Oxidative stress plays a crucial role in cadmium (Cd)-induced myocardial injury. Mitsugumin 53 (MG53) and its mediated reperfusion injury salvage kinase (RISK) pathway have been demonstrated to be closely related to myocardial oxidative damage. Potentilla anserina L. polysaccharide (PAP) is a polysaccharide with antioxidant capacity, which exerts protective effect on Cd-induced damage. However, it remains unknown whether PAP can prevent and treat Cd-induced cardiomyocyte damages. The present study was desgined to explore the effect of PAP on Cd-induced damage in H9c2 cells based on MG53 and the mediated RISK pathway. For in vitro evaluation, cell viability and apoptosis rate were analyzed by CCK-8 assay and flow cytometry, respectively. Furthermore, oxidative stress was assessed by 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) staining and using superoxide dismutase (SOD), catalase (CAT), and glutathione/oxidized glutathione (GSH/GSSG) kits. The mitochondrial function was measured by JC-10 staining and ATP detection assay. Western blot was performed to detect the expression of proteins related to MG53, the RISK pathway, and apoptosis. The results indicated that Cd increased the levels of reactive oxygen species (ROS) in H9c2 cells. Cd decreased the activities of SOD and CAT and the ratio of GSH/GSSG, resulting in decreases in cell viability and increases in apoptosis. Interestingly, PAP reversed Cd-induced oxidative stress and cell apoptosis. Meanwhile, Cd reduced the expression of MG53 in H9c2 cells and inhibited the RISK pathway, which was mediated by decreasing the ratio of p-Akt^Ser473/Akt, p-GSK3β^Ser9/GSK3β and p-ERK1/2/ERK1/2. In addition, Cd impaired mitochondrial function, which involved a reduction in ATP content and mitochondrial membrane potential (MMP), and an increase in the ratio of Bax/Bcl-2, cytoplasmic cytochrome c/mitochondrial cytochrome c, and Cleaved-Caspase 3/Pro-Caspase 3. Importantly, PAP alleviated Cd-induced MG53 reduction, activated the RISK pathway, and reduced mitochondrial damage. Interestingly, knockdown of MG53 or inhibition of the RISK pathway attenuated the protective effect of PAP in Cd-induced H9c2 cells. In sum, PAP reduces Cd-induced damage in H9c2 cells, which is mediated by increasing MG53 expression and activating the RISK pathway.
Cadmium/metabolism* ; Caspase 3/metabolism* ; Potentilla/metabolism* ; Glycogen Synthase Kinase 3 beta/pharmacology* ; Proto-Oncogene Proteins c-akt/metabolism* ; Cytochromes c/metabolism* ; Glutathione Disulfide/pharmacology* ; Oxidative Stress ; Myocytes, Cardiac ; Reactive Oxygen Species/metabolism* ; Reperfusion Injury/metabolism* ; Apoptosis ; Polysaccharides/pharmacology* ; Adenosine Triphosphate/metabolism*

Objective:To explore the role of arthroscopic exploration in the treatment of tibial plateau fractures with homeopathic double reverse traction reduction and internal fixation.Methods:A retrospective analysis was conducted on the data of 188 patients with tibial plateau fractures treated by homeopathic double reverse traction reduction assisted internal fixation and arthroscopic exploration at the Third Hospital of Hebei Medical University from January 2019 to December 2021. There were 129 males and 59 females, aged 46.7±11.8 years (range, 14-80 years); 115 cases on the left and 73 cases on the right. Schatzker classification of fractures: 81 cases of type II, 15 cases of type III, 23 cases of type IV, 29 cases of type V, and 40 cases of type VI. The time from injury to surgery was 1-14 days, with an average of 10±5 days. The surgery was performed with double reverse traction assisted reduction, locking bone plate and self-breaking compression bolt fixation. Then, arthroscopy was used to explore the quality of fracture reduction, meniscus and ligament damage, and the corresponding intra-articular lesions were treated, such as partial meniscus resection, complete meniscus resection, or suturing. The Rasmussen score was used to evaluate the quality of fracture reduction after surgery, and the Hospital for Special Surgery (HSS) knee joint score was used to evaluate the postoperative function of the knee joint.Results:All patients successfully completed fracture reduction, fixation, and arthroscopic exploration. The average surgical time was 95±21 min (range, 30-120 min); The average intraoperative bleeding volume was 120±58 ml (range, 50-300 ml). All patients were followed up for 10-24 months, with an average of 18±6.5 months. All patients' fractures achieved clinical healing after surgery, with a healing time of 2.5-6.0 months, with an average of 3±2.4 months. Among them, 165 patients (87.8%, 165/188) healed within 3 months after surgery, while the remaining 23 patients healed within 4-6 months after surgery. Arthroscopic exploration revealed that 188 patients had good fracture reduction and a flat articular surface. Among them, 97 cases (51.6%, 97/188) were complicated with meniscus injury, with longitudinal tear (29%, 28/97) being the most common, suture treatment was performed under arthroscopy; the remaining 69 patients underwent partial meniscectomy. All the patient's knee function recovered well at the last follow-up. 29 cases (15.4%, 29/188) were complicated with cruciate ligament injury, none of them underwent primary repair and were fixed with plaster or brace after operation. The Rasmussen score for the final follow-up after surgery was 16.8±2.4 points (range, 6-18 points), with 152 cases being excellent and 36 cases being good, with a 100% excellent and good rate. The HSS knee joint scores were 79.8±9.2 points, 85.1±10.1 points, and 94.9±7.6 points at 3, 6 months after surgery, and at the last follow-up, respectively, with statistically significant differences ( F=52.53, P<0.001). Superficial skin infection occurred in 2 cases after operation, which was cured by regular dressing change and anti-infection treatment with antibiotics. Deep vein thrombosis occurred in 7 cases within 1 week after operation, and low molecular weight heparin anticoagulation therapy was given. Conclusion:After using double reverse traction assisted reduction and internal fixation, arthroscopic examination can not only evaluate the quality of reduction for tibial plateau fractures, but also handle combined meniscus injuries and evaluate the condition of cruciate ligament injuries.

Objective:To study the safety and feasibility of laparoscopic surgery for treatment of hepaticojejunostomy strictures after cholangiectasis surgery in children.Methods:The clinical data of 12 children was retrospectively analysed. There were 5 males and 7 females, aged 4 (range 0.45 to 9.00) years old, who developed hepaticojejunostomy strictures after cholangiectasis surgery and underwent reoperative treatment at Anhui Provincial Children's Hospital from January 2013 to January 2021. These patients were divided into the laparoscopic surgery group ( n=5) and the open surgery group ( n=7) based on the mode of reoperation. The children were followed-up by outpatient review and the relevant clinical data of the children in the 2 groups was analyzed. Results:The reoperations were completed successfully in the 2 groups. The maximum preoperative dilated common hepatic duct diameter was significantly larger in the laparoscopic group (1.26±0.23) cm than the open group (0.64±0.19) cm ( P<0.05). The alkaline phosphatase and glutamyltransferase levels in the laparoscopic surgery group were significantly lower before the operation (all P<0.05), and the total bilirubin, direct bilirubin, alkaline phosphatase, and glutamyltransferase levels were significantly lower in the laparotomy group than before the operations (all P<0.05). In the laparoscopic group, the time of the reoperations, postoperative hospital stay, and blood loss were 268(117, 340) min, (9.0±2.9) d and (14.0±5.5) ml, respectively, while those in the open group were 180(150, 205) min, (9.7±3.4) d and (13.3±2.6) ml, respectively. There were no significant differences between the two groups (all P>0.05). On follow-up, all children were well except for one child who showed mild elevation levels of alanine aminotransferase and aspartate aminotransferase. Conclusion:Laparoscopic surgery for hepaticojejunostomy strictures after cholangiectasis surgery in children was safe and feasible. Its curative effect was no less than that of open surgery.

Objective:To investigate the associations of articular depression depth (ADD) and tibial plateau widening (TPW) by pre-operative CT measurement with incidence of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.Methods:Included in this retrospective study were 131 patients who had been admitted to Emergency Center of Trauma, The Third Hospital Affiliated to Hebei Medical University from January 2016 to January 2020 for Schatzker type Ⅱtibial plateau fractures. They were 88 males and 51 females, aged from 18 to 60 years (average, 41.5 years), with 74 right and 57 left sides injured. All patients were treated with closed reduction and internal fixation assisted by bidirectional traction. Arthroscopy was used to detect the status of lateral meniscus immediately after closed reduction and internal fixation of the fracture fragments. Furthermore, patients were divided into 2 groups according to the integrity of lateral meniscus: meniscal tear group ( n=70) and tear-free group ( n=61). The 2 groups were compared in terms of age, gender, body mass index(BMI), injury side, time interval from injury to surgery, TPW and ADD. The receiver operating curve (ROC) was drafted to calculate the cut-off values of TPW and ADD in complication of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture. Results:The overall incidence of lateral meniscal tear in this cohort was 53.4% (70/131). There was no statistically significant difference in terms of age, gender, injury side, BMI or time interval from injury to surgery between the 2 groups ( P>0.05); TPW and ADD were significantly higher in the meniscal tear group than in the tear-free group ( P<0.05). To predict lateral meniscal tear in patients with Schatzker type Ⅱtibial plateau fracture, the area under ROC was 0.656 (95% CI: 0.562 to 0.750, P=0.002) for TPW and 0.709 (95% CI: 0.619 to 0.800, P<0.001) for ADD, respectively; the cut-off values of TPW and ADD were 4.3 mm and 6.1 mm. Conclusion:TPW and ADD may be effective predictors for prediction of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.

The conception and the history ofpoint, tender point and myofascial trigger point are described in the paper. All of three kinds of point are the reaction of musculoskeletal pain and visceral diseases. Theoretically,point originates from the theory of muscle region of meridian, tender point from the theory of soft tissue and muscles and myofascial trigger point from the theory of muscular fasciae. Anatomically,point is localized in the muscle region of meridian, on the boundary between muscles, tender point is on the muscular attachment to skeleton (the starting and ending points) and myofascial trigger point is on the motor point of neuromuscles. Pathologically,point reflects the disorders of soft tissue and internal organ, tender point reflects the disorders of soft tissue and myofascial trigger point reflects the disorders of soft tissue and few disorders of internal organ. To identify the relationship among them is very significant in the target treatment with acupuncture.

Motion acupuncture (MA) refers to a special acupuncture technique where a patient carries out body motions under supervision of doctors with needles inserted and retained in the points. The motions include active movement, allocinesis and load exercise. The technique of MA involves three major procedures,namely target examination (finding target), acupuncture techniques (motion allowed after acupuncture) and motion methods (needle-retaining motion), which are described in detail in this article. The target can be found by examining along meridians, along sinews, along muscles and along fascia. The targets are examined with the techniques of pressing along the points, sliding and pressing, smoothly pushing, grasping, and poking. Common acupuncture needles are used for MA. The needling methods include floating insertion, perpendicular insertion, oblique insertion, single insertion, and multi-insertion. The motions involve the flexion and extension, stretching, and resistance of the affected muscle(s). MA is mainly applied for the treatment of pain and various soft tissue injuries as well as relevant visceral disorders, which shows clinical efficacy.

Objective To calculate the electric field intensity and transmembrane voltage of spherical cells and ellipsoi -dal red blood cells ( RBC) in an extremely low frequency electromagnetic field .Through this calculation , we can provide reference to the search for interaction targets and mechanics between the extremely low frequency electromagnetic field and organisms.Methods The Finite Element Method was used in the numerical computation for the spherical cell model and the ellipsoidal RBC model .Results The electric field intensity of the two types of cells on the cellular membrane was both significantly higher than the applied electric field strength , and the values of the induced field strength and transmembrane voltage varied with the direction of the electric field periodically .Conclusion The cell shape and direction of the applied electric field are not the main determinants of the cellular membrane electric field intensity and the transmembrane voltage compared with electromagnetic parameters .The distribution of the electric field intensity and transmembrane voltage are re-lated to the direction of the applied electric field.

ObjectiveTo evaluate the efficacy of mini-incisional double-tsuge suture method with 0-0 absorbable polydioxanone-cord (PDS-Ⅱ)in repair of acute achilles tendon rupture.MethodsA total of 34 patients were subjected to acute closed achilles tendon ruptures,including 25 males and 9 females at a mean age of 32 years ( range,20-45 years).Injury causes included sports injuries in 27 patients,falling injuries in six and heavy object impingement injury in one.The time from injury to operation was average 3 days (range,1-6 days).All patients underwent minimally invasive repair with double-tsuge suture method by using PDS-Ⅱ.The ankle joint was fixed with short leg plaster cast at 30° plantar flexion position and the cast was removed six weeks later to take functional exercise.The patients could walk with full weight-bearing 8-10 weeks later and could gradually return to activity 3-4 months later.Results There was one patient with poor incision healing and one patient with reflex sympathetic dystrophy postoperatively.The rest patients had stage Ⅰ incision healing without skin adhesions.No complications such as infection,lower extremity deep venous thrombosis or sural nerve injury occurred postoperatively.All the patients received follow-up of 12-24 months (average 15 months),which showed no complications like tendon rerupture occurred.According to clinical evaluation criterion of Termann,the average score was 92 points (range,76-96 points).The result was excellent in 28 patients,good in five and fair in one,with excellence rate of 97％.ConclusionsSmall incisional double-tsuge suture method achieves low rate of complications and good outcomes for repairing acute achilles tendon rupture and is an ideal tendon surgery approach.

Objective To compare the effects of different doses of FTY720 on inhibiting expression of Caspase-3 and neural apoptosisin rats with acute spinal cord injury (SCI), and find out the suitable dose. Methods 200 female SD rats were randomly divided into 5 groupswith 40 in each group. Group A (laminectomy but not contusion) were administered 0.3 ml normal saline by gavage. SCI model was establishedby Allen's WD method at the T9 level of spinal cord in other groups. Group B were administered 0.3 ml normal saline after modeling.Groups C, D and E were administered 0.3 ml FTY720- saline solution of 1, 3 and 5 mg/kg respectively. All the groups were sacrificed at 6 h,12 h, 24 h, 48 h, 72 h (n=8, per each time-point). Caspase-3 expression was detected with streptavidin-peroxidase immunohistochemistry,and neural apoptosis was detected with the TUNEL method. Results Positive Caspase-3 expression and neural apoptosis were not observedin Group A at 6 h. In Groups B、C、D and E, the number of apoptotic cells increased with increased time of acute SCI, peaked at 24 h afterinjury, and then gradually reduced. Caspase-3 expression was at equal pace with neural apoptosis. The difference of the number of apoptoticand Caspase-3 expression cells among all groups were significant, with the order Group B>Group C>Group D>Group A (P<0.05). However,there was no significant difference between Group D and Group E (P>0.05). The number of apoptotic and Caspase-3 expression cells negativelycorrelated with the dose of FTY720 when the dose was less than 3 mg/kg (P<0.05), and there was no relationship when the dose wasmore than 3 mg/kg (P>0.05). Conclusion FTY720 significantly reduces Caspase-3 expression and neural apoptosis in rats with acute SCI.There is a dose-effect relationship between the dose of FTY720 and the Caspase-3 expression and neural apoptosis. It's indicated that 3 mg/kg is the most appropriate dosage.

BACKGROUND: Secretion of various neurotrophic factors by Schwann cells plays important roles in neural regeneration. However, the secretion capability is affected by many factors. To seek a feasible method for promoting nerve growth factor secretion by Schwann cells is a key of regeneraion following neurologic defect.OBJECTIVE: To explore the effects of methylprednisolone(solu-medrol) on the secreted function of Schwann cells of cultured rats.METHODS: Schwann cells were isolated and cultured by enzyme digestion method. Cell growth was observed under an inverted phase contrast microscope. Following passage, purity of some Schwann cells was identified using S-100 protein immunity. Other Schwann cells were regulated using cell counting plate into 1×10~9/L, and incubated in a 6-well culture plate (15 wells) for further incubation. Following 4 days of culture, different concentrations of solu-medrol (10~(-3), 10~(-4), 10~(-6), 10~(-8) mol/L) were administrated to the cell, while blank control group (1 well) was given no drug. 24, 48 and 72 hours after administration, reverse trancription-polymerase chain reaction (RT-PCR) was used in the detection of the levels of nerve growth factor mRNA.RESULTS AND CONCLUSION: Number of primarily cultured cells was significantly increased at day 7, and 80% cells were confluent. Subcultured cells were spindle-shaped, with 2 thin long processes, showing positive fluorescence staining. Fibroblasts were round or flat, showing negative reaction of fluorescence staining. Reserve transcription-polymerase chain reaction demonstrated that nerve growth factor number at 72 hours affected by 10~(-8) mol/L radiosone was increased compared with the blank control group and other concentrations and other time points (P < 0.05). Number of nerve growth factor was reduced following treatment of 10~(-3) mol/L radiosone compared with the blank control group and other concentrations (P < 0.05). These results suggested that high concentration of solu-medrol prohibits secreted function of Schwann's cells, but long time and low dosage solu-medrol promotes secreted function of Schwann's cells.