Role of Ultrasound Therapy in the Healing of Tibial Stress Fractures

Background

Stress fracture is the single most common cause for the lost number of manpower days during training. The conventional treatment options begin with rest and cessation of precipitating activity. However the demands of military training provide little tolerance for prolonged periods of rest. In the recent past ultrasound therapy (UST) has been reported to speed up healing of stress fractures.

Methods

In the present study, a total of 67 cases of stress fracture were studied for the effect of ultrasound therapy on healing time. Study protocol used was double blind placebo controlled.

Result

Study results showed that the mean number of days of incapacitation was 25.46 days in the ultrasound treatment group as compared to 39.92 in the placebo group, a difference of 14 days, which was statistically highly significant.

Conclusion

The results of the study convincingly prove that ultrasound treatment is effective in cases of stress fracture.Key Words: Stress fracture, Ultrasound therapy     

Hypoxic hepatitis in children after cardiac surgery

<正>To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. The incidence rate of HH among patients in the intensive care unit(ICU) was found to be 0.9%-11.9% [1]. Occurrence of HH appears to have a significant impact on the clinical outcome.     

A Cross-sectional Study of Direct Immunofluorescence in the Diagnosis of Immunobullous Dermatoses

Background:

Autoimmune blistering diseases are a group of bullous disorders characterized by pathogenic antibodies directed at the target antigens, which are components of the desmosomes or adhesion complex at the dermoepidermal junction. Direct immunofluorescence (DIF) is invaluable in the diagnosis of these lesions.

Aim:

The aim of this study was to evaluate the sensitivity of DIF in immunobullous dermatoses and to study the pattern of DIF. The study also aims to correlate DIF with clinical and histologic findings and to analyze discrepancies.

Materials and Methods:

Total 100 biopsies received over a period of 2 years in the Department of Pathology were analyzed. DIF, histopathology and clinical data were reviewed.

Results:

Out of 100, 89 cases showed DIF patterns concordant with clinical/histologic diagnosis. The sensitivity of DIF was 94.44% (51/58) in the pemphigus and 84% (21/25) in the bullous pemphigoid (BP) group, 100% each in dermatitis herpetiformis (2/2) and linear IgA disease (1/1). A total of 11 histologically proven cases of immunobullous lesions were DIF negative-four (three of pemphigus vulgaris and one of BP) due to having no epidermis, three (cases of BP) owing to sampling/technical errors and the remaining four (cases of pemphigus vulgaris) due to being on treatment.

Conclusion:

Immunofluorescence helps confirm the diagnosis of bullous lesions in which there is clinical and the histopathologic overlap. Sampling errors contributed to false negative (FN) results.     

心肌梗死后不同时间移植骨髓间充质干细胞对心脏功能修复的作用

目的:观察心肌梗死后不同时间点移植骨髓间充质干细胞对梗死心肌修复的影响,寻找细胞治疗的有效移植时间窗。方法:实验于2006-04/10在郑州大学基础医学院完成。①实验动物:清洁级6周龄雄性SD大鼠81只,1只用于获取骨髓间充质干细胞,剩余80只随机数字表法分为细胞移植组、培养液对照组,再按心肌梗死后1d及1,2,3周进行移植的时间各分为4个亚组,10只/组。②实验方法:获取、培养大鼠骨髓间充质干细胞,培养至第3代接近70%融合时,加入5-溴脱氧尿嘧啶体外标记,调整细胞密度为4×1010L-1备用。两组大鼠均结扎左冠状动脉前降支建立心肌梗死模型。细胞移植组各亚组按对应时间点在心肌梗死中央及四周移植骨髓间充质干细胞悬液50μL/点(2×106个),培养液对照组各亚组于相同部位移植L-DMEM培养液,50μL/点。③实验评估:移植前和移植3周后检测心功能;苏木精-伊红、免疫组织化学染色观察心肌梗死区组织及细胞变化。结果:共79只大鼠进入结果分析。①骨髓间充质干细胞的生长特点:刚分离的细胞为圆形。5d后有集落形成,细胞呈梭形、纺锤形或多角形,胞核较大。传代后细胞体积较原代细胞增大,生长速度加快。②心肌梗死后不同时间移植骨髓间充质干细胞的心功能比较:与移植前比较,移植3周后细胞移植组各亚组左室射血分数、短轴缩短率均有所改善(P<0.05),以心肌梗死后2周细胞移植组最为明显(P<0.01);培养液对照组各亚组左室射血分数、短轴缩短率均下降(P<0.05)。③梗死心肌组织学观察:细胞移植组心肌梗死区及周边可见核蓝色深染的细胞,排列整齐,梗死区瘢痕化减轻。④骨髓间充质干细胞在心肌组织中的分化:细胞移植组梗死心肌内可见大量BrdU标记阳性的骨髓间充质干细胞,胞核呈棕黄色,对心肌特异性肌钙蛋白T呈阳性表达。结论:心肌梗死后早期移植骨髓间充质干细胞能够改善心功能,以2周内进行细胞移植的效果较佳。