Objective To study the effects of bone marrow mononuclear cells (MNCs) transplantation on left ventricular (LV) remodeling and its potential mechanism in swine myocardial infarction models. Methods The left anterior descending coronary arteries of swines were obstructed by balloon to create myocardial infarction models. Three weeks later, MNCs(n= 7)or PBS(n=5) were injected into the infarction related coronary arteries through balloon catheter. The cardiac function were measured by echocardiography and ventriculargraphy. Collagen amount was also assessed at 4 weeks after transplantation. Results At 4 weeks after transplantation, LV end-diastolic dimension decreased in the BM-MNC group than before (40.40?4.51 mm vs. 45.88?4.15 mm, P=0.026), but increased in the control group (48.50?9.31 mm vs. 42.40?7.29 mm, P=0.328). Left ventricular function was improved from 41.16%?9.83% to 47.50%?9.07% in the BM-MNC group (P=0.020) but there was no significant change in the control group. Significant differences existed between the 2 groups in their absolute change before and after the procedure in both LV dimension and LV function (P=0.046 and P=0.030 respectively). The results showed reduction of collagen content in the border and the remote infarct regions in the BM-MNC group compared with the control (P=0.047 and P=0.034 respectively). Conclusion BM-MNCs transplantation regulates collagen content in heart and attenuates the degree of post-MI LV dilation and the development of infarction area. This effect of BM-MNCs transplantation may be one of the mechanisms which intervene ventricular remodeling following myocardial infarction.

Objective To study the effect of bone marrow mononuclear cells transplantation on restenosis rate and its mechanism. Methods The left anterior descending coronary arteries of swines were obstructed by balloon to create myocardial infarction models. After 3 weeks coronary stents were implanted at the middle part of the left anterior descending coronary arteries followed by the injection of bone marrow mononuclear cells into the coronary arteries. The degree of restenosis were measure by quantitative coronary angiography (QCA) after four weeks. Vascular tissue at both ends of stents were tested by HE and Sirius staining to analyse the mechanism of restenosis. Results At end of the experiment there were 8 swines in the bone marrow mononuclear cells transplantation group and 9 in the control group. After injection of bone marrow mononuclear cells the restenosis rate was similar to the control group (50% vs 44%, P=0.762). The lumen late loss was also similar between the two groups (1.50?1.45 mm vs 1.31?1.07 mm,P=0.736). Conclusion Bone marrow mononuclear cells transplantation does not increase the restenosis rate after percutaneous coronary artery intervention.

OBJECTIVE: To observe and compare the shoulder joint function, complications and clinical effects of hemiarthroplasty and open reduction and locking plate in the treatment of comminuted proximal humeral fracture (Neer IV) with 3D printing technique. METHODS: From March 2012 to April 2018, 31 middle age and elderly patients with comminuted proximal humeral fractures (Neer IV) were treated, including 4 males and 27 females, aged from 55 to 94 years old with an average age of 71 years, with a course of 1 to 3 years. Among them, 20 cases were treated with open reduction and locking plate internal fixation (ORIF group) and 11 cases were treated with lower half shoulder replacement (HA group) assisted by 3D printing technology. Using CT data and Mimics software of Materialise Company in Belgium, the reconstruction of fracture was simulated on computer. The height of fracture end to humeral head, the height of tubercle to humeral head, the angle of humeral head backward obliquity were measured to assist the hemiarthroplasty. Follow-up and X-ray examination were performed, the incidence of complications were observed, and Neer score was used for the shoulder joint function. RESULTS: Thirty-one patients were followed up for 1 to 3 years with an average of 2 years. In HA group, there was no prosthesis loosening, fracture and subsidence, the head of artificial humerus was intact, the fracture of nodules and nodules did not heal in 1 case, Neer score was 84.18±3.55; in ORIF group, there were 8 cases of proximal humerus bone resorption, 1 case of fracture nonunion, 1 case of internal fixation loosening, Neer score was 55.91±10.78; there was significant difference in Neer score of shoulder joint function between the two groups(<0.05). CONCLUSIONS Ultrasound-guided minimal traverse-cross technique repair for acute closed Achilles tendon ruptures, which promise minimal incision, protect sural nerve, ensure quality of tendon anastomosis and fixation, and is a ideal method for repairing acute closed Achilles tendon ruptures.
Aged ; Aged, 80 and over ; Bone Plates ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted ; Humans ; Male ; Middle Aged ; Shoulder ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo discusses the clinical effects of arthroscopy combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) technology in treating Schatzker IV tibial plateau fractures.

METHODSFrom January 2012 to January 2016, 19 patients with Schatzker type IV tibial plateau fractures were treated with arthroscopy combined with minimally invasive technique including 12 males and 7 females with an average age of 46.5 years old ranging from 19 to 78 years old. Patients were suffering knee pain, swelling, flexion and extension limited, and other symptoms preoperative. Patients were followed up and assessed by Rasmussen knee function score.

RESULTSNo infection, traumatic arthritis, and knee joint valgus occurred after operation. Nineteen cases were followed up for 12 to 24 months with an average of 18.6 months. Fracture healing time was 3 to 5 months with an average of 3.8 months. The knee pain and limited mobility improved significantly. The range of autonomic movement of joints was from 90 to 136 degrees. According to Rasmussen functional score criteria, the total score was 27.00±2.49, the result was excellent in 16 cases, good in 2 cases, fair in 1 case.

CONCLUSIONSArthroscopic treatment for Schatzker type IV tibial plateau fractures combined with MIPPO can simultaneously treat internal structural injuries such as meniscus and other knee joints, with less trauma, fewer complications, and faster joint function recovery, but we must strictly grasp surgical indications and avoid expanding injuries.

Coronary Disease ; surgery ; Drug-Eluting Stents