OBJECTIVE: To explore risk factors for infections after arthroscopic rotator cuff repair, and improve the under standing for reducing infection. METHODS: Clinical data of 2 591 patients who underwent arthroscopic rotator cuff repair from January 2019 to January 2022 were retrospectively analyzed, including 1 265 males and 1 326 females, aged from 25 to 82 years old with an average age of (51.5±15.6) years old. They were divided into infection group(n=18) and uninfected group(n=2 573) according to whether or not patients had postoperative infection. Gender, age, smoking, diabetes, body mass index, local closure within 1 month before operation, operation time, preventive use of antibiotics, and internal fixation implantation between two groups were recorded. Univariate Logistic regression analysis screened factors associated with infections after arthroscopic rotator cuff repair. Theresultswere entered into the multivariate logistic regression analysis, screening the high risk factors for infections after arthroscopic rotator cuff repair. RESULTS: In 2 591 patients, 18 patients were infected after operation, infection rate was 0.69%. Univariate Logistic regression analysis showed that gender, age, operation time, antibiotic prophylaxis, internal fixation implantation were risk factors for infections after arthroscopic rotator cuff repair. Multivariate Logistic regression analysis showed male(OR=14.227), age≥65 years(OR=34.313), operation time≥2 h (OR=15.616), without antibiotic prophylaxis(OR=4.891), and internal fixation implantation(OR=5.103) were major risk factors for infection after arthroscopic rotator cuff repair(P<0.05). CONCLUSION Male, age≥65 years, operation time≥2 h, without antibiotic prophylaxis and internal fixation implantation were independent risk factors for infection after arthroscopic rotator cuff repair. Early diagnosis and timely treatment should be carried out to reduce the incidence of infection.
Female ; Humans ; Male ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Rotator Cuff ; Rotator Cuff Injuries/surgery* ; Retrospective Studies ; Arthroscopy/adverse effects* ; Risk Factors ; Treatment Outcome

Objective:To explore the effects of lutein on the adhesion,invasiveness and metastasis of human prostate cancer PC-3M cells and its action mechanism.Methods:We divided human prostate cancer PC-3M cells into a control,a low-dose lutein,a medium-dose lutein and a high-dose lutein group,and treated them with 0,10,20 and 40 μmol/L lutein,respectively.Then we ex-amined the adhesion of the cells to matrix by cell adhesion assay and the changes in cell pseudopodia by Phalloidin staining,detected the expressions of paxillin,matrix metalloproteinase 2(MMP-2),MMP-9,recombinant tissue inhibitors of metalloproteinase 1(TIMP-1),E-cadherin,N-cadherin and vimentin by Western blot,determined the invasiveness and migration of the cells by scratch and Tran-swell assays,and observed their dynamic movement by high-intension imaging.Results:Compared with the control,the lutein inter-vention groups showed significant reduction in the number of the cells adhered to matrix,the number of cell pseudopodia,the expres-sions of paxillin,MMP-2,MMP-9,N-cadherin and vimentin,the rates of migration,invasion and metastasis,and the distances of dis-placement and movement of the cells.However,the expressions of TIMP-1 and epithelial-mesenchymal transition-related E-cadherin were upregulated significantly.Conclusion:Lutein can inhibit cell adhesion,reduce the expressions of MMPs,and suppress cell in-vasion and migration by inhibiting the proeess of epithelial-mesenchymal transition.

OBJECTIVE: To investigate the incidence and related risk factors of healthy side fracture after hip fracture surgery in the elderly, so as to provide basis for the prevention of re-fracture. METHODS: The data of 452 patients over 65 years old with femoral neck fracture or intertrochanteric fracture treated with hip arthroplasty or proximal femoral intramedullary nailing from June 2012 to June 2017 were analyzed, including 168 males and 284 females, the age ranged from 65 to 97(75.5±7.5) years. There were 191 cases of femoral neck fracture and 261 cases of femoral intertrochanteric fracture. According to whether there was a fracture in the healthy hip after operation, the patients were divided into fracture group and no fracture group. The gender, age, body mass index, fracture type, initial treatment method, bone mineral density, bed time, medical compliance, postoperative short-term delirium, whether there were medical diseases before injury and Harris score of hip joint in the final follow-up were recorded. Univariate Logistic regression analysis was used to screen out the risk factors of healthy side fracture after operation, and then statistically significant risk factors were included in multi factor Logistic regression analysis to screen out the independent risk factors of healthy side fracture after operation of hip fracture in the elderly. RESULTS: Among them, 42 of the 452 patients had hip fractures on the healthy side with an incidence of 9.3%. The average interval between the two fractures was (2.9±2.1) years. Univariate Logistic regression analysis showed that there were significant differences in age, bone mineral density, medical compliance, short-term postoperative deliriun, pre-injury complicated with medical diseases and Harris score of hip joint in the final follow-up (P<0.05). Multivariate Logistic analysis showed that age(OR=4.227), bone mineral density(OR=4.313), combined with medical diseases (OR=5.616) and low hip Harris score at the final follow-up (OR=3.891) were independent risk factors for healthy side fractures after hip fracture surgery in elderly(P<0.05). CONCLUSION The age, bone mineral density, combined with medical diseases and low Harris score of hip joint in the final follow-up are the main risk factors of healthy side fracture after hip fracture in the elderly. It is necessary to strengthen the treatment of medical diseases, anti osteoporosis and improve hip joint function within 3 years after operation, so as to prevent the occurrence of healthy side hip fracture.
Aged ; Aged, 80 and over ; Bone Density ; Female ; Femoral Fractures ; Femoral Neck Fractures/surgery* ; Femur ; Hip Fractures/surgery* ; Humans ; Male ; Risk Factors

Ischaemic stroke is a common condition leading to human disability and death. Previous studies have shown that oleanolic acid (OA) ameliorates oxidative injury and cerebral ischaemic damage, and miR-186-5p is verified to be elevated in serum from ischaemic stroke patients. Herein, we investigated whether OA regulates miR-186-5p expression to control neuroglobin (Ngb) levels, thereby inhibiting neuronal pyroptosis in ischaemic stroke. Three concentrations of OA (0.5, 2, or 8 μM) were added to primary hippocampal neurons subjected to oxygen–glucose deprivation/ reperfusion (OGD/R), a cell model of ischaemic stroke. We found that OA treatment markedly inhibited pyroptosis. qRT–PCR and western blot revealed that OA suppressed the expression of pyroptosis-associated genes. Furthermore, OA inhibited LDH and proinflammatory cytokine release. In addition, miR-186-5p was downregulated while Ngb was upregulated in OA-treated OGD/R neurons. MiR-186-5p knockdown repressed OGD/R-induced pyroptosis and suppressed LDH and inflammatory cytokine release. In addition, a dual luciferase reporter assay confirmed that miR-186-5p directly targeted Ngb. OA reduced miR-186-5p to regulate Ngb levels, thereby inhibiting pyroptosis in both OGD/R-treated neurons and MCAO mice. In conclusion, OA alleviates pyroptosis in vivo and in vitro by downregulating miR-186-5p and upregulating Ngb expression, which provides a novel theoretical basis illustrating that OA can be considered a drug for ischaemic stroke.

OBJECTIVE: To establish a 3D finite element model of normal knee joint involved its meniscus, which can be used to simulate the anatomical morphology and characteristics of human knee joint, to verify the validity of the model by preliminary FEA mechanical analysis, and explain partially biomechanical mechanisms of meniscus. METHODS: CT and MRI data were harvested by scanning the knee joint of a healthy male volunteer, and then these data were imported into Mimics 10.01 software and Geomagic Studio software to constructed the 3D models of tissue structures of knee joint. These models were combined to constructed the 3D model of intact knee joint and meshed in ANSA software. Therefore the finite element model of intact knee joint was established. Finally, after the definitionof its material behavior, boundary conditions and loading. The finite element model of knee joint was analyzed and verified using ANSYS software. Meanwhile The biomechanical properties of meniscus were analyzed. RESULTS: The complete knee finite element model composed of bone, meniscus, articular cartilage, and major ligaments was established. It could effectively simulate the anatomical morphology and characteristics of knee joint and its meniscus. The contact area of medial meniscus was 771.05 mm, while the contact area of lateral meniscus was 634.31 mm, and the ratio was 1.216. The stress distribution was uniform, but the stress of the medial meniscus was higher than that of the lateral meniscus, and the peak stress located in the posterior horn of the medial meniscus and the anterior horn of the lateral meniscus, respectively, and the peak stress value was 4.11 MPa. The maximum displacement of the meniscus was located in body, and the displacement of the medial meniscus was more remarkable than that of the lateral meniscus, and the maximum displacement value is 0.33 mm. The obtained finite element analysis results corresponded to that reported in the literature, which mean the model's reliability. CONCLUSION The established finite element model of knee joint are proved to be have validity, and is a useful model for finite element analysis of meniscus tear and menisectomy. The results of finite element analysis can explain partially biomechanical mechanisms of meniscus which can provide theoretical guidance for clinical treatment of meniscus injury.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Knee Joint ; Male ; Menisci, Tibial ; Meniscus ; Reproducibility of Results ; Stress, Mechanical

Objective　The aim of this study was to compared the clinical effect of ureteroscopic holmium laser incision (USHLI) with that of ureteroscopic cold knife incision (USCKI) in the treatment of ureteral stricture.　Methods　Seventy-eight patients with ureteral stricture underwent USHLI (n = 40) or USCKI (n = 38) in the Armed Police Corps Hospital of Jiangsu Province from January 2010 to December 2016. Comparisons were made between the two surgical strategies in the operation time, postoperative complications, hospital days, short-term effect and long-term effect.Results　Mild postoperative hematuria occurred in all the patients of the USHLI group, which lasted 1-2 days before it disappeared without intervention, but with no other severe complications as adjacent organ injury, ureteral avulsion, or massive hemorrhage. Moderate postoperative hematuria was observed in all the patients of the USCKI group, which was stopped at 2-3 days by administration of hemostatics. Compared with USCKI, USHLI achieved a significantly shorter operation time ([43.4 ± 5.8] vs [35.3 ± 3.8] min, P < 0.05) and postoperative hospital stay ([5.0 ± 1.4] vs [4.0 ± 0.8] d, P < 0.05), lower incidence of postoperative infection (27.3% vs 7.7%, P < 0.05), and higher cure rate (57.6% vs 87.2%, P < 0.05).　Conclusion　USHLI, with its advantages of less damage, lower recurrence rate and fewer complications, is obviously superior to USCKI in the treatment of ureteral stricture.

The meniscus biomechanics is one of the hottest areas in medical research. Finite element analysis(FEA) provides a new method for biomechanical studies. Using the FEA, the stress force and strain distribution characteristics of the normal meniscus can be analysed by establishing the finite element model of the meniscus and utilizing finite element softwares. In addition, the finite simulation of the meniscus tears, meniscectomy, and knee tissue injury can assess the changes of meniscus biomechanical properties. These research results provide theoretical basis of biomechanics to prevent and treat knee joint injuries. However, the finite element analysis method has its limitations, future research will be aimed at establishing high quality finite element models, making the models offer more authentic simulations of the meniscus anatomy, and ensuring the FEA could be applied to research a variety of knee injuries.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Knee Injuries ; Menisci, Tibial ; Meniscus ; Models, Biological ; Tibial Meniscus Injuries

OBJECTIVE: To compare clinical efficacy of long Gamma 3 nail and proximal femur locking plate (PFLP) in treating femoral subtrochanteric fractures. METHODS: From January 2010 to January 2017, clinical data of 58 patients with subtrochanteric fractures followed more than 12 months were retrospective analyzed. Among them, 35 patients were treated with long Gamma 3 nail including 18 males and 17 females aged from 25 to 78 years old with an average of(66.5±23.5) years old;Causes of injury included fall on the ground in 18 cases, traffic accidents in 7 cases, and fall from height in 10 cases. The other 23 patients were treated with PFLP fixation including 8 males and 15 females aged from 31 to 81 years old with an average of (63.4±22.4) years old;Causes of injury included fall on the ground in 12 cases, traffic accidents in 6 cases, and fall from height in 5 cases. Operative time, blood loss (intraoperative and hidden blood loss), hospital stays, bone healing and complications were observed and compared. Harris hip score after 1-year following-up was used to evaluate postoperative clinical effect. RESULTS: Fifty-one patients were followed up from 14 to 36 months with an average of 24.8 months, including 31 patients were treated with long Gamma 3 and 20 patients were treated with PFLP. Blood loss(intraoperative and hidden blood loss) in PFLP group was less than that of long Gamma 3 nail group(<0.05). There was no significant in operative time, hospital stays and complications between two groups(>0.05). There was no significant differences in healing time of fractures between long Gamma 3 nail group (17.2±2.4) weeks and PFLP group (18.1±2.6) weeks(<0.05). At 1-year following-up, there was no significant differences in Harris hip score between long Gamma 3 nail group(80.29±10.28) and PFLP group (76.49±12.28)(<0.05). No complications such as pulmonary embolism and nonunion occurred. Two patients were treated with fitler whose occurred deep vein thrombosis. Postoperative pulmonary infection curred in 4 cases and was cured by anti-infection therapy. CONCLUSIONS Both of long Gamma 3 nail and PFLP in treating patients with femoral subtrochanteric fractures can receive good clinical effects, long Gamma 3 nail is not suitable for the patients of the narrow medullary cavity and prominent anterior arch. PFLP is eccentric fixation, so early weight-bearing was not stress.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Thoracolumbar fractures are common and severe traumas. Anterior approaches can achieve adirect spinal cord decompression and reconstruct anterior column height what load bearing the major load distribution of the spine. Therefore, anterior approach is an important method in the treatment of thoracolumbar fractures. With the application of pedicle screw, most of the patients were treated with posterior approaches.Because of the unique advantages of anterior approach, the posterior approach can not be replaced it.The review summarizes the biomechanical characteristics? indications? fixation devices? bone grafting method and technique of the anterior approach and in order to provide better evidence for clinical treatment of thoracolumbar fractures.