[Objective] To analyze the cases performed by unicompartmental knee arthroplasty in order to assess the early outcome,and to discuss the indications and the key points of surgical technique.[Methods]Under the principle of "slight undercorrection",15 patients were performed by unicompartmental knee arthoplasty with the technique of limited medial release if necessary.The HSS score,the fomeral tibial angle and the maxima degree of flexion and extension measured preoperatively and in the latest follow-up were analyzed by SPSS 13.0 with the method of paired t test.Meanwhile the angle of the posterior slope of the tibial implants was measured.[Results]Postoperatively the HSS score,the fomeral tibial angle and the maxima degree of flexion and extension were improved significantly in the latest follow-up,and the average angle of the posterior slope of the tibial implants was 4.2 degrees.[Conclusion]Unicompartmental knee arthroplasty has a satisfing early outcome.And it is very important to carry out the indications strictly.With the surgical technique of limited medial release,the flexional contracture could also be improved significantly.

Objective To summarize the clinical course of acute interstitial pneumonitis (AIP) associated pediatric acute respiratory distress syndrome (PARDS) in 8 recipients after liver transplantation,and further discuss the potential risk factors and therapeutic highlights.Methods A total of 476 pediatric patients received liver transplantation in Tianjin First Center Hospital from January 2012 to September 2016.Among them,8 cases of AIP associated PARDS in ICU were recruited in this study.Medical data including clinical presentation,ICU management and outcomes were analyzed retrospectively.Results The onset time-window of AIP associated PARDS was (2.67 ± 0.77) months after liver transplantation,and the time interval between initial symptom and ICU administration was (6.75 ± 5.82) days.Five cases had the history of acute rejection therapy,and 5 cases had CMV and/or EBV viremia history.All 8 cases received mechanical ventilation,2 cases given nasal non-invasive ventilation and the rest 6 cases given invasive ventilation,3 of which were switched to high frequency oscillatory ventilation (HFOV) combined with inhaled nitric oxide.At the stage of hypoxic climax,the fraction of inspired oxygen (FiO2) was up-regulated to 1.0 to maintain the oxygenation index (OI) of (25.24 ± 5.94).Temporary replacement of immunosuppressants with intravenous glucocorticoids was implemented in all 8 cases without acute rejection episode.Of 8 cases,2 cases died from PARDS,1 case died from portal thrombosis associated hepatic failure,and the rest 5 cases survived.Conclusion AIP associated PARDS is a critical complication with high mortality in pediatric patients after liver transplantation.Excessively strong immunosuppression therapy at early post-transplant stage shows a risk factor for AIP.Lung protective ventilation strategy and HFOV are recommended to reduce ventilator induced lung injury in pediatric patients.Temporary intravenous glucocorticoids may reduce acute inflammatory reaction in PARDS patients without increasing the risk of acute rejection.

Objective To investigate the role of macrophage?derived Act1 (nuclear factor kappa B activator 1) in the inflammatory bowel disease. Methods Genetically engineered mice carrying targeted suppression of Act1 in the mac?rophages (Anti?Act1) were used for the dextran sodium sulfate (DSS)?induced ulcerative colitis. The severity of colitis was assessed by weight loss, stool consistency, fecal blood index, colorectal length and H&E histology. The infiltration of CD45 + leukocytes and CD68 + macrophages in the inflammatory intestine was observed by immunohistochemical staining and expression levels of mRNA for inflammatory cytokines in colon tissues were analyzed by RT?qPCR. Results As com?pared with C57 mice, the anti?Act1 mice exhibited less severe acute colitis following DSS treatment, with reduced CD45 +leukocyte and CD68 + macrophage infiltrates in the colon tissue. Inflamed colons of the anti?Act1 mice expressed lower mR?NA levels of TNF?α, IL?1βand IL?6. Conclusions Targeted suppression of Act1 in the macrophages ameliorates dextran sodium sulfate?induced intestinal inflammation.

AIM: To discuss the mechanism of action of Zhiyu Granules on treating diabetic peripheral neuritis. METHODS: The model of diabetic peripheral neuritis in mice was induced by streptozotocin.The effect of Zhiyu Granules on the contents of sciatic nerve inositol in model mice through ELSD(evaporative light scattering detector) was examined,and the activity of Na~+-K~+ pump in sciatic nerve was measured,and the activity of SOD and the contents of MDA in erythrocytes were detected,and the ultrastructures of sciatic nerve,pancreas and kidney in model mice were observed by electric microscope. RESULTS: Zhiyu Granules could increase the contents of sciatic nerve inositol in model rats,and enhance the activity of Na~+-K~+ pump,and improve the ultrastructures of sciatic nerve and pancreas cell.Zhiyu Granules couldn't improve the ultrastructure of renal corpuscles,or affect the activity of SOD and the contents of MDA in erythrocytes of model mice yet. CONCLUSION: Zhiyu Granules is effective in clinical treatment of diabetic peripheral neuritis.

Objective To investigate the clinical effect of the treatment of osteoporotic vertebral compression fractures in the elderly populationthrough different surgical approaches.Methods 98 cases with a single-level osteoporotic vertebral compression fracture in the elderly population were randomly divided into two groups from February 201 1 to June 2013.48 patients were performed by percutaneous vertebroplasty (PVP)through unipedicular approach and 50 patients through bipedicular approachs.The clinical data of patients were prospectively analyzed and the clinical efficacy were compared between two groups using VAS (visual analogue scale method)and ODI (Oswestry disability index)in preoperative,postoperative 1 day and 1 year postoperatively .The data of age, gender,injury to the patients with operation time,postoperative follow-up time,operation time,bone cement injection,bone cement leakage and other complications were observed.Cobb angle,vertebral compression ration were observed by imaging data.Results All the cases were followed-up.There was no statistical difference in preoperative clinical data between the two groups (P >0.05).In unilateral group (48 cases),the data of operation time,bone cement injection,bone cement leakage,Cobb angle improve,vertebral compression ration improve were (34.87±5.91)min,(6.20±0.66)mL,1 6 cases(33%),(10.1 9±2.12)%,(13.23°±1.58°)and adjacent vertebral fractures was 10 cases (20.9%).VAS score was respectively improved (4.05 ± 0.12 ),(5.42 ± 0.12 ) in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.40 ±0.1 1 )in postoperative 1 year than 1 day.ODI score was respectively improved (35.46 ± 1.89)%,(47.88 ±2.21 )% in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.42±0.24)% in postoperative 1 year than 1 day.In bilateral group (50 cases).The data of operation time,bone cement injection,bone cement leakage,Cobb angle improve, vertebral compression ration improve were (41.66±6.90)min,(4.88±0.52)mL,9 cases(18.0%),(10.48±1.43)%,(13.04°±2.03°)and adjacent vertebral fractures was 6 cases(12.0%).VAS score was respectively improved (4.06±0.1 1),(5.30±0.10)in postoperative 1 day and 1 year than preoperative.VAS score was improved (1.34± 0.08)in postoperative 1 year than 1 day.ODI score was respectively improved (36.08±2.13)%,(47.54±1.97)%in postoperative 1 day and 1 year than preoperative.ODI score was improved (1 1.26 ± 0.54)% in postoperative 1 year than 1 day.There was no obvious clinical problems after occurred leakage in two groups.there was statistical difference in cement injection,bone cement leakage and postoperative adjacent vertebral fractures after operation between the two groups.there was no statistical difference in Cobb angle improve,vertebral compression ration improve,VAS score and ODI score between the two groups.Conclusion Both approaches are effective in the treatment of osteoporotic vertebral compression fractures in the elderly population ,but there is advantage of decrease the incidence of bone cement leakage and postoperative adjacent vertebral fractures through bilateral approach.

Objective:To study the use of digital subtraction angiography (DSA) guided transnasal ileus tube placement in management of abdominal compartment syndrome (ACS) after liver transplantation.Methods:From January 2015 to December 2019, a total of 30 patients who developed ACS after liver transplantation who were admitted to the Transplantation Intensive Care Unit of Tianjin First Central Hospital were retrospectively studied. According to the way of decompression, these patients were divided into the study group and the control group. Patients in the control group were treated with conventional abdominal decompression, while patients in the study group were treated with DSA guided transnasal ileus tube placement based on management principles developed in conventional abdominal decompression. Changes in intra-abdominal pressure, treatment efficacy rates and liver functions were monitored in the two groups up to 7 days after abdominal decompression.Results:There were 23 males and 7 females, aged (53.4±11.6) years. After treatment, the IAP, portal venous blood flow velocity, bile drainage volume, ALT and AST in the study group were significantly better when compared with the findings before treatment: [IAP: (7.13±3.87) vs (22.73±2.09) mmHg, portal vein blood flow velocity: (34.76±10.31) vs (21.45±6.47) cm/s, bile drainage volume: (198.43±19.94) vs (80.72±9.52) ml/d, ALT: (158.92±67.56) vs (278.73±99.17) U/L, AST: (79.36±15.63) vs (196.71±89.05) U/L], ( P<0.05). After treatment, when compared with the control group, the IAP, portal vein blood flow velocity, bile drainage and TBil in the study group were significantly better [IAP: (7.13±3.87) vs (13.47±6.19) mmHg, portal vein blood flow velocity: (34.76±10.31) vs (24.98±8.54) cm/s, bile drainage: (198.43±19.94) vs (108.73±21.30) ml/d, TBil: (258.85±91.95) vs (343.69±89.45) μmol/L], ( P<0.05). In the control group, the IAP significantly decreased on the fourth day after treatment, ( P<0.05); compared with the significant difference in the study group on the second day after treatment ( P<0.05). After 7 days of treatment, the efficacy rate of the control group was 46.7% (7/15), compared to 86.7% (13/15) in the study group. The difference between the two groups was significant (χ 2=5.400, P<0.05). Conclusion:DSA guided transnasal ileus tube placement for treatment of abdominal compartment syndrome after liver transplantation resulted in a better treatment efficacy rate than conventional treatment.

BACKGROUND:Surgical treatment for pigmented vil onodular synovitis can maximize the excision of synovial lesions and recovery of joint function.
OBJECTIVE:To investigate the knee joint function and relapse rate fol owing treatment of pigmented vil onodular synovitis with total knee replacement and arthroscopic synovectomy.
METHODS:We retrospectively analyzed 34 cases of knee pigmented vil onodular synovitis admitted for surgical treatment in the Department of Orthopedics, Xiangya Hospital of Central South University, China from December 2006 to December 2011. In these cases, 24 patients received arthroscopic synovectomy and 10 patients were subjected to total knee replacement. Adjuvant radiotherapy was conducted according to postoperative patient’s conditions. Lysholm scoring was employed in the arthroscopic synovectomy group, and American Knee Society scoring was used in the total knee replacement group. Knee function in two groups was compared before and after treatment. Fol ow-up observation was performed to compare knee function recovery and relapse rate between two groups.
RESULTS AND CONCLUSION:Thirty-four patients were effectively fol owed up for 12-66 months, mean 41.3 months. Statistical analysis showed that in the arthroscopic synovectomy group, the postoperative Lysholm score was (86.3± 10.3) points, significantly higher than the preoperative score which was (55.5±13.2) points (t=3.81, P=0.016, P<0.05). In the total knee arthroplasty group, the American Knee Society score was increased from (40.7±2.2) points preoperatively to (90.2±1.1) points postoperatively (t=6.27, P<0.01). In the arthroscopic synovectomy group, the American Knee Society score was increased from (34.2±3.9) points preoperatively to (80.8±1.9) points postoperatively (t=16.58, P<0.01). Arthroscopic synovectomy combined with adjuvant radiotherapy can achieve better outcomes in pigmented vil onodular synovitis patients, while the total knee replacement for advanced with advanced knee diffuse pigmented vil onodular synovitis is better to restore knee function and the recurrence rate is low.

Objective To establish a mouse model of diethylnitrosamine(DEN)-induced hepatocellular carcinoma (HCC),and to explore the effects of two different diet formulas on the establishment of DEN-induced HCC model.Methods SPF C57BL/6 mice (8 males and 8 females) were injected intraperitoneally with 25 mg/kg DEN at day 14 to establish a HCC model.The mice were divided into two groups after weaning.One group was fed with the SPF class rodents cereal-based diet,another group was fed with AIN-93G formula diet.The mice were sacrificed at the age of 9 months.The livers were weighed and the growth of liver cancer was observed and recorded.Results All the mice in the cereal-based diet group developed HCC as expected.The body weight and liver mass of the mice in the AIN-93G diet group were significantly lower than that of the cereal-based diet group.The incidence of HCC,and the number and size of tumor nodules were also significantly lower in the AIN-93G diet group than that in the cereal-based diet group.Conclusions DEN-induced HCC model has been successfully established in mice fed with cereal-based diet,while mice fed with AIN93-G diet prevented the development of DEN-induced HCC,and their body weight was decreased significantly,suggesting that dietary factors play a key role in establishment of animal disease models.

Objective To study the effect of heterozygous deficiency of SGT gene on the hematological and biochemical parameters of mice in young and elderly ages.Methods Blood samples were analyzed for complete hematological and biochemical parameters from heterozygous SGT-deficient and wild-type mice of 10-weeks and 6-months old mice, respectively.Results Age-related changes in most indexes were found statistically significantly different between young and elderly mice with the same genotype.Compared with the wild type at the same age, the platelet large cell ratio (P-LCR) was lower in young heterozygous SGT-deficient mice.However, platelet count, plateletcrit (PCT) and neutrophil count were more significantly lower in elderly heterozygous SGT-deficient mice (P<0.05).There was no significant difference for biochemical parameters ALT, AST, LDH, urea nitrogen, creatinine and blood glucose.Total and unconjugated bilirubin as well as ALP were significantly higher in elderly heterozygous SGT-deficient mice but not for conjugated bilirubin (P<0.05).In addition, significant differences existed for the lipids between two elderly groups (P<0.05).Conclusions Heterozygous deficiency of SGT gene induced changes of some hematological and biochemical parameters in elderly mice.It provides helpful information for further investigation on SGT involvement in some biological and pathological processes.

Objective To observe the survival and reproduction of Oncomelania hupensis snails and their susceptibility to schistosome in schistosomiasis non-endemic area of the Yangtze River estuary in Southern Jiangsu.Methods The soil and water from the Yangtze River estuary of Southern Jiangsu were used for the experiment.The snails reproduced in the same year were collected from the upper reaches of the Yangtze River and raised in the laboratory.The snail survival and reproduction rates and schistosome infection of the snails were observed.The soil collected from schistosomiasis endemic area was used in the control group.Results There was no significant difference between the experimental and control groups for the snail survival rates both in 6 and 12 months (X~2= 0.727 8,P > 0.05 and X~2 = 0.416 1,P > 0.05).Each female snail reproduced 67.69 eggs in average (95 % CI:24.026 0-110.097 4).The average hatchability rate of snail eggs was 83.60%,and there was no significant difference between the 2 groups (X~2= 9.131 8,P > 0.05).The schistosome infection rate of the second generation snails was 1.40% (5/356) 60 days after the infection in the laboratory.Conclusions The snails collected from the upper reaches of the Yangtze River marshland can survival and reproduce in the soil and water from schistosomiasis non-endemic area of the Yangtze River estuary of Southern Jiangsu,and the second generation of the snails can be infected with schistosome in the laboratory.