bluuebunny/crossref_metadata_2025 huggingface dataset:
Propofol enhances the field excitatory postsynaptic potentials in CA1 hippocampal slices of young and aged mice
Authors: Yin Yiqing , Middleton William J , Florez Carlos M. , Carlen Peter L. , Hossam EI-Beheiry
Published: January 2024

Background

Increasing age was shown to decrease the requirements for propfol. However, the mechanisms of ageinginduced potentiation of anesthetic actions have not been clearly explored. The aim of this study is to compare the effects of propofol on the field excitatory postsynaptic potentials (fEPSPs) in hippocampal slices of young and aging mice.

Methods

Brain slices were prepared from C57BL6 male young (2 months) and aging (>12 months) mice. The dendritic field excitatory postsynaptic potential was recorded from the CA1 stratum radiatum using patch clamp electrophysiological methods. A bipolar concentric stimulating electrode was placed along the Schaffer collateral for othodromic stimulation. The effects of clinically-relevant concentrations of propofol were studied in the young and ageing mouse tissues.

Results

Propofol application increased the orthodromically evoked fEPSP produced in slices taken from young and older animals. A striking feature in the I/O relationship was the decreased enhancement of the fEPSPs by propofol in slices from older mice. A clinically relevant concentration of propofol, 10 μmol/L, showed more significant enhancement in amplitude and area under the curve (AUC) of fEPSP in young compared to tissues from older mice (amplitude: young (24.9±3.4)%, old (4.6±1.6)%; AUC young (30.6±5.4)%, old (2.1±1.7)%). There was no statistically significant difference between the paired-pulse facilitation (PPF) ratios calculated for the responses obtained in tissues from young mice. In slices from older mice, in the presence of 10 μmol/L propofol, PPF was decreased and returned to baseline after washout (baseline 1.21±0.01, propofol: 1.16±0.01). Bicuculline (15 μmol/L) blocked the enhancement of propofol on fEPSP in tissues from young and old mice.

Conclusion

The fEPSP of slices from aging mice demonstrates diminished sensitivity to the enhancing actions of propofol.
Ang II type 1 receptor expression in rat aorta exposed to chronic intermittent hypoxia: effects of p38MAPK and ERK1/2 signaling
Authors: SHANG Jin , YANG Yuan-yuan , GUO Xue-ling , LIU Hui-guo
Published: January 2024

Background

Obstructive sleep apnea is a frequent medical condition consisting of repetitive sleep-related episodes of upper air ways obstruction and can lead to hypertension. Ang II type 1 receptor (AT1R) played important roles in hypertension since it binds with Ang II, controlling salt-water and blood pressure homeostasis. This study explores rat aorta AT1R expression during intermittent hypoxia (IH) and the signaling pathways involved.

Methods

A rat model and a cell model used a BioSpherix-OxyCycler A84 system and a ProOx C21 system respectively. The arterial blood pressure was recorded by a Nihon Kohden Polygraph System. Immunohistochemic was used to focus and analyze the expression of AT1R in rat aorta. Real-time PCR and Western blotting were used to explore the signaling pathways that participated in AT1R expression.

Results

In this study, we found that chronic intermittent hypoxia (CIH) induced AT1R transcription which increased the blood pressure in rat aorta compared to normoxia and to sustained hypoxia. The AT1R protein expression in the aorta was similar to the real-time PCR results. We explored the signaling mechanisms involved in the AT1R induction in both rat aorta and the aortic endothelial cells by real-time PCR and Western blotting. Compared to normoxia, CIH increased ERK1 mRNA transcription but not ERK2 or p38MAPK in the aorta; whereas sustained hypoxia (SH) upregulated ERK2 but not ERK1 or p38MAPK mRNA. In cells, IH induced AT1R expression with ERK1/2 phosphorylation but reduced p38MAPKs phosphorylation, whereas SH induced only ERK1/2 phosphorylation. The ERK1/2 inhibitor PD98059 attenuated the IH-induced AT1R increase but the p38MAPK inhibitor SB203580 did not.

Conclusions

Our results indicate that CIH induced the elevation of rat blood pressure and aorta AT1R expression. Moreover, AT1R expression in IH and sustained hypoxia might be regulated by different signal transduction pathways, highlighting a novel regulatory function through ERK1/2 signaling in IH.
Reducing the radiation dose with the adaptive statistical iterative reconstruction technique for chest CT in adults: a parameter study
Authors: Liu Wenyun , Ding Xiaobo , Kong Boyu , Fan Baoyan , Chen Liang
Published: January 2024

Background

Currently there is a trend towards reducing radiation dose while maintaining image quality during computer tomography (CT) examination. This results from the concerns about radiation exposure from CT and the potential increase in the incidence of radiation induced carcinogenesis. This study aimed to investigate the lowest radiation dose for maintaining good image quality in adult chest scanning using GE CT equipment.

Methods

Seventy-two adult patients were examined by Gemstone Spectral CT. They were randomly divided into six groups. We set up a different value of noise index (NI) when evaluating each group every other number from 13.0 to 23.0. The original images were acquired with a slice of 5 mm thickness. For each group, several image series were reconstructed using different levels of adaptive statistical iterative reconstruction (ASIR) (30%, 50%, and 70%). We got a total of 18 image sequences of different combinations of NI and ASIR percentage. On one hand, quantitative indicators, such as CT value and standard deviation (SD), were assessed at the region of interest. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The volume CT dose index (CTDI) and dose length product (DLP) were recorded. On the other hand, two radiologists with ≥5 years of experience blindly reviewed the subjective image quality using the standards we had previously set.

Results

The different combinations of noise index and ASIR were assessed. There was no significant difference in CT values among the 18 image sequences. The SD value was reduced with the noise index's reduction or ASIR's increase. There was a trend towards gradually lower SNR and CNR with an NI increase. The CTDI and DLP were diminishing as the NI increased. The scores from subjective image quality evaluation were reduced in all groups as the ASIR increased.

Conclusions

Increasing NI can reduce radiation dose. With the premise of maintaining the same image quality, using a suitable percentage of ASIR can increase the value of NI. To assure image quality, we concluded that when the NI was set at 17.0 and ASIR was 50%, the image quality could be optimal for not only satisfying the requirements of clinical diagnosis, but also achieving the purpose of low-dose scanning.
Cross-sectional association of serum C-reactive protein and uric acid with albuminuria in Chinese type 2 diabetic patients
Authors: LING Yan , LI Xiao-mu , GAO Xin
Published: January 2024

Background

Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein (CRP), serum uric acid, and albuminuria in Chinese type 2 diabetic patients.

Methods

A total of 1162 type 2 diabetic patients were recruited. All participants had relevant clinical and laboratory measurements. CRP was measured using a particle enhanced immunoturbidimetric assay.

Results

In the multiple linear regression model, natural log-transformed CRP (lnCRP) and uric acid were independent predictors of natural log-transformed urinary albumin to creatinine ratio (lnACR) (β=0.18, 95% CI 0.10-0.27, P <0.001 and β=0.18, 95% CI 0.09-0.27, P <0.001). The interaction of lnCRP with uric acid was also associated with lnACR (β=0.04, 95% CI 0.02-0.06, P <0.001). In the full-adjusted logistic regression model, the OR for albuminuria of the patients in the third tertile levels of CRP and uric acid was 3.94 compared with patients in the first tertile levels of CRP and uric acid (95% CI 1.73-8.94, P <0.001).

Conclusions

Elevated serum CRP and increased serum uric acid level were associated with albuminuria in Chinese type 2 diabetic patients. Moreover, CRP and uric acid had an interactive effect on albuminuria.
Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in intrapulmonary lesions
Authors: ZHAO Hui , XIE Zhen , ZHOU Zu-Li , SUI Xi-Zhao , WANG Jun
Published: January 2024

Background

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered to have high value in the staging of mediastinal lymph nodes in lung cancer. The current study was conducted to investigate the diagnostic value of EBUS-TBNA in intrapulmonary lesions located near the central airway.

Methods

From September 2009 to March 2013, 66 patients with pulmonary masses located close to the central airways suspected to be lung cancer were accessed by EBUS-TBNA. Conventional bronchoscopic biopsy before EBUS-TBNA was nondiagnostic in all cases. If EBUS-TBNA did not result in a formal pathological diagnosis of malignancy, patients were subsequently referred for a surgical procedure.

Results

Among the 66 cases, 59 were confirmed as pulmonary malignancies by EBUS-TBNA, of which 48 cases were non-small cell lung cancer, nine were small cell lung cancer, and two were metastatic lung tumors. No evidence of malignancy was found by biopsy and histopathological examination in the other seven cases. Thoracoscopy or thoracotomy was subsequently undergone for them. Postoperative pathological examinations confirmed three cases of squamous cell carcinoma of the lung, one case of lymphoma, two cases of sclerosing hemangioma, and one case of pulmonary tuberculoma. The definitive diagnosis rate of EBUS-TBNA for intrapulmonary lesions near the central airway was 89.4%. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant intrapulmonary lesions were 93.7%, 100.0%, and 93.9%, respectively. The positive and negative predictive values were 100.0% and 42.9%, respectively. The EBUS-TBNA procedures were well-tolerated by all patients. No associated complications were observed.

Conclusions

For intrapulmonary lesions near the central airway highly suspected of cancer, EBUS-TBNA has satisfactory diagnostic value. However, the negative predictive value of this technique is low, so negative results obtained by EBUS-TBNA should be confirmed by other methods.
Effects of low molecular weight heparin on clot rate and activated clotting time: an in vitro study
Authors: SHI Xu-bo , BAI Ying , LI Jie , XIAO Jie , WANG Jian-qi , ZHENG Hua
Published: January 2024

Background

Due to lack of point-of-care testing, the use of low-molecular-weight heparin (LMWH) therapy in some special patients is restricted. This study was designed to explore the effects of LMWH on clot rate (CR) and activated clotting time (ACT), and to search for an appropriate method for bedside monitoring of anticoagulant activity of LMWH.

Methods

Thirty-two healthy volunteers were selected from the staff of Beijing Tongren Hospital. CR and ACT were measured with different reagents (glass beads, diatomite, kaolin and magnetic bar) on blood samples spiked with increasing concentrations of LMWH (dalteparin, 0.2–1.8 IU/ml). Correlations between concentrations of LMWH and values of CR and ACT were analysed based on the data obtained and regression analysis was performed to establish a regression equation.

Results

With the increase in doses of dalteparin, CR values reduced gradually. The values of CR of four reagents (glass beads, diatomite, kaolin and magnetic bar) were 20.4–4.5 IU/min, 27.4–6.9 IU/min, 27.5–7.9 IU/min and 7.8–0.1 IU/min respectively and an linear relationship was observed between the CR values and dalteparin concentrations (P<0.05). The values of ACT were 173–615 seconds, 130–270 seconds, 123–226 seconds, 337–1411 seconds respectively, which showed a linear regression between the ACT values and dalteparin concentrations (P<0.01). Differences in slope of the regression curves of ACT were observed with all the reagents tested (glass beads 248.2 s/IU, diatomite 74.8 s/IU, kaolin 58.2 s/IU and magnetic bar 1112.2 s/IU, P<0.01). While the minimum concentration of dalteparin was 0.2 IU/ml, 0.4 IU/ml, 1.4 IU/ml and 0.2 IU/ml separately, the ACT values of the four coagulants (glass beads, diatomite, kaolin and magnetic bar) were beyond the normal limit and showed a noticeable increase respectively (P<0.01).

Conclusions

This study showed that there was an excellent linear relationship between the CR and ACT values and dalteparin concentrations for all the four reagents (glass beads, diatomite, kaolin and magnetic bar) in vitro. The sensitivity of different coagulation reagents to LMWH different. Choosing a suitable reagent, both CR and ACT were possible to be used as a convenient bedside test for LMWH.
Symptomatic pulmonary lipiodol embolism after transarterial chemoembolization for hepatic malignant tumor: clinical presentation and chest imaging findings
Authors: Xu Haifeng , Yang Renjie , Wang Xiaodong , Zhu Xu , Chen Hui
Published: January 2024

Background

Pulmonary lipiodol embolism after transarterial chemoembolization (TACE) was rare and life-threatening, occasionally reported in previous literatures. We aimed to review the records of 11 patients with pulmonary oily embolism and analyze their characteristics of radiographic findings and risk factors.

Methods

Records of 478 consecutive patients who underwent 1 026 percutaneous TACE procedures were retrospectively analyzed. Eleven cases with respiratory symptoms were identified as having symptomatic pulmonary lipiodol embolism after TACE. Data of these patients, including clinical presentation, techniques of TACE, imaging features of tumor and chest imaging findings, were assessed.

Results

Eleven (2.3%) of 478 consecutive patients who underwent percutaneous TACE procedures had a pulmonary oily embolism after procedures. The mean size of target tumors embolized was (13.6±2.0) cm. All were hyper-vascular. The mean volume of lipiodol was (21.8±8.2) ml. Pulmonary oily embolisms were revealed within 12-48 hours after TACE. The most severe respiratory symptoms and imaging abnormalities of the eight patients who survived presented between 2 and 5 days after TACE, becoming normal between 12 and 35 days after TACE. Three patients died. Chest CT revealed retention of radiopaque lipiodol in lungs.

Conclusions

Pulmonary lipiodol embolism occurs easily in patients who have large hyper-vascular hepatic malignant tumor. The high-density lipiodol deposition in the lung field can be used as diagnostic feature.
Effect of ouabain on the pathogenesis of hypertension in rats
Authors: Liu Meiyan , Ren Yanping , Guo Chengjun
Published: January 2024

Background

Ouabain and digoxin are important cardiac glycoside and related to many cardiovascular diseases. The purpose of this study was to investigate the changes of sodium pump α-subunit expression in rats and compare the effects of ouabain (OUA) and digoxin (DIG) on the development of hypertension.

Methods

In situ hybridization was performed. Specific sequence oligonucleotide probe tailing with a Dig-dUTP hybrid to target nucleic acids of the sodium pump α-subunit. According to counting positive particles sodium pump subunit expression was analyzed with statistical methods.

Results

On day 16 of drug administration, the blood pressure of rats increased significantly in the OUA group. In the DIG group, the blood pressure revealed no significant difference when compared to the control group. In addition, the effects of OUA and DIG on sodium pump α-subunit RNA expression in tissues differed.

Conclusions

OUA and DIG can not only change the configuration of the sodium pump to depress their activity, but also influence their gene expression which is important in the mechanism of hypertension. This may be a key point in the pathogenesis of hypertension in the manner in which OUA differs from DIG and changes the sodium pump gene expression in the arteries and kidneys of rats.
P1 gene of Mycoplasma pneumoniae in clinical isolates collected in Beijing in 2010 and relationship between genotyping and macrolide resistance
Authors: TIAN Xiu-jun , DONG Yan-qing , DONG Xiao-pei , LI Jing-yi , LI Dan , JIANG Yue , XIN De-li
Published: January 2024

Background

Mycoplasma pneumoniae is a common pathogen that caused community-acquired pneumonia (CAP). P1 protein served as major adhesion and immunodominant protein in Mycoplasma pneumoniae, but little about P1 gene was learned and the relationship between P1 genotype and macrolide resistance has yet to be explored.

Methods

The DNA sequence of the entire P1 gene from 35 strains isolated from clinical specimens collected in Beijing, China, in 2010 was determined. The resulting sequences were checked for known macrolide resistance mutations, such as A2063G, A2064G, C2617G in domain V of 23S rRNA. Antibiotic susceptibility test was done to further identify macrolide resistant strains.

Results

Thirty-four clinical strains were type 1, and were identical to type 1 reference strain MP129. Only one clinical strain, MpYYM22, was type 2, and proved to be variant 2c. One synonymous point mutation in the P1 type 1 gene from two isolates was identified relative to the MP129 P1 sequence at nucleotide position (nt) 552 (C>A), while another two isolates had missense mutations at nt 2504 (G>A). This point mutation caused an amino acid change from glycine to glutamic acid. An AGT tri-nucleotide variable-number tandem repeat (VNTR), coding for serine and repeating 6-11 times, up to 15-16 times, was found in the region between the RepMP4 and RepMP2/3 elements in the 35 isolates examined. All 35 clinical strains, including MpYYM22, demonstrated macrolide resistance with the range of minimum inhibitory concentration (MIC) of erythromycin from 64 to 256 μg/ml, having an A2063G transition in domain V of the 23S rRNA gene.

Conclusions

P1 type 1 was the dominant type of Mycoplasma pneumoniae in Beijing in 2010, although variant 2c strains were present. More samples are needed to determine whether there is a relationship between the P1 genotype and macrolide resistance, as the 35 strains examined did not allow a conclusive result. However, the AGT tri-nucleotide VNTR may be a more informative locus for multi-locus VNTR analysis.
Efficacy and safety of Changfu peritoneal dialysis solution: a multi-center prospective randomized controlled trial
Authors: ZHOU Jian-Hui , NI Zhao-Hui , MEI Chang-Lin , YU Xue-Qing , LIU Fu-You , MIAO Li-Ning , LIU Zhi-Hong , YUAN Weijie , ZHANG Ai-Ping , LIN Hong-Li , CHEN Meng-Hua , CHEN Jiang-Hua , ZHANG Jin-Yuan , HE Ya-Ni , CHEN Jian , ZHAO Jiu-Yang , DING Xiao-Qiang , LI Ying , LI Rong-Shan , XIE Ru-Juan , LIU Wen-Hu , XING Chang-Ying , WANG Rong , DENG Yue-Yi , CAO Xue-Ying , CAI Guang-Yan , MOU Shan , MAO Zhi-Guo , YANG Xiao , LIU Hong , SUN Jing , YU Yu-Sheng , LIU Jun , SHI Shu-Mei , LI Long-Kai , TIAN Na , ZHANG Xiao-Hui , ZHOU Wei , YANG Jie , ZHANG Yong , SUN Jing-Di , JI Jun , ZHANG Tao , YAN Yan , LIU Xiao-Gang , WANG Gang , ZHANG Li , ZHANG Hong , LUO Jian-Hua , CHEN Xiang-Mei
Published: January 2024

Background

A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions. Some researchers believe that 6 L/d is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.

Methods

Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices.

Results

Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr). Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR). Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L·1.73 m-2w-1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that.

Conclusions

The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution. During 48-week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.
Preoperative prediction of survival in resectable gallbladder cancer by a combined utilization of CA 19–9 and carcinoembryonic antigen
Authors: Yu Tunan , Yu Hong , Cai Xiujun
Published: January 2024

Background

Currently, all frequently used staging systems in gallbladder cancer (GBC) are based on postoperative pathological examinations. In patients undergoing curative operation, there is no effective method to predict survival preoperatively. In this study, we explored whether a combined utilization of two tumor biomarkers, namely carbohydrate antigen 19–9 (CA 19–9) and carcinoembryonic antigen (CEA), could give a preoperative prediction of survival in resectable GBC.

Methods

Seventy-three patients who underwent radical resection for GBC were included in this study. A retrospective analysis of clinical-pathological data was conducted.

Results

By multivariate analysis, CA 19–9 elevation (P <0.05) and CEA elevation (P <0.001) were discovered as two individual factors for postoperative survival. By a combined utilization, patients were divided into three groups: patients with elevation of CEA (group I), patients with elevation of CA 19–9 but without CEA (group II), and patients with nonelevations of either CA 19–9 or CEA (group III). The cumulative 5-year survival rates in groups I, II, and III were 0, 14.0%, and 42.8%, respectively (P <0.05).

Conclusions

By a combined utilization of CA 19–9 and CEA, individualized prediction of survival is available in resectable GBC before operation. Extended radical operation brings the most prognostic benefits in patients with nonelevations of either CA 19–9 or CEA. However, if operation would be in a larger-scale destructive manner, careful consideration of surgical decisions should be made in patients with elevation of tumor biomarkers, especially CEA.
Self-monitoring of blood glucose in type 2 diabetic patients in China: current status and influential factors
Authors: Yuan Li , Guo Xiaohui , Xiong Zhenzhen , Lou Qingqing , Shen Li , Zhao Fang , Sun Zilin , Li Jianwei
Published: January 2024

Background

Self-monitoring of blood glucose (SMBG) by individuals with type 2 diabetes (T2D) is crucial for long-term health, yet numerous cultural, economic and health factors can reduce SMBG. Most studies on SMBG adherence have come out of the US and Europe, and their relevance to Asia is unclear. The aims of the present study were to assess the current state of SMBG in China and analyze demographic and diabetes-related characteristics that may influence it.

Methods

In this multi-center, cross-sectional study, 5 953 individuals with T2D from 50 medical centers in 29 provinces across China filled out a standardized questionnaire that requested information on demographic characteristics, education level, occupation, income, lifestyle risk factors, duration of diabetes, chronic complications, and frequency of SMBG. Respondents were also asked whether their glycosylated hemoglobin (HbA1c) had been checked in the past 6 months. The most recent values for fasting plasma glucose, 2-hour postprandial blood glucose and HbA1c were recovered from medical records.

Results

Only 1 130 respondents (18.98%) performed SMBG with the recommended frequency, while 4 823 (81.02%) did not. In fact, nearly 2 105 (35.36%) reported never performing SMBG. In the subset of 3 661 individuals on insulin therapy, only 266 (7.27%) performed SMBG at least once a day, while 1 210 (33.05%) never performed it. In contrast, 895 of 2 292 individuals (39.05%) on diet/exercise therapy or oral hypoglycemic therapy never performed it. Multivariate Logistic regression identified several factors associated with SMBG adherence: female gender, higher education level, higher income, longer T2D duration and education about SMBG.

Conclusions

SMBG adherence in our Chinese population with T2D was less frequent than that in developed countries. Several factors influence SMBG adherence: gender, education level, income, T2D duration, therapy regimen and exposure to education about SMBG.
Anatomical references for tibial sagittal alignment in total knee arthroplasty: A comparison of three anatomical axes based on 3D reconstructed CT images
Authors: SHAO Jun-jie , Vail Thomas Parker , WANG Qiao-jie , SHEN Hao , CHEN Yun-su , WANG Qi , JIANG Yao , ZHANG Xian-long
Published: January 2024

Background

This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex (ATC) line, the fibular line (FL), and the anatomical axis of tibia (AAT) line, to determine which line most closely parallels the mechanical axis (MA) of the tibia in the sagittal plane. The clinical relevance of the study is that through finding a reliable landmark on the leg, a surgeon may minimize posterior tibial slope measurement errors thereby and improving the technique for assuring proper alignment of total knee arthroplasty.

Methods

The material for this study included CT scans of the tibia from 85 consecutive patients and 168 knees (78 without osteoarthritis (OA) and 90 knees with OA). Measurements of the angles between the tibial mechanical axis and each of three reference lines in the sagittal plane were carried out using 3D imaging software.

Results

Mean angles of 168 knees were as follows: aMT (3.96±0.85)°, aMF (0.70±0.58)°, and aMA (1.40±0.66)°, (aMT: an angle between MA and ATC, aMF: an angle between MA and FL, aMA: an angle between MA and AAT. All above-mentioned angles were measured in the sagittal plane of tibia) and the aMF was significantly smaller than the others (P <0.0001). The mean value of the medial tibial slope angle vs. the MA was (9.19±3.97)°, and this was significantly larger than the mean lateral slope angle of (6.62±4.23)° (P <0.0001). The difference between aMF without OA and with OA was not statistically significant (P=0.5015) and the association between the aMT and aMA was strong (r=0.82, P <0.01).

Conclusions

FL was more closely parallel to the MA of tibia, and more showed less variation between OA and non-OA controls than ATC and AAT lines. Furthermore, the amount of posterior slope in medial plateau was greater than that in lateral plateau. The findings of this analysis suggest that when using the anterior tibial cortex line as is commonly done with extramedullary tibial resection guides, the tibial resection should be sloped approximately four degrees more posteriorly.
Atorvastatin attenuates involvement of RhoA/Rho-kinase pathway and NF-κB activation in hypoxic pulmonary hypertensive rats
Authors: Zhang Yan , Dai Li , Wu Shangjie , Chen Ping , Zhao Shuiping
Published: January 2024

Background

Hypoxic pulmonary hypertension (HPH) contributes to the pathogenesis of cardiopulmonary diseases. Several lines of evidence indicate that the Rho A/Rho-kinase pathway play an important role in the progress of pulmonary hypertension. Stains have been shown exert numerous biological effects that are independent of their cholesterol-lowering property. We hypothesized that the Rho A/Rho-kinase pathway is involved in the pathogenesis of HPH, and that atorvastatin would attenuate involvement of the Rho A/Rho-kinase pathway in a HPH rat model.

Methods

Thirty-two Wistar rats were randomly divided into four groups: control group, hypoxic group, atovastatin group, and normal saline group. The control group was kept in a normoxia environment. The other groups were exposed to hypoxia for three weeks. Atovastatin was administered daily via a gastric gavage in the atovastatin group. We measured the mean pulmonary arterial pressure (mPAP), the ratio of the right ventricular weight to the sum of the weights of the left heart ventricle and septum (RV/(LV+S)), arteriole wall thickness/vascular external diameter (WT%), vascular area/total vascular area (WA%), expression of RhoA and phos-MYPT-1 protein in lung tissue, and NF-κB activation in pulmonary vascular smooth muscle cells.

Results

Compared with the control group, mPAP, RV/(LV+S), WT%, WA%, NF-κB activation, expression of RhoA, and phos-MYPT-1 were increased in the hypoxic and normal saline groups (P<0.05). Compared with the hypoxic group, mPAP, RV/(LV+S), WT%, WA%, NF-κB activation, expression of RhoA, and phos-MYPT-1 were decreased in the atovastatin group (P<0.05). Correlations between phos-MPTY-1 and mPAP, WA%, WT%, and NF-κB activation were all positive.

Conclusions

The Rho A/Rho-kinase pathway plays an important role in the development of HPH. Atorvastatin reversed HPH by inhibiting the activity of Rho A/Rho-kinase and NF-κB.
Morel-Lavallee lesion
Authors: Li Hui , Zhang Fangjie , Lei Guanghua
Published: January 2024

Objective

To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity. Familiarization may decrease missed diagnoses and misdiagnoses. It could also help steer the clinician to the proper treatment choice.

Data sources

A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords: Morel-Lavallee lesion, closed degloving injury, concealed degloving injury, Morel-Lavallee effusion, Morel-Lavallee hematoma, posttraumatic pseudocyst, posttraumatic soft tissue cyst.

Study selection

Chinese and English language literatures relevant to the subject were collected. Their references were also reviewed.

Results

Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury. It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia. Apart from the classic location over the region of the greater trochanter, MLLs have been described in other parts of the body. The natural history of MLL has not yet been established. The lesion may decrease in volume, remain stable, enlarge progressively or show a recurrent pattern. Diagnosis of MLL was often missed or delayed. Ultrasonography, computed tomography, and magnetic resonance imaging have great value in the diagnosis of MLL. Treatment of MLL has included compression, local aspiration, open debridement, and sclerodesis. No standard treatment has been established.

Conclusions

A diagnosis of MLL should be suspected when a soft, fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury. Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis. Treatment decisions should base on association with fractures, the condition of the lesion, symptom and desire of the patient.
Elevated levels of mitochonrial respiratory complexes activities and ATP production in 17-β-estradiol-induced prolactin-secretory tumor cells in male rats are inhibited by melatonin in vivo and in vitro
Authors: WANG Bao-qiang , YANG Quan-hui , XU Rong-kun , XU Jian-ning
Published: January 2024

Background

Our earlier studies indicate that melatonin inhibits the proliferation of prolactinoma and induces apoptosis of pituitary prolactin-secreting tumor in rats. Melatonin has also been shown to induce apoptosis and to reduce the production of ATP in breast tumor cells. This study analyzed the levels of the four mitochondrial respiratory complexes and the production of ATP and also the effects of melatonin treatment of prolactinoma.

Methods

In the in vivo study, mitochondria were harvested from control pituitaries or prolactinoma collected from the pituitaries of melatonin- and 17-β-estradiol (E2)-treated male rats. In the in vitro study, prolactinoma cells mitochondria were harvested. Activities of the four mitochondrial respiratory complexes were assayed using fluorometer. ATP production of prolactinoma cells was estimated using bioluminescent methods.

Results

Elevated levels of four mitochondrial respiratory complexes activities and ATP production were recorded in prolactinoma cells. Moreover, in both in vivo and in vitro studies, melatonin inhibited the activities of mitochondrial respiratory complexes and the production of ATP in prolactinoma cells.

Conclusions

There is a link between mitochondrial function increase and tumorigenesis. Melatonin induces apoptosis of pituitary prolactin-secreting tumor of rats via the induction of mitochondrial dysfunction and inhibition of energy metabolism.
Correlation between the coverage percentage of prosthesis and postoperative hidden blood loss in primary total knee arthroplasty
Authors: Gao Fuqiang , Guo Wanshou , Sun Wei , Li Zirong , Wang Weiguo , Wang Bailiang , Cheng Liming , Kush Nepali
Published: January 2024

Background

The aim of this study was to determine the relationship between prosthesis coverage and postoperative hidden blood loss (HBL) in primary total knee arthroplasty (TKA).

Methods

A total of 120 patients who had undergone unilateral TKA from August 2012 to May 2013 were retrospectively studied. The Gross formula was used to calculate the amount of HBL. Routine standard anteroposterior (AP) and lateral X-ray films of the knee joint were taken postoperatively and used to measure the percentages of coronal femoral and of coronal and sagittal tibial prosthetic coverage. Then Pearson's correlation analysis was performed to assess the correlations between the percentages of prosthetic coverage for each AP and lateral position and HBL on the first and third postoperative days.

Results

The volumes of HBL on the first and third postoperative days after TKA were (786.5±191.6) ml and (1 256.6±205.1) ml, respectively, and lateral X-ray film measurements of percentages of coronal femoral, tibial coronal, and sagittal prosthetic coverage were (87.9±2.5)%, (88.5±2.2)%, and (89.1±2.3)%, respectively. Pearson's correlation analysis showed statistically significant correlations between percentages of total knee prosthetic coverage for each AP and lateral position and volumes of HBL on the first and third postoperative days (P <0.05).

Conclusions

HBL after TKA correlates with degree of prosthetic coverage. To some extent, the size of the surfaces exposed by osteotomy determines the amount of HBL. Choice of the appropriate prosthesis can significantly reduce postoperative HBL. Designing individualized prostheses would be a worthwhile development in joint replacement surgery.
A randomized double-blinded sham-controlled trial of α electroencephalogram-guided transcranial magnetic stimulation for obsessive-compulsive disorder
Authors: Ma Xiaoyan , Huang Yueqin , Liao Liwei , Jin Yi
Published: January 2024

Background

Obsessive-compulsive disorder (OCD) is a highly prevalent and devastating psychiatric condition. Repetitive transcranial magnetic stimulation (rTMS) is a potential and non-invasive treatment for OCD. Diverse efficacies of rTMS have been reported in different locations or frequencies of the stimulation. The main objective of this study was to assess the treatment effect for OCD with alpha electroencephalogram (αEEG)-guided TMS over dorsal lateral prefrontal cortex bilaterally.

Methods

There were 25 OCD patients in the αTMS treatment group and 21 OCD patients in the sham control group. Each subject received 10 daily treatment sessions (5 days a week). The αTMS group had significant reduction in scores of Yale-Brown Obsessive Compulsive Scale and Hamilton Rating Scale for Anxiety (HAMA) compared with the control group at the end of 2-week treatment and 1-week follow-up. Analysis of variance with repeated measures was used to test the effects between the two groups.

Results

Significant difference in scores of obsession and HAMA were found between the two groups after treatment. No significant difference in scores of Hamilton Rating Scale for Depression was found between the two groups after the treatment, but statistical significance was shown at the end of 1-week follow-up.

Conclusions

αEEG-guided TMS may be an effective treatment for OCD and related anxiety. Delayed response to αTMS in depression suggests that it might be secondary to the improvement of primary response in OCD and anxiety.
Risk factors associated with emergency peripartum hysterectomy
Authors: Jin Rong , Guo Yuna , Chen Yan
Published: January 2024

Background

Use of an emergency peripartum hysterectomy (EPH) as a lifesaving measure to manage intractable postpartum hemorrhage (PPH) appears to be increasing recently around the world, and the indications for EPH have changed. The object of this study is to identify risk factors associated with EPH.

Methods

We conducted a case-control study of 21 patients who underwent EPH because of intractable PPH between January 1, 2005 and June 30, 2013, at the International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University, School of Medicine (IPMCH). The parametric t-test, chi-square tests and Logistic regression models were used for analysis to identify the risk factors. The results were considered statistically significant when P<0.05.

Results

There were 89 178 deliveries during the study period. Twenty-one women had an EPH, with an incidence of 24 per 100 000 deliveries. The loss of blood during postpartum hemorrhage of the EPH group was (5 060.7±3 032.6) ml, and that of the control group was (2 040.8±723.5) ml. There was a significant difference of PHH between the EHP group and the control group (P=0.001). Independent risk factors for EPH from a logistic regression model were: disseminated intravascular coagulation (DIC) (OR: 9.9, 95% CI 2.8-34, P=0.003), previous cesarean section (OR: 5.27; 95% CI: 1.48-17.9, P=0.009), placenta previa (OR: 6.9; 95% CI 1.6-2.9, P=0.008), the loss of PPH (OR: 1.001; 95% CI 1.001-1.002, P=0.002), placenta accreta (OR: 68; 95% CI 10-456, P=0.004), the use of tocolytic agents prenatally (OR: 6.55, 95% CI 1.34-32.1, P=0.049), and fetal macrosomia (OR: 6.9, 95% CI 1.25-38, P=0.049).

Conclusion

Significant risk factors of EPH are DIC, placenta previa, PPH, previous cesarean delivery, and placenta accrete, the use of tocolytic agents prenatally, and fetal macrosomia.
Ectopic osteogenesis and scaffold biodegradation of tissue engineering bone composed of chitosan and osteo-induced bone marrow mesenchymal stem cells in vivo
Authors: He Yiqun , Dong Youhai , Chen Xujun , Lin Rongqiang
Published: January 2024

Background

Chitosan (CS) scaffolds combined with osteogenically induced bone marrow mesenchymal stem cells (BMSCs) have been proved to be promising substitutes for repairing bone defects. Nevertheless, the bone-forming and scaffold-biodegrading processes are seldom studied. This study aimed to determine the osteogenic ability of CS/osteo-induced BMSC composites by observing the bone-forming process and explore the relationship between bone formation and scaffold biodegradation.

Methods

The CS/osteo-induced BMSC composites (CS+cells group) and the CS scaffolds (CS group) were, respectively, implanted into SD rat thigh muscles. At 2, 4, 6, 8, and 12 weeks postoperatively, the rat femurs were scanned by CT, and the CT values of the implants were measured and comparatively analyzed. Subsequently, the implants were harvested and stained with hematoxylin and eosin and Masson trichrome, and the percentages of bone area, scaffold area, and collagen area were calculated and compared between the two groups.

Results

The imaging results showed that the densities of implants of the two groups gradually increased along with time, but the CT values of implants in the CS+cells group were much higher than in the CS group at the same time point (P <0.05). The histological results showed that the de novo bone and collagen formed in the pores of the scaffolds and gradually increased since 2 weeks postoperation in both groups, and the scaffold gradually degraded along with the boneforming process. However, the comparative analysis results showed that the CS+cells group gained more de novo bone and collagen formation and had less scaffold than the CS group at the same time point (P <0.05).

Conclusion

The CS/osteo-induced BMSC composites are excellent bone tissue engineering substitutes, and the scaffold biodegradation is accordant with the bone formation.
Evaluation of the asynchronization and function of the left ventricle in patients with chronic pulmonary hypertension by velocity vector imaging
Authors: WANG Chao-hong , WANG Yue-heng , NIU Ning-ning , XIE Ying-xin , WANG Lin
Published: January 2024

Background

Pulmonary hypertension (PH) is a set of pathophysiological syndromes characterized by increased pulmonary artery pressure and pulmonary vascular resistance, resulting in increased right ventricular afterload. The left and right ventricles interact through hemodynamics. What impact will PH have on synchronization and function of the left ventricle (LV)? The aim of this study was to evaluate the synchronization of the left ventricular wall motion and left ventricular function in patients with varying degrees of PH using velocity vector imaging (VVI) technology.

Methods

Sixty patients with chronic PH served as the experimental group, and 20 healthy volunteers served as the control group. According to the different degrees of pulmonary artery systolic pressure, the experimental group was divided into three groups: mild, moderate, and severe PH groups. The time to peak systolic longitudinal velocity (Tvl), the peak systolic longitudinal velocity (Vsl), the peak diastolic longitudinal velocity (Vel), the peak systolic longitudinal strain (Sl), and strain rate (SRl) in 18 segments were measured in each group.

Results

Tvl in the control group and each group with PH was reduced from basal to apical segment, and in control group Tvl in various segments of the same wall and in different walls showed no significant difference (P >0.05). With increase in pulmonary artery pressure, Tvl values measured showed an increasing trend in groups with PH. In groups with PH, Vsl and Vel of each wall were reduced sequentially from basal to apical segments, showing gradient change; Vsl and Vel values measured showed a decreasing trend with increase in pulmonary artery pressure, in which the differences of Vel values measured in the control group and the mild PH group were statistically significant (P <0.01), and the differences between other groups were statistically significant (P <0.01). In groups with PH, Sl and SRl in basal segment and the middle segment of each wall were decreased; the difference between groups was statistically significant (P <0.01).

Conclusions

Asynchronization of the LV and decreased left ventricular function were present in patients with chronic PH; VVI technology can accurately evaluate left ventricular function in patients with PH, and indicators such as Tvl, Vsl, and Vel are valuable.
Treatments for primary aneurysmal bone cysts of the cervical spine: experience of 14 cases
Authors: Wang Chao , Liu Xiaoguang , Jiang Liang , Yang Shaomin , Wei Feng , Wu Fengliang , Liu Zhongjun
Published: January 2024

Background

Aneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive. The optimal treatment of cervical spine lesions remains controversial. This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.

Methods

This series included eight men and six women diagnosed between 2002 and 2012. A retrospective review of the hospital charts, operating room reports, office charts, and radiographs was performed. The data collected included patient age, sex, radiological features, pathology, treatment methods, outcomes, and complications from biopsies and treatments. The mean age at diagnosis was 17.5 years old with a range of 6-35 years. All patients had experienced local pain for a mean of 7.3 months (range, 0.5-18.0 months), and three patients had neurological deficits (one with radiculopathy and two with myelopathy). The Frankel classification before treatment was E in 12 cases, D in one case, and C in one case.

Results

Four patients received radiotherapy alone. Ten patients underwent surgery, including five total spondylectomies, two local resections, and three curettages. Three patients received preoperative selective arterial embolization, and four received adjuvant radiotherapy. The mean follow-up time was 44.5 months (range 12-96 months), and no recurrence was identified. Three patients with neurological deficits achieved complete recovery, as noted at the final follow-up examination. One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy. He refused further treatment.

Conclusions

The results can be achieved by different treatments (surgical resection/curettage, selective arterial embolization, and radiotherapy) for ABC of the cervical spine. Reconstruction of stability is also important for the treatment of cervical ABC.
Clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of osteochondral lesions of the talus
Authors: Shuyuan Li , Hongliang Li , Yujie Liu , feng Qu , Junliang Wang , Chang Liu
Published: January 2024

Background

The time until weight-bearing after arthroscopic microfracture when treating osteochondral lesions of the talus (OLT) is very important to the clinical outcomes of the operation. However, there have been no consistent opinions regarding the optimal time to start weight-bearing postoperatively. Many opinions advocate that weight-bearing should begin not earlier than the sixth or eighth week postoperatively, whereas others point out that earlier weight-bearing could also obtain satisfactory outcomes. The purpose of our study was to evaluate the clinical outcomes of early weight-bearing after arthroscopic microfracture during the treatment of OLT.

Methods

Fifty-eight ankles in 58 patients with a single OLT <2 cm2were retrospectively studied. All lesions were treated with arthroscopic debridement and microfracture under local anesthesia. After the operation, the patients were allowed to bear full weight under the protection of figure-8-shaped splints. The visual analog scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle—hindfoot scale were evaluated preoperatively and at six postoperative timepoints (1st day, 1st month, 3rd month, 6th month, 12th month, and 24th month). Patients were followed up for 24-52 months (mean (34.97±7.33) months).

Results

All 58 patients achieved excellent recovery with significant relief of their symptoms. The VAS score decreased from 7.31±1.0 preoperatively to 0.95±0.76 at the 24th month follow-up (P=0.000), whereas the AOFAS score improved from 53.53±8.57 preoperatively to 87.62±5.42 at the 24th month follow-up (P=0.000).

Conclusion

The successful clinical outcomes of this study demonstrated that early weight-bearing after the treatment of OLT with arthroscopic microfracture can be allowed.