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腓肠肌皮瓣防治全膝关节置换术切口并发症
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作者 甘文奕 佘国荣 +3 位作者 陈均源 张还添 刘文凭 查振刚 《中国矫形外科杂志》 CAS CSCD 北大核心 2021年第2期97-101,共5页
[目的]探讨腓肠肌皮瓣应用于复杂全膝关节置换术(total knee arthroplasty, TKA)后切口并发症的防治临床结果。[方法]回顾性分析2014-2019年本科收治的应用同侧腓肠肌皮瓣处理复杂TKA切口的12例患者。其中,4例为预防性肌皮瓣移植覆盖切... [目的]探讨腓肠肌皮瓣应用于复杂全膝关节置换术(total knee arthroplasty, TKA)后切口并发症的防治临床结果。[方法]回顾性分析2014-2019年本科收治的应用同侧腓肠肌皮瓣处理复杂TKA切口的12例患者。其中,4例为预防性肌皮瓣移植覆盖切口,其余8例为挽救性肌皮瓣闭合切口。比较两组围手术期、随访与实验室检查资料。[结果]两组患者均顺利完成手术,术中均无重要血管、神经损伤等严重并发症。预防性组术后下地行走时间、拆线时间和住院时间均显著优于挽救性组(P<0.05)。预防性组4例切口均甲级愈合;挽救性组7例甲级愈合,1例乙级愈合。两组共12例患者出院至末次随访均未发生手术部位局部感染、皮肤坏死或翻修手术。末次随访时,预防性组KSS评分和ROM均优于挽救性组,其中两组间KSS评分的差异有统计学意义(P<0.05)。实验室检查方面,除了CRP在肌皮瓣术后2周时预防组低于挽救组的差异有统计学意义(P<0.05),其余的差异均无统计学含义(P>0.05)。[结论]腓肠肌皮瓣转位覆盖伤口可以有效预防及治疗复杂TKA切口并发症。相比之下,采用预防性肌皮瓣的临床效果优于挽救性肌皮瓣。 展开更多
关键词 全膝关节置换 切口并发症 肌皮瓣
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Apigenin accelerates lipopolysaccharide induced apoptosis in mesenchymal stem ceils through suppressing vitamin D receptor expression 被引量:3
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作者 zhang huan-tian ZHA Zhen-gang +6 位作者 CAO Jia-hui LIANG Zu-jian WU Hao HE Ming-tao ZANG Xiao YAO Ping zhang Jia-qing 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第21期3537-3545,共9页
Background Transplantation of mensenchymal stem cells (MSCs) has been proposed as a promising way for tissue engineering. However, the application of MSCs for transplantation will undergo apoptosis due to the extrem... Background Transplantation of mensenchymal stem cells (MSCs) has been proposed as a promising way for tissue engineering. However, the application of MSCs for transplantation will undergo apoptosis due to the extremely harsh microenvironment such as excessive inflammation. Apigenin (API) has been reported to protect cells against inflammatory damage and cell death by exhibiting anti-inflammatory and anti-oxidative capacity. Here we investigated the modulatory effects of API in lipopolysaccharide (LPS)-mediated inflammation and apoptosis of MSCs, and further defined the underlying mechanism. Methods Effects of different concentrations of API (0, 5, 10, 20, 40 and 80 IJmol/L) for 24 hours, and LPS (0, 0.5 and 5.0 pg/ml) for 6 hours and 24 hours on MSCs viability were assayed by MTT. Based on this, MSCs were pretreated with different concentrations of API (0-40μmol/L) at the indicated times (6, 12 and 24 hours) followed by exposure to 5μg/ml LPS for 24 hours. MTT, phase-contrast microscopy, annexinV/propidium iodide (PI) double stain flow cytometry (FCM) and Hoechst staining were applied to explore the effects of API on MSCs induced by 5 μg/ml LPS for 24 hours. In addition, reverse-transcription polymerase chain reaction (RT-PCR) was applied to detect the mRNA expression of pro-inflammatory factors including cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), nuclear factor-kappa B (NF-KB), pro-apoptotic gene caspase-3, Bad, and anti-apoptotic gene Bcl-2. Moreover, AutoDock software was used to imitate the docking score of API and vitamin D receptor (VDR). In parallel, Western blotting and RT-PCR were used to investigate protein and mRNA expression of VDR. Results MSCs stimulated with LPS 5 IJg/ml for 24 hours was used as a model of apoptosis induced by over inflammatory stimulus. API (0-40μmol/L) had non-toxic effect on MSCs; however, it could decrease mRNA expression of COX-2, iNOS and NF-KB at different time points in MSCs induced by LPS, except for API at the concentration of 5 μmol/L Results from phase-contrast microscopy, MTT, Hoechst staining and AnnexinV/PI double stain FCM demonstrated that with the increasing concentrations of API and extension of administrating time, significant morphological changes of MSCs occurred, viability of cells was strongly inhibited, and meanwhile, apoptosis of LPS-administrated MSCs was exacerbated, compared with LPS individual group. In addition, API promoted caspase-3, Bad mRNA expression and inhibited Bcl-2 mRNA expression in a time-dePendent and concentration-dependent manner. Further study found that pro-apoptosis effect of API was related to suppress VDR expression. Conclusions API could inhibit the expression of inducible inflammatory factors, therefore exert the strong anti-inflammatory function. However, API could not protect MSC apoptosis induced by LPS but amplified the apoptosis, The apoptosis is related to Bad/Bcl-2 increasing and caspase-3 activation, which is mediated through suppressing VDR expression. 展开更多
关键词 vitamin D receptor mensenchymal stem cells LIPOPOLYSACCHARIDE APOPTOSIS APIGENIN
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