let-7a对血管平滑肌细胞迁移、增殖功能调控作用的体外研究

目的:观察let-7a对体外培养血管平滑肌细胞(VSMC)迁移和增殖能力的影响。方法:分离大鼠胸腹主动脉VSMC,并传代培养。将培养的VSMC通过慢病毒表达载体分别转染let-7a模拟物(实验组)及其阴性对照物(阴性对照组),或不做转染处理(空白对照组)。通过绿色荧光蛋白的表达估计转染效率;用real-time PCR检测各组细胞let-7a的表达水平;用细胞划痕试验和CCK-8法分别检测各组细胞的迁移能力及增殖情况。结果:荧光显微镜观察显示,96 h后细胞的转染效率达85%以上;real-time PCR结果显示,实验组VSMC的let-7a表达水平明显高于阴性对照组和空白对照组(均P<0.01);细胞划痕试验与增殖检测结果显示,实验组的细胞迁移数及增殖率明显低于阴性对照组和空白对照组(均P<0.01)。阴性对照组与空白对照组间上述项目无明显差异(均P>0.05)。结论:let-7a对体外培养的VSMC迁移与增殖有抑制作用。     

兔阴茎海绵体平滑肌细胞的体外培养及其生物学特性

目的 :研究体外培养的新西兰白兔阴茎海绵体平滑肌细胞的生物学特性。　方法 :采用组织块培养法 ,对兔阴茎海绵体平滑肌细胞进行活细胞观察 ,并测定其细胞生长曲线、贴壁率、细胞分裂指数。　结果 :①兔阴茎海绵体平滑肌细胞为梭形 ,呈长轴平行排列 ,具有明显的方向性 ;②体外贴壁快 ,生长迅速 ,体外培养的阴茎海绵体平滑肌细胞在合适的传代条件和比例下能够生存并保持其稳定的生物学特性。　结论 :体外培养的兔阴茎海绵体平滑肌细胞模型可用于检测某些药物对阴茎勃起的影响。     

心脏干细胞生长微环境及其体外生物学特性

目的 研究在体外培养心肌组织过程中,心脏干细胞生长的微环境及其生物学特性.方法 8周龄SD大鼠,心肌组织切碎后依次用胰酶和胶原酶消化,收集组织块培养,待新生细胞铺满容器底时传代.取第3代干细胞行免疫荧光染色检测相关分子标志物的表达.培养基中加入EdU标记的增殖细胞后,培养的组织行HE染色、Masson染色、免疫荧光染色及TUNEL细胞凋亡检测.结果 心肌组织培养7～10天后有明亮的圆形细胞长出,其在体外培养过程中具有自动分化倾向.免疫荧光检测示:分裂象细胞c-kit阳性;多数细胞o-sarcomeric actin、cardiac troponin T、flk-1、vemintin阳性;部分细胞α-smooth muscle actin、connexin-43、CD31、CD45阳性,CD90阴性.培养的组织块切片后染色见大量新生细胞生长的同时伴随心肌细胞的凋亡,心肌间胶原纤维重塑;增殖期细胞EdU染色阳性;MMP-2、MMP-9及TGF-β1在心肌组织表达丰富,而在增殖细胞则较少表达.结论 心肌组织体外培养可便捷获取心脏干细胞,心脏干细胞的生长、增殖过程伴随细胞外基质的降解,其在体外培养过程中有自动分化倾向.     

兔阴茎海绵体平滑肌细胞的体外培养及其生物学特性

目的；研究体外培养的新西兰白兔阴茎海绵体平滑纲细胞的生物学特性。方法：采用组织块培养法，对兔阴茎海绵体平滑肌细胞进行活细胞观察，并测定其细胞生长曲线，贴壁率，细胞分裂指数。结果：（1）兔阴茎海绵体平滑肌细胞为梭形，呈长轴平行排列，具有明显的方向性；（2）体外贴壁快，生长迅速，体外培养的阴茎海绵体平滑肌细胞在合适的传代条件和比例下能够生存并保持其稳定的生物学特性。结论：体外培养的兔阴茎海绵体平滑肌细胞模型可用于检测某些药物对阴茎勃起的影响。     

考马斯亮蓝染色法检测人精子形态和顶体反应

目的 :探讨考马斯亮蓝G2 5 0染色法在人精子畸形率、顶体完整率和顶体反应检测中的应用。　方法 :用瑞 吉染色法和考马斯亮蓝G2 5 0染色法分别对获能前后和孕酮诱导顶体反应后的人精子进行涂片染色 ,观察其形态 ,并计算精子畸形率、顶体完整率及顶体反应率。　结果 :瑞 吉染色法和考马斯亮蓝G2 5 0染色法在检测人精子畸形率和顶体完整率上差异无显著性 (P >0 .0 5 )。孕酮诱导顶体反应后的精子用考马斯亮蓝G2 5 0染色后呈现两种类型 :顶体区染成紫蓝色和不着色或染成淡紫色 ,后者随诱导时间延长而增加 ,可能代表了已发生顶体反应的精子。诱导 1h的顶体反应率为 (75 .1± 3.8) %。　结论 :考马斯亮蓝G2 5 0染色法可作为检测人精子形态和顶体反应的可靠而实用的方法     

大鼠胰腺星状细胞分离培养与鉴定

目的：分离培养大鼠胰腺星状细胞,为体外研究胰腺纤维化提供细胞模型。方法：采用酶消化结合Nycodenz密度梯度离心法分离胰腺星状细胞,通过倒置显微镜观察细胞形态,油红O染色和免疫细胞化学染色desmin,α-SMA进行细胞鉴定,并绘制传代后细胞生长曲线。结果：原代培养的大鼠胰腺星状细胞呈星形或梭形生长;原代胰腺星状细胞油红O染色胞浆均可见红色密集脂滴,直至传代后消失;原代胰腺星状细胞培养48 h后,desmin表达开始减弱,α-SMA表达开始增强;传代后desmin基本不表达,α-SMA阳性表达100%;传代后第3 d-5 d的胰腺星状细胞处于快速增殖阶段。结论：酶消化结合Nycodenz密度梯度离心法分离培养大鼠胰腺星状细胞纯度高,重复性好,可以满足体外研究的需要。     

人精子顶体反应3种检测方法的比较与评价

目的:寻找简便和准确的精子顶体反应检测方法。方法:正常人精液标本液化后混合,分成6组,分别用金霉素染色法、考马斯亮蓝染色法和酸性磷酸酶检测法对孕酮诱导顶体反应前后的人精子进行形态学观察并且对顶体反应率进行数据统计。结果:经考马斯亮蓝和金霉素染色后,发生顶体反应的精子和没有发生顶体反应的精子均有明显的形态差异;经考马斯亮蓝染色、金霉素荧光染色和酸性磷酸酶测试法检验,孕酮诱导组与阴性对照组的精子顶体反应率均有明显差异(P<0.05)。结论:3种方法均可作为顶体反应的检测手段,但考马斯亮蓝染色更为简便和稳定。     

成年恒河猴骨髓基质干细胞的体外培养

目的温对猴骨髓基质干细胞(BMSCs)进行体外培养及扩增，观察其原代及传代细胞的生长特点及生物学特点。方法 抽取4只成年猴髂骨骨髓，用全骨髓培养法进行体外培养获得BMSCs，胰酶消化传代，用条件培养基培养传代细胞。逐日倒置显微镜观察细胞生长情况，对传代细胞进行HE染色及碱性磷酸酶(ALP)染色。结果 成年雄性恒河猴BMSCs体外培养生长良好，原代细胞10-13d汇成单层，传代后4～7d长满瓶底。HE染色光镜下观察见BMSCs为单核细胞，细胞呈梭形、多角形，传代细胞碱性磷酸酶染色呈强阳性。结论 猴BMSc的体外培养增殖能力强，可诱导为成骨细胞，可作为灵长类动物骨组织工程的种子细胞。     

体外分离培养兔阴茎海绵体平滑肌细胞的纯度分析

目的比较和评价不同条件下体外培养兔阴茎海绵体平滑肌细胞的纯度。方法应用胶原酶消化法和组织贴块法分离培养幼兔海绵体平滑肌细胞。差速贴壁法纯化海绵体平滑肌细胞。采用α-平滑肌肌动蛋白(α-SM-actin)和肌球蛋白(Myosin)免疫荧光鉴定海绵体平滑肌细胞,波形蛋白(Vimentin)衬染检测成纤维细胞。流式细胞仪检测海绵体细胞表达α-SM-actin的阳性率,比较不同培养条件下海绵体平滑肌细胞的纯度。结果体外培养的海绵体来源细胞在荧光显微镜下对α-SM-actin和Myosin仅有少量表达,随传代次数的增加,细胞表达α-SM-actin和Myosin的阳性率进一步降低。流式细胞仪检测酶消化法和贴块法原代培养的海绵体平滑肌细胞的纯度分别为16.91%和11.13%。经差速贴壁纯化后第1代海绵体平滑肌细胞的纯度分别提高到26.88%和21.98%。Vimentin免疫荧光检测到大量阳性表达。结论目前常规方法体外分离、培养的海绵体平滑肌细胞纯度较低,大量海绵体间质来源的成纤维细胞混杂生长,差速贴壁法可在一定范围内提高海绵体平滑肌细胞的纯度。     

体外不同培养条件对脑动静脉畸形血管平滑肌细胞增殖和迁移的影响

血管平滑肌细胞(VSMC)的增殖和迁移与脑动静脉畸形(CAVM)的栓塞、放射治疗后的病理变化过程密切相关。我们研究了碱性成纤维细胞生长因子(bFGF)及重组骨桥蛋白(rhOPN)对体外培养的CAVM的VSMC增殖和迁移的影响。     

维生素D受体在糖尿病肾病足细胞损伤及蛋白尿缓解中的作用

目的探讨维生素D受体(VDR)在糖尿病肾病(DKD)足细胞中的表达水平及在足细胞损伤及蛋白尿缓解中的作用。方法(1)本研究纳入了65例诊断患有2型糖尿病(伴或不伴蛋白尿)的患者,并纳入了25例年龄和性别相匹配的健康体检者为对照组。根据白蛋白/肌酐(ACR)的尿排泄比例对2型糖尿病患者进行分组,分别为无蛋白尿(ACR<30 mg/g,n=24)、微量白蛋白尿(ACR 30~300 mg/g,n=18)和临床蛋白尿(ACR>300 mg/g,n=23)。另选择25例经肾活检确诊的DKD患者作为DKD组。正常肾脏组织标本均取自泌尿外科同一时期肾脏肿瘤切除患者10例。将各组检测指标进行对比,同时采用实时定量PCR、ELISA法和免疫组化法检测VDR在各组患者的血液、尿液样本和肾脏组织中的表达情况,以及使用Pearson相关分析分析VDR与尿蛋白的相关性。(2)在2型糖尿病肾病小鼠模型中对上述结果进行验证,将遗传背景均为C57BLKs/J的雄性db/db小鼠及同窝出生的db/m小鼠,随机分为正常对照组(A组)、DKD对照组(B组)、DKD二甲基亚砜处理组(C组)、DKD帕立骨化醇(VDR激动剂)处理组(D组),C、D组连续腹腔注射处理8周,对照组不做任何处理。小鼠10周龄时开始连续干预8周,在小鼠22周龄(开始干预后12周)检测各组小鼠体重、血、尿生化指标对比;Western印迹法检测β⁃catenin、VDR的变化;免疫荧光观察足细胞标志蛋白podocin及足细胞损伤蛋白α⁃SMA的表达变化。结果(1)与正常健康对照组相比,无蛋白尿组、微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿组的糖尿病患者相比,微量白蛋白尿组和临床蛋白尿组的糖尿病患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05)。(2)与正常健康对照组相比,无蛋白尿糖尿病组和DKD组患者血浆中VDR的mRNA和蛋白水平均较低(均P<0.05);与无蛋白尿糖尿病组患者相比,DKD组患者血浆中VDR的mRNA和蛋白水平亦较低(均P<0.05)。(3)免疫组化结果显示,DKD组肾组织中VDR的表达明显少于正常对照组。(4)DKD患者血浆中VDR mRNA相对水平与ACR呈负相关(r=-0.342,P<0.05)。(5)各组尿液上清液中VDR的水平与血浆中的水平呈相反趋势。(6)Western印迹结果显示,B组、C组肾小球足细胞β⁃catenin蛋白表达高于D组(均P<0.05),VDR蛋白的表达低于D组(均P<0.05);免疫荧光结果显示,B组、C组肾小球足细胞podocin的表达低于D组(均P<0.05),α⁃SMA的表达高于D组(均P<0.05)。结论VDR高表达缓解DKD足细胞损伤及蛋白尿。     

Anterior Interosseous Nerve Palsy After Shoulder Arthroscopy Treated With Surgical Decompression: A Case Series and Systematic Review of the Literature

Background: Anterior interosseous nerve (AIN) palsy is a very uncommon cause of upper extremity pain and weakness that comprises less than 1% of all upper extremity nerve palsies. Rarely reported but also mentioned in the literature is AIN palsy after shoulder arthroscopy. Methods: A systematic review of the literature to date using PubMed was conducted to identify patients who suffered AIN palsy after shoulder arthroscopy procedures. Articles included met the following criteria: (1) published in English; (2) primary presentation of the data; (3) patients had undergone shoulder arthroscopy before developing symptoms of AIN palsy; and (4) diagnosis was confirmed with clinical symptoms of AIN palsy. Measured outcomes included patient demographics, specific shoulder procedure, anesthesia procedure, intra-operative patient positioning, intra-operative compressive dressing, intra-operative traction, surgical versus conservative treatment, abnormal findings during decompression procedure, proposed mechanism of injury, and follow-up. Results: The search yielded 6 articles, of which 4 (13 cases) met inclusion criteria. An additional 2 cases were included in this report totaling 15 cases. The average patient age was 49 years (range: 31-64) with 73% males. At average follow-up of 24 months, 67% of patients experienced complete resolution of symptoms—more than half of which underwent surgical decompression. Patients who failed to progress experienced weakness of the flexor digitorum profundus and flexor pollicis longus muscles. Conclusions: Proposed injury mechanisms for AIN palsy after shoulder arthroscopy range from mechanical trauma, compressive hematoma, and direct anesthetic neurotoxicity. Management should be directed by clinical symptoms, imaging, and patient factors with majority of patients expected to have excellent clinical outcomes.     

不同尿钙水平的Gitelman综合征患者临床特点比较

目的观察不同尿钙水平Gitelman综合征(GS)患者的临床特点,探讨尿钙在GS疾病临床分型中的价值。方法收集2016—2018年来自中国国家罕见病注册系统(NRSC)、在北京协和医院行SLC12A3基因检测诊断为GS患者的临床资料,分析其尿钙特点,比较不同尿钙水平患者的临床和实验室检查指标。氢氯噻嗪试验按照标准操作流程进行,测定患者基线和用药后3 h内氯离子排泄分数改变量的最大值(ΔFECl)。结果共有83例GS患者被纳入研究,其中低尿钙患者53例(63.86%)。低尿钙组尿钙/肌酐比明显低于非低尿钙组[(0.085±0.058)mmol/mmol比(0.471±0.284)mmol/mmol,t=7.349,P<0.001]。两组患者在年龄、性别、估算肾小球滤过率、血压、血尿电解质水平、代谢性碱中毒方面差异均无统计学意义。低尿钙组患者乏力(χ2=4.595,P=0.032)及多尿(χ2=5.778,P=0.016)发生比例低于非低尿钙组,两组患者在其他临床症状方面差异无统计学意义。低尿钙和非低尿钙组各有16例患者行氢氯噻嗪试验,中位ΔFECl结果分别为0.539%(0.430%,1.283%)和0.829%(0.119%,1.298%),均提示对氢氯噻嗪无反应,组间差异无统计学意义(U=130.000,P=0.956)。结论GS患者中低尿钙比例为63.86%,尿钙水平与疾病临床表型、NCC功能损伤严重程度之间均无明确相关性。     

Fibrinogen-thrombin collagen patch reinforcement of highrisk colonic anastomoses in rats

AIM To evaluate the effectiveness of human fibrinogenthrombin collagen patch(TachoSil~?) in the reinforcement of high-risk colon anastomoses.METHODS A quasi-experimental study was conducted in Wistar rats(n = 56) that all underwent high-risk anastomoses(anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group(24 rats) and treatment group(24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil~? (a piece of Tacho Sil? was applied over this high-risk anastomosis, covering the gap). Leak incidence, overall survival, intra-abdominal adhesions, and histologic healing of anastomoses were analyzed. Survivors were divided into two subgroups and euthanized at 15 and 30 d after intervention in order to analyze the adhesions and histologic changes. RESULTS Overall survival was 71.4% and 57.14% in the TachoSil~? group and control group, respectively(P = 0.29); four rats died from other causes and six rats in the treatment group and 10 in the control group experienced colonic leakage(P 0.05). The intra-abdominal adhesion score was similar in both groups, with no differences between subgroups. We found non-significant differences in the healing process according to the histologic score used in both groups(P = 0.066).CONCLUSION In our study, the use of TachoSil~? was associated with a non-statistically significant reduction in the rate of leakage in high-risk anastomoses. TachoSil~? has been shown to be a safe product because it does not affect the histologic healing process or increase intra-abdominal adhesions.     

Role of Conventional and Diffusion-Weighted Magnetic Resonance Imaging of Spinal Treatment Protocol for Hydatid Disease

Objective:

To demonstrate the role of magnetic resonance imaging (MRI) in determining the treatment protocol for hydatid disease of the spine.

Design:

Case report; literature review.

Findings:

Diffusion-weighted MRI can help differentiate complicated infected hydatidosis from abscesses, epidermoid cysts from arachnoid cysts, and benign from malignant vertebral compression fractures. It is also helpful in differentiating between abscesses and necrotic tumors.

Conclusion:

Diffusion-weighted MRI can help differentiate between infections requiring immediate surgery and those that can be treated medically with antihelmintic treatment.     

Fluorescence in the Sclera,Nails, and Teeth Secondary to Favipiravir Use for COVID-19 Infections

Favipiravir, an antiviral agent originally used for influenza infections, has become popular due to its beneficial signals in coronavirus disease. It is currently used in some countries within COVID-19 treatment protocols. This is an initial report of favipiravir-related fluorescence observed in three healthcare providers working in the same ward in our hospital. All three individuals had been diagnosed with COVID-19 two months earlier and were treated with favipiravir. None of the three individuals received hydroxychloroquine or tetracyclines. Wood’s light examination led to an incidental discovery of favipiravir-induced fluorescence involving the sclera, nails, and teeth. In all patients, white linear, square, and band-like specks of fluorescence were noticed on the sclera of both eyes, some teeth, and the proximal part of all fingernails and toenails. Exposure of the eyes to the Wood’s light was for a brief duration of 3 to 5 seconds during examination and photodocumentation. Favipiravir might cause bright white fluorescence of nails, sclera, and teeth, detectable by Wood’s light even two months after its cessation.     

Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers

BACKGROUND: Sugammadex rapidly reverses rocuronium- and vecuronium-induced neuromuscular block. To investigate the effect of combination of sugammadex and rocuronium or vecuronium on QT interval, it would be preferable to avoid the interference of anaesthesia. Therefore, this pilot study was performed to investigate the safety, tolerability, and plasma pharmacokinetics of single i.v. doses of sugammadex administered simultaneously with rocuronium or vecuronium to anaesthetized and non-anaesthetized healthy volunteers. METHODS: In this phase I study, 12 subjects were anaesthetized with propofol/remifentanil and received sugammadex 16, 20, or 32 mg kg(-1) combined with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1); four subjects were not anaesthetized and received sugammadex 32 mg kg(-1) with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) (n=2 per treatment). Neuromuscular function was assessed by TOF-Watch SX monitoring in anaesthetized subjects and by clinical tests in non-anaesthetized volunteers. Sugammadex, rocuronium, and vecuronium plasma concentrations were measured at several time points. RESULTS: No serious adverse events (AEs) were reported. Fourteen subjects reported 23 AEs after study drug administration. Episodes of mild headache, tiredness, cold feeling (application site), dry mouth, oral discomfort, nausea, increased aspartate aminotransferase and gamma-glutamyltransferase levels, and moderate injection site irritation were considered as possibly related to the study drug. The ECG and vital signs showed no clinically relevant changes. Rocuronium/vecuronium plasma concentrations declined faster than those of sugammadex. CONCLUSIONS: Single-dose administration of sugammadex 16, 20, or 32 mg kg(-1) in combination with rocuronium 1.2 mg kg(-1) or vecuronium 0.1 mg kg(-1) was well tolerated with no clinical evidence of residual neuromuscular block, confirming that these combinations can safely be administered simultaneously to non-anaesthetized subjects. Rocuronium and vecuronium plasma concentrations decreased faster than those of sugammadex, reducing the theoretical risk of neuromuscular block developing over time.     

罗伊适应模式对腹股沟疝无张力疝修补术后恢复情况的影响

目的探讨罗伊适应模式对患者腹股沟疝无张力疝修补术后恢复情况的影响。 方法将2016年1月至2019年5月在秦皇岛市第二医院择期进行无张力修补术治疗的120例腹股沟疝患者，按照随机数字法分为对照组和观察组，每组各60例。对照组采用常规护理治疗，观察组在对照组的基础上采用罗伊适应模式。比较2组患者的术后临床指标、心理状态、围手术期并发症发生情况及满意度。 结果术后观察组患者的首次排气时间、恢复正常饮食时间、离床活动时间和术后住院时间均低于对照组（P<0.05）；术后观察组患者的抑郁自评量表（SDS）和焦虑自评量表（SAS）评分显著低于对照组（P<0.05）；术后2组患者均无切口感染发生，2组患者尿潴留、急性疼痛、认知功能障碍、发热、血肿等发生率相比无统计学差异（P>0.05）；术后观察组患者护理满意度为96.67%，显著高于对照组的83.33%（P<0.05）。 结论在常规护理的基础上，罗伊适应模式用于患者腹股沟疝无张力修补围手术期，能有效改善术后患者的焦虑/抑郁情绪，不增加围手术期并发症，促进术后患者的恢复及提高治疗满意度。     

血浆凝血因子VIII水平与IgA肾病患者临床病理改变及预后的关系

目的探讨血浆凝血因子VIII(factor VIII,FVIII)水平与IgA肾病(IgAN)患者临床参数及预后的关系。方法收集2016年1月至2016年12月中南大学湘雅二医院确诊的IgAN患者的临床资料。按照时间依赖的受试者工作特征曲线(ROC)得出的血浆FVIII预测IgAN预后的临界值,将患者分为高FVIII组(FVIII>140.50%)和低FVIII组(FVIII≤140.50%),比较两组患者肾活检时基线临床参数的差异。以估算肾小球滤过率(eGFR)下降≥30%或进入终末期肾脏病(ESRD)为终点事件,采用Kaplan-Meier生存曲线及Cox回归方程法分析血浆FVIII水平对IgAN患者预后的影响。结果共93例IgAN患者纳入本研究,中位随访时间为35.15(33.77,36.76)个月,12例(12.90%)患者发生终点事件。高FVIII组患者年龄、血肌酐、尿素氮、血三酰甘油、血总胆固醇、血浆纤维蛋白原、D-二聚体、24 h尿蛋白量、蛋白C、蛋白S和eGFR下降速率高于低FVIII组(均P<0.05);eGFR、血白蛋白、中位随访时间低于低FVIII组(均P<0.05)。Kaplan-Meier生存分析结果显示,与低FVIII组比较,高FVIII组患者肾脏累积生存率降低(χ2=5.635,P=0.018)。在校正收缩压、eGFR、尿蛋白、肾小管萎缩/间质纤维化程度等因素后,多因素Cox回归分析结果显示,高血浆FVIII水平是IgAN患者肾脏预后不良的独立危险因素(HR=4.147,95%CI 1.055~16.308,P=0.042)。结论血浆FVIII水平与IgAN患者临床指标及预后相关,高血浆FVIII水平是IgAN患者肾脏预后不良的独立危险因素。     

Factors Associated With Reoperation After Silicone Proximal Interphalangeal Joint Arthroplasty

Background: Silicone proximal interphalangeal (PIP) joint arthroplasty has a high revision rate. It has been suggested that persistent ulnar deviation and joint instability influence the durability of PIP silicone arthroplasties. The goal of this study was to evaluate what factors are associated with reoperation after silicone PIP arthroplasty. Methods: We retrospectively evaluated all adult patients who underwent PIP silicone arthroplasty between 2002 and 2016 at one institutional system for inflammatory-, posttraumatic-, and primary degenerative arthritis. After manual chart review, we included 91 patients who underwent 114 arthroplasties. Fingers operated included 14 index, 41 middle, 38 ring, and 21 small fingers. Results: The overall reoperation rate was 14% (n = 16). Non-Caucasian race (P = .040), smoking (P = .022) and PIP silicone arthroplasty for post-traumatic osteoarthritis (P = .021) were associated with reoperation. The 1-, 5- and 10-year implant survival rates were 87%, 85%, and 85%, respectively. Conclusion: Caution should be exercised when considering PIP silicone arthroplasty of the index finger or in patients with post-traumatic osteoarthritis. It may be worthwhile addressing smoking behavior before pursuing silicone PIP arthroplasty.