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Quick Search     Adv Search 2016 Vol. 33, No. 6 Published: 2016-06-27   1041 Experimental Study of The Expression Levels of MMPs in Bundles of Anterior Cruciate Ligament WANG Jing,DAI Chang,WANG Yusi 【Objective】To detect the expression level of MMPs in the anteromedial and posterolateral bundles of anterior cruciate ligament and to explore the potential place for clinical tendon reconstruction of anterior cruciate ligament. 【Methods】The knees and anterior cruciate ligaments (ACL) were cut out from 10 fresh cadavers that were donated voluntarily. The total RNA was extracted and reverse transcribed into cDNA, then realtime quantitative PCR was used to detect the MMP genes associated with tendon recovery in the anteromedial and posterolateral bundles of the ACL . Meanwhile the samples of anteromedial and posterolateral bundles of the anterior cruciate ligament were fixed and paraffinembedded. Immunohistochemistry experiments were conducted using the MMP2 and MMP3 polyclonal antibodies. Finally the anteromedial and posterolateral bundles of the anterior cruciate ligament were collected, and the total protein was extracted after homogenizing the bundles. MMP2 and MMP3 expression were analyzed between the different bundles by Western blotting. 【Results】There were significant differences for the expression of MMP2 and MMP3 in the anteromedial and posterolateral bundles of the ACL, but there were no significant differences for the expression of the genes MMP1, MMP10, MMP13, and MMP23 in each bundle of ACL. The detection of MMPs in the anterior cruciate ligament using immunohistochemistry and westernblot analysis showed that the expression level of MMP2 is higher in the anteromedial bundle than posterolateral, and that MMP3 expression level is lower in the anteromedial bundle than posterolateral. 【Conclusion】The anteromedial bundle of the anterior cruciate ligament has a better ability to reconstruct itself, and the front of its intersection on tibia plateau is likely to be the the sites of potential clinical tendon reconstruction. 2016 Vol. 33 (6): 1041-1047 [Abstract] ( 140 ) HTML (1 KB)  PDF  (0 KB)  ( 21 ) 1044 Effect of Sliding Bone Graft Combined with Locking Compression Plate (LCP)Internal Fixation for Femoral Fracture Nonunion GU Yu，Tethong Lhunzhub 【Objective】 To discuss the effect of sliding bone graft combined with locking compression plate (LCP)internal fixation for the treatment of nonunion after femoral fracture surgery.【Methods】Forty seven cases with nonunion of femoral fractures treated in the Department of Orthopedics of our hospital were selected. Upon the sliding bone graft combined with LCP internal fixation, the functional recovery and postoperative prognosis of patients were evaluated. 【Results】Forty seven patients were successfully operated: the average length of incision (17.4±10.8) cm, the operative time (152.6±19.4) min, blood loss (181.5±58.0) mL, postoperative drainage (139.4 ± 47.3) mL;3 patients were out of followed up, 1 patient occurred plate and screw loosening, 2 patients recurred nonunion due to infection. After internal fixation removal and infection control, the patients were treated with the inlay external fixation device for 7 months and the bone was healed duly. The healing time of fracture was 7.1 to 9.8 (8.2±1.4) months in the remaining 41 cases. The patients were followed up from 3.2 to 14 (11.6±2.9) months. The HSS scores of knee joint after 6 months and last followup and the Lysholm scores were significantly improved and compared with the preoperative (P<0.05).【Conclusion】 The effect of sliding bone graft combined with LCP fixation in the treatment of postoperative nonunion after femoral fracture is reliable with good recovery of the knee joint function and less complications. It is worthy of clinical application. 2016 Vol. 33 (6): 1044-1047 [Abstract] ( 153 ) HTML (1 KB)  PDF  (0 KB)  ( 35 ) 1048 Correlation of Plasma Brain Natriuretic Peptide and HighSensitivity C Reactive Protein Levels with Heart Failure in Chronic Renal Failure Patients HU Mingliang，Wang Li，ZHONG Xin 【Objective】 To investigate the correlation of plasma brain natriuretic peptide (BNP) and highsensitivity Creactive protein (hsCRP) levels with heart failure correlation in chronic renal failure patients. 【Methods】Cases were divided into patients with heart failure and chronic renal failure (A group), patients with chronic renal failure (group B), and healthy subjects (group C), with 30 cases in each group. Plasma levels of hsCRP and BNP were observed of each case, and color Doppler ultrasound measured left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular enddiastolic diameter (LVEDD). The parallel correlations were analyzed. 【Results】BNP and hsCRP levels in groups A and B were higher than in group C; the differences were statistically significant (P<0.05). In addition, BNP and hsCRP levels in group A were higher than in group B; the difference was statistically significant (P<0.05). LVESD and LVEDD levels were significantly higher in group A than in groups B and C, while LVEF level in group A was significantly lower than that in groups B and C (P<0.05). The detectable levels of BNP and hsCRP in chronic renal failure patients were positively correlated, and both were positively correlated with LVESD and LVEDD levels. However, they were negatively correlated with LVEF; the differences were statistically significant (P<0.05). 【Conclusion】BNP and hsCRP levels were significantly increased in chronic renal failure patients with heart failure. Detection of BNP and hsCRP levels has certain significance in the diagnosis and prognosis of the disease in patients. 2016 Vol. 33 (6): 1048-1050 [Abstract] ( 99 ) HTML (1 KB)  PDF  (0 KB)  ( 36 ) 1051 Influence of Pam3CysSK4 on Renal Function of Diabetic Mice and TLR2 Expression of Renal Tubular Epithelial Cells QIN Zhuohui，LI Fanglin，ZHANG Jianjie， et al 【Objective】To study the influence of Pam3CysSK4 on renal function of diabetic mice and TLR2 expression of the renal tubular epithelial cells. 【Methods】Twentyfour C57 mice were selected and randomly divided into the normal group, diabetic model group (the model group) and the intervention group, 8 rats in each group. The model group was induced by the use of streptozotocin (STZ) to establish diabetes model in mice. The diabetic mice model was established in the intervention group with intravenous injection of Pam3CysSK4, 100 μg/ week, The normal group mice was given with the same amounts of citrate buffer injection as the other two groups did . After they were fed for 8 weeks,24 h urine and 24 h urine protein were collected and evaluated, mice body and kidney were weighed and calculated , and serum creatinine (Cr), urea nitrogen (BUN), blood glucose and interleukin 1 (IL1) were detected to assess glomerular sclerosis index, and detection was also made on Toll like receptors(TLR2), Nuclear Translocation factor κB (NFκB), myeloiddifferentiationfactor88(MyD88) and monocyte chemotactic protein 1(MCP1) to find out their expression levels.【Results】The blood glucose levels of the intervention group and the model group were higher than that of the normal group. In the intervention group, the kidney weight and kidney weight / body weight were higher than that of the model group, while the model group was higher than the normal group, the difference was statistically significant (P<0.05). Of the intervention group and model group, the Cr, bun, IL1 and 24 h urinary protein content and glomerular sclerosis index ,TLR2, NFκB, MyD88 and MCP1 were higher than those in normal control group, the intervention group were significantly higher than the model group，the differences were statistically significant (P<0.05).【Conclusion】High glucose can increase TLR2 level of mouse renal tubular epithelial cells, activate TLR signaling pathway, promote the release of inflammatory factors and increase the damage to the kidney. 2016 Vol. 33 (6): 1051-1057 [Abstract] ( 89 ) HTML (1 KB)  PDF  (0 KB)  ( 30 ) 1054 Application of Absorbable Haemostat during Internal Fixation of Clavicle Fractures XU Yi, CHOU Ke, HE Zhiyong,et al 【Objective】To explore the clinical outcomes of application of absorbable haemostat (S100) during internal fixation of clavicle fractures. 【Methods】From February 2014 to March 2015, 52 patients with different types of clavicle fractures were subjected to surgical treatment. They were 38 men and 14 women, with a mean age of 44.5 years (from 22 to 78 years). They received internal fixation of clavicle fractures and were divided into the experimental group, which adopted S100 absorbable haemostat and regular hemostatic measures during the surgeries, and the control group, which adopted regular hemostatic measures. By random division each group had 26 cases. The two groups were observed for 2 weeks for bleeding volume, bacterial culture of secretion, and the recovery of the wound. After leaving the hospital, the patients got back to outpatient department for checking recovery of the wound and acquired Constant score of shoulder joint function test every 4 weeks until the 12th week after operations. The two groups were not significantly different in general clinical data (P>0.05). 【Results】The average drainage volume of the experimental group (8.3±2.6 mL) was significant less than that of the control group ( 20.2±4.3 mL)(P<0.05). Two patients （7.69%） of experimental group experienced congestion, swelling, and effusion of the wound in the surgical area, while nine patients（34.6%） had similar experiences in control group; the difference between the two was significant (P<0.05). No cases of infection were found in the experimental group but one was found in the control group, and staphylococcus aureus was cultured out of the secretion. According to the outpatient checkingin after 12 weeks, there was no significant difference between the two groups in situation of soft tissue or in the goodexcellent rates of Constant score (96.2% versus 92.3%) (P>0.05). One patient of the experimental group found continual pain in the operated shoulder and two patients found aching and stiff neckshoulder 3 months after surgery. 【Conclusion】Application of absorbable haemostat (S100) during internal fixation of clavicle fractures could reduce surgical bleeding, cause no infection, and speed up the recovery of incision and soft tissue, leading to satisfactory results. 2016 Vol. 33 (6): 1054-1057 [Abstract] ( 84 ) HTML (1 KB)  PDF  (0 KB)  ( 28 ) 1058 Risk Factors of Mortality of Patients with ASO WANG Duofa，LIU Bin，QIN Qianhong，et al 【Objective】 To analyze the factors influencing the mortality of patients with lower limbs arteriosclerosis obliterans (ASO). 【Methods】 The clinical data of 235 patients with ASO from January 2011 to June 2015 from our hospital were retrospectively collected. According to followup results, patients were divided into two groups i.e. survival and death . Methods of treatment，classification of ischemia, hematology indices, and complications which may affect the prognosis were analyzed. 【Results】 Only 186 patients out of the original 235 patients completed their followup; 58 patients died and the mortality rate was 31%. In the death group, the percentages of aging (more than 70 years old), critical limb ischemia (CLI),heart disease, cerebrovascular disease, chronic renal insufficiency, anemia, hypoalbuminemia, conservative treatment were higher than those of the survival group (significant differences with p<0.05). Further statistical results showed that CLI, hypoalbuminemia, heart disease, and conservative therapy method were independent risk factors of the mortality of ASO patients. 【Conclusion】 CLI, hypoalbuminemia, heart disease, and conservative therapy were independent risk factors of the mortality of ASO patients. Therefore it is very important to deal with these indicators properly in patients with ASO. 2016 Vol. 33 (6): 1058-1064 [Abstract] ( 91 ) HTML (1 KB)  PDF  (0 KB)  ( 22 ) 1061 Clinical Analysis of Composition of Urinary Tract Stones on 163 Cases in Children at Hunan Area TU Lei，ZHAO Yaowang，LIU Li，et al 【Objective】To study the clinical characteristics and composition of urinary calculi in children of Hunan area.【Methods】Data of 163 cases of children underwent surgery in our hospital from June 2013 to October 2014 were collected, and their stone specimens were obtained, and infrared spectrum analysis of stone was performed. The clinical data of patients were retrospectively analyzed.【Results】The ratio of male to female was about 3.7:1 in 163 cases. 115 (70.6%) patients got upper urinary calculi, 36 cases (22.1%) had lower urinary calculi, 12 cases (7.4%) were complicated with upper and lower urinary tract stones. Location ratio on left, right and bilateral upper urinary tracts were 41 cases (25.2%), 57 cases (35%) and 29 cases (17.8%) respectively. Stone composition showed that 110 cases (67.5%) contained calcium oxalate, and 62 (38%) contained calcium carbonate, 23 cases (14.1%) contained with infectious components, 53 cases (32.5%) contained uric acid, 14 (8.6%) contained cysteine, and 3 had other kinds of calculus. 77 cases (47.2%) were single component stones, and the calcium oxalate stone was the most common one, followed by simple uric acid ones. 86 cases (52.8%) were mixed stones, while calcium oxalate + calcium carbonate took the most common, followed by oxalic acid + uric acid. The main part of the site is in the upper urinary tract.【Conclusion】The occurrence of urinary stones in children of Hunan area covered all ages, mainly in male. In the stone components, calcium oxalate is the most , followed by calcium carbonate and uric acid. About 52.8% of the urinary calculi in children are composed of two or more ingredients of a mixture. 2016 Vol. 33 (6): 1061-1064 [Abstract] ( 75 ) HTML (1 KB)  PDF  (0 KB)  ( 28 ) 1065 Optimum Predictive Value of the Risk Factors of Progressive Stroke According to the ROC Curve ZHU Xiaoqi, LU Xuesheng, WANG Jie,et al 【Objective】 To investigate the predictors of progressive stroke and to obtain the optimum predictive value of progressive stroke. 【Methods】Patients admitted consecutively with acute stroke within 24 hours not taking rtPA between 2014.1.12014.12.31 were included. Progressive stroke was defined as an increase in the National Institutes of Health Stroke Scale≥1 point. Patients were divided into a progressive group (PS group) and a nonprogressive group (nonPS group). The differences in demographics,history, imaging data (MRA), and related risk factors (blood sugar, lipids and pressure) were compared between the two groups in order to screen for the predictors of progressive stroke. Independent predictors for progressive stroke were analyzed using stepwise logistic regression. The receiver operating characteristic (ROC) curve was drawn to evaluate the optimum predictive value of progressive stroke. 【Results】A total of 93 patients with acute infarction within 24 hours after onset not taking rtPA were enrolled. 36 were in PS group, and 57 of them were in nonPS group. Univariate analysis showed that there were no significant differences in the proportions of sexes and history of previous hypertension, diabetes mellitus, hypercholesterolemia, or smoking between two groups. No difference was found in , blood pressure, plasma glucose, HbA1C, Triglyceride, or HDLc between two groups. Serum total cholesterol (TC) and LDLc of the PS group were significantly higher than those of the nonPS group(P<0.05). The proportions of LAA of the PS group were higher than those of the nonPS group, without significant meaning. Multivariate stepwise logistic regression analysis showed that LDLc was the independent predictor for PS. A ROC (receiver operating characteristic) curve provided a cutpoint of 2.45 mmol/L,which the optimum prediction effect could be achieved. As LDL was stratified into high LDL (LDL >2.45 mmol/L) and low LDL (LDL<2.45 mmol/L), multivariate stepwise logistic regression analysis showed that high LDL was still the independent predictor for progressive stroke. 【Conclusion】LDLc is the independent predictor for progressive stroke. Stratified by the optimum predictive value, high LDLc was still independent predictor for progressive stroke. Therefore clinically LDLc could be a useful indicator to evaluate PS prognosis. 2016 Vol. 33 (6): 1065-1068 [Abstract] ( 81 ) HTML (1 KB)  PDF  (0 KB)  ( 39 ) 1069 Analysis of the Risk Factors of Ventilator Associated Pneumonia (VAP) in Intensive Care Unit YUAN Shuo,ZHANG Weiwei 【Objective】To discuss and analyze the risk factors of ventilator associated pneumonia (VAP) in patients in the intensive care unit and possible preventative measures. 【Methods】Sixtyone patients underground mechanical ventilation treatment in our hospital's intensive care unit from May 2014 to May 2015 were chosen as the study subjects. The patients were divided into two groups according to whether or not the patients had VAP. The first group had ventilator associated pneumonia (VAP) and the second group of did not have ventilator associated pneumonia (VAP). The clinical data of the two groups were observed and compared. Single factor analysis and multivariable analysis were made regarding VAP in the patients. 【Results】The single factor analysis showed that age, gender and incidence of anemia were not statistically different between the two groups (P>0.05). However, there were statistically significant differences (P<0.05) in terms of antimicrobial drug use time, invasive operation, mechanical ventilation time, acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ), respiratory immune dysfunction, incidence of gastrointestinal reflux and aspiration, and pipe pollution events . Logistic regression analysis also showed that an APACHE Ⅱ of 15 points or above, mechanical ventilation time of more than 7 days, pipe pollution, invasive operation, lower immune function of respiratory, incidence of gastrointestinal reflux and aspiration were risk factors of ventilator associated pneumonia in the intensive care unit (P<0.05). 【Conclusion】A mechanical ventilation time of more than 7 days, an APACHE Ⅱ score of more than 15, use of an invasive operation, respiratory immunocompromised, pipe pollution, and gastrointestinal reflux and aspiration are the intensive care unit risk factors of ventilator associated pneumonia. Medical staff should pay attention to the actual situation of patients with these risk factors and take corresponding prevention and control measures. 2016 Vol. 33 (6): 1069-1072 [Abstract] ( 90 ) HTML (1 KB)  PDF  (0 KB)  ( 31 ) 1072 Risk Factors of Infants Group B Streptococcus (GBS) for Septicemia and its Perinatal Clinical Features DENG Fawen，TIAN Hongyan 【Objective】To investigate the risk factors of infants Group B streptococcus (GBS) for septicemia and its perinatal clinical features.【Methods】The clinical data of 34 children with GBS in our hospital from May 2013 to May 2015 were analyzed retrospectively and compared with that of 30 cases of children with non GBS gram positive bacterial sepsis at the same period.【Results】The first symptom of early onset GBS sepsis occurred mainly in respiratory systems, while that of late onset GBS sepsis were with high fever or low body temperature. The difference of symptoms of lateonset GBS sepsis and lateonset non GBS sepsis like convulsions and shortness of breath had statistical significance (P<0.05). Penicillin was considered as the preferred drug for GBS treatment. GBS is highly sensitive to penicillin, ampicillin, ceftriaxone, meropenem and vancomycin, thus duplex treatment is usually used for the therapy.【Conclusion】 Early onset GBS sepsis invaded early with dangerous symptoms had high death rate. Late onset sepsis conceals at early stage with less specificity and many complications , which is easy to cause meningitis. For pregnant women with 32~37 weeks of gestation, the bacteria culture of rectum and vagina GBS should be carried out in advance. The use of antibiotics for prevention of suspected GBS sepsis in children can effectively reduce the infection rate of GBS sepsis. 2016 Vol. 33 (6): 1072-1074 [Abstract] ( 77 ) HTML (1 KB)  PDF  (0 KB)  ( 40 ) 1075 Protective effects of Astragaloside on the Function of Vascular Endothelium in Spontaneous Hypertension Rats CAO Xuemei,FU Xiaorong,CHEN Junfen 【Objective】To explore protective effects of astragaloside on the function of vascular endothelium in spontaneous hypertension rats (SHR). 【Methods】Fifty SHRs were randomly divided into the model group, the low, medium and high astragalosidedose groups ［5，10，20 mg/( kg.d)］ , the positive control group (10 mg/kg，captopril ) . In addition, 10 WitstarKyoto rats with normal blood pressure were selected as normal control group. The blood pressure of rats were detected before treatment by BP6 noninvasive blood pressure detector followed by medicine administration once a day for 8 weeks. Blood pressure were measured in second, forth, sixth and eighth week regularly. At eighth week, the rats were killed and the blood was taken from the aorta. The levels of nitric oxide (NO), endothelin1 (ET1), angiotensin Ⅱ (AngⅡ), thromboxaneA2 (TXA2), superoxide dismutase (SOD) and malondialdehyde (MDA) of serum in each group were detected respectively. 【Results】Compared with the model group, the blood pressure, ET1, AngⅡ,TAX2 and MDA contents of the low, medium and high astragaloside dose groups were decreased in turn (P<0.05) , and the contents of NO and SOD were increased in turn（P<0.05）.【Conclusion】 Astragaloside could decrease the blood pressure and improve vascular endothelial function in SHR, which may be related to the regulation of vascular contraction , the expression of relaxation factor and to the level of oxidative stress.  2016 Vol. 33 (6): 1075-1077 [Abstract] ( 83 ) HTML (1 KB)  PDF  (0 KB)  ( 38 ) 1078 Efficacy of Vermilion Tubercle Square Flap on Vermilion Reconstruction of Unilateral Cleft Lip YANG Hanlin,WU Kun, HE Xifan,et al 【Objective】To evaluate the efficacy of the vermilion tubercle square flap on vermilion reconstruction of unilateral cleft lips.【Methods】Eighty three cases of unilateral cleft lip were selected. 36 cases of them were incomplete cleft lip , and 49 cases were of complete cleft lip. 85 cases were randomly divided into two groups according to the admission: 40 cases for Group A, whose vermilion were reconstructed by the vermilion tubercle square flap; and 45 cases for Group B, to which the "Z" shape exchange method was used to repair the vermilion lips. Comparison of repair effect of the vermilion in the two groups was made in 7 d and 1~2 years after surgery .The contents included the indexes as whether the suffered lip was too thick or too thin, whether there was a whistling deformities and whether there was a sharp lip peak or discontinuous Cupid's bow.【Results】All wounds in 80 cases were healed at Phase One, only 5 cases had nasal floor infection. No necrosis nor infection occurred in all vermilion turning to flaps. In 1 ~ 2 years after the surgery ,the incidence of overthickness or overthinness of vermilion, sharp lip peak and discontinuous percentage of Cupid's bow in the Group A were significantly lower than those of the Group B, and the differences were statistically significant (P<0.05); But there was no significant difference in whistling deformities between the two groups (P>0.05).【Conclusion】The vermilion tubercle square flap for unilateral cleft lips is a good method to repair and reconstruct lip vermilion, lip peak and vermilion tubercle shape of patients with cleft lip. It is worthy of clinical popularization and application. 2016 Vol. 33 (6): 1078-1080 [Abstract] ( 75 ) HTML (1 KB)  PDF  (0 KB)  ( 31 )

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