内侧开放楔形胫骨高位截骨术治疗膝关节内翻畸形的疗效及对术后下肢力线和创伤应激的影响

摘要 目的：对比内侧开放楔形胫骨高位截骨术（OWHTO）、人工全膝关节置换术（TKA）治疗膝关节内翻畸形的疗效及对术后下肢力线和创伤应激的影响。方法：回顾性分析贵州医科大学附属医院2020年3月~2022年1月期间接收的膝关节内翻畸形患者临床资料,共计75例。根据手术方案的不同分为OWHTO组（n=40）和TKA组（n=35）。对比两组围术期指标、视觉疼痛模拟评分（VAS）评分、美国特种外科医院（HSS）膝关节评分、膝关节活动度（ROM）、应激指标和术后下肢力线改变情况。结果：OWHTO组手术时间、切口长度短于TKA组,术中出血量、住院费用少于TKA组（P<0.05）。OWHTO组术后1个月VAS评分低于TKA组,ROM、HSS膝关节评分高于对照组（P<0.05）。OWHTO组术后3 d、术后7 d血清皮质醇（COR）、促肾上腺皮质激素（ACTH）水平低于TKA组（P<0.05）。两组术后6个月股胫角（FTA）下降,髋-膝-踝角（HKA）升高（P<0.05）。两组术后6个月FTA、HKA组间对比差异不显著（P>0.05）。两组并发症发生率组间对比未见差异（P>0.05）。结论：OWHTO、TKA这两种治疗方案治疗膝关节内翻畸形,具有相当的疗效,均可有效改善下肢力线,但OWHTO的创伤小、应激程度轻。     

Nitric oxide inducing function and intracellular movement of chicken interleukin-18 in cultured cells

To evaluate the characteristics of chicken interleukin-18 （ChIL-18） in different forms in vitro, the ChIL-18 full-length gene （ChIL-18-F） and the ChIL-18 presumed mature protein gene （ChIL-18-M） were cloned and inserted into the eukaryotic expression vector pCI, to construct recombinant pCI-ChIL-18-F and pCI-ChIL-18-M. The recombinant plasmids were then transferred into chicken splenic lymphocytes （CSLs）. Western blot showed that ChIL-18-F, with a molecular weight of 23.0 kDa, was produced in CSLs transfected by pCI-ChIL-18-F; ChIL-18-M, with a molecular weight of 19.5 kDa, was produced in CSLs transfected by pCI-ChIL-18-M. The nitric oxide （NO） level in the transfected CSLs and the culture medium at different time points was further examined under confocal microscopy using 4,5-diaminofluorescein staining. The results showed that both pCI-ChIL-18-F and pCI-ChIL-18-M groups showed significant increase in intracellular and extracellular NO production compared with pCI transfected control cells. These results suggest that both ChIL- 18-F and ChIL- 18-M could stimulate NO secretion in CSLs. To characterize the intracellular distribution of ChIL-18, ChIL-18-F and ChIL-18-M were each fused to the enhanced green fluorescent protein gene, and expressed in Vero cells. The results showed that the ChIL-18-F tended to the membranous region in Veto cells, while ChIL- 18-M did not. This indicates that the N-terminal 27 amino acid peptide helped ChIL-18 target to Vero cell membranes.     

A simple method for discriminating between cell membrane and cytosolic proteins

* Transgenic plants expressing either green fluorescent protein (GFP)-genomic DNA or GFP-cDNA fusions have been used as powerful tools to define the subcellular localization of many proteins. Because most plant cells are highly vacuolated, the cytosol is confined to a thin layer at the periphery of the cells, making it very difficult to distinguish among cell wall, cell membrane and cytosolic GFP-fusion proteins. * Plasmolysis tests inform about cell-wall localization of GFP-tagged proteins, but they do not discriminate between its cell membrane and/or cytoplasmic localization. By observing the GFP signal in transgenic protoplasts placed at a hypotonic solution, it was possible to distinguish between cell membrane and cytosolic GFP-tagged proteins. * The osmotic disruption of the protoplast vacuole in the hypotonic solution allows the diffusion of the GFP signal from the cell periphery to the central part of the cell volume when the GFP is fused to a soluble protein. By contrast, such diffusion does not occur when the protein under study is attached to the cell membrane. * The present method is easier, faster and cheaper than subcellular fractionating studies and/or immunoelectron microscopy, which have been traditionally used to discern between cell membrane and cytosolic proteins.     

Radiation Processed Amniotic Membranes in the Treatment of Non-Healing Ulcers of Different Etiologies

The amniotic membranes were collected from the placentae of selected and screened donors. Processing was done by washing the fresh amniotic membrane successively in sterile saline, 0.05% sodium hypochlorite solution and sterile distilled water until it was completely cleared of blood particles. The membranes were sterilized by gamma irradiation at 25 kGy. The processed amniotic membranes were applied to 50 open wounds comprising of 42 full thickness defects and eight partial thickness defects. These included leprotic, diabetic, traumatic, gravitational ulcers and superficial burn in the form of scald and corrosive burn. The radiation processed amniotic membranes favoured healing of unresponsive and non-healing ulcers of different etiologies. Ulcers with duration of minimum 3 weeks to maximum 12 months were found to heal in 2-6 weeks by the application of amniotic membranes.     

Wetting and drying cycles in the maize rhizosphere under controlled conditions. Mechanics of the root-adhering soil

Mechanical properties of the topsoil (sandy Podsol and silty Luvisol, FAO) adhering to maize (Zea mays L.) roots and its bulk soil counterpart were studied as a function of soil texture and final soil water suction at harvest, with three soil water suction values of approximately 30, 50 and 60 kPa. Two scales of observation were also selected: the whole soil:root system and the root-adhering soil aggregates. Three methods were used to characterize the stability of the soil:root system: mechanical shaking in air, and dispersion by low-power ultrasonication, with or without preliminary immersion of the soil:root system in water. Soil disruption kinetics, which were fitted with first-order kinetics equations, were analyzed and discussed. For example, silty soil ultrasonication kinetics, without preliminary water-immersion, could be divided into two parts: the first faster part, which was characterized by a mean rate K value of 6.8–7.2 mJ^-1, is attributed to soil slaking, whereas the second slower part, which was characterized by a mean rate K value of 1.5–1.6 mJ^-1, was attributed to the rupture of the `firmly root-adhering soil' from the roots. A clear plant effect was observed for both aggregate tensile strength and friability, with higher aggregate strength for the root-adhering silty soil (450–500 kPa) than for its bulk silty soil counterpart (410–420 kPa), and lower friability (coefficient of variation of the aggregate strength) for the root-adhering silty soil (e.g. 67% at a soil water suction value of 30 kPa) than for its bulk silty soil counterpart (e.g. 49% at asoil water suction value of 30 kPa). These effects were attributed to root exudation, which was significantly higher for the driest silty topsoil than for the wetter ones. In conclusion, the mechanical properties of the silty topsoil adhering to the maize roots are attributed to both physical and biological interactions occurring in the maize rhizosphere. This revised version was published online in June 2006 with corrections to the Cover Date.     

The sensitivity to inter-subject variability of the bridging vein entry angles for prediction of acute subdural hematoma

Acute subdural hematoma (ASDH) is one of the most frequent traumatic brain injuries (TBIs) with high mortality rate. Bridging vein (BV) ruptures is a major cause of ASDH. The KTH finite element head model includes bridging veins to predict acute subdural hematoma due to BV rupture. In this model, BVs were positioned according to Oka et al. (1985). The aim of the current study is to investigate whether the location and entry angles of these BVs could be modelled using data from a greater statistical sample, and what the impact of this improvement would be on the model’s predictive capability of BV rupture.From the CT angiogram data of 78 patients, the relative position of the bridging veins and their entry angles along the superior sagittal sinus was determined. The bridging veins were repositioned in the model accordingly. The performance of the model, w.r.t. BV rupture prediction potential was tested on simulations of full body cadaver head impact experiments. The experiments were simulated on the original version of the model and on three other versions which had updated BV positions according to mean, maximum and minimum entry angles.Even though the successful prediction rate between the models stayed the same, the location of the rupture site significantly improved for the model with the mean entry angles. Moreover, the models with maximum and minimum entry angles give an insight of how BV biovariability can influence ASDH.In order to further improve the successful prediction rate, more biofidelic data are needed both with respect to bridging vein material properties and geometry. Furthermore, more experimental data are needed in order to investigate the behaviour of FE head models in depth.     

The influence of anisotropy on brain injury prediction

Traumatic Brain Injury (TBI) occurs when a mechanical insult produces damage to the brain and disrupts its normal function. Numerical head models are often used as tools to analyze TBIs and to measure injury based on mechanical parameters. However, the reliability of such models depends on the incorporation of an appropriate level of structural detail and accurate representation of the material behavior. Since recent studies have shown that several brain regions are characterized by a marked anisotropy, constitutive equations should account for the orientation-dependence within the brain. Nevertheless, in most of the current models brain tissue is considered as completely isotropic. To study the influence of the anisotropy on the mechanical response of the brain, a head model that incorporates the orientation of neural fibers is used and compared with a fully isotropic model. A simulation of a concussive impact based on a sport accident illustrates that significantly lowered strains in the axonal direction as well as increased maximum principal strains are detected for anisotropic regions of the brain. Thus, the orientation-dependence strongly affects the response of the brain tissue. When anisotropy of the whole brain is taken into account, deformation spreads out and white matter is particularly affected. The introduction of local axonal orientations and fiber distribution into the material model is crucial to reliably address the strains occurring during an impact and should be considered in numerical head models for potentially more accurate predictions of brain injury.     

调整阴道菌群失调在预防妊娠晚期未足月胎膜早破中的价值

目的探讨调整阴道菌群失调在预防妊娠晚期未足月胎膜早破(PPROM)中的价值。方法选取产科门诊进行产前检查无症状单胎妊娠晚期孕妇450例。根据检查结果将其分为菌群失常组138例和菌群正常组312例。菌群失常组根据患者的自愿行乳酸菌阴道胶囊治疗112例(治疗组),未行乳酸菌阴道胶囊治疗26例(对照组)。观察并比较菌群正常组和菌群失常组、治疗组与对照组PPROM发生率。结果菌群失常组孕妇138例中发生PPROM 8例(5.80%),菌群正常组孕妇312例中发生PPROM 3例(0.96%),菌群失常组孕妇PPROM发生率明显高于菌群正常组(χ2=7.46,P0.05)。治疗组孕妇112例中发生PPROM 3例(2.68%),对照组孕妇26例中发生PPROM 5例(19.23%),治疗组孕妇PPROM发生率明显低于对照组(χ2=7.77,P0.05)。结论妊娠晚期孕妇阴道菌群失调与PPROM发生关系密切,予以乳酸菌阴道胶囊调整阴道菌群失调可有利于预防和治疗妊娠妇女发生生殖道感染,降低PPROM发生率,减少其对母婴造成的不良结局。     

大鼠脑创伤后caspase-3的过度表达与细胞凋亡的关系

目的:探讨大鼠脑创伤后海马神经组织中casepase-3表达及其在细胞凋亡中的机制。方法:雄性Wistar大鼠72只随机分成对照组和创伤组,用Marmarou方法造成大鼠重型弥漫性颅脑创伤,采用免疫组织化学检测海马CA1区神经细胞casepase-3蛋白表达情况,原位细胞DNA断裂检测末端标记(TUNEL)法观察大鼠海马CA1区神经细胞凋亡动态变化。同时行TUNEL与caspase-3双标染色。结果:对照组海马区神经细胞casepase-3未见明显表达,创伤组海马CA1区神经细胞casepase-3表达在伤后3小时开始升高,伤后3天达高峰(P0.01),伤后7天下降明显。对照组海马区未见TUNEL阳性细胞,创伤组海马区TUNEL阳性细胞伤后3小时开始增多,伤后3天达高峰(P0.01),伤后7天下降。可见创伤组TUNEL染色与caspase-3免疫染色双标阳性的细胞伤后6小时细胞数量逐渐增多,于伤后3天达高峰(P0.01),伤后7天双标阳性细胞数量下降。Casepase-3表达与TUNEL阳性细胞明显相关(P0.01)。结论:大鼠脑创伤后casepase-3的过度表达是影响大鼠脑创伤后神经细胞凋亡原因之一,抑制casepase-3活性表达对神经组织起保护作用。     

Genome-wide profiling of in vivo LPS-responsive genes in splenic myeloid cells

Lipopolysaccharide (LPS), the major causative agent of bacterial sepsis, has been used by many laboratories in genome-wide expression profiling of the LPS response. However, these studies have predominantly used in vitro cultured macrophages (Macs), which may not accurately reflect the LPS response of these innate immune cells in vivo. To overcome this limitation and to identify inflammatory genes in vivo, we have profiled genome-wide expression patterns in non-lymphoid, splenic myeloid cells extracted directly from LPS-treated mice. Genes encoding factors known to be involved in mediating or regulating inflammatory processes, such as cytokines and chemokines, as well as many genes whose immunological functions are not well known, were strongly induced by LPS after 3 h or 8 h of treatment. Most of the highly LPSresponsive genes that we randomly selected from the microarray data were independently confirmed by quantitative RT-PCR, implying that our microarray data are quite reliable. When our in vivo data were compared to previously reported microarray data for in vitro LPS-treated Macs, a significant proportion (～20%) of the in vivo LPS-responsive genes defined in this study were specific to cells exposed to LPS in vivo, but a larger proportion of them (～60%) were influenced by LPS in both in vitro and in vivo settings. This result indicates that our in vivo LPS-responsive gene set includes not only previously identified in vitro LPS-responsive genes but also novel LPS-responsive genes. Both types of genes would be a valuable resource in the future for understanding inflammatory responses in vivo.