动力髋螺钉与股骨近端髓内钉内固定治疗股骨粗隆间骨折患者的疗效及安全性和关节功能对比观察

目的:比较动力髋螺钉(DHS)与股骨近端髓内钉(PFNA)内固定治疗股骨粗隆间骨折患者的疗效及安全性和关节功能。方法:选取滁州市第一人民医院于2013年3月～2018年4月期间收治的160例股骨粗隆间骨折患者,根据内固定方式的不同将患者分为DHS组(n=80,采用DHS内固定)和PFNA组(n=80,采用PFNA内固定),比较两组临床疗效,采用髋关节功能Harris评分评价所有患者关节功能恢复情况,比较两组患者术前及术后相关指标,并观察患者术后并发症发生情况。结果:PFNA组患者临床总有效率为90.00%,高于DHS组患者的68.75%(P0.05)。两组患者Harris评分的优良率比较差异无统计学意义(P0.05)。PFNA组患者手术时间、卧床时间、骨折愈合时间、切口长度均短于DHS组(P0.05),术中出血量、术后引流量均少于DHS组(P0.05)。两组患者术后并发症总发生率比较无统计学差异(P0.05)。结论:DHS与PFNA内固定治疗股骨粗隆间骨折在术后关节功能恢复、安全性方面效果相当,但与DHS内固定治疗比较,PFNA内固定治疗的临床疗效更佳,手术时间更短,出血量更少,患者术后恢复更快,是治疗股骨粗隆间骨折较理想的手术方式。     

Serum bone alkaline phosphatase in assessing illness severity of infected neonates in the neonatal intensive care unit

Background: Infections can influence bone metabolism of neonates, which may lead to changes in some bone metabolism biomarkers. The purpose of this study was to determine whether serum bone alkaline phosphatase (BALP), osteocalcin (OC) and beta carboxy-terminal peptide of type I collagen (CTX), as specific biomarkers of bone metabolism, can be used to assess the severity of neonatal infections.Methods: Sixty-three neonates in the NICU were enrolled in this study. The neonates were divided into infected group (n=33) and non-infected group (n=30). The scores for neonatal acute physiology-perinatal extension II (SNAPPE-II) were calculated and interleukin-6 (IL-6), procalcitonin (PCT), BALP, OC and CTX were measured among the neonates with or without infections, and among the infected neonates before and after treatment.Results: The serum BALP levels were lower in the infected group than that in the non-infected group (p<0.01). The serum BALP levels increased markedly in the infected neonates after treatment (p<0.01). The serum BALP levels were also inversely correlated with SNAPPE-II of infected neonates before and after treatment (r=-0.56, p<0.05; r=-0.37, p<0.05, respectively). In infected neonates, the differences between serum BALP levels before and after treatment were inversely correlated with those of IL-6 levels (p<0.05). There were no significant changes in the OC, CTX and PCT levels in the infected or non-infected group before and after treatment.Conclusion: Our data suggest that serum BALP level might be used as a marker for assessing the severity of illness in infected neonates.     

Evaluation of Electrical Impedance as a Biomarker of Myostatin Inhibition in Wild Type and Muscular Dystrophy Mice

ObjectivesNon-invasive and effort independent biomarkers are needed to better assess the effects of drug therapy on healthy muscle and that affected by muscular dystrophy (mdx). Here we evaluated the use of multi-frequency electrical impedance for this purpose with comparison to force and histological parameters.MethodsEight wild-type (wt) and 10 mdx mice were treated weekly with RAP-031 activin type IIB receptor at a dose of 10 mg kg⁻¹ twice weekly for 16 weeks; the investigators were blinded to treatment and disease status. At the completion of treatment, impedance measurements, in situ force measurements, and histology analyses were performed.ResultsAs compared to untreated animals, RAP-031 wt and mdx treated mice had greater body mass (18% and 17%, p < 0.001 respectively) and muscle mass (25% p < 0.05 and 22% p < 0.001, respectively). The Cole impedance parameters in treated wt mice, showed a 24% lower central frequency (p < 0.05) and 19% higher resistance ratio (p < 0.05); no significant differences were observed in the mdx mice. These differences were consistent with those seen in maximum isometric force, which was greater in the wt animals (p < 0.05 at > 70 Hz), but not in the mdx animals. In contrast, maximum force normalized by muscle mass was unchanged in the wt animals and lower in the mdx animals by 21% (p < 0.01). Similarly, myofiber size was only non-significantly higher in treated versus untreated animals (8% p = 0.44 and 12% p = 0.31 for wt and mdx animals, respectively).ConclusionsOur findings demonstrate electrical impedance of muscle reproduce the functional and histological changes associated with myostatin pathway inhibition and do not reflect differences in muscle size or volume. This technique deserves further study in both animal and human therapeutic trials.     

A Meta-Analysis of Oxidative Stress Markers in Depression

ObjectStudies have suggested that depression was accompanied by oxidative stress dysregulation, including abnormal total antioxidant capacity (TAC), antioxidants, free radicals, oxidative damage and autoimmune response products. This meta-analysis aims to analyse the clinical data quantitatively by comparing the oxidative stress markers between depressed patients and healthy controls.MethodsA search was conducted to collect the studies that measured the oxidative stress markers in depressed patients. Studies were searched in Embase, Medline, PsychINFO, Science direct, CBMDisc, CNKI and VIP from 1990 to May 2015. Data were subjected to meta-analysis by using a random effects model for examining the effect sizes of the results. Bias assessments, heterogeneity assessments and sensitivity analyses were also conducted.Results115 articles met the inclusion criteria. Lower TAC was noted in acute episodes (AEs) of depressed patients (p<0.05). Antioxidants, including serum paraoxonase, uric acid, albumin, high-density lipoprotein cholesterol and zinc levels were lower than controls (p<0.05); the serum uric acid, albumin and vitamin C levels were increased after antidepressant therapy (p<0.05). Oxidative damage products, including red blood cell (RBC) malondialdehyde (MDA), serum MDA and 8-F₂-isoprostanes levels were higher than controls (p<0.05). After antidepressant medication, RBC and serum MDA levels were decreased (p<0.05). Moreover, serum peroxide in free radicals levels were higher than controls (p<0.05). There were no differences between the depressed patients and controls for other oxidative stress markers.ConclusionThis meta-analysis supports the facts that the serum TAC, paraoxonase and antioxidant levels are lower, and the serum free radical and oxidative damage product levels are higher than controls in depressed patients. Meanwhile, the antioxidant levels are increased and the oxidative damage product levels are decreased after antidepressant medication. The pathophysiological relationships between oxidative stress and depression, and the potential benefits of antioxidant supplementation deserve further research.     

Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesity

[Purpose]Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity.[Methods]We enrolled 70 male children (age 9–17 years [sumo group, n = 14] and 9–14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels).[Results]The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups.[Conclusion]Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.     

Histological Evidence of Wound Healing Improvement in Rats Treated with Oral Administration of Hydroalcoholic Extract of Vitis labrusca

Plant extracts rich in phenolic compounds have been demonstrated to accelerate wound healing, but their use by oral route has been poorly studied. The leaves of Vitis labrusca are rich in phenolic acids and flavonoids. The goal of this study was to assess the healing properties of the oral administration of hydroalcoholic extract of V. labrusca leaves (HEVL) in a murine model. HEVL was obtained by Soxhlet and dynamic maceration, and their yield and phenolic acids and flavonoid contents were determined. For the wound healing assay, 8 mm wounds were performed on the back of 48 Wistar rats, assigned into four groups (n = 12): CTR (distilled water), HEVL100, HEVL200, and HEVL300 (HEVL at 100, 200, and 300 mg/kg, respectively). On days 7 and 14, wound closure rates were assessed, and the healing wounds were subjected to histological analysis. Soxhlet-obtained extract was selected for the wound healing assay because it provided a higher yield and phenolic acid and flavonoid contents. HEVL significantly reduced leukocytosis in the peripheral blood (p < 0.05), accelerated wound closure (p < 0.05), and improved collagenization (p < 0.05) on day 7, as well as enhanced the epidermal tissue thickness (p < 0.001) and elastic fiber deposition on day 14 (p < 0.01). Furthermore, HEVL promoted an increase in the histological grading of wound healing on both days 7 and 14 (p < 0.01). The doses of 200 and 300 mg/kg provided better results than 100 mg/Kg. Our data provide histological evidence that the oral administration of HEVL improves wound healing in rodents. Therefore, the extract can be a potential oral medicine for healing purposes.     

Upregulation of NLRP3 Inflammasome in the Tears and Ocular Surface of Dry Eye Patients

PurposeTo evaluate the mRNA and protein expressions of NLRP3 inflammasome and its downstream inflammatory factors in human dry eye.MethodsWe recruited 54 patients with Sjögren’s syndrome dry eye (SSDE), 50 patients with non-Sjögren’s syndrome dry eye (NSSDE), and 46 healthy controls. Tear film breakup time (TBUT), Schirmer I test, and fluorescein staining (FL) were performed on all subjects. Tear samples were obtained to analyze the inflammatory cytokine levels of IL-1β and IL-18 via enzyme-linked immunosorbent (ELISA). Conjunctival impression cytology (CIC) specimens were collected to detect the mRNA expression of NLRP3, caspase-1, IL-1β, and IL-18 using quantitative RT-PCR, and the protein expression of NLRP3 and caspase-1 by Western blotting.ResultsNLRP3 mRNA expression showed higher levels in both dry eye groups compared with controls, with a comparably significant elevation in the SSDE group (relative 2.47-fold upregulation, p<0.05). NLRP3 protein expression was also increased in SSDE group (relative1.94-fold upregulation) compared with the controls. mRNA expression of caspase-1 was significantly upregulated in both SSDE (relative 1.44-fold upregulation, p<0.05) and NSSDE (relative 1.32-fold upregulation, p<0.05). Procaspase-1 protein level was increased in SSDE (relative 1.84-fold upregulation) and NSSDE (relative 1.12-fold upregulation) versus controls; and caspase-1 protein expression was also increased in SSDE (relative 1.49-fold upregulation) and NSSDE (relative 1.17-fold upregulation) compared with the controls. The patients with SSDE and NSSDE had higher IL-1β and IL-18 mRNA values and protein expressions than the controls did. The relative mRNA expression of IL-1β upregulated 3.59-fold (p<0.001) in SSDE and 2.13-fold (p<0.01) in NSSDE compared with the controls. IL-1β protein level also showed significant upregulation in SSDE (p=0.01; vs. controls groups). IL-18 mRNA expression levels were significantly upregulated in the SSDE (relative 2.97-fold upregulation, p=0.001) and NSSDE (relative 2.05-fold upregulation, p=0.001) groups compared with the controls; tear IL-18 concentrations were also significantly increased in the SSDE (p<0.001) and NSSDE (p<0.05) groups.ConclusionsIn the current study, we found that mRNA and protein expressions of NLRP3 inflammasome were upregulated in human dry eyes, especially in SSDE; the downstream inflammatory factors caspase-1, IL-1β, and IL-18 were also elevated in dry eye patients. These observations suggest the involvement of NLRP3 inflammasome in the onset and development of the inflammation in dry eye.     

Effect of Pore Size and Porosity on the Biomechanical Properties and Cytocompatibility of Porous NiTi Alloys

Five types of porous Nickel-Titanium (NiTi) alloy samples of different porosities and pore sizes were fabricated. According to compressive and fracture strengths, three groups of porous NiTi alloy samples underwent further cytocompatibility experiments. Porous NiTi alloys exhibited a lower Young’s modulus (2.0 GPa ~ 0.8 GPa). Both compressive strength (108.8 MPa ~ 56.2 MPa) and fracture strength (64.6 MPa ~ 41.6 MPa) decreased gradually with increasing mean pore size (MPS). Cells grew and spread well on all porous NiTi alloy samples. Cells attached more strongly on control group and blank group than on all porous NiTi alloy samples (p < 0.05). Cell adhesion on porous NiTi alloys was correlated negatively to MPS (277.2 μm ~ 566.5 μm; p < 0.05). More cells proliferated on control group and blank group than on all porous NiTi alloy samples (p < 0.05). Cellular ALP activity on all porous NiTi alloy samples was higher than on control group and blank group (p < 0.05). The porous NiTi alloys with optimized pore size could be a potential orthopedic material.     

Expression changes of IL-17 in zoledronic acid combined with PVP technology in the treatment of postmenopausal osteoporotic vertebral compression fracture and its predictive value of relapse

Objective:To investigate the expression of interleukin-17 (IL-17) in zoledronic acid combined with PVP technology for patients with postmenopausal osteoporotic vertebral compression fracture (OVCF) and its predictive value for relapse.Methods:101 OVCF patients treated in our hospital from April 2013 to January 2015 were collected as a research group and treated by zoledronic acid combined with PVP technology. 80 healthy people with physical examination were assigned to the control group. ELISA was used to detect the expression of IL-17 in serum of the two groups. Patients were followed up for 2 years. The expression of IL-17 before treatment was compared between patients with relapse and patients without relapse. The predictive value of IL-17 in relapse was drawn according to ROC curve.Results:Before treatment, the expression of IL-17 in the research group increased significantly (p<0.05). After treatment, the expression of IL-17 in the research group decreased significantly (p<0.05). The level of IL-17 in patients with relapse was significantly higher than that in patients without relapse (p<0.05).Conclusions:IL-17 is highly expressed in postmenopausal patients with osteoporotic vertebral compression fracture and is expected to be a potential predictor of relapse in postmenopausal patients with OVCF.     

The effects of whole-body vibration on EMG activity of the lower body muscles in supine static bridge position

Objectives:The purpose of the current study was to firstly examine the effects of different whole-body vibration (WBV) frequencies in the lower-body muscles when applied simultaneously during a bridge exercise. Secondly, determine if there were any sex differences in the lower-body muscles of WBV during the bridge.Methods:Seven females and 7 males completed 2 familiarization and 1 test sessions. In the test session participants were randomized to complete one 30 s bout of a bridge exercise for 3 separate condition s followed by 3-min of rest. The 3 conditions (a) No-WBV (without WBV); (b) WBV-30 (30 Hz, low amplitude); (c) WBV-50 (50 Hz, low amplitude) were performed on a WBV platform. Muscle activity of the biceps femoris (BF), semitendinosus (ST), gluteus maximus (Gmax), multifidus muscle (MF) muscles were measured.Results:Muscle activity was increased with WBV in the BF and ST muscles at WBV-30 and WBV-50 conditions (p<0.05) vs. no-WBV. During No-WBV and WBV-50 conditions, males had a higher biceps femoris activity compared to females for (p<0.05) 45 and 27 %, respectively; however, during all conditions females had a high level of Gmax activity (57%) than males (p<0.05).Conclusion:Additional vibration at 30 and 50 Hz during the bridge exercise could be a useful method to enhance hamstring muscle activity.     

Changes in physical activity and energy intake according to abdominal obesity in Korean adult men before and after COVID-19: Data from 2019 and 2020 Korea National Health and Nutrition Examination Survey (KNHANES)

[Purpose] This study aimed to investigate changes in physical activity and energy intake according to abdominal obesity in Korean adult men before and after COVID-19.[Methods] Using data from the 2019 and 2020 KNHANES, the physical activity level measured by the Global Physical Activity Questionnaire (GPAQ) the physical activity level by GPAQ, number of days of walking and strength training, aerobic exercise, and total energy, protein, fat, carbohydrate, dietary fiber, and sugar intake for a total of 2,799 participants were analyzed.[Results] There were no changes in energy intake during the pandemic. The number of days of weekly walking was higher (2019, p = 0.006; 2020, p = 0.012) and strength training was significantly higher (2019, p < 0.0001; 2020 p < 0.0001) in the non-abdominal obesity group than in the abdominal obesity group before and after COVID-19. Strength training at least once a week suppressed abdominal obesity (0.628 times in 2019, p < 0.0001; 0.605 times in 2020, p < 0.0001). In addition, even when the total energy intake and age were adjusted for, strength training influenced the suppression of abdominal obesity (0.634 times in 2019, p < 0.0001; 0.614 times in 2020, p < 0.0001).[Conclusion] Even with the change in the physical activity level, such as walking and aerobic exercise, due to the influence of social distancing measures, strength training influenced the suppression of abdominal obesity, regardless of the COVID-19 pandemic.     

Role of Synaptic Structural Plasticity in Impairments of Spatial Learning and Memory Induced by Developmental Lead Exposure in Wistar Rats

Lead (Pb) is found to impair cognitive function. Synaptic structural plasticity is considered to be the physiological basis of synaptic functional plasticity and has been recently found to play important roles in learning and memory. To study the effect of Pb on spatial learning and memory at different developmental stages, and its relationship with alterations of synaptic structural plasticity, postnatal rats were randomly divided into three groups: Control; Pre-weaning Pb (Parents were exposed to 2 mM PbCl₂ 3 weeks before mating until weaning of pups); Post-weaning Pb (Weaned pups were exposed to 2 mM PbCl₂ for 9 weeks). The spatial learning and memory of rats was measured by Morris water maze (MWM) on PND 85–90. Rat pups in Pre-weaning Pb and Post-weaning Pb groups performed significantly worse than those in Control group (p<0.05). However, there was no significant difference in the performance of MWM between the two Pb-exposure groups. Before MWM (PND 84), the number of neurons and synapses significantly decreased in Pre-weaning Pb group, but not in Post-weaning Pb group. After MWM (PND 91), the number of synapses in Pre-weaning Pb group increased significantly, but it was still less than that of Control group (p<0.05); the number of synapses in Post-weaning Pb group was also less than that of Control group (p<0.05), although the number of synapses has no differences between Post-weaning Pb and Control groups before MWM. In both Pre-weaning Pb and Post-weaning Pb groups, synaptic structural parameters such as thickness of postsynaptic density (PSD), length of synaptic active zone and synaptic curvature increased significantly while width of synaptic cleft decreased significantly compared to Control group (p<0.05). Our data demonstrated that both early and late developmental Pb exposure impaired spatial learning and memory as well as synaptic structural plasticity in Wistar rats.     

Host Factors and Biomarkers Associated with Poor Outcomes in Adults with Invasive Pneumococcal Disease

BackgroundInvasive pneumococcal disease (IPD) causes considerable morbidity and mortality. We aimed to identify host factors and biomarkers associated with poor outcomes in adult patients with IPD in Japan, which has a rapidly-aging population.MethodsIn a large-scale surveillance study of 506 Japanese adults with IPD, we investigated the role of host factors, disease severity, biomarkers based on clinical laboratory data, treatment regimens, and bacterial factors on 28-day mortality.ResultsOverall mortality was 24.1%, and the mortality rate increased from 10.0% in patients aged ˂50 years to 33.1% in patients aged ≥80 years. Disease severity also increased 28-day mortality, from 12.5% among patients with bacteraemia without sepsis to 35.0% in patients with severe sepsis and 56.9% with septic shock. The death rate within 48 hours after admission was high at 54.9%. Risk factors for mortality identified by multivariate analysis were as follows: white blood cell (WBC) count <4000 cells/μL (odds ratio [OR], 6.9; 95% confidence interval [CI], 3.7–12.8, p < .001); age ≥80 years (OR, 6.5; 95% CI, 2.0–21.6, p = .002); serum creatinine ≥2.0 mg/dL (OR, 4.5; 95% CI, 2.5–8.1, p < .001); underlying liver disease (OR, 3.5; 95% CI, 1.6–7.8, p = .002); mechanical ventilation (OR, 3.0; 95% CI, 1.7–5.6, p < .001); and lactate dehydrogenase ≥300 IU/L (OR, 2.4; 95% CI, 1.4–4.0, p = .001). Pneumococcal serotype and drug resistance were not associated with poor outcomes.ConclusionsHost factors, disease severity, and biomarkers, especially WBC counts and serum creatinine, were more important determinants of mortality than bacterial factors.     

Determinants of muscle power and force as assessed by Jumping Mechanography in rural Indian children

Objectives:To: 1. Assess muscle function (MF) of rural Indian children (6-11y, n=232), using Jumping Mechanography (JM) and hand dynamometer, 2. Investigate gender differences, 3. Identify determinants of MF.Methods:Data on anthropometry, muscle mass%, diet, physical activity, sunlight exposure, MF (maximum relative power Pmax/mass, maximum relative force Fmax/BW by JM; relative grip strength (RGS) by hand dynamometer) were collected. Pearson’s correlation and hierarchical linear regression was performed.Results:Pmax/mass, Fmax/BW and RGS of the group were 31.7±5.0W/kg, 3.0±0.3 and 0.4±0.1 (mean±SD), respectively. The Pmax/mass Z-score was –1.1±0.9 and Fmax/BW Z-score was –0.9±1 (mean±SD) which was significantly lower than the machine reference data (p<0.05). Positive association of muscle mass% and protein intake was observed with all MF parameters and moderate+vigorous physical activity with Fmax/BW (p<0.05). Determinants of MF identified through regression for Pmax/mass were age (β=1.83,95% CI=0.973 – 2.686), muscle mass% (β=0.244,95% CI=0.131–0.358) and protein intake (β=3.211,95% CI=1.597–4.825) and for Fmax/BW was protein intake (β=0.130,95% CI=0.023–0.237) (p<0.05). Male gender was a positive predictor of having higher Pmax/mass (β=1.707,95% CI=0.040–3.373) (p<0.05).Conclusion:MF was lower than in western counterparts. To optimize MF of rural Indian children, focus should be on improving muscle mass, ensuring adequate dietary protein, and increasing physical activity, especially in girls.     

人工股骨头置换术与股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折患者的疗效比较研究

目的:探讨人工股骨头置换术(AFHR)与股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折(IFF)患者的疗效。方法:选择2010年3月至2016年8月本院收治的老年IFF患者102例为研究对象,采用随机数字表法分为AFHR组(n=51)和PFNA组(n=51),比较两组手术一般情况(包括手术时间、术中出血量、下地活动时间、完全负重时间、术后住院时间),术前与术后第3、6、12个月采用Harris评分量表对患者进行髋关节功能评分,观察术后病死率及并发症的发生情况。结果:PFNA组手术时间、术中出血量少于AFHR组,下地活动时间、完全负重时间多于AFHR组,差异有统计学意义(P0.05),两组术后住院时间比较差异无统计学意义(P0.05)。两组患者术前、术后6个月、术后12个月Harris评分比较差异无统计学意义(P0.05),术后3个月AFHR组患者Harris评分高于PFNA组,且两组患者术后Harris评分较治疗前均升高,差异有统计学意义(P0.05)。PFNA组病死率和并发症发生率分别为0.00%和5.88%,与AFHR组的1.96%和9.80%比较,差异无统计学意义(P0.05)。结论:在老年IFF的手术治疗中,PFNA内固定具有手术时间短、术中出血量少的优势,AFHR后患者可早期进行功能锻炼,术后髋关节功能恢复快。     

PFNA和DHS治疗老年性股骨粗隆间骨折的临床对照研究

目的:探讨PFNA和DHS治疗老年性股骨粗隆间骨折的临床疗效.方法:回顾分析2010年3月至2011年6月间69例行手术治疗的老年性股骨粗隆间骨折的临床资料,其中股骨近端抗旋髓内钉(PFNA)37例(PFNA组),动力髋螺钉(DHS)32例(DHS组);比较两组平均手术时间、术中出血量、术后并发症、治疗费用、骨折愈合时间和髋关节功能.结果:PFNA组平均手术时间和术中出血量均低于DHS组(P＜0.05);术后并发症差别无统计学意义(P＞ 0.05);PFNA组治疗费用高于DHS组(P＜0.05);术后随访时间11-20个月,两组病例均临床愈合,PFNA组优良率高于DHS组(P＜0.05).结论:PFNA与DHS均是治疗老年性股骨粗隆间骨折的较好材料,PFNA更符合生物学特点,具有手术创伤小、固定牢靠、恢复好的优点,但治疗费用较高,临床应用可根据患者病情和经济状况选用.     

Effects of BMP-2 compound with fibrin on osteoporotic vertebral fracture healing in rats

Objectives:To investigate the effects of bone morphogenetic protein-2 (BMP-2) compound with fibrin on osteoporotic vertebral fracture healing in rats.Methods:For the present study 160 Specific-Pathogen Free 32-week-old female Sprague-Dawley rats were used. 120 rats were randomly divided in three groups (experimental, model and sham operation group- n=40 per group) and were ovariectomized to establish the osteoporosis model. 40 rats served as a control group without treatment. The expression of BMP-2 in the fracture zone at the 4^th, 6^th, 8^th, and 12^th weeks was detected by qRT-PCR. The expression of BALP and CTX-I in serum at the 12^th week was detected by Elisa.Results:At week 8, the morphology of the sham operation group was the same and the fracture healing occurred more slowly than in the other groups. At week 12, the expression of BMP-2 in the model group was significantly higher than that in the other three groups (p<0.05). At week 12, the maximum load, maximum strain, and elastic modulus of model group were significantly lower than those of the other three groups.Conclusions:BMP-2 compound with fibrin can enhance the timing and quality of bone fracture healing in rats.     

Serum levels of appetite-regulating hormones and pro-inflammatory cytokines are ameliorated by a CLA diet and endurance exercise in rats fed a high-fat diet

[Purpose]

This study examined whether conjugated linoleic acid (CLA) supplementation and endurance exercise affect appetite-regulating hormones and pro-inflammatory cytokines in rats.

[Methods]

Seven-week-old male Sprague-Dawley rats were divided randomly into the high-fat diet sedentary group (HS, n=8), the 1.0% CLA supplemented high-fat diet sedentary group (CS, n=8), and the 1.0% CLA supplemented high-fat diet exercise group (CE, n=8). Rats in the CE group swam 60 min/day, 5 days/week for 4 weeks.

[Results]

Leptin and insulin levels in the CS and CE groups were significantly lower than those in the HS group (p<0.001), whereas leptin (p<0.01) and insulin (p<0.05) levels decreased significantly in the CE compared to those in the CS group. Interleukin (IL)-1β (p<0.001) and IL-6 (p<0.01) levels in the CS and CE groups decreased significantly compared to those in the HS group. Leptin (IL-1β: r=0.835, p<0.001), IL-6 (r=0.607, p<0.05), insulin (IL-1β: r=0.797, p<0.01), and IL-6 (r=0.827, p<0.01) levels were positively related with pro-inflammatory cytokine levels.

[Conclusion]

Endurance exercise may play an important role during CLA supplementation of rats on a high-fat diet.     

股骨近端解剖锁定钢板与股骨近端防旋髓内钉治疗不稳定型股骨转子间骨折的比较研究

目的:探讨股骨近端解剖锁定钢板(PFLP)与股骨近端防旋髓内钉(PFNA)治疗不稳定型股骨转子间骨折的疗效。方法:选取我院2013年6月至2016年3月期间收治的160例不稳定型股骨转子间骨折患者为研究对象,采用乱数表法分为观察组、对照组,各80例。对照组采用PFLP治疗,观察组患者采用PFNA治疗。统计分析两组的手术及术后相关指标以及术后3个月、6个月、12个月的髋关节功能Harris评分,比较两组的术后并发症。结果:观察组患者的手术时间、切口长度短于对照组,术中出血量、术中输血量、术后引流量均少于对照组(P0.05);观察组患者术后患侧负重时间、住院时间均短于对照组(P0.05);观察组患者骨折愈合时间短于对照组,但无统计学差异(P0.05);术后3个月、6个月,观察组患者髋关节功能Harris评分均高于对照组(P0.05);术后12个月,观察组患者髋关节功能Harris评分高于对照组,但无统计学差异(P0.05);两组患者并发症发生率比较无统计学差异(P0.05)。结论:PFNA与PFLP均能够有效治疗不稳定型股骨转子间骨折,但PFNA治疗方式在近期疗效中的作用优于PFLP,且患者髋关节功能恢复更快。     

Bone Marrow Mesenchymal Stem Cells Attenuate Mitochondria Damage Induced by Hypoxia in Mouse Trophoblasts

ObjectiveWe aimed to observe the change of mitochondrial function and structure as well as the cell function induced by hypoxia in mouse trophoblasts, and moreover, to validate the restoration of these changes after co-culture with bone marrow mesenchymal stem cells (hereinafter referred to as “MSCs”). Further, we explored the mechanism of MSCs attenuating the functional damage of trophoblasts caused by hypoxia.MethodsCells were divided into two groups, trophoblasts and MSCs+trophoblasts respectively, and the two groups of cells were incubated with normoxia or hypoxia. Chemiluminescence was used to assay the β-HCG and progesterone in cell culture supernatants quantitatively. Western blotting and PCR were applied to detect the expression of Mfn2, MMP-2, MMP-9 and integrin β1 in the two groups. The mitochondrial membrane potential of each group of cells was detected with JC-1 dye and the ATP content was measured by the phosphomolybdic acid colorimetric method. We utilized transmission electron microscopy for observing the ultrastructure of mitochondria in trophoblasts. Finally, we assessed the cell apoptosis with flow cytometry (FCM) and analyzed the expression of the apoptosis related genes—Bcl-2, Bax, Caspase3 and Caspase9 by western blotting.ResultsThe results showed that the Mfn2 expression was reduced after 4 h in hypoxia compared with that in normoxia, but increased in the co-culture group when compared with that in the separated-culture group (p<0.05). In addition, compared with the separated-culture group, theβ-HCG and progesterone levels in the co-culture group were significantly enhanced (p<0.05), and so were the expressions of MMP-2, MMP-9 and integrin β1 (p<0.05). Moreover, it exhibited significantly higher in ATP levels and intensified about the mitochondrial membrane potential in the co-culture group. TEM revealed disorders of the mitochondrial cristae and presented short rod-like structure and spheroids in hypoxia, however, in the co-culture group, the mitochondrial cristae had a relatively regular arrangement and the mitochondrial ultrastructure showed hyperfusion. The expression of Bax, Caspase3 and Caspase9 was decreased in the co-culture group when compared with that in trophoblast cells cultured alone (p<0.05), while the Bcl-2 levels and the Apoptosis Index (AI) were markedly increased in the co-culture group (p<0.05).ConclusionBone marrow mesenchymal stem cells can attenuate mitochondria damage and cell apoptosis induced by hypoxia; the mechanism could be upregulating the expression of Mfn2 in mouse trophoblasts and changing mitochondrial structure.