatively (Z=-5.092,P=0.000).The HSS scores were (42.7 ±16.3) points preoperatively and (88.1 ± 9.9) points postoperatively (t=-21.868, P=0.000).The WOMAC scores were (76.2 ±8.2) points preoperatively and (11.4 ± 9.7) points postoperatively (t=31.726, P=0.000).All of them were significantly improved in comparison with those before the surgery. Conclusions Using modified PC technique is safe and effective in medial releasing during primary TKA .Both extension and flexion gap value will be affected by releasing tensed fiber at extension or flexion position .

Objective To investigate the relationship between monocyte chemoattractant protein-1 (MCP-1) A-2518G single nucleotide polymorphism (SNPs) and susceptibility of epithelial ovarian cancer(EOC) in Chinese Han population of Hunan region.Methods MCP-1 A-2518G SNPs of the EOC were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 92 patients with EOC and 38 healthy women as control.Results MCP-1 A-2518G SNPs had AA,AG,and GG genotypes in cancer and control groups.The frequencies of AA,AG,and GG genotypes were not significantly different between cancer and control groups (AA:17.40％ and 15.79％ ; AG:44.56％ and 52.63％ ; and GG:38.04％ and 31.58％ ; P ＞0.05).Multivariate logistic regression analysis showed that there was no significant correlation between MCP-1 A-2518G polymorphism and EOC (P ＞0.05).Conclusions This present study suggested that MCP-1 A-2518G polymorphism should not be related to susceptibility of EOC in the Chinese Han population of Hunan region.

OBJECTIVE: To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic. METHODS: Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People's Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated. RESULTS: Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P < 0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P < 0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient －0.54, －0.62, P < 0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus. CONCLUSION Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.
Cohort Studies ; Humans ; Lower Urinary Tract Symptoms ; Male ; Urination ; Urodynamics

In the treatment of aortic arch dissections involving left subclavian artery (LSA), a double stent implantation is sometimes required to treat the disease of each branch. In this study, aortic arch and LSA were modeled by using Pro/engineer wildfire3. 0. Two deployed stents were inserted in the aortic arch and LSA. There are 3 kinds of model according to the stent struts protruding into the inlet of the collateral branch, and the healthy aortic arch model without any stent was provided as a reference case. We used computational fluid dynamics (CFD) to investigate the flows in the model stents and focused on the changes of blood speed and wall shear stress caused by the implanted stents of different models. The results showed that the stent strcuts protruding into the inlet of LSA induced the conspicuous decrease of blood speed and the emergence of large-scale low shear stress,which would cause thrombogenesis, neointimal hyperplasia and result in in-stent restenosis, so it would be judicious to use dedicated bifurcated stents for treatment of bifurcation lesions.
Aneurysm, Dissecting ; physiopathology ; surgery ; Aorta ; physiopathology ; Aortic Aneurysm ; physiopathology ; surgery ; Hemodynamics ; Humans ; Prosthesis Implantation ; methods ; Shear Strength ; Stents ; Stress, Mechanical ; Subclavian Artery ; surgery

OBJECTIVETo assess the time course of Q value after myopic laser-assisted in situ keratomileusis (LASIK) and preliminarily evaluate the determinants of the difference of Q value between before and after LASIK.

METHODSWe performed a retrospective, longitudinal investigation on patients undergoing wavefront optimized LASIK therapy for emmetropization. A total of 418 eyes from 222 cases were examined preoperatively, and partly followed up at one week (172 eyes), one month (134 eyes) and three months (51 eyes) after surgery. The horizontal, vertical and total Q values of cornea were calculated from eccentricity measured at the central 6-mm corneal zones respectively. Potential determinants of the change of Q value were analyzed using multiple linear regressions.

RESULTSThe mean Q value was -0.17 +/- 0.13 preoperatively, and 0.99 +/- 0.70, 0.97 +/- 0.66, and 0.86 +/- 0.41 one week, one and three months postoperatively, respectively. One way analysis of variance (ANOVA) demonstrated significant differences between measurements made before surgery and at all postoperative times (at one week, one and three months; all P<0.0001, Bonferroni post hoc), but no significant differences were found among postoperative groups. Significant differences of Q values between horizontal and vertical meridians were found before surgery and at all postoperative times (all P<0.0001). Multiple regression analysis revealed that change of Q value significantly correlated with manifest refraction spherical equivalent (r=0.116, P<0.0001) and axial length (r=0.264, P<0.0001).

CONCLUSIONSOver the study period, the primary changes in Q value occur within 1 week after surgery, and then become slightly decreased and nearly stable. Manifest refraction spherical equivalent and axial length play a significant role in the change of postoperative Q value.

Adolescent ; Adult ; Cornea ; surgery ; Female ; Humans ; Keratomileusis, Laser In Situ ; methods ; Male ; Middle Aged ; Myopia ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To compare the feasibility and prognosis of different surgical methods used for vesicovaginal fistulas and to explore the value of electrocoagulation treating small ones.Methods:The medical data of 19 patients who had undertaken transvaginal VVF repairs in Peking University People's Hospital between October 2008 and November 2016 were retrospectively collected.The follow-ups were performed.The patients' age ranged from 31 to 55 years with the median age of 48 years and the history length ranged from 1 month to 24 months with the median length of 3 months.Their fistula situation,surgical methods and prognosis were analyzed and the differences and similarities were compared.Results:Three patients (15.79％) was performed by electrocoagulation,4 (21.05％) by transvaginal repair,5 (21.32％) by laparoscopic repair and 7(36.84％) by open operation.Except one patient who rejected urinary catheter and D-J catheters,the rest of the patients discharged with catheters.Twelve patients (63.2％) got full satisfaction with one operation.One of the 3 patients who undertook electrocoagulation repeated the operation for twice and got completely cured within 1 month while the other two undertook the operation once and got dry within 1 month.Three patients who undertook transvaginal repair got dry within 1 month.Two of the 5 patients who undertook laparoscopic repair had readmission for a second operation and the other 3 got dry after operation.Five of the 7 open repair patients got dry while the other 2 attempted other center for treatment.Conclusion:Transvaginal repair has been the main surgery procedure for VVF,but it is limited by the location of fistula and the condition of vaginal.For patients not suitable for transvaginal repair,laparoscopic repair and open surgery are feasible.However both laparoscopic repair and open surgery are more invasive.Based on that,electrocoagnlation becomes a better choice.In our research,patients with small and high location fistula treated by electrocoagulation got a higher cure rate and bear less surgical trauma.Electrocoagulation used in the treatment of VVF showed advantages of less trauma,less bleeding and better satisfaction.Fistulas with low location were more suitable for transvaginal repair.Complex VVF,especially with narrow ureteral open and ureteral fistulas,were more suitable for open and laparoscopic repair.As for single and small fistula,the electrocoagulation can be the first choice.

OBJECTIVETo study the association between the epidermal growth factor (EGF) gene and intelligence in patients with major depression.

METHODSIntelligence measurement using Wechsler Adult Intelligence Scale (WAIS) was performed on 120 unrelated patients with major depression and 46 control subjects. Blood was collected from all subjects for extraction of genomic DNA. Four single nucleotide polymorphisms (SNPs) in the EGF gene were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI- TOF-MS).

RESULTSMean scores of both score lang and score task, two subtests in WAIS, differed significantly between major depression patients and controls (P<0.0001). Quantitative trait analysis showed that the genotype of rs2250724 was closely associated with score lang and score task in major depression patients. The associations were still significant after 10 000 permutations.

CONCLUSIONSAlthough preliminary, our results provide evidence for association between the EGF gene and intelligence in patients with major depression. Genetic variation in the EGF gene may increase the susceptibility of major depression.

Adult ; Case-Control Studies ; Depressive Disorder, Major ; genetics ; Epidermal Growth Factor ; genetics ; Female ; Humans ; Intelligence ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective:To establish a new molecular typing method for Treponema pallidum (TP) based on TP0136 protein sequence heterogeneity. Methods:The amino acid sequences of TP0136 open reading frame (ORF) of 9 strains of Treponema pallidum ssp. Pallidum (TPA) , 3 strains of Treponema pallidum ssp. Pertenue (TPE) , 1 unclassified simian strain of Treponema Fribourg-Blanc (FB) and 1 strain of Treponema pallidum ssp. Endemicum (TEN) were searched from Genbank, and multiple sequence comparisons were performed to obtain the molecular typing results of TP0136 protein. The TP0136 protein-based molecular typing method was used to classify 23 TPA clinical isolates, which were collected from Dermatology Hospital of Southern Medical University from January 2015 to December 2018, and the typing results were compared with those by the traditional typing method based on the tp0548/Arp/Tpr genes. Results:TP0136 protein was highly heterogeneous in different TP strains. According to the amino acid sequence of TP0136, TPE, FB and TEN strains were divided into 4 subtypes of Ⅰ- Ⅳ, TPA strains were divided into 6 subtypes of Ⅴ-Ⅹ, and TPA clinical strains were classified into 4 subtypes of Ⅶ, Ⅸ, Ⅹ, Ⅺ. Through the traditional typing method described above, 23 TPA clinical strains could be divided into 5 types (13D/d, 14D/f, 14D/g, 15D/f, 16A/e) . By using the TP0136 protein-based typing method combined with traditional typing method, the above clinical strains could be further subdivided into 10 types, and the 14D/f type could be further divided into 3 subtypes by using the TP0136 protein-based typing method.Conclusion:The TP0136 protein-based molecular typing method can be used to distinguish TP species, which is helpful for further improvement of traditional TPA molecular typing.

BACKGROUNDQuantitative T2 mapping has been a widely used method for the evaluation of pathological cartilage properties, and the histological assessment system of osteoarthritis in the rabbit has been published recently. The aim of the study was to investigate the effectiveness of quantitative T2 mapping evaluation for articular cartilage lesions of a rabbit model of anterior cruciate ligament transection (ACLT) osteoarthritis.

METHODSTwenty New Zealand White (NZW) rabbits were divided into ACLT surgical group and sham operated group equally. The anterior cruciate ligaments of the rabbits in ACLT group were transected, while the joints were closed intactly in sham operated group. Magnetic resonance (MR) examinations were performed on 3.0T MR unit at week 0, week 6, and week 12. T2 values were computed on GE ADW4.3 workstation. All rabbits were killed at week 13, and left knees were stained with Haematoxylin and Eosin. Semiquantitative histological grading was obtained according to the osteoarthritis cartilage histopathology assessment system. Computerized image analysis was performed to quantitate the immunostained collagen type II.

RESULTSThe average MR T2 value of whole left knee cartilage in ACLT surgical group ((29.05±12.01) ms) was significantly higher than that in sham operated group ((24.52±7.97) ms) (P=0.024) at week 6. The average T2 value increased to (32.18±12.79) ms in ACLT group at week 12, but remained near the baseline level ((27.66±8.08) ms) in the sham operated group (P=0.03). The cartilage lesion level of left knee in ACLT group was significantly increased at week 6 (P=0.005) and week 12 (P<0.001). T2 values had positive correlation with histological grading scores, but inverse correlation with optical densities (OD) of type II collagen.

CONCLUSIONThis study demonstrated the reliability and practicability of quantitative T2 mapping for the cartilage injury of rabbit ACLT osteoarthritis model.

Animals ; Anterior Cruciate Ligament ; metabolism ; physiopathology ; Cartilage, Articular ; metabolism ; physiopathology ; Collagen Type II ; metabolism ; Magnetic Resonance Imaging ; Male ; Osteoarthritis ; metabolism ; physiopathology ; Rabbits

AIMTo investigate the expression of Spindlin 1 (Spin 1) isoform2 and assess its function in mouse testis.

METHODSFirst, reverse-transcription polymerase chain reaction (RT-PCR) was used to determine whether Spin1 isoform2 is present in mouse testis. Then the expression patterns of the isoform between newborn and adult mice testes were compared by immunoblot analysis. Finally, the diversity of its localization in mice testes at different ages (days 0, 7, 14, 21, 28 and 60) was observed by immunohistochemistry. The localization of the protein in mouse sperm was also investigated by immunofluorescence.

RESULTSThe RT-PCR results show that Spin1 isoform2 is present in mouse testis. As shown by immunoblot analysis, the isoform was more highly expressed in adult testes compared with newborn testes. Interestingly, Spin1 isoform2 did not show up in the cytoplasm of primary spermatocytes until day 14. Also, the protein exists at the tail of the mouse sperm.

CONCLUSIONSpin1 isoform2 is a protein expressed highly in adult testis, which might be involved in spermatogenesis and could be necessary for normal sperm motility.

Age Factors ; Animals ; Animals, Newborn ; Blotting, Western ; Cell Cycle Proteins ; genetics ; metabolism ; Cytoplasm ; metabolism ; Female ; Immunohistochemistry ; Male ; Meiosis ; physiology ; Mice ; Mice, Inbred ICR ; Microtubule-Associated Proteins ; genetics ; metabolism ; Phosphoproteins ; genetics ; metabolism ; Pregnancy ; Reverse Transcriptase Polymerase Chain Reaction ; Sperm Motility ; physiology ; Spermatogenesis ; physiology ; Testis ; physiology