Objective To investigate effect of alendronate on OPG and RANKL in periprosthetic osdeolysis induced by polyethylene particles.Methods Twelve rabbits which had been implanted a titanium plug in femur by intercondylar notch were divided into two groups randomly,polyethylene particles were injected into the left knee joint,one received alendronate,and the other placebo as control.After 12 weeks,all rabbits were sacrificed.Periprosthetic tissues were observed by ELISA.Results The concentration of OPG in the experimental group was not higher than that of the control (P ＞0.05 ).But the concentration of RANKL in the experimental group was lower(P ＜0.01 ).And specific value of OPG/RANKL was higher in the experimental group ( P ＜ 0.05 ).Conclusion The therapy of alendronate can change the concentration of RANKL and specific value of OPG/RANKL in periprosthetic osdeolysis induced by polyethylene particles,inhibit aseptic loosening of prosthesis in rabbits.

Objective To evaluate the value of the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and P-POSSUM in predicting the risks of orthopedic surgeries for senile patients with femoral neck fracture.Methods A total of 108 patients with femoral neck fractures who underwent hip joint replacement were retrospectively studied using POSSUM and P-POSSUM scoring system to predict their mortality and complication rate.The difference between predictive value and observed value was analyzed by chi-square test.Meanwhile,the patients were divided into two groups based on their POSSUM scores.The differences between two groups were analyzed.Results According to POSSUM scores,47 patients were predicted to have complications(the mean rate was 43.52％),but only 37 did actually (the rate was 34.26％).There was no significant difference between predicted values and observed values (P =0.238).The predicted death toll was 11 cases (the mean rate was 10.19％),but actually only 2 patients died (the rate was 1.85％).Predicted value was higher than observed value.In terms of complications,death toll agreed well with the predicted values calculated by P-POSSUM (predicted death of 4 cases' the mean mortality being 3.70％ ; actual death of 2 cases' the mortality was 1.85％) without significant difference (P =0.625).We divided the patients into two groups with the POSSUM scores 40,and there was no significant difference between predicted values and observed values (P =0.527,P =0.285).Conclusions POSSUM has better predictive ability of morbidity,but overestimates mortality.P-POSSUM more accurately predicts mortality than POSSUM.The predicted results of POSSUM and P-POSSUM scoring systems are satisfactory in the high risk group.

Objective To investigate the perioperative hemodynamic features of mitral replacement of patients with small left ventricle.Methods Patients with left ventricle end-diastolic dimension (LVEDD) less than 40mm received mitral replacement sur- gery were divided into big size M-2 group and small size M-1 group.The perioperative echo results were analyzed with SPSS software. Results The big size M-2 group has lower trans mitral gradient [ (5.9?1.6) mm Hg vs.(10.7?3.2) mm Hg],larger in vivo va- lular acre[ (2.9?0.2) cm~2 vs.(2.6?0.2) cm~2],and high mitral match index [(1.92?0.23) cm~2/m~2 vs.(1.73?0.18) cm~2/m~2 ].Conclusion With the meticulous perioperative treatment and myocardial protection,the patients with small left ventricle should also receive a mitral replacement as big as possible to achieve the ideal hemodynamics results.

OBJECTIVETo investigate the effect of pulsed electromagnetic fields (PEMs) on inducing osteoclastic like cell (OLC) formation changes and apoptosis in ovariectomized (OVX) rats bone marrow culture in vitro.

METHODSThirty healthy three-month-old female Wistar rats were either sham-operated (Sham) or ovariectomized (OVX) and randomly divided into three groups: group A (OVX + PEMs, 18 rats), group B (OVX, 6 rats) and group C (Sham, 6 rats); group A was again randomly divided into three groups: A1, A2, A3. The frequencies adopted were 1.5, 2, 75 Hz and 30 minutes for once a day. All rats were fed with normal diet for 3 months, then the bone marrow of all rats were cultured, 2 days later, group A cells (including group A1, A2, A3) were collected and exposed to different frequencies PEMs for 2 weeks (30 min/day). In order to observe the changes of osteoclasts and count their numbers, cells were taken for Wright Giemsa staining, tartrate-resistance acid phosphatase (TRAP) staining and Hoechst 33258 staining.

RESULTSTRAP staining results indicated the number of OLC in group C was the least, then was group A2, A3, A1, B. The number of OLC in group B was remarkably increased (P < 0.01; vs group C, A2). The number of OLC in group B was significantly increased (P < 0.05; vs group A1, A3). Hoechst 33258 staining results indicated the number of apoptosis of OLC in group C was more than other groups, which of group C, A2 was significantly increased (P < 0.05; vs group B).

CONCLUSIONPEMs had decreased the formation of OLC and increased the number of apoptosis of OLC in ovariectomized (OVX) rats bone marrow culture in vitro, the effects of 2 Hz was the best. PEMs would be a new way of osteoporosis therapy.

Acid Phosphatase ; metabolism ; Animals ; Apoptosis ; radiation effects ; Bone Marrow Cells ; cytology ; enzymology ; radiation effects ; Cells, Cultured ; Electromagnetic Fields ; Female ; Isoenzymes ; metabolism ; Osteoclasts ; cytology ; enzymology ; radiation effects ; Ovariectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Tartrate-Resistant Acid Phosphatase

Adult ; Hematoma, Epidural, Spinal ; etiology ; Humans ; Male ; Spinal Fractures ; complications ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo investigate the application of free anterior serratus musculo-fascial flap in bridge style for the soft tissue defect at leg.

METHODSFrom Sept. 2006 to Jan. 2009, the free anterior serratus musculo-fascial flaps were used in bridge style in 7 cases with soft tissue defects at legs. The anterior serratus musculo-fascial flaps were elevated with subscapular and circumflex scapular vessels forming a T-shaped vascular pedicles. The T-shaped pedicle was end-to-end anastomosed with the two ends of the posterior tibial artery at the healthy leg. The musculo-fascial flap and its pedicle were covered with skin graft.

RESULTSAll the 7 flaps survived completely with satisfactory result. The patients were followed up for 9-42 months with good functional and esthetic result both in donor site and recipient site. The patency of posterior tibial artery was demonstrated by clinical and Doppler examination.

CONCLUSIONSThis technique is particularly useful in leg reconstructive surgery when only one vessel remains. The patency of the posterior tibial artery at the healthy leg is preserved and the morbidity in donor site is minimal.

Adult ; Fascia ; transplantation ; Female ; Free Tissue Flaps ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Muscle, Skeletal ; transplantation ; Soft Tissue Injuries ; surgery ; Young Adult

Objective To investigate the changes of visual acuity,fundus changes,and serum vitamin D concentration in diabetic retinopathy patients treated with metformin,and to evaluate its clinical efficacy.Methods Totally 80 cases (160 eyes) patients with background diabetic retinopathy were included in the study,and were divided into observation group (metformin + Pancreatic Kininogenase Enteric-coated Tablets) and control group (Pancreatic Kininogenase Enteric-coated Tablets) according to the different treatment methods used for 3 months.Fundus fluorescein angiography was used to evaluate the improvement of the fundus lesions.The serum levels of vitamin D were measured with electrochemiluminescence immunoassay (ECLIA).Results After 3 months of treatment,serum vitamin D concentration of the observation group increased,and the differences were statistically significant (P ＜ 0.05) when compared to before treatment.However,3 months after treatment,serum vitamin D levels of the control group increased slightly,but the difference was not statistically significant (P ＞ 0.05).The total effective rate of fundus improvement in the observation group and the control group was 70％ and 55％,respectively.There was significant difference between the two groups in the improvement of fundus (P ＜ O.05).Conclusions Metformin has an adjunctive effect on background diabetic retinopathy,and the increase of serum vitamin D may be one of the mechanisms of metformin in improving diabetic retinopathy.

Adult ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Neurofibromatosis 1 ; genetics ; pathology

Objective: To observe the clinical efficacy of mind-refreshing and balance-restoring needling method combined with Frenkel exercises in treating ataxia after cerebral stroke. Methods: The recruited 120 patients were randomized into an observation group and a control group, with 60 cases in each group. The control group was intervened by mind-refreshing and balance-restoring needling method, while the observation group was given additional lower-limb Frenkel exercises. Before and after treatment and at the follow-up, the ataxic lower-limb function was scored using Berg balance scale (BBS) and international cooperative ataxia rating scale (ICARS), and Barthel index (BI) was adopted to score the activities of daily living (ADL). Results: After treatment, the markedly effective rate was 70.2％ and the total effective rate was 96.5％ in the observation group, versus 39.7％ and 87.9％ in the control group, and the differences in the markedly effective rate and the total effective rate were statistically significant (P<0.01, P<0.05). The intra-group comparisons showed that the BBS, ICARS and BI scores after treatment and at the follow-up were significantly different from those before treatment in both groups (all P<0.01).There were significant differences in the BBS score between the two groups after treatment and at the follow-up (P<0.05, P<0.01); the between-group differences in the ICARS and BI scores were statistically insignificant after treatment (both P>0.05), while the between-group differences in the ICARS and BI scores were statistically significant at the follow-up (both P<0.05). The interaction effects between the scoring time of BBS and BI and the group factor were statistically significant (P<0.01, P<0.05). Conclusion: Mind-refreshing and balance-restoring needling can effectively improve the lower-limb ataxic symptoms and ADL after stroke; when combined with Fenkel exercises, this needling method can produce more significant efficacy.

Decoction is one of the most commonly used dosage forms of traditional Chinese medicine. The stability of chemical constituents in decoction is closely related to the clinical efficacy and safety. There were few reports about the influence of metal ions in the stability of chemical constituents in traditional Chinese medicine. However, there is no evidence that metal ions in decoction water need to be controlled. In this study, 2,3,5,4'-tetrahydroxy stilbene-2-O-β-D-glucoside (THSG), one of the main constituents in Polygoni Multiflori Radix was studied. Ordinary tap water, deionized water, and water containing different metal ions were used to investigate and compare the influence on THSG. The results showed that after storage in a dark place at the room temperature for 10 days, the degradation of THSG was 7% in deionized water, while undetectable in tap water. The content of THSG could be decreased by different kinds of metal ions, and the effect was concentration-dependent. Moreover, Fe3+ and Fe2+ showed the greatest influence at the same concentration; and our study has shown that THSG decreased more than 98% in Fe and Fe2+ solutions at 500 ppm concentration. In the same time we found out p-hydroxybenzaldehyde (molecular weight: 122.036 7) and 2,3,5-trihydroxybenzaldehyde-2-O-glycoside (molecular weight: 316.079 4) were the main degradation products of THSG in tap water and water containing Cu2+, Ca2+, Zn2+, Mg2+ and Al3+. The product of THSG dimer with a water molecule was found in water containing Fe3+ and Fe2+. The above results showed that the metal ions in water could significantly influence the stability of THSG in water, indicating that the clinical efficacy and safety of decoction would be affected if the metal ions in water were not under control. It's suggested that deionized water should be used in the preparation of decoction containing Polygoni Multiflori Radix in the clinic to avoid degradation of THSG. Meanwhile, decoction prepared by tap water should be taken by patients in a short time. Our investigation provides important information and reference about the influence of metal ions on the stability of decoctions in other traditional Chinese medicine that have unstable groups such as hydroxyls and unsaturated bonds, etc.
Drugs, Chinese Herbal ; chemistry ; Glucosides ; chemistry ; Ions ; chemistry ; Metals ; chemistry ; Plant Roots ; chemistry ; Polygonaceae ; chemistry ; Stilbenes ; chemistry