Prosthetic infection is one of the severe postoperative complications of arthroplasty. Mixed bacterial-fungal prosthetic infection is rare but can be disastrous. This case was a 76-year-old female suffered from prosthetic infection following total hip replacement due to femoral neck fracture and underwent multiple debridements. The culture of periprosthetic tissue was bacteriologically sterile following the first debridement, while the Staphylococcus hominis was identified in the second debridement in the previous hospitalization where fungal infection had not been considered. Thus the pathogen spectrum of anti-infection therapy failed to contain fungus. Ultimately, the culture result of our sampled periprosthetic tissue during the third debridement was Candida albicans without bacterium in our hospital. The fungal prosthetic infection was successfully treated by a two-stage revision with antifungal drugs. Accurate diagnosis and standardized treatment is the key to the therapy of infection after hip arthroplasty, especially for mixed bacterial-fungal prosthetic infection.
Aged ; Anti-Bacterial Agents/therapeutic use* ; Arthroplasty, Replacement, Hip/adverse effects* ; Debridement ; Female ; Fungi ; Hip Prosthesis/adverse effects* ; Humans ; Mycoses/drug therapy* ; Prosthesis-Related Infections/therapy* ; Reoperation ; Retrospective Studies ; Treatment Outcome

Objective:To compare the dose and image quality of selected photon shield (SPS) technique, organ-based tube current modulation (OBTCM) technique and the combination of these two techniques for reducing the organ dose in head CT examination for infants.Methods:Two anthropomorphic head phantoms (CIRS 1-yr-old and 5-yr-old) were scanned by using Reference mode, Reference + OBTCM mode, SPS mode and SPS + OBTCM mode, respectively. Radiation doses to the lens of the eye, the anterior of the brain, the posterior of the brain, noise level and CNR of orbit and brain in different phantoms were measured and compared by using different scanning modes.Results:Compared with Reference mode, the doses to the lens of the eye in 1-yr-old and 5-yr-old phantom decreased by (21.89 ± 0.01)% and (28.33 ± 0.34)%, respectively. In SPS mode, the reduction in doses to the lens of the eye in 1-yr-old and 5-yr-old phantom were (71.38 ± 1.30)% and (53.72 ± 2.42)%, respectively. In SPS + OBTCM mode, the reduction was (71.12 ± 2.54)% and (55.73 ± 1.90)%, respectively. There was significant difference in the noise level of orbit and brain in different phantoms under various scanning modes ( F=5.67-85.47, P< 0.05). The noise level in OBTCM mode compared with reference mode increased slightly (<1.45 HU) in various phantoms. SPS and SPS + OBTCM mode resulted in a small noise increase (<2.58 HU). There was no significant difference in CNR of different phantoms under various scanning modes ( P>0.05). Conclusions:SPS and SPS + OBTCM mode can significantly reduce the radiation dose of lens and the whole image plane in the head CT scan for infants, with maintaining the image quality.

The solubilization and protection of curcumin (Cur) by mixed surfactants were studied through the determination about the critical micellar concentration (CMC) of the mixed surfactants of Tween 80 and dodecyl trimethyl ammonium bromide (DTAB), molar solubilization ratio (MSR), degradation rate (k) of Cur in pH 13 solution and mixed surfactant solutions prepared at pH 13. The results showed that when Tween 80 was used alone, it exhibited high solubilization ability but poor stability. DTAB was used alone, it showed strong stability but poor solubilization ability. When DTAB was mixed with Tween 80 at different mole fractions, the stability of Cur was enhanced, and the best stability was observed when the mole fraction of DTAB was 0.4, although the solubilization ability was not the best at this mole fraction, but MSR was increased by 1.7 times compared to DTAB used alone. Mixed surfactant not only increased the solubility but also improved the stability of Cur. In addition, mixed surfactant has the advantages of less dosage and low toxicity, which is worth popularizing in application.

OBJECTIVE: To review the literature regarding diagnosis and treatment of labral tear. DATA SOURCES: A systematic search was performed in PubMed using various search terms and their combinations including hip, labrum, acetabular labral tear, arthroscopy, diagnosis, and anatomy. STUDY SELECTION: For each included study, information regarding anatomy, function, etiology, diagnosis, and management of acetabular labral tear was extracted. RESULTS: Five hundred and sixty abstracts about anatomy, function, etiology, diagnosis, and management of acetabular labral tear were reviewed and 66 selected for full-text review. The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown. CONCLUSIONS Labral tear is generally secondary to femoroacetabular impingement, trauma, dysplasia, capsular laxity, and degeneration. Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test. Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard. Conservative treatment consists of rest, non-steroidal anti-inflammatory medication, pain medications, modification of activities, physical therapy, and intra-articular injection. When fail to respond to conservative treatment, surgical treatment including labral debridement, labral repair, and labral reconstruction is often indicated.
Acetabulum ; injuries ; Arthroscopy ; Hip Injuries ; Humans ; Rotator Cuff Injuries ; Rupture ; diagnosis

To study the effects of surfactants on wettability of excipients, the contact angles of six types of surfactants on the surface of two common excipients and mixture of three surfactants with excipients were measured using hypsometry method. The results demonstrated that contact angle of water on the surface of excipients was associated with hydrophilcity of excipients. Contact angle was lowered with increase in hydrophilic groups of excipient molecules. The sequence of contact angle from small to large was starch < sodium benzoate < polyvinylpyrrolidone < sodium carboxymethylcellulose < sodium alginate < chitosan < hydroxypropyl methyl cellulose Chemistry, Pharmaceutical ; Excipients ; chemistry ; Hydrophobic and Hydrophilic Interactions ; Surface-Active Agents ; chemistry ; Tablets ; Water ; Wettability

Objective To investigate the effect of overexpression of cartilage oligomeric matrix protein (COMP) on BMP-2 induced cell osteogenic and chondrogenic differentiation of mesenchymal stem cells (MSCs).Methods MSCs,transfected with plasmid DNA encoding recombinant human COMP,were induced to differentiate into osteocytes and chondrocytes by BMP-2.Realtime PCR of osteogenic related markers (Col1a1,RUNX2,OPN,BGP) and chondrogenic related markers (Col2a1,SOX9,Aggrecan) were performed to evaluate the process of cell differentiation.ALP staining,Alizarin red S staining for osteogenic differentiation and alcian blue staining for chandrogenic differentiation were conducted to evaluate the tendency of cell differentiation.Results Real-time PCR assay presented the significantly higher (P＜0.05) COMP expression of MSCs when COMP gene was transfected into cells.The expression level of OPN was significantly (P＜0.05) down-regulated at all the time points in experimental group compared with that in control group.A final significant (P＜0.05) up-regulation of expression appeared in experimental group at the late stage of induction (day 7,14) compared with that in control group,even though a decrease (P＜0.05) expression of Col1a1,RUNX2 and BGP in experimental group occurred at the early stage of induction (day 3).The expression of Aggrecan and Col2a1 in experimental group was up-regulated (P＜0.05) at different time points compared with that in control group.And a significant higher (P＜0.05) expression of SOX9 in experimental group only appeared at day 7 compared with that in control group.ALP staining and Alizarin red S staining were weakened while alcian blue staining was enhanced.Conclusion COMP may inhibit BMP-2 induced osteogenic differentiation and promote BMP-2 induced chondrogenic differentiation,which may provide new insight for cartilage tissue engineering.

OBJECTIVETo compare the clinical therapeutic effects differences between acupuncture at Suliao (GV 25) and Shuigou (GV 26) on promoting regain of consciousness from coma in severe craniocerebral injury.

METHODSBased on regular emergency treatments of neurosurgery, eighty-two cases of craniocerebral injury who were under stable condition were randomly divided into an observation group (42 cases) and a control group (40 cases). Suliao (GV 25) was selected as main aupoint, while Laogong (PC 8) and Yongquan (KI 1), etc. were selected as adjuvant acupoints and Neiguan (PC 6), Sanyinjiao (SP 6), Yifeng (TE 17) and Wangu (GB 12), etc. were selected as matching acupoints in the observation group where a strong needle manipulation was applied to improve the regain of consciousness. The main acupoint of Shuigou (GV 26) along with identical adjuvant acupoints and matching acupoints in the observation group were selected in the control group with identical strong needle manipulation. The treatment was given once a day in both groups, five times per week and ten times were considered as one session. The immediate clinical symptoms after acupuncture at Suliao (GV 25) and Shuigou (GV 26) were observed as well as Glasgow coma scale (GCS) before the treatment, after 45 days and 90 days of treatment to assess the resuscitation time and rate. Also the clinical efficacy was compared between both groups.

RESULTSThe occurrence rate of sneezing reflex was 85.7% (36/42) in the observation group, which was higher than 25.0% (10/40) in the control group (P < 0.01). The average resuscitation time was (64.6 +/- 19.4) days in the observation group, which was obviously shorter than (73.8 +/- 14. 6) days in the control group (P < 0.05). The resuscitation rate was 88.1% (37/42) in the observation group, which was similar to 75.0% (30/40) in the control group (P > 0.05). Compared before the treatment, GCS were both improved after the treatment in two groups (both P < 0.01). The 90-day GCS was 9.52 +/- 2.32 in the observation group, which was superior to 8.47 +/-2.14 in the control group (P < 0.05). The curative and markedly effective rate was 45.2% (19/42) in the observation group, which was superior to 22.5% (9/40) in the control group (P < 0.05).

CONCLUSIONThe effect of acupuncture at Suliao (GV 25) on improving regain of consciousness from coma in severe craniocerebral injury is positive. It could specifically improve sneezing reflex and stimulate respiratory center, which has more obvious effect than acupuncture at Shuigou (GV 26).

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Coma ; etiology ; physiopathology ; psychology ; therapy ; Consciousness ; Craniocerebral Trauma ; complications ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effects of simvastatin on atherosclerosis and central aortic pressure in ApoE-knockout (ApoE-/-) mice.

METHODSTen 5-week-old male ApoE-/- mice and 5 C57 mice were fed with high-lipid diet for 3 weeks, and then C57 mice (WT group) and 5 ApoE-/- mice (ApoE-/- group) were given 1% carboxymethyl cellulose solution (8 ml·kg-1·d-1), and another 5 ApoE-/- mice (ApoE-/-/S group) were given simvastatin solution (50 mg·kg-1·d-1) by gavege for 3 weeks. The areas of atherosclerotic lesion in aortic root, central aortic pressure and serum lipid levels were examined.

RESULTSNo atherosclerotic plaques were observed in WT group. Compared with ApoE-/- group, simvastatin significantly decreased atherosclerotic lesion area in aortic root (89 818.05±16 980.93 μm2 vs 34 937.01±13 280.65 μm2, P<0.05). The systolic pressure (SP), mean arterial pressure (MAP), pulse pressure (PP) and diastolic pressure (DP) of central aortic pressure were significantly increased in ApoE-/- group compared with those in WT group (P<0.05). Compared to ApoE-/- group, the SP, MAP and PP of central aortic pressure were significantly reduced in ApoE-/-/S group (P<0.05). SP and MAP of central aortic pressure were positively correlated with atherosclerotic lesion area (SP: r=0.7152, P=0.0461; PP: r=0.7594， P=0.0288). Compared with WT group, serum triglyceride, total cholesterol and low-density lipoprotein levels were markedly increased in ApoE-/- group (P<0.05). Serum high-density lipoprotein level was decreased in ApoE-/- group compared with WT group. No differences in serum triglyceride, total cholesterol, low-density lipoprotein and high-density lipoprotein levels were found between ApoE-/- group and ApoE-/-/S group.

CONCLUSIONSimvastatin can attenuate atherosclerosis of aorta in ApoE-/- mice, which is associated with the reduced central aortic systolic pressure but not with the serum lipids levels.

Animals ; Apolipoproteins E ; genetics ; Arterial Pressure ; drug effects ; Atherosclerosis ; drug therapy ; genetics ; physiopathology ; Cholesterol ; blood ; Disease Models, Animal ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Male ; Mice ; Mice, Knockout ; Simvastatin ; pharmacology ; Triglycerides ; blood

The purpose of this research is to investigate the critical period of voltage-gated Na(+) channel development in hippocampal CA1 neurons. Changes of Na(+) currents in acutely isolated hippocampal CA1 neurons of rats at different ages (0-4 weeks after birth) were recorded using the whole-cell patch-clamp technique. The results indicated that the maximum current density of Na(+) channels was increasing with age, and the amplitudes in 1, 2, 3 and 4 weeks respectively grew by (42.76 ± 4.91)%, (146.80 ± 7.63)%, (208.79 ± 5.28)% and (253.72 ± 5.74)% (n = 10, P < 0.05) compared with that in 0 week. The current density in CA1 neurons of 1-2 weeks after birth increased more significantly than those of other groups. The activation curve of Na(+) channel shifted to the left. The half-activation voltages (mV) in 0-2 weeks were -39.06 ± 0.65, -43.41 ± 0.52, -48.29 ± 0.45 (n = 10, P < 0.05), respectively, showing significant age-dependent decrease, and there were no significant changes in other groups. The slope factors of activation curve for each group did not change significantly. There were no regular changes in inactivation curve and no significant changes in half-inactivation voltage. The slope factors of inactivation curve in 1-2 weeks were: 5.77 ± 0.56, 4.42 ± 0.43 (n = 10, P < 0.05). The inactivation rate of the second week after birth was faster than that of the first week, and there were no significant changes during 0-1 week and 2-4 weeks. The recovery from inactivation curve of Na(+) channel shifted to the left. The recovery time declined in 1-3 weeks. Changes of action potential properties were consistent with Na(+) current. These results suggest that the period of 1-2 weeks after birth may be the critical development period of voltage-gated Na(+) channel in hippocampal CA1 neurons. During this time, the distribution of Na(+) channel increases significantly; the activation curve of Na(+) channel shifts to the left; inactivation rate increases as well as recovery time shortens.
Action Potentials ; Animals ; CA1 Region, Hippocampal ; cytology ; Neurons ; physiology ; Patch-Clamp Techniques ; Rats ; Sodium Channels ; physiology

Brain growth spurt (BGS) is the critical period of neuronal growth and synaptic connection. The voltage-gated K(+) channel is the key channel for maintenance of cell excitability and information transfer among neurons. The purpose of the present study is to investigate the critical period of voltage-gated K(+) channel development in hippocampal CA1 neurons during the BGS. Changes of voltage-gated K(+) currents in neurons from acutely isolated hippocampal CA1 brain slices of rats at different ages (0-4 weeks after birth) were recorded by the whole-cell patch-clamp technique. The depolarization voltage was set at +90 mV, and 0 week was set as the control group. The experimental results showed that, with increasing ages (1-4 weeks), the maximum current densities of IA increased by (16.14 ± 0.51)%, (81.73 ± 10.71)%, (106.72 ± 5.29)%, (134.58 ± 8.81)% (n = 10, P < 0.05), and the maximum current densities of IK increased by (16.75 ± 3.88)%, (134.01 ± 2.85)%, (180.56 ± 8.49)%, (194.5 ± 8.53)% (n = 10, P < 0.05), respectively, compared with those in 0 week. During 0-4 weeks after birth, the activation kinetics of IA shifted to left, and the half activation voltages of IA were 14.67 ± 0.75, 13.46 ± 0.64, 8.39 ± 0.87, 4.60 ± 0.96, 0.54 ± 0.92 (mV, n = 10, P < 0.05), respectively; The activation kinetics of IK shifted to left and the half activation voltages of IK were 8.94 ± 0.85, 6.65 ± 0.89, 0.47 ± 1.15, -1.80 ± 0.89, -8.56 ± 1.08 (mV, n = 10, P < 0.05) respectively. The inactivation kinetics of IA also shifted to left, and the half inactivation voltages were -45.68 ± 1.26, -46.81 ± 0.78, -48.64 ± 0.81, -51.96 ± 1.02, -58.31 ± 1.35 (mV, n = 10) respectively at 0, 1, 2, 3 and 4 weeks after birth, which showed no significant changes between 0 and 1 week, but significant decreases during 1-4 weeks after birth (P < 0.05). These results indicate that the current densities of IA and IK increase and the kinetic characteristics of the voltage-gated K(+) channels change with increasing ages during 0-4 weeks after birth, and the differences are especially significant between the 1st week and the 2nd week after birth. These changes may be related to the maturation of hippocampal neurons and the progress of their functions.
Animals ; CA1 Region, Hippocampal ; cytology ; Membrane Potentials ; Neurons ; physiology ; Patch-Clamp Techniques ; Potassium Channels, Voltage-Gated ; physiology ; Rats