Comparison between tension band and cerclage with X-Plate and lag screws in treatment of comminuted patellar fractures

BackgroundComminuted patellar fractures are not rare, and the ideal treatment method remains controversial. The present study was conducted to evaluate effects and compare complications of two different methods used to treat comminuted patellar fractures.MethodsFrom March 2010 to August 2016, 102 cases of 34-C2 or 34-C3 comminuted patellar fractures were treated at our hospital, wherein patients received two different treatments: titanium cable tension band with cerclage method (group A) and intrafragmentary screws with X-shaped plating technique (group B). At follow-ups, articular step-off, range of motion (ROM), Lysholm scores, time of union, and complications were recorded and analyzed. Radiographic and clinical data as well as rate of complications were statistically analyzed.ResultsIn total, 87 patients were included in the final analysis (n = 47 in group A and n = 40 in group B). No significant differences were noted in terms of cost of implant, age, gender, rate of 34-C3 fractures, rate of layered inferior pole fractures, postoperative articular step-off and union time. At 2-year follow-up, average Lysholm scores, ROM and rate of complications were (89.0 ± 4.5), (122°±12°) and (27.7%) in group A and (90.2 ± 3.9), (124°±11°) and (17.5%) in group B, respectively, with no significant differences (p > 0.05). The mean time of surgery in group B was shorter than that in group A with significant difference (p < 0.05).ConclusionsTreatment using the intrafragmentary screws and plate method for amenable comminuted patellar fractures achieved similar complication rate and favorable functional outcomes at the 2-year follow-up, which was comparable to the titanium cable tension band with cerclage method. Thus, the intrafragmentary screws and plate method is effective, safe and convenient for 34-C2/C3 comminuted patellar fractures, especially appropriate for patients with layered fragments.     

N-acetyl-l-cysteine protects porcine oocytes undergoing meiotic resumption from heat stress

Heat stress (HS) is a notable risk factor for female reproductive performance. In particular, impaired oocyte maturation was thought to contribute largely to the HS-induced reproductive dysfunctions. In this study, we confirmed that oocytes undergoing GVBD were much susceptible to HS, and thus compromising subsequent embryonic development. Using N-acetyl-l-cysteine (NAC), we found supplementation of a relatively high dose NAC during in vitro maturation, can protect oocytes from HS-induced complications, and thus rescuing impaired embryonic development. Further analysis indicated that mechanisms responsible for protecting GVBD oocytes from HS by NAC may include: (1) reversing disorganized spindle assembly and inhibited extracellular signal–regulated kinase (ERK) signaling; (2) correcting erroneous H3K27me3 modification and dysregulated expression of imprinted genes; (3) alleviating increased intraoocyte reactive oxygen species accumulation and apoptosis initiation. Our study, focusing on the oocyte meiotic maturation, may provide a safe and promising strategy for protecting reproductive sows under environmental hyperthermal conditions.     

Association of weight-adjusted-waist index with incident hypertension: The Rural Chinese Cohort Study

AimsTo explore the association between WWI and the incidence of HTN in the Rural Chinese Cohort Study.Methods and ResultsWe examined data for 10,338 non-hypertensive participants (39.49% men) aged ≥ 18 years from the Rural Chinese Cohort Study who completed a baseline examination during 2007–2008 and follow-up during 2013–2014. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Multiple logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the probability of HTN across four WWI categories. Restricted cubic splines analysis was used to model the dose–response association of WWI and HTN. A total of 2078 participants had HTN during a median follow-up of 6 years. After adjusting for potential confounders, as compared with the lowest WWI category (<9.94 cm/√kg), with WWI 9.94 to 10.42, 10.42 to 10.91 and ≥ 10.91 cm/√kg, the ORs (95% CIs) for HTN were 1.12 (0.93–1.35), 1.40 (1.17–1.69) and 1.50 (1.24–1.82), respectively. Results of the sensitivity analyses were robust. The ORs were generally consistent on subgroup analysis by sex, smoking status, systolic blood pressure and diastolic blood pressure. Multiple logistic regression models with restricted cubic splines showed a non-linear positive association between WWI and HTN (P_nonlinearity < 0.001).ConclusionThe highest WWI category was significantly associated with increased risk of HTN. Our findings may facilitate the development and promotion of obesity prevention strategies aimed at reducing the risk of HTN and provide evidence for healthcare policy in rural China.     

缺血预处理对缺血-再灌注硬化肝脏P-选择素表达的影响及保护作用

目的 :探讨缺血预处理 (IPC)对肝硬化肝脏缺血再灌注 (I R)损伤的保护作用以及 IPC对 P 选择素表达的影响和作用。方法 :2 4只雄性肝硬化 SD大鼠 ,随机分为 3组 ,每组 8只 :假手术组 (SO组 ) ,缺血再灌注组 (I R组 ) ,缺血预处理组 (IPC组 )。用高效液相色谱法测定肝组织三磷酸腺苷 (ATP)、二磷酸腺苷(ADP)、一磷酸腺苷 (AMP)并计算能荷 (EC) ,用全自动生化仪测定血清丙氨酸转氨酶 (AL T)、天冬氨酸转氨酶 (AST)、乳酸脱氢酶 (L DH) ,记录肝脏胆汁分泌量 ,用链霉菌抗生物素蛋白过氧化酶 (SP)法免疫组织化学染色检测肝组织 P 选择素蛋白表达 ,并计算肝组织中性粒细胞浸润数和丙二醛含量 (TBA法 )。结果 :再灌注12 0分钟后 ,IPC组 ATP含量和 EC水平明显高于 I R组 ,AL T、AST、L DH释放受到明显抑制 (P均 <0 .0 0 1) ,肝组织胆汁分泌量明显多于 I R组 (P<0 .0 1) ,肝组织中性粒细胞浸润数受到抑制 (P<0 .0 5 ) ,丙二醛产生明显减少 (P<0 .0 0 1)。与 I R组比较 ,IPC组肝细胞 P选择素蛋白表达受到明显抑制 (P<0 .0 5 )。结论 :缺血预处理通过抑制肝组织 P选择素的表达 ,减少中性粒细胞黏附浸润 ,从而减轻肝脏缺血再灌注损伤程度 ,保护肝功能     

创伤性膝关节脱位失稳性的检查与治疗

目的：探讨创伤性膝关节脱位失稳性的检查方法、手术时机与治疗方法。方法：本组63例创伤性膝关节脱位，男48例，女15例；年龄16-75岁，平均36．6岁。鲜新膝关节脱位40例，陈旧膝关节脱位23例。按Wascher膝关节脱位分型标准：KD—Ⅰ型1例，KD—Ⅱ型13例，KD-Ⅲ型17例，KD—Ⅳ型18例，KD—Ⅴ型14例。结合物理与影像学检查评判患膝稳定性。单纯开放手术治疗53例，单纯关节镜治疗4例，关节镜加开放手术治疗4例，截肢1例，全膝关节置换1例。结果：膝MRI阳性率100％（39／39），膝应力位X线检查阳性率100％（19／19），膝关节镜阳性率93．3％（14／15）。按Lysholm膝关节评分标准：治疗前陈旧伤组平均（37．17±5．33）分，新鲜伤组平均（37．41±5．38）分；治疗后陈旧伤组平均（67．33±14．72）分，新鲜伤组平均（82．45±12．13）分（Z=-3．061，P=0．002）。结论：膝关节应力位X线检查、MR及关节镜检查对评判创伤性膝关节脱位的稳定性有积极意义，失稳性创伤膝关节脱住手术治疗的关键是早期，鲜新伤以修复为主，陈旧伤以重建为主。     

活动性类风湿关节炎患者sICAM-1、sVCAM-1的变化及意义

目的 :测定活动性类风湿关节炎 (RA)患者血清中sICAM 1、sVCAM 1水平 ,探讨sICAM 1、sVCAM 1与IL 1、TNF、IFN γ及病情的关系。方法 :用酶联免疫分析法 (ELISA)检测 30例活动性RA患者与 30例健康对照者sICAM 1、sVCAM 1、IL 1、TNF、IFN γ水平。结果 :RA患者血清sICAM 1、sVCAM 1、IL 1、TNF、IFN γ水平明显高于正常对照组 (P<0 0 0 1) ,sICAM 1与IL 1、IFN γ正相关 ,与RF亦呈正相关 ,sVCAM 1与IL 1、TNF、IFN γ正相关 ,与ESR、CRP、Stock指数正相关。结论 :RA患者血清sI CAM 1、sVCAM 1水平显著升高 ,sICAM 1、sVCAM 1可能参与RA发病过程 ,sICAM 1可作为判断病情严重性的指标 ,sVCAM 1可作为观察病情活动性的指标。     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

不同保存液对离体大鼠心脏保存效果的研究

目的:研究在冷缺血期3种液体对鼠心脏保存的效果。方法:将24只大鼠随机分为3组,每组8只。3组离体鼠心脏分别用Histidine-tryptophan-ketoglurate(HTK)液,UniversityofWisconsin(UW)液及St.ThomasⅡ(ST)液灌注停跳,并4℃冷冻保存6h。利用离体鼠心非循环式Langendorff灌流功能测定模型,测定左心室舒张期末压(LVEDP)、左心室发展压(LVDP)、左心室压力变化率(dp/dt_max,dp/dtmin)、冠脉流出量(CF),留取冠脉流出液检测心肌酶漏出量,并检测心肌线粒体三磷酸腺苷(ATP),取心肌标本测干湿比。结果:HTK组保存的心肌左心室功能恢复明显优于UW组(P＜0.05),UW组明显优于ST组(P＜0.05),LVEDP恢复HTK组和ST组无显著差异(P＞0.05),但均较UW组恢复好(P＜0.05)。保存后心肌ATP测定值HTK组高于UW组(P＜0.05),UW组高于ST组(P＜0.05)。3组心肌标本测干湿比结果无显著差异(P＞0.05)。结论:HTK液保存心肌效果最好,含有高钾的保存液对冠脉有损害。     

骶骨骨折的动态冲击试验研究

目的:探讨骶骨在冲击载荷作用下发生骨折的机理。方法:采集人体新鲜骨盆标本10具,分别行动态冲击试验和静态破坏试验,测量动态骨折时的一系列动力学参数,确定骨折的动力学特性。结果:⑴骶骨受垂直冲击时按应力波的传递方向发生骨折,其动力学性质呈粘弹性,应力波呈周期性衰减,得到了骶骨的载荷响应曲线与应变响应曲线;骶骨骨折的平均冲击载荷为(9366±514) N,冲击时间为(2.78±1.02) s,动荷系数为1.21。⑵骶骨的动态破坏机制与静态破坏机制有很大的不同,不但极限载荷不同,而且前者随应变速率的提高而快速增加,冲击能量在25 J以上时呈脆性劈裂状通过骶孔或骶髂关节骨折,并累及神经根损伤,而静态大多为骶髂关节骨折。结论:骶骨骨折大都在高速冲击下发生,与其动力学特性、力的传导以及动载荷响应等诸多因素相关。     

系统性红斑狼疮患者新的内源性逆转录病毒 NP9基因表达及其蛋白功能预测

目的研究新发现的人内源性逆转录病毒 NP9基因在系统性红斑狼疮(systemic lupus erythematosus, SLE)患者体内表达及其蛋白功能预测.方法逆转录PCR、T-A克隆技术和DNA序列测定分离、克隆和分析 NP9基因, 检测40例SLE患者和48名正常对照的 NP9基因表达, 借助NCBI BLAST系列分析工具及相应的基因分析软件预测其蛋白功能.结果 SLE患者组逆转录病毒 NP9基因表达阳性率为77.5%(31/40),明显高于正常对照的8.3%(4/48), P<0.01. NP9基因编码产物由74个氨基酸组成,含有多个细胞核内分布信号,其等电点(pI)为9.59,与SLE患者体内高表达的某些细胞因子具有较高同源性.结论 SLE患者存在逆转录病毒 NP9基因特异性转录, NP9表达可能与SLE发生发展相关.