The clinical outcomes and the ability to sit straight in the Japanese style following high tibial osteotomy combined with osteochondral autologous transfer for osteonecrosis of the medial femoral condyle

Background

There have been some reports of high tibial osteotomy combined with osteochondral autograft transfer for osteonecrosis of the medial femoral condyle of the knee. However, few of them have focused on the deep knee flexion needed to sit straight in the Japanese style.

FTA样本洗提卡用于子宫颈癌筛查的临床应用价值

【摘要】 目的 探讨固体FTA样本洗提卡（FTA卡）在宫颈癌筛查的HPV DNA分型检测中作为储存与转运待检样本载体的临床应用价值。方法 以北京大学深圳医院宫颈门诊因HPV或细胞学检查阳性行阴道镜下宫颈活检的102例患者为研究对象,由妇科医师采集宫颈脱落细胞样本,分别使用固体FTA卡和细胞保存液作为样本储存和转运的介质,均采用PCR为基础的质量阵列基质辅助激光电离解析飞行时间质谱系统（MALDI-TOF）法进行高危型HPV分型检测,比较FTA卡与常规的液体介质作为样本储存与转运载体在宫颈癌筛查中的有效性。结果 102例患者中,液体介质保存的样本检测的HPV感染率为69.6%,FTA卡为66.7%,两组比较,差异无统计学意义（χ2=0.250,P＞0.05）。两种保存方法检测HPV阳性率有很好的一致性（Kappa值=0.932,P＜0.001）。两种方法检测的HPV型别比较,差异无统计学意义（χ2=0.250,P＞0.05）,且两者具有很好的一致性（Kappa=0.930,P＜0.001）。以病理诊断为金标准, FTA卡和液体介质保存样本检测HPV对于检出≥CIN2的曲线下面积分别为0.718和0.699（P＜0.05）;检出≥CIN3的曲线下面积分别为0.695和0.678（P＜0.05）。结论 FTA卡和液体介质保存宫颈细胞样本在HPV分型检测中具有良好的一致性,对于高级别宫颈病变的诊断效率亦相当。由于固体FTA卡体积小、便于转运、污染风险小、且简化了样本DNA的提取,故将其作为一种新的HPV检测样本储存方法用于宫颈癌筛查具有很高的临床应用价值。 【关键词】 FTA卡;高危型HPV分型检测;质量阵列基质辅助激光电     

相干光断层扫描动态分析中心性浆液性脉络膜视网膜病变激光治疗后恢复情况

目的 应用相干光断层扫描(OCT)动态观察氩激光治疗中心性浆液性脉络膜视网膜病变(CSC)后黄斑水肿吸收情况,探索其在CSC患者预后追踪中的优势.方法 对经荧光素眼底血管造影(FFA)确诊的42例(42只眼)CSC患者进行氩激光光凝治疗,分别于治疗前、治疗后3 d,1、2、4、6周行OCT及FFA检查.结果 OCT适用面广,可清楚的发现神经上皮及色素上皮脱离情况,OCT动态随访观察显示激光光凝治疗3 d时黄斑水肿无明显吸收,1周后,黄斑水肿开始明显吸收,2例患者(4.76%)水肿完全吸收;2周后5例患者(11.90%)水肿完全吸收;4周后17例患者(40.48%)水肿完全吸收;6周后34例(81.95%)水肿完全吸收.结论 激光光凝治疗能缩短CSC病程,OCT为非侵入性,观察效果好,能定量分析黄斑水肿程度,比FFA更加直观、准确.更重要的是,OCT能对预后过程进行动态、精确、灵敏的追踪.     

Dual effect of hydrogen peroxide on store-mediated calcium entry in human platelets

Redox regulation is important for the modulation of cytosolic Ca(2+) concentration. Hence, we have investigated the effect of H(2)O(2) on store-mediated Ca(2+) entry (SMCE). In fura-2-loaded human platelets treatment with H(2)O(2) resulted in a concentration-dependent increase in Ca(2+) release from intracellular stores, while the effect on Ca(2+) entry was biphasic. In addition, 1mM H(2)O(2) reduced SMCE induced by agonists. The inhibitory effect of 1mM H(2)O(2) was prevented by inhibition of actin polymerization with cytochalasin D. Consistent with this, we found that 10microM H(2)O(2) and store depletion by treatment with thapsigargin plus ionomycin induced a similar temporal sequence of actin reorganization, while exposure to 1mM H(2)O(2) shifted the dynamics between polymerization and depolymerization in favor of the former. One millimolar H(2)O(2)-induced polymerization was reduced by treatment with methyl 2,5-dihydroxycinnamate and farnesylthioacetic acid, inhibitors of tyrosine kinases and Ras superfamily proteins, respectively. Finally, exposure to 1mM H(2)O(2) significantly increased store depletion-induced p60(src) activation. We conclude that H(2)O(2) exerted a biphasic effect on SMCE. The inhibitory role of high H(2)O(2) concentrations is mediated by an abnormal actin reorganization pattern involving both Ras- and tyrosine kinases-dependent pathways.     

The use of FTA cards for preserving unfixed cytological material for high-throughput molecular analysis

BACKGROUND:

Novel high‐throughput molecular technologies have made the collection and storage of cells and small tissue specimens a critical issue. The FTA card provides an alternative to cryopreservation for biobanking fresh unfixed cells. The current study compared the quality and integrity of the DNA obtained from 2 types of FTA cards (Classic and Elute) using 2 different extraction protocols (“Classic” and “Elute”) and assessed the feasibility of performing multiplex mutational screening using fine‐needle aspiration (FNA) biopsy samples.

METHODS:

Residual material from 42 FNA biopsies was collected in the cards (21 Classic and 21 Elute cards). DNA was extracted using the Classic protocol for Classic cards and both protocols for Elute cards. Polymerase chain reaction for p53 (1.5 kilobase) and CARD11 (500 base pair) was performed to assess DNA integrity.

RESULTS:

Successful p53 amplification was achieved in 95.2% of the samples from the Classic cards and in 80.9% of the samples from the Elute cards using the Classic protocol and 28.5% using the Elute protocol (P = .001). All samples (both cards) could be amplified for CARD11. There was no significant difference in the DNA concentration or 260/280 purity ratio when the 2 types of cards were compared. Five samples were also successfully analyzed by multiplex MassARRAY spectrometry, with a mutation in KRAS found in 1 case.

CONCLUSIONS:

High molecular weight DNA was extracted from the cards in sufficient amounts and quality to perform high‐throughput multiplex mutation assays. The results of the current study also suggest that FTA Classic cards preserve better DNA integrity for molecular applications compared with the FTA Elute cards. Cancer (Cancer Cytopathol) 2012;. © 2012 American Cancer Society.     

Changes in lower limb alignment and their effect on the functional outcome after treatment of varus degenerative OA knee by hemicallotasis using modular dynamic HTO fixator

ObjectiveHigh tibial osteotomy (HTO) is an established procedure to treat medial compartmental osteoarthritis (OA) knee associated with varus deformity. It is well documented that precise correction of deformity and maintenance of correction achieved is important to ensure long term good results. This study was undertaken to record changes in radiological parameters and its effect on the functional outcomes in first two years following HTO done for varus degenerative OA kneeby hemicallotasis technique using HTO fixator.Methods31 patients meeting our inclusion-exclusion criteria who underwent HTO by hemicallotasis method using self-adjusting unilateral HTO fixator were included in the study. Their femoro tibial angle (FTA), mechanical axis %, Insall- Salvati ratio, proximal tibial antero-posterior slope and knee injury and osteoarthritis outcome Score (KOOS) were recorded preoperatively, postoperatively at the time of removal of fixator, at 1 year and at 2 years.ResultsThe FTA and mechanical axis significantly improved from a mean of 183.12⁰ and −3.26% respectively preoperatively to 173.38⁰ and 61.81% at the time of removal of fixator but subsequently showed significant deterioration to 176.06⁰ and 57.96% at 1 year and further insignificant deterioration to 176.16⁰ and 57.74 at 2 years. The KOOS improved from mean 56.61 preoperatively to 70.48 at the time of fixator removal and further improved significantly to 85.68 at 1 year but significantly deteriorated to 84.54 at 2 years. The Insall-Salvati ratio, tibial slope showed no significant change throughout the study. Conclusion: Though desired alignment can be achieved by using the fixator, we found a significant deterioration in achieved radiological parameters after removal of fixator adversely affecting the functional outcome which is a matter of concern.     

Is the extraction by Whatman FTA filter matrix technology and sequencing of large ribosomal subunit D1–D2 region sufficient for identification of clinical fungi?

Although conventional identification of pathogenic fungi is based on the combination of tests evaluating their morphological and biochemical characteristics, they can fail to identify the less common species or the differentiation of closely related species. In addition these tests are time consuming, labour‐intensive and require experienced personnel. We evaluated the feasibility and sufficiency of DNA extraction by Whatman FTA filter matrix technology and DNA sequencing of D1–D2 region of the large ribosomal subunit gene for identification of clinical isolates of 21 yeast and 160 moulds in our clinical mycology laboratory. While the yeast isolates were identified at species level with 100% homology, 102 (63.75%) clinically important mould isolates were identified at species level, 56 (35%) isolates at genus level against fungal sequences existing in DNA databases and two (1.25%) isolates could not be identified. Consequently, Whatman FTA filter matrix technology was a useful method for extraction of fungal DNA; extremely rapid, practical and successful. Sequence analysis strategy of D1–D2 region of the large ribosomal subunit gene was found considerably sufficient in identification to genus level for the most clinical fungi. However, the identification to species level and especially discrimination of closely related species may require additional analysis.     

我国外资医疗机构准入制度相关问题研究

上海自贸区允许外商试点建立独资医疗机构,这是国内国际医疗服务贸易市场开放的一部分。当前国内设立外商独资医疗机构还面临一些现实问题与政策困境,外资医疗机构在投资审批、设备购买等方面程序复杂,缺乏配套医疗保险、面临人才匮乏等。未来应当以精细化的配套措施推进医疗服务市场的准入,为外资医疗机构提供法律、人力资源和医疗保险等方面支持。     

FlindersTechnology Associates (FTA) filter paper-based DNA extraction with polymerase chain reaction (PCR) for detection of Pneumocystis jirovecii from respiratory specimens of immunocompromised patients

We evaluated the diagnostic value of Flinders Technology Associates (FTA) filter paper together with polymerase chain reaction (PCR) for detection of Pneumocystis jirovecii (carinii) from induced sputum (IS) and bronchoalveolar lavage fluid (BALF) samples. The study involved 162 patients with clinical diagnosis of pneumocystis pneumonia (PcP) of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients and other immunocompromised patients. P. jirovecii cysts or trophozoites were detected in IS and BALF by cytological method. The mitochondrial 5S ribosomal ribonucleic acid (rRNA) gene of P. jirovecii was amplified from these samples by using FTA filters together with a one-step PCR method (FTA-PCR). With the FTA-PCR method, the sensitivity and specificity of the test compared to microscopic examination were 67% and 90% for IS, while they were 67% and 91% for BALF, respectively. The sensitivity and specificity of the FTA-PCR test was also comparable to PCR with the conventional deoxyribonucleic acid (DNA) extraction method. We concluded that FTA-PCR is useful to detect P. jirovecii in noninvasive IS.