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[Epidemiological and clinical characteristics of human ocular helaziasis in China from 2011 to 2022 based on bibliometrics]. ZHONGGUO XUE XI CHONG BING FANG ZHI ZA ZHI = CHINESE JOURNAL OF SCHISTOSOMIASIS CONTROL 2023; 35:513-516. [PMID: 38148542 DOI: 10.16250/j.32.1374.2023061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To understand the clinical and epidemiological characteristics of human ocular thelaziasis patients in China. METHODS Case reports regarding human ocular thelaziasis cases in China were retrieved in international and national electronic databases, including CNKI, VIP, CBM, Traditional Chinese Medical Literature Analysis and Retrieval System, Wanfang Database, PubMed and Web of Science from 2011 to 2022. Patients' gender, age, clinical symptoms, treatment, recurrence, site of infections, time of onset, affected eye, affected sites, number of infected Thelazia callipaeda, sex of T. callipaeda and source of infections were extracted for descriptive analyses. RESULTS A total of 85 eligible publications were included, covering 101 cases of human ocular thelaziasis, including 57 males (56.44%) and 44 females (43.56%) and aged from 3 months to 85 years. The main clinical manifestations included foreign body sensation (56 case-times, 22.49%), eye itching (38 case-times, 15.26%), abnormal or increased secretions (36 case-times, 14.46%), tears (28 case-times, 11.24%) and eye redness (28 case-times, 11.24%), and conjunctival congestion (50 case-times, 41.67%) was the most common clinical sign. The most common main treatment (99/101, 98.02%) was removal of parasites from eyes using ophthalmic forceps, followed by administration with ofloxacin and pranoprofen. In publications presenting thelaziasis recurrence, there were 90 cases without recurrence (97.83%) and 2 cases with recurrence (2.17%). Of all cases, 51.96% were reported in four provinces of Hubei, Shandong, Sichuan, Hebei and Henan, and ocular thelaziasis predominantly occurred in summer (42.19%) and autumn (42.19%). In addition, 56.45% (35/62) had a contact with dogs. CONCLUSIONS The human thelaziasis cases mainly occur in the continental monsoon and subtropical monsoon climate areas such as the Yellow River and the Yangtze River basin, and people of all ages and genders have the disease, with complex clinical symptoms and signs. Personal hygiene is required during the contact with dogs, cats and other animals, and individual protection is required during outdoor activities to prevent thelaziasis.
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An investigation of the PM 2.5 concentrations and cumulative inhaled dose during subway commutes in Changchun, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL SCIENCE AND TECHNOLOGY : IJEST 2023:1-14. [PMID: 37360559 PMCID: PMC10208554 DOI: 10.1007/s13762-023-04994-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/13/2023] [Accepted: 05/08/2023] [Indexed: 06/28/2023]
Abstract
Air quality in subway systems is crucial as it affects the health of passengers and staff. Although most tests of PM2.5 concentrations in subway stations have taken place in public areas, PM2.5 is less understood in workplaces. Few studies have estimated the cumulative inhaled dose of passengers based on real-time changes in PM2.5 concentrations as they commute. To clarify the above issues, this study first measured PM2.5 concentrations in four subway stations in Changchun, China, where measuring points included five workrooms. Then, passengers' exposure to PM2.5 during the whole subway commute (20-30 min) was measured and segmented inhalation was calculated. The results showed that PM2.5 concentration in public places ranged from 50 to 180 μg/m3, and was strongly correlated with outdoors. While the PM2.5 average concentration in workplaces was 60 µg/m3, and it was less affected by outdoor PM2.5 concentration. Passenger's cumulative inhalations in single commuting were about 42 μg and 100 μg when the outdoor PM2.5 concentrations were 20-30 μg/m3 and 120-180 μg/m3, respectively. The PM2.5 inhalation in carriages accounted for the largest proportion of the entire commuting, about 25-40%, because of the longer exposure time and higher PM2.5 concentrations. It is recommended to improve the tightness of the carriage and filter the fresh air to improve the air quality inside. The average daily PM2.5 inhaled by staff was 513.53 μg, which was 5-12 times higher than that of passengers. Installing air purification devices in workplaces and reminding staff to take personal protection can positively protect their health.
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[Micro-CT analysis of tooth development of C57BL/6 mice strain]. ZHONGHUA KOU QIANG YI XUE ZA ZHI = ZHONGHUA KOUQIANG YIXUE ZAZHI = CHINESE JOURNAL OF STOMATOLOGY 2023; 58:238-243. [PMID: 36854424 DOI: 10.3760/cma.j.cn112144-20220802-00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Objective: To investigate the normal process of tooth development of C57BL/6 mouse strain by using micro-CT for better understanding about the tooth development of the human being and other species. Methods: A total of 54 C57BL/6 mice were used at postnatal day 1 (P1), P3, P7, P10, P14, P21, P28, P42 and P56 (n=6 for each age group). After euthanasia, the skulls and alveolar bones (with molars) were isolated and scanned by micro-CT scanner. After three dimensional reconstruction, the developmental status of the crown and root(s) for each tooth type was examined in different views. Results: The tooth development of mice from birth to mature (P56) could be divided into three stages. The first stage was from P1 to P14, in which the crowns of all the first, second and third molars had formed, while the roots had not fully developed yet. The second stage was from ablactation (P21) to P28, in which all the roots of the molars had reached their normal length, and the apical foramens had closed. Due to the mastication and occlusal abrasion, the incisors exhibited sharp cutting edges at the buccal enamel layer, and the corresponding molars formed a pit-to-fossa articulated relationship. The third stage was from P42 to P56, in which the root canal differentiation occurred, and 1-2 canal configuration was formed in several flat roots. The development of molar roots had completed and the apexes were enlarged due to the deposition of cementum around. Conclusions: In the process of mouse tooth development, the mineralization of the cusps, followed by crown formation and roots elongation, was precisely regulated in a spatial-temporal pattern. The incisors and the molars exhibited different modes of development.
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[Research advances on prostate cancer related genes]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2022; 51:1065-1068. [PMID: 36207931 DOI: 10.3760/cma.j.cn112151-20220422-00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Tranexamic acid combined with compression dressing reduces blood loss in gluteal muscle contracture surgery. BMC Surg 2022; 22:46. [PMID: 35148736 PMCID: PMC8832768 DOI: 10.1186/s12893-022-01497-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/25/2022] [Indexed: 02/08/2023] Open
Abstract
Background Blood loss and incision-related complications caused by the surgical procedure to release gluteal muscle contracture (GMC) put negative effects on the surgical outcomes. Current procedures to prevent blood loss and complications are not satisfactory. The current study aimed to determine whether tranexamic acid (TXA) in combination with pressure dressing reduce the amount of blood loss, the rate of incision-related complications, and the rate of readmission for patients undergoing surgeries to release GMC. Methods 49 GMC patients were finally included in the study and were randomly divided into two groups: study group and control group. Patients in both groups received minimally invasive surgery to release GMC except that in the study group, patients were administered a dosage of 20 mg/kg of intravenous TXA preoperatively, and 2 subsequent dosages of TXA at 10 mg/kg at two time points: 3 and 6 h after the first dose. Gauze soaked with TXA was used to pack the wound for 10 min before the incision closure. Then the wound was pressure-wrapped with a hip-spica bandage for 24 h after the surgery in the study group. Results The level of UBL in the study group was significantly lower compared to that in the control group. Similar results were also found for UMHD and UMAD. The incision-related postoperative complications were greatly decreased in the study group compared to those of the control group as well. So was the 30-day readmission rate. All patients in both groups reached “excellent” or “good” level with respect to the postoperative function evaluation. Conclusions Intravenous and topical application of TXA combined with 24 h pressure hip-spica bandage reduces perioperative blood loss, rate of incision-related complications, and the rate of readmission for GMC patients undergoing minimally invasive surgical releasing procedure. Trial Registration Chinese Clinical and Trial Registry ChiCTR2000039216, registration date 2020/10/22, retrospectively registered
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Predicting postoperative transfusion in elective total HIP and knee arthroplasty: Comparison of different machine learning models of a case-control study. Int J Surg 2021; 96:106183. [PMID: 34863965 DOI: 10.1016/j.ijsu.2021.106183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/05/2021] [Accepted: 11/24/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Total joint arthroplasty (TJA) is a very successful orthopedics procedure but associates with a significantly high transfusion rate. OBJECTIVE In this study, we aimed to determine predictors of postoperative blood transfusion in patients undergoing elective hip and knee TJA patients and compare the accuracy of machine learning (ML) algorithms in predicting transfusion risk. METHODS We utilized data from 12,642 patients undergoing primary unilateral TJA. Risk factors and demographic information were extracted, and predictive models were developed using seven ML algorithms. The area under the receiver operating characteristic curve was used to measure the predictive accuracy of each algorithm. RESULTS The overall transfusion rate was 18.7%. Patient-related risk factors for transfusion included age 65-85 (Odds Ratio (OR): 1.175-1.222), female (OR: 1.246), American Society of Anesthesiologists grade Ⅱ or greater (OR: 1.264-2.758). Surgical factors included operation time (OR: 1.736), drain use (OR: 2.202) as well as intraoperative blood loss (OR: 7.895). Elevated preoperative Hb (OR: 0.615), Hct (OR: 0.800), BMI (≥24 kg/m2) (OR: 0.613-0.731) and tranexamic acid use (OR: 0.375) were associated with decreased risk of postoperative transfusion. The long short-term memory networks (LSTM) and random forest (RF) models achieved the highest predictive accuracy (p < 0.001). CONCLUSION The risk factors identified in the current study can provide specific, personalized postoperative transfusion risk assessment for a patient considering lower limb TJA. Furthermore, the predictive accuracies of LSTM and RF algorithms were significantly higher than the others, making them potential tools for future personalized preoperative prediction of risk for postoperative transfusion.
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Abstract
A comprehensive study of odontoblastic differentiation is essential to understand the process of tooth development and to achieve the ability of tooth regeneration in the future. Zinc finger E-box-binding homeobox 1 (Zeb1) is a transcription factor expressed in various neural crest-derived tissues, including the mesenchyme of the tooth germ. However, its role in odontoblastic differentiation remains unknown. In this study, we found the expression of Zeb1 gradually increased during odontoblast differentiation in vivo, as well as during induced differentiation of cultured primary murine dental papilla cells (mDPCs) in vitro. In addition, the differentiation of mDPCs was repressed in Zeb1-silenced cells. We used RNA sequencing (RNA-seq) to identify the transcriptome-wide targets of Zeb1 and used assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) to explore the direct targets of Zeb1 in both the early stage (embryonic day 16.5; E16.5) and the late stage (postnatal day 0; PN0) of tooth development. We identified the motifs of transcription factors enriched in Zeb1-dependent accessible chromatin regions and observed that only in the early stage of mDPCs could Zeb1 significantly change the accessibility of chromatin regions. In vivo and in vitro experiments confirmed that silencing of Zeb1 at E16.5 inhibited dentinogenesis. Analysis of RNA-seq and ATAC-seq resulted in the identification of Runx2, a gene directly regulated by Zeb1 during early odontoblast differentiation. Zeb1 enhances the expression of Runx2 by binding to its cis-elements, and ZEB1 interacts with RUNX2. In the late stage of tooth development, we found that ZEB1 could directly bind to and increase the enhancer activity of an element upstream of Dspp and promote dentinogenesis. In this study, for the first time, we revealed that ZEB1 promoted odontoblast differentiation in the early stage by altering chromatin accessibility of cis-elements near genes such as Runx2, while in the late stage, it directly enhanced Dspp transcription, thereby performing a dual role.
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[Effect of inhibiting the activity of double-stranded RNA-dependent protein kinase in sepsis mice]. ZHONGHUA YI XUE ZA ZHI 2020; 100:1033-1037. [PMID: 32294863 DOI: 10.3760/cma.j.cn112137-20190825-01888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the effects of 2-aminopurine (2-AP), a double-stranded RNA-dependent protein kinase (PKR) inhibitor, on organ function, plasma inflammatory factor expression and 7 days mortality in sepsis mice induced by cecal ligation puncture (CLP). Methods: Forty specific specific pathogen free C57BL/6 mice were randomly divided into sham group (n=10), CLP group (n=10), CLP+2-AP group (n=10) and 2-AP group (n=10). CLP was used to establish sepsis mice models.Peripheral blood serum was collected 24 hours after operation, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Cr), blood urea nitrogen (BUN) and inflammatory factors (IL-1β, IL-10 and TNF-α) were detected; peripheral blood and peritoneal lavage fluid were taken for bacterial clearance detection. Another 60 C57BL/6 mice were selected to observe the 7-day survival rate according to the above groups (n=15). Independent sample t test was used to compare the measurement data between groups. Results: The levels of ALT, AST, Cr and BUN in CLP Group and CLP+2-AP group were significantly higher than those in sham group (all P<0.001). The levels of ALT and AST in CLP+2-AP group were significantly lower than those in CLP Group (t=27.88, 11.33, both P<0.001); the levels of Cr and BUN in CLP+2-AP group were significantly lower than those in CLP Group (t=11.02, 7.15, bothP<0.001). Compared with sham group, the levels of pro-inflammatory (IL-1β and TNF-α) and anti-inflammatory (IL-10) cytokines in CLP group were significantly higher (all P<0.001); the levels of IL-1β and IL-10 in CLP+2-AP group were significantly lower (all P<0.001), but the levels of TNF-α in CLP+2-AP group were not significantly lower (P=0.33). The 7-day survival rate was 100% in sham group, 13.3% in CLP+2-AP group, 86.7% in 2-AP group and 20.0% in CLP+2-AP group. Inhibition of PKR activation slightly improved the trend of 7-days survival rate of CLP model mice (analysis by mantel Cox test, χ(2)=0.0012, P=0.97). Conclusion: In sepsis mice model, inhibition of PKR activity can reduce the expression of inflammatory factors in plasma, decrease bacterial load in blood and abdominal cavity, and protect organ function, which could suggest that inhibition of PKR activity has potential application in sepsis treatment.
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Faecal microbiota transplantation from metabolically compromised human donors accelerates osteoarthritis in mice. Ann Rheum Dis 2020; 79:646-656. [PMID: 32205337 PMCID: PMC7384301 DOI: 10.1136/annrheumdis-2019-216471] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Emerging evidence suggests that the microbiome plays an important role in the pathogenesis of osteoarthritis (OA). We aimed to test the two-hit model of OA pathogenesis and potentiation in which one 'hit' is provided by an adverse gut microbiome that activates innate immunity; the other 'hit' is underlying joint damage. METHODS Medical history, faecal and blood samples were collected from human healthy controls (OA-METS-, n=4), knee OA without metabolic syndrome (OA+METS-, n=7) and knee OA with metabolic syndrome (OA+METS+, n=9). Each group of human faecal samples, whose microbial composition was identified by 16S rRNA sequencing, was pooled and transplanted into germ-free mice 2 weeks prior to meniscal/ligamentous injury (MLI) (n≥6 per group). Eight weeks after MLI, mice were evaluated for histological OA severity and synovitis, systemic inflammation and gut permeability. RESULTS Histological OA severity following MLI was minimal in germ-free mice. Compared with the other groups, transplantation with the OA+METS+ microbiome was associated with higher mean systemic concentrations of inflammatory biomarkers (interleukin-1β, interleukin-6 and macrophage inflammatory protein-1α), higher gut permeability and worse OA severity. A greater abundance of Fusobacterium and Faecalibaterium and lesser abundance of Ruminococcaceae in transplanted mice were consistently correlated with OA severity and systemic biomarkers concentrations. CONCLUSION The study clearly establishes a direct gut microbiome-OA connection that sets the stage for a new means of exploring OA pathogenesis and potentially new OA therapeutics. Alterations of Fusobacterium, Faecalibaterium and Ruminococcaceae suggest a role of these particular microbes in exacerbating OA.
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Hemostatic and Anti-Inflammatory Effects of Carbazochrome Sodium Sulfonate in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial. J Arthroplasty 2020; 35:61-68. [PMID: 31471180 DOI: 10.1016/j.arth.2019.07.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Postoperative recovery after total knee arthroplasty (TKA) is associated with postoperative anemia, allogeneic transfusion, and stress immune responses to surgery. Carbazochrome sodium sulfonate (CSS) reduces bleeding through several mechanisms. We assessed the effect of CSS combined with tranexamic acid (TXA) on postoperative anemia, blood transfusion, and inflammatory responses. METHODS This study was designed as a randomized, placebo-controlled trial of 200 patients undergoing unilateral primary TKA. Patients were divided into 4 groups: group A received TXA plus topical and intravenous CSS; group B received TXA plus topical CSS only; group C received TXA plus intravenous CSS only; group D received TXA only. RESULTS Total blood loss in groups A (609.92 ± 221.24 mL), B (753.16 ± 247.67 mL), and C (829.23 ± 297.45 mL) was lower than in group D (1158.26 ± 334.13 mL, P < .05). There was no difference in total blood loss between groups B and C. We also found that compared with group D, the postoperative swelling rate, biomarker level of inflammation, visual analog scale pain score, and range of motion at discharge in groups A, B, and C were significantly improved (P < .05). No thromboembolic complications occurred. There were no differences in transfusion rate, intraoperative blood loss, platelet count, or average length of stay among the 4 groups (P > .05). CONCLUSION CSS combined with TXA was more effective than TXA alone in reducing perioperative blood loss and inflammatory response and did not increase the incidence of thromboembolism complications.
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Abstract
Each odontoblast is tightly linked to other odontoblasts. They form a line of defense and are capable of withstanding external stimuli, particularly the inflammation caused by caries. Thus, we investigated exosomes derived from odontoblasts as an intercellular mechanism by which inflamed odontoblasts are protected from apoptosis. CD63, an exosome marker, was expressed at high levels in caries-affected regions of the dental pulp. We conducted an ex vivo experiment by applying different concentrations of lipopolysaccharide (LPS) to the odontoblast-like cells (mineralization was induced in stem cells derived from the apical papilla). Odontoblast-like cells treated with a high concentration of LPS (20 µg/mL LPS, severely affected) exhibited an accelerated release of exosomes, which attenuated the LPS-induced cell apoptosis of odontoblast-like cells treated with a low concentration of LPS (1 µg/mL LPS, mildly affected). Next, we blocked exosome uptake with chlorpromazine, and the rescue effect vanished. Based on our findings, severely inflamed odontoblasts attenuate the apoptosis of mildly inflamed neighboring cells through an exosome-mediated intercellular signaling pathway.
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[Effect of Anluohuaxianwan on the expression of matrix metalloproteinases and their inhibitors in rat liver with fibrosis]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2019; 27:267-273. [PMID: 31082337 DOI: 10.3760/cma.j.issn.1007-3418.2019.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of anluohuaxianwan (ALHXW) using rat model of carbon tetrachloride (CCl(4)) induced liver fibrosis on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Methods: Thirty-six male Wistar rats were randomly assigned into control, model and treatment groups. Rats in the model and treatment groups were injected intraperitoneally with 40% CCl(4) (2 ml/kg), and the control group were given isotonic saline twice a week for six weeks. Meanwhile, the treatment group were gavaged with ALHXW solution daily (concentration 0.15 g/ml, 9.9 ml/kg) for 6 weeks, while the control and model groups were given isotonic saline once a day for 6 weeks. Serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at the end of third and sixth week. At the end of six weeks, liver tissues were harvested for histopathological evaluation and the detection of mRNA and protein expression levels of MMP-2/13 and TIMP-1/2. According to different data, LSD method, parametric (one-way ANOVA) and non-parametric tests (Kruskal-Wallis H-test and Mann-Whitney U test) were used for statistical analysis. Results: Compared with the model group, ALHXW markedly alleviated liver injury in the treatment group, and thereby improved the general state of rats, liver and spleen morphological characteristics, and ALT and AST levels. Histopathological examination demonstrated that the extent of liver fibrosis was improved (2.75 ± 0.75 vs. 3.55 ± 0.69, P = 0.015) in the treatment group as compared with the model group. The mRNA and protein expression levels of MMP-13 in the treatment group were significantly higher than that of the model group (mRNA: 10.50 ± 7.64 vs. 4.40 ± 2.97, P = 0.029. Protein: 1.15 ± 0.09 vs. 0.78 ± 0.21, P = 0.016), whereas the mRNA and protein expression levels of MMP-2, TIMP-1/2 in the treatment group were significantly lower than that of the model group (mRNA: 4.55 ± 3.29 vs. 7.83 ± 4.19, P = 0.048; 1.66 ± 0.73 vs. 3.69 ± 2.78, P = 0.023; 2.25 ± 1.16 vs. 3.41 ± 1.51, P = 0.049; respectively. Protein: 0.44 ± 0.11 vs. 0.65 ± 0.05, P = 0.03; 0.69 ± 0.06 vs. 1.07 ± 0.21, P = 0.016; 0.46 ± 0.09 vs. 0.81 ± 0.13, P = 0.003; respectively). Conclusion: ALHXW exerts anti-liver fibrosis effects mainly by improving liver function, inhibiting the activation of hepatic stellate cells, enhancing the expression of MMP-13, and inhibiting the expression of MMP-2 and TIMP-1/2.
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A comparison of adductor canal block and femoral nerve block after total-knee arthroplasty regarding analgesic effect, effectiveness of early rehabilitation, and lateral knee pain relief in the early stage. Medicine (Baltimore) 2018; 97:e13391. [PMID: 30508936 PMCID: PMC6283224 DOI: 10.1097/md.0000000000013391] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this study was to compare the analgesic effect on the lateral and overall knee and early rehabilitation between adductor canal block (ACB) and femoral nerve block (FNB) after total-knee arthroplasty. METHOD Two hundred patients randomly participated in the study and were divided into the ACB group and FNB group in a randomized manner. All patients received standardized anesthesia and analgesia upon hospitalization. Outcome evaluations included visual analog scale (VAS) scores at rest and during activity, quadriceps strength, range of motion (ROM), total opioid consumption and complication occurrence, sleep interruptions caused by pain, postoperative nausea and vomiting (PONV), and postoperative length of stay (PLOS) before discharge in all groups. In the 90-day postoperative follow-up, we also observed the acute deep periprosthetic joint infection, wound breakdown, readmission, reoperations, inpatient falls, ROM, and patient satisfaction score. RESULTS The lateral knee VAS scores are lower in the FNB group at rest and during activity (2-24 hours postoperatively) compared with those in the ACB group. However, the overall knee VAS score, total opioid consumption and complication occurrence, sleep interruptions caused by pain, and PONV are similar between the FNB and ACB groups. When evaluating early rehabilitation, the quadriceps strength in the ACB group is superior to that in the FNB group 24 hours postoperatively. At 24, 48, and 72 hours postoperatively, ROM in the ACB group is significantly better than that in the FNB group. Furthermore, the ACB group has a shorter PLOS (4.5 ± 0.60 days) than the FNB group (5.3 ± 0.7 days). However, patient satisfaction score, readmission rate, inpatient falls, acute deep periprosthetic joint infection, and wound breakdown are not statistically significantly different between the 2 groups. CONCLUSION The ACB does not relieve lateral knee pain in the early stage but provides similar analgesic effect and better effectiveness of early rehabilitation compared with FNB in patients undergoing TKA.
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[Treatment stragegy of immunosuprression for sepsis]. ZHONGHUA YI XUE ZA ZHI 2018; 98:2777-2780. [PMID: 30248779 DOI: 10.3760/cma.j.issn.0376-2491.2018.35.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Analysis of a large data set to identify predictors of blood transfusion in primary total hip and knee arthroplasty. Transfusion 2018; 58:1855-1862. [PMID: 30145838 DOI: 10.1111/trf.14783] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/05/2018] [Accepted: 03/05/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The aim of this study was to identify the predictors of need for allogenic blood transfusion (ALBT) in primary lower limb total joint arthroplasty (TJA). STUDY DESIGN AND METHODS This study utilized a large dataset of 15,187 patients undergoing primary unilateral TJA. Risk factors and demographic information were extracted from the electronic health record. A predictive model was developed by both a random forest (RF) algorithm and logistic regression (LR). The area under the receiver operating characteristic curve (AUC-ROC) was used to compare the accuracy of the two methods. RESULTS The rate of ALBT was 18.9% in total. Patient-related factors associated with higher risk of an ALBT included female sex, American Society of Anesthesiologists (ASA) II, ASA III, and ASA IV. Surgery-related risk factors for ALBT were operative time, drain use, and amount of intraoperative blood loss. Higher preoperative hemoglobin and tranexamic acid use were associated with decreased risk for ALBT. The RF model had a better predictive accuracy (area under the curve [AUC] 0.84) than the LR model (AUC, 0.77; p < 0.001). CONCLUSION The risk factors identified in the current study can provide specific, personalized perioperative ALBT risk assessment for a patient considering lower limb TJA. Furthermore, the predictive accuracy of the RF algorithm was significantly higher than that of LR, making it a potential tool for future personalized preoperative prediction of risk for perioperative ALBT.
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Chronic kidney disease in Chinese postmenopausal women: A cross-sectional survey. Niger J Clin Pract 2018; 20:153-157. [PMID: 28091429 DOI: 10.4103/1119-3077.198314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Despite advances in the management of chronic kidney disease (CKD), there is ongoing uncertainty regarding the prevalence of CKD in postmenopausal women. This study was designed to investigate both CKD prevalence and related risk factors in a cohort of postmenopausal Chinese women. MATERIALS AND METHODS A cross-sectional survey was administered to a nationally representative sample of female Chinese participants, including a total of 47,204 subjects, among whom were 8573 self-reported postmenopausal women. CKD was defined as either an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 body surface area or else the presence of albuminuria. All subjects completed a questionnaire that included items related to their lifestyles and medical histories. Data were collected on blood pressure, serum creatinine, urinary albumin, and urinary creatinine. Risk factors correlated with the presence of CKD were analyzed using logistic regression analysis. RESULTS Results showed that the adjusted prevalence of an eGFR of < 60 mL/min/1.73 m2 among this postmenopausal survey cohort was 5.3% (95% confidence interval: 4.7-6.1) and of albuminuria, 12.4% (11.7-13.1). The overall prevalence of CKD in this postmenopausal cohort was 16.6% (15.8-17.4). Factors associated with kidney pathology included nephrotoxic drug use, history of cardiovascular disease, hyperuricemia, hypertension, and diabetes (the lower limit of multivariable adjusted odds ratios > 1). CONCLUSION The current study revealed a high prevalence of CKD in Chinese postmenopausal women. These results provide baseline data for disease prevention and treatment.
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The effect of oral versus intravenous tranexamic acid in reducing blood loss after primary total hip arthroplasty: A randomized clinical trial. Thromb Res 2018; 164:48-53. [PMID: 29476990 DOI: 10.1016/j.thromres.2018.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether the administration of multiple boluses of oral and intravenous tranexamic acid (TXA) postoperatively was equivalent in reducing blood loss in primary THA. METHODS A total of 108 patients were randomized into two groups: oral TXA group (54 patients receiving 1 dose of 20 mg/kg intravenous TXA 5-10 min before skin incision and 3 doses of 2 g oral TXA 4 h, 10 h and 16 h postoperatively) and intravenous TXA group (54 patients receiving 1 dose of 20 mg/kg intravenous TXA 5-10 min before skin incision and 3 doses of 1 g intravenous TXA 6 h, 12 h and 18 h postoperatively). The primary outcomes were total blood loss, hidden blood loss, length of hospital stay, hemoglobin (Hb) and hematocrit (Hct) drop. The secondary outcomes were the level of inflammation markers and complications. RESULTS There was no difference in the mean total blood loss or hidden blood loss [728.4 (645.8-806.9) mL vs 703.6 (576.9-832.8) mL, p = 0.745; 634.6 (552.0-715.7) mL vs 606.4 (480.1-734.5) mL, p = 0.710] and length of hospital stay was similar between the two groups. No patients received allogenic blood transfusion. The Hb and Hct drop on the first and second postoperative days were similar (p > 0.05). The level of inflammation markers did not reach statistical significance. The incidence of complications did not differ significantly between the two groups. CONCLUSIONS Multiple boluses of oral TXA and intravenous TXA postoperatively are equivalent in reducing blood loss, Hb and Hct drop in primary THA without increasing the risk of thromboembolic diseases and wound complications.
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Evidence and mechanism by which upper partial fibulectomy improves knee biomechanics and decreases knee pain of osteoarthritis. J Orthop Res 2018; 36:10.1002/jor.23867. [PMID: 29424452 PMCID: PMC7480762 DOI: 10.1002/jor.23867] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 02/07/2018] [Indexed: 02/05/2023]
Abstract
To investigate the change in short-term clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy and to probe into the biomechanical mechanism underlying the clinical benefits of upper partial fibulectomy for medial compartment knee osteoarthritis (KOA). A total of 29 patients with medial compartment KOA underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery. Patients and 20 healthy controls were evaluated by 3D gait analysis and dynamic lower limb musculoskeletal analysis. Both VAS pain and HSS score were significantly improved (p < 0.001) one day after surgery and steadily improved during the subsequent 6 months. HKA angle improved (p = 0.025) immediately and remained stable by 3 months after surgery. The decreased overall peak KAM (decreased by 11.1%) and increased HKA angle (increased by 1.80 degrees from a more varus to more neutral alignment) of affected and operated side by 6 months after surgery were observed. Muscle activity of biceps femoris caput longum of affected and operated side increased immediately and was equivalent to healthy controls by 6 months after surgery (p = 0.007). This pilot study provides biomechanical evidence of benefit from partial upper fibulectomy and indicates a plausible rationale for the improvement in clinical symptoms. Long-term clinical outcomes and precise biomechanical mechanism of partial upper fibulectomy should be further investigated. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-10, 2018.
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Intravenous and Topical Tranexamic Acid Alone Are Superior to Tourniquet Use for Primary Total Knee Arthroplasty: A Prospective, Randomized Controlled Trial. J Bone Joint Surg Am 2017; 99:2053-2061. [PMID: 29257010 DOI: 10.2106/jbjs.16.01525] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Tourniquet use during primary total knee arthroplasty is thought to reduce intraoperative blood loss and improve visibility. Our goal was to investigate whether tourniquet use is necessary for controlling intraoperative blood loss when alternatives such as tranexamic acid (TXA) are available. METHODS One hundred and fifty patients were equally randomized to 3 groups. Group A was treated with a tourniquet as well as multiple doses of intravenous TXA (20 mg/kg 5 to 10 minutes before the skin incision and 10 mg/kg 3, 6, 12, and 24 hours later) along with 1 g of topical TXA, Group B was treated the same as Group A but without the tourniquet, and Group C was treated with the tourniquet only. RESULTS The amount of intraoperative blood loss was similar for the 3 groups. Group B had significantly less hidden blood loss than Group A (p = 0.018) and Group C (p < 0.001). No significant differences (p > 0.05) were observed between Group A and Group B with regard to total blood loss, drainage volume, intraoperative blood loss, transfusion rate, or maximum change in the hemoglobin (Hb) level. We also found significantly more benefits for Group B compared with Groups A and C with regard to postoperative swelling ratio, levels of inflammatory biomarkers, visual analog scale (VAS) pain scores, range of motion at discharge, Hospital for Special Surgery (HSS) score, and patient satisfaction. There were no significant differences (p > 0.05) in the deep venous thrombosis or pulmonary embolus rates among the 3 groups. More wound secretion was observed in the groups in which a tourniquet was used. CONCLUSIONS Patients treated with multiple doses of intravenous and topical TXA without a tourniquet had less hidden blood loss, a lower ratio of postoperative knee swelling, less postoperative knee pain, lower levels of inflammatory biomarkers, better early knee function, and even better early satisfaction than those treated with a tourniquet. Long-term follow-up should be performed to evaluate the effects on prosthetic fixation and long-term survival of total knee arthroplasty performed without a tourniquet. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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[Silencing of vacuolar ATPase c subunit ATP6V0C inhibits invasion of prostate cancer cells]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2017; 49:937-947. [PMID: 29263462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Vacuolar ATPase (V-ATPase) was found within the membranes and internal organelles of a vast array of eukaryotic cells, and was related to various kinds of highly metastatic tumors. LASS2/TMSG1 gene was a novel tumor metastasis suppressor gene cloned from human prostate cancer cell line PC-3M in 1999 by our laboratory. It was found out that protein encoded by LASS2/TMSG1 could interact with the c subunit of V-ATPase (ATP6V0C). In this study, To use RNA interference to suppress the expression of ATP6V0C and try to further investigate the molecular mechanism of ATP6V0C in tumor metastasis and its relationship with LASS2/TMSG1 gene. METHODS AND RESULTS The expression level of ATP6V0C mRNA and protein in high metastatic potential prostate cancer cell lines (PC-3M-1E8 and PC-3M) was significantly higher than that in low metastatic potential prostate cancer cell lines (PC-3M-2B4 and PC-3), the expression level in PC-3M-1E8 being the highest. Follow-up tests selected PC-3M-1E8 cells for gene silencing. The expression and secretion of MMP-2 and the expression of MMP-9 in ATP6V0C siRNA transfected PC-3M-1E8 cells displayed no obvious change, but the activity of secreted MMP-9 was abated noticeably compared with the controls (P<0.05). Extracellular hydrogen ion concentration and V-ATPase activity in interference group were both reduced significantly compared with the controls (P<0.05). The migration and invasion capacity of ATP6V0C siRNA interfered cells in vitro were diminished significantly compared with the controls (P<0.05). Furthermore, a dramatic reduction of LASS2/TMSG1 mRNA and protein level after transfection of siRNA in PC-3M-1E8 cells was discovered (P<0.05). Confocal immunofluorescence showed a vast co-localization of ATP6V0C protein and LASS2/TMSG1 protein in plasma and membrane. The co-localization signals of control group were much stronger than those of interference group. CONCLUSION Specific siRNA silencing of ATP6V0C gene inhi-bits the invasion of human prostate cancer cells in vitro by mechanism of inhibiting V-ATPase activity and then reducing the extracellular hydrogen ion concentration, inhibiting MMP-9 activation and affecting ECM degradation and reconstruction. Meanwhile, ATP6V0C and LASS2/TMSG1 have interaction and it is likely that ATP6V0C functions as a feedback regulator of LASS2/TMSG1.
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Upper partial fibulectomy improves knee biomechanics and function and decreases knee pain of osteoarthritis: A pilot and biomechanical study. J Biomech 2017; 71:22-29. [PMID: 29449003 DOI: 10.1016/j.jbiomech.2017.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 02/05/2023]
Abstract
To investigate the change in clinical outcomes and biomechanical properties of the knee in response to upper partial fibulectomy. Sixteen patients with medial compartment knee osteoarthritis (KOA) underwent upper partial fibulectomy. Visual analog scale (VAS) pain, the hospital for special surgery knee score (HSS), hip-knee-ankle (HKA) angle (measured in the frontal plane), and flexion/extension range of motion of the knee were assessed before and up to 6 months after surgery. Patients were evaluated for gait parameters and overall peak knee adduction moment (KAM). Patient-specific finite element knee models were developed to investigate changes in load in response to fibulectomy. Both VAS pain and HSS score were significantly improved (P < .001) one day after surgery and steadily improved during the subsequent 6 months. HKA angle improved (P = .006) immediately and remained stable by 3 months after surgery. A significant inverse relationship (R = -0.528, P = .012) between the overall peak KAM (decreased by 19.1%) and the HKA (increased by 1.24° from a more varus to more neutral alignment) angle was observed. The minor load supported by the fibula preoperatively was spread post-operatively over the cortical bone of the tibial shaft. The mean stress in the medial tibial plateau was significantly decreased (P < .001), with a portion of the stress transferred to the posterior-lateral region of the tibial plateau after upper partial fibulectomy. This pilot study provides objective 3D gait and plausible biomechanical evidence for the improvement in clinical symptoms from partial upper fibulectomy.
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Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss and the inflammatory response following enhanced-recovery primary total hip arthroplasty: a randomised clinical trial. Bone Joint J 2017; 99-B:1442-1449. [PMID: 29092982 DOI: 10.1302/0301-620x.99b11.bjj-2017-0488.r1] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/25/2017] [Indexed: 11/05/2022]
Abstract
AIMS The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). PATIENTS AND METHODS A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C). All patients were treated using a standard peri-operative enhanced recovery protocol. Primary outcomes were HBL and the level of haemoglobin (Hb) as well as the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) as markers of inflammation. Secondary outcomes included the length of stay in hospital and the incidence of venous thromboembolism (VTE). RESULTS The mean HBL was significantly lower in group C (402.13 ml standard deviation (sd) 225.97) than group A (679.28 ml sd 277.16, p < 0.001) or B (560.62 ml sd 295.22, p = 0.010). The decrease in the level of Hb between the pre-operative baseline and the level on the third post-operative day was 30.82 g/L (sd 6.31 g/L) in group A, 27.16 g/L (sd 6.83) in group B and 21.98 g/L (sd 3.72) in group C. This decrease differed significantly among the three groups (p < 0.01). The mean level of CRP was significantly lower in group C than in the other two groups on the second (p ≤ 0.034) and third post-operative days (p ≤ 0.014). The levels of IL-6 were significantly lower in group C than group A on the first three post-operative days (p = 0.023). The mean length of stay was significantly lower in group C than group A (p = 0.023). No VTE or other adverse events occurred. CONCLUSION Multiple boluses of IV-TXA can effectively reduce HBL following primary THA. A regime of three boluses leads to a smaller decrease in the level of Hb, less post-operative inflammation and a shorter length of stay in hospital than a single bolus. Cite this article: Bone Joint J 2017;99-B:1442-9.
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Both systemic and local lipopolysaccharide (LPS) burden are associated with knee OA severity and inflammation. Osteoarthritis Cartilage 2016; 24:1769-1775. [PMID: 27216281 PMCID: PMC5026878 DOI: 10.1016/j.joca.2016.05.008] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/12/2016] [Accepted: 05/09/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The microbiome is recognized as a new frontier in medicine with connections to a variety of diseases. We aimed to evaluate the association of lipopolysaccharide (LPS), a key pro-inflammatory product of the microbiome, with severity of inflammation, symptoms and radiographic abnormalities of knee osteoarthritis (OA). DESIGN LPS was measured using a recombinant Factor C (rFC) assay, carefully optimized for systemic and synovial fluid (SF) analyses. LPS binding protein (LBP) was tested in both serum and SF of 25 patients (31 knees) from the Etarfolatide cohort for association with OA phenotypic outcomes. Models were adjusted for age, gender and body mass index. RESULTS Based on LPS spike-and-recovery, both serum and SF dilutions of 0.1% were required to achieve recovery rates of at least 75% in all test specimens. Low coefficients of variation (CVs) (<10%) were achieved with both serum and SF dilutions <0.2%. Serum LPS and LBP were associated with the abundance of activated macrophages in the knee joint capsule and synovium. SF LPS and LBP were associated with the abundance of activated macrophages in the synovium. Serum LPS, LBP and SF LPS were associated with knee osteophyte severity. SF LPS was positively associated with knee joint space narrowing (JSN) severity and total WOMAC score. SF LBP was positively associated with self-reported knee pain score. CONCLUSION These data strongly support a role for LPS in the pathogenesis and severity of structural abnormalities and symptoms of knee OA.
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Abstract
Survival of odontoblasts during infection and inflammation determines prognosis of the dental pulp. CD47 is a “self”-label surface marker on viable cells. The aim of the present study is to investigate the interaction between CD47, autophagy, and apoptosis in inflamed human dental pulp and lipopolysaccharide (LPS)–treated mDPC6T cells. We identified activation of autophagy and apoptosis in the odontoblasts due to inflammation of the human dental pulp. Furthermore, downregulation of CD47 correlated with increased autophagy and apoptosis in dental pulp of the patients afflicted with either caries and/or pulpitis. We also detected colocalization of CD47 and LC3 in the inflamed odontoblasts. In addition, functional study indicated that loss of CD47 activates autophagy and increases apoptosis, indicating that CD47 plays a key role in the LPS-induced autophagy and apoptosis of odontoblasts.
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The effectiveness of low-level laser therapy for nonspecific chronic low back pain: a systematic review and meta-analysis. Arthritis Res Ther 2015; 17:360. [PMID: 26667480 PMCID: PMC4704537 DOI: 10.1186/s13075-015-0882-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/30/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In recent decades, low-level laser therapy (LLLT) has been widely used to relieve pain caused by different musculoskeletal disorders. Though widely used, its reported therapeutic outcomes are varied and conflicting. Results similarly conflict regarding its usage in patients with nonspecific chronic low back pain (NSCLBP). This study investigated the efficacy of low-level laser therapy (LLLT) for the treatment of NSCLBP by a systematic literature search with meta-analyses on selected studies. METHOD MEDLINE, EMBASE, ISI Web of Science and Cochrane Library were systematically searched from January 2000 to November 2014. Included studies were randomized controlled trials (RCTs) written in English that compared LLLT with placebo treatment in NSCLBP patients. The efficacy effect size was estimated by the weighted mean difference (WMD). Standard random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). RESULTS Of 221 studies, seven RCTs (one triple-blind, four double-blind, one single-blind, one not mentioning blinding, totaling 394 patients) met the criteria for inclusion. Based on five studies, the WMD in visual analog scale (VAS) pain outcome score after treatment was significantly lower in the LLLT group compared with placebo (WMD = -13.57 [95 % CI = -17.42, -9.72], I(2) = 0 %). No significant treatment effect was identified for disability scores or spinal range of motion outcomes. CONCLUSIONS Our findings indicate that LLLT is an effective method for relieving pain in NSCLBP patients. However, there is still a lack of evidence supporting its effect on function.
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Abstract
The goal of the clinical use of a bipolar blood-sealing system is to reduce perioperative blood loss in total joint arthroplasty (TJA). This study was performed to determine whether a bipolar sealer is safe and effective in TJA and whether there are any advantages over monopolar sealers. The authors searched electronic databases and reference lists of relevant articles; retrieved all published randomized, controlled trials concerning the subject; and then performed a meta-analysis. Nine clinical trials involving 871 patients were included. The results of the meta-analysis indicate that using a bipolar sealer in TJA could reduce total measured blood loss, intraoperative blood loss, and operative time, which was especially observed in revision TJA for infection and primary total knee arthroplasty without tourniquet use. However, there was no significant difference between the 2 groups in terms of calculated blood loss, hemoglobin decrease, transfusion requirements, length of stay, and complications. The results of the comparison between bipolar and monopolar sealers used in TJA indicate that the routine use of a bipolar sealer for TJA may be of limited benefit except in revision TJA and primary total knee arthroplasty without tourniquet use. In the future, more high-quality randomized, controlled trials are needed to provide robust evidence and confirm the best option.
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Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 2015; 23:1437-1444. [PMID: 25914044 PMCID: PMC4814167 DOI: 10.1016/j.joca.2015.04.005] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/16/2015] [Accepted: 04/02/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the efficacy of low-level laser therapy (LLLT) treatment of knee osteoarthritis (KOA) by a systematic literature search with meta-analyses on selected studies. DESIGN MEDLINE, EMBASE, ISI Web of Science and Cochrane Library were systematically searched from January 2000 to November 2014. Included studies were randomized controlled trials (RCTs) written in English that compared LLLT (at least eight treatment sessions) with sham laser in KOA patients. The efficacy effective size was estimated by the standardized mean difference (SMD). Standard fixed or random-effects meta-analysis was used, and inconsistency was evaluated by the I-squared index (I(2)). RESULTS Of 612 studies, nine RCTs (seven double-blind, two single-blind, totaling 518 patients) met the criteria for inclusion. Based on seven studies, the SMD in visual analog scale (VAS) pain score right after therapy (RAT) (within 2 weeks after the therapy) was not significantly different between LLLT and control (SMD = -0.28 [95% CI = -0.66, 0.10], I(2) = 66%). No significant difference was identified in studies conforming to the World Association of Laser Therapy (WALT) recommendations (four studies) or on the basis of OA severity. There was no significant difference in the delayed response (12 weeks after end of therapy) between LLLT and control in VAS pain (five studies). Similarly, there was no evidence of LLLT effectiveness based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, stiffness or function outcomes (five and three studies had outcome data right after and 12 weeks after therapy respectively). CONCLUSION Our findings indicate that the best available current evidence does not support the effectiveness of LLLT as a therapy for patients with KOA.
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Abstract
EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the available tourniquet application strategies for patients treated with total knee arthroplasty (TKA). 2. Differentiate the potential strengths and limitations of tourniquet release before and after wound closure in TKA. 3. Cite the available evidence regarding tourniquet release before and after wound closure in TKA. 4. Recognize the optimal tourniquet application strategy in TKA based on the available evidence. The authors conducted a meta-analysis to determine the optimal tourniquet application strategy in total knee arthroplasty (TKA). Fourteen high-quality randomized, controlled trials were retrieved. The results showed tourniquet release before wound closure for hemostasis could significantly increase not only the total measured blood loss but also the calculated blood loss in patients treated with TKA, regardless of fixation type. With proper control of the amount of pressure (less than 293 mm Hg) and the duration of application (less than 150 minutes), tourniquet release after wound closure can reduce blood loss in patients treated with primary TKA without increasing the risk of complications. [Orthopedics. 2015; 38(7):445-451.].
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General anesthesia: to catheterize or not? A prospective randomized controlled study of patients undergoing total knee arthroplasty. J Arthroplasty 2015; 30:502-6. [PMID: 25307883 DOI: 10.1016/j.arth.2014.09.028] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/05/2014] [Accepted: 09/23/2014] [Indexed: 02/01/2023] Open
Abstract
This study was to investigate whether urinary catheterization could be avoided for patients undergoing total knee arthroplasty (TKA) under general anesthesia with saphenous nerve block. 314 patients from a single surgical team were randomized to receive either an indwelling urinary catheter or no urinary catheter before the surgery. The results revealed that the prevalence of postoperative urinary retention (POUR) was quite low in both groups (5.7% vs 6.4%, P=1). Additionally, the prevalence of urinary tract infection was significantly higher in patients using an indwelling catheter (5.1% vs 0.6%, P=0.036). We also identified age, male gender, ASA grade, benign prostatic hypertrophy, intraoperative intravenous fluid and duration of surgery as the risk factors for POUR in these patients.
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Combination of intravenous and topical application of tranexamic acid in primary total knee arthroplasty: a prospective randomized controlled trial. J Arthroplasty 2014; 29:2342-6. [PMID: 25007725 DOI: 10.1016/j.arth.2014.05.026] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 05/20/2014] [Accepted: 05/31/2014] [Indexed: 02/01/2023] Open
Abstract
This study was aimed to determine the efficacy and safety of combined intravenous (IV) and topical application of tranexamic acid (TXA) in unilateral total knee arthroplasty (TKA) compared with the IV-TXA. One hundred eight-four patients were enrolled. Participants received either 3g of IV-TXA or 1.5g topical TXA combined with 1.5g IV-TXA. The results revealed that compared with the 3g IV-TXA, adding 1.5g topical TXA to 1.5g IV-TXA in unilateral TKA can have the similar effectiveness in reducing transfusion rate and total blood loss without sacrificing safety. The most important is that by adding topical TXA, patients can gain a smaller maximum decline of hemoglobin (Hb), less drainage volume, less postoperative knee pain, less knee swelling, shorter length of hospital stays and higher short-term satisfaction.
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Blood management of staged bilateral total knee arthroplasty in a single hospitalization period. J Orthop Surg Res 2014; 9:116. [PMID: 25392119 PMCID: PMC4232703 DOI: 10.1186/s13018-014-0116-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 11/03/2014] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Few literatures have studied the blood management in patients treated with staged bilateral primary total knee arthroplasty (TKA) in a single hospitalization period. Therefore, this study aims to evaluate the effectiveness and safety of the newly introduced multimodal blood management (MBM) in these patients. MATERIALS AND METHODS We retrospectively compared the perioperative parameters in 70 cases undergoing staged bilateral primary TKA in a single hospitalization period from 2012-2013 in a single center with two different groups of patients, allocating cases to the group with the newly introduced MBM (Group A, n =33) and controls to the group without the newly introduced MBM (Group B, n =37). The newly introduced MBM protocols include preoperative hemoglobin (Hb) evaluation, high protein diet, tourniquet release after skin closure, preoperative oral iron treatment and femoral canal obturation, and one dose of tranexamic acid (TXA) IV with another one if necessary. While in the control group, only routine blood-saving techniques were used. RESULTS Group A had a transfusion rate of 9% (3/33), whereas 32.4% of patients (12/37) in Group B received allogenic blood transfusion. Significant benefits were also found in Group A in terms of postoperative Hb and hematocrit (Hct), reduction of postoperative pain, swelling, postoperative pain, length of stays, and hospital costs. No deep vein thrombosis (DVT) events were found in all these patients. CONCLUSIONS The newly introduced MBM in staged bilateral TKA in a single hospitalization period can reduce blood loss effectively as well as pain and knee joint swelling instead of leading to increased complications and result in significant cost savings.
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Comparison of three plate system for lateral malleolar fixation. BMC Musculoskelet Disord 2014; 15:360. [PMID: 25358474 PMCID: PMC4223732 DOI: 10.1186/1471-2474-15-360] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/16/2014] [Indexed: 02/05/2023] Open
Abstract
Background This study was to compare clinical and radiographic outcomes with three different implants and evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) technique for the distal fibular fractures. Methods We performed a retrospective cohort single-surgical team single-facility study between 2000 and 2011. 147 patients receiving surgical interventions for closed, displaced distal fibular fractures were included. Based on the different implants, patients were divided into three groups: Group A: one-third tubular plate; Group B: locking compression (LCP) metaphyseal plate; Group C: LCP distal fibula plate. Clinical and radiographic outcomes were compared among the three groups. Results Totally, we found that patients in Group C had significant higher functional scores than those in Group A (p1 = 0.004; p2 = 0.002) (p1 stands for the p value for Olerud & Molandar Score, p2 stands for the p value for American Orthopaedic Foot & Ankle Society score). The healing time was significant less in Group C than that in Group A (p < 0.0001) and Group B (p < 0.0001). Subgroup analysis showed that: (1) For Weber A fracture, the functional scores of the Group C were higher than those in Group A (p1 = 0.020; p2 = 0.029) and B (p1 = 0.020; p2 = 0.034). (2) For Weber B fracture, the functional scores of the Group B (p1 = 0.033; p2 = 0.030) and C (p1 = 0.027; p2 = 0.017) were higher than those in Group A. No significant differences were observed in terms of the ankle range of motion, reduction accuracy and complication rate. Conclusions Our study demonstrated using LCP metaphyseal plate in patients associated with lateral malleolar fracture could achieve significantly better OMS & AOFAS scores and less healing time than using one-third tubular plate. Specifically, For Weber A fracture, LCP distal fibula plate is much better than one-third tubular plate and LCP metaphyseal plate. While for Weber B fracture, LCP distal fibula plate and LCP metaphyseal plate are better than one-third tubular plate. As to the complications, using MIPO technique in patients with distal fibular fractures is at least comparable to the traditional one. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-360) contains supplementary material, which is available to authorized users.
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Abstract
Odontoblasts derive from neural crest-derived odontogenic mesenchymal cells, and they are an important barrier of defense for the host. Survival and immunity of odontoblasts play important roles in protecting the dentin-pulp structure. Autophagy can eliminate damaged organelles and recycle cellular components to facilitate cellular homeostasis. Autophagy can be activated with external stressors, such as starvation, hypoxia, and infection. In this study, the role of autophagy in inflamed odontoblasts was explored, and its possible mechanism was investigated. Cell viability was not affected by mild lipopolysaccharide (LPS) stimulation, and autophagy was activated during this process. Immunofluorescence of light chain 3 confirmed that autophagy was induced with LPS treatment. Early-stage autophagy inhibition resulted in down-regulated cell viability, contrary to the up-regulated cell viability at late-stage autophagy inhibition. Western blot suggested that p-Akt and survivin were not activated in the early stage, and they gradually increased and peaked in the late stage. Meanwhile, autophagy was down-regulated through the Akt/mTOR/survivin pathway in the late stage. Thus, autophagy has a dual role in inflamed odontoblasts, which indicates its importance in maintaining the microenvironment homeostasis of odontoblasts. Autophagy was induced as a survival mechanism in the early stage, and it decreased through the Akt/mTOR/survivin signaling pathway in the late stage.
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A direct measure of the role of attention in apparent motion. J Vis 2014. [DOI: 10.1167/14.10.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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An animal model of Kashin-Beck disease induced by a low-nutrition diet and exposure to T-2 toxin. Osteoarthritis Cartilage 2013; 21:1108-15. [PMID: 23701828 DOI: 10.1016/j.joca.2013.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 04/21/2013] [Accepted: 05/03/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We investigated the combined roles of a low-nutrition diet (low levels of protein, iodine, and selenium) and T-2 toxin in bone development and to establish an experimental animal model of Kashin-Beck disease (KBD) that reliably mimics the disease's pathological changes for further study of the pathogenesis and prevention of the disease. METHODS Sprague-Dawley rats were randomly divided among four groups: group A, normal diet; group B, normal diet plus T-2 toxin; group C, low-nutrition diet; and group D, low-nutrition diet plus T-2 toxin exposure. The radiographic and histopathological changes in the tibial growth zone, plate cartilage and metaphysis were examined. RESULTS In group D, all epiphyseal plates were blurred, thin, and irregular. Tibias were significantly shorter in group D than in groups A and B. After 4 weeks, epiphyseal plates showed chondrocyte necrosis, with the more obvious necrosis appearing in groups C and D. The positive rate of lamellar necrosis was significantly higher in group D than in groups B and A (P < 0.01). In group D, metaphyseal trabecular bone was sparse, disordered, and disrupted, and massive transverse trabecular bone appeared in the metaphysis at 12 weeks. CONCLUSIONS A rat model of KBD induced by a low-nutrition diet and T-2 toxin exposure demonstrated radiographic and histopathological abnormalities of the proximal epiphyseal plate and the tibial metaphysis that are very similar to the bone changes found in patients with KBD. This animal model will be helpful for further study of the pathogenesis and prevention of KBD.
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A valley-spin qubit in a carbon nanotube. NATURE NANOTECHNOLOGY 2013; 8:565-568. [PMID: 23892984 DOI: 10.1038/nnano.2013.140] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 06/18/2013] [Indexed: 06/02/2023]
Abstract
Although electron spins in III-V semiconductor quantum dots have shown great promise as qubits, hyperfine decoherence remains a major challenge in these materials. Group IV semiconductors possess dominant nuclear species that are spinless, allowing qubit coherence times up to 2 s. In carbon nanotubes, where the spin-orbit interaction allows for all-electrical qubit manipulation, theoretical predictions of the coherence time vary by at least six orders of magnitude and range up to 10 s or more. Here, we realize a qubit encoded in two nanotube valley-spin states, with coherent manipulation via electrically driven spin resonance mediated by a bend in the nanotube. Readout uses Pauli blockade leakage current through a double quantum dot. Arbitrary qubit rotations are demonstrated and the coherence time is measured for the first time via Hahn echo, allowing comparison with theoretical predictions. The coherence time is found to be ∼65 ns, probably limited by electrical noise. This shows that, even with low nuclear spin abundance, coherence can be strongly degraded if the qubit states are coupled to electric fields.
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Abstract
Use of closed drainage systems after total knee arthroplasty (TKA) is a routine practice. Currently, a debate exists regarding whether temporary or no clamping is optimal. A systematic review of the English literature was conducted, and randomized controlled trials comparing all forms of temporary or no clamping drainage were included. Two authors independently extracted articles and predefined data. Data were pooled using a fixed-effects model to perform the meta-analysis. Nine randomized controlled trials totaling 850 patients were retrieved. The results indicate that temporary clamping could significantly reduce the drainage volume, including total drainage volume, drainage volume within 24 hours postoperatively, and drainage volume within 48 hours postoperatively. Furthermore, patients treated with temporary drainage clamping for 4 hours or more had a higher hemoglobin level 24 hours postoperatively than the patients treated with no clamping, and the number of blood transfusions per patient decreased significantly. No significant difference was identified between the 2 practices regarding postoperative range of motion, wound-related complications, and deep vein thrombosis. More randomized controlled trials are needed to provide robust evidence and to definitively determine which practice is most effective in reducing postoperative blood loss.
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Hypoxia differentially regulates human nucleus pulposus and annulus fibrosus cell extracellular matrix production in 3D scaffolds. Osteoarthritis Cartilage 2013; 21:582-8. [PMID: 23313531 DOI: 10.1016/j.joca.2013.01.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 12/21/2012] [Accepted: 01/01/2013] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We hypothesize that intervertebral disc (IVD) cells from distinct region respond differently to oxygen environment, and that IVD cells from patients with disc degeneration can benefit from hypoxia condition. Therefore, we aimed to determine the transcriptional response and extracellular matrix (ECM) production of nucleus pulposus (NP) and annulus fibrosus (AF) cells to different oxygen tension. METHOD Human NP and AF from degenerated IVD were seeded in 3D scaffolds and subjected to varying oxygen tension (2% and 20%) for 3 weeks. Changes in ECM were evaluated using quantitative real-time reverse transcriptase polymerase chain reaction, histological and immunohistological analyses. RESULTS Hypoxia significantly enhances NP cells phenotype, which resulted in greater production of sulfated glycosaminoglycan (GAG) and collagen type II within the constructs and the cells expressed higher levels of genes encoding NP ECM. A significantly stronger fluorescent signal for hypoxia-inducible factor (HIF-1α) as also found in the NP cells under the hypoxic than normoxic condition. However, there was little effect of hypoxia on the AF cells. CONCLUSIONS The NP and AF cells respond differently to hypoxia condition on the 3D scaffold, and hypoxia could enhance NP phenotype. When used in concert with appropriate scaffold material, human NP cells from degenerated disc could be regenerated for tissue engineering application.
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Abstract
OBJECTIVE To evaluate a new biodegradable copolymer calcium sulfate/poly amino acid (CS/PAA) as a graft substitute for the repair of the surgically created cancellous bone defects in rabbits and its biological properties in vivo. MATERIALS AND METHODS Cancellous bone defects were created by drilling holes in the unilateral lateral aspect of the femoral condyle of New Zealand white rabbits. Three groups were assigned: Group A rabbits were grafted with 80% CS/PAA and group B rabbits were grafted with 95% CS/PAA as two treatment groups; group C was sham-operation control group. To study the osteogenic capability in vivo, specimens were harvested at 4, 8, 12, and 16 weeks after implantation and were evaluated by gross assessment, X-ray, histological examination, and histomorphometry. In order to identify the molecular mechanism of bone defect repair, the expression of bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) was detected using Western blot at 4 weeks. RESULTS Group A and group B showed more vigorous and rapid repair leading to regeneration of cancellous bone than sham-operation control group on gross observation, radiology, and histomorphometry. There was no significant difference between groups A and B. Morphological observation and histological examination showed that the copolymers degraded in sync with the new bone formation process. The expression of BMP-2 and VEGF in implantation groups was higher than that in control group by western blot. CONCLUSION These findings demonstrated that the novel biodegradable copolymers can repair large areas of cancellous bone defects. With its controllable degradation rate, it suggests that CS/PAA may be a series of useful therapeutic substitute for bone defects.
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e0101 Interleukin-17A gene variants and risk of coronary artery disease:a large angiography-based study. BRITISH HEART JOURNAL 2010. [DOI: 10.1136/hrt.2010.208967.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Texture thresholds in aults and infants. J Vis 2010. [DOI: 10.1167/3.9.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Neural correlates of perceptual coherence in a multi-stable motion display. J Vis 2010. [DOI: 10.1167/1.3.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mid-term results using a cementless hip prosthesis in young Chinese patients: a five- to seven-year follow-up study. INTERNATIONAL ORTHOPAEDICS 2008; 33:1507-12. [PMID: 19050881 DOI: 10.1007/s00264-008-0705-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Revised: 10/10/2008] [Accepted: 10/28/2008] [Indexed: 02/05/2023]
Abstract
A retrospective study was undertaken to evaluate the clinical and radiographic outcomes of 74 cementless total hip arthroplasties (THA) in 69 young Chinese patients. The Asian size and MMA AML stems with smoothly tapered tip were used, and the patients were followed up for at least five years. The mean Harris hip score was 45.4 preoperatively and 95.3 at the last follow-up. The incidence of thigh pain was 5.4%, and was related to the short stature of the patient (<160 cm) (P = 0.030). Six patients (6 hips, 8.1%) had acetabular osteolysis in zone 2; reoperation was performed in one patient because of osteolysis and wear of the polyethylene liner. The survival rate of the metal acetabular and femoral components was 100% (95% confidence interval, 0.95-1.0). Primary THA with this AML prosthesis had an acceptable mid-term result in young Chinese patients.
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The assessment of visual acuity in children with periventricular damage: a comparison of behavioural and electrophysiological techniques. Vision Res 2008; 48:1233-41. [PMID: 18384834 DOI: 10.1016/j.visres.2008.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 02/11/2008] [Accepted: 02/18/2008] [Indexed: 10/22/2022]
Abstract
It has been controversial whether electrophysiology offers better precision than behavioural techniques in measuring visual acuity in children with brain damage. We investigated the concordance between sweep VEPs and Acuity Cards (AC) in 29 children with periventricular leukomalacia (PVL), the most common type of brain damage in preterm infants. An overall good correlation was shown but with relatively better behavioural acuity values. VEP/AC ratio was significantly correlated to corpus callosum posterior thinning. We propose that this result reflects the efficacy of the compensatory mechanisms following early brain damage which may differentially affect the two methods.
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Abstract
INTRODUCTION Bone xenografts from pig to human appear to be an alternative to resolve the shortage of bone autologous and allografts. However, the major obstacle of pig-to-human xenotransplantation is the interaction between human natural anti-Gal antibody and the alpha-Gal epitope abundantly expressed on pig endothelium. It was important to investigate the expression of alpha-Gal epitopes in porcine bone tissue to look for an ideal method to remove the alpha-Gal epitopes. METHODS The cortical and trabecular bone were retrieved from five pigs. After the soft tissues and periosteum were removed, the blood and marrow cavity were cleaned with phosphate-buffered solution. All 5 mm x 5 mm x 5 mm samples were imbedded in paraffin and methyl methacrylate resin for histological sections. The mouse IgM M86 monoclonal antibody, which was highly specific for alpha-Gal epitopes, was used to document alpha-Gal epitope expression by immunostaining of tissues and immunofluorescence. RESULTS Gal-positive immunostaining and immunofluorescence were observed on the surface of osteocytes and Haversian canals. There was a significant difference in Gal expression between cortical and trabecular bone tissues. There was no Gal expression in the extracellular matrix of bone. CONCLUSIONS Major alpha-Gal epitopes were on the surface of osteocytes of porcine bone tissues. A method should be used to damage the osteocytes and eliminate the alpha-Gal epitopes to avoid the xenogenic rejection in xenotransplantation of porcine bone tissues.
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Texture detection in infants. J Vis 2002. [DOI: 10.1167/2.10.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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[Advances in the study of diagnostic antigens in clonorchiasis]. ZHONGGUO JI SHENG CHONG XUE YU JI SHENG CHONG BING ZA ZHI = CHINESE JOURNAL OF PARASITOLOGY & PARASITIC DISEASES 2002; 16:304-6. [PMID: 12078264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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[Effect of macrolides on biofilm of mucoid Pseudomonas aeruginosa]. ZHONGHUA YI XUE ZA ZHI 2001; 81:934-6. [PMID: 11702671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To observe the effect of macrolides with different structures on biofilm of mucoid Pseudomonas aeruginosa so as to provide a theoretical basis for treatment of bacterial biofilm diseases. METHODS Modified plate culture method was used to establish in vitro bacterial biofilm model, which was identified by silver nitrate staining. After the biofilm was treated by gatifloxacin and/or macrolides with different structures and of different concentrations, the number of viable bacteria was measured by MTT method and bacterial adherence was measured by crystal violet staining. RESULTS Clarithromycin and azithromycin of 1/4 and 1/16 MIC combined with gatifloxacin significantly inhibited the adherence of mucoid Pseudomonas aeruginosa (P < 0.05) and reduced the number of viable mucoid Pseudomonas aeruginosa compared with gatifloxacin alone (P < 0.05), while such effects could not be seen for rovamycin. CONCLUSION Inhibiting the adherence of mucoid Pseudomonas aeruginosa may be one of the mechanisms by which macrolides such as clarithromycin and azithromycin enhance the antibacterial activity of gatifloxacin against mucoid Pseudomonas aeruginosa.
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Abstract
Three new steroidal saponins were isolated from the fruits of Tribulus terrestris, and their structures were elucidated as (25R,S)-5 alpha-spirostane-12-one-3 beta-ol-3-O-beta-xylopyranosyl(1-->2)- [beta-xylopyranosyl(1-->3)]-beta-glucopyranosyl(1-->4)-[alpha-rhamno- pyranosyl(1-->2)]-beta-galactopyranoside; 26-O-beta-glucopyranosyl-(25S)-5 alpha-furostane-12-one-3 beta,22 alpha,26-triol-3-O-beta-glucopyranosyl(1-->2)-beta-galactopyranoside; 26-O-beta-glucopyranosyl-(25S)-5 alpha-furostane-12-one-3 beta,22 alpha,26-triol-3-O-beta-glucopyranosyl(1-->4)-[alpha- rhamnopyranosyl(1-->2)]-beta-galactopyranoside, respectively, by spectroscopic analysis and color reaction.
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