Objective To verify the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velar movement through the lateral radiography. Methods From October 1988 to October 2000, 62 patients with cleft palate and velopharyngeal insufficiency were treated. Of them, 32 were repaired by velopharyngeal muscular reconstruction (group A) and 30 by modified von Langenbeck’s procedure (group B). The lateral radiographs and cephalometric analysis were taken. The velopharyngeal closure, velar extensibility, the angle changes of velar elevation, the distance changes of velar levator eminence based on anatomy (LEA) to velopharyngeal closure line (VCL), the varieties in LEA, the comparison of LEA and velar levator eminence based on phonation (LEP), the distance comparison between posterior nasal spine (PNS) to LEA and LEP through soft palate line (SPL) were measured. Results During the phonation, group A was significantly greater than group B in the velopharyngeal closure rate(Plt;0.01)， the velar extensibility(Plt;0.05) and the location comparison between LEA and LEP(Plt;0.01); group B was significantly greater than group A in velar elevation angle (Plt;0.05), the varieties in LEA(Plt;0.05). In velar rest position, the distance of LEA to VCL was greater inB group than in A group(Plt;0.01). There was significant difference in thedistance comparison between LEA and LEP(Plt;0.05), difference between LEA and LEP(Plt;0.01) and the distance PNS-SPL-LEA and PNSSPL-LEP(Plt;0.05) within group B; contrary to the results within group A(P＞0.05). Conclusion The velopharyngeal muscular reconstruction in palatoplasty can result in a near normalizationof anatomic measurement of velar levator muscles and improve the velar functionand velopharyngeal competence. Repositioning of velar muscles in a more anatomic correct, transverse position is more important to improve the velar length andaccordant velar movement with velopharyngeal muscles in functional palatoplasty. The velar angle change and velar elevation during phonation are not determinative factors for velopharyngeal competence.
Objective To observe the effect of epidermal growth factor (EGF) on integrin alpha;5 expression and its influence on human retinal pigment epithelium (RPE) cells.Methods Human RPE cells were treated in vitro with 0.1,1.0,10.0,20.0 and 100.0 ng/ml of EGF, the mRNA and protein of integrin alpha;5 was measured by reverse transcription polymerase chain reaction（RT-PCR）and flow cytometry. Human RPE cells were cultured under 4 conditions including DMEM/F12,DMEM/F12+10 ng/ml EGF, DMEM/F12+10 ng/ml EGF+rabbit antihuman integrin alpha;5 antibody (1∶100)，DMEM/F12+10 ng/ml EGF+rabbit antihuman vimentin antibody (1∶100), and their proliferation and migration were measured by methylthiazole tetrazolium（MTT）and Boyden chamber.Results The integrin alpha;5 mRNA level of human RPE cells was not changed after 12 hours of EGF stimulation (F=0.618, P=0.687), however it was induced in a dosedependent manner after 24 and 48 hours of EGF stimulation (F=465.303, 212.340; P=0.000,0.000).The protein level of integrinalpha;5 was higher in 10 ng/ml EGF stimulation compared with the control group and 0.1 ng/ml group（P＜0.01）.MTT and Boyden chamber showed that the integrin alpha;5 expression increased the proliferation and migration of human RPE cells. Conclusion EGF can induce integrin alpha;5 expression,thus increase the proliferation and migration of human RPE cells.
The surgical installation accuracy of the components in unicompartmental knee arthroplasty (UKA) is an important factor affecting the joint function and the implant life. Taking the ratio of the medial-lateral position of the femoral component relative to the tibial insert (a/A) as a parameter, and considering nine installation conditions of the femoral component, this study established the musculoskeletal multibody dynamics models of UKA to simulate the patients’ walking gait, and investigated the influences of the medial-lateral installation positions of the femoral component in UKA on the contact force, joint motion and ligament force of the knee joint. The results showed that, with the increase of a/A ratio, the medial contact force of the UKA implant was decreased and the lateral contact force of the cartilage was increased; the varus rotation, external rotation and posterior translation of the knee joint were increased; and the anterior cruciate ligament force, posterior cruciate ligament force and medial collateral ligament force were decreased. The medial-lateral installation positions of the femoral component in UKA had little effect on knee flexion-extension movement and lateral collateral ligament force. When the a/A ratio was less than or equalled to 0.375, the femoral component collided with the tibia. In order to prevent the overload on the medial implant and lateral cartilage, the excessive ligament force, and the collision between the femoral component and the tibia, it is suggested that the a/A ratio should be controlled within the range of 0.427−0.688 when the femoral component is installed in UKA. This study provides a reference for the accurate installation of the femoral component in UKA.
ObjectiveTo review the current status and progress of locking plate for the treatment of distal femoral comminuted fractures.MethodsThe related literature was extensively reviewed to summarize the current status and progress in the treatment of distal femoral comminuted fracture with locking plate from four aspects: the current treatment situation, the shortcomings of locking plate and countermeasures, the progress of locking technology, locking plate and digital orthopedic technology.ResultsTreatment of distal femoral comminuted fractures is challenging. Locking plates, the most commonly used fixation for distal femoral comminuted fractures, still face a high rate of treatment failure. Double plates can improve the mechanical stability of comminuted fractures, but specific quantitative criteria are still lacking for when to choose double plates for fixation. The far cortial locking screw has shown good application value in improving the micro-movement and promoting the growth of callus. The biphasic plating is a development of the traditional locking plate, but needs further clinical examination. As an auxiliary means, digital orthopedic technology shows a good application prospect.ConclusionThe inherent defect of locking plate is a factor that affects the prognosis of distal femoral comminuted fracture. The optimization of locking technology combined with digital orthopedic technology is expected to reduce the failure rate of treatment of distal femoral comminuted fracture.
Functional electronic stimulation (FES) may provide a means to restore motor function in patients with spinal cord injuries. The goal of this study is to determine the regions in the spinal cord controlling different hindlimb movements in the rats. Normalization was used for the regions dominating the corresponding movements. It has been verified that FES can be used in motor function recovery of the hindlimb. The spinal cord was stimulated by FES with a three-dimensional scan mode in experiments. The results show that stimulation through the electrodes implanted in the ventral locations of the lumbosacral enlargement can produce coordinated single- and multi-joint hindlimb movements. A variety of different hindlimb movements can be induced with the appropriate stimulation sites, and movement vectors of the hindlimb cover the full range of movement directions in the sagittal plane of the hindlimb. This article drew a map about spinal cord motor function of the rat. The regions in the spinal cord which control corresponding movements are normalized. The data in the study provide guidance about the location of electrode tips in the follow-up experiments.
Objective To investigate the expression of transforminggrowth factor β1(TGF-β1) and insulin-like growth factorⅠ(IGF-Ⅰ)in new bone after low frequency micromovement. Methods Fifteen female sheep from Shandong province were involved in the study and their bilateral tibias transversely osteotomized in the middle shafts with a defect of 2 mm.The hind limbs were fixed with unilateral external fixators connected to a controlled micromovement device. Ten days after osteotomy, one hind limb of each sheep randomlywas selected to perform micromovement at an amplitude of 0.25 mm and a frequency of 1 Hertz, 30 min a day for 4 weeks ( micromovement group). The other hindlimb served as the control group. Five sheep were sacrificed at 3,4 and 6 weeks after osteotomy, respectively, and specimens were harvested for detecting the expression of TGF-β1 and IGF-Ⅰby immunohistochemistry and RT-PCR. Results Immunohistochemistry: In the third postoperative week in the micromovement group, the expression of TGF-β1 was detected in different areas of new chondrocytes at the margin of callus, mainly in proliferating area, and IGF-Ⅰexpressed in osteoblasts at the margin of endochondral ossification area, calcified and mature chondrocytes and osteocytes. There was seldom expression ofIGF-Ⅰ and little expression of TGF-β1 in the corresponding area in the control one. In the 4th postoperative week in the micromovement group, theexpression of TGF-β1 diminished gradually with the mature of new bone and be located in extracellular matrix and osteoblasts around ossified areas; The expression ofIGF-Ⅰ reached the peak and be located mainly in osteoblasts of new bone surface, maturing osteocytes and calcifing osteoid. But there was little expression of them in the control group. In the sixth postoperative week in the micromovement group, there was a little expression of IGF-Ⅰ expression but little expression of TGF-β1; there was nearly no expression of them in the control group. In the micromovement group, the absorbance values of TGF-β1 at 3 and 4 weeksand of IGF-Ⅰat 3, 4 and 6 weeks were significantlyhigher than those in control group（P＜0.05）. RTPCR: In the third and fourth postoperative weeks in the micromovement group, there was higher expression of mRNA of TGF-β1 and TGF-I than those in control group; in the sixth postoperative week, the expression diminished gradually, but was higher than that in control group. The absorbance values of TGF-β1 at 3 and 4 weeks and IGF-Ⅰat 3, 4 and 6weeks were significantly higher than those of control group（P＜0.05）. Conclusion Low frequency and controlled micromovement in the early stage of the fracture healing can promote the expression of TGF-β1 and IGF-Ⅰ.They worked together to regulate the process of the endochondral ossification, while in the late stage the differentiation of osteocytes and mineralization of osteoid were regulated mainly by IGF-Ⅰ, which played an important role in regulating the cell biological behavior during micromovement.
For the questions of deeply researching abnormal neuromuscular coupling and better evaluating motor function of stroke patients with motor dysfunction, an effective intermuscular coherence analysis method and index are studied to explore the neuromuscular oscillation and the pathomechanism of motor dysfunction, based on which an assessment standard of muscle function is established. Firstly, the contrastive analysis about the intermuscular coherence of antagonistic muscle of affected and intact upper limbs of stroke patients was conducted. Secondly, a significant indicator of Fisher's Z-transformed coherence significant indicator was defined to quantitatively describe the coupling differences in certain functional frequency domain between surface electromyogram (sEMG) of affected and intact sides. Further more, the relationship between intermuscular coherence and motor task was studied. Through the analysis of intermuscular coherence during elbow flexion-extension of affected and intact sides, we found that the intermuscular coherence was associated with motor task and the stroke patients exhibited significantly lower beta-band intermuscular coherence in performing the task with their affected upper limbs. More conclusion can be drawn that beta-band intermuscular coherence has been found concerned with Fugle-Meyer scale, which indicates that beta-band intermuscular coherence could be an index assisting in evaluating motor function of patients.
ObjectiveTo study the clinical significance of the 3-hydroxyisobutyrate dehydrogenase (HIBADH) expressions in gastric adenocarcinoma tissues and its biological function in gastric cancer cells.MethodsSeventy-six patients with gastric adenocarcinoma who were hospitalized in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiaotong University, School of Medicine between January 2006 and December 2007 were recruited in our research. Immunohistochemical (IHC) staining was used to detect the HIBADH protein in primary gastric adenocarcinoma tissues, adjacent tissues, and metastatic lymph node tissues of gastric cancer. Then, the relationships among the expression of HIBADH protein, the clinical features, and the prognosis were analyzed. The MKN45 gastric cancer cell line of HIBADH overexpression was picked up and constructed as stable HIBADH knockdown cell lines. The biological function of HIBADH protein in gastric cancer cells was confirmed through in vitro experiments such as cell proliferation assay, migration and invasion assay, and scratch-wound assay.ResultsThe positive expression rate of HIBADH protein in the 76 gastric adenocarcinoma tissues was significantly higher than that of the adjacent tissues (χ2=54.738, P<0.001). Moreover, the higher expression level of HIBADH protein was related to the larger tumor diameter, the higher tumor lymphatic invasion rate, the later pT stage, the higher the lymph node metastasis rate, and the later pTNM stage (P<0.05). HIBADH protein was also highly expressed in lymph nodes with metastatic carcinoma, and positiverate was 100% (48/48). The 10-year survival rate of patients in the HIBADH protein positive group and HIBADH protein negative group were 16.4% and 69.4%, respectively, which showed the latter group had a longer survival time (χ2=19.612, P<0.001). The migration capacity, invasion capacity, and scratch-wound capacity of the MKN45 cells were significantly decreased after HIBADH protein knockdown (P<0.05), but the proliferation capacity of the cells was not significantly changed (P>0.05).ConclusionsThe overexpression of HIBADH protein in gastric cancer suggests later tumor stage and poor prognosis. Inhibition expression of HIBADH protein can reduce the motility capacity of gastric cancer cells.
ObjectiveTo explore the clinical, genetic and prognostic features of early infantile epileptic encephalopathy caused by DNM1 gene pathogenic variations.MethodsClinical phenotype, genotype and prognosis of 3 individuals with de novo variants in DNM1 gene were analyzed retrospectively. Through using “Dynamin-1” or “DNM1” as key words to search literature at database of China National Knowledge Infrastructure, Wanfang, PubMed and OMIM. Genotype-phenotype correlations were analyzed by analysis of variance (ANOVA).ResultAmong the 3 patients, 1 female and 2 males. 2 cases with epileptic spasm and 1 case with focal clonic seizure or secondary generalized tonic-clonic seizure were manifested with onset age from 2 to 17 months. De novo variants at NM_004408.4: c.415 G>A(P. Gly 139Arg) in 2 inviduals and NM_004408.4: c.545 C>A(P. Ala 182Asp)in 1 invidual of DNM1 gene were identified by gene testing. After follow-up at age of 2~3 years, all patients were presented with hypotonia, severe intellectual disability, non-verbal, non-ambulatory, drug-resistant epilepsy and feeding difficulties. 36 cases with pathogenic DNM1 variants were reported by far, totally 39 cases were included. Of the 39 patients, hypotonia were found to be independent of the locus of genetic variants, while those inviduals with variants in the GTPase and middle domains almost presented severe or profound intellectual disability and epilepsy. 31 patients diagnosed with epilepsy and complete clinical data were further analyzed, epileptic spasm was the most common types of seizure. Absent seizure was significantly more common in those patients with variants in the GTPase domains (P=0.02), compared to those patients with variants in the middle domains. No statistical differences were found in gender, onset age, other types of seizure and drug treatment response between variants in the GTPase and middle domains.ConclusionHypotonia, early onset epilepsy, severe intellectual and movement disability were the common features in patients with DMN1 related encephalopathy. Epileptic spasm was the most common types of seizure, no significant differences were found in the phenotype between the GTPase and middle domains expect for absent seizure. Our patients also presented with feeding difficulties.
Objective To investigate the association between types of rapid eye movements during sleep and ICD-10 as a mothod for diagnosing depression. Methods Depression was diagnosed according to ICD-10 and changes of 9 variables of REM sleep in 120 psychiatric outpatients and inpatients by calculating the Kappa values. Results In 120 psychiatric patients, 52 depressive patients were diagnosed by using ICD-10, and 58 patients were diagnosed as depression according to decreased REM sleep latency and increased REM activity, REM intensity, REM density, and increasing amount of REM sleep. Kappa value was 0.73, Plt;0.05, which implied that these two diagnosing ways were significantly consistent. Conclusions Measuremen of REM sleep variable should be investigated further as a supplementary method for diagnosing depression.