OBJECTIVE: To explore the feasibility and effectiveness of suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique for avulsion fractures of the inferior pole of the patella. METHODS: A clinical data of 38 patients with avulsion fractures of the inferior pole of the patella, who met the selective criteria and were admitted between September 2021 and April 2023, was retrospectively analyzed. The fractures were treated with suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique in 18 cases (group A) and steel wire tension-band fixation in 20 cases (group B). There was no significant difference in terms of age, gender, cause of fracture, side of fracture, and disease duration between the two groups ( P>0.05). The length of incision, operation time, occurrence of complications, the range of motion of knee joint, and Böstman score of knee joint at last follow-up were recorded. The fracture healing was evaluated through X-ray films and the time of fracture healing was recorded. RESULTS: All incisions healed by first intention. The length of incision was significantly shorter in group A than in group B ( P<0.05). There was no significant difference in the operation time between the two groups ( P>0.05). All patients were followed up 12-24 months (mean, 16.1 months). X-ray films showed that all fractures healed and there was no significant difference in the healing time between the two groups ( P>0.05). At last follow-up, the range of motion and Böstman score of the knee joint in group A were significantly better than those in group B ( P<0.05). During follow-up, 1 patient (5.6%) in group A had one anchor mild prolapse and 3 patients (15.0%) occured internal fixation irritation in group B. But there was no significant difference in the incidence of complications between the two groups ( P>0.05). CONCLUSION For the avulsion fractures of the inferior pole of the patella, the suture anchor double-pulley technique combined with suture three-dimensional binding via bone tunnel technique has advantages of reliable fixation, small incision, avoidance of secondary operation to remove internal fixator, and fewer complications, with definite effectiveness.
Humans ; Male ; Female ; Patella/surgery* ; Suture Anchors ; Fracture Fixation, Internal/instrumentation* ; Adult ; Retrospective Studies ; Middle Aged ; Fractures, Avulsion/surgery* ; Treatment Outcome ; Young Adult ; Range of Motion, Articular ; Fracture Healing ; Adolescent ; Suture Techniques ; Knee Joint/physiopathology*

OBJECTIVE: To compare the effectiveness of using a composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process and using a clavicular hook plate for fixation in treatment of Rockwood type Ⅲ acute acromioclavicular joint dislocation. METHODS: A retrospective analysis was conducted on the clinical data of 60 patients with Rockwood type Ⅲ acute acromioclavicular joint dislocation who were admitted between June 2022 and September 2023 and met the selection criteria. Among them, 30 patients were treated with the composite loop plate to reconstruct the coracoclavicular ligament around the coracoid process (loop plate group) and 30 with clavicular hook plate fixation (hook plate group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, injured side, cause of injury, disease duration, preoperative visual analogue scale (VAS) score for pain, and Constant-Murley score. The incision length, operation time, length of hospital stay, and the occurrence of complications during follow-up were recorded. The Constant-Murley score and VAS score were used to evaluate shoulder joint function and pain, and the differences (change values) of the indicators between before operation and at 6 months after operation were calculated for inter-group comparison. In the loop plate group, the coracoclavicular distance (CCD) on the anteroposterior X-ray films of the acromioclavicular joint was measured at 1 day and 6 months after operation to assess the loss of acromioclavicular joint reduction. RESULTS: The incision length of the loop plate group was significantly shorter than that of the hook plate group ( P<0.05). There was no significant difference in the operation time and the length of hospital stay between the two groups ( P>0.05). All incisions healed by first intention after operation. All patients were followed up 12-18 months (mean, 16.3 months). There was no significant difference in the follow-up time between groups ( P>0.05). The Constant-Murley scores and VAS scores of both groups significantly improved at 6 months after operation when compared with those before operation ( P<0.05); the differences in the change values of the two indicators between groups were significant ( P<0.05). The CCD of the loop plate group were (10.40±0.83) mm at 1 day and (10.70±0.68) mm at 6 months and no repositioning loss was observed. Three cases in the hook plate group had residual shoulder joint pain after operation. The difference in the accidence of complications between groups was not significant ( P>0.05). CONCLUSION For Rockwood type Ⅲ acute acromioclavicular joint dislocation, compared with the clavicular hook plate fixation, the composite loop plate for reconstructing the coracoclavicular ligament around the coracoid process has the advantages of simple operation, safety, minimally invasive, good functional recovery, and fewer complications. Moreover, it avoids the need for a second surgery to remove the internal fixation device, and the patient acceptance and satisfaction are higher.
Humans ; Acromioclavicular Joint/surgery* ; Bone Plates ; Male ; Retrospective Studies ; Female ; Adult ; Ligaments, Articular/injuries* ; Joint Dislocations/surgery* ; Coracoid Process/injuries* ; Treatment Outcome ; Middle Aged ; Plastic Surgery Procedures/instrumentation* ; Fracture Fixation, Internal/instrumentation* ; Young Adult ; Clavicle/surgery*

Objective: To evaluate the effectiveness of SRS-Schwab grade Ⅳ osteotomy combined with satellite rod for thoracolumbar old osteoporotic fracture with severe kyphosis. Methods: Between April 2013 and August 2016, 20 cases of thoracolumbar old osteoporotic fracture with severe kyphosis were treated with SRS-Schwab grade Ⅳ osteotomy combined with satellite rod. All the patients were females, aged 49-71 years (mean, 54.8 years). The disease duration was 6-28 months with an average of 14 months. The T value of bone density was -4.4 to -1.8 (mean, -2.8). The preoperative Cobb angle was (43.0±11.3)°. The vertebral compression fracture segment was T 12 in 9 cases, L 1 in 8 cases, and L 2 in 3 cases. Preoperative spinal cord function was evaluated by Frankel classification; there were 5 cases of grade D and 15 cases of grade E. The operation time, intraoperative blood loss, and perioperative complication were recorded. The Cobb angle for kyphosis and sagittal vertical axis (SVA) were recorded beforeoperation, at 3 months after operation, and at last follow-up. Oswestry disability index (ODI) was used to evaluate the effectiveness before operation and at last follow-up, and the evaluation indicators included pain degree, daily life self-care ability, extracting, walking, sitting, standing, sleeping, social activities, and traveling. Results: The operation time was 180-314 minutes (mean, 226 minutes). The intraoperative blood loss was 390-1 800 mL (mean, 750 mL). All the incisions healed by first intension without incision infection. Twenty patients were followed up 24-52 months, with an average of 30.9 months. During the follow-up period, no significant complication such as correction loss, nail breakage, rod breakage, pseudoarthrosis formation, or proximal and distal junctional kyphosis occurred. All patients were able to walk upright after operation, and the pain relieved significantly at 6 months after operation. Bone fusion achieved at 12 months after operation. The Frankel grade of nerve function improved from grade D to grade E at last follow-up in 5 patients with nerve damage before operation. At last follow-up, the indicator scores of ODI significantly improved when compared with preoperative values ( P<0.05). Cobb angle significantly improved at 3 months after operation and at last follow-up ( P<0.05) when compared with preoperative one, but there was no significant difference in the Cobb angles between 3 months after operation and last follow-up ( P>0.05). There was no significant difference in SVA between pre- and post-operation ( P>0.05). Conclusion: SRS-Schwab grade Ⅳ osteotomy combined with satellite rod for thoracolumbar old osteoporotic fracture with severe kyphosis is effective in achieving satisfactory clinical outcomes, as well as maintaining correction of kyphosis.

Paget's disease of bone (PDB) is a common metabolic bone disease that is characterized by aberrant focal bone remodeling, which is caused by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. Genetic factors are a critical determinant of PDB pathogenesis, and several susceptibility genes and loci have been reported, including SQSTM1, TNFSF11A, TNFRSF11B, VCP, OPTN, CSF1 and DCSTAMP. Herein, we report a case of Chinese familial PDB without mutations in known genes and identify a novel c.163G>C (p.Val55Leu) mutation in FKBP5 (encodes FK506-binding protein 51, FKBP51) associated with PDB using whole-exome sequencing. Mutant FKBP51 enhanced the Akt phosphorylation and kinase activity in cells. A study of osteoclast function using FKBP51V55L KI transgenic mice proved that osteoclast precursors from FKBP51V55L mice were hyperresponsive to RANKL, and osteoclasts derived from FKBP51V55L mice displayed more intensive bone resorbing activity than did FKBP51WT controls. The osteoclast-specific molecules tartrate-resistant acid phosphatase, osteoclast-associated receptor and transcription factor NFATC1 were increased in bone marrow-derived monocyte/macrophage cells (BMMs) from FKBP51V55L mice during osteoclast differentiation. However, c-fos expression showed no significant difference in the wild-type and mutant groups. Akt phosphorylation in FKBP51V55L BMMs was elevated in response to RANKL. In contrast, IκB degradation, ERK phosphorylation and LC3II expression showed no difference in wild-type and mutant BMMs. Micro-CT analysis revealed an intensive trabecular bone resorption pattern in FKBP51V55L mice, and suspicious osteolytic bone lesions were noted in three-dimensional reconstruction of distal femurs from mutant mice. These results demonstrate that the mutant FKBP51V55L promotes osteoclastogenesis and function, which could subsequently participate in PDB development.
Acid Phosphatase ; Animals ; Asian Continental Ancestry Group ; Bone Diseases, Metabolic ; Bone Remodeling ; Bone Resorption ; Femur ; Humans ; Mice ; Mice, Transgenic ; Osteitis Deformans* ; Osteoblasts ; Osteoclasts ; Osteogenesis ; Phosphorylation ; Phosphotransferases ; Tacrolimus Binding Proteins ; Transcription Factors

OBJECTIVETo investigate the role of matrix metalloproteinase-7 (MMP-7) expression in caricinogenesis and progression of gastric cancer.

METHODSWe studied MMP-7 expression and microvessel density (MVD) in adjacent mucosa and primary foci of 113 cases of gastric cancer by streptavidin-biotin-immunoperoxidase method using anti-MMP-7 and anti-CD34 antibodies. MMP-7 expression and mean MVD were compared with clinicopathological features of gastric cancer, with the relationship between MMP-7 expression and MVD concerned in gastric cancer.

RESULTSMMP-7 showed positive expression in adjacent mucosa of gastric cancer (29.20%, 33/113), less than that in gastric cancer (69.03%, 78/113). MMP-7 expression in primary foci of gastric cancer was positively correlated with tumor size, invasive depth, metastasis and TNM staging (P<0.05), but not with differentiation or growth pattern of gastric cancer (P>0.05). Positive correlation of mean MVD with tumor size, invasive depth, metastasis and TNM staging was found (P<0.05), despite no relationship between mean MVD and differentiation of gastric cancer (P>0.05). Mean MVD was dependent on MMP-7 expression in gastric cancer (P<0.05).

CONCLUSIONUpregulated expression of MMP-7 played an important role in carcinogenesis and progression by participating in growth, invasion, metastasis and angiogenesis of gastric cancer. MMP-7 expression could be regarded as an effective and objective marker to reflect the biological behaviors of gastric cancer.

Biomarkers, Tumor ; metabolism ; Humans ; Lymphatic Metastasis ; Matrix Metalloproteinase 7 ; metabolism ; Neoplasm Invasiveness ; Neoplasm Staging ; Neovascularization, Pathologic ; pathology ; Stomach Neoplasms ; blood supply ; metabolism ; pathology

Objective To develop a novel synergism compound suspension concentrate of niclosamide and chlorphoxim (Co-SCN) and sdudy its characteristics. Methods Niclosamide and chlorphoxim were milled by a ball mill and mixed with different amounts of wetting agent. disper-sant agent, thickener, and water etc. , to develop Co-SCN, and the pH value, thickener, grain size were evaluated. The ultraviolet absorption spectrum of niclosamide and chlorphoxim were measured. The content of niclosamide and chlorphoxim in the solution were assayed by HPLC. Results Co-SCN was a gray thickener fluidity liquid. It was very easy to disperse and could be mixed with water in any proportion. Its pH was 8. 65 and thickener was 137 mpa? s. The grain sizes (diameter) were from 0. 138-19. 953 ?m. Of them more than 95. 6% was smaller than 10 ?m and more than 82. 24% was smaller than 5 ?m. There were three peaks of ultraviolet absorption spectrum for niclosamide: 210, 234 nm and 334 nm respectively. One peak of chlorphoxim was at 269 nm. The novel formulation contained 20.64% niclosamide and 5.26% chlorphoxim. The suspension stability of Co-SCN was 100% for 2 hours and 89. 14% for 4 hours, and otherwise WPN in water was speedy sediment. Conclusion The novel synergism compound suspension concentrate of niclosamide and chlorphoxim is a stable quality and standard formulation.

Objective To understand whether the breeding time of snails influences the evaluation on molluscicidal efficacy against Oncomelania snails so as to make a standardization of methods for screening molluscicides in laboratory. Methods Snails collected from the endemic areas in Nanjing and Tongling cities bred for 1,6,11,16,21.31,61 and 91 days respectively, and then were immersed in 1.000 0,0.500 0,0.250 0,0.125 0,0.062 5 and 0.031 3 mg/L solution of niclosamide for 24 and 48 hours at 25℃ in laboratory. Results One hundred percent killing rate was achieved in the groups of the snails bred for 1 - 11 days and immersed in 1.0 mg/L niclosamide for 24 hours. The LC_(50) concentrations of snails collected from Nanjing, Jiangsu Province and immersed for 24 hours varied from 0.094 7 to 0.133 9 mg/L, and for 48 hours from 0.071 8 to 0.092 6 mg/L.Those of snails collected from Tongling, Anhui Province for 24 hours varied from 0.082 5 to 0.103 9 mg/L, and for 48 hours from 0. 071 8 to 0.082 5 mg/L. The molluscicidal effect was unstable in the groups of snails bred for more than 16 days. There was a significant difference (X_(Nanjing24 h)~2 = 22.26,P

Objective To screen and identify B cell epitopes in SAG1, SAG2, SAG3, GRA1, GRA6 and P35 antigens of Toxoplasma gondii. Methods The indexes such as hydrophilicity, accessibility, flexibility, secondary structure and polarity of the 6 antigen moleculars above mentioned were analyzed by BioSun system. Two B cell epitopes with high antigenicity from each antigen molecular were selected, and the total twelve pairs of oligonucleotide chains were designed according to the 12 B cell epitopes’ sequence and synthesized, then cloned into plasmid pET-32c. The 12 fragment B cell epitopes were expressed and the expressed fusion proteins were identified with Western blot. Results Twelve B cell epitopes from 6 Toxoplasma antigens (two from each antigen) were predicted and selected. The epitope genes were successfully cloned into pET-32c and expressed. Western blot results showed that 3 of 12 expressed fusion proteins could be recognized by the immunized rabbit sera with soluble antigen of Toxoplasma gondii, but not by the unimmunized rabbit sera Conclusion Three B cell epitopes of Toxoplasma[with potential diagnostic value are obtained.

Objective To enhance the protective immunity effects of nucleic acid vaccines against Schistosoma japonicum infection by electroporation(EP)in vivo in infected BALB/c mice.Methods Plasmids and proteins for immunization were prepared and diluted in no bacterial saline solution to final concentration of 1.5 mg/ml.pcDNA3.1-SjC23,pcDNA3.1-SjCTPI,pcDNA3.1-(CDR3)6 plasmid DNAs were mixed by equal volume to form the cocktail DNA vaccine,and also mixed with recombinant proteins SjC23-HD,SjCTPI,and NP30 by equal volume to form the cocktail protein vaccine.Seventy female BALB/c mice of 4-5 weeks old were randomly divided into 5 groups(A,B,C,D,E).In Group A(control group),each mouse was immunized with 100 ?l saline solution by intramuscular(i.m.);in Group B(pcDNA3.1/EP control group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 followed by EP in vivo for three times at week 0,3,6;in Group C(pcDNA3.1/EP plus cocktail protein vaccine group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 followed by EP for three times at week 0,3,6 and boosted with 100 ?l cocktail protein vaccine plus 100 ?l FCA by subcutaneous at week 9;in Group D(cocktail DNA vaccine/EP group),each mouse was immunized(i.m.)with 100 ?l cocktail DNA vaccine followed by EP for three times at week 0,3,6;in Group E(cocktail DNA vaccine/EP plus cocktail protein vaccine group),each mouse was immunized(i.m.)with 100 ?l cocktail DNA vaccine followed by EP for three times at week 0,3,6 and boosted with 100 ?l cocktail protein vaccine plus 100 ?l FCA by subcutaneous at week 9.Four weeks after the last DNA immunization or two weeks after protein boosting,all the mice were challenged with(40?1)cercariae of Schistosoma japonicum by abdominal skin penetration.Forty-two days post-challenge,the mice were sacrificed and perfused,and the numbers of recovered worms and eggs in liver were counted.The blood was collected from the tail veins of all the mice two days before the first immunization and challenge,respectively,the serum was prepared for detection of IgG,IgG1 and IgG2a.Two days before the challenge,the spleen cells of two mice from each group were cultured and stimulated with ConA and soluble egg antigen(SEA),and the supernatant was collected for detection of IL-2,IL-4 and IFN-? by flow cytometre.Results The worm reduction rates in Group C,D and E were 18.09%,45.00% and 57.09%,respectively,compared with the control group.The worm reduction rates in Group D and E were significantly higher than that in Group C(P

Objective To understand the potential impact of south-north water transfer project on transmission and distribution of Schistosomiasis japonica, and to put forward the countermea-sures of prevention of the disease transferring into other places. Methods The information on the progress of south-north water transfer project and factors related to the distribution of Schistosoma juponicum were collected, and the suggestions on improving the countermeasures were obtained through the group discussions and field visits. Results The potential impact of the project on the disease transferring is existed, mainly the disease transferring will be through the Lixia River basin in Jiangsu Province, and Chaohu areas of Anhui Province in the east route, and Sihu areas of Hubei Province in the middle route. The snail transferring northward will be affected both by the project and global warming, as a result, the endemic areas of Schistosomiasis will probably transfer into the Hongzehu and Chaohu areas in the future. Conclusion In the east route of the project, if the project is not combined with Schistosomiasis control, the endemic areas of Schistosomiasis will extend into other regions, the loss in the society and economy will be very large.