OBJECTIVETo investigate the feasibility and therapeutic effect of subcutaneous pedicle screw-rod system with modified placement in treatment of Tile B pelvic fractures.

METHODSFrom June 2014 to August 2015, 14 patients with Tile B pelvic fractures were treated by subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle. There were 8 males and 6 females, aged from 23 to 65 years with an average of 42 years. Operative time, intraoperative blood loss, fracture healing and postoperative complication were observed and clinical effects were evaluated by Matta reduction standard and Majeed score.

RESULTSAll patients were followed up from 8 to 15 months with an average of 10.5 months. Operative time was 25 to 45 min with an average of 32 min;intraoperative blood loss was 10 to 35 ml with an average of 18 ml. All fractures got primary healing and healed time was 9 to 14 weeks with an average of 12.5 weeks. No postoperative incision infection, internal fixation failure and ectopic ossification were found, 4 cases occurred unilateral lateral femoral cutaneous nerve injury and 1 case occurred unilateral femoral nerve paralysis, but all restored finally. According to Matta criteria, reduction was excellent in 7 cases, good in 5 cases, fair in 2 case. According to Majeed score system, the functional evaluation at last follow-up was excellent in 5 cases, good in 7 cases, fair in 2 cases with the average score of 81.50±8.05.

CONCLUSIONSSubcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle have advantages of strong reduction, less trauma and complications, and is a promising surgical method in the treatment of Tile B pelvic fractures.

OBJECTIVE: To explore expression of β-catenin and NF-κB signaling pathway in synovial tissue of rats with different degrees of knee osteoarthritis (KOA). METHODS: Forty-eight SPF male rats weighed (200±20) g were randomly divided into three groups, namely model group (32 rats), sham operation group (8 rats) and control group (8 rats). KOA model rats were established by Hulth method, and 8 rats were killed at 2, 4, 8, 12 weeks respectively after modeling, in order to establish KOA model rats with moderate, early, mild and severe degree. Sham operation group was only cut off capsule of knee joint and suture to exclude interference factor, control group was untreated. Behavior, synovial hyperplasia and cartilage degeneration of rats among each group were observed. Expression of NF-κB and signaling pathway and β-catenin in synovial tissue of rats were detected by real-time PCR. RESULTS: KOA rat model was successfully established, and synovial hyperplasia was observed in KOA model at mild and early degree, and then gradually decreased; while cartilage degeneration in the early moderate and severe KOA model was significantly expressed, and gradually aggravated with time. The results of PCR showed that expression of β-catenin in 4-week group (8.57±0.46) and 8-week group (4.23±0.09) were higher than those in control group (<0.05); expression of TLR-2 in 2-week group (12.04±4.02) and 4-week group (8.54±2.13) were higher than those in control group(<0.05), and TLR-4 in 2-week group(5.04±0.93), 4-week group (3.29±0.58) and 8-week group (1.63±0.12) were higher than those in control group; expression of NF-κB was significantly higher in 2-week group (10.15±2.04), 4-week group (15.97±4.17), 8-week group (7.69±1.48) and 12-week group (6.70±1.58) than that in control group (<0.05), and expression of IL-1β was significantly higher in 4-week group (2.79±0.25) and 8-week group (2.46±0.32) than that of control group (<0.05). CONCLUSIONS On the RNA expression level, both of β-catenin and NF-κB signaling pathways are involved in synovial inflammation in KOA model rats, and they play a regulatory role in expression of IL-1β, degeneration of KOA.
Animals ; Inflammation ; Male ; NF-kappa B ; Osteoarthritis, Knee ; Rats ; Signal Transduction ; beta Catenin

OBJECTIVE: To compare the correlation between musculoskeletal ultrasound features, dysfunction and X-ray findings in patients with knee osteoarthritis, and to analyze the pathological mechanism of soft tissue inflammation in knee osteoarthritis. METHODS: Cross-sectional method was performed in this research (Evidence level: III). The patients with knee osteoarthritis were collected according to the screening criteria from September 2016 to January 2017 in Orthopedic clinic in our hospital. Musculoskeletal ultrasound and X-ray images were obtained and measured, knee function was measured by Lysholm scale. Pearson coefficient, t test and Wilcoxon were applied to analyze the correlation between soft tissue inflammation, knee dysfunction and X-ray features. RESULTS: Total 123 patients with knee osteoarthritis were recruited in this research. Soft tissue inflammation around knee had a high incidence in patients with knee osteoarthritis (infrapatellar fat pad inflammation 81%), and the synovial membrane thickness, joint effusion depth and meniscus bulging were beyond the normal range. Correlation analysis showed that the about Lysholm score and joint effusion depth had negative correlations with "Squat" score(=-0.21, =0.02). and Medial meniscus bulging had negative correlations with "Sustain" score(=-0.26, <0.01) and Lysholm total score (=-0.19, =0.04). Lateral meniscus bulging had a negative correlation with "Unstable" score (=-0.22, =0.02). The X-ray features, and medial joint space narrow had negative correlations with joint effusion depth(=-0.27, <0.01) and synovial membrane thickness(=-0.17, =0.007), and had a positive correlation with medial meniscus bulging. Medial joint space narrow was significantly correlated with patellar ligament inflammation and fat pad inflammation(<0.05). Lateral joint space narrow was significantly correlated with patellar ligament inflammation(=0.02). CONCLUSIONS Soft tissue inflammation around the knee-a major pathological manifestation of knee osteoarthritis, has significant correlations with knee dysfunction and bony structure lesions, and affects the progression of knee osteoarthritis by damaging knee joint function and promoting the destruction of articular cartilage.
Cartilage, Articular ; Cross-Sectional Studies ; Humans ; Knee Joint ; Menisci, Tibial ; Osteoarthritis, Knee

Objective To provide reference indexes and theoretical basis for age estimation of blood pools by investigating the entire drying process and monitoring the change of morphology and mass. Methods Four 15 mL blood pool samples were prepared on the clean ceramic plate. The change of morphology and mass of blood pools in a closed dark environment with a temperature of （20.0±0.5） ℃ and a humidity of 35%-45% were dynamically observed from 0 h to 60 h. Images of the blood pools were recorded by digital camera. The area of blood pools was calculated by MATLAB R2014b, the length of cracks was measured by Image J and the statistical analysis was performed by SPSS 16.0. Results By summarizing and analyzing, the drying of blood pools was divided into five stages： coagulation （0-4.5 h）, gelation （>4.5-20.0 h）, gel-solid mixing （>20.0-37.0 h）, solid （>37.0-40.0 h） and final desiccation （>40.0-45.0 h）. From 0 to 45 h, the mass of the blood pools decreased linearly with time, and the decrease was not obvious from 45.0 to 60.0 h. The standardized mass （y₂） showed strong correlation with the time （x） y₂=0.018 2 x+0.271 4（R²=0.967 9）. The area change rate of blood pools, the distance that the edge of blood pools moved, the average length of radical cracks had little correlation with the time that passed. Conclusion The overall morphological characteristics of blood pools show a certain regularity with the time and the standardized indexes established provide a reference for the age estimation of blood pools.
Blood Coagulation ; Humidity ; Temperature ; Time Factors

Objective:To explore the effect of enteral nutrition on gut microbiota for ischemic stroke. Methods:From March to April, 2017, 121 patients with convalescent ischemic stroke were enrolled. The patients received routine rehabilitation combing with 1-week enteral nutrition. The patients' fresh feces and blood samples were obtained at admission, one week and one month after the enteral nutrition, while nutritional status was assessed with Nutrition Risk Screening (NRS2002). Cytokines, including tumor necrosis factor (TNF) -α, interleukin (IL)-1α, IL-1β, IL-6 and IL-8 were tested with ELISA. Ten patients were tested with 16S rDNA Illumina HiSeq/MiSeq for gut microbiota alterations. Results:The scores of NRS2002 decreased (P < 0.05), the level of serum IL-1β and IL-6 raised, while the level of IL-8 dropped one month after enteral nutrition (P < 0.05). In addition, the enteral nutrition altered the dominant bacterial community, and alleviated the diversity and species richness of bacteria, while the difference was statistically significant one week after enteral nutrition. Conclusion:Enteral nutrition can alter gut microbiota to facilitate to recover ischemic stroke.

ObjectiveTo analyze the effect of different fixation methods on the chemical quality characteristics and antioxidant activity of Rehmannia glutinosa leaves， so as to lay a foundation for the selection of processing technology and quality evaluation of this medicinal materials. MethodR. glutinosa leaves was dried at 55 ℃ after treating by three fixation methods （55 ℃， boiling water， 105 ℃）， and then the fingerprints of R. glutinosa leaves were collected by high performance liquid chromatography （HPLC） and near infrared spectroscopy （NIRS）， and their antioxidant activities were analyzed by the 2，2-biphenyl-1-picrylhydrazyl （DPPH） method. Finally， similarity analysis， principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA） and Pearson correlation analysis were used to comprehensively evaluate the quality of R. glutinosa leaves with different fixation methods. ResultThe results of HPLC and NIRS fingerprint analysis indicated that there were differences in the quality characteristics of R. glutinosa leaves by different fixation treatments. The comprehensive score of chemical quality of R. glutinosa leaves by fixation at 55 ℃ was the highest， its average comprehensive score was 2.096， followed by fixation at 105 ℃， and the lowest was fixation with boiling water. The antioxidant activity of sample with fixation at 55 ℃ was the highest， followed by fixation with boiling water. The results of OPLS-DA showed that verbascoside， isoacteoside and catalpol were the main components causing the difference in chemical quality of the leaves from the three treatments， and the three components were positively correlated with the antioxidant activity of R. glutinosa leaves. Among them， the correlation between verbascoside and antioxidant activity was extremely significant， and the isoacteoside was significant. ConclusionThe chemical quality and antioxidant activity of R. glutinosa leaves are affected by the method of fixation， and the fixation at low temperature is the best primary processing method of R. glutinosa leaves.

ObjectiveTo investigate the metabolites and gene expression characteristics in fibrous roots of Dioscorea zingiberensis in response to low phosphorus stress. MethodThe severe stress group， the moderate stress group， and the normal group were set up to stimulate the low phosphorus stress experiment. The fibrous roots of D. zingiberensis were collected during initial stress. The metabolites and transcriptomic characteristics were analyzed by gas chromatography-mass spectrometry （GC-MS） derivatization and RNA-seq techniques. Through multivariate statistical analysis of metabolites treated by different methods，functional analysis of differentially expressed genes， and data mining， the metabolism markers produced in fibrous roots of D. zingiberensis under low phosphorus stress were screened out， and the metabolic pathway characteristics of different genes were analyzed. ResultA total of 116 GC-MS metabolites were detected from the fibrous roots of D. zingiberensis. The metabolic characteristics of fibrous roots of D. zingiberensis under different low phosphorus treatments were obviously different. Orthogonal partial least squares discriminant analysis（OPLS-DA） model was used to screen six differential metabolites represented by sugars and alcohols from metabolites of fibrous roots treated with different methods，and these components were presumedly metabolism markers of fibrous roots of D. zingiberensis in response to low phosphorus stress. The differential genes screened out from the severe stress group and the normal group were mainly enriched in peroxidase pathway，phosphate and hypophosphate metabolism pathway，while the differential genes screened out from the severe stress group and the moderate stress group were mainly enriched in glutathione metabolism pathway and phosphopentose pathway. A total of 177 differential genes in response to low phosphorus stress were screened out from fibrous roots， involving many pathways such as terpenoid skeleton and inositol biosynthesis，which was consistent with the fact that the metabolic differential components in fibrous roots in response to low phosphorus stress were mainly saccharides and inositol. ConclusionThe metabolites and gene expression in fibrous roots of D. zingiberensis responded to low phosphorus stress，and the differential metabolites were closely related to differentially expressed genes. This study is expected to provide a theoretical basis for the research on the molecular mechanism of D. zingiberensis in response to low phosphorus stress.

OBJECTIVEAcupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease (COPD), and the cholinergic anti-inflammatory pathway (CAP) has been shown to be involved in regulation of inflammation. In this study, we investigated whether electro-acupuncture (EA) affects the CAP in COPD.

METHODSSprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli (ST36) and Feishu (BL13) points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal + EA, normal + α-bungarotoxin (α-BGT) (the antagonist of the nicotinic acetylcholine receptor α7 subunit (α7nAChR)) + EA, COPD, COPD + EA, and COPD + α-BGT + EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine (ACh), acetylcholinesterase (AChE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid (BALF) and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreactivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 (JAK2), signal transducers and activators of transcription 3 (STAT3), nuclear factor-κB (NF-κB), were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry.

RESULTSCompared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve (P < 0.01), a marked sign of lung inflammation and an increase of ACh, AChE, IL-6 and TNF-α level in BALF or lung tissue (P < 0.05, P < 0.01) and higher expression of α7nAChR, JAK2, STAT3 and NF-κB (P < 0.05, P < 0.01) in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced (P < 0.01), lung inflammation was improved and the levels of ACh, AChE, IL-6 and TNF-α were decreased (P < 0.01). Further, the expression of α7nAChR, JAK2, STAT3 and NF-κB was downregulated (P < 0.05, P < 0.01). However, the above effects of EA were blocked in rats injected with α-BGT (P < 0.01).

CONCLUSIONEA treatment can reduce the lung inflammatory response and improve lung function in COPD, which may be related to its involvement in the regulation of CAP.