2.Changes of glucocorticoid-induced osteonecrosis of the femoral head under mechanics load
Chinese Journal of Tissue Engineering Research 2010;14(11):1963-1966
BACKGROUND:Femoral head necrosis induced by glucocorticoid is typical under mechanics load.OBJECTIVE:To create the rat models of the femoral head necrosis by long-term glucocorticoid treatment,and to Observe the changes of femoral head necrosis induced by glucocorticoid under mechanics load.METHODS:Wistar rats with 4-month old were randomly divided into the experimental and control groups.After the buttocks injection of dexamethasone 20mg/kg weakly for 8 weeks,rats in the experimental group were made to run on the running machine at a speed of 1 km/h to forme the hyper-weight model;at the same time those in the control group were with the normal physiological weight.Rats in both groups were sacrificed at weeks 2,4,6 and 8.The left legs were taken for the biomechanics test on the EnduraTEC ELF3200,the biggest vertical deformation and stiftness were calculated,the number of empty osteocyte lacunas was calculated,and the cumulative absorbance value was compared between two groups.RESULTS AND CONCLUSION:The femoral head presented with necrosis at 8 weeks in the experimental group.and the width of bone trabecula,and the stiffness of which were smaller than that of the control group.but the biggest vertical deformation was greater the concurrent control group(P<0.05).The Bcl-2 cumulative absorbance value of 2 groups had significant differences at 4 weeks(P<0.05),which was increased with time prolonged in the experimental group(P<0.05).The results demonstrated that:in glucocorticoid-induced osteonecrosis of the femoral head,mechanics Ioad induces the obviously osteocyte necrosis.more cartilage repair,and trabeculae rupture,which is considered as the direct reason of the necrosis of the femoral head The typical femoral head necrosis is presented.
3.The review analysis of Chinese systemic lupus erythematosus patients complicated with tuberculosis infection
Chinese Journal of Rheumatology 2009;13(9):599-602
Objective To investigate the prevalence and clinical features of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE). Methods All articles published in Chinese between 1998-2008 were searched by using "systemic lupus erythematosus (SLE)" and "tuberculosis infection" as the keywords.Data were extracted and then Meta-analysis was done. Results Four hundred and twenty-four patients with the age(32±9) years from 30 studies were available for analysis, in which 45 were males and 379 were females. The duration of SLE when TB infection was diagnosed was (26±19) months.TB was found in 2.3%~19.6% of patients and 15.6% of them died. 73.0% of patients of SLE were in stable phase when infected with TB.7.50% of patients had a history of TB infection years ago. The common manifestations observed were fever (95.2%), weight loss (63.1%), cough and expectoration (60.2%), night-sweat (47.8%), chest pain (44.7%), chest distress and dyspnea (41.1%). 35.0% of patients had hematogenous disseminated pulmonary tuberculosis and 15.1% of patients had tuberculous meningitis. 45.3% of patients had extra-pulmonary TB. The focus of infection could not be identified in 2.8% of patients. Both ESR and CRP were elevated in patients(93.9%, 77.1%), but the positive rate of tuberculin test, anti-TB antibody and sputum smear posivity was low (19.3%, 41.8%, 14.3%). Conclusion TB incidence in patients with SLE is evidently high and the clinical mani-festation is not typical. Extra-pulmonary TB and serious infection are more frequently. Severe TB infection and extra-pulmonary TB are frequent. More patients with SLE are in stable phase when infected with TB. Early diagnosis of TB infection is important.
4.Liver regeneration after 30% rat liver transplantation
Chinese Journal of General Surgery 2009;24(5):383-386
Objective To explore the molecular mechanisms involved in liver regeneration after different cold ischemic (CI) times for the liver graft in 30% volume rat liver transplantation. Methods A model of 30% volume Lewis to lewis rat liver transplantation with hepatic artery reconstruction was established. Rats were grouped as follows: 1 h CI group (n =25), 8 h CI group (n =25) and 16h CI group (n = 25). Survival rate of rats in each group and liver regeneration were observed. Specimen were collected at predetermined intervals from 90 min, 1,4 and 7 d post-reperfusion. TNF-α and IL-6 expression, STAT3 activation were determined in liver grafts. Expression of cyclin D1 and hepatocyte replication with BrdU uptake were studied by immunohiatochemistry. Statistical analysis was used to compare BrdU positively stained hepatoeytes at 1 d post- reperfusion in each group. Results 30% liver transplantation was performed in a total of 75 rats. Compared with rats in 1 h CI group, TNF-α and IL-6 expression in 8 h CI and 16 h CI groups were markedly increased after 30% liver transplantation. STAT3 activity in 8 h CI and 16 h CI groups was significantly increased. Cyclin D1 expression in 8 CI group was demonstrated with cytoplasmic and nuclear staining. Grafts in 16 h CI group showed large areas with no cyclin D1 expression. Number of hepatoeytes with positively stained neclei in 1 h CI group was more than that in 8 h CI group at 1 d after transplantation (t = 6.14, P < 0.05). Conclusion Liver regeneration following 30% liver graft transplantation may be through TNF-α/IL-6/STAT3/ Cyclin D1/DNA synthesis pathways. The reason for 30% liver graft failure with significant cold ischemic injury is that hepatocytes may not respond to initiating signals for liver graft regeneration.
5.Preliminary development of college students' physical exercise behavior scale
Chinese Journal of Behavioral Medicine and Brain Science 2009;18(8):760-762
Objective The college and university students' physical exercise behavior scale has been de-veloped. Methods Baaed on the theory of planning behavior,after investigation and analysis,a questionnaire was made to test 1180 students from some colleges and universities in Changjiang Delta area. Its reliability and validity was tested,and confirmatory factor analysis was carried out. Results The scale consists of 4 factors: behavioral intention,subjective criterion,cognitive behavior,and integrative attitude. Its retest reliability was 0.920, correla-tion coefficient of the factors between 0.732 and 0.854 ,and the total scale Cronbach α 0.931. The correlated co-efficients between subseales and total scales range 0.455~0.785 ;the IFI, CFI,and NFI fit indices of the four di-mensions were over 0.9 ;RMSEA 0.042. Conclusion The reliability and validity of the scale are suitable as an effective tool to test university students' sports exercise behavior.
6.Study on the relationship between QT interval and the compement of antipsychotic-induced metabolic syndrome
Chinese Journal of Behavioral Medicine and Brain Science 2009;18(5):421-423
Objective To study the relationship between QT interval and the compements of antipsychotic-induced metabolic syndrome in schizophrenic patients. Methods Totally 460 schizophrenic patients(240 men and 220 women)aged 19~60 from the study cohort of the schizophrenic patients in treatment with antipsychotant were recruited in the study for epidemiologic examinations,involving anthropometry and measurements of blood pressure,fasting ang 2hr plasma levels of glucose and insulin and serum levels of lipid.A standard 12-lead ECG was recorded and the corrected QT (QTc)was calculated accordingly by Bazett formula.HOMA-IR index was calculated for estimating individual insulin resistance.Metabolic syndrome(MS)was diagnosed according to the definition issued by the International Diabetes Federation(IDF)in 2005.Results The prolonged QT interval was found in 124 of the 460 cases(27.0%),and the rates of prolonged QT interval being 21.7% and 32.7% in men and women respectively (χ2=7.13,P<0.01).The prevalences of MS,IR,central obesity,IFG,higher serum level of triglyceride(TG)and lower serum level of high-density lipoprotein cholesterol(HDL-C) were 39.3%,38.7%,35.4%,34.1%,31.3%,29.8% and 27.0% in schizophrenic patients population respectively.The prolonged QT interval was significantly associated with MS,IR,IFG,higher serum level of triglyceride(TG)and central obesity respectively(χ2=4.95~13.63,P<0.05).Conclusion The prolonged QT interval was significantly correlated with antipsychotic-induced metabolic syndrome(MS) and components of abnormal metabolism.
7.Importance of standardization of Stark cesarean section——664 cases analysis
Chinese Journal of Perinatal Medicine 2008;11(4):222-225
Objective To investigate the process of Stark cesarean section (CS) and analyze its key procedures and patients outcomes in order to understand its advantages and promote its standardization. Methods Elective Stark CS cases were divided into two groups according to time sequence and procedure difference. Group A refered to cases underwent modified approaches before standardization (n=362), and group B refered to cases afterward (n= 302). Duration of operation, time interval from incision to delivery, intraoperative hemorrhage, postoperative flatus time, postoperative morbidity, duration of retained urinary catheter, urinary tract irritation, wound infection, and abdominopelvie adhesion in the second operation were compared between the two groups. Results The average duration of the operations and time interval from incision to delivery in group B, which were (27.7± 10. 8) min and (4.92±1.21) min, respectively, were significantly shorter than those in group A, which were (35.6±15.2) min and (7.81±2. 79) min, respectively (P<0. 05). No significant differences was found with regard to average intraoperative hemorrhage between group A and B [(214.34±62. 1) ml vs (201.54-53.1) ml, P>0.05]. Postoperative flatus time in group B was significantly shorter than that in group A [(16.85±11.8) h vs (25.9±12. 7) h, P<0. 05]. Postoperative morbidity in group B was significantly lower than that in group A [1.3%(4/302) vs 4.7%(17/362), P<0.05]. The average duration of retained urinary catheter in group B was significantly shorter than that in group A [(15.6±5.3)h vs (26. 2±6.1)h, P<0. 05], and the urinary tract irritation rate in group B was also lower than that in group A [2. 5%(9/362) vs 0(0/302), P < 0. 05)], No incisional infection or delayed healing was found in either group. Rectus muscles, fascia and peritoneum adhesions were found in three cases with second surgery in group A and none in group B. No omentum, peritoneum and visceral peritoneum adhesion was found in either group. Conclusions Compared to the modified Stark operation, standardized procedure decreases operation associated complications and improves maternal outcomes. Therefore, standardized Stark CS should be promoted for better operative outcomes.
8.Neoadjuvant therapy for rectal cancer
Cancer Research and Clinic 2010;22(7):440-442
The neoadjuvant therapy for rectal cancer included neoadjuvant radiotherapy, neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy and neoadjuvant molecular targeted therapy. Recent reports on neoadjuvant therapy clearly showed a downstaging and downgrading effect on the primary rectal cancer. The rates of R0 resection and sphincter preservation were improved and local recurrence was decreased, but the long term survival was not improved. The results of using new chemotherapeutics and molecular targeted drugs in neoadjuvant therapy for rectal cancer were expected.
9.Clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease
Chinese Journal of Orthopaedics 2010;30(11):1101-1104
Objective To discuss clinical features and surgical treatment of the coexistence of cervical,thoracic and lumber degenerative disease.Methods From January 2004 to December 2008,79 cases with the coexistence of cervical,thoracic and lumber degenerative disease were surgically treated,including 51 males and 28 females,aged from 30 to 80 years(average,58.1 years).All 79 cases presented coexistence of cervical,thoracic and lumbar compression symptoms,such as limb numbness,weakness,zonesthesia and positive Hoffmann and Babinski sign.Forty-one cases mainly presented cervical symptoms,5 presented thoracic symptoms and 12 presented lumbar symptoms.According to affected segments,41 cases received cervical operations,5 cases received thoracic operations,12 cases received lumber operations,and 21 cases received two parts operations.Surgical outcomes were evaluated by Japanese Orthopaedic Association(JOA)score.Results JOA score of all cases improved in varying degrees.The improvement rate of received cervical operation was 66.06%±14.33%,and that of received mere thoracic operation was 56.19%±9.85%,and that of lumbar operation was 63.49%±9.78%.Twenty-one cases received tow parts operations.Forteen cases received one-stage two parts operations with improvement rate of 76.78%±3.94% and 7 cases received twostage two part operations with improvement rate of 71.79%±8.74%.Conclusion The coexistence of cervical,thoracic and lumber degenerative disease is a kind of complex disease,which involves multi-segments and presents various clinical manifestations.The condition was caused by disk herniation,spinal stenosis and ossification of posterior longitudinal ligament and hypertrophy or ossification of ligamentum flavum.The optimal surgical procedures should be selected by integrated judgment of symptoms and imaging manifestations.
10.Repairing a bone defect model by using autogenous bone powder and implant materials
Chinese Journal of Tissue Engineering Research 2008;12(10):1987-1990
BACKGROUND: Sampling the autogenous bone always needs to develop the second operational area or harvest surrounding the implant, which will increase the risk of trauma and infection. Therefore autogenous bone powder may be taken into consideration to reclaim and use for the treatment of local bone defect.OBJECTIVE: To construct experimental models of repairing bone defect by autogenous bone powder and implant material, and observe the biocompatibility between materials and host.DESIGN: Single sample observation.SETTING: College of Stomatology, Dalian Medical University.MATERIALS: The experiment was performed at the Animal Experimental Center of Dalian Medical University from August 2005 to April 2006. Five healthy hybrid dogs were used in this study. Titanium nail and Bio-Oss bone implant materials were designed and produced by Xi'an Zhonghang Titanium Biological Materials Co., Ltd.METHODS: The first, second and third premolars of dogs were uprooted and received implantation 3 months later. Four implant sockets were prepared at left and right sides respectively of each dog, totally 40 sockets. One titanium nail was implanted into each socket, totally 40 nails. Autogenous bone powder collected when drilling hole, Bio-Oss implant materials and their mixture at 1:1 were implanted in artificial bone defect at bucca side, respectively, while non-implanted bone was served as blank control.MAIN OUTCOME MEASURES: ①At week 9, recovery of bone mass was recorded. Height of alveolar bone, density of bone trabecula and osseointegration were observed by X-ray film.②Histological change was determined by methylene blue-basic fuchsin method.RESULTS: No titanium nail fell off, so five dogs were all involved in the result analysis.①General condition and bone defect: At week 9 of implantation, wound was well healed, and the titanium nail was stable with total reserved rate of 100%. Compared with blank control, the bone defect mass was less in bones implanted with autogenous bone powder (P<0.01), and the least in bones implanted with mixed powder, which had optimal recovery.②Recovery of bone mass: X-ray film demonstrated that, 40 titanium nails were closely connected with bone, and the healing was well.③Biocompatibility between materials and host: All titanium nails were closely surrounded by erythroic compact bone, no blue soft tissues were seen between implant materials and bone, and direct bone interface appeared under low power lens.CONCLUSION: It is effective to repair bone defect by autogenous bone powder and implant material in dog models,good hiocompatibility is observed between materials and host.