OBJECTIVE: To evaluate the effects of two different femoral cortical suspension devices (fixation loop and adjustable loop) on tunnel widening and knee function in patients following anterior cruciate ligament reconstruction for 12 months. METHODS: A total of 60 patients who had undergone anterior cruciate ligament reconstruction were included in this study. According to the length of the loop(n)[n= total length of loop-(total length of femoral tunnel-total length of coarse tunnel)] in the rough bone tunnel, the patients were divided into A (adjustable loop was 0 mm in the coarse bone tunnel), B (fixation loop was greater than 0 mm and less than or equal to 10 mm in the coarse bone tunnel) and C (fixation loop was greater than 10 mm in the coarse bone tunnel) groups, of which 11 cases were in group A, 27 cases in group B and 22 cases in group C. In the three-dimensional reconstruction of the knee joint with multi-slice spiral CT, the widening of the bone tunnel in the three groups was compared. At the same time, IKDC, Lysholm and Tegner scores of the patients in the three groups were compared. RESULTS: There were differences in the widening degree of the femoral canal among groups A, B and C, and the median difference of the widening degree of the femoral tunnel 12 months and immediately after the surgery was A < B < C. The difference of femoral canal widening in group A was significantly different from that in groups B and C (P < 0.05).According to the linear regression the relationship between the difference of the width of the femoral canal and the change of the length (n) of the loop in the coarse canal, it was found that there was a linear relationship between the value of n and the difference of the width of the bone canal. With the increase of the value of n, the difference of the width of the bone canal gradually became larger. The median difference of the width of the middle and superior tunnel was negative, while the median difference of the width of the middle and inferior tunnel was positive. During the follow-up, we found that there were no statistical differences in IKDC, Lysholm and Tegner scores among the three groups one year after surgery (P > 0.05). CONCLUSION Twelve months after surgery, compared with group B (fixed loop group) and group C (fixed loop group), group A (adjustable loop group) had less bone tunnel widening.In groups A, B and C, as the length of the loop in coarse bone tunnel gradually increased, the width of bone tunnel became more significant. At the end of 12 months follow-up after anterior cruciate ligament reconstruction, the medial and inferior femoral tunnel was significantly wider than immediately after surgery, and the medial and superior femoral tunnel had gradually begun to undergo tendon-bone healing. There was no significant difference in knee function scores among groups A, B, and C in the follow-up 12 months after surgery.
Anterior Cruciate Ligament Injuries/surgery* ; Anterior Cruciate Ligament Reconstruction ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Tendons ; Treatment Outcome

To explore influence of dual antiplatelet therapy combined different dose of atorvastatin calci‐um on serum levels of monocyte chemoattractant protein (MCP)‐1 and vascular endothelial cadherin (VE‐cadherin) in patients with acute cerebral infarction atorvastatin routine dose group (ACI).Methods :A total of 119 ACI patients admitted in our hospital from 2016 to 2017 were randomly divided into atorvastatin routine dose group (n＝61) and large dose group (n＝58 ,40mg ,once／d) ,both groups received routine treatment and aspirin + clopidogrel for 30d. NIHSS ,serum levels of hsCRP ,TNF‐α ,IL‐8 ,MCP‐1 and VE‐cadherin ,carotid atherosclerotic plaque size and IMT before and after treatment ,and incidence of adverse reactions were measured and compared between two groups . Results :Compared with before treatment ,there was significant reduction in NIHSS score after 15d and 30d in two groups ,and those of 30d were significantly lower than those of 15d ,P＝0. 001 all ;compared with routine dose group after 15d and 30d ,there was significant reduction in NIHSS score [15d :(5.32 ± 1. 63 ) scores vs .(4. 13 ± 1.25 ) scores] in large dose group ,P＝ 0.001 ;Compared with routine dose group after 30d ,there were significant reduc‐tions in serum levels of hsCRP [(9.37 ± 1.85)mg／L vs.(6. 35 ± 1.94)mg／L] ,TNF‐α[(10. 15 ± 2.47)μg／L vs.(7. 44 ± 1.94)μg／L ] ,IL‐8 [(20. 35 ± 4.48 )μmol／L vs.(15. 14 ± 3. 61 ) μmol／L ] ,MCP‐1 [(234.54 ± 32. 53 ) ng／L vs. (185.46 ± 29. 47) ng／L] ,VE‐cadherin [(5. 32 ± 0. 49)mg／L vs.(4. 18 ± 0.54) mg／L] ,plaque size [(17.25 ± 3.14) mm2 vs.(14.13 ± 2.07)mm2 ] and IMT[(1.08 ± 0.25)mm vs.(0.85 ± 0. 17)mm] in large dose group ,P＝0.001 all. There was no significant difference in incidence rate of adverse reaction between two groups .Conclusion :Large dose atorvastatin combined dual antiplatelet therapy can significantly reduce serum levels of MCP‐1 and VE‐cadherin ,im‐prove brain function without increasing incidence rate of adverse reactions .

OBJECTIVETo study the effect of polydatin on the expression level of miR-214 and liver function in atherosclerotic mice.

METHODSForty male ApoE(-/-) mice were randomly allocated into 4 groups (n=10), namely the model group, low- and high-dose polydatin groups, and simvastin group, with 10 male C57BL/6J mice serving as the normal control group. Mouse models of atherosclerosis were established by feeding the ApoE(-/-) mice with a high-fat diet. After 12 weeks of treatment, blood levels of glucose, lipids, AST, and ALT and the contents of T-SOD and MDA in the liver tissue were detected. The pathologies of the liver were examined with HE staining, and miR-214 expression in the liver was detected using quantitative real-time PCR.

RESULTSCompared with the normal control mice, the mice in the model group showed significantly increased blood glucose, serum TC, TG, LDL-C, ALT, and AST levels, and MDA contents in the liver (P<0.01), with significantly decreased serum HDL-C level and SOD and miR-214 levels in liver (P<0.01). Polydatin treatment significantly ameliorated such changes in blood glucose, serum ALT, AST, TC, TG, LDL-C, and HDL-C levels, and MDA, SOD, and miR-214 contents in liver tissue (P<0.05).

CONCLUSIONs Polydatin can reduce blood glucose and lipid levels and protect the liver function in atherosclerotic mice possibly by up-regulating the expression of miR-214 and T-SOD and down-regulating MDA in the liver.

Animals ; Apolipoproteins E ; genetics ; Atherosclerosis ; drug therapy ; Blood Glucose ; analysis ; Diet, High-Fat ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Glucosides ; pharmacology ; Lipids ; blood ; Liver ; drug effects ; Male ; Malondialdehyde ; metabolism ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; MicroRNAs ; metabolism ; Stilbenes ; pharmacology ; Superoxide Dismutase ; metabolism

OBJECTIVETo investigate the use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy.

METHODSFrom April 2008 to March 2010, anterior cervical discectomy and fusion with self-locking cages were performed on 45 patients who suffered from multi-segmental cervical myelopathy, among of them there were 23 male and 22 female, aged from 32 to 67 years (average 53 years). Recording the Japanese Orthopedic Association (JOA) scores and SF-36 scores in the protocol time point, in order to investigate the clinical outcome, meanwhile, accumulating the pre-operation and postoperation X-ray films of cervical spine for measuring the height of intervertebral space, whole curvature of cervical spine and the rate of fusion by repeated measures analysis of variance.

RESULTSThe mean follow-up time was 28.4 months (24 - 35 months). JOA scores ascended from preoperative 6.5 ± 3.1 to postoperative 13.4 ± 1.7 (F = 17.84, P = 0.001), the 7 scores of SF-36 improved significantly after operation (t = 1.151 - 12.207, P < 0.05), but mental health not. The fineness rate was 91.1%. Height of disc space ascended from preoperative (5.5 ± 1.8) mm to postoperative (8.3 ± 0.8) mm (F = 11.71, P = 0.043), globle curvature of cervical spine ascended from preoperative 5° ± 7° to postoperative 10° ± 14° (F = 234.53, P = 0.000), the change of the two index was significantly, respectively. Fat necrosis in one case and hematoma in another case at the bone donor-site were found, both of the two cases were cured by physiotherapy. All of the 45 cases (111 segments) achieved bone fusion.

CONCLUSIONThe use of anterior cervical discectomy and fusion with self-locking cages to treat multi-segmental cervical myelopathy possess many advantages as follows: satisfactory clinical outcome, minimally invasive, higher fusion rate, higher orthopaedic ability.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Diskectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Internal Fixators ; Male ; Middle Aged ; Spinal Cord Diseases ; surgery ; Spinal Fusion ; instrumentation ; methods ; Treatment Outcome

OBJECTIVETo explore whether endothelin-1 and NO are involved in the instant changes in cardiac function at early stage of severe burn.

METHODS(1) Thirty-one Wistar rats were divided into sham burn A group (SA, n = 7), burn A group (BA, n = 10), non-selective endothelin A/B receptor antagonist PD142893 group (n = 7), and the selective endothelin A receptor antagonist BQ-123 group (n = 7) according to the random number table. Rats in the latter three groups were inflicted with 30% TBSA full-thickness burn. Immediately after injury, rats in PD142893 group and BQ-123 group were intravenously injected with PD142893 (0.1 mg/kg) and BQ-123 (30 nmol x kg(-1) x min(-1)) respectively. Rats in SA group were treated the same as rats in BA group except for sham injury. The cardiac function indexes of rats in BA and SA groups including left ventricular systolic pressure (LVSP) heart rate (HR) and LV + or - dp/dt max were monitored before injury and 10, 30, 60, 180 minutes post injury (PIM) using physiological signal acquisition and processing system. The respective changes in cardiac function indexes of rate in each group between PIM 10 and pre-injury in the value of percentage were calculated. (2) Another 20 Wistar rats were enrolled and divided into sham burn B group (SB, n = 4) and burn B group (BB, n = 16) according to the random number table, and they were subjected to above-mentioned injury. Heart tissues of rats in BB group were obtained at PIM 10, 30, 60, and 180 respectively (4 rats at each time point), and that in SB group were obtained immediately after injury. Endothelin-1 and NO contents in heart tissues were determined with ELISA.

RESULTS(1) Compared with the pre-injury value, LVSP, HR, LV +dp/dt max, LV -dp/dt max of rats in BA group decreased significantly since PIM 10 (with F value respectively 7.14, 16.40, 14.09 14.98, P < 0.05 or P < 0.01). No significant change was observed in above 4 indexes in rats of SB group between above mentioned two time points (with F value respectively 0.59, 0.51, 1.03, 1.04, P values all above 0.05). (2) In BA group, compared with the pre-injury value, LVSP decreased 27%, HR decreased 14%, LV +dp/dt max decreased 51%, LV -dp/dt max decreased 50% at PIM 10. Compared with those in BA group at PIM 10, cardiac function indexes were improved significantly in PD142893 group, with LVSP decreased 14% (F = 8.10, P < 0.01), HR increased 4% (F = 6.50, P < 0.01), LV +dp/dt max decreased 31% (F = 23.67, P < 0.05), LV -dp/dt max decreased 14% (F = 10.39, P < 0.01). In BQ-123 group, compared with the pre-injury value, HR increased 3%, LV -dp/dt max decreased 26% at PIM 10, which were obviously improved as compared with those in BA group (with F value respectively 6.50 and 10.39, P < 0.05 or P < 0.01); the percentage changes of LVSP and LV +dp/dt max in BQ-123 group were close to that in BA group (with F value respectively 8.10 and 23.67, P values both above 0.05). (3) Compared with those in SB group, myocardial tissue endothelin-1 content of rats in BB group increased significantly at PIM 10, 60, 180 (F = 2.85, P < 00.05 or P < 0.01), and NO content increased significantly at PIM 60, 180 (F = 1.87, with P values all below 0.05).

CONCLUSIONSEndothelin-1 may participate in the instant decline of cardiac function of rats at early stage of severe burn, and plays an important role in the instant myocardial damage after injury.

Animals ; Burns ; metabolism ; physiopathology ; Endothelin-1 ; metabolism ; Heart ; physiopathology ; Male ; Myocardium ; metabolism ; Nitric Oxide ; metabolism ; Rats ; Rats, Wistar

OBJECTIVETo investigate the instant changes in heart function and organ blood flow, and their relations in rats at early stage of severe burn.

METHODSThirty-six SD rats were divided into sham injury group (S, n = 6) and burn group (B, n = 30) according to the random number table. Rats in B group were subjected to 30% TBSA full-thickness burn. Five time points for observation: 10 and 30 minutes, and 1, 3, and 6 hour (s) post injury (PIM/H) were set up, with 6 rats at each time point. Rats in S group were sham scalded with 37 degrees C warm water. Hemodynamics indexes including heart rate (HR), mean artery pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), LV + or - dp/dt max were determined. Blood flow of heart, brain, kidney, spleen, stomach, and ileum was determined respectively with fluorescent microspheres method. The correlation between LV + or - dp/dt max and myocardial blood flow was analyzed.

RESULTS(1) Compared with those of S group, HR in B group decreased gradually after injury; MAP, LVSP, LV +dp/dt max, LV -dp/dt max and myocardial blood flow in B group decreased obviously at PIM 10 (with F value respectively 12.062, 12.629, 11.066, 18.374, 9.468, and P values all below 0.01). Among them, myocardial blood flow decreased from (6.8 + or - 0.8) mL x min(-1) g(-1) to (2.6 + or - 0.5) mL x min(-1) x g(-1). Above-mentioned indexes increased gradually as the time after injury went on, with the highest values (except for LV +dp/dt max) observed at PIH 1, which decreased again later, with values at PIH 3 and 6 significantly lower than those in S group (the same F values as above, P values all below 0.01). There was no obvious difference in LVEDP between S group and B group at each time point (F = 1.205, with P values all above 0.05). (2) Compared with those of S group, blood flow of kidney, spleen, stomach, and ileum of rats in B group at PIM 10 declined obviously (with F value respectively 22.694, 20.856, 12.653, 7.293, P < 0.05 or P < 0.01), but the decline range was smaller than that in heart. The lowest values of above-mentioned indexes were observed at PIH 1 or PIH 3. Brain blood flow of rats in B group at each time point was close to that in S group (F = 1.812, with P values all above 0.05). (3) The correlation coefficient r between LV +dp/dt max, LV -dp/dt max and myocardial blood flow was respectively 0.651 and 0.617, showing significant positive correlation (with t value respectively 4.456 and 4.222, and P values all below 0.01).

CONCLUSIONSThe myocardial ischemia and decrease in cardiac function may occur in a very short time after severe burn (PIM 10). The rapid decrease of heart blood flow plays an important role in the change in cardiac function. Myocardial damage and decrease of cardiac function may be one of the important factors result in the decline of blood flow in other organs.

Animals ; Brain ; blood supply ; Burns ; physiopathology ; Disease Models, Animal ; Heart ; physiopathology ; Hemodynamics ; Ileum ; blood supply ; Kidney ; blood supply ; Male ; Myocardial Ischemia ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Regional Blood Flow ; Spleen ; blood supply ; Stomach ; blood supply

OBJECTIVETo analyze the influence of thoracic kyphosis on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after the selective thoracic fusion.

METHODSNinety AIS patients (mean age 14.5 years old) who received selective thoracic fusion from February 1999 to December 2005 in one institution with at least 24-month follow-up were evaluated. Forty-one patients underwent anterior spinal fusion and forty-nine patients underwent posterior spinal fusion. And then the patients were divided into two subgroups according to the magnitude of preoperative thoracic kyphosis (TK): Group A, TK less than 10 degrees ; and Group B, TK more than 10 degrees . The radiological parameters were measured including: thoracic and lumbar curve magnitude, TK, lumbar lordosis (LL), thoracolumbar junction kyphosis (T(10)-L(2), TJK), distal junctional kyphosis (DJK), sagittal vertical axis (SVA).

RESULTSAt final follow-up, TK, TJK and DJK increased significantly compared with preoperative Cobb angle in subgroup A patients who underwent anterior spinal fusion (P < 0.05). Generally, there was a lordosis loss of TJK and DJK during follow-up. While in subgroup B, TJK at final follow-up increased apparently compared with preoperative Cobb angle (P < 0.05). And there was a increased trend of DJK in spite of no significant difference, however, there was no obvious change of TK in subgroup B. At the final follow-up, TK and TJK increased significantly in subgroup A patients who underwent posterior spinal fusion (P < 0.05). And there was a increased tendency of DJK during follow-up, although there was no significant difference. And there was no obvious change of TK, TJK and DJK in subgroup B. There was a increased trend of LL in spite of no significant difference in group A patients who underwent anterior or posterior spinal fusion. The sagittal balance maintained well during follow-up in both groups.

CONCLUSIONSFor AIS patients with thoracic hypokyphosis, normal TK and LL could be achieved during follow-up with selective thoracic instrumentation. However, the increase of DJK and TJK may occur during the follow-up, and the risk factors may be the anterior short segmental fusion and the reconstruction of the sagittal profile in the hypokyphosis patients.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; pathology ; Male ; Perioperative Period ; Retrospective Studies ; Scoliosis ; pathology ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; pathology ; surgery

Objective To assess the mutation in exon 8 of C1 esterase inhibitor(C1INH)gene in a patient with hereditary angioedema(HAE).Methods Genomic DNA was extracted from a female patient with HAE as well as her mother and a normal human control.The fragment of exon 8 of C1INH gene was amplified by PCR and inserted into plasmid carrier pUC19 with the help of ligase.Then,the recombinant plasmid was transformed into competent cells of E coli TG1 strains.After culture of positive transformant,plasmid DNA Was extracted and subjected to sequencing.SDS-PAGE and We:stem blot were performed on the sera of the patient to detect the concentration and function of C1INH protein.Results An A1677G mutation at exon 8 of C1INH gene.which resulted in a substitution of isoleucine to valine at codon 440,Was found in the patient who SUfiered from HAE type I.Additionally.SDS-PAGE and Western blot revealed that the molecular weight of C1INH protein was 96 000.but not 105 000 observed in noHnal human control.Conclusion The newly identified mutation 1440V.which is located at P4 residue of reactive center loop in C1INH.may result in conformational alteration of C1INH.

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology

OBJECTIVETo explore the effect of one dressing of porcine acellular dermal matrix on deep partial thickness burns.

METHODSFrom January 1997 to January 2004, sixty-seven cases of deep partial thickness total burned surface area (TBSA) from 50% to 90% burn wound were treated by a single dressing of porcine acellular dermal matrix (the porcine acellular dermal matrix group). Ten cases of deep partial thickness burned patients with the same TBSA treated by exposure method served as the exposure method group. The healing time of the wound was observed. The patients were followed up for 3 months to 2 years, and the scar proliferation was observed.

RESULTSThe deep partial-thickness wound would be healed without dressing change in the porcine acellular dermal matrix group, and the average healing time was (12.2 +/- 2.6) days. The average healing time of the exposure method group was (27.4 +/- 3.5) days. Follow up of the patients within 3 months to 2 years showed that scar proliferation in the porcine acellular dermal matrix group was much less than that in the exposure method group, even no scar proliferation was observed in some patients.

CONCLUSIONWithout tangential excision, autografting and dressing change, a single dressing of porcine acellular dermal matrix on deep partial thickness burn wound could shorten the healing time and inhibit scar proliferation.

Animals ; Biological Dressings ; Burns ; pathology ; therapy ; Cicatrix ; prevention & control ; Female ; Follow-Up Studies ; Humans ; Male ; Swine ; Treatment Outcome ; Wound Healing