OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

BACKGROUND:Nano-size inorganic filling greatly improves mechanic characteristic of composite resin.However,its effects on pulp tissue remain unclear.OBJECTIVE:To evaluate the biocompatibility of FiltekTM Z350 nano-composite resin on dog pulp tissue by means of histology observation.DESIGN,TIME AND SETTING:Randomized control animal experiment was performed at the animal experiment center of Fuzhou General Hospital,Nanjing Military Area Command of Chinese PLA from April 2007 to April 2008.MATERIALS:Sixty healthy teeth from three adult male beagle dogs were recruited in this study.METHODS:Buccal Class V deep cavities were prepared in beagle dogs,which were then divided into four groups at random.FiltekTM Z350 resin,Dyract AP compomer and TPH resin were used to restore the cavities in three testing groups and glass ionomer cement was used as control.All cavities were treated with Clearfil SE BOND before filling.Intact healthy teeth were used as blank control.MAIN OUTCOME MEASURES:The pulp condition of each tooth was studied histologically.The remaining dentine thickness of each cavity was measured.RESULTS:After 7 days,mild inflammatory response was observed in most of the specimens.After 30 and 90 days,normal histological characteristics were observed in almost all specimens except TPH resin group.The histological structure disturbance of dentin cell layer emerged in some specimens of TPH group,which was higher than other testing groups(P 0.05).CONCLUSION:FiltekTM Z350 nano-composite resin has similar biocompatibility as Dyract AP compomer and glass ionomer cement,better than TPH resin.

Objective To explore the effect of the synthetic rehabilitation therapy for the stroke patients with cognitive deficits,and the improvement of the patients'motor function and independent living ability.Methods The synthetic rehabilitation therapy was carried out in 136 stroke patients with cognitive deficits.The synthetic rehabilitation therapy including :acupuncture,hyperbaric oxygen therapy ,cognitive training and physical therapy etc.The patients'cognitive function,motor function and independent living ability were evaluated and analyzed statistically before and after the treatment.Results the patients'cognitive function,motor function and independent living ability are significantly higher after the treatment (P＜0.01).Conduston The synthetic rehabilitation therapy can significantly improve the cognitive function of the patients with cognitive deficits,and it can improve their motor function and independent living ability.

OBJECTIVETo observe the effect of tensile stress on human heel skin fibroblast proliferation in vitro, providing a theoretical basis for preventing the wound edge skin necrosis and nonunion after calcaneal fracture surgery.

METHODSFibroblast cells were taken from lateral heel skin of a 40 year-old-man, then cultured and subcultured in vitro. After that, they were divided into three groups: 0 hours group, 6 hours group and 24 hours group and were tested by tensile stress testing. The levels of TGF-β1 and IL-6 in nutrient fluid were measured. Transmission electron microscope and light microscope was applied for observe mitochondria and nucleus.

RESULTSUnder 10% of the tensile stress, mitochondria decreased, the levels of TGF-β1 and IL-6 in nutrient fluid were decreased and cell proliferation was inhibited gradually with time increasing.

CONCLUSIONThe human lateral heel skin in a long-time tensile stress state is an important cause of wound edge skin necrosis and nonunion after calcaneus fracture surgery.

Adult ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; chemistry ; cytology ; Heel ; physiology ; Humans ; In Vitro Techniques ; Interleukin-6 ; metabolism ; Male ; Skin ; chemistry ; cytology ; metabolism ; Tensile Strength ; Transforming Growth Factor beta1 ; metabolism

Adult ; Cardiovascular Diseases ; physiopathology ; Cardiovascular Physiological Phenomena ; Case-Control Studies ; Female ; Heart ; physiopathology ; Humans ; Pregnancy ; Sports ; Stress, Psychological ; physiopathology

AIM:To investigate the role of microRNA-486-5p (miR-486-5p) in the apoptosis of human bone marrow mesenchymal stem cells (hMSCs) induced by hydrogen peroxide (H2O2).METHODS: The hMSCs were cul-tured in vitro and exposed to serum-free medium and H2O2(10 mmol/L).The changes of miR-486-5p expression in oxida-tive stress-related apoptosis of hMSCs were measured by real-time PCR.The hMSCs were transfected with miR-486-5p mimic or inhibitor at concentration of 30 nmol/L by Lipofectamine RNAiMAX.The effect of miR-486-5p on H2 O2-induced decrease in cell viability was evaluated by MTT assay.Hoechst 33342 staining and flow cytometry were applied to determine the role of miR-486-5p in the apoptosis of hMSCs.The protein expression was evaluated by Western blotting.Caspase-3 ac-tivity was determined using a caspase-3 activity kit.RESULTS:Compared with control group, the expression of miR-486-5p significantly decreased after treated with H2O2(P<0.05).In addition, over-expression of miR-486-5p in the hMSCs reduced the cell viability, accelerated apoptosis, down-regulated Bcl-2/Bax ratio, caspase-3 enzyme precursor content and phosphorylation of Akt, and activated caspase-3 activity.Conversely, down-regulation of miR-486-5p significantly inhibited H2 O2-induced cell apoptosis and the caspase-3 activity, increased cell viability and up-regulated Bcl-2/Bax ratio and phos-phorylation level of Akt.CONCLUSION:Over-expression of miR-486-5p promotes H2 O2-induced hMSCs apoptosis, and repression of miR-486-5p protects hMSCs from H2 O2-induced cellular apoptosis, which may be mediated by regulating Akt signaling pathway.

Objective To investigate the method and clinical effect of interventional treatment on placenta increta.Methods Fifteen patients with placenta increta were treated interventionally through uterine artery.and Methotrexate 50-100 mg were superselectively infused.Then gel foam particulate or stripes were used for embolization of uterine artery.The therapeutic effect,prognosis and side effects were observed and analyzed.Results All patients underwent uterine artery embolization (UAE) .One week after UAE,curettage was successfully performed.No heavily hemorrhage nor hysterectomy occurred.Conclusion Transcatheter uterine artery intervention is simple,safe and effective with highly successful rate and has little side effects for the treatment of placenta increta.

Background Diabetic retinopathy (DR) leads to blindness because of the retinal angiogenesis caused by the ischemia of retina.Vascular endothelial growth inhibitor (VEGI) is a recently identified anti-angiogenic cytokine,which can suppress endothelial cell proliferation and angiogenesis.Objective The aim of this study was to detect the change of serum and vitreous VEGI/TL1A and its relative cytokines in patients with DR.Methods A non-randomized controlled clinical trial was performed.Fifty-five DR patients were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent.The patients were divided into non-proliferative DR (NPDR) group (20 cases) and PDR group (35 cases).Eleven cataract patients served as normal control group,and 15 patients with diabetic mellitus (DM) were included as DM group.The demography was matched among the groups,but the course of DM and the blood glucose level were elevated in the PDR group and the DM group compared with DR group (all at P＜0.05).We collected the serum of all the patients above.Another 23 PDR patients (25 eyes) were enrolled in Tianjin Medical University General Hospital from November 2012 to March 2013 with the informed consent and served as PDR group,healthy corpse's eyes (n=7) as control group,the patients were assigned to the retinal photocoagulation group,surgery group and photocoagulation +surgery group according to different treatment procedures.Vitreous samples were collected during the progress of vitrectomy.TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 concentrations in the serum and vitreous specimens were detected using ELISA.The differences of serum and vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1β and NF-κB p65 in various groups were statistically analyzed by ANOVA and independent sample t test,respectively.The correlation between TL1A/VEGI 251 and VEGF,TNF-α,IL-1β,NF-κB p65 were calculated by Pearson correlation analysis.Results TL1A/VEGI 251 concentration was elevated in the DM group,NPDR group and PDR group compared with the normal control group,with significant difference among the 4 group (F =27.431,P =0.009),and TL1A/VEGI 251 concentration was higher in the PDR group than that in the DM group or the NPDR group (P＜0.05).VEGF,TNF-α,IL-1 β and NF-κB p65 concentrations in serum were increased in the PDR group in comparison with the DM group,NPDR group and the normal control group (P＜0.05).However,no significant difference among the DM group,NPDR group and the normal control group (P＞0.05).Serum TL1A/VEGI 251 concentration was significant correlated with VEGF,TNF-α,IL-1β and NF-κB p65 concentration (r=0.951,0.951,0.851,0.944,all at P＜0.01).Vitreous TL1A/VEGI 251,VEGF,TNF-α,IL-1 β concentrations were ascended in the PDR group compared with the normal control group (P =0.024,0.001,0.000,0.037),but there was no significantly difference in vitreous NF-κB p65 concentration between the two groups (P =0.073).Vitreous TL1A/VEGI 251 concentrations declined in the retinal photocoagulation group and the surgery group compared with the normal group (all at P＜ 0.05),and significant positive correlations were found between vitreous TL1A/VEGI 251 concentration and VEGF or TNF-α concentration (r =0.675,0.950,P ＜ 0.01) ;while Pearson correlation coefficient was not statistically significant between vitreous TL1A/VEGI 251 concentration and IL-1β or NF-κB p65 concentration (r=0.233,0.318,P＞0.05).Conclusions VEGI is involved in the pathogenesis of DR,and it interacts with VEGF,TNF-α,IL-1β and NF-κB to affect the development of DR.These results provide a new clue for the further study of DR.

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) in the macroscopic classification of rectal carcinoma. Methods Seventy-one patients with rectal carcinoma were examined by ultrasound after intrarectal infusion and intravenous bolus injection of SonoVue preoperatively. And three types were divided according to the shape of the tumor:protruding type, ulcerative type and invasive type. After surgery, DCUS and perfusion contrast-enhanced ultrasonography (PCUS) were compared with final pathologic results respectively, and the relationship between general tumor type and TN staging were analyzed.Results The accuracy of DCUS [88.7%(63/71) ] in macroscopic classification of rectal carcinoma was significantly higher than that of PCUS [73.2%(52/71) ](χ2=5.534,P<0.05). For the invasion depth into the intestinal wall, the protruding type was mainly in T1, T2 and T3 stages while ulcerative and invasive type in T2, T3 and T4 stages (χ2=12.322, P<0.05 ). For the stage of lymph node, the protruding type was mainly in N0 and N1 while ulcerative and invasive type in N1 and N2(χ2=6.733,P < 0.05 ). Conclusions DCUS, with its high accuracy, is a new valuable method for macroscopic classification of rectal carcinoma.In the aspect of intestinal wall invasion and the lymph node, protruding type is less severe than ulcerative type and invasive type.