Objective To investigate surgical techniques and results of arthroscopic reduction and fixation for the treatment of avulsion fracture of the posterior cruciate ligament from the tibia through an additional posterolateral portal. Methods An additional posterolateral portal was established by using the inside-out technique under arthroscopic view.After a protective sleeve was placed through the portal and the displaced fracture was reduced,the fragment was fixed by the guide wire drilled through the sleeve temporarily.If the fluoroscopic control showed an anatomic reduction of the fragment and good placement of the wire,the self-attacked cannulated screw and washer was placed intra-articularly over the guide wire through the sleeve for the directive internal fixation of the avulsion fracture.Aggressive rehabilitation programs were recommended postoperatively.Results Except 1 case with 11 mm displacement and rotation of the fragment treated by the arthrotomy after the failure of arthroscopic reduction,the arthroscopic operation was accomplished in all the remaining 10 cases.The operative time was 63～98 min(mean,87.3 min).No injuries of popliteal vessels or nerves occurred.The postoperative X-ray firms showed an anatomic reduction of the fragment and good placement of the screw and washer.With the negative posterior drawer test confirmed by the physical examination,normal range of motion of the injured knee joint and gait were achieved in the 10 patients at 4～7 weeks after surgery.The bone union was confirmed by X-ray films at the 3 months postoperatively.The computer KT-2000 arthrometer measurements of posterior tibial displacement of both knee joints showed side-to-side difference not more than 1.2 mm in 6 patients at 5 months after surgery.Conclusions The additional posterolateral portal can be established by the arthroscopic inside-out technique safely.The displaced fragment of the avulsion fracture of the posterior cruciate ligament from the tibia can be reduced and fixed with the self-attacked cannulated screw and washer arthroscopicly.

[Objective]To analyze the therapeutic effects of percutaneous kyphoplasty for acute versus chronic osteoporotic vertebral compressive fracture.[Method]Percutaneous kyphoplasty was performed in 56 patients(137 vertebraes) with osteoporotic vertebral compression fracture (VCF).Based on the changes on MRI,all compression fractures were divided into 3 types:acute VCF,repairing VCF and chronic VCF.Types were examined for differences in treatment efficacy,according to the anterior/middle vertebral body height,Cobb's angle and visual analogue scale(VAS) at pre-and post-operation.[Result]All patients with the VCFs had rapid and significant improvement in back pain following percutaneous kyphoplasty.VAS was from 8.09?1.12 preoperatively to 2.31?0.91 postoperatively,and 2.26?0.88 at final follow-up.The results showed that 41 cases were Type Ⅰ on MRI,69 were Type Ⅱ and 27 were Type Ⅲ.Significant improvement was observed at the post-operative versus pre-operative assessments in Type Ⅰ and Type Ⅱ.No significant differences were observed between post-and pre-operative assessments in Type Ⅲ.[Conclusion]The curative effect of percutaneous kyphoplasty for the treatment of acute VCFs appears superior to that of chronic VCFs.After a definite diagnosis of VCFs,percutaneous kyphoplasty should be performed as early as possible in order to obtain a better therapeutic effect.

[Objective]To observe the correlation between electromyogram(EMG) combined with MRI and clinical outcome in patients with cervical spondylotic myelopathy(CSM). [Methods]Patients with CSM who were confirmed by clinical and image examination were examined by EMG.Peripheral nerve injury such as cubital tunnel syndrome and carp tunnelsyndrome were excluded.Eighty-nine cases were selected and followed-up after surgical treatment with anterior,posterior,or posterior-anterior combined surgery.Four types were classified according to EMG and MRI.Type I:EMG/MRI(-/-).Type II:EMG/MRI(-/+).Type III: EMG/MRI(+/-).Type IV:EMG/MRI(+/+).The clinical outcome were also graded according to the Japanese Orthopaedic Association(JOA) scoring system.Furthermore,the data were analyzed statistically to explore the correlation of the factors.[Results]The results showed that 36 cases were in Type Ⅰ,17 were in Type Ⅱ,10 were in Type Ⅲ and 26 were in Type Ⅳ.Clinical function was excellent in 42 patients,good in 20 patients,fair in 18 patients,and poor in 9 patients.There was a good correlation between types and the clinical outcome(Hc=30.72,P

Long-term endurance training or physical activity has been confirmed not only to improve physical performance, but to bring about an obvious beneficial effect on human health; however, the mechanism of this effect is not clear. The most studied health adaptations in skeletal muscle response to endurance exercise are increased muscle glycogen level and insulin sensitivity, fiber type transformation toward oxidative myofibers, and increased mitochondrial content/function. Mitochondria are dynamic organelles in eukaryotic cells critical in physical performance and disease occurrence. The mitochondrial life cycle spans biogenesis, maintenance, and clearance. Exercise training may promote each of these processes and confer positive impacts on skeletal muscle contractile and metabolic functions. This review focused on the regulation of these processes by endurance exercise and discussed its potential benefits in health and disease. We presented evidence suggesting that exercise training potentiates not only the biogenesis of mitochondria but also the removal of old and unhealthy mitochondria through mitochondrial quality control.
Adaptation, Physiological ; Exercise ; Humans ; Mitochondria ; physiology ; Muscle Contraction ; Muscle, Skeletal ; physiology

Objective To study histone H3 lysine 4 trimethylation (H3K4me3) in peripheral blood mononuclear cells (PBMCs) of systemic lupus erythematosus(SLE) patients.Methods PBMCs were isolated by density gradient centrifugation from 10 active SLE patients,7 inactive SLE patients and 8 healthy volunteers.Chromatin immunopreeipitation linked to mieroarrays (ChIP-chip) was used to profile the variations in H3K4me3 in CpG island regions in PBMCs of SLE patients and controls.ChIP-qPCR was used to validate the mieroarray results.To confirm correlations between H3K4me3 and gene expression,expression analysis by qRT-PCR was performed on three randomly selected H3K4me3 candidates.Results 413 (137 increased and 276 decreased H3K4me3) and 393 genes (112 increased and 281 decreased H3K4me3) displayed significant differences in H3K4me3 between active and inactive SLE when compared with healthy SUhjeets.The results of ChiP-qPCR were consistent with microarray.ConclusiOn There are significant differences in H3K4me3 profiling between SLE and healthy subjects.These novel candidate genes may be potential biomarkers for future therapeutic targets.The ChIP-chip technology can help further reveal SLE molecular mechanisms and discover new therapeutic targets.

Objective To assess the incidence,clinic feature,pathological characteristics and prognosis of incidental prostate cancer from specimens via radical cystoprostatectomy (RCP) for muscleinvasive bladder cancer.The postoperative erectile function in patients with NVB operation are also to be evaluated.Methods Between Jan 2002 and Jan 2015,150 male patients with bladder cancer who underwent radical cystoprostatectomy in our center were included in this study.133 patients underwent open surgery and 17 cases underwent laparoscopic operation (13 patients underwent NVB operation).The average age of 150 patients was 63 years (ranging 41 to 83 years).The average tPSA was 3 ng/ml(ranging 0.2 to 7.8 ng/ml).The digital rectal examination was negative,CT results didnt exhibit the evident of abnormality in prostate.Results Overall,incidental prostate cancer was diagnosed in 11 male patients (7.3％).The pathological diagnosis are all prostatic adenocarcinoma.In those patients,the mean age was 65.5 years (ranging 42 to 82 years).The mean tPSA at the time of surgery was 2.6 ng/ml (0.3-4.0 ng/ml).There was no statistical significance of tPSA values in the incidental prostate cancer group and non risk group (2.6vs.3.2ng/ml)(P ＞ 0.05).The preoperative enhanced CT imaging showed normal prostate in 7 cases,prostate hyperplasia in 2 cases,prostate calcification in 1 cases and bladder cancer invasion into the prostate in 1 cases.9 cases of incidental prostate cancer are low risk grade (Gleason score ≤ 6,the clinical stage ≤T2).Among 11 cases,bladder cancer histologic type in 10 cases was transitional cell carcinoma and small cell carcinoma in 1 case.According to the TNM classification,4 cases were less than pT2 stage and 7 cases were more than pT3 stage.11 patients were followed up between 6 to 24 months (mean 10 months).All patient survived at the end of study without the treatment of castration.Among 13 cases accepted NVB operation,8 cases achieve the preoperative level of erectile function to achieve.Conclusions The rate of incidental prostate cancer from RCP specimens is low,Most patients have low risk level,and there was no statistical significance of tPSA values between the incidental prostate cancer group and non risk group.

Objective To investigate the prevalence of adult epileptic patients with interictal depression symptoms(IDs) and identify early predictors of IDs. Methods Adult patients with epilepsy were recruited ( n =110,45 females and 65 males) ,age between 16 and 67 years ( median 24 years). The sociodemographic and clinical factors of patients were recorded. Hamilton Depression Scale ( HAMD ) were applied to evaluate interictal symptoms of depression ( at least 72 hours after the last epileptic seizure). According to HAMD score,the epileptic patients were divided into IDs ( ≥8 ) and non-IDs(＜8) groups. The sociodemographic and clinical factors were compared between the two groups to identify the prevalence and early predictors of IDs in adult epileptic patients.Results The prevalence of IDs in adult patients with epilepsy was 38.2% ,49.0% in active epilepsy and 12.1 %in seizure freedom. 30.0% ,5.5% ,and 2.7% were experiencing mild-to-moderate (HAMD score≥8),moderateto-severe ( ≥ 18 ) and severe ( ≥25 ) depression. 42 patients who met the HAMD score≥8 were classified as IDs group,and the remaining 68 patients were classified as non-IDs group. With multiple stepwise backward logistic regreasion, independent predictors of IDs were epileptic seizures ( OR = 8. 845, P = 0. 003 ); symptomatic or cryprogenic epilepsy ( OR = 3.132, P = 0. 045 ); prolonged duration of illness ( OR = 1. 106, P = 0.004 ) and employment status (OR =0. 154, P=0.001 ). There were no relationship between seizure frequency and severity of IDs ( Kruskal-Wallis test, x2 = 4.5, P = 0. 104). Conclusion IDs is a frequent psychiatric comorbidity in adult patients with epilepsy. The prevalence of IDs is higher in those with active epilepsy compared with those in seizure freedom and most of them are mild-to-moderate. Epileptic seizure, symptomatic or cryprogenic epilepsy, prolonged duration of illness and employment status are independent predictors of IDs, but seizure frequency has nothing to do with the IDs severity of patients.

Objective To investigate surgical techniques for tibial plateau fractures involving the posterior column and the corresponding clinical effect.Methods From March 2009 to January 2012,32 patients with tibial plateau fracture involving the posterior column underwent surgical treatment in our hospital,including 21 males and 11 females,aged from 23 to 60 years (average,40.4 years).There were 30 cases of closed fracture and 2 cases of open fracture.Two patients combined with anterior cruciate ligament avulsion fracture,and 3 patients with posterior cruciate ligament avulsion fracture.Posterolateral and anteromedial approaches were used in 6 patients with posterolateral and medial columns fracture.Posteromedial and anterolateral approaches were used in 7 patients with posteromedial,medial and lateral columns fracture; a small anteromedial incision was added in 2 of them.Posteromedial and anterolateral approaches were used in 11 patients with posteromedial and lateral columns fracture.Posteromedial and posterolateral approaches were used in 2 patients with posteromedial and posterolateral columns fracture,while a single posteromedial approach was used in another patient with same fracture.Posteromedial and anterolateral approaches were used in 3 patients with posteromedial,posterolateral and lateral columns fracture,while posterolateral and anterolateral approaches were used in other 2 patients with same fracture.Results All patients obtained satisfactory exposure and reduction.They were followed up for 5 to 24 months (average,10.7 months).The average bone union time was 15.9 weeks,and the average time from operation to full weight-bearing was 18.1 weeks.The average range of motion of knee was 113.3°.According to HSS (Hospital for Special Surgery) score,the results were excellent in 22 cases,good in 6 cases,fair in 3 cases and bad in 1 case; the total excellent and good rate was 87.5％.Conclusion For tibial plateau fractures involving posterior column,satisfactory reduction and fixation can be obtained via posteromedial and posterolateral approaches which have many advantages such as earlier functional exercise,fewer complications and excellent clinical results.

As CD40 transduces activation signals involved in inflammatory and immune disorders, we explored the expression and response to CD40 engagement in human glioma cell lines in this study. The CD40 expression in BT-325 and U251 cells was flow cytometrically detected. The cells were incubated with srhCD40L for 72 h to assess its effects on cell growth in vitro. TNF-α expression was quantified by real-time PCR, and protein expression was analyzed by ELISA. The I-κb mRNA was detected by RT-PCR. I-κB expression decreased after stimulation with 1 μg/mL srhCD40L, but it was upregulated after the cells were pretreated with CD40 antibody. srhCD40L significantly inhibited the proliferation of the CD40+ human glioma cells. The stimulation of CD40+ glioma cells with soluble CD40L (CD154) up-regulated the expression of TNF-α at both mRNA and protein levels. We are led to conclude that CD40L/CD40 could inhibit human glioma cells through I-κb signaling pathway. Interferon-γ can augment CD40 expression and the inhibitory effect of CD40 ligand on cell growth in vitro. These results suggest that srhCD40L may benefit the therapy strategy of glioma.

Objective To identify the possible existing suppressive oligodeoxynucleotides(ODNs)in the DNA sequence which encodes Schistosoma japonicum 22.6 kDa(Sj22.6)antigen.Methods Several ODNs within the DNA sequence encoding Sj22.6 antigen were synthesized.Splenocytes separated from mice were stimulated with optimal immunostimulatory CpG 1826 in the absence or presence of different synthetical ODNs.The suppressive efficacy of each ODN was examined by 3H-TdR incorporation.Results ODN F311 suppressed the proliferation of splenocytes caused by CpG 1826 stimulation.The significant suppression was observed when ODN F311∶CpG 1826 at a ratio of 1∶1 and 3∶1,the suppression reached 11% and 58% respectively.The maximal inhibition was observed when ODN F311 was pre-administered with CpG ODN for 2 h.Conclusions Certain suppressive ODN exists in the DNA sequence encoding Sj22.6 antigen,and this effect shows dose-and time-dependent manner.