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 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.

ObjectiveTo investigate the genomic and non-genomic effects of 17β-estradiol on gallbladder smooth muscle strips of guinea pig and their possible mechanism. MethodsAfter ovariectomized operation (OVX) and subcutaneous injection of 17β-estradiol, the contents of serum estradiol and cholecystokinin-octopeptide (CCK-8) of the sham operation group (Sham) guinea pigs, the OVX group, the OVX and subcutaneous injection 17β-estradiol for 1 day (OVX+E2, 1 d), 3 days (OVX+E2, 3 d) and 7 days (OVX+E2, 7 d) were detected by EILSA respectively. The effects of CCK-8/Ach on constriction of gallbladder muscle strip were observed among various groups by using tension transducer, and the acute effects of 17β-estradiol on guinea pig gallbladder smooth muscle strips were observed to probe its possible mechanism. ResultsCompared with the Sham group, the serum contents of estradiol and CCK-8 decreased in OVX group (P＜ 0. 05) whereas the sensitivity of OVX guinea pigs gallbladder muscle strips to CCK-8/Ach increased (P＜0.05). With the extension of the subcutaneous injection 17β-estradiol time (for 1, 3, 7 days), both the serum estradiol and CCK level increased (P＜ 0.05) while the guinea pig gallbladder strips sensitivity to CCK-8/Ach decreased (P＜0.05).17β-estradiol at concentration ranging from 10 9 to 10-7 mol/L have no effect on the guinea pig gallbladder strips contraction (P＞0.05), but at concentration of 10-6 and 10 5 mol/L, it can inhibit the gallbladder contraction (P＜0.05). The blocking agents, such as nimodipine, atropine, devazepide, ICI 182,780 and Y-27632, can block the inhibited effects of 17β-estradiol. ConclusionThe 17β-estradiol can affect the gallbladder motility, both by genomic and non-genomic pathway.

Objective To study the potential therapeutic effect of potassium antimonyl tartrate (PAT) on human colon cancer in transplanted tumor nude mice models. MethodsSixty transplanted animal models were constructed with colon cancer cell line SW480 injected in nude mice. Nude mice were then random divided into 4 groups ( n = 15) :Normal saline group, 5-Fu group and different dose of PAT groups [ (20 mg/( Kg · d) ,40 mg/( Kg · d) ]. The volume of mass was measured every 3 days. After final-administration for 24 hours, immunohistochemical staining was used to detect the expression of PCNA in colon cancer cells. ResultsAfter the use of PAT, the growth of mass slowed down. PCNA levels [ (63. 63 ±8. 88)％ ,(59. 13 ±6. 15)％ ,(33. 38 ± 12. 76)％ ] in SW480 cells was reduced by PAT( P <0. 05, P <0. 01 ). ConclusionPAT potentially inhibited the growth of colon cell lines and induced apoptosis of SW480 colon cancer cells.

Objective To assess the neuropsychological characteristics in active epileptic patients and investigate itsrisk factors. Methods Ninety adult epileptic patients included 60 active epileptic patients (two or more unprovoked seizures within 12 months) and 30 age-, sex-, education-, course of disease- and seizure type-matched seizure-free subjects (without epileptic seizure for at least 1 year) . The neuropsychological tests including trail making test,digit symbol test, verbal fluency test,digit span test and hamilton depression scale( HAMD) ,were used to detect mental and motor speed, attention, language, working memory and depression symptoms respectively. The neuropsychological tests were compared between active and seizure-free epileptic patients and identified the risk factors of neuropsychological deficits in active epileptic patients. Results Compared to seizure-free subjects, active epileptic patients had significantly worse scores in digit symbol test, verbal fluency test, digit span test ((47.45 ±18. 812) vs(56.40 ±13. 631), (25. 25 ±8. 163) vs(30.40 ±8. 414), (10. 39 ±2. 228) vs( 11. 80 ± 2.074) respectively) ; more time to accomplish the trail making test A and B((64. 35 ±31.710) vs( 45. 47 ± 16. 309) , ( 133. 18 ± 47. 331 ) vs ( 98. 00 ± 35. 003 ) respectively) ; and higher scores in depressive symptoms ((9.12 ±6.219)vs(3.77 ±3.997) ,all P<0.05). Within active epileptic group,significant predictors of neuropsychological deficits were identified in a stepwise linear regression analysis: advancing age was significantly negatively correlated with digit symbol test(β = -0. 468, P = 0. 000) , digit span test (β = -0. 439, P = 0. 000), trail making test A (β =0.365, P = 0.003) and B(β = 0.346, P=0.002) ; higher scores on depressive symptoms was significantly negatively correlated with digit symbol test (β = -0.244, P = 0.015) ; mental work,high-education level and monotherapy were positively correlated with some of the cognitive function subscales. Conclusion This study suggests that active epilepsy can have a direct adverse effect on cognition and depression symptoms. Multi-drug therapy, severity of depression symptoms, advancing age, low-education level and non-mental work are the predictors of neuropsychological impairment in active epilepsy. In addition, good seizure control even after 1 year can have a beneficial impact on cognitive and depression prognosis.

Objective The aim of this study was designed to investigate the changes of macrophages and activated microglias in white matter damage (WMD) in premature infants and effects of allopurinol. Methods An animal model for WMD was established by bilateral carotid artery occulation (BCAO). Forty-two newborn SD rats (1 day old) were divided randomly into 3 groups: sham surgery group (Sham), BCAO group (BCAO) and allopurinol treated group (ALLO). Pathological changes were studied 7 days and 14 days after BCAO, respectively. Macrophages and activated microglias were detected by immunohistochemistry 7 days and 14 days after BCAO, respectively. Results In BCAO group, Ten cases had mild or severe rarefaction in the corpus callosum area, especially at the cingulum. Pathological changes of white matter were found in 4 cases in internal capsule. Eight cases had subcortex white matter rarefaction. The extent of white matter rarefaction in ALLO group was reduced significantly. Enlargement of bilateral ventricles was found in 6 of 8 cases in BCAO group. Compared to BCAD group [(3.27±0.73)%] the average ventricle size was reduced significantly in ALLO group [(2.44±0.71)%] (P<0.05). ED1 positive cells were found in corpus callosum,hippocampus, and internal capsule in all groups. BCAO group had more ED1 positive cells than the other two groups, and the staining extent in BCAO group was stronger than that in the other two groups. Conclusions BCAO could be used in newborn rats (1 day old) to establish a premature WMD animal model. Macrophages and microglias may play an important role in premature WMD. ALLO may have a potential protective effect on premature SD rat with ischemic WMD.