BACKGROUND:Drainage has been applied as a routine to hip and knee replacement surgery. However, as a potential channel, drainage could become a portal for bacteria and other pathogens to invade the joint cavity. OBJECTIVE:To evaluate the clinical significance and safety of drainage in total knee arthroplasty.
METHODS:The 80 patients were prospectively randomized into two groups:Group 1 included 38 patients with wound drainage;Group 2 included 42 patients without any drainage. According to a formula calculation, blood loss, the number of subjects requiring blood transfusion, volume of blood transfusion, complications and the recovery of function after total knee arthroplasty were statistical y analyzed.
RESULTS AND CONCLUSION:The subjects were fol owed up for 2 years after discharge. Two patients lost to fol ow up in the non-drainage group. 78 patients were involved in the result analysis. The total blood loss, the number of subjects requiring blood transfusion and volume of blood transfusion were more in the drainage group than those in the non-drainage group after surgery. At 3 days after arthroplasty, active range of motion was larger in the drainage group than that in the non-drainage group. No significant differences in hemoglobin levels and Keen Society Score scores were detected after arthroplasty between the two groups. Results suggested that draining wil increase the blood loss and blood transfusion, but it may contribute to the early recovery of knee function. No significant differences in long-period Keen Society Score scores and postoperative complications were detectable between the two groups.

BACKGROUND:Alcohol has become pathogenic factors of avascular necrosis, and the alcohol induced
abnormal lipid metabolism in bone marrow may be the important reason for the onset of avascular necrosis, but the mechanism is not clear yet.
OBJECTIVE:To observe the changes of structure and function of fat cel s under the action of alcohol, in order to analyze the pathogenesis of alcoholic femoral head necrosis.
METHODS:Primary adipocytes in vitro culture technique was used to obtain rabbit femoral head intramedul ary adipose tissue, and then the fat cel s were separated, and the phenotype was identified with oil red O staining. The passaged stable intramedul ary fat cel s were col ected. Coverslip was cut into 1 cm × 1 cm in size, and placed in the 24-wel culture plate before planting. The cel s were randomly divided into alcohol group and control group, 24 holes (each hole for a sample) in each group. The control group was without alcohol, while the alcohol group was added with 0.15 mol/L alcohol. At 4, 6, 8 and 10 days, the culture medium was replaced. Medium was changed and no longer adding alcohol, and then cultured for 10 days. When the culture terminated, the coverslip was removed for oil red O staining. Final y, the morphology and the number of the fat cel s were observed under light
microscope.
RESUTLS AND CONCLUSION:With time prolonging, the number of fat cel s in the alcohol group was significantly more than that in the control group (P<0.001). The lipid droplets in the two groups were gradual y increased and enlarged, but more significant in the alcohol group. The number of intramedul ary fat cel s in the alcohol group after cultured for 4, 6, 8 and 10 days was respectively (200.90±24.60), (1 102.30±76.73), (1 160.30±28.37) and (1 199.70±44.74)/cm2;the
number of intramedul ary fat cel s in the control group was respectively (99.80±10.82), (0.40±94.71), (1 000.20± 41.85) and (1 059.80±26.79)/cm2, the number of fat cel s increased with the time of alcohol influence. Alcohol can promote the intramedul ary fat cel s to increase and enlarge, and this may be the main reason for femoral head necrosis, as long-term alcoholism can lead to bone marrow fat tissue increasing, intraosseous pressure increasing and perfusion reducing, thus resulting ischemia.

Objective To elucidate the action of carbohydrates metabolism-associated genes on rat liver regeneration(LR). Methods We obtained the above genes through collecting website data and retrieving related articles,and detected their expression changes in rat LR with Rat Genome 230 2.0 array,then determined LR-associated genes by comparison of gene expression discrepancy between partial hepatectomy(PH) group and sham operation(SO) group. Results 118 carbohydrates metabolism genes were proved to be LR-associated.Number of the initial and total expressing genes occurring in forepart(0.5-4 hours after PH),prophase(6-12 hours after PH),metaphase(16-66 hours after PH) and anaphase(72-168 hours after PH),were 33,6,68,7 and 68,44,210,83,respectively,demonstrating that expression of these genes were triggered mainly at the initial stage of LR,and functioned in different phases.The number of their up-regulation and down-regulation was 205 and 200,and their expression patterns were classified into 12 types,implying that the cellular Carbohydrate metabolism during LR were characterized by diversity and complication.Monosaccharides and glycogen metabolism-associated genes,glycoprotein and glycosphingolipid(mainly gangliosides) biosynthesis-associated genes were up-regulated almost in the whole LR.In contrast,oligosaccharides and glycosaminoglycans biosynthesisassociated genes,glycoprotein and glycosphingolipid degradation-associated genes were down regulated.Conclusion Liver regeneration was closely related to carbohydrate metabolism.

Objective To study the effect of self-efficacy on learning effect of medical students.Methods Self-efficacy scores of the questionnaire to clinical medical students who practice in our hospital from September 2012 to April 2013 were measured.Students with score lower than the average were recruited into group A,and the others were recruited into group B.Then the scores of both-group students in the process of clinical practice,the theoretical knowledge,and triguaiacyl tests were gotten for statistical analysis.Results Group B (88.02 ± 3.902; 89.02 ± 3.902; 89.94 ± 3.794) were significantly better than group A (67.07 ± 5.131,66.02± 5.866,65.23 ±6.741) in the scores of the theory of knowledge,operation skills and triguaiacyl test.The correlation analysis showed that self-efficacy was positively related to these three aspects (P=0.032,0.024,0.001).Conclusion Clinical teachers should consciously improve students' self-efficacy in the process of their clinical practice,in order to improve the learning effect of the clinical medical students preferably.

BACKGROUND:Studies have shown that human cartilage glycoprotein-39 has a certain relationship to articular cartilage degeneration and repair, but the mechanism of action is not very clear. OBJECTIVE:To investigate the effect of human cartilage glycoprotein-39 on chondrogenesis of precartilaginous stem cels. METHODS: Precartilaginous stem cels were isolated from the adult articular cartilage. Cels which could express CD105 and CD166 were detected using flow cytometry folowed by isolation and purification. Isolated precartilaginous stem cels werecultured using monolayer method, and then, passage 2 cels were cultured in the medium containing human cartilage glycoprotein-39 and normal chondrogenic medium for 14 days, respectively. Immunohistochemical staining was used to observe expression of type II colagen and gross observation was done for evaluation of cartilage formation. RESULTS AND CONCLUSION:The precartilaginous stem cels isolated from the adult articular cartilage could express CD105 and CD166. After induction, differentiated precartilaginous stem cels gradualy gathered and formed nudes. The induced cels were positive for type II colagen; after induction by human cartilage glycoprotein-39, the nodules became larger and the expression of type II colagen was increased. These findings indicate that precartilaginous stem cels with chondrogenic ability can be isolated from the adult articular cartilage, and can be induced to differentiate into chondrocytes, in which human cartilage glycoprotein-39 plays an important role.

BACKGROUND:Previous studies have confirmed that ethanol can promote adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and up-regulate the expression of PPARγ and aP2 in the tumor necrosis factor α (TNF-α) signaling pathway. As a member of the ZIP protein family, Zrt/Irt-like protein 1 (ZIP1) is closely related to bone metabolism and osteogenic differentiation.OBJECTIVE:To study the effect of BMSCs transfected by ZIP1 on TNF-α signaling pathway in the process of adipogenic differentiation.METHODS:The BMSCs from rabbits were isolated and cultured under different concentrations of alcohol (0.03, 0.09,0.15, 0.21 mol/L), followed by transfection by ZIP1 siRNA and ZIP1 expression vector.RESULTS AND CONCLUSION:After culture in alcohol, the expression levels of aP2 and PPARγ proteins were both significantly increased (P < 0.05), and the level of triglyceride was increased in all alcohol groups except for 0.03 mol/L alcohol group (P < 0.05). After siRNA transfection, the expression levels of aP2 and PPARγ as well as the level of triglyceride were increased significantly in all the alcohol groups (P < 0.05); however, ZIP1 transfection decreased the expression levels of aP2 and PPARγ proteins (P < 0.05). To conclude, ZIP1 siRNA could promote the adipogenic differentiation of BMSCs through the activation of TNF-α signaling pathway.

BACKGROUND: With the increasing number of patients undergoing knee arthroplasty in China, the complications caused by the mismatch of prosthesis with anatomical parameters arouse extensive attentions.OBJECTIVE: To measure the anatomical parameters of the knee joints in healthy Zhuang ethnic group from Guangxi Zhuang Autonomous Region, China, using three-dimensional (3D) reconstruction technology, thus providing reference for the design and placement of the hip prosthesis.METHODS: Sixty-eight individuals, including 30 females and 38 males, were selected from 217 healthy people undergoing CT examination. All data were imported into Mimics 15.0 software used for 3D reconstruction, and then the knee parameters were then measured and analyzed.RESULTS AND CONCLUSION: There was no significant difference in the parameters of the bilateral femur and tibia (P > 0.05). The femoral parameters had significant differences between genders (P < 0.05). The width of tibial platform, sagittal length of lateral tibial platform, distance between medial tibial plateau and fibular head, and posterior slope of tibial plateau showed no significant differences between genders (P > 0.05), while there were significant differences in the width of medial/lateral tibial platform, and sagittal length of medial tibial platform between genders (P < 0.05). The sagittal length of medial femoral condyle was negatively correlated with age, and all femoral parameters were positively correlated with height; while only the width of medial and lateral tibial platform were positively correlated with height. To conclude, 3D reconstruction technology is available for research on the morphology of the knee joint in the Zhuang ethnic group from Guangxi Zhuang Autonomous Region, which provides references for prosthesis design and research appropriate for the Zhuang ethnic group.

BACKGROUND:In recent years,artificial cervical disc replacement surgery as a new method for the treatment of cervical disease has gradualy been accepted and understood,but relevant complications have gradualy attracted attention.OBJECTIVE:To investigate the clinical outcomes of artificial cervical disc replacement in the treatment of cervical disease and the range of motion of the replacement segment.METHODS: A total of 25 patients with artificial cervical disc replacement in the treatment of cervical spondylosis,who were treated in the Department of Orthopedics,Air Force General Hospital of Chinese PLA from August 2006 to April 2012,were enroled in this study,including 15 males and 10 females,aged 31-76 years,averagely 51.04 years.There were 6 cases of double segments and 19 cases of single segment.They were folowed up for 24 to 93 months.Clinical results were assessed using the Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores.Imaging was used to observe range of motion,cervical curvature,heterotopic ossification,and degeneration of adjacent segments.RESULTS AND CONCLUSION:Neurological function in al patients was improved to different degrees.One case suffered from mild heterotopic ossification,but no clinical symptoms were found.No significant difference in range of motion of surgical segment,and range of motion of upper and lower adjacent segments was detected between pre-replacement and final folow-up results (P＞0.05).No significant difference in range of motion of C2-C7 was found between pre-replacement and final folow-up results (P＞0.05).Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores were significantly improved during final folow-up compared with pre-replacement (P＜0.05).These results indicated that artificial cervical disc replacement in the treatment of cervical disease can achieve better clinical efficacy,can keep the range of motion of replacement segment and avoid the accelerated degeneration of adjacent segments.

BACKGROUND:Our previous research found that Panax notoginseng can repair the morphological structure of bone cells,which has a good application prospect in the treatment of osteoarthritis,but the specific mechanism of Panax notoginseng is still unclear. OBJECTIVE:To identify the main components of Panax notoginseng using ultra-high performance liquid chromatography-Q exactive-mass spectrometry(UHPLC-QE-MS),and to explore the mechanism of Panax notoginseng in the treatment of osteoarthritis by combining network pharmacology,molecular docking and molecular dynamics simulation. METHODS:After identifying the main components of Panax notoginseng by UHPLC-QE-MS technology,the active components were screened by TCMSP database,and the targets of active components were found by TCMSP and Uniprot database.Osteoarthritis targets were screened out through disease databases.After the intersection of drug targets and disease targets,the protein-protein interaction network was constructed by importing STRING database and Cytoscape software,and the"active ingredient-action target"network was constructed to screen key active ingredients.Then the key targets were enriched and analyzed,and the key active components and key targets were verified by molecular docking.Finally,the results with the lowest binding energy were selected for molecular dynamics simulation. RESULTS AND CONCLUSION:A total of 57 active components were identified in the solution of Panax Notoginseng,including 50 intersection targets of components and disease targets,5 key active components(quercetin,ursodeoxycholic acid,kaempferol,naringenin and erythrocyanine),and 5 key targets(interleukin 6,matrix metalloproteinase 9,interleukin 1β,albumin and recombinant chemokine c-motif ligand 2).Gene ontology enriched 642 entries,among which 620 entries represent biological processes,21 entries represent molecular functions,and 1 entry represents cellular components.Kyoto encyclopedia of genes and genomes analysis indicated 63 pathways,mainly including estrogen signaling pathway,interleukin 17 signaling pathway and hyperglycosylation end product-hyperglycosylation end product receptor signaling pathway.Molecular docking showed good binding activity of key active components and key targets.Molecular dynamics simulation indicated that the stable interaction between quercetin and matrix metalloproteinase 9.The composition of Panax notoginseng was comprehensively studied,and the material basis of its efficacy was preliminarily clarified.It was predicted that Panax notoginseng could play an anti-inflammatory,cartilage-protective,and immunomodulatory role in treating osteoarthritis through multiple components,targets,approaches and pathways.

Objective:To investigate the efficacy and safety of black tomato concentrated sauce in the treatment of benign prostatic hyperplasia(BPH) with lower urinary tract symptoms(LUTS).Methods:An open, randomized and controlled trial was conducted, and 150 BPH patients with LUTS were randomly assigned to three groups: experimental group(60 cases), placebo group (45 cases) and positive control group(45 cases) in the Department of Urology, Lanzhou University Second Hospital from December 2018 to September 2020.Inclusion criteria: age≥50 years old; first diagnosis of BPH, or interrupted medical treatment of BPH for more than 1 month; maximum urinary flow rate (Q max) <15ml/s; prostate volume (PV)≥20ml; IPSS≥8, QOL≥2. Exclusion criteria: lower urinary tract obstruction not caused by BPH, post-void residual urine volume(PVR) >250 ml; history of acute urinary retention in the last 3 months; prostate nodules and suspected prostate cancer were revealed by digital rectal examination and transrectal B-ultrasoundor; prostate-specific antigen (PSA)≥10 ng/ml; neurogenic bladder, perivous history of bladder, prostate, or urethra operations; suffering from serious heart, lung, liver, kidney and other diseases. The patients in the experimental group were orally treated with black tomato concentrated sauce(30 g/once, 3 times/day). The patients in the placebo group were orally administrated with placebo. In the positive control group, the patients with PV≤30ml were orally treated with tamsulosin(0.2mg/once, 1 time/day), the patients with PV>30ml were orally administrated with tamsulosin and finasteride(5 mg/once, 1 time/day). All enrolled patients were treated for 3 months. At the end of third month, the IPSS, QOL, PV, PVR, Q max, average urinary flow rate(Q ave), total PSA(tPSA), free PSA (fPSA), testosterone(TST) and the incidence of adverse reaction were assessed. Results:128 of 150 cases, including 52 cases in experimental group, 36 cases in placebo group and 40 cases in positive control group, completed the study, the rest was excluded due to not take medication regularly and fail to follow-up. There were no significant differences in baseline parameters among experimental group, placebo group and positive control group ( P>0.05) in age[(63.21±8.61) vs.(62.36±6.32) vs. (63.94±7.78)years old], body mass index[(23.74±3.17) vs. (23.94±3.09) vs. (24.26±2.91)kg/m 2], IPSS[(17.5±6.6) vs. (15.4±5.8) vs. (17.9±6.8)], QOL[4.0(3.0, 4.0) vs. 4.0(3.0, 4.5) vs. 4.0(3.0, 5.0)], Q max [(8.60±3.04) vs. (9.13±2.92) vs. (9.58±3.26) ml/s], Q ave[(4.39±1.69) vs. (4.66±1.76) vs. (4.88±1.60)ml/s], PV [32.00(25.55, 45.40)vs. 30.00(24.45, 38.35)vs. 34.80(27.65, 56.65)ml], PVR[23.50(8.25, 45.75) vs.5.50(0, 47.75) vs. 29.00(0, 84.00)ml], tPSA [1.53(0.89, 3.00) vs. 1.23(0.69, 1.98) vs. 2.23(0.90, 4.15)ng/ml], fPSA [0.37(0.28, 0.76) vs. 0.37(0.22, 0.52) vs. 0.54(0.30, 0.97) ng/ml] and TST[(443.64±156.32) vs. (493.97±176.16) vs. (450.89±135.08)ng/dl]. After 3 months of treatment, the IPSS in experimental group was(9.9±5.7), QOL score 2.0(2.0, 3.0), Q max(11.78±5.24)ml/s, Q ave(5.86±3.00)ml/s, tPSA 1.64(0.96, 3.32)ng/ml and TST (475.91±177.33)ng/dl, which were significantly different compared with pre-treatment( P<0.05). In positive control group, IPSS was (9.0±6.2), QOL 2.0(2.0, 3.0), Q max(11.73±4.50)ml/s, Q ave(6.11±2.53)ml/s, tPSA 1.57(0.80, 3.09)ng/ml, fPSA 0.37(0.24, 0.63)ng/ml and TST (526.11±126.88)ng/dl, which were statistically different compared with pre-treatment( P<0.01). However, there were no significant differences in all the above indexes in placebo control group compared with the baseline( P>0.05). The numerical changes of IPSS, QOL, Q maxand Q ave between experimental group and placebo group had statistically significant differences ( P<0.05). The changes of IPSS, QOL, Q max, Q ave, PV, tPSA, fPSA and TST between positive control group and placebo group had significant differences ( P<0.05). The changes of PV, tPSA and fPSA between positive control group and experimental group had statistically significant differences ( P<0.05). The incidence of adverse reactions was 5.77% (3/52, including 1 headache and 2 stomach discomfort) in experimental group, 5.56% (2/36, including 1 headache and 1 stomach discomfort) in placebo group, and 10.00%(4/40, including 1 dizzy, 1 nasal obstruction and 2 erectile dysfunction) in positive control group. And there was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:Black tomato concentrated sauce shows an excellent effect on patients with LUTS/BPH, and improves the quality of life with few adverse events.